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WELLTOWER INC. (WELL) FY 2024 MD&A

Verbatim Item 7 Management's Discussion and Analysis from WELLTOWER INC.'s 10-K for fiscal year 2024. Filing date: 2025-02-12. Report date: 2024-12-31. Accession: 0000766704-25-000009.

This page reproduces the company's own Item 7 MD&A text from the linked SEC filing. It is filer text, not grepcent analysis, scoring, or investment advice.

Extracted structurally from real Item 7 body heading to real Item 7A/8 boundary. Confidence: high.

Company profile: WELL · All MD&A years: index · Previous year: FY 2023 · Next year: FY 2025

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

EXECUTIVE SUMMARY
Company Overview52
Business Strategy52
Key Transactions53
Key Performance Indicators, Trends and Uncertainties54
Corporate Governance56
LIQUIDITY AND CAPITAL RESOURCES
Sources and Uses of Cash56
Off-Balance Sheet Arrangements57
Contractual Obligations58
Capital Structure58
Supplemental Guarantor Information59
RESULTS OF OPERATIONS
Summary59
Seniors Housing Operating61
Triple-net63
Outpatient Medical65
Non-Segment/Corporate66
OTHER
Non-GAAP Financial Measures67
Critical Accounting Policies and Estimates74

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis is based primarily on the consolidated financial statements of Welltower Inc. presented in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for the periods presented and should be read together with the notes thereto contained in this Annual Report on Form 10-K. Other important factors are identified in “Item 1 — Business” and “Item 1A — Risk Factors” above.

We are organized in an UPREIT structure. In February 2022, the company formerly known as Welltower Inc. ("Old Welltower") formed WELL Merger Holdco Inc. ("New Welltower") as a wholly owned subsidiary, and New Welltower formed WELL Merger Holdco Sub Inc. ("Merger Sub") as a wholly owned subsidiary. On April 1, 2022, Merger Sub merged with and into Old Welltower, with Old Welltower continuing as the surviving corporation and a wholly owned subsidiary of New Welltower (the "Merger"). In connection with the Merger, Old Welltower's name was changed to "Welltower OP Inc.", and New Welltower inherited the name "Welltower Inc." Effective May 24, 2022, Welltower OP Inc. converted from a Delaware corporation into Welltower OP, a Delaware limited liability company (the "LLC Conversion"). Following the LLC Conversion, New Welltower's business continues to be conducted through Welltower OP and New Welltower does not have substantial assets or liabilities, other than through its investment in Welltower OP.

Unless stated otherwise or the context otherwise requires, references to "Welltower" mean Welltower Inc. and references to "Welltower OP" mean Welltower OP LLC. References to "we," "us" and "our" mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.

Executive Summary

Company Overview

Welltower Inc. (NYSE:WELL), a real estate investment trust ("REIT") and S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of healthcare infrastructure. Welltower invests with leading seniors housing operators, post-acute providers and health systems to fund the real estate and infrastructure needed to scale innovative care delivery models and improve people’s wellness and overall healthcare experience. Welltower owns interests in properties concentrated in major, high-growth markets in the United States ("U.S."), Canada and the United Kingdom ("U.K."), consisting of seniors housing and post-acute communities and outpatient medical properties.

Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.707% as of December 31, 2024. All of our property ownership, development and related business operations are conducted through Welltower OP and Welltower has no material assets or liabilities other than its investment in Welltower OP. Welltower issues equity from time to time, the net proceeds of which it is obligated to contribute as additional capital to Welltower OP. All debt including credit facilities, senior notes and secured debt is incurred by Welltower OP and its subsidiaries, and Welltower has fully and unconditionally guaranteed all existing senior unsecured notes.

The following table summarizes our consolidated portfolio for the year ended December 31, 2024 (dollars in thousands):

Percentage ofNumber of
Type of PropertyNOI(1)NOIProperties
Seniors Housing Operating$1,511,68153.7%1,156
Triple-net748,04926.6%592
Outpatient Medical556,47719.7%371
Totals$2,816,207100.0%2,119

(1) Represents consolidated net operating income ("NOI") and excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount. Non-segment/Corporate NOI, which includes the loan portfolio, is excluded. See Non-GAAP Financial Measures for additional information and reconciliation.

Business Strategy

Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders through annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and healthcare real estate and diversify our investment portfolio by property type, relationship and geographic location.

Substantially all of our revenues are derived from operating lease rentals, resident fees and services, interest earned on outstanding loans receivable and interest earned on short-term deposits. These items represent our primary sources of liquidity to fund distributions and depend upon the continued ability of our obligors to make contractual rent and interest payments to us and the profitability of our operating properties. To the extent that our obligors/partners experience operating difficulties and become unable to generate sufficient cash to make payments or operating distributions to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property. Our asset management process for seniors housing properties generally includes review of monthly financial statements and other operating data for each property, review of obligor/partner creditworthiness, property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. Our internal property management division manages and monitors the outpatient medical portfolio with a comprehensive process, including review of tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs and market conditions, among other things. We evaluate the operating environment in each property’s market to determine the likely trend in operating performance of the facility. When we identify unacceptable trends, we seek to mitigate, eliminate or transfer the risk. Through these efforts, we generally aim to intervene at an early stage to address any negative trends, and in so doing, support both the collectability of revenue and the value of our investment.

In addition to our asset management and research efforts, we aim to structure our relevant investments to mitigate payment risk. Operating leases and loans are normally credit enhanced by guarantees and/or letters of credit. Also, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other real estate loans, operating leases or agreements between us and the obligor and its affiliates.

For the year ended December 31, 2024, resident fees and services and rental income represented 75% and 20% of total revenues, respectively. Substantially all of our operating leases are designed with escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.

Our primary sources of cash include resident fees and services revenue, rental income and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities including through our ATM Program (as defined below), proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash.

We also continuously evaluate opportunities to finance future investments. New investments are generally funded from temporary borrowings under our unsecured revolving credit facility and commercial paper program, internally generated cash and the proceeds from investment dispositions. Our investments generate cash from NOI and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under our unsecured revolving credit facility and commercial paper program, has historically been provided through a combination of the issuance of debt and equity securities and the incurrence or assumption of secured debt. Given the general economic conditions during 2023 and 2024, investments were generally funded proactively via issuances of common stock.

Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. It is also likely that investment dispositions may occur in the future. To the extent that investment dispositions exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any investment dispositions in new investments. To the extent that new investment requirements exceed our available cash on-hand, we expect to borrow under our unsecured revolving credit facility and commercial paper program or issue debt or equity securities, including through our ATM Program. At December 31, 2024, we had $3,506,586,000 of cash and cash equivalents, $204,871,000 of restricted cash and $5,000,000,000 of available borrowing capacity under our unsecured revolving credit facility.

Key Transactions

Capital  The following summarizes key capital transactions that occurred during the year ended December 31, 2024:

•In October 2024, we entered into an equity distribution agreement whereby we may offer and sell up to $5,000,000,000 of common stock, which replaced our prior equity distribution agreement dated April, 2024, allowing us to sell up to $3,500,000,000 aggregate amount of our common stock (collectively, along with other previous agreements, referred to as the "ATM Programs"). During the year ended December 31, 2024, we sold 70,419,530 shares of common stock under our current and previous ATM Programs generating gross proceeds of approximately $7,452,108,000.

•In January 2024, we repaid our $400,000,000 4.5% senior unsecured notes at maturity. In March 2024, we repaid our $950,000,000 3.625% senior unsecured notes at maturity.

•In July 2024, we closed on an expanded $5,000,000,000 unsecured revolving credit facility, which replaced our $4,000,000,000 existing line of credit. The new facility is comprised of a $3,000,000,000 revolving line of credit maturing in June 2028 that can be extended for an additional year and a $2,000,000,000 revolving line of credit maturing in June 2029. The revolving lines of credit will bear interest at a borrowing rate of 0.725% over the adjusted SOFR rate and include an annual facility fee of 0.125%.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

•In July 2024, Welltower OP issued $1,035,000,000 aggregate principal amount of 3.125% exchangeable senior unsecured notes maturing July 15, 2029 (the "2029 Exchangeable Notes") unless earlier exchanged, purchased or redeemed. The 2029 Exchangeable Notes will pay interest semi-annually in arrears on January 15 and July 15 of each year.

•In August 2024, we increased the size of the commercial paper program to $2,000,000,000.

•During the year ended December 31, 2024, we extinguished $450,720,000 of secured debt at a blended average interest rate of 6.13% and disposed $359,140,000 of secured debt at a blended average interest rate of 4.79%.

