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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
FORM 10-K
 
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 2023

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ____ to ____
 Commission File Number 1-8923
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WELLTOWER INC.
(Exact name of registrant as specified in its charter)
Delaware34-1096634
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
   
4500 Dorr Street,Toledo,Ohio43615
(Address of principal executive offices)(Zip Code)
(419247-2800
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading Symbol(s)Name of Each Exchange on Which Registered
Common Stock, $1.00 par valueWELLNew York Stock Exchange
Guarantee of 4.800% Notes due 2028 issued by Welltower OP LLCWELL/28New York Stock Exchange
Guarantee of 4.500% Notes due 2034 issued by Welltower OP LLCWELL/34New York Stock Exchange
 
Securities registered pursuant to Section 12(g) of the Act:  None 
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.  Yes    No 
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Act.  Yes    No 
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes    No 
Indicate by check mark whether the registrant has submitted electronically, every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).  Yes    No    
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act. 
Large accelerated filer
Accelerated filer

Non-accelerated filer

Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. 
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes    No 
Indicate by check mark whether the registrant has filed a report on and attestation of the effectiveness of its internal control over financial reporting under Section 404(b) of Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by registered public accounting firm that prepared or issued its audit report
If securities are registered pursuant to Section 12(b) of the Exchange Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to previously issued financial statements
Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant's executive officers during the relevant recovery period pursuant to §240.10D-1(b)
The aggregate market value of the shares of voting common stock held by non-affiliates of the registrant, computed by reference to the closing sales price as of the last business day of the registrant’s most recently completed second fiscal quarter was $41,131,361,000.
As of February 9, 2024, the registrant had 568,878,059 shares of common stock outstanding.
 
DOCUMENTS INCORPORATED BY REFERENCE 
Portions of the registrant’s definitive proxy statement for the annual stockholders’ meeting to be held May 23, 2024, are incorporated by reference into Part III.



WELLTOWER INC. AND SUBSIDIARIES
2023 FORM 10-K ANNUAL REPORT
TABLE OF CONTENTS
 
  Page
 PART I
   
Item 1.Business
Item 1A.Risk Factors
Item 1B.Unresolved Staff Comments
Item 1C.Cybersecurity
Item 2.Properties
Item 3.Legal Proceedings
Item 4.Mine Safety Disclosures
   
 PART II
   
Item 5.Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Item 6.[Reserved]
Item 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations
Item 7A.Quantitative and Qualitative Disclosures About Market Risk
Item 8.Financial Statements and Supplementary Data
Item 9.Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Item 9A.Controls and Procedures
Item 9B.Other Information
Item 9C.Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
   
 PART III
   
Item 10.Directors, Executive Officers and Corporate Governance
Item 11.Executive Compensation
Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Item 13.Certain Relationships and Related Transactions and Director Independence
Item 14.Principal Accounting Fees and Services
   
 PART IV
   
Item 15.Exhibits and Financial Statement Schedules
Item 16.Form 10-K Summary
 Signature



PART I 
Item 1. Business 
General
Welltower Inc. (NYSE:WELL), an S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. The company 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 health care experience. Welltower, a real estate investment trust (“REIT”), 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, post-acute communities and outpatient medical properties. More information is available on the Internet at www.welltower.com. 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.
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 as a result of annual increases in net operating income and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and health care real estate and diversify our investment portfolio by property type, relationship and geographic location.
On March 7, 2022, we announced our intent to complete an UPREIT reorganization. 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. ("Welltower OP") converted from a Delaware corporation into a Delaware limited liability company named Welltower OP LLC (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.
Welltower Inc. is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.765% as of December 31, 2023. Welltower Inc. 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 or its subsidiaries, and Welltower Inc. has fully and unconditionally guaranteed all existing and future senior unsecured notes.
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,” “our” or the “company” mean collectively Welltower, Welltower OP and those entities/subsidiaries owned or controlled by Welltower and/or Welltower OP.
Portfolio of Properties
Please see “Item 7 – Management’s Discussion and Analysis of Financial Condition and Results of Operation – Executive Summary – Company Overview” for a table that summarizes our portfolio as of December 31, 2023.
Property Types
We invest in seniors housing and health care real estate and evaluate our business through three reportable segments: Seniors Housing Operating, Triple-net and Outpatient Medical. For additional information regarding our segments, please see Note 18 to our consolidated financial statements. The accounting policies of the segments are the same as those described in the summary of significant accounting policies in Note 2 to our consolidated financial statements. The following is a summary of our various property types. 
Seniors Housing Operating
Our Seniors Housing Operating properties include seniors apartments, independent living and independent supportive living, continuing care retirement communities, assisted living, Alzheimer's/dementia care and include care homes with or without nursing (U.K.), which assist with activities of daily living that preserve a person's mobility and social systems to promote cognitive engagement. Our properties include stand-alone properties that provide one level of service, combination properties that provide multiple levels of service and communities or campuses that provide a wide range of services. Properties are often held in joint venture entities with operating partners. We utilize the structure authorized by the REIT Investment Diversification and Empowerment Act of 2007, which is commonly referred to as a “RIDEA” structure (the provisions of the Internal Revenue Code authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). 
Seniors Apartments Seniors apartments generally refer to age-restricted or age-targeted multi-unit housing with self-contained living units for older adults, usually aged 55+ who are able to care for themselves. Seniors apartments generally do not offer other additional services such as meals.
2


Independent Living and Independent Supportive Living (Canada)  Independent living and independent supportive living generally refers to age-restricted, multifamily properties with central dining that provide residents access to meals and other services such as housekeeping, linen service, transportation and social and recreational activities. 
Continuing Care Retirement Communities  Continuing care retirement communities typically include a combination of detached homes and properties offering independent living, assisted living and/or long-term/post-acute care services on one campus. These communities appeal to residents because there is no need to relocate when health and medical needs change. Resident payment plans vary, but can include entrance fees, condominium fees and rental fees. Many of these communities also charge monthly maintenance fees in exchange for a living unit, meals and some health services. 
Assisted Living  Assisted living refers to state-regulated rental properties that provide independent living services, but also provide supportive care from trained employees to residents who require assistance with activities of daily living, including, but not limited to, management of medications, bathing, dressing, toileting, ambulating and eating.
Alzheimer’s/Dementia Care  Alzheimer's/Dementia Care refers to state-regulated rental properties that generally provide assisted living and independent living services, but also provide supportive care to residents with memory loss, Alzheimer's disease and/or other types of dementia. Amenities vary, but may include enhanced security, specialized design features and memory-enhancing therapies that promote relaxation and help slow cognitive decline.
Care Homes with or without Nursing (U.K.)  Care homes without nursing, regulated by the Care Quality Commission ("CQC”), are rental properties that provide essentially the same services as U.S. assisted living. Care homes with nursing, also regulated by the CQC, are licensed daily rate or rental properties where most individuals require 24-hour nursing and/or medical care. Generally, these properties are licensed for various national and local reimbursement programs. Unlike the U.S., care homes with nursing in the U.K. generally do not provide post-acute care.
Our Seniors Housing Operating segment accounted for 72%, 72% and 68% of total revenues for the years ended December 31, 2023, 2022 and 2021, respectively. As of December 31, 2023, we had relationships with 51 partners to manage our Seniors Housing Operating properties. In each instance, our partner provides management services to the properties pursuant to an incentive-based management contract. We rely on our partners to effectively and efficiently manage these properties. For the year ended December 31, 2023, our relationship with Sunrise Senior Living ("Sunrise") accounted for approximately 17% of our Seniors Housing Operating segment revenues and 12% of our total revenues.
Triple-net
Our Triple-net properties offer services including independent living and independent supportive living (Canada), assisted living, continuing care retirement communities, Alzheimer's/dementia care and care homes with or without nursing (U.K.) described above, as well as long-term/post-acute care. Our properties include stand-alone properties that provide one level of service, combination facilities that provide multiple levels of service, and communities or campuses that provide a wide range of services. We invest primarily through acquisitions, development and joint venture partnerships. Our properties are primarily leased to operators under long-term, triple-net master leases that obligate the tenant to pay all operating costs, utilities, real estate taxes, insurance, maintenance costs and all obligations under certain ground leases. In addition, such triple-net master leases often require our tenants to fund a minimum amount related to capital expenditures. We are not involved in property management.
Long-Term/Post-Acute Care Facilities  Post-acute care is at the leading edge of reducing health care costs while improving quality. These high-impact centers help patients recover from illness or surgery with the goals of getting the patient home and healed faster and reducing hospital readmission rates. Our long-term/post-acute care properties generally offer skilled nursing/post-acute care, inpatient rehabilitation and long-term acute care services. Skilled nursing/post-acute care refers to licensed daily rate or rental properties where most individuals require 24-hour nursing and/or medical care. Generally, these properties are licensed for Medicaid and/or Medicare reimbursement in the U.S. or provincial reimbursement in Canada. All properties offer some level of rehabilitation services. Some properties focus on higher acuity patients and offer rehabilitation units specializing in cardiac, orthopedic, dialysis, neurological or pulmonary rehabilitation. Inpatient rehabilitation properties provide intensive inpatient services after illness, injury or surgery to patients able to tolerate and benefit from three hours of rehabilitation per day. Long-term acute care properties provide inpatient services for patients with complex medical conditions that require more intensive care, monitoring or emergency support than is available in most skilled nursing/post-acute care properties.
Our Triple-net segment accounted for 16%, 16% and 19% of total revenues for the years ended December 31, 2023, 2022 and 2021, respectively. For the year ended December 31, 2023, our revenues related to our relationship with Integra Healthcare Properties ("Integra") accounted for approximately 21% of our Triple-net segment revenues and 3% of total revenues. In December 2022, ProMedica relinquished to Welltower its 15% interest in 147 skilled nursing facilities previously owned by the Welltower/ProMedica joint venture in exchange for a lease modification, which relieved ProMedica from its lease obligation on the 147 skilled nursing properties and amended the lease on the remaining 58 assisted living and memory care properties that continue to be held by the Welltower/ProMedica joint venture. The 58 assisted living and memory care assets continue to be
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operated by ProMedica and backed by the existing guaranty. Concurrently, Welltower and Integra entered into master leases for the skilled nursing portfolio, which are subleased to a variety of regional operators to manage the properties.
For the years ended December 31, 2023 and 2022 our revenues related to our relationship with Genesis Healthcare ("Genesis") accounted for approximately 2% of our Triple-net segment revenues and less than 1% of our total revenues, compared to 6% of our Triple-net segment revenue and 1% of our total revenues for the year ended December 31, 2021. In March 2021, we entered into definitive agreements to substantially exit our operating relationship with Genesis. As of December 31, 2023, our relationship with Genesis was comprised of one property owned 100% by us and leased to Genesis, a loan balance net of allowance for credit losses of $191,105,000, approximately 9.5 million shares of GEN Series A common stock and a 25% ownership stake in an unconsolidated joint venture that includes two master leases for 28 properties operated by Genesis.
Outpatient Medical
Outpatient Medical Buildings  Demand for outpatient medical services is growing as more procedures are performed safely and efficiently outside the hospital setting. State-of-the-art outpatient centers are needed in accessible, consumer-friendly locations. Our portfolio of outpatient medical buildings is an integral part of creating health care provider connectivity in local markets and generally include physician offices, ambulatory surgery centers, diagnostic facilities, outpatient services and/or labs. Approximately 87% of our outpatient medical building portfolio is affiliated with health systems (buildings directly on or adjacent to hospital campuses or with tenants that are satellite locations for the health system and its physicians). We typically lease our outpatient medical buildings to multiple tenants and provide varying levels of property management. Our Outpatient Medical segment accounted for 11%, 12% and 13% of total revenues for each of the years ended December 31, 2023, 2022 and 2021, respectively. No single tenant exceeds 20% of segment revenues.
Investments
Providing high-quality and affordable health care to an aging global population requires vast investments and infrastructure development. We invest in seniors housing and health care real estate primarily through acquisitions, developments and joint venture partnerships. For additional information regarding acquisition and development activity, please see Note 3 to our consolidated financial statements. Our portfolio creates opportunities to connect partners across the continuum of care and drive efficiency. We seek to diversify our investment portfolio by property type, relationship and geographic location. In determining whether to invest in a property, we focus on the following: (1) the experience of the obligor’s/partner’s management team; (2) the historical and projected financial and operational performance of the property; (3) the credit of the obligor/partner; (4) the security for any lease or loan; (5) the real estate attributes of the building and its location; (6) the capital committed to the property by the obligor/partner; and (7) the operating fundamentals of the applicable industry. 
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, among other things, tenant relations, lease expirations, the mix of health service providers, hospital/health system relationships, property performance, capital improvement needs, and market conditions. 
Investment Types 
Real Property  Our properties are primarily comprised of land, buildings, improvements and related rights. Our triple-net properties are generally leased to operators under long-term operating leases. The leases generally have a fixed contractual term of 12 to 15 years and contain one or more five to 15-year renewal options. Certain of our leases also contain purchase options, a portion of which could result in the disposition of properties for less than full market value if the options were to be exercised. Most of our rents are received under triple-net leases requiring the operator to pay rent and all additional charges incurred in the operation of the leased property. The tenants are required to repair and maintain the leased properties, and our leases often require the tenants to fund a minimum amount related to capital expenditures. Substantially all these 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. 
At December 31, 2023, approximately 97% of our triple-net properties were subject to master leases. A master lease is a lease of multiple properties to one tenant entity under a single lease agreement. From time to time, we may acquire additional properties that are then leased to the tenant under the master lease. The tenant is required to make one monthly payment that represents rent on all the properties that are subject to the master lease. Typically, the master lease tenant can exercise its right to purchase the properties or to renew the master lease only with respect to all leased properties at the same time. We believe this bundling feature benefits us because the tenant cannot limit the purchase or renewal to better performing properties and terminate the leasing arrangement with respect to poorer performing properties. This spreads our risk among the entire group of
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properties within the master lease. The bundling feature should provide a similar advantage to us if the master lease tenant is in bankruptcy. Subject to certain restrictions, a debtor in bankruptcy has the right to assume or reject its unexpired leases and executory contracts. In the context of integrated master leases such as ours, our tenants in bankruptcy would be required to assume or reject the master lease as a whole, rather than deciding on a property by property basis. 
Our Outpatient Medical portfolio is primarily self-managed and consists mainly of multi-tenant properties leased to health care providers. Our leases typically include increasers and some form of operating expense reimbursement by the tenant. As of December 31, 2023, 62% of our portfolio included leases with full pass through, 31% with a partial expense reimbursement (modified gross) and 7% with no expense reimbursement (gross). Our outpatient medical leases are non-cancellable operating leases that have a weighted-average remaining term of seven years at December 31, 2023 and are often credit enhanced by security deposits, guarantees and/or letters of credit.
Construction  We are party to agreements to develop or redevelop properties funded through capital that we and/or our joint venture partners provide. We capitalize certain interest costs associated with funds used for the construction of properties owned by us. The amount capitalized is based upon the amount advanced during the construction period using the rate of interest that approximates our company-wide cost of financing. Our interest expense is reduced by the amount capitalized. The construction period commences once expenditures for the property have been made and activities necessary to get the property ready for its intended use are in progress and terminates when the applicable property is substantially complete and ready for its intended use. During the construction period, we advance funds in accordance with agreed upon terms and conditions which require, among other things, periodic site visits by a company representative. During the construction period, we generally require an additional credit enhancement in the form of holding back a portion of the development fee, requiring a credit support for cost-overrun obligations and/or completion guarantees. As of December 31, 2023, we had outstanding construction investments of $1,304,441,000 and were committed to provide additional funds of approximately $966,829,000 to complete construction for consolidated investment properties. We also provide for construction loans which, depending on the terms and conditions, could be treated as loans or investments in unconsolidated entities. 
Loans  Our real estate loans are typically structured to provide us with interest income, principal amortization and transaction fees. Real estate loans consist of mortgage loans and other real estate loans which are primarily collateralized by a first, second or third mortgage lien, a leasehold mortgage on, or an assignment of the partnership interest in the related properties, corporate guarantees and/or personal guarantees. Non-real estate loans are generally corporate loans with no real estate backing. As of December 31, 2023, we had outstanding loans, net of allowances, of $1,691,706,000 with an interest yield of approximately 10.5% per annum. Our yield on loans depends upon a number of factors, including the stated interest rate, average principal amount outstanding during the term of the loan and any interest rate adjustments. The loans outstanding as of December 31, 2023 are generally subject to one to 15-year terms with principal amortization schedules and/or balloon payments of the outstanding principal balances at the end of the term.
Investments in Unconsolidated Entities Investments in entities that we do not consolidate but for which we can exercise significant influence over operating and financial policies are reported under the equity method of accounting. As of December 31, 2023, we had investments in unconsolidated entities of $1,636,531,000. Our investments in unconsolidated entities generally represent interests ranging from 10% to 95% in real estate assets. Under the equity method of accounting, our share of the investee’s earnings or losses is included in our consolidated results of operations. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the entity interest inclusive of transaction costs. We evaluate our equity method investments for impairment based upon a comparison of the estimated fair value of the equity method investment to its carrying value. When we determine a decline in the estimated fair value of such an investment below its carrying value is other-than-temporary, an impairment is recorded. 
In Substance Real Estate Additionally, we provide loans to third parties for the acquisition, development and construction of real estate. Under these arrangements, it is possible that we will participate in the expected residual profits of the project through the sale, refinancing or acquisition of the property. We evaluate the characteristics of each arrangement, including its risks and rewards, to determine whether they are more similar to those associated with a loan or an investment in real estate. Arrangements with characteristics implying real estate joint ventures are treated as in substance real estate investments, accounted for using the equity method, and are presented as investments in unconsolidated entities. We have made loans related to 24 properties with a carrying value of $832,746,000 as of December 31, 2023, which are classified as in substance real estate investments.
Principles of Consolidation
The consolidated financial statements are in conformity with U.S general accepted accounting principles (“U.S. GAAP”) and include the accounts of our wholly owned subsidiaries and joint venture entities that we control, through voting rights or other means. All material intercompany transactions and balances have been eliminated in consolidation.
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At inception of joint venture transactions, we identify entities for which control is achieved through means other than voting rights (“variable interest entities” or “VIEs”) and determine which business enterprise is the primary beneficiary of its operations. A VIE is broadly defined as an entity where either (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 consolidate investments in VIEs when we are determined to be the primary beneficiary. Accounting Standards Codification Topic 810, "Consolidations", requires enterprises to perform a qualitative approach to determining whether or not a VIE will need to be consolidated. This evaluation is based on an enterprise’s ability to direct and influence the activities of a VIE that most significantly impact that entity’s economic performance.
For investments in joint ventures, U.S. GAAP may preclude consolidation by the sole general partner in certain circumstances based on the type of rights held by the limited partner(s). We assess the limited partners’ rights and their impact on our consolidation conclusions, and we reassess if there is a change to the terms or in the exercisability of the rights of the limited partners, the sole general partner increases or decreases its ownership of limited partnership interests, or there is an increase or decrease in the number of outstanding limited partnership interests. We similarly evaluate the rights of managing members of limited liability companies.
Borrowing Policies
We utilize a combination of debt and equity to fund investments. Generally, we intend to issue unsecured, fixed-rate public debt with long-term maturities to approximate the maturities on our triple-net leases and investment strategy. For short-term purposes, we may borrow on our primary unsecured credit facility or issue commercial paper. We typically replace these borrowings with long-term capital such as senior unsecured notes or common stock. When terms are deemed favorable, we may invest in properties subject to existing mortgage indebtedness. In addition, we may obtain secured financing for unleveraged properties in which we have invested or may refinance properties acquired on a leveraged basis. In certain agreements with our lenders, we are subject to restrictions with respect to secured and unsecured indebtedness.
Competition
We compete with other real estate investment trusts, real estate partnerships, private equity and hedge fund investors, banks, insurance companies, finance/investment companies, government-sponsored agencies, taxable and tax-exempt bond funds, health care operators, developers and other investors in the acquisition, development, leasing and financing of health care and seniors housing properties. We compete for investments based on a number of factors including relationships, certainty of execution, investment structures and underwriting criteria. Our ability to successfully compete is impacted by economic and demographic trends, availability of acceptable investment opportunities, our ability to negotiate beneficial investment terms, availability and cost of capital, construction and renovation costs and applicable laws and regulations.
The operators/tenants of our properties compete with properties that provide comparable services in the local markets. Operators/tenants compete for patients and residents based on a number of factors including quality of care, reputation, physical appearance of properties, location, services offered, family preferences (including a preference for home health services instead of residing in one of our communities), physicians, staff and price. We also face competition from other health care facilities for tenants, such as physicians and other health care providers that provide comparable facilities and services.
For additional information on the risks associated with our business, please see “Item 1A — Risk Factors” of this Annual Report on Form 10-K.
Environmental, Social and Governance
Environmental, Social and Governance ("ESG") Approach We strive to operate in a responsible, transparent and sustainable manner. Our leadership, through the cross-functional ESG Steering Committee and the Board of Directors (the "Board"), through the Nominating Corporate/Governance Committee, oversees and advances our ESG initiatives. We recognize that focusing on ESG engagement, integration and impact benefits our stakeholders and is fundamental to our business. Our corporate responsibility and sustainability strategy is focused on adopting leading ESG practices across our business and we were recognized for our leadership in this space over the past year in the following ways:
Achieved a MSCI ESG rating of AA;
Recognized by the U.S. Environmental Protection Agency (EPA) and U.S. Department of Energy as an ENERGY STAR Partner of the Year for the fifth consecutive year and maintained the level of Sustained Excellence, the EPA’s highest recognition within the ENERGY STAR program, for the third consecutive year;
Achieved the level of Executive Member in the EPA’s Certification Nation program;
Maintained top 30% (3rd decile) ISS Quality Score ranking for each of Environment and Social;
Listed in the FTSE4Good Index since 2012;
Named to the Bloomberg Gender-Equality Index for the fifth consecutive year;
Maintained Prime status under the ISS-ESG Corporate Rating for the fifth consecutive year;
Improved GRESB score and maintained GRESB Green Star status for the third consecutive year;
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Received the Labrador 2023 Transparency Award Top 3 in Real Estate for the second consecutive year;
Recognized for industry-leading governance practices, including #1 ranking from Green Street Advisors for Corporate Governance amongst all US REITs; and
Honored by the Women’s Forum of New York for the ratio of women on our Board being above the national average.
Environmental We are committed to operating in a sustainable manner that helps to reduce the Company’s environmental impact. Our goal is prudent environmental stewardship with a focus on reducing our greenhouse gas emissions, energy consumption, water usage, and waste production; mitigating climate change risks; and implementing energy efficiency, water efficiency, and renewable energy technologies across our portfolio. We work with our stakeholders, including employees, vendors, operators, residents, and tenants, in an effort to meet these objectives by encouraging and following evolving practices of environmental sustainability, including benchmarking our portfolio in ENERGY STAR Portfolio Manager, obtaining green building certifications, implementing green technologies, and performing portfolio-wide physical and transition risk analysis to identify opportunities to help mitigate these risks.
In December 2019, we issued our inaugural green bond of $500,000,000 of 2.700% senior unsecured notes due 2027 and in March 2022 we issued an additional green bond of $550,000,000 of 3.85% senior unsecured notes due 2032. The net proceeds from the offerings have been used to fund energy efficiency, water conservation and green building projects. As of September 30, 2023, we have utilized all of the proceeds from these issuances on such projects.
Social We value and are committed to our employees. We believe that a diverse workplace produces a variety of perspectives, motivates employees and helps us understand and better serve our stakeholders, and the communities in which we do business. As of December 31, 2023, our U.S. employees self-identified as follows:
Ethnicity
Male
Female
Asian%13 %
Black or African American%%
Hispanic or Latino%10 %
Native Hawaiian or Other Pacific Islander— %— %
Two or More Races%%
White77 %68 %
100 %100 %
Gender 51 %49 %
We have reinforced our already strong commitment to diversity and inclusion through our Diversity Council and support of our seven employee network groups ("ENGs"). Our ENGs include women, families, racial and ethnic minorities, military, young professionals, and those who identify as LGBTQI+ and their allies. Our ENGs provide support, education, networking opportunities and community belonging for our employees. Our support of diversity and inclusion through our Diversity Council and ENGs, taken together with other employee initiatives, such as tailored messaging, training and discussions on equality and belonging, support our efforts to compete for and foster talent and inclusiveness in an ever-changing workforce.
In addition, we have several social initiatives in place that are focused on fostering a more diverse workforce, engaging with our communities and promoting the health and well-being of our employees, tenants and residents. The Welltower Charitable Foundation (the "Foundation") financially supports charitable initiatives related to aging, health care, the environment, education and the arts. We encourage our employees to give back to the community by matching their contributions and donating their time to eligible charitable organizations. Funds are also allocated to each of our ENGs to make charitable contributions in support of their programming efforts. Additionally, the Foundation facilitates presentations for charities to compete in the Give-WELL campaign. This campaign enables our employees to present and vote for charities that will receive donations from the Foundation. During 2023, we sponsored our fourth annual Day of Giving so our employees could collaborate to make an impact with local charitable organizations through volunteer opportunities. See the Human Capital section below for additional information regarding employee initiatives and programs.
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Governance Our commitment to diversity starts at the top with a highly knowledgeable, skilled and diverse Board. As of December 31, 2023, our ten Directors self-identified as follows:
Board Composition
EthnicityGender
Asian10 %Male60 %
Black or African American20 %Female40 %
Hispanic or Latino20 %100 %
White50 %
100 %
Nine of our ten Directors are independent, and the independent Chair of our Board is held by a Black/African American male. Four of five, or 80%, of our Board committees are chaired by either a Female (2), Hispanic/Latino (1) or Black/African American (1) Director.
Additional information regarding our ESG programs and initiatives is available in our 2022 Environmental, Social and Governance Report (located on our website at www.welltower.com). Information on our website, including our Environmental, Social and Governance Report or sections thereof, is not incorporated by reference into this Annual Report.
Human Capital
Our employees are our greatest asset. As of December 31, 2023, we had 533 employees (511 located in United States, 14 in the United Kingdom and eight in Canada). We are committed to the success of our people and the unique combination of skills and experiences they bring to achieving our mission.
Employee Engagement High employee engagement and satisfaction are critical to attracting and retaining top talent. Annually, we conduct an employee engagement survey through an independent third party, measuring our progress on important employee issues such as manager relationships, employee empowerment, performance management and resources and support, and identifying opportunities for growth and improvement.
Employee Development Programs and Performance Management Development through the talent pipeline, recognizing and rewarding performance and providing opportunities for continued growth are the cornerstones of our Human Capital strategy. We offer employees resources, trainings and tools designed to develop future leaders, advance careers and attract and retain talent, including but not limited to our robust early career programs, formal mentorship and coaching programs, manager development training, skill development courses and education assistance. During 2023, we continued executive management coaching programs to equip leaders with structured 360 feedback, customized development plans and guidance on company-wide succession planning. For many of our vice presidents and senior vice presidents, we provided one-on-one leadership coaching, focusing on maximizing their executive leadership potential.
Compensation and Benefits In addition to salary, our compensation and benefits programs include annual short-term incentive bonuses, long-term incentive stock awards, retirement plans, an employee stock purchase plan, healthcare and insurance benefits, health savings and flexible spending accounts, paid time off, parental and caregiver leave, senior wellness leave, employee assistance programs, tuition assistance and health and wellness reimbursement programs, among many others. We are committed to supporting the diverse needs of our workforce, and with the assistance of independent third parties, we annually evaluate and benchmark the competitiveness of our compensation and benefits programs. Our focus remains on fair pay practices that reward performance while aligning with the evolving needs of our employees.
Health, Safety and Wellness The success of our business is fundamentally connected to the safety and well-being of our employees, tenants, operators and managers, and their residents and visitors, as the case may be. We provide our employees and their families access to numerous innovative, flexible and convenient health and wellness programs that support physical, mental and financial well-being. In 2023, our focus remained on providing a safe office environment for our employees while continuing to allow for remote work, hybrid work and flexible work schedules where feasible. With the support of the varying work arrangements and a geographically dispersed workforce, we continued to develop ways to best support and communicate with our people. We continued to improve our employee experience by growing our internal communication platform (intranet), enhancing connectivity and collaboration. The mobile applications used created an easily accessible digital home-base where all company communications, including important office announcements, must-read company articles and external media engagements are located. Additional communication tools, including podcasts, town hall meetings, team events (virtually and in person) and dedicated communication channels for ENGs, demonstrate our commitment to ensuring employee alignment and engagement.
Credit Concentrations  Please see Note 9 to our consolidated financial statements.
Geographic Concentrations  Please see “Item 2 – Properties” below and Note 18 to our consolidated financial statements.
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Certain Government Regulations
United States
Health Law Matters — Generally
Typically, operators of seniors housing facilities do not receive significant funding from government programs and are largely subject to state laws, as opposed to federal laws. Operators of long-term/post-acute care facilities and hospitals do receive significant funding from government programs, and these facilities are subject to extensive regulation, including federal and state laws covering the type and quality of medical and/or nursing care provided, ancillary services (e.g., respiratory, occupational, physical and infusion therapies), qualifications of the administrative personnel and nursing staff, the adequacy of the physical plant and equipment, reimbursement and rate setting and operating policies. In addition, as described below, operators of these facilities are subject to extensive laws and regulations pertaining to health care fraud and abuse, including, but not limited to, the federal Anti-Kickback Statute (“AKS”), the federal Stark Law (“Stark Law”), and the federal False Claims Act (“FCA”), as well as comparable state laws. Hospitals, physician group practice clinics, and other health care providers that operate in our portfolio are subject to extensive federal, state, and local licensure, registration, certification, and inspection laws, regulations, and industry standards, as well as other conditions of participation in federal and state government programs such as Medicare and Medicaid. Further, operators of long-term care facilities are required to have in place compliance and ethics programs that meet the requirements of federal laws and regulations. Our tenants’ failure to comply with applicable laws and regulations could result in, among other things: loss of accreditation; denial of reimbursement; imposition of fines; suspension, decertification, or exclusion from federal and state health care programs; loss of license; or closure of the facility. See risk factors “The requirements of, or changes to, governmental reimbursement programs, such as Medicare or Medicaid, could have a material adverse effect on our obligors’ liquidity, financial condition and results of operations, which could adversely affect our obligors’ ability to meet their obligations to us” and “Our operators’ or tenants’ failure to comply with federal, state, local and industry-regulated licensure, certification and inspection laws, regulations, and standards could adversely affect such operators’ or tenants’ operations, which could adversely affect our operators’ and tenants’ ability to meet their obligations to us” in “Item 1A – Risk Factors” below. Moreover, in light of certain arrangements that Welltower may pursue with healthcare entities who are directly subject to laws and regulations pertaining to health care, and, given that certain of our arrangements are structured under the provisions of the REIT Investment Diversification and Empowerment Act of 2007 ("RIDEA"), certain health care fraud and abuse laws and data privacy laws could apply directly to Welltower. See risk factor "We assume operational and legal risks with respect to our properties managed in RIDEA structures that could have a material adverse effect on our business results of operations, and financial condition" in "Item 1A - Risk Factors" below.
Licensing and Certification
The primary regulations that affect seniors housing facilities are state licensing and certification laws. For example, certain health care facilities are subject to a variety of licensure and certificate of need (“CON”) laws and regulations. Where applicable, CON laws generally require, among other requirements, that a facility demonstrate the need for (1) constructing a new facility, (2) adding beds or expanding an existing facility, (3) investing in major capital equipment or adding new services, (4) changing the ownership or control of an existing licensed facility or (5) terminating services that have been previously approved through the CON process. Certain state CON laws and regulations may restrict the ability of operators to add new properties or expand an existing facility’s size or services. In addition, CON laws may constrain the ability of an operator to transfer responsibility for operating a particular facility to a new operator.
With respect to licensure, generally our seniors housing and long-term/post-acute care facilities are required to be licensed by the applicable state regulatory authority. The failure of our operators to maintain or renew any required license or regulatory approval as well as the failure of our operators to correct serious deficiencies identified in a compliance survey could require those operators to discontinue operations at a property and could result in suspension of new admissions or loss of licensure. Our entities are named on licenses for nearly all of the RIDEA portfolio and the loss of a license for one facility can require reporting in other jurisdictions. 
Reimbursement
The reimbursement methodologies applied to health care facilities continue to evolve. Federal and state authorities have considered and implemented and may continue seeking to implement new or modified reimbursement methodologies, including value-based reimbursement methodologies that may negatively impact health care property operations. Likewise, third-party payors may continue imposing greater controls on operators, including through changes in reimbursement rates and fee structures. The impact of any such changes, if implemented, may result in a material adverse effect on our portfolio. No assurance can be given that current revenue sources or levels will be maintained. Accordingly, there can be no assurance that payments under a government health care program are currently, or will be in the future, sufficient to fully reimburse the property operators for their operating and capital expenses.
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Seniors Housing Facilities  The majority of the revenues received by the operators of U.S. seniors housing facilities are from private pay sources. The remaining revenue source is primarily Medicaid provided under state waiver programs for home and community-based care. There can be no guarantee that a state Medicaid program operating pursuant to a waiver will be able to maintain its waiver status. Rates paid by self-pay residents are set by the facilities and are determined by local market conditions and operating costs. Generally, facilities receive a higher payment per day for a private pay resident than for a Medicaid beneficiary who requires a comparable level of care. The level of Medicaid reimbursement varies from state to state. Thus, the revenues generated by operators of our assisted living facilities may be adversely affected by payor mix, acuity level, or changes in Medicaid eligibility and reimbursement levels.
Long-Term/Post-Acute Care Facilities  The majority of the revenues received by the operators of these facilities are from the Medicare and Medicaid programs, with the balance representing reimbursement payments from private payors and patients. Consequently, changes in federal or state reimbursement policies may adversely affect an operator’s ability to cover its expenses, including our rent or debt service. Long-term/post-acute care facilities are subject to periodic pre- and post-payment reviews and other audits by federal and state authorities. A review or audit of a property operator’s claims could result in recoupments, denials or delay of payments in the future. Due to the significant judgments and estimates inherent in payor settlement accounting, no assurance can be given as to the adequacy of any reserves maintained by our property operators to cover potential adjustments to reimbursements or to cover settlements made to payors.
Medicare Reimbursement Generally, long-term/post-acute care facilities are reimbursed by Medicare under prospective payment systems, which generally provide reimbursement based upon a predetermined fixed amount per episode of care and are updated by the Centers for Medicare and Medicaid Services ("CMS"), an agency of the Department of Health and Human Services (“HHS”) annually. There is a risk under these payment systems that costs will exceed the fixed payments, or that payments may be set below the costs to provide certain items and services. The HHS Office of Inspector General has released recommendations to address skilled nursing facility ("SNF") billing practices and Medicare payment rates, which may impact our tenants and operators. In September 2022, HHS announced that additional data about the ownership of all Medicare-certified nursing homes will be released to the public, and in June 2023, CMS began publishing additional information regarding Medicare-certified nursing homes with common owners and operators, referred to as “affiliated entities,” including names of affiliated owners and aggregate data on the safety, staffing, and quality of affiliated entities. This information will make it easier for stakeholders (such as state licensing officials, state and federal law enforcement and researchers) and the public to identify common owners of nursing homes across different nursing home locations. The information will also allow for greater accessibility to information regarding facilities' performance and any common ownership links among facilities with poor performance. CMS announced it is increasing scrutiny and oversight over the country's poorest performing nursing facilities by strengthening requirements for completion of the Special Focus Facility Program and increasing enforcement actions against facilities that fail to demonstrate improvement, including denial of payment and potential loss of Medicare certification.
Medicaid Reimbursement  Many states reimburse SNFs using fixed daily rates, which are applied prospectively based on patient acuity and the historical costs incurred in providing patient care. In most states, Medicaid does not fully reimburse the cost of providing services. Certain states are attempting to slow the rate of Medicaid growth by freezing rates or restricting eligibility and benefits. In addition, Medicaid reimbursement rates may decline if state revenues in a particular state are not sufficient to fund budgeted expenditures. Health reform measures could be implemented as a result of political, legislative, regulatory and administrative developments and judicial proceedings. On February 28, 2022, President Biden announced reforms to be implemented by CMS to ensure that: (a) every nursing home provides a sufficient number of staff who are adequately trained to provide high-quality care; (b) poorly performing nursing homes are held accountable for improper and unsafe care and immediately improve their services or are cut off from taxpayer dollars; and (c) the public has better information about nursing home conditions so that they can find the best available options. These reforms include minimum staffing requirements, reinforced safeguards against unnecessary medications, more funding for inspection activities, increased scrutiny on poor performers and expanded financial penalties and other sanctions. More recently, on November 15, 2023, CMS issued a Final Rule to implement portions of the Patient Protection and Affordable Care Act that require the disclosure of certain ownership and managerial information regarding Medicare SNFs and Medicaid nursing facilities, including updates to identify REIT ownership of SNFs. We cannot predict whether the existing Health Reform Laws, or future health care reform legislation, executive order, or regulatory changes, will have a material impact on our operators’ or tenants’ property or business.
Medicare Reimbursement for Physicians, Hospital Outpatient Departments (“HOPDs”), and Ambulatory Surgical Centers (“ASCs”) Changes in reimbursement to physicians, HOPDs and ASCs may further affect our tenants and operators. Generally, Medicare reimburses physicians under the Physician Fee Schedule, while HOPDs and ASCs are reimbursed under prospective payment systems. The Physician Fee Schedule and the HOPD and ASC prospective payment systems are updated annually by CMS. These annual Medicare payment regulations have resulted in lower net pay increases than providers of those services have often expected. In addition, the Medicare and Children’s Health Insurance Program Reauthorization Act of 2015 (“MACRA”) includes payment reductions for providers who do not meet
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government quality standards. The implementation of pay-for-quality models like those required under MACRA has the potential to produce funding disparities that could adversely impact some provider tenants in outpatient medical buildings and other health care properties. Changes in Medicare Advantage plan payments may also indirectly affect our operators and tenants that contract with Medicare Advantage plans.
Fraud & Abuse Enforcement
Long-term/post-acute care facilities (and seniors housing facilities that receive Medicaid payments) are subject to federal, state, and local laws, regulations, and applicable guidance that govern the operations and financial and other arrangements that may be entered into by health care providers. Certain of these laws, such as the AKS and Stark Law, prohibit direct or indirect payments of any kind for the purpose of inducing or encouraging the referral of patients for medical products or services reimbursable by government health care programs. Other government health program laws require providers to furnish only medically necessary services and submit to the government valid and accurate statements for each service. Our operators and tenants that receive payments from federal health care programs, such as Medicare and Medicaid, are subject to substantial financial penalties under the Civil Monetary Penalties Act and the FCA upon a finding of noncompliance with such laws. In addition, states may also have separate false claims acts, which, among other things, generally prohibit health care providers from filing false claims or making false statements to receive payments. Federal and state FCAs contain "whistleblower" provisions that permit private individuals to bring health care fraud enforcement claims on behalf of the government. Still other laws require providers to comply with a variety of safety, health and other requirements relating to the condition of the licensed property and the quality of care provided. Sanctions for violations of these laws, regulations and other applicable guidance may include, but are not limited to, criminal and/or civil penalties and fines, loss of licensure, immediate termination of government payments, exclusion from any government health care program, damage assessments and imprisonment. In certain circumstances, violation of these rules (such as those prohibiting abusive and fraudulent behavior) with respect to one property may subject other facilities under common control or ownership to sanctions, including exclusion from participation in the Medicare and Medicaid programs, as well as other government health care programs, and revocation of healthcare licenses. In the ordinary course of its business, a property operator is regularly subjected to inquiries, investigations and audits by the federal and state agencies that oversee these laws and regulations.
Prosecutions, investigations or whistleblower actions could have a material adverse effect on a property operator’s liquidity, financial condition, and operations, which could adversely affect the ability of the operator to meet its financial obligations to us. In addition, government investigations and enforcement actions brought against the health care industry have increased dramatically over the past several years and are expected to continue. The costs for an operator of a health care property associated with both defending such enforcement actions and the undertakings in settling these actions can be substantial and could have a material adverse effect on the ability of an operator to meet its obligations to us. In addition, Welltower could potentially be directly subject to these health care fraud and abuse laws, as well as potential investigation or enforcement, as a result of our RIDEA-structured arrangements, and certain collaboration or other arrangements we may pursue with stakeholders who are directly subject to these laws.
Federal and State Data Privacy and Security Laws
The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and numerous other state and federal laws govern the collection, security, dissemination, use, access to and confidentiality of personal information, including individually identifiable health information. Violations of these laws may result in regulatory scrutiny, lawsuits or substantial civil and/or criminal fines and penalties, including regulatory consent orders. The costs to a business such as ours or to an operator of a health care property associated with developing and maintaining programs and systems to comply with data privacy and security laws, defending against privacy and security related claims or enforcement actions and paying any assessed fines, can be substantial. Moreover, such costs could have a material adverse effect on the ability of an operator to meet its obligations to us. Finally, data privacy and security laws and regulations continue to develop, including with regard to HIPAA and U.S. state privacy laws. The California Consumer Privacy Act ("CCPA") has been amended by the California Privacy Rights Act. These updates and the comprehensive privacy laws from California, Colorado, Connecticut and Utah are all in effect, and further state comprehensive privacy laws and certain health-focused privacy laws, such as the Washington My Health My Data Act, will become effective over the course of 2024. Furthermore, many states have introduced legislation that would revise or implement new such laws and many states have promulgated regulations, which continue to evolve, to implement existing legislation. As we use data to better inform our investments and the efficacy of care in our communities, these developments may add potential uncertainty and costs towards compliance obligations, business operations or transactions that depend on data. These evolving privacy laws may create restrictions or requirements in our, our operators' and other business partners' use, sharing and retention of data. New privacy and security laws could require substantial investment in resources to comply with regulatory changes as privacy and security laws proliferate in divergent ways or impose additional obligations, and potentially create new privacy related legal risks.
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United Kingdom
In the U.K., care home services are principally regulated by the Health and Social Care Act 2008 (as amended) and other regulations including the Health and Care Act 2022. This legislation subjects service providers to a number of legally binding “Fundamental Standards” and requires, amongst other things, that all persons carrying out “Regulated Activities” in the U.K., and the managers of such persons, be registered. Providers of care home services are also subject (as data controllers) to laws governing their use of personal data (including in relation to their employees, clients and recipients of their services). These laws currently take the form of the U.K.’s Data Protection Act 2018 and the U.K. General Data Protection Regulation (collectively “U.K. DP Laws”). U.K. DP Laws impose a significant number of obligations on controllers with the potential for fines of up to 4% of annual worldwide turnover or £17.5 million, whichever is greater. Further, entities may also be subject to the E.U. General Data Protection Regulation ("E.U. GDPR"). Similarly, the E.U. GDPR imposes obligations on controllers with the potential for fines of up to 4% of annual worldwide turnover or €20 million, whichever is greater. The U.K. DP Laws may be subject to change with the introduction of the Data Protection and Digital Information ("DPDI") Bill in 2023. Entities incorporated in or carrying on a business in the U.K., as well as individuals residing in the U.K., are also subject to the U.K. Bribery Act 2010. The U.K. has national minimum wage legislation with a maximum fine for non-payment of £20,000 per worker and employers who fail to pay will be banned from being a company director for up to 15 years. 
Canada
Senior living residences in Canada are provincially regulated. Within each province, there are different categories for senior living residences that are generally based on the level of care sought and/or required by a resident (e.g. assisted or retirement living, senior living residences, residential care, long-term care). In some of these categories and depending on the province, residences may be government funded, or the individual residents may be eligible for a government subsidy, while other residences are exclusively private pay. The governing legislation and regulations vary by province, but generally the object of the laws is to set licensing requirements and minimum standards for senior living residences, and regulate operations. These laws empower regulators in each province to take a variety of steps to ensure compliance, conduct inspections, issue reports and generally regulate the industry.
Our operations in Canada are subject to privacy legislation, including, in certain provinces, privacy laws specifically related to personal health information. Although the obligations of senior living residences in the various provinces differ, they all include the obligation to protect personal information. Under some of these laws, notification to the regulator in the event of an actual or suspected privacy breach is mandatory. The powers of privacy regulators and penalties for violations of privacy law vary according to the applicable law or are left to the courts. In September 2021, the province of Quebec adopted significant amendments to its privacy legislation, including a new enforcement scheme with significant penalties and fines: up to CAD $10 million or 2% of global turnover (whichever is greater) for administrative monetary penalties and up to CAD $25 million or 4% of global turnover for penal fines. The amendments take effect in three stages: (i) a few provisions on September 22, 2022, (ii) most provisions on September 22, 2023 (including the new enforcement scheme), and (iii) one provision on September 23, 2024. Senior living residences may also be subject to laws pertaining to residential tenancy, provincial and/or municipal laws applicable to fire safety, food services, zoning, occupational health and safety, public health and the provision of community health care and funded long-term/post-acute care.
Taxation
The following summary of the taxation of the Company and the material U.S. federal income tax consequences to the holders of the equity of the Company and the debt securities of the Company and Welltower OP (defined below) is for general information only and is not tax advice. This summary does not address all aspects of taxation that may be relevant to certain types of holders of stock or securities (including, but not limited to, insurance companies, tax-exempt entities, financial institutions or broker-dealers, persons holding shares of common stock as part of a hedging, integrated conversion, or constructive sale transaction or a straddle, traders in securities that use a mark-to-market method of accounting for their securities, investors in pass-through entities and non-U.S. corporations and persons who are not citizens or residents of the United States).
This summary does not discuss all of the aspects of U.S. federal income taxation that may be relevant to you in light of your particular investment or other circumstances. In addition, this summary does not discuss any state or local income taxation or non-U.S. income taxation or other non-U.S. tax consequences. This summary is based on current U.S. federal income tax laws. Subsequent developments in U.S. federal income tax law, including changes in law or differing interpretations, which may be applied retroactively, could have a material effect on the U.S. federal income tax consequences of purchasing, owning and disposing of our securities as set forth in this summary. Before you purchase our securities, you should consult your own tax advisor regarding the particular U.S. federal, state, local, non-U.S. and other tax consequences of acquiring, owning and selling our securities.
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General
Prior to the Reorganization on April 1, 2022, whereby Old Welltower, became a wholly owned subsidiary of WELL Merger Holdco Sub Inc. in a transaction intending to qualify as a reorganization under Section 368(a)(1)(F) of the Internal Revenue Code of 1986, as amended (the “Code”). In connection with the Reorganization, Old Welltower changed its name to Welltower OP Inc., WELL Merger Holdco Sub Inc. changed its name to Welltower Inc. and Old Welltower became a “qualified REIT subsidiary” of the Company. Effective on May 24, 2022, Welltower OP Inc. converted from a Delaware corporation into a Delaware limited liability company named Welltower OP LLC. Prior to the Reorganization, Old Welltower elected to be taxed as a REIT and was organized and operated in a manner intended to qualify as a REIT. As a result of the Reorganization, the Company is treated as a continuation of Old Welltower for U.S. federal income tax purposes and references in this summary to “the Company,” “us,” or “we” include references to Old Welltower unless otherwise specified or clearly required by the context.
We have been organized and operated in a manner intended to qualify as a REIT and we intend to continue to operate in such a manner as to qualify as a REIT, but there can be no assurance that we will qualify or remain qualified as a REIT. Qualification and taxation as a REIT depend upon our ability to meet a variety of qualification tests imposed under U.S. federal income tax law with respect to our income, assets, distributions and share ownership, as discussed below under “Qualification as a REIT.”
In any year in which we qualify as a REIT, in general, we will not be subject to U.S. federal income tax on that portion of our REIT taxable income or capital gain that is distributed to stockholders. We may, however, be subject to tax at normal corporate rates on any taxable income or capital gain not distributed. If we elect to retain and pay income tax on our net capital gain, stockholders would be taxed on their proportionate shares of our undistributed net capital gain and would receive a refundable credit for their shares of any taxes paid by us on such gain.
Despite qualifying as a REIT, we may be subject to U.S. federal income and excise tax as follows:
To the extent that we do not distribute all of our net capital gain or distribute at least 90%, but less than 100%, of our “REIT taxable income,” as adjusted, we will be subject to tax on the undistributed amount at regular corporate tax rates;
If we have net income from the sale or other disposition of “foreclosure property” that is held primarily for sale to customers in the ordinary course of business or other non-qualifying income from foreclosure property, such income will be taxed at the highest corporate rate;
Any net income from prohibited transactions (which are, in general, sales or other dispositions of property held primarily for sale to customers in the ordinary course of business, other than dispositions of foreclosure property) will be subject to a 100% tax;
If we fail to satisfy either the 75% or 95% gross income tests (as discussed below), but nonetheless maintain our qualification as a REIT because certain other requirements are met, we will be subject to a 100% tax on an amount equal to (1) the gross income attributable to the greater of (i) 75% of our gross income over the amount of qualifying gross income for purposes of the 75% gross income test (discussed below) or (ii) 95% of our gross income over the amount of qualifying gross income for purposes of the 95% gross income test (discussed below) multiplied by (2) a fraction intended to reflect our profitability;
If we fail to distribute during each year at least the sum of (1) 85% of our REIT ordinary income for the year, (2) 95% of our REIT capital gain net income for such year (other than capital gain that we elect to retain and pay tax on) and (3) any undistributed taxable income from preceding years, we will be subject to a 4% excise tax on the excess of such required distribution over amounts actually distributed and;
We will be subject to a 100% tax on certain amounts from certain transactions involving our “taxable REIT subsidiaries” that are not conducted on an arm’s length basis. See “Investments in Taxable REIT Subsidiaries.”
We have acquired assets from “C” corporations in carryover basis transactions and may do so again in the future. A “C” corporation is generally defined as a corporation that is required to pay full corporate level U.S. federal income tax. If we recognize gain on the disposition of such assets during the five-year period beginning on the date on which the assets were acquired by us, then, to the extent of the assets’ “built-in gain” (e.g., the excess of the fair market value of the asset over the adjusted tax basis of the asset, in each case determined as of the beginning of the five-year period), we will be subject to tax on the gain at the highest regular corporate rate applicable. The results described in this paragraph with respect to the recognition of built-in gain assume that the “C” corporation did not make and was not treated as making an election to treat the built-in gain assets as sold to an unrelated party on the date they were acquired by us. For our assets that are subject to the built-in gains tax, the potential amount of built-in gains tax will be an additional factor when considering a possible sale of such assets within the five-year period beginning on the date on which the assets were acquired by us. See Note 19 to our consolidated financial statements for additional information regarding the built-in gains tax.
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Qualification as a REIT
A REIT is defined as a corporation, trust or association:
(1) which is managed by one or more trustees or directors;
(2) the beneficial ownership of which is evidenced by transferable shares or by transferable certificates of beneficial interest;
(3) which would be taxable as a domestic corporation but for the U.S. federal income tax law relating to REITs;
(4) which is neither a financial institution nor an insurance company;
(5) the beneficial ownership of which is held by 100 or more persons in each taxable year of the REIT except for its first
    taxable year;
(6) not more than 50% in value of the outstanding stock of which is owned during the last half of each taxable year, excluding its first taxable year, directly, indirectly or constructively, by or for five or fewer individuals (which includes certain entities) (the “Five or Fewer Requirement”); and
(7) which meets certain income and asset tests described below.
Conditions (1) to (4), inclusive, must be met during the entire taxable year and condition (5) must be met during at least 335 days of a taxable year of 12 months or during a proportionate part of a taxable year of less than 12 months. For purposes of condition (6), pension funds and certain other tax-exempt entities are treated as individuals, subject to a “look-through” exception in the case of certain pension funds.
Based on publicly available information, we believe we have satisfied the share ownership requirements set forth in (5) and (6) above. In addition, Article VI of our by-laws provides for restrictions regarding ownership and transfer of shares. These restrictions are intended to assist us in continuing to satisfy the share ownership requirements described in (5) and (6) above but may not ensure that we will, in all cases, be able to satisfy such requirements.
We have complied with, and will continue to comply with, tax regulatory rules to send annual letters to certain of our stockholders requesting information regarding the actual ownership of our stock. If, despite sending the annual letters, we do not know, or after exercising reasonable diligence would not have known, whether we failed to meet the Five or Fewer Requirement, we will be treated as having met the Five or Fewer Requirement. If we fail to comply with these tax regulatory rules, we will be subject to a monetary penalty. If our failure to comply were due to intentional disregard of the requirement, the penalty would be increased. However, if our failure to comply were due to reasonable cause and not willful neglect, no penalty would be imposed.
For purposes of the REIT income and asset tests our assets and income will include any asset owned and any income earned directly or indirectly through a disregarded entity, including a “qualified REIT subsidiary,” and a proportionate share of the assets of, and any income earned through, any entity we own that is treated as a partnership for U.S. federal income tax purposes, including Welltower OP. A corporation will qualify as a “qualified REIT subsidiary” if 100% of its stock is owned by a REIT, and the REIT does not elect to treat the subsidiary as a taxable REIT subsidiary.
We will own substantially all of our assets and earn substantially all of our income through Welltower OP and its direct or indirect subsidiaries. Prior to the LLC Conversion, Welltower OP was treated as a “qualified REIT subsidiary,” provided that we qualified as a REIT during this period. After the LLC Conversion, Welltower OP became a disregarded entity for U.S. federal income tax purposes and was treated as a disregarded entity until additional regarded members were admitted to Welltower OP, at which time Welltower OP became a regarded entity treated as a partnership for U.S. federal income tax purposes.
Although we intend for any partnership in which we have acquired or will acquire an interest, directly or indirectly (a “Subsidiary Partnership”), to operate in a manner consistent with the requirements for our qualification as a REIT, we will be an indirect limited partner or non-managing member in some of the Subsidiary Partnerships. Though we nonetheless expect that all such Subsidiary Partnerships will be required to operate in a manner consistent with the requirements for our qualification as a REIT, if a Subsidiary Partnership in which we own an interest but do not have control takes or expects to take actions that could jeopardize our status as a REIT or require us to pay tax, we may be forced to dispose of our interest in such entity. In addition, it is possible that a Subsidiary Partnership could take an action which could cause us to fail a gross income or asset test and that we would not become aware of such action in time for us to dispose of our interest in the Subsidiary Partnership or take other corrective action on a timely basis. In that case, we could fail to qualify as a REIT unless we were able to qualify for a statutory REIT “savings” provision, which could require us to pay a significant penalty tax to maintain our REIT qualification.
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Income Tests  There are two separate percentage tests relating to our sources of gross income that we must satisfy each taxable year:
At least 75% of our gross income (excluding gross income from certain sales of property held primarily for sale) generally must be directly or indirectly derived each taxable year from “rents from real property,” dividends or other distributions on, and gain (other than gain from prohibited transactions) from the sale or other disposition of, REIT shares, mortgages on real property, other income from investments relating to real property or certain income from qualified temporary investments (the “75% gross income test”).
At least 95% of our gross income (excluding gross income from certain sales of property held primarily for sale) generally must be directly or indirectly derived each taxable year from any of the sources qualifying for the 75% gross income test and from dividends (including dividends from taxable REIT subsidiaries) and interest (the “95% gross income test”).
Income from hedging and non-U.S. currency transactions is excluded from the 95% and 75% gross income tests if certain requirements are met but otherwise will constitute gross income which does not qualify under the 95% or 75% gross income tests.
Rents received by us will qualify as “rents from real property” for purposes of satisfying the gross income tests for a REIT only if several conditions are met:
The amount of rent must not be based in whole or in part on the income or profits of any person, although rents generally will not be excluded merely because they are based on a fixed percentage or percentages of receipts or sales.
Rents received from a tenant will not qualify as rents from real property if the REIT, or an owner of 10% or more of the REIT, directly or constructively owns 10% or more of the tenant, unless the tenant is our taxable REIT subsidiary and certain other requirements are met with respect to the real property being rented.
If rent attributable to personal property leased in connection with a lease of real property is greater than 15% of the total rent received under the lease, then the portion of rent attributable to such personal property will not qualify as “rents from real property.”
For rents to qualify as rents from real property, we generally must not furnish or render services to tenants, other than through a taxable REIT subsidiary or an “independent contractor” from whom we derive no income, except that we may directly provide services that are usually or customarily rendered in the geographic area in which the property is located in connection with the rental of real property for occupancy only or are not otherwise considered rendered to the occupant for the occupant’s convenience.
We may lease “qualified health care properties” on an arm’s-length basis to a taxable REIT subsidiary if the property is operated on behalf of such subsidiary by a person that qualifies as an “independent contractor” and that is, or is related to a person that is, actively engaged in the trade or business of operating health care facilities for any person unrelated to us or our taxable REIT subsidiary (such person, an “eligible independent contractor”). If this is the case, the rent that the REIT receives from the taxable REIT subsidiary generally will be treated as “rents from real property.” A “qualified health care property” includes any real property and any personal property that is, or is necessary or incidental to the use of, a hospital, nursing facility, assisted living facility, congregate care facility, qualified continuing care facility, or other licensed facility that extends medical or nursing or ancillary services to patients and is operated by a provider of such services that is eligible for participation in the Medicare program with respect to such facility.
A REIT is permitted to render a de minimis amount of impermissible services to tenants of a property and still treat rents received with respect to that property as rent from real property. The amount received or accrued by the REIT during the taxable year for the impermissible services with respect to a property may not exceed 1% of all amounts received or accrued by the REIT directly or indirectly from the property. The amount received for any service or management operation for this purpose shall be deemed to be not less than 150% of the direct cost of the REIT in furnishing or rendering the service or providing the management or operation. Furthermore, impermissible services may be furnished to tenants by a taxable REIT subsidiary subject to certain conditions, which would permit us to still treat rents received with respect to the property as rent from real property.
The term “interest” generally does not include any amount if the determination of the amount depends in whole or in part on the income or profits of any person, although an amount generally will not be excluded from the term “interest” solely by reason of being based on a fixed percentage of receipts or sales or by reason of being based on the income or profits of a debtor which derives substantially all of its income with respect to the property securing such debt from the leasing of substantially all of such property to tenants, to the extent that the rents paid by the tenants would qualify as rents from real property if the Company earned such amounts directly.
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If we fail to satisfy one or both of the 75% or 95% gross income tests for any taxable year, we may nevertheless qualify as a REIT for such year if we are eligible for certain relief provisions provided by the Code. These relief provisions generally will be available if (1) following our identification of the failure, we file a schedule for such taxable year describing each item of our gross income, and (2) the failure to meet such tests was due to reasonable cause and not due to willful neglect. It is not now possible to determine the circumstances under which we may be entitled to the benefit of these relief provisions. If these relief provisions apply, a 100% tax is imposed on an amount equal to (1) the gross income attributable to (i) 75% of our gross income over the amount of qualifying gross income for purposes of the 75% gross income test and (ii) 95% of our gross income over the amount of qualifying gross income for purposes of the 95% gross income test, multiplied by (2) a fraction intended to reflect our profitability. The Secretary of the Treasury is given broad authority to determine whether particular items of income or gain qualify under the 75% and 95% gross income tests and to exclude items from the measure of gross income for such purposes.
Asset Tests  Within 30 days after the close of each quarter of our taxable year, we must also satisfy several tests relating to the nature and diversification of our assets determined in accordance with generally accepted accounting principles. At least 75% of the value of our total assets must be represented by real estate assets (including interests in real property, interests in mortgages on real property or on interests in real property, shares in other REITs and debt instruments issued by publicly offered REITs), cash, cash items (including receivables arising in the ordinary course of our operation), government securities and qualified temporary investments (the “75% asset test”). Although the remaining 25% of our assets generally may be invested without restriction, we are prohibited from owning securities representing more than 10% of either the vote (the “10% vote test”) or value (the “10% value test”) of the outstanding securities of any issuer other than another REIT or a taxable REIT subsidiary. Further, no more than 20% of our total assets may be represented by securities of one or more taxable REIT subsidiaries (the “20% asset test”) and no more than 5% of the value of our total assets may be represented by securities of any non-governmental issuer (the “5% asset test”) other than a qualified REIT subsidiary, another REIT or a taxable REIT subsidiary. Each of the 10% vote test, the 10% value test and the 20% and 5% asset tests must be satisfied at the end of each quarter. There are special rules which provide relief if the value-related tests are not satisfied due to changes in the value of the assets of a REIT.
Certain items are excluded from the 10% value test, including: (1) straight debt securities meeting certain requirements; (2) any loan to an individual or an estate; (3) any rental agreement described in Section 467 of the Code, other than with a “related person”; (4) any obligation to pay rents from real property; (5) certain securities issued by a state or any subdivision thereof, the District of Columbia, a non-U.S. government, or any political subdivision thereof, or the Commonwealth of Puerto Rico; (6) any security issued by a REIT; and (7) any other arrangement that, as determined by the Secretary of the Treasury, is excepted from the definition of security (“10% Value Excluded Securities”). If a REIT, or its taxable REIT subsidiary, holds (1) straight debt securities of a corporate or partnership issuer and (2) securities of such issuer that are not 10% Value Excluded Securities and have an aggregate value greater than 1% of such issuer’s outstanding securities, the straight debt securities will be included in the 10% value test.
A REIT’s interest as a partner in a partnership is not treated as a security for purposes of applying the 10% value test to securities issued by the partnership. Further, any debt instrument issued by a partnership that is not a 10% Value Excluded Security will not be a security for purposes of applying the 10% value test (1) to the extent of the REIT’s interest as a partner in the partnership or (2) if at least 75% of the partnership’s gross income (excluding gross income from prohibited transactions) would qualify for the 75% gross income test. For purposes of the 10% value test, a REIT’s interest in a partnership’s assets is determined by the REIT’s proportionate interest in any securities issued by the partnership (other than the excluded securities described in the preceding paragraph).
If a REIT or its “qualified business unit” uses a non-U.S. currency as its functional currency, the term “cash” includes such non-U.S. currency, but only to the extent such non-U.S. currency is (i) held for use in the normal course of the activities of the REIT or “qualified business unit” which give rise to items of income or gain that are included in the 95% and 75% gross income tests or are directly related to acquiring or holding assets qualifying under the 75% asset test, and (ii) not held in connection with dealing or engaging in substantial and regular trading in securities.
With respect to corrections of failures as to violations of the 10% vote test, the 10% value test or the 5% asset test, a REIT may avoid disqualification as a REIT by disposing of sufficient assets to cure a violation due to the ownership of assets that do not exceed the lesser of 1% of the REIT’s assets at the end of the relevant quarter or $10,000,000, provided that the disposition occurs within six months following the last day of the quarter in which the REIT first identified the violation. For violations of any of the REIT asset tests due to reasonable cause and not willful neglect that exceed the thresholds described in the preceding sentence, a REIT can avoid disqualification as a REIT after the close of a taxable quarter by taking certain steps, including disposition of sufficient assets within the six month period described above to meet the applicable asset test, paying a tax equal to the greater of $50,000 or the highest corporate tax rate multiplied by the net income generated by the non-qualifying assets during the period of time that the assets were held as non-qualifying assets and filing a schedule with the Internal Revenue Service ("IRS") that describes the non-qualifying assets.
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Investments in Taxable REIT Subsidiaries REITs may own more than 10% of the voting power and value of securities in taxable REIT subsidiaries. Unlike a qualified REIT subsidiary, other disregarded entity or partnership, the income and assets of a taxable REIT subsidiary are not attributable to the REIT for purposes of satisfying the income and asset ownership requirements applicable to REIT qualification. Except as noted below with respect to a corporate entity that operates a health care or lodging facility, we and any taxable corporate entity in which we own an interest, directly or indirectly, are allowed to jointly elect to treat such entity as a “taxable REIT subsidiary.”
Certain of our subsidiaries have elected or will elect taxable REIT subsidiary status. Taxable REIT subsidiaries are subject to full corporate level U.S. federal taxation on their earnings but are permitted to engage in certain types of activities that cannot be performed directly by REITs without jeopardizing the REIT status of their parent REIT. The taxes to which our taxable REIT subsidiaries are subject will reduce the cash available for such taxable REIT subsidiaries to distribute as dividends to us.
The IRS may redetermine amounts from transactions between a REIT and its taxable REIT subsidiary where there is a lack of arm’s-length dealing between the parties. Any taxable income allocated to, or deductible expenses allocated away, from a taxable REIT subsidiary would increase its tax liability. Further, redetermined amounts from certain transactions involving a REIT and its taxable REIT subsidiaries could be subject to a 100% tax if not conducted on an arm’s length basis.
A taxable REIT subsidiary does not include any corporation that directly or indirectly operates or manages a lodging facility or a health care facility unless such facility is operated on behalf of such subsidiary by a person that is an independent contractor and certain other requirements are met. The failure of a subsidiary of ours to qualify as a taxable REIT subsidiary as a result of operating a lodging facility or a health care facility could have an adverse effect on the Company’s ability to comply with the REIT income and asset tests, and thus could impair the Company’s ability to qualify as a REIT unless the Company could avail itself of certain relief provisions under the Code and pay any tax resulting therefrom.
For tax years beginning after December 31, 2022, the Inflation Reduction Act of 2022 (“IRA”) imposes among other things, a 15% Corporate Alternative Minimum Tax (“Corporate AMT”) on certain U.S. corporations with average adjusted financial statement income in excess of $1 billion. Although, by its terms, the Corporate AMT is not applicable to REITs, it is not certain whether or how the Corporate AMT would apply to our TRSs.
The IRS has issued several notices indicating its intention to propose regulations providing guidance regarding the Corporate AMT and issuing certain interim rules on which taxpayers may rely. Until further regulations and guidance from the IRS is released, the impact of the Corporate AMT on our TRSs is uncertain and it is possible that our taxable REIT subsidiaries will be subject to material U.S. federal income taxes under the Corporate AMT.
Investments in REIT Subsidiaries The Company, through Welltower OP, owns and may acquire direct or indirect interests in one or more entities that have elected or will elect to be taxed as REITs under the Code (each, a “Subsidiary REIT”). A Subsidiary REIT is subject to the various REIT qualification requirements and other limitations described herein that are applicable to the Company. If a Subsidiary REIT were to fail to qualify as a REIT, then (i) that Subsidiary REIT would become subject to U.S. federal income tax and (ii) the Subsidiary REIT’s failure to qualify could have an adverse effect on the Company’s ability to comply with the REIT income and asset tests, and thus could impair the Company’s ability to qualify as a REIT unless the Company could avail itself of certain relief provisions under the Code and pay any tax resulting therefrom.
Annual Distribution Requirements In order to avoid being taxed as a regular corporation, we are required to make distributions (other than capital gain distributions) to our stockholders which qualify for the dividends paid deduction in an amount at least equal to (1) the sum of (i) 90% of our “REIT taxable income” (computed without regard to the dividends paid deduction and our net capital gain) and (ii) 90% of the after-tax net income, if any, from foreclosure property, minus (2) a portion of certain items of non-cash income. These distributions must be paid in the taxable year to which they relate, or in the following taxable year if declared before we timely file our tax return for that year and if paid on or before the first regular distribution payment after such declaration. Prior to 2014, with respect to all REITs, the amount distributed could not be preferential. This means that every stockholder of the class of stock to which a distribution is made must be treated the same as every other stockholder of that class, and no class of stock may be treated otherwise than in accordance with its dividend rights as a class (the “preferential dividend rule”). The preferential dividend rule no longer applies to publicly offered REITs; however, the rule is still applicable to REITs which are not publicly offered, which would include several of our Subsidiary REITs. To the extent that we do not distribute all of our net capital gain or distribute at least 90%, but less than 100%, of our “REIT taxable income,” as adjusted, we will be subject to tax on the undistributed amount at regular corporate tax rates. As discussed above, we may be subject to an excise tax if we fail to meet certain other distribution requirements. Although we intend to make timely distributions sufficient to satisfy these annual distribution requirements, economic, market, legal, tax or other factors could limit our ability to meet those requirements.
It is also possible that, from time to time, we may not have sufficient cash or other liquid assets to meet the 90% distribution requirement, or to distribute such greater amount as may be necessary to avoid income and excise taxation, due to, among other things, (1) timing differences between (i) cash receipts and cash expenditures and (ii) the inclusion of income and deduction of expenses in arriving at our taxable income, or (2) the payment of expenditures that may not be deductible to us. In the event that timing differences occur, we may find it necessary to arrange for borrowings or, if possible, pay dividends in the form of taxable stock dividends in order to meet the distribution requirement.
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Under certain circumstances, including in the event of a deficiency determined by the IRS, we may be able to rectify a resulting failure to meet the distribution requirement for a year by paying “deficiency dividends” to stockholders in a later year, which may be included in our deduction for distributions paid for the earlier year. Thus, we may be able to avoid being disqualified as a REIT and/or taxed on amounts distributed as deficiency dividends; however, we will be required to pay applicable penalties and interest based upon the amount of any deduction taken for deficiency dividend distributions.
Failure to Qualify as a REIT If we fail to qualify for taxation as a REIT in any taxable year, we will be subject to U.S. federal income tax on our taxable income at regular corporate rates. Distributions to stockholders in any year in which we fail to qualify as a REIT will not be deductible by us. As a result, we anticipate that our failure to qualify as a REIT would reduce the cash available for distribution by us to our stockholders. In addition, if we fail to qualify as a REIT, we will not be required to distribute any amounts to our stockholders, and all distributions to stockholders will be taxable as regular corporate dividends to the extent of our current and accumulated earnings and profits and will not be eligible for the 20% deduction under Section 199A of the Code applicable to certain non-corporate shareholders, including individuals, prior to January 1, 2026. In such event, corporate stockholders may be eligible for the dividends-received deduction. In addition, non-corporate stockholders, including individuals, may be eligible for the preferential tax rates on qualified dividend income. If we fail to qualify as a REIT, such stockholders may not claim this deduction with respect to dividends paid by us. Unless entitled to relief under specific statutory provisions, we also will be disqualified from taxation as a REIT for the four taxable years following the year during which qualification was lost. It is not possible to state whether in all circumstances we would be entitled to statutory relief. Failure to qualify for even one year could result in our need to incur indebtedness or liquidate investments in order to pay potentially significant resulting tax liabilities.
In addition to the relief described above under “Income Tests” and “Asset Tests,” statutory relief is available in the event that we violate a provision of the Code that would result in our failure to qualify as a REIT if: (1) the violation is due to reasonable cause and not due to willful neglect; (2) we pay a penalty of $50,000 for each failure to satisfy the provision; and (3) the violation does not include a violation described under “Income Tests” or “Asset Tests” above. It is not now possible to determine the circumstances under which we may be entitled to the benefit of these relief provisions.
Material U.S. Federal Income Tax Consequences to Holders of Our Stock and the Debt Securities of the Company and Welltower OP
The following discussion is a summary of the material U.S. federal income tax consequences to you of acquiring, owning and disposing of stock of the Company or debt securities of the Company or Welltower OP. This discussion is limited to holders who hold stock of the Company or debt securities of the Company or Welltower OP as “capital assets” within the meaning of Section 1221 of the Code (generally, property held for investment). This discussion does not address all U.S. federal income tax consequences relevant to a holder’s particular circumstances, including the alternative minimum tax. In addition, except where specifically noted, it does not address consequences relevant to holders subject to special rules, including, without limitation:
U.S. expatriates and former citizens or long-term residents of the United States;
U.S. holders (as defined below) whose functional currency is not the U.S. dollar;
persons holding stock or debt securities as part of a hedge, straddle or other risk reduction strategy or as part of a conversion transaction or other integrated investment;
banks, insurance companies, and other financial institutions;
REITs or regulated investment companies;
brokers, dealers or traders in securities;
“controlled foreign corporations,” “passive foreign investment companies,” and corporations that accumulate earnings to avoid U.S. federal income tax;
S corporations, partnerships or other entities or arrangements treated as partnerships for U.S. federal income tax purposes (and investors therein);
tax-exempt organizations or governmental organizations;
persons subject to special tax accounting rules as a result of any item of gross income with respect to stock or debt securities being taken into account in an applicable financial statement;
persons deemed to sell stock or debt securities under the constructive sale provisions of the Code; and
persons who hold or receive our stock pursuant to the exercise of any employee stock option or otherwise as compensation.
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THIS DISCUSSION IS FOR INFORMATIONAL PURPOSES ONLY AND IS NOT INTENDED AS TAX ADVICE. INVESTORS SHOULD CONSULT THEIR TAX ADVISORS WITH RESPECT TO THE APPLICATION OF THE U.S. FEDERAL INCOME TAX LAWS TO THEIR PARTICULAR SITUATIONS AS WELL AS ANY TAX CONSEQUENCES OF THE ACQUISITION, OWNERSHIP AND DISPOSITION OF OUR STOCK OR DEBT SECURITIES ARISING UNDER OTHER U.S. FEDERAL TAX LAWS (INCLUDING ESTATE AND GIFT TAX LAWS), UNDER THE LAWS OF ANY STATE, LOCAL OR NON-U.S. TAXING JURISDICTION OR UNDER ANY APPLICABLE TAX TREATY.
For purposes of this discussion, a “U.S. holder” is a beneficial owner of stock of the Company or debt securities of the Company or Welltower OP that, for U.S. federal income tax purposes, is or is treated as:
an individual who is a citizen or resident of the United States;
an entity classified as a corporation for U.S. federal income tax purposes and created or organized under the laws of the United States, any state thereof or the District of Columbia;
an estate the income of which is subject to U.S. federal income tax regardless of its source; or
a trust that (1) is subject to the primary supervision of a U.S. court and the control of one or more “United States persons” (within the meaning of Section 7701(a)(30) of the Code) or (2) has a valid election in effect to be treated as a United States person for U.S. federal income tax purposes.
For purposes of this discussion, a “non-U.S. holder” is any beneficial owner of our stock or debt securities that is neither a U.S. holder nor an entity treated as a partnership for U.S. federal income tax purposes.
If an entity treated as a partnership for U.S. federal income tax purposes holds our stock or debt securities, the tax treatment of a partner in the partnership will depend on the status of the partner, the activities of the partnership and certain determinations made at the partner level. Accordingly, partnerships holding stock of the Company or debt securities of the Company or Welltower OP and the partners in such partnerships should consult their tax advisors regarding the U.S. federal income tax consequences to them.
Taxation of Taxable U.S. Holders of Our Stock
Distributions Generally Distributions out of our current or accumulated earnings and profits will be treated as dividends and, other than with respect to capital gain dividends and certain amounts which have previously been subject to corporate level tax, as discussed below, will be taxable to our taxable U.S. holders as ordinary income when actually or constructively received. See “Tax Rates” below. As long as we qualify as a REIT, these distributions will not be eligible for the dividends-received deduction in the case of U.S. holders that are corporations or, except to the extent described in “Tax Rates” below, the preferential rates on qualified dividend income applicable to non-corporate U.S. holders, including individuals. For purposes of determining whether distributions to holders of our stock are out of our current or accumulated earnings and profits, our earnings and profits will be allocated first to our outstanding preferred stock, if any, and then to our outstanding common stock.
To the extent that we make distributions on our stock in excess of our current and accumulated earnings and profits allocable to such stock, these distributions will be treated first as a tax-free return of capital to a U.S. holder to the extent of the U.S. holder’s adjusted tax basis in such shares of stock. This treatment will reduce the U.S. holder’s adjusted tax basis in such shares of stock by such amount, but not below zero. Distributions in excess of our current and accumulated earnings and profits and in excess of a U.S. holder’s adjusted tax basis in its shares will be taxable as capital gain. Such gain will be taxable as long-term capital gain if the shares have been held for more than one year. Dividends we declare in October, November, or December of any year and which are payable to a holder of record on a specified date in any of these months will be treated as both paid by us and received by the holder on December 31 of that year, provided we actually pay the dividend on or before January 31 of the following year. U.S. holders may not include in their own income tax returns any of our net operating losses or capital losses.
U.S. holders that receive taxable stock distributions, including distributions partially payable in our common stock and partially payable in cash, would be required to include the full amount of the distribution (i.e., the cash and the stock portion) as a dividend (subject to limited exceptions) to the extent of our current and accumulated earnings and profits for U.S. federal income tax purposes, as described above. The amount of any distribution payable in our common stock generally is equal to the amount of cash that could have been received instead of the common stock. Depending on the circumstances of a U.S. holder, the tax on the distribution may exceed the amount of the distribution received in cash, in which case such U.S. holder would have to pay the tax using cash from other sources. If a U.S. holder sells the common stock it received in connection with a taxable stock distribution in order to pay this tax and the proceeds of such sale are less than the amount required to be included in income with respect to the stock portion of the distribution, such U.S. holder could have a capital loss with respect to the stock sale that could not be used to offset such income. A U.S. holder that receives common stock pursuant to such distribution generally has a tax basis in such common stock equal to the amount of cash that could have been received instead of such common stock as described above, and has a holding period in such common stock that begins on the day immediately following the payment date for the distribution.
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Capital Gain Dividends Dividends that we properly designate as capital gain dividends will be taxable to our taxable U.S. holders as a gain from the sale or disposition of a capital asset held for more than one year, to the extent that such gain does not exceed our actual net capital gain for the taxable year. U.S. holders that are corporations may, however, be required to treat up to 20% of certain capital gain dividends as ordinary income.
Retention of Net Capital Gains We may elect to retain, rather than distribute as a capital gain dividend, all or a portion of our net capital gains. If we make this election, we would pay tax on our retained net capital gains. In addition, to the extent we so elect, our earnings and profits (determined for U.S. federal income tax purposes) would be adjusted accordingly, and a U.S. holder generally would:
include its pro rata share of our undistributed capital gain in computing its long-term capital gains in its U.S. federal income tax return for its taxable year in which the last day of our taxable year falls, subject to certain limitations as to the amount that is includable;
be deemed to have paid its share of the capital gains tax imposed on us on the designated amounts included in the U.S. holder’s income as long-term capital gain;
receive a credit or refund for the amount of tax deemed paid by it; and
increase the adjusted tax basis of its stock by the difference between the amount of includable gains and the tax deemed to have been paid by it.
In addition, a U.S. holder that is a corporation is required to appropriately adjust its earnings and profits for the retained capital gains in accordance with Treasury Regulations. These Treasury Regulations have not yet been promulgated so the appropriate method for making such adjustment is unclear.
Passive Activity Losses and Investment Interest Limitations Distributions we make and gain arising from the sale or exchange of our stock by a U.S. holder will not be treated as passive activity income. As a result, U.S. holders generally will not be able to apply any “passive losses” against this income or gain. A U.S. holder generally may elect to treat capital gain dividends, capital gains from the disposition of our stock and income designated as qualified dividend income, as described in “Tax Rates” below, as investment income for purposes of computing the investment interest limitation, but in such case, the holder will be taxed at ordinary income rates on such amount. Other distributions made by us, to the extent they do not constitute a return of capital, generally will be treated as investment income for purposes of computing the investment interest limitation.
Dispositions of Our Stock Except as described below under “Redemption or Repurchase by Us,” if a U.S. holder sells or disposes of shares of our stock, it will recognize gain or loss for U.S. federal income tax purposes in an amount equal to the difference between the amount of cash and the fair market value of any property received on the sale or other disposition of the shares and the holder’s adjusted tax basis in the shares. This gain or loss, except as provided below, will be long-term capital gain or loss if the holder has held such stock for more than one year. However, if a U.S. holder recognizes a loss upon the sale or other disposition of stock that it has held for six months or less, after applying certain holding period rules, the loss recognized will be treated as a long-term capital loss to the extent the U.S. holder received distributions from us which were required to be treated as long-term capital gains. The deductibility of capital losses is subject to limitations.
Redemption or Repurchase by Us A redemption or repurchase of shares of our stock will be treated under Section 302 of the Code as a distribution (and taxable as a dividend to the extent of our current and accumulated earnings and profits as described above under “Distributions Generally”) unless the redemption or repurchase satisfies one of the tests set forth in Section 302(b) of the Code and is therefore treated as a sale or exchange of the redeemed or repurchased shares. The redemption or repurchase generally will be treated as a sale or exchange if it:
is “substantially disproportionate” with respect to the U.S. holder,
results in a “complete redemption” of the U.S. holder’s stock interest in us, or
is “not essentially equivalent to a dividend” with respect to the U.S. holder,
all within the meaning of Section 302(b) of the Code.
In determining whether any of these tests has been met, shares of our stock, including common stock and other equity interests in us, considered to be owned by the U.S. holder by reason of certain constructive ownership rules set forth in the Code, as well as shares of our stock actually owned by the U.S. holder, generally must be taken into account. Because the determination as to whether any of the alternative tests of Section 302(b) of the Code will be satisfied with respect to the U.S. holder depends upon the facts and circumstances at the time that the determination must be made, U.S. holders are advised to consult their tax advisors to determine such tax treatment.
If a redemption or repurchase of shares of our stock is treated as a distribution, the amount of the distribution will be measured by the amount of cash and the fair market value of any property received. See “Distributions Generally.” A U.S. holder’s adjusted tax basis in the redeemed or repurchased shares generally will be transferred to the holder’s remaining shares
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of our stock, if any. If a U.S. holder owns no other shares of our stock, under certain circumstances, such basis may be transferred to a related person or it may be lost entirely. Prospective investors should consult their tax advisors regarding the U.S. federal income tax consequences of a redemption or repurchase of our stock.
If a redemption or repurchase of shares of our stock is not treated as a distribution, it will be treated as a taxable sale or exchange in the manner described under “Dispositions of Our Stock.”
Tax Rates Currently, the maximum tax rate for non-corporate taxpayers for (1) long-term capital gains, including certain “capital gain dividends,” generally is 20% (although depending on the characteristics of the assets which produced these gains and on designations which we may make, certain capital gain dividends may be taxed at a 25% rate) and (2) “qualified dividend income” generally is 20%. In general, dividends payable by REITs are not eligible for the reduced tax rate applicable to qualified dividend income, except to the extent that certain holding period requirements have been met and the REIT’s dividends are attributable to dividends received from taxable corporations (such as its taxable REIT subsidiaries) or to income that was subject to tax at the corporate/REIT level (for example, if the REIT distributed taxable income that it retained and paid tax on in the prior taxable year). Capital gain dividends will only be eligible for the rates described above to the extent that they are properly designated by us as “capital gain dividends.” As mentioned above, U.S. holders that are corporations may be required to treat up to 20% of some capital gain dividends as ordinary income. In addition, non-corporate U.S. holders, including individuals, generally may deduct up to 20% of dividends from a REIT, other than capital gain dividends and dividends treated as qualified dividend income, for taxable years beginning before January 1, 2026 for purposes of determining their U.S. federal income tax (but not for purposes of the 3.8% Medicare tax), subject to certain holding period requirements and other limitations.
Taxation of Tax-Exempt U.S. Holders of Our Stock
Dividend income from us and gain arising upon a sale of shares of our stock generally should not be unrelated business taxable income (“UBTI”) to a tax-exempt U.S. holder, except as described below. This income or gain will be UBTI, however, to the extent a tax-exempt U.S. holder holds its shares as “debt-financed property” within the meaning of the Code. Generally, “debt-financed property” is property the acquisition or holding of which was financed through a borrowing by the tax-exempt holder.
For tax-exempt U.S. holders that are social clubs, voluntary employee benefit associations or supplemental unemployment benefit trusts exempt from U.S. federal income taxation under Sections 501(c)(7), (c)(9) or (c)(17) of the Code, respectively, income from an investment in our shares will constitute UBTI unless the organization is able to properly claim a deduction for amounts set aside or placed in reserve for specific purposes so as to offset the income generated by its investment in our shares. These prospective investors should consult their tax advisors concerning these “set aside” and reserve requirements.
Notwithstanding the above, however, a portion of the dividends paid by a “pension-held REIT” may be treated as UBTI as to certain trusts that hold more than 10%, by value, of the interests in the REIT. A REIT will not be a “pension-held REIT” if it is able to satisfy the “not closely held” requirement without relying on the “look-through” exception with respect to certain trusts or if such REIT is not “predominantly held” by “qualified trusts.” As a result of restrictions on ownership and transfer of our stock contained in our charter, we do not expect to be classified as a “pension-held REIT,” and as a result, the tax treatment described above should be inapplicable to our holders. However, because our common stock is (and, we anticipate, will continue to be) publicly traded, we cannot guarantee that this will always be the case.
Taxation of Non-U.S. Holders of Our Stock
The following discussion addresses the rules governing U.S. federal income taxation of the acquisition, ownership and disposition of our stock by non-U.S. holders. These rules are complex, and no attempt is made herein to provide more than a brief summary of such rules. Accordingly, the discussion does not address all aspects of U.S. federal income taxation and does not address other U.S. federal, state, local or non-U.S. tax consequences that may be relevant to a non-U.S. holder in light of its particular circumstances. We urge non-U.S. holders to consult their tax advisors to determine the impact of U.S. federal, state, local and non-U.S. income and other tax laws and any applicable tax treaty on the acquisition, ownership and disposition of shares of our stock, including any reporting requirements.
Distributions Generally Distributions (including any taxable stock distributions) that are neither attributable to gains from sales or exchanges by us of United States real property interests (“USRPIs”) nor designated by us as capital gain dividends (except as described below) will be treated as dividends of ordinary income to the extent that they are made out of our current or accumulated earnings and profits. Such distributions ordinarily will be subject to withholding of U.S. federal income tax at a 30% rate or such lower rate as may be specified by an applicable income tax treaty, unless the distributions are treated as effectively connected with the conduct by the non-U.S. holder of a trade or business within the United States (and, if required by an applicable income tax treaty, the non-U.S. holder maintains a permanent establishment in the United States to which such dividends are attributable). Under certain treaties, however, lower withholding rates generally applicable to dividends do not apply to dividends from a REIT. Certain certification and disclosure requirements must be satisfied for a non-U.S. holder to be exempt from withholding under the effectively connected income exemption. Dividends that are treated as effectively connected with a U.S. trade or business generally will not be subject to withholding but will be subject to U.S. federal income tax on a net basis in the same manner as dividends paid to U.S. holders are subject to U.S. federal income tax. Any such
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dividends received by a non-U.S. holder that is a corporation may also be subject to an additional branch profits tax at a 30% rate (applicable after deducting U.S. federal income taxes paid on such effectively connected income) or such lower rate as may be specified by an applicable income tax treaty.
Except as otherwise provided below, we expect to withhold U.S. federal income tax at the rate of 30% on any distributions made to a non-U.S. holder unless:
(1) a lower treaty rate applies and the non-U.S. holder furnishes an IRS Form W-8BEN or W-8BEN-E (or other applicable documentation) evidencing eligibility for that reduced treaty rate; or
(2) the non-U.S. holder furnishes an IRS Form W-8ECI (or other applicable documentation) claiming that the distribution is income effectively connected with the non-U.S. holder’s trade or business.
Distributions in excess of our current and accumulated earnings and profits will not be taxable to a non-U.S. holder to the extent that such distributions do not exceed the adjusted tax basis of the holder’s stock, but rather will reduce the adjusted tax basis of such stock. To the extent that such distributions exceed the non-U.S. holder’s adjusted tax basis in such stock, they generally will give rise to gain from the sale or exchange of such stock, the tax treatment of which is described below. However, such excess distributions may be treated as dividend income for certain non-U.S. holders. For withholding purposes, we expect to treat all distributions as made out of our current or accumulated earnings and profits. However, amounts withheld may be refundable if it is subsequently determined that the distribution was, in fact, in excess of our current and accumulated earnings and profits, provided that certain conditions are met.
Capital Gain Dividends and Distributions Attributable to a Sale or Exchange of United States Real Property Interests Distributions to a non-U.S. holder that we properly designate as capital gain dividends, other than those arising from the disposition of a USRPI, generally should not be subject to U.S. federal income taxation, unless:
(1) the investment in our stock is treated as effectively connected with the conduct by the non-U.S. holder of a trade or business within the United States (and, if required by an applicable income tax treaty, the non-U.S. holder maintains a permanent establishment in the United States to which such dividends are attributable), in which case the non-U.S. holder will be subject to the same treatment as U.S. holders with respect to such gain, except that a non-U.S. holder that is a corporation may also be subject to a branch profits tax of up to 30%, as discussed above; or
(2) the non-U.S. holder is a nonresident alien individual who is present in the United States for 183 days or more during the taxable year and certain other conditions are met, in which case the non-U.S. holder will be subject to U.S. federal income tax at a rate of 30% on the non-U.S. holder’s capital gains (or such lower rate specified by an applicable income tax treaty), which may be offset by U.S. source capital losses of such non-U.S. holder (even though the individual is not considered a resident of the United States), provided the non-U.S. holder has timely filed U.S. federal income tax returns with respect to such losses.
Pursuant to the Foreign Investment in Real Property Tax Act, which is referred to as “FIRPTA,” distributions to a non-U.S. holder that are attributable to gain from sales or exchanges by us of USRPIs, whether or not designated as capital gain dividends, will cause the non-U.S. holder to be treated as recognizing such gain as income effectively connected with a U.S. trade or business. Non-U.S. holders generally would be taxed at the regular rates applicable to U.S. holders, subject to any applicable alternative minimum tax and a special alternative minimum tax in the case of nonresident alien individuals. We also will be required to withhold and to remit to the IRS 21% of any distribution to non-U.S. holders attributable to gain from sales or exchanges by us of USRPIs. Distributions subject to FIRPTA may also be subject to a 30% branch profits tax in the hands of a non-U.S. holder that is a corporation. The amount withheld is creditable against the non-U.S. holder’s U.S. federal income tax liability. However, any distribution with respect to any class of stock that is “regularly traded,” as defined by applicable Treasury Regulations, on an established securities market located in the United States is not subject to FIRPTA, and therefore, not subject to the 21% U.S. withholding tax described above, if the non-U.S. holder did not own more than 10% of such class of stock at any time during the one-year period ending on the date of the distribution. Instead, such distributions generally will be treated as ordinary dividend distributions and subject to withholding in the manner described above with respect to ordinary dividends. Furthermore, distributions to “qualified foreign pension funds” or entities all of the interests of which are held by “qualified pension funds” are exempt from FIRPTA. Non-U.S. holders should consult their tax advisors regarding the application of these rules.
Retention of Net Capital Gains Although the law is not clear on the matter, it appears that amounts we designate as retained net capital gains in respect of our stock should be treated with respect to non-U.S. holders as actual distributions of capital gain dividends. Under this approach, the non-U.S. holders may be able to offset as a credit against their U.S. federal income tax liability their proportionate share of the tax paid by us on such retained net capital gains and to receive from the IRS a refund to the extent their proportionate share of such tax paid by us exceeds their actual U.S. federal income tax liability. If we were to designate any portion of our net capital gain as retained net capital gain, non-U.S. holders should consult their tax advisors regarding the taxation of such retained net capital gain.
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Sale of Our Stock Except as described below under “Redemption or Repurchase by Us,” gain realized by a non-U.S. holder upon the sale, exchange or other taxable disposition of our stock generally will not be subject to U.S. federal income tax unless such stock constitutes a USRPI. In general, stock of a domestic corporation that is a “United States real property holding corporation,” or USRPHC, will constitute a USRPI. We believe that we are a USRPHC. Our stock will not, however, constitute a USRPI so long as we are a “domestically controlled qualified investment entity.” A “domestically controlled qualified investment entity” includes a REIT in which at all times during a five-year testing period less than 50% in value of its stock is held directly or indirectly by non-United States persons, subject to certain rules. For purposes of determining whether a REIT is a “domestically controlled qualified investment entity,” a person who at all applicable times holds less than 5% of a class of stock that is “regularly traded” is treated as a United States person unless the REIT has actual knowledge that such person is not a United States person. Because our common stock is (and, we anticipate, will continue to be) publicly traded, no assurance can be given that we are or will continue to be a “domestically controlled qualified investment entity.”
Even if we do not qualify as a “domestically controlled qualified investment entity” at the time a non-U.S. holder sells our stock, gain realized from the sale or other taxable disposition by a non-U.S. holder of such stock would not be subject to U.S. federal income tax under FIRPTA as a sale of a USRPI if:
(1) such class of stock is “regularly traded,” as defined by applicable Treasury Regulations, on an established securities market such as the New York Stock Exchange; and
(2) such non-U.S. holder owned, actually and constructively, 10% or less of such class of stock throughout the shorter of the five-year period ending on the date of the sale or other taxable disposition or the non-U.S. holder’s holding period.
In addition, dispositions of our stock by “qualified foreign pension funds” or entities all of the interests of which are held by “qualified foreign pension funds” are exempt from FIRPTA. Non-U.S. holders should consult their tax advisors regarding the application of these rules.
Notwithstanding the foregoing, gain from the sale, exchange or other taxable disposition of our stock not otherwise subject to FIRPTA will be taxable to a non-U.S. holder if either (a) the investment in our stock is treated as effectively connected with the conduct by the non-U.S. holder of a trade or business within the United States (and, if required by an applicable income tax treaty, the non-U.S. holder maintains a permanent establishment in the United States to which such gain is attributable), in which case the non-U.S. holder will be subject to the same treatment as U.S. holders with respect to such gain, except that a non-U.S. holder that is a corporation may also be subject to the 30% branch profits tax (or such lower rate as may be specified by an applicable income tax treaty) on such gain, as adjusted for certain items, or (b) the non-U.S. holder is a nonresident alien individual who is present in the United States for 183 days or more during the taxable year and certain other conditions are met, in which case the non-U.S. holder will be subject to a 30% tax on the non-U.S. holder’s capital gains (or such lower rate specified by an applicable income tax treaty), which may be offset by U.S. source capital losses of the non-U.S. holder (even though the individual is not considered a resident of the United States), provided the non-U.S. holder has timely filed U.S. federal income tax returns with respect to such losses. In addition, even if we are a domestically controlled qualified investment entity, upon disposition of our stock, a non-U.S. holder may be treated as having gain from the sale or other taxable disposition of a USRPI if the non-U.S. holder (1) disposes of such stock within a 30-day period preceding the ex-dividend date of a distribution, any portion of which, but for the disposition, would have been treated as gain from the sale or exchange of a USRPI and (2) acquires, or enters into a contract or option to acquire, or is deemed to acquire, other shares of that stock during the 61-day period beginning with the first day of the 30-day period described in clause (1), unless such class of stock is “regularly traded” and the non-U.S. holder did not own more than 10% of such class of stock at any time during the one-year period ending on the date of the distribution described in clause (1).
If gain on the sale, exchange or other taxable disposition of our stock were subject to taxation under FIRPTA or otherwise as a result of being effectively connected with the conduct by the non-U.S. holder of a trade or business within the United States, the non-U.S. holder would be required to file a U.S. federal income tax return and would be subject to regular U.S. federal income tax with respect to such gain in the same manner as a taxable U.S. holder (subject to any applicable alternative minimum tax and a special alternative minimum tax in the case of nonresident alien individuals). In addition, if the sale, exchange or other taxable disposition of our stock were subject to taxation under FIRPTA, and if shares of the applicable class of our stock were not “regularly traded” on an established securities market, the purchaser of such stock generally would be required to withhold and remit to the IRS 15% of the purchase price.
Redemption or Repurchase by Us A redemption or repurchase of shares of our stock will be treated under Section 302 of the Code as a distribution (and taxable as a dividend to the extent of our current and accumulated earnings and profits) unless the redemption or repurchase satisfies one of the tests set forth in Section 302(b) of the Code and is therefore treated as a sale or exchange of the redeemed or repurchased shares. See “Redemption or Repurchase by Us” under “Taxation of Taxable U.S. Holders of Our Stock” above. Qualified shareholders and their owners may be subject to different rules, and should consult their tax advisors regarding the application of such rules. If the redemption or repurchase of shares is treated as a distribution, the amount of the distribution will be measured by the amount of cash and the fair market value of any property received. See “Distributions Generally” above. If the redemption or repurchase of shares is not treated as a distribution, it will be treated as a taxable sale or exchange in the manner described above under “- Sale of Our Stock.”
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Taxation of Holders of Debt Securities of the Company or Welltower OP
The following summary describes the material U.S. federal income tax consequences of acquiring, owning and disposing of debt securities of the Company or Welltower OP. This discussion assumes the debt securities will be issued with less than a statutory de minimis amount of original issue discount for U.S. federal income tax purposes. In addition, this discussion is limited to persons purchasing the debt securities for cash at original issue and at their original “issue price” within the meaning of Section 1273 of the Code (i.e., the first price at which a substantial amount of the debt securities is sold to the public for cash).
U.S. Holders
Payments of Interest. Interest on a debt security generally will be taxable to a U.S. holder as ordinary income at the time such interest is received or accrued, in accordance with such U.S. holder’s method of accounting for U.S. federal income tax purposes.
Sale or Other Taxable Disposition A U.S. holder will recognize gain or loss on the sale, exchange, redemption, retirement or other taxable disposition of a debt security. The amount of such gain or loss generally will be equal to the difference between the amount received for the debt security in cash or other property valued at fair market value (less amounts attributable to any accrued but unpaid interest, which will be taxable as interest to the extent not previously included in income) and the U.S. holder’s adjusted tax basis in the debt security. A U.S. holder’s adjusted tax basis in a debt security generally will be equal to the amount the U.S. holder paid for the debt security. Any gain or loss generally will be capital gain or loss, and will be long-term capital gain or loss if the U.S. holder has held the debt security for more than one year at the time of such sale or other taxable disposition. Otherwise, such gain or loss will be short-term capital gain or loss. Long-term capital gains recognized by certain non-corporate U.S. holders, including individuals, generally will be taxable at reduced rates. The deductibility of capital losses is subject to limitations.
Non-U.S. Holders
Payments of Interest. Interest paid on a debt security to a non-U.S. holder that is not effectively connected with the non-U.S. holder’s conduct of a trade or business within the United States generally will not be subject to U.S. federal income tax or withholding, provided that:
the non-U.S. holder does not, actually or constructively, own 10% or more of the total combined voting power of all classes of our voting stock or 10% or more of the profits or capital in Welltower OP;
the non-U.S. holder is not a controlled foreign corporation related to us through actual or constructive stock ownership; and
either (1) the non-U.S. holder certifies in a statement provided to the applicable withholding agent under penalties of perjury that it is not a United States person and provides its name and address; (2) a securities clearing organization, bank or other financial institution that holds customers’ securities in the ordinary course of its trade or business and holds the debt security on behalf of the non-U.S. holder certifies to the applicable withholding agent under penalties of perjury that it, or the financial institution between it and the non-U.S. holder, has received from the non-U.S. holder a statement under penalties of perjury that such holder is not a United States person and provides the applicable withholding agent with a copy of such statement; or (3) the non-U.S. holder holds its debt security directly through a “qualified intermediary” (within the meaning of the applicable Treasury Regulations) and certain conditions are satisfied.
If a non-U.S. holder does not satisfy the requirements above, such non-U.S. holder will be subject to withholding tax of 30%, subject to a reduction in or an exemption from withholding on such interest as a result of an applicable tax treaty. To claim such entitlement, the non-U.S. holder must provide the applicable withholding agent with a properly executed IRS Form W-8BEN or W-8BEN-E (or other applicable documentation) claiming a reduction in or exemption from withholding tax under the benefit of an income tax treaty between the United States and the country in which the non-U.S. holder resides or is established.
If interest paid to a non-U.S. holder is effectively connected with the non-U.S. holder’s conduct of a trade or business within the United States (and, if required by an applicable income tax treaty, the non-U.S. holder maintains a permanent establishment in the United States to which such interest is attributable), the non-U.S. holder will be exempt from the U.S. federal withholding tax described above. To claim the exemption, the non-U.S. holder must furnish to the applicable withholding agent a valid IRS Form W-8ECI, certifying that interest paid on a debt security is not subject to withholding tax because it is effectively connected with the conduct by the non-U.S. holder of a trade or business within the United States.
Any such effectively connected interest generally will be subject to U.S. federal income tax at the regular rates. A non-U.S. holder that is a corporation may also be subject to a branch profits tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty) on such effectively connected interest, as adjusted for certain items.
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The certifications described above must be provided to the applicable withholding agent prior to the payment of interest and must be updated periodically. Non-U.S. holders that do not timely provide the applicable withholding agent with the required certification, but that qualify for a reduced rate under an applicable income tax treaty, may obtain a refund of any excess amounts withheld by timely filing an appropriate claim for refund with the IRS. Non-U.S. holders should consult their tax advisors regarding their entitlement to benefits under any applicable income tax treaty.
Sale or Other Taxable Disposition A non-U.S. holder will not be subject to U.S. federal income tax on any gain realized upon the sale, exchange, redemption, retirement or other taxable disposition of a debt security (such amount excludes any amount allocable to accrued and unpaid interest, which generally will be treated as interest and may be subject to the rules discussed above in “Payments of Interest”) unless:
the gain is effectively connected with the non-U.S. holder’s conduct of a trade or business within the United States (and, if required by an applicable income tax treaty, the non-U.S. holder maintains a permanent establishment in the United States to which such gain is attributable); or
the non-U.S. holder is a nonresident alien individual present in the United States for 183 days or more during the taxable year of the disposition and certain other requirements are met.
Gain described in the first bullet point above generally will be subject to U.S. federal income tax on a net income basis at the regular rates. A non-U.S. holder that is a corporation also may be subject to a branch profits tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty) on such effectively connected gain, as adjusted for certain items.
A non-U.S. holder described in the second bullet point above will be subject to U.S. federal income tax at a rate of 30% (or such lower rate specified by an applicable income tax treaty) on gain realized upon the sale or other taxable disposition of a debt security, which may be offset by U.S. source capital losses of the non-U.S. holder (even though the individual is not considered a resident of the United States), provided the non-U.S. holder has timely filed U.S. federal income tax returns with respect to such losses.
Non-U.S. holders should consult their tax advisors regarding any applicable income tax treaties that may provide for different rules.
Information Reporting and Backup Withholding
U.S. Holders A U.S. holder may be subject to information reporting and backup withholding when such holder receives payments on stock of the Company or debt securities of the Company or Welltower OP or proceeds from the sale or other taxable disposition of such stock or debt securities (including a redemption or retirement of a debt security). Certain U.S. holders are exempt from backup withholding, including corporations and certain tax-exempt organizations. A U.S. holder will be subject to backup withholding if such holder is not otherwise exempt and:
the holder fails to furnish the holder’s taxpayer identification number, which for an individual is ordinarily his or her social security number;
the holder furnishes an incorrect taxpayer identification number;
the applicable withholding agent is notified by the IRS that the holder previously failed to properly report payments of interest or dividends; or
the holder fails to certify under penalties of perjury that the holder has furnished a correct taxpayer identification number and that the IRS has not notified the holder that the holder is subject to backup withholding.
Backup withholding is not an additional tax. Any amounts withheld under the backup withholding rules may be allowed as a refund or a credit against a U.S. holder’s U.S. federal income tax liability, provided the required information is timely furnished to the IRS. U.S. holders should consult their tax advisors regarding their qualification for an exemption from backup withholding and the procedures for obtaining such an exemption.
Non-U.S. Holders Payments of dividends on stock of the Company or interest on debt securities of the Company or Welltower OP generally will not be subject to backup withholding, provided the applicable withholding agent does not have actual knowledge or reason to know the holder is a United States person and the holder either certifies its non-U.S. status, such as by furnishing a valid IRS Form W-8BEN, W-8BEN-E or W-8ECI, or otherwise establishes an exemption. However, information returns are required to be filed with the IRS in connection with any distributions on stock of the Company or interest on debt securities of the Company or Welltower OP paid to the non-U.S. holder, regardless of whether such distributions constitute a dividend or whether any tax was actually withheld. In addition, proceeds of the sale or other taxable disposition of such stock or debt securities (including a retirement or redemption of a debt security) within the United States or conducted through certain U.S.-related brokers generally will not be subject to backup withholding or information reporting if the applicable withholding agent receives the certification described above and does not have actual knowledge or reason to know that such holder is a United States person, or the holder otherwise establishes an exemption. Proceeds of a disposition of such stock or debt securities conducted through a non-U.S. office of a non-U.S. broker generally will not be subject to backup withholding or information reporting.
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Copies of information returns that are filed with the IRS may also be made available under the provisions of an applicable treaty or agreement to the tax authorities of the country in which the non-U.S. holder resides or is established.
Backup withholding is not an additional tax. Any amounts withheld under the backup withholding rules may be allowed as a refund or a credit against a non-U.S. holder’s U.S. federal income tax liability, provided the required information is timely furnished to the IRS.
Medicare Contribution Tax on Unearned Income
Certain U.S. holders that are individuals, estates or trusts are required to pay an additional 3.8% tax on, among other things, dividends on stock, interest on debt obligations, and capital gains from the sale or other disposition of stock or debt obligations, subject to certain limitations. U.S. holders should consult their tax advisors regarding the effect, if any, of these rules on their ownership and disposition of our stock or debt securities.
Additional Withholding Tax on Payments Made to Non-U.S. Accounts
Withholding taxes may be imposed under Sections 1471 to 1474 of the Code (such sections commonly referred to as the Foreign Account Tax Compliance Act (“FATCA”)) on certain types of payments made to non-U.S. financial institutions and certain other non-U.S. entities. Specifically, a 30% withholding tax may be imposed on dividends on stock of the Company, interest on debt securities of the Company or Welltower OP, in each case paid to a “foreign financial institution” or a “non-financial foreign entity” (each as defined in the Code), unless (1) the foreign financial institution undertakes certain diligence and reporting obligations, (2) the non-financial foreign entity either certifies it does not have any “substantial United States owners” (as defined in the Code) or furnishes identifying information regarding each substantial United States owner, or (3) the foreign financial institution or non-financial foreign entity otherwise qualifies for an exemption from these rules. If the payee is a foreign financial institution and is subject to the diligence and reporting requirements in clause (1) above, it must enter into an agreement with the U.S. Department of the Treasury requiring, among other things, that it undertake to identify accounts held by certain “specified United States persons” or “United States owned foreign entities” (each as defined in the Code), annually report certain information about such accounts, and withhold 30% on certain payments to non-compliant foreign financial institutions and certain other account holders. Foreign financial institutions located in jurisdictions that have an intergovernmental agreement with the United States governing FATCA may be subject to different rules.
Under the applicable Treasury Regulations and administrative guidance, withholding under FATCA generally applies to payments of dividends on stock of the Company or interest on debt securities of the Company or Welltower OP. While withholding under FATCA would have applied also to payments of gross proceeds from the sale or other disposition of stock or debt securities on or after January 1, 2019, proposed Treasury Regulations eliminate FATCA withholding on payments of gross proceeds entirely. Taxpayers generally may rely on these proposed Treasury Regulations until final Treasury Regulations are issued. Because we may not know the extent to which a distribution is a dividend for U.S. federal income tax purposes at the time it is made, for purposes of these withholding rules we may treat the entire distribution as a dividend.
Non-U.S. holders should consult their tax advisors regarding the potential application of withholding under FATCA to their investment in stock of the Company or debt securities of the Company or Welltower OP.
Other Tax Consequences
State, local and non-U.S. income tax laws may differ substantially from the corresponding U.S. federal income tax laws, and this discussion does not purport to describe any aspect of the tax laws of any state, local or non-U.S. jurisdiction, or any U.S. federal tax other than income tax. You should consult your tax advisor regarding the effect of state, local and non-U.S. tax laws with respect to our tax treatment as a REIT and on an investment in our stock or debt securities.
In addition, the tax laws and regulations in non-U.S. jurisdictions may impose costs and expenses on the Company, its subsidiaries, and assets and investments of the Company held in non-U.S. jurisdictions (including the costs of compliance with and filings under applicable laws, rules and regulations). The Company has substantial assets, and will likely be subject to tax, reporting, legal, regulatory, and other obligations, in the U.K. and Canada. The treatment of an entity for U.S. federal income tax purposes may not be determinative of its treatment for certain state, local, or non-U.S. tax purposes.
Tax Aspects of Our Investments in Welltower OP and Subsidiary Partnerships
The following discussion summarizes certain U.S. federal income tax considerations applicable to our direct or indirect investments in subsidiary partnerships (including Welltower OP).
Classification as Partnerships We are required to include in our income our distributive share of Welltower OP’s and Subsidiary Partnerships’ income and are entitled to deduct our distributive share of Welltower OP’s and Subsidiary Partnerships’ losses only if the applicable partnership is classified for U.S. federal income tax purposes as a partnership rather than as a corporation or association taxable as a corporation. An organization will be classified as a partnership, rather than as a corporation, for U.S. federal income tax purposes if it (1) is treated as a partnership under Treasury regulations relating to entity classification (the “check-the-box regulations”) and (2) is not a “publicly traded partnership” taxable as a corporation.
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Under the check-the-box regulations, an unincorporated entity with at least two members may elect to be classified either as an association taxable as a corporation or as a partnership. Generally, if such an entity fails to make an election, it generally will be treated as a partnership for U.S. federal income tax purposes. We believe that Welltower OP is classified as a partnership for U.S. federal income tax purposes.
A publicly traded partnership is a partnership whose interests are traded on an established securities market or are readily tradable on a secondary market (or the substantial equivalent thereof). While interests in Welltower OP and Subsidiary Partnerships will not be traded on an established securities market, they could possibly be deemed to be traded on a secondary market or its equivalent due to the redemption rights enabling the limited members to dispose of their interests. A publicly traded partnership will not, however, be treated as a corporation for any taxable year if 90% or more of the partnership’s gross income for such year consists of certain passive-type income, including (as may be relevant here) real property rents, gains from the sale or other disposition of real property, interest, and dividends (the “90% Passive Income Exception”). The income requirements applicable to us in order for us to qualify as a REIT under the Code and the definition of qualifying income under the Passive Income Exception are very similar. Although differences exist between these two income tests, we do not believe that these differences would cause Welltower OP or Subsidiary Partnerships not to satisfy the 90% Passive Income Exception applicable to publicly traded partnerships.
If for any reason Welltower OP or a Subsidiary Partnership were taxable as a corporation, rather than as a partnership, for U.S. federal income tax purposes, our ability to qualify as a REIT could be jeopardized. See “Income Tests” and “Asset Tests.” In addition, any change in Welltower OP’s or a Subsidiary Partnership’s status for tax purposes might be treated as a taxable event, in which case we might incur tax liability without any related cash distribution. See “Annual Distribution Requirements.” Further, items of income and deduction of Welltower OP or a Subsidiary Partnership would not pass through to its members, and its members would be treated as shareholders for tax purposes. Consequently, Welltower OP or a Subsidiary Partnership would be required to pay income tax at corporate tax rates on its net income, and distributions to its members would constitute dividends that would not be deductible in computing such Welltower OP’s or Subsidiary Partnership’s taxable income.
Members, Not Partnership, Subject to Tax Except as discussed below in “Revised Partnership Audit Rules,” a partnership itself is not a taxable entity for U.S. federal income tax purposes. Rather, we are required to take into account our allocable share of each partnership’s income, gains, losses, deductions and credits for any taxable year of the partnership ending during our taxable year, without regard to whether we have received or will receive any distribution from such partnership.
Partnership Allocations Although a partnership agreement generally will determine the allocation of income and losses among partners, such allocations will be disregarded for tax purposes if they do not comply with the provisions of Section 704(b) of the Code and the Treasury regulations promulgated thereunder. If an allocation is not recognized for U.S. federal income tax purposes, the item subject to the allocation will be reallocated in accordance with the partners’ interests in the partnership, which will be determined by considering all of the facts and circumstances relating to the economic arrangement of the partners with respect to such item. Welltower OP’s and each Subsidiary Partnerships’ allocations of taxable income, gain and loss are intended to comply with the requirements of Section 704(b) of the Code and the Treasury regulations promulgated thereunder.
Tax Allocations with Respect to Certain Properties Pursuant to Section 704(c) of the Code, income, gain, loss and deduction attributable to appreciated or depreciated property that is contributed to a partnership in exchange for an interest in the partnership must be allocated in a manner such that the contributing partner is charged with, or benefits from, respectively, the unrealized gain or unrealized loss associated with the property at the time of the contribution. The amount of such unrealized gain or unrealized loss is generally equal to the difference between the fair market value of contributed property at the time of contribution and the adjusted tax basis of such property at the time of contribution (a “Book-Tax Difference”). Such allocations are solely for U.S. federal income tax purposes and do not affect the book capital accounts or other economic or legal arrangements among the partners. Welltower OP’s partnership agreement requires such allocations to be made in a manner permitted under Section 704(c) of the Code.
In general, the members who contribute property to Welltower OP will be allocated depreciation deductions for tax purposes which are lower than such deductions would be if determined on a pro rata basis. In addition, in the event of the disposition of any of the contributed assets (including our properties) which have a Book-Tax Difference, all gain or loss attributable to such Book-Tax Difference (to the extent not previously taken into account) will generally be allocated to the contributing members, including us, and other members will generally be allocated only their share of income attributable to gain or loss, if any, occurring after such contribution. This will tend to eliminate the Book-Tax Difference over the life of Welltower OP. However, the special allocation rules of Section 704(c) do not always entirely eliminate the Book-Tax Difference on an annual basis or with respect to a specific taxable transaction such as a sale. Thus, the carryover basis of the contributed assets in the hands of Welltower OP may cause us to be allocated lower depreciation and other deductions, and possibly an amount of taxable gain in the event of a sale of such contributed assets in excess of the economic or book income allocated to us as a result of such sale.

