# EDGAR Filing Document

**Accession Number:** 0001632970
**File Stem:** 0001632970-23-000029
**Filing Date:** 2023-3
**Character Count:** 1827825
**Document Hash:** 31684591e6c533d5c4029a058ead7f15
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001632970-23-000029.hdr.sgml**: 20230317

**ACCESSION NUMBER**: 0001632970-23-000029

**CONFORMED SUBMISSION TYPE**: 10-K

**PUBLIC DOCUMENT COUNT**: 237

**CONFORMED PERIOD OF REPORT**: 20221231

**FILED AS OF DATE**: 20230317

**DATE AS OF CHANGE**: 20230317

**FILER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** American Healthcare REIT, Inc.
- **CENTRAL INDEX KEY:** 0001632970
- **STANDARD INDUSTRIAL CLASSIFICATION:** REAL ESTATE INVESTMENT TRUSTS [6798]
- **IRS NUMBER:** 472887436
- **STATE OF INCORPORATION:** MD
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 10-K
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-55775
- **FILM NUMBER:** 23742372

**BUSINESS ADDRESS:**
- **STREET 1:** 18191 VON KARMAN AVENUE
- **STREET 2:** SUITE 300
- **CITY:** IRVINE
- **STATE:** CA
- **ZIP:** 92612
- **BUSINESS PHONE:** 949-270-9200

**MAIL ADDRESS:**
- **STREET 1:** 18191 VON KARMAN AVENUE
- **STREET 2:** SUITE 300
- **CITY:** IRVINE
- **STATE:** CA
- **ZIP:** 92612

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Griffin-American Healthcare REIT IV, Inc.
- **DATE OF NAME CHANGE:** 20151231

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Griffin-American Healthcare REIT 4, Inc.
- **DATE OF NAME CHANGE:** 20150428

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Griffin-American Healthcare REIT IV, Inc.
- **DATE OF NAME CHANGE:** 20150205

?xml version="1.0" ? ahr-20221231

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

    

**UNITED STATES**

**SECURITIES AND EXCHANGE COMMISSION**

**Washington, D.C. 20549**

**FORM 10-K**

**(Mark One)**

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| | |
|:---|:---|
| ☒ | **ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934** |
| | For the fiscal year ended **December 31, 2022** |

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**or**

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| | |
|:---|:---|
| ☐ | **TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934** |
| | For the transition period from&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;to &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; |

---

Commission File Number: **000-55775**

**AMERICAN HEALTHCARE REIT, INC.**

(Exact name of registrant as specified in its charter)

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| | |
|:---|:---|
| **Maryland** | **47-2887436** |
| (State or other jurisdiction of<br>incorporation or organization) | (I.R.S. Employer<br>Identification No.) |
| **18191 Von Karman Avenue, Suite 300**<br>**Irvine, California** | **92612** |
| (Address of principal executive offices) | (Zip Code) |

---

Registrant's telephone number, including area code: **(949) 270-9200**

Securities registered pursuant to Section 12(b) of the Act:

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| | | |
|:---|:---|:---|
| **Title of each class** | **Trading Symbol(s)** | **Name of each exchange on which registered** |

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Securities registered pursuant to Section 12(g) of the Act:

**Common Stock, $0.01 par value per share**

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.&nbsp;&nbsp;&nbsp;&nbsp;☐ Yes&nbsp;&nbsp;&nbsp;&nbsp;☒ No

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.&nbsp;&nbsp;&nbsp;&nbsp; ☐ Yes&nbsp;&nbsp;&nbsp;&nbsp;☒ No

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Sections 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.&nbsp;&nbsp;&nbsp;&nbsp;☒ Yes&nbsp;&nbsp;&nbsp;&nbsp;☐ 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).&nbsp;&nbsp;&nbsp;&nbsp;☒ Yes&nbsp;&nbsp;&nbsp;&nbsp;☐ 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.

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| | | | |
|:---|:---|:---|:---|
| 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 has filed a report on and attestation to its management's assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C.7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☐

If securities are registered pursuant to Section 12(b) of the 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). ☐

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

There is no established market for the registrant's common stock. On March 24, 2022, the registrant's board of directors established an updated estimated per share net asset value, or NAV, of the registrant's common stock of $37.16 as of December 31, 2021. As of the last business day of the registrant's most recently completed second fiscal quarter, there were approximately 19,174,079 shares of Class T common stock and 46,354,260 shares of Class I common stock held by non-affiliates, for an aggregate market value of $712,509,000 and $1,722,524,000, respectively, assuming a market value as of that date of $37.16 per share.

As of March 10, 2023, there were 19,536,622 shares of Class T common stock and 46,675,367 shares of Class I common stock of American Healthcare REIT, Inc. outstanding.

______________________________________

**DOCUMENTS INCORPORATED BY REFERENCE**

The registrant incorporates by reference portions of the American Healthcare REIT, Inc. definitive proxy statement for the 2023 annual meeting of stockholders (into Items 10, 11, 12, 13 and 14 of Part III of this Annual Report on Form 10-K).

    

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**(A Maryland Corporation)**

**TABLE OF CONTENTS**

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| | |
|:---|:---|
| | **Page** |
| **<u>[PART I](#if3ea478aad1243998fd851f05f33f584_13)</u>** | **<u>[PART I](#if3ea478aad1243998fd851f05f33f584_13)</u>** |
| <u>[Item 1. Business](#if3ea478aad1243998fd851f05f33f584_16)</u> | <u>[3](#if3ea478aad1243998fd851f05f33f584_16)</u> |
| <u>[Item 1A. Risk Factors](#if3ea478aad1243998fd851f05f33f584_19)</u> | <u>[18](#if3ea478aad1243998fd851f05f33f584_19)</u> |
| <u>[Item 1B. Unresolved Staff Comments](#if3ea478aad1243998fd851f05f33f584_22)</u> | <u>[51](#if3ea478aad1243998fd851f05f33f584_22)</u> |
| <u>[Item 2. Properties](#if3ea478aad1243998fd851f05f33f584_25)</u> | <u>[51](#if3ea478aad1243998fd851f05f33f584_25)</u> |
| <u>[Item 3. Legal Proceedings](#if3ea478aad1243998fd851f05f33f584_28)</u> | <u>[54](#if3ea478aad1243998fd851f05f33f584_28)</u> |
| <u>[Item 4. Mine Safety Disclosures](#if3ea478aad1243998fd851f05f33f584_31)</u> | <u>[54](#if3ea478aad1243998fd851f05f33f584_31)</u> |
| **<u>[PART II](#if3ea478aad1243998fd851f05f33f584_34)</u>** | **<u>[PART II](#if3ea478aad1243998fd851f05f33f584_34)</u>** |
| <u>[Item 5. Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities](#if3ea478aad1243998fd851f05f33f584_37)</u> | <u>[55](#if3ea478aad1243998fd851f05f33f584_37)</u> |
| <u>[Item 6. \[Reserved\]](#if3ea478aad1243998fd851f05f33f584_43)</u> | <u>[57](#if3ea478aad1243998fd851f05f33f584_43)</u> |
| <u>[Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations](#if3ea478aad1243998fd851f05f33f584_46)</u> | <u>[58](#if3ea478aad1243998fd851f05f33f584_46)</u> |
| <u>[Item 7A. Quantitative and Qualitative Disclosures About Market Risk](#if3ea478aad1243998fd851f05f33f584_58)</u> | <u>[77](#if3ea478aad1243998fd851f05f33f584_58)</u> |
| <u>[Item 8. Financial Statements and Supplementary Data](#if3ea478aad1243998fd851f05f33f584_61)</u> | <u>[79](#if3ea478aad1243998fd851f05f33f584_61)</u> |
| <u>[Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure](#if3ea478aad1243998fd851f05f33f584_64)</u> | <u>[79](#if3ea478aad1243998fd851f05f33f584_64)</u> |
| <u>[Item 9A. Controls and Procedures](#if3ea478aad1243998fd851f05f33f584_67)</u> | <u>[79](#if3ea478aad1243998fd851f05f33f584_67)</u> |
| <u>[Item 9B. Other Information](#if3ea478aad1243998fd851f05f33f584_70)</u> | <u>[79](#if3ea478aad1243998fd851f05f33f584_70)</u> |
| <u>[Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections](#if3ea478aad1243998fd851f05f33f584_73)</u> | <u>[79](#if3ea478aad1243998fd851f05f33f584_73)</u> |
| **<u>[PART III](#if3ea478aad1243998fd851f05f33f584_76)</u>** | **<u>[PART III](#if3ea478aad1243998fd851f05f33f584_76)</u>** |
| <u>[Item 10. Directors, Executive Officers and Corporate Governance](#if3ea478aad1243998fd851f05f33f584_79)</u> | <u>[80](#if3ea478aad1243998fd851f05f33f584_79)</u> |
| <u>[Item 11. Executive Compensation](#if3ea478aad1243998fd851f05f33f584_82)</u> | <u>[80](#if3ea478aad1243998fd851f05f33f584_82)</u> |
| <u>[Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters](#if3ea478aad1243998fd851f05f33f584_85)</u> | <u>[80](#if3ea478aad1243998fd851f05f33f584_85)</u> |
| <u>[Item 13. Certain Relationships and Related Transactions, and Director Independence](#if3ea478aad1243998fd851f05f33f584_88)</u> | <u>[80](#if3ea478aad1243998fd851f05f33f584_88)</u> |
| <u>[Item 14. Principal Accountant Fees and Services](#if3ea478aad1243998fd851f05f33f584_91)</u> | <u>[80](#if3ea478aad1243998fd851f05f33f584_91)</u> |
| **<u>[PART IV](#if3ea478aad1243998fd851f05f33f584_94)</u>** | **<u>[PART IV](#if3ea478aad1243998fd851f05f33f584_94)</u>** |
| <u>[Item 15. Exhibits, Financial Statement Schedules](#if3ea478aad1243998fd851f05f33f584_97)</u> | <u>[81](#if3ea478aad1243998fd851f05f33f584_97)</u> |
| <u>[Item 16. Form 10-K Summary](#if3ea478aad1243998fd851f05f33f584_205)</u> | <u>[160](#if3ea478aad1243998fd851f05f33f584_205)</u> |
| **<u>[SIGNATURES](#if3ea478aad1243998fd851f05f33f584_208)</u>** | <u>[161](#if3ea478aad1243998fd851f05f33f584_208)</u> |

---

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**PART I**

**Item 1. Business.** 

*The use of the words "we," "us" or "our" refers to Griffin-American Healthcare REIT III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT III Holdings, LP, for periods prior to the Merger, as defined below, and American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc., or GAHR IV) and its subsidiaries, including American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), for periods following the Merger, except where otherwise noted. Certain historical information of GAHR IV is included for background purposes.*

**Company**

American Healthcare REIT, Inc., a Maryland corporation, is a leading internally-managed real estate investment trust, or REIT, that owns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, or MOBs, senior housing, skilled nursing facilities, or SNFs, hospitals and other healthcare-related facilities. We have built a fully-integrated management platform, with approximately 113 employees, that operates clinical healthcare properties throughout the United States, the United Kingdom, and the Isle of Man. We also operate healthcare-related facilities utilizing the structure permitted 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 of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). Our healthcare facilities operated under a RIDEA structure include our senior housing operating properties, or SHOP, and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We have elected to be taxed as a REIT for U.S. federal income tax purposes. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code.

***Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc.***

On October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with Merger Sub being the surviving company, or the REIT Merger. On October 1, 2021, also pursuant to the Merger Agreement, Griffin-American Healthcare REIT IV Holdings, LP, a Delaware limited partnership and subsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our operating partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the REIT Merger and the Partnership Merger as the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and our operating partnership, also referred to as the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The REIT Merger was intended to qualify as a reorganization under, and within the meaning of, Section 368(a) of the Code. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and GAHR IV Operating Partnership ceased.

At the effective time of the REIT Merger and prior to the reverse stock split, each issued and outstanding share of GAHR III's common stock, $0.01 par value per share, converted into the right to receive 0.9266 shares of GAHR IV's Class I common stock, $0.01 par value per share. Further, at the effective time of the Partnership Merger and prior to the reverse stock split, (i) each unit of limited partnership interest in the surviving partnership outstanding immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership and (ii) each unit of limited partnership interest in GAHR IV Operating Partnership immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.

***AHI Acquisition***

Also on October 1, 2021, immediately prior to the consummation of the Merger, GAHR III acquired a newly formed entity, American Healthcare Opps Holdings, LLC, or NewCo, which we refer to as the AHI Acquisition, pursuant to a contribution and exchange agreement dated June 23, 2021, or the Contribution Agreement, between GAHR III; our operating partnership; American Healthcare Investors, LLC, or AHI; Griffin Capital Company, LLC, or Griffin Capital; Platform Healthcare Investor T-II, LLC; Flaherty Trust; and Jeffrey T. Hanson, the non-executive Chairman of our board of directors, or our board, Danny Prosky, our Chief Executive Officer and President, and Mathieu B. Streiff, one of our directors, or collectively, the AHI Principals. NewCo owned substantially all of the business and operations of AHI, as well as all of the

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

equity interests in (i) Griffin-American Healthcare REIT IV Advisor, LLC, or GAHR IV Advisor, a subsidiary of AHI that served as the external advisor of GAHR IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our former advisor, a subsidiary of AHI that served as the external advisor of GAHR III.

Pursuant to the Contribution Agreement, AHI contributed substantially all of its business and operations to the surviving partnership, including its interest in GAHR III Advisor and GAHR IV Advisor, and Griffin Capital contributed its then-current ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, or OP units. Subject to working capital and other customary adjustments, the total approximate value of these OP units at the time of consummation of the transactions contemplated by the Contribution Agreement, and prior to the reverse stock split, was approximately $131,674,000, with a reference value for purposes thereof of $8.71 per OP unit, such that the surviving partnership issued 15,117,529 OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the AHI Acquisition, the Combined Company became self-managed. See "Operating Partnership and Former Advisor" below for a further discussion. Such OP units were owned by AHI Group Holdings, LLC, or AHI Group Holdings, which is owned and controlled by the AHI Principals, Platform Healthcare Investor TII, LLC, Flaherty Trust and a wholly owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers.

The AHI Acquisition was treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While GAHR IV was the legal acquiror of GAHR III in the REIT Merger, GAHR III was determined to be the accounting acquiror in the REIT Merger in accordance with Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 805, *Business Combinations*, after considering the relative share ownership and the composition of the governing body of the Combined Company. Thus, the financial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the Combined Company, and the financial information set forth herein prior to the Merger and the AHI Acquisition reflects GAHR III's results. For this reason, period to period comparisons may not be meaningful.

See Note 4, Business Combinations — 2021 Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of the Merger and the AHI Acquisition.

***Operating Partnership and Former Advisor***

We conduct substantially all of our operations through our operating partnership and we are the sole general partner of our operating partnership. As of December 31, 2022 and 2021, we owned an approximately 95.0% and 94.9% general partnership interest therein, respectively, and the remaining 5.0% and 5.1%, respectively, was owned by the NewCo Sellers.

Through September 30, 2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor, subject to the oversight and review of our board, provided asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Following the Merger and the AHI Acquisition, we became self-managed and are no longer externally advised. As a result, any fees that would have otherwise been payable to our former advisor are no longer being paid to a third party. Upon consummation of the AHI Acquisition, we redeemed all 51 limited partnership units that our former advisor held in our operating partnership, as well as all 52 limited partnership units held by GAHR IV Advisor in GAHR IV Operating Partnership. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 5,148 shares of our common stock owned by our former advisor and all 5,208 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV.

Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by DigitalBridge Group, Inc. (NYSE: DBRG), or DigitalBridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, DigitalBridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings.

See the "Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc." and "AHI Acquisition" sections above for a further discussion. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity – Noncontrolling Interests in Total Equity, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of the ownership in our operating partnership.

***Public Offerings***

GAHR IV raised $754,118,000 through a best efforts initial public offering, or the initial offering, and issued 18,909,920 aggregate shares of its Class T common stock and Class I common stock. In addition, during the initial offering, GAHR IV

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issued 813,384 aggregate shares of its Class T common stock and Class I common stock pursuant to GAHR IV's distribution reinvestment plan, as amended, or the DRIP, for a total of $31,021,000 in reinvested distributions. Following the deregistration of the initial offering, GAHR IV continued issuing shares of its common stock up to $100,000,000 pursuant to the DRIP through a subsequent offering, or the 2019 GAHR IV DRIP Offering, pursuant to a Registration Statement on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act. GAHR IV commenced offering shares pursuant to the 2019 GAHR IV DRIP Offering on March 1, 2019, following the termination of the initial offering on February 15, 2019. On March 18, 2021, the GAHR IV board of directors authorized the suspension of the DRIP, effective as of April 1, 2021.

On October 4, 2021, our board authorized the reinstatement of the DRIP, as amended, or the AHR DRIP, to offer up to $100,000,000 of shares of our common stock pursuant to a Registration Statement on Form S-3 under the Securities Act previously filed by GAHR IV, or the AHR DRIP Offering. On November 14, 2022, our board suspended the AHR DRIP Offering beginning with distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP Offering, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP were and will be paid distributions in cash. As of December 31, 2022, a total of $91,448,000 in distributions were reinvested that resulted in 2,431,695 shares of common stock being issued pursuant to the AHR DRIP.

On September 16, 2022, we filed with the U.S. Securities and Exchange Commission, or SEC, a Registration Statement on Form S-11 (File No. 333-267464) with respect to a proposed public offering by us of our shares of common stock in conjunction with a contemplated listing of our common stock on the New York Stock Exchange, or NYSE. Such registration statement and contemplated listing are not yet effective.

On November 10, 2022, our board approved charter amendments to effect, on November 15, 2022, a one-for-four reverse stock split of our common stock and a corresponding reverse split of the OP units, or the Reverse Splits. All numbers of common shares and per share data, as well as the OP units, in this Annual Report on Form 10-K have been retroactively adjusted for all periods presented to give effect to the Reverse Splits. See Note 14, Equity, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of our public offerings.

On March 15, 2023, our board, at the recommendation of the audit committee of our board, which is comprised solely of independent directors, unanimously approved and established an updated estimated per share net asset value, or NAV, of our common stock of $31.40. We provide this updated estimated per share NAV annually to assist broker-dealers in connection with their obligations under Financial Industry Regulatory Authority, or FINRA, Rule 2231 with respect to customer account statements. The updated estimated per share NAV is based on the estimated value of our assets less the estimated value of our liabilities, divided by the number of shares outstanding on a fully diluted basis, calculated as of December 31, 2022. The valuation was performed in accordance with the methodology provided in Practice Guideline 2013-01, *Valuations of Publicly Registered Non-Listed REITs,* issued by the Institute for Portfolio Alternatives, or the IPA, in April 2013, in addition to guidance from the SEC. See our Current Report on Form 8-K filed with the SEC on March 17, 2023 for more information on the methodologies and assumptions used to determine, and the limitations and risks of, our updated estimated per share NAV.

***COVID-19***

Our residents, tenants, operating partners and managers, our industry and the U.S. economy continue to be adversely affected by the COVID-19 pandemic and related supply chain disruptions and labor shortages. While the COVID 19 pandemic is subsiding, the timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the emergence and severity of COVID-19 variants, the effectiveness and frequency of booster vaccinations and the duration and implications of restrictions and safety measures. As the lasting effect of the COVID-19 pandemic is still impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments.

We have evaluated the impacts of the COVID-19 pandemic on our business thus far and incorporated information concerning such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of December 31, 2022. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information. For a further discussion of the impact of the COVID-19 pandemic to our business, see Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**Key Developments**

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;**•** On January 19, 2022, we, through our operating partnership, entered into a credit agreement for a credit facility with an aggregate maximum principal amount up to $1,050,000,000. See Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• On September 16, 2022, we filed with the SEC a Registration Statement on Form S-11 (File No. 333-267464), with respect to a proposed public offering of our shares of common stock in conjunction with a contemplated listing of our common stock on the NYSE, or the Proposed Listing. Such registration statement and contemplated listing are not yet effective. The potential public offering is subject to market conditions and other factors, and there can be no assurance as to whether, or when, any such offering may be completed, or as to the size, public offering price or other terms of such offering.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• On November 10, 2022, our board approved charter amendments to effect a one-for-four reverse stock split of our common stock and a corresponding reverse split of the OP units on November 15, 2022.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• In connection with the Proposed Listing, on November 14, 2022, our board suspended the AHR DRIP Offering beginning with the distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP Offering, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP will be paid future distributions in cash. On November 14, 2022, our board also suspended our share repurchase plan beginning with share repurchase requests for the quarter ending December 31, 2022. All share repurchase requests, including requests resulting from the death or qualifying disability of stockholders, commencing with the quarter ended December 31, 2022, will not be processed, will be considered canceled in full and will not be considered outstanding repurchase requests. See Note 14, Equity — Common Stock, and Note 14, Equity— Share Repurchase Plan, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• On December 20, 2022, we, through our majority-owned subsidiary, Trilogy Investors, LLC, or Trilogy, entered into an amendment to the 2019 Trilogy Credit Agreement to increase the aggregate maximum principal amount from $360,000,000 to $400,000,000. See Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We appointed three new independent directors, Scott A. Estes in August 2022 and Marvin R. O'Quinn and Valerie Richardson in January 2023, as part of our board's commitment to diversity when considering director candidates with a mix of experience, knowledge, age, gender and backgrounds.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• In 2022, we launched our Environmental, Social and Governance, or ESG, program and began conducting a materiality assessment to assist us in prioritizing our efforts and maximizing the efficacy of our ESG program.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• To further assist us in establishing a work environment that promotes Diversity, Equity, and Inclusion, or DE&I, for our employees, in 2022, we developed a DE&I action plan and provided DE&I education for all employees and executive leadership.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• During 2022, we expanded our integrated senior health campuses and SHOP segments by $253,908,000 primarily through the acquisition of buildings and campuses and completed development projects. See Note 3, Real Estate Investments, Net, and Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We improved our corporate governance structure and procedures in 2022 by amending our Code of Business Conduct and Ethics and our Whistleblower Policy and adopting Corporate Governance Guidelines, an Insider Trading Policy, a Regulation FD and Disclosure Policy and a Related Party Transactions Policy.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We entered into an interest rate swap transaction, or the Swap, with Fifth Third Financial Risk Solutions, a division of Fifth Third Bank, with an effective date of February 1, 2023. We entered into the Swap to mitigate the potential interest rate risk associated with $275,000,000 of our floating rate term loan under our existing credit facility, effectively fixing the interest rate associated with that portion of our term loan and limiting our exposure to interest rate movements. See Note 22, Subsequent Events — Interest Rate Swap, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• In response to interest rates that have increased significantly since the beginning of 2022, from a Federal Funds Rate of 0.08% as of January 2022 to 4.57% as of February 2023, and greater uncertainty surrounding further interest rate movements, our board elected to reduce our quarterly distribution to $0.25 per share in order to preserve our liquidity, better align distributions with available cash flows and position our company for its long-term strategic goals. On March 15, 2023, our board authorized a reduced quarterly distribution from $0.40 per share to $0.25 per share to our Class T common stockholders and Class I common stockholders of record as of the close of business on April 4, 2023. The distribution for the quarter commencing January 1, 2023 to March 31, 2023, which will be paid on or about April 18, 2023, represents an annualized distribution rate of $1.00 per share. See our Current Report on Form 8-K filed with the SEC on March 17, 2023 for more information.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• On March 15, 2023, our board, at the recommendation of the audit committee of our board, comprised solely of independent directors, unanimously approved and established an updated estimated per share NAV of our common stock of $31.40 as of December 31, 2022. For further discussion, see Part II, Item 5, Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities, and Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• As of March 17, 2023, we owned and/or operated 314 buildings and integrated senior health campuses, or approximately 19,957,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $4,626,119,000. In addition, as of March 17, 2023, we also owned a real estate-related debt investment purchased for $60,429,000.

Our principal executive offices are located at 18191 Von Karman Avenue, Suite 300, Irvine, California 92612, and our telephone number is (949) 270-9200. We maintain a web site at *www.americanhealthcarereit.com,* at which there is additional information about us. The contents of that site are not incorporated by reference in, or otherwise a part of, this filing. We make our periodic and current reports and all amendments to those reports available at *www.americanhealthcarereit.com* as soon as reasonably practicable after such materials are electronically filed with the SEC. They also are available for printing by any stockholder upon request. In addition, copies of our filings with the SEC may be obtained from the SEC's website, *http://www.sec.gov*. Access to these filings is free of charge.

**Business Objectives and Growth Strategies** 

Our business objectives are to grow our cash flows, maintain financial flexibility, increase the value of our portfolio, make regular cash distributions to our stockholders, and generate risk-adjusted returns through the following growth strategies:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• capture embedded growth from COVID-19 recovery through leasing and expense controls at our senior housing facilities, integrated senior health campuses and SNFs;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• external growth through disciplined and targeted acquisitions to expand our diversified portfolio;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• continue to develop integrated senior health campuses through experienced development partner (i.e., Trilogy); and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• provide sustained stability through consistent MOB performance with opportunity for revenue growth driven by occupancy gains and improving mark-to-market lease spreads.

**Investment Strategy**

We have acquired, and may continue to acquire, properties either directly or jointly with third parties. We have disposed, and may continue to dispose, non-core properties from time to time to improve the quality of our portfolio. We also have originated and acquired, and may continue to originate or acquire, secured loans and other real estate-related investments on an infrequent and opportunistic basis.

We generally seek investments that produce current income; however, we have selectively developed, are currently developing (through Trilogy), and may continue to selectively develop, real estate properties. Our portfolio may include properties in various stages of development other than those producing current income. These stages include unimproved land both with and without entitlements and permits, property to be redeveloped and repositioned, newly constructed properties and properties in lease-up or other stabilization stages, all of which have limited or no relevant operating histories and current income. We make such investment determinations based upon a variety of factors, including the anticipated risk-adjusted returns for such properties when compared with other available properties, the appropriate diversification of the portfolio and our objectives of realizing both current income and capital appreciation.

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We seek to grow our cash flows, maintain financial flexibility, increase the value of our portfolio, make regular cash distributions, and generate risk-adjusted returns for our stockholders through the business objectives and growth strategies discussed above. In order to achieve these objectives, we may invest using a number of investment structures, which may include direct acquisitions, joint ventures, leveraged investments, issuing securities for property and direct and indirect

investments in real estate. In order to maintain our exemption from regulation as an investment company under the Investment Company Act of 1940, as amended, or the Investment Company Act, we may be required to limit our investments in certain types of real estate-related investments. See "Investment Company Act Considerations" below for a further discussion.

For each of our investments, regardless of property type, we seek to invest in properties with the following attributes:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Strong Local Health Systems and Operating Partners.* We seek to invest in properties associated with strong health systems and operators, that provide exceptional care, have dominant market share and/or are critical to the healthcare delivery system in the communities that they serve.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Quality.* We seek to acquire properties that are suitable for their intended use with a quality of construction that is capable of sustaining the property's investment potential for the long-term, assuming funding of budgeted maintenance, repairs and capital improvements.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Location.* We seek to acquire properties that are located in established or otherwise appropriate markets, with access and visibility suitable to meet the needs of its occupants. In addition to United States properties, we may also seek to acquire international properties that meet our investment criteria.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Market; Supply and Demand.* We focus on local or regional markets that have potential for stable and growing property level cash flows over the long-term. These determinations are based in part on an evaluation of local and regional economic, demographic and regulatory factors affecting the property. For instance, we favor markets that indicate a growing population and employment base and markets that exhibit potential limitations on additions to supply, such as barriers to new construction. Barriers to new construction include lack of available land, stringent zoning restrictions and states where certificates of need are required. Conversely, we generally seek to limit our investments in areas that have limited potential for growth.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Predictable Capital Needs.* We seek to acquire properties where the future expected capital needs can be reasonably projected in a manner that would enable us to meet our objectives.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• *Cash Flows.* We seek to acquire properties where the current and projected cash flows, including the potential for appreciation in value, would enable us to maximize long-term stockholder value. We evaluate cash flows as well as expected growth and the potential for appreciation.

We are not limited as to the geographic areas where we may acquire properties. We are not specifically limited in the number or size of properties we may acquire or on the percentage of our assets that we may invest in a single property or investment. The number and mix of properties and real estate-related investments we will acquire will depend upon real estate and market conditions and other circumstances existing at the time we are acquiring our properties and making our investments and the amount of debt financing available.

***Real Estate Investments***

We generally seek investments that produce current income. We expect our real estate investments to include:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• MOBs;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• integrated senior health campuses;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• senior housing facilities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• SNFs; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• healthcare-related facilities operated utilizing a RIDEA structure.

Our real estate investments may also include:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• hospitals;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• long-term acute care facilities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• surgery centers;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• memory care facilities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• specialty medical and diagnostic service facilities;

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• laboratories and research facilities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• pharmaceutical and medical supply manufacturing facilities; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• offices leased to tenants in healthcare-related industries, including life sciences.

We generally seek to acquire real estate of the types described above that will best enable us to meet our investment objectives, taking into account, among other things, the diversification of our portfolio at the time, relevant real estate and financial factors, the location, the income-producing capacity and the prospects for long-range appreciation of a particular property. As a result, we may acquire properties other than the types described above. In addition, we may acquire properties that vary from the parameters described above for a particular property type.

Our real estate investments generally take the form of holding fee title or long-term leasehold interests. Our investments may be made either directly through our operating partnership or indirectly through investments in joint ventures, limited liability companies, general partnerships or other co-ownership arrangements with the developers of the properties or other persons. See "Joint Ventures" below for a further discussion.

We have exercised, and may continue to exercise, our purchase options to acquire properties that we currently lease. In addition, we have participated in sale-leaseback transactions, in which we purchase real estate investments and lease them back to the sellers of such properties. We seek to structure any such sale-leaseback transaction such that the lease will be characterized as a "true lease" and so that we will be treated as the owner of the property for U.S. federal income tax purposes.

Our obligation to close a transaction involving the purchase of real estate is generally conditioned upon the delivery and verification of certain documents, including, where appropriate: (i) plans and specifications; (ii) environmental reports (generally a minimum of a Phase I investigation); (iii) building condition reports; (iv) surveys; (v) evidence of marketable title subject to such liens and encumbrances; (vi) audited financial statements covering recent operations of real properties having operating histories unless such statements are not required to be filed with the SEC and delivered to stockholders; (vii) title insurance policies; and (viii) the availability of property and liability insurance policies.

In determining whether to purchase a particular real estate investment, we may obtain an option on such property, including land suitable for development. The amount paid for an option is normally surrendered if the real estate is not purchased, and is normally credited against the purchase price if the real estate is purchased. We also may enter into arrangements with the seller or developer of a real estate investment whereby the seller or developer agrees that if, during a stated period, the real estate investment does not generate specified cash flows, the seller or developer will pay us cash in an amount necessary to reach the specified cash flows level, subject in some cases to negotiated dollar limitations.

We have obtained, and we intend to continue to obtain, adequate insurance coverage for all real estate investments in which we invest.

We have acquired, and we intend to continue to acquire, leased properties with long-term leases and we generally do not intend to operate any healthcare-related facilities directly. As a REIT, we are prohibited from operating healthcare-related facilities directly; however, we have leased, and may continue to lease, healthcare-related facilities that we acquire to wholly owned taxable REIT subsidiaries, or TRS, utilizing a RIDEA structure permitted by the Code. In such an event, our TRS will engage a third party in the business of operating healthcare-related facilities to manage the property. Through our TRS, we bear all operational risks and liabilities associated with the operation of such healthcare-related facilities unlike our triple-net leased properties. Such operational risks and liabilities might include, but are not limited to, resident quality of care claims and governmental reimbursement matters.

*Development and Construction Activities*

On an opportunistic basis, we have selectively developed, are currently developing (through Trilogy), and may continue to selectively develop, real estate assets within our integrated senior health campuses segment and other segments of our portfolio when market conditions warrant, which may be funded through capital that we, and in certain circumstances, our joint venture partners, provide. In doing so, we may be able to reduce overall purchase costs by developing property versus purchasing an existing property. We retain and will continue to retain independent contractors to perform the actual construction work on tenant improvements, as well as property development.

*Terms of Leases*

The terms and conditions of any lease we enter into with our tenants may vary substantially. However, we expect that a majority of our tenant leases will require the tenant to pay or reimburse us for some or all of the operating expenses of the building based on the tenant's proportionate share of rentable space within the building. Operating expenses typically include, but are not limited to, real estate and other taxes, utilities, insurance and building repairs, and other building operation and

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management costs. For our multi-tenanted properties, we generally expect to be responsible for the replacement of certain capital improvements affecting a property, including structural components of a property such as the roof of a building, and other capital improvements such as parking facilities. We expect that many of our tenant leases will have terms of five or more years, some of which may have renewal options.

Substantially all of our leases with residents at our SHOP and integrated senior health campuses are for a term of one year or less, which creates the opportunity for operators to adjust rents to reflect current market conditions.

***Joint Ventures***

We have entered into, and we may continue to enter into, joint ventures, general partnerships, and other arrangements with one or more institutions or individuals, including real estate developers, operators, owners, investors and others, for the purpose of acquiring real estate. Our investment in Trilogy is an example of a joint venture into which we have entered. Such joint ventures may be leveraged with debt financing or unleveraged. We have entered into, and may continue to enter into, joint ventures to further diversify our investments or to access investments which meet our investment criteria that would otherwise be unavailable to us. In determining whether to invest in a particular joint venture, we will evaluate the real estate that such joint venture owns or is being formed to own under the same criteria described elsewhere in this Annual Report on Form 10-K for the selection of our other properties. However, we will not participate in tenant in common syndications or transactions.

Joint ventures with unaffiliated third parties may be structured such that the investment made by us and the other joint venture party are on substantially different terms and conditions. This type of investment structure may result in the other joint venture party receiving more of the cash flows, including appreciation, of an investment than we would receive, or may result in certain conflict of interest. See Item 1A, Risk Factors — Risks Related to Joint Ventures, for a further discussion.

***Real Estate-Related Investments***

In addition to our acquisition of properties, we have invested on an infrequent and opportunistic basis and may continue to invest, in real estate-related investments, including loans and securities investments.

*Investment in Real Estate Mortgages*

We have invested, and we may continue to invest, in first and second mortgage loans, mezzanine loans and bridge loans. However, we will not make or invest in any loans that are subordinate to any mortgage or equity interest of any of our directors, or any of our affiliates. We also may invest in participations in mortgage loans. Second mortgage loans are secured by second deeds of trust on real property that is already subject to prior mortgage indebtedness. A mezzanine loan is a loan made in respect of certain real property but is secured by a lien on the ownership interests of the entity that, directly or indirectly, owns the real property. A bridge loan is short term financing, for an individual or business, until permanent or the next stage of financing can be obtained. Mortgage participation investments are investments in partial interests of mortgages of the type described above that are made and administered by third-party mortgage lenders. We may also make seller financing loans in connection with the disposition of our properties. In evaluating prospective loan investments, we consider factors, including, but not limited to: (i) the ratio of the investment amount to the underlying property's value; (ii) current and projected cash flows of the property; (iii) the degree of liquidity of the investment; (iv) the quality, experience and creditworthiness of the borrower; and (v) in the case of mezzanine loans, the ability to acquire the underlying real property.