•During the year ended December 31, 2024, we issued $197,930,000 of secured debt at a blended average interest rate of 4.27% and assumed $960,300,000 of secured debt at a blended average interest rate of 3.98%.

Investments The following summarizes our property acquisitions and joint venture investments completed during the year ended December 31, 2024 (dollars in thousands):

PropertiesBook Amount(1)Capitalization Rates(2)
Seniors Housing Operating198$4,542,7527.2%
Triple-net521,126,4928.4%
Outpatient Medical146,8547.7%
Totals251$5,716,0987.5%

(1) Represents amounts recorded in net real estate investments including fair value adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial statements for additional information.

(2) Represents annualized contractual or projected NOI to be received in cash divided by investment amounts.

Dispositions The following summarizes property dispositions completed during the year ended December 31, 2024 (dollars in thousands):

PropertiesProceeds(1)Book Amount(2)Capitalization Rates(3)
Seniors Housing Operating(4)31$525,462$390,2264.3%
Triple-net(5)21195,572355,5807.3%
Outpatient Medical(4)349,81742,7616.8%
Totals55$770,851$788,5675.7%

(1) Represents net proceeds received upon disposition, excluding non-cash consideration.

(2) Represents carrying value of net real estate assets at time of disposition. See Note 5 to our consolidated financial statements for additional information.

(3) Represents annualized contractual income that was being received in cash at date of disposition divided by stated purchase price.

(4) Includes the disposition of unconsolidated equity method investments that owned six Seniors Housing Operating properties and one Outpatient Medical property.

(5) Excludes $79,695,000 of net real property derecognized related to four properties upon the reclassification of one lease from operating to sales-type and includes $297,000,000 of net real property derecognized in the third quarter related to 11 properties upon reclassification of one lease from operating to sales-type for which the underlying properties were sold and the sales-type lease terminated in the fourth quarter.

During 2023, we entered into definitive agreements to dissolve our existing Revera joint venture relationships across the U.S., U.K. and Canada. The transactions included acquiring the remaining interests in 110 properties from Revera while simultaneously selling interest in 31 properties to Revera. See Note 5 to our consolidated financial statements for further information regarding the transactions.

During 2024, Welltower, which held a 25% minority interest in an existing equity method joint venture that owned 39 properties subject to triple-net leases with two tenants, acquired the remaining beneficial interest. See Note 3 to our consolidated financial statements for further information regarding the transaction.

Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2024 of $0.67 per share. On March 6, 2025, we will pay our 215th consecutive quarterly cash dividend to stockholders of record on February 25, 2025.

Key Performance Indicators, Trends and Uncertainties

We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, credit strength and concentration risk. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions and for budget planning purposes.

Operating Performance We believe that net income and net income attributable to common stockholders ("NICS") as reflected in the Consolidated Statements of Comprehensive Income are the most appropriate earnings measures. Other useful supplemental measures of our operating performance include funds from operations attributable to common stockholders ("FFO") and consolidated net operating income ("NOI"); however, these supplemental measures are not defined by U.S.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

GAAP. Please refer to the section entitled "Non-GAAP Financial Measures" for further discussion and reconciliations. These earnings measures are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies.

The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands):

Year Ended December 31,
202420232022
Net income$972,857$358,139$160,568
Net income attributable to common stockholders951,680340,094141,214
Funds from operations attributable to common stockholders2,323,4331,763,2271,478,072
Consolidated net operating income3,160,9072,690,2192,301,845

Credit Strength We measure our credit strength both in terms of leverage ratios and coverage ratios. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt, net of cash and restricted cash. The coverage ratios indicate our ability to service interest and fixed charges (interest and secured debt principal amortization). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain a capital structure consistent with our current profile. The coverage ratios are based on earnings before interest, taxes, depreciation and amortization ("EBITDA") and adjusted earnings before interest, taxes, depreciation and amortization ("Adjusted EBITDA"). Please refer to the section entitled "Non-GAAP Financial Measures" for further discussion and reconciliation of these measures. Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

Year Ended December 31,
202420232022
Net debt to book capitalization ratio26.8%34.3%39.5%
Net debt to undepreciated book capitalization ratio21.6%27.8%32.1%
Net debt to enterprise ratio12.9%20.9%29.5%
Interest coverage ratio5.39x3.74x3.73x
Fixed charge coverage ratio4.99x3.44x3.37x
Adjusted interest coverage ratio5.34x3.95x3.94x
Adjusted fixed charge coverage ratio4.95x3.64x3.56x

Concentration Risk We evaluate our concentration risk in terms of NOI by property mix, relationship mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our NOI could be at risk if certain sectors were to experience downturns. Property mix measures the portion of our NOI that relates to our various property types and excludes interest income earned on our loan portfolio, which is classified as Non-segment/Corporate. Relationship mix measures the portion of our NOI that relates to our current top five relationships. Geographic mix measures the portion of our NOI that relates to our current top five states (or countries outside the U.S.).

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:

Year Ended December 31,(1)
202420232022
Property mix:
Seniors Housing Operating54%45%45%
Triple-net27%34%34%
Outpatient Medical19%21%21%
Relationship mix:
Cogir Management Corporation7%4%3%
Integra Healthcare Properties7%8%—%
Sunrise Senior Living5%6%7%
Avery Healthcare4%4%3%
Oakmont Management Group4%4%2%
Remaining73%74%85%
Geographic mix:
California11%12%14%
United Kingdom11%9%10%
Florida8%6%6%
Texas8%8%8%
Canada6%6%6%
Remaining56%59%56%

(1) Excludes our share of investments in unconsolidated entities. Entities in which we have a joint venture with a minority partner are shown at 100% of the joint venture amount.

We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved, and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in "Item 1 — Business — Cautionary Statement Regarding Forward-Looking Statements" and "Item 1A — Risk Factors" and other sections of this Annual Report on Form 10-K. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to "Item 1 — Business," "Item 1A — Risk Factors" in this Annual Report on Form 10-K for further discussion of these risk factors.

Corporate Governance

Maintaining investor confidence and trust is important in today's business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on the Internet at www.welltower.com/investors/governance. The information on our website is not incorporated by reference in this Annual Report on Form 10-K, and our web address is included as an inactive textual reference only.

Liquidity and Capital Resources

Sources and Uses of Cash

Our primary sources of cash include resident fees and services, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, issuances of debt and equity securities, proceeds from investment dispositions and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including acquisitions, capital expenditures, construction advances and transaction costs), loan advances, property operating expenses, general and administrative expenses and other expenses. Depending upon the availability and cost of external capital, we believe our liquidity is sufficient to fund these uses of cash. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows for the periods presented (dollars in thousands):

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Cash, cash equivalents and restricted cash at beginning of period$2,076,083$722,292$1,353,791187%$346,755$375,537108%$1,729,328499%
Net cash provided from (used in):
Operating activities2,256,4211,601,861654,56041%1,328,708273,15321%927,71370%
Investing activities(5,514,681)(5,707,742)193,061-3%(3,703,815)(2,003,927)54%(1,810,866)49%
Financing activities4,905,3515,448,647(543,296)-10%2,761,2772,687,37097%2,144,07478%
Effect of foreign currency translation(11,717)11,025(22,742)n/a(10,633)21,658n/a(1,084)10%
Cash, cash equivalents and restricted cash at end of period$3,711,457$2,076,083$1,635,37479%$722,292$1,353,791187%$2,989,165414%

Operating Activities Please see "Results of Operations" for discussion of net income fluctuations. For the years ended December 31, 2024, 2023 and 2022, cash flows provided from operations exceeded cash distributions to stockholders.

Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in "Key Transactions." Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
New development$827,900$1,014,935$(187,035)-18%$631,737$383,19861%$196,16331%
Recurring capital expenditures, tenant improvements and lease commissions290,832199,35991,47346%198,576783%92,25646%
Renovations, redevelopments and other capital improvements566,714318,323248,39178%277,44040,88315%289,274104%
Total$1,685,446$1,532,617$152,82910%$1,107,753$424,86438%$577,69352%

The change in new development is primarily due to the number and size of construction projects ongoing during the relevant periods. Renovations, redevelopments and other capital improvements include expenditures to maximize property value, increase net operating income, maintain a market-competitive position and/or achieve property stabilization. The increase in renovations, redevelopments and other capital improvements is due primarily to portfolio growth.