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A Book-Tax Difference may also arise as a result of the revaluation of property owned by a partnership in connection with certain types of transactions, including in connection with certain non-pro rata contributions of assets to, or distributions of assets by, Welltower OP in exchange for, or in redemption of, interests in Welltower OP. In the event of such a revaluation, the members (including us) who were members in the partnership immediately prior to the revaluation will be required to take any Book-Tax Difference created as a result of such revaluation into account in substantially the same manner as under the Section 704(c) rules discussed above. This would result in us being allocated income, gain, loss and deduction for tax purposes in amounts different than the economic or book income allocated to us by the partnership.
The application of Section 704(c) to Welltower OP may cause us to recognize taxable income in excess of cash proceeds, which might adversely affect our ability to comply with the REIT distribution requirements. See “Annual Distribution Requirements.” The foregoing principles also apply in determining our earnings and profits for purposes of determining the portion of distributions taxable as dividend income. The application of these rules over time may result in a higher portion of distributions being taxed as dividends than would have occurred had we purchased the contributed or revalued assets at their agreed values.
The IRS has issued regulations requiring partnerships to use a “reasonable method” for allocating items affected by Section 704(c) of the Code and outlining several reasonable allocation methods. We have the discretion to determine which of the methods of accounting for Book-Tax Differences (specifically approved in the Treasury regulations) will be elected with respect to any properties contributed to or revalued by Welltower OP. We have not determined which method of accounting for Book-Tax Differences will be elected for properties contributed to or revalued by Welltower OP in the future.
Basis in Partnership Interest Our adjusted tax basis in a partnership interest generally is equal to:
the amount of cash and the adjusted tax basis of any other property contributed (or deemed contributed) by us to the partnership,
increased by our allocable share of the partnership’s income, and
reduced, but not below zero, by
our allocable share of the partnership’s loss, and
the amount of cash and the basis of any property distributed (or deemed distributed) to us.
If the allocation of our distributive share of the partnership’s loss would reduce the adjusted tax basis of our partnership interest in the partnership below zero, the recognition of such loss will be deferred until such time as the recognition of such loss would not reduce our adjusted tax basis below zero. To the extent that the partnership’s distributions (including deemed distributions) would reduce our adjusted tax basis below zero, such distributions would constitute taxable gain to us, which could be treated as ordinary income or long-term or short-term capital gain.
Partnership Audit Rules A partnership (and not its partners) must pay any “imputed underpayments,” consisting of delinquent taxes, interest, and penalties deemed to arise out of an audit of the partnership, unless certain alternative methods are available and the partnership elects to utilize them. The IRS has issued regulations providing details on many of these provisions, but it is still not entirely clear how all of these rules will be implemented. Accordingly, it is possible that in the future, we and/or any partnership in which we are a partner could be subject to, or otherwise bear the economic burden of, U.S. federal income tax, interest, and penalties resulting from a U.S. federal income tax audit.
Internet Access to Our SEC Filings
Our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and amendments to those reports, as well as our proxy statements and other materials that are filed with, or furnished to, the Securities and Exchange Commission (“SEC”) are made available, free of charge, on the Internet at www.welltower.com/investors, as soon as reasonably practicable after they are filed with, or furnished to, the SEC. We routinely post important information on our website at www.welltower.com in the “Investors” section, including corporate and investor presentations and financial information. We intend to use our website as a means of disclosing material, non-public information and for complying with our disclosure obligations under Regulation FD. Such disclosures will be included on our website under the heading “Investors.” Accordingly, investors should monitor such portion of our website in addition to following our press releases, public conference calls, and filings with the SEC. 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.
Cautionary Statement Regarding Forward-Looking Statements
This Annual Report on Form 10-K and the documents incorporated by reference contain statements that constitute “forward-looking statements,” within the meaning of the Private Securities Litigation Reform Act of 1995. When we use words such as “may,” “will,” “intend,” “should,” “believe,” “expect,” “anticipate,” “project,” “estimate” or similar expressions that do not relate solely to historical matters, we are making forward-looking statements. In particular, these forward-looking statements include, but are not limited to, those relating to our opportunities to acquire, develop or sell properties; our ability to close our
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anticipated acquisitions, investments or dispositions on currently anticipated terms, or within currently anticipated timeframes; the expected performance of our operators/tenants and properties; our expected occupancy rates; our ability to declare and to make distributions to stockholders; our investment and financing opportunities and plans; our continued qualification as a REIT; and our ability to access capital markets or other sources of funds. 
Forward-looking statements are not guarantees of future performance and involve risks and uncertainties that may cause our actual results to differ materially from our expectations discussed in the forward-looking statements. This may be a result of various factors, including, but not limited to:
status of the economy;
the status of capital markets, including availability and cost of capital;
issues facing the health care industry, including compliance with, and changes to, regulations and payment policies, responding to government investigations and punitive settlements and operators’/tenants’ difficulty in cost-effectively obtaining and maintaining adequate liability and other insurance;
changes in financing terms;
competition within the health care and seniors housing industries;
negative developments in the operating results or financial condition of operators/tenants, including, but not limited to, their ability to pay rent and repay loans;
our ability to transition or sell properties with profitable results;
the failure to make new investments or acquisitions as and when anticipated;
natural disasters, health emergencies (such as the COVID-19 pandemic) and other acts of God affecting our properties;
our ability to re-lease space at similar rates as vacancies occur;
our ability to timely reinvest sale proceeds at similar rates to assets sold;
operator/tenant or joint venture partner bankruptcies or insolvencies;
the cooperation of joint venture partners;
government regulations affecting Medicare and Medicaid reimbursement rates and operational requirements;
liability or contract claims by or against operators/tenants;
unanticipated difficulties and/or expenditures relating to future investments or acquisitions;
environmental laws affecting our properties;
changes in rules or practices governing our financial reporting;
the movement of U.S. and foreign currency exchange rates;
our ability to maintain our qualification as a REIT;
key management personnel recruitment and retention; and
the risks described under “Item 1A — Risk Factors.”
We undertake no obligation to update or revise publicly any forward-looking statements, whether because of new information, future events, or otherwise.
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Item 1A. Risk Factors
Risk Factor Summary
The following summarizes the principal factors that make an investment in our company speculative or risky, all of which are more fully described in the Risk Factors section below. This summary should be read in conjunction with the Risk Factors section and should not be relied upon as an exhaustive summary of the material risks facing our business. The order of presentation is not necessarily indicative of the level of risk that each factor poses to us.
Risks Arising from Our Business:
Our business model and the operations of our business involve risks, including those related to:
investments in and acquisitions of health care and seniors housing properties;
unknown liability exposure related to acquired properties;
competition for acquisitions may result in increased prices;
our joint venture partners;
Seniors Housing Operating properties operational risks;
our ability to terminate our management agreements with Seniors Housing Operating managers;
operational and legal risks with respect to our properties managed in RIDEA structures;
the ability of operators and tenants to make payments to us;
the impacts of severe cold and flu seasons or other widespread illnesses on occupancy;
the insolvency or bankruptcy of our tenants, operators, borrowers, managers and other obligors;
our ability to timely reinvest our sale proceeds on terms acceptable to us;
any adverse developments in the business or financial condition of Sunrise and Integra;
any failure, inability or unwillingness by Integra to satisfy obligations under their agreements with us;
ownership of property outside the U.S.;
our ability to lease or sell properties on favorable terms;
tenant, operator and manager insurance coverage;
loss of properties owned through ground leases upon breach or termination of the ground leases;
requirements of, or changes to governmental reimbursement programs, such as Medicare, Medicaid or government funding;
controls imposed on certain of our tenants who provide health care services that are reimbursed by Medicare, Medicaid and other third-party payors to reduce admissions and length of stay;
our operators’ or tenants’ failure to comply with federal, state, province, local, and industry-regulated licensure, certification and inspection laws, regulations, and standards;
development, redevelopment and construction;
bank failures or other events affecting financial institutions;
losses caused by severe weather conditions, natural disasters or the physical effects of climate change;
costs incurred to remediate environmental contamination at our properties;
our reliance on data and technology systems and the increasing risks of cybersecurity incidents;
evolving privacy regulations;
ESG-related commitments and expectations;
our dependence on key personnel; and
Welltower's holding company status.
Risks Arising from Our Capital Structure
Our capital structure involves exposure to risks, including those related to:
our future leverage;
the availability of cash for distributions to stockholders;
covenants in our debt agreements;
limitations on our ability to access capital;
any downgrades in our credit ratings; and
increases in interest rates.
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Risks Arising from Our Status as a REIT
As a result of our status as a REIT, we are exposed to risks, including those related to:
our ability to remain qualified as a REIT;
Welltower OP's ability to maintain status of a partnership;
the ability of our subsidiaries to qualify as a REIT;
the impact of tax imposed on any net income from "prohibited transactions" may limit our ability to engage in transactions which would be treated as sales for federal income tax purposes;
the impact of the 90% annual distribution requirement on our liquidity and ability to engage in otherwise beneficial transactions;
our limited ability to use taxable REIT subsidiaries under the Code;
special requirements applicable to the lease of qualified health care properties to a taxable REIT subsidiary;
the tax imposed on any net income from "prohibited transactions";
tax consequences if certain sale-leaseback transactions are not characterized by the IRS as “true leases";
changes in our tax rate or exposure to additional tax liabilities; and
the impact to our TRSs of the Corporate Alternative Minimum Tax imposed by the Inflation Reduction Act of 2022.
Risks Factors
This section highlights significant factors, events and uncertainties that could create risk with an investment in our securities. The events and consequences discussed in these risk factors could, in circumstances we may not be able to accurately predict, recognize or control, have a material adverse effect on our business, growth, reputation, prospects, financial condition, operating results, cash flows, liquidity, ability to pay dividends and stock price. These risk factors do not identify all risks that we face: our operations could also be affected by factors, events or uncertainties that are not presently known to us or that we currently do not consider to present significant risks to our operations. We group these risk factors into three categories:
Risks arising from our business;
Risks arising from our capital structure; and
Risks arising from our status as a REIT. 
Risks Arising from Our Business
Our investments in and acquisitions of health care and seniors housing properties may be unsuccessful or fail to meet our expectations 
Some of our acquisitions may not prove to be successful. We could encounter unanticipated difficulties and expenditures relating to any acquired properties, including contingent liabilities, and acquired properties might require significant management attention that would otherwise be devoted to our ongoing business. If we agree to provide construction funding to an operator/tenant and the project is not completed, we may need to take steps to ensure completion of the project. Such expenditures may negatively affect our results of operations. Investments in and acquisitions of seniors housing and health care properties entail risks associated with real estate investments generally, including risks that the investment will not achieve expected returns, that the cost estimates for necessary property improvements will prove inaccurate or that the tenant, operator or manager will fail to meet performance expectations. Furthermore, there can be no assurance that our anticipated acquisitions and investments, the completion of which is subject to various conditions, will be consummated in accordance with anticipated timing, on anticipated terms, or at all. We may be unable to obtain or assume financing for acquisitions on favorable terms or at all. Health care properties are often highly customizable, and the development or redevelopment of such properties may require costly tenant-specific improvements. The actual costs of development or redevelopment may be greater than our estimates. We have experienced delays and disruptions to property redevelopment as a result of supply chain issues and construction material and labor shortages and may experience additional or more significant such delays in the future. We also may be unable to quickly and efficiently integrate new acquisitions, particularly acquisitions of portfolios of properties, into our existing operations, and this could have an adverse effect on our results of operations and financial condition. Acquired properties may be located in new markets, either within or outside the United States, where we may face risks associated with a lack of market knowledge or understanding of the local economy, lack of business relationships in the area, costs associated with opening a new regional office and unfamiliarity with local governmental and permitting procedures. These risks may be exacerbated by the volume and complexity of such activity, as well as geopolitical tension or instability, inflationary pressures, interest rate fluctuations and supply chain disruptions. As a result, we cannot assure you that we will achieve the economic benefit we expect from acquisitions, investment, development and redevelopment opportunities and may lead to impairment of such assets. 

