ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The discussion below contains forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in these forward-looking statements as a result of various factors, including those which are discussed in the “Risk Factors” section in Part I, Item 1A of our 2025 Annual Report on Form 10-K. Also see “Statement Regarding Forward-Looking Statements” preceding Part I.
The following discussion and analysis should be read in conjunction with our accompanying unaudited consolidated financial statements and the notes thereto.
Our Management’s Discussion and Analysis of Financial Condition and Results of Operations is organized as follows:
•Overview
•Critical Accounting Policies and Estimates
•Recently Issued Accounting Standards Updates
•Results of Operations
•Liquidity and Capital Resources
•Concentration of Credit Risk
•Medicare Reimbursement Rates
Overview
We operate as a self-administered, self-managed REIT that, through our subsidiaries, owns and invests in real estate serving the healthcare industry.
Our primary business consists of acquiring, financing and owning real estate property to be leased to third-party tenants in the healthcare sector. We primarily generate revenues by leasing properties to tenants and owning properties operated by third-party property managers throughout the United States (“U.S.”) and Canada.
Our investment portfolio is primarily comprised of skilled nursing/transitional care facilities, senior housing communities (“Senior Housing - Leased”), behavioral health facilities, and specialty hospitals and other facilities, in each case leased to third-party operators; senior housing communities operated by third-party property managers pursuant to property management agreements (“Senior Housing - Managed”); investments in joint ventures; loans receivable; and preferred equity investments.
We expect to grow our investment portfolio while diversifying our portfolio by tenant, facility type and geography within the healthcare sector. We plan to achieve these objectives primarily through making investments directly or indirectly in healthcare real estate, including the development of purpose-built healthcare facilities with select developers. We also intend to achieve our objective of diversifying our portfolio by tenant and facility type through select asset sales and other arrangements with our tenants.
We employ a disciplined approach in our healthcare real estate investment strategy by investing in assets that provide attractive opportunities for earnings growth and appreciation of asset values, while maintaining balance sheet strength and liquidity, thereby creating long-term stockholder value.
We elected to be treated as a REIT with the filing of our U.S. federal income tax return for the taxable year beginning January 1, 2011. We believe that we have been organized and have operated, and we intend to continue to operate, in a manner to qualify as a REIT. We operate through an umbrella partnership, commonly referred to as an UPREIT structure, in which substantially all of our properties and assets are held by Sabra Health Care Limited Partnership, a Delaware limited partnership (the “Operating Partnership”), or by subsidiaries of the Operating Partnership. We are the sole general partner of the Operating Partnership and we and one of our wholly owned subsidiaries are the sole limited partners of the Operating Partnership.
Market Trends and Uncertainties
Our operations have been and are expected to continue to be impacted by economic and market conditions. Increases in operating expenses, inflation and increased volatility in public equity and fixed income markets have led to increased costs and limited the availability of capital.
To the extent that our tenants, borrowers and Senior Housing - Managed portfolio have faced or will face the negative impacts of such conditions, they may be unable to meet their obligations to us or experience a deterioration in operating results. If our tenants and borrowers default on these obligations, such defaults could result in the determination that the full amounts of
our investments are not recoverable, which could result in an impairment charge. Further, prolonged deterioration in the operating results for our investments in our Senior Housing - Managed portfolio could result in the determination that the full amounts of our investments are not recoverable, which could result in an impairment charge.
We regularly monitor the effects of economic and market conditions, as well as actions by national, state and local government administrations and regulatory agencies that affect healthcare policy and general market conditions, on our operations and financial position, as well as on the operations and financial position of our tenants and borrowers, in order to respond and adapt to the ongoing changes in our operating environment.
Acquisitions
During the six months ended June 30, 2026, we acquired seven Senior Housing - Managed communities, two skilled nursing/transitional care facilities and exercised our option to acquire one skilled nursing/transitional care facility for aggregate consideration of $287.6 million, including acquisition costs. Additionally, during the six months ended June 30, 2026, we invested $8.2 million in the purchase of bed rights and land related to the development of one skilled nursing/transitional care facility and purchased the operations of one Senior Housing - Managed community previously leased to the tenant under a triple-net operating lease for $16.3 million. See Note 3, “Recent Real Estate Acquisitions (Consolidated),” in the Notes to Consolidated Financial Statements for additional information regarding these investments.
Dispositions
During the six months ended June 30, 2026, we completed the sale of six skilled nursing/transitional care facilities and one Senior Housing - Managed community for aggregate consideration, net of closing costs, of $93.6 million. The net carrying value of the assets and liabilities of these facilities was $55.9 million, which resulted in an aggregate $46.1 million net gain on sale from the disposition of three facilities, partially offset by an aggregate $8.4 million net loss on sale from the disposition of four facilities. We continue to evaluate additional assets for sale as we look to further improve our portfolio quality.
Loans Receivable and Other Investments
During the six months ended June 30, 2026, we agreed to and received a reduced cash payment of $200.0 million in full satisfaction of the $300.0 million Recovery Centers of America mortgage loan, resulting in a write-off of $100.0 million.
Critical Accounting Policies and Estimates
Our consolidated interim financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) and in conjunction with the rules and regulations of the Securities and Exchange Commission (the “SEC”). The preparation of our financial statements requires significant management judgments, assumptions and estimates about matters that are inherently uncertain. These judgments affect the reported amounts of assets and liabilities and our disclosure of contingent assets and liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. With different estimates or assumptions, materially different amounts could be reported in our financial statements. Additionally, other companies may utilize different estimates that may impact the comparability of our results of operations to those of companies in similar businesses. A discussion of the accounting policies that management considers critical in that they involve significant management judgments and assumptions, require estimates about matters that are inherently uncertain and because they are important for understanding and evaluating our reported financial results is included in Part II, Item 7 of our 2025 Annual Report on Form 10-K filed with the SEC. There have been no significant changes to our critical accounting policies during the six months ended June 30, 2026.
Recently Issued Accounting Standards Updates
See Note 2, “Summary of Significant Accounting Policies,” in the Notes to Consolidated Financial Statements for information concerning recently issued accounting standards updates.