Financing Activities The changes in net cash provided from/used in financing activities are primarily attributable to changes related to our long-term debt arrangements, the issuances of common stock and dividend payments. Financing activities occurring during the year ended December 31, 2024 are summarized above in “Key Transactions.” Please also refer to Notes 10, 11 and 14 to our consolidated financial statements for additional information.

In May 2023, we issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028.

During the year ended December 31, 2023, we sold 53,300,874 shares of common stock under our ATM Programs generating gross proceeds of approximately $4,313,007,000.

In November 2023, we issued 20,125,000 shares of common stock generating gross proceeds of approximately $1,772,216,000.

Off-Balance Sheet Arrangements

At December 31, 2024, we had investments in unconsolidated entities with our ownership generally ranging from 10% to 95%. We use financial derivative instruments to hedge interest rate and foreign currency exchange rate exposure. At December 31, 2024, we had 20 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Contractual Obligations

The following table summarizes our payment requirements under contractual obligations as of December 31, 2024 (in thousands):

Payments Due by Period
Contractual ObligationsTotal20252026-20272028-2029Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$10,620,000$1,250,000$1,200,000$3,870,000$4,300,000
Canadian Dollar senior unsecured notes(2)208,290208,290
Pounds Sterling senior unsecured notes(2)1,314,600688,600626,000
U.S. Dollar term credit facility1,010,00010,0001,000,000
Canadian Dollar term credit facility(2)173,575173,575
Secured debt:(1,2)
Consolidated2,467,223216,034484,970552,7311,213,488
Unconsolidated851,459590,357117,38666,00477,712
Contractual interest obligations:(3)
Senior unsecured notes and term loans(2)3,101,669480,204831,079552,1301,238,256
Consolidated secured debt(2)709,14897,243173,870130,332307,703
Unconsolidated secured debt(2)46,04521,01413,4737,1534,405
Financing lease liabilities(4)455,7547,88315,12510,653422,093
Operating lease liabilities(4)2,289,57179,616158,926158,1031,892,926
Purchase obligations(5)674,130538,937118,4521,41115,330
Total contractual obligations$23,921,464$3,291,288$4,495,146$6,037,117$10,097,913

(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the Consolidated Balance Sheets.

(2) Based on foreign currency exchange rates in effect as of the balance sheet date.

(3) Based on variable interest rates in effect as of December 31, 2024.

(4) See Note 6 to our consolidated financial statements for additional information.

(5) See Note 13 to our consolidated financial statements for additional information. Excludes amounts related to asset acquisitions under contract that have not yet closed as of December 31, 2024.

Capital Structure

Please refer to "Credit Strength" above for a discussion of our leverage and coverage ratio trends. Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of December 31, 2024, we were in compliance in all material respects with the covenants under our debt agreements. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings. However, under our primary unsecured credit facility, the ratings on our senior unsecured notes are used to determine the fees and interest charged. We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.

On April 1, 2022, Welltower and Welltower OP jointly filed with the SEC an open-ended automatic or "universal" shelf registration statement on Form S-3 (the "Shelf Form S-3") covering an indeterminate amount of future offerings of Welltower's debt securities, common stock, preferred stock, depositary shares, guarantees of debt securities issued by Welltower OP, warrants and units and Welltower OP’s debt securities and guarantees of debt securities issued by Welltower. On April 1, 2022, Welltower also filed with the SEC a registration statement in connection with its enhanced dividend reinvestment plan ("DRIP") under which it may issue up to 15,000,000 shares of common stock. On May 3, 2023, Welltower and Welltower OP filed post-effective amendment no. 1 to the Shelf Form S-3 pursuant to which Welltower OP expressly adopted the Shelf Form S-3 as its own registration statement following its statutory conversion from a corporation to a limited liability company. As of February 7, 2025, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On October 29, 2024, Welltower and Welltower OP entered into an equity distribution agreement with (i) the sales agents and forward sellers named therein and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $5,000,000,000 aggregate amount of common stock of Welltower (together with the existing master forward sale confirmations relating thereto, the "ATM Program"). The ATM Program also allows Welltower to enter into forward sale agreements. As of February 7, 2025, we had $2,697,834,000 of remaining capacity under the ATM Program and there were no

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

outstanding forward sales agreements. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured revolving credit facility and commercial paper program.

In connection with the filing of the Shelf Form S-3, Welltower also filed with the SEC a prospectus supplement that will continue an offering that was previously covered by a prior registration statement relating to the registration of up to 475,327 shares of common stock of Welltower Inc. (the "DownREIT II Shares") that may be issued from time to time if, and to the extent that, certain holders of Class A units (the "DownREIT II Units") of HCN G&L DownREIT II LLC, a Delaware limited liability company (the "DownREIT II"), tender such DownREIT II Units for redemption by the DownREIT II, and HCN DownREIT Member, LLC, a majority-owned indirect subsidiary of Welltower (including its permitted successors and assigns, the "Managing Member"), or a designated affiliate of the Managing Member, elects to assume the redemption obligations of the DownREIT II and to satisfy all or a portion of the redemption consideration by issuing DownREIT II Shares to the holders instead of or in addition to paying a cash amount. On July 22, 2022, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 300,026 shares of common stock of Welltower Inc. that may be issued from time to time if, and to the extent that, certain holders of Class A Common Units (the "OP Units") of Welltower OP tender the OP Units for redemption by Welltower OP, and Welltower Inc. elects to assume the redemption obligations of Welltower OP and to satisfy all or a portion of the redemption consideration by issuing shares of its common stock to the holders instead of or in addition to paying a cash amount. On October 8, 2024, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 23,471,419 shares of common stock of Welltower Inc. (the "Exchanged Shares") that may, under certain circumstances, be issuable upon exchange of 2.750% exchangeable senior notes due 2028 or 3.125% exchangeable senior notes due 2029 of Welltower OP and the resale from time to time by the recipients of the Exchanged Shares.

Supplemental Guarantor Information

Welltower OP has issued the unsecured notes described in Note 11 to our Consolidated Financial Statements. All unsecured notes are fully and unconditionally guaranteed by Welltower, and Welltower OP is 99.707% owned by Welltower as of December 31, 2024. Effective January 4, 2021, the SEC adopted amendments to the financial disclosure requirements applicable to registered debt offerings that include certain credit enhancements. We have adopted these new rules, which permits subsidiary issuers of obligations guaranteed by the parent to omit separate financial statements if the consolidated financial statements of the parent company have been filed, the subsidiary obligor is a consolidated subsidiary of the parent company, the guaranteed security is debt or debt-like, and the security is guaranteed fully and unconditionally by the parent. Accordingly, separate consolidated financial statements of Welltower OP have not been presented. Furthermore, Welltower and Welltower OP have no material assets, liabilities or operations other than financing activities and their investments in non-guarantor subsidiaries. Therefore, we meet the criteria in Rule 13-01 of Regulation S-X to omit the summarized financial information from our disclosures.

Results of Operations

Summary

Our primary sources of revenue include resident fees and services revenue, rental income, interest income and interest earned on short-term deposits. Our primary expenses include property operating expenses, depreciation and amortization, interest expense, general and administrative expenses and other expenses. We evaluate our business and make resource allocations on our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. The primary performance measures for our properties are NOI and same store NOI ("SSNOI") and other supplemental measures include FFO and Adjusted EBITDA, which are further discussed below. Please see Non-GAAP Financial Measures for additional information and reconciliations related to these supplemental measures.

This section of this Form 10-K generally discusses 2024 and 2023 items and year-to-year comparisons between 2024 and 2023. Discussions of 2022 items and year-to-year comparisons between 2023 and 2022 that are not included in this Form 10-K can be found in “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023.

During the year ended December 31, 2024, we reclassified loans receivable balances, the related interest income and provision for loan losses from our three operating segments to Non-segment/Corporate to better align with the manner in which the CODM reviews results. Accordingly, the segment information provided in the Results of Operations section has been updated to conform to the current presentation for all periods presented.