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Acquired properties may expose us to unknown liability
We may acquire properties or invest in joint ventures that own properties subject to liabilities and without any recourse, or with only limited recourse, against the prior owners or other third parties with respect to unknown liabilities. As a result, if a liability were asserted against us based upon ownership of those properties, we might have to pay substantial sums to settle or contest it, which could adversely affect our results of operations and cash flow. Unknown liabilities with respect to acquired properties might include: liabilities for clean-up of undisclosed environmental contamination, claims by tenants, vendors or other persons against the former owners of the properties, liabilities incurred in the ordinary course of business and claims for indemnification by general partners, directors and others indemnified by the former owners of the properties.
Competition for acquisitions may result in increased prices for properties
In order to maintain current revenues and continue generating attractive returns, we seek to reinvest cash available from the proceeds of sales of our securities, principal payments on our loans receivable or the sale of properties, including non-elective dispositions in a timely manner. We face competition for acquisition opportunities from other well-capitalized investors, including publicly traded and privately held REITs, private real estate funds, domestic and foreign financial institutions, life insurance companies, sovereign wealth funds, pension trusts, partnerships and individual investors. In addition, limited development during the COVID-19 pandemic has reduced the number of new properties becoming available. This competition may adversely affect us by subjecting us to the following risks: we may be unable to acquire a desired property because of competition from other well-capitalized real estate investors and, even if we are able to acquire a desired property, competition from other real estate investors may significantly increase the purchase price.
Our investments in joint ventures could be adversely affected by our lack of exclusive control over these investments, our partners’ insolvency or failure to meet their obligations, and disputes between us and our partners 
We have entered into, and may continue in the future to enter into, partnerships or joint ventures with other persons or entities. Joint venture investments involve risks that may not be present with other methods of ownership, including the possibility that our partner might become insolvent, refuse to make capital contributions when due or otherwise fail to meet its obligations, which may result in certain liabilities to us for guarantees and other commitments; that our partner might at any time have economic or other business interests or goals that are or become inconsistent with our interests or goals; that we could become engaged in a dispute with our partner, which could require us to expend additional resources to resolve such dispute and could have an adverse impact on the operations and profitability of the joint venture; that our partner may be in a position to take action or withhold consent contrary to our instructions or requests; and that our joint venture partners may be structured differently than us for tax purposes, which could create conflicts of interest and risks to our REIT status. In some instances, we and/or our partner may have the right to trigger a buy-sell, put right or forced sale arrangement, which could cause us to sell our interest, acquire our partner’s interest or sell the underlying asset at a time when we otherwise would not have initiated such a transaction. Our ability to acquire our partner’s interest may be limited if we do not have sufficient cash, available borrowing capacity or other capital resources. In such event, we may be forced to sell our interest in the joint venture when we would otherwise prefer to retain it. On the other hand, our ability to transfer our interest in a joint venture to a third party may be restricted and the market for our interest may be limited and/or valued lower than fair market value. Joint ventures may require us to share decision-making authority with our partners, which could limit our ability to control the properties in the joint ventures. Even when we have a controlling interest, certain major decisions may require partner approval, such as the sale, acquisition or financing of a property.
We assume operational and legal risks with respect to our properties managed in RIDEA structures that could have a material adverse effect on our business, results of operations and financial condition
We have entered into various joint ventures that were structured under the provisions of RIDEA, which permits REITs to own or partially own “qualified health care properties” in a structure through which we can participate directly in the cash flow of the properties’ operations (as compared to receiving only contractual rent payments) in compliance with REIT requirements. A “qualified health care property” includes real property and any personal property that is, or is necessary or incidental to the use of, a hospital, nursing facility, assisted living facility, congregate care facility, qualified continuing care facility, or other licensed facility which extends medical or nursing or ancillary services to patients.
Under a RIDEA structure, we are required to rely on our operator to manage and operate the property, including complying with laws and providing resident care. However, as the owner of the property under a RIDEA structure, we are responsible for operational and legal risks and liabilities of the property, including, those relating to employment matters of our operators, compliance with health care fraud and abuse and other laws, governmental reimbursement matters, data privacy and security laws, compliance with federal, state, local and industry-related licensure, certification and inspection laws, regulations, and standards, and litigation involving our properties or residents/patients, even though we have limited ability to control or influence our operators’ management of these risks. Further, our taxable REIT subsidiary (“TRS”) is generally required to hold the applicable health care license and enroll in the applicable government health care programs (e.g., Medicare and Medicaid), which subjects us to potential liability under various health care laws. Penalties for failure to comply with applicable laws may include loss or suspension of licenses and certificates of need, certification or accreditation, exclusion from government health care programs (e.g., Medicare and Medicaid), administrative sanctions and civil monetary penalties. Although we have some general oversight approval rights and the right to review operational and financial reporting information, our operators are
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ultimately in control of the day-to-day business of the property, including clinical decision-making, and we rely on them to operate the properties in a manner that complies with applicable law.
We are exposed to operational risks with respect to our Seniors Housing Operating properties that could adversely affect our revenue and operations
We are exposed to various operational risks with respect to our Seniors Housing Operating properties that may increase our costs or adversely affect our ability to generate revenues. These risks include fluctuations in occupancy experienced during the normal course of business, Medicare and Medicaid reimbursement, if applicable, and private pay rates; economic conditions; the availability and increases in the cost of labor (as a result of unionization or otherwise); competition; federal, state, local, and industry-regulated licensure, certification and inspection laws, regulations, and standards; the availability and increases in cost of general and professional liability insurance coverage; increases in property taxes; state regulation and rights of residents related to entrance fees; and federal and state housing laws and regulations. Any one or a combination of these factors may adversely affect our revenue and operations and could eventually lead to impairment of our properties.
We have rights to terminate our management agreements with operators, in whole or with respect to specific properties under certain circumstances, and we may be unable to replace operators if our management agreements are terminated or not renewed
We are party to long-term management agreements with our Seniors Housing Operating managers pursuant to which they provide comprehensive property management, accounting and other services with respect to our Seniors Housing Operating properties. We have the ability to terminate any of our management agreements upon the occurrence of certain events such as insolvency relating to such manager, and in some cases, upon the failure to meet specific NOI targets without curing (to the extent there is an ability to cure). In addition, many of our management agreements are terminable by us for no cause upon a reasonable notice period and in some cases, upon payment of a termination fee.
We regularly monitor and review our rights and remedies under our management agreements. When determining if we will take significant action under those agreements, including terminating a manager, we consider numerous legal, contractual, regulatory, business and other relevant factors. In exercising our rights to terminate or not renew a management agreement, we would work with our existing seniors housing operators or potentially new operators to manage the properties; however, there is no assurance that we would be able to timely source a replacement or that any replacement manager would be effective. Any transition to a new manager would most likely require regulatory approval and potentially the approval of the holders of any liens on the property. The failure to replace on a timely basis, as well as the failure to receive these approvals, either at all or in a timely manner, could have an adverse effect on the properties and our revenue.
Decreases in our operators’ or tenants' revenues or increases in our operators’ or tenants' expenses, including as a result of increased labor costs, could affect their ability to make payments to us
We have very limited control over the success or failure of our operators' or tenants' businesses and, at any time, an operator or tenant may experience a downturn in their business that weakens their financial condition. Our operators’ and tenants' revenues are primarily driven by occupancy, private pay rates, and Medicare and Medicaid reimbursement, if applicable. Expenses are primarily driven by the costs of labor, supplies, food, utilities, taxes, insurance and rent or debt service. Revenues from government reimbursement have, and may continue to, come under pressure due to reimbursement cuts and state budget shortfalls. Operating and borrowing costs have increased, and are expected to continue to increase, for our operators and tenants. In particular, our operators' and tenants' businesses have experienced increases in labor costs resulting from shortages of medical and non-medical staff. A number of factors have adversely affected the labor force available to our operators and tenants or labor costs, including increased industry competition, high employment levels, increased wages offered by other employers, and government regulations. In many geographic areas the scarcity of specialized medical personnel, experienced senior care professionals and other workers has been a significant operating issue affecting a wide range of healthcare providers and senior care and housing facilities. Such shortages have and may continue to impact the operations of our operators and tenants, resulting in increased labor and operating costs. Continued labor shortages or cost inflation may impact our operators' and tenants' abilities to comply with minimum staffing requirements under applicable federal and state regulations. Failure to comply with these requirements can, among other things, jeopardize a facility's compliance with the conditions of participation under relevant state and federal healthcare programs. In addition, if a facility is determined to be out of compliance with these requirements, it may be subject to fines and other regulatory penalties, including the suspension of patient admissions, the termination of Medicaid participation or the suspension or revocation of licenses.
To the extent that any decrease in revenues and/or any increase in operating expenses result in an operator or tenant not generating enough cash to make payments to us, the credit of our operator or tenant and the value of other collateral would have to be relied upon. To the extent the value of such property is reduced, we may need to record an impairment for such asset. Furthermore, if we determine to dispose of an underperforming property, such sale may result in a loss. Any such impairment or loss on sale would negatively affect our financial results. These risks are magnified where we lease multiple properties to a single operator or tenant under a master lease, as a failure or default under a master lease would expose us to these risks across multiple properties. Although our lease agreements give us the right to exercise certain remedies in the event of default on the obligations owing to us, we may determine not to do so if we believe that enforcement of our rights would be more detrimental to our business than seeking alternative approaches.
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Increased competition and oversupply may affect our operators’ and managers' ability to meet their obligations to us 
The operators and managers of our properties compete on a local and regional basis with operators and managers of properties and other health care providers that provide comparable services for residents and patients, including on the basis of the scope and quality of care and services provided, reputation and financial condition, physical appearance of the properties, price, and location. In addition, in light of labor shortages for medical and non-medical workers in many geographic areas, our operators and tenants increasingly compete to attract qualified and experienced employees. Our operators and managers are expected to encounter increased competition in the future that could limit their ability to attract residents and employees or expand their businesses. In addition, we expect that there will continue to be a more than adequate inventory of seniors housing facilities. We cannot be certain that the operators of all of our facilities will be able to achieve and maintain occupancy and rate levels that meet our expected yields and fulfill their obligations to us. If our operators and managers cannot compete effectively or if there is an oversupply of facilities, their financial performance could have a material adverse effect on our financial results.
A severe cold and flu season, epidemics or any other widespread illnesses could adversely affect the occupancy of our Seniors Housing Operating and Triple-net properties
Our business and operations are exposed to risks from COVID-19, severe cold and flu seasons or the occurrence of other epidemics, pandemics or other widespread illnesses. Our revenues and our operators' revenues are dependent on occupancy and the occupancy of our Seniors Housing Operating and Triple-net properties could significantly decrease in the event of a severe cold and flu season, a resurgence of COVID-19 or other epidemics, pandemics, widespread illness or public health crises. Such a decrease would affect the operating income of our Seniors Housing Operating properties and the ability of our Triple-net operators to make payments to us. As we experienced during the COVID-19 pandemic, a future flu or other pandemic could significantly increase the cost burdens faced by our operators, including if they are required to implement quarantines for residents or see a reduction in occupancy, and adversely affect their ability to meet their obligations to us, which would have a material adverse effect on our financial results. 
The impacts of such events could be severe and far-reaching, and may impact our operations in several ways, including: (i) operators and tenants could experience deteriorating financial conditions and be unable or unwilling to pay payments to us on time and in full; (ii) we may have to restructure operators' or tenants' obligations and may not be able to do so on terms that are favorable to us; (iii) we may experience increased operational challenges and costs resulting from logistical challenges such as supply chain interruptions, business closures, restrictions on the movement of people and remote or hybrid work schedules, which introduce additional operational risks including cybersecurity risks; (iv) increased operational costs incurred by us and our operators across all of our properties as a result of public health measures and other regulations affecting our properties and operations, as well as additional health and safety measures adopted by us and our operators and tenants, unique pressures on seniors housing and medical practice employees during pandemics like the COVID-19 pandemic including labor shortages resulting from macroeconomic trends; and (v) costs of development including expenditures for materials utilized in construction and labor essential to complete existing developments in progress, may increase substantially.
The insolvency or bankruptcy of our tenants, operators, borrowers, managers and other obligors may adversely affect our business, results of operations and financial condition 
We are exposed to the risk that our tenants, operators, borrowers, managers or other obligors may not be able to meet the rent, principal and interest or other payments due us, which may result in a tenant, operator, borrower, manager or other obligor bankruptcy or insolvency, or that a tenant, operator, borrower, manager or other obligor might become subject to bankruptcy or insolvency proceedings for other reasons. Although our operating lease agreements provide us with the right to evict a tenant, demand immediate payment of rent and exercise other remedies, and our loans provide us with the right to terminate any funding obligation, demand immediate repayment of principal and unpaid interest, foreclose on the collateral and exercise other remedies, the bankruptcy and insolvency laws afford certain rights to a party that has filed for bankruptcy or reorganization. A tenant, operator, borrower, manager or other obligor in bankruptcy or subject to insolvency proceedings may be able to limit or delay our ability to collect unpaid rent in the case of a lease or to receive unpaid principal and interest in the case of a loan, and to exercise other rights and remedies. In addition, if a lease is rejected in a tenant bankruptcy, our claim against the tenant may be limited by applicable provisions of the bankruptcy law. We may be required to fund certain expenses (e.g., real estate taxes and maintenance) to preserve the value of an investment property, avoid the imposition of liens on a property and/or transition a property to a new tenant. In some instances, we have terminated our lease with a tenant and relet the property to another tenant. In some of those situations, we have provided working capital loans to and limited indemnification of the new obligor. If we cannot transition a leased property to a new tenant, we may take possession of that property, which may expose us to certain successor liabilities. Publicity about the operator's financial condition and insolvency proceedings may also negatively impact their and our reputations, decreasing customer demand and revenues. Should such events occur, our revenue and operating cash flow may be adversely affected. 
The properties managed by Sunrise account for a significant portion of our revenues and net operating income and any adverse developments in its business or financial condition could adversely affect us 
As of December 31, 2023, Sunrise managed 88 of our Seniors Housing Operating properties. These properties account for a significant portion of our revenues and net operating income. Under our management agreements, we rely on Sunrise’s personnel, expertise, technical resources and information systems, proprietary information, good faith and judgment to manage
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our Seniors Housing Operating properties efficiently and effectively. We also rely on Sunrise to set appropriate resident fees, to provide accurate property-level financial results for our properties in a timely manner and to otherwise operate them in compliance with the terms of our management agreements and all applicable laws and regulations. Any adverse developments in Sunrise’s business or financial condition could impair its ability to manage our properties efficiently and effectively, which could adversely affect our business, results of operations, and financial condition. For example, we depend on Sunrise’s ability to attract and retain skilled management personnel who are responsible for the day-to-day operations of our Seniors Housing Operating properties. A shortage of nurses or other trained personnel or general inflationary pressures may force Sunrise to enhance its pay and benefits packages to compete effectively for such personnel, but it may not be able to offset these added costs by increasing the rates charged to residents. Any increase in labor costs and other property operating expenses, any failure by Sunrise to attract and retain qualified personnel, or significant changes in Sunrise’s senior management or equity ownership could adversely affect the income we receive from our Seniors Housing Operating properties and have a material adverse effect on us. Also, if Sunrise experiences any significant financial, legal, accounting or regulatory difficulties, such difficulties could result in, among other things, acceleration of its indebtedness, impairment of its continued access to capital or the commencement of insolvency proceedings by or against it under the U.S. Bankruptcy Code, which, in turn, could adversely affect our business, results of operations and financial condition. If we determine to sell or transition properties currently managed by Sunrise, we may experience operational challenges and/or significantly declining financial performance for those properties.
We depend on Integra for a significant portion of our revenues and any failure, inability or unwillingness by them to satisfy obligations under their agreements with us could adversely affect us
As of December 31, 2023, we lease 147 properties to Integra under a triple-net master lease, which account for a significant portion of our revenues. Integra subleases these properties to various regional operators who manage the property operations. We depend on Integra to pay all insurance, taxes, utilities and maintenance and repair expenses in connection with the leased properties. We cannot assure you that Integra will have sufficient assets, income and access to financing to enable them to make rental payments to us or to otherwise satisfy their respective obligations under our lease, and any failure, inability or unwillingness by Integra to do so could have an adverse effect on our business, results of operations and financial condition. Integra has also agreed to indemnify, defend and hold us harmless from and against various claims, litigation and liabilities arising in connection with the facilities, and we cannot assure you that Integra will have sufficient assets, income, access to financing and insurance coverage to enable them to satisfy their respective indemnification obligations. Integra's failure to effectively oversee the operations of their subtenants or their obligation to maintain and improve our properties could adversely affect the subtenant operators' business reputations and the subtenant operators' ability to attract and retain patients and residents in our properties, which in turn, could adversely affect our business, results of operations and financial condition.
Ownership of property outside the U.S. may subject us to different or greater risks than those associated with our domestic operations 
We have operations in the U.K. and Canada which represent 9.1% and 7.7% of total Welltower revenues, respectively. International development, ownership, and operating activities involve risks that are different from those we face with respect to our domestic properties and operations. These risks include, but are not limited to, any international currency gain or loss recognized with respect to changes in exchange rates, which may not qualify under the 75% gross income test or the 95% gross income test required for us to satisfy annually in order to qualify and maintain our status as a REIT; challenges with respect to the repatriation of foreign earnings and cash; impact from international trade disputes and the associated impact on our tenants' supply chain and consumer spending levels; changes in foreign political, regulatory, and economic conditions (regionally, nationally and locally) including, challenges in managing international operations; challenges of complying with a wide variety of foreign laws and regulations, including those relating to real estate, corporate governance, operations, taxes, employment and other civil and criminal legal proceedings; foreign ownership restrictions with respect to operations in foreign countries; local businesses and cultural factors that differ from our usual standards and practices; differences in lending practices and the willingness of domestic or foreign lenders to provide financing; regional or country-specific business cycles and political and economic instability; and failure to comply with applicable laws and regulations in the U.S. that affect foreign operations, including, but not limited to, the U.S. Foreign Corrupt Practices Act.
Further, our operations in the U.K. may be adversely impacted by global and local economic volatility experienced as a result of geopolitical tensions or conflicts, such as the ongoing conflict between Russia and Ukraine, rising inflation and interest rates, the energy crisis that has seen supply shortages and higher oil, gas and electricity prices, volatility in commodity prices, credit and capital markets, an increase in cybersecurity incidents, as well as labor market challenges affecting the recruitment and retention of employees.
If our tenants do not renew their existing leases, or if we are required to sell properties for liquidity reasons, we may be unable to lease or sell the properties on favorable terms, or at all
We cannot predict whether our tenants will renew existing leases at the end of their lease terms, which expire at various times. If these leases are not renewed, we would be required to find other tenants to occupy those properties, or sell them. There can be no assurance that we would be able to identify suitable replacement tenants or enter into leases with new tenants on terms as favorable to us as the current leases or that we would be able to lease those properties at all. Our competitors may offer
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space at rental rates below current market rates or below the rental rates we currently charge our customers, we may lose potential customers, and we may be pressured to reduce our rental rates below those we currently charge to retain customers when leases expire. In addition, our ability to reposition our properties with a suitable replacement tenant or operator could be significantly delayed or limited by state licensing, receivership, CON or other laws, as well as by the Medicare and Medicaid change-of-ownership rules, and we could incur substantial additional expenses in connection with any licensing, receivership or change-of-ownership proceedings. Even if tenants decide to renew or lease new space, the terms of renewals or new leases, including the cost of required renovations or concessions to tenants, may be less favorable to us than current lease terms.
Real estate investments are relatively illiquid and most of the property we own is highly customized for specific uses. Our ability to quickly sell or exchange any of our properties in response to changes in operator, economic and other conditions will be limited. Although our properties are less affected by the commercial real estate market trends, this limitation could be exacerbated by the current decline of commercial real estate as a result of high interest rates, inflation and declining property values across sectors. No assurances can be given that we will recognize full value for any property that we are required to sell. Our inability to respond rapidly to changes in the performance of our investments could adversely affect our financial condition and results of operations. In addition, we are exposed to the risks inherent in concentrating investments in real estate, and in particular, the seniors housing and health care industries. A downturn in the real estate industry could adversely affect the value of our properties and our ability to sell properties for a price or on terms acceptable to us. 
Our tenants, operators and managers may not have the necessary insurance coverage to insure adequately against losses 
We maintain or require our tenants, operators and managers to maintain comprehensive insurance coverage on our properties and their operations with terms, conditions, limits and deductibles that we believe are customary for similarly situated companies in our industry and we frequently review our insurance programs and requirements. Our tenants, operators and managers may not be able to maintain adequate levels of insurance and required coverages. Also, we may not be able to require the same levels of insurance coverage under our lease, management and other agreements, which could adversely affect us in the event of a significant uninsured loss. We cannot make any guarantee as to the future financial viability of the insurers that underwrite our policies and the policies maintained by our tenants, operators and managers. Insurance may not be available at a reasonable cost in the future or policies may not be maintained at a level that will fully cover all losses on our properties upon the occurrence of a catastrophic event. This may be especially the case due to increases in property insurance costs. In addition, in recent years, long-term/post-acute care and seniors housing operators and managers have experienced substantial increases in both the number and size of patient care liability claims. As a result, general and professional liability costs have increased in some markets. Finally, our use, and the usage by some of our tenants, operators and managers of self-insurance and/or use of a wholly owned captive insurance company, if not adequately funded, could have a material adverse effect on our liquidity and that of our tenants, operators and managers.
Our ownership of properties through ground leases exposes us to the loss of such properties upon breach or termination of the ground leases 
We have acquired an interest in certain of our properties by acquiring a leasehold interest in the property on which the building is located, and we may acquire additional properties in the future through the purchase of interests in ground leases. Many of these ground leases impose significant limitations on our uses of the subject properties, restrict our ability to sell or otherwise transfer our interests in the properties or restrict the leasing of the properties. These restrictions may limit our ability to timely sell or exchange the properties, impair the properties’ value or negatively impact our ability to find suitable tenants for the properties. As the lessee under a ground lease, we are exposed to the possibility of losing the property upon termination of the ground lease or an earlier breach of the ground lease by us.
The requirements of, or changes to, governmental reimbursement programs, such as Medicare, Medicaid or government funding, could have a material adverse effect on our obligors’ liquidity, financial condition and results of operations, which could adversely affect our obligors’ ability to meet their obligations to us 
Some of our obligors’ businesses are affected by government reimbursement. To the extent that an operator/tenant receives a significant portion of its revenues from government payors, primarily Medicare and Medicaid, such revenues may be subject to statutory and regulatory changes, retroactive rate adjustments, recovery of program overpayments or set-offs, court decisions, administrative rulings, policy interpretations, payment or other delays by fiscal intermediaries or carriers, change-of-ownership rules, government funding restrictions (at a program level or with respect to specific facilities), any lapse in Congressional funding of the Centers for Medicare and Medicaid Services and interruption or delays in payments due to any ongoing government investigations and audits at such property. Federal and state authorities may continue seeking to implement new or modified reimbursement methodologies that may negatively impact health care property operations. See “Item 1 - Business - Certain Government Regulations - United States - Reimbursement” above for additional information. Health care reimbursement will likely continue to be of paramount importance to federal and state authorities. We cannot make any assessment as to the ultimate timing or effect any future legislative reforms may have on the financial condition of our obligors and properties. There can be no assurance that adequate reimbursement levels will be available for services provided by any property operator, whether the property receives reimbursement from Medicare, Medicaid or private payors. Significant limits on the scope of services reimbursed and on reimbursement rates and fees could have a material adverse effect on an obligor’s liquidity, financial condition and results of operations, which could adversely affect the ability of an obligor to meet its
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obligations to us. In addition, if a partial or total federal government shutdown were to occur for a prolonged period of time, federal government payment obligations, including its obligations under Medicaid and Medicare, may be delayed. Similarly, if state government shutdowns were to occur, state payment obligations may be delayed. If the federal or state governments fail to make payments under these programs on a timely basis, our business could suffer, and our financial position, results of operations or cash flows may be materially affected.
Since January 1, 2014, the Health Reform Laws have provided those states that expand their Medicaid coverage to otherwise ineligible state residents with incomes at or below 138% of the federal poverty level with an increased federal medical assistance percentage, effective January 1, 2014, when certain conditions are met. The federal government substantially funds the Medicaid expansion and as of December 2023, the number of states implementing expansion has grown to more than 80% of all states. The participation by states in the Medicaid expansion could have the dual effect of increasing our tenants’ revenues, through new patients, but further straining state budgets and their ability to pay our tenants.
Health reform measures could be implemented as a result of political, legislative, regulatory, and administrative developments and judicial proceedings. Further the impact that the recent change of control of the House and future changes in the federal government may have on health reform (including through new legislative, executive or regulatory efforts) remains uncertain, and any changes will likely take time to unfold and could have an impact on coverage and reimbursement for health care items and services covered by plans that were authorized by the Health Reform Laws. If the operations, cash flows or financial condition of our operators and tenants are materially adversely impacted by the Health Reform Laws or future legislation, our revenue and operations may be adversely affected as well. More generally, and because of the dynamic nature of the legislative and regulatory environment for health care products and services, and in light of existing federal deficit and budgetary concerns, we cannot predict the impact that broad-based, far-reaching legislative or regulatory changes could have on the U.S. economy, our business, or that of our operators and tenants. 
If controls imposed on certain of our tenants who provide health care services that are reimbursed by Medicare, Medicaid and other third-party payors to reduce admissions and length of stay affect inpatient volumes at our health care facilities, the financial condition or results of operations of those tenants could be adversely affected
Controls imposed by Medicare, Medicaid and commercial third-party payors designed to reduce admissions and lengths of stay, commonly referred to as “utilization reviews,” have affected and are expected to continue to affect certain of our health care facilities, specifically our acute care hospitals and post-acute facilities. Utilization review entails the review of the admission and course of treatment of a patient by managed care plans. Inpatient utilization, average lengths of stay and occupancy rates continue to be negatively affected by payor-required pre-admission authorization and utilization review and by payor pressures to maximize outpatient and alternative health care delivery services for less acutely ill patients. Efforts to impose more stringent cost controls and reductions are expected to continue, which could negatively impact the financial condition of our tenants who provide health care services in our hospitals and post-acute facilities. If so, this could adversely affect these tenants’ ability and willingness to comply with the terms of their leases with us and/or renew those leases upon expiration, which could have a material adverse effect on us.
Our operators’ or tenants’ failure to comply with federal, state, province, local, and industry-regulated licensure, certification and inspection laws, regulations, and standards could adversely affect such operators’ or tenants’ operations, which could adversely affect our operators’ and tenants’ ability to meet their obligations to us 
Our operators and tenants generally are subject to or impacted by varying levels of federal, state, local, and industry-regulated licensure, certification and inspection laws, regulations, and standards. These laws and regulations include, among others: laws protecting consumers against deceptive practices; laws relating to the operation of our facilities and how our tenants and operators conduct their business, such as fire, health and safety, data security and privacy laws; federal and state laws affecting hospitals, clinics and other health care communities that participate in both Medicare and Medicaid that specify reimbursement rates, pricing, reimbursement procedures and limitations, quality of services and care, background checks, food service and physical plants, and similar foreign laws regulating the health care industry; resident rights laws (including abuse and neglect laws) and fraud laws; anti-kickback and physician referral laws; the Americans with Disabilities Act of 1990 and similar state and local laws; and safety and health standards set by the Occupational Safety and Health Administration or similar foreign agencies. Our operators’ or tenants’ failure to comply with any of these laws, regulations, or standards could result in loss of accreditation, denial of reimbursement, imposition of fines, suspension, decertification or exclusion from federal and state health care programs, civil liability, and in certain limited instances, criminal penalties, material restrictions on or loss of license, closure of the facility and/or the incurrence of considerable costs arising from an investigation or regulatory action. Such actions may have an effect on our operators’ or tenants’ ability to make lease payments to us and, therefore, adversely impact us. In addition, we may be directly subject to these laws, regulations and standards, as well as potential investigation or enforcement and liability, as a result of our RIDEA-structured arrangements, and certain other arrangements we may pursue with healthcare entities who are directly subject to these laws. See “Item 1 - Business - Certain Government Regulations - United States - Fraud & Abuse Enforcement” and “Item 1 - Business - Certain Government Regulations - United States - Health Care Matters - Generally” above.
Many of our properties may require a license, registration, and/or CON to operate. Failure to obtain a license, registration, or CON, or loss of a required license, registration, or CON would prevent a facility from operating in the manner intended by the operators or tenants. These events could materially adversely affect our operators’ or tenants’ ability to make a profit or our
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operators' or tenants' ability to make rent or other obligatory payments to us. State and local laws also may regulate the expansion, including the addition of new beds or services or acquisition of medical equipment, and the construction or renovation of health care facilities, by requiring a CON or other similar approval from a state agency. See “Item 1 — Business — Certain Government Regulations — United States — Licensing and Certification” above. 
In addition, we cannot assure you that future changes in government regulation will not adversely affect the health care industry, including our tenants and operators, nor can we be certain that our tenants and operators will achieve and maintain occupancy and rate levels or labor cost levels that will enable them to satisfy their obligations to us.
Unfavorable resolution of pending and future litigation matters and disputes could have a material adverse effect on our financial condition
From time to time, we are directly involved or named as a party in legal proceedings, lawsuits and other claims that involve class actions, disputes regarding property damage, care matters and other issues. We also are named as defendants in lawsuits allegedly arising out of our actions or the actions of our operators/tenants or managers in which such operators/tenants or managers have agreed to indemnify, defend and hold us harmless from and against various claims, litigation and liabilities arising in connection with their respective businesses. Employment related class action lawsuits have increased in recent years, including class action lawsuits brought against our operators in certain states regarding employee and government requirements regarding wage and hour claims and fair housing complaints, as well as class action lawsuits related to staffing and care. There can be no assurance that we will be able to prevail in, or achieve a favorable settlement of, pending or future litigation. In addition, pending litigation or future litigation, government proceedings or environmental matters could lead to increased costs or interruption of our normal business operations. An unfavorable resolution of pending or future litigation or legal proceedings may have a material adverse effect on our business, results of operations and financial condition. Regardless of its outcome, litigation may result in substantial costs and expenses, significantly divert the attention of management, and could damage our reputation and our brand. In addition, any such resolution could involve our agreement to terms that restrict the operation of our business. We cannot guarantee losses incurred in connection with any current or future legal or regulatory proceedings or actions will not exceed any provisions we may have set aside in respect of such proceedings or actions or will not exceed any available insurance coverage.
Development, redevelopment and construction risks could affect our profitability
We invest in various development and redevelopment projects. In deciding whether to acquire or develop a particular property, we make assumptions regarding the expected future performance of that property. In particular, we estimate the return on our investment based on expected construction costs, lease up velocity, occupancy, rental rates, operating expenses, capital costs and future competition. If our financial projections with respect to a new property are inaccurate, the property may fail to perform as we expected in analyzing our investment. Our estimate of the costs of repositioning or redeveloping an acquired property may prove to be inaccurate, which may result in our failure to meet our profitability goals.
Our development/redevelopment and construction projects are vulnerable to the impact of material shortages and inflation. For example, shortages and fluctuations in the price of lumber or in other important raw materials have resulted in and could continue to result in delays in the start or completion of, or increase the cost of, developing one or more of our projects. Pricing for labor and raw materials can be affected by various national, regional, local, economic and political factors, including changes to immigration laws that impact the availability of labor or tariffs on imported construction materials. Additional conditions and risks affecting our development/redevelopment and construction projects include: (i) liability if our communities are not constructed in compliance with the accessibility provisions of the Americans with Disabilities Acts, the Fair Housing Act or other federal, state or local requirements, which noncompliance could result in imposition of fines, an award of damage to private litigants and a requirement that we undertake structural modifications to remedy the noncompliance; (ii) cost overruns, especially in the current inflationary environment, and untimely completion of construction (including risks beyond our control, such as weather or labor conditions, material shortages or supply chain delays); (iii) the potential for fluctuation of occupancy rates and rents at redeveloped properties, which may result in our investment not being profitable; (iv) the potential that we may expend funds and management time, or fail to recover expenses already incurred, if we do not complete projects already started or abandon development or redevelopment opportunities after we begin to explore them; (v) the inability to complete leasing of a property on schedule or at all, resulting in an increase in carrying or development or redevelopment costs; (vi) the possibility that properties will be leased at below expected rental rates and (vii) to the extent the development or redevelopment activities are conducted in partnership with third parties, the possibility of disputes with our joint venture partners and the potential that we miss certain project management deadlines.
In connection with our renovation, redevelopment, development and related construction activities, we may be unable to obtain, or suffer delays in obtaining, necessary zoning, land-use, building, occupancy and other required governmental permits and authorizations, or satisfactory tax rates, incentives or abatements. Operators of new facilities we construct may need to obtain Medicare and Medicaid certification and enter into Medicare and Medicaid provider agreements and/or third-party payor contracts. In the event that the operator is unable to obtain the necessary licensure, certification, provider agreements or contracts after the completion of construction, there is a risk that we will not be able to earn any revenues on the facility until either the initial operator obtains a license or certification to operate the new facility and the necessary provider agreements or contracts or we find and contract with a new operator that is able to obtain a license to operate the facility for its intended use
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and the necessary provider agreements or contracts. We have experienced such delays in obtaining necessary licensing for constructed properties and may experience additional or more significant delays in the future.
We rely on our development managers, general contractors and subcontractors to oversee and manage day-to-day construction activities. If any such party underperforms or experiences financial or other problems during the construction process, we could experience significant delays, increased costs to complete the project and/or other negative impacts to our expected returns and may need to exercise contractual remedies against such party, which may include termination of the applicable underlying service contract. In the event such termination occurs mid-construction, we would likely need to engage a new service provider, which would likely result in additional costs and delays as the transition between providers occurs.
The above-described factors could result in increased costs or our abandonment of these projects. In addition, we may abandon opportunities we have begun to investigate, for a range of reasons, including changes in expected financing or construction costs, adverse changes in expected rents or expenses, adverse environmental and/or geotechnical findings, conditions to zoning approval, legal and regulatory hurdles, including moratoriums on development and redevelopment activities, changes in market and economic conditions, natural disasters and other catastrophic events; damage, vandalism or accidents, higher requirements for capital improvements; decreased demand due to competition or other market and economic conditions, or defects that we do not discover through the inspection processes, which would result in additional expenses beyond those originally expected. In addition, we may not be able to obtain financing on favorable terms, or at all, which may render us unable to proceed with our development activities. We may not be able to complete construction and lease-up of a property on budget and on schedule, which could result in increased debt service expense or construction costs. Additionally, the time frame required for development, construction and lease-up of these properties means that we may have to wait years for significant cash returns. Because we are required to make cash distributions to our stockholders, if the cash flow from operations or refinancing is not sufficient, we may be forced to borrow additional money to fund such distributions. Newly developed and acquired properties may not produce the cash flow that we expect, which could adversely affect our overall financial performance. 
Bank failures or other events affecting financial institutions could have a material adverse effect on our and our operators' and tenants' liquidity, results of operations and financial condition
The failure of a bank, or events involving limited liquidity, defaults, non-performance or other adverse conditions in the financial or credit markets impacting financial institutions, or concerns or rumors about such events, may adversely impact us, either directly or through an adverse impact on our tenants, operators and borrowers. A bank failure or other event affecting financial institutions could lead to disruptions in our or our tenants', operators' and borrowers' access to bank deposits or borrowing capacity, including access to letters of credit from certain of our tenants relating to lease obligations. In addition, our or our tenants', operators' and borrowers' deposits in excess of the Federal Deposit Insurance Corporation limits may not be backstopped by the U.S. government, and banks or financial institutions with which we or our tenants, operators and borrowers do business may be unable to obtain needed liquidity from other banks, government institutions or by acquisition in the event of a failure or liquidity crisis. Any adverse effects to our tenants', operators' or borrowers' liquidity or financial performance could affect their ability to meet their financial and other contractual obligations to us, which could have a material adverse effect on our business, results of operations and financial condition.
We may experience losses caused by severe weather conditions, natural disasters or the physical effects of climate change, which could result in an increase of our or our tenants’ cost of insurance, unanticipated costs associated with evacuation, a decrease in our anticipated revenues or a significant loss of the capital we have invested in a property 
We maintain or require our tenants to maintain comprehensive insurance coverage on our properties with terms, conditions, limits and deductibles that we believe are appropriate given the relative risk and costs of such coverage. However, a large number of our properties are located in areas particularly susceptible to revenue loss, cost increase or damage caused by severe weather conditions or natural disasters such as hurricanes, earthquakes, tornadoes and floods, as well as the effects of climate change. For example, in 2023, the weather phenomenon known as El Niño returned. This phenomenon generally results in an increase in storms, flooding and landslides in Southern California, heavier precipitation along the Gulf of Mexico and an increase in severe weather in Florida. We believe, given current industry practice and analysis prepared by outside consultants, that our and our tenants’ insurance coverage is appropriate to cover reasonably anticipated losses that may be caused by hurricanes, earthquakes, tornadoes, floods, wildfires and other severe weather conditions and natural disasters, including the effects of climate change. Nevertheless, we are always subject to the risk that such insurance will not fully cover all losses and, depending on the severity of the event and the impact on our properties, such insurance may not cover a significant portion of the losses including the costs associated with evacuation. Moreover, an increase in volatility and difficulty predicting adverse weather events, such as the changes in tornado patterns in recent years, may result in additional losses. These losses may lead to an increase of our and our tenants’ cost of insurance, a decrease in our anticipated revenues from an affected property and a loss of all or a portion of the capital we have invested in an affected property. In addition, we or our tenants may not purchase insurance under certain circumstances if the cost of insurance exceeds, in our or our tenants’ judgment, the value of the coverage relative to the risk of loss. Also, changes in federal and state legislation and regulation relating to climate change could result in increased capital expenditures to improve the energy efficiency and resiliency of our existing properties and could also necessitate us to spend more on our new development properties without a corresponding increase in revenue.
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To the extent that significant changes in the climate occur in areas where our communities are located, we may experience extreme weather and changes in precipitation and temperature, all of which may result in physical damage to or a decrease in demand for properties located in these areas or affected by these conditions. Should the impact of climate change be material, including significant property damage to or destruction of our communities, or occur for lengthy periods of time, our financial condition or results of operations may be adversely affected. In addition, changes in federal, state and local legislation and regulation based on concerns about climate change could result in increased capital expenditures on our existing properties and our new development properties without a corresponding increase in revenue, resulting in adverse impacts to our results of operations.
We may incur costs to remediate environmental contamination at our properties, which could have an adverse effect on our or our obligors’ business or financial condition
Under various laws, owners or operators of real estate may be required to respond to the presence or release of hazardous substances on the property and may be held liable for property damage, personal injuries or penalties that result from environmental contamination or exposure to hazardous substances. These laws often impose liability without regard to whether the owner or operator knew of the release of the substances or caused the release. We may become liable to reimburse the government for damages and costs it incurs in connection with the contamination. Generally, such liability attaches to a person based on the person’s relationship to the property. Our tenants or borrowers are primarily responsible for the condition of the property. Moreover, we review environmental site assessments of the properties that we own or encumber prior to taking an interest in them. Those assessments are designed to meet the “all appropriate inquiry” standard, which we believe qualifies us for the innocent purchaser defense if environmental liabilities arise. Based upon such assessments, we do not believe that any of our properties are subject to material environmental contamination. However, environmental liabilities may be present in our properties and we may incur costs to remediate contamination, which could have a material adverse effect on our business or financial condition or the business or financial condition of our obligors. 
Cybersecurity incidents could disrupt our business and result in the loss of confidential information and legal liability
Our business is at risk from and may be impacted by cybersecurity attacks, including attempts to gain unauthorized access to our confidential data through phishing or other malicious activity, attempts to interrupt our access to, or use of information technology systems through distributed denial-of-service or ransomware attacks, breaches related to our increased receipt and use of data from multiple sources, and other electronic security breaches or other cybersecurity incidents within our environment or our business partners' environments, including those resulting from human error, product defects and technology failures. Such cyber-attacks can range from individual attempts to gain unauthorized access to our or our business partners' information technology systems to more sophisticated security threats and may be specifically targeted to our business or more general industry wide risks. Our information technology networks, and those of our business partners are important enablers to our ability to perform day-to-day operations of our business. While we employ a number of measures to prevent, detect and mitigate these threats, there is no guarantee such efforts will be successful in preventing or detecting a cyber-attack. Even the most well-protected information, networks, systems and facilities remain vulnerable because the techniques used in such attempted cybersecurity breaches evolve and generally are not recognized until launched against a target, and in some cases are designed not to be detected and, in fact, may not be detected. Accordingly, we may be unable to anticipate these techniques, implement adequate cybersecurity barriers or other preventative measures, or respond, mitigate the risks from and recover from an attack without operational impact, and thus it is impossible for us to entirely mitigate this risk. We regularly defend against, respond to and mitigate risks from cybersecurity breaches, which to date have not had a material impact on our operations; however, there is no assurance that such impacts will not be material in the future. Cybersecurity incidents could disrupt our or our critical business partners’ business, damage our reputation, cause us to incur significant remediation expense and expose us to legal or regulatory claims or proceedings, including enforcement actions under data privacy or disclosure regulations.
Evolving privacy regulations could expose our business to reputational harm and losses
Regulatory authorities around the world have implemented or are considering implementing a number of legislative changes or regulations concerning data protection, which have required or may require us to incur additional expenses and may expose us to additional risks. We and our operators and managers are subject to numerous laws and regulations governing the protection of personal and confidential information of our clients, residents and/or employees, including U.S. federal and state laws (including the CCPA and HIPAA), and non-U.S. laws, such as the U.K. General Data Protection Regulation and the E.U. GDPR, which impose a number of obligations on us. These obligations vary from state to state and country to country, but generally have accountability and transparency requirements. Some jurisdictions (including the EU and U.K.) impose restrictions on transfers of data from their jurisdictions to jurisdictions that they do not consider adequate. This may have implications for our cross-border data flows and may result in additional compliance costs.
Many jurisdictions assess fines, the magnitude of which may depend on the annual global revenue of the company and the nature, gravity and duration of, the violation. Additionally, in some jurisdictions, data subjects may have a right to compensation for financial or non-financial losses. Complying with these laws may cause us or our operators and managers to incur substantial operational and compliance costs or require us to change our business practices. Despite efforts to bring our practices into compliance with these laws, we or our operators and managers may not be successful either due to internal or
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external factors such as resource allocation limitations or a lack of cooperation among our business partners. Such laws may be interpreted and applied differently depending on the jurisdiction and continue to evolve, making it difficult to predict how they may develop and apply to us. Non-compliance or alleged non-compliance with laws, contractual agreements or industry standards could result in scrutiny or proceedings against us by governmental entities, regulators, our business partners, residents of our communities, data subjects, suppliers, vendors or other parties. Further, there is a risk that compliance measures we undertake will not be implemented correctly or that individuals within our business or those of our business partners will not be fully compliant with legal obligations. If there are breaches of these measures, we could face significant administrative and monetary sanctions, as well as reputational damage, which may have a material adverse effect on our operations, financial condition and prospects.
ESG-related commitments and expectations expose us to numerous risks
We have made, and expect to continue to make, commitments and disclosures related to ESG initiatives and goals. Statements related to ESG goals, targets and objectives reflect our current plans and do not constitute a guarantee that they will be achieved. Our ability to achieve any stated goal, target, or objective, including with respect to emissions reduction, is subject to numerous factors and conditions, some of which are outside of our control. In addition, standards for tracking and reporting on ESG matters, including emissions, have not been harmonized and continue to evolve. Similarly, our failure or perceived failure to pursue or fulfill our ESG goals, targets, and objectives, to comply with ethical, environmental, or other standards, regulations, or expectations, or to satisfy various reporting standards with respect to these matters, within the timelines we announce, or at all, could adversely affect our business or reputation, as well as expose us to government enforcement actions and private litigation.
Investors and other stakeholders have become increasingly focused on understanding how companies address a variety of ESG factors. Investors may consider a company's ESG-related business practices, scores and reporting, including the company's disclosures and ESG rating systems developed by third parties, as they evaluate investment decisions. The criteria used in these rating systems may conflict and change frequently, and we cannot predict how these third parties will score us, nor can we have any assurance that they score us or other companies accurately. We supplement our participation in ratings systems with published disclosures of our ESG activities, but some investors may desire other disclosures that we do not provide. Failure to participate in certain of the third-party ratings systems, score well in third-party rating systems or provide certain ESG disclosures could result in reputational harm when investors compare us to other companies, and could cause certain investors to be unwilling to invest in our common stock, which could adversely affect our stock price. Our business may also face increased scrutiny from investors and other stakeholders related to our ESG activities, including the goals, targets, and objectives that we announce, and our methodologies and timelines for pursuing them. If our ESG practices do not meet investor or other stakeholder expectations and standards, which continue to evolve, our reputation, our ability to attract or retain employees, and our attractiveness as an investment or business partner could be negatively affected.
At the same time, some stakeholders and regulators have expressed or pursued contrary views, legislation, and investment expectations with respect to ESG ratings and commitments, including the enactment or proposal of “anti-ESG” legislation or policies, which may expose us to additional legal or reputational risks based upon our ESG commitments and disclosures.
Our success and the success of our operators and managers depends on key personnel whose continued service is not guaranteed 
Our success and the success of our operators and managers depends on the continued availability and service of key personnel, including executive officers and other highly qualified employees, and competition for their talents is intense. There is substantial competition for qualified personnel. We cannot assure you that we will retain our key personnel or that we will be able to recruit and retain other highly qualified employees in the future. Losing any key personnel could, at least temporarily, have a material adverse effect on our business and that of our operators and managers', financial position and results of operations. 
Welltower is a holding company with no direct operations, and it relies on funds received from Welltower OP to pay its obligations and make distributions to stockholders
Welltower is a holding company with no direct operations. All of Welltower's 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. As a result, Welltower relies on distributions from Welltower OP to make dividend payments and meet its obligations, including any tax liability on taxable income allocated to Welltower from Welltower OP. Welltower exercises exclusive control over Welltower OP, including the authority to cause Welltower OP to make distributions, subject to certain limited approval and voting rights of Welltower OP's other members as described in the Limited Liability Agreement. In addition, because Welltower is a holding company, your claims as stockholders are structurally subordinated to all existing and future liabilities and obligations to preferred equity holders of Welltower OP and its subsidiaries. Therefore, in the event of a bankruptcy, insolvency, liquidation or reorganization of Welltower OP or its subsidiaries, assets of Welltower OP or the applicable subsidiary will be available to satisfy any claims of our stockholders only after such liabilities and obligations have been satisfied in full.
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Welltower is the initial member and majority owner of Welltower OP, with an approximate ownership interest of 99.765% as of December 31, 2023. In connection with our future acquisition activities or otherwise, Welltower OP may issue additional Class A Common Units ("OP Units") to third parties and admit additional members. Such issuances would reduce Welltower's percentage ownership in Welltower OP.
Risks Arising from Our Capital Structure 
We may become more leveraged 
Permanent financing for our investments is typically provided through a combination of public offerings of debt and equity securities and the incurrence or assumption of secured debt. The incurrence or assumption of indebtedness may cause us to become more leveraged, which could (1) require us to dedicate a greater portion of our cash flow to the payment of debt service, (2) make us more vulnerable to a downturn in the economy, (3) limit our ability to obtain additional financing, (4) negatively affect our credit ratings or outlook by one or more of the rating agencies or (5) make us more vulnerable to increases in interest rates because of the variable interest rates on some of our borrowings to the extent we have not entirely hedged such variable rate debt. In addition, any changes to benchmark rates may have an uncertain impact on our cost of funds and our access to the capital markets, which could impact our results of operations and cash flows. Uncertainty as to the nature of such potential changes may also adversely affect the trading market for our securities. Additional financing, therefore, may be unavailable, more expensive or restricted by the terms of our outstanding indebtedness.
Cash available for distributions to stockholders may be insufficient to make dividend contributions at expected levels and are made at the discretion of the Board of Directors 
If cash available for distribution generated by our assets decreases due to dispositions or otherwise, we may be unable to make dividend distributions at expected levels. Our inability to make expected distributions would likely result in a decrease in the market price of our common stock. All distributions are made at the discretion of our Board of Directors in accordance with Delaware law and depend on our earnings, our financial condition, debt and equity capital available to us, our expectation of our future capital requirements and operating performance, restrictive covenants in our financial and other contractual arrangements, maintenance of our REIT qualification, restrictions under Delaware law and other factors as our Board of Directors may deem relevant from time to time. Additionally, our ability to make distributions will be adversely affected if any of the risks described herein, or other significant adverse events, occur. 
We are subject to covenants in our debt agreements that could have a material adverse effect on our business, results of operations and financial condition
Our debt agreements contain various covenants, restrictions and events of default. Among other things, these provisions require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. Breaches of these covenants could result in defaults under the instruments governing the applicable indebtedness, in addition to any other indebtedness cross-defaulted against such instruments. These defaults could have a material adverse effect on our business, results of operations and financial condition. 
Limitations on our ability to access capital could have an adverse effect on our ability to make future investments or to meet our obligations and commitments
We cannot assure you that we will be able to raise the capital necessary to make future investments or to meet our obligations and commitments as they mature. Our access to capital depends upon a number of factors over which we have little or no control, including rising interest rates, inflation and other general market conditions; the market’s perception of our growth potential and our current and potential future earnings and cash distributions; the market price of the shares of our common stock and the credit ratings of our debt securities; changes in the credit ratings on U.S. government debt securities; uncertainty from the transition to Secured Overnight Financing Rate ("SOFR") or any other interest rate benchmark; and default or delay in payment by the U.S. of its obligations. We also rely on the financial institutions that are parties to our revolving credit facilities. If these institutions become capital constrained, tighten their lending standards or become insolvent or if they experience excessive volumes of borrowing requests from other borrowers within a short period of time, they may be unable or unwilling to honor their funding commitments to us, which would adversely affect our ability to draw on our revolving credit facilities and, over time, could negatively impact our ability to consummate acquisitions, repay indebtedness as it matures, fund capital expenditures or make distributions to our stockholders. If our access to capital is limited by these factors or other factors, it could negatively impact our ability to acquire properties, repay or refinance our indebtedness, fund operations or make distributions to our stockholders.
Downgrades in our credit ratings could have a material adverse effect on our cost and availability of capital
We plan to manage the company to maintain a capital structure consistent with our current profile, but there can be no assurance that we will be able to maintain our current credit ratings. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse effect on our cost and availability of capital, which could in turn have a material adverse effect on our results of operations, liquidity, cash flows, the trading/redemption price of our securities and our ability to satisfy our debt service obligations and to pay dividends and distributions to our equity holders.
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Increases in interest rates could have a material adverse effect on our cost of capital, and our decision to hedge against interest rate risk might not be effective
The current high interest rate environment has been increasing interest cost on new and existing variable rate debt.  Such increases in the cost of capital, and any further increases resulting from future interest rate hikes, could adversely impact our ability to finance operations, acquire and develop properties, and refinance existing debt. Specifically, rate increases have corresponding impacts to our costs of borrowing and may have adverse impacts on our ability to raise funds through the offering of our securities or through the issuance of debt due to higher debt capital costs, diminished credit availability and less favorable equity markets. Additionally, increased interest rates may also result in less liquid property markets, limiting our ability to sell existing assets. Higher interest rates may also lead purchasers of our common stock to demand a greater annual dividend yield, which could adversely affect the market price of our common stock and could result in increased capitalization rates, which may lead to reduced valuation of our assets.
We may from time to time seek to manage our exposure to interest rate volatility with hedging arrangements, which involve additional risks, including the risks that counterparties may fail to honor their obligations under these arrangements, that these arrangements may not be effective in reducing our exposure to interest rate changes, that the amount of income we earn from hedging transactions may be limited by federal tax provisions governing REITs, and that these arrangements may reduce the benefits to us if interest rates decline. Developing and implementing an interest rate risk strategy is complex and no strategy can completely insulate us from risks associated with interest rate fluctuations and there can be no assurance that our hedging activities will be effective. Failure to hedge effectively against interest rate risk, if we choose to engage in such activities, could adversely affect our business, financial condition and results of operations.
Risks Arising from Our Status as a REIT 
We might fail to qualify or remain qualified as a REIT 
We intend to operate as a REIT under the Code, and believe we have operated and will continue to operate in such a manner. If we lose our status as a REIT, we will face serious income tax consequences that will substantially reduce the funds available for satisfying our obligations and for distribution to our stockholders because:
Welltower would not be allowed a deduction for distributions to stockholders in computing our taxable income and would be subject to U.S. federal income tax at regular corporate rates;
Welltower would be subject to increased state and local taxes; and
unless Welltower is entitled to relief under statutory provisions, it could not elect to be subject to tax as a REIT for four taxable    years following the year during which it was disqualified. 
Since REIT qualification requires us to meet a number of complex requirements, it is possible that we may fail to fulfill them, and if we do, our earnings will be reduced by the amount of U.S. federal and other income taxes owed. A reduction in our earnings would affect the amount we could distribute to our stockholders. If we do not qualify as a REIT, we will not be required to make distributions to stockholders, since a non-REIT is not required to pay dividends to stockholders in order to maintain REIT status or avoid an excise tax. In addition, if we fail to qualify as a REIT, all distributions to stockholders will continue to be treated as dividends to the extent of our current and accumulated earnings and profits, although corporate stockholders may be eligible for the dividends received deduction, and individual stockholders may be eligible for taxation at the rates generally applicable to long-term capital gains with respect to distributions. 
As a result of all these factors, our failure to qualify as a REIT also could impair our ability to implement our business strategy and would adversely affect the value of our common stock. Qualification as a REIT involves the application of highly technical and complex Code provisions for which there are only limited judicial and administrative interpretations. The determination of various factual matters and circumstances not entirely within our control may affect our ability to remain qualified as a REIT. Although we believe that we qualify as a REIT, we cannot assure you that we will remain qualified as a REIT for U.S. federal income tax purposes. 
Failure of Welltower OP to maintain status as a partnership for U.S. federal income tax purposes
We believe Welltower OP qualifies as a partnership for U.S. federal income tax purposes. As a partnership, Welltower OP is generally not subject to U.S. federal income tax on its income. Instead, each of the partners is allocated its share of Welltower OP's income. We cannot assure you, however, that the IRS will not challenge the status of Welltower OP as a partnership for U.S. federal income tax purposes. If the IRS were to successfully challenge the status of Welltower OP as a partnership, it would be taxable as a corporation. In such event, this would reduce the amount of distributions that Welltower OP could make. The treatment of Welltower OP as a corporation would also cause us to fail to qualify as a REIT. This would substantially reduce our cash available to pay distributions and the return on a unitholder and/or shareholder's investment.
Certain subsidiaries might fail to qualify or remain qualified as a REIT
We own interests in a number of entities which intend to operate as REITs for U.S. federal income tax purposes, some of which we consolidate for financial reporting purposes but each of which is treated as a separate REIT for federal income tax purposes (each a “Subsidiary REIT”). To qualify as a REIT, each Subsidiary REIT must independently satisfy all of the REIT qualification requirements under the Code, together with all other rules applicable to REITs. Provided that each Subsidiary
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REIT qualifies as a REIT, our interests in the Subsidiary REITs will be treated as qualifying real estate assets for purposes of the REIT asset tests. If a Subsidiary REIT fails to qualify as a REIT in any taxable year, such Subsidiary REIT would be subject to federal and state income taxes and would not be able to qualify as a REIT for the four subsequent taxable years following the year during which it was disqualified. Any such failure could have an adverse effect on our ability to comply with the REIT income and asset tests, and thus our ability to qualify as a REIT, unless we are able to avail ourselves of certain relief provisions and pay any tax required by such relief provisions. 
The tax imposed on any net income from "prohibited transactions" may limit our ability to engage in transactions which would be treated as sales for federal income tax purposes
Any net income of a REIT from prohibited transactions (which are, in general, sales or other dispositions of property held primarily for sale to customers in the ordinary course of business, other than dispositions of foreclosure property) is subject to a 100% tax, unless certain safe harbor exceptions apply. Although we do not intend to hold any properties that would be characterized as held for sale to customers in the ordinary course of our business (other than through a TRS), such characterizations is a factual determination and no guarantee can be given that the IRS would agree with our characterization of our properties or that we will always be able to make use of the available safe harbors.
The 90% annual distribution requirement will decrease our liquidity and may limit our ability to engage in otherwise beneficial transactions 
To comply with the 90% distribution requirement applicable to REITs and to avoid the nondeductible excise tax, we must make distributions to our stockholders. Although we anticipate that we generally will have sufficient cash or liquid assets to enable us to satisfy the REIT distribution requirement, it is possible that, from time to time, we may not have sufficient cash or other liquid assets to meet the 90% distribution requirement. This may be due to timing differences between the actual receipt of income and actual payment of deductible expenses, on the one hand, and the inclusion of that income and deduction of those expenses in arriving at our taxable income, on the other hand. In addition, non-deductible expenses such as principal amortization or repayments or capital expenditures in excess of non-cash deductions may cause us to fail to have sufficient cash or liquid assets to enable us to satisfy the 90% distribution requirement. In the event that timing differences occur, or we deem it appropriate to retain cash, we may borrow funds, even if the then-prevailing market conditions are not favorable for these borrowings, issue additional equity securities (although we cannot assure you that we will be able to do so), pay taxable stock dividends, if possible, distribute other property or securities or engage in other transactions intended to enable us to meet the REIT distribution requirements. This may require us to raise additional capital to meet our obligations. 
Our use of TRSs is limited under the Code
Under the Code, no more than 20% of the value of the gross assets of a REIT may be represented by securities of one or more TRSs. This limitation may affect our ability to increase the size of our TRSs’ operations and assets, and there can be no assurance that we will be able to comply with the applicable limitation, or that such compliance will not adversely affect our business. Also, our TRSs may not, among other things, operate or manage certain health care facilities, which may cause us to forgo investments we might otherwise make. Finally, we may be subject to a 100% excise tax on the income derived from certain transactions with our TRSs that are not on an arm's-length basis. We believe our arrangements with our TRSs are on arm's-length terms and intend to continue to operate in a manner that allows us to avoid incurring the 100% excise tax described above, but there can be no assurance that we will be able to avoid application of that tax.
The lease of qualified health care properties to a TRS is subject to special requirements
We lease certain qualified health care properties to TRSs (or subsidiaries of TRSs), which lessees contract with managers (or related parties) to manage the health care operations at these properties. The rents from this TRS lessee structure are treated as qualifying rents from real property if (1) they are paid pursuant to an arm's-length lease of a qualified health care property with a TRS and (2) the manager qualifies as an eligible independent contractor (as defined in the Code). If any of these conditions are not satisfied, then the rents will not be qualifying rents. 
If certain sale-leaseback transactions are not characterized by the IRS as “true leases,” we may be subject to adverse tax consequences 
We have purchased certain properties and leased them back to the sellers of such properties, and we may enter into similar transactions in the future. We intend for any such sale-leaseback transaction to be structured in such a manner that the lease will be characterized as a “true lease,” thereby allowing us to be treated as the owner of the property for U.S. federal income tax purposes. However, depending on the terms of any specific transaction, the IRS might take the position that the transaction is not a “true lease” but is more properly treated in some other manner. In the event any sale-leaseback transaction is challenged and successfully re-characterized by the IRS, we would not be entitled to claim the deductions for depreciation and cost recovery generally available to an owner of property. Furthermore, if a sale-leaseback transaction were so re-characterized, we might fail to satisfy the REIT asset tests or income tests and, consequently, could lose our REIT status effective with the year of re-characterization. Alternatively, the amount of our REIT taxable income could be recalculated, which may cause us to fail to meet the REIT annual distribution requirements for a taxable year. 
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We could be subject to changes in our tax rates, the adoption of new U.S. or international tax legislation, or exposure to additional tax liabilities 
We are subject to taxes in the U.S. and foreign jurisdictions. Because the U.S. maintains a worldwide corporate tax system, the foreign and U.S. tax systems are somewhat interdependent. Longstanding international norms that determine each country's jurisdiction to tax cross-border international trade are evolving and could reduce the ability of our foreign subsidiaries to deduct for foreign tax purposes the interest they pay on loans from us, thereby increasing the foreign tax liability of the subsidiaries; it is also possible that foreign countries could increase their withholding taxes on dividends and interest.
Our effective tax rates could be affected by changes in the mix of earnings in countries with differing statutory tax rates or changes in tax laws or their interpretation. We are also subject to the examination of our tax returns and other tax matters by the IRS and other tax authorities and governmental bodies. We regularly assess the likelihood of an adverse outcome resulting from these examinations to determine the adequacy of our provision for taxes. There can be no assurance as to the outcome of these examinations. If we were subject to review or examination by the IRS or applicable foreign jurisdiction as the result of any new tax law changes, the ultimate determination of which may change our taxes owed for an amount in excess of amounts previously accrued or recorded, our financial condition, operating results, and cash flows could be adversely affected.
The present federal income tax treatment of REITs may be modified, possibly with retroactive effect, by legislative, judicial or administrative action at any time, which could affect the federal income tax treatment of an investment in us. The federal income tax rules dealing with U.S. federal income taxation and REITs are constantly under review by persons involved in the legislative process, the IRS and the U.S. Treasury Department, which results in statutory changes as well as frequent revisions to regulations and interpretations. Also, the law relating to the tax treatment of other entities or an investment in other entities could change, making an investment in such other entities more attractive relative to an investment in a REIT.
We cannot predict how changes in the tax laws in the U.S. or foreign jurisdictions might affect our investors or us. Revisions in tax laws and interpretations thereof could significantly and negatively affect our ability to qualify as a REIT, as well as the tax considerations relevant to an investment in us, could require us to pay additional taxes on our assets or income and/or be subject to additional restrictions, could cause us to change our investments and commitments, and could adversely affect our earnings and cash flow. These changes could, among other things, adversely affect the trading price for our common stock, our financial condition, our results of operations and the amount of cash available for the payment of dividends.
The impact to our TRSs of the Corporate Alternative Minimum Tax imposed by the Inflation Reduction Act of 2022 is uncertain and may be adverse
For tax years beginning after December 31, 2022, the Inflation Reduction Act of 2022 ("IRA") imposes among other things, a 15% Corporate Alternative Minimum Tax ("Corporate AMT") on certain U.S. corporations with average adjusted financial statement income in excess of $1 billion. Although, by its terms, the Corporate AMT is not applicable to REITs, it is not certain whether or how the Corporate AMT would apply to our TRSs.
The IRS has issued a number of rulings indicating its intention to propose regulations providing guidance regarding the Corporate AMT and issuing certain interim rules on which taxpayers may rely. Until further regulations and guidance from the IRS and Treasury are released, the impact of the Corporate AMT on our TRSs is uncertain and it is possible that our TRSs will be subject to material U.S. federal income taxes under the Corporate AMT.
Item 1B.  Unresolved Staff Comments
None.
Item 1C.  Cybersecurity
Our information technology networks, those of our operators and managers, and those of third parties on whom we rely, are important enablers to our ability to perform day-to-day operations of our business. Our business operations depend on the secure collection, storage, transmission and other processing of proprietary, confidential or sensitive data.
We have implemented and maintain various information security processes designed to identify, assess and manage material risks from cybersecurity threats. Our cybersecurity program includes several safeguards such as access controls, multi-factor authentication, continuous monitoring and alerting systems for internal and external threats and penetration testing. Additionally, we conduct regular evaluation of our cybersecurity program, encompassing internal reviews and third-party assessments to ensure its effectiveness and resilience.
Governance
The Board of Directors (the "Board") retains ultimate oversight of cybersecurity risk, which it manages through our enterprise risk management program. The Board has delegated primary responsibility of overseeing cybersecurity risks to the Audit Committee. The Audit Committee's responsibilities include reviewing cybersecurity strategies with management, assessing processes and controls pertaining to the management of our information technology operations and their effectiveness, and seeking to confirm that management's response to potential cybersecurity incidents is timely and effective. At least annually, the Audit Committee receives a cybersecurity report from management. This report may cover a variety of relevant topics, potentially including recent developments, evolving standards, vulnerability assessments, third-party and independent reviews, the threat environment, technological trends and information security considerations related to our
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operators, managers and third parties. The scope and focus of each report are determined based on current priorities and emerging issues in cybersecurity. The Audit Committee and management also report to the Board at least annually on data protection and cybersecurity matters.
Management and Cybersecurity Working Group
Reporting to the Chief Operating Officer, our Chief Technology Officer, with extensive cybersecurity knowledge and skills from over 20 years of relevant work experience at Welltower and elsewhere, leads the team responsible for developing and implementing our information security program across our business. This team comprises individuals with relevant educational and technical experience, many having held similar positions with responsibility for various aspects of cybersecurity at large organizations. This team works closely with the Legal department to oversee compliance and regulatory and contractual security requirements. The Chief Technology Officer also leads our Cyber Security Working Group, which is comprised of a cross-functional team including Internal Audit, Legal, Information Technology, Risk Management and Accounting leaders. These individuals meet regularly and are informed about and monitor the prevention, mitigation, detection and remediation of cybersecurity incidents. The Chief Technology Officer is responsible for reporting on cybersecurity and information technology to the Audit Committee.
Information Security Program
The information security team provides regular reports to the Chief Technology Officer and other relevant teams on various cybersecurity threats, assessments and findings. In addition to our internal cybersecurity capabilities, we also periodically engage assessors, consultants, auditors or other third parties to provide consultation and advice to assist with assessing, identifying and managing cybersecurity risks. Our management team identifies and assesses information security risks using industry practices informed by the National Institute of Standards and Technology ("NIST"), including the NIST Cybersecurity Framework.
To ensure that cybersecurity is an organization-wide effort, we provide mandatory cybersecurity training at least annually for all employees with network access, including training designed to simulate and help prevent phishing and other social engineering attacks. We also employ systems and processes designed to oversee, identify and reduce the potential impact of a security incident at a third-party vendor, service provider or otherwise implicating the third-party technology and systems we use. Additionally, we maintain cybersecurity insurance providing coverage for certain costs related to cybersecurity-related incidents that impact our cybersecurity and information technology infrastructure.
Incident Response
The Cybersecurity Working Group maintains and oversees an incident response plan that applies in the event of a cybersecurity threat or incident to provide a standardized framework for responding to cybersecurity incidents. The incident response plan sets out a coordinated approach to investigating, containing, documenting and mitigating incidents, including reporting findings and keeping senior management and other key stakeholders informed and involved as appropriate. The objectives of the incident response plan are to reduce the number of systems and users affected by security incidents, reduce the time a threat actor spends within our network, reduce the damage caused by the breach and reduce the time required to restore normal operations. The incident response plan also specifies the use of third-party experts for legal advice, consulting and cyber incident response.
Material Cybersecurity Risks, Threats and Incidents
While we employ several measures to prevent, detect and mitigate cybersecurity threats, there is no guarantee such efforts will be successful. We also rely on information technology and other third-party vendors to support our business, including securely processing personal, confidential, financial, sensitive or proprietary and other types of information. Despite our efforts to improve our ability, and the ability of relevant third parties', to protect against cyber threats, we may not be able to protect all information, systems, products and services. While we are not aware of any cybersecurity incidents that have materially affected us to date, there can be no guarantee that we will not be the subject of future attacks, threats or incidents, that may have a material impact on our business strategy, results of operations or financial condition. Additional information on cybersecurity risks we face can be found in Part I, Item 1A "Risk Factors" of this Form 10-K under the heading "Cybersecurity incidents could disrupt our business and result in the loss of confidential information and legal liability," which should be read in conjunction with the foregoing information.

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Item 2.  Properties 
We lease our corporate headquarters located at 4500 Dorr Street, Toledo, Ohio 43615. We also lease corporate offices throughout the U.S., Canada and the United Kingdom and have ground leases relating to certain of our properties. The following table sets forth certain information regarding the properties that comprise our consolidated real property and real estate loan investments as of December 31, 2023 (dollars in thousands):
 Seniors Housing OperatingTriple-netOutpatient Medical
Property LocationNumber of PropertiesTotal Investment
Annualized Revenues(1)
Number of PropertiesTotal Investment
Annualized Revenues(1)
Number of PropertiesTotal Investment
Annualized Revenues(1)
Alabama$54,058 $14,606 $32,442 $4,607 $174,961 $13,091 
Arkansas26,758 5,445 — — — 19,716 2,281 
Arizona13 313,573 52,852 — — 144 89,447 12,199 
California107 3,794,605 901,464 23 418,370 55,870 43 1,027,948 127,911 
Colorado17 504,482 116,561 217,215 19,361 2,024 — 
Connecticut156,876 32,735 81,453 7,976 96,464 9,218 
District Of Columbia139,124 14,689 — — — 77,112 8,216 
Delaware61,488 31,023 117,409 15,337 — — — 
Florida31 1,071,179 221,843 101 1,443,056 177,880 25 221,349 43,078 
Georgia18 334,750 61,823 36,712 3,545 18 223,381 34,297 
Hawaii69,929 22,187 — — — — — — 
Iowa10 128,726 40,965 45,419 3,281 — — — 
Idaho112,082 10,520 — — — 47,782 4,306 
Illinois37 667,524 184,586 21 250,640 20,458 10 128,916 19,448 
Indiana17 418,024 65,395 19 227,652 19,343 29,264 4,353 
Kansas10 146,406 49,970 20 164,611 23,131 — — — 
Kentucky58,878 17,954 48,918 5,440 — — — 
Louisiana195,341 50,681 6,934 720 22,123 815 
Massachusetts19 658,548 107,353 160,657 9,662 154,718 14,423 
Maryland10 548,701 108,441 16 171,336 41,146 12 237,668 28,319 
Maine23,061 12,457 — — — — — — 
Michigan29 477,490 119,763 25 233,157 22,438 13 176,348 19,536 
Minnesota74,761 14,334 12 221,642 23,023 138,393 30,263 
Missouri13 319,790 57,700 — — — 16 222,901 29,368 
Mississippi88,753 20,338 — — — 46,752 3,784 
Montana22,858 8,547 — — — — — — 
North Carolina14 581,410 94,097 50 496,773 78,361 25 607,853 48,794 
North Dakota12,690 1,400 — — — — — — 
Nebraska103,184 20,837 — — — 10,505 2,322 
New Hampshire82,391 8,722 — — — — — — 
New Jersey28 696,855 233,930 27 741,750 85,879 16 334,280 43,903 
New Mexico— — — — — — 31,061 — 
Nevada122,711 35,922 — — — 122,566 10,700 
New York41 809,833 195,804 34,025 1,513 15 397,615 34,233 
Ohio49 940,675 201,115 41 448,950 52,953 125,836 14,937 
Oklahoma14 182,051 52,514 12 87,550 13,789 25,054 3,626 
Oregon14 158,472 48,307 2,306 909 41,995 3,104 
Pennsylvania26 447,525 117,573 56 558,164 101,308 92,175 6,812 
South Carolina223,789 30,853 31,428 7,215 9,452 1,566 
Tennessee186,340 44,327 56,410 7,849 64,268 5,717 
Texas83 1,790,432 397,246 23 321,329 35,221 71 1,463,494 109,352 
Utah71,291 25,368 21,144 2,100 10,556 1,108 
Virginia13 538,467 128,187 29 323,151 61,466 109,708 7,124 
Washington33 917,452 218,974 85,367 12,142 194,660 33,384 
Wisconsin18,136 6,696 81,547 10,214 81,127 8,817 
West Virginia— — — 6,134 999 — — — 
Total domestic739 $18,351,469 $4,206,104 546 $7,173,651 $925,280 369 $6,859,472 $740,405 
Canada119 3,132,032 598,856 128,881 10,334 — — — 
United Kingdom60 1,667,483 473,615 62 1,462,925 110,168 — — — 
Total international179 $4,799,515 $1,072,471 68 $1,591,806 $120,502 — $— $— 
Grand total918 $23,150,984 $5,278,575 614 $8,765,457 $1,045,782 369 $6,859,472 $740,405 
(1) Represents revenue for the month ended December 31, 2023 annualized.
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The following table sets forth occupancy and average annualized revenues for certain property types (excluding investments in unconsolidated entities):
 
Occupancy(1)
Average Annualized Revenues(2)
 
 2023202220232022 
Seniors Housing Operating(3)
81.8%78.1%$52,709 $49,987 per unit
Triple-net(4)
78.6%76.2%19,124 17,330 per bed/unit
Outpatient Medical(5)
94.8%95.2%37 38 per sq. ft.
(1) We use unaudited, periodic financial information provided solely by tenants/borrowers to calculate occupancy for properties other than Outpatient Medical buildings and have not independently verified the information.
(2) Represents December annualized revenues as presented in the tables above, divided by total beds, units or square feet in service.
(3) Occupancy represents average occupancy of properties in service for the three months ended December 31.
(4) Occupancy represents average quarterly operating occupancy based on the quarters ended September 30 and excludes properties that are unstabilized, closed or for which data is not available or meaningful.
(5) Occupancy represents the percentage of total rentable square feet leased and occupied (including month-to-month and holdover leases and excluding terminations) as of December 31.

The following table sets forth information regarding lease expirations for certain portions of our portfolio as of December 31, 2023 (dollars in thousands):
 
Expiration Year(1)
 2024202520262027202820292030203120322033Thereafter
Triple-net:           
Properties
16 13 34 127 42 348 
Base rent(2)
$13,495 $7,803 $12,855 $1,232 $6,404 $1,035 $70,998 $10,762 $99,472 $54,813 $459,973 
% of base rent
1.8 %1.1 %1.7 %0.2 %0.9 %0.1 %9.6 %1.5 %13.5 %7.4 %62.2 %
Units
1,182 521 1,695 80 616 219 3,669 423 6,163 3,267 39,419 
% of units
2.1 %0.9 %3.0 %0.1 %1.1 %0.4 %6.4 %0.7 %10.8 %5.7 %68.8 %
Outpatient Medical:     we may experiences losses      
Square feet
2,108,859 1,296,491 1,635,726 1,524,274 1,552,764 1,314,461 1,254,813 1,780,700 1,470,798 1,195,919 4,469,245 
Base rent(2)
$62,546 $38,352 $45,124 $39,534 $43,408 $37,184 $35,361 $49,581 $42,971 $31,045 $127,189 
% of base rent
11.3 %6.9 %8.2 %7.2 %7.9 %6.7 %6.4 %9.0 %7.8 %5.6 %23.0 %
Leases
464 263 266 234 260 147 113 84 157 104 183 
% of leases
20.4 %11.6 %11.7 %10.3 %11.4 %6.5 %5.0 %3.7 %6.9 %4.6 %7.9 %
(1) Excludes investments in unconsolidated entities, developments, land parcels, loans receivable and sub-leases. Investments classified as held for sale are included in 2024.
(2) The most recent monthly cash base rent annualized. Base rent does not include tenant recoveries or amortization of above and below market lease intangibles or other non-cash income.
Item 3. Legal Proceedings
From time to time, there are various legal proceedings pending against us that arise in the ordinary course of our business.  Management does not believe that the resolution of any of these legal proceedings either individually or in the aggregate will have a material adverse effect on our business, results of operations or financial condition. Further, from time to time, we are party to certain legal proceedings for which third parties, such as tenants, operators and/or managers are contractually obligated to indemnify, defend and hold us harmless. In some of these matters, the indemnitors have insurance for the potential damages.  In other matters, we are being defended by tenants and other obligated third parties and these indemnitors may not have sufficient insurance, assets, income or resources to satisfy their defense and indemnification obligations to us. The unfavorable resolution of such legal proceedings could, individually or in the aggregate, materially adversely affect the indemnitors’ ability to satisfy their respective obligations to us, which, in turn, could have a material adverse effect on our business, results of operations or financial condition. It is management’s opinion that there are currently no such legal proceedings pending that will, individually or in the aggregate, have such a material adverse effect. Despite management’s view of the ultimate resolution of these legal proceedings, we may have significant legal expenses and costs associated with the defense of such matters. Further, management cannot predict the outcome of these legal proceedings and if management’s expectation regarding such matters is not correct, such proceedings could have a material adverse effect on our business, results of operations or financial condition.
Item 4. Mine Safety Disclosures
None.
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PART II
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 
Our common stock trades on the New York Stock Exchange (NYSE:WELL). There were 2,758 stockholders of record as of February 9, 2024.
Please see "Item 7 - Management's Discussion and Analysis of Financial Condition and Results of Operation - Executive Summary - Key Transactions - Dividends" for a discussion of cash dividends declared on our common stock.
Stockholder Return Performance Presentation 
The graph and table below compares the yearly percentage change and the cumulative total stockholder return on our shares of common stock against the cumulative total return of the S&P Composite-500 Stock Index and the FTSE NAREIT Equity Index. The data are based on the closing prices as of December 31 for each of the five years presented. 2018 equals $100 and dividends are assumed to be reinvested.
700
 12/31/201812/31/201912/31/202012/31/202112/31/202212/31/2023
S & P 500$100.00 $131.49 $155.68 $200.37 $164.08 $207.21 
Welltower Inc.100.00 123.03 101.52 139.06 109.62 155.40 
FTSE NAREIT Equity100.00 126.00 115.92 166.04 125.58 142.83 
Except to the extent that we specifically incorporate this information by reference, the foregoing Stockholder Return Performance Presentation shall not be deemed incorporated by reference by any general statement incorporating by reference this Annual Report on Form 10-K into any filing under the Securities Act of 1933, as amended, or under the Securities Exchange Act of 1934, as amended. This information shall not otherwise be deemed filed under such Acts.
During the three months ended December 31, 2023, we acquired shares of our common stock held by employees who tendered shares to satisfy tax withholding obligations upon the vesting of previously issued restricted stock awards. Specifically, the number of shares of common stock acquired from employees and the average prices paid per share for each month in the fourth quarter ended December 31, 2023 are as shown in the table below:
Issuer Purchases of Equity Securities
PeriodTotal Number of Shares PurchasedAverage Price Paid Per ShareTotal Number of Shares Purchased as Part of Publicly Announced Repurchase ProgramMaximum Dollar Value of Shares that May Yet Be Purchased Under the Repurchase Program
October 1, 2023 through October 31, 2023834 $84.16 — $3,000,000,000 
November 1, 2023 through November 30, 2023541 85.15 — 3,000,000,000 
December 1, 2023 through December 31, 2023— — — 3,000,000,000 
Totals1,375 $84.55 — $3,000,000,000 
Under the terms of various partnership agreements of certain of our affiliated limited partnerships, the interest of limited partners may be redeemed, subject to certain conditions, for cash or common shares, at our option. During the three months ended December 31, 2023, we redeemed 980 OP Units for common shares.
On November 7, 2022, our Board of Directors approved a share repurchase program for up to $3,000,000,000 of common stock (the "Stock Repurchase Program"). Under the Stock Repurchase Program, we are not required to purchase shares but may choose to do so in the open market or through privately-negotiated transactions, through block trades, by effecting a tender offer, by way of an accelerated share repurchase program, through the purchase of call options or the sale of put options, or otherwise, or by any combination of the foregoing. We expect to finance any share repurchases using available cash and may use proceeds from borrowings or debt offerings. The Stock Repurchase Program has no expiration date and does not obligate us to repurchase any specific number of shares. We did not repurchase any shares of our common stock through the Stock Repurchase Program during the three months ended December 31, 2023.
Item 6. [Reserved]
49

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
EXECUTIVE SUMMARY
  
Company Overview
Business Strategy
Key Transactions
Key Performance Indicators, Trends and Uncertainties
Corporate Governance
LIQUIDITY AND CAPITAL RESOURCES
  
Sources and Uses of Cash
Off-Balance Sheet Arrangements
Contractual Obligations
Capital Structure
Supplemental Guarantor Information
  
RESULTS OF OPERATIONS
  
Summary
Seniors Housing Operating
Triple-net
Outpatient Medical
Non-Segment/Corporate
  
OTHER
  
Non-GAAP Financial Measures
Critical Accounting Policies and Estimates
 
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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.
On March 7, 2022, we announced our intent to complete an UPREIT reorganization. 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. ("Welltower OP") converted from a Delaware corporation into a Delaware limited liability company named Welltower OP LLC (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 health care 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 health care 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 99.765% as of December 31, 2023. 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, 2023 (dollars in thousands):
  Percentage ofNumber of
Type of Property
NOI(1)
NOIProperties
Seniors Housing Operating$1,118,135 42.4 %918
Triple-net1,001,135 37.9 %614
Outpatient Medical519,199 19.7 %369
Totals$2,638,469 100.0 %1,901 
(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. 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 as a result of annual increases in NOI and portfolio growth. To meet these objectives, we invest across the full spectrum of seniors housing and health care 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. 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
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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, 2023, resident fees and services and rental income represented 72% and 23%, respectively, of total revenues. 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, rent and interest receipts, interest earned on short-term deposits, borrowings under our unsecured revolving credit facility and commercial paper program, public 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.
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 public debt and equity securities and the incurrence or assumption of secured debt. Given general economic conditions in 2023, 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. At December 31, 2023, we had $1,993,646,000 of cash and cash equivalents, $82,437,000 of restricted cash and $4,000,000,000 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, 2023:
In May 2023, we issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028 unless earlier exchanged, purchased or redeemed.
During the year ended December 31, 2023, we issued $385,115,000 of secured debt at a blended average interest rate of 5.13% and assumed $428,578,000 of secured debt at a blended average interest rate of 6.42%. We extinguished $687,780,000 of secured debt at a blended average interest rate of 6.21%.
In August 2023, Welltower and Welltower OP entered into the ATM Program (as defined below) pursuant to which we may offer and sell up to $4,000,000,000 of common stock of Welltower from time to time. During the twelve months ended December 31, 2023, we sold 53,300,874 shares of common stock under our current and previous 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.