Our criteria for making or investing in loans are substantially the same as those involved in our investment in properties. We do not intend to make loans to other persons, to underwrite securities of other issuers or to engage in the purchase and sale of any types of investments other than those relating to real estate. We generally will not make or invest in mortgage loans on any one property if the aggregate amount of all mortgage loans outstanding on the property, including our loan, would exceed an amount equal to 85.0% of the appraised value of the property, as determined by an appraiser, unless we find substantial justification due to other underwriting criteria; however, our policy generally will be that the aggregate amount of all mortgage loans outstanding on the property, including our loan, would not exceed 75.0% of the appraised value of the property. We may find such justification in connection with the purchase of loans in cases in which we believe there is a high probability of our foreclosure upon the property in order to acquire the underlying assets and in which the cost of the loan investment does not exceed the fair market value of the underlying property. We will not invest in or make loans unless an appraisal has been obtained concerning the underlying property, except for those loans insured or guaranteed by a government or government agency or in connection with seller financing loans. In the event the transaction is with any of our directors or their respective affiliates, the appraisal will be obtained from a certified independent appraiser to support its determination of fair market value. In addition, we will seek to obtain a customary lender's title insurance policy or commitment as to the priority of the mortgage or condition of the title. Because the factors considered, including the specific weight we place on each factor, will vary for each prospective loan investment, we do not, and are not able to, assign a specific weight or level of importance to any particular factor.

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We will evaluate all potential loan investments to determine if the security for the loan and the loan-to-value ratio meets our investment criteria and objectives. Most loans that we will consider for investment would provide for monthly payments of interest and some may also provide for principal amortization, although many loans of the nature that we will consider provide for payments of interest only and a payment of principal in full at the end of the loan term. We will not originate loans with negative amortization provisions.

We are not limited as to the amount of our assets that may be invested in mezzanine loans, bridge loans and second mortgage loans. However, we recognize that these types of loans are riskier than first deeds of trust or first priority mortgages on income-producing, fee-simple properties, and we expect to minimize the amount of these types of loans in our portfolio. We will evaluate the fact that these types of loans are riskier in determining the rate of interest on the loans. We do not have any policy that limits the amount that we may invest in any single loan or the amount we may invest in loans to any one borrower. We have not established a portfolio turnover policy with respect to loans we invest in or originate.

*Investment in Other Securities* 

We have invested, and may continue to invest, in debt securities such as commercial mortgage-backed securities issued by other unaffiliated real estate companies. We may also invest in equity securities of public or private real estate companies. Commercial mortgage-backed securities are securities that evidence interests in, or are secured by, a single commercial mortgage loan or a pool of commercial mortgage loans. Commercial mortgage-backed securities generally are pass-through certificates that represent beneficial ownership interests in common law trusts whose assets consist of defined portfolios of one or more commercial mortgage loans. They typically are issued in multiple tranches whereby the more senior classes are entitled to priority distributions from the trust's income. Losses and other shortfalls from expected amounts to be received in the mortgage pool are borne by the most subordinate classes, which receive payments only after the more senior classes have received all principal and/or interest to which they are entitled. Commercial mortgage-backed securities are subject to all of the risks of the underlying mortgage loans. We may invest in investment grade and non-investment grade commercial mortgage-backed securities.

The specific number and mix of securities in which we invest will depend upon real estate market conditions, other circumstances existing at the time we are investing in securities and the amount of any future indebtedness that we may incur. We will not invest in securities of other issuers for the purpose of exercising control and the first or second mortgages in which we intend to invest will likely not be insured by the Federal Housing Administration or guaranteed by the Department of Veterans Affairs or otherwise guaranteed or insured. Real estate-related equity securities are generally unsecured and also may be subordinated to other obligations of the issuer. Our investments in real estate-related equity securities will involve special risks relating to the particular issuer of the equity securities, including the financial condition and business outlook of the issuer.

**Financing Policies**

We have used, and intend to continue to use, secured and unsecured debt as a means of providing additional funds for the acquisition of properties and real estate-related investments. Our ability to enhance our investment returns and to increase our diversification by acquiring assets using additional funds provided through borrowing could be adversely impacted if banks and other lending institutions reduce the amount of funds available for the types of loans we seek. When interest rates are high or financing is otherwise unavailable on a timely basis, we may purchase certain assets for cash with the intention of obtaining debt financing at a later time. We have also used, and may continue to use, derivative financial instruments such as fixed interest rate swaps and caps to add stability to interest expense and to manage our exposure to interest rate movements.

We anticipate that our overall leverage will not exceed 50.0% of the combined fair market value of all of our properties and other real estate-related investments, as determined at the end of each calendar year. For these purposes, the market value of each asset will be equal to the contract purchase price paid for the asset or, if the asset was appraised subsequent to the date of purchase, then the market value will be equal to the value reported in the most recent independent appraisal of the asset. Our policies do not limit the amount we may borrow with respect to any individual investment. As of December 31, 2022, our aggregate borrowings were 48.5% of the combined market value of all of our real estate and real estate-related investments.

We seek to obtain financing on the most favorable terms available to us and refinance assets during the term of a loan only in limited circumstances, such as when a decline in interest rates makes it beneficial to prepay an existing loan, when an existing loan matures or if an attractive investment becomes available and the proceeds from the refinancing can be used to purchase such investment. The benefits of the refinancing may include increased cash flows resulting from reduced debt service requirements, an increase in distributions from proceeds of the refinancing, and an increase in diversification and assets owned if all or a portion of the refinancing proceeds are reinvested.

If we incur mortgage indebtedness, we will endeavor to obtain level payment financing, meaning that the amount of debt service payable would be substantially the same each year, although some mortgages are likely to provide for one large payment and we may incur floating or adjustable rate financing when our board determines it to be in our best interest.

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**Dispositions**

We have disposed, and may continue to dispose, of assets. We will determine whether a particular property or real estate-related investment should be sold or otherwise disposed of after consideration of the relevant factors, including prevailing economic conditions, with a view toward maximizing our investment objectives. We intend to hold each property or real estate-related investment we acquire for an extended period. However, circumstances might arise which could result in a shortened holding period for certain investments. A property or real estate-related investment may be sold before the end of the expected holding period if: (i) diversification benefits exist associated with disposing of the investment and rebalancing our investment portfolio; (ii) an opportunity arises to pursue a more attractive investment; (iii) the value of the investment might decline; (iv) with respect to properties, a major tenant involuntarily liquidates or is in default under its lease; (v) the investment was acquired as part of a portfolio acquisition and does not meet our general acquisition criteria; (vi) an opportunity exists to enhance overall investment returns by raising capital through sale of the investment; (vii) the sale of the investment is in the best interest of our stockholders; or (viii) in connection with the strategic goals of one of our joint ventures.

The determination of whether a particular property or real estate-related investment should be sold or otherwise disposed of will be made after consideration of the relevant factors, including prevailing economic conditions, with a view toward maximizing our investment objectives.

**Tax Status and Distribution Policy**

We have elected to be taxed as a REIT for U.S. federal income tax purposes commencing with our taxable year ended December 31, 2016. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code. Our qualification as a REIT, and maintenance of such qualification, will depend on our ability to meet, on a continuing basis, various complex requirements under the Code relating to, among other things, the sources of our gross income, the composition and values of our assets, our distribution levels and the concentration of ownership of our stock.

As a REIT, we generally are not subject to U.S. federal income tax on the REIT taxable income that we currently distribute to our stockholders. Under the Code, REITs are subject to numerous organizational and operational requirements, including a requirement that they distribute annually at least 90.0% of their REIT taxable income to their stockholders. If we fail to qualify as a REIT in any calendar year and do not qualify for certain statutory relief provisions, our REIT taxable income would be subject to U.S. federal income tax at the regular corporate rate, and we would likely be precluded from qualifying for treatment as a REIT until the fifth calendar year following the year in which we fail to qualify. Accordingly, our failure to qualify as a REIT could have a material adverse effect on us. Even if we qualify as a REIT, we may still be subject to certain U.S. federal, state and local taxes on our income and assets and to U.S. federal income and excise taxes on our undistributed REIT taxable income. In addition, subject to maintaining our qualification as a REIT, a portion of our business has been, and is likely to continue to be, conducted through, and a portion of our income may be earned in, one or more TRSs that are themselves subject to regular corporate income taxation.

We cannot predict if we will generate sufficient cash flows to continue to pay cash distributions to our stockholders on an ongoing basis or at all. The amount of any cash distributions is determined by our board and depends on the amount of distributable funds, current and projected cash requirements, tax considerations, any limitations imposed by the terms of indebtedness we may incur as well as other factors. If our investments produce sufficient cash flows, we expect to continue paying distributions to our stockholders as determined at the discretion of our board of directors. Because our cash available for distribution in any year may be less than 90.0% of our annual taxable income, excluding net capital gains, for the year, we may be required to borrow money, use proceeds from the issuance of securities (in subsequent offerings, if any) or sell assets to pay out enough of our taxable income to satisfy the distribution requirement. These methods of obtaining funds could affect future distributions by increasing operating costs. We did not establish any limit on the amount of net proceeds from the initial offering or borrowings that may be used to fund distributions, except that, in accordance with our organizational documents and Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business; or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences.

To the extent that any distributions to our stockholders are paid out of our current or accumulated earnings and profits, such distributions are taxable as ordinary income. To the extent that any of our distributions exceed our current and accumulated earnings and profits, such amounts constitute a return of capital to our stockholders for U.S. federal income tax purposes, to the extent of their basis in their stock and thereafter will constitute capital gain. Any portion of distributions to our stockholders paid from net offering proceeds or borrowings constitutes a return of capital to our stockholders.

Since September 2021, our board authorized distributions to our stockholders of record as of a designated record date each month and paid such distributions monthly in arrears. Beginning with distributions made after July 2022, our board elected

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to pay distributions quarterly to reduce administrative costs. The amount of distributions we pay to our stockholders is determined by our board and is dependent on a number of factors, including funds available for the payment of distributions, our financial condition, capital expenditure requirements, annual distribution requirements needed to maintain our status as a REIT under the Code and restrictions imposed by our organizational documents and Maryland Law.

See Part II, Item 5, Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities — Distributions, for a further discussion of distributions approved by our board.

**Competition**

We compete with many other entities engaged in real estate investment activities for acquisitions and dispositions of MOBs, hospitals, SNFs, senior housing and other healthcare-related facilities. Our ability to successfully compete is impacted by economic trends, availability of acceptable investment opportunities, our ability to negotiate beneficial investment terms, availability and cost of capital, construction and development costs, and applicable laws and regulations.

Income from our investments is dependent on the ability of our tenants and operators to compete with other healthcare operators. These operators compete on a local and regional basis for patients and residents and the operators' ability to successfully attract and retain patients and residents depends on key factors such as the number of properties in the local market, the quality of the affiliated health system, proximity to hospital campuses, the price and range of services available, the scope and quality of care, reputation, age and appearance of each property, demographic trends and the cost of care in each locality. Additionally, referral sources, including physicians and managed care organizations, may change their lists of hospitals or physicians to which they refer patients or that are permitted to participate in a payor program. As a result, we may have to provide rent concessions, incur charges for tenant improvements, or offer other inducements, or we may be unable to timely lease vacant space in our properties, all of which may have an adverse impact on our results of operations. Private, federal and state payment programs and the effect of other laws and regulations may also have a significant impact on the ability of our tenants and operators to compete successfully for patients and residents at the properties. For additional information on the risks associated with our business, please see Item 1A, Risk Factors.

**Government Regulations**

Our properties are subject to various federal, state and local regulatory requirements, and changes in these laws and regulations, or their interpretation by agencies, occur frequently. Further, our tenants and our healthcare facility operators, including our TRS entities that own and operate our properties under a RIDEA structure, are typically subject to extensive and complex federal, state and local healthcare laws and regulations relating to quality of care, government reimbursement, fraud and abuse practices, and similar laws governing the operation of healthcare facilities, and we expect the healthcare industry, in general, will continue to face increased regulation and pressure in the areas of healthcare management, fraud and provision of services, among others. If we fail to comply with these various requirements, we may incur governmental fines or private damage awards. While we believe that our properties are and will be in substantial compliance with all of these regulatory requirements, we do not know whether existing requirements will change or whether future requirements will require us to make significant unanticipated capital expenditures that will adversely affect our ability to make distributions to our stockholders. We believe, based in part on third-party due diligence reports which are generally obtained at the time we acquire the properties, that all of our properties comply in all material respects with current regulations or are currently being remediated pursuant to a government approved plan. However, if we were required to make significant expenditures under applicable regulations, we could be materially and adversely affected.

*Privacy and Security Laws and Regulations*

There are various federal and state privacy laws and regulations that provide for consumer protection of personal health information, particularly electronic security and privacy. Compliance with such laws and regulations may require us, among other things, to conduct additional risk analysis, modify our risk management plan, implement new policies and procedures and conduct additional training. We are generally dependent on our tenants and management companies to fulfill our compliance obligations, and we have in certain circumstances developed a program to periodically monitor compliance with such obligations. However, there can be no assurance we would not be required to alter one or more of our systems and data security procedures to be in compliance with these laws. If we fail to adequately protect health information, we could be subject to civil or criminal liability and adverse publicity, which could harm our business and impact our ability to attract new tenants and residents. We may be required to notify individuals, as well as government agencies and the media, if we experience a data breach.

*Healthcare Licensure and Certification* 

Generally, certain properties in our portfolio are subject to licensure, may require a certificate of need, or CON, or other certification through regulatory agencies in order to operate and participate in Medicare and Medicaid programs. Requirements

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pertaining to such licensure and certification relate to the quality of care provided by the operator, qualifications of the operator's staff and continuing compliance with applicable laws and regulations. In addition, CON laws and regulations may place restrictions on certain activities such as the addition of beds at our facilities and changes in ownership. Failure to obtain a license, CON or other certification, or revocation, suspension or restriction of such required license, CON or other certification, could adversely impact our properties' operations and their ability to generate revenue from services provided. State CON laws are not uniform throughout the United States and are subject to change. We cannot predict the impact of state CON laws on our facilities or the operations of our tenants.

*Compliance with the Americans with Disabilities Act*

Under the Americans with Disabilities Act of 1990, as amended, or the ADA, all public accommodations must meet federal requirements for access and use by disabled persons. Additional federal, state and local laws also may require modifications to our properties or restrict our ability to renovate our properties. We cannot predict the cost of compliance with the ADA or other legislation. We may incur substantial costs to comply with the ADA or any other legislation.

*Government Environmental Regulation and Private Litigation*

Environmental laws and regulations hold us liable for the costs of removal or remediation of certain hazardous or toxic substances which may be on our properties. These laws could impose liability without regard to whether we are responsible for the presence or release of the hazardous materials. Government investigations and remediation actions may have substantial costs and the presence of hazardous substances on a property could result in personal injury or similar claims by private plaintiffs. Various laws also impose liability on a person who arranges for the disposal or treatment of hazardous or toxic substances and such person often must incur the cost of removal or remediation of hazardous substances at the disposal or treatment facility. These laws often impose liability whether or not the person arranging for the disposal ever owned or operated the disposal facility. As the owner of our properties, we may be deemed to have arranged for the disposal or treatment of hazardous or toxic substances.

**Geographic Concentration**

For a discussion of our geographic information, see Item 2, Properties — Geographic Diversification/Concentration Table, as well as Note 19, Segment Reporting, and Note 20, Concentration of Credit Risk, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Corporate Responsibility — Environmental, Social and Governance (ESG)** 

We are committed to conducting our business in a manner that benefits all of our stakeholders and ensures a lasting and positive impact from our operations. As a result, we measure our success not only by our ability to generate profits but also our ability to reduce our impact on the environment, affect positive social change in our community and conduct our operations in accordance with the highest ethical standards. To achieve this, we are developing a comprehensive ESG strategy and related ESG policy.

***Environmental***

In 2022, we launched our ESG program and began conducting a materiality assessment to assist us in prioritizing our efforts and maximizing the efficacy of our program. We strive to consciously manage our operations in a way that minimizes our impact on the environment and promotes sustainability. At our headquarters, we leverage the latest technology to minimize our energy use, such as efficient and automated lighting systems, moderation, and monitoring of heating and air conditioning, and recycling paper, plastics, metals, and electronics. In addition, we encourage all of our employees to adopt sustainable best practices. For example, we promote the use of electronic communication over printing whenever possible and have implemented electronic approval systems. Our corporate office in California is located in Leadership in Energy and Environmental Design (known as LEED) certified buildings. Within our portfolio, we work with tenants and operators to implement energy efficiency wherever possible, including light-emitting diode (known as LED) retrofitting and water conservation efforts.

We follow a policy of monitoring our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material adverse effect on us. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency.

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***Social***

*Human Capital Resources*

As of December 31, 2022, we had approximately 113 employees.

We believe our employees are our greatest asset, and we pride ourselves on the diversity they bring to our company. Because of this, we have implemented a number of programs to foster not only their professional growth, but also their growth as global citizens. All of our employees are provided with a comprehensive benefits and wellness package, which may include high-quality medical, dental, and vision insurance, life insurance, 401(k) matching, long-term incentive plans, educational grants, fitness programs, and other benefits. We provide our employees, consultants and executive officers with competitive compensation and, where applicable, opportunities for equity ownership through our Amended and Restated 2015 Incentive Plan, or the AHR Incentive Plan. See Note 14, Equity — AHR 2015 Incentive Plan, to the Consolidated Financial Statements that are part of this Annual Report on Form 10-K, for a further discussion.

We also believe that one of the keys to our success is our ability to benefit from a wide range of opinions and experiences. We believe the best way to accomplish this is through promoting racial, gender, and generational diversity across all layers of our organization. As of December 31, 2022, 69.0% of our employees were minorities and 63.7% were females. Generationally, our organization was composed of 4.4% Generation Z, 48.7% Millennials, 39.8% Generation X and 7.1% Baby Boomers. In addition, we have implemented a DE&I action plan to create a workplace environment that is both meaningful and rewarding to all employees and where there are no barriers to success for our employees. Through DE&I, we create stronger teamwork and relationships that allows us to create a performance driven culture of success for one another and our stakeholders.

*Health and Safety*

We are committed to providing a safe and healthy workplace. We continuously strive to meet or exceed compliance with all laws, regulations and accepted practices pertaining to workplace safety. All employees and contractors are required to comply with established safety policies, standards and procedures. Throughout the COVID-19 pandemic, our focus has remained on promoting employee health and safety and ensuring business continuity. Beginning in March 2020, our employees were instructed to work from home. As certain offices have reopened due to the lifting of local government restrictions, we have maintained a voluntary work-from-home policy, providing our people with valued flexibility. We have also substantially reduced employee travel to only essential business needs in favor of ongoing video-based meetings.

***Governance***

We believe maintaining a rigorous corporate governance framework is essential to the success of our organization, and we seek to adhere to policies and procedures that ensure transparency, accountability, oversight, and risk minimization. This includes committees of our board, comprised solely of independent directors, which oversee a wide range of matters such as financial reporting, executive compensation, ESG policies and conflict of interest related matters.

We have structured our corporate governance in a manner we believe closely aligns our interests with those of our stockholders. Notable features of our corporate governance structure include the following:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our board is not classified and each of our directors is subject to election annually;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we have fully independent audit, compensation and nominating and corporate governance committees;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• at least one of our directors qualifies as an "audit committee financial expert" under applicable SEC regulations and all members of the Audit Committee are financially literate in accordance with the NYSE listing rules and requirements;

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our board has opted out of the business combination statute in the MGCL (provided that such business combination is first approved by our board) and, pursuant to our bylaws, we have opted out of the control share acquisition statute in the MGCL;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we do not have a stockholder rights plan, and do not intend to adopt a stockholder rights plan in the future without (i) the approval of our stockholders or (ii) seeking ratification from our stockholders within 12 months of adoption of the plan if our board determines, in the exercise of the directors' duties under applicable law, that it is in our best interests to adopt a rights plan without the delay of seeking prior stockholder approval; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our Corporate Governance Guidelines adopted by our board require our directors and officers to own certain minimum amounts of our common stock.

We also adhere to what we believe to be industry leading policies to ensure our management and employees are acting in a manner which protects the best interest of our stakeholders. This includes our Code of Business Conduct and Ethics, Whistleblower Policy, Insider Trading Policy, Corporate Governance Guidelines, Regulation FD and Disclosure Policy and Related Party Transactions Policy.

**Investment Company Act Considerations** 

We conduct, and intend to continue to conduct, our operations, and the operations of our operating partnership and any other subsidiaries, so that no such entity meets the definition of an "investment company" under Section 3(a)(1) of the Investment Company Act. We primarily engage in the business of investing in real estate assets; however, our portfolio does include, to a much lesser extent, other real estate-related investments. We have also acquired, and may continue to acquire, real estate assets through investments in joint venture entities, including joint venture entities in which we may not own a controlling interest. We anticipate that our assets generally will be held in wholly and majority-owned subsidiaries of the company, each formed to hold a particular asset. We monitor our operations and our assets on an ongoing basis in order to ensure that neither we, nor any of our subsidiaries, meet the definition of "investment company" under Section 3(a)(1) of the Investment Company Act. Among other things, we monitor the proportion of our portfolio that is placed in investments in securities.

**Information About Industry Segments** 

We segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions. As of December 31, 2022, we operated through six reportable business segments — integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals.

***Integrated Senior Health Campuses***

As of December 31, 2022, we owned and/or operated 120 integrated senior health campuses. These facilities allow residents to "age-in-place" by providing independent living, assisted living, memory care, skilled nursing and certain ancillary services, all within a single campus setting. Integrated senior health campuses predominantly focus on needs-driven segments of senior care (i.e., assisted living, memory care and skilled nursing) and charge market rents in lieu of entry fees, as is commonly the case with continuing care retirement communities. Nearly all of our integrated senior health campuses are operated utilizing a RIDEA structure, allowing us to participate in the upside from any improved operational performance and bear the risk of any decline in operating performance. Integrated senior health campuses are a valuable component of our portfolio because of their ability to provide a continuum of care as residents require increasing levels of care.

***MOBs***

As of December 31, 2022, we owned 104 MOBs that we lease to third parties. These properties are similar to commercial office buildings, but typically require specialized infrastructure to accommodate a medical use (e.g., physicians' offices and examination rooms, as well as some ancillary uses, including pharmacies, hospital ancillary service space and outpatient services, such as diagnostic centers, rehabilitation clinics and outpatient-surgery operating rooms). Our MOBs are typically multi-tenant properties leased to healthcare providers (hospitals and physician practices) under leases that generally provide for recovery of certain operating expenses and certain capital expenditures and have initial terms of five to 10 years with fixed annual rent escalations. We value the stable and reliable cash flows our MOBs provide our company, which we believe are particularly valuable during market disruptions and recessionary periods.

***SNFs***

As of December 31, 2022, we owned 17 SNFs that we lease to third parties. SNF residents are generally higher acuity and need assistance with eating, bathing, dressing and/or medication management and also require available 24-hour nursing

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care. SNFs offer restorative, rehabilitative and custodial nursing care for people who cannot live independently but do not require the more extensive and sophisticated treatment available at hospitals. Skilled nursing services provided by our tenants in SNFs are paid for either by private sources or through the Medicare and Medicaid programs. Our SNFs are leased to a single tenant under a triple-net lease, typically with 12 to 15 year initial terms, fixed annual rent escalations and require minimum lease coverage ratios. We commonly structure SNFs under a master lease with multiple facilities in order to diversify our master tenant's sources of rent and mitigate risk. We typically focus on SNF investments in states that require a CON in order to develop new SNFs, which we believe reduces the risk of over-supply.

***SHOP***

As of December 31, 2022, we owned and operated 51 senior housing facilities in our SHOP segment. Senior housing facilities cater to different segments of the elderly population based upon their personal needs and include independent living, assisted living and memory care facilities. Residents of assisted living facilities typically require limited medical care but need assistance with eating, bathing, dressing and/or medication management. Services provided by operators at these facilities are primarily paid for by the residents directly or through private insurance and are therefore less reliant on government reimbursement programs, such as Medicaid and Medicare. The facilities in our SHOP segment are operated utilizing RIDEA structures, allowing us to participate in the upside from any improved operational performance but requiring us to bear the risk of any decline in operating performance. Our SHOP segment has the potential for embedded growth through the ongoing recovery from the COVID-19 pandemic and demand growth from an aging U.S. population.

***Senior Housing — Leased***

As of December 31, 2022, we owned 20 senior housing facilities that we lease to third parties within our senior housing — leased segment. The facilities are leased to a single tenant under a triple-net lease structure with approximately 12 to 15 year initial terms and fixed annual rent escalations and require minimum lease coverage ratios. We commonly structure senior housing — leased assets under a single master lease covering multiple facilities in order to diversify our master tenant's sources of rent and mitigate risk.

***Hospitals***

As of December 31, 2022, we have one wholly-owned hospital and one hospital in which we own an approximately 90.6% interest. Services provided by operators and tenants in our hospitals are paid for by private sources, third-party payors (e.g., insurance and health maintenance organizations) or through the Medicare and Medicaid programs. Our hospital properties include acute care, long-term acute care, specialty and rehabilitation services and are leased to single tenants or operators under triple-net lease structures.

For a further discussion of our segment reporting for the years ended December 31, 2022, 2021 and 2020, see Item 2, Properties, Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations, and Note 19, Segment Reporting, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

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**Item 1A. Risk Factors**

*Investing in our common stock involves risks. Our stockholders should carefully consider the risk factors below, together with all of the other information included in this Annual Report on Form 10-K, including our Consolidated Financial Statements and the notes thereto included herein. If any of these risks were to occur, our business, financial condition, liquidity, results of operations and prospects and our ability to service our debt and make distributions to our stockholders at a particular rate, or at all, could be materially and adversely affected (which we refer to collectively as "materially and adversely affecting us" or having "a material adverse effect on us" and comparable phrases).*

**Risk Factor Summary** 

*Below is a summary of the principal factors that make an investment in our common stock speculative or risky. This summary should be read in conjunction with the full risk factors contained below*.

*Investment Risks* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• There is no public market for the shares of our common stock. Therefore, it will be difficult for our stockholders to sell their shares of our common stock and, if our stockholders are able to sell their shares of our common stock, they will likely sell them at a substantial discount.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We have paid, and may continue to pay, a portion of distributions from the net proceeds of the initial offering and borrowings or from other sources. Any such distributions may reduce the amount of capital we ultimately invest in assets and may negatively impact the value of our stockholders' investment.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• The estimated per share NAV of our common stock may not be an accurate reflection of fair value of our assets and liabilities and likely will not represent the amount of net proceeds that would result if we were liquidated, dissolved or completed a merger or other sale of our company.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We may not effect a liquidity event within any targeted time frame, or at all. If we do not effect a liquidity event, our stockholders may have to hold their investment in shares of our common stock indefinitely.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We may not complete the contemplated underwritten offering of our common stock or be successful in listing our common stock on the NYSE. Similarly, there can be no assurance that any public offering price per share of common stock in any offering or subsequent trading price per share of our common stock on the NYSE, if we are successful in listing our common stock thereon, will exceed our current NAV per share.

*Risks Related to Our Business and Financial Results* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• The COVID-19 pandemic has adversely impacted, and could continue to adversely impact, our business and financial results.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We have experienced net losses in the past and we may experience additional losses in the future.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Our prior performance may not be an accurate predictor of our ability to achieve our business objectives or of our future results.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Our success is dependent on the performance and continued contributions of certain of our key personnel and, in the event they are no longer employed by us, we could be materially and adversely affected.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• All of our integrated senior health campuses are managed by Trilogy Management Services, LLC, or the Trilogy Manager, and account for a significant portion of our revenues and operating income. Adverse developments in the Trilogy Manager's business or financial strength could have a material adverse effect on us.

*Risks Related to Investments in Real Estate* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Uncertain market conditions could lead our real estate investments to decrease in value or may cause us to sell our properties at a loss in the future.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Most of our costs, such as operating and general and administrative expenses, interest expense and real estate acquisition and construction costs, are subject to inflation and may not be recoverable.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Our high concentrations of properties in particular geographic areas magnify the effects of negative conditions affecting those geographic areas.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Our real estate investments may be concentrated in MOBs, senior housing, SNFs, hospitals or other healthcare-related facilities, making us more vulnerable to negative factors affecting these classes than if our investments were diversified beyond the healthcare industry.

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Our business, tenants, residents and operators may face litigation and experience rising liability and insurance costs, which may materially and adversely affect us.

*Risks Related to Real Estate-Related Investments* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Unfavorable real estate market conditions and delays in liquidating defaulted mortgage loan investments may negatively impact mortgage loans in which we have invested and may invest, which could result in losses to us.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We expect a portion of our real estate-related investments to be illiquid and we may not be able to adjust our portfolio in a timely manner in response to changes in economic and other conditions.

*Risks Related to the Healthcare Industry* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• The healthcare industry is heavily regulated and new laws or regulations, changes to existing laws or regulations, loss of licensure, or failure to obtain licensure could result in the inability of our tenants to make rent payments to us or adversely affect our operators' ability to operate facilities held in RIDEA structures.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Reductions in reimbursement from third-party payors could adversely affect our tenants' operations and ability to make rental payments to us or our operators' ability to operate facilities held in RIDEA structures.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• If seniors delay moving to senior housing facilities until they require greater care or forgo moving to senior housing facilities altogether, such action could have a material adverse effect on us.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We, our tenants and our operators for our senior housing facilities and SNFs may be subject to various government reviews, audits and investigations that could materially and adversely affect us, including an obligation to refund amounts previously paid to us.

*Risks Related to Joint Ventures*

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*•* Property ownership through joint ventures could limit our control of those investments or our decisions with respect to other investments, restrict our ability to operate and finance properties on our terms, and reduce their expected return.

*Risks Related to Debt Financing*

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*•* We have substantial indebtedness and may incur additional indebtedness in the future, which could materially and adversely affect us.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• To the extent we borrow funds at floating interest rates, we will be adversely affected by rising interest rates unless fully hedged. Rising interest rates will also increase our interest expense on future fixed-rate debt.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Lenders may require us to enter into restrictive covenants relating to our business.

*Risks Related to Our Corporate Structure and Organization* 

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Future offerings of debt securities, which would be senior to our common stock, or equity securities, which would dilute our existing stockholders and may be senior to our common stock, may adversely affect our stockholders.

*Risks Related to Taxes and Our REIT Status*

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Failure to maintain our qualification as a REIT for U.S. federal income tax purposes would subject us to U.S. federal income tax on our REIT taxable income at the regular corporate rate, which would substantially reduce our ability to make distributions to our stockholders.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• We may be subject to adverse legislative or regulatory tax changes that could increase our tax liability or reduce our operating flexibility.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• If the REIT Merger does not qualify as a tax-free reorganization, there may be adverse tax consequences.

*Risks Related to Tax Exempt Investors*

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• If a stockholder that is a benefit plan or IRA fails to meet the fiduciary and other standards under ERISA or the Code as a result of an investment in shares of our common stock, such stockholder could be subject to civil and, if the failure is willful, criminal penalties.

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**Investment Risks**

***There is no public market for the shares of our common stock. Therefore, it will be difficult for our stockholders to sell their shares of our common stock and, if our stockholders are able to sell their shares of our common stock, they will likely sell them at a substantial discount.***

There currently is no public market for the shares of our common stock. We do not expect a public market for our stock to develop prior to the listing of the shares of our common stock on a national securities exchange, which may not occur in the near future or at all. Additionally, our charter contains restrictions on the ownership and transfer of shares of our stock and these restrictions may inhibit our stockholders' ability to sell their shares of our common stock. Our charter provides that no person may own more than 9.9% in value of our issued and outstanding shares of capital stock or more than 9.9% in value or in number of shares, whichever is more restrictive, of the issued and outstanding shares of our common stock. Any purported transfer of the shares of our common stock that would result in a violation of either of these limits will result in such shares being transferred to a trust for the benefit of a charitable beneficiary or such transfer being declared null and void. We have adopted a share repurchase plan, but it is limited in terms of the amount of shares of our common stock which may be repurchased annually, is subject to our board's discretion and is currently suspended except with respect to requests resulting from the death or qualifying disability of stockholders. As such, it will be difficult for our stockholders to sell their shares of our common stock promptly or at all. If our stockholders are able to sell their shares of our common stock, our stockholders may only be able to sell them to an unrelated third party at a substantial discount from the price they paid. This may be the result, in part, of the fact that, at the time we made our investments, the amount of funds available for investment were reduced by up to 12.0% of the gross offering proceeds, which amounts were used to pay selling commissions, a dealer manager fee and other organizational and offering expenses. We also were required to use gross offering proceeds to pay acquisition fees, acquisition expenses and asset management fees. Unless our aggregate investments increase in value to compensate for these fees and expenses, which may not occur, it is unlikely that our stockholders will be able to sell their shares of our common stock, whether pursuant to our share repurchase plan or otherwise, without incurring a substantial loss. We cannot assure our stockholders that their shares of our common stock will ever appreciate in value to equal the price our stockholders paid for their shares of our common stock. Therefore, shares of our common stock should be considered illiquid and a long-term investment, and our stockholders must be prepared to hold their shares of our common stock for an indefinite length of time.

***We have paid a portion of distributions from the net proceeds of the initial offering and borrowings, and in the future, may continue to pay distributions from borrowings or from other sources in anticipation of future cash flows. Any such distributions may reduce the amount of capital we ultimately invest in assets and may negatively impact the value of our stockholders' investment.***

We have used the net proceeds from the initial offering, borrowings and certain fees payable to our former advisor which have been waived, and in the future, may use borrowed funds or other sources, to pay cash distributions to our stockholders, which may reduce the amount of proceeds available for investment and operations, cause us to incur additional interest expense as a result of borrowed funds or cause subsequent investors to experience dilution. Further, if the aggregate amount of cash distributed in any given year exceeds the amount of our current and accumulated earnings and profits, the excess amount will be deemed a return of capital. Therefore, distributions payable to our stockholders may partially include a return of capital, rather than a return on capital, and we have paid a portion of our distributions from the net proceeds of the initial offering. We have not established any limit on the amount of net proceeds from the initial offering or borrowings that may be used to fund distributions, except that, in accordance with our organizational documents and Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business; or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences. The actual amount and timing of distributions is determined by our board, in its sole discretion, and typically depends on the amount of funds available for distribution, which depend on items such as our financial condition, current and projected capital expenditure requirements, tax considerations and annual distribution requirements needed to maintain our qualification as a REIT. As a result, our distribution rate and payment frequency have varied, and may continue to vary, from time to time.