Results of Operations
As of June 30, 2026, our investment portfolio consisted of 364 real estate properties held for investment, 11 investments in loans receivable, four preferred equity investments and two investments in unconsolidated joint ventures. As of June 30, 2025, our investment portfolio consisted of 359 real estate properties held for investment, 13 investments in loans receivable, four preferred equity investments and two investments in unconsolidated joint ventures. In general, we expect that income and expenses related to our portfolio will fluctuate in future periods in comparison to the corresponding prior periods as a result of investment and disposition activity and anticipated future changes in our portfolio. The results of operations presented are not directly comparable due to ongoing acquisition and disposition activity.
Comparison of results of operations for the three months ended June 30, 2026 versus the three months ended June 30, 2025 (dollars in thousands):
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended June 30, | | Increase / (Decrease) | | Percentage Difference | | Variance due to Acquisitions, Originations and Dispositions (1) | | Remaining Variance (2) |
| 2026 | | 2025 | | | | |
| Revenues: | | | | | | | | | | | |
| Rental and related revenues | $ | 101,308 | | | $ | 99,823 | | | $ | 1,485 | | | 1 | % | | $ | (1,371) | | | $ | 2,856 | |
| Resident fees and services | 128,802 | | | 78,985 | | | 49,817 | | | 63 | % | | 34,484 | | | 15,333 | |
| Interest and other income | 5,756 | | | 10,342 | | | (4,586) | | | (44) | % | | (4,124) | | | (462) | |
| Expenses: | | | | | | | | | | | |
| Depreciation and amortization | 56,379 | | | 43,586 | | | 12,793 | | | 29 | % | | 13,758 | | | (965) | |
| Interest | 29,779 | | | 27,548 | | | 2,231 | | | 8 | % | | — | | | 2,231 | |
| Triple-net portfolio operating expenses | 3,656 | | | 3,698 | | | (42) | | | (1) | % | | (136) | | | 94 | |
| Senior housing - managed portfolio operating expenses | 88,616 | | | 57,404 | | | 31,212 | | | 54 | % | | 21,969 | | | 9,243 | |
| General and administrative | 16,819 | | | 12,514 | | | 4,305 | | | 34 | % | | — | | | 4,305 | |
| Provision for (recovery of) loan losses and other reserves | 102,445 | | | (227) | | | 102,672 | | | (45,230) | % | | 101,403 | | | 1,269 | |
| Impairment of real estate | — | | | 4,103 | | | (4,103) | | | (100) | % | | (4,103) | | | — | |
| Other income: | | | | | | | | | | | |
| | | | | | | | | | | |
| Other (expense) income | (2,683) | | | 14,709 | | | (17,392) | | | (118) | % | | — | | | (17,392) | |
| Net gain on sales of real estate | 37,717 | | | 9,974 | | | 27,743 | | | 278 | % | | 27,743 | | | — | |
| Income from unconsolidated joint ventures | 2,224 | | | 832 | | | 1,392 | | | 167 | % | | — | | | 1,392 | |
| Income tax expense | (678) | | | (497) | | | (181) | | | 36 | % | | — | | | (181) | |
(1) Represents the dollar amount increase (decrease) for the three months ended June 30, 2026 compared to the three months ended June 30, 2025 as a result of investments/dispositions made after April 1, 2025.
(2) Represents the dollar amount increase (decrease) for the three months ended June 30, 2026 compared to the three months ended June 30, 2025 that is not a direct result of investments/dispositions made after April 1, 2025.
Rental and Related Revenues
During the three months ended June 30, 2026, we recognized $101.3 million of rental income compared to $99.8 million for the three months ended June 30, 2025. The $1.5 million net increase in rental income is related to (i) a $4.4 million increase in revenue as the result of changing our estimates of collectability for certain leases within our triple-net leased portfolio, lease amendments and annual rental increases based on changes in the Consumer Price Index, (ii) a $3.5 million net increase in revenue related to leases that are not accounted for on an accrual basis and (iii) a $1.1 million increase from properties acquired after April 1, 2025. These increases are partially offset by (i) a $4.5 million decrease related to facilities that were transitioned to Senior Housing - Managed communities after April 1, 2025, (ii) a $2.5 million decrease from properties disposed of after April 1, 2025 and (iii) a $0.6 million decrease related to facilities that were transitioned to new operators after April 1, 2025.
Our reported rental and related revenues may be subject to increased variability in the future as a result of lease accounting standards. If at any time we cannot determine that it is probable that substantially all rents over the life of a lease are collectible, rental revenue will be recognized only to the extent of payments received and all receivables associated with the lease will be written off, irrespective of amounts expected to be collectible. However, there can be no assurances regarding the timing and amount of these revenues. Amounts due under the terms of all of our lease agreements are subject to contractual increases, and contingent rental income may be earned from certain lease agreements. No material contingent rental income was derived during the three months ended June 30, 2026 and 2025.
Our rental income in future years will be impacted by changes in inflation. Certain of our lease agreements provide for an annual rent escalator based on the percentage change in the Consumer Price Index (but not less than zero), subject to minimum or maximum fixed percentages that range from 1.0% to 5.0%.
Resident Fees and Services
During the three months ended June 30, 2026, we recognized $128.8 million of resident fees and services compared to $79.0 million for the three months ended June 30, 2025. The $49.8 million net increase is due to (i) a $34.9 million increase related to 18 Senior Housing - Managed communities acquired after April 1, 2025, (ii) a $10.6 million increase related to five facilities that were transitioned to Senior Housing - Managed communities after April 1, 2025 and (iii) a $5.4 million increase primarily related to increased occupancy and an increase in rates. These increases are partially offset by a $0.7 million decrease due to one Senior Housing - Managed community that was closed in August 2025 and a $0.4 million decrease due to one Senior Housing - Managed community that was sold after April 1, 2025.
Interest and Other Income
Interest and other income primarily consists of income earned on our loans receivable investments and preferred returns earned on our preferred equity investments. During the three months ended June 30, 2026, we recognized $5.8 million of interest and other income compared to $10.3 million for the three months ended June 30, 2025. The net decrease of $4.6 million is primarily due to a $4.1 million decrease from investments that were repaid after April 1, 2025 and a $0.5 million decrease in late fee income.
Depreciation and Amortization
During the three months ended June 30, 2026, we incurred $56.4 million of depreciation and amortization expense compared to $43.6 million for the three months ended June 30, 2025. The net increase of $12.8 million is due to a $15.0 million increase from properties acquired after April 1, 2025 and the acquisition of the operations of five Senior Housing - Managed communities previously leased to the tenant under triple-net operating leases and a $0.6 million increase from additions to real estate. These increases are partially offset by a $1.3 million decrease due to assets that have been fully depreciated and a $1.3 million decrease from properties disposed of after April 1, 2025.