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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Investments
Investments The following summarizes our property acquisitions and joint venture investments completed during the year ended December 31, 2023 (dollars in thousands):
 Properties
Book Amount(1)
Capitalization Rates(2)
Seniors Housing Operating52 $2,655,913 5.4%
Triple-net66 1,097,004 9.4%
Outpatient Medical35 474,058 6.9%
Totals153 $4,226,975 6.6%
(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, 2023 (dollars in thousands):
 Properties
Proceeds(1)
Book Amount(2)
Capitalization Rates(3)
Seniors Housing Operating23 $453,983 $385,128 2.1%
Triple-net6,954 6,391 5.0%
Totals25 $460,937 $391,519 2.1%
(1) Represents pro rata proceeds received upon disposition including 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. Excludes properties sold that were recent development conversions.
Strategic Dissolution of Revera Joint Ventures 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 include 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 statement for further information regarding the transaction.
Dividends Our Board of Directors declared a cash dividend for the quarter ended December 31, 2023 of $0.61 per share. On March 7, 2024, we will pay our 211th consecutive quarterly cash dividend to stockholders of record on February 23, 2024.
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”) per 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. 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,
 202320222021
Net income$358,139 $160,568 $374,479 
Net income attributable to common stockholders340,094 141,214 336,138 
Funds from operations attributable to common stockholders1,763,227 1,478,072 1,220,722 
Consolidated net operating income2,690,219 2,301,845 1,967,553 
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.
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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,
 202320222021
Net debt to book capitalization ratio34.3%39.5%42.2%
Net debt to undepreciated book capitalization ratio27.8%32.1%34.9%
Net debt to market capitalization ratio20.9%29.5%25.9%
Interest coverage ratio3.74x3.73x3.89x
Fixed charge coverage ratio3.44x3.37x3.43x
Adjusted interest coverage ratio3.95x3.94x3.89x
Adjusted fixed charge coverage ratio3.64x3.56x3.43x
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. 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 international countries).
The following table reflects our recent historical trends of concentration risk by NOI for the years indicated below:
 
Year Ended December 31,(1)
 202320222021
Property mix:   
 Seniors Housing Operating42%41%35%
 Triple-net38%38%43%
 Outpatient Medical20%21%22%
Relationship mix:   
 Integra Healthcare Properties8%—%—%
Sunrise Senior Living6%7%10%
 Cogir Management Corporation4%3%2%
 Avery Healthcare4%3%4%
 Oakmont Management Group4%2%1%
 Remaining74%85%83%
Geographic mix:   
 California12%14%13%
 United Kingdom9%10%13%
 Texas8%8%8%
 Canada6%6%6%
 Florida6%6%4%
 Remaining59%56%56%
(1) Excludes our share of investments in unconsolidated entities and non-segment/corporate NOI. 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.
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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, public 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):
 Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
 December 31,December 31,  December 31,    
 20232022$%2021$%$%
Cash, cash equivalents and restricted cash at beginning of period$722,292 $346,755 $375,537 108 %$2,021,043 $(1,674,288)-83 %$(1,298,751)-64 %
Net cash provided from (used in): 
Operating activities1,601,861 1,328,708 273,153 21 %1,275,325 53,383 %326,536 26 %
Investing activities(5,707,742)(3,703,815)(2,003,927)54 %(4,516,268)812,453 -18 %(1,191,474)26 %
Financing activities5,448,647 2,761,277 2,687,370 97 %1,567,664 1,193,613 76 %3,880,983 248 %
Effect of foreign currency translation11,025 (10,633)21,658 n/a(1,009)(9,624)954 %12,034 n/a
Cash, cash equivalents and restricted cash at end of period$2,076,083 $722,292 $1,353,791 187 %$346,755 $375,537 108 %$1,729,328 499 %
Operating Activities Please see “Results of Operations” for discussion of net income fluctuations. For the years ended December 31, 2023, 2022 and 2021, cash flows provided from operations exceeded cash distributions to stockholders.
Investing Activities  The changes in net cash provided from/used in investing activities are primarily attributable to net changes in real property investments and dispositions, loans receivable and investments in unconsolidated entities, which are summarized above in “Key Transactions.” Please refer to Notes 3 and 5 of our consolidated financial statements for additional information. The following is a summary of cash used in non-acquisition capital improvement activities for the periods presented (dollars in thousands):
 Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
 December 31,December 31,  December 31,    
 20232022$%2021$%$%
New development$1,014,935 $631,737 $383,198 61 %$417,963 $213,774 51 %$596,972 143 %
Recurring capital expenditures, tenant improvements and lease commissions199,359 198,576 783 — %99,994 98,582 99 %99,365 99 %
Renovations, redevelopments and other capital improvements318,323 277,440 40,883 15 %182,594 94,846 52 %135,729 74 %
Total$1,532,617 $1,107,753 $424,864 38 %$700,551 $407,202 58 %$832,066 119 %
The change in new development is primarily due to the number and size of construction projects on-going 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 overall development and recurring capital expenditures, tenant improvements and lease commissions is due primarily to portfolio growth and increased spending after a contraction during the pandemic. 
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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 which are summarized above in “Key Transactions.” Please refer to Notes 10, 11 and 14 to our consolidated financial statements for additional information.
In April 2022, we closed on an amended $5,200,000,000 unsecured credit facility, increasing our term loan capacity by $500,000,000. 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 twelve months ended December 31, 2023, we issued $385,115,000 of secured debt at a blended average interest rate of 5.13% and assumed $428,578,000 of secured debt at a blended average interest rate of 6.42%. As of December 31, 2023, we have total near-term available liquidity of approximately $6.1 billion.
Off-Balance Sheet Arrangements
At December 31, 2023, 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, 2023, we had 23 outstanding letter of credit obligations. Please see Notes 8, 12 and 13 to our consolidated financial statements for additional information.
Contractual Obligations
The following table summarizes our payment requirements under contractual obligations as of December 31, 2023 (in thousands):
 Payments Due by Period
Contractual ObligationsTotal20242025-20262027-2028Thereafter
Senior unsecured notes and term credit facilities:(1)
U.S. Dollar senior unsecured notes$10,935,000 $1,350,000 $1,950,000 $2,285,000 $5,350,000 
     Canadian Dollar senior unsecured notes(2)
227,239 — — 227,239 — 
     Pounds Sterling senior unsecured notes(2)
1,338,015 — — 700,865 637,150 
U.S. Dollar term credit facility1,010,000 — 10,000 1,000,000 — 
     Canadian Dollar term credit facility(2)
189,365 — — 189,365 — 
Secured debt:(1,2)
    
Consolidated2,222,445 400,258 584,321 317,637 920,229 
     Unconsolidated  
1,111,216 229,175 557,721 139,840 184,480 
Contractual interest obligations:(3)
    
     Senior unsecured notes and term loans(2)
3,741,633 528,777 908,731 673,248 1,630,877 
     Consolidated secured debt(2)
454,513 99,336 123,873 95,763 135,541 
     Unconsolidated secured debt(2)
124,597 38,003 30,965 14,199 41,430 
Finance lease liabilities(4)
391,388 5,547 8,010 7,939 369,892 
Operating lease liabilities(4)
951,398 19,329 35,437 32,785 863,847 
Purchase obligations(5)
2,171,304 1,923,419 244,794 2,561 530 
Total contractual obligations$24,868,113 $4,593,844 $4,453,852 $5,686,441 $10,133,976 
(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 balance sheet date.
(3) Based on variable interest rates in effect as of December 31, 2023.
(4) See Note 6 to our consolidated financial statements for additional information.
(5) See Note 13 to our consolidated financial statements for additional information.
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, 2023, 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.
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
On April 1, 2022, Welltower and Welltower OP jointly filed with the Securities and Exchange Commission (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 to replace Old Welltower’s existing “universal” shelf registration statement filed with the SEC on May 4, 2021. 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 to replace Old Welltower’s existing DRIP registration statement on Form S-3 filed with the SEC on May 4, 2021. 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 9, 2024, 15,000,000 shares of common stock remained available for issuance under the DRIP registration statement. On August 1, 2023, Welltower and Welltower OP entered into an equity distribution agreement (the “EDA”) with (i) Barclays Capital Inc., BMO Capital Markets Corp., BNP Paribas Securities Corp., BNY Mellon Capital Markets, LLC, BofA Securities, Inc., BOK Financial Securities, Inc., Capital One Securities Inc., Citigroup Global Markets Inc., Citizens JMP Securities, LLC, Comerica Securities, Inc., Credit Agricole Securities (USA) Inc., Deutsche Bank Securities Inc., Fifth Third Securities, Inc., Goldman Sachs & Co. LLC, Jefferies LLC, J.P. Morgan Securities LLC, KeyBanc Capital Markets Inc., Loop Capital Markets LLC, Mizuho Securities USA LLC, Morgan Stanley & Co. LLC, MUFG Securities Americas Inc., RBC Capital Markets, LLC, Regions Securities LLC, Robert W. Baird & Co. Incorporated, Scotia Capital (USA) Inc., Synovus Securities, Inc., TD Securities (USA) LLC, Truist Securities, Inc. and Wells Fargo Securities, LLC as sales agents and forward sellers and (ii) the forward purchasers named therein relating to issuances, offers and sales from time to time of up to $4,000,000,000 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 9, 2024, we had $1,451,479,501 of remaining capacity under the ATM Program and there were no 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 Old Welltower's prospectus supplement and the accompanying prospectus to the 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 August 9, 2023, Welltower filed with the SEC a prospectus supplement relating to the registration of up to 13,559,535 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 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 99.765% owned by Welltower as of December 31, 2023. 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.
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Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Results of Operations
Summary
Our primary sources of revenue include resident fees and services, rent, 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 business 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 2023 and 2022 items and year-to-year comparisons between 2023 and 2022. Discussions of 2021 items and year-to-year comparisons between 2022 and 2021 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, 2022.
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,    
 20232022Amount%2021Amount%Amount%
Net income$358,139 $160,568 $197,571 123 %$374,479 $(213,911)-57 %$(16,340)-4 %
NICS340,094 141,214 198,880 141 %336,138 (194,924)-58 %3,956 %
FFO1,763,227 1,478,072 285,155 19 %1,220,722 257,350 21 %542,505 44 %
EBITDA2,373,450 2,007,702 365,748 18 %1,910,611 97,091 %462,839 24 %
Adjusted EBITDA2,509,003 2,122,399 386,604 18 %1,913,546 208,853 11 %595,457 31 %
NOI2,690,219 2,301,845 388,374 17 %1,967,553 334,292 17 %722,666 37 %
Per share data (fully diluted):      
Net income attributable to common stockholders (1)
$0.66 $0.30 $0.36 120 %$0.78 $(0.48)-62 %$(0.12)-15 %
Funds from operations attributable to common stockholders$3.40 $3.18 $0.22 %$2.86 $0.32 11 %$0.54 19 %
Interest coverage ratio3.74x3.73x0.01x— %3.89x-0.16x-4 %-0.15x-4 %
Fixed charge coverage ratio3.44x3.37x0.07x%3.43x-0.06x-2 %0.01x— %
Adjusted interest coverage ratio3.95x3.94x0.01x— %3.89x0.05x%0.06x%
Adjusted fixed charge coverage ratio3.64x3.56x0.08x%3.43x0.13x%0.21x%
(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, 2021 to December 31, 2023 (in thousands):
 Year Ended December 31, 
 December 31, 2023December 31, 2022December 31, 2021Totals
Beginning balance490,508 447,239 417,401 417,401 
Redemption of OP Units and DownREIT Units336 — 341 
Option exercises— 
ATM Program issuances53,301 43,093 29,667 126,061 
Equity issuances20,125 — — 20,125 
Other, net(33)169 171 307 
Ending balance564,241 490,508 447,239 564,241 
Weighted average number of shares outstanding:   
Basic515,629 462,185 424,976  
Diluted518,701 465,158 426,841  
A portion of our earnings are 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.
58

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,    
 20232022$%2021$%$%
Revenues:         
Resident fees and services$4,753,804 $4,173,711 $580,093 14 %$3,197,223 $976,488 31 %$1,556,581 49 %
Interest income10,096 7,867 2,229 28 %4,231 3,636 86 %5,865 139 %
Other income9,743 63,839 (54,096)-85 %11,796 52,043 441 %(2,053)-17 %
Total revenues4,773,643 4,245,417 528,226 12 %3,213,250 1,032,167 32 %1,560,393 49 %
Property operating expenses3,655,508 3,292,045 363,463 11 %2,529,344 762,701 30 %1,126,164 45 %
NOI(1)
1,118,135 953,372 164,763 17 %683,906 269,466 39 %434,229 63 %
Other expenses:   
Depreciation and amortization906,771 854,800 51,971 %593,565 261,235 44 %313,206 53 %
Interest expense56,509 34,833 21,676 62 %39,327 (4,494)-11 %17,182 44 %
Loss (gain) on extinguishment of debt, net— 386 (386)-100 %(2,628)3,014 115 %2,628 100 %
Provision for loan losses, net3,197 1,039 2,158 208 %394 645 164 %2,803 711 %
Impairment of assets24,999 13,146 11,853 90 %22,317 (9,171)-41 %2,682 12 %
Other expenses96,972 66,026 30,946 47 %27,132 38,894 143 %69,840 257 %
 1,088,448 970,230 118,218 12 %680,107 290,123 43 %408,341 60 %
Income (loss) from continuing operations before income taxes and other items 29,687 (16,858)46,545 276 %3,799 (20,657)-544 %25,888 681 %
Income (loss) from unconsolidated entities(69,835)(53,318)(16,517)-31 %(39,225)(14,093)-36 %(30,610)-78 %
Gain (loss) on real estate dispositions, net68,290 5,794 62,496 n/a6,146 (352)-6 %62,144 n/a
Income (loss) from continuing operations28,142 (64,382)92,524 144 %(29,280)(35,102)-120 %57,422 196 %
Net income (loss)28,142 (64,382)92,524 144 %(29,280)(35,102)-120 %57,422 196 %
Less: Net income (loss) attributable to noncontrolling interests(6,391)(16,258)9,867 61 %(2,224)(14,034)-631 %(4,167)-187 %
Net income (loss) attributable to common stockholders$34,533 $(48,124)$82,657 172 %$(27,056)$(21,068)-78 %$61,589 228 %
 (1) See Non-GAAP Financial Measures below.
Resident fees and services and property operating expenses for the year ended December 31, 2023 increased compared to the prior year primarily due to acquisitions outpacing dispositions. Additionally, our Seniors Housing Operating revenues are dependent on occupancy and rate growth, both of which have continued to steadily increase during 2023. Average occupancy is as follows:
Three Months Ended(1)
March 31,June 30,September 30,December 31,
202276.3%77.1%78.0%78.3%
202379.0%79.6%80.7%82.2%
(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.
Effective on April 1, 2022, our leasehold interest relating to the master lease with National Health Investors, Inc. ("NHI") for 17 properties assumed in conjunction with the Holiday Retirement acquisition was terminated as a result of the transition or sale of the properties by NHI. The lease termination was part of an agreement to resolve outstanding litigation with NHI. In conjunction with the agreement, a wholly owned subsidiary and the lessee on the master lease agreed to release $6,883,000 of cash to the landlord, which represents the net cash flow generated from the properties since we assumed the leasehold interest. Additionally, in connection with the lease termination, during the year ended December 31, 2022 we recognized $58,621,000 in other income on our Consolidated Statements of Comprehensive Income, from the derecognition of the right of use asset and related lease liability.
We received government grants under the CARES Act primarily to cover increased expenses and lost revenue during the COVID-19 pandemic, as well as under similar programs in the U.K. and Canada. We recognized $21,220,000 and $38,607,000 during the years ended December 31, 2023 and 2022, respectively. These grants represent a reduction to property operating expenses in our Consolidated Statements of Comprehensive Income.
59

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 Seniors Housing Operating segment (dollars in thousands):
 QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
 December 31, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)
$236,993 $193,149 $43,844 22.7 %$788,605 $654,320 $134,285 20.5 %
(1) Relates to 647 properties for the QTD Pool and 556 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.
During the year ended December 31, 2023, we recorded impairment charges of $14,315,000 related to four held for sale properties for which the carrying value exceeded the estimated fair value less costs to sell and $10,684,000 related to three held for use properties for which the carrying value exceeded the estimated fair value. During the year ended December 31, 2022, we recorded impairment charges of $13,146,000 related to one held for sale property. 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.
Depreciation and amortization fluctuates as a result of acquisitions, disposition and transitions. 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, 2023, we completed ten Seniors Housing Operating construction conversions representing $463,644,000 or $306,846 per unit. The following is a summary of our consolidated Seniors Housing Operating construction projects in process, excluding expansions (dollars in thousands):

As of December 31, 2023
Expected Conversion Year(1)
PropertiesUnits/BedsAnticipated Remaining FundingConstruction in Progress Balance
2024213,389 $296,186 $756,968 
202561,423 299,647 175,867 
TBD(2)
1092,752 
Total37 $1,025,587 
(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 foreign currency 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,
202320222021
Beginning balance$1,701,939 $1,599,522 $1,706,189 
Debt transferred in— 32,478 — 
Debt issued385,115 113,183 23,569 
Debt assumed381,837 288,522 — 
Debt extinguished(486,825)(227,910)(77,959)
Principal payments(47,672)(47,399)(50,603)
Foreign currency20,654 (56,457)(1,674)
Ending balance$1,955,048 $1,701,939 $1,599,522 
Ending weighted average interest4.68 %4.32 %2.81 %
The majority of our Seniors Housing Operating properties 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.
60

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,    
 20232022$%2021$%$%
Revenues:         
Rental income$814,751 $782,329 $32,422 %$761,441 $20,888 %$53,310 %
Interest income157,592 142,402 15,190 11 %124,540 17,862 14 %33,052 27 %
Other income70,986 6,776 64,210 948 %4,603 2,173 47 %66,383 n/a
Total revenues1,043,329 931,507 111,822 12 %890,584 40,923 %152,745 17 %
Property operating expenses42,194 44,483 (2,289)-5 %49,462 (4,979)-10 %(7,268)-15 %
NOI(1)
1,001,135 887,024 114,111 13 %841,122 45,902 %160,013 19 %
Other expenses:   
Depreciation and amortization231,028 215,887 15,141 %220,699 (4,812)-2 %10,329 %
Interest expense(65)963 (1,028)-107 %6,376 (5,413)-85 %(6,441)-101 %
Loss (gain) on derivatives and financial instruments, net(2,120)8,334 (10,454)-125 %(7,333)15,667 214 %5,213 71 %
Loss (gain) on extinguishment of debt, net— 80 (80)-100 %— 80 n/a— n/a
Provision for loan losses, net6,348 9,289 (2,941)-32 %10,339 (1,050)-10 %(3,991)-39 %
Impairment of assets11,098 3,595 7,503 209 %26,579 (22,984)-86 %(15,481)-58 %
Other expenses5,060 13,043 (7,983)-61 %4,189 8,854 211 %871 21 %
 251,349 251,191 158 — %260,849 (9,658)-4 %(9,500)-4 %
Income (loss) from continuing operations before income taxes and other items749,786 635,833 113,953 18 %580,273 55,560 10 %169,513 29 %
Income (loss) from unconsolidated entities16,700 34,495 (17,795)-52 %20,687 13,808 67 %(3,987)-19 %
Gain (loss) on real estate dispositions, net259 16,648 (16,389)-98 %135,881 (119,233)-88 %(135,622)-100 %
Income (loss) from continuing operations766,745 686,976 79,769 12 %736,841 (49,865)-7 %29,904 %
Net income (loss)766,745 686,976 79,769 12 %736,841 (49,865)-7 %29,904 %
Less: Net income (loss) attributable to noncontrolling interests23,698 28,958 (5,260)-18 %35,653 (6,695)-19 %(11,955)-34 %
Net income (loss) attributable to common stockholders$743,047 $658,018 $85,029 13 %$701,188 $(43,170)-6 %$41,859 %
(1) See Non-GAAP Financial Measures below.
Rental income has increased primarily due to acquisitions and annual rent increases. 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, 2023, we had 87 leases with rental rate increases ranging from 0.58% to 549.38% in our Triple-net portfolio.
These increases are partially offset by the write off of straight-line rent receivable balances of $16,642,000 during the year ended December 31, 2023, which relate to leases for which the collection of substantially all contractual lease payments was no longer deemed probable.
The increase in interest income during the year ended December 31, 2023 is primarily driven by increased advances on loans receivable during the year.
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 with 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.
61

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, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)
$110,219 $107,627 $2,592 2.4 %$436,238 $426,557 $9,681 2.3 %
(1) Relates to 364 properties for the QTD Pool and 364 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.
Depreciation and amortization fluctuates 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, 2023, we recorded impairment charges of $1,086,000 for one held for sale property for which the carrying value exceeded the estimated fair value less costs to sell and $10,012,000 related to two held for use properties for which the carrying value exceeded the estimated fair value. During the year ended December 31, 2022, we recorded impairment charges of $3,595,000 related to two held for use 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.
During the year ended December 31, 2023, there was one Triple-net construction project completed representing $141,142,000 or $738,963 per unit.
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 foreign currency 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,
202320222021
Beginning balance$39,179 $72,536 $123,652 
Debt assumed— 39,574 — 
Debt extinguished— (39,574)(46,402)
Debt transferred out— (32,478)— 
Principal payments(919)(879)(4,679)
Foreign currency— — (35)
Ending balance$38,260 $39,179 $72,536 
Ending weighted average interest4.39 %4.39 %4.57 %
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 transactions that closed in 2021 and 2023.
A portion of our Triple-net properties 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 in income from unconsolidated entities during the year ended December 31, 2022 is primarily related to the write off of a right of use asset and related lease liability on an unconsolidated joint venture that was restructured during the year. Net income attributable to noncontrolling interests represents our partners’ share of net income relating to those partnerships where we are the controlling partner.
62

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,    
  20232022$%2021$%$%
Revenues:         
 Rental income$741,322 $669,457 $71,865 11 %$613,254 $56,203 %$128,068 21 %
 Interest income666 302 364 121 %8,792 (8,490)-97 %(8,126)-92 %
 Other income9,167 8,998 169 %13,243 (4,245)-32 %(4,076)-31 %
 Total revenues751,155 678,757 72,398 11 %635,289 43,468 %115,866 18 %
Property operating expenses231,956 205,997 25,959 13 %186,939 19,058 10 %45,017 24 %
 
NOI(1)
519,199 472,760 46,439 10 %448,350 24,410 %70,849 16 %
Other expenses:      
 Depreciation and amortization263,302 239,681 23,621 10 %223,302 16,379 %40,000 18 %
 Interest expense10,543 18,078 (7,535)-42 %17,506 572 %(6,963)-40 %
 Loss (gain) on extinguishment of debt, net15 (8)-53 %(4)19 475 %11 275 %
 Provision for loan losses, net264 (8)272 n/a(3,463)3,455 100 %3,727 108 %
 Impairment of assets— 761 (761)-100 %2,211 (1,450)-66 %(2,211)-100 %
 Other expenses2,289 2,537 (248)-10 %2,523 14 %(234)-9 %
  276,405 261,064 15,341 %242,075 18,989 %34,330 14 %
Income (loss) from continuing operations before income taxes and other item242,794 211,696 31,098 15 %206,275 5,421 %36,519 18 %
Income (loss) from unconsolidated entities(307)(2,467)2,160 88 %(4,395)1,928 44 %4,088 93 %
Gain (loss) on real estate dispositions, net(651)(6,399)5,748 90 %93,348 (99,747)-107 %(93,999)-101 %
Income (loss) from continuing operations241,836 202,830 39,006 19 %295,228 (92,398)-31 %(53,392)-18 %
Net income (loss)241,836 202,830 39,006 19 %295,228 (92,398)-31 %(53,392)-18 %
Less: Net income (loss) attributable to noncontrolling interests1,910 7,180 (5,270)-73 %4,916 2,264 46 %(3,006)-61 %
Net income (loss) attributable to common stockholders$239,926 $195,650 $44,276 23 %$290,312 $(94,662)-33 %$(50,386)-17 %
(1) See Non-GAAP Financial Measures below.
Rental income has increased due primarily to acquisitions and construction conversions that occurred during 2022 and 2023. 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, 2023, our consolidated Outpatient Medical portfolio signed 512,694 square feet of new leases and 2,255,492 square feet of renewals. The weighted-average term of these leases was seven years, with a rate of $37.52 per square foot and tenant improvement and lease commission costs of $28.00 per square foot. Substantially all of these leases contain an annual fixed or contingent escalation rent structure ranging from 1.0% to 28.0%.
The fluctuation in property operating expenses and depreciation and amortization are primarily attributable to acquisitions and construction conversions that occurred during 2022 and 2023. To the extent that we acquire or dispose of additional properties in the future, these amounts will change accordingly.
The following is a summary of our SSNOI at Welltower share for the Outpatient Medical segment (dollars in thousands):
 QTD PoolYTD Pool
Three Months EndedChangeYear EndedChange
 December 31, 2023December 31, 2022$%December 31, 2023December 31, 2022$%
SSNOI(1)
$119,706 $115,180 $4,526 3.9 %$451,959 $441,664 $10,295 2.3 %
(1) Relates to 377 properties for the QTD Pool and 366 properties for the YTD Pool. Please see Non-GAAP Financial Measures for additional information and reconciliations.
During the year ended December 31, 2023, no impairment charge was recorded. During the year ended December 31, 2022, we recognized an impairment charge of $761,000 related to one held for use property. 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 gains/losses on sales of properties are related to volume of property sales and the sales prices.
63

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
During the year ended December 31, 2023, we completed four Outpatient Medical construction conversions representing $190,770,000 or $582 per square foot. The following is a summary of our consolidated Outpatient Medical construction projects in process, excluding expansions (dollars in thousands):
As of December 31, 2023
Expected Conversion YearPropertiesSquare FeetAnticipated Remaining FundingConstruction in Progress Balance
202410788,925 $277,333 $174,476 
20252149,290 93,663 7,249 
TBD(1)
133,369 
Total13$215,094 
(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, extinguishments and principal amortizations. The following is a summary of our Outpatient Medical secured debt principal activity (dollars in thousands):
Year Ended December 31,
202320222021
Beginning balance$388,836 $530,254 $548,229 
Debt assumed46,741 — — — 
Debt extinguished(200,955)(131,582)(7,670)
Principal payments(5,485)(9,836)(10,305)
Ending balance$229,137 $388,836 $530,254 
Ending weighted average interest5.42 %4.38 %3.49 %
A portion of our Outpatient Medical properties were formed through partnerships. Income or loss from unconsolidated entities represents our share of net income or losses from partnerships where we are the noncontrolling partner. Net income attributable to noncontrolling interests represents our partners’ share of net income or loss relating to those partnerships where we are the controlling partner.
Non-Segment/Corporate
The following is a summary of our results of operations for the Non-Segment/Corporate activities for the periods presented (dollars in thousands):
 Year EndedOne Year ChangeYear EndedOne Year ChangeTwo Year Change
 December 31,December 31,  December 31,    
 20232022$%2021$%$%
Revenues:         
Other income$69,868 $4,934 $64,934 n/a$2,992 $1,942 65 %$66,876 n/a
Total revenues69,868 4,934 64,934 n/a2,992 1,942 65 %66,876 n/a
Property operating expenses18,118 16,245 1,873 12 %8,817 7,428 84 %9,301 105 %
NOI(1)
51,750 (11,311)63,061 558 %(5,825)(5,486)-94 %57,575 988 %
Other expenses:   
Interest expense540,859 475,645 65,214 14 %426,644 49,001 11 %114,215 27 %
General and administrative expenses179,091 150,390 28,701 19 %126,727 23,663 19 %52,364 41 %
Loss (gain) on extinguishments of debt, net— 199 (199)-100 %52,506 (52,307)-100 %(52,506)-100 %
Other expenses4,020 20,064 (16,044)-80 %7,895 12,169 154 %(3,875)-49 %
Total expenses723,970 646,298 77,672 12 %613,772 32,526 %110,198 18 %
Loss from continuing operations before income taxes and other items(672,220)(657,609)(14,611)-2 %(619,597)(38,012)-6 %(52,623)-8 %
Income tax (expense) benefit(6,364)(7,247)883 12 %(8,713)1,466 17 %2,349 27 %
Loss from continuing operations(678,584)(664,856)(13,728)-2 %(628,310)(36,546)-6 %(50,274)-8 %
Net income (loss)(678,584)(664,856)(13,728)-2 %(628,310)(36,546)-6 %(50,274)-8 %
Less: Net income (loss) attributable to noncontrolling interests(1,172)(526)(646)-123 %(4)(522)n/a(1,168)n/a
Net loss attributable to common stockholders$(677,412)$(664,330)$(13,082)-2 %$(628,306)$(36,024)-6 %$(49,106)-8 %
(1) See Non-GAAP Financial Measures below.
64

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, 2023 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,    
 20232022$%2021$%$%
Senior unsecured notes$508,681 $436,185 $72,496 17 %$401,247 $34,938 %$107,434 27 %
Unsecured credit facility and commercial paper program6,977 19,576 (12,599)-64 %6,759 12,817 190 %218 %
Loan expense25,201 19,884 5,317 27 %18,638 1,246 %6,563 35 %
Totals$540,859 $475,645 $65,214 14 %$426,644 $49,001 11 %$114,215 27 %
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, 2023, 2022 and 2021 were 2.70%, 2.57% and 2.67%, respectively. The increase during the year ended December 31, 2023 is primarily driven by compensation costs associated with increased employee headcount. Other expenses includes non-capitalizable legal expenses, including related to our umbrella partnership REIT reorganization during 2022. 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.
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 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 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 sub-leases, 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
65

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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/loss/impairments on properties, 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 market capitalization. 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. Market capitalization 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, these measures are utilized by the Board of Directors to evaluate management. 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.
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:202320222021
Net income attributable to common stockholders$340,094 $141,214 $336,138 
Depreciation and amortization1,401,101 1,310,368 1,037,566 
Impairment of assets36,097 17,502 51,107 
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Noncontrolling interests(46,393)(56,529)(54,190)
Unconsolidated entities100,226 81,560 85,476 
Funds from operations attributable to common stockholders$1,763,227 $1,478,072 $1,220,722 
Average diluted shares outstanding:518,701 465,158 426,841 
Per diluted share data:   
Net income attributable to common stockholders(1)
$0.66 $0.30 $0.78 
Funds from operations attributable to common stockholders$3.40 $3.18 $2.86 
(1) Includes adjustment to the numerator for income (loss) attributable to OP Unitholders.

66

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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:202320222021
Net income (loss)$358,139 $160,568 $374,479 
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Loss (income) from unconsolidated entities53,442 21,290 22,933 
Income tax expense (benefit)6,364 7,247 8,713 
Other expenses108,341 101,670 41,739 
Impairment of assets36,097 17,502 51,107 
Provision for loan losses, net9,809 10,320 7,270 
Loss (gain) on extinguishment of debt, net680 49,874 
Loss (gain) on derivatives and financial instruments, net(2,120)8,334 (7,333)
General and administrative expenses179,091 150,390 126,727 
Depreciation and amortization1,401,101 1,310,368 1,037,566 
Interest expense607,846 529,519 489,853 
Consolidated net operating income (NOI)$2,690,219 $2,301,845 $1,967,553 
NOI by segment:   
Seniors Housing Operating$1,118,135 $953,372 $683,906 
Triple-net1,001,135 887,024 841,122 
Outpatient Medical519,199 472,760 448,350 
Non-segment/corporate51,750 (11,311)(5,825)
Total NOI$2,690,219 $2,301,845 $1,967,553 

Quarterly NOI by Segment:
(in thousands)Three Months EndedYear Ended
 March 31, June 30, September 30, December 31,December 31,
2023202220232022202320222023202220232022
Seniors Housing Operating:
Total revenues$1,136,681 $996,612 $1,164,439 $1,071,210 $1,203,899 $1,072,600 $1,268,624 $1,104,995 $4,773,643 $4,245,417 
Property operating expenses883,784 789,928 885,187 789,299 918,990 841,914 967,547 870,904 3,655,508 3,292,045 
Consolidated NOI$252,897 $206,684 $279,252 $281,911 $284,909 $230,686 $301,077 $234,091 $1,118,135 $953,372 
Triple-net:
Total revenues$238,065 $235,163 $302,128 $234,360 $236,322 $228,819 $266,814 $233,165 $1,043,329 $931,507 
Property operating expenses11,723 11,211 10,598 11,491 10,044 11,495 9,829 10,286 42,194 44,483 
Consolidated NOI$226,342 $223,952 $291,530 $222,869 $226,278 $217,324 $256,985 $222,879 $1,001,135 $887,024 
Outpatient Medical:
Total revenues$184,831 $163,323 $186,192 $166,322 $191,958 $172,178 $188,174 $176,934 $751,155 $678,757 
Property operating expenses58,365 49,915 58,697 50,648 62,204 52,921 52,690 52,513 231,956 205,997 
Consolidated NOI$126,466 $113,408 $127,495 $115,674 $129,754 $119,257 $135,484 $124,421 $519,199 $472,760 
Corporate:
Total revenues$1,152 $606 $12,719 $644 $29,834 $247 $26,163 $3,437 $69,868 $4,934 
Property operating expenses3,8812,615 4,1902,645 4,0355,850 6,0125,135 18,11816,245 
Consolidated NOI$(2,729)$(2,009)$8,529 $(2,001)$25,799 $(5,603)$20,151 $(1,698)$51,750 $(11,311)
67

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 properties918 614 369 1,901 918 614 369 1,901 
Unconsolidated properties82 39 78 199 82 39 78 199 
Total properties1,000 653 447 2,100 1,000 653 447 2,100 
Recent acquisitions/development
    conversions(1)
(78)(74)(42)(194)(169)(74)(53)(296)
Under development(32)— (11)(43)(32)— (11)(43)
Under redevelopment(2)
(5)(4)(2)(11)(5)(4)(2)(11)
Current held for sale(37)(40)(4)(81)(37)(40)(4)(81)
Land parcels, loans and subleases(19)(5)(8)(32)(19)(5)(8)(32)
Transitions(3)
(168)(162)— (330)(168)(162)— (330)
Other(4)
(14)(4)(3)(21)(14)(4)(3)(21)
Same store properties647 364 377 1,388 556 364 366 1,286 
(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.

68

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, 2023December 31, 2022December 31, 2023December 31, 2022
Seniors Housing Operating: 
Consolidated NOI$301,077 $234,091 $1,118,135 $953,372 
NOI attributable to unconsolidated investments20,488 11,291 65,281 47,190 
NOI attributable to noncontrolling interests(15,976)(16,718)(63,867)(122,874)
NOI attributable to non-same store properties(67,994)(35,860)(330,696)(223,436)
Non-cash NOI attributable to same store properties(186)(1,064)(89)(1,374)
Currency and ownership adjustments (1)
(416)1,409 (159)1,442 
SSNOI at Welltower Share236,993 193,149 788,605 654,320 
Triple-net:
Consolidated NOI256,985 222,879 1,001,135 887,024 
NOI attributable to unconsolidated investments5,711 8,947 27,574 29,516 
NOI attributable to noncontrolling interests(8,031)(9,555)(31,373)(41,099)
NOI attributable to non-same store properties(138,314)(104,199)(518,519)(404,629)
Non-cash NOI attributable to same store properties(5,551)(10,800)(39,949)(42,090)
Currency and ownership adjustments (1)
(581)355 (2,630)(2,165)
SSNOI at Welltower Share110,219 107,627 436,238 426,557 
Outpatient Medical:
Consolidated NOI135,484 124,421 519,199 472,760 
NOI attributable to unconsolidated investments4,586 4,712 18,925 19,233 
NOI attributable to noncontrolling interests(2,308)(5,576)(15,400)(22,089)
NOI attributable to non-same store properties(12,799)(5,700)(60,144)(25,343)
Non-cash NOI attributable to same store properties(5,262)(5,369)(16,566)(14,831)
Currency and ownership adjustments (1)
2,692 5,945 11,934 
SSNOI at Welltower Share119,706 115,180 451,959 441,664 
SSNOI at Welltower Share:
Seniors Housing Operating236,993 193,149 788,605 654,320 
Triple-net110,219 107,627 436,238 426,557 
Outpatient Medical119,706 115,180 451,959 441,664 
Total$466,918 $415,956 $1,676,802 $1,522,541 
(1) Includes adjustments to reflect consistent property ownership percentages, to translate Canadian properties at a USD/CAD rate of 1.37 and to translate U.K. properties at a GBP/USD rate of 1.20.
69

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:202320222021
Net income (loss)$358,139 $160,568 $374,479 
Interest expense607,846 529,519 489,853 
Income tax expense (benefit)6,364 7,247 8,713 
Depreciation and amortization1,401,101 1,310,368 1,037,566 
EBITDA2,373,450 2,007,702 1,910,611 
Loss (income) from unconsolidated entities53,442 21,290 22,933 
Stock-based compensation expense36,611 26,027 16,933 
Loss (gain) on extinguishment of debt, net680 49,874 
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Impairment of assets36,097 17,502 51,107 
Provision for loan losses, net9,809 10,320 7,270 
Loss (gain) on derivatives and financial instruments, net(2,120)8,334 (7,333)
Other expenses108,341 101,670 41,739 
Lease termination and leasehold interest adjustment (1)
(65,485)(64,854)760 
Casualty losses, net of recoveries10,107 10,391 5,786 
Other impairment, net (2)
16,642 (620)49,241 
Adjusted EBITDA$2,509,003 $2,122,399 $1,913,546 
Adjusted Interest Coverage Ratio:   
Interest expense$607,846 $529,519 $489,853 
Capitalized interest50,699 30,491 19,352 
Non-cash interest expense(23,494)(21,754)(17,506)
Total interest635,051 538,256 491,699 
EBITDA$2,373,450 $2,007,702 $1,910,611 
Interest coverage ratio3.74x3.73x3.89x
Adjusted EBITDA$2,509,003 $2,122,399 $1,913,546 
Adjusted interest coverage ratio3.95x3.94x3.89x
Adjusted Fixed Charge Coverage Ratio:   
Total interest$635,051 $538,256 $491,699 
Secured debt principal payments54,076 58,114 65,587 
Total fixed charges689,127 596,370 557,286 
EBITDA$2,373,450 $2,007,702 $1,910,611 
Fixed charge coverage ratio3.44x3.37x3.43x
Adjusted EBITDA$2,509,003 $2,122,399 $1,913,546 
Adjusted fixed charge coverage ratio3.64x3.56x3.43x
(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.



















70

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Our leverage ratios include book capitalization, undepreciated book capitalization and market capitalization. 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. Market capitalization 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,
 202320222021
Book capitalization:   
Unsecured credit facility and commercial paper$— $— $324,935 
Long-term debt obligations(1)
15,815,226 14,661,552 13,917,702 
Cash and cash equivalents and restricted cash(2,076,083)(722,292)(346,755)
Total net debt13,739,143 13,939,260 13,895,882 
Total equity and noncontrolling interests(2)
26,371,727 21,393,996 18,997,873 
Book capitalization$40,110,870 $35,333,256 $32,893,755 
Net debt to book capitalization ratio34.3 %39.5 %42.2 %
Undepreciated book capitalization:
Total net debt$13,739,143 $13,939,260 $13,895,882 
Accumulated depreciation and amortization9,274,814 8,075,733 6,910,114 
Total equity and noncontrolling interests(2)
26,371,727 21,393,996 18,997,873 
Undepreciated book capitalization$49,385,684 $43,408,989 $39,803,869 
Net debt to undepreciated book capitalization ratio27.8 %32.1 %34.9 %
Market capitalization:
Common shares outstanding564,241 490,509 447,239 
Period end share price$90.17 $65.55 $85.77 
Common equity market capitalization$50,877,611 $32,152,865 $38,359,689 
Total net debt13,739,143 13,939,260 13,895,882 
Noncontrolling interests(2)
967,351 1,099,182 1,361,872 
Market capitalization:$65,584,105 $47,191,307 $53,617,443 
Net debt to market capitalization ratio20.9 %29.5 %25.9 %
(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 the ASC 842 adoption 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.



71

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 Estimate
Assumptions/Approach
Used
Impairment of Real Property Owned and Investments in Unconsolidated Entities

Assessing 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. This evaluation of indicators of impairment is dependent on a number of factors including when there is an event or adverse change in the operating performance of the property, or a change in management's intent to hold and operate the property. 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 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 reduce to its estimated fair value and an impairment charge is recognized for the difference between the carrying value and the fair value. This 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 upon 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, 2023, our net real property owned was approximately $37,063,357,000 and investments in unconsolidated entities totaled $1,636,531,000. During the year ended December 31, 2023, we recorded impairment charges of $15,401,000 related to two Seniors Housing Operating properties and one Triple-net property which were classified as held for sale for which the carrying values exceeded the fair values less costs to sell. Additionally, we recorded $20,696,000 of impairment charges related to three Seniors Housing Operating properties and two Triple-net properties that were held for use in which the carrying values exceeded the estimated fair values. We recorded $35,293,000 of impairment losses related to investments in unconsolidated entities.
72

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

We believe that substantially all 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.

 

The allocation of the purchase price to the related real estate acquired (tangible assets and intangible assets and liabilities) are based on a relative fair value analysis. In determining the fair values that drive such analysis, 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.

During the year ended December 31, 2023, we disbursed $3,558,266,000 of cash related to real estate acquisitions. These transactions were accounted for as asset acquisitions and the purchase price of each was allocated based on the relative fair values of the assets acquired and liabilities assumed.
73

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Nature of Critical
Accounting Estimate
Assumptions/Approach
Used
Principles of Consolidation

The 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 Receivable

The 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. 


The determination of the allowance for credit losses 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, 2023, we recognized provision for loan losses of $9,809,000, which includes changes in the reserve based on our historical loss experience.

74


Item 7A. Quantitative and Qualitative Disclosures About Market Risk
We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates and foreign currency exchange rates. We seek to mitigate the underlying foreign currency exposures with gains and losses on derivative contracts hedging these exposures. We seek to mitigate the effects of fluctuations in interest rates by matching the terms of new investments with new long-term fixed rate borrowings to the extent possible. We may or may not elect to use financial derivative instruments to hedge interest rate exposure. These decisions are principally based on our policy to match our variable rate investments with comparable borrowings, but are also based on the general trend in interest rates at the applicable dates and our perception of the future volatility of interest rates. This section is presented to provide a discussion of the risks associated with potential fluctuations in interest rates and foreign currency exchange rates. For more information, see Notes 12 and 17 to our consolidated financial statements.
We historically borrow on our unsecured revolving credit facility and commercial paper program to acquire, construct or make loans relating to health care and seniors housing properties. Then, as market conditions dictate, we will issue equity or long-term fixed rate debt to repay the borrowings under our unsecured revolving credit facility and commercial paper program. We are subject to risks associated with debt financing, including the risk that existing indebtedness may not be refinanced or that the terms of refinancing may not be as favorable as the terms of current indebtedness. The majority of our borrowings were completed under indentures or contractual agreements that limit the amount of indebtedness we may incur. Accordingly, in the event that we are unable to raise additional equity or borrow money because of these limitations, our ability to acquire additional properties may be limited.
A change in interest rates will not affect the interest expense associated with our fixed rate debt. Interest rate changes, however, will affect the fair value of our fixed rate debt. Changes in the interest rate environment upon maturity of this fixed rate debt could have an effect on our future cash flows and earnings, depending on whether the debt is replaced with other fixed rate debt, variable rate debt or equity or repaid by the sale of assets. To illustrate the impact of changes in the interest rate markets, we performed a sensitivity analysis on our fixed rate debt instruments after considering the effects of interest rate swaps, whereby we modeled the change in net present values arising from a hypothetical 1% increase in interest rates to determine the instruments’ change in fair value. The following table summarizes the analysis performed as of the dates indicated (in thousands):
 December 31, 2023December 31, 2022
 Principal balanceChange in fair valuePrincipal balanceChange in fair value
Senior unsecured notes$12,800,253 $(515,723)$10,839,782 $(488,159)
Secured debt1,625,364 (58,066)1,448,567 (36,654)
Totals$14,425,617 $(573,789)$12,288,349 $(524,813)
Our variable rate debt, including our unsecured revolving credit facility and commercial paper program, is reflected at fair value. At December 31, 2023, we had $1,496,447,000 outstanding related to our variable rate debt after considering the effects of interest rate swaps. Assuming no changes in outstanding balances, a 1% increase in interest rates would result in increased annual interest expense of $14,964,000. At December 31, 2022, we had $2,426,134,000 of outstanding variable rate debt. Assuming no changes in outstanding balances, a 1% increase in interest rates would have resulted in increased annual interest expense of $24,261,000.
We are subject to currency fluctuations that may, from time to time, affect our financial condition and results of operations. Increases or decreases in the value of the Canadian Dollar or British Pounds Sterling relative to the U.S. Dollar impact the amount of net income we earn from our investments in Canada and the United Kingdom. Based solely on our results for the year ended December 31, 2023, including the impact of existing hedging arrangements, if these exchange rates were to increase or decrease by 10%, our net income from these investments would increase or decrease, as applicable, by less than $9,000,000. We will continue to mitigate these underlying foreign currency exposures with non-U.S. denominated borrowings and gains and losses on derivative contracts. If we increase our international presence through investments in, or acquisitions or development of, seniors housing and health care properties outside the U.S., we may also decide to transact additional business or borrow funds in currencies other than U.S. Dollars, Canadian Dollars or British Pounds Sterling. To illustrate the impact of changes in foreign currency markets, we performed a sensitivity analysis on our derivative portfolio whereby we modeled the change in net present values arising from a hypothetical 1% increase in foreign currency exchange rates to determine the instruments’ change in fair value. The following table summarizes the results of the analysis performed (dollars in thousands):
 December 31, 2023December 31, 2022
 Carrying valueChange in fair valueCarrying valueChange in fair value
Foreign currency exchange contracts$10,811 $5,087 $190,418 $14,238 
Debt designated as hedges1,527,380 15,274 1,452,832 14,528 
Totals$1,538,191 $20,361 $1,643,250 $28,766 
75


Item 8.  Financial Statements and Supplementary Data
Report of Independent Registered Public Accounting Firm 
To the Stockholders and the Board of Directors of Welltower Inc. 
Opinion on the Financial Statements 
We have audited the accompanying consolidated balance sheets of Welltower Inc. and subsidiaries (the Company) as of December 31, 2023 and 2022, the related consolidated statements of comprehensive income, equity and cash flows for each of the three years in the period ended December 31, 2023, and the related notes and financial statement schedules listed in the Index at Item 15(a) (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company at December 31, 2023 and 2022 and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2023, in conformity with U.S. generally accepted accounting principles. 
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the Company’s internal control over financial reporting as of December 31, 2023, based on criteria established in Internal Control–Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) and our report dated February 15, 2024 expressed an unqualified opinion thereon.
Basis for Opinion 
These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. 
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.
Critical Audit Matter
The critical audit matter communicated below is a matter arising from the current period audit of the financial statements that was communicated or required to be communicated to the Audit Committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of the critical audit matter does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
    Impairment of Real Property and Investments in Unconsolidated Entities
Description of the Matter    The Company, on a periodic basis, assesses whether there are indicators that (i) the carrying value of real property owned may not be recoverable or (ii) investments in unconsolidated entities may be other than temporarily impaired. At December 31, 2023, the Company’s consolidated net real property owned totaled $37.1 billion and its investments in unconsolidated entities totaled $1.6 billion. During 2023, the Company recorded impairment losses of $36.1 million related to real property owned and $35.3 million related to investments in unconsolidated entities.
As discussed in Note 2 to the consolidated financial statements, the Company reviews real property owned on a property by property basis to determine if facts and circumstances suggest the property may be impaired. This evaluation of indicators of impairment of a property is dependent on a number of factors, including when there is an event or adverse change in the operating performance of the property or a change in management's intent to hold and operate the property. 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. 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.
76


The Company also evaluates investments in unconsolidated entities for indicators of impairment and, when present, records impairment charges based upon 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. This 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, the Company estimates the fair value of an investment and assesses whether any impairment is other than temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates.
Auditing management's evaluation of impairment of real property owned and investments in unconsolidated entities was complex due to (i) the significant judgment employed by management in identifying whether indicators of impairment were present and (ii) the estimation uncertainty in determining the undiscounted cash flows of real property owned and, when necessary, the fair value of real property owned or investment in an unconsolidated entity. In particular, the evaluation was sensitive to significant assumptions such as forecasted cash flows, including leasing prospects and occupancy projections, and estimated capitalization rates, all of which can be affected by expectations about future market or economic conditions, demand and competition.
How We Addressed the
Matter in Our Audit

        We obtained an understanding, evaluated the design, and tested the operating effectiveness of controls over the Company’s process for evaluating impairment of real property owned and investments in unconsolidated entities, including controls over management's review of the significant assumptions described above.
To test the Company's evaluation of impairment of real property owned and investments in unconsolidated entities, we performed audit procedures that included, among others, assessing the methodologies applied, evaluating the significant assumptions discussed above and testing the completeness and accuracy of the underlying data used by management in its analysis. We evaluated the appropriateness of indicators of impairment and the identification by management of real property owned and investments in unconsolidated entities where such indicators are present. We further assessed the progression of properties with impairment indicators identified in historical periods.
In addition, we compared the significant assumptions used by management to current industry and economic trends and other relevant market information, and as needed, involved a valuation specialist to assist in evaluating certain assumptions. We performed sensitivity analyses of significant assumptions used to determine recoverability and/or fair value (each where applicable) of the related real property owned or investments in unconsolidated entities and evaluated significant variances between the forecasted cash flows and historical actual results. We also assessed whether any declines in investments in unconsolidated entities were other-than-temporary.



/s/ Ernst & Young LLP

We have served as the Company’s auditor since 1970.
Toledo, Ohio
February 15, 2024
77


CONSOLIDATED BALANCE SHEETS
WELLTOWER INC. AND SUBSIDIARIES
(in thousands)
December 31, 2023December 31, 2022
Assets 
Real estate investments:  
Real property owned:  
Land and land improvements$4,697,824 $4,249,834 
Buildings and improvements37,796,553 33,651,336 
Acquired lease intangibles2,166,470 1,945,458 
Real property held for sale, net of accumulated depreciation372,883 133,058 
Construction in progress1,304,441 1,021,080 
Less accumulated depreciation and amortization(9,274,814)(8,075,733)
Net real property owned37,063,357 32,925,033 
Right of use assets, net350,969 323,942 
Real estate loans receivable, net of credit allowance1,361,587 890,844 
Net real estate investments38,775,913 34,139,819 
Other assets:
Investments in unconsolidated entities1,636,531 1,499,790 
Goodwill68,321 68,321 
Cash and cash equivalents1,993,646 631,681 
Restricted cash82,437 90,611 
Straight-line rent receivable443,800 322,173 
Receivables and other assets1,011,518 1,140,838 
Total other assets5,236,253 3,753,414 
Total assets$44,012,166 $37,893,233 
Liabilities and equity
Liabilities:
Unsecured credit facility and commercial paper$ $ 
Senior unsecured notes13,552,222 12,437,273 
Secured debt2,183,327 2,110,815 
Lease liabilities383,230 415,824 
Accrued expenses and other liabilities1,521,660 1,535,325 
Total liabilities17,640,439 16,499,237 
Redeemable noncontrolling interests290,605 384,443 
Equity:
Common stock565,894 491,919 
Capital in excess of par value32,741,949 26,742,750 
Treasury stock(111,578)(111,001)
Cumulative net income9,145,044 8,804,950 
Cumulative dividends(16,773,773)(15,514,097)
Accumulated other comprehensive income (loss)(163,160)(119,707)
Total Welltower Inc. stockholders’ equity25,404,376 20,294,814 
Noncontrolling interests676,746 714,739 
Total equity26,081,122 21,009,553 
Total liabilities and equity$44,012,166 $37,893,233 
See accompanying notes
78


CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
WELLTOWER INC. AND SUBSIDIARIES
(In thousands, except per share data)
 Year Ended December 31,
 202320222021
Revenues:
Resident fees and services$4,753,804 $4,173,711 $3,197,223 
Rental income1,556,073 1,451,786 1,374,695 
Interest income168,354 150,571 137,563 
Other income159,764 84,547 32,634 
Total revenues6,637,995 5,860,615 4,742,115 
Expenses:
Property operating expenses3,947,776 3,558,770 2,774,562 
Depreciation and amortization1,401,101 1,310,368 1,037,566 
Interest expense607,846 529,519 489,853 
General and administrative expenses179,091 150,390 126,727 
Loss (gain) on derivatives and financial instruments, net(2,120)8,334 (7,333)
Loss (gain) on extinguishment of debt, net7 680 49,874 
Provision for loan losses, net9,809 10,320 7,270 
Impairment of assets36,097 17,502 51,107 
Other expenses108,341 101,670 41,739 
Total expenses6,287,948 5,687,553 4,571,365 
Income (loss) from continuing operations before income taxes and other items350,047 173,062 170,750 
Income tax (expense) benefit(6,364)(7,247)(8,713)
Income (loss) from unconsolidated entities(53,442)(21,290)(22,933)
Gain (loss) on real estate dispositions, net67,898 16,043 235,375 
Income (loss) from continuing operations358,139 160,568 374,479 
Net income358,139 160,568 374,479 
Less:  Net income (loss) attributable to noncontrolling interests(1)
18,045 19,354 38,341 
Net income (loss) attributable to common stockholders$340,094 $141,214 $336,138 
Weighted average number of common shares outstanding:
Basic515,629 462,185 424,976 
Diluted518,701 465,158 426,841 
Earnings per share:
Basic:
Income (loss) from continuing operations$0.69 $0.35 $0.88 
Net income (loss) attributable to common stockholders$0.66 $0.31 $0.79 
Diluted:
Income (loss) from continuing operations$0.69 $0.35 $0.88 
Net income (loss) attributable to common stockholders(2)
$0.66 $0.30 $0.78 
(1) Includes amounts attributable to redeemable noncontrolling interests
(2) Includes adjustment to the numerator for income (loss) attributable to OP Units and DownREIT Units.

See accompanying notes
79


CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (CONTINUED)
WELLTOWER INC. AND SUBSIDIARIES
(In thousands)
 Year Ended December 31,
 202320222021
Net income$358,139 $160,568 $374,479 
Other comprehensive income (loss):
Foreign currency translation gain (loss)
223,920 (466,910)(52,826)
Derivative and financial instruments designated as hedges gain (loss)
(245,095)442,620 79,702 
Total other comprehensive income (loss)(21,175)(24,290)26,876 
Total comprehensive income (loss)336,964 136,278 401,355 
Less: Total comprehensive income (loss) attributable to
noncontrolling interests(1)
27,637 (6,545)38,029 
Total comprehensive income (loss) attributable to common stockholders$309,327 $142,823 $363,326 
(1) Includes amounts attributable to redeemable noncontrolling interests.
See accompanying notes
80


CONSOLIDATED STATEMENTS OF EQUITY
WELLTOWER INC. AND SUBSIDIARIES
(in thousands)Common StockCapital in Excess of Par ValueTreasury StockCumulative Net IncomeCumulative DividendsAccumulated Other Comprehensive Income (Loss)Noncontrolling InterestsTotal
Balances at December 31, 2020$418,691 $20,823,145 $(104,490)$8,327,598 $(13,343,721)$(148,504)$908,853 $16,881,572 
Comprehensive income:
Net income (loss)336,138 36,795 372,933 
Other comprehensive income (loss)27,188 (366)26,822 
Total comprehensive income399,755 
Net change in noncontrolling interests(23,743)15,296 (8,447)
Amounts related to stock incentive plans, net of forfeitures246 18,087 (3,260)15,073 
Net proceeds from issuance of common stock29,668 2,316,152 2,345,820 
Dividends paid:
Common stock dividends(1,037,194)(1,037,194)
Balances at December 31, 2021448,605 23,133,641 (107,750)8,663,736 (14,380,915)(121,316)960,578 18,596,579 
Comprehensive income:
Net income (loss)141,214 36,151 177,365 
Other comprehensive income (loss)1,609 (24,161)(22,552)
Total comprehensive income154,813 
Net change in noncontrolling interests(88,756)(210,974)(299,730)
Adjustment to members' interest from change in ownership in Welltower OP46,649 (46,649) 
Redemption of OP Units and DownREIT Units5 1,464 (206)1,263 
Amounts related to stock incentive plans, net of forfeitures214 27,018 (3,251)23,981 
Net proceeds from issuance of common stock43,095 3,622,734 3,665,829 
Dividends paid:
Common stock dividends(1,133,182)(1,133,182)
Balances at December 31, 2022491,919 26,742,750 (111,001)8,804,950 (15,514,097)(119,707)714,739 21,009,553 
Comprehensive income:
Net income (loss)340,094 17,819 357,913 
Other comprehensive income (loss)(30,767)8,839 (21,928)
Total comprehensive income335,985 
Net change in noncontrolling interests25,571 (12,686)(80,009)(67,124)
Adjustment to members' interest from change in ownership in Welltower OP(18,399)18,399  
Redemption of OP Units and DownREIT Units336 20,061 (3,041)17,356 
Amounts related to stock incentive plans, net of forfeitures210 38,026 (577)37,659 
Net proceeds from issuance of common stock73,429 5,933,940 6,007,369 
Dividends paid:
Common stock dividends(1,259,676)(1,259,676)
Balances at December 31, 2023$565,894 $32,741,949 $(111,578)$9,145,044 $(16,773,773)$(163,160)$676,746 $26,081,122 
See accompanying notes
81


CONSOLIDATED STATEMENTS OF CASH FLOWS
WELLTOWER INC. AND SUBSIDIARIES
(in thousands)
Year Ended December 31,
 202320222021
Operating activities:
Net income$358,139 $160,568 $374,479 
Adjustments to reconcile net income to net cash provided from (used in) operating
activities:
Depreciation and amortization1,401,101 1,310,368 1,037,566 
Other amortization expenses42,645 28,234 19,148 
Provision for loan losses9,809 10,320 7,270 
Impairment of assets36,097 17,502 51,107 
Stock-based compensation expense37,199 26,149 17,812 
Loss (gain) on derivatives and financial instruments, net(2,120)8,334 (7,333)
Loss (gain) on extinguishment of debt, net7 680 49,874 
Loss (income) from unconsolidated entities53,442 21,290 22,933 
Rental income less than (in excess of) cash received(135,758)(108,883)(30,820)
Amortization related to above (below) market leases, net(529)(1,693)(3,536)
Loss (gain) on real estate dispositions, net(67,898)(16,043)(235,375)
Loss (gain) on loss of control of subsidiary(65,485)  
Distributions by unconsolidated entities11,623 12,462 16,763 
Increase (decrease) in accrued expenses and other liabilities(79,801)50,857 77,554 
Decrease (increase) in receivables and other assets3,390 (191,437)(122,117)
Net cash provided from (used in) operating activities1,601,861 1,328,708 1,275,325 
Investing activities:
Cash disbursed for acquisitions, net of cash acquired(3,558,266)(2,306,020)(4,084,174)
Cash disbursed for capital improvements to existing properties(517,682)(476,016)(282,588)
Cash disbursed for construction in progress(1,014,935)(631,737)(417,963)
Capitalized interest(50,699)(30,491)(19,352)
Investment in loans receivable(490,736)(156,045)(997,449)
Principal collected on loans receivable90,215 196,310 343,260 
Other investments, net of payments(100,128)(98,459)(26,595)
Contributions to unconsolidated entities(343,498)(502,171)(396,020)
Distributions by unconsolidated entities149,753 37,571 286,772 
Proceeds from (payments on) derivatives31,493 63,747 7,519 
Proceeds from sales of real property96,741 199,496 1,070,322 
Net cash provided from (used in) investing activities(5,707,742)(3,703,815)(4,516,268)
Financing activities:
Net increase (decrease) under unsecured credit facility and commercial paper (324,935)324,935 
Proceeds from issuance of senior unsecured notes1,011,780 1,040,232 1,703,626 
Payments to extinguish senior unsecured notes  (1,533,752)
Net proceeds from the issuance of secured debt385,115 113,183 23,569 
Payments on secured debt(741,856)(457,180)(197,618)
Net proceeds from the issuance of common stock6,010,129 3,667,854 2,348,201 
Payments for deferred financing costs and prepayment penalties(7,220)(5,062)(73,735)
Contributions by noncontrolling interests(1)
280,678 138,656 156,318 
Distributions to noncontrolling interests(1)
(216,273)(272,414)(138,756)
Cash distributions to stockholders(1,260,578)(1,131,527)(1,035,906)
Other financing activities(13,128)(7,530)(9,218)
Net cash provided from (used in) financing activities5,448,647 2,761,277 1,567,664 
Effect of foreign currency translation on cash and cash equivalents and restricted cash11,025 (10,633)(1,009)
Increase (decrease) in cash, cash equivalents and restricted cash1,353,791 375,537 (1,674,288)
Cash, cash equivalents and restricted cash at beginning of period722,292 346,755 2,021,043 
Cash, cash equivalents and restricted cash at end of period$2,076,083 $722,292 $346,755 
Supplemental cash flow information:
Interest paid$628,582 $531,672 $492,742 
Income taxes paid (received)7,682 3,435 (4,812)
(1) Includes amounts attributable to redeemable noncontrolling interests.
See accompanying notes.

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1. Business 
Welltower Inc., an S&P 500 company headquartered in Toledo, Ohio, is driving the transformation of health care infrastructure. We invest 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 health care experience. Welltower Inc., a real estate investment trust (“REIT”), 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. 
As of May 24, 2022, we are structured as an umbrella partnership REIT under which substantially all of our business is conducted through Welltower OP LLC, the day-to-day management of which is exclusively controlled by Welltower Inc. 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. Welltower's weighted average ownership in Welltower OP was 99.740% during the year ended December 31, 2023. As of December 31, 2023, Welltower owned 99.765% of the issued and outstanding units of Welltower OP, with other investors owning the remaining 0.235% of outstanding units. We adjust the noncontrolling members' interest at the end of each period to reflect their interest in the net assets of Welltower OP.
2. Accounting Policies and Related Matters
Use of Estimates
The preparation of the consolidated financial statements in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) requires us to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
Principles of Consolidation
The consolidated financial statements include the accounts of our wholly owned subsidiaries and joint venture entities that we control, through voting rights or other means. All material intercompany transactions and balances have been eliminated in consolidation. At inception of transactions, we identify entities for which control is achieved through means other than voting rights (“variable interest entities” or “VIEs”) and determine which business enterprise is the primary beneficiary of its operations. A VIE is broadly defined as an entity where either (i) substantially all of an entity's activities either involve or are conducted on behalf of an investor that has disproportionately few voting rights, (ii) the equity investment at risk is insufficient to finance that entity’s activities without additional subordinated financial support or (iii) the equity investors as a group lack any of the following: (a) the power through voting or similar rights to direct the activities of an entity that most significantly impact the entity's economic performance, (b) the obligation to absorb the expected losses of an entity or (c) the right to receive the expected residual returns of an entity. Criterion (iii) is generally applied to limited partnerships and similarly structured entities by assessing whether a simple majority of the limited partners hold substantive rights to participate in significant decisions of the entity or have the ability to remove the decision maker or liquidate the entity without cause. If neither of those criteria are met, the entity is a VIE.
We consolidate investments in VIEs when we are determined to be the primary beneficiary. Accounting Standards Codification Topic 810, Consolidations (“ASC 810”), requires enterprises to perform a qualitative approach to determining whether or not a VIE will need to be consolidated. This evaluation is based on an enterprise’s ability to direct and influence the activities of a VIE that most significantly impact that entity’s economic performance and the rights held by limited partners or non-managing members.
The designation of an entity as a VIE is reassessed upon certain events, including but not limited to: (i) a change to the contractual arrangements of the entity or in the ability of a party to exercise its participation or kick-out rights, (ii) a change to the capitalization structure of the entity or (iii) acquisitions or sales of interests that constitute a change in control.
Revenue Recognition
For our Triple-net and Outpatient Medical segments, a significant source of our revenue is generated through leasing arrangements and accounted for under ASC 842, Leases ("ASC 842"). 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. Leases in our Outpatient Medical portfolio typically include some form of operating expense reimbursement by the tenant and upon adoption of ASC 842, we elected the lessor practical expedient to not separate non-lease components from the associated lease components resulting in presenting all revenue associated with Outpatient Medical leases as leasing revenue on the Consolidated Statements of Comprehensive Income. Certain payments made to tenants are treated as lease incentives and amortized as a reduction of revenue over the lease term. 
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For our Seniors Housing Operating segment, revenue from resident fees and services is predominantly service-based, and generally is recognized monthly as services are provided. Agreements with residents generally have varying terms and are cancellable by the resident with 30 days’ notice. We have elected the lessor practical expedient within ASC 842 and recognize and disclose the revenues for Seniors Housing Operating resident agreement based upon the predominant component, generally the non-lease service component, under ASC 606, Revenue from Contracts with Customers. Within that reportable segment, we also recognize revenue from residential seniors apartment leases in accordance with ASC 842. Management contracts are present in some of our joint venture agreements to provide asset and property management, leasing, marketing and other services and are recognized monthly as services are provided.
Our Seniors Housing Operating segment also contains continuing care retirement communities, which operate as entrance fee communities. The entrance fee communities offer different contracts which vary in terms of how much of the entrance fee is considered to be refundable upon move-out, temporarily refundable until a period of time has passed, or nonrefundable. Refundable entrance fees are recorded as a payable within the accrued expenses and other liabilities line item of our Consolidated Balance Sheets. Nonrefundable entrance fees are recorded as deferred revenue within the same line item and are recognized into revenue over the estimated remaining stay of the resident. We use a third party actuarial expert to determine the estimated remaining stay of each resident based on demographic data.
Interest income on loans is recognized as earned based upon the principal amount outstanding, subject to an evaluation of collectability risk.
We recognize gains on the disposition of real estate when control transfers to the buyer, generally when consideration and title are exchanged and the risks and rewards of ownership transfer. We recognize losses from dispositions of real estate when known.
Cash and Cash Equivalents
Cash and cash equivalents consist of all highly liquid investments with an original maturity of three months or less.
Restricted Cash
Restricted cash primarily consists of amounts held by lenders to provide future payments for real estate taxes, insurance, tenant and capital improvements, amounts held in escrow relating to transactions we are entitled to receive over a period of time as outlined in the escrow agreement and net proceeds from property sales that were executed as tax-deferred dispositions under Internal Revenue Code (“IRC”) Section 1031.
Deferred Loan Expenses
Deferred loan expenses are costs incurred by us in connection with the issuance, assumption and amendments of debt arrangements. Deferred loan expenses related to debt instruments, excluding the primary unsecured credit facility, are recorded as a reduction of the related debt liability. Deferred loan expenses related to the primary unsecured credit facility are included in receivables and other assets. We amortize these costs over the term of the debt using the straight-line method, which approximates the effective interest method.
Investments in Unconsolidated Entities
Investments in entities that we do not consolidate but have the ability to exercise significant influence over operating and financial policies are reported under the equity method of accounting. Under the equity method, our share of the investee’s earnings or losses is included in our consolidated results of operations. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the equity interest inclusive of transaction costs. To the extent that our cost basis is different from the basis reflected at the entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the entity. For earnings of equity method investments with pro rata distribution allocations, net income or loss is allocated between the partners in the joint venture based upon their respective stated ownership. In other instances, net income or loss may be allocated between the partners in the joint venture based on the hypothetical liquidation at book value method ("HLBV method"). Under the HLBV method, we recognize income and loss in each period based on the change in liquidation proceeds we would receive from a hypothetical liquidation of the underlying investment at book value.
We evaluate our investments in unconsolidated entities for impairment and, when present, record impairment charges based upon 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. This 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 conditions or a change in management's investment strategy. When required, we estimate the fair value of an investment and assess whether any impairment is other-than-temporary using observable and unobservable inputs such as historical and forecasted cash flows and estimated capitalization rates.
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Welltower OP Noncontrolling Interests
Members of Welltower OP other than Welltower have the right under the limited liability company agreement to redeem their Class A Common Units ("OP Units") for shares of Welltower common stock or cash, at Welltower's sole discretion, as the initial member. Accordingly, we classify the non-Welltower OP Units held by such other members in permanent equity because Welltower may elect to issue shares of Welltower common stock to the non-Welltower members who choose to redeem their OP Units rather than using cash.
Redeemable Noncontrolling Interests
Certain noncontrolling interests are redeemable at fair value. Accordingly, we record the carrying amount of the noncontrolling interests at the greater of (i) the initial carrying amount, increased or decreased for the noncontrolling interest’s share of net income or loss and its share of other comprehensive income or loss, and contributions or distributions or (ii) the redemption value. If the interests are redeemable in the future, we accrete the carrying value to the redemption value over the period until expected redemption, currently a weighted-average period of approximately five years. In accordance with ASC 810, the redeemable noncontrolling interests are classified outside of permanent equity, as a mezzanine item, on the balance sheet. At December 31, 2023, the current redemption value of redeemable noncontrolling interests exceeded the carrying value of $290,605,000 by $46,178,000.
We entered into certain DownREIT partnerships which give a real estate seller the ability to exchange its property on a tax deferred basis for equity membership interests (“DownREIT Units”). The DownREIT Units may be redeemed any time following the first anniversary of the date of issuance at the election of the holders for one share of our common stock per unit or, at our option, cash.
Real Property Owned
Real estate acquisitions are generally classified as asset acquisitions for which we record 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 primarily consist of land, buildings and improvements. In making estimates of relative fair value, we utilize 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.
Identifiable intangible assets and liabilities consist primarily of the above or below market component of in-place leases and the value associated with the presence of in-place leases. The value allocable to the above or below market component of the acquired in-place lease is determined based upon the present value (using a discount rate which reflects the risks associated with the acquired leases) of the difference between (i) the contractual amounts to be paid pursuant to the lease over its remaining term, and (ii) management’s estimate of the amounts that would be paid using fair market rates over the remaining term of the lease. The amounts allocated to above market leases are included in acquired lease intangibles and below market leases are included in other liabilities on the balance sheet and are amortized to rental income over the remaining terms of the respective leases.
The total amount of other intangible assets acquired is further allocated to in-place lease values and customer relationship values for in-place tenants based on management’s evaluation of the specific characteristics of each tenant’s lease and our overall relationship with that respective tenant. Characteristics considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality and expectations of lease renewals, among other factors. The total amount of other intangible assets acquired is further allocated to in-place lease values for in-place residents with such value representing (i) value associated with lost revenue related to tenant reimbursable operating costs that would be incurred in an assumed re-leasing period, and (ii) value associated with lost rental revenue from existing leases during an assumed re-leasing period. This intangible asset is amortized over the remaining life of the lease or the assumed re-leasing period.
Real property developed by us is recorded at cost, including the capitalization of construction period interest. Owned properties are depreciated on a straight-line basis over their estimated useful lives which range from 15 to 40 years for buildings and 5 to 15 years for improvements. We consider costs incurred in conjunction with re-leasing properties, including tenant improvements and lease commissions, to represent the acquisition of productive assets and, accordingly, such costs are reflected as investment activities in our Consolidated Statement of Cash Flows.
The net book value of real property owned is reviewed quarterly on a property by property basis to determine if facts and circumstances suggest that a property may be impaired. This evaluation of indicators of impairment of a property is dependent on a number of factors, including when there is an event or adverse change in the operating performance of the property or a change in management's intent to hold and operate the property. 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. 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 the estimated fair market value and an impairment charge is recognized for the difference between the carrying value and the fair value. Additionally, properties that meet the held for sale criteria are recorded at the lesser of fair value less costs to sell or the carrying value.
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Expenditures for repairs and maintenance are expensed as incurred.
Capitalization of Construction Period Interest
We capitalize interest costs associated with funds used for the construction of properties owned by us. The amount capitalized is based upon the balance outstanding during the construction period using the rate of interest which approximates our company-wide cost of financing. Our interest expense reflected in the Consolidated Statements of Comprehensive Income has been reduced by the amounts capitalized.
Loans Receivable
Loans receivable are recorded on our Consolidated Balance Sheets in real estate loans receivable, net of credit allowance, or for non-real estate loans receivable, in receivables and other assets. Real estate loans receivable consists of mortgage loans and other real estate loans which are primarily collateralized by a first, second or third mortgage lien, a leasehold mortgage on, or an assignment or pledge of the partnership interest in, the related properties, corporate guarantees and/or personal guarantees. Non-real estate loans are generally corporate loans with no real estate backing. Interest income on loans is recognized as earned based upon the principal amount outstanding, subject to an evaluation of the risk of credit loss.
In Substance Real Estate Investments
We provide loans to third parties for the acquisition, development and construction of real estate. Under these arrangements, it is possible that we will participate in the expected residual profits of the project through the sale, refinancing or acquisition of the property. We evaluate the characteristics of each arrangement, including its risks and rewards, to determine whether they are more similar to those associated with a loan or an investment in real estate. Arrangements with characteristics implying loan classification are presented as real estate loans receivable and result in the recognition of interest income. Arrangements with characteristics implying real estate joint ventures are treated as in substance real estate investments and presented as investments in unconsolidated entities and are accounted for using the equity method. The classification of each arrangement as either a real estate loan receivable or investment in unconsolidated entity involves judgment and relies on various factors, including market conditions, amount and timing of expected residual profits, credit enhancements in the form of guarantees, estimated fair value of the collateral, and significance of borrower equity in the project, among others. The classification of such arrangements is performed at inception, and periodically reassessed when significant changes occur in the circumstances or conditions described above.
Allowance for Credit Losses on Loans Receivable
The allowance for credit losses on loans receivable 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 credit quality indicators, 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 status 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 and expectations of future performance of the borrowers to determine the reserve for credit losses.
Goodwill
Goodwill is tested annually for impairment and is tested for impairment more frequently if events and circumstances indicate that the asset might be impaired. An impairment loss is recognized to the extent that the carrying amount, including goodwill, exceeds the reporting unit’s fair value and the implied fair value of goodwill is less than the carrying amount of that goodwill. We have not had any goodwill impairments.
 Fair Value of Derivative Instruments
Derivatives are recorded at fair value on the balance sheet as assets or liabilities. The valuation of derivative instruments requires us to make estimates and judgments that affect the fair value of the instruments. Fair values of our derivatives are estimated by pricing models that consider the forward yield curves and discount rates. The fair value of our forward exchange contracts are estimated by pricing models that consider foreign currency spot rates, forward trade rates and discount rates. Such amounts and the recognition of such amounts are subject to estimates that may change in the future. See Note 12 for additional information.
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Accrued Expenses and Other Liabilities
Accrued expenses and other liabilities consist of the following (in thousands):
 Year Ended December 31,
 20232022
Unearned revenue$374,545 $432,941 
Other liabilities325,715 311,506 
Accounts payable173,215 216,732 
Taxes payable130,006 144,021 
Other accrued expenses139,691 135,944 
Accrued payroll 158,255 120,713 
Accrued interest124,210 117,741 
Derivative liabilities96,023 55,727 
Total$1,521,660 $1,535,325 
Federal Income Tax
We have elected to be treated as a REIT under the applicable provisions of the IRC, commencing with our first taxable year, and made no provision for U.S. federal income tax purposes prior to our acquisition of our taxable REIT subsidiaries (“TRSs”). As a result of these, as well as subsequent acquisitions, we now record income tax expense or benefit with respect to certain of our entities that are taxed as TRSs under provisions similar to those applicable to regular corporations and not under the REIT provisions. We account for deferred income taxes using the asset and liability method and recognize deferred tax assets and liabilities for the expected future tax consequences of events that have been included in our consolidated financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes a change in our judgment about expected future tax consequences of events, is included in the tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss and tax credit carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes a change in our judgment about the realizability of the related deferred tax asset, is included in the tax provision when such changes occur. See Note 19 for additional information.
Foreign Currency
Certain of our subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. Dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income, a component of stockholders’ equity, on our Consolidated Balance Sheets.
Earnings Per Share
Basic earnings per share is computed by dividing net income available to common stockholders by the weighted-average number of shares outstanding for the period, adjusted for non-vested shares of restricted stock. The computation of diluted earnings per share is similar to basic earnings per share, except that the number of shares is increased to include the number of additional common shares that would have been outstanding if the potentially dilutive common shares had been issued. Additionally, net income (loss) allocated to OP Units and DownREIT Units (discussed above) has been included in the numerator and redeemable common stock related to the OP Units and DownREIT Units have been included in the denominator for the purpose of computing diluted earnings per share.
Reclassifications
Certain amounts in prior years have been reclassified to conform to current year presentation.
Government Grant Income
On March 27, 2020, the federal government enacted the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) to provide financial aid to individuals, businesses, and state and local governments. During the years ended December 31, 2023, 2022 and 2021, we received government grants under the CARES Act primarily to cover increased expenses and lost revenue during the COVID-19 pandemic, as well as under similar programs in the U.K. and Canada. For the years ended December 31, 2023, 2022 and 2021 we recognized $21,220,000, $38,607,000 and $97,933,000, respectively, of government
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grant income as a reduction to property operating expenses in our Consolidated Statements of Comprehensive Income. Additionally, for the year ended December 31, 2021, we recognized $4,642,000 of government grant income in other income in our Consolidated Statements of Comprehensive Income. The amount of qualifying expenditures and lost revenue exceeded grant income recognized and we believe we have complied and will continue to comply with all grant conditions. In the event of non-compliance, all such amounts are subject to recapture.
New Accounting Standards
In March 2020, the FASB issued an amendment to the reference rate reform standard, which provides the option for a limited period of time to ease the potential burden in accounting for, or recognizing the effects of, reference rate reform on contract modifications and hedge accounting. An example of such reform is the expected market transition from the London Interbank Offered Rate ("LIBOR") and other interbank offered rates to alternative reference rates. Entities that make this optional expedient election would not have to remeasure the contracts at the modification date or reassess the accounting treatment if certain criteria are met and would continue applying hedge accounting for relationships affected by reference rate reform. In December 2022, the FASB extended the date for which this guidance can be applied from December 31, 2022 to December 31, 2024. We continue to monitor developments related to the LIBOR transition and identification of an alternative, market-accepted rate.
In November 2023, the FASB issued Accounting Standards Update No. 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures," which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The guidance is to be applied retrospectively to all periods presented in the financial statements. We are currently evaluating the potential impact of adopting this new guidance on our consolidated financial statements and disclosures.
In December 2023, the FASB issued Accounting Standards Update No. 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures ("ASU 2023-09")," which modifies the rules on income tax disclosures to require entities to disclose (1) specific categories in the rate reconciliation, (2) the income or loss from continuing operations before income tax expense or benefit (separated between domestic and foreign) and (3) income tax expense or benefit from continuing operations (separated by federal, state and foreign). ASU 2023-09 also requires entities to disclose their income tax payments to international, federal, state and local jurisdictions, among other changes. The guidance is effective for annual periods beginning after December 15, 2024. Early adoption is permitted for annual financial statements that have not yet been issued or made available for issuance. ASU 2023-09 should be applied on a prospective basis, but retrospective application is permitted. We are currently evaluating the potential impact of adopting this new guidance on our consolidated financial statements and disclosures.
3. Real Property Acquisitions and Development 
The total purchase price for all properties acquired has been allocated to the tangible 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. The results of operations for these acquisitions have been included in our consolidated results of operations since the date of acquisition and are a component of the appropriate segments. Transaction costs primarily represent costs incurred with acquisitions, including due diligence costs, fees for legal and valuation services, termination of pre-existing relationships computed based on the fair value of the assets acquired, lease termination fees and other acquisition-related costs. Transaction costs directly related to asset acquisitions are capitalized as a component of purchase price and all other non-capitalizable costs are reflected in other expenses on our Consolidated Statements of Comprehensive Income. Our acquisition of properties are at times subject to earn out provisions based on the future operating performance of the acquired properties, which could result in incremental payments in the future. Our policy is to recognize such contingent consideration when the contingency is resolved and the consideration becomes payable. As of December 31, 2023, we do not expect future payments under these provisions to be material and no liabilities for such amounts have been accrued.
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The following is a summary of our real property investment activity by segment for the periods presented (in thousands):
Year Ended December 31, 2023
 Seniors Housing OperatingTriple-netOutpatient MedicalTotal
Land and land improvements  $251,507 $127,523 $79,506 $458,536 
Buildings and improvements  2,006,021 969,481 343,252 3,318,754 
Acquired lease intangibles  208,239  50,373 258,612 
Construction in progress165,934   165,934 
Right of use assets, net24,212  927 25,139 
Total net real estate assets2,655,913 1,097,004 474,058 4,226,975 
Receivables and other assets21,999  1,632 23,631 
Total assets acquired(1)
2,677,912 1,097,004 475,690 4,250,606 
Secured debt  
(372,482) (40,953)(413,435)
Lease liabilities(24,212) (953)(25,165)
Accrued expenses and other liabilities(26,666) (11,528)(38,194)
Total liabilities acquired(423,360) (53,434)(476,794)
Noncontrolling interests(2)
(32,692) (925)(33,617)
Non-cash acquisition related activity(3)
(181,929)  (181,929)
 Cash disbursed for acquisitions2,039,931 1,097,004 421,331 3,558,266 
Construction in progress additions646,466 25,646 422,103 1,094,215 
Less: Capitalized interest(39,799)(2,416)(8,484)(50,699)
Accruals(4)
(4,735)(1,358)(22,488)(28,581)
Cash disbursed for construction in progress601,932 21,872 391,131 1,014,935 
Capital improvements to existing properties399,130 33,592 84,960 517,682 
Total cash invested in real property, net of cash acquired  
$3,040,993 $1,152,468 $897,422 $5,090,883 
(1) Excludes $4,708,000 of unrestricted and restricted cash acquired.
(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests.
(3) Relates to the acquisition of assets previously financed as loans receivable and the acquisition of assets previously recognized as investments in unconsolidated entities.
(4) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, off-set by amounts paid in the current period.
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Year Ended December 31, 2022
 Seniors Housing OperatingTriple-netOutpatient MedicalTotal
Land and land improvements  $206,618 $7,536 $68,379 $282,533 
Buildings and improvements  2,067,051 59,248 253,358 2,379,657 
Acquired lease intangibles  129,429  35,316 164,745 
Construction in progress108,141   108,141 
Right of use assets, net169  3,852 4,021 
Total net real estate assets2,511,408 66,784 360,905 2,939,097 
Receivables and other assets  14,406  501 14,907 
Total assets acquired(1)
2,525,814 66,784 361,406 2,954,004 
Secured debt  (279,788)(39,574) (319,362)
Lease liabilities  (3,852)(3,852)
Accrued expenses and other liabilities(112,962)(1,428)(1,414)(115,804)
Total liabilities acquired(392,750)(41,002)(5,266)(439,018)
Noncontrolling interests(2)
(115,112)(4)(1,095)(116,211)
Non-cash acquisition related activity(3)
(64,975)(27,780) (92,755)
Cash disbursed for acquisitions1,952,977 (2,002)355,045 2,306,020 
Construction in progress additions489,001 83,368 91,662 664,031 
Less: Capitalized interest(24,432)(4,210)(1,849)(30,491)
Accruals (4)
(4,621) 2,818 (1,803)
Cash disbursed for construction in progress459,948 79,158 92,631 631,737 
Capital improvements to existing properties352,099 48,052 75,865 476,016 
Total cash invested in real property, net of cash acquired$2,765,024 $125,208 $523,541 $3,413,773 
(1) Excludes $6,563,000 of unrestricted and restricted cash acquired.
(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests. For the year ended December 31, 2022, 1,227,000 OP Units were issued as a component of funding for certain transactions.
(3) Relates to the acquisition of assets previously financed as loans receivable and the acquisition of assets previously recognized as investments in unconsolidated entities.
(4) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, off-set by amounts paid in the current period.
Year Ended December 31, 2021
 Seniors Housing OperatingTriple-netOutpatient MedicalTotal
Land and land improvements  $449,335 $88,839 $64,843 $603,017 
Buildings and improvements  2,347,609 809,328 313,864 3,470,801 
Acquired lease intangibles  264,589  24,751 289,340 
Right of use assets, net77,455   77,455 
Total net real estate assets3,138,988 898,167 403,458 4,440,613 
Receivables and other assets  6,096 411 3,534 10,041 
Total assets acquired(1)
3,145,084 898,578 406,992 4,450,654 
Lease liabilities(138,126)  (138,126)
Accrued expenses and other liabilities(191,454)(8,703)(266)(200,423)
Total liabilities acquired(329,580)(8,703)(266)(338,549)
Noncontrolling interests(2)
(4,942)(6,449)(16,540)(27,931)
Cash disbursed for acquisitions2,810,562 883,426 390,186 4,084,174 
Construction in progress additions322,050 77,412 42,464 441,926 
Less: Capitalized interest(13,834)(3,078)(2,440)(19,352)
Accruals(3)
35  (4,646)(4,611)
Cash disbursed for construction in progress308,251 74,334 35,378 417,963 
Capital improvements to existing properties197,829 37,345 47,414 282,588 
Total cash invested in real property, net of cash acquired$3,316,642 $995,105 $472,978 $4,784,725 
(1) Excludes $4,201,000 of unrestricted and restricted cash acquired.
(2) Includes amounts attributable to both redeemable noncontrolling interests and noncontrolling interests.
(3) Represents non-cash accruals for amounts to be paid in future periods for properties that converted, off-set by amounts paid in the current period.
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Canadian Pension Plan Investment Board ("CPPIB")
During the year ended December 31, 2023, we paid $69,606,000 to acquire the 45% redeemable noncontrolling ownership interest in two consolidated joint ventures with CPPIB, which owned interests in ten medical office buildings. In conjunction with the transaction, $118,256,000 was removed from redeemable noncontrolling interests with the difference recorded to capital in excess of par value on our Consolidated Balance Sheets. The transaction is excluded from the table above.
Holiday Retirement Acquisition
On July 30, 2021, we acquired a portfolio of 85 seniors housing properties owned by Holiday Retirement for $1,576,600,000, which are included in our Seniors Housing Operating segment and in the table above for the year ended December 31, 2021. Atria Senior Living assumed operations of the portfolio following its acquisition of the Holiday Retirement management company pursuant to an incentive-based management agreement. As part of this transaction, a wholly owned subsidiary assumed the leasehold interest in a 26 property portfolio and subsequently purchased eight of the leased properties and one of the properties was sold by the landlord, National Health Investors ("NHI"), and removed from the master lease. Effective April 1, 2022, our leasehold interest related to the master lease with NHI for the remaining 17 properties was terminated as a result of the transition or sale of the properties by NHI. The lease termination was part of an agreement to resolve outstanding litigation with NHI. In conjunction with the agreement, a wholly owned subsidiary and the lessee on the master lease agreed to release $6,883,000 of cash to the landlord, which represents the net cash flow generated from the properties since we assumed the leasehold interest. Additionally, in conjunction with the lease termination, during the year ended December 31, 2022, we recognized $58,621,000 in other income on our Consolidated Statements of Comprehensive Income from the derecognition of the right of use asset and related liability.
Affinity Living Communities ("Affinity") Acquisition
In February 2024, we entered into a definitive agreement to acquire 25 Seniors Housing Operating properties for a total purchase price of $969 million, which will be managed under the Affinity brand. The transaction is expected to be funded through a combination of cash and the assumption of $523 million of secured debt, subject to customary closing conditions and lender consents.
Construction Activity 
The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented (in thousands):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
Development projects:
Seniors Housing Operating$463,644 $227,796 $117,386 
Triple-net141,142  22,990 
Outpatient Medical190,770 44,777 125,179 
Total development projects795,556 272,573 265,555 
Expansion projects71,250 18,280 5,292 
Total construction in progress conversions$866,806 $290,853 $270,847 
 