59

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our results of operations for the periods presented (dollars in thousands, except per share amounts):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023Amount%2022Amount%Amount%
Net income$972,857$358,139$614,718172%$160,568$197,571123%$812,289506%
NICS951,680340,094611,586180%141,214198,880141%810,466574%
FFO2,323,4331,763,227560,20632%1,478,072285,15519%845,36157%
EBITDA3,181,9112,373,450808,46134%2,007,702365,74818%1,174,20958%
Adjusted EBITDA3,151,8112,509,003642,80826%2,122,399386,60418%1,029,41249%
NOI3,160,9072,690,219470,68817%2,301,845388,37417%859,06237%
Per share data (fully diluted):
Net income attributable to common stockholders (1)$1.57$0.66$0.91138%$0.30$0.36120%$1.27423%
Funds from operations attributable to common stockholders$3.82$3.40$0.4212%$3.18$0.227%$0.6420%
Interest coverage ratio5.39x3.74x1.65x44%3.73x0.01x%1.66x45%
Fixed charge coverage ratio4.99x3.44x1.55x45%3.37x0.07x2%1.62x48%
Adjusted interest coverage ratio5.34x3.95x1.39x35%3.94x0.01x%1.40x36%
Adjusted fixed charge coverage ratio4.95x3.64x1.31x36%3.56x0.08x2%1.39x39%
(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2022 to December 31, 2024 (in thousands):

Year Ended December 31,
202420232022Totals
Beginning balance564,241490,508447,239447,239
Redemption of OP Units and DownREIT Units4953365836
Option exercises184224
ATM Program issuances70,42053,30143,093166,814
Equity issuances20,12520,125
Other, net115(33)169251
Ending balance635,289564,241490,508635,289
Weighted average number of shares outstanding:
Basic602,975515,629462,185
Diluted608,750518,701465,158

A portion of our earnings is derived primarily from long-term investments with predictable rates of return. These investments are mainly financed with a combination of equity, senior unsecured notes, secured debt and borrowings under our primary unsecured credit facility. During inflationary periods, which generally are accompanied by rising interest rates, our ability to grow may be adversely affected because the yield on new investments may increase at a slower rate than new borrowing costs.

60

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Seniors Housing Operating

The following is a summary of our results of operations for the Seniors Housing Operating segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Resident fees and services$6,027,149$4,753,804$1,273,34527%$4,173,711$580,09314%$1,853,43844%
Other income8,3129,743(1,431)-15%63,839(54,096)-85%(55,527)-87%
Total revenues6,035,4614,763,5471,271,91427%4,237,550525,99712%1,797,91142%
Property operating expenses4,523,7803,655,508868,27224%3,292,045363,46311%1,231,73537%
NOI(1)1,511,6811,108,039403,64236%945,505162,53417%566,17660%
Other expenses:
Depreciation and amortization1,107,116906,771200,34522%854,80051,9716%252,31630%
Interest expense42,94956,509(13,560)-24%34,83321,67662%8,11623%
Loss (gain) on extinguishment of debt, net1,7111,711n/a386(386)-100%1,325343%
Impairment of assets85,56424,99960,565242%13,14611,85390%72,418551%
Other expenses96,43596,972(537)-1%66,02630,94647%30,40946%
1,333,7751,085,251248,52423%969,191116,06012%364,58438%
Income (loss) from continuing operations before income taxes and other items177,90622,788155,118681%(23,686)46,474196%201,592851%
Income (loss) from unconsolidated entities1,376(70,940)72,316102%(53,507)(17,433)-33%54,883103%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net134,08268,29065,79296%5,79462,496n/a128,288n/a
Income (loss) from continuing operations313,36420,138293,226n/a(71,399)91,537128%384,763539%
Net income (loss)313,36420,138293,226n/a(71,399)91,537128%384,763539%
Less: Net income (loss) attributable to noncontrolling interests(2,694)(5,975)3,28155%(15,689)9,71462%12,99583%
Net income (loss) attributable to common stockholders$316,058$26,113$289,945n/a$(55,710)$81,823147%$371,768667%

(1) See Non-GAAP Financial Measures below.

Resident fees and services revenue and property operating expenses for the year ended December 31, 2024 increased compared to the prior year primarily due to acquisitions, construction conversions outpacing dispositions and the conversions of Triple-net properties to Seniors Housing Operating RIDEA structures throughout the year. Additionally, our Seniors Housing Operating revenues are dependent on occupancy and rate growth, both of which have continued to steadily increase during 2024. Average occupancy is as follows:

Three Months Ended(1)
March 31,June 30,September 30,December 31,
202379.0%79.6%80.7%82.2%
202482.5%82.8%83.8%84.8%

(1) Average occupancy includes our minority ownership share related to unconsolidated properties and excludes the minority partners' noncontrolling ownership share related to consolidated properties. Also excludes land parcels and properties under development.

The following is a summary of our SSNOI at Welltower's share for the Seniors Housing Operating segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$295,897$238,547$57,35024.0%$977,345$817,584$159,76119.5%

(1) Relates to 660 properties for the QTD Pool and 545 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2024, we recorded impairment charges of $85,564,000 related to 18 properties. During the year ended December 31, 2023, we recorded impairment charges of $24,999,000 related to seven properties.

Transaction costs related to asset acquisitions are capitalized as a component of the purchase price. The fluctuation in other expenses is primarily due to the timing of noncapitalizable transaction costs associated with acquisitions and operator transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

Depreciation and amortization has increased as a result of acquisitions and segment transitions. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

61

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

During the year ended December 31, 2024, we completed Seniors Housing Operating construction conversions representing $778,834,000 or $550,413 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects in process, excluding expansions, overhead and capitalized interest (dollars in thousands):

As of December 31, 2024
Expected Conversion Year(1)PropertiesUnits/BedsAnticipated Remaining FundingConstruction in Progress Balance
2025182,978$174,735$705,248
202691,321254,900105,684
TBD(2)346,665
Total30$857,597
(1) Properties expected to be converted in phases over multiple years are reflected in the last expected year.
(2) Represents projects for which a final budget or expected conversion date are not yet known.

Interest expense represents secured debt interest expense, which fluctuates based on the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, extinguishments and principal amortizations. The fluctuations in loss (gain) on extinguishment of debt is primarily attributable to the volume of extinguishments and terms of the related secured debt.

The following is a summary of our Seniors Housing Operating segment property secured debt principal activity (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$1,955,048$1,701,939$1,599,522
Debt transferred27,08432,478
Debt issued197,930385,115113,183
Debt assumed427,725381,837288,522
Debt extinguished(303,081)(486,825)(227,910)
Debt disposed(164,640)
Principal payments(41,220)(47,672)(47,399)
Foreign currency(56,263)20,654(56,457)
Ending balance$2,042,583$1,955,048$1,701,939
Ending weighted average interest4.29%4.68%4.32%

A portion of our Seniors Housing Operating property investments are formed through partnership interests. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Income from unconsolidated entities during the year ended December 31, 2023 includes other-than-temporary impairment charges of $35,293,000, primarily related to unconsolidated management companies. Net income attributable to noncontrolling interests represents our partners’ share of net income (loss) related to joint ventures.

62

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Triple-net

The following is a summary of our results of operations for the Triple-net segment for the years presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Rental income$777,297$814,751$(37,454)-5%$782,329$32,4224%$(5,032)-1%
Interest income8,1671,3696,798497%1,606(237)-15%6,561409%
Other income3,30770,986(67,679)-95%6,77664,210948%(3,469)-51%
Total revenues788,771887,106(98,335)-11%790,71196,39512%(1,940)%
Property operating expenses40,72242,194(1,472)-3%44,483(2,289)-5%(3,761)-8%
NOI(1)748,049844,912(96,863)-11%746,22898,68413%1,821%
Other expenses:
Depreciation and amortization258,830231,02827,80212%215,88715,1417%42,94320%
Interest expense6,918(65)6,983n/a963(1,028)-107%5,955618%
Loss (gain) on derivatives and financial instruments, net1298(86)-88%1,499(1,401)-93%(1,487)-99%
Loss (gain) on extinguishment of debt, netn/a80(80)-100%(80)-100%
Provision for loan losses, net297(297)-100%297n/an/a
Impairment of assets5,65811,098(5,440)-49%3,5957,503209%2,06357%
Other expenses10,7935,0605,733113%13,043(7,983)-61%(2,250)-17%
282,211247,51634,69514%235,06712,4495%47,14420%
Income (loss) from continuing operations before income taxes and other items465,838597,396(131,558)-22%511,16186,23517%(45,323)-9%
Income (loss) from unconsolidated entities(17,554)7,158(24,712)-345%29,255(22,097)-76%(46,809)-160%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net309,453259309,194n/a16,648(16,389)-98%292,805n/a
Income (loss) from continuing operations757,737604,813152,92425%557,06447,7499%200,67336%
Net income (loss)757,737604,813152,92425%557,06447,7499%200,67336%
Less: Net income (loss) attributable to noncontrolling interests19,76421,804(2,040)-9%28,161(6,357)-23%(8,397)-30%
Net income (loss) attributable to common stockholders$737,973$583,009$154,96427%$528,903$54,10610%$209,07040%

(1) See Non-GAAP Financial Measures below.