Interest
We incur interest expense comprised of costs of borrowings plus the amortization of deferred financing costs related to our indebtedness. During the three months ended June 30, 2026, we incurred $29.8 million of interest expense compared to $27.5 million for the three months ended June 30, 2025. The $2.2 million net increase is primarily related to an increase in interest expense related to borrowings under the Credit Agreement (as defined below).
Senior Housing - Managed Portfolio Operating Expenses
During the three months ended June 30, 2026, we recognized $88.6 million of Senior Housing - Managed portfolio operating expenses compared to $57.4 million for the three months ended June 30, 2025. The $31.2 million net increase is primarily due to (i) a $22.4 million increase related to 18 Senior Housing - Managed communities acquired after April 1, 2025, (ii) a $6.4 million increase related to five facilities that were transitioned to Senior Housing - Managed communities after April 1, 2025, (iii) a $1.4 million increase in employee compensation primarily due to increased labor rates and staffing, (iv) a $0.9 million increase in management fees and housekeeping costs due to increased occupancy and in dining expenses primarily due to outsourcing the service to a third party at certain communities, (v) a $0.6 million increase in advertising and marketing, (vi) a $0.3 million increase in repairs and maintenance and (vii) a $0.2 million increase in utilities due to increased rates and usage, partially offset by a $0.6 million decrease related to one Senior Housing - Managed community that was closed in August 2025 and a $0.4 million decrease related to one Senior Housing – Managed community that was sold after April 1, 2025.
General and Administrative
General and administrative expenses include compensation-related expenses as well as professional services, office costs, other costs associated with asset management, and acquisition costs. During the three months ended June 30, 2026, general and administrative expenses were $16.8 million compared to $12.5 million for the three months ended June 30, 2025. The $4.3 million net increase is primarily related to a $3.9 million increase in compensation for our teammates as a result of increased staffing, changes in performance-based payout assumptions on incentive compensation and annual salary adjustments.
Provision for (Recovery of) Loan Losses and Other Reserves
During the three months ended June 30, 2026, we recognized a $102.4 million provision for loan losses and other reserves primarily associated with the reduced cash repayment of $200.0 million in full satisfaction of the $300.0 million Recovery Centers of America mortgage loan. During the three months ended June 30, 2025, we recognized a $0.2 million recovery of loan losses associated with our loans receivable investments.
Impairment of Real Estate
During the three months ended June 30, 2026, we did not recognize any impairment of real estate. During the three months ended June 30, 2025, we recognized a $4.1 million impairment of real estate related to one sold facility.
Other (Expense) Income
During the three months ended June 30, 2026, we recognized $2.7 million of other expense primarily due to lease termination expense related to one community that was transitioned from our triple-net portfolio to Senior Housing - Managed communities. During the three months ended June 30, 2025, we recognized $14.7 million of other income, including the reclassification of $17.2 million of gain related to six previously terminated interest rate swaps from accumulated other comprehensive loss to other income as the related forecasted transactions were determined to be probable not to occur and $1.0 million of other income related to insurance proceeds received related to a fire that occurred at one of our Senior Housing - Managed communities in 2022, partially offset by $3.2 million of transition expenses related to the transition of Senior Housing - Managed communities to new operators.
Net Gain on Sales of Real Estate
During the three months ended June 30, 2026, we recognized an aggregate net gain of $37.7 million related to the disposition of seven facilities, including a $46.1 million gain on sale related to the disposition of three facilities, partially offset by an $8.4 million net loss on sale related to the disposition of four facilities. During the three months ended June 30, 2025, we recognized an aggregate net gain of $10.0 million related to the disposition of six facilities.
Income from Unconsolidated Joint Ventures
During the three months ended June 30, 2026 and 2025, we recognized $2.2 million and $0.8 million of income from our unconsolidated joint ventures, respectively. The $1.4 million net increase is primarily related to a $0.8 million increase in revenues net of operating expenses primarily due to increased occupancy and rates and a $0.6 million decrease in depreciation expense primarily due to assets that have been fully depreciated.
Income Tax Expense
During the three months ended June 30, 2026 and 2025, we recognized $0.7 million and $0.5 million of income tax expense, respectively. The $0.2 million change is primarily due to higher taxable income.
Comparison of results of operations for the six months ended June 30, 2026 versus the six months ended June 30, 2025 (dollars in thousands):
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
| Six Months Ended June 30, | | Increase / (Decrease) | | Percentage Difference | | Variance due to Acquisitions, Originations and Dispositions (1) | | Remaining Variance (2) |
| 2026 | | 2025 | | | | |
| Revenues: | | | | | | | | | | | |
| Rental and related revenues | $ | 196,358 | | | $ | 195,860 | | | $ | 498 | | | — | % | | $ | (2,550) | | | $ | 3,048 | |
| Resident fees and services | 245,487 | | | 156,432 | | | 89,055 | | | 57 | % | | 60,286 | | | 28,769 | |
| Interest and other income | 15,774 | | | 20,401 | | | (4,627) | | | (23) | % | | (4,449) | | | (178) | |
| Expenses: | | | | | | | | | | | |
| Depreciation and amortization | 109,510 | | | 87,080 | | | 22,430 | | | 26 | % | | 23,893 | | | (1,463) | |
| Interest | 58,188 | | | 54,648 | | | 3,540 | | | 6 | % | | — | | | 3,540 | |
| Triple-net portfolio operating expenses | 7,429 | | | 7,177 | | | 252 | | | 4 | % | | 51 | | | 201 | |
| Senior housing - managed portfolio operating expenses | 170,485 | | | 113,858 | | | 56,627 | | | 50 | % | | 38,688 | | | 17,939 | |
| General and administrative | 31,681 | | | 25,242 | | | 6,439 | | | 26 | % | | — | | | 6,439 | |
| Provision for (recovery of) loan losses and other reserves | 102,232 | | | (400) | | | 102,632 | | | (25,658) | % | | 101,341 | | | 1,291 | |
| Impairment of real estate | 440 | | | 4,103 | | | (3,663) | | | (89) | % | | (3,790) | | | 127 | |
| Other income: | | | | | | | | | | | |
| | | | | | | | | | | |
| Other (expense) income | (2,738) | | | 14,747 | | | (17,485) | | | (119) | % | | — | | | (17,485) | |
| Net gain on sales of real estate | 37,717 | | | 9,974 | | | 27,743 | | | 278 | % | | 27,743 | | | — | |
| Income from unconsolidated joint ventures | 4,136 | | | 1,050 | | | 3,086 | | | 294 | % | | — | | | 3,086 | |
| Income tax expense | (1,204) | | | (910) | | | (294) | | | 32 | % | | — | | | (294) | |
(1) Represents the dollar amount increase (decrease) for the six months ended June 30, 2026 compared to the six months ended June 30, 2025 as a result of investments/dispositions made after January 1, 2025.