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4. Real Estate Intangibles 
The following is a summary of our real estate intangibles, excluding those related to ground leases or classified as held for sale, as of the dates indicated (dollars in thousands):
December 31, 2023December 31, 2022
Assets:
In place lease intangibles$2,001,827 $1,817,580 
Above market tenant leases66,663 57,203 
Lease commissions97,980 70,675 
Gross historical cost2,166,470 1,945,458 
Accumulated amortization(1,651,656)(1,484,048)
Net book value$514,814 $461,410 
Weighted-average amortization period in years6.77.6
Liabilities:
Below market tenant leases$70,364 $77,985 
Accumulated amortization(47,939)(52,701)
Net book value$22,425 $25,284 
Weighted-average amortization period in years8.48.4
The following is a summary of real estate intangible amortization income (expense) for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Rental income related to (above)/below market tenant leases, net$384 $1,551 $1,680 
Amortization related to in place lease intangibles and lease commissions(226,663)(217,187)(115,579)
The future estimated aggregate amortization of intangible assets and liabilities is as follows for the periods presented (in thousands):
 AssetsLiabilities
2024$212,725 $4,450 
202576,031 3,534 
202644,257 2,889 
202734,860 2,440 
202829,095 1,834 
Thereafter117,846 7,278 
Totals$514,814 $22,425 
5. Dispositions, Real Property Held for Sale and Impairment
We periodically sell properties for various reasons, including favorable market conditions, the exercise of tenant purchase options or reduction of concentrations (e.g. property type, relationship or geography). At December 31, 2023, 15 Seniors Housing Operating, one Triple-net and four Outpatient Medical properties, with an aggregate net real estate balance of $372,883,000, were classified as held for sale. In addition to the real property balances, secured debt balances of $185,263,000 and net other assets and (liabilities) of $21,568,000 were included in the Consolidated Balance Sheets related to the held for sale properties. Expected gross sales proceeds related to the held for sale properties are approximately $546,568,000, which includes non-cash consideration relating to 14 Canadian Revera properties discussed below.
During the year ended December 31, 2023, we recorded impairment charges of $15,401,000 related to four Seniors Housing Operating properties and one Triple-net property which were classified as held for sale for which the carrying value exceeded the estimated fair values less costs to sell. Additionally, during 2023 we recorded impairment charges of $20,696,000 related to three Seniors Housing Operating properties and two Triple-net properties, which were held for use for which the carrying value exceeded the fair values. During the year ended December 31, 2022, we recorded impairment charges of $13,146,000 related to one Seniors Housing Operating property, which was classified as held for sale. Additionally, we recorded $4,356,000 of impairment charges related to two Triple-net properties and one Outpatient Medical property that were held for use. During the year ended December 31, 2021, we recorded impairment charges of $19,567,000 related to four Triple-net properties and one Outpatient Medical property, which were disposed of or classified as held for sale. Additionally, during the year ended December 31, 2021, we recorded $31,540,000 of impairment charges related to two Seniors Housing Operating and two Triple-net properties that were held for use.
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Operating results attributable to properties sold or classified as held for sale which do not meet the definition of discontinued operations, are not reclassified on our Consolidated Statements of Comprehensive Income. We recognized income (loss) from continuing operations before income taxes and other items from properties sold or classified as held for sale of $58,816,000 for the year ended December 31, 2023 and $(8,941,000) and $11,437,000 for the same periods in 2022 and 2021, respectively.
The following is a summary of our real property disposition activity for the periods presented (in thousands):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
Real estate dispositions:
Seniors Housing Operating(1)
$385,128 $85,413 $112,837 
Triple-net6,391 89,827 486,369 
Outpatient Medical 393 229,660 
Total dispositions391,519 175,633 828,866 
Gain (loss) on real estate dispositions, net67,898 16,043 235,375 
Net other assets (liabilities) disposed(846)7,820 6,081 
Non-cash consideration(361,830)  
Cash proceeds from real estate dispositions$96,741 $199,496 $1,070,322 
(1) Dispositions occurring in the year ended December 31, 2023 include the disposition of unconsolidated equity method investments related to Revera. See discussion below for further information.
Strategic Dissolution of Revera Joint Ventures
During the year ended December 31, 2023, we entered into definitive agreements to dissolve our existing Revera joint venture relationships across the U.S., U.K. and Canada. The transactions include acquiring the remaining interests in 110 properties from Revera, while simultaneously selling interests in 31 properties to Revera.
In June 2023, we closed the U.K. portfolio portion of the transaction through the acquisition of the remaining ownership interest in 29 properties previously held in two separate consolidated joint venture structures in which we owned 75% and 90% of the interests in exchange for the disposition to Revera of our interests in four properties. In addition, we received cash from Revera of $107,341,000 relating to the net settlement of loans previously made to the joint ventures. Operations for the 29 retained properties were transitioned to Avery Healthcare.
Total proceeds related to the four properties disposed were $222,521,000, which included non-cash consideration from Revera of $241,728,000, comprised of the fair value of interests received by us of $198,837,000 and an allocation of Revera's noncontrolling interests of $42,891,000, partially offset by $9,049,000 of transaction-related expenses as well as the $10,158,000 of cash paid to equalize the value exchanged between the parties. We disposed of net real property owned of $224,208,000, resulting in a loss of $1,687,000 recognized within gain (loss) on real estate dispositions, net within our Consolidated Statements of Comprehensive Income. Consideration transferred to acquire the additional interests in the 29 properties was comprised of the fair value of interests transferred by us of $198,837,000 and $5,776,000 of cash paid for transaction-related expenses. We derecognized $180,497,000 of noncontrolling interests and $22,270,000 of liabilities previously due to Revera with an adjustment of $1,846,000 recognized in capital in excess of par value. The non-cash investing activity with respect to the sale of the four properties and non-cash financing activity with respect to the acquisition of Revera's interests in the 29 properties has been excluded from our Consolidated Statement of Cash Flows.
We closed the portion of the transactions predominantly related to the U.S. portfolio during the third quarter of 2023 through (i) the acquisition of the remaining interests in ten properties currently under development or recently developed by Sunrise Senior Living that were previously held within an equity method joint venture owned 34% by us and 66% by Revera, (ii) the disposition of our minority interests in 12 U.S. properties and one Canadian development project and (iii) the disposition of our 34% interest in the Sunrise Senior Living management company. We recorded net real estate investments of $479,525,000 related to the ten acquired and now consolidated properties, which was comprised of $31,456,000 of cash consideration and $448,069,000 of non-cash consideration. Non-cash consideration primarily includes $270,486,000 of assumed mortgage debt secured by the acquired properties, which was subsequently repaid in full by us immediately following the transaction, $47,734,000 of carryover investment from our prior 34% equity method ownership interest and $119,258,000 of fair value interests in the 13 properties transferred by us to Revera. We also derecognized $56,905,000 of equity method investments related to the 13 properties retained by Revera and recorded a gain on real estate dispositions of $62,075,000. In conjunction with this transaction, operations for two of the now wholly owned properties, along with operations for 26 existing wholly owned properties, transitioned to Oakmont Management Group. The non-cash investing activity with respect to the fair value of interests exchanged in the transaction, non-cash investing activity with respect to the carrying value of prior equity method interests now included in the basis of the acquired properties and non-cash financing activity with respect to the assumption of the secured mortgage debt have been excluded from our Consolidated Statements of Cash Flows.
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The Canadian portfolio consists of 85 properties in a joint venture owned 75% by us and 25% by Revera. As a part of the transaction, we intend to acquire Revera's interest in 71 properties and sell our interests in the remaining 14 properties. As of December 31, 2023, operations for all 71 retained properties have transitioned to new operators. The transaction is expected to close in the first half of 2024.
Genesis HealthCare
As part of the substantial exit of the Genesis HealthCare ("Genesis") operating relationship, which we disclosed on March 2, 2021, we transitioned the sublease of a portfolio of seven facilities from Genesis 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 with 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 (excluded from the dispositions table above) 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.
6. Leases
We lease land, buildings, office space and certain equipment. Many of our leases include a renewal option to extend the term from one to 25 years or more. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide a rate implicit in the lease agreement, we generally use our incremental borrowing rate available at lease commencement, underlying collateral for the lease and the ability to borrow against that collateral on a secured basis to determine the present value of lease payments. The incremental borrowing rates were determined using our longer term borrowing rates (actual pricing through 30 years, as well as other longer term market rates).
The components of lease expense were as follows for the periods presented (in thousands):
Year Ended December 31,
 Classification202320222021
Operating lease cost: (1)
Real estate lease expenseProperty operating expenses$21,970 $22,150 $22,642 
Non-real estate investment lease expenseGeneral and administrative expenses7,243 5,794 4,596 
Finance lease cost:
Amortization of leased assetsProperty operating expenses5,854 6,837 8,105 
Interest on lease liabilitiesInterest expense4,050 6,164 6,574 
Sublease incomeRental income(3,933)(11,487)(8,687)
Total $35,184 $29,458 $33,230 
(1) Includes short-term leases which are immaterial.
Maturities of lease liabilities as of December 31, 2023 are as follows (in thousands):
Operating LeasesFinance Leases
2024$19,329 $5,547 
202518,800 3,980 
202616,637 4,030 
202716,494 3,991 
202816,291 3,948 
Thereafter863,847 369,892 
Total lease payments951,398 391,388 
Less: Imputed interest(647,845)(311,711)
Total present value of lease liabilities$303,553 $79,677 
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Supplemental balance sheet information related to leases in which we are the lessee is as follows for the periods presented (in thousands, except lease terms and discount rate):
 ClassificationDecember 31, 2023December 31, 2022
Right of use assets:
Operating leases - real estateRight of use assets, net$283,293 $287,984 
Finance leases - real estateRight of use assets, net67,676 35,958 
Real estate right of use assets, net350,969 323,942 
Operating leases - non-real estate investmentsReceivables and other assets11,338 10,119 
Finance leases - held for sale(1)
Real property held for sale, net of accumulated depreciation 116,453 
Total right of use assets, net$362,307 $450,514 
Lease liabilities:
Operating leases$303,553 $302,360 
Finance leases79,677 113,464 
Total lease liabilities$383,230 $415,824 
Weighted average remaining lease term (years):
Operating leases45.646.0
Finance leases60.719.8
Weighted average discount rate:
Operating leases5.27 %5.56 %
Finance leases7.71 %5.01 %
(1) During the year ended December 31, 2023, we contributed finance leases at seven properties previously classified as held for sale into a newly formed unconsolidated joint venture, which recognized the purchase option within the leases. See Note 5 for further discussion.
Supplemental cash flow information related to leases was as follows for the periods indicated (in thousands):
Year Ended December 31,
 Classification202320222021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leasesDecrease (increase) in receivables and other assets$(590)$8,805 $9,081 
Operating cash flows from operating leasesIncrease (decrease) in accrued expenses and other liabilities(2,037)(5,570)(6,008)
Operating cash flows from finance leasesDecrease (increase) in receivables and other assets3,061 8,672 8,336 
Financing cash flows from finance leasesOther financing activities(2,704)(2,255)(3,578)
Substantially all of our operating leases in which we are the lessor contain 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. During the years ended December 31, 2023, 2022 and 2021, we wrote-off previously recognized straight-line rent receivable balances of $16,642,000, $0 and $49,241,000, respectively, through a reduction of rental income, which relate to leases for which collection of substantially all contractual lease payments were no longer deemed probable.
Leases in our Triple-net and Outpatient Medical portfolios typically include some form of operating expense reimbursement by the tenant. Rental income related to operating leases and the corresponding variable lease payments, which primarily represents the reimbursement of operating costs such as common area maintenance expenses, utilities, insurance and real estate taxes for the periods indicated were as follows (in thousands):
Year Ended December 31,
202320222021
Fixed income from operating leases$1,344,096 $1,258,238 $1,193,837 
Variable lease income211,977 193,548 180,858 
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For the majority of our Seniors Housing Operating segment, revenue from resident fees and services is predominantly service-based, and as such, resident agreements are accounted for under ASC 606. Within that reportable segment, we also recognize revenue from residential seniors apartment leases in accordance with ASC 842. The amount of revenue related to these leases was $466,162,000, $410,749,000 and $194,078,000 for the years ended December 31, 2023, 2022 and 2021, respectively.
The following table sets forth the future minimum lease payments receivable for leases in effect at December 31, 2023 (excluding properties in our Seniors Housing Operating portfolio and excluding any operating expense reimbursements) (in thousands):
2024$1,391,509 
20251,379,176
20261,343,749
20271,323,525
20281,307,766
Thereafter10,469,656
Totals$17,215,381 
7. Loans Receivable
Loans receivable are recorded on our Consolidated Balance Sheets in real estate loans receivable, net of allowance for credit losses, or for non-real estate loans receivable, in receivables and other assets, net of allowance for credit losses.
Accrued interest receivable was $31,798,000 and $22,878,000 as of December 31, 2023 and December 31, 2022, respectively, and is included in receivables and other assets on the Consolidated Balance Sheets. The following is a summary of our loans receivable (in thousands):
 Year Ended December 31,
 20232022
Mortgage loans$1,057,516 $707,464 
Other real estate loans324,660 195,566 
Allowance for credit losses on real estate loans receivable(20,589)(12,186)
Real estate loans receivable, net of credit allowance1,361,587 890,844 
Non-real estate loans503,993 441,231 
Allowance for credit losses on non-real estate loans receivable(173,874)(152,063)
Non-real estate loans receivable, net of credit allowance330,119 289,168 
Total loans receivable, net of credit allowance$1,691,706 $1,180,012 
The following is a summary of our loan activity for the periods presented (in thousands):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
Advances on loans receivable$490,736 $156,045 $997,449 
Less: Receipts on loans receivable90,215 196,310 343,260 
Net cash advances (receipts) on loans receivable$400,521 $(40,265)$654,189 
During the year ended December 31, 2021, we provided £540 million (approximately $750,330,000 based on the Sterling/ U.S. Dollar exchange rate as of the date of funding) of senior loan financing and a £30 million delayed facility for working capital and capital expenditures to affiliates of Safanad, a global real estate and private equity firm, as part of the recapitalization of its investment in HC-One Group ("HC-One"). During the year ended December 31, 2023, we amended the loan agreement to provide an additional £65 million of financing relating to HC-One's acquisition of an operating platform and extended the maturity to October 2028. As of December 31, 2023, the outstanding principal balance on the expanded loan is £611,453,000 (approximately $779,175,000 based on the Sterling/U.S. Dollar exchange rate as of December 31, 2023). As part of the original loan and as part of the 2023 expansion, we received equity warrants, which provide us the right to participate in the capital appreciation of HC-One above a designated price upon liquidation. See Note 12 for additional details.
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The following is a summary of our loans by credit loss category (in thousands):
December 31, 2023
Loan categoryYears of OriginationLoan Carrying ValueAllowance for Credit LossNet Loan BalanceNo. of Loans
Deteriorated loans 2007 - 2023 $215,283 $(172,045)$43,238 9
Collective loan pool 2007 - 2018 227,810 (3,028)224,782 14
Collective loan pool201923,960 (319)23,641 4
Collective loan pool202034,938 (464)34,474 5
Collective loan pool2021871,754 (11,794)859,960 11
Collective loan pool2022126,324 (1,680)124,644 18
Collective loan pool2023386,100 (5,133)380,967 17
Total loans$1,886,169 $(194,463)$1,691,706 78 
During the year ended December 31, 2021, we entered into definitive agreements to substantially exit our operating relationship with Genesis primarily through the transition of 51 properties to other operators. To effectuate this transition, we agreed to provide Genesis a lease termination fee of $86,310,000 upon successful transition of all properties, which was to be used to immediately repay indebtedness to us. These property transitions substantially occurred throughout 2021, and as of December 31, 2023, $85,043,000 of the lease termination fee has been earned by Genesis and repaid to us to reduce substantially all of the outstanding balance of this indebtedness.
Additionally, upon achievement of certain restructuring milestones, we agreed to reduce the balance of Genesis' unsecured notes payable to us by an additional $169,771,000 in exchange for an equity interest in Genesis. As of December 31, 2023, the amount of the potential reduction of the balance of these unsecured notes has increased to $238,104,000 due to accrued unpaid interest. The maturity date on the unsecured notes has been extended to March 29, 2024. The unsecured notes are included in the deteriorated loan category, and per our policy have had no interest recognized in the three years ended December 31, 2023. The achievement of milestones required for forgiveness has not yet occurred and as of December 31, 2023, the outstanding contractual balance of the unsecured notes, before potential debt reduction, is $290,296,000 and the carrying value is $24,246,000 after application of an allowance for credit losses and consideration of unrecognized interest.
During the year ended December 31, 2023, certain secured indebtedness payable by Genesis to us, which has a carrying value of $166,859,000, was modified to extend the maturity date to March 29, 2024, with no other changes to the terms. Both the unsecured and the secured notes with Genesis are included in non-real estate loans receivable.
The total allowance for credit losses is deemed to be sufficient to absorb expected losses relating to our loan portfolio. The following is a summary of the allowance for credit losses on loans receivable for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Balance at beginning of year$164,249 $166,785 $224,036 
Provision for loan losses, net(1)
8,797 (1,394)7,270 
Loan write-offs(2)
  (64,075)
Purchased deteriorated loan19,077   
Reserve for unrecognized interest added to principal2,066   
Foreign currency translation274 (1,142)(446)
Balance at end of year$194,463 $164,249 $166,785 
(1) Excludes the provision for loan loss on held-to-maturity debt securities.
(2) Includes $64,075,000 related to the Genesis lease terminations for the twelve months ended December 31, 2021.
The following is a summary of our deteriorated loans (in thousands):
 Year Ended December 31,
 202320222021
Balance of deteriorated loans at end of year$215,283 $174,841 $178,369 
Allowance for credit losses(172,045)(148,438)(148,438)
Balance of deteriorated loans not reserved$43,238 $26,403 $29,931 
Interest recognized on deteriorated loans(1)
$1,681 $ $3,185 
(1 Represents cash interest recognized in the period.
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8. Investments in Unconsolidated Entities 
We participate in a number of joint ventures, which generally invest in seniors housing and health care real estate. Our share of the results of operations for these properties has been included in our consolidated results of operations from the date of acquisition by the joint ventures and are reflected in our Consolidated Statements of Comprehensive Income as income or loss from unconsolidated entities. The following is a summary of our investments in unconsolidated entities (dollars in thousands):
Percentage Ownership(1)
December 31, 2023December 31, 2022
Seniors Housing Operating
10% to 95%
$1,248,774 $1,171,307 
Triple-net
10% to 88%
147,679 111,812 
Outpatient Medical
15% to 50%
240,078 216,671 
Total$1,636,531 $1,499,790 
(1) As of December 31, 2023 and includes ownership of investments classified as liabilities and excludes ownership of in-substance real estate.
During the year ended December 31, 2023, we recognized $35,293,000 of impairment losses related to investments in unconsolidated entities in our Consolidated Statements of Comprehensive Income as income or loss from unconsolidated entities. No such impairment losses were recognized during the years ended December 31, 2022 or 2021.
Through June 30, 2023, we owned 34% of Sunrise Senior Living Management, Inc. ("Sunrise ManCo"), who provided comprehensive property management and accounting services with respect to certain of our Seniors Housing Operating properties operated by Sunrise. We pay Sunrise annual management fees pursuant to long-term management agreements. The majority of our management agreements have initial terms expiring in 2028, plus, if applicable, optional renewal periods ranging from an additional 3 to 15 years depending on the property. The management fees payable to Sunrise under the management agreements include a fee based on a percentage of revenues generated by the applicable properties plus, if applicable, positive or negative adjustments based on specified performance targets. For the period in which we owned Sunrise ManCo in 2023, we recognized management fees of $14,185,000 which are reflected within property operating expenses in our Consolidated Statements of Comprehensive Income. For the years ended December 31, 2022 and 2021, we recognized $27,660,000 and $37,052,000 of management fees, respectively. Prior to the sale of our interest in Sunrise ManCo, we recognized an impairment charge of $28,708,000 in income from unconsolidated entities on our Consolidated Statements of Comprehensive Income for the year ended December 31, 2023, calculated as the excess of the carrying value of our investment in the management company compared to estimated sales proceeds for its sale.  
At December 31, 2023, the aggregate unamortized basis difference of our joint venture investments of $144,144,000 is primarily attributable to the difference between the amount for which we purchased our interest in the entity, including transaction costs, and the historical carrying value of the net assets of the joint venture. This difference is being amortized over the remaining useful life of the related properties and included in the reported amount of income from unconsolidated entities.
We have made loans related to 24 properties as of December 31, 2023 for the development and construction of certain properties which are classified as in substance real estate investments and have a carrying value of $832,746,000. We believe that such borrowers typically represent VIEs in accordance with ASC 810. VIEs are required to be consolidated by their primary beneficiary, which is the enterprise that has both: (i) the power to direct the activities of the VIE that most significantly impacts the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. We have concluded that we are not the primary beneficiary of such borrowers, therefore, the loan arrangements were assessed based on among other factors, the amount and timing of expected residual profits, the estimated fair value of the collateral and the significance of the borrower’s equity in the project. Based on these assessments the arrangements have been classified as in substance real estate investments. We expect to fund an additional $195,763,000 related to these investments.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
9. Credit Concentration
We use consolidated net operating income (“NOI”) as our credit concentration metric. See Note 18 for additional information and reconciliation. The following table summarizes certain information about our credit concentration for the year ended December 31, 2023, excluding our share of NOI in unconsolidated entities (dollars in thousands):
Number ofTotalPercent of
Concentration by relationship:(1)
PropertiesNOI
NOI(2)
Integra Healthcare Properties147 $215,466 8%
Sunrise Senior Living(3)
88 150,801 6%
Cogir Management Corporation120 112,571 4%
Avery Healthcare84 100,017 4%
Oakmont Management Group64 94,487 4%
Remaining portfolio1,398 2,016,877 74%
Totals1,901 $2,690,219 100%
(1) Integra Healthcare Properties is in our Triple-net segment. Sunrise Senior Living ("Sunrise"), Cogir Management Corporation and Oakmont Management Group are in our Seniors Housing Operating segment. Avery Healthcare is in both our Seniors Housing Operating and Triple-net segments.
(2) NOI with our top five relationships comprised 30% of total NOI for the year ending December 31, 2022.
(3) For the year ended December 31, 2023, we recognized $793,920,000 of revenue from properties managed by Sunrise.
In December 2022, ProMedica relinquished to Welltower its 15% interest in 147 skilled nursing facilities previously owned by the Welltower/ProMedica joint venture in exchange for a lease modification, which relieved ProMedica from its lease obligation on the properties and amended the lease on the remaining 58 assisted living and memory care properties that continue to be held by the Welltower/ProMedica joint venture. The reduction of ProMedica's noncontrolling interest of $273,504,000 resulting from its relinquishment of the interest in the joint venture previously holding the 147 skilled nursing facilities is a non-cash financing activity excluded from our Consolidated Statement of Cash Flows. The 58 assisted living and memory care assets continue to be operated by ProMedica and backed by the existing guaranty.
Concurrently with the above, Welltower and Integra Healthcare Properties ("Integra") entered into master leases for the skilled nursing portfolio, which were subsequently subleased to regional operators. Also in December 2022, we sold to Integra a 15% ownership interest in 54 of those skilled nursing facilities for approximately $73 million, with no gain recognized as the properties continue to be consolidated following the transaction. This transaction represents the initial tranche of the newly formed joint venture owned 85% by Welltower and 15% by Integra. In January 2023, Integra acquired a 15% interest in an additional 31 of the remaining 93 skilled nursing facilities for approximately $74 million.
10. Borrowings Under Credit Facilities and Commercial Paper Program
At December 31, 2023, we had a primary unsecured credit facility with a consortium of 31 banks that included a $4,000,000,000 unsecured revolving credit facility, a $1,000,000,000 unsecured term credit facility and a $250,000,000 Canadian-denominated unsecured term credit facility. The unsecured revolving credit facility is comprised of a $1,000,000,000 tranche that matures on June 4, 2026 (none outstanding at December 31, 2023) and a $3,000,000,000 tranche that matures on June 4, 2025 (none outstanding at December 31, 2023). The term credit facilities mature on July 19, 2026. Each tranche of the revolving facility and term loans may be extended for two successive terms of six months at our option. We have an option, through an accordion feature, to upsize the unsecured revolving credit facility and the $1,000,000,000 unsecured term credit facility by up to an additional $1,250,000,000, in the aggregate, and the $250,000,000 Canadian-denominated unsecured term credit facility by up to an additional $250,000,000. The primary unsecured credit facility also allows us to borrow up to $1,000,000,000 in alternate currencies (none outstanding at December 31, 2023). Borrowings under the unsecured revolving credit facility are subject to interest payable at the applicable margin over the secured overnight financing rate ("SOFR") interest rate. Based on our current credit ratings, the loans under the unsecured revolving credit facility currently bear interest at 0.775% over the adjusted SOFR rate at December 31, 2023. In addition, we pay a facility fee quarterly to each bank based on the bank’s commitment amount. The facility fee depends on our debt ratings and was 0.15% at December 31, 2023. 
Under the terms of our commercial paper program, we may issue unsecured commercial paper notes with maturities that vary, but do not exceed 397 days from the date of issue, up to a maximum aggregate face or principal amount outstanding at any time of $1,000,000,000 (none outstanding at December 31, 2023).
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
The following information relates to aggregate borrowings under the unsecured revolving credit facility and commercial paper program for the periods presented (dollars in thousands):
 Year Ended December 31,
 202320222021
Balance outstanding at year end$ $ $325,000 
Maximum amount outstanding at any month end$205,000 $1,565,000 $994,000 
Average amount outstanding (total of daily principal balances
divided by days in period)$16,233 $766,167 $384,418 
Weighted-average interest rate (actual interest expense divided
by average borrowings outstanding)5.05 %1.75 %0.33 %
 
11. Senior Unsecured Notes and Secured Debt
At December 31, 2023, the annual principal payments due on debt obligations were as follows (in thousands):
Senior Unsecured Notes (1,2)
Secured Debt (3)
Totals
2024$1,350,000 $400,258 $1,750,258 
20251,260,000 428,821 1,688,821 
2026700,000 155,500 855,500 
2027(4,5)
1,916,604 210,091 2,126,695 
2028(6)
2,485,865 107,546 2,593,411 
Thereafter(7)
5,987,150 920,229 6,907,379 
Total principal balance$13,699,619 $2,222,445 $15,922,064 
Unamortized discounts and premiums, net(26,271) (26,271)
Unamortized debt issuance costs, net(72,812)(20,237)(93,049)
Fair value adjustments and other, net(48,314)(18,881)(67,195)
Total carrying value of debt$13,552,222 $2,183,327 $15,735,549 
(1) Annual interest rates range from 2.05% to 7.02%. The ending weighted average interest rate, after considering the effects of interest rate swaps, was 4.05%, 4.06%, and 3.67%. as of December 31, 2023, December 31, 2022, and December 31, 2021, respectively.
(2) All senior unsecured notes with the exception of the $300,000,000 Canadian-denominated 2.95% senior unsecured notes due 2027 have been issued by Welltower OP and are fully and unconditionally guaranteed by Welltower. The $300,000,000 Canadian-denominated 2.95% senior unsecured notes due 2027 have been issued through private placement by a wholly owned subsidiary of Welltower OP and are fully and unconditionally guaranteed by Welltower OP.
(3) Annual interest rates range from 1.25% to 8.13%. The ending weighted average interest rate, after considering the effects of interest rate swaps and caps, was 4.76%, 4.33%, and 3.03% as of December 31, 2023, December 31, 2022, and December 31, 2021, respectively. Gross real property value of the properties securing the debt totaled $5,511,479,000 at December 31, 2023.
(4) Includes a $1,000,000,000 unsecured term loan and a $250,000,000 Canadian-denominated unsecured term loan (approximately $189,365,000 based on the Canadian/U.S. Dollar exchange rate on December 31, 2023). Both term loans mature on July 19, 2026 and may be extended for two successive terms of six months at our option. The loans bear interest at adjusted SOFR plus 0.85% (6.31% at December 31, 2023) and Canadian Dealer Offered Rate plus 0.85% (6.31% at December 31, 2023), respectively.
(5) Includes $300,000,000 of Canadian-denominated 2.95% senior unsecured notes due 2027 (approximately $227,239,000 based on the Canadian/U.S. Dollar exchange rate on December 31, 2023).
(6) Includes £550,000,000 of 4.80% senior unsecured notes due 2028 (approximately $700,865,000 based on the Pounds Sterling/U.S. Dollar exchange rate in effect on December 31, 2023).
(7) Includes £500,000,000 of 4.50% senior unsecured notes due 2034 (approximately $637,150,000 based on the Pounds Sterling/U.S. Dollar exchange rate in effect on December 31, 2023).
The following is a summary of our senior unsecured notes principal activity during the periods presented (dollars in thousands):
 Year Ended December 31,
 202320222021
Beginning balance$12,584,529 $11,707,961 $11,509,533 
Debt issued1,035,000 1,050,000 1,750,000 
Debt extinguished  (1,533,752)
Foreign currency80,090 (173,432)(17,820)
Ending balance$13,699,619 $12,584,529 $11,707,961 

In January 2024, we repaid our $400,000,000 4.5% senior unsecured notes at maturity.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Welltower, the parent entity that consolidates Welltower OP and all other subsidiaries, fully and unconditionally guarantees to each holder of all series of senior unsecured notes issued by Welltower OP that the principal of and premium, if any, and interest on the notes will be promptly paid in full when due, whether at the applicable maturity date, by acceleration or redemption or otherwise, and interest on the overdue principal of and interest on the notes, if any, if lawful, and all other obligations of Welltower OP to the holders of the notes will be promptly paid in full or performed. Welltower’s guarantees of such notes are its senior unsecured obligation and rank equally with all of Welltower’s other future unsecured senior indebtedness and guarantees from time to time outstanding. Welltower’s guarantees of such notes are effectively subordinated to all liabilities of its subsidiaries and to its secured indebtedness to the extent of the assets securing such indebtedness. Because Welltower conducts substantially all of its business through its subsidiaries, Welltower's ability to make required payments with respect to the guarantees depends on the financial results and condition of its subsidiaries and its ability to receive funds from its subsidiaries, whether by dividends, loans, distributions or other payments.
We may repurchase, redeem or refinance senior unsecured notes from time to time, taking advantage of favorable market conditions when available. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, a tender offer or, in some cases, through the early redemption of such securities pursuant to their terms. The senior unsecured notes are redeemable at our option, at any time in whole or from time to time in part, subject to certain contractual restrictions, at a redemption price equal to the sum of: (i) the principal amount of the notes (or portion of such notes) being redeemed plus accrued and unpaid interest thereon up to the redemption date and (ii) any “make-whole” amount due under the terms of the notes in connection with early redemptions. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors.
Exchangeable Senior Unsecured Notes
In May 2023, Welltower OP issued $1,035,000,000 aggregate principal amount of 2.75% exchangeable senior unsecured notes maturing May 15, 2028 (the "Exchangeable Notes" or the "Notes") unless earlier exchanged, purchased or redeemed. The Exchangeable Notes will pay interest semi-annually in arrears on May 15 and November 15 of each year. The net proceeds from the offering of the Exchangeable Notes were approximately $1,011,780,000 after deducting the underwriting fees and other expenses. We recognized contractual interest expense on the Exchangeable Notes of approximately $18,184,000 for the year end December 31, 2023. Additionally, amortization of related issuance costs for the year end December 31, 2023 were $2,975,000. Unamortized issuance costs were $20,245,000 as of December 31, 2023.
Prior to the close of business on the business day immediately preceding November 15, 2027, the Notes are exchangeable at the option of the holders only upon certain circumstances and during certain periods, including upon a notice of redemption described below. On or after November 15, 2027, the Notes will be exchangeable at the option of the holders at any time prior to the close of business on the second scheduled trading day preceding the maturity date. Welltower OP will settle exchanges of the Notes by delivering cash up to the principal amount of the Notes exchanged and, in respect of the remainder of the exchanged value, if any, in excess thereof, cash or shares of Welltower's common stock, or a combination thereof, at the election of Welltower OP. The exchange rate initially equals 10.4808 shares of common stock per $1,000 principal amount of Notes (equivalent to an exchange price of approximately $95.41 per share of common stock). The exchange rate is subject to adjustment upon the occurrence of certain events but will not be adjusted for any accrued and unpaid interest.
Welltower OP may redeem the Notes, at its option, in whole or in part, on any business day on or after May 20, 2026, if the last reported sales price of the common stock has been at least 130% of the exchange price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which Welltower OP provides notice of redemption. The redemption price will be equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to but excluding the redemption date.
The following is a summary of our secured debt principal activity for the periods presented (dollars in thousands):
 Year Ended December 31,
 202320222021
Beginning balance$2,129,954 $2,202,312 $2,378,073 
Debt issued385,115 113,183 23,569 
Debt assumed428,578 328,096  
Debt extinguished(687,780)(399,066)(132,031)
Principal payments(54,076)(58,114)(65,587)
Foreign currency20,654 (56,457)(1,712)
Ending balance$2,222,445 $2,129,954 $2,202,312 
Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain 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, 2023, we were in compliance in all material respects with all of the covenants under our debt agreements.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
12. Derivative Instruments
We are exposed to, among other risks, the impact of changes in foreign currency exchange rates as a result of our non-U.S. investments and interest rate risk related to our capital structure. Our risk management program is designed to manage the exposure and volatility arising from these risks, and utilizes foreign currency forward contracts, cross currency swap contracts, interest rate swaps, interest rate locks and debt issued in foreign currencies to offset a portion of these risks.
Cash Flow Hedges and Fair Value Hedges of Interest Rate Risk
We enter into interest rate swaps in order to maintain a capital structure containing targeted amounts of fixed and floating-rate debt and manage interest rate risk. Interest rate swaps designated as cash flow hedges involve the receipt of variable amounts from a counterparty in exchange for our fixed-rate payments. These interest rate swap agreements are used to hedge the variable cash flows associated with variable-rate debt.
Interest rate swaps designated as fair value hedges involve the receipt of fixed amounts from a counterparty in exchange for our variable-rate payments. These interest rate swap agreements hedge the exposure to changes in the fair value of fixed-rate debt attributable to changes in the designated benchmark interest rate. For derivative instruments that are designated and qualify as a fair value hedge, the gain or loss on the derivative instrument, as well as the offsetting loss or gain on the hedged item attributable to the hedged risk, are recognized in earnings. We record the gain or loss on the hedged items in interest expense, the same line item as the offsetting loss or gain on the related interest rate swaps. In March 2022, we entered into a fixed to floating swap in connection with our March 2022 senior note issuance. As of December 31, 2023, the carrying amount of the notes, exclusive of the hedge, is $545,872,000. The fair value of the swap as of December 31, 2023 was ($48,314,000) and was recorded as a derivative liability with an offset to senior unsecured notes on our Consolidated Balance Sheets.
Periodically, we enter into and designate interest rate locks to partially hedge the risk of changes in interest payments attributable to increases in the benchmark interest rate during the period leading up to the probable issuance of fixed-rate debt. We designate our interest rate locks as cash flow hedges. Gains and losses when we settle our interest rate locks are amortized into earnings over the life of the related debt, except where a material amount is deemed to be ineffective, which would be immediately recognized in the Consolidated Statements of Comprehensive Income. Approximately $2,562,000 of losses, which are included in other comprehensive income ("OCI"), are expected to be reclassified into earnings in the next 12 months.
Cash flows from derivatives accounted for as a fair value or cash flow hedge are classified in the same category as the cash flows from the items being hedged in the Consolidated Statement of Cash Flows.
Foreign Currency Forward Contracts and Cross Currency Swap Contracts Designated as Net Investment Hedges
We use foreign currency forward and cross currency forward swap contracts to hedge a portion of the net investment in foreign subsidiaries against fluctuations in foreign exchange rates. For instruments that are designated and qualify as net investment hedges, the variability in the foreign currency to U.S. Dollar of the instrument is recorded as a cumulative translation adjustment component of OCI. 
During the years ended December 31, 2023, 2022, and 2021 we settled certain net investment hedges generating cash proceeds of $29,553,000, $61,853,000 and $14,505,000, respectively. The balance of the cumulative translation adjustment will be reclassified to earnings if the hedged investment is sold or substantially liquidated.
Derivative Contracts Undesignated
We use foreign currency exchange contracts to manage existing exposures to foreign currency exchange risk. Gains and losses resulting from the changes in fair value of these instruments are recorded in interest expense on the Consolidated Statements of Comprehensive Income and are substantially offset by net revaluation impacts on foreign currency denominated balance sheet exposures. In addition, we have several interest rate cap contracts related to variable rate secured debt agreements. Gains and losses resulting from the changes in fair values of these instruments are also recorded in interest expense.
Equity Warrants
We received equity warrants through our lending activities further described in Note 7, which were accounted for as loan origination fees. The warrants provide us the right to participate in the capital appreciation of the underlying HC-One real estate portfolio above a designated price upon liquidation and contain net settlement terms qualifying as derivatives under ASC Topic 815. The warrants are classified within receivables and other assets on our Consolidated Balance Sheets. These warrants are measured at fair value with changes in fair value being recognized within gain (loss) on derivatives and financial instruments in our Consolidated Statements of Comprehensive Income.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
The following presents the notional amount of derivatives and other financial instruments as of the dates indicated (in thousands):
December 31, 2023December 31, 2022
Derivatives designated as net investment hedges:
Denominated in Canadian Dollars$2,025,000 $1,075,000 
Denominated in Pound Sterling£1,660,708 £1,890,708 
Financial instruments designated as net investment hedges:
Denominated in Canadian Dollars$250,000 $250,000 
Denominated in Pound Sterling£1,050,000 £1,050,000 
Interest rate swaps and caps designated as cash flow hedges:
Denominated in U.S. Dollars(1)
$872,601 $25,000 
Interest rate swaps designated as fair value hedges:
Denominated in U.S. Dollars$550,000 $550,000 
Derivative instruments not designated:
Interest rate caps denominated in U.S. Dollars$ $26,137 
Foreign currency exchange contracts denominated in Canadian Dollars$80,000 $80,000 
(1) At December 31, 2023 the maximum maturity date was September 1, 2028.
The following presents the impact of derivative instruments on the Consolidated Statements of Comprehensive Income for the periods presented (in thousands):
  Year Ended
DescriptionLocationDecember 31, 2023December 31, 2022December 31, 2021
Gain (loss) on derivative instruments designated as hedges recognized in incomeInterest expense$18,068 $28,894 $23,133 
Gain (loss) on derivative instruments not designated as hedges recognized in incomeInterest expense$(1,383)$4,255 $(433)
Gain (loss) on equity warrants recognized in incomeGain (loss) on derivatives and financial instruments, net$2,218 $(6,837)$10,361 
Gain (loss) on derivative and financial instruments designated as hedges recognized in OCIOCI$(245,095)$442,620 $79,702 
13. Commitments and Contingencies
At December 31, 2023, we had 23 outstanding letter of credit obligations totaling $49,680,000 and expiring during 2024 and 2025. At December 31, 2023, we had outstanding construction in progress of $1,304,441,000 and were committed to providing additional funds of approximately $966,829,000 to complete construction. Additionally, at December 31, 2023, we had outstanding investments classified as in substance real estate of $832,746,000 and were committed to provide additional funds of $195,763,000 (see Note 8 for additional information). Purchase obligations include $969 million representing a definitive agreement to acquire 25 Seniors Housing Operating properties entered into in February 2024 (see Note 3 for additional information) and $39,387,000 of contingent purchase obligations to fund capital improvements. Rents due from the tenants are increased to reflect the additional investment in the property.
14. Stockholders’ Equity 
The following is a summary of our stockholders’ equity capital accounts as of the dates indicated:
December 31, 2023December 31, 2022
Preferred Stock, $1.00 par value:
Authorized shares50,000,000 50,000,000
Issued shares  
Outstanding shares  
Common Stock, $1.00 par value:
Authorized shares700,000,000 700,000,000 
Issued shares566,001,632 492,283,488 
Outstanding shares564,241,181 490,508,937 
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Common Stock
In August 2023, we entered into an equity distribution agreement whereby we can offer and sell up to $4,000,000,000 aggregate amount of our common stock ("ATM Program", as amended from time to time). The ATM Program also allows us to enter into forward sale agreements (none outstanding at December 31, 2023). As of December 31, 2023, we had $1,854,611,000 of remaining capacity under the ATM Program. Subsequent to December 31, 2023, we sold 5,046,308 shares of common stock under the ATM Program.
In November 2023, we issued 20,125,000 shares of common stock. The shares were sold pursuant to an underwriting agreement, dated as of November 6, 2023.
On May 1, 2020, our Board of Directors authorized a share repurchase program whereby we may repurchase up to $1 billion of common stock through December 31, 2021. On November 7, 2022, our Board of Directors approved a follow-on share repurchase program for up to $3 billion of common stock (the "Stock Repurchase Program"). Under the Stock Repurchase Program, we are not required to purchase shares but may choose to do so in the open market or through privately-negotiated transactions, through block trades, by effecting a tender offer, by way of an accelerated share repurchase program, through the purchase of call options or the sale of put options, or otherwise, or by any combination of the foregoing. We expect to finance any share repurchases using available cash and may use proceeds from borrowings or debt offerings. The Stock Repurchase Program has no expiration date and does not obligate us to repurchase any specific number of shares. We did not repurchase any shares of our common stock during the years ended December 31, 2023, 2022, and 2021.
The following is a summary of our common stock issuances during the periods indicated (dollars in thousands, except shares and average price amounts):
Shares IssuedAverage PriceGross ProceedsNet Proceeds
2021 Option exercises
338 $56.21 $19 $19 
2021 ATM Program issuances
29,667,348 80.41 2,385,683 2,348,182 
2021 Stock incentive plans, net of forfeitures
171,189 — — 
2021 Totals
29,838,875 $2,385,702 $2,348,201 
2022 Option exercises
2,433 $67.00 $163 $163 
2022 ATM Program issuances
43,092,888 86.23 3,715,971 3,667,691 
2022 Redemption of OP Units and DownREIT Units
5,498 — — 
2022 Stock incentive plans, net of forfeitures
168,641 — — 
2022 Totals
43,269,460 $3,716,134 $3,667,854 
2023 Option exercises
3,541$78.23 $277 $277 
2023 ATM Program issuances
53,300,87480.924,313,007 4,290,766 
2023 Equity issuance20,125,00088.061,772,216 1,719,086 
2023 Redemption of OP Units and DownREIT Units
335,562— — 
2023 Stock incentive plans, net of forfeitures
(32,733)— — 
2023 Totals
73,732,244 $6,085,500 $6,010,129 
Dividends 
Please refer to Note 19 for information related to federal income tax of dividends. The following is a summary of our dividend payments (in thousands, except per share amounts):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
  Per ShareAmountPer ShareAmountPer ShareAmount
Common stock$2.44 $1,259,676 $2.44 $1,133,182 $2.44 $1,037,194 
Accumulated Other Comprehensive Income
The following is a summary of accumulated other comprehensive income/(loss) for the periods presented (in thousands):
 December 31, 2023December 31, 2022
Foreign currency translation$(913,675)$(1,115,317)
Derivative and financial instruments designated as hedges750,515 995,610 
Total accumulated other comprehensive income (loss)$(163,160)$(119,707)
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
15. Stock Incentive Plans
In March 2022, our Board of Directors approved the 2022 Long-Term Plan ("2022 Plan"), which authorizes up to 10,000,000 shares of common stock or units to be issued at the discretion of the Compensation Committee of the Board of Directors. Awards granted after March 28, 2022 are issued out of the 2022 Plan. The awards granted under the 2016 Long-Term Incentive Plan continue to vest and options expire ten years from the date of grant. Our non-employee directors, officers and key employees are eligible to participate in the 2022 Plan. The 2022 Plan allows for the issuance of, among other things, stock options, stock appreciation rights, restricted stock units, deferred stock units, performance units and dividend equivalent rights. Vesting periods for options, deferred stock units and restricted stock units generally range from three to five years. Options expire ten years from the date of grant.
Under our long-term incentive plan, certain restricted stock awards are market, performance and time-based. For market and performance based awards, we will grant a target number of restricted stock units, with the ultimate award determined by the total shareholder return and operating performance metrics, measured in each case over a measurement period of three to four years. Performance based awards vest after the end of the performance periods. The expected term represents the period from the grant date to the end of the performance period. Compensation expense for performance based awards is measured based on the probability of achievement of certain performance goals and is recognized over the performance period. For the portion of the grant for which the award is determined by the operating performance metrics, the compensation cost is based on the grant date closing price and management’s estimate of corporate achievement of the financial metrics. If the estimated number of performance based restricted stock to be earned changes, an adjustment will be recorded to recognize the accumulated difference between the revised and previous estimates. For the portion of the grant determined by the total shareholder return ("TSR"), management used a Monte Carlo model to assess the fair value and compensation cost. For time based awards, the fair value of the restricted stock is equal to the market price of the Company’s common stock on the date of grant and is amortized over the vesting periods. For purposes of measuring stock-based compensation expense, we consider whether an adjustment to the observable market price is necessary to reflect material nonpublic information that is known to us at the time the award is granted. No adjustments were deemed necessary for the years ended December 31, 2023, 2022, or 2021. Forfeitures are accounted for as they occur.
The following table summarizes compensation expense recognized for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Stock options$2,741 $2,378 $1,088 
Restricted stock units34,458 23,771 16,724 
Total compensation expense$37,199 $26,149 $17,812 
Stock Options
The following is a summary of time-based stock option activity in 2023:
SharesWeighted Average Exercise PriceWeighted Average Remaining Contractual Life (years)Intrinsic Value ($000's)
Outstanding as of December 31, 2022
551,515 $75.82 
Options granted93,674 75.50
Options exercised(5,189)79.82
Options forfeited(3,740)77.77
Outstanding as of December 31, 2023
636,260$75.73 7.8$9,190 
Exercisable as of December 31, 2023
210,262$72.72 7.4$7,817 
We used the Black-Scholes option pricing model to determine the grant date fair value of time-based options. The weighted-average assumptions used are as follows:
2023
Dividend yield3.20%
Estimated volatility(1)
34.82%
Risk free rate4.12%
Expected life of options4.8
Estimated fair value$20.55
(1) Estimated volatility over the life of the plan is using 50% historical volatility and 50% implied volatility.
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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
As of December 31, 2023, there was $4,895,000 of total unrecognized compensation expense related to unvested time-based stock options that is expected to be recognized over a weighted-average period of two years.
During December 2021, we granted performance-based stock options. The grant date fair value of $20.31 was estimated on the date of grant using the Black-Scholes option pricing model. These options have a performance condition based on a Funds From Operations goal measured over the performance period of January 1, 2022 to December 31, 2024. These awards vest over two years after the end of the performance period, with a portion vesting immediately at the end of the performance period. Compensation expense is measured based on the probability of achievement of the performance goal and is recognized over both the performance period and vesting period. At December 31, 2022 and December 31, 2023, the performance goal was not probable of being achieved. The following is a summary of performance-based stock option activity as of December 31, 2023:
SharesWeighted Average Exercise Price
Outstanding as of December 31, 2022
825,216 $83.44 
Options forfeited(10,095)83.44 
Outstanding as of December 31, 2023
815,121$83.44 
Restricted Stock
During January 2022, we granted performance-based restricted stock awards under the terms of an Out Performance Program ("OPP"). The grant date fair value was estimated on the date of grant using a Monte Carlo model. These awards have performance conditions based on a Funds From Operations goal and absolute and relative TSR goals measured over the performance period of January 1, 2022 to December 31, 2025. These awards vest after the end of the performance period. Compensation expense is measured based on the probability of achievement of the performance goals and is recognized over the performance period. At December 31, 2022 and December 31, 2023, the performance goals were not probable of being achieved. The following is a summary of our non-vested OPP restricted stock activity as of December 31, 2023:
 Restricted Stock
 Number of SharesWeighted-Average
Grant Date Fair Value
Non-vested at December 31, 2022
936,915 $27.60 
Forfeited or expired(4,690)27.60 
Non-vested at December 31, 2023
932,225 $27.60 

The following is a summary of the status of our non-vested restricted stock (including market, performance and time-based awards, and excluding OPP awards) as of December 31, 2023:
 Restricted Stock
 Number of SharesWeighted-Average
Grant Date Fair Value
Non-vested at December 31, 2022
803,327 $84.78 
Vested(255,514)82.40
Granted414,177 97.20
Change in awards based on performance(1)
798,065 106.59
Forfeited or expired(14,040)87.80
Non-vested at December 31, 2023
1,746,015 $98.03 
(1) Represents the change in number of market and performance based awards earned based on performance achievement.
We used a Monte Carlo model to assess the compensation cost associated with the portion of the market awards granted for which achievement will be determined using total shareholder return measures. The model also considers a post-vesting holding period. The weighted-average assumptions used are as follows:
2023
Dividend yield3.20%
Estimated volatility over the life of the plan(1)
27.33% - 39.02%
Risk free rate
4.44% - 5.08%
Estimated market based performance award value based on total shareholder return measure$118.87
(1) Estimated volatility over the life of the plan is using 50% historical volatility and 50% implied volatility.
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As of December 31, 2023, there was $40,721,000 of total unrecognized compensation expense related to unvested restricted stock that is expected to be recognized over a weighted-average period of two years. 
16. Earnings Per Share
The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data):
 Year Ended December 31,
 202320222021
Numerator for basic earnings per share - net income attributable to common stockholders$340,094 $141,214 $336,138 
Adjustment for net income (loss) attributable to OP Units and DownREIT Units(303)165 (3,020)
Numerator for diluted earnings per share$339,791 $141,379 $333,118 
Denominator for basic earnings per share - weighted average shares515,629 462,185 424,976 
Effect of dilutive securities:
Employee stock options32 20  
Non-vested restricted shares and units1,031 1,058 447 
OP Units and DownREIT Units
1,983 1,865 1,396 
Employee stock purchase program26 30 22 
Dilutive potential common shares3,072 2,973 1,865 
Denominator for diluted earnings per share - adjusted weighted average shares518,701 465,158 426,841 
Basic earnings per share$0.66 $0.31 $0.79 
Diluted earnings per share$0.66 $0.30 $0.78 
As of December 31, 2021, outstanding forward sales agreements for the sale of 5,187,250 shares were not included in the computation of diluted earnings per share because such forward sales were anti-dilutive for the period. There were no outstanding forward sale agreements as of December 31, 2023 or December 31, 2022. Employee stock options were anti-dilutive for 2021.
The Exchangeable Notes were not included in the computation of diluted earnings per share as they were anti-dilutive for the year ended December 31, 2023.
17. Disclosure about Fair Value of Financial Instruments
Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. A three-level valuation hierarchy exists for disclosures of fair value measurements based upon the transparency of inputs to the valuation of an asset or liability as of the measurement date. A financial instrument's categorization within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The three levels are defined below:
Level 1 - Quoted prices in active markets for identical assets or liabilities.
Level 2 - Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. 
Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. 
The following methods and assumptions were used to estimate the fair value of each class of financial instruments for which it is practicable to estimate that value: 
Mortgage Loans, Other Real Estate Loans and Non-real Estate Loans Receivable — The fair value of mortgage loans, other real estate loans and non-real estate loans receivable is generally estimated by using Level 2 and Level 3 inputs such as discounting the estimated future cash flows using the current rates at which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. 
Cash and Cash Equivalents and Restricted Cash — The carrying amount approximates fair value. 
Equity Warrants — The fair value of equity warrants is estimated using Level 3 inputs and includes data points such as enterprise value of the underlying HC-One Group real estate portfolio, marketability discount for private company warrants,
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dividend yield, volatility and risk-free rate. The enterprise value is driven by projected cash flows, weighted average cost of capital and a terminal capitalization rate.
Borrowings Under Primary Unsecured Credit Facility and Commercial Paper Program — The carrying amount of the primary unsecured credit facility and commercial paper program approximates fair value because the borrowings are interest rate adjustable. 
Senior Unsecured Notes — The fair value of the senior unsecured notes payable is estimated based on Level 1 publicly available trading prices. The carrying amount of the variable rate senior unsecured notes approximates fair value because they are interest rate adjustable. 
Secured Debt — The fair value of fixed rate secured debt is estimated using Level 2 inputs by discounting the estimated future cash flows using the current rates at which similar loans would be made with similar credit ratings and for the same remaining maturities. The carrying amount of variable rate secured debt approximates fair value because the borrowings are interest rate adjustable. 
Foreign Currency Forward Contracts, Interest Rate Swaps and Cross Currency Swaps — Foreign currency forward contracts, interest rate swaps and cross currency swaps are recorded in other assets or other liabilities on the balance sheet at fair value that is derived from Level 2 observable market data, including yield curves and foreign exchange rates.
Redeemable DownREIT Unitholder Interests — Our redeemable DownREIT Unitholder interests are recorded on the balance sheet at fair value using Level 2 inputs unless the fair value is below the initial amount, in which case the redeemable DownREIT Unitholder interests are recorded at the initial amount adjusted for distributions to the unitholders and income or loss attributable to the unitholders. The fair value is measured using the closing price of our common stock, as units may be redeemed at the election of the holder for cash or, at our option, one share of our common stock per unit, subject to adjustment in certain circumstances. 
The carrying amounts and estimated fair values of our financial instruments are as follows (in thousands):
 December 31, 2023December 31, 2022
 CarryingFairCarryingFair
 AmountValueAmountValue
Financial assets:    
Mortgage loans receivable$1,043,252 $1,105,260 $697,906 $739,159 
Other real estate loans receivable318,335 319,905 192,938 190,977 
Cash and cash equivalents1,993,646 1,993,646 631,681 631,681 
Restricted cash82,437 82,437 90,611 90,611 
Non-real estate loans receivable330,119 312,985 289,168 277,601 
Foreign currency forward contracts, interest rate swaps and cross currency swaps37,118 37,118 191,357 191,357 
Equity warrants35,772 35,772 30,436 30,436 
Financial liabilities:
Senior unsecured notes$13,552,222 $13,249,247 $12,437,273 $11,381,873 
Secured debt2,183,327 2,144,059 2,110,815 2,054,889 
Foreign currency forward contracts, interest rate swaps and cross currency swaps96,023 96,023 55,727 55,727 
Redeemable DownREIT Unitholder interests$77,928 $77,928 $75,355 $75,355 
Items Measured at Fair Value on a Recurring Basis 
The market approach is utilized to measure fair value for our financial assets and liabilities reported at fair value on a recurring basis. The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities. The following summarizes items measured at fair value on a recurring basis (in thousands):
 
Fair Value Measurements as of December 31, 2023
 TotalLevel 1Level 2Level 3
Equity warrants$35,772 $ $ $35,772 
Foreign currency forward contracts, interest rate swaps and cross currency swaps, net asset (liability) (1)
(58,905) (58,905) 
Totals $(23,133)$ $(58,905)$35,772 
(1) Please see Note 12 for additional information.
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The following table summarizes the change in fair value for equity warrants using unobservable Level 3 inputs for the years presented (in thousands):
Years Ended
 December 31, 2023December 31, 2022
Beginning balance$30,436 $41,909 
Warrants acquired1,202  
Mark-to-market adjustment2,218 (6,837)
Foreign currency1,916 (4,636)
Ending balance$35,772 $30,436 
The most significant assumptions utilized in the valuation of the equity warrants are the cash flows of the underlying HC-One Group enterprise, as well as the terminal capitalization rate which was 10.0% and 10.5% at year end December 31, 2023 and 2022, respectively.
Items Measured at Fair Value on a Nonrecurring Basis 
In addition to items that are measured at fair value on a recurring basis, we also have assets and liabilities in our balance sheet that are measured at fair value on a nonrecurring basis that are not included in the tables above. Assets, liabilities and noncontrolling interests that are measured at fair value on a nonrecurring basis include those acquired, exchanged or assumed. Asset impairments (if applicable, see Note 5 for impairments of real property and Note 7 for impairments of loans receivable) are also measured at fair value on a nonrecurring basis. We have determined that the fair value measurements included in each of these assets and liabilities rely primarily on company-specific inputs and our assumptions about the use of the assets and settlement of liabilities, as observable inputs are not available. As such, we have determined that each of these fair value measurements generally resides within Level 3 of the fair value hierarchy. We estimate the fair value of real estate and related intangibles using the income approach and unobservable data such as net operating income and estimated capitalization and discount rates. We also consider local and national industry market data including comparable sales, and commonly engage an external real estate appraiser to assist us in our estimation of fair value. We estimate the fair value of assets held for sale based on current sales price expectations or, in the absence of such price expectations, Level 3 inputs described above. We estimate the fair value of loans receivable using projected payoff valuations based on the expected future cash flows and/or the estimated fair value of collateral, net of sales costs, if the repayment of the loan is expected to be provided solely by the collateral. We estimate the fair value of secured debt assumed in asset acquisitions using current interest rates at which similar borrowings could be obtained on the transaction date. 
18. Segment Reporting
We invest in seniors housing and health care real estate. We evaluate our business and make resource allocations on our three operating segments: Seniors Housing Operating, Triple-net and Outpatient Medical. Our Seniors Housing Operating properties include seniors apartments, assisted living, independent living/continuing care retirement communities, independent supportive living communities (Canada), care homes with and without nursing (U.K.) and combinations thereof that are generally owned and/or operated through RIDEA structures (see Note 19). Our Triple-net properties include the property types described above as well as long-term/post-acute care facilities. Under the Triple-net segment, we invest in seniors housing and health care real estate through acquisition and financing of primarily single tenant properties. Properties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our Outpatient Medical properties are typically leased to multiple tenants and generally require a certain level of property management by us.
We evaluate performance based upon consolidated NOI of each segment. We define NOI as total revenues, including tenant reimbursements, less property operating expenses. We believe NOI provides investors relevant and useful information as it measures the operating performance of our properties at the property level on an unleveraged basis. We use NOI to make decisions about resource allocations and to assess the property level performance of our properties.
Non-segment revenue consists mainly of interest income on cash investments recorded in other income. Non-segment assets consist of corporate assets including cash, deferred loan expenses and corporate offices and equipment among others. Non-property specific revenues and expenses are not allocated to individual segments in determining NOI.
The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 2). The results of operations for all acquisitions described in Note 3 are included in our consolidated results of operations from the acquisition dates and are components of the appropriate segments. All inter-segment transactions are eliminated.
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Summary information for the reportable segments (which excludes unconsolidated entities) during the years ended December 31, 2023, 2022 and 2021 is as follows (in thousands):
Year Ended December 31, 2023:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$4,753,804 $ $ $ $4,753,804 
Rental income 814,751 741,322  1,556,073 
Interest income10,096 157,592 666  168,354 
Other income9,743 70,986 9,167 69,868 159,764 
Total revenues4,773,643 1,043,329 751,155 69,868 6,637,995 
Property operating expenses3,655,508 42,194 231,956 18,118 3,947,776 
Consolidated net operating income (loss)1,118,135 1,001,135 519,199 51,750 2,690,219 
Depreciation and amortization906,771 231,028 263,302  1,401,101 
Interest expense56,509 (65)10,543 540,859 607,846 
General and administrative expenses   179,091 179,091 
Loss (gain) on derivatives and financial instruments, net (2,120)  (2,120)
Loss (gain) on extinguishment of debt, net  7  7 
Provision for loan losses, net3,197 6,348 264  9,809 
Impairment of assets24,999 11,098   36,097 
Other expenses96,972 5,060 2,289 4,020 108,341 
Income (loss) from continuing operations before income taxes and other items29,687 749,786 242,794 (672,220)350,047 
Income tax (expense) benefit   (6,364)(6,364)
Income (loss) from unconsolidated entities(69,835)16,700 (307) (53,442)
Gain (loss) on real estate dispositions, net68,290 259 (651) 67,898 
Income (loss) from continuing operations28,142 766,745 241,836 (678,584)358,139 
Net income (loss)$28,142 $766,745 $241,836 $(678,584)$358,139 
Total assets$24,857,722 $9,985,952 $7,353,819 $1,814,673 $44,012,166 
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Year Ended December 31, 2022:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$4,173,711 $ $ $ $4,173,711 
Rental income 782,329 669,457  1,451,786 
Interest income7,867 142,402 302  150,571 
Other income63,839 6,776 8,998 4,934 84,547 
Total revenues4,245,417 931,507 678,757 4,934 5,860,615 
Property operating expenses3,292,045 44,483 205,997 16,245 3,558,770 
Consolidated net operating income (loss)953,372 887,024 472,760 (11,311)2,301,845 
Depreciation and amortization854,800 215,887 239,681  1,310,368 
Interest expense34,833 963 18,078 475,645 529,519 
General and administrative expenses   150,390 150,390 
Loss (gain) on derivatives and financial instruments, net 8,334   8,334 
Loss (gain) on extinguishment of debt, net386 80 15 199 680 
Provision for loan losses, net1,039 9,289 (8) 10,320 
Impairment of assets13,146 3,595 761  17,502 
Other expenses66,026 13,043 2,537 20,064 101,670 
Income (loss) from continuing operations before income taxes and other items(16,858)635,833 211,696 (657,609)173,062 
Income tax (expense) benefit   (7,247)(7,247)
Income (loss) from unconsolidated entities(53,318)34,495 (2,467) (21,290)
Gain (loss) on real estate dispositions, net5,794 16,648 (6,399) 16,043 
Income (loss) from continuing operations(64,382)686,976 202,830 (664,856)160,568 
Net income (loss)$(64,382)$686,976 $202,830 $(664,856)$160,568 
Total assets$22,000,732 $8,619,314 $6,614,887 $658,300 $37,893,233 
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Year Ended December 31, 2021:Seniors Housing OperatingTriple-netOutpatient MedicalNon-segment/CorporateTotal
Resident fees and services$3,197,223 $ $ $ $3,197,223 
Rental income 761,441 613,254  1,374,695 
Interest income4,231 124,540 8,792  137,563 
Other income11,796 4,603 13,243 2,992 32,634 
Total revenues3,213,250 890,584 635,289 2,992 4,742,115 
Property operating expenses2,529,344 49,462 186,939 8,817 2,774,562 
Consolidated net operating income (loss)683,906 841,122 448,350 (5,825)1,967,553 
Depreciation and amortization593,565 220,699 223,302  1,037,566 
Interest expense39,327 6,376 17,506 426,644 489,853 
General and administrative expenses   126,727 126,727 
Loss (gain) on derivatives and financial instruments, net (7,333)  (7,333)
Loss (gain) on extinguishment of debt, net(2,628) (4)52,506 49,874 
Provision for loan losses, net394 10,339 (3,463) 7,270 
Impairment of assets22,317 26,579 2,211  51,107 
Other expenses27,132 4,189 2,523 7,895 41,739 
Income (loss) from continuing operations before income taxes and other items3,799 580,273 206,275 (619,597)170,750 
Income tax (expense) benefit   (8,713)(8,713)
Income (loss) from unconsolidated entities(39,225)20,687 (4,395) (22,933)
Gain (loss) on real estate dispositions, net6,146 135,881 93,348  235,375 
Income (loss) from continuing operations(29,280)736,841 295,228 (628,310)374,479 
Net income (loss)$(29,280)$736,841 $295,228 $(628,310)$374,479 
Our portfolio of properties and other investments are located in the United States, the United Kingdom and Canada. Revenues and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for the periods presented (dollars in thousands):
 Year Ended
 December 31, 2023December 31, 2022December 31, 2021
Revenues:Amount%Amount%Amount%
United States$5,521,933 83.2 %$4,843,417 82.6 %$3,766,707 79.4 %
United Kingdom606,750 9.1 %558,308 9.5 %552,650 11.7 %
Canada509,312 7.7 %458,890 7.9 %422,758 8.9 %
Total$6,637,995 100.0 %$5,860,615 100.0 %$4,742,115 100.0 %
Year Ended
December 31, 2023December 31, 2022December 31, 2021
Resident fees and services:Amount%Amount%Amount%
United States$3,811,915 80.2 %$3,325,466 79.7 %$2,389,257 74.7 %
United Kingdom447,219 9.4 %401,195 9.6 %396,610 12.4 %
Canada494,670 10.4 %447,050 10.7 %411,356 12.9 %
Total$4,753,804 100.0 %$4,173,711 100.0 %$3,197,223 100.0 %
 As of  
 December 31, 2023December 31, 2022  
Assets:Amount%Amount%  
United States$36,929,186 83.9 %$31,740,907 83.8 % 
United Kingdom3,587,230 8.2 %3,476,793 9.2 % 
Canada3,495,750 7.9 %2,675,533 7.0 %  
Total$44,012,166 100.0 %$37,893,233 100.0 %  
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19. Income Taxes and Distributions 
We elected to be taxed as a REIT commencing with our first taxable year. To qualify as a REIT for federal income tax purposes, at least 90% of taxable income (excluding 100% of net capital gains) must be distributed to stockholders. REITs that do not distribute a certain amount of taxable income in the current year are also subject to a 4% federal excise tax. The main differences between undistributed net income for federal income tax purposes and financial statement purposes are the recognition of straight-line rent for reporting purposes, basis differences in acquisitions, recording of impairments, differing useful lives and depreciation and amortization methods for real property and the provision for loan losses for reporting purposes versus bad debt expense for tax purposes. 
Cash distributions paid to common stockholders, for federal income tax purposes, are as follows for the periods presented:
 Year Ended December 31,
 202320222021
Per share:
Ordinary dividend(1)
$1.6719 $2.4400 $1.4828 
Long-term capital gain/(loss)(2)
0.1159  0.8371 
Return of capital0.6522  0.1201 
Totals$2.4400 $2.4400 $2.4400 
(1) For the years ended December 31, 2023, 2022 and 2021, includes Section 199A dividends of $1.6719, $2.4400 and $1.4828 respectively.
(2) For the years ended December 31, 2023, 2022 and 2021, includes Unrecaptured Section 1250 Gains of $0.0150, $0.0000 and $0.4523, respectively.