Prior to March 31, 2020, the GAHR IV board of directors authorized, on a quarterly basis, a daily distribution to its stockholders of record as of the close of business on each day of the period commencing on May 1, 2016 and ending on March 31, 2020. The daily distributions were calculated based on 365 days in the calendar year and were equal to $0.001643836 per share of GAHR IV's Class T common stock and Class I common stock, which is equal to an annualized distribution rate of $0.60 per share. These distributions were aggregated and paid monthly in arrears in cash or shares of common stock pursuant to the DRIP offerings, only from legally available funds.

In response to the COVID-19 pandemic and its effects on GAHR IV's business and operations, the GAHR IV board of directors decided to take steps to protect GAHR IV's capital and maximize GAHR IV's liquidity in an effort to strengthen GAHR IV's long-term financial prospects. Consequently, on March 31, 2020, the GAHR IV board of directors authorized a reduced distribution to its stockholders which is payable monthly in arrears only from legally available funds and equal to an annualized distribution rate of $0.40 per share, a decrease from the annualized distribution rate of $0.60 per share previously paid by GAHR IV. On October 4, 2021, our board reinstated the DRIP. As a result of the reinstatement of the DRIP, beginning with the October 2021 distribution, stockholders who previously enrolled as participants in the DRIP will receive distributions

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in shares of our common stock pursuant to the terms of the DRIP, instead of cash distributions. See our Current Report on Form 8-K filed with the SEC on October 5, 2021 for more information.

In connection with a proposed public offering by us of our shares of common stock in conjunction with a contemplated listing of our common stock on the NYSE, on November 14, 2022, our board approved the suspension of the AHR DRIP Offering beginning with the distributions declared for the quarter ending December 31, 2022. Consequently, until such time as our board approves the reinstatement of the AHR DRIP Offering, if at all, any future distributions to be paid to stockholders will be payable 100% in cash. See our Current Report on Form 8-K filed with the SEC on November 16, 2022.

***The estimated per share NAV of our common stock may not be an accurate reflection of fair value of our assets and liabilities and likely will not represent the amount of net proceeds that would result if we were liquidated, dissolved or completed a merger or other sale of our company.***

On March 15, 2023, our board, at the recommendation of the audit committee of our board, which is comprised solely of independent directors, unanimously approved and established an updated estimated per share NAV of our Class T common stock and Class I common stock of $31.40 as of December 31, 2022. We provide this updated estimated per share NAV to assist broker-dealers in connection with their obligations under FINRA Rule 2231, with respect to customer account statements. The valuation was performed in accordance with the methodology provided in the Practice Guideline 2013-01, *Valuations of Publicly Registered Non-Listed REITs,* issued by the IPA in April 2013, in addition to guidance from the SEC. In the event we list on a national securities exchange in the future, we would not plan to continue publishing these valuations.

The updated estimated per share NAV was determined after consultation with an independent third-party valuation firm, the engagement of which was approved by the audit committee of our board. FINRA rules provide no guidance on the methodology an issuer must use to determine its estimated per share NAV. As with any valuation methodology, our independent valuation firm's methodology was based upon a number of estimates and assumptions that may not have been accurate or complete. Different parties with different assumptions and estimates could derive a different estimated per share NAV, and these differences could be significant.

The updated estimated per share NAV was not audited or reviewed by our independent registered public accounting firm and did not represent the fair value of our assets or liabilities according to accounting principles generally accepted in the United States, or GAAP. In addition, the updated estimated per share NAV was an estimate as of a given point in time and the value of shares of our common stock will fluctuate over time as a result of, among other things, the number of shares of our common stock outstanding, developments related to individual assets and changes in the real estate and capital markets. Accordingly, with respect to the updated estimated per share NAV, we can give no assurance that:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a stockholder would be able to resell his, her or its shares at our updated estimated per share NAV;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a stockholder would ultimately realize distributions per share equal to our updated estimated per share NAV upon liquidation of our assets and settlement of our liabilities or a sale of our company;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our shares of common stock would trade at our updated estimated per share NAV on a national securities exchange;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an independent third-party appraiser or other third-party valuation firm, other than the third-party valuation firm engaged by our board to assist in its determination of the updated estimated per share NAV, would agree with our estimated per share NAV; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the methodology used to estimate our updated per share NAV would be acceptable to FINRA or comply with reporting requirements under the Employee Retirement Income Security Act of 1974, or ERISA, the Code, other applicable law, or the applicable provisions of a retirement plan or individual retirement account, or IRA.

Further, our board has ultimately been responsible for determining the estimated per share NAV. Our independent valuation firm calculates estimates of the value of our assets, and our board then determines the net value of assets and liabilities taking into consideration such estimate provided by the independent valuation firm. After any particular valuation, there are likely to be changes in the value of our assets that would not be reflected in the published estimated per share NAV. As a result, the published estimated per share NAV may not fully reflect changes in value that may have occurred since the prior valuation. Furthermore, we will monitor our portfolio, but it has been, and may continue to be, difficult to reflect changing market conditions or material events, such as the COVID-19 pandemic, inflation, prevailing interest rates and movements in capitalization rates that may impact the value of our portfolio between valuations, or to obtain timely or complete information regarding any such events. Therefore, the estimated per share NAV published before and during the announcement of an extraordinary event may differ significantly from our actual per share NAV until such time as sufficient information is available and analyzed, the financial impact is fully evaluated, and the appropriate adjustment is made to our estimated per share NAV, as determined by our board.

For a full description of the methodologies used to value our assets and liabilities in connection with the calculation of the updated estimated per share NAV, see our Current Report on Form 8-K filed with the SEC on March 17, 2023.

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***We may not effect a liquidity event within any targeted time frame, or at all. If we do not effect a liquidity event, our stockholders may have to hold their investment in shares of our common stock for an indefinite period of time.***

Although we are currently positioning our company for a potential future listing on a national securities exchange at an opportune time, we are not obligated, through our charter or otherwise, to effectuate a transaction or liquidity event and may not effectuate a transaction or liquidity event within any time frame or at all. If we do not effectuate a transaction or liquidity event, it will be very difficult for our stockholders to have liquidity for their investment in the shares of our common stock other than limited liquidity through our share repurchase plan, if our share repurchase plan is fully reinstated by our board.

***If and when we complete a liquidity event, the market value ascribed to our shares of common stock upon the liquidity event may be significantly lower than the current estimated per share NAV.***

In the event that we complete a liquidity event, such as a listing of our shares on a national securities exchange, a merger in which our stockholders receive securities that are listed on a national securities exchange, or a sale for cash, the market value of our shares upon consummation of such liquidity event may be significantly lower than the current estimated per share NAV of our common stock that may be reflected on the account statements of our stockholders. For example, if our shares are listed on a national securities exchange, the trading price of the shares may be significantly lower than the most recent estimated per share NAV of our common stock of $31.40 as of December 31, 2022.

***No assurance can be given that we will complete the contemplated underwritten offering by us of our common stock or that we will be successful in listing our common stock on the NYSE. Similarly, there can be no assurance that the public offering price per share of common stock in any offering that we may complete or that the subsequent trading price per share of our common stock on the NYSE, if we are successful in listing our common stock thereon, will exceed our current NAV per share.***

In September 2022, we filed a registration statement with the SEC relating to a proposed public offering by us of shares of our common stock in conjunction with the contemplated listing of our common stock on the NYSE. Completing a public offering will require the SEC to declare the registration statement effective, and listing on the NYSE will require approval by the NYSE. Moreover, in addition to required regulatory actions, a decision to proceed with an offering and listing depends on our evaluation of market conditions and other factors, many of which are beyond our control. Accordingly, there can be no assurance as to when, or even if, we will be able to complete the public offering or successfully list our common stock on the NYSE.

We do not know the terms, including the public offering price per share, on which the contemplated underwritten public offering of common stock may be completed. The initial public offering price of the common stock sold in any such offering will be discussed between us and the representatives of the underwriters of such offering. Among the factors that we expect to consider in determining the initial public offering price, in addition to prevailing market conditions, will be our historical performance, estimates of our business potential and earnings prospects, an assessment of our management and the consideration of the above factors in relation to market valuation of companies in related businesses. Thereafter, the market price of shares of our common stock on the NYSE will depend on numerous factors and may be volatile, and an active trading market may not develop or be maintained. There can be no assurance that the public offering price per share of common stock will equal or exceed our NAV per share, which our Board determined on March 15, 2023 to be $31.40 as of December 31, 2022, and the subsequent trading price may be below the public offering price per share.

Prior to suspension of the AHR DRIP Offering in November 2022, the purchase price per share of common stock sold under the AHR DRIP was the most recently published estimated NAV per share. No assurance can be given that the public offering price per share of common stock sold in any underwritten offering or that the trading price per share of our common stock on the NYSE will equal or exceed the price at which shares of common stock were sold under the AHR DRIP. The public offering price per share of common stock sold in any underwritten offering or the subsequent trading price per share of our common stock on the NYSE could be below our NAV per share and the price per share that investors purchased shares in the AHR DRIP Offering.

***If we do complete the contemplated underwritten offering by us, shares of Class T common stock and Class I common stock held by current stockholders might not be listed initially on the NYSE.***

It is contemplated that we will list our common stock sold in the potential underwritten public offering on the NYSE in conjunction with any such offering. Currently, our stockholders own either Class T common stock or Class I common stock, and we do not intend to list our Class T common stock or Class I common stock on the NYSE. However, it is contemplated that on the six-month anniversary of any listing of our common stock on the NYSE, outstanding shares of Class T common stock and Class I common stock will automatically be converted into shares of our NYSE-listed common stock. Accordingly, if we do complete the contemplated underwritten offering by us, current stockholders are not expected to be able to sell their Class T common stock or Class I common stock on the NYSE until such conversion occurs, and such shares would be less liquid than our listed common stock until such time as the automatic conversion occurs.

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**Risks Related to Our Business and Financial Results**

***The COVID-19 pandemic has adversely impacted, and could continue to adversely impact, our business and financial results, and the ultimate impact will depend on future developments including the extent of changes in policies and funding resulting from the expiration of the COVID-19 public health emergency declaration, which are highly uncertain and cannot be predicted.***

Our residents, tenants, operating partners and managers, our industry and the U.S. economy continue to be adversely affected by the COVID-19 pandemic and related supply chain disruptions and labor shortages. While the COVID 19 pandemic is subsiding, the timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the emergence and severity of COVID-19 variants, the effectiveness and frequency of booster vaccinations and the duration and implications of restrictions and safety measures. As the lasting effect of the COVID-19 pandemic is still impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments.

The COVID-19 pandemic resulted in a significant decline in resident occupancies at our leased senior housing facilities and SNFs, SHOP and integrated senior health campuses and an increase in COVID-19 related operating expenses with more costly short-term hires due to the shortage of healthcare personnel. Therefore, our focus at such properties continues to be on resident occupancy recovery and operating expense management. Resident occupancies at our senior housing and SNFs have been gradually improving. We believe the operational recovery of such classes from the impact of the COVID-19 pandemic will generally continue and that such recovery over time towards pre-pandemic levels will drive our overall portfolio performance.

As a result of the federal government's COVID-19 public health emergency declaration in January 2020, certain federal and state pandemic-related relief measures, such as funding, procedural waivers and/or reimbursement increases, became available to some of our tenants and operators. On January 30, 2023, the Biden Administration announced that the COVID-19 public health emergency declaration will expire on May 11, 2023, creating uncertainty as to how widespread these measures will continue to be and to what extent they may be distributed to and benefit our tenants and operators.

The lasting effect of the COVID-19 pandemic and pace of recovery will largely depend on future developments, which cannot be predicted with confidence at this time.

***We have experienced net losses in the past and we may experience additional losses in the future.***

Historically, we have experienced net losses (calculated in accordance with GAAP) and we may not be profitable or realize growth in the value of our investments. Many of our losses can be attributed to start-up costs, general and administrative expenses, depreciation and amortization, as well as acquisition expenses incurred in connection with purchasing properties or making other investments. For a further discussion of our operational history and the factors affecting our net losses, see Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations and our Consolidated Financial Statements and the notes thereto that are a part of this Annual Report on Form 10-K.

***Our prior performance may not be an accurate predictor of our ability to achieve our business objectives or of our future results.***

Our stockholders should not rely on our past performance to predict our future results. Our stockholders should review our prospects in light of the risks, uncertainties and difficulties frequently encountered by companies that have a limited operating history, many of which may be beyond our control. For example, due to challenging economic conditions in the past, distributions to stockholders were reduced. Therefore, to be successful in this market, we must, among other things:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• identify and acquire investments that further our business objectives and growth strategies;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• attract, integrate, motivate and retain qualified personnel to manage our day-to-day operations;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• respond to competition both for investment opportunities and potential investors' investment in us; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• build and expand our operational structure to support our business.

We cannot guarantee that we will succeed in achieving these goals, and our failure to do so could materially and adversely affect us and our stockholders could lose all or a portion of their investment.

***Our success is dependent on the performance and continued contributions of certain of our key personnel and, in the event they are no longer employed by us, we could be materially and adversely affected.***

Our success depends, to a significant degree, upon the continued contributions of our executives and key officers. In particular, Danny Prosky would be difficult to replace. Mr. Prosky currently serves as our Chief Executive Officer and one of

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our directors. In the event that Mr. Prosky or one of our other executives or key executive officers are no longer employed by us, for any reason, it could have a material adverse effect on us and we may not be able to attract and hire equally capable individuals to replace them. If we were to lose the benefit of the experience, efforts and abilities of one or more of our executives or other key officers, we could be materially and adversely affected.

***Our financial results, our ability to make distributions to our stockholders and our ability to dispose of our investments are subject to international, national and local market conditions we cannot control or predict.***

We are subject to the risks of an international or national economic slowdown or downturn and other changes in international, national and local market conditions. The following factors may have affected, and may continue to affect, income from our properties, our ability to acquire and dispose of properties, and our overall financial results and ability to make distributions to our stockholders:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• poor economic times may result in defaults by tenants of our properties due to bankruptcy, lack of liquidity or operational failures. We may provide rent concessions, tenant improvement expenditures or reduced rental rates to maintain or increase occupancy levels;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• fluctuations as a result of supply and demand imbalances and reduced occupancies and rental rates may cause the properties that we own to decrease in value. Consequently, we may not be able to recover the carrying amount of our properties, which may require us to recognize an impairment charge or record a loss on sale in our financial results;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• reduced values of our properties may limit our ability to dispose of assets at attractive prices or to obtain or maintain debt financing secured by our properties and may reduce the availability of unsecured loans;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• constricted access to credit may result in tenant defaults or non-renewals under leases;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• layoffs may lead to a lower demand for medical services and cause vacancies to increase and a lack of future population and job growth may make it difficult to maintain or increase occupancy levels;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• disruptions in the financial markets, deterioration in economic conditions or a public health crisis, such as the COVID-19 pandemic, have resulted, and may continue to result, in lower occupancy in our facilities, increased vacancy rates for commercial real estate due to generally lower demand for rentable space, as well as an oversupply of rentable space;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• governmental actions and initiatives, including risks associated with the impact of a prolonged government shutdown or budgetary reductions or impasses; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased insurance premiums, real estate taxes or utilities or other expenses, such as inflation costs, will decrease our financial results and may reduce funds available for distribution to our stockholders or, to the extent such increases are passed through to tenants, may lead to tenant defaults. Also, any such increased expenses may not coincide with our ability to increase rents to tenants on turnover, which would adversely impact our financial results.

The length and severity of any economic slowdown or downturn cannot be predicted with confidence at this time. We have been, and we expect may continue to be, negatively impacted to the extent an economic slowdown or downturn is prolonged or becomes more severe.

***We face significant competition for the acquisition and disposition of MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities, which may impede our ability to take, and increase the cost of, such actions, which may materially and adversely affect us.***

We face significant competition from other entities engaged in real estate investment activities for acquisitions and dispositions of MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities, some of whom may have greater resources, lower costs of capital and higher risk tolerances than we do. Increased competition makes it more challenging for us to identify and successfully capitalize on opportunities that meet our business objectives and could improve the bargaining power of our counterparties, thereby impeding our investment, acquisition and disposition activities. If we pay higher prices per property or receive lower prices for dispositions of our MOBs, senior housing, SNFs, hospitals or other healthcare-related facilities as a result of such competition, we may be materially and adversely affected.

***Our investments in, and acquisitions of, MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities 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. Such expenditures may negatively affect our results of operations. Investments in and acquisitions of MOBs, senior housing, SNFs, hospitals and other healthcare-

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related facilities 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 or operator 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. In addition, we may not be able to identify off-market investment opportunities or investment opportunities that are strategically marketed to a limited number of investors at the rate that we anticipate or at all. We may be unable to obtain or assume financing for acquisitions on favorable terms or at all. Healthcare properties are often highly customizable and the development or redevelopment of such properties may require costly tenant-specific improvements. We may experience delays and disruptions to property redevelopment as a result of supply chain issues and construction material and labor shortages. 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 a material adverse effect on us. 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. As a result, we cannot assure our stockholders that we will achieve the economic benefit we expect from acquisitions, investment, development and redevelopment opportunities and may lead to impairment of such assets.

***We are uncertain of all of our sources of debt or equity for funding our capital needs. If we cannot obtain funding on favorable terms, our ability to acquire, and make necessary capital improvements to, properties may be impaired or delayed, which could have a material adverse effect on us.***

We have not identified all of our sources of debt or equity for funding, and such sources of funding may not be available to us on favorable terms or at all. If we do not have access to sufficient funding on favorable terms in the future, we may not be able to acquire, and make necessary capital improvements to, properties, pay other expenses, or expand our business when desired, or at all, which could have a material adverse effect on us.

***We are dependent on tenants for our revenue, and lease terminations could reduce our ability to make distributions to our stockholders.***

The successful performance of our real estate investments is materially dependent on the financial stability of our tenants. Lease payment defaults by tenants would cause us to lose the revenue associated with such leases and could reduce our ability to make distributions to our stockholders. If a property is subject to a mortgage, a default by a significant tenant on its lease payments to us may result in a foreclosure on the property if we are unable to find an alternative source of revenue to meet our mortgage payments. In the event of a tenant default, we may experience delays in enforcing our rights as landlord and may incur substantial costs in protecting our investment and re-leasing our property. Further, we cannot assure our stockholders that we will be able to re-lease the property for the rent previously received, if at all, or that lease terminations will not cause us to sell the property at a loss.

***All of our integrated senior health campuses are managed by the Trilogy Manager and account for a significant portion of our revenues and operating income. Adverse developments in the Trilogy Manager's business or financial strength could have a material adverse effect on us.***

As of March 17, 2023, the Trilogy Manager managed all of the day-to-day operations for all of our integrated senior health campuses pursuant to a long-term management agreement. These integrated senior health campuses accounted for approximately 41.1% of our portfolio (based on aggregate contract purchase price) as of December 31, 2022 and contributed approximately 46.8% of our annualized base rent/annualized NOI as of such date. Although we have various rights as the joint venture owner of these integrated senior health campuses under our management agreement, we rely on the Trilogy Manager's personnel, expertise, technical resources and information systems, proprietary information, good faith and judgment to manage our integrated senior health campuses operations efficiently and effectively, and to identify and manage development opportunities for new integrated senior health campuses. We also rely on the Trilogy Manager to provide accurate campus-level financial results for our integrated senior health campuses in a timely manner and to otherwise operate our integrated senior health campuses in compliance with the terms of our management agreement and all applicable laws and regulations. We depend on the Trilogy Manager's ability to attract and retain skilled personnel to provide these services. A shortage of nurses or other trained personnel or general inflationary pressures may force the Trilogy Manager to enhance its pay and benefits package to compete effectively for such personnel, the cost of which we would bear in proportion to our joint venture interest, but it may not be able to offset these added costs by increasing the rates charged to residents. As such, any adverse developments in the Trilogy Manager's business or financial strength, including its ability to retain key personnel, could impair its ability to manage our integrated senior health campuses efficiently and effectively and could have a material adverse effect on us. In addition, if the Trilogy Manager experiences any significant financial, legal, accounting or regulatory difficulties due to a weak economy, industry downturn or otherwise, such difficulties could result in, among other adverse events, acceleration of its indebtedness, impairment of its continued access to capital, the enforcement of default remedies by its counterparties, or the commencement

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of insolvency proceedings by or against it under the U.S. Bankruptcy Code. Any one or a combination of these risks could have a material adverse effect on us.

***In the event that our management agreement with the Trilogy Manager is terminated or not renewed, we may be unable to replace the Trilogy Manager with another suitable operator, or, if we were successful in locating such an operator, we cannot guarantee that it would manage the integrated senior health campuses efficiently and effectively or that any such transition would be completed timely, which may have a material adverse effect on us.***

In the event we were to contemplate pursuing any existing or future contractual rights or remedies under our management agreement with the Trilogy Manager, including termination rights, we would consider numerous factors, including legal, contractual, regulatory, business and other relevant considerations. In the event that we exercise our rights to terminate the management agreement with the Trilogy Manager for any reason or such agreements are not renewed upon expiration of their terms, we would attempt to reposition the affected integrated senior health campuses with another operator. Although we believe that other qualified national and regional operators would be interested in managing our integrated senior health campuses, we cannot provide any assurance that we would be able to locate another suitable operator or, if we were successful in locating such an operator, that it would manage the integrated senior health campuses efficiently and effectively or that any such transition would be completed timely or would not require substantial capital expenditures. Any such transition would likely result in disruption of the operation of such facilities, including matters relating to staffing and reporting. Moreover, the transition to a replacement operator may require approval by the applicable regulatory authorities and, in most cases, one or more of our lenders, including the mortgage lenders for certain of the integrated senior health campuses, and we cannot provide any assurance that such approvals would be granted on a timely basis, if at all. Any inability to replace, or delay in replacing the Trilogy Manager as the operator of integrated senior health campuses with a highly qualified successor on favorable terms could have a material adverse effect on us.

***The financial deterioration, insolvency or bankruptcy of one or more of our major tenants, operators, borrowers or other obligors could have a material adverse effect on us.***

A downturn in any of our tenants', operators', borrowers' or other obligors' businesses could ultimately lead to voluntary or involuntary bankruptcy or similar insolvency proceedings, including but not limited to assignment for the benefit of creditors, reorganization, liquidation or winding-up. Bankruptcy and insolvency laws afford certain rights to a defaulting tenant, operator or borrower that has filed for bankruptcy or reorganization that may render certain of our remedies unenforceable or, at the least, delay our ability to pursue such remedies and realize any related recoveries. A debtor has the right to assume, or to assume and assign to a third party, or to reject its executory contracts and unexpired leases in a bankruptcy proceeding. If a debtor were to reject its leases with us, obligations under such rejected leases would cease. The claim against the rejecting debtor would be an unsecured claim, which would be limited by the statutory cap set forth in the U.S. Bankruptcy Code, and there may be insufficient assets to satisfy all unsecured claims, even ones limited by the statutory cap. This statutory cap may be substantially less than the remaining rent actually owed under the lease. In addition, a debtor may also assert in bankruptcy proceedings that leases should be re-characterized as financing agreements, which could result in our being deemed a lender instead of a landlord. A lender's rights and remedies, as compared to a landlord's, generally are materially less favorable, and our rights as a lender may be subordinated to other creditors' rights.

Furthermore, the automatic stay provisions of the U.S. Bankruptcy Code would preclude us from enforcing our remedies unless we first obtain relief from the court having jurisdiction over the bankruptcy case. This would effectively limit or delay our ability to collect unpaid rent or interest payments, and we may ultimately not receive any payment at all. In addition, we would likely be required to fund certain expenses and obligations to preserve the value of our properties, avoid the imposition of liens on our properties or transition our properties to a new tenant or operator. Additionally, we lease many of our properties to healthcare providers who provide long-term custodial care to the elderly. Evicting operators for failure to pay rent while the property is occupied typically involves specific procedural or regulatory requirements and may not be successful. Even if eviction is possible, we may determine not to do so due to reputational or other risks. Bankruptcy or insolvency proceedings typically also result in increased costs to the operator, significant management distraction and performance declines. If we are unable to transition affected properties, they would likely experience prolonged operational disruption, leading to lower occupancy rates and further depressed revenues. Publicity about the operator's financial troubles and bankruptcy or insolvency proceedings may also negatively impact their and our reputations, decreasing customer demand and revenues. Any or all of these risks could have a material adverse effect on us.

***We may incur additional costs in re-leasing properties with specialized uses, which could materially and adversely affect us.***

Some of the properties we have acquired and will seek to acquire are healthcare properties designed or built primarily for a particular tenant of a specific type of use known as a single-user facility. If we or our tenants terminate the leases for these properties or our tenants default on their lease obligations or lose their regulatory authority to operate such properties, we may not be able to locate suitable replacement tenants to lease the properties for their specialized uses. Alternatively, we may be

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required to spend substantial amounts to adapt the properties to other uses or incur other significant re-leasing costs. Any loss of revenues or additional capital expenditures required as a result may have a material adverse effect on us.

***We may be unable to secure funds for future tenant or other capital improvements, which could limit our ability to attract, replace or retain tenants, pay our expenses and make distributions to our stockholders.***

When tenants do not renew their leases or otherwise vacate their space, in order to attract replacement tenants, we have expended, and may be required to expend in the future, substantial funds for tenant improvements and leasing commissions related to the vacated space. Such tenant improvements have required, and may continue to require, us to incur substantial capital expenditures. If we have not established capital reserves for such tenant or other capital improvements, we will have to obtain financing from other sources and we have not identified any sources for such financing. We may also have future financing needs for other capital improvements to refurbish or renovate our properties. If we need to secure financing sources for tenant or other capital improvements in the future, but are unable to secure such financing or are unable to secure financing on terms we feel are acceptable, we may be unable to make tenant and other capital improvements or we may be required to defer such improvements. If this happens, it may cause one or more of our properties to suffer from a greater risk of obsolescence or a decline in value, or a greater risk of decreased cash flows as a result of fewer potential tenants being attracted to the property or our existing tenants not renewing their leases. If we do not have access to sufficient funding in the future, we may also not be able to pay our expenses or make distributions to our stockholders.

***A breach of information technology systems on which we rely could materially and adversely impact us.***

We and our tenants and operators rely on information technology systems, including the internet and networks and systems maintained and controlled by third-party vendors and other third parties, to process, transmit and store information and to manage or support our business processes. Third-party vendors collect and hold personally identifiable information and other confidential information of our tenants, operators, patients, stockholders and employees. We also maintain confidential financial and business information regarding us and persons and entities with which we do business on our information technology systems. While we and our tenants and operators take steps to protect the security of the information maintained in our information technology systems, including the use of commercially available systems, software, tools and monitoring to provide security for processing, transmitting and storing of the information, it is possible that such security measures will not be able to prevent human error or the systems' improper functioning, or the loss, misappropriation, disclosure or corruption of personally identifiable information or other confidential or sensitive information, including information about our tenants and employees. Cybersecurity breaches, including physical or electronic break-ins, computer viruses, phishing scams, attacks by hackers, breaches due to employee error or misconduct and similar breaches, can create, and in some instances in the past have resulted in, system disruptions, shutdowns or unauthorized access to information maintained on our information technology systems or the information technology systems of our third-party vendors or other third parties or otherwise cause disruption or negative impacts to occur to our business and materially and adversely affect us. While we and, we believe, most of our tenants and operators maintain cyber risk insurance to provide some coverage for certain risks arising out of cybersecurity breaches, there is no assurance that such insurance would cover all or a significant portion of the costs or consequences associated with a cybersecurity breach. As our reliance on technology increases, so will the risks posed to our information systems, both internal and those we outsource. In addition, as the techniques used to obtain unauthorized access to information technology systems become more varied and sophisticated and the occurrence of such breaches becomes more frequent, we and our third-party vendors and other third parties may be unable to adequately anticipate these techniques or breaches and implement appropriate preventative measures. There is no guarantee that any processes, procedures and internal controls we have implemented or will implement will prevent cyber intrusions. Any failure to prevent cybersecurity breaches and maintain the proper function, security and availability of our or our third-party vendors' and other third parties' information technology systems could interrupt our operations, damage our reputation and brand, damage our competitive position, make it difficult for us to attract and retain tenants, and subject us to liability claims or regulatory penalties, which could materially and adversely affect us. Additionally, as increased regulatory compliance for cybersecurity protocols and disclosures are required by state or federal authorities, the increased amount of resources, both time and expense, could also materially and adversely affect us.

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**Risks Related to Investments in Real Estate**

***Uncertain market conditions could lead our real estate investments to decrease in value or may cause us to sell our properties at a loss in the future.***

Our management, subject to the oversight of our board, may exercise its discretion as to whether and when to sell a property, and we have no obligation to sell properties at any particular time or at all. We cannot predict with any certainty the various market conditions affecting real estate investments that will exist at any particular time in the future. As such, we may be purchasing our properties at a time when capitalization rates are at historically low levels and purchase prices are high. In addition, we may be required to expend funds to correct defects or to make improvements before a property can be sold. We may not have adequate funds available to correct such defects or to make such improvements. Moreover, in acquiring a property, we may agree to restrictions that prohibit the sale of that property for a period of time or impose other restrictions, such as a limitation on the amount of debt that can be placed or repaid on that property. We cannot predict the length of time needed to find a willing purchaser and to close the sale of a property. The value of our properties may not increase over time, which may restrict our ability to sell our properties, or in the event we are able to sell such properties, may lead to sale prices less than the prices that we paid to purchase the properties or the price at which we value the property. Additionally, we may incur prepayment penalties in the event we sell a property subject to a mortgage earlier than we otherwise had planned. Accordingly, our ability to realize potential appreciation on our real estate investments and make distributions to our stockholders will, among other things, be dependent upon uncertain market conditions.

***Most of our costs, such as operating and general and administrative expenses, interest expense, and real estate acquisition and construction costs, are subject to inflation and may not be recoverable.***

A significant portion of our operating expenses is sensitive to inflation. These include expenses for property-related costs such as insurance, utilities and repairs and maintenance. We also have ground lease expenses in certain of our properties. Ground lease costs are contractual, but in some cases, lease payments reset every few years based on changes on consumer price indexes.

Operating expenses on our non-RIDEA properties, with the exception of ground lease rental expenses, are typically recoverable through our lease arrangements, which allow us to pass through substantially all expenses associated with property taxes, insurance, utilities, repairs and maintenance, and other operating expenses (including increases thereto) to our tenants. As of December 31, 2022, the majority of our existing leases were either triple-net leases or leases that allow us to recover certain operating expenses and certain capital expenditures. Our remaining leases are generally modified gross, or base year, leases, which only provide for recoveries of operating expenses above the operating expenses from the initial year within each lease. During inflationary periods, we expect to recover increases in operating expenses from our triple-net leases and our modified gross, or base year, leases. As a result, we do not believe that inflation would result in a significant adverse effect on our net operating income, results of operations, and operating cash flows at the property level. For our RIDEA properties, increases in operating expenses, including labor, that are caused by inflationary pressures will generally be passed through to us and may materially and adversely affect us.

Our general and administrative expenses consist primarily of compensation costs, as well as professional and legal fees. Annually, our employee compensation is adjusted to reflect merit increases; however, to maintain our ability to successfully compete for the best talent, rising inflation rates has required and may continue to require us to provide compensation increases beyond historical annual merit increases, which may significantly increase our compensation costs. Similarly, professional and legal fees are also subject to the impact of inflation and expected to increase proportionately with increasing market prices for such services. Consequently, inflation is expected to increase our general and administrative expenses over time and may materially and adversely affect us.

Also, during inflationary periods, interest rates have historically increased, which would have a direct effect on the interest expense of our borrowings. Our exposure to increases in interest rates is limited to our variable-rate borrowings, which consist of borrowings under our credit facilities and variable-rate mortgage loans payable. As of December 31, 2022, our outstanding variable-rate borrowings aggregated to $1,651,221,000, all of which was unhedged. In January 2023, we entered into an interest rate swap contract to hedge $275,000,000 of our floating rate term loan under our existing credit facility. Rising interest rates will also increase our interest expense on future fixed-rate borrowings. Therefore, a significant increase in inflation rates would have a material adverse impact on our financing costs and interest expense.

We have long term lease agreements with our tenants that contain effective annual rent escalations that were either fixed or indexed based on a consumer price index or other index. We believe our annual lease expirations allow us to reset these leases to market rents upon renewal or re-leasing and that annual rent escalations within our long-term leases are generally sufficient to offset the effect of inflation on non-recoverable costs, such as general and administrative expenses and interest expense. However, it is possible that during higher inflationary periods like the one existing in 2021 and 2022, the impact of

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inflation will not be adequately offset by the resetting of rents from our renewal and re-leasing activities and our annual rent escalations. As a result, during periods when the impact of inflation exceeds the annual rent escalation percentages in our current leases and the percentage increase in rents in new leases, our financial results will be impaired, potentially significantly.

Additionally, inflationary pricing may have a negative effect on the real estate acquisitions and construction costs necessary to complete our development and redevelopment projects, including, but not limited to, costs of construction materials, labor, and services from third-party contractors and suppliers. Higher acquisition and construction costs could adversely impact our net investments in real estate and expected yields in our development and redevelopment projects, which may make otherwise lucrative investment opportunities less profitable to us. Any of these matters may materially and adversely affect us over time.

***Our real estate assets may decline in value and be subject to significant impairment losses, which may reduce our net income.***

We periodically evaluate long-lived assets, primarily consisting of investments in real estate that are carried at historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that the carrying value may not be recoverable. In our evaluation of impairment, we consider indicators such as significant negative industry or economic trends, significant underperformance relative to historical or projected future operating results and a significant change in the extent or manner in which the asset is used or significant physical change in the asset. If indicators of impairment of long-lived assets are present, we evaluate the carrying value of the related real estate investment in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. If we determine that an impairment has occurred, we would be required to make a downward adjustment to the net book value of the property, which could have a material adverse effect on us in the period in which the impairment charge is recorded. We have recorded impairment charges related to certain properties in the year ended December 31, 2022, and may record future impairments based on actual results and changes in circumstances. Negative developments in the real estate market may cause management to reevaluate the business and macro-economic assumptions used in its impairment analysis. Changes in management's assumptions based on actual results may have a material impact on our Consolidated Financial Statements and the notes thereto that are a part of this Annual Report on Form 10-K.