(2) Represents the dollar amount increase (decrease) for the six months ended June 30, 2026 compared to the six months ended June 30, 2025 that is not a direct result of investments/dispositions made after January 1, 2025.
Rental and Related Revenues
During the six months ended June 30, 2026, we recognized $196.4 million of rental income compared to $195.9 million for the six months ended June 30, 2025. The $0.5 million net increase in rental income is related to (i) a $7.7 million increase in revenue as the result of changing our estimates of collectability for certain leases within our triple-net leased portfolio, lease amendments and annual rental increases based on changes in the Consumer Price Index, (ii) a $4.5 million net increase in revenue related to leases that are not accounted for on an accrual basis and (iii) a $1.4 million increase from properties acquired after January 1, 2025. These increases are partially offset by (i) a $7.5 million decrease related to facilities that were transitioned to Senior Housing - Managed communities after January 1, 2025, (ii) a $3.9 million decrease from properties disposed of after January 1, 2025 and (iii) a $1.3 million decrease related to facilities that were transitioned to new operators after January 1, 2025.
Our reported rental and related revenues may be subject to increased variability in the future as a result of lease accounting standards. If at any time we cannot determine that it is probable that substantially all rents over the life of a lease are collectible, rental revenue will be recognized only to the extent of payments received and all receivables associated with the lease will be written off, irrespective of amounts expected to be collectible. However, there can be no assurances regarding the timing and amount of these revenues. Amounts due under the terms of all of our lease agreements are subject to contractual increases, and contingent rental income may be earned from certain lease agreements. No material contingent rental income was derived during the six months ended June 30, 2026 and 2025.
Our rental income in future years will be impacted by changes in inflation. Certain of our lease agreements provide for an annual rent escalator based on the percentage change in the Consumer Price Index (but not less than zero), subject to minimum or maximum fixed percentages that range from 1.0% to 5.0%.
Resident Fees and Services
During the six months ended June 30, 2026, we recognized $245.5 million of resident fees and services compared to $156.4 million for the six months ended June 30, 2025. The $89.1 million net increase is due to (i) a $60.9 million increase related to 18 Senior Housing - Managed communities acquired after January 1, 2025, (ii) a $20.7 million increase related to eight facilities that were transitioned to Senior Housing - Managed communities after January 1, 2025 and (iii) a $9.5 million increase primarily related to increased occupancy and an increase in rates. These increases are partially offset by a $1.3 million decrease due to one Senior Housing - Managed community that was closed in August 2025 and a $0.6 million decrease due to one Senior Housing - Managed community that was disposed of after January 1, 2025.
Interest and Other Income
Interest and other income primarily consists of income earned on our loans receivable investments and preferred returns earned on our preferred equity investments. During the six months ended June 30, 2026, we recognized $15.8 million of interest and other income compared to $20.4 million for the six months ended June 30, 2025. The net decrease of $4.6 million is primarily due to investments that were repaid after January 1, 2025.
Depreciation and Amortization
During the six months ended June 30, 2026, we incurred $109.5 million of depreciation and amortization expense compared to $87.1 million for the six months ended June 30, 2025. The net increase of $22.4 million is due to a $26.1 million increase from properties acquired after January 1, 2025 and the acquisition of the operations of five Senior Housing - Managed communities previously leased to the tenant under triple-net operating leases and a $1.4 million increase from additions to real estate. These increases are partially offset by a $3.5 million decrease due to assets that have been fully depreciated and a $2.2 million decrease from properties disposed of after January 1, 2025.
Interest
We incur interest expense comprised of costs of borrowings plus the amortization of deferred financing costs related to our indebtedness. During the six months ended June 30, 2026, we incurred $58.2 million of interest expense compared to $54.6 million for the six months ended June 30, 2025. The $3.5 million net increase is primarily related to an increase in interest expense related to borrowings under the Credit Agreement.
Triple-Net Portfolio Operating Expenses
During the six months ended June 30, 2026, we recognized $7.4 million of triple-net portfolio operating expenses compared to $7.2 million for the six months ended June 30, 2025. The $0.3 million net increase is primarily due to adjustments in our estimates related to property taxes.
Senior Housing - Managed Portfolio Operating Expenses
During the six months ended June 30, 2026, we recognized $170.5 million of Senior Housing - Managed portfolio operating expenses compared to $113.9 million for the six months ended June 30, 2025. The $56.6 million net increase is primarily due to (i) a $39.3 million increase related to 18 Senior Housing - Managed communities acquired after January 1, 2025, (ii) a $13.6 million increase related to eight facilities that were transitioned to Senior Housing - Managed communities after January 1, 2025, (iii) a $2.5 million increase in employee compensation primarily due to increased labor rates and staffing, (iv) a $1.4 million increase in management fees and housekeeping costs due to increased occupancy and in dining expenses primarily due to outsourcing the service to a third party at certain communities, (v) a $0.8 million increase in advertising and marketing, (vi) a $0.4 million increase in utilities due to increased rates and usage and (vii) a $0.3 million increase in repairs and maintenance, partially offset by a $1.4 million decrease related to one Senior Housing - Managed community that was closed in August 2025 and a $0.6 million decrease related to one Senior Housing – Managed community that was disposed of after January 1, 2025.
General and Administrative
General and administrative expenses include compensation-related expenses as well as professional services, office costs, other costs associated with asset management, and acquisition costs. During the six months ended June 30, 2026, general and administrative expenses were $31.7 million compared to $25.2 million for the six months ended June 30, 2025. The $6.4 million net increase is primarily related to a $5.5 million increase in compensation for our teammates as a result of increased staffing, changes in performance-based payout assumptions on incentive compensation and annual salary adjustments and a $0.4 million increase related to hosting our 2026 Operator Conference during the six months ended June 30, 2026.