Our consolidated provision for income tax expense (benefit) is as follows for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Current tax expense$8,840 $18,289 $10,199 
Deferred tax benefit(2,476)(11,042)(1,486)
Income tax expense (benefit)$6,364 $7,247 $8,713 
REITs generally are not subject to U.S. federal income taxes on that portion of REIT taxable income or capital gain that is distributed to stockholders. For the tax year ended December 31, 2023, as a result of ownership of investments in Canada and the U.K., we were subject to foreign income taxes under the respective tax laws of these jurisdictions. 
The provision for income taxes for the year ended December 31, 2023 primarily relates to state taxes, foreign taxes, and taxes based on income generated by entities that are structured as TRSs. For the tax years ended December 31, 2023, 2022 and 2021, the foreign tax provision/(benefit) amount included in the consolidated provision for income taxes was $5,938,000, $5,222,000 and $6,787,000, respectively.
A reconciliation of income taxes, which is computed by applying the federal corporate tax rate for the years ended December 31, 2023, 2022 and 2021, to the income tax expense/(benefit) is as follows for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Tax at statutory rate on earnings from continuing operations before unconsolidated entities, noncontrolling interests and income taxes$76,547 $35,241 $80,470 
Increase (decrease) in valuation allowance(1)
35,515 30,237 19,383 
Tax at statutory rate on earnings not subject to federal income taxes(141,044)(75,729)(117,931)
Foreign permanent depreciation2,103 2,033 1,449 
Other differences33,243 15,465 25,342 
Totals$6,364 $7,247 $8,713 
(1) Excluding purchase price accounting.
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Each TRS and foreign entity subject to income taxes is a tax paying component for purposes of classifying deferred tax assets and liabilities. The tax effects of taxable and deductible temporary differences, as well as tax asset/(liability) attributes, are summarized as follows for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Investments and property, primarily differences in investment basis, depreciation and amortization, the basis of land assets and the treatment of interests and certain costs$(40,336)$(39,212)$(32,616)
Operating loss and interest deduction carryforwards323,852 254,852 247,015 
Expense accruals and other64,970 94,999 53,367 
Valuation allowances(330,073)(294,558)(264,321)
Net deferred tax assets (liabilities)$18,413 $16,081 $3,445 
On the basis of the evaluations performed as required by the codification, valuation allowances totaling $330,073,000 were recorded on U.S. taxable REIT subsidiaries as well as entities in other jurisdictions to limit the deferred tax assets to the amount that we believe is more likely than not realizable. However, the amount of the deferred tax asset considered realizable could be adjusted if (i) estimates of future taxable income during the carryforward period are reduced or increased or (ii) objective negative evidence in the form of cumulative losses is no longer present (and additional weight may be given to subjective evidence such as our projections for growth). The valuation allowance rollforward is summarized as follows for the periods presented (in thousands):
 Year Ended December 31,
 202320222021
Beginning balance$294,558 $264,321 $244,938 
Expense (benefit)35,515 30,237 19,383 
Ending balance$330,073 $294,558 $264,321 
As a REIT, we are subject to certain corporate level taxes for any related asset dispositions that may occur during the five-year period immediately after such assets were owned by a C corporation (“built-in gains tax”). The amount of income potentially subject to this special corporate level tax is generally equal to the lesser of (i) the excess of the fair value of the asset over its adjusted tax basis as of the date it became a REIT asset, or (ii) the actual amount of gain. Some but not all gains recognized during this period of time could be offset by available net operating losses and capital loss carryforwards. 
Given the applicable statute of limitations, we generally are subject to audit by the Internal Revenue Service (“IRS”) for the year ended December 31, 2020 and subsequent years. The statute of limitations may vary in the states in which we own properties or conduct business. We do not expect to be subject to audit by state taxing authorities for any year prior to the year ended December 31, 2019. We are also subject to audit by the Canada Revenue Agency and provincial authorities generally for periods subsequent to May 2019 related to entities acquired or formed in connection with acquisitions, and by the U.K.’s HM Revenue & Customs for periods subsequent to August 2017 related to entities acquired or formed in connection with acquisitions. 
At December 31, 2023, we had a net operating loss (“NOL”) carryforward related to the REIT of $358,461,000. Due to our uncertainty regarding the realization of certain deferred tax assets, we have not recorded a deferred tax asset related to NOLs generated by the REIT. These amounts can be used to offset future taxable income (and/or taxable income for prior years if an audit determines that tax is owed), if any. The REIT will be entitled to utilize NOLs and tax credit carryforwards only to the extent that REIT taxable income exceeds our deduction for dividends paid. The NOL carryforwards generated through December 31, 2019 will expire through 2039. Beginning with the tax years after December 31, 2017, the law eliminates the NOL carryback period for REITs, replaces the 20-year NOL carryforward period with an indefinite carryforward period and, with respect to tax years beginning after 2020, limits the use of NOLs to 80% of taxable income.
At December 31, 2023 and 2022, we had an NOL carryforward related to Canadian entities of $467,804,000 and $368,979,000 respectively. These Canadian losses have a 20-year carryforward period. At December 31, 2023 and 2022, we had an NOL carryforward related to U.K. entities of $218,258,000 and $184,779,000 respectively. These U.K. losses do not have a finite carryforward period. 
114

WELLTOWER INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
20. Variable Interest Entities 
We have entered into joint ventures and have certain subsidiaries that are either wholly owned by us or by consolidated joint ventures which own real estate investments and are deemed to be VIEs. Our VIEs primarily hold real estate assets within our Seniors Housing Operating and Triple-net portfolios, the nature and risk of which are consistent with our overall portfolio. We have concluded that we are the primary beneficiary of these VIEs based on a combination of operational control of the entities and the rights to receive residual returns or the obligation to absorb losses arising from the entities. Except for capital contributions associated with the initial entity formations, the entities have been and are expected to be funded from the ongoing operations of the underlying properties. Accordingly, such entities have been consolidated, and the table below summarizes the balance sheets of consolidated VIEs in the aggregate (in thousands):
 December 31, 2023December 31, 2022
Assets:
Net real estate investments$3,277,741 $1,499,078 
Cash and cash equivalents19,529 15,582 
Receivables and other assets43,513 9,949 
Total assets(1)
$3,340,783 $1,524,609 
Liabilities and equity:
Secured debt$76,507 $155,992 
Lease liabilities2,539 1,329 
Accrued expenses and other liabilities13,850 28,417 
Total equity3,247,887 1,338,871 
Total liabilities and equity$3,340,783 $1,524,609 
(1) Note that assets of the consolidated VIEs can only be used to settle obligations relating to such VIEs. Liabilities of the consolidated VIEs represent claims against the specific assets of the VIEs and VIE's creditors do not have recourse to Welltower.
We recognized revenues from consolidated VIEs in the aggregate of $253,989,000, $48,347,000 and $40,251,000 for the years ending December 31, 2023, 2022 and 2021.
In addition, we have certain entities that qualify as unconsolidated VIEs including borrowers of loans receivable and in substance real estate investments. Our maximum exposure on these entities is limited to the net carrying value of the investments. Refer to Note 7 and Note 8 for additional details.
115


Item 9.  Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Not applicable.
Item 9A.  Controls and Procedures
Disclosure Controls and Procedures
An evaluation was carried out under the supervision and with the participation of our management, including our Chief Executive Officer and Chief Financial Officer, of the effectiveness of the disclosure controls and procedures (as defined in Rule 13a-15(e) of the Securities Exchange Act of 1934, as amended) as of the end of the period covered by this report. Based on that evaluation, the Chief Executive Officer and Chief Financial Officer concluded that the disclosure controls and procedures were effective as of the end of the period covered by this report.
Management’s Report on Internal Control over Financial Reporting
Management is responsible for establishing and maintaining adequate internal control over financial reporting (as defined in Rule 13a-15(f) of the Securities Exchange Act of 1934, as amended). The Company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with U.S. generally accepted accounting principles. The Company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with U.S. generally accepted accounting principles, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management and directors of the Company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the Company’s assets that could have a material effect on the financial statements. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
Management has assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2023 based on the criteria established by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) in a report entitled Internal Control — Integrated Framework.
Based on this assessment, using the criteria above, management concluded that the Company’s system of internal control over financial reporting was effective as of December 31, 2023.
The independent registered public accounting firm of Ernst & Young LLP, as auditors of the Company’s consolidated financial statements, has issued an attestation report on the Company’s internal control over financial reporting.
Changes in Internal Control over Financial Reporting
There were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) of the Securities Exchange Act of 1934, as amended) that occurred during the fourth quarter of the one-year period covered by this report that materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.
116


Report of Independent Registered Public Accounting Firm
To the Stockholders and the Board of Directors of Welltower Inc. 
Opinion on Internal Control Over Financial Reporting
We have audited Welltower Inc. and subsidiaries’ internal control over financial reporting as of December 31, 2023, based on criteria established in Internal Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria). In our opinion, Welltower Inc. and subsidiaries (the Company) maintained, in all material respects, effective internal control over financial reporting as of December 31, 2023, based on the COSO criteria.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the consolidated balance sheets of Welltower Inc. and subsidiaries as of December 31, 2023 and 2022, the related consolidated statements of comprehensive income, equity and cash flows for each of the three years in the period ended December 31, 2023, and the related notes and financial statement schedules listed in the Index at Item 15(a) and our report dated February 15, 2024 expressed an unqualified opinion thereon.
Basis for Opinion
The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects.
Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.
Definition and Limitations of Internal Control Over Financial Reporting 
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
 
/s/  Ernst & Young LLP
 
Toledo, Ohio
February 15, 2024
117


Item 9B. Other Information
None.
Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
Not applicable.
PART III 
Item 10. Directors, Executive Officers and Corporate Governance 
The information required by this Item is incorporated herein by reference to the information under the headings “Election of Directors,” “Corporate Governance,” “Executive Officers,” and “Security Ownership of Directors and Management and Certain Beneficial Owners — Section 16(a) Beneficial Ownership Reporting Compliance” in our definitive proxy statement, which will be filed with the Securities and Exchange Commission (the “Commission”) within 120 days after the end of our fiscal year ended December 31, 2023 in connection with our 2023 Annual Meeting of Stockholders.
We have adopted a Code of Business Conduct and Ethics that applies to our directors, officers and employees. The code is posted on the Internet at www.welltower.com/investors/governance. Any amendment to, or waivers from, the code that relate to any officer or director of the company will be promptly disclosed on the Internet at www.welltower.com. 
In addition, the Board has adopted charters for the Audit, Compensation and Nominating/Corporate Governance Committees. These charters are posted on the Internet at www.welltower.com/investors/governance. Please refer to “Item 7 – Management’s Discussion and Analysis of Financial Condition and Results of Operations – Executive Summary – Corporate Governance” in the Annual Report on Form 10-K for further discussion of corporate 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. 
Item 11. Executive Compensation 
The information required under Item 11 is incorporated herein by reference to the information under the headings “Executive Compensation” and “Director Compensation” in our definitive proxy statement, which will be filed with the Commission within 120 days after the end of our fiscal year ended December 31, 2023 in connection with our 2023 Annual Meeting of Stockholders.
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 
The information required under Item 12 is incorporated herein by reference to the information under the headings “Security Ownership of Directors and Management and Certain Beneficial Owners” and “Equity Compensation Plan Information” in our definitive proxy statement, which will be filed with the Commission within 120 days after the end of our fiscal year ended December 31, 2023 in connection with our 2023 Annual Meeting of Stockholders.
Item 13. Certain Relationships and Related Transactions and Director Independence
The information required under Item 13 is incorporated herein by reference to the information under the headings “Corporate Governance — Independence and Meetings” and “Security Ownership of Directors and Management and Certain Beneficial Owners — Certain Relationships and Related Transactions” in our definitive proxy statement, which will be filed with the Commission within 120 days after the end of our fiscal year ended December 31, 2023 in connection with our 2023 Annual Meeting of Stockholders.
Item 14. Principal Accounting Fees and Services
The information required under Item 14 is incorporated herein by reference to the information under the heading “Ratification of the Appointment of the Independent Registered Public Accounting Firm” in our definitive proxy statement, which will be filed with the Commission within 120 days after the end of our fiscal year ended December 31, 2023 in connection with our 2023 Annual Meeting of Stockholders.
118


PART IV
Item 15. Exhibits and Financial Statement Schedules
(a)     1. Our Consolidated Financial Statements are included in Part II, Item 8:  
Report of Independent Registered Public Accounting Firm (PCAOB ID: 42)
Consolidated Balance Sheets – December 31, 2023 and 2022
Consolidated Statements of Comprehensive Income — Years ended December 31, 2023, 2022 and 2021
Consolidated Statements of Equity — Years ended December 31, 2023, 2022 and 2021
Consolidated Statements of Cash Flows — Years ended December 31, 2023, 2022 and 2021
Notes to Consolidated Financial Statements
2. The following Financial Statement Schedules are included beginning on page 127
III – Real Estate and Accumulated Depreciation
IV – Mortgage Loans on Real Estate 
All other schedules have been omitted because they are inapplicable or not required or the information is included elsewhere in the Consolidated Financial Statements or notes thereto.
3.     Exhibits:
The exhibits listed below are either filed with this Form 10-K or incorporated by reference in accordance with Rule 12b-32 of the Securities Exchange Act of 1934.




















119


120



121


10.1(a)    Credit Agreement, dated as of June 4, 2021, by and among the Company; the lenders listed therein; KeyBank National Association, as administrative agent and L/C issuer; BofA Securities, Inc. and JPMorgan Chase Bank, N.A., as joint book runners; BofA Securities, Inc., JPMorgan Chase Bank, N.A., KeyBanc Capital Markets Inc. and Wells Fargo Securities LLC, as U.S. joint lead arrangers; BofA Securities, Inc., JPMorgan Chase Bank, N.A., KeyBanc Capital Markets Inc. and RBC Capital Markets, as Canadian joint lead arrangers; Bank of America, N.A. and JPMorgan Chase Bank, N.A., as co-syndication agents; Wells Fargo Bank, N.A., MUFG Bank, Ltd., Barclays Bank PLC, Citibank, N.A., Credit Agricole Corporate and Investment Bank, Deutsche Bank Securities Inc., Goldman Sachs Bank USA, Mizuho Bank, Ltd., Morgan Stanley Bank, N.A., PNC Bank, National Association and Royal Bank of Canada, as co-documentation agents; BNP Paribas, Capital One, National Association, Citizens Bank, N.A., Fifth Third Bank, National Association, The Huntington National Bank, Regions Bank, The Bank of Nova Scotia, Sumitomo Mitsui Banking Corporation, TD Bank, NA, Truist Bank and Bank of Montreal, as co-senior managing agents and Credit Agricole Corporate and Investment Bank, as sustainability structuring agent. (filed with the Commission as Exhibit 10.1 to the Company’s 8-K filed June 8, 2021 (File No. 001-08923), and incorporated herein by reference thereto).
122


123


21          Subsidiaries of the Company.
124


24           Powers of Attorney.
101.INS   Inline XBRL Instance Document. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCH   Inline XBRL Taxonomy Extension Schema Document
101.CAL   Inline XBRL Taxonomy Extension Calculation Linkbase Document
101.LAB   Inline XBRL Taxonomy Extension Label Linkbase Document
101.PRE    Inline XBRL Taxonomy Extension Presentation Linkbase Document
101.DEF    Inline XBRL Taxonomy Extension Definition Linkbase Document
104    The cover page from the Company's Annual Report on Form 10-K for the year ended December 31, 2023, formatted in Inline XBRL (included in Exhibit 101)
                  
* Management Contract or Compensatory Plan or Arrangement.
Item 16. Form 10-K Summary
None.
125


SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized. 
Date:  February 15, 2024
WELLTOWER INC. 
By: /s/  Shankh Mitra                                            
Shankh Mitra,
Chief Executive Officer and Director
Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below on February 15, 2024 by the following persons on behalf of the Registrant and in the capacities indicated. 
/s/  Kenneth J. Bacon **/s/  Johnese M. Spisso **
Kenneth J. Bacon, Chairman and DirectorJohnese M. Spisso, Director
  
/s/  Karen B. DeSalvo **/s/  Kathryn M. Sullivan **
Karen B. DeSalvo, DirectorKathryn M. Sullivan, Director
  
/s/  Philip L. Hawkins **/s/  Shankh Mitra **
Philip L. Hawkins, DirectorShankh Mitra, Chief Executive Officer and Director
 (Principal Executive Officer)
/s/  Dennis G. Lopez **/s/  Timothy G. McHugh **
Dennis G. Lopez, DirectorTimothy G. McHugh, Executive Vice President - Chief
            Financial Officer (Principal Financial Officer)
/s/  Ade J. Patton **/s/  Joshua T. Fieweger**
Ade J. Patton, DirectorJoshua T. Fieweger, Chief Accounting Officer
 (Principal Accounting Officer)
/s/  Diana W. Reid **
Diana W. Reid, Director
/s/  Sergio D. Rivera ****By:     /s/  Shankh Mitra          
Sergio D. Rivera, Director                          Shankh Mitra, Attorney-in-Fact
126


Welltower Inc. 
Schedule III 
Real Estate and Accumulated Depreciation 
December 31, 2023 
(Dollars in thousands) 
  Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Seniors Housing Operating:          
Adderbury, UK$ $2,144 $12,549 $276 $2,142 $12,827 $2,528 20152017Banbury Road
Adrian, MI 1,171 4,785 344 1,171 5,129 675 202220152625 N Adrian Highway
Aiken, SC 2,256 21,496 1,273 2,256 22,769 166 20232018530 Benton House Way
Albertville, AL 170 6,203 2,787 176 8,984 3,296 20101999151 Woodham Drive
Alexandria, VA 8,280 50,914 606 8,280 51,520 7,986 201620185550 Cardinal Place
Alexandria, VA   60,687 8,700 51,987 1,829 20182021400 N Washington Street
Alexandria, VA 12,168 21,210 4,556 12,225 25,709 9,374 202119725100 Fillmore Avenue
Allegan, MI 858 6,252 98 858 6,350 442 20222008620 Ely Street
Altrincham, UK 4,244 25,187 2,419 4,374 27,476 9,425 20122009295 Hale Road
Amarillo, TX 719 11,591 667 756 12,221 2,202 202119854707 Bell Street
Ames, IA 330 8,870 2,562 330 11,432 3,297 201019991325 Coconino Road
Amherst, NY10,148 1,233 11,429  1,233 11,429 2,406 201920131880 Sweet Home Road
Amherstview, ON 473 4,446 707 509 5,117 1,670 201519744567 Bath Road
Anderson, SC 710 6,290 2,715 866 8,849 5,639 20031986311 Simpson Road
Anjou, QC14,670 14,451 60,572 13,663 14,831 73,855 8,543 202220056923 Boulevard des Galeries d'Anjou
Ankeny, IA 1,129 10,270 432 1,164 10,667 2,482 201620121275 SW State Street
Ankeny, IA 2,518 13,350 1,364 2,535 14,697 1,693 202220181225 SW 28th Street
Apple Valley, CA 480 16,639 7,021 486 23,654 8,178 2010199911825 Apple Valley Road
Arlington, TX 1,660 37,395 7,742 1,660 45,137 16,944 201220001250 W Pioneer Parkway
Arlington, TX 894 13,003 1,041 1,021 13,917 1,782 202119962315 Little Road
Arlington, VA 8,385 31,198 18,179 8,393 49,369 21,998 20171992900 N Taylor Street
Arlington, VA   8,631 77 8,554 2,123 20181992900 N Taylor Street
Arnprior, ON 788 6,283 952 834 7,189 2,553 2013199115 Arthur Street
Atlanta, GA 2,058 14,914 6,408 2,080 21,300 14,700 199719991460 S Johnson Ferry Road
Atlanta, GA 2,100 20,603 2,993 2,206 23,490 7,616 201420001000 Lenox Park Boulevard NE
Auburn, NY9,591 1,176 14,371 810 1,183 15,174 1,398 20222014138 Standart Avenue
Augusta, GA 1,590 15,228 1,067 1,590 16,295 127 20232015204 Frazier Court
Austin, TX 880 9,520 5,334 885 14,849 8,277 1999199812429 Scofield Farms Drive
Austin, TX 1,560 21,413 1,445 1,574 22,844 6,351 2014201311330 Farrah Lane
Austin, TX 4,200 74,850 3,393 4,200 78,243 19,258 201520144310 Bee Caves Road
Austin, TX 4,832 20,631 1,530 4,877 22,116 4,159 2021198911279 Taylor Draper Lane
Avon, IN 1,830 14,470 4,369 1,830 18,839 5,669 20102004182 S County Road 550e
Bagshot, UK 4,960 29,881 6,548 5,123 36,266 14,575 2012200914 - 16 London Road
Baie - Comeau, QC 2,863 25,343 6,991 2,863 32,334 2,279 202320091401 Boul. Jolliet
Bakersfield, CA   22,491 2,822 19,669 2,432 202120154301 Buena Vista Road
Bakersfield, CA 1,127 15,126 945 1,146 16,052 2,267 202119883201 Columbus
Ballston Spa, NY 5,540 17,901 324 5,565 18,200 1,969 202020192000 Carlton Hollow Way

(Dollars in thousands) 
  Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Seniors Housing Operating:          
Barnet, UK 19,777 39,598 4,660 20,867 43,168 2,298 20192022Wood Street
Bartlesville, OK 2,339 12,001 239 2,377 12,202 2,408 202120002633 SE Mission Drive
Basingstoke, UK 3,420 18,853 1,583 3,532 20,324 5,612 20142012Grove Road
Basking Ridge, NJ 2,356 37,710 3,309 2,410 40,965 13,362 20132002404 King George Road
Bassett, UK 4,874 32,304 9,488 5,034 41,632 18,015 20132006111 Burgess Road
Bath, UK 2,696 11,876 425 2,689 12,308 2,429 20152017Clarks Way, Rush Hill
Baton Rouge, LA12,930 790 29,436 2,247 939 31,534 10,418 201320099351 Siegen Lane
Baton Rouge, LA 1,605 6,717 554 1,693 7,183 1,042 202119898680 Jefferson Highway
Baton Rouge, LA 3,241 23,330 2,420 3,241 25,750 188 202320199394 Siegen Lane
Bay City, MI 1,225 6,424 564 1,243 6,970 950 202220133932 Monitor Road
Beaconsfield, UK 5,566 50,952 3,356 5,749 54,125 17,713 2013200930-34 Station Road
Beaconsfield, QC 1,149 17,484 902 1,265 18,270 6,564 20132008505 Elm Avenue
Beaver, PA 1,189 13,240 197 1,197 13,429 653 202020221195 Western Avenue
Beavercreek, OH6,184 1,007 11,274  1,007 11,274 1,599 201920202475 Lillian Lane
Beckenham, UK 1,156 27,194 27,955 20,665 35,640 2,578 201920212 Roman Way
Bedford, NH18,357 3,565 29,929 1,756 3,565 31,685 2,852 2022201743 Technology Drive
Bee Cave, TX 1,820 21,084 1,047 1,838 22,113 5,191 2016201414058 A Bee Cave Parkway
Bellevue, WA 2,800 19,004 4,015 2,816 23,003 8,727 2013199815928 NE 8th Street
Bellevue, WA   42,227 6,345 35,882 1,211 2019202215241 NE 20th Street
Bellevue, WA 6,307 9,632 3,116 6,396 12,659 1,569 2021199013350 SE 26th Street
Bellevue, WA 20,170 44,232  20,170 44,232 10,498 20211986919 109th Avenue NE
Bellingham, WA 1,500 19,861 4,864 1,507 24,718 9,066 201019964415 Columbine Drive
Bellingham, WA 1,290 16,292 1,766 1,290 18,058 3,060 20201999848 W Orchard Drive
Belmont, CA  35,300 2,898 188 38,010 13,325 201320021010 Alameda de Las Pulgas
Berea, OH 1,658 12,791 103 1,658 12,894 840 2020202245 Sheldon Road
Bethel Park, PA14,721 1,666 12,977  1,666 12,977 2,334 20192019631 McMurray Road
Bethel Park, PA 3,476 12,787 2,307 3,477 15,093 2,204 202119982960 Bethel Church Road
Bethesda, MD  45,309 2,889 3 48,195 15,617 201320098300 Burdett Road
Bethesda, MD   69,988 3,520 66,468 8,427 201620184925 Battery Lane
Bethesda, MD   1,860  1,860 753 201320098300 Burdett Road
Bethesda, MD   1,319  1,319 970 201320098300 Burdett Road
Beverly, MA 5,879 10,378 20,000 5,879 30,378 839 202118743 Essex Street
Birmingham, MI 3,110 21,512 2,526 3,110 24,038 258 202320182400 E Lincoln Street
Birmingham, UK   15,488 1,529 13,959 2,838 2015201647 Bristol Road S
Birmingham, UK   19,341 69 19,272 4,839 201320065 Church Road, Edgbaston
Blainville, QC 2,077 8,902 1,893 2,275 10,597 3,799 2013200850 Des Chateaux Boulevard
Bloomfield Hills, MI 2,000 35,662 1,931 2,204 37,389 12,307 201320096790 Telegraph Road
Blue Springs, MO 3,995 31,501 2,532 3,995 34,033 506 20232015550 NE Napoleon Drive
Boca Raton, FL32,270 6,565 111,247 42,310 7,033 153,089 41,632 201819946343 Via De Sonrise Del Sur
Boise, ID 1,391 16,067 6,528 2,224 21,762 5,180 2019199910250 W Smoke Ranch Drive
Boise, ID 1,625 10,468 224 1,626 10,691 1,765 202119847250 Poplar Street
Bolingbrook, MI 3,568 25,211 3,899 3,568 29,110 317 20232018370 N Weber Road
Bossier City, LA 2,009 31,198 132 2,009 31,330 2,132 202120182000 Blake Boulevard
Boston, MA 3,456 19,227 1,712 3,456 20,939 323 202319941190 Adams Street
Bothell, WA 1,350 13,439 7,716 1,350 21,155 7,745 2015198810605 NE 185th Street
Boulder, CO 2,994 27,458 3,373 3,207 30,618 11,884 201320033955 28th Street
Boynton Beach, FL   35,819 3,772 32,047 788 2018202010605 Jog Road
Bradenton, FL 480 9,953 348 480 10,301 3,103 201220002800 60th Avenue W
Bradenton, FL 4,664 11,202 1,518 4,692 12,692 2,305 202119871055 301 Boulevard E
Braintree, MA  41,290 2,177 247 43,220 14,457 20132007618 Granite Street
Brampton, ON 10,196 59,989 3,899 10,538 63,546 18,169 20152009100 Ken Whillans Drive
Brandon, MS 1,220 10,241 3,906 1,220 14,147 4,742 20101999140 Castlewoods Boulevard
Brea, CA 6,302 80,468 2,478 6,302 82,946 5,339 20222013460 S La Floresta Drive
Bremerton, WA 2,417 22,627 3,175 2,417 25,802 4,221 20201999966 Oyster Bay Court
Brentwood, CA 4,602 32,594 4,050 4,602 36,644 4,555 20222007150 Cortona Way
Brentwood, UK 8,537 45,869 3,434 8,818 49,022 9,817 20162013London Road
Brick, NJ 1,170 17,372 2,650 1,324 19,868 7,277 20101998515 Jack Martin Boulevard
Brick, NJ 690 17,125 6,791 817 23,789 7,399 201019991594 Route 88
Bridgewater, NJ 1,730 48,201 4,124 1,881 52,174 17,672 201019992005 Route 22 W
Broadview Heights, OH14,886 1,567 20,541 2,373 1,575 22,906 2,383 202220169500 Broadview Road
Brockport, NY 1,500 23,496 4,207 1,642 27,561 8,687 2015199990 West Avenue
Brockville, ON3,697 484 7,445 1,104 515 8,518 2,431 201519961026 Bridlewood Drive
Brookfield, WI 1,300 12,830 1,024 1,300 13,854 3,770 201220131105 Davidson Road
Brookline, MA   3,799 3,799   20191900125 Holland Road
Broomfield, CO 4,140 44,547 16,850 10,206 55,331 27,647 20132009400 Summit Boulevard
Broomfield, CO   29,146 2,566 26,580 2,999 2016201812600 Lowell Boulevard
Brossard, QC8,184 5,499 31,854 3,271 5,650 34,974 11,998 201519892455 Boulevard Rome
Brunswick, OH 1,460 17,974 1,087 1,460 19,061 1,935 202220183430 Brunswick Lake Parkway
Buckingham, UK   18,505 3,077 15,428 4,226 20141883Church Street
Buffalo, NY6,872 1,117 11,022 654 1,117 11,676 1,129 20222011100 Weiss Avenue
Buffalo Grove, IL 2,850 49,129 5,389 2,850 54,518 18,769 20122003500 McHenry Road
Burbank, CA 4,940 43,466 7,011 4,940 50,477 17,860 20122002455 E Angeleno Avenue
Burbank, CA17,204 3,610 50,817 5,157 3,610 55,974 12,942 201619852721 Willow Street
Burke, VA   52,892 2,616 50,276 6,475 201620189617 Burke Lake Road
Burleson, TX 3,150 10,437 833 3,150 11,270 2,968 20122014621 Old Highway 1187
Burlingame, CA  62,786 431  63,217 13,543 201620151818 Trousdale Avenue
Burlington, MA 2,443 34,354 2,664 2,578 36,883 12,538 2013200524 Mall Road
Burlington, WA 877 16,098  877 16,098 3,433 20191999410 S Norris Street
Burlington, WA 768 9,186  768 9,186 2,019 20191996112 / 210 N Skagit Street
Bushey, UK 12,690 36,482 513 12,679 37,006 6,069 20152018Elton House, Elton Way
Buzzards Bay, MA 3,424 28,854 100 3,424 28,954 656 2022202313 Kendall Rae Place
Calgary, AB9,796 2,793 41,179 3,787 2,950 44,809 14,851 2013199880 Edenwold Drive NW
Calgary, AB17,958 3,431 28,983 3,815 3,613 32,616 10,204 201319899229 16th Street SW
Calgary, AB22,797 2,385 36,776 4,264 2,509 40,916 9,867 201520062220-162nd Avenue SW
Camberley, UK 9,974 39,168 517 9,965 39,694 7,227 20162017Pembroke Broadway
Camberley, UK 2,654 5,736 14,974 4,859 18,505 3,800 20142016Fernhill Road
Camberley, UK   3,465 688 2,777 531 20142017Fernhill Road
Camillus, NY13,404 1,249 7,360 5,469 2,121 11,957 2,620 201920163877 Milton Avenue
Canton, OH 709 8,608 817 709 9,425 717 20231997181 Applegrove Street NE
Canton, MI 968 8,523 355 971 8,875 841 20222017445 N Lotz Road
Cape Coral, FL 760 18,868 902 760 19,770 5,966 20122009831 Santa Barbara Boulevard
Cardiff, UK 3,191 12,566 6,641 3,288 19,110 6,483 20132007127 Cyncoed Road
Cardiff by the Sea, CA 5,880 64,711 7,307 5,880 72,018 27,273 201120093535 Manchester Avenue
Carmel, IN 2,766 53,419 824 2,787 54,222 6,402 20212017689 Pro-med Lane
Carmichael, CA22,752 739 7,698 37,418 2,440 43,415 6,922 201920144717 Engle Road
Caro, MI 614 4,366 396 614 4,762 602 202220091430 Cleaver Road
Carol Stream, IL 1,730 55,048 8,692 1,730 63,740 21,283 20122001545 Belmont Lane
Carrollton, TX 4,280 31,444 1,937 4,280 33,381 8,958 201320102105 N Josey Lane
Carrollton, GA 2,537 9,159 1,278 2,537 10,437 2,215 20211996150 Cottage Lane
Carson City, NV 1,601 23,542 568 1,602 24,109 3,055 202119862120 E Long
Cary, NC 740 45,240 1,432 742 46,670 14,390 201320091206 W Chatham Street
Cary, NC 6,112 70,008 12,233 6,242 82,111 20,549 20181999300 Kildaire Woods Drive
Cedar Falls, IA 1,259 9,930 282 1,293 10,178 1,742 202119972603 Orchard Drive
Cedar Hill, TX 1,971 24,590 40 1,971 24,630 2,327 202020201240 E Pleasant Run
Cedar Park, TX 1,750 15,664 1,520 1,750 17,184 3,824 20162015800 C-bar Ranch Trail
Cerritos, CA  27,494 8,254  35,748 12,283 2016200211000 New Falcon Way
Charleston, IL 552 810 51 552 861 357 20212001300 Lincoln Highway Road
Charleston, SC 2,912 19,817 1,052 2,913 20,868 2,467 202120051451 Tobias Gadson Boulevard
Charlotte, NC 4,799 42,734 3,666 4,799 46,400 762 202320209246 Highland Creek Parkway
Charlotte, NC 4,881 44,553 4,677 4,881 49,230 688 2023201510225 Old Ardrey Kell Road
Charlotte, NC45,641   70,854 2,500 68,354 609 202119001132 Greenwood Cliff
Charlotte, NC 5,279 19,325 571 5,306 19,869 3,382 202119875512 Carmel Road
Charlottesville, VA 4,651 91,468 17,844 5,236 108,727 18,088 201819912600 Barracks Road
Charlottesville, VA 2,542 40,746 100 2,542 40,846 2,573 20212019250 Nichols Court
Chatham, ON 1,098 12,462 3,622 1,229 15,953 4,226 2015196525 Keil Drive N
Chattanooga, TN 3,373 15,791 553 3,374 16,343 2,996 202119987511 Shallowford Road
Chelmsford, MA 1,040 10,951 6,854 1,131 17,714 7,284 200319974 Technology Drive
Chelmsford, MA 2,364 33,143 2,683 2,421 35,769 4,217 2021199520 Summer Street
Chertsey, UK 9,566 25,886 2,155 9,557 28,050 5,317 20152018Parklands Drive
Chesapeake, VA 2,214 22,566 2,583 2,237 25,126 3,749 20212004933 Cedar Road
Chesterfield, MO 1,857 48,366 2,323 1,917 50,629 16,111 201320011880 Clarkson Road
Chesterfield, VA 3,817 31,544 3,148 3,817 34,692 333 2023202111210 Robious Road
Chesterton, IN 2,980 37,614 1,423 2,980 39,037 5,165 20202019700 Dickinson Road
Chico, CA 1,780 14,754 377 1,931 14,980 2,683 202119842801 Cohasset
Chorleywood, UK 5,636 43,191 5,502 5,803 48,526 18,518 20132007High View, Rickmansworth Road
Chula Vista, CA 4,217 31,866 40 4,217 31,906 5,065 202120181290 Santa Rosa Drive
Chula Vista, CA   25,946 2,216 23,730 8,153 201320033302 Bonita Road
Church Crookham, UK 2,591 14,215 1,693 2,676 15,823 4,887 201420142 Bourley Road
Cincinnati, OH10,322 1,790 11,426  1,790 11,426 1,848 20192019732 Clough Pike Road
Cincinnati, OH 1,606 3,994 349 1,606 4,343 1,664 202119984650 E Galbraith Road
Cincinnati, OH 3,345 52,867 531 3,352 53,391 9,025 202119868135 Beechmont Avenue
Citrus Heights, CA 2,300 31,876 4,122 2,300 35,998 14,132 201019977418 Stock Ranch Road
Clackamas, OR 1,240 3,920 640 1,240 4,560 942 2021199914370 SE Oregon Trail Drive
Claremont, CA 2,430 9,928 2,804 2,553 12,609 4,972 201320012053 N Towne Avenue
Clay, NY11,981 1,421 11,540  1,421 11,540 2,459 201920148547 Morgan Road
Clearwater, FL 1,727 4,903 457 1,744 5,343 791 202119851100 Ponce De Leon Boulevard
Cleburne, TX 520 5,369 952 520 6,321 2,560 20062007402 S Colonial Drive
Cohasset, MA 2,485 26,147 3,487 2,566 29,553 10,307 20131998125 King Street (Route 3a)
Colleyville, TX 1,050 17,082 105 1,050 17,187 3,253 201620138100 Precinct Line Road
Collierville, TN   42,239 2,306 39,933 2,938 20192020691 S Byhalia Road
Colorado Springs, CO 800 14,756 2,493 1,034 17,015 6,171 201320012105 University Park Boulevard
Colorado Springs, CO 1,142 15,510 1,211 1,167 16,696 2,583 202119855820 Flintridge Drive
Colts Neck, NJ 780 14,733 4,244 1,496 18,261 6,863 201020023 Meridian Circle
Columbus, IN 610 3,190 1,090 610 4,280 1,316 201019982564 Foxpointe Drive
Columbus, IN 1,593 12,186 1,514 1,594 13,699 2,263 202120003660 Central Avenue
Columbus, OH 916 7,112 272 916 7,384 680 202220172920 Snouffer Road
Columbus, OH12,428 1,547 17,126 1,294 1,547 18,420 1,883 202220152870 Snouffer Road
Concord, NH13,538 2,825 21,636 1,446 2,825 23,082 2,314 2022201723 Triangle Park Drive
Conroe, TX 980 7,771 1,557 980 9,328 3,240 20092010903 Longmire Road
Coos Bay, OR 864 7,971 1,161 864 9,132 1,847 20201996192 Norman Avenue
Coos Bay, OR 1,792 9,852 1,339 1,792 11,191 2,589 202020061855 Ocean Boulevard SE
Coppell, TX 1,550 8,386 866 1,550 9,252 2,766 201220131530 E Sandy Lake Road
Coquitlam, BC6,818 3,047 24,567 3,758 3,236 28,136 10,087 201319901142 Dufferin Street
Crowley, TX 2,955 9,908  2,955 9,908 104 20231900Tobin Drive
Crystal Lake, IL 875 12,461 2,534 987 14,883 5,774 20132001751 E Terra Cotta Avenue
Crystal Lake, IL 7,643 39,687 3,620 7,562 43,388 8,006 20211988965 N Brighton Circle W
Crystal Lake, IL   117 117   20211900965 N Brighton Circle W
Cuyahoga Falls, OH 592 2,804 622 592 3,426 772 202220121691 Queens Gate Circle
Cuyahoga Falls, OH6,286 1,301 8,715 47 1,301 8,762 359 202320041695 Queens Gate Circle
Dallas, TX 6,330 114,794 4,683 6,330 119,477 30,496 201520133535 N Hall Street
Dallas, TX 4,119 21,689 2,000 4,119 23,689 380 202319995585 Caruth Haven Lane
Dana Point, CA 5,508 54,079  5,508 54,079 7,003 2021199425411 Sea Bluffs Drive
Danville, IN 2,236 28,757 8,648 2,255 37,386 2,652 20212021200 S Arbor Lane
Dardenne Prairie, MO 1,309 11,507 494 1,309 12,001 1,383 202120101030 Barathaven Boulevard
Decatur, GA 1,098 15,302 3,088 1,098 18,390 3,066 20211987341 Winn Way
Decatur, GA   31,452 1,951 29,501 10,523 20131998920 Clairemont Avenue
Delaware, OH 1,919 26,250 352 1,919 26,602 1,675 2022202090 Burr Oak Drive
Denton, TX 1,760 8,305 909 1,760 9,214 3,214 201020112125 Brinker Road
Denton, TX   26,966 5,034 21,932 401 202120221509 Canvas Way
Denton, TX 4,542 10,014  4,542 10,014 401 202120232028 Ladera Lane
Denver, CO 1,450 16,094  1,450 16,094 8,544 201219974901 S Monaco Street
Denver, CO 2,910 35,838 9,835 2,910 45,673 16,870 201220078101 E Mississippi Avenue
Denver, CO 1,533 9,221 110,734 5,402 116,086 21,699 201920141500 Little Raven Street
Denver, CO 1,989 21,556 1,463 1,989 23,019 3,223 202020172979 Uinta Street
Des Moines, IA 1,196 9,629 1,095 1,383 10,537 1,701 202119904610 Douglas Avenue
Dix Hills, NY 3,808 39,014 3,208 4,133 41,897 14,291 20132003337 Deer Park Road
Dollard-des-ormeaux, QC 1,957 14,431 960 2,110 15,238 6,084 201320084377 Saint Jean Boulevard
Dresher, PA8,380 1,900 10,664 1,437 1,914 12,087 5,279 201320061650 Susquehanna Road
Drummondville, QC 5,765 54,353 10,569 5,765 64,922 907 20232007400 Rue Rose-Ellis
Dublin, OH 1,169 25,345 561 1,186 25,889 5,907 201620154175 Stoneridge Lane
Dublin, OH 3,688 23,035 1,100 3,688 24,135 2,330 202220174050 Hawthorne Lane
Durham, NC 3,212 23,350 2,973 3,216 26,319 3,251 20211998205 Emerald Pond Lane
Eagle, ID 4,508 18,360 570 4,508 18,930 515 202320191260 E Lone Creek Drive
East Amherst, NY11,602 2,070 11,714  2,070 11,714 2,649 201920158040 Roll Road
East Lansing, MI 3,919 19,373 904 3,944 20,252 3,548 202120005968 Park Lake Road
East Meadow, NY 69 45,991 2,601 127 48,534 16,357 201320021555 Glen Curtiss Boulevard
East Setauket, NY 4,920 37,354 3,050 4,986 40,338 13,501 201320021 Sunrise Drive
Eastbourne, UK 4,145 33,744 3,175 4,269 36,795 12,824 201320086 Upper Kings Drive
Edgbaston, UK 2,720 13,969 1,552 2,810 15,431 3,141 20142015Speedwell Road
Edgewater, NJ 4,561 25,047 4,365 4,609 29,364 9,832 20132000351 River Road
Edison, NJ 1,892 32,314 4,588 2,044 36,750 14,313 201319961801 Oak Tree Road
Edmond, OK 410 8,388 475 410 8,863 2,768 2012200115401 N Pennsylvania Avenue
Edmonds, WA 1,650 24,449 10,554 1,650 35,003 10,543 2015197621500 72nd Avenue W
Edmonds, WA 2,891 26,413 2,677 2,891 29,090 4,353 20202000180 2nd Avenue S
Edmonton, AB6,194 1,589 29,819 3,742 1,723 33,427 11,392 20131999103 Rabbit Hill Court NW
Edmonton, AB8,195 2,063 37,293 5,238 2,181 42,413 15,570 2013196810015 103rd Avenue NW
Effingham, IL 606 3,699 534 660 4,179 760 202119971101 N Maple Street
El Dorado Hills, CA   56,599 5,190 51,409 6,691 201720192020 Town Center W Way
Elkhorn, NE11,645 1,846 21,426 1,265 1,806 22,731 2,028 202220143535 Piney Creek Drive
Elstree, UK   50,971 5,544 45,427 15,708 20122003Edgwarebury Lane
Encino, CA 5,040 46,255 8,273 5,040 54,528 18,968 2012200315451 Ventura Boulevard
Englishtown, NJ 690 12,520 3,266 882 15,594 6,087 2010199749 Lasatta Avenue
Epsom, UK 20,159 34,803 3,497 20,822 37,637 7,753 20162014450-458 Reigate Road
Erie, PA10,935 1,611 9,254  1,611 9,254 2,234 201920134400 E Lake Road
Esher, UK 5,783 48,361 6,959 5,951 55,152 19,908 2013200642 Copsem Lane
Evans, GA 3,211 20,503 2,036 3,219 22,531 4,280 20211999100 Washington Commons Drive
Evansville, IN 1,038 11,983 550 1,045 12,526 2,400 202119915050 Lincoln Avenue
Everett, WA 638 8,708 1,311 638 10,019 1,708 20201998524 75th Street SE
Everett, WA 1,912 16,647 2,894 1,913 19,540 3,071 202119893915 Colby Avenue N
Fairfield, NJ 3,120 43,868 3,744 3,286 47,446 15,739 2013199847 Greenbrook Road
Fairfield, IL 561 3,995 654 561 4,649 709 20211997315 Market Street
Fairfield, CA 1,460 14,040 11,654 1,460 25,694 11,457 200219983350 Cherry Hills Street
Fairfield, CT   49,430 4,783 44,647 2,132 201720191571 Stratfield Road
Fairfield, OH12,223 1,477 12,979  1,477 12,979 2,218 20192018520 Patterson Boulevard
Fareham, UK 3,408 17,970 1,481 3,517 19,342 5,402 20142012Redlands Lane
Fishers, IN 1,500 14,500 3,841 1,500 18,341 5,650 201020009745 Olympia Drive
Fishers, IN 2,314 33,731 549 2,314 34,280 2,827 2021201812950 Tablick Street
Fleet, UK   32,776 4,309 28,467 9,881 2013200622-26 Church Road
Florence, AL 353 13,049 3,815 385 16,832 6,148 201019993275 County Road 47
Flossmoor, IL 1,292 9,496 3,005 1,362 12,431 5,119 2013200019715 Governors Highway
Flower Mound, TX 1,800 8,414 1,230 1,800 9,644 3,033 201120124141 Long Prairie Road
Flowood, MS 3,147 24,350 2,036 3,147 26,386 192 20232013350 Town Center Way
Folsom, CA 1,490 32,754 560 1,490 33,314 8,761 201520141574 Creekside Drive
Folsom, CA 2,306 10,948 1,566 2,306 12,514 1,848 202120101801 E Natoma Street
Fort Wayne, IN 3,637 42,242 923 3,637 43,165 4,932 202020183715 Union Chapel Road
Fort Wayne, IN 1,770 19,930 1,964 1,770 21,894 7,402 20102008611 W County Line Road S
Fort Worth, TX 2,080 27,888 14,443 2,080 42,331 14,873 201220012151 Green Oaks Road
Fort Worth, TX 4,179 40,328 19,678 7,160 57,025 10,572 201920173401 Amador Drive
Fort Worth, TX 2,538 18,909 147 2,538 19,056 2,439 202020203401 Amador Drive
Fort Worth, TX   26,084 2,781 23,303 2,801 202120158600 N Riverside Drive
Franklin, TN 5,733 15,437 2,970 5,787 18,353 3,349 20211999314 Cool Springs Boulevard
Fremont, CA 3,400 25,300 9,571 3,456 34,815 15,251 200519872860 Country Drive
Fresno, CA22,139 896 10,591 25,465 2,459 34,493 6,015 201920145605 N Gates Avenue
Frome, UK 2,720 14,813 1,836 2,810 16,559 4,512 20142012Welshmill Lane
Fullerton, CA 1,964 19,989 2,450 1,998 22,405 7,611 201320082226 N Euclid Street
Fullerton, CA 1,801 6,195 1,256 1,801 7,451 1,050 202119871510 E Commonwealth Avenue
Fullerton, CA 6,739 54,075 1,449 6,739 55,524 4,721 20222021433 W Bastanchury Road
Gahanna, OH 772 11,214 2,327 847 13,466 5,056 20131998775 E Johnstown Road
Gainesville, GA 1,908 27,036 1,436 1,950 28,430 4,043 20212000940 S Enota Drive
Gainesville, FL   31,769 2,374 29,395 3,710 201620183605 NW 83rd Street
Garden Grove, CA 2,107 4,549 1,541 2,107 6,090 1,174 2021199911848 Valley View Street
Gardnerville, NV 1,143 10,831 4,699 1,164 15,509 10,671 199819991565-a Virginia Ranch Road
Georgetown, TX 5,481 31,586 1,210 5,481 32,796 545 202120235101 N Mays Street
Gig Harbor, WA 1,560 15,947 6,029 1,583 21,953 7,839 201019943213 45th Street Court NW
Gilbert, AZ14,200 2,160 28,246 3,226 2,208 31,424 12,656 20132008580 S Gilbert Road
Glen Cove, NY 4,594 35,236 3,090 4,718 38,202 14,690 2013199839 Forest Avenue
Glendale, AZ 3,114 24,668 124 3,115 24,791 2,144 202120188847 W Glendale Avenue
Glendale, AZ   1,534 136 1,398 12 2022190051st and Bell Road
Glenview, IL 2,090 69,288 6,996 2,090 76,284 26,658 201220012200 Golf Road
Golden Valley, MN3,600 1,520 33,513 1,793 1,634 35,192 11,695 201320054950 Olson Memorial Highway
Granbury, TX 2,040 30,670 1,001 2,040 31,671 10,669 20112009100 Watermark Boulevard
Grand Forks, ND 1,050 13,147 60 1,050 13,207 1,567 202120143783 S 16th Street #112
Grand Prairie, TX 1,880 23,827 74 1,884 23,897 1,791 202120213013 Doryn Drive
Grand Rapids, MI 2,179 15,745 527 2,354 16,097 2,432 202120033121 Lake Michigan Drive NW
Grandville, MI 1,533 7,219 424 1,539 7,637 839 202220183939 44th Street SW
Granger, IN 1,670 21,280 2,860 1,670 24,140 8,072 201020096330 N Fir Road
Grants Pass, OR 561 8,874 247 561 9,121 1,101 202119851001 NE A Street
Grapevine, TX 2,220 17,648 859 2,220 18,507 3,920 201320144545 Merlot Drive
Greeley, CO 1,077 18,051 630 1,077 18,681 3,626 201720095300 W 29th Street
Greenville, SC 893 22,795 2,622 993 25,317 3,365 202119891180 Haywood Road
Greenwood, IN 1,550 22,770 484 1,550 23,254 7,886 201020072339 S State Road 135
Gresham, OR 1,966 6,566 939 1,966 7,505 971 202119852895 SE Powell Valley Road
Grimsby, ON 636 5,617 1,046 677 6,622 2,004 2015199184 Main Street E
Grosse Pointe Woods, MI 950 13,662 1,197 961 14,848 4,906 201320061850 Vernier Road
Grosse Pointe Woods, MI 1,430 31,777 1,280 1,452 33,035 10,821 2013200521260 Mack Avenue
Grove City, OH 3,575 85,764 2,506 3,509 88,336 14,037 201820173717 Orders Road
Grove City, OH 1,099 5,246 749 1,122 5,972 1,069 202119902320 Sonora Drive
Gurnee, IL 890 27,931 3,047 957 30,911 10,408 20132002500 N Hunt Club Road
Haddonfield, NJ 520 16,363 1,120 539 17,464 4,510 20112015132 Warwick Road
Hamburg, NY10,437 984 10,991  984 10,991 2,349 201920094600 Southwestern Boulevard
Hamilton, OH11,222 1,128 10,940 1,165 1,209 12,024 2,312 201920191740 Eden Park Drive
Happy Valley, OR 721 10,416  721 10,416 2,094 201919988915 SE Monterey
Harahan, LA 2,628 38,864 190 2,628 39,054 2,438 202120207904 Jefferson Highway
Harrisburg, IL 858 4,940 411 876 5,333 1,015 20212005165 Ron Morse Drive
Hattiesburg, MS 450 13,469 480 450 13,949 4,607 20102009217 Methodist Hospital Boulevard
Haverford, PA 1,880 33,993 4,072 1,907 38,038 12,756 20102000731 Old Buck Lane
Helena, MT 1,850 19,045 141 1,857 19,179 4,157 202119982801 Colonial Drive
Hemet, CA 1,877 9,488 1,818 2,224 10,959 1,427 20211988800 W Oakland Avenue
Henderson, NV 1,190 11,600 1,765 1,298 13,257 5,605 201320081555 W Horizon Ridge Parkway
Henrico, VA 3,955 30,682 2,968 3,955 33,650 280 20232021567 N Parham Road
Hermitage, PA 1,084 15,449 2,464 1,084 17,913 2,470 20212001260 S Buhl Farm Drive
Hickory, NC 1,600 28,419 338 1,600 28,757 4,133 20212002915 29th Avenue NE
High Point, NC 1,355 21,735 1,358 1,518 22,930 3,692 202120021573 Skeet Club Road
High Wycombe, UK 3,567 13,422 871 3,564 14,296 2,750 20152017The Row Lane End
Highland Park, IL 2,820 15,832 1,438 2,820 17,270 5,311 201120121651 Richfield Avenue
Highland Park, IL 2,250 25,313 2,270 2,271 27,562 9,986 201320051601 Green Bay Road
Hindhead, UK 17,852 48,645 4,480 18,439 52,538 10,366 20162012Portsmouth Road
Hingham, MA 1,440 32,292 821 1,444 33,109 8,789 201520121 Sgt. William B Terry Drive
Holbrook, NY 3,957 35,337 4,156 4,331 39,119 13,067 20132001320 Patchogue Holbrook Road
Honolulu, HI 22,918 56,046 2,731 23,053 58,642 11,766 20211998428 Kawaihae Street
Hoover, AL 2,165 18,043 915 2,184 18,939 3,346 202120043517 Lorna Road
Horley, UK 2,332 12,144 1,676 2,408 13,744 4,436 20142014Court Lodge Road
Houston, TX 960 16,079  960 16,079 11,643 2011199510225 Cypresswood Drive
Houston, TX 3,830 55,674 11,001 3,830 66,675 24,696 201219982929 W Holcombe Boulevard
Houston, TX   42,432 1,040 41,392 13,499 20121999505 Bering Drive
Houston, TX   19,761 1,750 18,011 4,334 2016201410120 Louetta Road
Howell, NJ 1,066 21,577 2,611 1,158 24,096 8,388 20102007100 Meridian Place
Hudson, OH 1,586 11,314 280 1,594 11,586 828 20222019125 Omni Lake Parkway
Hudson, OH 1,754 34,395 738 1,754 35,133 2,298 20222019150 Omni Lake Parkway
Huntington Beach, CA 3,808 31,172 3,720 3,931 34,769 13,061 201320047401 Yorktown Avenue
Hutchinson, KS 600 10,590 6,346 600 16,936 5,465 200419972416 Brentwood
Independence, MO13,981 1,584 14,507  1,584 14,507 2,507 2019201919301 E Eastland Center Court
Independence, MO 3,215 24,471 1,150 3,250 25,586 4,605 202119902100 Swope Drive
Independence, MO10,335 2,017 15,796 1,061 2,098 16,776 1,680 2022201419301 E 50th Terrace Court S
Indianola, IA 2,211 11,501 657 2,192 12,177 1,177 20222018610 E Scenic Valley Avenue
Iowa City, IA 891 6,011 1,086 951 7,037 1,028 202119912423 Walden Road
Jackson, TN 1,370 12,490 771 1,386 13,245 2,243 2021199625 Max Lane Drive
Jacksonville, FL 750 25,231 341 750 25,572 5,003 201320145939 Roosevelt Boulevard
Jacksonville, FL  26,381 2,189 1,691 26,879 5,260 201320144000 San Pablo Parkway
Jacksonville, FL 1,205 11,991 23,400 6,550 30,046 5,377 2019201910520 Validus Drive
Jeannette, PA 1,642 22,377 1,192 1,642 23,569 1,985 202220184000 Village Drive
Johns Creek, GA 1,580 23,285 1,527 1,588 24,804 8,445 2013200911405 Medlock Bridge Road
Johnson City, NY10,720 1,440 11,675 1,347 1,607 12,855 2,812 201920131035 Anna Maria Drive
Kalamazoo, MI 7,511 45,942 969 6,291 48,131 10,507 202119891700 Bronson Way
Kalamazoo, MI   1,274 1,274   202119001700 Bronson Way
Kanata, ON 1,689 28,670 1,710 1,718 30,351 10,553 2012200570 Stonehaven Drive
Kansas City, MO11,002 1,938 11,694 974 1,938 12,668 1,378 20222016111 NW 94 Street
Kelowna, BC3,988 2,688 13,647 2,425 2,856 15,904 5,926 20131999863 Leon Avenue
Kelowna, BC 6,302 46,346 6,122 6,460 52,310 5,565 202220211360 K.L.O Road
Kelowna, BC 5,443 42,606 5,667 5,579 48,137 5,986 20222000580 Yates Road
Kelowna, BC 6,171 51,949 6,305 6,326 58,099 5,676 202220051075 Barnes Avenue
Kelowna, BC 3,718 44,690 5,000 3,811 49,597 5,796 202220121277 Gordon Drive
Kelowna, BC 3,069 11,524 1,348 3,146 12,795 1,285 202219883200 Lakeshore Road
Kennebunk, ME 2,700 30,204 7,908 3,532 37,280 17,750 20132006One Huntington Common Drive
Kenner, LA 1,100 10,036 5,796 1,100 15,832 12,034 199820001600 Joe Yenni Boulevard
Kenner, LA 809 12,344 755 814 13,094 1,641 202119881101 Sunset Boulevard
Kennett Square, PA 1,050 22,946 1,587 1,186 24,397 8,209 20102008301 Victoria Gardens Drive
Kingsport, TN 2,123 33,130 110 2,123 33,240 2,248 20212019915 Holston Hills Drive
Kingston, ON 1,030 11,416 2,161 1,409 13,198 3,503 20151983181 Ontario Street
Kingwood, TX 480 9,777 1,756 480 11,533 4,305 2011199922955 Eastex Freeway
Kingwood, TX 1,683 24,207 2,733 1,683 26,940 6,657 2017201224025 Kingwood Place
Kirkland, WA 1,880 4,315 2,297 1,880 6,612 2,562 200319966505 Lakeview Drive
Kitchener, ON8,381 1,341 13,939 5,591 1,447 19,424 5,390 201620031250 Weber Street E
Klamath Falls, OR 1,335 10,174 2,794 1,335 12,968 3,121 20202000615 Washburn Way
Kuna, ID   20 20   202219001640 W Hubbard Road
LA Palma, CA 2,950 16,591 1,463 2,996 18,008 6,444 201320035321 La Palma Avenue
La Vista, NE9,025 1,199 14,840 887 1,199 15,727 1,523 202220127544 Gertrude Street
Lackawanna, NY6,591 1,422 6,066  1,422 6,066 1,486 20192002133 Orchard Place
Lafayette, LA 2,618 22,986 1,889 2,618 24,875 196 20232016400 Polly Lane
Lafayette Hill, PA 1,750 11,848 2,854 1,878 14,574 6,298 20131998429 Ridge Pike
Laguna Hills, CA 12,820 75,926 22,414 12,894 98,266 31,611 2016198824903 Moulton Parkway
Laguna Woods, CA 11,280 76,485 15,167 11,280 91,652 27,206 2016198724441 Calle Sonora
Laguna Woods, CA 9,150 57,842 14,397 9,150 72,239 21,981 2016198624962 Calle Aragon
Lake Havasu City, AZ 364 1,599 544 364 2,143 647 20202009320 Lake Havasu Avenue N,
Lake Jackson, TX   13,621 2,046 11,575 141 20211900301 Huisache Street
Lake Zurich, IL 1,470 9,830 3,918 1,470 13,748 6,186 20112007550 America Court
Lakeland, FL 2,416 19,791 249 2,416 20,040 3,310 202119991325 Grasslands Boulevard
Lakeview, MI 733 2,212 135 733 2,347 358 202220139494 Paden Road
Lakewood, NY9,836 1,031 17,410 839 1,031 18,249 1,549 202220162123 Southwestern Drive
Lakewood Ranch, FL 650 6,714 2,102 650 8,816 2,606 201120128230 Nature's Way
Lakewood Ranch, FL 1,000 22,388 809 1,000 23,197 6,907 201220058220 Natures Way
Lancaster, CA 700 15,295 6,153 712 21,436 7,950 2010199943051 15th Street W
Lancaster, OH 1,029 7,699 503 1,035 8,196 1,425 202119812750 W Fair Avenue
Lancaster, PA 1,680 14,039 209 1,680 14,248 2,816 2015201731 Millersville Road
Lancaster, NY11,996 1,897 12,202  1,897 12,202 2,801 2019201118 Pavement Road
Las Vegas, NV 5,908 36,955 4,957 5,908 41,912 9,385 202019991600 S Valley View Road
Las Vegas, NV 1,274 13,748 1,109 1,292 14,839 2,276 202020013300 Winterhaven Street
Las Vegas, NV 2,412 22,045 3,217 2,428 25,246 4,511 202019973210 S Sandhill Road
Laval, QC18,560 2,105 32,161 6,106 2,174 38,198 8,679 20182005269, Boulevard Sainte-Rose
Laval, QC3,392 2,383 5,968 1,722 2,462 7,611 1,674 20181989263, Boulevard Sainte-Rose
Laval, QC 17,231 113,967 13,138 17,231 127,105 1,357 202319881400 Bd Chomedey
Lawrence, KS 250 8,716 322 250 9,038 2,685 201219963220 Peterson Road
Lawrenceville, GA 1,500 29,003 1,493 1,562 30,434 10,083 201320081375 Webb Gin House Road
Lawrenceville, GA 3,513 24,173 2,749 3,583 26,852 3,268 202120072899 Five Forks Trickum Road
Leatherhead, UK 4,682 17,835 1,200 4,674 19,043 3,547 20152017Rectory Lane
Leawood, KS 2,490 32,493 11,938 5,610 41,311 15,080 201219994400 W 115th Street
Lenexa, KS9,700 826 26,251 1,932 927 28,082 10,227 2013200615055 W 87th Street Parkway
Levis, QC4,125 3,322 24,502 2,878 3,322 27,380 3,052 202320097 Rue St Thomas
Lexington, SC 1,843 15,301 2,420 1,869 17,695 2,174 20212001203 Old Chapin Road
Lexington, SC 3,171 22,214 1,421 3,171 23,635 343 20232001800 N Lake Drive
Libertyville, IL 6,500 40,024 5,467 6,500 45,491 14,040 20112001901 Florsheim Drive
Lincoln, NE 390 13,807 802 390 14,609 5,098 201020007208 Van Dorn Street
Lincoln, NE 884 10,637 2,179 1,054 12,646 1,721 202119901111 S 70th
Lincroft, NJ 9 19,958 3,021 170 22,818 7,836 20132002734 Newman Springs Road
Linwood, NJ 800 21,984 2,848 885 24,747 8,708 20101997432 Central Avenue
Litchfield, CT 1,240 17,908 12,732 1,362 30,518 9,092 2010199819 Constitution Way
Lititz, PA 1,200 13,836 314 1,200 14,150 2,784 2015201680 W Millport Road
Little Neck, NY 3,350 38,461 6,724 3,468 45,067 14,688 201020005515 Little Neck Parkway
Littleton, CO 3,378 26,360 1,843 3,378 28,203 213 202320188160 W Coal Mine Avenue
Livingston, NJ 8,000 44,424 2,556 8,103 46,877 9,959 20152017369 E Mount Pleasant Avenue
Lombard, IL17,010 2,130 59,943 2,457 2,218 62,312 20,692 201320092210 Fountain Square Drive
London, UK   14,900 3,224 11,676 3,375 2014201271 Hatch Lane
London, ON9,475 1,969 16,985 3,535 2,068 20,421 5,545 201519531486 Richmond Street N
London, ON 1,445 13,631 2,149 1,643 15,582 4,267 2015195081 Grand Avenue
Londonderry, NH14,982 2,872 24,521 1,357 2,872 25,878 2,351 202220162 Golen Drive
Long Grove, IL   26,243 2,733 23,510 2,824 202120172300 Illinois Route 53
Longmont, CO 1,756 11,825 2,935 1,895 14,621 2,359 202119862210 Main Street
Longueuil, QC7,111 3,992 23,711 4,677 4,276 28,104 8,841 2015198970 Rue Levis
Longueuil, QC18,119 9,049 70,707 11,134 9,049 81,841 2,689 202320071235 chemin du Tremblay
Longview, TX 610 5,520 1,412 610 6,932 2,646 20062007311 E Hawkins Parkway
Lorain, OH11,309 1,409 13,060  1,409 13,060 2,066 201920185401 N Pointe Parkway
Los Angeles, CA  114,438 10,793  125,231 45,785 2011200910475 Wilshire Boulevard
Los Angeles, CA 3,540 19,007 4,813 3,540 23,820 9,496 201220012051 N Highland Avenue
Los Angeles, CA  28,050 6,976 91 34,935 9,490 201620064061 Grand View Boulevard
Louisville, KY 2,420 20,816 4,494 2,420 25,310 9,465 201219994600 Bowling Boulevard
Louisville, KY13,650 1,600 20,326 2,069 1,607 22,388 8,016 201320106700 Overlook Drive
Louisville, CO 2,266 13,002 22,757 1,939 36,086 6,425 201920081336 E Hecla Drive
Louisville, CO 1,042 8,396 19,142 1,156 27,424 3,603 201920191800 Plaza Drive
Louisville, CO 1,432 6,684 56,566 2,584 62,098 13,617 201919991855 Plaza Drive
Louisville, CO 1,323 7,547 11,120 1,391 18,599 3,246 20191999282 McCaslin Boulevard
Louisville, CO 1,630 12,001 38,278 2,332 49,577 8,905 201920041331 E Hecla Drive
Louisville, KY 1,588 9,254 1,189 1,613 10,418 1,609 20212000620 Valley College Drive
Louisville, KY 2,274 10,768 3,261 2,459 13,844 2,091 202119988021 Christian Court
Ludington, MI 747 6,406 157 747 6,563 476 20222002502 N Sherman Street
Lynnfield, MA 3,165 45,200 3,340 3,793 47,912 16,622 2013200655 Salem Street
Macungie, PA   27,077 2,558 24,519 2,776 201720186043 Lower Macungie Road
Madison, TN 2,093 8,306 53 2,092 8,360 778 20211986200 E Webster Street
Mahwah, NJ 1,605 27,249 1,578 1,644 28,788 6,464 2012201515 Edison Road
Malvern, PA 1,651 17,194 3,428 1,804 20,469 8,721 20131998324 Lancaster Avenue
Manassas, VA 2,946 16,609 327 2,979 16,903 2,709 202119949852 Fairmont Avenue
Mansfield, TX 660 5,251 896 660 6,147 2,471 200620072281 Country Club Drive
Mansfield, TX   21,515 2,807 18,708 2,255 201720192500 N Walnut Creek
Manteca, CA 1,300 12,125 6,175 1,312 18,288 8,711 20051986430 N Union Road
Maple Ridge, BC8,562 2,875 11,922 3,196 3,221 14,772 3,082 2015200912241 224th Street
Marieville, QC5,048 1,278 12,113 1,414 1,372 13,433 3,871 20152002425 Rue Claude De Ramezay
Marlboro, NJ 2,222 14,888 3,116 2,336 17,890 6,305 201320023a S Main Street
Marlow, UK 9,068 39,720 1,127 9,060 40,855 8,683 20132014210 Little Marlow Road
Marysville, WA 620 4,780 5,475 620 10,255 4,203 200319989802 48th Drive NE
Massillon, OH 1,117 16,687 1,103 1,117 17,790 1,912 202220162550 University Drive SE
Mattoon, IL 791 1,905 376 835 2,237 564 202119992008 S 9th Street
Mattoon, IL 505 2,258 490 530 2,723 520 202120011920 Brookstone Lane
McKinney, TX 1,570 7,389 1,279 1,570 8,668 3,083 200920102701 Alma Road
McKinney, TX 4,314 23,777 277 4,314 24,054 2,607 20212018220 S Crutcher Crossing
McKinney, TX 5,769 32,691  5,769 32,691 406 202320233220 Turkey Trot Lane
McMasterville, QC3,176 5,555 27,814 6,810 5,555 34,624 1,550 20231961701 Chem. du Richelieu
Meadville, PA 2,084 17,623  2,084 17,623 660 20222023637 Pine Street
Medicine Hat, AB8,752 1,432 14,141 803 1,514 14,862 5,076 20151999223 Park Meadows Drive SE
Medina, OH12,156 1,309 10,540 2,463 1,750 12,562 2,429 20192017699 N Huntington Street
Medina, OH   42,612 2,131 40,481 2,227 20192020122 Medina Road
Melbourne, FL 7,070 48,257 45,945 7,070 94,202 35,526 200720097300 Watersong Lane
Melville, NY 4,280 73,283 11,815 4,453 84,925 28,019 2010200170 Pinelawn Road
Memphis, TN 1,800 17,744 4,224 1,800 21,968 9,230 201219996605 Quail Hollow Road
Memphis, TN 1,578 9,435  1,578 9,435 1,517 202120188722 Winchester Road
Menomonee Falls, WI 1,020 6,984 2,745 1,020 9,729 3,996 20062007W128 N6900 Northfield Drive
Mentor, OH11,225 957 13,206 1,109 960 14,312 1,627 202220199150 Lakeshore Boulevard
Merced, CA 2,806 13,292 2,145 2,924 15,319 2,043 202119973460 R Street
Mesa, AZ 950 9,087 6,397 950 15,484 8,273 199920007231 E Broadway Road
Metairie, LA14,200 725 27,708 2,857 1,448 29,842 9,552 201320093732 W Esplanade Avenue S
Midland, MI 1,084 5,623 391 1,091 6,007 772 202220154124 Waldo Avenue
Mill Creek, WA 10,150 60,274 5,540 10,179 65,785 27,251 2010199814905 Bothell-Everett Highway
Millbrook, NY 12,448 12,390 2,439 12,947 14,330 6,318 2021198579 Flint Road
Millersburg, OH 1,293 17,788 775 1,293 18,563 1,771 202220214245 Glen Drive
Milton, ON17,759 4,542 25,321 7,286 4,801 32,348 6,899 20152012611 Farmstead Drive
Milwaukie, OR 2,391 20,262 2,853 2,415 23,091 3,623 202119964017 SE Vineyard Road
Minnetonka, MN 920 29,344 1,988 1,051 31,201 10,150 2013200618605 Old Excelsior Boulevard
Mission Viejo, CA12,333 6,600 52,118 9,508 6,602 61,624 15,791 2016199827783 Center Drive
Mississauga, ON7,052 1,602 17,996 1,812 1,686 19,724 6,751 201319841130 Bough Beeches Boulevard
Mississauga, ON5,584 2,548 15,158 4,481 2,673 19,514 5,693 2015198985 King Street E
Missoula, MT 550 7,490 2,186 553 9,673 4,247 200519983620 American Way
Mobberley, UK 5,146 26,665 2,459 5,315 28,955 11,011 20132007Barclay Park, Hall Lane
Mobile, AL 737 10,205 633 749 10,826 1,975 20211995650 University Boulevard S
Molalla, OR 1,210 3,903 1,190 1,210 5,093 1,206 20201998835 E Main Street
Monterey, CA 6,440 29,101 3,982 6,443 33,080 11,695 201320091110 Cass Street
Montgomery, AL 524 10,923 375 538 11,284 2,077 202119915801 Eastdale Drive
Montgomery, MD 6,482 83,642 18,570 6,804 101,890 25,776 201819923701 International Drive
Montgomery Village, MD 3,530 18,246 8,536 4,291 26,021 14,107 2013199319310 Club House Road
Montreal-nord, QC8,995 4,407 23,719 9,764 4,566 33,324 8,502 201819886700 Boulevard Gouin Est
Moorestown, NJ 2,060 51,628 9,320 2,095 60,913 19,011 201020001205 N Church Street
Moose Jaw, SK1,052 582 12,973 1,938 612 14,881 4,806 20132001425 4th Avenue NW
Murphy, TX 1,950 19,182 519 1,950 19,701 4,231 20152012304 W FM 544
Nacogdoches, TX 390 5,754 1,067 390 6,821 2,752 200620075902 North Street
Naperville, IL 3,470 29,547 6,818 3,470 36,365 10,588 20112001504 N River Road
Naperville, IL 1,550 12,237 2,813 1,550 15,050 5,513 201220131936 Brookdale Road
Naperville, IL 1,540 28,204 2,084 1,602 30,226 10,531 20132002535 W Ogden Avenue
Nashville, TN 3,900 35,788 5,862 3,900 41,650 16,660 201219994206 Stammer Place
New Braunfels, TX 1,200 19,800 10,739 2,729 29,010 8,819 201120092294 E Common Street
New Palestine, IN 2,259 22,010 609 2,290 22,588 3,275 202120174400 Terrace Drive
New Rochelle, NY 5,732 34,270 32 5,732 34,302 629 2021202311 Mill Road
New York, NY  29   29  201820232330 Broadway
Newberg, OR 2,806 15,260 2,349 2,809 17,606 1,763 202120023801 Hayes Street
Newbury, UK 2,850 12,796 1,239 2,944 13,941 2,811 20152016370 London Road
Newmarket, UK 4,071 11,902 2,598 4,205 14,366 4,163 20142011Jeddah Way
Newtown Square, PA 1,930 14,420 2,006 1,975 16,381 6,782 20132004333 S Newtown Street Road
Norman, OK 1,480 33,330 1,409 1,480 34,739 10,103 20121985800 Canadian Trails Drive
North Canton, OH 1,726 24,588 2,224 1,726 26,812 2,917 20222017850 Applegrove Street
North Ridgeville, OH 1,780 29,390 157 1,790 29,537 1,688 2022202033770 Bagley Road
North Tonawanda, NY8,180 1,249 7,360 995 1,573 8,031 1,812 20192005705 Sandra Lane
North Tonawanda, NY 1,426 17,572 930 1,528 18,400 1,505 202220093959 Forest Park Way
North Tustin, CA 2,880 18,059 1,881 3,044 19,776 6,320 2013200012291 Newport Avenue
North Wales, PA 1,968 18,356 1,059 1,971 19,412 3,002 202120131419 Horsham Road
Northville, MI 2,221 12,710 1,961 2,221 14,671 210 2023201944600 Five Mile Road
Novi, MI 3,877 30,891 6,155 3,877 37,046 432 2023202142400 W 12 Mile Road
Oak Harbor, WA 739 7,698 963 739 8,661 1,837 20191998171 SW 6th Avenue
Oak Park, IL 1,250 40,383 4,272 1,250 44,655 16,251 201220041035 Madison Street
Oakdale, PA13,745 1,917 11,954 971 1,934 12,908 2,865 201920177420 Steubenville Pike
Oakland, CA 3,877 47,508 4,764 4,117 52,032 18,233 2013199911889 Skyline Boulevard
Oakton, VA 2,250 37,576 4,286 2,393 41,719 14,470 201319972863 Hunter Mill Road
Oakville, ON7,117 2,134 29,963 3,953 2,258 33,792 11,529 2013199425 Lakeshore Road W
Oakville, ON3,743 1,271 13,754 2,304 1,343 15,986 4,962 20131988345 Church Street
Ocala, FL 1,340 10,564 694 1,340 11,258 4,266 200820092650 SE 18th Avenue
Odessa, TX 346 3,506 422 384 3,890 524 20211954311 W 4th Street
Ogden, UT 360 6,700 2,114 360 8,814 4,043 200419981340 N Washington Boulevard
Oklahoma City, OK 590 7,513 335 590 7,848 3,292 2007200813200 S May Avenue
Oklahoma City, OK 760 7,017 461 760 7,478 3,027 2007200911320 N Council Road
Oklahoma City, OK   18,268 1,590 16,678 2,216 201420162800 SW 131st Street
Oklahoma City, OK 5,962 27,717  5,962 27,717 32,208 202119841404 NW 122nd Street
Okotoks, AB18,482 714 20,943 1,702 771 22,588 6,400 2015201047 Riverside Gate
Olney, IL 897 4,805 435 923 5,214 932 202119991110 N East Street
Olney, IL 534 2,234 511 563 2,716 590 202119981110 N East Street
Omaha, NE 370 10,230 362 370 10,592 3,779 2010199811909 Miracle Hills Drive
Omaha, NE 380 8,769 493 380 9,262 3,444 201019995728 S 108th Street
Omaha, NE7,809 1,623 12,027 780 1,623 12,807 1,226 202220107205 N 73rd Plaza Circle
Orange, CA33,935 8,021 64,689 2,778 8,021 67,467 11,040 20192018630 the City Drive S
Orem, UT 1,395 8,775 451 1,419 9,202 1,662 20211987325 W Center
Ormond Beach, FL 3,428 16,941 460 3,441 17,388 3,103 20211984101 Clyde Morris Boulevard
Ottawa, ON11,901 1,341 15,425 4,468 1,438 19,796 4,388 20152001110 Berrigan Drive
Ottawa, ON7,264 2,809 27,299 4,608 2,935 31,781 11,604 2013199843 Aylmer Avenue
Ottawa, ON3,767 1,156 9,758 1,124 1,245 10,793 3,691 201319981351 Hunt Club Road
Ottawa, ON4,920 746 7,800 1,425 822 9,149 3,019 20131999140 Darlington Private
Ottawa, ON 1,176 12,764 1,355 1,271 14,024 3,012 2015198710 Vaughan Street
Ottawa, ON17,386 4,256 39,141 2,624 4,406 41,615 10,838 20152005751 Peter Morand Crescent
Ottawa, ON6,088 2,252 7,575  2,252 7,575 3,514 201519891 Eaton Street
Ottawa, ON11,602 2,963 26,424 3,758 3,172 29,973 7,059 20152008691 Valin Street
Ottawa, ON8,748 1,561 18,170 3,773 1,765 21,739 5,167 2015200622 Barnstone Drive
Ottawa, ON11,131 3,403 31,090 4,115 3,647 34,961 7,602 20152009990 Hunt Club Road
Ottawa, ON 3,411 28,335 6,754 3,649 34,851 9,107 201520092 Valley Stream Drive
Outremont, QC15,011 6,746 45,981 13,819 6,971 59,575 15,071 201819761000, Avenue Rockland
Overland Park, KS 1,540 16,269 4,637 1,670 20,776 7,075 201219989201 Foster
Oviedo, FL 3,350 31,147 357 3,346 31,508 5,102 202120027015 Red Bug Lake Road
Painesville, OH 1,407 12,500 158 1,407 12,658 678 202020221504 Jackson Street
Painted Post, NY8,812 1,326 13,400 690 1,259 14,157 1,355 20222012110 Creekside Drive
Palestine, TX 180 4,320 3,363 180 7,683 2,696 200620051625 W Spring Street
Palm Coast, FL 870 10,957 690 870 11,647 4,290 2008201050 Town Court
Palm Desert, CA 13,628 58,446 3,052 13,683 61,443 11,396 2021198541505 Carlotta Drive
Palm Desert, CA 6,193 83,052 2,297 6,193 85,349 5,432 2022201039905 Via Scena
Palo Alto, CA25,050  39,639 3,881 43 43,477 15,111 201320072701 El Camino Real
Paramus, NJ 2,840 35,728 2,377 2,986 37,959 12,860 20131998567 Paramus Road
Paris, IL 688 6,203 562 719 6,734 899 20212001146 Brookstone Lane
Paris, TX 490 5,452 1,186 490 6,638 5,597 20052006750 N Collegiate Drive
Parma, OH11,115 1,533 9,221 785 1,536 10,003 2,235 2019201611500 Huffman Road
Paso Robles, CA 1,770 8,630 7,252 1,770 15,882 6,857 200219981919 Creston Road
Peabody, MA 2,250 16,071 1,459 2,380 17,400 5,320 2013199473 Margin Street
Peasmarsh, UK   67,110 5,533 61,577 19,939 20132006Astolat Way, Peasmarsh
Pella, IA 870 6,716 538 938 7,186 2,207 201220022602 Fifield Road
Pembroke, ON 1,931 9,427 1,921 1,963 11,316 3,908 201219991111 Pembroke Street W
Pennington, NJ 1,380 27,620 4,879 1,542 32,337 9,961 20112000143 W Franklin Avenue
Pensacola, FL 2,945 29,148 2,798 2,945 31,946 251 20232017428 Airport Boulevard
Penticton, BC 3,706 46,717 4,962 3,799 51,586 5,915 202220153475 Wilson Street
Peoria, AZ 766 21,796 2,676 766 24,472 5,496 2018201413391 N 94th Drive
Peoria, AZ 2,006 12,091 976 2,023 13,050 2,337 2021199713619 N 94th Drive
Pflugerville, TX   40,987 5,978 35,009 258 20212024305 E Pflugerville Parkway
Pickerington, OH 2,815 26,921 695 2,864 27,567 1,956 20222019602 Redbud Road
Pittsburgh, PA 1,580 18,017 11,928 1,635 29,890 8,167 20132009900 Lincoln Club Drive
Pittsburgh, PA 2,850 22,019 2,689 2,850 24,708 292 202320198651 Care Lane
Pittsburgh, PA 3,815 33,052 3,764 3,815 36,816 359 202320218870 Duncan Avenue
Pittston, PA 1,644 13,756 863 1,644 14,619 1,538 20222019900 N Twp Boulevard
Placentia, CA 8,480 17,076 6,977 8,528 24,005 8,442 201619871180 N Bradford Avenue
Plainview, NY 3,066 19,901 2,236 3,197 22,006 7,238 201320011231 Old Country Road
Plano, TX28,960 3,120 59,950 7,395 3,294 67,171 25,545 201320064800 W Parker Road
Plano, TX 1,750 15,390 2,259 1,750 17,649 4,325 201620143690 Mapleshade Lane
Plano, TX 3,079 32,970 3,978 3,079 36,948 1,120 202320067001 Plano Parkway
Plattsmouth, NE 250 5,650 261 250 5,911 2,192 201019991913 E Highway 34
Playa Vista, CA 1,580 40,531 4,935 1,707 45,339 15,466 201320065555 Playa Vista Drive
Pleasanton, CA   52,474 3,676 48,798 6,667 201620175700 Pleasant Hill Road
Port Perry, ON9,777 3,685 26,788 3,861 3,879 30,455 6,983 2015200915987 Simcoe Street
Port St. Lucie, FL 8,700 47,230 21,945 8,700 69,175 26,278 2008201010685 SW Stony Creek Way
Portage, MI40,055 2,880 59,764 3,038 2,892 62,790 11,500 201920173951 W Milham Avenue
Porterville, CA 1,739 15,190 1,664 1,866 16,727 2,399 202119992500 W Henderson Avenue
Potomac, MD   58,278 6,648 51,630 6,034 2018202110800 Potomac Tennis Lane
Princeton, NJ 1,730 30,888 7,792 1,845 38,565 11,536 20112001155 Raymond Road
Princeton, NJ  (151)31,468 3,719 27,598 1,234 20202001775 Mount Lucas Road
Purley, UK 7,365 35,161 4,650 7,590 39,586 14,766 2012200521 Russell Hill Road
Puyallup, WA 1,150 20,776 7,313 1,156 28,083 10,223 20101985123 Fourth Avenue NW
Quebec City, QC5,426 2,420 21,977 5,197 2,500 27,094 5,809 20182000795, Rue Alain
Quebec City, QC10,350 3,300 28,325 6,398 3,409 34,614 7,600 20181987650 and 700, Avenue Murray
Quebec City, QC8,835 8,251 53,286 10,426 8,251 63,712 3,485 20232005777 Rue de Belmont
Quebec City, QC2,391 4,314 29,822 3,465 4,314 33,287 3,669 202320081050 Bd Lebourgneuf
Queensbury, NY 1,260 21,744 4,345 1,273 26,076 6,673 2015199927 Woodvale Road
Quincy, IL 2,328 16,254 625 2,332 16,875 2,396 20212005823 S 36th Street
Rancho Cucamonga, CA 1,480 10,055 2,674 2,084 12,125 5,203 201320019519 Baseline Road
Rancho Palos Verdes, CA 5,450 60,034 9,893 5,450 69,927 23,699 201220045701 Crestridge Road
Randolph, NJ29,300 1,540 46,934 3,454 1,760 50,168 16,519 20132006648 Route 10 W
Rantoul, IL 579 4,576 439 584 5,010 770 20212002300 Twin Lakes Drive
Red Deer, AB 1,247 19,283 2,687 1,318 21,899 5,737 201520043100 - 22 Street
Red Deer, AB 1,199 22,339 3,509 1,247 25,800 7,109 2015200410 Inglewood Drive
Redding, CA24,995 4,474 36,557 2,028 4,474 38,585 7,108 201920172150 Bechelli Lane
Redding, CA 2,639 10,290 537 2,675 10,791 1,971 20211985451 Hilltop Drive
Redlands, CA 1,966 40,425 1,176 1,977 41,590 5,545 2021198810 Terracina Boulevard
Redwood City, CA   61,421 457 60,964 2,027 201920212991 El Camino Real
Regina, SK4,722 1,485 21,148 2,407 1,666 23,374 8,266 201319993651 Albert Street
Regina, SK4,770 1,244 21,036 2,287 1,343 23,224 7,640 201320043105 Hillsdale Street
Regina, SK13,186 1,539 24,053 4,775 1,644 28,723 6,784 201519921801 McIntyre Street
Rehoboth Beach, DE 960 24,248 9,715 993 33,930 10,800 2010199936101 Seaside Boulevard
Reno, NV 1,060 11,440 4,104 1,060 15,544 6,954 200419985165 Summit Ridge Court
Richmond, VA 6,501 23,697 207 6,528 23,877 3,919 2021200710300 Three Chopt Road
Ridgeland, MS 520 7,675 4,300 520 11,975 5,354 20031997410 Orchard Park
Ridgeland, MS 2,659 27,435 1,973 2,659 29,408 213 20232010608 Steed Road
Rimouski, QC6,323 2,820 30,658 8,000 2,820 38,658 920 20231954280 Ave Belzile
Riviere-du-loup, QC2,085 592 7,601 1,678 681 9,190 2,763 2015195635 Rue des Cedres
Riviere-du-loup, QC10,486 1,454 16,848 6,057 1,797 22,562 7,164 20151993230-235 Rue des Chenes
Robinson, IL 660 3,667 415 663 4,079 770 202119991101 N Monroe Street
Rockford, IL 1,006 5,119 652 1,024 5,753 984 202120033495 McFarland Road
Rockwall, TX 2,220 17,650 1,050 2,220 18,700 4,047 20122014720 E Ralph Hall Parkway
Rocky Hill, CT 1,090 6,710 6,299 45 14,054 5,216 2003199660 Cold Spring Road
Rohnert Park, CA 6,500 18,700 6,405 6,546 25,059 11,749 200519864855 Snyder Lane
Romeoville, IL 854 12,646 63,433 6,139 70,794 24,739 20062010605 S Edward Drive
Roseburg, OR 979 14,453 324 980 14,776 2,705 202119841800 Hughwood
Roseville, MN 1,540 35,877 2,218 1,648 37,987 12,107 201320022555 Snelling Avenue N
Roseville, CA 3,300 41,652 7,781 3,300 49,433 14,162 201620005161 Foothills Boulevard
Roseville, CA 3,011 55,669  3,011 55,669 3,104 202220212400 Pleasant Grove Boulevard
Roswell, GA 1,107 9,627 5,402 1,114 15,022 10,322 19971999655 Mansell Road
Roswell, GA 2,080 6,486 4,504 2,380 10,690 4,168 2012199775 Magnolia Street
Round Rock, TX 2,358 15,477 111 2,358 15,588 1,978 20212007310 Chisholm Trail
Rowlett, TX 1,612 21,319 280 1,629 21,582 2,185 202020194205-4209 Dalrock Road
Sabre Springs, CA   47,177 3,726 43,451 5,751 2016201712515 Springhurst Drive
Sachse, TX 6,346 30,025 905 6,225 31,051 1,007 20212023Bunker Hill Road
Sacramento, CA 940 14,781 7,499 952 22,268 7,395 201019786350 Riverside Boulevard
Sacramento, CA 1,300 23,394 2,485 1,369 25,810 8,641 20132004345 Munroe Street
Saginaw, MI 1,483 17,915 1,005 1,535 18,868 3,164 202119974141 McCarty Road
Sainte Marie, QC10,577 3,960 26,336 6,418 3,960 32,754 2,098 2023200646 Av du Bocage
Saint-Georges, QC6,901 3,105 20,518 6,516 3,105 27,034 556 202319861020 175e Rue
Saint-lambert, QC28,857 10,259 61,903 11,782 11,238 72,706 25,551 201519891705 Avenue Victoria
Salaberry-de-Valleyfield, QC13,843 1,874 15,120 2,830 1,924 17,900 2,306 2022197088 Rue Dufferin
Salem, OR 918 9,659 1,452 918 11,111 2,093 202019994452 Lancaster Drive NE
Salem, OR 1,227 8,632 1,601 1,227 10,233 2,059 202019974050 12th Street Cutoff SE
Salem, OR   23,014 2,877 20,137 3,354 20211980707 Madrona Avenue SE
Salinas, CA 5,110 41,424 12,123 5,155 53,502 16,332 201619901320 Padre Drive
Salisbury, UK 2,720 15,269 4,044 2,810 19,223 4,814 20142013Shapland Close
Salt Lake City, UT 1,360 19,691 2,604 1,396 22,259 9,201 201119861430 E 4500 S
San Antonio, TX   37,179 6,120 31,059 10,474 201020112702 Cembalo Boulevard
San Antonio, TX   67,009 5,045 61,964 12,864 2017201511300 Wild Pine
San Antonio, TX 11,686 69,930 8,852 11,686 78,782 15,163 201920166870 Heuermann Road
San Antonio, TX 2,262 31,075 2,720 2,262 33,795 1,259 2023201615430 Huebner Road
San Diego, CA 5,810 63,078 9,848 5,810 72,926 26,934 2012200113075 Evening Creek Drive S
San Diego, CA 3,000 27,164 2,652 3,016 29,800 9,618 20132003810 Turquoise Street
San Diego, CA27,765 4,179 40,328 1,829 4,179 42,157 6,717 20192017955 Grand Avenue
San Francisco, CA 5,920 91,639 15,040 5,920 106,679 29,368 201619981550 Sutter Street
San Francisco, CA 11,800 77,214 12,022 11,800 89,236 24,463 201619231601 19th Avenue
San Francisco, CA   52,609 13,894 38,715 2,271 201919921450 Post Street
San Gabriel, CA 3,120 15,566 2,273 3,170 17,789 6,147 201320058332 Huntington Drive
San Jose, CA 3,280 46,823 9,509 3,280 56,332 18,928 20122002500 S Winchester Boulevard
San Jose, CA 11,900 27,647 6,213 11,966 33,794 10,049 201620024855 San Felipe Road
San Rafael, CA 1620273925,716 162033108861020162001111 Merrydale Road
San Ramon, CA 8,700 72,223 13,937 8,781 86,079 22,887 201619929199 Fircrest Lane
Sand Springs, OK 910 19,654 714 915 20,363 6,041 201220024402 S 129th Avenue W
Sandy Springs, GA 2,214 8,360 2,036 2,220 10,390 4,741 201219975455 Glenridge Drive NE
Santa Ana, CA 2,077 3,145 1,720 2,077 4,865 1,124 202119923730 S Greenville Street
Santa Monica, CA15,820 5,250 28,340 2,079 5,266 30,403 10,074 201320041312 15th Street
Santa Rosa, CA 2,250 26,273 4,400 2,309 30,614 8,376 201620014225 Wayvern Drive
Santa Rosa, CA 6,484 52,195 1,910 6,484 54,105 4,294 202220134210 Thomas Lake Harris Drive
Sarasota, FL 20,105 96,495 8,622 19,723 105,499 11,717 202119853260 Lake Pointe Boulevard
Saskatoon, SK2,913 981 13,905 1,530 1,031 15,385 4,360 20131999220 24th Street E
Saskatoon, SK11,301 1,382 17,609 2,237 1,553 19,675 6,223 201320041622 Acadia Drive
Savannah, GA 1,733 16,218 1,372 1,748 17,575 2,428 202119986206 Waters Avenue
Schaumburg, IL 2,460 22,863 2,107 2,504 24,926 8,967 20132001790 N Plum Grove Road
Schererville, IN 3,693 30,512 4,264 3,693 34,776 811 202320177770 Burr Street
Scottsdale, AZ 2,500 3,890 3,770 2,500 7,660 3,099 200819989410 E Thunderbird Road
Scranton, PA9,934 896 10,591 788 896 11,379 2,380 201920141651 Dickson Avenue
Seal Beach, CA 6,204 72,954 4,709 6,308 77,559 28,806 201320043850 Lampson Avenue
Seattle, WA27,180 10,670 37,291 4,692 10,700 41,953 17,584 20102005805 4th Avenue N
Seattle, WA 1,150 19,887 3,277 1,150 23,164 6,576 2015199511039 17th Avenue
Selbyville, DE 750 25,912 1,999 769 27,892 9,393 2010200821111 Arrington Drive
Sevenoaks, UK 6,181 402404849638444886175382012200964 - 70 Westerham Road
Severna Park, MD  67,623 7,159 447473818,643 2016199743 W McKinsey Road
Shawnee, KS 2,109 22,141 560 2,109 22,701 1,597 202220207200 Silverheel Street
Shelby Township, MI13,180 1,040 26,344 1,399 1,110 27,673 9,321 2013200646471 Hayes Road
Sherman, TX 700 5,221 1,823 700 7,044 2,578 200520061011 E Pecan Grove Road
Sherman, TX 1,712 22,567 585 1,850 23,014 3,802 202119863701 N Loy Lake Road
Shrewsbury, NJ 2,120 38,116 5,101 2,165 43,172 14,377 201020005 Meridian Way
Sidcup, UK 7,446 56,570 9,015 7,659 65,372 24,911 20122000Frognal Avenue
Silver Spring, MD   64,994 3,449 61,545 8,093 201620182201 Colston Drive
Simi Valley, CA 3,200 16,664 3,019 3,340 19,543 7,791 20132009190 Tierra Rejada Road
Simi Valley, CA 5,510 51,406 9,793 5,510 61,199 18,153 201620035300 E Los Angeles Avenue
Simi Valley, CA 3,084 41,629  3,084 41,629 2,528 202220213110 Royal Avenue
Solihull, UK 2,844 26,402  2,844 26,402 11,749 201220091270 Warwick Road
Solihull, UK   25,274 2,393 22,881 7,201 201820091270 Warwick Road
Solihull, UK 3,571 26,053 2,730 3,666 28,688 9,781 201320071 Worcester Way
Solihull, UK 1,851 10,585 1,322 1,911 11,847 2,555 20152016Warwick Road
Sonning, UK 5,644 42,155 4,022 5,807 46,014 15,953 20132009Old Bath Road
Sonoma, CA 1,100 18,400 6,821 1,109 25,212 11,692 20051988800 Oregon Street
Sonoma, CA 2,820 21,890 4,285 2,819 26,176 7,551 2016200591 Napa Road
South Haven, MI 1,140 7,793 675 1,140 8,468 1,105 20222001706 Kentucky Avenue
South Jordan, UT 4,646 42,705 5,078 4,646 47,783 9,826 2020201511289 Oakmond Road
Southbourne, UK   53,212 5,709 47,503 16,249 2013200842 Belle Vue Road
Southlake, TX 6,207 56,805 9,829 6,207 66,634 16,348 20192008101 Watermere Drive
Spokane, WA 3,200 25,064 5,966 3,200 31,030 11,525 201320013117 E Chaser Lane
Spokane, WA 2,580 25,342 5,204 2,580 30,546 10,612 201319991110 E Westview Court
Spokane, WA 1,334 11,997 357 1,334 12,354 1,906 202119851616 E 30th Avenue
Springdale, AR 2,950 28,237 475 2,965 28,697 4,904 202119965000 Arkanshire Circle
Springfield, IL 1,166 18,767 842 1,172 19,603 2,595 202119902601 Montvale Drive
Springfield, MO 1667179721,007 1691189552405202119872900 S Jefferson
St Bruno, QC 9,260 62,817 5,808 9,260 68,625 1,208 202320221470 Rue Roberval
St Charles, MO 3,451 41,346 3,570 3,451 44,916 632 202320183330 Ehlmann Road
St. Albert, AB6,057 1,145 17,863 1,965 1,234 19,739 7,359 2014200578c McKenney Avenue
St. Johns, MI 794 5,682 293 794 5,975 653 202220081507 Glastonbury Drive
St. Petersburg, FL 9,218 39,883 3,292 9,540 42,853 13,400 202119731255 Pasadena Avenue S
Stephenville, TX 1,072 3,464 1,447 1,072 4,911 906 202119902305 Lingleville Highway
Stittsville, ON 1,175 17,397 1,839 1,300 19,111 6,212 201319961340 - 1354 Main Street
Stockport, UK   31,929 4,511 27,418 9,936 201320081 Dairyground Road
Stockton, CA 2,280 5,983 5,575 2,372 11,466 4,048 201019886725 Inglewood
Strongsville, OH8,726 1,128 10,940 758 1,132 11,694 2,870 2019201715100 Howe Road
Strongsville, OH 2,577 13,463 825 2,578 14,287 2,462 2021200219205 Pearl Road
Stuart, FL 5,276 24,182 1,284 5,276 25,466 4,819 201920192625 SE Cove Road
Studio City, CA 4,006 25,307 2,541 4,124 27,730 10,008 201320044610 Coldwater Canyon Avenue
Suffield, CT 4,439 31,660 3,665 4,736 35,028 7,296 201919987 Canal Road
Sugar Land, TX 960 31,423 2,192 960 33,615 12,651 201119961221 Seventh Street
Sugar Land, TX 4,272 60,493 7,231 4,272 67,724 16,647 20172015744 Brooks Street
Summerville, SC 2,175 18,017 655 2,175 18,672 2,186 202120174015 2nd Avenue
Summerville, SC 6,862 75991290768627889843620232022267 Grand Cypress Road
Summit, NJ 3,080 14,152 14,665 3084288135,401 2011200141 Springfield Avenue
Sun City West, AZ 1,250 21,778 3,877 1,250 25,655 8,523 2012199813810 W Sandridge Drive
Sunninghill, UK 11,632 42,233 713 11,622 42,956 7,765 20142017Bagshot Road
Sunnyvale, CA 5,420 41,682 4,881 5,420 46,563 16,763 201220021039 E El Camino Real
Sunnyvale, CA 15,005 61,543 4,721 15,005 66,264 610 20202023581 E Fremont Avenue
Surrey, BC4,796 3,605 18,818 2,965 3,807 21,581 8,517 2013200016028 83rd Avenue
Sutton, UK 4,096 14,532 2,188 4,231 16,585 3,261 20152016123 Westmead Road
Sutton Coldfield, UK 2,807 11,313 1,391 2,899 12,612 2,521 20152016134 Jockey Road
Suwanee, GA 1,560 11,538 1,972 1,560 13,510 5,658 201220004315 Johns Creek Parkway
Swartz Creek, MI 925 7,524 454 935 7,968 877 202220174276 Kroger Drive
Sway, UK 4,145 15,508 1,836 4,282 17,207 5,263 20142008Sway Place
Swift Current, SK 492 10,119 1,547 521 11,637 4,114 20132001301 Macoun Drive
Sycamore, IL 1,033 11,401 668 1,048 12,054 1,714 202120031440 Somonauk Street
Sylvania, OH10,686 1,205 11,991 70 1,209 12,057 2,119 201920194120 King Road
Syracuse, NY12,103 1,440 11,675 1,140 1,577 12,678 2,796 201920116715 Buckley Road
Tacoma, WA 4,170 73,377 19,528 4,170 92,905 30,345 201619878201 6th Avenue
Tallmadge, OH14,195 1,096 19,504 1,176 1,096 20,680 1,868 2022201673 East Avenue
Tarboro, NC 1,643 11,124 1,696 1,709 12,754 7,140 20211983200 Trade Street
Taylor, PA11,700 1,942 12,011 77 1,983 12,047 1,875 20192020512 Oak Street
Temple, TX   794 182 612 1 202119008015 W Adams Avenue
Texarkana, TX 1,403 7,512 1,711 1,491 9,135 1,252 202119995415 Cowhorn Creek Road
The Villages, FL 1,268 57,570 8,837 1,268 66,407 840 202320131490 Killingsworth Way
The Woodlands, TX 480 12,379 999 480 13,378 5,096 201119997950 Bay Branch Drive
Tipp City, OH 1,223 15,421 1,482 1,223 16,903 2,214 202220188001 Red Buckeye Drive
Toms River, NJ 1,610 34,627 2,622 1,708 37,151 12,720 201020051587 Old Freehold Road
Tonawanda, NY13,656 1,554 13,332 1,473 1,649 14,710 3,320 20192011300 Fries Road
Tonawanda, NY14,230 2,460 12,564 1,618 2,489 14,153 3,361 20192009285 Crestmount Avenue
Topeka, KS 26012712363 260130754042201220111931 SW Arvonia Place
Toronto, ON4,058 1,079 5,364 1,114 1,097 6,460 2,233 2013198225 Centennial Park Road
Toronto, ON 3,400 32,757 3,946 3,697 36,406 12,561 201319731055 and 1057 Don Mills Road
Toronto, ON 5,304 53,488 5,742 5,596 58,938 22,846 201319888 the Donway E
Toronto, ON 2,008 19,620 7,445 2,054 27,019 5,874 201519994251 Dundas Street W
Toronto, ON31,242 5,132 41,657 6,261 5,417 47,633 16,375 2015196410 William Morgan Drive
Toronto, ON7,018 2,480 7,571 4,119 2,906 11,264 3,022 20151971123 Spadina Road
Torrance, CA 3,497 73,138 608 3,519 73,724 13,933 2016201625535 Hawthorne Boulevard
Traverse City, MI 1,042 26,327 2,488 1,074 28,783 4,005 202120013950 Sumac Drive
Troy, NY 1,787 14,123 639 1,777 14,772 1,808 2021199759 Harris Road
Tuckahoe, NY 9,298 30,934 1,796 9,350 32,678 4,832 202119991 Rivervue Place
Tucson, AZ 830 6,179 8,196 830 14,375 4,704 201219975660 N Kolb Road
Tucson, AZ 6,978 78,932 5,026 7,049 83,887 17,316 202119872001 W Rudasill Road
Tulsa, OK 1,330 21,285 3,104 1,448 24,271 11,765 201019868887 S Lewis Avenue
Tulsa, OK 1,614 20,504  1,614 20,504 11,121 201019849524 E 71st Street
Tulsa, OK 1,320 10,087 252 1,320 10,339 3,375 201120127902 S Mingo Road E
Tulsa, OK12,301 1,752 28,421 243 1,752 28,664 5,328 20172014701 W 71st Street S
Tulsa, OK 3,161 14,219 289 3,220 14,449 2,522 202120057401 Riverside Drive
Tulsa, OK 3,053 15,596 2,933 3,053 18,529 911 2023201710802 E 81st Street
Turlock, CA 2,266 13,002 1,862 2,266 14,864 3,468 201920013791 Crowell Road
Tuscola, IL 477 5,582 427 506 5,980 863 202120041106 E Northline Road
Twinsburg, OH8,366 1,042 8,396 616 1,071 8,983 2,305 201920163092 Kendal Lane
Tyler, TX 650 5,268 1,288 650 6,556 2,556 200620075550 Old Jacksonville Highway
Tyler, TX 1,306 10,515 954 1,386 11,389 1,657 20211998506 Rice Road
Upland, CA 3,160 42,596 649 3,160 43,245 11,006 201520142419 N Euclid Avenue
Upper Providence, PA 1,900 28,195 999 1,909 29,185 6,667 201320151133 Black Rock Road
Upper St Claire, PA 1,102 13,455 2,252 1,232 15,577 5,932 20132005500 Village Drive
Urbandale, IA 1,758 5,514 1,098 1,758 6,612 1,529 202120128525 Urbandale Avenue
Utica, NY 2,596 36,067 2,392 2,596 38,459 4,330 202220181 Patriot Circle
Vacaville, CA 900 17,100 6,722 900 23,822 10,803 20051987799 Yellowstone Drive
Vallejo, CA 4,000 18,000 7,347 4,030 25,317 11,630 20051989350 Locust Drive
Vallejo, CA 2,330 15,407 2,650 2,330 18,057 7,091 201019902261 Tuolumne
Vancouver, WA 1,820 19,042 2,239 1,821 21,280 8,189 2010200610011 NE 118th Avenue
Vancouver, WA 1,406 14,328 1,239 1,406 15,567 2,705 20202001201 NW 78th Street
Vancouver, WA 4,783 97,858 12,825 4,783 110,683 12,042 202220015500 NE 82nd Avenue
Vancouver, WA 5,188 101,400 11,839 5,188 113,239 12,034 20222008415 SE 177th Avenue
Vancouver, WA 1,477 22,773 862 1,477 23,635 1,882 202220155300 NE 82nd Avenue
Vancouver, BC 7,282 6,572 2,880 7,552 9,182 6,134 201519742803 W 41st Avenue
Vandalia, IL 800 5,334 353 832 5,655 1,037 202120031607 W Fillmore Street
Vankleek Hill, ON 389 2,960 648 412 3,585 1,438 2013198748 Wall Street
Vaudreuil, QC6,794 1,852 14,214 2,578 1,932 16,712 5,034 20151975333 Rue Querbes
Venice, FL 13,646 102,226 359 13,692 102,539 12,857 2021201919600 Floridian Club Drive
Venice, FL 1,150 10,674 661 1,150 11,335 4,228 200820091600 Center Road
Vernon, BC 3,911 43,983 4,590 4,020 48,464 5,540 202220181800 58th Avenue
Vero Beach, FL 2,930 40,070 27,617 2,930 67,687 33,300 200720037955 16th Manor
Victoria, BC5,272 2,856 18,038 2,046 3,025 19,915 7,421 201319743000 Shelbourne Street
Victoria, BC 3,681 15,774 1,939 3,886 17,508 6,749 201319883051 Shelbourne Street
Victoria, BC 2,476 15,379 2,343 2,626 17,572 4,602 201519903965 Shelbourne Street
Virginia Water, UK 7,106 29,937 6,808 5,579 38,272 17,618 20122002Christ Church Road
Visalia, CA 868 16,855 2,967 911 19,779 2,814 202119874119 W Walnut Avenue
Voorhees, NJ 3,700 24,312 3,499 3,873 27,638 8,505 20122013311 Route 73
Waco, TX 1,383 11,020 679 1,416 11,666 1,560 202119973209 Village Green Driver
Wall, NJ 1,650 25,350 4,443 1,731 29,712 9,709 201120032021 Highway 35
Walla Walla, WA 1,414 2,399 135 1,415 2,533 592 202119871400 Dalles Military Road
Walnut Creek, CA 3,700 12,467 3,796 3,826 16,137 6,969 201319982175 Ygnacio Valley Road
Walnut Creek, CA 10,320 100,890 23,303 10,469 124,044 34,763 201619881580 Geary Road
Walnut Creek, CA 7,167 107,732 12,962 7,224 120,637 10,986 202219911700 Tice Valley Boulevard
Walnut Creek, CA 4,243   4,243   202219001700 Tice Valley Boulevard
Wandsworth, UK   72,363 23,166 49,197 5,475 2017202094 N Side Wandsworth Common
Warner Robins, GA 4,277 57,330 956 4,277 58,286 307 2023202391 Bass Road
Warsaw, NY 2,148 8,452 832 2,148 9,284 1,367 202220195378 Conable Way
Washington, DC 4,021 68,700  4,021 68,700 19,672 201320045111 Connecticut Avenue NW
Washington Court House, OH 228 2,408 412 230 2,818 337 20211995500 Glenn Avenue
Watchung, NJ 1,920 24,880 5,227 2,210 29,817 9,335 20112000680 Mountain Boulevard
Waterford, MI 988 13,206 1,788 1,022 14,960 2,026 20211999900 N Cass Lake Road
Waterville, OH 2,574 44,647 1,372 2,609 45,984 5,602 202020181470 Pray Boulevard
Waukee, IA 1,870 31,878 2,009 1,903 33,854 9,873 201220071650 SE Holiday Crest Circle
Waxahachie, TX 650 5,763 906 650 6,669 2,633 200720081329 Brown Street
Wayland, MA 1,207 27,462 2,485 1,364 29,790 10,880 20131997285 Commonwealth Road
Weatherford, TX 660 5,261 919 660 6,180 2,494 200620071818 Martin Drive
Webster Groves, MO 1,790 15,425 3,143 1,846 18,512 7,141 2011201245 E Lockwood Avenue
Wellesley, MA 4,690 77,462 1,711 4,690 79,173 21,688 2015201223 & 27 Washington Street
Wentzville, MO 2,489 34,358 2,184 2,489 36,542 483 20232019110 Perry Cate Boulevard
West Babylon, NY 3,960 47,085 3,157 4,062 50,140 16,458 20132003580 Montauk Highway
West Bloomfield, MI 1,040 12,300 991 1,103 13,228 4,668 201320007005 Pontiac Trail
West Chester Township, OH 2,319 47,857 1,562 2,319 49,419 6,100 202020197129 Gilmore Road
West Hills, CA 2,600 7,521 2,130 2,658 9,593 4,346 201320029012 Topanga Canyon Road
West Kelowna, BC 3,739 32,443 3,386 3,833 35,735 3,881 202220052505 Ingram Road
West Seneca, NY8,589 1,432 6,684 1,298 1,835 7,579 1,944 201920001187 Orchard Park Drive
West Seneca, NY8,812 1,323 7,547 761 1,434 8,197 1,860 201920072341 Union Road
West Vancouver, BC14,830 7,059 28,155 8,294 7,444 36,064 11,833 201319872095 Marine Drive
Westbourne, UK 5,441 41,420 8,127 5,610 49,378 17,974 2013200616-18 Poole Road
Westerville, OH 1,257 9,550 416 1,257 9,966 952 20222013865 Maxtown Road
Westerville, OH20,207 1,908 29,363 106 1,908 29,469 915 20232012730 N Spring Road
Westfield, MA 3,406 29,114 2,222 3,406 31,336 442 20232013551 North Road
Westford, MA 1,440 32,607 974 1,468 33,553 8,650 20152013108 Littleton Road
Westworth Village, TX 2,060 31,296 164 2,060 31,460 7,493 2014201425 Leonard Trail
Weymouth, MA 7,688 71,023  7,688 71,023 342 202120231435 Main Street
Weymouth, UK 2,591 16,551 1,826 2,676 18,292 4,912 20142013Cross Road
Wheatfield, NY 1,357 9,601 1,090 1,462 10,586 1,315 202220083979 Forest Park Way
White Marsh, MD   10,251 10,251   202119008110 Perry Hall Boulevard
White Oak, MD 2,304 24,768 3,483 2,463 28,092 9,738 2013200211621 New Hampshire Avenue
Whitesboro, NY11,639 1,630 12,001 1,219 1,840 13,010 2,806 201920154770 Middle Settlement Road
Wichita, KS 1,400 11,000 710 1,400 11,710 7,300 20061997505 N Maize Road
Wichita, KS 630 19,747 1,194 630 20,941 6,173 201220092050 N Webb Road
Wichita, KS 900 10,134 486 900 10,620 3,498 2011201210600 E 13th Street N
Willoughby, OH11,514 1,309 10,540 753 1,332 11,270 2,367 2019201635100 Chardon Road
Wilmington, DE 1,040 23,338 2,864 1,326 25,916 9,161 201320042215 Shipley Street
Wilmington, NC 1,538 28,202 499 1,550 28,689 4,117 202119911402 Hospital Plaza Drive
Wilmington, NC26,019 6,427 35,832 960 6,427 36,792 210 202320177220 Myrtle Grove Road
Wilmington, NC 7,974 93,012 9,051 7,974 102,063 1,341 20232016630 Carolina Bay Drive
Wimbledon, UK   25,531 7,684 17,847 4,121 201520166 Victoria Drive
Winchester, UK 6,009 29,405 2,938 6,206 32,146 11,633 20122010Stockbridge Road
Winnipeg, MB22,557 1,276 21,732 3,208 1,607 24,609 8,011 201319883161 Grant Avenue
Winnipeg, MB10,314 1,317 15,609 3,465 1,401 18,990 5,546 20151999125 Portsmouth Boulevard
Woking, UK   16,268 2,988 13,280 2,373 2016201712 Streets Heath, W End
Wolverhampton, UK   13,466 3,033 10,433 4,332 2013200873 Wergs Road
Woodland Hills, CA 3,400 20,478 1,774 3,456 22,196 8,138 2013200520461 Ventura Boulevard
Wooster, OH13,582 1,560 22,555 2,093 1,560 24,648 2,758 20222014939 Portage Road
Wyoming, MI 3,373 25,319 2,591 3,380 27,903 4,322 202119992380 Aurora Pond Drive SW
Yakima, WA 1,104 10,707 618 1,195 11,234 1,589 20211988620 N 34th Avenue
Yonkers, NY 3,962 50,107 3,572 4,074 53,567 17,995 2013200565 Crisfield Street
Yorkton, SK2,388 463 8,760 1,047 487 9,783 3,208 2013200194 Russell Drive
Zionsville, IN 1,610 22,400 2,153 1,610 24,553 8,261 2010200911755 N Michigan Road
Zionsville, IN 2,162 33,238 252 2,162 33,490 2,880 202120186800 Central Boulevard
Seniors Housing Operating Total$1,760,778 $2,296,482 $20,037,488 $4,923,531 $2,620,060 $24,637,441 $5,754,186 