***Our high concentrations of properties in particular geographic areas magnify the effects of negative conditions affecting those geographic areas.***

We have a concentration of properties in particular geographic areas; therefore, any adverse situation that disproportionately effects one of those areas would have a magnified adverse effect on our portfolio. As of March 17, 2023, properties located in Indiana, Ohio and Michigan accounted for approximately 37.8%, 11.9% and 10.7%, respectively, of our total property portfolio's annualized base rent or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in each such state's economy, real estate and other market conditions.

***Our real estate investments may be concentrated in MOBs, senior housing, SNFs, hospitals or other healthcare-related facilities, making us more vulnerable to negative factors affecting these classes than if our investments were diversified beyond the healthcare industry.***

As a REIT, we invest primarily in real estate. Within the real estate industry, we have acquired, and may continue to acquire, or selectively develop and own MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities. We are subject to risks inherent in concentrating investments in real estate. These risks resulting from a lack of diversification become even greater as a result of our business objectives and growth strategies, which involve investing substantially all of our assets in clinical healthcare real estate.

A downturn in the commercial real estate industry generally could significantly adversely affect the value of our properties. A downturn in the healthcare industry could negatively affect our lessees' ability to make lease payments to us and our operators' ability to manage our properties efficiently and effectively. These matters could materially and adversely affect us and could be more pronounced than if we diversified our investments outside of real estate or if our portfolio did not include a substantial concentration in MOBs, senior housing, SNFs, hospitals or healthcare-related facilities.

***Terrorist attacks, acts of violence or war, political protests and unrest or public health crises have affected and may affect the markets in which we operate and have a material adverse effect on us.***

Terrorist attacks, acts of violence or war, political protests and unrest or public health crises (including the COVID-19 pandemic) have negatively affected, and may continue to negatively affect, our operations and our stockholders' investments. We have acquired, and may continue to acquire, real estate assets located in areas that are susceptible to terrorist attacks, acts of violence or war, political protests or public health crises. These events may directly impact the value of our assets through

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damage, destruction, loss or increased security costs. Although we may obtain terrorism insurance, we may not be able to obtain sufficient coverage to fund any losses we may incur. Risks associated with potential acts of terrorism could sharply increase the premiums we pay for coverage against property and casualty claims. Further, certain losses resulting from these types of events are uninsurable or not insurable at reasonable costs. In addition, other than any reserves we may establish, we have no source of funding to repair or reconstruct any uninsured damaged property, and we cannot assure our stockholders that any such sources of funding will be available to us for such purposes in the future. Also, to the extent we must pay unexpectedly large amounts for uninsured losses, our cash flows could be impaired in a manner that would result in little or no cash being distributed to our stockholders. More generally, any terrorist attack, other act of violence or war, political protest and unrest or public health crisis could result in increased volatility in, or damage to, the United States and worldwide financial markets and economy, all of which could adversely affect our tenants' ability to pay rent on their leases with us, our operators' ability to manage our properties efficiently and effectively and our ability to borrow money or issue capital stock on favorable terms, which could have a material adverse effect on us.

***Our business, tenants, residents and operators may face litigation and experience rising liability and insurance costs, which may materially and adversely affect us.***

We currently intend to pursue insurance recovery for any losses caused by the COVID-19 pandemic, but there can be no assurance that coverage will be available under our existing policies or if such coverage is available, which and how much of our losses will be covered and what other limitations may apply. Due to the likely increase in claims as a result of the impact of the COVID-19 pandemic, insurance companies may limit or stop offering coverage to companies like ours for pandemic related claims and/or significantly increase the cost of insurance so that it is no longer available at commercially reasonable rates.

With respect to our SHOP and integrated senior health campuses, we are ultimately responsible for operational risks and other liabilities of the facility, other than those arising out of certain actions by our operator, such as gross negligence or willful misconduct. As such, operational risks include, and our resulting revenues therefore depend on, the availability and cost of general and professional liability insurance coverage or increases in insurance policy deductibles. Furthermore, because we bear such operational risks and liabilities related to our SHOP and integrated senior health campuses, we may be directly adversely impacted by potential litigation or investigations related to the COVID-19 pandemic that have occurred or may occur at those facilities, and our insurance coverage may not cover or may not be sufficient to cover any potential losses.

Additionally, as a result of the COVID-19 pandemic, the cost of insurance for our tenants, operators and residents is expected to increase as well, and such insurance may not cover certain claims related to COVID-19, which could impair their ability to pay rent to us. Our exposure to COVID-19 related litigation or investigation risk may be further increased if our operators or residents of such facilities are subject to bankruptcy or insolvency.

Any of these matters could materially and adversely affect us.

***If we contract with a development company for newly developed property, our earnest money deposit made to the development company may not be fully refunded.***

We may acquire one or more properties under development. We anticipate that if we do acquire properties that are under development, we will be obligated to pay a substantial earnest money deposit at the time of contracting to acquire such properties, and that we will be required to close the purchase of the property upon completion of the development of the property. We may enter into such a contract with the development company even if at the time we enter into the contract, we have not yet secured sufficient financing to enable us to close the purchase of such property. However, we may not be required to close a purchase from the development company, and may be entitled to a refund of our earnest money, generally in any of the following circumstances depending on the contract:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the development company fails to complete the development of the property according to contractual requirements;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• all or a specified portion of the pre-leased tenants fail to take possession under their leases for any reason; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we are unable to secure sufficient financing to pay the purchase price at closing.

The obligation of the development company to refund our earnest money deposit will be unsecured, and we may not be able to obtain a refund of such earnest money deposit from it under these circumstances since the development company may be an entity without substantial assets or operations.

***We may not retain any profits resulting from the sale of our properties, or receive such profits in a timely manner, because we may provide financing to the purchaser of such property.***

When we decide to sell one of our properties, we may provide financing to the purchasers. When we provide financing to purchasers, we will bear the risk that the purchaser may default on its obligations under the financing, which could negatively

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impact cash flows from operations. Even in the absence of a purchaser default, the distribution of sale proceeds or their reinvestment in other assets, will be delayed until the promissory notes or other property we may accept upon the sale are actually paid, sold, refinanced or otherwise disposed of. In some cases, we may receive initial down payments in cash and other property in the year of sale in an amount less than the selling price, and subsequent payments will be spread over a number of years. Additionally, if any purchaser defaults under a financing arrangement with us, it could negatively impact our ability to make distributions to our stockholders.

***Representations and warranties made by us in connection with sales of our properties may subject us to liability that could materially and adversely affect us.***

When we sell a property, we have been required, and may continue to be required, to make representations and warranties regarding the property and other customary items. In the event of a breach of such representations or warranties, the purchaser of the property may have claims for damages against us, rights to indemnification from us or otherwise have remedies against us. In any such case, we may incur liabilities that could materially and adversely affect us.

***We face possible liability for environmental cleanup costs and damages for contamination related to properties we acquire, which could materially and adversely affect us.***

Because we own and operate real estate, we are subject to various international, U.S. federal, state and local environmental laws, ordinances and regulations. Under these laws, ordinances and regulations, a current or previous owner or operator of real estate may be liable for the cost of removal or remediation of hazardous or toxic substances on, under or in such property. The costs of removal or remediation could be substantial. Such laws often impose liability whether or not the owner or operator knew of, or was responsible for, the presence of such hazardous or toxic substances. Under such laws, a current owner or operator of property can be held liable for contamination on the property caused by the former owner or operator. Environmental laws also may impose restrictions on the manner in which property may be used or businesses may be operated, and these restrictions may require substantial expenditures. Environmental laws provide for sanctions in the event of noncompliance and may be enforced by governmental agencies or, in certain circumstances, by private parties. Certain environmental laws and common law principles could be used to impose liability for release of and exposure to hazardous substances, including the release of asbestos-containing materials into the air, and third parties may seek recovery from owners or operators of real estate for personal injury or property damage associated with exposure to released hazardous substances. In addition, new or more stringent laws or stricter interpretations of existing laws could change the cost of compliance or liabilities and restrictions arising out of such laws. The cost of defending against these claims, complying with environmental regulatory requirements, conducting remediation of any contaminated property, or of paying personal injury claims could be substantial and could materially and adversely affect us. In addition, the presence of hazardous substances on a property or the failure to meet environmental regulatory requirements may materially impair our ability to use, lease or sell a property, or to use the property as collateral for borrowing.

***Our current and future properties and our tenants may be unable to compete successfully, which could result in lower rent payments and could materially and adversely affect us.***

Our current and future properties often will face competition from nearby properties that provide comparable services. Some of those competing properties are owned by governmental agencies and supported by tax revenues, and others are owned by nonprofit corporations and may be supported to a large extent by endowments and charitable contributions. These types of support are not available to our properties. Operators of competing properties may provide superior services than those provided by our operators, which could reduce the competitiveness of our properties, which could have a material adverse effect on us.

Similarly, our MOB and senior housing—leased tenants face competition from other medical practices in nearby hospitals and other medical facilities and their failure to compete successfully with these other practices could adversely affect their ability to make rental payments to us, which could materially and adversely affect us. Further, from time to time and for reasons beyond our control, referral sources, including physicians and managed care organizations, may change their lists of hospitals or physicians to which they refer patients or that are permitted to participate in the payor program. This could also adversely affect our tenants' ability to make rental payments to us, which could materially and adversely affect us.

***Ownership of property outside the United States may subject us to different or greater risks than those associated with our domestic operations.***

As of December 31, 2022, we had $68,085,000 invested in the United Kingdom, or UK, and the Isle of Man, or 1.4% of our portfolio, based on our aggregate purchase price of real estate investments. International development, ownership, and operating activities involve risks that are different from those we face with respect to our domestic development, ownership, and operating activities. For example, we have limited investing experience in international markets. If we are unable to

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successfully manage the risks associated with international expansion and operations, we may be materially and adversely affected.

Additionally, our ownership of properties in the UK and the Isle of Man currently subjects us to fluctuations in the exchange rates between U.S. dollars and the UK Pound Sterling, which may, from time to time, impact our financial condition, cash flows and results of operations. Revenues generated from any properties or other real estate-related investments we acquire or ventures we enter into relating to transactions involving assets located in markets outside the United States likely will be denominated in the local currency. Therefore, any investments we make outside the United States will subject us to foreign currency risk due to potential fluctuations in exchange rates between foreign currencies and the U.S. dollar, and there can be no assurance that any attempt to mitigate foreign currency risk through hedging transactions or otherwise will be successful. As a result, changes in exchange rates of any such foreign currency to U.S. dollars may materially and adversely affect us and the book value of our assets. In addition, changes in foreign currency exchange rates used to value a REIT's foreign assets may be considered changes in the value of the REIT's assets. These changes may adversely affect our status as a REIT. Further, bank accounts in a foreign currency which are not considered cash or cash equivalents may adversely affect our status as a REIT.

***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.

***Severe weather events, natural disasters and the effects of climate change and regulatory and societal responses thereto could materially and adversely affect us.***

Natural disasters and severe weather events, including earthquakes, fires, storms, tornados, floods, hurricanes, snow and freezing temperatures could cause significant damage to our properties and the surrounding environment or area. Climate change is causing such events to become more frequent and increasingly severe in their effects, which could increase the costs to and impact on us and our operators over time. The effects of such events on our properties may include increased operational costs, including energy costs, delays and cost increases in our construction projects, damage to our facilities and periods when impacted facilities may be partially or wholly unoccupied, power outages and reputational damage.

Additionally, international, governmental, and societal responses to climate change may materially and adversely affect us or our operators', including through shifts in fuel sources leading to short or long-term increases in energy costs and new and more stringent building codes pertaining to energy efficiency, reduced emissions, or weather resistance that may be more costly to comply with, any of which could increase our building costs and our and our operators' capital expenditures, maintenance, and operating costs. These and other changes in federal, state, or local regulation or in societal expectations could materially and adversely affect us directly or indirectly through the impact on our operators.

**Risks Related to Real Estate-Related Investments**

***Unfavorable real estate market conditions and delays in liquidating defaulted mortgage loan investments may negatively impact mortgage loans in which we have invested and may invest, which could result in losses to us.***

The investment in mortgage loans or mortgage-backed securities we have made, and may continue to make, involve special risks relating to the particular borrower or issuer of the mortgage-backed securities and we will be at risk of loss on those investments, including losses as a result of defaults on our mortgage loan investments. These losses may be caused by many conditions beyond our control, including economic conditions affecting real estate values, tenant defaults and lease expirations, interest rate levels, and the other economic and liability risks associated with real estate. If we acquire property by foreclosure following defaults under our mortgage loan investments, we will have the economic and liability risks as the owner described above. We do not know whether the values of the property securing any of our mortgage loan investments will remain at the levels existing on the dates we initially make the related investment. If the values of the underlying properties drop, our risk will increase and the values of our interests may decrease. Furthermore, if there are defaults under our mortgage loan investments, we may not be able to foreclose on or obtain a suitable remedy with respect to such investments. Specifically, we may not be able to repossess and sell the underlying properties quickly, which could reduce the value of our investment. For example, an action to foreclose on a property securing a mortgage loan is regulated by state statutes and rules and is subject to many of the delays and expenses of lawsuits if the defendant raises defenses or counterclaims. Additionally, in the event of default by a mortgagor, these restrictions, among other things, may impede our ability to foreclose on or sell the mortgaged property or to obtain proceeds sufficient to repay all amounts due to us on the mortgage loan.

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***The commercial mortgage-backed securities in which we have invested, and may continue to invest, are subject to several types of risks.***

Commercial mortgage-backed securities are securities which evidence interests in, or are secured by, a single commercial mortgage loan or a pool of commercial mortgage loans. Accordingly, the commercial mortgage-backed securities in which we have invested, and may continue to invest, are subject to all the risks of the underlying mortgage loans.

In a rising interest rate environment, the value of commercial mortgage-backed securities may be adversely affected when payments on underlying mortgages loan(s) do not occur as anticipated, resulting in the extension of the security's effective maturity and the related increase in interest rate sensitivity of a longer-term instrument. The value of commercial mortgage-backed securities may also change due to shifts in the market's perception of securitization sponsors and borrower sponsors and regulatory or tax changes adversely affecting the mortgage securities markets as a whole. In addition, commercial mortgage-backed securities are subject to the credit risk associated with the performance of the underlying mortgage properties.

Commercial mortgage-backed securities are also subject to several risks created through the securitization structuring process. Subordinate commercial mortgage-backed securities are paid to the extent that there are funds available to make payments. To the extent the collateral pool includes a large percentage of delinquent loans, there is a risk that payments on subordinate commercial mortgage-backed securities will not be fully paid. In addition, commercial mortgage-backed securities are also subject to greater credit risk than those commercial mortgage-backed securities of the same series that are more highly rated.

***The mezzanine loans in which we have invested in the past, and may continue to invest, involve greater risks of loss than senior loans secured by income-producing real estate.***

We have in the past, and may in the future, invest in mezzanine loans that take the form of subordinated loans secured by second mortgages on the underlying real estate or loans secured by a pledge of the ownership interests of either the entity owning the real estate or the entity that owns the interest in the entity owning the real estate. These types of investments involve a higher degree of risk than long-term senior mortgage lending secured by income-producing real estate because the investment may become unsecured as a result of foreclosure by the senior lender. In the event of a bankruptcy of the entity providing the pledge of its ownership interests as security, we may not have full recourse to the assets of such entity or the assets of the entity may not be sufficient to satisfy our mezzanine loan. If a borrower defaults on our mezzanine loan or debt senior to our loan or in the event of a borrower bankruptcy, our mezzanine loan will be satisfied only after the senior debt. As a result, we may not recover some or all of our investment. In addition, mezzanine loans may have higher loan-to-value ratios than conventional mortgage loans, resulting in less equity in the real estate and increasing the risk of loss of principal.

***We expect a portion of our real estate-related investments to be illiquid and we may not be able to adjust our portfolio in a timely manner in response to changes in economic and other conditions.***

We may acquire real estate-related investments in connection with privately negotiated transactions which are not registered under the relevant securities laws, resulting in a prohibition against their transfer, sale, pledge or other disposition except in a transaction that is exempt from the registration requirements of, or is otherwise not subject to, those laws. As a result, our ability to vary our portfolio in response to changes in economic and other conditions may be relatively limited. The mezzanine and bridge loans we may purchase will be particularly illiquid investments due to their short life, their unsuitability for securitization, and the greater difficulty of recoupment in the event of a borrower's default.

***Bridge loans involve a greater risk of loss than traditional investment-grade mortgage loans with fully insured borrowers.***

We have in the past, and may in the future, acquire bridge loans secured by first lien mortgages on a property to borrowers who are typically seeking short-term capital to be used in an acquisition, construction or rehabilitation of a property, or other short-term liquidity needs. The typical borrower under a bridge loan has usually identified an undervalued asset that has been under-managed and/or is located in a recovering market. If the market in which the asset is located fails to recover according to the borrower's projections, or if the borrower fails to improve the quality of the asset's management and/or the value of the asset, the borrower may not receive a sufficient return on the asset to satisfy the bridge loan, and we bear the risk that we may not recover some or all of our initial expenditure.

In addition, borrowers usually use the proceeds of a conventional mortgage to repay a bridge loan. A bridge loan therefore is subject to the risk of a borrower's inability to obtain permanent financing to repay the bridge loan. Bridge loans are also subject to risks of borrower defaults, bankruptcies, fraud, losses, and special hazard losses that are not covered by standard hazard insurance. In the event of any default under bridge loans held by us, we bear the risk of loss of principal and non-payment of interest and fees to the extent of any deficiency between the value of the mortgage collateral and the principal amount and unpaid interest of the bridge loan. To the extent we suffer such losses with respect to our bridge loans, we may be materially and adversely affected.

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***If we sell real estate-related investments prior to their maturity, we may be forced to sell those investments on unfavorable terms or at a loss.***

Our board may choose to sell certain of our assets from time to time, including our real estate-related investments. If we plan to sell those investments prior to their maturity, we may be forced to do so at undesirable times and on unfavorable terms, which may result in losses. For instance, if we sell mortgage loans at a time when prevailing interest rates are higher than the interest rates of such mortgage loans, we would likely sell such loans at a discount to their stated principal values.

**Risks Related to the Healthcare Industry** 

***The healthcare industry is heavily regulated and new laws or regulations, changes to existing laws or regulations, loss of licensure or failure to obtain licensure could result in the inability of our tenants to make rent payments to us or adversely affect our operators' ability to operate facilities held in RIDEA structures.***

The healthcare industry is heavily regulated by federal, state and local governmental bodies. The tenants and operators of our healthcare facilities generally will be subject to laws and regulations covering, among other things, licensure, certification for participation in government programs and relationships with physicians and other referral sources. Changes in these laws and regulations, or a tenant's or operator's failure to comply with these laws and regulations, could adversely affect us. For example, such non-compliance could materially and adversely affect a tenant's ability to make rent payments to us. Similarly, were an operator of a facility held in a RIDEA structure (where we are entitled to participate in any positive operating performance of the facility) to fail to comply with a regulatory obligation, it could adversely affect the operating performance of the facility and our participation therein.

Many of our healthcare facilities and their tenants and operators require a license or CON. Failure to obtain a license or CON, or the loss of a required license or CON, would prevent a facility from operating in the manner intended by the tenant or operator. These events could materially and adversely affect a tenant's ability to make rent payments to us or for an operator to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us. Similarly, state and local laws also may regulate expansion, including the addition of new beds or services or the acquisition of medical equipment at a facility, and the construction of healthcare-related facilities, by requiring a CON or other similar approval. State CON laws and other similar laws are not uniform throughout the United States and are subject to change. Restrictions on the expansion of our facilities could materially and adversely affect a tenant's ability to make rent payments to us or for an operator to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us. We cannot predict the impact of state CON laws or similar laws on our development or expansion of facilities or the operations of our tenants or operators.

In addition, in certain areas state CON laws materially limit the ability of competitors to enter into the markets served by our facilities, thereby limiting competition. The repeal of CON laws could allow competitors to freely operate in previously closed markets. Any such increased competition could materially and adversely affect a tenant's ability to make rent payments to us or for an operator to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us. These CON laws could also restrict our ability to expand in new markets.

In certain circumstances, loss of state licensure or certification or closure of a facility could ultimately result in loss of authority to operate the facility or provide services at the facility and require new CON authorization licensure and/or authorization or potential authorization from CMS to re-institute operations. As a result, the value of the facility may be reduced, which could materially and adversely affect us.

***Reductions in reimbursement from third-party payors, including Medicare and Medicaid, could adversely affect the operations of our tenants and their ability to make rental payments to us or our operators' ability to operate facilities held in RIDEA structures, either of which could materially and adversely affect us.***

Sources of revenue for our tenants and operators may include the federal Medicare program, state Medicaid programs, private insurance carriers and health maintenance organizations, among others. Efforts by such payors to reduce healthcare costs will likely continue, which may result in reductions or slower growth in reimbursement for certain services provided by some of our tenants and operators, which could have a material adverse effect on us. In addition, the healthcare billing rules and regulations are complex, and the failure of any of our tenants or operators to comply with various laws and regulations could jeopardize their ability to continue participating in Medicare, Medicaid, and other government sponsored payment programs. Moreover, the state and federal governmental healthcare payment programs are subject to reductions by state and federal legislative actions, and changes in reimbursement models may reduce our tenants' and operators' revenues and adversely affect our tenants' ability to make rent payments to us or our operators' ability to operate facilities held in RIDEA structures efficiently, either of which could have a material adverse effect on us.

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The healthcare industry continues to face various challenges, including increased government and private payor pressure on healthcare providers to control or reduce costs. It is possible that our tenants and operators will continue to experience a shift in payor mix away from fee-for-service payors, resulting in an increase in the percentage of revenues attributable to reimbursement based upon value-based principles and quality driven managed care programs, and general industry trends that include pressures to control healthcare costs. Pressures to control healthcare costs and a shift away from traditional health insurance reimbursement based upon a fee for service payment to payment based upon quality outcomes have increased the uncertainty of payments.

In addition, the Patient Protection and Affordable Care Act of 2010, or the Healthcare Reform Act, was passed with an intent to reduce the number of individuals in the United States without health insurance and effect significant other changes to the ways in which healthcare is organized, delivered and reimbursed. Included within the legislation is a limitation on physician-owned hospitals from expanding facility capacity, unless the facility satisfies very narrow federal exceptions to this limitation. Therefore, if our tenants are physicians that own and refer to a hospital, the hospital may be limited in its operations and expansion potential, which may limit the hospital's services and resulting revenues and may impact the owner's ability to make rental payments.

Furthermore, the Healthcare Reform Act included new payment models with new shared savings programs and demonstration programs that include bundled payment models and payments contingent upon reporting on satisfaction of quality benchmarks. The new payment models will likely change how physicians are paid for services. These changes could negatively affect some of our tenants and operators, which could have a material adverse effect on us.

On December 22, 2017, the Tax Cuts and Jobs Act of 2017 was signed into law and repealed the individual mandate financial penalty portion of the Healthcare Reform Act beginning in 2019. With the elimination of the individual mandate enforcement mechanism, several states brought suit seeking to invalidate the entire Healthcare Reform Act. On June 17, 2021, the U.S. Supreme Court dismissed this lawsuit without specifically ruling on the constitutionality of the law. However, challenges to the Healthcare Reform Act may continue. If all or a portion of the Healthcare Reform Act, including the individual mandate, is eventually ruled unconstitutional, our tenants and operators may have more patients and residents who do not have insurance coverage, which may adversely impact the tenants' and operators' collections and revenues. Additionally, in October 2022, the Biden Administration announced new actions by CMS to strengthen accountability for nursing homes participating in the Special Focus Facilities, or SFF, an oversight program designed to monitor poor-performing nursing homes. These reforms include strengthened penalties for SFF nursing homes that fail to improve, increases in safety standards that SFF nursing homes must implement and increased communication between CMS and SFF nursing homes. The announcement further noted that the administration will continue to take administrative action to improve oversight of nursing homes moving forward. The financial impact on our tenants and operators could adversely affect a tenant's ability to make rent payments to us or an operator's ability to operate facilities held in RIDEA structures efficiently, either of which could have a material adverse effect on us.

We cannot predict the ultimate content, timing or effect of any further healthcare reform legislation or the impact of potential legislation on us. We expect that additional state and federal healthcare reform measures will be adopted in the future, any of which could limit the amounts that federal and state governments will pay for healthcare services, which may adversely impact our tenants' ability to make rental payments to us or our operators' ability to operate facilities held in RIDEA structures efficiently, either of, which could have a material adverse effect on us.

***If seniors delay moving to senior housing facilities until they require greater care or forgo moving to senior housing facilities altogether, such action could have a material adverse effect on us.***

Seniors have been increasingly delaying their moves to senior housing facilities, including to our senior housing—leased facilities and SHOP, until they require greater care and are increasingly forgoing moving to senior housing facilities altogether. Further, rehabilitation therapy and other services are increasingly being provided to seniors on an outpatient basis or in seniors' personal residences in response to market demand and government regulation, which may increase the trend for seniors to delay moving to senior housing facilities. Such delays may cause decreases in occupancy rates and increases in resident turnover rates at our senior housing facilities. Moreover, seniors may have greater care needs and require higher acuity services, which may increase our tenants' and operators' cost of business, expose our tenants and operators to additional liability, or result in lost business and shorter stays at our leased and managed senior housing facilities if our tenants and operators are not able to provide the requisite care services or fail to adequately provide those services. These trends may negatively impact the occupancy rates and revenues at our leased and managed senior housing, which could have a material adverse effect on us. Further, if any of our tenants or operators are unable to offset lost revenues from these trends by providing and growing other revenue sources, such as new or increased service offerings to seniors, our senior housing facilities may be unprofitable, we may receive lower returns and rent, and the value of our senior housing facilities may decline.

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***Events that adversely affect the ability of seniors and their families to afford resident fees at our senior housing facilities could cause our occupancy rates and revenues to decline, which could have a material adverse effect on us.***

Costs to seniors associated with independent and assisted living services are generally not reimbursable under Medicare, and the scope of services that may be covered by Medicaid varies by state. In many cases, only seniors with income or assets meeting or exceeding the comparable median in the regions where our facilities are located typically will be able to afford to pay the entrance fees and monthly resident fees, and a weak economy, depressed housing market or changes in demographics could adversely affect their continued ability to do so. If our tenants and operators are unable to retain and attract seniors with sufficient income, assets or other resources required to pay the fees associated with independent and assisted living services and other services provided by our tenants and operators at our healthcare facilities, our occupancy rates and revenues could decline, which could, in turn, materially and adversely affect us.

***Some tenants and operators of our facilities will be subject to fraud and abuse laws, the violation of which could materially and adversely affect a tenant's ability to make rent payments to us or an operator's ability to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us.***

There are various federal, foreign and state laws prohibiting fraudulent and abusive business practices by healthcare providers who participate in, receive payments from, or are in a position to make referrals in connection with government-sponsored healthcare programs, including Medicare and Medicaid. Our contractual arrangements with tenants and operators may also be subject to these fraud and abuse laws, including federal laws such as the Anti-Kickback Statute and the Stark Law. Moreover, our agreements with tenants and operators may be required to satisfy individual state law requirements that vary from state to state, which impacts the terms and conditions that may be negotiated in such agreements.

These federal and foreign laws include:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the Federal Anti-Kickback Statute, a criminal law which prohibits, among other things, the offer, payment, solicitation or receipt of any form of remuneration, directly or indirectly, overtly or covertly, in cash or in kind, in return for, or to induce, the referral of an individual for, or the purchase, order or recommendation of, any item or service for which payment may be made under a federal healthcare program such as Medicare and Medicaid;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the Federal Physician Self-Referral Prohibition, which, subject to specific exceptions, restricts physicians from making referrals for specifically designated health services for which payment may be made under federal healthcare programs to an entity with which the physician, or an immediate family member, has a financial relationship;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the False Claims Act, which prohibits any person from knowingly presenting, or causing to be presented, false or fraudulent claims for payment or approval that are false or fraudulent or making a false statement to avoid, decrease or conceal an obligation to pay money to the federal government, including claims paid by the Medicare and Medicaid programs;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the Civil Monetary Penalties Law, which authorizes the U.S. Department of Health & Human Services to impose monetary penalties or exclusion from participating in state or federal healthcare programs for certain fraudulent acts;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the Health Insurance Portability and Accountability Act of 1996, as amended, which makes it a federal crime to defraud any health benefit plan, including private payors;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the Exclusions Law, which authorizes the U.S. Department of Health & Human Services to exclude persons or entities from participating in state or federal healthcare programs for certain fraudulent acts; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the UK Bribery Act 2010, a criminal law which relates to any function of a public nature, connected with a business, performed in the course of a person's employment or performed on behalf of a company or another body of persons, covering bribery both in the public and private sectors.

Each of these laws includes criminal and/or civil penalties for violations that range from punitive sanctions, damage assessments, penalties, imprisonment, denial of Medicare and Medicaid payments and/or exclusion from the Medicare and Medicaid programs. Monetary penalties associated with violations of these laws have been increased in recent years. Certain laws, such as the False Claims Act, allow for individuals to bring whistleblower actions on behalf of the government for violations thereof. Additionally, states in which the facilities are located may have similar fraud and abuse laws. Investigation by a federal or state governmental body for violation of fraud and abuse laws or imposition of any of these penalties upon one of our tenants or operators could materially and adversely affect a tenant's ability to make rent payments to us or an operator's ability to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us.

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Efforts to ensure compliance with applicable healthcare laws and regulations may cause our tenants and operators to incur substantial costs that could materially and adversely affect a tenant's ability to make rent payments to us or an operator's ability to operate a facility held in a RIDEA structure efficiently, either of which could have a material adverse effect on us.

***Adverse trends in healthcare provider operations may materially and adversely affect us.***

The healthcare industry is currently experiencing:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• changes in the demand for and methods of delivering healthcare services;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• changes in third-party reimbursement policies;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• significant unused capacity in certain areas, which has created substantial competition for patients among healthcare providers in those areas;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased expenses for uninsured patients;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased competition among healthcare providers;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased liability insurance expenses;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• continued pressure by private and governmental payors to reduce payments to providers of services;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased scrutiny of billing, referral and other practices by federal and state authorities;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• changes in federal and state healthcare program payment models;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased emphasis on compliance with privacy and security requirements related to personal health information; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• increased instability in the Health Insurance Exchange market and lack of access to insurance plans participating in the exchange.

Additionally, in connection with the COVID-19 pandemic, many governmental entities relaxed certain licensure and other regulatory requirements relating to telemedicine, allowing more patients to virtually access care without having to visit a healthcare facility. If governmental and regulatory authorities continue to allow for increased virtual healthcare, this may affect the demand for some of our properties, such as MOBs.

These factors may negatively affect the economic performance of some or all of our tenants and operators, which could have a material adverse effect on us.

***Our tenants and operators may be affected by the financial deterioration, insolvency and/or bankruptcy of other companies in the healthcare industry.***

Certain companies in the healthcare industry, including some key senior housing operators, are experiencing considerable financial, legal and/or regulatory difficulties which have resulted or may result in financial deterioration and, in some cases, insolvency and/or bankruptcy. The adverse effects on these companies could have a significant impact on the industry as a whole, including but not limited to negative public perception by investors, lenders, patients and residents. As a result, our tenants and properties managed by our operators could experience the damaging financial effects of a weakened industry sector driven by negative headlines, and we could be materially and adversely affected.

***Our tenants and operators may be subject to significant legal and regulatory actions that could subject them to increased operating costs and substantial uninsured liabilities, which could have a material adverse effect on us.***

Our tenants and operators may become subject to claims that their services have resulted in patient injury or other adverse effects. Healthcare providers have experienced an increasing trend in the frequency and severity of professional liability and general liability insurance claims and litigation asserted against them. The insurance coverage maintained by our tenants and operators may not cover all claims made against them nor continue to be available at a reasonable cost, if at all. In some states, insurance coverage for the risk of punitive damages arising from professional liability and general liability claims and/or litigation may not, in certain cases, be available to our tenants and operators due to state law prohibitions or limitations of availability. As a result, tenants and operators of our MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities operating in these states may be liable for punitive damage awards that are either not covered or are in excess of their insurance policy limits. We also believe that there has been, and will continue to be, an increase in regulatory or other governmental investigations of certain healthcare providers, particularly in the area of Medicare/Medicaid false claims, as well as an increase in enforcement actions resulting from these investigations. Insurance may not always be available to cover such losses. Any adverse determination in a legal proceeding or regulatory or other governmental investigation, whether currently asserted or arising in the future, could negatively affect a tenant's or operator's business and financial strength. If a tenant or

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operator is unable to obtain or maintain insurance coverage, if judgments are obtained in excess of the insurance coverage, if uninsured punitive damages are required to be paid, or if an uninsurable government enforcement action is brought, the tenant or operator could be exposed to substantial additional liabilities, which may affect the tenant's ability to pay rent to us or the operator's ability to manage our properties efficiently and effectively, which could have a material adverse effect on us.

***We, our tenants and our operators for our senior housing facilities and SNFs may be subject to various government reviews, audits and investigations that could materially and adversely affect us, including an obligation to refund amounts previously paid to us, potential criminal charges, the imposition of fines and/or the loss of the right to participate in Medicare and Medicaid programs.***

We, our tenants and our operators for our senior housing facilities and SNFs are subject to various governmental reviews, audits and investigations to verify compliance with the Medicaid and Medicare programs and applicable laws and regulations. We, our tenants and our operators for our senior housing facilities and SNFs are also subject to audits under various government programs, including Recovery Audit Contractors, Unified Program Integrity Contractors, and other third party audit programs, in which third-party firms engaged by CMS conduct extensive reviews of claims data and medical and other records to identify potential improper payments under the Medicare and Medicaid programs. Private pay sources also reserve the right to conduct audits. An adverse review, audit or investigation could result in:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an obligation to refund amounts previously paid to us, our tenants or our operators pursuant to the Medicare or Medicaid programs or from private payors, in amounts that could be material to us;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• state or federal agencies imposing fines, penalties and other sanctions on us, our tenants or our operators;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• loss of our right, our tenants' right or our operators' right to participate in the Medicare or Medicaid programs or one or more private payor networks;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an increase in private litigation against us, our tenants or our operators; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• damage to our reputation in various markets.

While we, our tenants and our operators for our senior housing facilities and SNFs have always been subject to post-payment audits and reviews, more intensive "probe reviews" appear to be a permanent procedure with our fiscal intermediaries. If the government or a court were to conclude that such errors, deficiencies or disagreements constituted criminal violations or were to conclude that such errors, deficiencies or disagreements resulted in the submission of false claims to federal healthcare programs, or if the government were to discover other problems in addition to the ones identified by the probe reviews that rose to actionable levels, our tenants and operators might face potential criminal charges and/or civil claims, administrative sanctions and penalties for amounts that could be material to us. In addition, other key personnel and our tenants and operators and their other key personnel could be temporarily or permanently excluded from future participation in state and federal healthcare reimbursement programs such as Medicaid and Medicare. In any event, it is likely that a governmental investigation alone, regardless of its outcome, would divert material time, resources and attention from our management team and our staff or those of our tenants and our operators and could materially and adversely affect us during and after any such investigation or proceedings.