Provision for (Recovery of) Loan Losses and Other Reserves
During the six months ended June 30, 2026, we recognized a $102.2 million provision for loan losses and other reserves primarily associated with the reduced cash repayment of $200.0 million in full satisfaction of the $300.0 million Recovery Centers of America mortgage loan. During the six months ended June 30, 2025 we recognized a $0.4 million recovery of loan losses associated with our loans receivable investments.
Impairment of Real Estate
During the six months ended June 30, 2026, we recognized a $0.4 million impairment of real estate related to one closed facility and one sold facility. During the six months ended June 30, 2025, we recognized a $4.1 million impairment of real estate related to one sold facility.
Other (Expense) Income
During the six months ended June 30, 2026, we recognized $2.7 million of other expense primarily due to lease termination expense related to one community that was transitioned from our triple-net portfolio to Senior Housing - Managed communities. During the six months ended June 30, 2025, we recognized $14.7 million of other income, including the reclassification of $17.2 million of gain related to six previously terminated interest rate swaps from accumulated other comprehensive loss to other income as the related forecasted transactions were determined to be probable not to occur and $1.0 million of other income related to insurance proceeds received related to a fire that occurred at one of our Senior Housing - Managed communities in 2022, partially offset by $3.2 million of transition expenses related to the transition of Senior Housing - Managed communities to new operators.
Net Gain on Sales of Real Estate
During the six months ended June 30, 2026, we recognized an aggregate net gain of $37.7 million related to the disposition of seven facilities, including a $46.1 million net gain on sale related to the disposition of three facilities, partially offset by an $8.4 million net loss on sale from the disposition of four facilities. During the six months ended June 30, 2025, we recognized an aggregate net gain of $10.0 million related to the disposition of five skilled nursing/transitional care facilities and one behavioral health facility.
Income from Unconsolidated Joint Ventures
During the six months ended June 30, 2026 and 2025, we recognized $4.1 million and $1.1 million of income from our unconsolidated joint ventures, respectively. The $3.1 million net increase is primarily related to a $1.9 million increase in revenues net of operating expenses primarily due to increased occupancy and rates and a $1.2 million decrease in depreciation expense primarily due to assets that have been fully depreciated.
Income Tax Expense
During the six months ended June 30, 2026 and 2025, we recognized $1.2 million and $0.9 million of income tax expense, respectively. The $0.3 million change is primarily due to higher taxable income.
Funds from Operations and Adjusted Funds from Operations
We believe that net income as defined by GAAP is the most appropriate earnings measure. We also believe that funds from operations (“FFO”), as defined in accordance with the definition used by the National Association of Real Estate Investment Trusts (“Nareit”), and adjusted funds from operations (“AFFO”) (and related per share amounts) are important non-GAAP supplemental measures of our operating performance. Because the historical cost accounting convention used for real estate assets requires straight-line depreciation (except on land), such accounting presentation implies that the value of real estate assets diminishes predictably over time. However, since real estate values have historically risen or fallen with market and other conditions, presentations of operating results for a REIT that use historical cost accounting for depreciation could be less informative. Thus, Nareit created FFO as a supplemental measure of operating performance for REITs that excludes historical cost depreciation and amortization, among other items, from net income, as defined by GAAP. FFO is defined as net income, computed in accordance with GAAP, excluding gains or losses from real estate dispositions and our share of gains or losses from real estate dispositions related to our unconsolidated joint ventures, plus real estate depreciation and amortization, net of amounts related to noncontrolling interests, plus our share of depreciation and amortization related to our unconsolidated joint ventures, and real estate impairment charges of both consolidated and unconsolidated entities when the impairment is directly attributable to decreases in the value of the depreciable real estate held by the entity. AFFO is defined as FFO excluding stock-based compensation expense, non-cash rental and related revenues, non-cash interest income, non-cash interest expense, non-cash portion of loss on extinguishment of debt, provision for (recovery of) loan losses and other reserves, non-
cash lease termination income and deferred income taxes, as well as other non-cash revenue and expense items (including noncapitalizable acquisition costs, transaction costs related to operator transitions and organizational or other restructuring activities, gain/loss on derivative instruments, and non-cash revenue and expense amounts related to noncontrolling interests) and our share of non-cash adjustments related to our unconsolidated joint ventures. We believe that the use of FFO and AFFO (and the related per share amounts), combined with the required GAAP presentations, improves the understanding of our operating results among investors and makes comparisons of operating results among REITs more meaningful. We consider FFO and AFFO to be useful measures for reviewing comparative operating and financial performance because, by excluding the applicable items listed above, FFO and AFFO can help investors compare our operating performance between periods or as compared to other companies. While FFO and AFFO are relevant and widely used measures of operating performance of REITs, they do not represent cash flows from operations or net income as defined by GAAP and should not be considered an alternative to those measures in evaluating our liquidity or operating performance. FFO and AFFO also do not consider the costs associated with capital expenditures related to our real estate assets nor do they purport to be indicative of cash available to fund our future cash requirements. Further, our computation of FFO and AFFO may not be comparable to FFO and AFFO reported by other REITs that do not define FFO in accordance with the current Nareit definition or that interpret the current Nareit definition or define AFFO differently than we do.