127


Welltower Inc. 
Schedule III 
Real Estate and Accumulated Depreciation 
December 31, 2023 
(Dollars in thousands) Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Triple-net:        
Abilene, TX$ $950 $20,987 $11,833 $950 $32,820 $6,884 201419986565 Central Park Boulevard
Abilene, TX 990 8,187 1,232 990 9,419 2,318 201419851250 E N 10th Street
Agawam, MA 880 13,942  880 13,942 9,534 200219931200 Suffield Street
Akron, OH 633 3,002  633 3,002 460 20181999171 N Cleveland Massillon Road
Akron, OH   6,206 991 5,215 40 202120163522 Commercial Drive
Alexandria, VA 2,452 6,826  2,452 6,826 1,011 201819641510 Collingwood Road
Alhambra, CA 600 6,305 8,971 600 15,276 4,031 201119231118 N Stoneman Avenue
Allen Park, MI 1,767 5,025  1,767 5,025 753 201819609150 Allen Road
Allentown, PA 494 11,845  494 11,845 1,731 201819955151 Hamilton Boulevard
Allentown, PA 1,491 4,822  1,491 4,822 740 201819881265 Cedar Crest Boulevard
Alma, MI 1,267 6,543  1,267 6,543 888 202020091320 Pine Avenue
Amarillo, TX 1,273 11,705  1,273 11,705 1,488 202220151610 Research Street
Ann Arbor, MI 2,172 11,123  2,172 11,123 1,755 201819974701 E Huron River Drive
Annandale, VA 1,687 18,974  1,687 18,974 2,713 201820027104 Braddock Road
Arlington, VA 4,016 8,801  4,016 8,801 1,284 20181976550 S Carlin Springs Road
Asheboro, NC 290 5,032 454 290 5,486 2,777 20031998514 Vision Drive
Asheville, NC 204 3,489 30 204 3,519 2,260 199919994 Walden Ridge Drive
Asheville, NC 280 1,955 796 280 2,751 1,324 20031992308 Overlook Road
Atchison, KS 140 5,610 24 140 5,634 1,272 201520011301 N 4th Street
Austin, TX 1,691 5,005  1,691 5,005 974 2018200011630 Four Iron Drive
Avon, IN 900 19,444  900 19,444 5,154 2014201310307 E County Road 100 N
Avon, CT 2,132 7,624  2,132 7,624 1,362 20182000100 Fisher Drive
Azusa, CA 570 3,141 7,933 570 11,074 4,918 19981953125 W Sierra Madre Avenue
Bad Axe, MI 1,317 5,972  1,317 5,972 908 20202010150 Meadow Lane
Baldwin City, KS 190 4,810 58 190 4,868 1,129 20152000321 Crimson Avenue
Ballymena, UK 487 8,503  487 8,503 256 2023200028 Broughshane Road
Ballymena, UK 550 5,465  550 5,465 185 2023202328 Broughshane Road
Baltimore, MD 4,306 4,303  4,306 4,303 687 201819786600 Ridge Road
Baltimore, MD 3,069 3,148  3,069 3,148 535 201819964669 Falls Road
Banbridge, UK 1,053 7,110  1,053 7,110 271 2023201323 Bannview Road
Barberton, OH 1,307 9,310  1,307 9,310 1,350 2018197985 Third Street
Bartlesville, OK 100 1,380  100 1,380 989 199619955420 SE Adams Boulevard
Bay City, MI 633 2,619  633 2,619 434 20181968800 Mulholland Street
Bedford, PA 637 4,432  637 4,432 761 20181965136 Donahoe Manor Road
Belfast, UK 1,066 6,401  1,066 6,401 254 20232015420 Crumlin Road
Belfast, UK 145 6,561  145 6,561 177 20232020420 Crumlin Road
Belfast, UK 816 4,957  816 4,957 196 20232010250 Ballygomartin Road
Belfast, UK 777 20,072  777 20,072 571 20232021375 N Queen Street
Belmont, CA 3,000 23,526 2,138 3,000 25,664 10,098 201119711301 Ralston Avenue
Belvidere, NJ 2,001 26,191 117 2,001 26,308 4,160 201920091 Brookfield Court