In cases where claim and documentation review by any CMS contractor results in repeated poor performance, a facility can be subjected to protracted oversight. This oversight may include repeat education and re-probe, extended pre-payment review, referral to recovery audit or integrity contractors, or extrapolation of an error rate to other reimbursement outside of specifically reviewed claims. Sustained failure to demonstrate improvement towards meeting all claim filing and documentation requirements could ultimately lead to Medicare and Medicaid decertification, which materially and adversely affects us. Adverse actions by CMS may also cause third party payor or licensure authorities to audit our tenants or operators. These additional audits could result in termination of third-party payor agreements or licensure of the facility, which could have a material adverse effect on us.

In addition, our tenants and operators that accepted relief funds distributed to combat the adverse effects of COVID-19 and reimburse providers for unreimbursed expenses and lost revenues may be subject to certain reporting and auditing obligations associated with the receipt of such relief funds. If these tenants or operators fail to comply with the terms and conditions associated with relief funds, they may be subject to government recovery and enforcement actions. Furthermore, regulatory guidance relating to use of the relief funds, recordkeeping requirements and other terms and conditions continues to evolve and there is a high degree of uncertainty surrounding many aspects of the relief funds. This uncertainty may create compliance challenges for tenants and operators who accepted relief funds.

***The Healthcare Reform Act and similar foreign laws impose additional requirements regarding compliance and disclosure.***

The Healthcare Reform Act requires SNFs to have a compliance and ethics program that is effective in preventing and detecting criminal, civil and administrative violations and in promoting quality of care. The U.S. Department of Health and

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Human Services included in the final rule published on October 4, 2016 the requirement for operators to implement a compliance and ethics program as a condition of participation in Medicare and Medicaid. Long-term care facilities, including SNFs, had until November 28, 2019 to comply. If our operators fall short in their compliance and ethics programs and quality assurance and performance improvement programs, if and when required, their reputations and ability to attract patients and residents could be adversely affected, which could have a material adverse effect on us.

Similar requirements also apply to healthcare properties in the UK under national law and guidance. The Health & Care Professions Council, the regulator of health, psychological and care professionals in the UK, requires a qualification to demonstrate standards of proficiency and also set standards, hold a register, quality assure education and investigate complaints. They have set out an ethical framework with standards of conduct, performance and ethics including restrictions on confidentiality and the use of social media. If any of our operators in the UK fall short in their obligations, their reputations and ability to attract patients and residents may be adversely affect which might have a material adverse effect on their business and by extension us.

**Risks Related to Joint Ventures**

***Property ownership through joint ventures could limit our control of those investments or our decisions with respect to other investments, restrict our ability to operate and finance properties on our terms, and reduce their expected return.***

In connection with the purchase of real estate, we have entered, and may continue to enter, into joint ventures with third parties. We may also purchase or develop properties in co-ownership arrangements with the property sellers, developers or other parties. We may own properties through both consolidated and unconsolidated joint ventures. These structures involve participation in the investment by other parties whose interests and rights may not be the same as ours. Our joint ventures, and joint ventures we may enter into in the future, may involve risks not present with respect to our wholly owned properties, including the following:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we may share with, or even delegate decision-making authority to, our joint venture partners regarding certain major decisions affecting the ownership or operation of the joint venture and the joint venture property, such as, but not limited to, (1) additional capital contribution requirements, (2) obtaining, refinancing or paying off debt and (3) obtaining consent prior to the sale or transfer of our interest in the joint venture to a third party, which may prevent us from taking actions that are opposed by our joint venture partners;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our joint venture partners may have business interests or goals with respect to the joint venture property that conflict with our business interests and goals, which could increase the likelihood of disputes regarding the ownership, management or disposition of the property;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• in some instances, we may enter into arrangements with our joint venture partners that may (1) require an acquisition opportunity to be allocated to the joint venture when we otherwise may have acquired the asset ourselves or (2) cause the joint venture to sell an asset at a time when we otherwise may not have initiated such a transaction;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• disputes may develop with our joint venture partners over decisions affecting the joint venture property or the joint venture, which may result in litigation or arbitration that would increase our expenses and distract our officers from focusing their time and effort on our business, disrupt the day-to-day operations of the property, such as by delaying the implementation of important decisions until the conflict is resolved, have an adverse impact on the operations and profitability of the joint venture and possibly force a sale of the property if the dispute cannot be resolved;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our joint venture partners may be unable to or refuse to make capital contributions when due, or otherwise fail to meet their obligations, which could require us to fund the shortfall or forego our equity in the joint venture; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the activities of a joint venture could adversely affect our ability to maintain our qualification as a REIT.

As of December 31, 2022, we indirectly own a 73.1% interest in Trilogy, a consolidated joint venture representing approximately 41.1% of our portfolio (based on aggregate contract purchase price) and contributing approximately 46.8% of our Annualized Base Rent / Annualized NOI as of such date. Approximately 23.1% of Trilogy is indirectly owned by NorthStar Healthcare Income, Inc., or NorthStar, with the remaining 3.8% primarily owned by affiliates of the Trilogy Manager, an eligible independent contractor, or EIK, that manages the day-to-day operations of the joint venture. In addition to relying on the Trilogy Manager to manage the joint venture effectively, our investment in Trilogy exposes us to many of the risks described above with respect to joint venture investments generally. For example, other parties with interests in Trilogy have certain rights that could affect our investment in Trilogy. There are certain decisions that are deemed "major decisions" with respect to Trilogy's business (such as terminating the management agreement with the Trilogy Manager, taking certain actions under the management agreement, making certain sales of the Trilogy properties, and taking certain other actions with respect

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to the Trilogy portfolio) that require the approval of NorthStar. It is possible that NorthStar will have interests that differ from ours, and our ability to pursue our interests we may be limited by their rights under the joint venture arrangements. Additionally, if we seek to transfer our indirect ownership interests in Trilogy, we are required to first offer such interests to NorthStar, which could delay our ability to sell such interests or adversely affect the price we receive in connection with a sale. In addition, in certain circumstances, we and NorthStar have the right to force the sale of all of Trilogy's assets, provided that, if this right is triggered by a party, the non-triggering party has a right to elect to purchase the Trilogy assets. This could cause us to increase our investment in Trilogy or result in the sale of Trilogy at a time when we would not to choose to effect a sale.

***If we serve as a managing member, general partner or controlling party with respect to investments or joint ventures, we may be subject to risks and liabilities that we would not otherwise face.***

In certain circumstances, we may serve as managing member, general partner or controlling party with respect to investments and joint ventures. In such instances, we may face additional risks including, among others, the following:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we may have increased duties to the other investors or partners in the investment or venture;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• in the event of certain events or conflicts, our partners may have recourse against us, including the right to monetary penalties, the ability to force a sale or exit the investment or venture;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our partners may have the right to remove us as the general partner or managing member in certain cases involving cause; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our subsidiaries that would be the general partner or managing member of the investment or venture could be generally liable, under applicable law or the governing agreement of a venture, for the debts and obligations of the investment or venture, subject to certain exculpation and indemnification rights pursuant to the terms of the governing agreement.

***We may structure our joint venture relationships in a manner which limits the amount we participate in the cash flows or appreciation of an investment.***

We have entered, and may continue to enter, into joint venture agreements, the economic terms of which may provide for the distribution of income to us otherwise than in direct proportion to our ownership interest in the joint venture. For example, while we and another joint venture party may invest an equal amount of capital in an investment, the investment may be structured such that one joint venture partner has a right to priority distributions of cash flows up to a certain target return while another joint venture partner may receive a disproportionately greater share of cash flows once such target return has been achieved. This type of investment structure may result in our joint venture partner receiving more of the cash flows, including any from appreciation, of an investment than we receive. If we do not accurately judge the appreciation prospects of a particular investment or structure the venture appropriately, we may incur losses on joint venture investments or have limited participation in the profits of a joint venture investment, either of which could reduce our ability to make distributions to our stockholders.

**Risks Related to Debt Financing**

***We have substantial indebtedness and may incur additional indebtedness in the future, which could materially and adversely affect us.***

We have substantial indebtedness and may incur additional indebtedness in the future, which could materially and adversely affect us. As of December 31, 2022, we had indebtedness of $2,537,113,000, which comprises $1,282,634,000 in unsecured debt (lines of credit and term loans) and $1,254,479,000 in mortgage loans payable. Though we anticipate that our overall leverage will not exceed 50.0% of the combined fair market value of all of our properties and other real estate-related investments, as determined at the end of each calendar year, our organizational documents do not place a limitation on the amount of leverage that we may incur, and we could incur leverage substantially in excess of this amount. We expect to fund a portion of our cash needs, including funding investment activity, with additional indebtedness. Our ability to access additional debt capital and the cost of other terms thereof will be significantly influenced by our creditworthiness and any rating assigned by a rating agency, as well as by general economic and market conditions. Significant secured and unsecured indebtedness adversely affects our creditworthiness and could prevent us from achieving an investment grade credit rating or cause a rating agency to lower a rating or to place a rating on a "watchlist" for possible downgrade. Deteriorations in our creditworthiness or in any ratings that we may achieve, or the perception that any such deterioration may occur, would adversely affect our ability to access additional debt capital and increase the cost of any debt capital that is available to us and may require us to accept restrictive covenants. A reduction in our access to debt capital, an increase in the cost thereof or our acceptance of restrictive covenants could limit our ability to achieve our business objectives and pursue our growth strategies.

Additionally, interest rates have significantly increased, and may continue to significantly increase, our interest costs. Expensive debt could reduce or limit our available cash flow to fund working capital, capital expenditures, acquisitions and

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development projects, hinder our ability to meet certain debt service ratios under our credit agreements or impose restrictions on our ability to incur additional debt for so long as certain debt service ratios are not met.

We may also incur mortgage debt and other property-level debt on properties that we already own in order to obtain funds to acquire additional properties or make other capital investments. In addition, we may borrow as necessary or advisable to ensure that we maintain our qualification as a REIT for U.S. federal income tax purposes, including borrowings to satisfy the REIT requirement that we distribute at least 90.0% of our annual REIT taxable income to our stockholders. However, we cannot guarantee that we will be able to obtain any such borrowings on favorable terms or at all.

If we mortgage a property and there is a shortfall between the cash flows from that property and the cash flows needed to service mortgage debt on that property, our financial results would be negatively affected and the amount of cash available for distributions to stockholders would be reduced. In addition, incurring mortgage debt increases the risk of loss of a property since defaults on indebtedness secured by a property may result in lenders initiating foreclosure actions. If any mortgages contain cross-collateralization or cross-default provisions, a default on a single property could affect multiple properties. In addition, lenders may have recourse to assets other than those specifically securing the repayment of indebtedness. For tax purposes, a foreclosure on any of our properties will be treated as a disposition of the property, which could cause us to recognize taxable income on foreclosure, without receiving corresponding cash proceeds. We may give full or partial guarantees to lenders of mortgage debt on behalf of the entities that own our properties. When we give a guaranty on behalf of an entity that owns one of our properties, we will be responsible to the lender for satisfaction of the debt if it is not paid by such entity.

***A significant amount of debt subjects us to many risks that, if realized, would materially and adversely affect us, including the risk that:***

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our cash flow from operating activities could become insufficient to make required payments of principal and interest on our debt, which would likely result in (i) acceleration of the debt (and any other debt containing a cross-default or cross-acceleration provision), increasing the likelihood of further distress if refinancing is not available on favorable terms or at all, (ii) our inability to borrow undrawn amounts under other existing financing arrangements, even if we have timely made all required payments under such arrangements, further compromising our liquidity and/or (iii) the loss of some or all of our assets that are pledged as collateral in connection with our financing arrangements;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our debt may increase our vulnerability to adverse economic and industry conditions with no assurance that such debt will increase our investment returns in an amount sufficient to offset the associated risks relating to leverage;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we may be required to dedicate a substantial portion of our cash flow from operating activities to payments on our debt, thereby reducing funds available for operations, future business opportunities, stockholder distributions and/or other purposes; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• to the extent the maturity of certain debt occurs prior to the maturity of a related asset pledged or transferred as collateral for such debt, we may not be able to refinance that debt on favorable terms or at all, which may reduce available liquidity and/or cause significant losses to us.

***To the extent we borrow funds at floating interest rates, we will be adversely affected by rising interest rates unless fully hedged. Rising interest rates will also increase our interest expense on future fixed-rate debt.***

Interest we pay on our debt obligations reduces our financial results and cash available for distributions to our stockholders. Whenever we incur variable-rate debt, increases in interest rates would increase our interest expense unless fully hedged. As of December 31, 2022, our outstanding debt aggregated $2,537,113,000, of which 65.1% was unhedged variable-rate debt. In January 2023, we entered into an interest rate swap contract to hedge $275,000,000 of our floating rate term loan under our existing credit facility. Rising interest rates will also increase our interest expense on future fixed-rate debt**.** If we need to repay existing debt during periods of rising interest rates, which is currently the case, we could be required to sell one or more of our properties at times which may not permit realization of the maximum return on such investments, which could result in losses.

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***To the extent we borrow at fixed rates or enter into fixed interest rate swaps, we will not benefit from reduced interest expense if interest rates decrease.***

We are exposed to the effects of interest rate changes primarily as a result of borrowings we have used to maintain liquidity and fund expansion and refinancing of our real estate investment portfolio and operations. To limit the impact of interest rate changes on earnings, prepayment penalties and cash flows and to lower overall borrowing costs while taking into account variable interest rate risk, we have borrowed, and may continue to borrow, at fixed rates or variable rates depending upon prevailing market conditions. We have and may also continue to enter into derivative financial instruments such as interest rate swaps and caps in order to mitigate our interest rate risk on a related financial instrument. Therefore, to the extent we borrow at fixed rates or enter into fixed interest rate swaps, we will not benefit from reduced interest expense if interest rates decrease.

***Hedging activity may expose us to risks.***

We have used, and may continue to use, derivative financial instruments to hedge our exposure to changes in exchange rates and interest rates. If we use derivative financial instruments to hedge against exchange rate or interest rate fluctuations, we will be exposed to credit risk and legal enforceability risks. In this context, credit risk is the failure of the counterparty to perform under the terms of the derivative contract. If the fair value of a derivative contract is positive, the counterparty owes us, which creates credit risk for us. Legal enforceability risks encompass general contractual risks, including the risk that the counterparty will breach the terms of, or fail to perform its obligations under, the derivative contract. These derivative instruments are speculative in nature and there is no guarantee that they will be effective. If we are unable to manage these risks effectively, we could be materially and adversely affected.

***Lenders may require us to enter into restrictive covenants relating to our business.***

When providing financing, a lender may impose restrictions on us that affect our ability to incur additional debt, make distributions to our stockholders and operate our business. We have entered into, and may continue to enter into, loan documents that contain covenants that limit our ability to further mortgage the property or discontinue insurance coverage. These or other limitations may adversely affect our flexibility and our ability to achieve our business objectives.

***Interest-only indebtedness may increase our risk of default, adversely affect our ability to refinance or sell properties and ultimately may reduce our funds available for distribution to our stockholders.***

We may finance or refinance our properties using interest-only mortgage indebtedness. During the interest-only period, the amount of each scheduled payment will be less than that of a traditional amortizing mortgage loan. The principal balance of the mortgage loan will not be reduced (except in the case of prepayments) because there are no scheduled monthly payments of principal during this period. After the interest-only period, we will be required either to make scheduled payments of amortized principal and interest or to make a lump-sum or "balloon" payment at maturity. At the time such a balloon payment is due, we may or may not be able to refinance the balloon payment on terms as favorable as the original loan or sell the particular property at a price sufficient to make the balloon payment. Furthermore, these required principal or balloon payments will increase the amount of our scheduled payments and may increase our risk of default under the related mortgage loan. If the mortgage loan has an adjustable interest rate, the amount of our scheduled payments would likely increase at a time of rising interest rates, depending upon the adjustment terms. In addition, payments of principal and interest made to service our debt, including balloon payments, may leave us with insufficient cash to pay the distributions to our stockholders, including those that we are required to pay to maintain our qualification as a REIT. Any of these results could have a material adverse effect on us.

***If we are required to make payments under any "bad boy" carve-out guaranties that we may provide in connection with certain mortgages and related loans, we could be materially and adversely affected.***

In obtaining certain nonrecourse loans, we have provided, and may continue to provide, standard carve-out guaranties. These guaranties are only applicable if and when the borrower directly, or indirectly through agreement with an affiliate, joint venture partner or other third party, voluntarily files a bankruptcy or similar liquidation or reorganization action or takes other actions that are fraudulent or improper (commonly referred to as "bad boy" guaranties). Although we believe that "bad boy" carve-out guaranties are not guaranties of payment in the event of foreclosure or other actions of the foreclosing lender that are beyond the borrower's control, some lenders in the real estate industry have recently sought to make claims for payment under such guaranties. In the event such a claim was made against us under a "bad boy" carve-out guaranty following foreclosure on mortgages or related loans, and such claim was successful, we could be materially and adversely affected.

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***We may be adversely affected by the transition away from LIBOR and the use of SOFR or other alternative benchmark rates.***

London Interbank Offered Rate, or LIBOR, the Secured Overnight Financing Rate, or SOFR, and other indices which are deemed "benchmarks" are the subject of recent national, international and other regulatory guidance and proposals for reform. The Financial Conduct Authority ceased publishing one-week and two-month LIBOR after December 31, 2021 and intends to cease publishing all remaining LIBOR index maturities after June 30, 2023. It currently appears that U.S. dollar LIBOR will likely be replaced by SOFR, though it is not certain whether or when SOFR or other alternative reference rates will attain market traction as replacements for LIBOR.

SOFR and SOFR-based rates have a limited history, and there is no assurance that SOFR, or rates derived from SOFR, will perform in the same or a similar way as LIBOR would have performed at any time, and there is no assurance that SOFR-based rates will ultimately prove to be a suitable substitute for LIBOR. SOFR-based reference rates cannot be predicted based on SOFR's history, and future levels of SOFR may bear little or no relation to historical levels of SOFR, LIBOR or other rates. Additionally, SOFR has been more volatile than other benchmark or market rates, such as three-month LIBOR. Accordingly, there can be no assurance that our transition to term SOFR in connection with our floating rate or future fixed-rate borrowings will not result in increased volatility in our cost of borrowing or increased interest expense compared to our historical experience. Additionally, the inability or any inefficiency in market participants' ability to hedge SOFR-based transactions or the illiquidity or relative illiquidity in the market for SOFR-based instruments may increase the costs associated with SOFR-based debt instruments or our ability to hedge our exposure to floating interest rates. Any of these changes could have a material adverse effect on the value of financial assets and liabilities based on or linked to SOFR or another benchmark, including our own.

**Risks Related to Our Corporate Structure and Organization**

***Future offerings of debt securities, which would be senior to our common stock, or equity securities, which would dilute our existing stockholders and may be senior to our common stock, may adversely affect our stockholders.***

We may in the future attempt to increase our capital resources by offering debt or equity securities, including notes and classes of preferred or common stock. Debt securities or shares of preferred stock will generally be entitled to receive interest payments or distributions, both current and in connection with any liquidation or sale, prior to the holders of our common stock. We are not required to offer any such additional debt or preferred stock to existing common stockholders on a preemptive basis. Therefore, issuances of common stock or other equity securities will generally dilute the holdings of our existing stockholders. Because we may generally issue any such debt or preferred stock in the future without obtaining the approval of our stockholders, you will bear the risk of our future issuances reducing the market price of our common stock and diluting your proportionate ownership. Because our decision to issue debt or equity securities in any future offering will depend on market conditions and other factors beyond our control, we cannot predict or estimate the form amount, timing or nature of our future issuances.

In addition, subject to any limitations set forth under Maryland law, our board may amend our charter to increase or decrease the number of authorized shares of stock, or the number of shares of any class or series of stock designated, or reclassify any unissued shares into other classes or series of stock without the necessity of obtaining stockholder approval. All such shares may be issued in the sole discretion of our board. In addition, we have granted, and expect to grant in the future, equity awards under our incentive plan to our independent directors and certain of our employees, including our executive officers, which to date have consisted of our restricted stock and restricted share units, which are exchangeable into shares of our common stock subject to satisfaction of certain conditions. Finally, we have OP units outstanding which are redeemable for cash or, at our election, exchangeable into shares of our common stock.

Therefore, existing stockholders will experience dilution of their equity investment in us as we (1) sell additional shares of our common stock in the future, (2) sell securities that are convertible into or exchangeable for shares of our common stock, including OP units, (3) issue restricted shares of our common stock, restricted stock units or other equity-based securities under the AHR Incentive Plan or (4) issue shares of our common stock in a merger or to sellers of properties acquired by us in connection with an exchange of OP units.

Because the OP units may, at our election, be exchanged for shares of our common stock, any merger, exchange or conversion between our operating partnership and another entity ultimately could result in the issuance of a substantial number of shares of our common stock, thereby diluting the percentage ownership interest of other stockholders. Because of these and other reasons, our stockholders may experience substantial dilution in their equity investment in us.

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***Our ability to issue preferred stock may include a preference in distributions superior to our common stock and also may deter or prevent a sale of shares of our common stock in which our stockholders could profit.***

Our charter authorizes our board to issue up to 200,000,000 shares of preferred stock. Our board has the discretion to establish the preferences and rights, including a preference in distributions superior to our common stockholders, of any issued preferred stock. If we authorize and issue preferred stock with a distribution preference over our common stock, payment of any distribution preferences of outstanding preferred stock would reduce the amount of funds available for the payment of distributions on our common stock. Further, holders of preferred stock are normally entitled to receive a preference payment in the event we liquidate, dissolve or wind up before any payment is made to our common stockholders, likely reducing the amount our common stockholders would otherwise receive upon such an occurrence. In addition, under certain circumstances, the issuance of preferred stock or a separate class or series of common stock may render more difficult or tend to discourage:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a merger, tender offer or proxy contest;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• assumption of control by a holder of a large block of our securities; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• removal of incumbent management.

***We may be unable to raise additional capital needed to grow our business.***

We may not be able to increase our capital resources by engaging in additional debt or equity financings. Even if we complete such financings, they may not be on favorable terms. These circumstances could materially and adversely affect our financial results and impair our ability to achieve our business objectives. Additionally, we may be required to accept terms that restrict our ability to incur additional indebtedness or take other actions (including terms that require us to maintain specified liquidity or other ratios) that would otherwise be in the best interests of our stockholders.

***The limit on the percentage of shares of our common stock that any person may own may discourage a takeover or business combination that may have benefited our stockholders.***

Our charter restricts the direct or indirect ownership by one person or entity to no more than 9.9% of the value of shares of our then outstanding capital stock (which includes common stock and any preferred stock we may issue) and no more than 9.9% of the value or number of shares, whichever is more restrictive, of our then outstanding common stock. This restriction may discourage a change of control of us and may deter individuals or entities from making tender offers for shares of our stock on terms that might be financially attractive to our stockholders or which may cause a change in our management. This ownership restriction may also prohibit business combinations that would have otherwise been approved by our board and our stockholders. In addition to deterring potential transactions that may be favorable to our stockholders, these provisions may also decrease our stockholders' ability to sell their shares of our common stock.

***Our stockholders' ability to control our operations is severely limited.***

Our board determines our major strategies, including our strategies regarding investments, financing, growth, capitalization, REIT qualification and distributions. Our board may amend or revise these and other strategies without a vote of the stockholders. Under our charter and Maryland law, our stockholders have a right to vote only on the following matters:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the election or removal of directors;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the amendment of our charter, except that our board may amend our charter without stockholder approval to change our name or the name of other designation or the par value of any class or series of our stock and the aggregate par value of our stock, increase or decrease the aggregate number of shares of stock or the number of shares of stock of any class or series that we have the authority to issue, or effect certain reverse stock splits;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our dissolution; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• certain mergers, consolidations, conversions, statutory share exchanges and sales or other dispositions of all or substantially all of our assets.

All other matters are subject to the sole discretion of our board.

***Conflicts of interest could arise as a result of our officers' other positions and/or interests outside of our company.***

We rely on our management for implementation of our policies and our day-to-day operations. Although a majority of their business time is spent working for our company, they may engage in other investment and business activities in which we have no economic interest. Their responsibilities to these other entities could result in action or inaction that is detrimental to our business, which could harm the implementation of our growth strategies and achievement of our business strategies. They

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may face conflicts of interest in allocating time among us and their other business ventures and in meeting obligations to us and those other entities.

***Maryland law prohibits certain business combinations, which may make it more difficult for us to be acquired and may limit or delay our stockholders' ability to dispose of their shares of our common stock.***

Certain provisions of the Maryland General Corporation Law, or the MGCL, such as the business combination statute and the control share acquisition statute, are designed to prevent, or have the effect of preventing, someone from acquiring control of us. The MGCL prohibits "business combinations" between a Maryland corporation and:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• any person who beneficially owns, directly or indirectly, 10.0% or more of the voting power of the corporation's outstanding voting stock, which is referred to as an "interested stockholder";

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an affiliate or associate of the corporation who, at any time within the two-year period prior to the date in question, was an interested stockholder; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an affiliate of an interested stockholder.

These prohibitions last for five years after the most recent date on which the interested stockholder became an interested stockholder. Thereafter, any business combination with the interested stockholder or an affiliate of the interested stockholder must be recommended by the corporation's board and approved by the affirmative vote of at least 80.0% of the votes entitled to be cast by holders of outstanding shares of voting stock of the corporation, and two-thirds of the votes entitled to be cast by holders of voting stock of the corporation other than shares of voting stock held by the interested stockholder. These requirements could have the effect of inhibiting a change in control even if a change in control were in our stockholders' best interests.

Pursuant to the MGCL, our bylaws exempt us from the control share acquisition statute, which eliminates voting rights for certain levels of shares that could exercise control over us, and our board has adopted a resolution providing that any business combination between us and any other person is exempted from the business combination statute, provided that such business combination is first approved by our board. However, if the bylaws provision exempting us from the control share acquisition statute or our board resolution opting out of the business combination statute were repealed in whole or in part at any time, these provisions of the MGCL could delay or prevent offers to acquire us and increase the difficulty of consummating any such offers, even if such a transaction would be in our stockholders' best interest.

***The MGCL and our organizational documents limit our stockholders' right to bring claims against our officers and directors.***

The MGCL provides that a director has no liability in such capacity if he or she performs his or her duties in good faith, in a manner he or she reasonably believes to be in the corporation's best interests and with the care that an ordinarily prudent person in a like position would use under similar circumstances. Our charter requires us, to the maximum extent permitted by Maryland law, to indemnify and advance expenses to our directors and officers and our subsidiaries' directors and officers. Additionally, our charter limits, to the maximum extent permitted by Maryland law, the liability of our directors and officers to us and our stockholders for monetary damages. Moreover, we have entered into separate indemnification agreements with each of our directors and executive officers and intend to enter into indemnification agreements with each of our future directors and executive officers. Although our charter does not limit the liability of our directors and officers or allow us to indemnify our directors and officers to a greater extent than permitted under Maryland law, we and our stockholders may have more limited rights against our directors and officers than might otherwise exist under common law, which could reduce our stockholders' and our recovery against them. In addition, we may be obligated to fund the defense costs incurred by our directors and officers in some cases, which would decrease the cash otherwise available for distribution to our stockholders.

***Our stockholders' investment return may be reduced if we are required to register as an investment company under the Investment Company Act. If we become subject to registration under the Investment Company Act, we may not be able to continue our business.***

We do not intend to register as an investment company under the Investment Company Act. We monitor our operations and our assets on an ongoing basis in order to ensure that neither we, nor any of our subsidiaries, meet the definition of "investment company" under Section 3(a)(1) of the Investment Company Act. If we were obligated to register as an investment company, we would have to comply with a variety of substantive requirements under the Investment Company Act imposing, among other things: limitations on capital structure; restrictions on specified investments; prohibitions on transactions with affiliates; compliance with reporting, record keeping, voting, proxy disclosure and other rules and regulations that would significantly change our operations; and potentially, compliance with daily valuation requirements.

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To maintain compliance with our Investment Company Act exemption, we may be unable to sell assets we would otherwise want to sell and may need to sell assets we would otherwise wish to retain. Similarly, we may have to acquire additional income- or loss-generating assets that we might not otherwise have acquired or may have to forgo opportunities to acquire interests in companies that we would otherwise want to acquire and would be important to our investment strategy. Accordingly, our board may not be able to change our investment policies as our board may deem appropriate if such change would cause us to meet the definition of an "investment company." In addition, a change in the value of any of our assets could negatively affect our ability to avoid being required to register as an investment company. If we were required to register as an investment company under the Investment Company Act, but failed to do so, we would be prohibited from engaging in our business, and criminal and civil actions could be brought against us. In addition, our contracts would be unenforceable unless a court were to require enforcement, and a court could appoint a receiver to take control of us and liquidate our business, which would result in our stockholders' losing all of their investment in us.

***Our structure may result in potential conflicts of interest with limited partners in our operating partnership whose interests may not be aligned with those of our stockholders.***

Our directors and officers have duties to us and our stockholders under Maryland law and our charter in connection with their management of us. At the same time, the general partner of our operating partnership, of which we are the sole owner, has fiduciary duties under Delaware law to our operating partnership and to the limited partners in connection with the management of our operating partnership. The duties of the general partner to our operating partnership and its partners may come into conflict with the duties of our directors and officers to us and our stockholders. Under Delaware law, a general partner of a Delaware limited partnership owes its limited partners the duties of good faith and fair dealing. Other duties, including fiduciary duties, may be modified or eliminated in the partnership agreement. If there is a conflict in the fiduciary duties owed by us (as the sole member of the general partner) to our stockholders on one hand and by the general partner to any limited partners on the other, we shall be entitled to resolve such conflict in favor of our stockholders.

Additionally, the partnership agreement expressly limits our liability by providing that we and our officers, directors, stockholders, trustees, representatives, agents and employees will not be liable or accountable to our operating partnership for (i) any act or omission performed or failed to be performed, or for any losses, claims, costs, damages, or liabilities arising from any such act or omission, (ii) any tax liability imposed on our operating partnership or (iii) any losses due to the misconduct, negligence (gross or ordinary), dishonesty or bad faith of any agents of our operating partnership, if we or any such person acted consistent with the obligation of good faith and fair dealing and with applicable duties of care and loyalty. In addition, our operating partnership is required to indemnify us and our officers, directors, employees and designees to the extent permitted by applicable law from and against any and all claims arising from operations of our operating partnership, unless it is established that: (i) the act or omission was material to the matter giving rise to the proceeding and either was committed in bad faith or was the result of active and deliberate dishonesty; (ii) the indemnified party received an improper personal benefit, in money, property or services; or (iii) in the case of a criminal proceeding, the indemnified person had reasonable cause to believe that the act or omission was unlawful. The provisions of Delaware law that allow the fiduciary duties of a general partner to be modified by a partnership agreement have not been tested in a court of law, and we have not obtained an opinion of counsel covering the provisions set forth in the partnership agreement that purport to waive or restrict our fiduciary duties.

**Risks Related to Taxes and Our REIT Status**

***Failure to maintain our qualification as a REIT for U.S. federal income tax purposes would subject us to U.S. federal income tax on our REIT taxable income at the regular corporate rate, which would substantially reduce our ability to make distributions to our stockholders.***

We have elected to be taxed as a REIT under the Code commencing with our taxable year ended December 31, 2016. We believe that we have been, and, through the time of the REIT Merger, GAHR III was, organized and operated, and we intend to continue to operate in conformity with the requirements for qualification and taxation as a REIT under the Code. To continue to maintain our qualification as a REIT, we must meet various requirements set forth in the Code concerning, among other things, the ownership of our outstanding common stock, the nature of our assets, the sources of our income, and the amount of our distributions to stockholders. In addition, if it is determined that GAHR III lost, in any year prior to the REIT Merger, its qualification as a REIT without being entitled to any relief under the statutory provisions to preserve REIT status, we, as a "successor" to GAHR III under the REIT rules, will not be able to qualify as a REIT to the extent we are unable to avail ourselves of any relief under the statutory provisions to preserve REIT status. The REIT qualification requirements are extremely complex, and interpretations of the U.S. federal income tax laws governing qualification as a REIT are limited. In addition, the determination of various factual matters and circumstances not entirely within our control may affect our ability to continue to qualify as a REIT. Accordingly, we cannot be certain that we will be successful in operating in compliance with the REIT rules in such manner as to allow us to maintain our qualification as a REIT. At any time, new laws, interpretations or court decisions may change the U.S. federal tax laws relating to, or the U.S. federal income tax consequences of, qualification as a REIT. It is possible that future economic, market, legal, tax or other considerations may cause our board to determine that it

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is not in our best interest to maintain our qualification as a REIT, and to revoke our REIT election, which it may do without stockholder approval.

If we fail to maintain our qualification as a REIT for any taxable year, we will be subject to U.S. federal income tax on our REIT taxable income at the corporate rate and could also be subject to increased state and local taxes. In addition, we would generally be disqualified from treatment as a REIT for the four taxable years following the year of losing our REIT status unless the Internal Revenue Services, or IRS, grants us relief under certain statutory provisions. Losing our REIT status would reduce our net earnings available for investment and amounts available for distribution to our stockholders because of the additional tax liability. In addition, distributions would no longer qualify for the distributions paid deduction, and we would no longer be required to make distributions to our stockholders. If this occurs, we might be required to raise debt or equity capital or sell some investments in order to pay the applicable tax.

As a result of all these factors, our failure to maintain our qualification as a REIT could impair our ability to expand our business and raise capital, could materially and adversely affect the trading price of our common stock and would substantially reduce our ability to make distributions to our stockholders.

***TRSs are subject to corporate-level taxes and our dealings with TRSs may be subject to a 100% excise tax.***

A REIT may own up to 100% of the stock of one or more taxable REIT subsidiaries, or TRSs. Both the subsidiary and the REIT must jointly elect to treat the subsidiary as a TRS. A corporation of which a TRS directly or indirectly owns more than 35.0% of the voting power or value of the stock will automatically be treated as a TRS. Overall, no more than 20.0% (25.0% for taxable years beginning prior to January 1, 2018) of the gross value of a REIT's assets may consist of stock or securities of one or more TRSs. A TRS may hold assets and earn income that would not be qualifying assets or income if held or earned directly by a REIT, including gross income from operations pursuant to management contracts. We lease our properties that are "qualified health care properties" to one or more TRSs which, in turn, contract with independent third-party management companies to operate those "qualified health care properties" on behalf of those TRSs. In addition, we may use one or more TRSs generally to hold properties for sale in the ordinary course of a trade or business or to hold assets or conduct activities that we cannot conduct directly as a REIT. A TRS is subject to applicable U.S. federal, state, local and foreign income tax on its taxable income, as well as limitations on the deductibility of its interest expenses. In addition, the Code imposes a 100% excise tax on certain transactions between a TRS and its parent REIT that are not conducted on an arm's-length basis.