The following table reconciles our calculations of FFO and AFFO to net income, the most directly comparable GAAP financial measure (in thousands, except share and per share amounts):
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| Three Months Ended June 30, | | Six Months Ended June 30, |
| 2026 | | 2025 | | 2026 | | 2025 |
| Net (loss) income attributable to Sabra Health Care REIT, Inc. | $ | (25,202) | | | $ | 65,542 | | | $ | 15,678 | | | $ | 105,846 | |
| Depreciation and amortization of real estate assets | 56,379 | | | 43,586 | | | 109,510 | | | 87,080 | |
| Depreciation and amortization of real estate assets related to noncontrolling interests | (122) | | | — | | | (244) | | | — | |
| Depreciation and amortization of real estate assets related to unconsolidated joint ventures | 1,477 | | | 2,043 | | | 3,004 | | | 4,223 | |
| Net gain on sales of real estate | (37,717) | | | (9,974) | | | (37,717) | | | (9,974) | |
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| Impairment of real estate | — | | | 4,103 | | | 440 | | | 4,103 | |
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| FFO attributable to Sabra Health Care REIT, Inc. | (5,185) | | | 105,300 | | | 90,671 | | | 191,278 | |
| Stock-based compensation expense | 4,089 | | | 2,704 | | | 7,187 | | | 5,415 | |
| Non-cash rental and related revenues | (3,654) | | | (3,903) | | | (5,253) | | | (6,331) | |
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| Non-cash interest expense | 2,370 | | | 1,726 | | | 4,738 | | | 3,455 | |
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| Provision for (recovery of) loan losses and other reserves | 101,172 | | | (227) | | | 100,959 | | | (400) | |
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| Other adjustments related to unconsolidated joint ventures | 77 | | | 128 | | | 153 | | | 19 | |
| Other adjustments | 638 | | | (16,528) | | | 1,145 | | | (16,082) | |
| AFFO attributable to Sabra Health Care REIT, Inc. | $ | 99,507 | | | $ | 89,200 | | | $ | 199,600 | | | $ | 177,354 | |
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FFO attributable to Sabra Health Care REIT, Inc. per diluted common share | $ | (0.02) | | | $ | 0.44 | | | $ | 0.35 | | | $ | 0.79 | |
| AFFO attributable to Sabra Health Care REIT, Inc. per diluted common share | $ | 0.39 | | | $ | 0.37 | | | $ | 0.78 | | | $ | 0.73 | |
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| Weighted average number of common shares outstanding, diluted: | | | | | | | |
| FFO | 252,268,939 | | | 240,929,866 | | | 255,755,497 | | | 240,711,387 | |
| AFFO | 256,733,670 | | | 241,996,970 | | | 256,640,712 | | | 241,865,769 | |
The following table sets forth additional information related to certain other items included in net income above, and the portions of each that are included in FFO and AFFO, which may be helpful in assessing our operating results. Please refer to “—Results of Operations” above for additional information regarding these items (in millions):
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| Three Months Ended June 30, | | Six Months Ended June 30, |
| 2026 | | 2025 | | 2026 | | 2025 | | 2026 | | 2025 | | 2026 | | 2025 | | 2026 | | 2025 | | 2026 | | 2025 |
| Net Income | | FFO | | AFFO | | Net Income | | FFO | | AFFO |
| Rental and related revenues: | | | | | | | | | | | | | | | | | | | | | | | |
| Rental and related revenue recoveries | $ | 1.6 | | | $ | 1.5 | | | $ | 1.6 | | | $ | 1.5 | | | $ | — | | | $ | — | | | $ | 1.5 | | | $ | 1.5 | | | $ | 1.5 | | | $ | 1.5 | | | $ | — | | | $ | — | |
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| Provision for (recovery of) loan losses and other reserves | 102.4 | | | (0.2) | | | 102.4 | | | (0.2) | | | 1.3 | | | — | | | 102.2 | | | (0.4) | | | 102.2 | | | (0.4) | | | 1.3 | | | — | |
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| Other income (expense): | | | | | | | | | | | | | | | | | | | | | | | |
| Non-cash gain on interest rate swaps | — | | | 17.2 | | | — | | | 17.2 | | | — | | | — | | | — | | | 17.2 | | | — | | | 17.2 | | | — | | | — | |
| Lease termination expense | (2.9) | | | — | | | (2.9) | | | — | | | (2.9) | | | — | | | (2.9) | | | — | | | (2.9) | | | — | | | (2.9) | | | — | |
| Transition costs | (0.2) | | | (3.2) | | | (0.2) | | | (3.2) | | | (0.2) | | | (3.2) | | | (0.2) | | | (3.2) | | | (0.2) | | | (3.2) | | | (0.2) | | | (3.2) | |
| Insurance income | — | | | 1.0 | | | — | | | 1.0 | | | — | | | 1.0 | | | — | | | — | | | — | | | — | | | — | | | — | |
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Liquidity and Capital Resources
As of June 30, 2026, we had approximately $1.3 billion in liquidity, consisting of unrestricted cash and cash equivalents of $231.6 million, available borrowings under our Revolving Credit Facility (as defined below) of $682.5 million and $411.8 million related to shares outstanding under forward sale agreements under our ATM Program (as defined below). The Credit Agreement and Term Loan Credit Agreement (as defined below) each contain an accordion feature that can increase the total available borrowings to $2.75 billion (from U.S. $1.4 billion plus CAD $150.0 million) and to $1.0 billion (from $500.0 million), respectively, subject to terms and conditions.
We have filed a shelf registration statement with the SEC that expires in August 2028, which allows us to offer and sell shares of common stock, preferred stock, warrants, rights, units, and certain of our subsidiaries to offer and sell debt securities, through underwriters, dealers or agents or directly to purchasers, on a continuous or delayed basis, in amounts, at prices and on terms we determine at the time of the offering, subject to market conditions.
On February 23, 2023, we established an at-the-market equity offering program (the “Prior ATM Program”) pursuant to which shares of our common stock having an aggregate gross sales price of up to $500.0 million may be sold from time to time (i) by us through a consortium of banks acting as sales agents or directly to the banks acting as principals or (ii) by a consortium of banks acting as forward sellers on behalf of any forward purchasers pursuant to a forward sale agreement. On August 5, 2025, we terminated the Prior ATM Program pursuant to our termination rights.
During each of the three and six months ended June 30, 2026, we issued 3.2 million shares in settlement of the remaining outstanding forward sale agreements under the Prior ATM Program, at a weighted average net price of $17.50 per share, after commissions and fees, resulting in net proceeds of $56.3 million.
As of June 30, 2026, no shares remained outstanding under the Prior ATM Program’s forward sale agreements.
On August 5, 2025, we established a new at-the-market equity offering program (the “ATM Program”) pursuant to which shares of our common stock having an aggregate gross sales price of up to $750.0 million may be sold from time to time (i) by us through a consortium of banks acting as sales agents or directly to the banks acting as principals or (ii) by a consortium of banks acting as forward sellers on behalf of any forward purchasers pursuant to a forward sale agreement.
During the three and six months ended June 30, 2026, we utilized the forward feature of the ATM Program to allow for the sale of up to 0.9 million and 7.3 million shares of our common stock, respectively, at an initial weighted average price of $20.72 and $20.26 per share, net of commissions, respectively.