(Dollars in thousands) Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Triple-net:        
Benbrook, TX 1,550 13,553 2,825 1,550 16,378 4,936 201119844242 Bryant Irvin Road
Berkeley, CA10,853 3,050 32,677 5,172 3,050 37,849 10,428 201619662235 Sacramento Street
Bethel Park, PA 1,700 16,007 19 1,700 16,026 6,316 200720095785 Baptist Road
Bethel Park, PA 1,008 6,740  1,008 6,740 1,047 2018198660 Highland Road
Bethesda, MD 2,218 6,869  2,218 6,869 983 201819746530 Democracy Boulevard
Bethlehem, PA 1,191 16,887  1,191 16,887 2,350 201819792021 Westgate Drive
Bethlehem, PA 1,143 13,588  1,143 13,588 1,902 201819822029 Westgate Drive
Beverly Hills, CA 6,000 13,385 203 6,000 13,588 3,151 20142000220 N Clark Drive
Bexleyheath, UK 3,750 10,807 480 3,874 11,163 2,691 2014199635 West Street
Bingham Farms, MI 781 15,671  781 15,671 2,261 2018199924005 W 13 Mile Road
Birmingham, UK   21,364 1,644 19,720 4,402 20152010Braymoor Road, Tile Cross
Birmingham, UK   11,640 1,223 10,417 2,343 20151997122 Tile Cross Road, Garretts Green
Birmingham, UK   17,043 1,701 15,342 3,475 20152010Clinton Street, Winson Green
Birmingham, UK   10,864 1,510 9,354 2,151 20152010Clinton Street, Winson Green
Blaine, MN   11,764 1,780 9,984 59 2021201611748 Ulysses Lane NE
Bloomington, IN 670 17,423  670 17,423 4,130 20152015363 S Fieldstone Boulevard
Boca Raton, FL 2,200 4,974  2,200 4,974 935 201819947225 Boca Del Mar Drive
Boca Raton, FL 2,826 4,061  2,826 4,061 683 20181984375 NW 51st Street
Boulder, CO 3,601 21,364  3,601 21,364 3,298 201819902800 Palo Parkway
Bournemouth, UK 2,488 17,248  2,488 17,248 2,259 20192017Poole Lane
Boynton Beach, FL 2,138 10,201  2,138 10,201 1,611 201819913600 Old Boynton Road
Boynton Beach, FL 2,804 14,222  2,804 14,222 2,051 201819843001 S Congress Avenue
Bracknell, UK 4,078 11,065  4,078 11,065 1,859 20142017Crowthorne Road N
Bradenton, FL 252 3,298  252 3,298 2,375 199619956101 Pointe W Boulevard
Bradenton, FL 2,562 19,717  2,562 19,717 126 202320006305 Cortez Road W
Bradenton, FL 1,551 13,517  1,551 13,517 86 20231996105 15th Street E
Bradenton, FL 507 4,424  507 4,424 28 20231996105 15th Street E
Braintree, UK  13,296 438  13,734 3,380 20142009Meadow Park Tortoiseshell Way
Brandon, FL 2,378 17,414  2,378 17,414 112 202319971465 Oakfield Drive
Brandon, FL 2,186 16,256  2,186 16,256 103 20231991702 S Kings Avenue
Brecksville, OH 990 19,353 614 990 19,967 5,021 201420118757 Brecksville Road
Brick, NJ 1,290 25,247 1,464 1,290 26,711 8,944 20112000458 Jack Martin Boulevard
Bridgewater, NJ 1,800 31,810 1,849 1,800 33,659 11,260 20112001680 US-202/206 N
Bristol, UK   21,337 4,087 17,250 4,169 20152017339 Badminton Road
Bristol, UK   14,694 2,180 12,514 1,862 20172019Avon Valley Care Home, Tenniscourt Road
Brooks, AB 376 4,951 267 394 5,200 1,299 20142000951 Cassils Road W
Brooksville, FL 2,281 18,506  2,281 18,506 116 2023199712170 Cortez Boulevard
Brooksville, FL 1,943 14,550  1,943 14,550 92 202319821445 Howell Avenue
Bucyrus, OH 1,119 2,611  1,119 2,611 463 201819761170 W Mansfield Street
Burleson, TX 670 13,985 2,843 670 16,828 5,301 20111988300 Huguley Boulevard
Burlington, NC 280 4,297 849 280 5,146 2,646 200320003619 S Mebane Street
Burlington, NC 460 5,467 110 460 5,577 2,926 200319973615 S Mebane Street
Burnaby, BC 7,623 13,844 1,047 7,991 14,523 3,661 201420067195 Canada Way
Calgary, AB 2,341 42,768 2,245 2,454 44,900 10,891 201419711729-90th Avenue SW
Calgary, AB 4,569 70,199 3,617 4,789 73,596 17,735 20142001500 Midpark Way SE
Callaway, FL 1,464 10,637  1,464 10,637 68 20231981626 N Tyndall Parkway
Camp Hill, PA 517 3,596  517 3,596 537 201819701700 Market Street
Canonsburg, PA 911 4,828  911 4,828 786 20181986113 W McMurray Road
Canton, OH 300 2,098 181 300 2,279 1,363 199819981119 Perry Drive NW
Canton, MI 1,399 16,966  1,399 16,966 2,441 201820057025 Lilley Road
Cape Coral, FL 530 3,281 35 530 3,316 1,863 20022000911 Santa Barbara Boulevard
Cape Coral, FL 1,802 14,467  1,802 14,467 92 20231987216 Santa Barbara Boulevard
Carlisle, PA 978 8,204  978 8,204 1,256 20181987940 Walnut Bottom Road
Carmel, IN 1,700 19,491 1 1,700 19,492 4,723 2015201512315 Pennsylvania Street
Carmel, IN 2,222 31,004 749 2,222 31,753 2,596 2021201813390 N Illinois Street
Carrollton, TX 2,010 19,549 224 2,010 19,773 3,854 201420162645 E Trinity Mills Road
Cary, NC 1,500 4,350 1,980 1,500 6,330 3,413 19981996111 Macarthur
Castleton, IN 920 15,137  920 15,137 4,181 201420138405 Clearvista Lake
Cedar Rapids, IA 596 9,354 16 614 9,352 1,321 201819651940 1st Avenue NE
Centerville, OH 920 3,958  920 3,958 866 201819971001 E Alex Bell Road
Chagrin Falls, OH 832 10,837  832 10,837 1,633 201819998100 E Washington Street
Chambersburg, PA 1,373 8,862  1,373 8,862 1,404 201819761070 Stouffer Avenue
Chapel Hill, NC 354 2,646 1,617 354 4,263 1,970 20021997100 Lanark Road
Chatham, VA 320 14,039 300 320 14,339 3,735 20142009100 Rorer Street
Chattanooga, TN 2,085 11,837 1,128 2,085 12,965 3,920 202119991148 Mountain Creek Road
Cherry Hill, NJ 1,416 9,871  1,416 9,871 1,548 201819972700 Chapel Avenue W
Chester, VA 1,320 18,127 532 1,320 18,659 4,776 2014200912001 Iron Bridge Road
Chevy Chase, MD 4,515 8,685  4,515 8,685 1,282 201819648700 Jones Mill Road
Chickasha, OK 85 1,395  85 1,395 994 19961996801 Country Club Road
Chillicothe, OH 1,145 8,994  1,145 8,994 1,318 201819771058 Columbus Street
Cincinnati, OH 912 14,010  912 14,010 2,086 201820006870 Clough Pike
Citrus Heights, CA 5,207 31,715  5,207 31,715 4,442 201819887807 Upland Way
Claremore, OK 155 1,427 6,130 155 7,557 2,531 199619961605 N Highway 88
Clarksville, TN 330 2,292  330 2,292 1,485 199819982183 Memorial Drive
Clayton, NC 520 15,733 183 520 15,916 3,934 2014201384 Johnson Estate Road
Clearwater, FL 1,149 7,762  1,149 7,762 59 202319901980 Sunset Point Road
Cleburne, TX 1,113 10,484  1,113 10,484 1,343 20222015902 Walter P. Holliday Drive
Clevedon, UK 2,838 16,927 650 2,931 17,484 4,301 2014199418/19 Elton Road
Clifton, NJ 3,881 34,941 66 3,881 35,007 3,173 20212021782 Valley Road
Cloquet, MN 340 4,660 120 340 4,780 1,638 20112006705 Horizon Circle
Cobham, UK 9,808 24,991 1,145 10,131 25,813 7,030 20132013Redhill Road
Colorado Springs, CO 4,280 62,168  4,280 62,168 13,324 201520081605 Elm Creek View
Colorado Springs, CO 1,730 25,493 693 1,730 26,186 5,918 201620162818 Grand Vista Circle
Columbia, TN 341 2,295  341 2,295 1,483 199919995011 Trotwood Avenue
Columbia, SC 1,699 2,319  1,699 2,319 380 201819682601 Forest Drive
Columbia Heights, MN 825 14,175 163 825 14,338 4,626 201120093807 Hart Boulevard
Concord, NC 550 3,921 715 550 4,636 2,273 200319972452 Rock Hill Church Road
Congleton, UK 2,036 5,120 235 2,103 5,288 1,278 20141994Rood Hill
Connor, UK 512 3,714  512 3,714 138 202320002-6 Carncome Road
Connor, UK 331 2,406  331 2,406 89 202320222-6 Carncome Road
Conroe, TX 1,440 6,091  1,440 6,091 791 20222013608 Conroe Medical Drive
Corby, UK 1,228 5,144 392 1,156 5,608 1,018 2017199725 Rockingham Road
Costa Mesa, CA 2,050 19,969 1,093 2,050 21,062 8,329 20111965350 W Bay Street
Coventry, UK   16,311 2,026 14,285 3,335 201520141 Glendale Way
Crawfordsville, IN 720 17,239 1,426 720 18,665 4,991 20142013517 Concord Road
Crestview, FL 2,139 17,281  2,139 17,281 108 20232000500 Hospital Drive
Cypress, TX 2,145 14,446  2,145 14,446 1,813 2022201517935 Longenbaugh Road
Dallastown, PA 1,377 16,797  1,377 16,797 2,504 20181979100 W Queen Street
Danville, VA 410 3,954 1,097 410 5,051 2,536 20031998149 Executive Court
Danville, VA 240 8,436 1,352 240 9,788 2,339 20141996508 Rison Street
Daphne, AL 2,880 8,670 872 2,880 9,542 2,948 2012200127440 County Road 13
Davenport, IA 566 2,017  566 2,017 308 20181966815 E Locust Street
Davenport, IA 910 20,038  910 20,038 2,904 201820083800 Commerce Boulevard
Dayton, OH 1,188 5,412  1,188 5,412 860 201819771974 N Fairfield Road
Dearborn Heights, MI 1,197 3,394  1,197 3,394 594 2018196426001 Ford Road
Decatur, GA 1,413 13,796  1,413 13,796 1,913 201819772722 N Decatur Road
Delray Beach, FL 1,158 13,572  1,158 13,572 2,036 2018199816150 Jog Road
Delray Beach, FL 2,125 11,840  2,125 11,840 1,826 2018199816200 Jog Road
Deltona, FL 2,095 16,042  2,095 16,042 259 202319831851 Elkcam Boulevard
Denver, CO 3,222 24,804  3,222 24,804 3,455 20181988290 S Monaco Parkway
Derby, UK   10,888 2,357 8,531 1,796 20142015Rykneld Road
Dowagiac, MI 825 1,778  825 1,778 406 2020200629601 Amerihost Drive
Droitwich, UK   15,278 3,633 11,645 1,083 20182020Former Spring Meadows Ph, Mulberry Tree Hill
Dublin, OH 1,393 2,911  1,393 2,911 528 201820144075 W Dublin-Granville Road
Dubuque, IA 568 8,902  568 8,902 1,260 20181971901 W Third Street
Dunedin, FL 1,883 13,325  1,883 13,325 1,897 20181983870 Patricia Avenue
Dunedin, FL 1,151 8,978  1,151 8,978 59 202319821061 Virginia Street
Dunedin, FL 445 1,275  445 1,275 13 202319821059 Virginia Street
Dunmurry, UK 1,014 6,086  1,014 6,086 242 20232005299 Kingsway
Durham, NC 1,476 10,659 3,569 1,476 14,228 12,900 199719994434 Ben Franklin Boulevard
Eagan, MN14,910 2,260 31,643 300 2,260 31,943 6,714 201520043810 Alder Avenue
East Brunswick, NJ 1,380 34,229 1,270 1,380 35,499 11,547 20111998606 Cranbury Road
Eastbourne, UK 4,071 24,438 938 4,205 25,242 6,130 20141999Carew Road
Easton, PA 1,109 7,500  1,109 7,500 1,455 201820154100 Freemansburg Avenue
Easton, PA 1,430 13,396  1,430 13,396 2,006 201819812600 Northampton Street
Easton, PA 1,620 10,049  1,620 10,049 1,777 201820004100 Freemansburg Avenue
Eden, NC 390 4,877 351 390 5,228 2,637 20031998314 W Kings Highway
Edmond, OK 1,810 14,849 3,843 1,810 18,692 4,482 201419851225 Lakeshore Drive
Edmond, OK 1,650 25,167 1,722 1,650 26,889 4,993 201420172709 E Danforth Road
Elizabeth City, NC 200 2,760 2,841 200 5,601 2,886 19981999400 Hastings Lane
Elk Grove Village, IL 1,344 7,073  1,344 7,073 1,108 201819951940 Nerge Road Elk
Elk Grove Village, IL 3,733 18,745  3,733 18,745 2,598 201819881920 Nerge Road
Encinitas, CA 1,460 7,721 2,229 1,460 9,950 6,047 20001988335 Saxony Road
Englewood, FL 1,832 14,851  1,832 14,851 93 202319831111 Drury Lane
Escondido, CA 1,520 24,024 1,386 1,520 25,410 9,671 201119871500 Borden Road
Everett, WA 1,400 5,476  1,400 5,476 3,472 199919992015 Lake Heights Drive
Exton, PA 3,600 27,267 342 3,600 27,609 4,826 20172018501 Thomas Jones Way
Fairfax, VA 1,827 17,304  1,827 17,304 2,614 2018199712469 Lee Jackson Memorial Highway
Fairfax, VA 4,099 17,614  4,099 17,614 2,604 2018199012475 Lee Jackson Memorial Highway
Fairhope, AL 570 9,119 236 570 9,355 2,936 2012198750 Spring Run Road
Fall River, MA 620 5,829 4,856 620 10,685 6,724 199619731748 Highland Avenue
Fanwood, NJ 2,850 55,175 2,117 2,850 57,292 18,230 20111982295 South Avenue
Faribault, MN 780 11,539 300 780 11,839 2,495 20152003828 1st Street NE
Farmington, CT 1,693 10,455  1,693 10,455 1,611 2018199745 South Road
Farnborough, UK 2,036 5,737 255 2,103 5,925 1,391 20141980Bruntile Close, Reading Road
Fayetteville, PA 2,150 20,318  2,150 20,318 6,102 201519916375 Chambersburg Road
Fayetteville, NY 410 3,962 500 410 4,462 2,508 200119975125 Highbridge Street
Findlay, OH 200 1,800 515 200 2,315 1,232 19971997725 Fox Run Road
Fishersville, VA 788 2,101 3 788 2,104 1,623 2018199883 Crossroad Lane
Flint, MI 1,271 18,050  1,271 18,050 2,534 201819693011 N Center Road
Florence, NJ 300 2,978 89 300 3,067 1,687 20021999901 Broad Street
Floyd, VA 680 3,618 4 680 3,622 1,332 20181979237 Franklin Pike Road SE
Forest City, NC 320 4,497 366 320 4,863 2,446 20031999493 Piney Ridge Road
Fort Collins, CO 3,680 58,608  3,680 58,608 12,521 201520074750 Pleasant Oak Drive
Fort Lauderdale, FL 1,043 6,429  1,043 6,429 97 202319861615 Miami Road
Fort Myers, FL 2,205 15,100  2,205 15,100 103 202319983735 Evans Avenue
Fort Myers, FL 1,110 10,559  1,110 10,559 1,600 2018199915950 McGregor Boulevard
Fort Myers, FL 2,139 18,235  2,139 18,235 2,703 201819901600 Matthew Drive
Fort Myers, FL 2,502 9,741  2,502 9,741 1,746 2018200013881 Eagle Ridge Drive
Fort Pierce, FL 1,282 20,775  1,282 20,775 291 20231984611 S 13th Street
Fort Worth, TX 450 13,615 5,086 450 18,701 7,099 20102011425 Alabama Avenue
Fort Worth, TX 1,565 15,864  1,565 15,864 1,980 202220153141 Dalhart Drive
Fountain Valley, CA 5,259 9,375  5,259 9,375 1,382 2018198811680 Warner Avenue
Fredericksburg, VA 1,000 20,000 2,220 1,000 22,220 10,081 200519993500 Meekins Drive
Fredericksburg, VA 1,130 23,202 716 1,130 23,918 6,051 20142010140 Brimley Drive
Gahanna, OH 2,432 34,645 530 2,432 35,175 2,638 202120175435 Morse Road
Gainesville, FL 972 8,809 125 972 8,934 1,066 202120001415 Fort Clarke Boulevard
Gainesville, FL 2,109 12,443  2,109 12,443 202 202319846700 NW 10th Place
Galesburg, IL 1,708 3,839  1,708 3,839 576 20181964280 E Losey Street
Gardner, KS 200 2,800 98 200 2,898 703 20152000869 Juniper Terrace
Gastonia, NC 470 6,129 284 470 6,413 3,268 200319981680 S New Hope Road
Gastonia, NC 310 3,096 113 310 3,209 1,718 200319941717 Union Road
Gastonia, NC 400 5,029 807 400 5,836 2,800 200319961750 Robinwood Road
Geneva, IL 1,502 16,193  1,502 16,193 2,391 201820002388 Bricher Road
Georgetown, TX 200 2,100 110 200 2,210 1,429 199719972600 University Drive E
Gig Harbor, WA 3,000 4,463 689 3,000 5,152 812 201819903309 45th Street Court NW
Glen Ellyn, IL 1,496 6,634  1,496 6,634 1,090 201820012s706 Park Boulevard
Granbury, TX 2,550 2,940 883 2,550 3,823 1,443 20121996916 E Highway 377
Green Cove Springs, FL 1,275 17,602  1,275 17,602 295 20231982803 Oak Street
Greensboro, NC 330 2,970 662 330 3,632 1,921 200319965809 Old Oak Ridge Road
Greensboro, NC 560 5,507 2,405 560 7,912 3,628 200319974400 Lawndale Drive
Greenville, MI 1,490 4,341  1,490 4,341 777 202020161515 Meijer Drive
Greenville, SC 310 4,750 521 310 5,271 2,534 2004199723 Southpointe Drive
Greenville, SC 1,751 8,771  1,751 8,771 1,330 20181966600 Sulphur Springs Road
Greenville, SC 947 1,445  947 1,445 367 20181976601 Sulphur Springs Road
Greenville, NC 290 4,393 353 290 4,746 2,434 200319982715 Dickinson Avenue
Grosse Pointe, MI 867 2,385  867 2,385 379 2018196421401 Mack Avenue
Hamilton, NJ 440 4,469 209 440 4,678 2,530 200119981645 Whitehorse-Mercerville Road
Hanford, UK 1,382 9,829 368 1,427 10,152 2,793 20132012Bankhouse Road
Harrisburg, PA 569 12,822  569 12,822 1,884 201820002625 Ailanthus Lane
Harrow, UK 7,402 8,266 516 7,646 8,538 2,143 20142001177 Preston Hill
Hastings, MI 1,603 6,519  1,603 6,519 974 202020021110 N East Street
Hatboro, PA  28,112 1,771  29,883 10,036 201119963485 Davisville Road
Hatboro, PA 1,192 7,608  1,192 7,608 1,525 20182000779 W County Line Road
Hatfield, UK 2,924 7,527 344 3,020 7,775 2,155 20132012St Albans Road E
Haverhill, MA 5,519 19,554 64 5,519 19,618 1,469 2021201810 Residences Way
Hemet, CA 6,224 8,410  6,224 8,410 1,284 201819891717 W Stetson Avenue
Hermitage, TN 1,500 9,943 540 1,500 10,483 3,286 201120064131 Andrew Jackson Parkway
Herne Bay, UK 1,900 24,353 1,577 1,962 25,868 7,534 20132011165 Reculver Road
Hiawatha, KS 40 4,210 31 40 4,241 994 20151996400 Kansas Avenue
Hickory, NC 290 987 392 290 1,379 777 200319942530 16th Street NE
High Point, NC 560 4,443 1,605 560 6,048 2,862 200320001568 Skeet Club Road
High Point, NC 370 2,185 1,187 370 3,372 1,484 200319991564 Skeet Club Road
High Point, NC 330 3,395 142 330 3,537 1,858 20031994201 Hartley Drive
High Point, NC 430 4,143 1,085 430 5,228 2,304 200319981560 Skeet Club Road
Highlands Ranch, CO 940 3,721 4,983 940 8,704 3,366 200219999160 S University Boulevard
Hillsboro, OH 1,792 6,339  1,792 6,339 1,314 201819831141 Northview Drive
Hinckley, UK 2,159 4,194 209 2,230 4,332 1,316 20132013Tudor Road
Hinsdale, IL 4,033 24,280  4,033 24,280 3,388 20181971600 W Ogden Avenue
Holton, KS 40 7,460 13 40 7,473 1,631 20151996410 Juniper Drive
Homewood, IL 2,395 7,649  2,395 7,649 1,092 20181989940 Maple Avenue
Howard, WI 579 32,122 5,943 684 37,960 6,899 201720162790 Elm Tree Hill
Huntingdon Valley, PA 1,150 3,728  1,150 3,728 793 201819933430 Huntingdon Pike
Huntsville, AL 1,382 14,286 90 1,382 14,376 1,519 202120014801 Whitesport Cir SW
Independence, VA 1,082 6,767 7 1,082 6,774 2,405 20181998400 S Independence Avenue
Indianapolis, IN 870 14,688  870 14,688 4,074 201420141635 N Arlington Avenue
Jackson, NJ 6,500 26,405 9,123 6,500 35,528 8,366 201220012 Kathleen Drive
Jacksonville, FL 2,932 14,269 129 2,932 14,398 1,622 202119993455 San Pablo Road S
Jacksonville, FL 1,815 15,096  1,815 15,096 240 202319859355 San Jose Boulevard
Jacksonville, FL 2,359 13,338  2,359 13,338 230 202319664101 Southpoint Drive E
Jefferson Hills, PA 2,265 13,614  2,265 13,614 2,923 20181997380 Wray Large Road
Jersey Shore, PA 600 8,104  600 8,104 1,115 201819731008 Thompson Street
Kansas City, KS 700 20,115  700 20,115 4,599 201520158900 Parallel Parkway
Katy, TX 1,778 22,622 31 1,778 22,653 4,357 2017201524802 Kingsland Boulevard
Kensington, MD 1,753 18,621  1,753 18,621 2,649 201820024301 Knowles Avenue
Kenwood, OH 821 11,040  821 11,040 1,623 201820004580 E Galbraith Road
Kettering, OH 1,229 4,701  1,229 4,701 786 201819773313 Wilmington Pike
King of Prussia, PA 720 14,776  720 14,776 2,252 20181995620 W Valley Forge Road
King of Prussia, PA 1,205 4,725  1,205 4,725 851 20181990600 W Valley Forge Road
Kingsford, MI 1,362 10,594  1,362 10,594 1,622 201819681225 Woodward Avenue
Kirkstall, UK 2,437 9,414 390 2,517 9,724 2,683 2013200929 Broad Lane
Kissimmee, FL 1,051 16,254  1,051 16,254 227 202320061120 W Donegan Avenue
Kissimmee, FL 540 4,474  540 4,474 73 202320061092 W Donegan Avenue
Knoxville, TN 2,207 12,849 1,270 2,207 14,119 4,291 202120018501 S Northshore Drive
Kokomo, IN 710 16,044  710 16,044 4,414 201420142200 S Dixon Road
Lacey, WA 2,582 18,175  2,582 18,175 2,623 201820124524 Intelco Loop SE
Lafayette, CO 1,420 20,192  1,420 20,192 4,860 20152015329 Exempla Circle
Lafayette, IN 670 16,834  670 16,834 4,366 201520142402 South Street
Lake Mary, FL 2,041 15,428  2,041 15,428 95 20232000710 N Sun Drive
Lakeland, FL 1,524 14,810  1,524 14,810 252 202319991010 Carpenters Way
Lakeway, TX 5,142 23,203  5,142 23,203 6,891 200720112000 Medical Drive
Lakewood, CO 2,160 28,091 62 2,160 28,153 7,254 201420107395 W Eastman Place
Lancaster, OH 289 2,077 3,490 289 5,567 326 20211996800 Becks Knob Road
Lancaster, PA 1,011 7,502  1,011 7,502 1,121 20181966100 Abbeyville Road
Lapeer, MI 1,827 8,794  1,827 8,794 1,234 20202004101 Devonshire Drive
Largo, FL 1,166 3,426  1,166 3,426 662 20181997300 Highland Avenue NE
Largo, FL 3,443 19,073  3,443 19,073 336 202319999035 Bryan Dairy Road
Laureldale, PA 1,171 14,420  1,171 14,420 2,080 201819802125 Elizabeth Avenue
Lebanon, PA 728 10,367  728 10,367 1,637 20181998100 Tuck Court
Lebanon, PA 1,214 5,960  1,214 5,960 1,055 20181980900 Tuck Street
Lecanto, FL 1,817 14,773  1,817 14,773 92 202319842333 N Brentwood Circle
Lee, MA 290 18,135 926 290 19,061 10,688 20021998600 & 620 Laurel Street
Leeds, UK   15,714 2,039 13,675 3,082 20152013100 Grove Lane
Leicester, UK   28,373 3,160 25,213 7,245 20122010307 London Road
Lenoir, NC 190 3,748 950 190 4,698 2,376 200319981145 Powell Road NE
Lethbridge, AB 1,214 2,750 202 1,273 2,893 878 20142003785 Columbia Boulevard W
Lexana, KS 480 1,770 162 480 1,932 512 201519948710 Caenen Lake Road
Lexington, NC 200 3,900 1,153 200 5,053 2,718 20021997161 Young Drive
Libertyville, IL 2,993 11,546  2,993 11,546 1,634 201819881500 S Milwaukee
Lichfield, UK 1,382 30,324 1,043 1,427 31,322 7,040 20152012Wissage Road
Lillington, NC 470 17,579 774 470 18,353 4,719 2014201354 Red Mulberry Way
Lillington, NC 500 16,451 331 500 16,782 4,109 201419992041 NC-210 N
Livermore, CA 4,100 24,996 79 4,100 25,075 5,824 2014197435 Fenton Street
Livonia, MI 985 13,555  985 13,555 2,064 2018199932500 Seven Mile Road
Longwood, FL 1,260 6,445  1,260 6,445 2,305 20112011425 S Ronald Reagan Boulevard
Los Angeles, CA  11,430 1,285  12,715 5,055 20081971330 N Hayworth Avenue
Louisburg, KS 280 4,320 47 280 4,367 967 20151996202 Rogers Street
Louisville, KY 490 10,010 2,768 490 12,778 6,268 200519784604 Lowe Road
Loxley, UK 1,369 15,668 1,313 1,414 16,936 4,607 20132008Loxley Road
Lutherville, MD 1,100 19,786 1,744 1,100 21,530 7,404 20111988515 Brightfield Road
Lynchburg, VA 340 16,114 463 340 16,577 4,355 20142013189 Monica Boulevard
Lynchburg, VA 2,904 3,696  2,904 3,696 546 201819782200 Landover Place
Lynnwood, WA 2,302 5,632  2,302 5,632 843 201819873701 188th Street
Manalapan, NJ 900 22,624 1,273 900 23,897 7,712 20112001445 Route 9 S
Manassas, VA 750 7,446 1,384 750 8,830 4,107 200319968341 Barrett Drive
Mankato, MN 1,460 32,104 300 1,460 32,404 6,788 20152006100 Dublin Road
Marietta, OH 1,149 9,373  1,149 9,373 1,372 201819775001 State Route 60
Marietta, GA 2,406 12,229  2,406 12,229 1,751 201819804360 Johnson Ferry Place
Marietta, PA 1,050 13,633 801 1,050 14,434 3,021 201519992760 Maytown Road
Marion, IN 720 9,604  720 9,604 3,320 20142012614 W 14th Street
Marion, IN 990 7,600  990 7,600 4,157 20141976505 N Bradner Avenue
Marion, OH 2,768 17,415  2,768 17,415 3,245 20182004400 Barks Road W
Marlborough, UK 2,677 6,822 313 2,765 7,047 1,727 20141999The Common
Martinsville, VA 349   349   20031900Rolling Hills Road & US Highway 58
Marysville, OH 408 858 2,833 408 3,691 254 20211990715 S Walnut Street
Matthews, NC 560 4,738 797 560 5,535 2,642 200319982404 Plantation Center Drive
Mchenry, IL 1,576   1,576   200619005200 Block of Bull Valley Road
Mcmurray, PA 1,440 15,805 3,915 1,440 19,720 6,386 20102011240 Cedar Hill Drive
Medicine Hat, AB 932 5,566 323 977 5,844 1,489 2014199965 Valleyview Drive SW
Mentor, OH 1,827 9,938  1,827 9,938 1,474 201819858200 Mentor Hills Drive
Mequon, WI 2,238 17,761 600 2,238 18,361 1,435 202120156751 W Mequon Road
Merritt Island, FL 1,498 14,335  1,498 14,335 226 20231972125 Alma Boulevard
Miamisburg, OH 786 3,232  786 3,232 676 20181983450 Oak Ridge Boulevard
Miamisburg, OH   7,040 1,215 5,825 43 202120162961 W Spring Valley Pike
Middleton, WI 420 4,006 669 420 4,675 2,481 200119916701 Stonefield Road
Midlothian, VA 2,015 8,602  2,015 8,602 983 2021201513800 Bon Secours Drive
Milton Keynes, UK   21,153 1,886 19,267 4,460 20152007Tunbridge Grove, Kents Hill
Minnetonka, MN 2,080 24,360 4,154 2,080 28,514 9,483 20121999500 Carlson Parkway
Mishawaka, IN 740 12,514  740 12,514 3,868 2014201360257 Bodnar Boulevard
Moline, IL 2,946 18,672  2,946 18,672 2,587 20181964833 Sixteenth Avenue
Monroe, NC 470 3,681 1,010 470 4,691 2,364 20032001918 Fitzgerald Street
Monroe, NC 310 4,799 1,122 310 5,921 2,994 20032000919 Fitzgerald Street
Monroe, NC 450 4,021 444 450 4,465 2,264 200319971316 Patterson Avenue
Monroe Township, NJ 3,250 27,771 1,197 3,250 28,968 6,205 20151996319 Forsgate Drive
Monroeville, PA 1,216 12,749  1,216 12,749 2,246 20181997120 Wyngate Drive
Monroeville, PA 1,237 3,641  1,237 3,641 855 20181996885 Macbeth Drive
Montgomeryville, PA 1,176 9,824  1,176 9,824 1,531 20181989640 Bethlehem Pike
Montville, NJ 3,500 31,002 2,762 3,500 33,764 11,033 20111988165 Changebridge Road
Moorestown, NJ 4,143 23,902  4,143 23,902 6,786 20122014250 Marter Avenue
Morehead City, NC 200 3,104 2,039 200 5,143 2,846 19991999107 Bryan Street
Moulton, UK 1,695 12,510 984 1,596 13,593 2,340 20171995Northampton Lane N
Mountainside, NJ 3,097 7,807  3,097 7,807 1,172 201819881180 Route 22
Mt. Pleasant, MI 1,863 6,467  1,863 6,467 1,088 202020132378 S Lincoln Road
Naples, FL 1,222 10,639  1,222 10,639 1,672 201819986125 Rattlesnake Hammock Road
Naples, FL 1,672 23,119  1,672 23,119 4,048 201819931000 Lely Palms Drive
Naples, FL 1,854 12,398  1,854 12,398 1,755 201819873601 Lakewood Boulevard
Nashville, TN 4,910 29,590  4,910 29,590 12,243 2008200715 Burton Hills Boulevard
Needham, MA 1,610 12,667  1,610 12,667 6,910 20021994100 West Street
Needham, MA 3,957 71,163 191 3,957 71,354 4,139 20212013235 Gould Street
New Lenox, IL 1,225 21,575  1,225 21,575 2,986 201920071023 S Cedar Road
New Moston, UK 1,480 4,378 193 1,529 4,522 1,299 2013201090a Broadway
New Port Richey, FL 1,984 15,885  1,984 15,885 98 202319904927 Voorhees Road
Newark, DE 560 21,220 2,500 560 23,720 10,939 20041998200 E Village Road
Newcastle-under-lyme, UK 1,110 5,655 223 1,147 5,841 1,603 20132010Hempstalls Lane
Newcastle-under-lyme, UK 1,125 5,537 219 1,162 5,719 1,403 20141999Silverdale Road
Newport News, VA 839 6,077 6 839 6,083 2,075 2018199812997 Nettles Drive
Newtownabbey, UK 843 4,143  843 4,143 178 2023201036 Mill Road
Norman, OK 55 1,484 132 55 1,616 1,093 199519951701 Alameda Drive
North Augusta, SC 332 2,558  332 2,558 1,646 19991998105 N Hills Drive
North Fort Myers, FL 3,361 12,951  3,361 12,951 230 20231985991 Pondella Road
Northampton, UK 5,182 17,348 741 5,352 17,919 5,113 20132011Cliftonville Road
Northampton, UK 2,013 6,257 273 2,080 6,463 1,495 20142014Cliftonville Road
Northbrook, IL 1,298 13,337  1,298 13,337 1,934 201819993240 Milwaukee Avenue
Nottingham, UK   8,151 1,682 6,469 1,482 20142014172a Nottingham Road
Nuneaton, UK 3,325 8,983 404 3,434 9,278 2,548 20132011132 Coventry Road
Nuthall, UK 2,498 10,436 425 2,580 10,779 2,991 20132011172 Nottingham Road
Oak Lawn, IL 2,418 5,426  2,418 5,426 781 201819779401 S Kostner Avenue
Oak Lawn, IL 3,876 7,985  3,876 7,985 1,193 201819606300 W 95th Street
Oakland, CA 4,760 16,143 282 4,760 16,425 4,140 20142002468 Perkins Street
Ocala, FL 2,644 20,388  2,644 20,388 132 202319901501 SE 24th Road
Olathe, KS 1,930 19,765 553 1,930 20,318 4,864 2016201521250 W 151 Street
Oldsmar, FL 1,851 15,062  1,851 15,062 91 202319903865 Tampa Road
Ona, WV 950 7,732  950 7,732 2,548 20152007100 Weatherholt Drive
Orange Park, FL 1,238 8,424  1,238 8,424 63 202319901215 Kingsley Avenue
Orem, UT 2,150 24,107 18 2,150 24,125 5,131 20152014250 E Center Street
Orlando, FL 1,880 16,959  1,880 16,959 237 202319749311 S Orange Blossom Trail
Orlando, FL 2,215 17,499  2,215 17,499 108 202319843920 Rosewood Way
Osage City, KS 50 1,700 151 50 1,851 512 201519961403 Laing Street
Osawatomie, KS 130 2,970 145 130 3,115 782 201520031520 Parker Avenue
Ottawa, KS 160 6,590 47 160 6,637 1,490 201520072250 S Elm Street
Overland Park, KS   31,146 3,730 27,416 10,586 2008200912000 Lamar Avenue
Overland Park, KS 4,500 29,105 7,295 4,500 36,400 13,528 201019886101 W 119th Street
Overland Park, KS 410 2,840 98 410 2,938 764 2015200414430 Metcalf Avenue
Overland Park, KS 1,300 25,311 677 1,300 25,988 6,062 201620157600 Antioch Road
Owasso, OK 215 1,380  215 1,380 963 1996199612807 E 86th Place N
Palm Bay, FL 2,262 17,158  2,262 17,158 110 202319985405 Babcock Street NE
Palm Beach Gardens, FL 2,082 6,622  2,082 6,622 1,095 2018199111375 Prosperity Farms Road
Palm Coast, FL 1,998 14,299  1,998 14,299 100 202319973001 Palm Coast Parkway SE
Palm Desert, CA 6,195 8,918  6,195 8,918 1,337 2018198974350 Country Club Drive
Palm Harbor, FL 1,306 13,807  1,306 13,807 2,148 201819972895 Tampa Road
Palm Harbor, FL 3,281 22,450  3,281 22,450 3,427 201819902851 Tampa Road
Palm Harbor, FL 2,490 23,901 125 2,490 24,026 2,410 202119962960 Tampa Road
Palm Harbor, FL 3,653 18,567  3,653 18,567 291 202319873825 Countryside Boulevard N
Palm Harbor, FL 1,637 12,697  1,637 12,697 80 202319902600 Highlands Boulevard N
Palos Heights, IL 1,225 12,453  1,225 12,453 1,774 201819997880 W College Drive
Palos Heights, IL 3,431 28,803  3,431 28,803 3,966 201819877850 W College Drive
Palos Heights, IL 2,591 7,647  2,593 7,645 1,107 2018199611860 SW Highway
Panama City Beach, FL 900 6,402 734 900 7,136 2,105 201120056012 Magnolia Beach Road
Paola, KS 190 5,610 63 190 5,673 1,302 20152000601 N East Street
Parma, OH 960 12,718  960 12,718 1,942 201819989205 Sprague Road
Parma, OH 1,833 10,314  1,833 10,314 1,773 201820069055 W Sprague Road
Paulsboro, NJ 3,264 8,023  3,264 8,023 1,240 20181987550 Jessup Road
Paw Paw, MI 1,687 5,602  1,687 5,602 980 20202012677 Hazen
Pensacola, FL 1,647 14,748  1,647 14,748 90 2023198410040 Hillview Road
Perry, FL 1,530 13,141  1,530 13,141 217 20231989207 Marshall Drive
Perrysburg, OH 1,456 5,431  1,456 5,431 847 2018197310540 Fremont Pike
Perrysburg, OH 1,213 7,108  1,213 7,108 1,027 2018197810542 Fremont Pike
Philadelphia, PA 2,930 10,433 3,536 2,930 13,969 5,327 201119521526 Lombard Street
Pickerington, OH 2,072 27,651 472 2,072 28,123 2,081 20212017611 Windmiller Drive
Pikesville, MD  2,487   2,487 338 201819988911 Reisterstown Road
Pikesville, MD 4,247 8,379  4,247 8,379 1,352 201819968909 Reisterstown Road
Pinehurst, NC 290 2,690 818 290 3,508 1,776 2003199817 Regional Drive
Piqua, OH 204 1,885  204 1,885 1,248 199719971744 W High Street
Piscataway, NJ 3,100 33,351  3,100 33,351 6,147 2013201710 Sterling Drive
Pittsburgh, PA 603 11,354  603 11,354 1,724 201819981125 Perry Highway
Pittsburgh, PA 1,005 15,160  1,005 15,160 2,215 20181997505 Weyman Road
Pittsburgh, PA 1,140 3,164  1,140 3,164 467 20181962550 S Negley Avenue
Pittsburgh, PA 761 4,213  761 4,213 596 201819655609 Fifth Avenue
Pittsburgh, PA 1,480 9,712  1,480 9,712 1,603 201819861105 Perry Highway
Pittsburgh, PA 1,139 5,844  1,139 5,844 944 201819861848 Greentree Road
Pittsburgh, PA 1,750 8,572 6,344 1,750 14,916 5,143 20051998100 Knoedler Road
Plainview, NY 3,990 11,969 2,221 3,990 14,190 5,180 20111963150 Sunnyside Boulevard
Plano, TX 1,840 20,152 560 1,840 20,712 4,639 201620163325 W Plano Parkway
Pompano Beach, FL 774 10,832  774 10,832 60 202319832401 NE 2nd Street
Poole, UK 3,283 16,501  3,283 16,501 2,336 20192019Kingsmill Road
Potomac, MD 1,448 14,622  1,448 14,622 2,096 2018199410718 Potomac Tennis Lane
Potomac, MD 4,119 14,916  4,119 14,916 2,209 2018198810714 Potomac Tennis Lane
Pottstown, PA 984 4,563  984 4,563 726 20181907724 N Charlotte Street
Powell, OH 1,910 18,008 281 1,910 18,289 1,574 202120183872 Attucks Drive
Powell, OH 2,300 26,198 344 2,300 26,542 1,972 2021201710351 Sawmill Parkway
Prior Lake, MN12,498 1,870 29,849 300 1,870 30,149 6,311 201520034685 Park Nicollet Avenue
Prospect, KY 2,533 9,963 176 2,533 10,139 1,225 202120176901 Carslaw Court
Raleigh, NC 7,598 88,870 900 7,598 89,770 15,680 200820174030 Cardinal at N Hills Street
Raleigh, NC 3,530 59,589  3,530 59,589 17,696 201220025301 Creedmoor Road
Raleigh, NC 2,580 16,837  2,580 16,837 5,312 201219887900 Creedmoor Road
Raleigh, NC 7,092 142,300  7,092 142,300 2,276 20172023320 Saint Albans Drive
Red Bank, NJ 1,050 21,275 1,560 1,050 22,835 7,379 20111997One Hartford Drive
Redondo Beach, CA  9,557 857  10,414 9,998 20111957514 N Prospect Avenue
Reidsville, NC 170 3,830 1,473 170 5,303 2,642 200219982931 Vance Street
Richardson, TX 1,468 12,975  1,468 12,975 1,936 20181999410 Buckingham Road
Richmond, IN 700 14,222 393 700 14,615 3,475 20162015400 Industries Road
Richmond, VA 3,261 17,974  3,261 17,974 2,548 201819901719 Bellevue Avenue
Richmond, VA 1,046 8,233  1,046 8,233 1,249 201819662125 Hilliard Road
Roanoke, VA 748 4,483 5 748 4,488 1,846 201819974355 Pheasant Ridge Road
Rock Hill, SC 1,825 7,676 190 1,825 7,866 1,173 202119951611 Constitution Boulevard
Rockford, MI 2,386 13,546  2,386 13,546 1,616 202020146070 Northland Drive
Rockville Centre, NY 4,290 20,310 1,581 4,290 21,891 7,521 20112002260 Maple Avenue
Romeoville, IL 1,895   1,895   20061900Grand Haven Circle
Roseville, MN 2,140 24,679 100 2,140 24,779 5,232 201519892750 N Victoria Street
Rugeley, UK 1,900 10,262 400 1,962 10,600 3,083 20132010Horse Fair
Ruston, LA 710 9,790  710 9,790 3,566 201119881401 Ezelle Street
S Holland, IL 1,423 8,907  1,423 8,907 1,359 201819972045 E 170th Street
Safety Harbor, FL 2,058 16,100  2,058 16,100 247 202319871410 Dr. M.L. King Jr. Street N
Saint Cloud, FL 2,200 16,050  2,200 16,050 99 202319954641 Old Canoe Creek Road
Salem, OR 450 5,171  449 5,172 3,314 199919981355 Boone Road SE
Salisbury, NC 370 5,697 390 370 6,087 3,133 200319972201 Statesville Boulevard
San Angelo, TX 260 8,800 449 260 9,249 4,474 200419972695 Valleyview Boulevard
San Angelo, TX 1,050 24,689 1,404 1,050 26,093 6,455 201419996101 Grand Court Road
San Antonio, TX 1,499 12,658  1,499 12,658 1,868 2018200015290 Huebner Road
San Diego, CA  22,003 1,845  23,848 9,052 20081992555 Washington Street
San Juan Capistrano, CA 1,390 6,942 1,542 1,390 8,484 5,014 2000200130311 Camino Capistrano
Sandusky, MI 967 6,738  967 6,738 854 2020200870 W Argyle Avenue
Sarasota, FL 475 3,175  475 3,175 2,286 199619958450 McIntosh Road
Sarasota, FL 443 8,892  443 8,892 1,448 201819985509 Swift Road
Sarasota, FL 4,101 11,204  4,101 11,204 2,657 201819935401 Sawyer Road
Sarasota, FL 1,370 4,082  1,370 4,082 620 201819683250 12th Street
Sarasota, FL 2,792 11,173  2,792 11,173 1,646 201819935511 Swift Road
Sarasota, FL 2,437 13,982  2,437 13,982 243 202319941507 S Tuttle Avenue
Sarasota, FL 1,941 16,193  1,941 16,193 100 20231982741 S Beneva Road
Sarasota, FL 1,824 7,088  1,824 7,088 59 20231982743 S Beneva Road
Scranton, PA 440 17,609 712 440 18,321 4,558 201420052741 Boulevard Avenue
Scranton, PA 320 12,144 115 320 12,259 3,105 201420132751 Boulevard Avenue
Seminole, FL 1,165 8,975  1,165 8,975 1,415 201819989300 Antilles Drive
Seminole, FL 2,654 14,171  2,654 14,171 239 202319959393 Park Boulevard
Seven Fields, PA 484 4,663 1,122 484 5,785 3,027 19991999500 Seven Fields Boulevard
Sewell, NJ 3,127 14,090  3,127 14,090 2,364 20182010378 Fries Mill Road
Shawnee, OK 80 1,400 2,506 80 3,906 1,002 199619953947 Kickapoo
Silver Spring, MD 1,469 10,392  1,469 10,392 1,533 201819952505 Musgrove Road
Silver Spring, MD 4,678 11,679  4,678 11,679 1,837 201819902501 Musgrove Road
Silvis, IL 880 16,420 139 880 16,559 5,857 201020051900 10th Street
Sinking Spring, PA 1,393 19,842  1,393 19,842 2,895 201819823000 Windmill Road
Sittingbourne, UK 1,357 6,539 260 1,402 6,754 1,591 20141997200 London Road
Smithfield, NC 290 5,680 844 290 6,524 3,100 20031998830 Berkshire Road
Smithfield, NC 360 8,216 444 360 8,660 2,105 20141999250 Highway 210 W
South Bend, IN 670 17,770  670 17,770 4,751 2014201452565 State Highway 933
South Daytona, FL 1,462 6,437  1,462 6,437 104 20231989650 Reed Canal Road
South Pasadena, FL 1,162 7,456  1,162 7,456 110 202319901820 Shore Drive S
South Point, OH 1,135 9,387  1,135 9,387 1,371 201819847743 County Road 1
Southampton, UK 1,518 16,027  1,518 16,027 2,736 20172013Botley Road, Park Gate
Southbury, CT 1,860 23,613 4,684 1,860 28,297 8,118 20112001655 Main Street
Spokane, WA 2,649 11,699  2,649 11,699 1,728 201819856025 N Assembly Street
Springfield, IL 990 9,475  990 9,475 3,726 201420133089 Old Jacksonville Road
St. Paul, MN 2,100 33,019 100 2,100 33,119 6,932 20151996750 Mississippi River
Stafford, UK 2,007 8,231  2,007 8,231 1,624 20142016Stone Road
Stamford, UK 1,820 3,238 167 1,880 3,345 840 20141998Priory Road
Statesville, NC 150 1,447 377 150 1,824 952 200319902441 E Broad Street
Statesville, NC 310 6,183 868 310 7,051 3,309 200319962806 Peachtree Place
Statesville, NC 140 3,627 89 140 3,716 1,941 200319992814 Peachtree Road
Staunton, VA 899 6,391 6 899 6,397 2,243 201819991410 N Augusta Street
Sterling Heights, MI 790 10,784  790 10,784 1,603 2018199611095 E Fourteen Mile Road
Sterling Heights, MI 1,583 15,634  1,583 15,634 2,359 2018201338200 Schoenherr Road
Stillwater, OK 80 1,400 33 80 1,433 1,003 199519951616 McElroy Road
Stratford-upon-avon, UK 790 14,508 504 816 14,986 3,364 20152012Scholars Lane
Stroudsburg, PA 340 16,313 174 340 16,487 4,686 20142011370 Whitestone Corner Road
Sunbury, PA 695 7,244  695 7,244 1,034 20181981800 Court Street Circle
Sunnyvale, CA 4,946 22,123  4,946 22,123 3,144 201819901150 Tilton Drive
Superior, WI 1,020 13,735 6,159 1,020 19,894 5,659 200920101915 N 34th Street
Tacoma, WA 2,522 8,573  2,522 8,573 1,245 201819845601 S Orchard Street
Tallahassee, FL 1,264 9,652 55 1,264 9,707 1,186 20211999100 John Knox Road
Tallahassee, FL 1,800 14,009  1,800 14,009 91 202319921650 Phillips Road
Tallahassee, FL 2,529 22,064  2,529 22,064 132 202319833101 Ginger Drive
Tampa, FL 1,315 6,911  1,315 6,911 1,185 2018199914950 Casey Road
Tampa, FL 2,630 14,085  2,630 14,085 249 20231989518 W Fletcher Avenue
Tampa, FL 1,500 20,765  1,500 20,765 111 202319822916 Habana Way
Telford, UK 988 10,672  988 10,672 746 20212021Shifnal Road
Terre Haute, IN 1,370 18,016  1,370 18,016 4,577 20152015395 8th Avenue
Texarkana, TX 192 1,403 97 192 1,500 978 199619964204 Moores Lane
The Villages, FL 1,035 7,446  1,035 7,446 2,227 201320142450 Parr Drive
Thomasville, GA 530 12,520 1,347 530 13,867 3,864 20112006423 Covington Avenue
Thousand Oaks, CA 3,425 19,573 12 3,425 19,585 2,054 20192021980 Warwick Avenue
Three Rivers, MI 1,255 2,760  1,255 2,760 538 20181976517 S Erie Street
Titusville, FL 2,581 12,751  2,581 12,751 221 202319851550 Jess Parrish Court
Tomball, TX 1,050 13,300 1,003 1,050 14,303 4,635 201120011221 Graham Drive
Toms River, NJ 3,466 23,311 151 3,466 23,462 4,128 201920061657 Silverton Road
Tonganoxie, KS 310 3,690 81 310 3,771 957 20152009120 W 8th Street
Towson, MD 1,715 13,111  1,715 13,111 1,932 201820008101 Bellona Avenue
Towson, MD 3,100 6,465  3,100 6,465 911 20181960509 E Joppa Road
Towson, MD 4,527 3,126  4,527 3,126 556 201819707001 N Charles Street
Troy, MI 1,381 24,445  1,381 24,445 3,446 20182006925 W South Boulevard
Troy, OH 200 2,000 4,254 200 6,254 2,983 1997199781 S Stanfield Road
Trumbull, CT 4,440 43,384 7,269 4,440 50,653 14,610 201120016949 Main Street
Tulsa, OK 1,390 7,110 1,275 1,390 8,385 3,302 201019987220 S Yale Avenue
Tulsa, OK 1,100 27,007 2,278 1,100 29,285 5,739 2015201718001 E 51st Street
Tulsa, OK 890 4,391  890 4,391 1,631 201720097210 S Yale Avenue
Tustin, CA 840 15,299 659 840 15,958 5,819 20111965240 E 3rd Street
Twinsburg, OH 1,446 5,919  1,446 5,919 965 201820148551 Darrow Road
Union, KY   33,927 2,242 31,685 3,456 201820209255 US-42
Union, SC 1,932 2,372  1,932 2,372 540 20181981709 Rice Avenue
Valparaiso, IN 112 2,558  112 2,558 1,506 200119982601 Valparaiso Street
Valparaiso, IN 108 2,962 50 108 3,012 1,730 200119992501 Valparaiso Street
Vancouver, WA 2,503 28,393  2,503 28,393 3,968 201820112811 NE 139th Street
Venice, FL 2,246 10,094  2,246 10,094 1,585 201819971450 E Venice Avenue
Venice, FL 2,087 15,529  2,087 15,529 99 202319831026 Albee Farm Road
Vero Beach, FL 263 3,187 25 263 3,212 1,854 20011999420 4th Court
Vero Beach, FL 297 3,263  297 3,263 1,906 20011996410 4th Court
Vero Beach, FL 1,256 11,204 187 1,256 11,391 1,366 202120074150 Indian River Boulevard
Vero Beach, FL 3,580 31,735 4,732 3,580 36,467 3,296 20212005910 Regency Square
Virginia Beach, VA 1,540 22,593 519 1,540 23,112 5,775 201419935520 Indian River Road
Virginia Beach, VA 2,004 19,634  2,004 19,634 1,521 202120081853 Old Donation Parkway
Voorhees, NJ 3,100 25,950 26 3,100 25,976 8,294 20112013113 S Route 73
Voorhees, NJ 2,193 6,990  2,193 6,990 1,142 201820061086 Dumont Circle
Wabash, IN 671 14,588  670 14,589 4,040 2014201320 John Kissinger Drive
Waconia, MN 890 14,726 4,495 890 19,221 6,103 20112005500 Cherry Street
Wake Forest, NC 200 3,003 2,625 200 5,628 2,932 19981999611 S Brooks Street
Wallingford, PA 1,356 6,487  1,356 6,487 1,080 20181930115 S Providence Road
Walnut Creek, CA 4,358 18,407  4,358 18,407 2,683 201819971975 Tice Valley Boulevard
Walnut Creek, CA 5,394 39,084  5,394 39,084 5,417 201819901226 Rossmoor Parkway
Walsall, UK   10,067 1,223 8,844 2,103 20152015Little Aston Road
Wamego, KS 40 2,510 61 40 2,571 604 201519961607 4th Street
Warren, NJ 2,000 30,810 1,605 2,000 32,415 10,484 20111999274 King George Road
Waterloo, IA 605 3,030  605 3,030 488 20181964201 W Ridgeway Avenue
Wayne, NJ 1,427 15,674  1,427 15,674 2,904 20181998800 Hamburg Turnpike
Wellingborough, UK 1,480 5,724 237 1,529 5,912 1,564 20152015159 Northampton
West Bend, WI 620 17,790 38 620 17,828 5,677 201020112130 Continental Drive
West Des Moines, IA 828 5,103  828 5,103 831 201820065010 Grand Ridge Drive
West Milford, NJ 1,960 24,614 327 1,960 24,941 4,000 20192000197 Cahill Cross Road
West Orange, NJ 1,347 19,389  1,347 19,389 3,365 20181998510 Prospect Avenue
West Palm Beach, FL 1,175 8,294  1,175 8,294 1,328 201819962330 Village Boulevard
West Palm Beach, FL 1,921 5,731  1,921 5,731 886 201819962300 Village Boulevard
West Palm Beach, FL 2,746 17,977  2,746 17,977 287 202319886414 13th Road S
West Palm Beach, FL 1,787 14,378  1,787 14,378 92 202319865065 Wallis Road
West Palm Beach, FL 1,366 17,908  1,366 17,908 96 202319932939 S Haverhill Road
West Reading, PA 890 12,118  890 12,118 1,672 20181975425 Buttonwood Street
Westerville, OH 740 8,287 6,657 740 14,944 11,311 19982001690 Cooper Road
Westerville, OH   26,121 2,566 23,555 2,554 20172020702 Polaris Parkway
Westerville, OH 1,420 5,371  1,420 5,371 825 201819821060 Eastwind Drive
Westerville, OH 1,582 10,279  1,582 10,279 1,605 20181980215 Huber Village Boulevard
Westfield, IN 891 15,964  890 15,965 4,365 20142013937 E 186th Street
Westlake, OH 855 11,963  855 11,963 1,798 2018199728400 Center Ridge Road
Weston Super Mare, UK 2,517 7,054 315 2,600 7,286 2,012 20132011141b Milton Road
Wheaton, MD 3,864 3,788  3,864 3,788 604 2018196111901 Georgia Avenue
Whippany, NJ 1,571 14,977  1,571 14,977 2,263 2018200018 Eden Lane
Whitehall, MI 1,645 6,789  1,645 6,789 1,021 202020126827 Whitehall Road
Wichita, KS 860 8,873  860 8,873 3,125 2011201210604 E 13th Street N
Wichita, KS 260 2,240 137 260 2,377 568 20151992900 N Bayshore Drive
Williamsburg, VA 1,187 5,728 6 1,187 5,734 2,118 201820001811 Jamestown Road
Willoughby, OH 1,774 8,653  1,774 8,653 1,322 2018197437603 Euclid Avenue
Wilmington, DE 1,376 13,450  1,376 13,450 1,992 20181998700 1/2 Foulk Road
Wilmington, DE 2,843 36,948  2,843 36,948 5,260 201819885651 Limestone Road
Wilmington, DE 2,266 9,500  2,266 9,500 1,445 20181984700 Foulk Road
Wilmington, NC 210 2,991 56 210 3,047 1,912 199919993501 Converse Drive
Wilmington, NC 400 15,355 592 400 15,947 4,118 201420123828 Independence Boulevard
Windsor, VA 1,148 6,514 7 1,148 6,521 2,379 2018199923352 Courthouse Highway
Winston-salem, NC 360 2,514 595 360 3,109 1,622 200319962980 Reynolda Road
Winter Garden, FL 1,110 7,937  1,110 7,937 2,568 20122013720 Roper Road
Winter Garden, FL 3,238 21,486  3,238 21,486 340 2023198415204 W Colonial Drive
Winter Springs, FL 1,152 14,822  1,152 14,822 2,171 201819991057 Willa Springs Drive
Witherwack, UK 944 6,915 258 975 7,142 1,974 20132009Whitchurch Road
Wolverhampton, UK 1,573 6,678 272 1,625 6,898 1,922 20132011378 Prestonwood Road
Woodbury, MN 1,317 20,935 298 1,317 21,233 4,116 201720152195 Century Avenue S
Woodstock, VA 594 5,108 5 594 5,113 1,623 20182001803 S Main Street
Worcester, MA 3,500 54,099  3,500 54,099 20,008 20072009101 Barry Road
Yardley, PA 773 14,914  773 14,914 2,310 20181995493 Stony Hill Road
Yardley, PA 1,561 9,439  1,561 9,439 1,740 201819901480 Oxford Valley Road
York, PA 976 9,354  976 9,354 1,408 20181972200 Pauline Drive
York, PA 1,050 4,210  1,050 4,210 750 201819832400 Kingston Court
York, PA 1,121 7,584  1,121 7,584 1,220 201819791770 Barley Road
York, UK 2,961 8,266 369 3,058 8,538 2,103 20142006Rosetta Way, Boroughbridge Road
Youngsville, NC 380 10,689 175 380 10,864 2,796 20142013100 Sunset Drive
Zephyrhills, FL 2,131 6,669  2,131 6,669 1,128 2018198738220 Henry Drive
Triple-net Total$38,261 $970,310 $7,578,624 $645,258 $1,016,599 $8,177,593 $1,694,904 
128


Welltower Inc. 
Schedule III 
Real Estate and Accumulated Depreciation 
December 31, 2023 
(Dollars in thousands) 
  Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Outpatient Medical:        
Addison, IL$ $102 $19,089 $423 $102 $19,512 $2,965 20182012303 W Lake Street
Agawam, MA 1,072 4,544 688 1,072 5,232 1,189 20192005230-232 Main Street
Allen, TX 726 14,196 2,489 726 16,685 7,560 201220061105 N Central Expressway
Alpharetta, GA 476 14,757 103 476 14,860 5,690 2011200311975 Morris Road
Alpharetta, GA 1,862   1,862   20111900940 N Point Parkway
Alpharetta, GA 548 17,103 1,353 548 18,456 8,774 201120073300 Old Milton Parkway
Alpharetta, GA   20,525 773 19,752 10,123 201119933400-a Old Milton Parkway
Alpharetta, GA   39,219 1,769 37,450 19,483 201119993400-c Old Milton Parkway
American Fork, UT6,395 2,769 7,688 619 2,769 8,307 520 202320041159 E 200 N
Ann Arbor, MI 4,234 30,085 104 4,234 30,189 3,416 202120164350 Jackson Road
Ann Arbor, MI 4,044 15,915 68 4,044 15,983 2,640 202120144200 Whitehall Drive
Anna, TX 3,050  8 3,058   202219001029 W White Street
Appleton, WI 1,881 7,540 1,333 1,881 8,873 1,598 201920045320 W Michael Drive
Appleton, WI 3,782 18,003 2,452 3,782 20,455 3,562 201920052323 N Casaloma Drive
Arcadia, CA   35,102 5,637 29,465 15,896 20061984301 W Huntington Drive
Arlington, TX   19,827 82 19,745 7,303 20122012902 W Randol Mill Road
Arlington, TX 1,785 8,926 559 1,785 9,485 379 202320143533 Matlock Road
Arlington Heights, IL 1,233 2,826 649 1,233 3,475 1,049 202019971632 W Central Road
Atlanta, GA 4,931 18,720 8,911 5,387 27,175 16,411 20061991755 Mount Vernon Highway
Atlanta, GA   45,769  45,769 19,091 201220065670 Peachtree-dunwoody Road
Atlanta, GA   29,754 2,172 27,582 12,685 20121984975 Johnson Ferry Road
Austin, TX 1,066 10,112  1,066 10,112 2,642 201720175301-b Davis Lane
Austin, TX 1,688 5,865 919 1,688 6,784 1,618 201920155301-a Davis Lane
Baltimore, MD 4,490 28,667 2,627 4,490 31,294 4,706 201920141420 Key Highway
Batavia, OH 30 9,929 1,741 30 11,670 625 202320062055 Hospital Drive
Beaumont, CA 7,555 28,294 3,019 7,555 31,313 692 2023200981 S Highland Springs Avenue
Beaumont, TX  12,115   12,115 177 202220233010 Harrison Avenue
Bellevue, NE   16,835  16,835 7,713 201020102510 Bellevue Medical Center Drive
Bend, OR 16,516 28,429 3,637 16,516 32,066 6,587 201920011501 NE Medical Center Drive
Berkeley Heights, NJ 49,555 79,091 13,715 49,555 92,806 14,501 201919781 Diamond Hill Road
Beverly Hills, CA 20,766 40,730 4,726 20,766 45,456 13,506 201519469675 Brighton Way
Beverly Hills, CA 18,863 1,192 653 18,885 1,823 1,069 20151955415 N Bedford
Beverly Hills, CA 19,863 31,690 2,791 19,863 34,481 9,850 20151946416 N Bedford
Beverly Hills, CA33,729 32,603 28,639 5,373 32,603 34,012 10,126 20151950435 N Bedford
Beverly Hills, CA78,271 52,772 87,366 6,539 52,772 93,905 24,049 20151989436 N Bedford
Birmingham, AL 90 34,349 4,430 90 38,779 2,279 20221994513 Brookwood Boulevard
Birmingham, AL 40 34,096 4,392 40 38,488 2,249 202219852006 Brookwood Medical Center Drive
(Dollars in thousands) 
  Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLandBuilding & ImprovementsCost Capitalized Subsequent to AcquisitionLandBuilding & Improvements
Accumulated Depreciation(1)
Year AcquiredYear BuiltAddress
Outpatient Medical:        
Birmingham, AL 60 42,792 5,507 60 48,299 2,844 202219792022 Brookwood Medical Center Drive
Birmingham, AL 50 20,514 2,649 50 23,163 1,364 202219752018 Brookwood Medical Center Drive
Boca Raton, FL 109 34,002 6,097 214 39,994 19,800 200619959970 S Central Park Boulevard
Boca Raton, FL 31 12,312 1,223 251 13,315 5,824 201219939960 S Central Park Boulevard
Bridgeton, MO   23,146 450 22,696 10,711 2010200612266 Depaul Drive
Bridgeton, MO   8,349 1,501 6,848 2,340 201720083440 De Paul Lane
Brooklyn, NY   104,919  104,919 8,780 20152021NE Corner of 9th & 49th Street
Burleson, TX   14,518 10 14,508 6,441 2011200712001 South Freeway
Burnsville, MN   35,232  35,232 13,076 2013201414101 Fairview Drive
Canton, MI 1,168 14,561 198 1,168 14,759 1,657 2021200449650 Cherry Hill Road
Cape Coral, FL 2,273 12,169 1,434 2,273 13,603 1,895 202119952721 Del Prado Boulevard
Carmel, IN   12  12  2011200512188-a N Meridian Street
Carmichael, CA 1,957 9,521 1,677 1,957 11,198 1,557 202219706620 Coyle Avenue
Cary, NC 2,816 10,645 1,912 2,816 12,557 3,518 20192007540 Waverly Place
Cedar Park, TX   32,308 132 32,176 10,311 201720141401 Medical Parkway, Building 2
Chapel Hill, NC 488 2,242 149 488 2,391 477 20192010100 Perkins Drive
Chapel Hill, NC 1,970 8,874 144 1,970 9,018 2,076 201820076011 Farrington Road
Chapel Hill, NC 1,970 8,925 54 1,970 8,979 2,334 201820076013 Farrington Road
Chapel Hill, NC 5,681 25,035 165 5,681 25,200 5,808 201820062226 N Carolina Highway 54
Charlotte, NC 10 23,265 2,365 10 25,630 6,216 201919711900 Randolph Road
Charlotte, NC 30 59,039 8,961 30 68,000 15,754 201919941918 Randolph Road
Charlotte, NC 40 40,533 5,484 40 46,017 10,140 201919891718 E Fourth Street
Charlotte, NC 1,746 8,378 1,507 1,746 9,885 2,678 20191998309 S Sharon Amity Road
Charlotte, NC   93,565 15,678 77,887 8,615 201820211237 Harding Place
Charlotte, NC  22,949 89  23,038 1,535 20212021830 Kenilworth Avenue
Charlotte, NC   58,056 11,783 46,273 4,527 201820211225 Harding Place
Cherry Hill, NJ 1,844 4,635 961 1,844 5,596 370 202219658 Ranoldo Terrace
Chesapeake, VA 1,146 2,702 733 1,146 3,435 260 20231981110 Wimbledon Square
Chicopee, MA 6,078 13,793 2,151 6,078 15,944 3,921 20192005444 Montgomery Street
Chula Vista, CA 1,114 14,902 1,194 1,114 16,096 2,779 20192008971 Lane Avenue
Chula Vista, CA 1,075 6,828 421 1,075 7,249 1,314 20192006959 Lane Avenue
Cincinnati, OH   18,417 2 18,415 7,039 201220133301 Mercy Health Boulevard
Cincinnati, OH 537 9,719 692 537 10,411 2,071 201920014850 Red Bank Expressway
Clarkson Valley, MO   36,746  36,746 20,178 2009201015945 Clayton Road
Clear Lake, TX   26,001 2,319 23,682 2,861 201320141010 S Ponds Drive
Clinton, MI 1,138 824 5 1,138 829 291 2021198711775 Tecumseh-Clinton Highway
Clyde, NC 1,433 21,099 967 1,433 22,066 3,148 20192012581 Leroy George Drive
College Station, TX 1,111 7,194  1,111 7,194 399 202120211204 Copperfield Parkway
Columbia, MD 23 33,885 5,659 9,353 30,214 15,176 201519825450 & 5500 Knoll N Drive
Columbia, MD 12,159 72,636 1,631 12,159 74,267 15,300 2018200910710 Charter Drive
Columbia, MD 2,333 19,232 1,961 2,333 21,193 9,167 2012200210700 Charter Drive
Columbia, MO 438 12,426 1,625 438 14,051 2,856 201919941601 E Broadway
Columbia, MO 488 15,702 1,389 488 17,091 3,979 201919991605 E Broadway
Columbia, MO 199 22,289 3,341 199 25,630 4,892 201920071705 E Broadway
Coon Rapids, MN   29,846  29,846 11,485 2013201411850 Blackfoot Street NW
Costa Mesa, CA17,559 22,033 24,332 4,796 22,033 29,128 9,173 201720071640 Newport Boulevard
Dade City, FL 1,211 5,511  1,211 5,511 2,323 2011199813413 US Highway 301
Dallas, TX   15,902 122 15,780 4,778 201320148196 Walnut Hill Lane
Dallas, TX 6,086 18,007 6,308 6,542 23,859 6,523 2018201010740 N Central Expressway
Danbury, CT 2,382 25,403 370 2,414 25,741 2,083 2021201940 Old Ridgebury Road
Danbury, CT 914 10,844 156 926 10,988 910 20212010226 White Street
Danbury, CT 4,209 22,740 424 4,306 23,067 2,446 202120172 Riverview Drive
Decatur, GA 743 2,572 528 743 3,100 201 20231976484 Irvin Court
Decatur, GA 1,465 2,524 535 1,465 3,059 276 20231971465 Winn Way
Decatur, GA 963 2,423 373 963 2,796 379 20231971487 Winn Way
Decatur, GA 1,505 2,053 471 1,505 2,524 226 20231976495 Winn Way
Decatur, GA 1,485 1,529 429 1,485 1,958 235 20231976497 Winn Way
Decatur, GA 1,355 2,892 702 1,355 3,594 379 20231976500 Irvin Court
Deerfield Beach, FL   11,229 2,540 8,689 4,540 201120011192 E Newport Center Drive
Delray Beach, FL 1,882 34,767 3,826 2,449 38,026 22,919 200619855130-5150 Linton Boulevard
Des Peres, MO6,709 1,014 14,248 1,161 1,014 15,409 1,034 202319791010 - 1090 Old Des Peres Road
Dunkirk, MD 259 2,263 713 259 2,976 821 2019199710845 Town Center Boulevard
Durham, NC 1,403 23,788 1,377 1,403 25,165 4,327 20192000120 William Penn Plaza
Durham, NC 1,751 42,391 2,037 1,751 44,428 6,271 201920043916 Ben Franklin Boulevard
El Paso, TX   19,965 1,254 18,711 9,187 200619972400 Trawood Drive
Elgin, IL 1,634 9,443 1,662 1,753 10,986 2,402 20202004745 Fletcher Drive
Elmhurst, IL 41 39,562 595 41 40,157 7,377 20182011133 E Brush Hill Road
Elyria, OH 3,263 27,163 1,027 3,263 28,190 4,837 20192008303 Chestnut Commons Drive
Enola, PA 3,286 8,135 689 3,286 8,824 442 202320201824 Good Hope Road
Escondido, CA 2,278 19,724 1,757 2,278 21,481 4,194 20191994225 E 2nd Avenue
Everett, WA   31,244 4,842 26,402 12,790 2010201113020 Meridian Avenue S
Fall River, MA10,463 2,738 15,380 2,381 2,738 17,761 707 20231975235 Hanover Street
Fenton, MO 958 27,485 1,235 958 28,720 11,696 201320091011 Bowles Avenue
Fenton, MO   14,707 369 14,338 5,455 201320091055 Bowles Avenue
Florham Park, NJ 8,578 61,779  8,578 61,779 11,729 20172017150 Park Avenue
Flower Mound, TX 737 9,276 1,015 737 10,291 3,363 201520142560 Central Park Avenue
Flower Mound, TX 4,164 27,027 2,533 4,164 29,560 10,692 201420124370 Medical Arts Drive
Flower Mound, TX 4,620   4,620   20141900Medical Arts Drive
Fort Washington, PA 2,015 16,104 2,679 2,015 18,783 3,210 20201980467 Pennsylvania Avenue
Fort Worth, TX   28,004 462 27,542 9,981 2012201210840 Texas Health Trail
Fort Worth, TX 401 6,099 9,036 2,805 12,731 3,174 201420077200 Oakmont Boulevard
Fort Worth, TX 1,790 5,082 51 1,790 5,133 477 202119832001 W Rosedale Street
Fort Worth, TX 2,462 7,891 1,651 2,462 9,542 94 202320229750 Hillwood Parkway
Frederick, MD 1,065 6,817 613 1,065 7,430 1,948 20191979194 Thomas Johnson Drive
Frederick, MD 1,930 18,311 1,687 1,930 19,998 3,920 2019200645 Thomas Johnson Drive
Fresno, CA 1,497 11,896 1,041 1,497 12,937 2,355 201920041105 E Spruce Avenue
Gardendale, AL 1,150 8,162 472 1,150 8,634 2,052 201820052217 Decatur Highway
Garland, TX 4,952 30,151 2,897 4,952 33,048 6,938 201920187217 Telecom Parkway
Gastonia, NC 569 1,638 55 569 1,693 489 20192000934 Cox Road
Gig Harbor, WA   32,869 80 32,789 9,813 2010200911511 Canterwood Boulevard NW
Glendale, CA 70 41,837 4,073 70 45,910 7,636 201920081500 E Chevy Chase Drive
Gloucester, VA 2,128 9,169 428 2,128 9,597 2,278 201820085659 Parkway Drive
Goodyear, AZ 4,128 9,122 958 4,128 10,080 613 20231997140 N Litchfield Road
Grand Prairie, TX 981 6,086 320 981 6,406 3,302 201220092740 N State Highway 360
Grapevine, TX   10,768 2,081 8,687 3,339 201420022040 W State Highway 114
Grapevine, TX   24,508 3,365 21,143 8,164 201420022020 W State Highway 114
Greenville, SC 1,790 4,421 1,766 1,790 6,187 2,772 2019198710 Enterprise Boulevard
Harrisburg, NC 1,347 2,652 527 1,347 3,179 1,106 201920129550 Rocky River Road
Hattiesburg, MS 3,155 31,155 4,444 3,155 35,599 5,959 201920123688 Veterans Memorial Drive
Haymarket, VA 1,250 26,621 3,079 1,250 29,700 5,663 2019200815195 Heathcote Boulevard
Henderson, NV 2,587 5,376 279 2,587 5,655 1,108 201920022825 Siena Heights Drive
Henderson, NV 7,372 22,172 3,447 7,372 25,619 5,485 201920052845 Siena Heights Drive
Henderson, NV 5,492 18,448 2,272 5,492 20,720 3,619 201920052865 Siena Heights Drive
Hopewell Junction, NY 2,164 4,659 692 2,164 5,351 925 2019199910 Cranberry Drive
Hopewell Junction, NY 2,316 4,525 812 2,316 5,337 837 201920151955 NY-52
Houston, TX 9,550   9,550  14 20111900FM 1960 & Northgate Forest Drive
Houston, TX 5,837 33,128 19,115 5,837 52,243 17,233 2012200515655 Cypress Woods Medical Drive
Houston, TX   21,373 2,988 18,385 1,879 2016201913105 Wortham Center Drive
Houston, TX   17,133 3,688 13,445 6,157 2012200710701 Vintage Preserve Parkway
Houston, TX   95,772 12,815 82,957 28,251 201219982727 W Holcombe Boulevard
Houston, TX 377 13,726 792 377 14,518 3,056 2018201120207 Chasewood Park Drive
Houston, TX 2,351 7,980 900 2,351 8,880 1,543 2020201311476 Space Center Boulevard
Houston, TX 1,292 7,797  1,292 7,797 97 202220232940 Eldridge Parkway
Howell, MI 2,000 13,928 646 2,001 14,573 3,830 201620171225 S Latson Road
Howell, MI 579 4,428 13 579 4,441 636 20212019202 W Highland Road
Humble, TX   19,081 1,702 17,379 2,040 201320148233 N Sam Houston Parkway E
Huntersville, NC  41,055 9,664  50,719 7,760 2019200410030 Gilead Road
Independence, MO 762 3,480 704 762 4,184 701 2020200719401 E 37th Terrace Court S
Jackson, MI   18,041 668 17,373 6,855 201320091201 E Michigan Avenue
Jacksonville, FL 3,562 24,379 3,988 3,562 28,367 6,228 2019200610475 Centurion Parkway N
Jacksonville, FL 1,113 10,970 1,389 1,113 12,359 2,278 202020005742 Booth Road
Jefferson City, TN 109 16,035 1,202 109 17,237 3,228 20192001120 Hospital Drive
Joliet, IL4,731 1,460 6,445 687 1,460 7,132 482 20231980330 Madison Street
Jonesboro, GA 567 15,146 1,267 567 16,413 3,632 201920097813 Spivey Station Boulevard
Jonesboro, GA 627 15,844 1,089 627 16,933 3,415 201920077823 Spivey Station Boulevard
Jupiter, FL   20,283 2,639 17,644 9,570 20062001550 Heritage Drive
Jupiter, FL   10,979 3,036 7,943 4,390 20072004600 Heritage Drive
Kalamazoo, MI  13,193   13,193 1,276 202020212520 Robert Jones Way
Katy, TX  11,530 8,820  20,350 1,002 201920202510 W Grand Parkway N
Katy, TX 2,025 7,557 1,255 2,025 8,812 1,393 2020201621502 Merchants Way
Katy, TX 3,699 12,701 3,039 3,699 15,740 3,412 202020061331 W Grand Parkway N
Knoxville, TN 199 43,771 4,825 199 48,596 8,007 201920121926 Alcoa Highway
LA Jolla, CA 12,855 32,658 2,962 12,936 35,539 12,296 201519894150 Regents Park Row
LA Jolla, CA 9,425 26,525 3,681 9,494 30,137 9,624 201519884120 & 4130 La Jolla Village Drive
La Jolla, CA 20,324 33,675 5,194 20,324 38,869 3,917 202219854180 La Jolla Village Drive
Lacey, WA 1,751 10,383 137 1,751 10,520 2,319 201819712555 Marvin Road NE
Lake St Louis, MO   15,187 240 14,947 6,964 20102008400 Medical Drive
Lakeway, TX   2,801 2,801   20071900Lohmans Crossing Road
Las Vegas, NV   10,383 2,319 8,064 4,032 200619912870 S Maryland Parkway
Las Vegas, NV   6,262 433 5,829 2,740 200719971776 E Warm Springs Road
Las Vegas, NV 4,180 20,064 2,913 4,180 22,977 3,528 202020179880 W Flamingo Road
Las Vegas, NV 5,864 22,502 3,070 5,864 25,572 3,678 202020174980 W Sahara Avenue
Lawrenceville, NJ 2,691 3,739 3,625 2,691 7,364 1,042 202219752 Princess Road
Lawrenceville, NJ 1,410 5,932 976 1,410 6,908 81 202320192A Princess Road
Lawton, OK 40 3,362 114 40 3,476 244 202319855604 SW Lee Boulevard
Lawton, OK 90 8,774 251 90 9,025 515 202320085606 SW Lee Boulevard
League City, TX 1,150 8,386  1,150 8,386 174 202220233625 E League City Parkway
Little Rock, AR 3,021 20,095 1,946 3,021 22,041 5,346 201920146119 Midtown Avenue
Los Alamitos, CA   22,685 39 22,646 9,386 200720033771 Katella Avenue
Lowell, MA   13,807 3,016 10,791 2,414 20112020839 Merrimack Street
Loxahatchee, FL   9,538 1,440 8,098 4,736 2006199312989 Southern Boulevard
Loxahatchee, FL   8,390 1,650 6,740 3,889 2006199412983 Southern Boulevard
Loxahatchee, FL   8,153 1,719 6,434 3,636 2006199712977 Southern Boulevard
Lubbock, TX 2,286 66,022 6,917 2,286 72,939 9,846 201920064515 Marsha Sharp Freeway
Lynbrook, NY24,574 10,028 37,319 2,982 10,028 40,301 8,241 20181962444 Merrick Road
Madison, WI 3,670 24,615 3,901 3,671 28,515 4,893 201920121102 S Park Street
Margate, FL 219 8,743 665 219 9,408 1,967 201920042960 N State Road 7
Marietta, GA 2,682 20,053 1,830 2,703 21,862 8,607 201620164800 Olde Towne Parkway
Mars, PA 1,925 8,307 1,472 1,925 9,779 2,055 202020066998 Crider Road
Matthews, NC 10 32,108 2,405 10 34,513 6,442 201919941450 Matthews Township Parkway
Menasha, WI   18,608 1,384 17,224 5,930 201619941550 Midway Place
Merced, CA   14,887  14,887 6,976 20092010315 Mercy Avenue
Meridian, ID 3,206 23,619 5,098 3,206 28,717 5,824 201920093277 E Louise Drive
Mesa, AZ 3,158 5,588 1,122 3,158 6,710 935 202020161910 S Gilbert Road
Mesa, AZ 3,889 5,816 1,257 3,889 7,073 1,060 202020161833 N Power Road
Milan, MI 1,216 6,487 59 1,216 6,546 918 20212008870 E Arkona Road
Mission Hills, CA  42,276 7,776 4,791 45,261 17,127 2014198611550 Indian Hills Road
Missouri City, TX 1,360 7,143  1,360 7,143 1,312 201520167010 Highway 6
Mobile, AL 2,759 25,180 351 2,759 25,531 4,962 201820036144 Airport Boulevard
Monroeville, PA 1,544 10,012 1,546 1,544 11,558 2,863 202019792550 Mosside Boulevard
Moorestown, NJ   53,453 362 53,091 22,381 20112012401 Young Avenue
Mount Juliet, TN   15,847 1,601 14,246 7,602 200720055002 Crossings Circle
Mount Kisco, NY 12,632 46,294 5,524 12,632 51,818 7,569 2019199690 - 110 S Bedford Road
Mount Vernon, IL   25,880  25,880 11,141 201120122 Good Samaritan Way
Muncie, IN 1,435 8,836 1,273 1,435 10,109 704 202320063631 N Morrison Road
Munster, IN 201 4,157 588 201 4,745 303 202319907847 Calumet Avenue
Munster, IN 2,790 10,170 1,872 2,790 12,042 1,064 202319617905 Calumet Avenue
Murrieta, CA   48,777  48,777 26,235 2010201128078 Baxter Road
Murrieta, CA 3,800   3,800   2014190028078 Baxter Road
Myrtle Beach, SC 1,357 3,131 1,153 1,357 4,284 1,395 201919968170 Rourk Street
Nampa, ID14,940 3,439 18,648 2,933 3,439 21,581 3,336 201920171510 12th Avenue
Naperville, IL 1,067 3,421 756 1,067 4,177 119 202319991012 W 95th Street
Naperville, IL 1,576 9,288 1,516 1,576 10,804 284 202319891020 E Ogden Avenue
New Milford, CT 1,006 3,541 23 1,019 3,551 485 20211995131 Kent Road
New Milford, CT 2,033 6,819 151 2,060 6,943 976 20211995131 Kent Road
Newburgh, NY 9,213 28,300 4,079 9,213 32,379 4,169 201920151200 NY-300
Newburyport, MA 3,104 18,492 1,788 3,104 20,280 4,030 20192008One Wallace Bashaw Jr. Way
Newtown, CT 2,176 9,140 1,047 2,205 10,158 1,201 20212015164 Mount Pleasant
Newtown, CT 3,039 9,364 160 3,079 9,484 1,378 20212016170 Mount Pleasant Road
Niagara Falls, NY   13,207 1,721 11,486 7,589 200719956932 - 6934 Williams Road
Niagara Falls, NY   8,649 454 8,195 4,664 200720046930 Williams Road
Norfolk, VA 1,138 23,416 5,375 1,138 28,791 6,102 20192014155 Kingsley Lane
North Canton, OH 2,518 21,523 2,946 2,518 24,469 3,483 201920147442 Frank Avenue
North Easton, MA 2,336 17,936 2,202 2,336 20,138 3,733 2019200715 Roche Brothers Way
North Easton, MA 2,882 14,463 1,890 2,882 16,353 3,042 2019200831 Roche Brothers Way
Norwood, OH 1,017 5,642 1,025 1,017 6,667 1,672 201920064685 Forest Avenue
Novi, MI 895 34,573 3,704 896 38,276 7,491 2019200826750 Providence Parkway
Oklahoma City, OK   19,544 216 19,328 7,599 20132008535 NW 9th Street
Oxford, NC 478 4,724 247 478 4,971 982 20192011107 E McClanahan Street
Pasadena, TX   15,362 1,700 13,662 2,463 201220135001 E Sam Houston Parkway S
Pearland, TX   25,909 1,500 24,409 3,027 201220132515 Business Center Drive
Pearland, TX   42,538 9,807 32,731 11,210 2014201311511 Shadow Creek Parkway
Phoenix, AZ   64,851 1,149 63,702 35,676 200619982222 E Highland Avenue
Phoenix, AZ 199 3,967 1,517 199 5,484 985 201919809225 N 3rd Street
Phoenix, AZ 109 2,134 530 109 2,664 499 201919869327 N 3rd Street
Phoenix, AZ 229 5,442 861 229 6,303 1,433 201919949100 N 2nd Street
Pinckney, MI 1,708 3,816 14 1,708 3,830 710 2021202010200 Dexter-pinckney Road
Plano, TX 793 83,209 9,171 793 92,380 35,665 201220056020 W Parker Road
Plantation, FL   25,988 8,575 17,413 11,257 20061997851-865 SW 78th Avenue
Pleasanton, CA 6,748 25,065 3,878 6,748 28,943 3,130 202220015860 Owens Drive
Plymouth Meeting, PA 4,047 9,442 1,570 4,047 11,012 762 202220024060 Butler Pike
Port Orchard, WA 2,810 22,716 770 2,810 23,486 4,749 20181995450 S Kitsap Boulevard
Porter, TX 3,746 15,119  3,746 15,119 1,481 2018201925553 US Highway 59
Poughkeepsie, NY 2,144 32,820 4,326 2,144 37,146 4,739 201920082507 South Road
Poughkeepsie, NY 4,035 26,001 4,479 4,035 30,480 3,493 2019201030 Columbia Street
Poughkeepsie, NY 6,513 23,787 4,110 6,513 27,897 3,611 20192006600 Westage Drive
Poughkeepsie, NY 5,128 18,080 2,704 5,128 20,784 2,749 201920121910 South Road
Prince Frederick, MD 229 25,905 1,774 229 27,679 4,839 20192009130 Hospital Road
Prince Frederick, MD 179 12,243 1,401 179 13,644 3,019 20191991110 Hospital Road
Raleigh, NC 8,255 25,589 3,301 8,255 28,890 2,652 202220058300 Health Park
Rancho Mirage, CA 7,292 13,214 2,424 7,292 15,638 3,306 2019200572780 Country Club Drive
Redmond, WA   32,850 5,017 27,833 14,037 2010201118100 NE Union Hill Road
Richmond, VA 2,969 26,697 3,934 3,090 30,510 13,494 201220087001 Forest Avenue
Richmond, TX 2,000 9,118 4 2,000 9,122 1,770 2015201622121 FM 1093 Road
Rockwall, TX 132 17,197 577 132 17,774 6,976 201220083142 Horizon Road
Rolla, MO 1,931 47,639 1,318 1,931 48,957 21,776 201120091605 Martin Spring Drive
Rome, GA 99 29,846 2,079 99 31,925 5,950 20192005330 Turner McCall Boulevard
Roseville, MN 2,963 18,785 3,394 2,963 22,179 4,171 201919941835 W County Road C
Roxboro, NC 368 2,327 150 368 2,477 495 20192000799 Doctors Court
Ruston, LA 1,214 19,717 2,283 1,214 22,000 1,092 202319841200 S Farmerville Street
San Antonio, TX   15,495 3,050 12,445 2,820 201620175206 Research Drive
San Antonio, TX 2,915 11,473 3,133 2,915 14,606 2,889 20192006150 E Sonterra Boulevard
Santa Clarita, CA  2,338 20,862 5,364 17,836 6,332 2014197623861 McBean Parkway
Santa Clarita, CA  28,384 4,443 5,295 27,532 8,685 2014199823929 McBean Parkway
Santa Clarita, CA 278 185 11,594 11,872 185 301 2014199623871 McBean Parkway
Santa Clarita, CA 295 39,589  295 39,589 11,205 2014201323803 McBean Parkway
Santa Clarita, CA  20,618 1,958 4,457 18,119 5,722 2014198924355 Lyons Avenue
Seattle, WA 4,410 38,428 993 4,410 39,421 21,982 201020105350 Tallman Avenue
Sewell, NJ 1,242 11,616 37 1,242 11,653 3,126 20182007556 Egg Harbor Road
Shakopee, MN 508 11,412 753 509 12,164 6,188 201019961515 Saint Francis Avenue
Shakopee, MN 707 18,089 554 773 18,577 7,597 201020071601 Saint Francis Avenue
Shenandoah, TX   21,197 4,574 16,623 3,768 20132014106 Vision Park Boulevard
Sherman Oaks, CA  32,186 5,069 3,121 34,134 11,626 201419694955 Van Nuys Boulevard
Silverdale, WA 3,451 21,176 12 3,451 21,188 4,615 201820042200 NW Myhre Road
Southborough, MA 4,911 30,473 3,827 4,911 34,300 802 2023198724-32 Newton Street
Southlake, TX 3,000   3,000   20141900Central Avenue
Southlake, TX   19,035 592 18,443 8,436 201220041545 E Southlake Boulevard
Southlake, TX   31,932 698 31,234 12,904 201220041545 E Southlake Boulevard
Southlake, TX 2,875 14,126 1,829 2,875 15,955 3,786 20192017925 E Southlake Boulevard
Spokane, WA 1,276 22,357 2,804 1,276 25,161 2,441 20232004601 W 5th Avenue
Spring, TX 4,425 94,034  4,425 94,034 491 202319002255 E Mossey Oaks Road
Springfield, MA 2,721 5,698 923 2,721 6,621 1,723 20192012305 Bicentennial Highway
St. Louis, MO 336 17,247 3,587 336 20,834 10,717 200720012325 Dougherty Ferry Road
St. Louis, MO2,607 1,085 3,624 275 1,085 3,899 339 202319715000 Manchester Avenue
St. Louis, MO3,936 1,460 4,826 786 1,460 5,612 817 202319808888 Ladue Road
St. Louis, MO10,863 2,180 14,613 2,051 2,180 16,664 1,673 20231980555 N New Ballas Road
St. Paul, MN   38,313 49 38,264 11,441 20142006225 Smith Avenue N
St. Paul, MN 2,706 39,507 1,700 2,701 41,212 18,697 20112007435 Phalen Boulevard
Stafford, TX 3,389 14,292  3,389 14,292 387 2021202211211 Nexus Avenue
Stockton, CA 4,966 14,412 2,445 4,966 16,857 3,197 201920092388 - 2488 N California Street
Strongsville, OH 15,997  67 16,064   2022190016761 Southpark Center
Suffern, NY 653 37,255 2,097 696 39,309 17,959 20112007257 Lafayette Avenue
Suffolk, VA 1,566 11,511 184 1,620 11,641 6,294 201020075838 Harbour View Boulevard
Sugar Land, TX   19,075 3,543 15,532 8,010 2012200511555 University Boulevard
Sycamore, IL 1,113 12,910 2,473 1,113 15,383 2,291 202020021630 Gateway Drive
Tacoma, WA   64,307  64,307 30,846 201120131608 S J Street
Tampa, FL 4,319 12,234  4,319 12,234 4,519 2011200314547 Bruce B Downs Boulevard
Tarzana, CA 6,115 15,510 3,270 6,115 18,780 3,583 202019865620 Wilbur Avenue
Timonium, MD   21,743 8,949 12,794 3,546 201520172118 Greenspring Drive
Towson, MD 2,654 10,627 3,373 2,654 14,000 1,058 202219928322 Bellona Avenue
Tustin, CA 3,345 541 480 3,345 1,021 600 2015197614591 Newport Avenue
Tustin, CA 3,361 12,039 4,703 3,361 16,742 5,890 2015198514642 Newport Avenue
Tyler, TX 2,903 104,300 10,980 2,898 115,285 15,212 201920131814 Roseland Boulevard
Tyler, TX 330 35,534 370 330 35,904 1,118 20212022501 S Saunders Avenue
Van Nuys, CA   36,187  36,187 15,318 200919916815 Noble Avenue
Vicksburg, MS 853 12,584 1,236 853 13,820 1,050 202320152200 Highway 61 N
Voorhees, NJ   32,833 6,617 26,216 13,568 20061997900 Centennial Boulevard
Voorhees, NJ   99,325 99 99,226 42,000 20102012200 Bowman Drive
Waco, TX 601 2,594 1,460 628 4,027 1,504 201820006600 Fish Pond Road
Waco, TX   15  15 15 201819626612 Fish Pond Road
Waco, TX   10  10 10 201819616620 Fish Pond Road
Waco, TX 2,250 28,632 609 2,250 29,241 6,109 20181981601 Highway 6 W
Washington, PA 3,981 31,706 17 3,981 31,723 6,968 20182010100 Trich Drive
Washington, DC 21,898 47,415 13,323 21,898 60,738 5,523 202319722021 K Street NW
Wausau, WI   14,225 2,050 12,175 2,902 201520171901 Westwood Center Boulevard
Waxahachie, TX 303 18,278  303 18,278 5,821 201620142460 N I-35 E
Webster, TX 1,961 63,358  1,961 63,358 132 2023190018833 Eastfield Drive
Wellington, FL   19,880 326 19,554 10,243 2006200010115 Forest Hill Boulevard
Wellington, FL   11,672 580 11,092 6,459 200720031395 State Road 7
Westlake Village, CA6,360 2,487 9,776 287 2,487 10,063 2,272 201819891220 La Venta Drive
Westlake Village, CA8,000 2,553 15,851 909 2,553 16,760 4,235 201819751250 La Venta Drive
Wharton, TX 64 1,433 166 64 1,599 147 202320002112 Regional Medical Drive
Wharton, TX 67 1,628 221 67 1,849 180 202320002112 Regional Medical Drive
Winston-salem, NC 2,006 6,542 1,583 2,006 8,125 2,445 201919982025 Frontis Plaza
Woodbridge, VA 346 16,617  346 16,617 3,103 2018201212825 Minnieville Road
Wyandotte, MI 581 8,023 773 581 8,796 1,337 202020021700 Biddle Avenue
Ypsilanti, MI 3,615 12,696 287 3,615 12,983 1,603 202119894918, 4936, 4940, 4972, and 4990 W Clark Road
Yuma, AZ 1,592 9,589 884 1,592 10,473 2,642 201920042270 S Ridgeview Drive
Zephyrhills, FL 3,875 27,270  3,875 27,270 11,217 2011197438135 Market Square Drive
Outpatient Medical Total$229,137 $848,834 $4,756,618 $2,603,702 $1,061,165 $7,147,989 $1,825,724 
















129


Welltower Inc. 
Schedule III 
Real Estate and Accumulated Depreciation 
December 31, 2023 
(Dollars in thousands) 
  Initial Cost to Company Gross Amount at Which Carried at Close of Period   
DescriptionEncumbrancesLand & Land ImprovementsBuildings & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuildings & ImprovementsAccumulated DepreciationYear AcquiredYear BuiltAddress
Assets Held For Sale: 
Bellevue, WA$ $ $ $25,480 $ $25,480 $ 20211900919 109th Avenue NE
Braintree, MA 170 7,157   170  199719681102 Washington Street
Burlington, ON15,339 1,309 19,311   16,092  20131990500 Appleby Line
Calgary, AB13,845 2,252 37,415   29,755  2013200320 Promenade Way SE
Calgary, AB7,883 3,122 38,971   32,373  20131998150 Scotia Landing NW
Chula Vista, CA 1,045 21,387   20,112  20191973480 4th Avenue
Chula Vista, CA 826 6,106 407  7,339  20191985450 4th Avenue
Fort Worth, TX 1,740 19,799   5,451  201620147001 Bryant Irvin Road
Highland, IL   5,879  5,879  2012201312860 Troxler Avenue
Las Vegas, NV   2,945  2,945  20071900Sw Corner of Deer Springs Way and Riley Street
Markham, ON46,660 3,727 48,939   37,403  201319817700 Bayview Avenue
Mississauga, ON23,007 3,649 35,137   30,488  201519881490 Rathburn Road E
Oakville, ON4,789 1,252 7,382   6,960  20131982289 and 299 Randall Street
Ottawa, ON16,133 3,454 23,309   20,751  201519662370 Carling Avenue
St. John's, NL4,092 706 11,765   10,267  2015200564 Portugal Cove Road
Surrey, BC12,819 4,552 22,338   20,488  2013198715501 16th Avenue
Toronto, ON5,812 2,513 19,695   18,013  20132002305 Balliol Street
Toronto, ON4,964 1,447 3,918   4,490  201319871340 York Mills Road
Toronto, ON17,649 2,927 20,713   22,921  2015190054 Foxbar Road
Toronto, ON5,163 5,082 25,493   25,586  20151988645 Castlefield Avenue
Winnipeg, MB8,886 1,960 38,612   29,920  20131999857 Wilkes Avenue
Assets Held For Sale Total$187,041 $41,733 $407,447 $34,711 $ $372,883 $ 
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  Initial Cost to Company Gross Amount at Which Carried at Close of Period
EncumbrancesLand & Land ImprovementsBuildings & ImprovementsCost Capitalized Subsequent to AcquisitionLand & Land ImprovementsBuildings & Improvements
Accumulated Depreciation (1)
Summary:       
Seniors Housing Operating$1,760,778 $2,296,482 $20,037,488 $4,923,531 $2,620,060 $24,637,441 $5,754,186 
Triple-net38,261 970,310 7,578,624 645,258 1,016,599 8,177,593 1,694,904 
Outpatient Medical229,137 848,834 4,756,618 2,603,702 1,061,165 7,147,989 1,825,724 
Construction in progress7,228  1,304,441   1,304,441  
Total continuing operating properties2,035,404 4,115,626 33,677,171 8,172,491 4,697,824 41,267,464 9,274,814 
Assets held for sale187,041 41,733 407,447 34,711  372,883  
Total investments in real property owned$2,222,445 $4,157,359 $34,084,618 $8,207,202 $4,697,824 $41,640,347 $9,274,814 
(1) Please see Note 2 to our consolidated financial statements for information regarding lives used for depreciation and amortization.

 Year Ended December 31,
 202320222021
 (in thousands) 
Investment in real estate:   
Beginning balance$41,000,766 $37,605,747 $33,670,006 
Acquisitions and development5,296,051 3,599,107 4,805,086 
Improvements517,682 476,017 282,834 
Impairment of assets(36,097)(17,502)(51,107)
Dispositions(1)
(688,370)(97,102)(1,063,990)
Foreign currency translation248,139 (565,501)(37,082)
Ending balance(2)
$46,338,171 $41,000,766 $37,605,747 
Accumulated depreciation:
Beginning balance$8,075,733 $6,910,114 $6,104,297 
Depreciation and amortization expenses1,401,101 1,310,368 1,037,566 
Amortization of above market leases5,658 3,991 4,036 
Dispositions and other (1)
(237,280)(38,327)(234,397)
Foreign currency translation29,602 (110,413)(1,388)
Ending balance$9,274,814 $8,075,733 $6,910,114 
(1) Includes property dispositions and dispositions of leasehold improvements which are generally fully depreciated. Additionally, during the year ended December 31, 2022, seven financing leases were classified as held for sale on our Consolidated Balance Sheet. During the year ended December 31, 2023, we executed a series of transactions that included the assignment of the leasehold interests in the properties to a newly formed tri-party unconsolidated joint venture and culminated in the closing of the purchase option by the joint venture. The transactions resulted in a gain from the loss of control and derecognition of the leasehold interests.
(2) The unaudited aggregate cost for tax purposes for real property equals $34,142,821,000 at December 31, 2023.

131


Welltower Inc.
Schedule IV - Mortgage Loans on Real Estate
December 31, 2023
    (in thousands)
LocationSegmentInterest RateFinal Maturity DatePeriodic Payment TermsPrior LiensFace Amount of MortgagesCarrying Amount of MortgagesPrincipal Amount of Loans Subject to Delinquent Principal or Interest
First mortgages relating to 1 property located in:    
North CarolinaTriple-net18.50%2023Interest only until maturity $ $32,783 $32,347 $32,783 
First mortgages relating to multiple properties located in:
United KingdomTriple-net12.40%2028Interest until maturity; Interest paid-in-kind until maturity 779,175 753,333  
United States - OR, NV, MT, SD, WA, WYTriple-net8.00%2026Interest only until maturity  40,000 39,120  
United States - OR, NV, MT, SD, WA, WYTriple-net13.65%2026Interest only until maturity  170,000 166,260  
First mortgages less than three percent of total:    
United States - DE, GA, MI, OH, SC, TX, WAVarious
6% - 18.50%
2023 - 2030N/AN/AN/A52,192 17,062 
Totals    $ $1,021,958 $1,043,252 $49,845 
 
 Year Ended December 31,
 202320222021
Reconciliation of mortgage loans:(in thousands)
Balance at beginning of year$697,906 $877,102 $293,752 
Additions:
Advances on loans receivable313,877 33,555 843,249 
Interest added39,768 49,932 11,815 
            Total additions353,645 83,487 855,064 
Deductions:
Receipts on loans receivable(42,415)(181,040)(214,132)
Loan balance transferred to non-real estate loans receivable  (9,142)
Change in allowance for credit losses and charge-offs(4,706)2,894 (6,984)
Other  (29,619)
Total deductions(47,121)(178,146)(259,877)
Change in balance due to foreign currency translation38,822 (84,537)(11,837)
Balance at end of year$1,043,252 $697,906 $877,102 

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