***If our "qualified health care properties" are not properly leased to a TRS or the operators of those "qualified health care properties" do not qualify as EIKs, we could fail to qualify as a REIT.***

In general, under the REIT rules, we cannot directly operate any properties that are "qualified health care properties" and can only indirectly participate in the operation of "qualified health care properties" on an after-tax basis by leasing those properties to independent health care facility operators or to TRSs. A "qualified health care property" is any real property (and any personal property incident to that real property) which 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 and is operated by a provider of those services that is eligible for participation in the Medicare program with respect to that facility. Furthermore, rent paid by a lessee of a "qualified health care property" that is a "related party tenant" of ours will not be qualifying income for purposes of the two gross income tests applicable to REITs. However, a TRS that leases "qualified health care properties" from us will not be treated as a "related party tenant" with respect to our "qualified health care properties" that are managed by an EIK. If we incorrectly classified a property as a "qualified health care property" and leased it to a TRS, any rental income therefrom would likely not be qualifying income for purposes of the two gross income tests applicable to REITs.

An EIK is an independent contractor that, at the time such contractor enters into a management or other agreement with a TRS to operate a "qualified health care property," is actively engaged in the trade or business of operating "qualified health care properties" for any person not related to us or the TRS. Among other requirements to qualify as an independent contractor, an operator must not own, directly or indirectly (or applying attribution provisions of the Code), more than 35.0% of the shares of our outstanding stock (by value), and no person or group of persons can own more than 35.0% of the shares of our outstanding stock and 35.0% of the ownership interests of the operator (taking into account only owners of more than 5.0% of our shares and, with respect to ownership interest in such operators that are publicly traded, only holders of more than 5.0% of such ownership interests). The ownership attribution rules that apply for purposes of the 35.0% thresholds are complex. There can be no assurance that the amount of our shares beneficially owned by our operators and their owners will not exceed the above thresholds. If a healthcare facility operator at one of our properties that uses the RIDEA structure was determined to not be an EIK, any rental income we receive from the TRS with respect to such property would likely not be qualifying income for purposes of the two gross income tests applicable to REITs.

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***If our leases with TRSs are not respected as true leases for U.S. federal income tax purposes, we likely would fail to qualify as a REIT.***

To qualify as a REIT, we must satisfy two gross income tests, under which specified percentages of our gross income must be derived from certain sources, such as "rents from real property." Rent paid by TRSs pursuant to the lease of our "qualified health care properties" will constitute a substantial portion of our gross income. For that rent to qualify as "rents from real property" for purposes of the REIT gross income tests, the leases must be respected as true leases for U.S. federal income tax purposes and not be treated as service contracts, joint ventures or some other type of arrangement. If our leases are not respected as true leases for U. S. federal income tax purposes, we may fail to qualify as a REIT.

***We may be subject to adverse legislative or regulatory tax changes that could increase our tax liability or reduce our operating flexibility.***

In recent years, numerous legislative, judicial and administrative changes have been made in the provisions of U.S. federal and state income tax laws applicable to investments similar to an investment in shares of our common stock. Additional changes to the tax laws are likely to continue to occur, and we cannot assure our stockholders that any such changes will not adversely affect our taxation and our ability to continue to qualify as a REIT or the taxation of a stockholder. Any such changes could have a material adverse effect on an investment in shares of our common stock or on the market price thereof or the resale potential of our assets. Our stockholders are urged to consult with their tax advisor with respect to the impact of recent legislation on their investment in our stock and the status of legislative, regulatory or administrative developments and proposals and their potential effect on an investment in shares of our common stock.

Although REITs generally receive better tax treatment than entities taxed as regular corporations, it is possible that future legislation would result in a REIT having fewer tax advantages, and it could become more advantageous for a company that invests in real estate to elect to be treated for U.S. federal and state income tax purposes as a regular corporation. As a result, our charter provides our board with the power, under certain circumstances, to revoke or otherwise terminate our REIT election and cause us to be taxed as a regular corporation, without the vote of our stockholders. Our board has fiduciary duties to us and our stockholders and could only cause such changes in our tax treatment if it determines in good faith that such changes are in the best interests of our stockholders.

***In certain circumstances, we may be subject to U.S. federal, state and foreign income taxes even if we maintain our qualification as a REIT, which would reduce our cash available for distribution to our stockholders.***

Even if we maintain our qualification as a REIT, we may be subject to U.S. federal income taxes, state income taxes or foreign income taxes. For example, net income from a "prohibited transaction" will be subject to a 100% tax. We may not be able to make sufficient distributions to avoid excise taxes applicable to REITs. We may also decide to retain capital gains we earn from the sale or other disposition of our property and pay income tax directly on such income. In that event, our stockholders would be treated as if they earned that income and paid the tax on it directly. However, our stockholders that are tax-exempt, such as charities or qualified pension plans, would have no benefit from their deemed payment of such tax liability. We may also be subject to state and local taxes or foreign taxes on our income or property, either directly or at the level of the companies through which we indirectly own our assets. Any U.S. federal, state or foreign taxes we pay will reduce our cash available for distribution to our stockholders.

***Dividends payable by REITs generally do not qualify for the reduced tax rates on dividend income as compared to regular corporations, which could adversely affect the value of our shares.***

The maximum U.S. federal income tax rate for certain qualified dividends payable to domestic stockholders that are individuals, trusts and estates generally is 20.0%. Dividends payable by REITs, however, are generally not eligible for these reduced rates for qualified dividends except to the extent the REIT dividends are attributable to "qualified dividends" received by the REIT itself. For taxable years beginning after December 31, 2017 and before January 1, 2026, U.S. individuals, trusts and estates are permitted a deduction for certain pass-through business income, including "qualified REIT dividends" (generally, dividends received by a REIT stockholder that are not designated as capital gain dividends or qualified dividend income), allowing them to deduct up to 20.0% of such amounts, subject to certain limitations. Although the reduced U.S. federal income tax rate applicable to dividend income from regular corporate dividends does not adversely affect the taxation of REITs or dividends paid by REITs, the more favorable rates applicable to qualified dividends from C corporations could cause investors who are individuals, trusts and estates to perceive investments in REITs to be relatively less attractive than investments in the stocks of non-REIT corporations that pay qualified dividends, which could adversely affect the market price of the shares of common stock of REITs, including our shares of common stock.

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***Dividends on, and gains recognized on the sale of, shares by a tax-exempt stockholder may be subject to U.S. federal income tax as unrelated business taxable income.***

If (1) we are a "pension-held REIT," (2) a tax-exempt stockholder has incurred (or is deemed to have incurred) debt to purchase or hold our shares or (3) a holder of our shares is a certain type of tax-exempt stockholder, dividends on, and gains recognized on the sale of, shares by such tax-exempt stockholder may be subject to U.S. federal income tax as unrelated business taxable income under the Code.

***Characterization of our sale-leaseback transactions may be challenged, which could jeopardize our REIT status or require us to make an unexpected distribution.***

We have participated, and may continue to participate, in sale-leaseback transactions in which we purchase real estate investments and lease them back to the sellers of such properties. We believe we have structured and intend to structure any of our sale-leaseback transactions such that the lease will be characterized as a "true lease" and so that we will be treated as the owner of the property for U.S. federal income tax purposes. However, we cannot assure our stockholders that the IRS will not take the position that specific sale-leaseback transactions that we treated as leases be re-characterized as financing arrangements or loans for U.S. federal income tax purposes. In the event that any such sale-leaseback transaction is re-characterized as a financing transaction for U.S. federal income tax purposes, deductions for depreciation and cost recovery relating to such real estate investment would be disallowed or significantly reduced. If a sale-leaseback transaction is so re-characterized, we might fail to satisfy the REIT asset tests, income tests or distribution requirements and, consequently, lose our REIT status or be required to elect to distribute an additional distribution of the increased taxable income to avoid the loss of REIT status. This distribution would be paid to all stockholders at the time of declaration rather than the stockholders existing in the taxable year affected by the re-characterization.

***Complying with the REIT requirements may cause us to forego otherwise attractive opportunities.***

To maintain our qualification as a REIT for U.S. federal income tax purposes, we must continually satisfy tests concerning, among other things, the sources of our income, the nature and diversification of our assets, the amounts we distribute to our stockholders and the ownership of shares of our common stock. We may be required to make distributions to our stockholders at disadvantageous times or when we do not have funds readily available for distribution, or we may be required to raise debt or equity capital or forego otherwise attractive investments in order to comply with the REIT tests. We may need to borrow funds to meet the REIT distribution requirements even if market conditions are not favorable for these borrowings. We cannot assure our stockholders that we will have access to such capital on favorable terms at the desired times, or at all. Thus, compliance with the REIT requirements could materially and adversely affect us and may hinder our ability to operate solely on the basis of maximizing our financial results.

***If the Operating Partnership fails to maintain its status as a partnership and were to be treated as a corporation for U.S. federal income tax purposes, its income may be subject to taxation, which would reduce the cash available for distribution to stockholders and likely result in a loss of our REIT status.***

We intend to maintain the status of our operating partnership as a partnership for U.S. federal income tax purposes. However, if the IRS were to successfully challenge the status of our operating partnership as a partnership for such purposes, it would be taxable as a corporation. In such event, this would reduce the amount of distributions that our operating partnership could make to us. This would also likely result in us losing REIT status, and, if so, becoming subject to a corporate level tax on our own income. This would substantially reduce any cash available to pay distributions. In addition, if any of the partnerships or limited liability companies through which our operating partnership owns its properties, in whole or in part, loses its characterization as a partnership and is otherwise not disregarded for U.S. federal income tax purposes, such partnership or limited liability company would be subject to taxation as a corporation, thereby reducing distributions to our operating partnership. Such a recharacterization of an underlying partnership or limited liability company could also threaten our ability to maintain our status as a REIT.

***Foreign purchasers of shares of our common stock may be subject to FIRPTA tax upon the sale of their shares of our common stock or upon the payment of a capital gains dividend.***

A foreign person disposing of a U.S. real property interest, including shares of stock of a U.S. corporation whose assets consist principally of U.S. real property interests, is generally subject to withholding pursuant to the Foreign Investment in Real Property Tax Act of 1980, as amended, or FIRPTA, on the amount received from the disposition. However, foreign pension plans and certain foreign publicly traded entities are exempt from FIRPTA withholding. Further, such FIRPTA tax does not apply to the disposition of stock in a REIT if the REIT is "domestically controlled." A REIT is "domestically controlled" if less than 50.0% of the REIT's stock, by value, has been owned directly or indirectly by persons who are not qualifying U.S. persons during a continuous five-year period ending on the date of disposition or, if shorter, during the entire period of the REIT's existence. We cannot assure our stockholders that we will qualify as a "domestically controlled" REIT. If we were to fail to so qualify, amounts received by foreign investors on a sale of shares of our common stock would be subject to FIRPTA tax, unless the shares of our common stock are regularly traded on an established securities market and the foreign investor did not at any time during a specified period directly or indirectly own more than 10.0% of the value of our outstanding common stock.

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Additionally, a foreign stockholder will likely be subject to FIRPTA upon the payment of any distribution by us that is attributable to gain from sales or exchanges of U.S. real property interests, unless the shares of our common stock are regularly traded on a U.S. established securities market and the foreign investor did not own at any time during the 1-year period ending on the date of such distribution more than 10.0% of such class of common stock.

***If the REIT Merger does not qualify as a tax-free reorganization, there may be adverse tax consequences.***

The REIT Merger was intended to qualify as a tax-free reorganization within the meaning of Section 368(a) of the Code. The closing of the REIT Merger was conditioned on the receipt by us and GAHR III of an opinion of counsel to the effect that the REIT Merger will qualify as a tax-free reorganization within the meaning of Section 368(a) of the Code. However, these legal opinions will not be binding on the IRS or on the courts. If, for any reason, the REIT Merger were to fail to qualify as a tax-free reorganization, then there would be adverse tax implications to us and our stockholders, which could materially and adversely affect us.

**Employee Benefit Plan, IRA, and Other Tax-Exempt Investor Risks**

***If a stockholder that is a benefit plan or IRA fails to meet the fiduciary and other standards under ERISA or the Code as a result of an investment in shares of our common stock, such stockholder could be subject to civil and, if the failure is willful, criminal penalties.***

There are special considerations that apply to benefit plans and IRAs investing in shares of our common stock. Stockholders that are benefit plans and IRAs should consider whether, among other things:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• their investment is consistent with their fiduciary obligations under ERISA and the Code;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• their investment is made in accordance with the documents and instruments governing the benefit plan or IRA, including any investment policy;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• their investment satisfies the prudence and diversification requirements of ERISA;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• their investment will not impair the liquidity of the benefit plan or IRA;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• their investment will not produce UBTI for the benefit plan or IRA; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• they will be able to value the assets of the benefit plan or IRA annually in accordance with ERISA, the Code and the applicable provisions of the benefit plan or IRA.

ERISA and Section 4975 of the Code prohibit certain transactions that involve (i) benefit plans or IRAs, and (ii) any person who is a "party-in-interest" or "disqualified person" with respect to such a benefit plan or IRA. Consequently, the fiduciary or owner of a benefit plan or an IRA contemplating an investment in our common stock should consider whether we, any other person associated with the issuance of the common stock, or any of our or their affiliates is or might become a "party-in-interest" or "disqualified person" with respect to the benefit plan or IRA and, if so, whether an exemption from such prohibited transaction rules is applicable. In addition, the U.S. Department of Labor plan asset regulations provide that, subject to certain exceptions, the assets of an entity in which a plan holds an equity interest may be treated as assets of the investing plan, in which event investment made by and certain other transactions entered into by such entity would be subject to the prohibited transaction rules. To avoid our assets from being considered "plan assets," our charter prohibits "benefit plan investors" from owning 25% or more of the shares of our common stock prior to the time that the common stock qualifies as a class of publicly-offered securities, within the meaning of the plan assets regulation. However, we cannot assure our stockholders that those provisions in our charter will be effective in limiting benefit plan investors' ownership to less than the 25% limit. Due to the complexity of these rules and the potential penalties that may be imposed, it is important that stockholders that are benefit plans and IRAs consult with their own advisors regarding the potential applicability of ERISA, the Code and any similar applicable law.

***Stockholders that are benefit plans and IRAs may be limited in their ability to withdraw required minimum distributions as a result of an investment in shares of our common stock.***

If benefit plans or IRAs invest in our common stock, the Code may require such plan or IRA to withdraw required minimum distributions in the future. Our stock will be highly illiquid, and our share repurchase plan only offers limited liquidity. If a benefit plan or IRA requires liquidity, it may generally sell its shares, but such sale may be at a price less than the price at which such plan or IRA initially purchased its shares of our common stock. If a benefit plan or IRA fails to make required minimum distributions, it may be subject to certain taxes and tax penalties.

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***Specific rules apply to foreign, governmental and church plans.***

As a general rule, certain employee benefit plans, including foreign pension plans, governmental plans established or maintained in the United States (as defined in Section 3(32) of ERISA), and certain church plans (as defined in Section 3(33) of ERISA), are not subject to ERISA's requirements and are not "benefit plan investors" within the meaning of the plan assets regulation. Any such plan that is qualified and exempt from taxation under Sections 401(a) and 501(a) of the Code may nonetheless be subject to the prohibited transaction rules set forth in Section 503 of the Code and, under certain circumstances in the case of church plans, Section 4975 of the Code. Also, some foreign plans and governmental plans may be subject to foreign, state, or local laws which are, to a material extent, similar to the provisions of ERISA or Section 4975 of the Code. Each fiduciary of a plan subject to any such similar law should make its own determination as to the need for, and the availability of, any exemption relief.

**Item 1B. Unresolved Staff Comments.**

Not applicable.

**Item 2. Properties.**

As of December 31, 2022, our principal executive offices are located at 18191 Von Karman Avenue, Suite 300, Irvine, California 92612. As of December 31, 2022, we also leased office and building space in Arizona. We believe our existing leased facilities are in good condition and suitable for the conduct of our business.

**Real Estate Investments** 

As of December 31, 2022, we operated through six reportable business segments: integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals. We own and/or operate 100% of our properties as of December 31, 2022, with the exception of our investments through Trilogy, or Trilogy Portfolio, Lakeview IN Medical Plaza, Southlake TX Hospital, Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF, Pinnacle Warrenton ALF and Louisiana Senior Housing Portfolio. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity — Noncontrolling Interests in Total Equity, to the Consolidated Financial Statements that are part of this Annual Report on Form 10-K, for a further discussion of our noncontrolling interests. The following table presents certain additional information about our real estate investments as of December 31, 2022:

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| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
| **Reportable Segment** | **Number of <br>Buildings/<br>Campuses** | **GLA<br>(Sq Ft)** | **% of<br>GLA** | **Aggregate<br>Contract<br>Purchase Price** | **Annualized<br>Base<br>Rent/NOI(1)** | **% of<br>Annualized<br>Base Rent/NOI** | **Leased <br>Percentage(2)** |
| Integrated senior health campuses | 120 | 9089000 | 45.7% | $1898591000 | $152652000 | 46.8% | 84.5% |
| MOBs | 104 | 4964000 | 24.9 | 1369596000 | 108862000 | 33.4 | 89.0% |
| SHOP | 51 | 3856000 | 19.4 | 787797000 | 19535000 | 6.0 | 77.0% |
| Senior housing — leased | 20 | 673000 | 3.4 | 179285000 | 12149000 | 3.7 | 100% |
| SNFs | 17 | 1142000 | 5.7 | 249200000 | 24009000 | 7.3 | 100% |
| Hospitals | 2 | 173000 | 0.9 | 139780000 | 9181000 | 2.8 | 100% |
| &nbsp;&nbsp;&nbsp;Total/weighted average(3) | 314 | 19897000 | 100% | $4624249000 | $326388000 | 100% | 92.2% |

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(1)With the exception of our SHOP and integrated senior health campuses, amount is based on annualized contractual base rent from leases as of December 31, 2022. For our SHOP and integrated senior health campuses, amount is based on annualized NOI, a non-GAAP financial measure, due to the characteristics of the RIDEA structure. See Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations — Net Operating Income, for a further discussion of NOI.

(2)Leased percentage includes all third-party leased space at our non-RIDEA properties (including master leases), and excludes our SHOP and integrated senior health campuses where leased percentage represents resident occupancy on the available units/beds therein.

(3)Total portfolio weighted average leased percentage excludes our SHOP and integrated senior health campuses.

We own fee simple interests in all of our land, buildings and campuses except for 17 MOBs and seven integrated senior health campuses, for which we own fee simple interests in the buildings and other improvements on such properties subject to the respective ground leases and for 21 integrated senior health campuses that were leased to Trilogy Portfolio by third parties.

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The following information generally applies to our properties:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we believe all of our properties are adequately covered by insurance and are suitable for their intended purposes;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• we have no plans for any material renovations, improvements or development with respect to any of our properties, except in accordance with planned budgets and within our Trilogy Portfolio;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• our properties are located in markets where we are subject to competition for attracting new tenants and residents, as well as retaining current tenants and residents; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• depreciation is provided on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, over the shorter of the lease term or useful lives of the tenant improvements, up to 34 years, and over the estimated useful life of furniture, fixtures and equipment, up to 28 years.

For additional information regarding our real estate investments, see Schedule III, Real Estate and Accumulated Depreciation, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Lease Expirations**

Substantially all of our leases with residents at our SHOP and integrated senior health campuses are for a term of one year or less. The following table presents the sensitivity of our annual base rent due to lease expirations for the next 10 years and thereafter at our properties as of December 31, 2022, excluding our SHOP and integrated senior health campuses:

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| | | | | | |
|:---|:---|:---|:---|:---|:---|
| **Year** | **Number of<br>Expiring <br>Leases** | **Total Square<br>Feet of Expiring <br>Leases** | **% of GLA<br>Represented by<br>Expiring Leases** | **Annual Base Rent <br>of Expiring Leases(1)** | **% of Total<br>Annual Base Rent<br>Represented by <br>Expiring Leases** |
| 2023 | 134 | 497000 | 7.7% | $12098000 | 6.8% |
| 2024 | 93 | 526000 | 8.2 | 12301000 | 6.9 |
| 2025 | 93 | 677000 | 10.5 | 17963000 | 10.0 |
| 2026 | 58 | 263000 | 4.1 | 6084000 | 3.4 |
| 2027 | 67 | 424000 | 6.6 | 11408000 | 6.4 |
| 2028 | 44 | 523000 | 8.1 | 15483000 | 8.7 |
| 2029 | 39 | 385000 | 6.0 | 11001000 | 6.1 |
| 2030 | 33 | 417000 | 6.5 | 14106000 | 7.9 |
| 2031 | 15 | 281000 | 4.4 | 6958000 | 3.9 |
| 2032 | 28 | 649000 | 10.1 | 18774000 | 10.5 |
| Thereafter | 48 | 1787000 | 27.8 | 52504000 | 29.4 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total | 652 | 6429000 | 100% | $178680000 | 100% |

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(1)Amount is based on the total annual contractual base rent expiring in the applicable year, based on leases as of December 31, 2022.

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**Geographic Diversification/Concentration Table**

The following table lists our property locations and provides certain information regarding our portfolio's geographic diversification/concentration as of December 31, 2022:

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| | | | | | |
|:---|:---|:---|:---|:---|:---|
| **State** | **Number of<br>Buildings/<br>Campuses** | **GLA (Sq Ft)** | **% of GLA** | **Annualized Base <br>Rent/NOI(1)** | **% of Annualized<br>Base Rent/NOI** |
| Alabama | 5 | 290000 | 1.5% | $4948000 | 1.5% |
| Arizona | 1 | 34000 | 0.2 | 848000 | 0.3 |
| Arkansas | 1 | 51000 | 0.3 | 448000 | 0.1 |
| California | 9 | 333000 | 1.7 | 3595000 | 1.1 |
| Colorado | 6 | 287000 | 1.4 | 6673000 | 2.0 |
| Connecticut | 6 | 187000 | 0.9 | 3892000 | 1.2 |
| District of Columbia | 1 | 134000 | 0.7 | 4861000 | 1.5 |
| Florida | 8 | 715000 | 3.5 | 907000 | 0.3 |
| Georgia | 16 | 494000 | 2.5 | 10323000 | 3.2 |
| Iowa | 1 | 38000 | 0.2 | 584000 | 0.2 |
| Illinois | 13 | 411000 | 2.1 | 7201000 | 2.2 |
| Indiana | 74 | 5208000 | 26.2 | 118131000 | 36.2 |
| Kansas | 2 | 116000 | 0.5 | 3044000 | 0.9 |
| Kentucky | 14 | 1377000 | 6.9 | (2686000) | (0.8) |
| Louisiana | 7 | 257000 | 1.3 | 1625000 | 0.5 |
| Maryland | 1 | 77000 | 0.4 | 1687000 | 0.5 |
| Massachusetts | 7 | 513000 | 2.5 | 12999000 | 4.0 |
| Michigan | 27 | 1588000 | 8.0 | 27995000 | 8.6 |
| Minnesota | 1 | 46000 | 0.2 | 1075000 | 0.3 |
| Mississippi | 2 | 76000 | 0.4 | 626000 | 0.2 |
| Missouri | 12 | 769000 | 3.9 | 15710000 | 4.8 |
| Nebraska | 2 | 282000 | 1.4 | 1882000 | 0.6 |
| Nevada | 1 | 191000 | 1.0 | 4819000 | 1.6 |
| New Jersey | 5 | 327000 | 1.6 | 8278000 | 2.5 |
| New York | 1 | 91000 | 0.5 | 2970000 | 0.9 |
| North Carolina | 8 | 330000 | 1.7 | 5279000 | 1.6 |
| Ohio | 33 | 2534000 | 12.7 | 25045000 | 7.7 |
| Oregon | 1 | 62000 | 0.3 | 1709000 | 0.5 |
| Pennsylvania | 9 | 592000 | 3.0 | 13797000 | 4.2 |
| South Carolina | 1 | 59000 | 0.3 | 1671000 | 0.5 |
| Tennessee | 1 | 46000 | 0.2 | 605000 | 0.2 |
| Texas | 23 | 1466000 | 7.4 | 22323000 | 6.8 |
| Utah | 1 | 66000 | 0.3 | (1682000) | (0.6) |
| Virginia | 2 | 284000 | 1.4 | 4684000 | 1.4 |
| Washington | 2 | 77000 | 0.4 | 2158000 | 0.7 |
| Wisconsin | 4 | 334000 | 1.7 | 3897000 | 1.2 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total Domestic | 308 | 19742000 | 99.2 | 321921000 | 98.6 |
| Isle of Man and UK | 6 | 155000 | 0.8 | 4467000 | 1.4 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total | 314 | 19897000 | 100% | $326388000 | 100% |

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(1)Amount is based on contractual base rent from leases as of December 31, 2022, with the exception of our SHOP and integrated senior health campuses, which amount is based on annualized NOI due to the characteristics of the RIDEA structure. See Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations — Net Operating Income, for a further discussion of NOI.

**Indebtedness**

For a discussion of our indebtedness, see Note 8, Mortgage Loans Payable, Net, and Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Item 3. Legal Proceedings.**

For a discussion of our legal proceedings, see Note 12, Commitments and Contingencies — Litigation, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Item 4. Mine Safety Disclosures.**

Not applicable.

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**PART II**

 **Item 5. Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities.** 

**Market Information**

There is no established public trading market for shares of our common stock.

To assist the members of FINRA and their associated persons, pursuant to FINRA Rule 2231, we disclose in each annual report distributed to stockholders a per share estimated value of the shares, the method by which it was developed, and the date of the data used to develop the estimated value. In addition, we prepare annual statements of the estimated per share value to assist fiduciaries of benefit plans and IRAs subject to the annual reporting requirements of ERISA in the preparation of their reports relating to an investment in shares of our common stock. For these purposes, our updated estimated per share NAV is $31.40 calculated as of December 31, 2022, and represents a decrease from our previously determined estimated per share NAV of $37.16, which management believes generally reflects changes in property specific factors, such as the age of a property, demand for space and the financial stability of major tenants, and to an even greater degree, broader market factors such as the continued impact on operations from COVID-19, inflation, prevailing interest rates and movements in capitalization rates that also significantly impact values. The updated estimated per share NAV of $31.40 was approved and established by our board on March 15, 2023 based on the estimated value of our assets less the estimated value of our liabilities, divided by the number of shares outstanding on a fully diluted basis, calculated as of December 31, 2022. Please see our Current Report on Form 8-K, filed with the SEC on March 17, 2023, for additional information regarding the methodology used to determine the updated estimated per share NAV, the information and valuation materials considered by our board in determining the updated estimated per share NAV and our independent third-party valuation firm. However, there is no established public trading market for the shares of our common stock at this time, and there can be no assurance that stockholders could receive $31.40 per share if such a market did exist and they sold their shares of our common stock or that they would be able to receive such amount for their shares of our common stock in the future.

Pursuant to FINRA rules, we generally disclose an estimated per share NAV of our shares based on a valuation performed at least annually, and we disclose the resulting estimated per share NAV in our Annual Reports on Form 10-K distributed to stockholders. When determining the estimated per share NAV, there are currently no SEC, federal and state rules that establish requirements specifying the methodology to employ in determining an estimated per share NAV; provided, however, that the determination of the estimated per share NAV must be conducted by, or with the material assistance or confirmation of, a third-party valuation expert or service and must be derived from a methodology that conforms to standard industry practice. In determining the updated estimated per share NAV of our shares, our board considered information and analysis, including valuation materials that were provided by an independent third-party valuation firm, and the estimated per share NAV recommendation made by the audit committee of our board, which committee is comprised entirely of independent directors.

**Stockholders**

As of March 10, 2023, we had approximately 47,938 stockholders of record.

**Distributions**

The following information represents distributions of GAHR IV for the nine months ended September 30, 2021 and the year ended December 31, 2020. Following the consummation of the Merger between GAHR III and GAHR IV on October 1, 2021, the information included below represents the distributions of the Combined Company.

Prior to March 31, 2020, the GAHR IV board authorized a daily distribution to our stockholders of record as of the close of business on each day of the period commencing on May 1, 2016 and ending on March 31, 2020. The daily distributions were calculated based on 365 days in the calendar year and were equal to $0.006575344 per share of our Class T common stock and Class I common stock, which was equal to an annualized distribution rate of $2.40 per share. These distributions were aggregated and paid in cash or shares of our common stock pursuant to the DRIP on a monthly basis, in arrears, only from legally available funds.

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In response to the COVID-19 pandemic and its effects to our business and operations, at the end of the first quarter of 2020, the GAHR IV board decided to take steps to protect our capital and maximize our liquidity in an effort to strengthen our long-term financial prospects by reducing our distribution payments to stockholders. Consequently, the GAHR IV board authorized a daily distribution to our stockholders of record as of the close of business on each day of the period commencing on April 1, 2020 and ending on August 31, 2021, which was calculated based on 365 days in the calendar year and was equal to $0.004383560 per share of our Class T common stock and Class I common stock. Such daily distribution was equal to an annualized distribution rate of $1.60 per share. The distributions were aggregated and paid in cash or shares of our common stock pursuant to the DRIP on a monthly basis, in arrears, only from legally available funds.

On March 18, 2021, in connection with the GAHR IV special committee's strategic alternative review process, the GAHR IV board of directors authorized the suspension of the DRIP, effective as of April 1, 2021. As a result, beginning with the April 2021 distributions, which were paid in May 2021, there were no further issuances of shares pursuant to the DRIP, and stockholders who were participants in the AHR DRIP received cash distributions instead. On October 4, 2021, our board authorized the reinstatement of the DRIP and as a result, beginning with the October 2021 distribution, which was paid in November 2021, stockholders who previously enrolled as participants in the DRIP (including former GAHR III stockholders who participated in the GAHR III distribution reinvestment plan) received distributions in shares of our common stock pursuant to the terms of the AHR DRIP, instead of cash distributions.

The GAHR IV board of directors also authorized distributions to our Class T common stockholders and Class I common stockholders of record as of the close of business on September 17, 2021, equal to $0.131506800 per share of our common stock, which was equal to an annualized distribution rate of $1.60 per share. Further, our board authorized record date distributions to our Class T common stockholders and Class I common stockholders of record as of each monthly record date from October 2021 through June 2022, equal to $0.133333332 per share of our common stock, which was equal to an annualized distribution rate of $1.60 per share. The distributions were paid in cash or shares of our common stock pursuant to the AHR DRIP.

Effective beginning with the third quarter of 2022, distributions, if any, were or shall be authorized by our board on a quarterly basis, in such amounts as our board determined or shall determine, and each quarterly record date for the purposes of such distributions was or shall be determined and authorized by our board in the last month of each calendar quarter until such time as our board changes our distribution policy. On September 28, 2022, our board authorized a distribution to our Class T common stockholders and Class I common stockholders of record as of the close of business on September 29, 2022, for the quarter commencing on July 1, 2022 and ending on September 30, 2022. The quarterly distribution was equal to $0.40 per share of our common stock, which was equal to an annualized distribution rate of $1.60 per share. The third quarter distribution was paid in October 2022 in cash or shares of our common stock pursuant to the AHR DRIP, only from legally available funds.

On November 14, 2022, our board suspended the AHR DRIP Offering beginning with distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP were or will be paid distributions in cash. On December 12, 2022, our board authorized a distribution to our Class T common stockholders and Class I common stockholders of record as of the close of business on December 29, 2022, for the quarter commencing on October 1, 2022 and ending on December 31, 2022. The quarterly distribution was equal to $0.40 per share of our common stock, which was equal to an annualized distribution rate of $1.60 per share and paid in cash, only from legally available funds.

In response to interest rates that have increased drastically since the beginning of 2022, from a Federal Funds Rate of 0.08% as of January 2022 to 4.57% as of February 2023, and greater uncertainty surrounding further interest rate movements, our board elected to reduce our quarterly distribution to $0.25 per share in order to preserve our liquidity, better align distributions with available cash flows and position our company for its long-term strategic goals. On March 15, 2023, our board authorized a reduced quarterly distribution from $0.40 per share to $0.25 per share to our Class T common stockholders and Class I common stockholders of record as of the close of business on April 4, 2023. The distribution for the quarter commencing January 1, 2023 to March 31, 2023, which will be paid on or about April 18, 2023, represents an annualized distribution rate of $1.00 per share. See our Current Report on Form 8-K filed with the SEC on March 17, 2023 for more information.

The amount of the distributions paid to our common stockholders was determined quarterly or monthly, as applicable, by our board and was dependent on a number of factors, including funds available for payment of distributions, our financial condition, capital expenditure requirements and annual distribution requirements needed to maintain our qualification as a REIT under the Code. We have not established any limit on the amount of borrowings that may be used to fund distributions, except that, in accordance with Maryland law, we may not make distributions that would: (i) cause us to be unable to pay our debts as they become due in the usual course of business; or (ii) cause our total assets to be less than the sum of our total liabilities plus senior liquidation preferences.

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**Recent Sales of Unregistered Securities**

None.

**Purchase of Equity Securities by the Issuer and Affiliated Purchasers**

*Share Repurchase Plan*

Our share repurchase plan allowed for repurchases of shares of our common stock by us when certain criteria were met. Share repurchases were made at the sole discretion of our board. Funds for the repurchase of shares of our common stock originated exclusively from the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP Offerings.

On October 4, 2021, our board approved our amended and restated share repurchase plan that included a change in the repurchase price with respect to repurchases resulting from the death or qualifying disability (as such term is defined in our share repurchase plan) of stockholders, to the most recently published estimated per share NAV. In addition, on October 4, 2021, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders were rejected.

On November 14, 2022, our board suspended our share repurchase plan with respect to all repurchase requests, including repurchases resulting from the death or qualifying disability of stockholders, beginning with share repurchases for the quarter ending December 31, 2022. See Note 14, Equity — Share Repurchase Plan, to the Consolidated Financial Statements that are part of this Annual Report on Form 10-K, for a further discussion.