Rental income decreased primarily due to agreements to convert Triple-net properties to Seniors Housing Operating RIDEA structures and the write-off of straight-line rent receivable balances of $139,652,000 and $16,642,000 during the years ended December 31, 2024 and 2023, respectively. These write-offs relate to leases for which the collection of substantially all contractual lease payments was no longer deemed probable, due primarily to agreements reached to convert Triple-net properties to Seniors Housing Operating RIDEA structures. These decreases are partially offset by acquisitions during the relevant periods.

Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. For the year ended December 31, 2024, we had 64 leases with rental rate increases ranging from 0.05% to 20.05% in our Triple-net portfolio.

Interest income primarily related to leases that were classified as sales-type leases in 2024.

As part of the substantial exit of the Genesis HealthCare operating relationship, which we disclosed on March 2, 2021, we transitioned the sublease of a portfolio of seven facilities from Genesis HealthCare to Complete Care Management in the second quarter of 2021. As part of the March 2021 transaction, we entered into a forward sale agreement for the seven properties valued at $182,618,000, which was expected to close when the Welltower-held purchase option became exercisable. As of March 31, 2023, the right of use assets related to the properties were $115,359,000 and were reflected as held for sale with the corresponding lease liabilities of $66,530,000 on our Consolidated Balance Sheet.

On May 1, 2023, we executed a series of transactions that included the assignment of the leasehold interest to a newly formed tri-party unconsolidated joint venture comprised of Aurora Health Network, Peace Capital (an affiliate of Complete Care Management) and us, and culminated with the closing of the purchase option by the joint venture. The transactions resulted in net cash proceeds to us of $104,240,000 after our retained interest of $11,571,000 in the joint venture and a gain from the loss of control and derecognition of the leasehold interest of $65,485,000, which we recorded in other income within our Consolidated Statements of Comprehensive Income during the year ended December 31, 2023.

63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a summary of our SSNOI at Welltower's share for the Triple-net segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$146,864$141,036$5,8284.1%$530,520$508,056$22,4644.4%

(1) Relates to 482 properties for the QTD Pool and 450 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

Depreciation and amortization fluctuate as a result of the acquisitions, dispositions and segment transitions of Triple-net properties. To the extent we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.

During the year ended December 31, 2024, we recorded impairment charges of $5,658,000 related to three properties. During the year ended December 31, 2023, we recorded impairment charges of $11,098,000 related to three properties.

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs from acquisitions and segment transitions. Changes in the gain on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

Interest expense represents secured debt interest expense and related fees. The change in secured debt interest expense is due to the net effect and timing of assumptions, segment transitions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Triple-net secured debt principal activity for the periods presented (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$38,260$39,179$72,536
Debt transferred(27,084)(32,478)
Debt assumed532,57539,574
Debt extinguished(10,628)(39,574)
Debt disposed(194,500)
Principal payments(3,071)(919)(879)
Ending balance$335,552$38,260$39,179
Ending weighted average interest3.44%4.39%4.39%

A portion of our Triple-net property investments were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The decrease in income from unconsolidated entities during the year ended December 31, 2024 is primarily related to the hypothetical liquidation at book value ("HLBV") adjustments to our unconsolidated entities (refer Note 2 for additional information.) Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.

64

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Outpatient Medical

The following is a summary of our results of operations for the Outpatient Medical segment for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Rental income$792,981$741,322$51,6597%$669,457$71,86511%$123,52418%
Other income9,1329,167(35)%8,9981692%1341%
Total revenues802,113750,48951,6247%678,45572,03411%123,65818%
Property operating expenses245,636231,95613,6806%205,99725,95913%39,63919%
NOI(1)556,477518,53337,9447%472,45846,07510%84,01918%
Other expenses:
Depreciation and amortization266,147263,3022,8451%239,68123,62110%26,46611%
Interest expense1,15010,543(9,393)-89%18,078(7,535)-42%(16,928)-94%
Loss (gain) on extinguishment of debt, net7(7)-100%15(8)-53%(15)-100%
Impairment of assets1,5711,571n/a761(761)-100%810106%
Other expenses6482,289(1,641)-72%2,537(248)-10%(1,889)-74%
269,516276,141(6,625)-2%261,07215,0696%8,4443%
Income (loss) from continuing operations before income taxes and other item286,961242,39244,56918%211,38631,00615%75,57536%
Income (loss) from unconsolidated entities5,046(549)5,595n/a(2,626)2,07779%7,672292%
Gain (loss) on real estate dispositions and acquisitions of controlling interests, net8,076(651)8,727n/a(6,399)5,74890%14,475226%
Income (loss) from continuing operations300,083241,19258,89124%202,36138,83119%97,72248%
Net income (loss)300,083241,19258,89124%202,36138,83119%97,72248%
Less: Net income (loss) attributable to noncontrolling interests1,3071,309(2)%6,919(5,610)-81%(5,612)-81%
Net income (loss) attributable to common stockholders$298,776$239,883$58,89325%$195,442$44,44123%$103,33453%

(1) See Non-GAAP Financial Measures below.

Rental income increased due primarily to acquisitions and construction conversions that occurred during 2023 and 2024. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Our leases could renew above or below current rental rates, resulting in an increase or decrease in rental income. For the year ended December 31, 2024, our consolidated Outpatient Medical portfolio signed 384,643 square feet of new leases and 1,992,131 square feet of renewals. The weighted average term of these leases was eight years, with a rate of $42.22 per square foot and tenant improvement and lease commission costs of $30.50 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 2.0% to 6.5%.

The fluctuations in property operating expenses and depreciation and amortization are primarily attributable to acquisitions and construction conversions that occurred during 2023 and 2024. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly.

The following is a summary of our SSNOI at Welltower share for the Outpatient Medical segment (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
December 31, 2024December 31, 2023$%December 31, 2024December 31, 2023$%
SSNOI(1)$129,752$128,417$1,3351.0%$481,635$472,136$9,4992.0%

(1) Relates to 415 properties for the QTD Pool and 379 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.

During the year ended December 31, 2024, we recorded an impairment charge of $1,571,000 related to one property. No impairment was recorded in 2023.

Transaction costs related to asset acquisitions are capitalized as a component of purchase price. The fluctuation in other expenses is primarily due to noncapitalizable transaction costs. Changes in the gains/losses on sales of properties are related to the volume and timing of property sales and the sales prices, which are further discussed in Note 5 to our consolidated financial statements.

During the year ended December 31, 2024, we completed construction conversions representing $228,515,000 or $1,563 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects in process, excluding expansions, overhead and capitalized interest (dollars in thousands):

65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

As of December 31, 2024
Expected Conversion YearPropertiesSquare FeetAnticipated Remaining FundingConstruction in Progress Balance
20257646,940$110,664$256,505
TBD(1)134,132
Total8$290,637
(1) Represents projects for which a final budget or expected conversion date are not yet known.

Total interest expense represents secured debt interest expense. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, fluctuations in interest rates, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity (dollars in thousands):

Year Ended December 31,
202420232022
Beginning balance$229,137$388,836$530,254
Debt assumed46,741
Debt extinguished(137,011)(200,955)(131,582)
Principal payments(3,038)(5,485)(9,836)
Ending balance$89,088$229,137$388,836
Ending weighted average interest4.19%5.42%4.38%

A portion of our Outpatient Medical property investments were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. The increase from prior year is attribute to the gain recognized as part of the sale of one our unconsolidated properties. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.