As of June 30, 2026, 21.4 million shares (which amount includes the 7.3 million shares referenced in the prior paragraph) remained outstanding under the ATM Program’s forward sale agreements, with an initial weighted average price of $19.24 per share, net of commissions.
No other shares were sold under the ATM Program during the three and six months ended June 30, 2026.
As of June 30, 2026, we had $334.1 million available under the ATM Program. Subject to market conditions, we expect to use proceeds from our ATM Program to finance future investments in properties.
Our short-term liquidity requirements consist primarily of operating expenses, including our planned capital expenditures and funding commitments, interest expense, scheduled debt service payments under our loan agreements, dividend requirements, general and administrative expenses and other requirements described under “Material Cash Requirements” below. Based on our current assessment, we believe that our available cash, operating cash flows and borrowings available to us under our Revolving Credit Facility provide sufficient funds for such requirements for the next twelve months. In addition, we do not believe that the restrictions under our Senior Notes Indentures (as defined below) or Credit Agreement significantly limit our ability to use our available liquidity for these purposes.
Our long-term liquidity requirements consist primarily of future investments in properties, including any improvements or renovations of current or newly-acquired properties, as well as scheduled debt maturities. We expect to meet these liquidity needs using the sources above as well as the proceeds from issuances of common stock, preferred stock, debt or other securities, additional borrowings, including mortgage debt or a new or refinanced credit facility, and proceeds from the sale of properties. In addition, we may seek financing from U.S. government agencies, including through Fannie Mae, Freddie Mac and the U.S. Department of Housing and Urban Development, in appropriate circumstances in connection with acquisitions.
Cash Flows from Operating Activities
During the six months ended June 30, 2026, net cash provided by operating activities was $184.2 million. Operating cash inflows were derived primarily from the rental payments received under our lease agreements, resident fees and services net of the corresponding operating expenses, interest payments from borrowers under our loan and preferred equity investments and distributions from our unconsolidated joint ventures. Operating cash outflows consisted primarily of interest payments on borrowings and payment of general and administrative expenses, including corporate overhead. Increases to operating cash flows primarily relate to completed investment activity and decreases to operating cash flows primarily relate to disposition activity. Interest payment outflows are impacted by increases or decreases in borrowings and changes in interest rates. In addition, the change in operating cash flows was impacted by the timing of collections from our tenants and borrowers and fluctuations in the operating results of our Senior Housing - Managed communities. We expect our annualized cash flows provided by operating activities to fluctuate as a result of such activity.
Cash Flows from Investing Activities
During the six months ended June 30, 2026, net cash used in investing activities was $18.6 million and included $292.5 million used for the acquisition of ten facilities, bed rights and land related to the development of one skilled nursing/transitional care facility and the operations of one Senior Housing - Managed community previously leased under a triple-net operating lease, $25.2 million used for additions to real estate, $1.0 million used to provide funding for loans receivable and $0.7 million used for fundings of preferred equity investments, partially offset by $205.1 million in repayments of loans receivable, $93.6 million of net proceeds from the sales of real estate and $2.3 million in repayments of preferred equity investments.
Cash Flows from Financing Activities
During the six months ended June 30, 2026, net cash used in financing activities was $5.3 million and included $151.3 million of dividends paid to stockholders, a $1.2 million contingent consideration payment and $1.1 million of principal repayments on secured debt, partially offset by $100.8 million of net borrowings from our Revolving Credit Facility and $47.7 million of proceeds from shares sold through our Prior ATM Program, net of costs related to payroll tax payments related to the issuance of common stock pursuant to equity compensation arrangements.
Please see the accompanying consolidated statements of cash flows for details of our operating, investing and financing cash activities.
Material Cash Requirements
Our material cash requirements include the following contractual and other obligations.
Senior Unsecured Notes. Our senior unsecured notes consisted of the following (collectively, the “Senior Notes”) as of June 30, 2026 (dollars in thousands):
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| Title | | Maturity Date | | Principal Balance (1) |
5.38% senior unsecured notes due 2027 (the “2027 Notes”) | | May 17, 2027 | | $ | 100,000 | |
3.90% senior unsecured notes due 2029 (the “2029 Notes”) | | October 15, 2029 | | 350,000 | |
3.20% senior unsecured notes due 2031 (the “2031 Notes”) | | December 1, 2031 | | 800,000 | |
| | | | $ | 1,250,000 | |
(1) Principal balance does not include discount, net of $6.4 million and deferred financing costs, net of $6.6 million as of June 30, 2026.
See Note 8, “Debt,” in the Notes to Consolidated Financial Statements and “Subsidiary Issuer and Guarantor Financial Information” below for additional information concerning the Senior Notes, including information regarding the indentures and agreements governing the Senior Notes (the “Senior Notes Indentures”). As of June 30, 2026, we were in compliance with all applicable covenants under the Senior Notes Indentures.
Credit Agreement. Effective January 4, 2023, the Operating Partnership and Sabra Canadian Holdings, LLC (together, the “Borrowers”), and the other parties thereto entered into a sixth amended and restated unsecured credit agreement (the “Credit Agreement”). The Credit Agreement includes a $1.0 billion revolving credit facility (the “Revolving Credit Facility”), a $430.0 million U.S. dollar term loan and a CAD $150.0 million Canadian dollar term loan (collectively, the “Term Loans”). Further, up to $350.0 million of the Revolving Credit Facility may be used for borrowings in certain foreign currencies. The Credit Agreement also contains an accordion feature that can increase the total available borrowings to $2.75 billion, subject to terms and conditions.
The Revolving Credit Facility has a maturity date of January 4, 2027, and includes two six-month extension options. The Term Loans have a maturity date of January 4, 2028.
The obligations of the Borrowers under the Credit Agreement are guaranteed by us and certain of our subsidiaries.
See Note 8, “Debt,” in the Notes to Consolidated Financial Statements for additional information concerning the Credit Agreement, including information regarding covenants contained in the Credit Agreement. As of June 30, 2026, we were in compliance with all applicable covenants under the Credit Agreement.
Term Loan Credit Agreement. On July 30, 2025, the Borrowers, Sabra and the other parties thereto entered into an unsecured credit agreement for a $500.0 million U.S. dollar term loan which matures on July 30, 2030 (the “Term Loan Credit Agreement”). The Term Loan Credit Agreement also contains an accordion feature that can increase the total available borrowings to $1.0 billion, subject to terms and conditions.