During the three months ended December 31, 2022, we repurchased shares of our common stock pursuant to our share repurchase plan, as follows:

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| | | | | |
|:---|:---|:---|:---|:---|
| **Period** | **Total Number of<br>Shares Purchased** | **Average Price<br>Paid per Share** | **Total Number of Shares<br>Purchased As Part of<br>Publicly Announced<br>Plan or Program** | **Maximum Approximate<br>Dollar Value<br>of Shares that May<br>Yet Be Purchased<br>Under the<br>Plans or Programs** |
| October 1, 2022 to October 31, 2022 | 119389 | $37.16 | 119389 | (1) |
| November 1, 2022 to November 30, 2022 | 145 | $37.16 | 145 | (1) |
| December 1, 2022 to December 31, 2022 | 668 | $37.16 | 668 | (1) |
| Total | 120202 | $37.16 | 120202 |  |

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___________

(1)A description of the maximum number of shares that may be purchased under our share repurchase plan is included in Note 14, Equity — Share Repurchase Plan, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

*AHR Incentive Plan*

In October 2022, we repurchased 11,679 shares of our common stock, for an aggregate of $434,000, at a repurchase price of $37.16 per share in order to satisfy minimum statutory withholding tax obligations associated with the vesting of restricted stock awards issued pursuant to the AHR Incentive Plan.

**Item 6. [Reserved].**

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

*The use of the words "we," "us" or "our" refers to Griffin-American Healthcare REIT III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT III Holdings, LP, for periods prior to the Merger, as defined below, and American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc., or GAHR IV) and its subsidiaries, including American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), for periods following the Merger, except where otherwise noted. Certain historical information of GAHR IV is included for background purposes.*

The following Management's Discussion and Analysis of Financial Condition and Results of Operations is intended to promote understanding of our results of operations and financial condition. The following discussion is provided as a supplement to, and should be read in conjunction with our accompanying consolidated financial statements and notes thereto appearing elsewhere in this Annual Report on Form 10-K. Such consolidated financial statements and information have been prepared to reflect our financial position as of December 31, 2022 and 2021, together with our results of operations and cash flows for the years ended December 31, 2022, 2021 and 2020. This section discusses the results of operations and cash flows for fiscal year 2022 compared to fiscal year 2021. We have omitted the discussion related to the results of operations and changes in financial condition for fiscal year 2021 compared to fiscal year 2020 from this Annual Report on Form 10-K, but such discussion may be found in Part II, Item 7, Management's Discussion and Analysis of Financial Condition and Results of Operations, in our fiscal year 2021 Annual Report Form 10-K, which was filed with the U.S. Securities and Exchange Commission, or the SEC, on March 25, 2022.

In connection with the Merger as discussed and defined below, GAHR IV was the legal acquiror of GAHR III, whereas GAHR III was the accounting acquiror of GAHR IV in accordance with accounting principles generally accepted in the United States of America, or GAAP, and as discussed in Note 1, Organization and Description of Business, and Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K. Thus, the financial information set forth herein subsequent to the Merger reflects results of the Combined Company (as defined below), and the financial information set forth herein prior to the Merger reflects GAHR III's results. For this reason, period to period comparisons may not be meaningful.

**Forward-Looking Statements** 

Certain statements contained in this report, other than historical facts, may be considered forward-looking statements within the meaning of Section 27A of the Securities Act, Section 21E of the Securities Exchange Act of 1934, as amended, or the Exchange Act, and the Private Securities Litigation Reform Act of 1995 (collectively with the Securities Act and Exchange Act, or the Acts). We intend for all such forward-looking statements to be covered by the applicable safe harbor provisions for forward-looking statements contained in the Acts. Such forward-looking statements generally can be identified by the use of forward-looking terminology such as "may," "will," "can," "expect," "intend," "anticipate," "estimate," "believe," "continue," "possible," "initiatives," "focus," "seek," "objective," "goal," "strategy," "plan," "potential," "potentially," "preparing," "projected," "future," "long-term," "once," "should," "could," "would," "might," "uncertainty," or other similar words. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date this report is filed with the SEC.

Any such forward-looking statements are based on current expectations, estimates and projections about the industry and markets in which we operate, and beliefs of, and assumptions made by, our management and involve uncertainties that could significantly affect our financial results. Such statements include, but are not limited to: (i) statements about our plans, strategies, initiatives and prospects, including our proposed listing and future capital-raising initiatives; (ii) statements about the impact of the Merger; (iii) statements about the coronavirus, or COVID-19, pandemic, including its duration and potential or expected impact on our business and our view on forward trends; and (iv) statements about our future results of operations, capital expenditures and liquidity. Such statements are subject to known and unknown risks and uncertainties, which could cause actual results to differ materially from those projected or anticipated, including, without limitation: changes in economic conditions generally and the real estate market specifically; the continuing adverse effects of the COVID-19 pandemic, including its effects on the healthcare industry, senior housing and skilled nursing facilities, or SNFs, and the economy in general; legislative and regulatory changes, including changes to laws governing the taxation of real estate investment trusts, or REITs; the availability of capital; our ability to pay down, refinance, restructure or extend our indebtedness as it becomes due; our ability to maintain our qualification as a REIT for U.S. federal income tax purposes; changes in interest rates and foreign currency risk; uncertainty from the discontinuance of the London Interbank Offered Rate, or LIBOR, and the transition to the Secured Overnight Financing Rate, or SOFR; competition in the real estate industry; changes in GAAP policies and guidelines applicable to REITs; the success of our investment strategy; information technology security breaches; our ability to retain our executives and key employees; and unexpected labor costs and inflationary pressures. These risks and uncertainties should be considered in evaluating forward-looking statements and undue reliance should not be placed on such statements. Forward-looking statements in this Annual Report on Form 10-K speak only as of the date on which such statements are made, and

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undue reliance should not be placed on such statements. We undertake no obligation to update any such statements that may become untrue because of subsequent events. Additional information concerning us and our business, including additional factors that could materially affect our financial results, is included herein and in our other filings with the SEC.

**Overview and Background** 

American Healthcare REIT, Inc., a Maryland corporation, is a leading internally-managed REIT that owns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, or MOBs, senior housing, SNFs, hospitals and other healthcare-related facilities. We have built a fully-integrated management platform, with approximately 113 employees, that operates clinical healthcare properties throughout the United States, the United Kingdom, and the Isle of Man. We also operate healthcare-related facilities utilizing the structure permitted 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 of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). Our healthcare facilities operated under a RIDEA structure include our senior housing operating properties, or SHOP, and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We have elected to be taxed as a REIT for U.S. federal income tax purposes. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code.

***Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc.***

On October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with Merger Sub being the surviving company, or the REIT Merger. On October 1, 2021, also pursuant to the Merger Agreement, Griffin-American Healthcare REIT IV Holdings, LP, a Delaware limited partnership and subsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our operating partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the REIT Merger and the Partnership Merger as the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and our operating partnership, also referred to as the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The REIT Merger was intended to qualify as a reorganization under, and within the meaning of, Section 368(a) of the Code. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and GAHR IV Operating Partnership ceased.

At the effective time of the REIT Merger and prior to the reverse stock split, each issued and outstanding share of GAHR III's common stock, $0.01 par value per share, converted into the right to receive 0.9266 shares of GAHR IV's Class I common stock, $0.01 par value per share. Further, at the effective time of the Partnership Merger and prior to the reverse stock split, (i) each unit of limited partnership interest in the surviving partnership outstanding immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership, and (ii) each unit of limited partnership interest in GAHR IV Operating Partnership immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.

***AHI Acquisition***

Also on October 1, 2021, immediately prior to the consummation of the Merger, GAHR III acquired a newly formed entity, American Healthcare Opps Holdings, LLC, or NewCo, which we refer to as the AHI Acquisition, pursuant to a contribution and exchange agreement dated June 23, 2021, or the Contribution Agreement, between GAHR III; our operating partnership; American Healthcare Investors, LLC, or AHI; Griffin Capital Company, LLC, or Griffin Capital; Platform Healthcare Investor T-II, LLC; Flaherty Trust; and Jeffrey T. Hanson, the non-executive Chairman of our board of directors, or our board, Danny Prosky, our Chief Executive Officer and President, and Mathieu B. Streiff, one of our directors, or collectively, the AHI Principals. NewCo owned substantially all of the business and operations of AHI, as well as all of the equity interests in (i) Griffin-American Healthcare REIT IV Advisor, LLC, or GAHR IV Advisor, a subsidiary of AHI that served as the external advisor of GAHR IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our former advisor, a subsidiary of AHI that served as the external advisor of GAHR III.

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Pursuant to the Contribution Agreement, AHI contributed substantially all of its business and operations to the surviving partnership, including its interest in GAHR III Advisor and GAHR IV Advisor, and Griffin Capital contributed its then-current ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, OP units. Subject to working capital and other customary adjustments, the total approximate value of these OP units at the time of consummation of the transactions contemplated by the Contribution Agreement, and prior to the reverse stock split, was approximately $131,674,000, with a reference value for purposes thereof of $8.71 per OP unit, such that the surviving partnership issued 15,117,529 OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the AHI Acquisition, the Combined Company became self-managed. See "Operating Partnership and Former Advisor" below for a further discussion. Such OP units were owned by AHI Group Holdings, LLC, or AHI Group Holdings, which is owned and controlled by the AHI Principals, Platform Healthcare Investor TII, LLC, Flaherty Trust and a wholly owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers.

The AHI Acquisition was treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While GAHR IV was the legal acquiror of GAHR III in the REIT Merger, GAHR III was determined to be the accounting acquiror in the REIT Merger in accordance with Financial Accounting Standards Board Accounting Standards Codification Topic 805, *Business Combinations,* after considering the relative share ownership and the composition of the governing body of the Combined Company. Thus, the financial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the Combined Company, and the financial information set forth herein prior to the Merger and the AHI Acquisition reflects GAHR III's results. For this reason, period to period comparisons may not be meaningful.

See Note 4, Business Combinations — 2021 Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of the Merger and the AHI Acquisition.

***Operating Partnership and Former Advisor***

We conduct substantially all of our operations through our operating partnership and we are the sole general partner of our operating partnership. As of December 31, 2022 and 2021, we owned an approximately 95.0% and 94.9% general partnership interest therein, respectively, and the remaining 5.0% and 5.1%, respectively, was owned by the NewCo Sellers.

Through September 30, 2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor, subject to the oversight and review of our board provided asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Following the Merger and the AHI Acquisition, we became self-managed and are no longer externally advised. As a result, any fees that would have otherwise been payable to our former advisor are no longer being paid to a third party. Upon consummation of the AHI Acquisition, we redeemed all 51 limited partnership units that our former advisor held in our operating partnership, as well as all 52 limited partnership units held by GAHR IV Advisor in GAHR IV Operating Partnership. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 5,148 shares of our common stock owned by our former advisor and all 5,208 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV.

Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by DigitalBridge Group, Inc. (NYSE: DBRG), or DigitalBridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, DigitalBridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings.

See the "Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc." and "AHI Acquisition" sections above for a further discussion. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity — Noncontrolling Interests in Total Equity, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of the ownership in our operating partnership.

***Public Offerings***

GAHR IV raised $754,118,000 through a best efforts initial public offering, or the initial offering, and issued 18,909,921 aggregate shares of its Class T common stock and Class I common stock. In addition, during the initial offering, GAHR IV issued 813,384 aggregate shares of its Class T common stock and Class I common stock pursuant to GAHR IV's distribution reinvestment plan, as amended, or the DRIP, for a total of $31,021,000 in reinvested distributions. Following the deregistration of the initial offering, GAHR IV continued issuing shares of its common stock up to $100,000,000 pursuant to the DRIP through a subsequent offering, or the 2019 GAHR IV DRIP Offering, pursuant to a Registration Statement on Form S-3 under

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the Securities Act. GAHR IV commenced offering shares pursuant to the 2019 GAHR IV DRIP Offering on March 1, 2019, following the termination of the initial offering on February 15, 2019. On March 18, 2021, the GAHR IV board of directors authorized the suspension of the DRIP, effective as of April 1, 2021.

On October 4, 2021, our board authorized the reinstatement of the DRIP, as amended, or the AHR DRIP, to offer up to $100,000,000 of shares of our common stock pursuant to a Registration Statement on Form S-3 under the Securities Act previously filed by GAHR IV, or the AHR DRIP Offering. On November 14, 2022, our board suspended the AHR DRIP Offering beginning with distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP Offering, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP will be paid future distributions in cash. As of December 31, 2022, a total of $91,448,000 in distributions were reinvested that resulted in 2,431,695 shares of common stock being issued pursuant to the AHR DRIP.

On September 16, 2022, we filed with the SEC a Registration Statement on Form S-11 (File No. 333-267464) with respect to a proposed public offering by us of our shares of common stock in conjunction with a contemplated listing of our common stock on the New York Stock Exchange, or the NYSE. Such registration statement and contemplated listing are not yet effective.

On November 10, 2022, our board approved charter amendments to effect, on November 15, 2022 a one-for-four reverse stock split of our common stock and a corresponding reverse split of the OP units, or the Reverse Splits. All numbers of common shares and per share data, as well as the OP units in this Annual Report on Form 10-K have been retroactively adjusted for all periods presented to give effect to the Reverse Splits. See Note 14, Equity, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of our public offerings.

On March 15, 2023, our board, at the recommendation of the audit committee of our board, which is comprised solely of independent directors, unanimously approved and established an updated estimated per share net asset value, or NAV, of our common stock of $31.40. We provide this updated estimated per share NAV annually to assist broker-dealers in connection with their obligations under Financial Industry Regulatory Authority, or FINRA, Rule 2231 with respect to customer account statements. The updated estimated per share NAV is based on the estimated value of our assets less the estimated value of our liabilities, divided by the number of shares outstanding on a fully diluted basis, calculated as of December 31, 2022. The valuation was performed in accordance with the methodology provided in Practice Guideline 2013-01, *Valuations of Publicly Registered Non-Listed REITs,* issued by the Institute for Portfolio Alternatives, or the IPA, in April 2013, in addition to guidance from the SEC. See our Current Report on Form 8-K filed with the SEC on March 17, 2023 for more information on the methodologies and assumptions used to determine, and the limitations and risks of, our updated estimated per share NAV.

***Our Real Estate Investments Portfolio***

We currently operate through six reportable business segments: integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals. As of December 31, 2022, we owned and/or operated 314 buildings and integrated senior health campuses including completed development and expansion projects, or approximately 19,897,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $4,624,249,000. In addition, as of December 31, 2022, we also owned a real estate-related debt investment purchased for $60,429,000.

**Critical Accounting Estimates**

Our critical accounting policies are those that will have the most impact on the reporting of our financial condition and results of operations and those requiring significant judgments and estimates. We believe that our judgments and estimates are consistently applied and produce financial information that fairly present our financial condition and results of operations. Our most critical accounting policies that involve judgments and estimates include (1) real estate investments purchase price allocation, (2) impairment of long-lived assets, (3) goodwill, (4) revenue recognition and grant income, (5) resident receivable allowances and (6) income taxes.

These critical accounting policies involve estimates that may require complex judgment in their application and are evaluated on an on-going basis using information that is available as well as various other assumptions believed to be reasonable under the circumstances. However, if our judgment or interpretation of the facts and circumstances relating to various transactions or other matters had been different, we may have applied a different accounting treatment, resulting in a different presentation of our financial statements. A discussion of our significant accounting policies is included within Note 2, Summary of Significant Accounting Policies, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K. There have been no significant changes to our critical accounting policies during 2022. Below is a summary of the key judgments and estimates used in our critical accounting policies.

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***Real Estate Investments Purchase Price Allocation***

Upon the acquisition of real estate properties or entities owning real estate properties, we determine whether the transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we capitalize transaction costs and allocate the purchase price using a relative fair value method allocating all accumulated costs, whereas, for a transaction accounted for as a business combination, we immediately expense transaction costs incurred associated with the business combination and allocate the purchase price based on the estimated fair value of each separately identifiable asset and liability.

In accounting for asset acquisitions and business combinations, we, with assistance from independent valuation specialists, measure the fair value of tangible and intangible identified assets and liabilities, as applicable, based on their respective fair values for acquired properties, which is then allocated to acquired investments in real estate. The fair value measurement and its allocation require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our financial statements.

***Impairment of Long-Lived Assets***

We also periodically perform analysis that requires us to judge whether indicators of impairment exist and to estimate likely future cash flows. Projections of expected future operating cash flows require that we estimate future revenue amounts, future property operating expenses and the number of years the property is held for investment, among other factors. The subjectivity of assumptions used in the future cash flow analysis, including discount rates, where applicable, could result in an incorrect assessment of the real estate fair value and could result in the misstatement of the carrying value of our real estate assets and net income (loss).

***Goodwill***

Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of a business acquired. This allocation is based upon our determination of the value of the acquired assets and assumed liabilities, which requires judgment and some of the estimates involve complex calculations. These allocation assessments have a direct impact on our financial statements. Our goodwill has an indeterminate life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or changes in circumstances indicate that the asset might be impaired. Such evaluation could involve estimated future cash flows, which is highly subjective, and is based in part on assumptions regarding future events. We compare the fair value of a reporting segment with its carrying amount. We recognize an impairment loss to the extent the carrying value of goodwill exceeds the implied value in the current period. We take a qualitative approach, as applicable, to consider whether an impairment of goodwill exists prior to quantitatively determining the fair value of the reporting segment in step one of the impairment test.

***Revenue Recognition and Grant Income***

A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and include variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Such variable consideration is included in the determination of the estimated transaction price for providing care. These settlements include estimates based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations.

We recognize amounts granted through federal and state government programs (such as through the CARES Act) that were established for eligible healthcare providers to preserve liquidity in response to the COVID-19 pandemic as grant income or as a reduction of property operating expenses, as applicable, when there is reasonable assurance that the grants will be received and all conditions to retain the funds will be met. We adjust our estimates and assumptions of such grants based on the applicable guidance provided by the government and the best available information that we have.

***Resident Receivable Allowances***

An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct

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reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents' financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors.

***Income Taxes*** 

We have elected to be taxed as a REIT under the Code for U.S. federal income tax purposes commencing with our taxable year ended December 1, 2016. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code. Our qualification as a REIT, and maintenance of such qualification, will depend on our ability to meet, on a continuing basis, various complex requirements under the Code relating to, among other things, the sources of our gross income, the composition and values of our assets, our distribution levels and the concentration of ownership of our stock. As a REIT, we generally will not be subject to U.S. federal income tax on REIT taxable income that we currently distribute to our stockholders.

If we fail to qualify as a REIT in any calendar year and do not qualify for certain statutory relief provisions, our income would be subject to U.S. federal income tax at the corporate rate, and we would likely be precluded from qualifying for treatment as a REIT until the fifth calendar year following the year in which we fail to qualify. Accordingly, our failure to qualify as a REIT could have a material adverse effect on our results of operations and amounts available for distribution to our stockholders. Even if we qualify as a REIT, we may still be subject to certain U.S. federal, state and local taxes on our income and assets and to U.S. federal income and excise taxes on our undistributed income. In addition, subject to maintaining our qualification as a REIT, a portion of our business may be conducted through, and a portion of our income may be earned in, one or more TRSs that are themselves subject to regular corporate income taxation.

**Recently Issued Accounting Pronouncements**

For a discussion of recently issued accounting pronouncements, see Note 2, Summary of Significant Accounting Policies — Recently Issued Accounting Pronouncements, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Acquisitions and Dispositions in 2022, 2021 and 2020** 

For a discussion of our acquisitions and dispositions of investments in 2022, 2021 and 2020, see Note 2, Summary of Significant Accounting Policies — Properties Held for Sale, Note 3, Real Estate Investments, Net, and Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Factors Which May Influence Results of Operations** 

In connection with the Merger, GAHR IV was the legal acquiror and GAHR III was the accounting acquiror for financial reporting purposes, as discussed in Note 1, Organization and Description of Business, and Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K. Thus, the financial information set forth herein subsequent to the Merger reflects results of the Combined Company, and the financial information set forth herein prior to the Merger reflects GAHR III's results. Furthermore, as a result of the AHI Acquisition and the Merger on October 1, 2021, we employed a workforce necessary to operate as a self-managed company. The impact on our results of operations from operating as a self-managed company is predominantly an increase in general and administrative costs related to employing the necessary workforce and cost savings associated with no longer paying advisory fees to our former advisor. For these reasons, period to period comparisons may not be meaningful.

Other than the effects of the Merger and the AHI Acquisition discussed above, and the impacts of the COVID-19 pandemic and inflation discussed below, as well as other national economic conditions affecting real estate generally, or as otherwise disclosed in our risk factors, we are not aware of any material trends or uncertainties that may reasonably be expected to have a material impact, favorable or unfavorable, on revenues or income from the acquisition, disposition, management and operation of our properties. For a further discussion of these and other factors that could impact our future results or performance, see Part I, Item 1A, Risk Factors, of this Annual Report on Form 10-K.

***COVID-19***

Our residents, tenants, operating partners and managers, our industry and the U.S. economy may continue to be adversely affected by the COVID-19 pandemic and related supply chain disruptions and labor shortages. While the COVID 19 pandemic is subsiding, the timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the emergence and severity of COVID-19 variants, the effectiveness and frequency of booster vaccinations and the duration and implications of restrictions and safety measures. As the lasting effect of the COVID-19 pandemic is still

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impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments. COVID-19 is particularly dangerous among the senior population and results in heightened risk to our senior housing and SNFs, and we continue to work diligently to maintain aggressive protocols at such facilities as well as actively collaborate with our tenants, operating partners and managers to respond and take action to mitigate the impact of the COVID-19 pandemic.

We have evaluated the impacts of the COVID-19 pandemic on our business thus far and incorporated information concerning such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of December 31, 2022. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information.

The COVID-19 pandemic resulted in a significant decline in resident occupancies at our leased senior housing facilities and SNFs, SHOP and integrated senior health campuses and an increase in COVID-19 related operating expenses with more costly short-term hires due to the shortage of healthcare personnel. Therefore, our focus at such properties continues to be on resident occupancy recovery and operating expense management. Resident occupancies at our senior housing and SNFs have gradually improved to near pre-pandemic levels. We believe the operational recovery of such classes from the impact of the COVID-19 pandemic will generally continue and that such recovery over time towards pre-pandemic levels will drive our overall portfolio performance.

As a result of the federal government's COVID-19 public health emergency declaration in January 2020, certain federal and state pandemic-related relief measures, such as funding, procedural waivers and/or reimbursement increases, became available to some of our tenants and operators. On January 30, 2023, the Biden Administration announced that the COVID-19 public health emergency declaration will expire on May 11, 2023, creating uncertainty as to how widespread these measures will continue to be and to what extent they may be distributed to and benefit our tenants and operators.

The lasting effect of the COVID-19 pandemic over the next 12 months will largely depend on future developments, which cannot be predicted with confidence at this time. See the "Results of Operations" and "Liquidity and Capital Resources" sections below, as well as Part I, Item 1A, Risk Factors, of this Annual Report on Form 10-K, for a further discussion.

***Inflation***

For the years ended December 31, 2022 and 2021, inflation has affected our operations. The annual rate of inflation in the United States was 6.0% in February 2023, as measured by the Consumer Price Index. We believe inflation has impacted our operations such that, we have experienced, and continue to experience, increases in the cost of labor, services, energy and supplies, and therefore continued inflationary pressures on our integrated senior health campuses and SHOP could continue to impact our profitability in future periods. For properties that are not operated under a RIDEA structure, there are provisions in the majority of our tenant leases that help us mitigate the impact of inflation. These provisions include negotiated rental increases, which historically range from 2% to 3% per year, reimbursement billings for operating expense pass-through charges and real estate tax and insurance reimbursements. However, due to the long-term nature of existing leases, among other factors, the leases may not reset frequently enough to cover inflation. A period of inflation could also cause an increase in the cost of our variable-rate debt due to rising interest rates. See Item 7A, Quantitative and Qualitative Disclosures About Market Risk — Interest Rate Risk, for a further discussion.

***Scheduled Lease Expirations***

Excluding our SHOP and integrated senior health campuses, as of December 31, 2022, our properties were 92.2% leased and during 2023, 7.7% of the leased GLA is scheduled to expire. Our leasing strategy focuses on negotiating renewals for leases scheduled to expire during the next twelve months. In the future, if we are unable to negotiate renewals, we will try to identify new tenants or collaborate with existing tenants who are seeking additional space to occupy. As of December 31, 2022, our remaining weighted average lease term was 7.2 years, excluding our SHOP and integrated senior health campuses.

Our combined SHOP and integrated senior health campuses were 82.5% leased as of December 31, 2022. Substantially all of our leases with residents at such properties are for a term of one year or less.

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**Results of Operations** 

***Comparison of the Years Ended December 31, 2022 and 2021***

Our operating results are primarily comprised of income derived from our portfolio of properties and expenses in connection with the acquisition and operation of such properties. Our primary sources of revenue include rent generated by our leased, non-RIDEA properties, and resident fees and services revenue from our RIDEA properties. Our primary expenses include property operating expenses and rental expenses. In addition, beginning in the fourth quarter of 2021, following the AHI Acquisition that resulted in our company being self managed, general and administrative expenses include payroll and other corporate operating expenses but no longer include advisory fees to our former advisor. In general, and under a normal operating environment without the adverse effect of the COVID-19 pandemic and challenging economic conditions resulting from inflation, we expect amounts related to our portfolio of leased, non-RIDEA properties to increase in the future due to fixed annual rent escalations and amounts related to our portfolio of RIDEA properties to increase in the future due to an overall increase in occupancies and market rents as well as an increase in the pricing of care services provided. The ability to compare one period to another is also impacted by the closing of the AHI Acquisition and the increase in size of our real estate portfolio as a result of the Merger. See Note 1, Organization and Description of Business and Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

We segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions. As of both December 31, 2022 and 2021, we operated through six reportable business segments: integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals.

Except where otherwise noted, the changes in our consolidated results of operations for 2022 as compared to 2021 are primarily due to the acquisition of GAHR IV's portfolio of 92 buildings, or approximately 4,799,000 square feet of GLA, as a result of the Merger on October 1, 2021, the disruption to our normal operations as a result of the COVID-19 pandemic and grant income received, as well as the adverse effect of inflation. As of December 31, 2022 and 2021, we owned and/or operated the following types of properties:

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| | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|
| | **December 31,** | **December 31,** | **December 31,** | **December 31,** | **December 31,** | **December 31,** |
| | **2022** | **2022** | **2022** | **2021** | **2021** | **2021** |
| | **Number of<br>Buildings/<br>Campuses** | **Aggregate <br>Contract<br>Purchase Price** | **Leased %** | **Number of<br>Buildings/<br>Campuses** | **Aggregate <br>Contract<br>Purchase Price** | **Leased %** |
| Integrated senior health campuses | 120 | $1898591000 | (1) | 122 | $1787686000 | (1) |
| MOBs | 104 | 1369596000 | 89.0% | 105 | 1378995000 | 92.0% |
| SHOP | 51 | 787797000 | (2) | 47 | 706871000 | (2) |
| Senior housing — leased | 20 | 179285000 | 100% | 20 | 179285000 | 100% |
| SNFs | 17 | 249200000 | 100% | 17 | 249200000 | 100% |
| Hospitals | 2 | 139780000 | 100% | 2 | 139780000 | 100% |
| &nbsp;&nbsp;&nbsp;Total/weighted average(3) | 314 | $4624249000 | 92.2% | 313 | $4441817000 | 94.3% |

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___________

(1)The leased percentage for the resident units of our integrated senior health campuses was 84.5% and 77.0% as of December 31, 2022 and 2021, respectively.

(2)The leased percentage for the resident units of our SHOP was 77.0% and 72.5% as of December 31, 2022 and 2021, respectively.

(3)Leased percentage includes all third-party leased space at our non-RIDEA properties (including master leases), and excludes our SHOP and integrated senior health campuses where leased percentage represents resident occupancy on the available units/beds therein.

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***Revenues and Grant Income***

Our primary sources of revenue include rent generated by our leased, non-RIDEA properties, and resident fees and services revenue from our RIDEA properties. For the years ended December 31, 2022 and 2021, resident fees and services revenue primarily consisted of rental fees related to resident leases, extended health care fees and other ancillary services, and real estate revenue primarily consisted of base rent and expense recoveries. The amount of revenues generated by our properties depends principally on our ability to maintain the occupancy rates of currently leased space and to lease available space at the then existing rental rates. We also receive grant income. Revenues and grant income by reportable segment consisted of the following for the periods then ended:

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| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| ***Resident Fees and Services Revenue*** |  |  |
| Integrated senior health campuses | $1254665000 | $1025699000 |
| SHOP | 157491000 | 98236000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services revenue | 1412156000 | 1123935000 |
| ***Real Estate Revenue*** |  |  |
| MOBs | 148717000 | 97297000 |
| SNFs | 26159000 | 17309000 |
| Senior housing — leased | 20802000 | 16530000 |
| Hospitals | 9666000 | 10232000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total real estate revenue | 205344000 | 141368000 |
| ***Grant Income*** |  |  |
| Integrated senior health campuses | 24820000 | 13911000 |
| SHOP | 855000 | 3040000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total grant income | 25675000 | 16951000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenues and grant income | $1643175000 | $1282254000 |

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*Resident Fees and Services Revenue*

For the year ended December 31, 2022, $43,582,000 in resident fees and services revenue for our SHOP segment was due to the increase in the size of our portfolio as a result of the Merger. The remaining increase in resident fees and services revenue for our SHOP segment for the year ended December 31, 2022, as compared to the prior year period, was primarily attributable to: (i) increased resident occupancy; (ii) higher move-in fees; (iii) an increase of $5,661,000 due to transitioning the leased senior housing facilities within Delta Valley ALF portfolio to a RIDEA structure and including such facilities within SHOP on December 1, 2021; and (iv) an increase of $1,995,000 due to the acquisition of a portfolio of seven senior housing facilities in Texas that are now included within our SHOP segment.

For our integrated senior health campuses segment, we experienced an increase in resident fees and services revenue of $69,992,000 for the year ended December 31, 2022 due to our acquisition of the 50.0% controlling interest in a privately held company, RHS Partners, LLC, or RHS. We previously held a 50.0% equity interest in RHS, which owns and/or operates 16 integrated senior health campuses located in Indiana. For the year ended December 31, 2022, we also experienced an increase in resident fees and services revenue of $11,480,000 due to our acquisition of an integrated senior health campus in Kentucky on January 3, 2022. See Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of such acquisitions. The remaining increase in resident fees and services revenue for our integrated senior health campuses segment was primarily attributable to increased resident occupancy.

*Real Estate Revenue*

For the year ended December 31, 2022, $67,234,000 of real estate revenue was primarily due to the increase in the size of our portfolio as a result of the Merger. Such amounts were partially offset by a decrease in rental revenue for our senior housing — leased segment of $2,200,000 for the year ended December 31, 2022, primarily due to transitioning the leased senior housing facilities within Delta Valley ALF portfolio to a RIDEA structure and including such facilities within SHOP on December 1, 2021. In addition, for the year ended December 31, 2022, we experienced a decrease in rental revenue for our MOBs segment of $782,000, primarily due to a one-time lease termination fee recognized in June 2021 for one of our MOBs.

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*Grant Income*

For the years ended December 31, 2022 and 2021, we recognized $25,675,000 and $16,951,000, respectively, of grant income at our integrated senior health campuses and SHOP primarily related to government grants received through the CARES Act economic stimulus programs.

***Property Operating Expenses and Rental Expenses***

Property operating expenses and property operating expenses as a percentage of resident fees and services revenue and grant income, as well as rental expenses and rental expenses as a percentage of real estate revenues, by reportable segment consisted of the following for the periods then ended:

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| | | | | |
|:---|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2022** | **2021** | **2021** |
| ***Property Operating Expenses*** |  |  |  |  |
| Integrated senior health campuses | $1133480000 | 88.6% | $943743000 | 90.8% |
| SHOP | 148046000 | 93.5% | 86450000 | 85.4% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total property operating expenses | $1281526000 | 89.1% | $1030193000 | 90.3% |
| ***Rental Expenses*** |  |  |  |  |
| MOBs | $56390000 | 37.9% | $36375000 | 37.4% |
| SNFs | 2179000 | 8.3% | 1507000 | 8.7% |
| Hospitals | 433000 | 4.5% | 477000 | 4.7% |
| Senior housing — leased | 682000 | 3.3% | 366000 | 2.2% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total rental expenses | $59684000 | 29.1% | $38725000 | 27.4% |

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Integrated senior health campuses and SHOP typically have a higher percentage of direct operating expenses to revenue than MOBs, hospitals, and leased senior housing and SNFs due to the nature of RIDEA-type facilities where we conduct day-to-day operations. For the year ended December 31, 2022, as compared to the year ended December 31, 2021, rental expenses increased by $19,760,000 and property operating expenses increased by $46,897,000 for our SHOP due to the increase in the size of our portfolio as a result of the Merger. The remaining increase in total property operating expenses for our SHOP segment was due to: (i) higher operating expenses as a result of increased occupancy; (ii) an increase in labor costs, such as a significant increase in employee wages, agency fees and temporary labor expenses; (iii) an increase of $4,743,000 due to transitioning the leased senior housing facilities within Delta Valley ALF portfolio to a RIDEA structure and including such facilities within SHOP on December 1, 2021; and (iv) an increase of $1,961,000 due to the acquisition of a portfolio of seven senior housing facilities in Texas within our SHOP segment on December 5, 2022. The increase in total property operating expenses for our integrated senior health campuses segment was predominately due to higher operating expenses as a result of increased occupancy, as well as $77,097,000 due to our acquisition of the 50.0% controlling interest in RHS on August 1, 2022 and our acquisition of an integrated senior health campus on January 3, 2022. See Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of such acquisitions.

***General and Administrative***

For the year ended December 31, 2022, general and administrative expenses were $43,418,000 compared to $43,199,000 for the year ended December 31, 2021. The increase in general and administrative expenses of $219,000 was primarily the result of an increase of $17,638,000 in payroll and compensation costs for the personnel hired as a result of the AHI Acquisition, partially offset by a decrease in our asset management and property management oversight fees of $17,141,000 as a result of the AHI Acquisition.

***Business Acquisition Expenses***

For the years ended December 31, 2022 and 2021, we recorded business acquisition expenses of $4,388,000 and $13,022,000, respectively. For the year ended December 31, 2022, the decrease in such expenses primarily related to a decrease of $12,599,000 in third-party legal costs and professional services incurred related to the Merger and the AHI Acquisition, partially offset by an increase of $3,158,000 in transaction costs related to our business combinations and an increase of $807,000 in dead-deal costs incurred in the pursuit of real estate investments that did not close. See Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of our acquisitions accounted for as business combinations.

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***Depreciation and Amortization***

For the years ended December 31, 2022 and 2021, depreciation and amortization was $167,957,000 and $133,191,000, respectively, which primarily consisted of depreciation on our operating properties of $141,257,000 and $109,036,000, respectively, and amortization of our identified intangible assets of $23,934,000 and $21,111,000, respectively. For the year ended December 31, 2022, the increase in depreciation and amortization of $34,766,000 was primarily the result of the increase in depreciable assets in our portfolio as a result of the Merger resulting in depreciation and amortization expense of $27,280,000 as well as an increase in depreciable assets in our portfolio as a result of acquisitions at our integrated senior health campuses segment of $9,368,000. Such amounts were partially offset by a decrease of $1,979,000 in depreciable assets in our portfolio as a result of a real estate disposition within our MOB segment during the year ended December 31, 2022.