Non-segment/Corporate

The following is a summary of our results of operations for the Non-segment/Corporate activities for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Revenues:
Interest income$248,024$166,985$81,03949%$148,965$18,02012%$99,05966%
Other income116,74969,86846,88167%4,93464,934n/a111,815n/a
Total revenues364,773236,853127,92054%153,89982,95454%210,874137%
Property operating expenses20,07318,1181,95511%16,2451,87312%3,82824%
NOI(1)344,700218,735125,96558%137,65481,08159%207,046150%
Other expenses:
Interest expense523,244540,859(17,615)-3%475,64565,21414%47,59910%
General and administrative expenses235,491179,09156,40031%150,39028,70119%85,10157%
Loss (gain) on derivatives and financial instruments, net(27,899)(2,218)(25,681)n/a6,835(9,053)-132%(34,734)-508
Loss (gain) on extinguishments of debt, net419419n/a199(199)-100%220111%
Provision for loan losses, net10,1259,5126136%10,320(808)-8%(195)-2%
Other expenses9,5834,0205,563138%20,064(16,044)-80%(10,481)-52%
Total expenses750,963731,26419,6993%663,45367,81110%87,51013%
Loss from continuing operations before income taxes and other items(406,263)(512,529)106,26621%(525,799)13,2703%119,53623%
Income (loss) from unconsolidated entities10,63610,889(253)-2%5,5885,30195%5,04890%
Income tax (expense) benefit(2,700)(6,364)3,66458%(7,247)88312%4,54763%
Loss from continuing operations(398,327)(508,004)109,67722%(527,458)19,4544%129,13124%
Net income (loss)(398,327)(508,004)109,67722%(527,458)19,4544%129,13124%
Less: Net income (loss) attributable to noncontrolling interests2,8009071,893209%(37)944n/a2,837n/a
Net loss attributable to common stockholders$(401,127)$(508,911)$107,78421%$(527,421)$18,5104%$126,29424%

(1) See Non-GAAP Financial Measures below.

The increase in interest income during the year ended December 31, 2024 is primarily driven by increased advances on loans receivable during the year.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The increase in other income for the year ended December 31, 2024 is primarily due to interest earned on deposits. Property operating expenses represent insurance costs related to our captive insurance company, which acts as a direct insurer of property level insurance coverage for our portfolio.

The following is a summary of our Non-segment/Corporate interest expense for the periods presented (dollars in thousands):

Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
December 31,December 31,December 31,
20242023$%2022$%$%
Senior unsecured notes$497,223$508,681$(11,458)-2%$436,185$72,49617%$61,03814%
Unsecured credit facility and commercial paper program6,2396,977(738)-11%19,576(12,599)-64%(13,337)-68%
Loan expense19,78225,201(5,419)-22%19,8845,31727%(102)-1%
Totals$523,244$540,859$(17,615)-3%$475,645$65,21414%$47,59910%

The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments, as well as the movement in foreign exchange rates and related hedge activity. Please refer to Note 11 to the consolidated financial statements for additional information. The change in interest expense on our unsecured revolving credit facility and commercial paper program is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. Please refer to Note 10 of our consolidated financial statements for additional information regarding our unsecured revolving credit facility and commercial paper program. Loan expenses represent the amortization of costs incurred in connection with senior unsecured notes issuances.

General and administrative expenses as a percentage of consolidated revenues for the years ended December 31, 2024, 2023 and 2022 were 2.95%, 2.70% and 2.57%, respectively. The increase during the year ended December 31, 2024 is primarily driven by compensation costs associated with increased employee headcount. During the three months ended September 30, 2024, we also recognized $29,838,000 as a cumulative catch up of stock compensation expense due to the change in the probability of achievement of specific performance goals related to special nonrecurring performance-based stock option and restricted stock awards granted in December 2021 and January 2022. Please refer to Note 15 for additional information related to these grants.

Other expenses includes noncapitalizable legal expenses. The provision for income taxes primarily relates to state taxes, foreign taxes and taxes based on income generated by entities that are structured as taxable REIT subsidiaries.

Loss (gain) on derivatives and financial instruments, net is primarily attributable to the mark-to-market of the equity warrants received as part of the HC-One Group transactions that closed in 2021 and 2023.

Other

Non-GAAP Financial Measures

We believe that net income and net income attributable to common stockholders, as defined by U.S. GAAP, are the most appropriate earnings measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA to be useful supplemental measures of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts ("NAREIT") created funds from operations attributable to common stockholders ("FFO") as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means NICS, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate and acquisitions of controlling interests, and impairment of depreciable assets, plus depreciation and amortization, and after adjustments for unconsolidated entities and noncontrolling interests.

NOI is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. Property operating expenses represent costs associated with managing, maintaining, and servicing tenants for our properties. These expenses include, but are not limited to, property-related payroll and benefits, property management fees paid to managers, marketing, housekeeping, food service, maintenance, utilities, property taxes and insurance. General and administrative expenses represent general overhead costs that are unrelated to property operations and unallocable to the properties. These expenses include, but are not limited to, payroll and benefits related to corporate employees, professional services, office expenses and depreciation of corporate fixed assets. Same store NOI ("SSNOI") is used to evaluate the operating performance of our properties using a consistent population which controls for changes in the composition of our portfolio. We believe the drivers of property level NOI for both consolidated properties and unconsolidated properties are generally the same and therefore, we evaluate SSNOI based on our ownership interest in each property ("Welltower Share"). To arrive at Welltower's Share, NOI is adjusted by adding our minority ownership share related to unconsolidated properties and by subtracting the minority partners' noncontrolling ownership interests for consolidated properties. We do not control investments in unconsolidated properties and while we consider disclosures at Welltower Share to

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

be useful, they may not accurately depict the legal and economic implications of our joint venture arrangements and should be used with caution. As used herein, same store is generally defined as those revenue-generating properties in the portfolio for the relevant year-over-year reporting periods. Acquisitions and development conversions are included in SSNOI five full quarters or eight full quarters after acquisition or being placed into service for the QTD Pool and the YTD Pool, respectively. Land parcels, loans and leased properties, as well as any properties sold or classified as held for sale during the respective periods are excluded from SSNOI. Redeveloped properties (including major refurbishments of a Seniors Housing Operating property where 20% or more of units are simultaneously taken out of commission for 30 days or more or Outpatient Medical properties undergoing a change in intended use) are excluded from SSNOI until five full quarters or eight full quarters post completion of the redevelopment for the QTD Pool and YTD Pool, respectively. Properties undergoing operator transitions and/or segment transitions are also excluded from SSNOI until five full quarters or eight full quarters post completion of the transition for the QTD Pool and YTD Pool, respectively. In addition, properties significantly impacted by force majeure, acts of God, or other extraordinary adverse events are excluded from SSNOI until five full quarters or eight full quarters after the properties are placed back into service for the QTD Pool and YTD Pool, respectively. SSNOI excludes non-cash NOI and includes adjustments to present consistent ownership percentages and to translate Canadian properties and U.K. properties using a consistent exchange rate. We believe NOI and SSNOI provide investors relevant and useful information because they measure the operating performance of our properties at the property level on an unleveraged basis. We use NOI and SSNOI to make decisions about resource allocations and to assess the property level performance of our properties.

EBITDA is defined as earnings (net income) before interest, taxes, depreciation and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated entities and including adjustments for stock-based compensation expense, provision for loan losses, gains/losses on extinguishment of debt, gains/losses on disposition of properties and acquisitions of controlling interests, impairment of assets, gains/losses on derivatives and financial instruments, other expenses, other impairment charges and other adjustments as deemed appropriate. We believe that EBITDA and Adjusted EBITDA, along with net income, are important supplemental measures because they provide additional information to assess and evaluate the performance of our operations. We primarily use these measures to determine our interest coverage ratio, which represents EBITDA and Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed charges include total interest and secured debt principal amortization. Covenants in our unsecured senior notes and primary credit facility contain financial ratios based on a definition of EBITDA and Adjusted EBITDA that is specific to those agreements. Our leverage ratios are defined as the proportion of net debt to total capitalization and include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt, excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock.

Our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, the Board of Directors utilizes these measures to evaluate management performance. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of FFO to NICS, the most directly comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest and unconsolidated entity amounts represent adjustments to reflect our share of depreciation and amortization, gains/loss on real estate dispositions and impairment of assets. Amounts are in thousands except for per share data.

Year Ended December 31,
FFO Reconciliation:202420232022
Net income attributable to common stockholders$951,680$340,094$141,214
Depreciation and amortization1,632,0931,401,1011,310,368
Impairment of assets92,79336,09717,502
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Noncontrolling interests(30,812)(46,393)(56,529)
Unconsolidated entities129,290100,22681,560
Funds from operations attributable to common stockholders$2,323,433$1,763,227$1,478,072
Average diluted shares outstanding:608,750518,701465,158
Per diluted share data:
Net income attributable to common stockholders(1)$1.57$0.66$0.30
Funds from operations attributable to common stockholders$3.82$3.40$3.18
(1) Includes adjustment to the numerator for income (loss) attributable to OP Unitholders.