See Note 8, “Debt,” in the Notes to Consolidated Financial Statements for additional information concerning the Term Loan Credit Agreement.
Secured Indebtedness. As of June 30, 2026, eight of our properties held for investment were subject to secured indebtedness to third parties, and our secured debt consisted of the following (dollars in thousands):
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| Interest Rate Type | | Principal Balance (1) | | | | Weighted Average Interest Rate | | | | Maturity Date |
| Fixed Rate | | $ | 42,955 | | | | | 2.86 | % | | | | May 2031 - August 2051 |
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(1) Principal balance does not include deferred financing costs, net of $0.7 million as of June 30, 2026.
Interest. Our estimated interest and facility fee payments based on principal amounts of debt outstanding as of June 30, 2026, applicable interest rates in effect as of June 30, 2026, and including the impact of interest rate swaps are $54.9 million for the remainder of 2026, $89.2 million in 2027, $64.2 million in 2028, $63.8 million in 2029, $40.2 million in 2030 and $34.0 million thereafter.
Capital and Other Expenditures and Funding Commitments. For the six months ended June 30, 2026 and 2025, our aggregate capital expenditures were $25.2 million and $13.6 million, respectively. As of June 30, 2026, our aggregate commitment for future capital and other expenditures related to facilities leased under triple-net operating leases was approximately $75 million, of which $74 million will directly result in incremental rental income, and approximately $74 million is expected to be spent over the next 12 months. We also expect to fund capital expenditures related to our Senior Housing - Managed communities.
In addition, as of June 30, 2026, we have committed to provide up to an aggregate $7.9 million of future funding related to one preferred equity investment and three loan receivable investments.
Dividends. To maintain REIT status, we are required each year to distribute to stockholders at least 90% of our annual REIT taxable income after certain adjustments. All distributions will be made by us at the discretion of our board of directors and will depend on our financial position, results of operations, cash flows, capital requirements, debt covenants (which include limits on distributions by us), applicable law, and other factors as our board of directors deems relevant.
We paid dividends of $151.3 million on our common stock during the six months ended June 30, 2026. On August 3, 2026, our board of directors declared a quarterly cash dividend of $0.30 per share of common stock. The dividend will be paid on August 31, 2026 to common stockholders of record as of the close of business on August 14, 2026.
Subsidiary Issuer and Guarantor Financial Information. The 2029 Notes and 2031 Notes are issued by the Operating Partnership and guaranteed, fully and unconditionally, by us.
These guarantees are subordinated to all existing and future senior debt and senior guarantees of us, as guarantor, and are unsecured. We conduct all of our business through and derive virtually all of our income from our subsidiaries. Therefore, our ability to make required payments with respect to our indebtedness (including the Senior Notes) and other obligations depends on the financial results and condition of our subsidiaries and our ability to receive funds from our subsidiaries.
In accordance with Regulation S-X, the following aggregate summarized financial information is provided for Sabra and the Operating Partnership. This aggregate summarized financial information has been prepared from the books and records maintained by us and the Operating Partnership. The aggregate summarized financial information does not include the investments in, nor the earnings from, subsidiaries other than the Operating Partnership and therefore is not necessarily indicative of the results of operations or financial position had the Operating Partnership operated as an independent entity. Intercompany transactions have been eliminated. The aggregate summarized balance sheet information and aggregate summarized statement of loss information is as follows (in thousands):
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| | June 30, 2026 | | December 31, 2025 |
| Total assets | | $ | 247,814 | | | $ | 79,440 | |
| Total liabilities | | 2,490,665 | | | 2,397,026 | |
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| | Six Months Ended June 30, 2026 | | |
| Total revenues | | $ | 445 | | | |
| Total expenses | | 85,202 | | | |
| Net loss | | 88,115 | | | |
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Concentration of Credit Risk
Concentrations of credit risk arise when a number of tenants or obligors related to our investments are engaged in similar business activities, or activities in the same geographic region, or have similar economic features that would cause their ability to meet contractual obligations, including those to us, to be similarly affected by changes in economic conditions. We regularly monitor our portfolio to assess potential concentrations of risks.
Management believes our current portfolio is reasonably diversified across healthcare related real estate and geographical location and does not contain any other significant concentration of credit risks. Our portfolio of 364 real estate properties held for investment as of June 30, 2026 is diversified by location across the U.S. and Canada.
For the three and six months ended June 30, 2026, no tenant relationship represented 10% or more of our total revenues.
Medicare Reimbursement Rates
For the six months ended June 30, 2026, 31.9% of our revenues was derived directly or indirectly from skilled nursing/transitional care facilities. Medicare reimburses skilled nursing facilities for Medicare Part A services under the Prospective Payment System (“PPS”), as implemented pursuant to the Balanced Budget Act of 1997 and modified pursuant to subsequent laws. PPS regulations predetermine a payment amount per patient, per day, based on a market basket index calculated for all covered costs.
On April 22, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule that (i) established minimum nurse staffing requirements for long-term care facilities (the “Minimum Staffing Standards”) and (ii) required
facilities to meet new facility assessment requirements (the “Assessment Requirements”). The Minimum Staffing Standards were repealed by CMS, effective February 2, 2026, through an interim final rule issued on December 2, 2025. The compliance deadline for the Assessment Requirements was August 8, 2024 and they remain in effect.
On July 31, 2025, CMS issued a final rule regarding fiscal year 2026 Medicare rates for skilled nursing facilities providing an estimated net increase of 3.2% compared to fiscal year 2025 (comprised of (i) a market basket increase of 3.3% plus (ii) a market basket forecast error adjustment of 0.6% and less (iii) a productivity adjustment of 0.7%). These figures do not incorporate any of the estimated value-based purchasing reductions for skilled nursing facilities. The new payment rates became effective on October 1, 2025.
On July 29, 2026, CMS issued a final rule regarding fiscal year 2027 Medicare rates for skilled nursing facilities providing an estimated net increase of 2.4% compared to fiscal year 2026 (comprised of (i) a market basket increase of 3.3% less (ii) a productivity adjustment of 0.9%). These figures do not incorporate any of the estimated value-based purchasing reductions for skilled nursing facilities. The new payment rates become effective on October 1, 2026.