The tables below reflects the reconciliation of consolidated NOI to net income, the most directly comparable U.S. GAAP measure, for the years presented (dollars in thousands):

Year Ended December 31,
NOI Reconciliation:202420232022
Net income (loss)$972,857$358,139$160,568
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Loss (income) from unconsolidated entities49653,44221,290
Income tax expense (benefit)2,7006,3647,247
Other expenses117,459108,341101,670
Impairment of assets92,79336,09717,502
Provision for loan losses, net10,1259,80910,320
Loss (gain) on extinguishment of debt, net2,1307680
Loss (gain) on derivatives and financial instruments, net(27,887)(2,120)8,334
General and administrative expenses235,491179,091150,390
Depreciation and amortization1,632,0931,401,1011,310,368
Interest expense574,261607,846529,519
Consolidated net operating income (NOI)$3,160,907$2,690,219$2,301,845
NOI by segment:
Seniors Housing Operating$1,511,681$1,108,039$945,505
Triple-net748,049844,912746,228
Outpatient Medical556,477518,533472,458
Non-segment/Corporate344,700218,735137,654
Total NOI$3,160,907$2,690,219$2,301,845

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
March 31,June 30,September 30,December 31,December 31,
2024202320242023202420232024202320242023
Seniors Housing Operating:
Total revenues$1,361,737$1,134,130$1,395,373$1,162,344$1,514,022$1,201,705$1,764,329$1,265,368$6,035,461$4,763,547
Property operating expenses1,019,347883,7841,034,906885,1871,135,887918,9901,333,640967,5474,523,7803,655,508
Consolidated NOI$342,390$250,346$360,467$277,157$378,135$282,715$430,689$297,821$1,511,681$1,108,039
Triple-net:
Total revenues$222,943$204,709$142,082$266,015$228,649$196,809$195,097$219,573$788,771$887,106
Property operating expenses10,81711,72310,49510,5989,34510,04410,0659,82940,72242,194
Consolidated NOI$212,126$192,986$131,587$255,417$219,304$186,765$185,032$209,744$748,049$844,912
Outpatient Medical:
Total revenues$198,310$184,740$197,237$186,097$204,995$191,860$201,571$187,792$802,113$750,489
Property operating expenses62,46358,36561,18558,69762,77862,20459,21052,690245,636231,956
Consolidated NOI$135,847$126,375$136,052$127,400$142,217$129,656$142,361$135,102$556,477$518,533
Non-segment/Corporate:
Total revenues$76,751$37,150$90,192$51,022$107,997$71,639$89,833$77,042$364,773$236,853
Property operating expenses4,2863,8814,7114,1904,6914,0356,3856,01220,07318,118
Consolidated NOI$72,465$33,269$85,481$46,832$103,306$67,604$83,448$71,030$344,700$218,735

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of the properties included in our QTD Pool and YTD Pool for SSNOI:

QTD PoolYTD Pool
SSNOI Property Reconciliations:Seniors Housing OperatingTriple-netOutpatient MedicalTotalSeniors Housing OperatingTriple-netOutpatient MedicalTotal
Consolidated properties1,1565923712,1191,1565923712,119
Unconsolidated properties76761527676152
Total properties1,2325924472,2711,2325924472,271
Recent acquisitions and development conversions(1)(167)(74)(12)(253)(282)(106)(48)(436)
Under development(34)(8)(42)(34)(8)(42)
Under redevelopment(2)(2)(4)(2)(8)(2)(4)(2)(8)
Current held for sale(22)(1)(23)(22)(1)(23)
Land parcels, loans and leased properties(105)(8)(9)(122)(105)(8)(9)(122)
Transitions(3)(234)(19)(253)(234)(19)(253)
Other(4)(8)(4)(1)(13)(8)(4)(1)(13)
Same store properties6604824151,5575454503791,374
(1) Acquisitions and development conversions will enter the QTD Pool five full quarters and the YTD Pool eight full quarters after acquisition or certificate of occupancy.
(2) Redevelopment properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations post redevelopment completion.
(3) Transitioned properties will enter the QTD Pool after five full quarters and the YTD Pool after eight full quarters of operations with the new operator in place or under the new structure.
(4) Represents properties that are either closed or being closed.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following is a reconciliation of our consolidated NOI to same store NOI for the periods presented for the respective pools (dollars in thousands):

QTD PoolYTD Pool
Three Months EndedTwelve Months Ended
SSNOI Reconciliations:December 31, 2024December 31, 2023December 31, 2024December 31, 2023
Seniors Housing Operating:
Consolidated NOI$430,689$297,821$1,511,681$1,108,039
NOI attributable to unconsolidated investments23,28220,48890,81265,281
NOI attributable to noncontrolling interests(12,369)(15,688)(52,437)(62,838)
NOI attributable to non-same store properties(143,604)(62,817)(571,693)(294,139)
Non-cash NOI attributable to same store properties(1,834)(2,757)(756)(2,328)
Currency and ownership adjustments (1)(267)1,500(262)3,569
SSNOI at Welltower Share295,897238,547977,345817,584
Triple-net:
Consolidated NOI185,032209,744748,049844,912
NOI attributable to unconsolidated investments5,7113,5049,901
NOI attributable to noncontrolling interests(5,314)(12,584)(29,387)(31,361)
NOI attributable to non-same store properties(56,108)(38,316)(172,633)(240,832)
Non-cash NOI attributable to same store properties23,533(25,647)(23,865)(82,917)
Currency and ownership adjustments (1)(279)2,1284,8528,353
SSNOI at Welltower Share146,864141,036530,520508,056
Outpatient Medical:
Consolidated NOI142,361135,102556,477518,533
NOI attributable to unconsolidated investments4,0994,58617,24418,925
NOI attributable to noncontrolling interests(2,491)(2,308)(9,898)(15,400)
NOI attributable to non-same store properties(8,742)(3,607)(63,145)(35,787)
Non-cash NOI attributable to same store properties(5,488)(5,433)(19,100)(20,404)
Currency and ownership adjustments (1)1377576,269
SSNOI at Welltower Share129,752128,417481,635472,136
SSNOI at Welltower Share:
Seniors Housing Operating295,897238,547977,345817,584
Triple-net146,864141,036530,520508,056
Outpatient Medical129,752128,417481,635472,136
Total$572,513$508,000$1,989,500$1,797,776
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.36 and to translate U.K. properties at a GBP/USD rate of 1.25.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Dollars are in thousands.

Year Ended December 31,
Adjusted EBITDA Reconciliation:202420232022
Net income (loss)$972,857$358,139$160,568
Interest expense574,261607,846529,519
Income tax expense (benefit)2,7006,3647,247
Depreciation and amortization1,632,0931,401,1011,310,368
EBITDA3,181,9112,373,4502,007,702
Loss (income) from unconsolidated entities49653,44221,290
Stock-based compensation expense74,48236,61126,027
Loss (gain) on extinguishment of debt, net2,1307680
Loss (gain) on real estate dispositions and acquisitions of controlling interests, net(451,611)(67,898)(16,043)
Impairment of assets92,79336,09717,502
Provision for loan losses, net10,1259,80910,320
Loss (gain) on derivatives and financial instruments, net(27,887)(2,120)8,334
Other expenses117,459108,341101,670
Lease termination and leasehold interest adjustment (1)(65,485)(64,854)
Casualty losses, net of recoveries12,26110,10710,391
Other impairment, net (2)139,65216,642(620)
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted Interest Coverage Ratio:
Interest expense$574,261$607,846$529,519
Capitalized interest58,11550,69930,491
Non-cash interest expense(42,388)(23,494)(21,754)
Total interest589,988635,051538,256
EBITDA$3,181,911$2,373,450$2,007,702
Interest coverage ratio5.39x3.74x3.73x
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted interest coverage ratio5.34x3.95x3.94x
Adjusted Fixed Charge Coverage Ratio:
Total interest$589,988$635,051$538,256
Secured debt principal payments47,32954,07658,114
Total fixed charges637,317689,127596,370
EBITDA$3,181,911$2,373,450$2,007,702
Fixed charge coverage ratio4.99x3.44x3.37x
Adjusted EBITDA$3,151,811$2,509,003$2,122,399
Adjusted fixed charge coverage ratio4.95x3.64x3.56x

(1) Primarily relates to the derecognition of leasehold interests and the gain recognized in other income.

(2) Represents the write-off or recovery of straight-line rent receivables balances relating to leases placed on cash recognition.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our leverage ratios include book capitalization, undepreciated book capitalization and enterprise value. Book capitalization represents the sum of net debt (defined as total long-term debt excluding operating lease liabilities, less cash and cash equivalents and restricted cash), total equity and redeemable noncontrolling interests. Undepreciated book capitalization represents book capitalization adjusted for accumulated depreciation and amortization. Enterprise value represents book capitalization adjusted for the fair market value of our common stock. Our leverage ratios are defined as the proportion of net debt to total capitalization. The table below reflects the reconciliation of our leverage ratios to our balance sheets for the periods presented. Amounts are in thousands, except share price.

Year Ended December 31,
202420232022
Book capitalization:
Unsecured credit facility and commercial paper$$$
Long-term debt obligations(1)15,608,29415,815,22614,661,552
Cash and cash equivalents and restricted cash(3,711,457)(2,076,083)(722,292)
Total net debt11,896,83713,739,14313,939,260
Total equity and noncontrolling interests(2)32,572,58626,371,72721,393,996
Book capitalization$44,469,423$40,110,870$35,333,256
Net debt to book capitalization ratio26.8%34.3%39.5%
Undepreciated book capitalization:
Total net debt$11,896,837$13,739,143$13,939,260
Accumulated depreciation and amortization10,626,2639,274,8148,075,733
Total equity and noncontrolling interests(2)32,572,58626,371,72721,393,996
Undepreciated book capitalization$55,095,686$49,385,684$43,408,989
Net debt to undepreciated book capitalization ratio21.6%27.8%32.1%
Enterprise value:
Common shares outstanding635,289564,241490,509
Period end share price$126.03$90.17$65.55
Common equity market capitalization$80,065,473$50,877,611$32,152,865
Total net debt11,896,83713,739,14313,939,260
Noncontrolling interests(2)616,378967,3511,099,182
Consolidated enterprise value$92,578,688$65,584,105$47,191,307
Net debt to consolidated enterprise value ratio12.9%20.9%29.5%

(1) Amounts include senior unsecured notes, secured debt and lease liabilities related to finance leases, as reflected on our Consolidated Balance Sheets. Operating lease liabilities related to ASC 842 are excluded.

(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies and Estimates

Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:

•the nature of the estimates or assumptions 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

•the impact of the estimates and assumptions on financial condition or operating performance is material.

Management has discussed the development and selection of its critical accounting policies and estimates with the Audit Committee of the Board of Directors. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. 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. Please refer to Note 2 to our consolidated financial statements for further information on significant accounting policies that impact us and for the impact of new accounting standards, including accounting pronouncements that were issued but not yet adopted by us.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following table presents information about our critical accounting policies and estimates:

Nature of Critical Accounting EstimateAssumptions/Approach Used
Impairment of Real Property Owned and Investments in Unconsolidated EntitiesAssessing impairment of real property owned and investments in unconsolidated entities involves subjectivity in determining if indicators of impairment are present and in estimating the future undiscounted cash flows or estimated fair value of an asset. The evaluation of indicators of impairment is dependent on a number of factors, including when there is an unfavorable change in the operating performance of the property, a change in management's intent to hold and operate the property or a change in the property's use. If an indicator of impairment of the property is identified, management estimates whether the carrying value is recoverable using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates, all of which are affected by our expectations of future market or economic conditions. These inputs can have a significant impact on the undiscounted cash flows. The evaluation of indicators of impairment of investments in unconsolidated entities is dependent on a number of factors including the performance of each investment, a change in market conditions or a change in management's investment strategy. When required, we estimate the fair value of an investment and, if such fair value is lower than carrying value, assess whether any impairment is other-than-temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates. These inputs can have a significant impact on the calculation of the fair value of the investment.Quarterly, we review our real property owned on a property by property basis to determine if facts and circumstances suggest the property may be impaired. These indicators may include expected operational performance, the tenant's ability to make rent payments, a change in management's intent to hold and operate the property and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, an undiscounted cash flow analysis will be prepared to determine if the value of the property will be recoverable. If the estimated undiscounted cash flows indicate that the carrying value of the property will not be recoverable, the carrying value of the property is reduced to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. The analysis requires us to use judgment in determining whether indicators of impairment exist and to estimate the expected future undiscounted cash flows or estimated fair values of the property. Properties that meet the held for sale criteria are recorded at the lesser of the fair value less costs to sell or carrying value.We also evaluate investments in unconsolidated entities for indicators of impairment and, when present, record impairment charges based on a comparison of the estimated fair value of the equity method investment to its carrying value if the decline in the estimated fair value of such an investment below its carrying value is other-than-temporary. At December 31, 2024, our net real property owned was approximately $40,673,242,000 and investments in unconsolidated entities totaled $1,768,772,000. During the year ended December 31, 2024, we recorded impairment charges of $92,793,000 related to 18 Seniors Housing Operating properties, three Triple-net properties and one Outpatient Medical property. No impairment losses related to investments in unconsolidated entities were recorded during the year ended December 31, 2024.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Real Estate AcquisitionsMost of our real estate acquisitions are considered asset acquisitions for which we record the related real estate acquired (tangible assets and identifiable intangible assets and liabilities) at cost on a relative fair value basis. Liabilities assumed and any associated noncontrolling interests are reflected at fair value. Tangible assets consist primarily of land, building and improvements. Identifiable intangible assets and liabilities primarily consist of the above or below market component of in-place leases and the value of in-place leases. The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values based on management's evaluation of the specific characteristics of each tenant's lease and our overall relationship with respect to that tenant. For real estate acquisitions accounted for as business combinations, we allocate the acquisition consideration to the assets acquired, liabilities assumed and noncontrolling interests at fair value as of the acquisition date. Any excess of the consideration transferred relative to the fair value of the net assets acquired is accounted for as goodwill.In determining the fair values that drive the recorded tangible assets and identifiable intangible assets and liabilities, we estimate the fair value of each component of the real estate acquired, which generally includes land, buildings and improvements, the above or below market component of in-place leases and the value of in-place leases using a number of sources including independent appraisals, our own analysis of recently acquired or developed and existing comparable properties in our portfolio and other market data. Significant assumptions used to determine such fair values include comparable land sales, capitalization rates, discount rates, market rental rates and property operating data, all of which can be impacted by expectations about future market or economic conditions. Our estimates of the values of these components affect the amount of depreciation and amortization we record over the estimated useful life of the property or the term of the lease and the amount of goodwill recognized in an acquisition accounted for as a business combination.During the year ended December 31, 2024, we disbursed $3,525,449,000 of cash related to real estate asset acquisitions and business combinations.

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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Nature of Critical Accounting EstimateAssumptions/Approach Used
Principles of ConsolidationThe consolidated financial statements include our accounts, the accounts of our wholly owned subsidiaries and the accounts of joint venture entities in which we own a majority voting interest with the ability to control operations and where no substantive participating rights or substantive kick out rights have been granted to the noncontrolling interests. In addition, we consolidate those entities deemed to be variable interest entities (“VIEs”) in which we are determined to be the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.We make judgments about which entities are VIEs based on an assessment of whether (i) the equity investors as a group, if any, do not have a controlling financial interest or (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support. We make judgments with respect to our level of influence or control of an entity and whether we are (or are not) the primary beneficiary of a VIE. Consideration of various factors include, but is not limited to, our ability to direct the activities that most significantly impact the entity's economic performance, our form of ownership interest, our representation on the entity's governing body, the size and seniority of our investment, our ability and the rights of other investors to participate in policy making decisions, replace the manager and/or liquidate the entity, if applicable. Our ability to correctly assess our influence or control over an entity at inception of our involvement or on a continuous basis when determining the primary beneficiary of a VIE affects the presentation of these entities in our consolidated financial statements. If we perform a primary beneficiary analysis at a date other than at inception of the VIE, our assumptions may be different and may result in the identification of a different primary beneficiary.
Allowance for Credit Losses on Loans ReceivableThe allowance for credit losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the credit allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments.We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, payment status, historical loan charge-offs, financial strength of the borrower and guarantors, and nature, extent and value of the underlying collateral. A loan is considered to have deteriorated credit quality when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the loan agreement. For those loans we identified as having deteriorated credit quality, we determine the amount of credit loss on an individual basis. Placement on non-accrual status may be required. Consistent with this definition, all loans on non-accrual are deemed to have deteriorated credit quality. To the extent circumstances improve and the risk of collectability is diminished, we may return these loans to income accrual status. While a loan is on non-accrual status, any cash receipts are applied against the outstanding principal balance. For the remaining loans, we assess credit loss on a collective pool basis and use our historical loss experience for similar loans to determine the reserve for credit losses.During the year ended December 31, 2024, we recognized provision for loan losses of $10,125,000, which includes changes in the reserve based on our historical loss experience.

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