***Interest Expense***

Interest expense, including gain or loss in fair value of derivative financial instruments, consisted of the following for the periods then ended:

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| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| Interest expense: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Lines of credit and term loans and derivative financial instruments | $52351000 | $33966000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mortgage loans payable | 41417000 | 36253000 |
| Amortization of deferred financing costs: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Lines of credit and term loans | 3000000 | 4261000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mortgage loans payable | 1988000 | 1652000 |
| Amortization of debt discount/premium, net | 827000 | 773000 |
| Gain in fair value of derivative financial instruments | (500000) | (8200000) |
| Loss on extinguishment of debt | 5166000 | 2655000 |
| Interest on finance lease liabilities | 261000 |  |
| Interest expense on financing obligations and other liabilities | 946000 | 1377000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total | $105456000 | $72737000 |

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The increase in total interest expense was primarily related to an increase in interest expense incurred on our lines of credit and term loans and mortgage loans payable due to: (i) a larger debt portfolio as a result of the Merger; (ii) an increase in variable interest rates; (iii) a decrease in the gain in fair value recognized on our derivative financial instruments of $7,700,000; and (iv) an increase in loss on debt extinguishment of $2,511,000. Such increase in total interest expense was partially offset by a decrease in amortization of deferred financing costs on our lines of credit and term loans of $1,261,000. See Note 8, Mortgage Loans Payable, Net, and Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion on debt extinguishments.

***Gain or loss on dispositions of real estate investments***

For the year ended December 31, 2022, we recognized an aggregate gain on dispositions of our real estate investments of $5,481,000 primarily related to the sale of one MOB, three senior housing facilities within our Central Florida Senior Housing Portfolio and two integrated senior health campuses. For the year ended December 31, 2021, we recognized an aggregate net loss on dispositions of our real estate investments of $100,000 related to the sale of one MOB, one SNF and two integrated senior health campuses. See Note 2, Summary of Significant Accounting Policies, and Note 3, Real Estate Investments, Net, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

***Impairments***

For the year ended December 31, 2022, we recognized aggregate impairment charges on our real estate investments of $54,579,000 related to our SHOP within the Central Florida Senior Housing Portfolio, Pinnacle Warrenton ALF and Mountain Crest Senior Housing Portfolio. For the year ended December 31, 2021, we recognized an impairment charge of $3,335,000 on a MOB, Mount Dora Medical Center. See Note 3, Real Estate Investments, Net, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of such real estate investments.

As a result of our annual assessment of goodwill, we determined that goodwill pertaining to our SHOP reporting segment was fully impaired as of December 31, 2022 and recognized an impairment loss of $23,277,000 in our accompanying consolidated statements of operations and comprehensive income (loss). See Note 19, Segment Reporting, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of such goodwill impairment.

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***Gain on Re-measurement of Previously Held Equity Interest***

For the year ended December 31, 2022, we recognized a $19,567,000 gain on re-measurement of the fair value of our previously held equity interest in RHS. For the year ended December 31, 2021, we did not recognize a gain on re-measurement of previously held equity interest. See Note 4, Business Combinations, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

**Liquidity and Capital Resources**

In the normal course of business, our material cash requirements consist of payment of operating expenses, capital improvement expenditures, interest on our indebtedness, distributions to our stockholders (including distributions necessary to maintain our qualification as a REIT) and general and administrative expenses. Our sources of funds primarily consist of operating cash flows and borrowings. We do not have any material off-balance sheet arrangements that we expect would materially affect our liquidity and capital resources.

***Material Cash Requirements***

*Capital Improvement Expenditures*

A capital plan for each investment is established upon acquisition that contemplates the estimated capital needs of that investment, including costs of refurbishment, tenant improvements or other major capital expenditures. The capital plan also sets forth the anticipated sources of the necessary capital, which may include operating cash generated by the investment, capital reserves, a line of credit or other loan established with respect to the investment, other borrowings or additional equity investments from us and joint venture partners. The capital plan for each investment is adjusted through ongoing, regular reviews of our portfolio or as necessary to respond to unanticipated additional capital needs. As of December 31, 2022, we had $17,776,000 of restricted cash in loan impounds and reserve accounts to fund a portion of such capital expenditures. Based on the budget for the properties we own as of December 31, 2022, we estimated discretionary expenditures for capital and tenant improvements of $68,821,000 for 2023, although actual expenditures are dependent on many factors which are not presently known.

*Contractual Obligations*

The following table provides information with respect to: (i) the maturity and scheduled principal repayment of our secured mortgage loans payable and our lines of credit and term loans; (ii) interest payments on our mortgage loans payable and our lines of credit and term loans; (iii) ground and other lease obligations; and (iv) financing obligations as of December 31, 2022:

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| | | | | | |
|:---|:---|:---|:---|:---|:---|
| | **Payments Due by Period** | **Payments Due by Period** | **Payments Due by Period** | **Payments Due by Period** | **Payments Due by Period** |
| | **2023** | **2024-2025** | **2026-2027** | **Thereafter** | **Total** |
| Principal payments — fixed-rate debt | $19022000 | $208901000 | $189154000 | $468815000 | $885892000 |
| Interest payments — fixed-rate debt | 28549000 | 48187000 | 31944000 | 184138000 | 292818000 |
| Principal payments — variable-rate debt | 490803000 | 174605000 | 966337000 | 19476000 | 1651221000 |
| Interest payments — variable-rate debt (based on rates in effect as of December 31, 2022) | 91980000 | 127070000 | 39417000 | 4699000 | 263166000 |
| Ground and other lease obligations | 38163000 | 74625000 | 74717000 | 228550000 | 416055000 |
| Financing obligations | 29399000 | 5227000 | 3732000 | 14964000 | 53322000 |
| &nbsp;&nbsp;&nbsp;&nbsp;Total | $697916000 | $638615000 | $1305301000 | $920642000 | $3562474000 |

---

*Distributions and Share Repurchases*

For information on distributions, see Part II, Item 5, Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities — Distributions, and the "Distributions" section below. For information on our share repurchase plan, see Note 14, Equity — Share Repurchase Plan, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

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***Credit Facilities***

On January 19, 2022, we terminated our credit agreement, as amended, for our line of credit and term loans with an aggregate maximum principal amount of $530,000,000, or the 2018 Credit Facility, and, through our operating partnership, entered into an agreement that superseded and replaced our amended credit facility with a maximum principal amount of $480,000,000, or the 2019 Credit Facility, with a credit facility with an aggregate maximum principal amount of up to $1,050,000,000, or the 2022 Credit Facility. In addition, we are subject to an amended and restated loan agreement regarding a senior secured revolving credit facility with an aggregate maximum principal amount of $360,000,000, or the 2019 Trilogy Credit Facility, which was further amended on December 20, 2022 to increase the aggregate maximum principal amount to $400,000,000. See Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion. Our total capacity to pay operating expenses, capital improvement expenditures, interest, distributions and general and administrative expenses is a function of our current cash position, our borrowing capacity on our lines of credit and term loans, as well as any future indebtedness that we may incur.

As of December 31, 2022, our aggregate borrowing capacity under the 2022 Credit Facility and the 2019 Trilogy Credit Facility, as amended, was $1,450,000,000. As of December 31, 2022, our aggregate borrowings outstanding under our credit facilities was $1,282,634,000 and we had an aggregate of $167,366,000 available on such facilities. We believe that the resources described above will be sufficient to satisfy our cash requirements for the next 12 months and the longer term thereafter.

***Cash Flows***

The following table sets forth changes in cash flows:

---

| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| Cash, cash equivalents and restricted cash — beginning of period | $125486000 | $152190000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash provided by operating activities | 147768000 | 17913000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash used in investing activities | (118578000) | (138652000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash (used in) provided by financing activities | (42924000) | 94109000 |
| Effect of foreign currency translation on cash, cash equivalents and restricted cash | 154000 | (74000) |
| Cash, cash equivalents and restricted cash — end of period | $111906000 | $125486000 |

---

The following summary discussion of our changes in our cash flows is based on our accompanying consolidated statements of cash flows and is not meant to be an all-inclusive discussion of the changes in our cash flows for the periods presented below.

*Operating Activities* 

The increase in net cash provided by operating activities during the year ended December 31, 2022 as compared to the prior year period of $129,855,000 was due to the increase in the size of our portfolio as a result of the Merger on October 1, 2021, thereby increasing our net operating income. Additionally, our net operating income increased substantially for our integrated senior health campuses segment, which experienced improved margins primarily due to improved resident occupancy and expense management. In general, cash flows from operating activities are affected by the timing of cash receipts and payments. See the "Results of Operations" section above for a further discussion.

*Investing Activities*

The decrease in net cash used in investing activities during the year ended December 31, 2022 as compared to the prior year period of $20,074,000 was primarily due to a $43,798,000 increase in proceeds from dispositions of real estate, a $17,852,000 decrease in cash, cash equivalents and restricted cash acquired in connection with the Merger on October 1, 2021 and a $8,175,000 decrease in developments and capital expenditures. Such amounts were partially offset by a $13,714,000 payment to acquire the 50.0% controlling interest in RHS in August 2022. See Note 4, Business Combinations, to our accompanying condensed consolidated financial statements for a further discussion of our acquisition of RHS.

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*Financing Activities*

The decrease in net cash provided by financing activities during the year ended December 31, 2022 as compared to the prior year period of $137,033,000 was primarily due to a decrease in net borrowings under our mortgage loans payable of $269,296,000, a $28,334,000 increase in distributions paid to our common stockholders and a $20,317,000 payment to repurchase our common stock. During the year ended December 31, 2022, we also paid $2,075,000 in offering costs in connection with the filing of our Registration Statement on Form S-11 for a proposed public offering by us of our shares of common stock in conjunction with a contemplated listing of our common stock on the New York Stock Exchange, as discussed in the "Overview and Background — Public Offerings" section above. No such costs were paid during the year ended December 31, 2021. Such amounts were partially offset by an increase in net borrowings under our lines of credit and term loans of $161,900,000 and borrowings under a financing obligation of $25,900,000. The change in distributions paid to common stockholders was due to the suspension of all stockholder distributions on May 29, 2020 in response to the impact of the COVID-19 pandemic, which the board of directors of GAHR III subsequently reinstated in June 2021. The change in share repurchases was due to the suspension of the GAHR III share repurchase plan from May 31, 2020 through October 4, 2021, when the partial reinstatement of our share repurchase plan was approved by our board.

***Distributions***

The income tax treatment for distributions reportable for the years ended December 31, 2022 and 2021 was as follows:

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| | | | | |
|:---|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2022** | **2021** | **2021** |
| Ordinary income | $40745000 | 46.5% | $7989000 | 26.3% |
| Capital gain |  |  |  |  |
| Return of capital | 46890000 | 53.5 | 22406000 | 73.7 |
|  | $87635000 | 100% | $30395000 | 100% |

---

Amounts listed above do not include distributions paid on nonvested shares of our restricted common stock which have been separately reported.

The following tables reflect distributions we paid for the year ended December 31, 2022 compared to distributions we paid for the year ended December 31, 2021, along with the amount of distributions reinvested pursuant to the AHR DRIP or GAHR III distribution reinvestment plan, as applicable, and the sources of distributions as compared to cash flows from operations or funds from operations attributable to controlling interest, or FFO, a non-GAAP financial measure:

---

| | | | | |
|:---|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2022** | **2021** | **2021** |
| Distributions paid in cash | $51122000 |  | $22788000 |  |
| Distributions reinvested | 36812000 |  | 7666000 |  |
|  | $87934000 |  | $30454000 |  |
| Sources of distributions: |  |  |  |  |
| Cash flows from operations | $87934000 | 100% | $17913000 | 58.8% |
| Proceeds from borrowings |  |  | 12541000 | 41.2 |
|  | $87934000 | 100% | $30454000 | 100% |

---

---

| | | | | |
|:---|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2022** | **2021** | **2021** |
| Distributions paid in cash | $51122000 |  | $22788000 |  |
| Distributions reinvested | 36812000 |  | 7666000 |  |
|  | $87934000 |  | $30454000 |  |
| Sources of distributions: |  |  |  |  |
| FFO attributable to controlling interest | $87934000 | 100% | $30454000 | 100% |
| Proceeds from borrowings |  |  |  |  |
|  | $87934000 | 100% | $30454000 | 100% |

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As of December 31, 2022, any distributions of amounts in excess of our current and accumulated earnings and profits have resulted in a return of capital to our stockholders, and some portion of a distribution to our stockholders may have been paid from borrowings. For a further discussion of FFO, including a reconciliation of our GAAP net loss to FFO, see "Funds from Operations and Modified Funds from Operations" below.

For information on future distributions of the Combined Company, see Item 5, Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities — Distributions.

***Financing***

We anticipate that our overall leverage will not exceed 50.0% of the combined fair market value of all of our properties, and other real estate-related investments, as determined at the end of each calendar year. For these purposes, the market value of each asset will be equal to the contract purchase price paid for the asset or, if the asset was appraised subsequent to the date of purchase, then the market value will be equal to the value reported in the most recent independent appraisal of the asset. Our policies do not limit the amount we may borrow with respect to any individual investment. As of December 31, 2022, our aggregate borrowings were 48.5% of the combined market value of all of our real estate and real estate-related investments.

*Mortgage Loans Payable, Net*

For a discussion of our mortgage loans payable, see Note 8, Mortgage Loans Payable, Net, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

*Lines of Credit and Term Loans*

For a discussion of our lines of credit and term loans, see Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**REIT Requirements**

In order to maintain our qualification as a REIT for U.S. federal income tax purposes, we are required to distribute to our stockholders a minimum of 90.0% of our REIT taxable income. Existing Internal Revenue Service, or IRS, guidance includes a safe harbor pursuant to which publicly offered REITs can satisfy the distribution requirement by distributing a combination of cash and stock to stockholders. In general, to qualify under the safe harbor, each stockholder must elect to receive either cash or stock, and the aggregate cash component of the distribution to stockholders must represent at least 20.0% of the total distribution. In the event that there is a shortfall in net cash available due to factors including, without limitation, the timing of such distributions or the timing of the collection of receivables, we may seek to obtain capital to make distributions by means of secured and unsecured debt financing through one or more unaffiliated third parties. We may also make distributions with cash from capital transactions including, without limitation, the sale of one or more of our properties.

**Commitments and Contingencies**

For a discussion of our commitments and contingencies, see Note 12, Commitments and Contingencies, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Debt Service Requirements**

A significant liquidity need is the payment of principal and interest on our outstanding indebtedness. As of December 31, 2022, we had $1,254,479,000 of fixed-rate and variable-rate mortgage loans payable outstanding secured by our properties. As of December 31, 2022, we had $1,282,634,000 outstanding and $167,366,000 remained available under our lines of credit. The weighted average effective interest rate on our outstanding debt was 5.82% per annum. See Note 8, Mortgage Loans Payable, Net, and Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

We are required by the terms of certain loan documents to meet various financial and non-financial covenants, such as leverage ratios, net worth ratios, debt service coverage ratios and fixed charge coverage ratios. As of December 31, 2022, we were in compliance with all such covenants and requirements on our mortgage loans payable and our lines of credit and term loans. See Note 22, Subsequent Events — 2022 Credit Agreement Amendment, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion. While the extent and severity of the COVID-19 pandemic on our business has been subsiding, any potential future deterioration of operations in excess of management's projections as a result of COVID-19 could impact future compliance with these covenants. If any future covenants are violated, we anticipate seeking a waiver or amending the debt covenants with the lenders when and if such event should occur. However, there can be no assurances that management will be able to effectively achieve such plans.

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**Related Party Transactions**

For a discussion of related party transactions, see Note 15, Related Party Transactions, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K.

**Funds from Operations and Modified Funds from Operations**

Due to certain unique operating characteristics of real estate companies, the National Association of Real Estate Investment Trusts, or NAREIT, an industry trade group, has promulgated a measure known as funds from operations, a non-GAAP financial measure, which we believe to be an appropriate supplemental performance measure to reflect the operating performance of a REIT. The use of funds from operations is recommended by the REIT industry as a supplemental performance measure, and our management uses FFO to evaluate our performance over time. FFO is not equivalent to our net income (loss) as determined under GAAP.

We define FFO, a non-GAAP financial measure, consistent with the standards established by the White Paper on funds from operations approved by the Board of Governors of NAREIT, or the White Paper. The White Paper defines funds from operations as net income (loss) computed in accordance with GAAP, excluding gains or losses from sales of certain real estate assets, gains or losses upon consolidation of a previously held equity interest, and impairment writedowns of certain real estate assets and investments, plus depreciation and amortization related to real estate, and after adjustments for unconsolidated partnerships and joint ventures. While impairment charges are excluded from the calculation of FFO as described above, investors are cautioned that impairments are based on estimated future undiscounted cash flows. Adjustments for unconsolidated partnerships and joint ventures are calculated to reflect funds from operations. Our FFO calculation complies with NAREIT's policy described above.

Historical accounting for real estate involves the use of GAAP. Any other method of accounting for real estate such as the fair value method cannot be construed to be any more accurate or relevant than the comparable methodologies of real estate valuation found in GAAP. Nevertheless, we believe that the use of FFO, which excludes the impact of real estate-related depreciation and amortization and impairments, provides a further understanding of our performance to investors and to our management, and when compared year over year, reflects the impact on our operations from trends in occupancy rates, rental rates, operating costs, general and administrative expenses and interest costs, which may not be immediately apparent from net income (loss).

The Institute for Portfolio Alternatives, or the IPA, an industry trade group, has standardized a measure known as modified funds from operations, which the IPA has recommended as a supplemental performance measure and which we believe to be another appropriate supplemental performance measure to reflect operating performance. Modified funds from operations is not equivalent to our net income (loss) as determined under GAAP, and modified funds from operations may not be a useful measure of the impact of long-term operating performance on value if we do not continue to operate with a limited life and targeted exit strategy, as currently intended. We believe that, because modified funds from operations excludes expensed acquisition fees and expenses that affect our operations only in periods in which properties are acquired and that we consider more reflective of investing activities, as well as other non-operating items included in FFO, modified funds from operations can provide, on a going forward basis, an indication of the sustainability (that is, the capacity to continue to be maintained) of our operating performance after the period in which we are acquiring our properties and once our portfolio is in place. Investors are cautioned that modified funds from operations should only be used to assess the sustainability of our operating performance after properties have been acquired, as it excludes expensed acquisition fees and expenses that have a negative effect on our initial operating performance during the periods in which properties are acquired.

The IPA issued the Practice Guideline 2010-01, *Supplemental Performance Measure for Publicly Registered, Non-Listed REITs: Modified Funds from Operations*, or the Practice Guideline, which defines modified funds from operations as funds from operations further adjusted for the following items included in the determination of GAAP net income (loss): expensed acquisition fees and costs; amounts relating to deferred rent and amortization of above- and below-market leases and liabilities (which are adjusted in order to reflect such payments from a GAAP accrual basis to closer to an expected to be received cash basis of disclosing the rent and lease payments); accretion of discounts and amortization of premiums on debt investments; mark-to-market adjustments included in net income (loss); gains or losses included in net income (loss) from the extinguishment or sale of debt, hedges, foreign exchange, derivatives or securities holdings where trading of such holdings is not a fundamental attribute of the business plan; and after adjustments for consolidated and unconsolidated partnerships and joint ventures, with such adjustments calculated to reflect modified funds from operations on the same basis. In order to arrive at our reported modified funds from operations attributable to controlling interest, or MFFO, we further adjust the IPA's definition of modified funds from operations for the impairment of goodwill.

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However, FFO and MFFO should not be construed to be more relevant or accurate than the current GAAP methodology in calculating net income (loss) or in its applicability in evaluating our operating performance. The method utilized to evaluate the value and performance of real estate under GAAP should be construed as a more relevant measure of operational performance and considered more prominently than the non-GAAP FFO and MFFO measures and the adjustments to GAAP in calculating FFO and MFFO.

Presentation of this information is intended to provide useful information to investors as they compare the operating performance of different REITs, although it should be noted that not all REITs calculate funds from operations and modified funds from operations the same way, so comparisons with other REITs may not be meaningful. Furthermore, FFO and MFFO are not necessarily indicative of cash flow available to fund cash needs and should not be considered as an alternative to net income (loss) as an indication of our performance, as an alternative to cash flows from operations, which is an indication of our liquidity, or indicative of funds available to fund our cash needs including our ability to make distributions to our stockholders. FFO and MFFO should be reviewed in conjunction with other measurements as an indication of our performance. MFFO may be useful in assisting management and investors in assessing the sustainability of operating performance in future operating periods, and in particular, after the offering and acquisition stages are complete.

None of the SEC, NAREIT, or any other regulatory body has passed judgment on the acceptability of the adjustments that we use to calculate FFO or MFFO. In the future, the SEC, NAREIT or another regulatory body may decide to standardize the allowable adjustments across the REIT industry and we would have to adjust our calculation and characterization of FFO.

For the years ended December 31, 2022 and 2021, we recognized government grants as grant income or as a reduction of property operating expenses, as applicable, and within loss from unconsolidated entities. Such amounts were granted through federal and state government programs, such as through the CARES Act, and which were established for eligible healthcare providers to preserve liquidity in response to the COVID-19 pandemic. See the "Results of Operations" section above for a further discussion. The government grants helped mitigate some of the negative impact that the COVID-19 pandemic had on our financial condition and results of operations. Without such relief funds, the COVID-19 pandemic would have had a material adverse impact to our FFO and MFFO. For the years ended December 31, 2022 and 2021, FFO would have been approximately $74,994,000 and $54,516,000, respectively, excluding government grants recognized. For the years ended December 31, 2022 and 2021, MFFO would have been approximately $108,812,000 and $62,480,000, respectively, excluding government grants recognized.

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The following is a reconciliation of net income or loss, which is the most directly comparable GAAP financial measure, to FFO and MFFO for the periods presented below:

---

| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| Net loss | $(73383000) | $(53269000) |
| Depreciation and amortization related to real estate — consolidated properties | 167860000 | 133191000 |
| Depreciation and amortization related to real estate — unconsolidated entities | 1102000 | 3116000 |
| Impairment of real estate investments — consolidated properties | 54579000 | 3335000 |
| (Gain) loss on dispositions of real estate investments — consolidated properties | (5481000) | 100000 |
| Gain on re-measurement of previously held equity interest(1) | (19567000) |  |
| Net (income) loss attributable to noncontrolling interests | (7919000) | 5475000 |
| Depreciation, amortization, impairments, gain/loss on dispositions and gain on re-measurement — noncontrolling interests | (22614000) | (22270000) |
| FFO attributable to controlling interest | $94577000 | $69678000 |
| Business acquisition expenses(2) | $4388000 | $13022000 |
| Amortization of above- and below-market leases(3) | 2596000 | 953000 |
| Amortization of closing costs(4) | 237000 | 201000 |
| Change in deferred rent(5) | (3355000) | (20000) |
| Loss on debt extinguishments(6) | 5166000 | 2655000 |
| Gain in fair value of derivative financial instruments(7) | (500000) | (8200000) |
| Foreign currency loss(8) | 5206000 | 564000 |
| Impairment of goodwill(9) | 23277000 |  |
| Adjustments for unconsolidated entities(10) | 222000 | 573000 |
| Adjustments for noncontrolling interests(10) | (3419000) | (1784000) |
| MFFO attributable to controlling interest | $128395000 | $77642000 |
| Weighted average Class T and Class I common shares outstanding — basic and diluted | 65807868 | 50081140 |
| Net loss per Class T and Class I common share — basic and diluted | $(1.12) | $(1.06) |
| FFO attributable to controlling interest per Class T and Class I common share — basic and diluted | $1.44 | $1.39 |
| MFFO attributable to controlling interest per Class T and Class I common share — basic and diluted | $1.95 | $1.55 |

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___________

(1)We recognized a gain upon the acquisition of the 50.0% controlling interest in RHS. Such acquisition resulted in the consolidation of RHS, which was previously accounted for as an equity method investment. We believe that adjusting for such non-recurring gains provides useful supplemental information because such gains may not be reflective of on-going business transactions and operations and is consistent with management's analysis of our operating performance.

(2)In evaluating investments in real estate, we differentiate the costs to acquire the investment from the operations derived from the investment. By excluding business acquisition expenses that have been deducted as expenses in the determination of GAAP net income or loss, we believe MFFO provides useful supplemental information that is comparable for each type of real estate investment and is consistent with management's analysis of the investing and operating performance of our properties. Business acquisition expenses include payments to our former advisor or its affiliates and third parties.

(3)Under GAAP, above- and below-market leases are assumed to diminish predictably in value over time and amortized, similar to depreciation and amortization of other real estate related assets that are excluded from FFO. However, because real estate values and market lease rates historically rise or fall with market conditions, including inflation, interest rates, the business cycle, unemployment and consumer spending, we believe that by excluding charges relating to the amortization of above- and below-market leases, MFFO may provide useful supplemental information on the performance of the real estate.

(4)Under GAAP, closing costs are amortized over the term of our debt security investment as an adjustment to the yield on our debt security investment. This may result in income recognition that is different than the contractual cash flows under our debt security investment. By adjusting for the amortization of the closing costs, MFFO may provide useful supplemental information on the realized economic impact of our debt security investment, providing insight on the

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expected contractual cash flows of such investment, and aligns results with management's analysis of operating performance.

(5)Under GAAP, as a lessor, rental revenue is recognized on a straight-line basis over the terms of the related lease (including rent holidays). As a lessee, we record amortization of right-of-use assets and accretion of lease liabilities for our operating leases. This may result in income or expense recognition that is significantly different than the underlying contract terms. By adjusting such amounts, MFFO may provide useful supplemental information on the realized economic impact of lease terms, providing insight on the expected contractual cash flows of such lease terms, and aligns results with management's analysis of operating performance.

(6)The loss associated with the early extinguishment of debt primarily relates to the write-off of unamortized deferred financing fees, write-off of unamortized debt discount or premium, penalties, or other fees incurred. We believe that adjusting for such non-recurring losses provides useful supplemental information because such charges (or losses) may not be reflective of on-going business transactions and operations and is consistent with management's analysis of our operating performance.

(7)Under GAAP, we are required to include changes in fair value of our derivative financial instruments in the determination of net income or loss. We believe that adjusting for the change in fair value of our derivative financial instruments to arrive at MFFO is appropriate because such adjustments may not be reflective of on-going operations and reflect unrealized impacts on value based only on then current market conditions, although they may be based upon general market conditions. The need to reflect the change in fair value of our derivative financial instruments is a continuous process and is analyzed on a quarterly basis in accordance with GAAP.

(8)We believe that adjusting for the change in foreign currency exchange rates provides useful information because such adjustments may not be reflective of on-going operations.

(9)We recognized an impairment loss of our goodwill pertaining to our SHOP reporting segment as a result of our annual assessment of goodwill. We believe that adjusting for such non-recurring impairment loss provides useful supplemental information because such losses may not be reflective of on-going business transactions and operations and is consistent with management's analysis of our operating performance.

(10)Includes all adjustments to eliminate the unconsolidated entities' share or noncontrolling interests' share, as applicable, of the adjustments described in notes (2) – (9) above to convert our FFO to MFFO.

**Net Operating Income**

Net operating income, or NOI, is a non-GAAP financial measure that is defined as net income (loss), computed in accordance with GAAP, generated from properties before general and administrative expenses, business acquisition expenses, depreciation and amortization, interest expense, gain or loss on dispositions, impairment of real estate investments, impairment of goodwill, income or loss from unconsolidated entities, gain on re-measurement of previously held equity interest, foreign currency gain or loss, other income and income tax benefit or expense.

NOI is not equivalent to our net income (loss) as determined under GAAP and may not be a useful measure in measuring operational income or cash flows. Furthermore, NOI should not be considered as an alternative to net income (loss) as an indication of our performance, as an alternative to cash flows from operations, as an indication of our liquidity, or indicative of cash flow available to fund our cash needs including our ability to make distributions to our stockholders. NOI should not be construed to be more relevant or accurate than the current GAAP methodology in calculating net income (loss) or in its applicability in evaluating our operating performance. Investors are also cautioned that NOI should only be used to assess our operational performance in periods in which we have not incurred or accrued any business acquisition expenses.

We believe that NOI is an appropriate supplemental performance measure to reflect the performance of our operating assets because NOI excludes certain items that are not associated with the operations of the properties. We believe that NOI is a widely accepted measure of comparative operating performance in the real estate community. However, our use of the term NOI may not be comparable to that of other real estate companies as they may have different methodologies for computing this amount.

For the years ended December 31, 2022 and 2021, we recognized government grants as grant income or as a reduction of property operating expenses, as applicable. The government grants helped mitigate some of the negative impact that the COVID-19 pandemic had on our financial condition and results of operations. Without such relief funds, the COVID-19 pandemic would have had a material adverse impact to our NOI. For the years ended December 31, 2022 and 2021, NOI would have been approximately $276,290,000 and $196,385,000, respectively, excluding government grants recognized.

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To facilitate understanding of this financial measure, the following is a reconciliation of net income or loss, which is the most directly comparable GAAP financial measure, to NOI for the periods presented below:

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| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| Net loss | $(73383000) | $(53269000) |
| General and administrative | 43418000 | 43199000 |
| Business acquisition expenses | 4388000 | 13022000 |
| Depreciation and amortization | 167957000 | 133191000 |
| Interest expense | 105456000 | 72737000 |
| (Gain) loss on dispositions of real estate investments | (5481000) | 100000 |
| Impairment of real estate investments | 54579000 | 3335000 |
| Impairment of goodwill | 23277000 |  |
| (Income) loss from unconsolidated entities | (1407000) | 1355000 |
| Gain on re-measurement of previously held equity interest | (19567000) |  |
| Foreign currency loss | 5206000 | 564000 |
| Other income | (3064000) | (1854000) |
| Income tax expense | 586000 | 956000 |
| Net operating income | $301965000 | $213336000 |

---

**Subsequent Events**

For a discussion of subsequent events, see Note 22, Subsequent Events, to our accompanying consolidated financial statements.

**Item 7A. Quantitative and Qualitative Disclosures About Market Risk.**

Market risk includes risks that arise from changes in interest rates, foreign currency exchange rates, commodity prices, equity prices and other market changes that affect market sensitive instruments. In pursuing our business plan, we expect that the primary market risk to which we will be exposed is interest rate risk. There were no material changes in our market risk exposures, or in the methods we use to manage market risk, between the years ended December 31, 2022 and 2021.

**Interest Rate Risk** 

We are exposed to the effects of interest rate changes primarily as a result of long-term debt used to acquire and develop properties and other investments. Our interest rate risk is monitored using a variety of techniques. Our interest rate risk management objectives are to limit the impact of interest rate increases on earnings, prepayment penalties and cash flows and to lower overall borrowing costs while taking into account variable interest rate risk. To achieve our objectives, we may borrow or lend at fixed or variable rates.

We have entered into, and may continue to enter into, derivative financial instruments such as interest rate swaps and interest rate caps in order to mitigate our interest rate risk on a related financial instrument, and for which we have not and may not elect hedge accounting treatment. We did not elect to apply hedge accounting treatment to these derivatives; therefore, changes in the fair value of interest rate derivative financial instruments were recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying consolidated statements of operations and comprehensive income (loss). As of December 31, 2022, we did not have any derivative financial instruments. We do not enter into derivative transactions for speculative purposes. See Note 22, Subsequent Events — Interest Rate Swap, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

The Financial Conduct Authority, or FCA, ceased publishing one-week and two-month LIBOR after December 31, 2021 and intends to cease publishing all remaining LIBOR after June 30, 2023. On January 19, 2022, we through our operating partnership, entered into the 2022 Credit Facility that bears interest at varying SOFR rates, at our option. On December 20, 2022, we entered into an amendment to the 2019 Trilogy Credit Facility, that among other things, replaced all references of LIBOR to SOFR. See Note 9, Lines of Credit and Term Loans — 2022 Credit Facility, and 2019 Trilogy Credit Facility, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion of the interest rate terms applicable to such facilities.

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**<u>[Table of](#if3ea478aad1243998fd851f05f33f584_10)[Contents](#if3ea478aad1243998fd851f05f33f584_10)</u>**

We have variable-rate debt outstanding and maturing on various dates from 2023 to 2031 that are indexed to LIBOR. As such, we are monitoring and evaluating the related risks of the discontinuation of LIBOR, which include possible changes to the interest on loans or amounts received and paid on derivative instruments we may enter into in the future. These risks arise in connection with transitioning contracts to a new alternative rate, including any resulting value transfer that may occur. The value of loans or derivative instruments tied to LIBOR could also be impacted when LIBOR is discontinued. For some instruments, the method of transitioning to an alternative rate may be challenging, as they may require negotiation with the respective counterparty. If a contract is not transitioned to an alternative rate when LIBOR is discontinued, the impact on our contracts is likely to vary. When LIBOR is discontinued, interest rates on our current or future indebtedness may be adversely affected. Currently we cannot estimate the overall impact of the phase-out of LIBOR on our current debt agreements, although it is possible that an alternative variable rate could raise our borrowing costs. It is not possible to predict whether LIBOR will continue to be viewed as an acceptable market "benchmark" prior to June 30, 2023, and it is possible that LIBOR will become unavailable prior to that point. This could result, for example, if a sufficient number of banks decline to make submissions to the LIBOR administrator. In that case, the risks associated with the transition to an alternative reference rate will be accelerated and magnified.

As of December 31, 2022, the table below presents the principal amounts and weighted average interest rates by year of expected maturity to evaluate the expected cash flows and sensitivity to interest rate changes.

---

| | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** | **Expected Maturity Date** |
| | **2023** | **2024** | **2025** | **2026** | **2027** | **Thereafter** | **Total** | **Fair Value** |
| **Assets** |  |  |  |  |  |  |  |  |
| Debt security held-to-maturity | $— | $— | $93433000 | $— | $— | $— | $93433000 | $93230000 |
| Weighted average interest rate on maturing fixed-rate debt security | —% | —% | 4.24% | —% | —% | —% | 4.24% |  |
| **Liabilities** |  |  |  |  |  |  |  |  |
| Fixed-rate debt — principal payments | $19022000 | $73545000 | $135356000 | $154957000 | $34197000 | $468815000 | $885892000 | $717458000 |
| Weighted average interest rate on maturing fixed-rate debt | 3.17% | 3.55% | 4.28% | 2.98% | 3.29% | 2.97% | 3.24% |  |
| Variable-rate debt — principal payments | $490803000 | $144407000 | $30198000 | $416111000 | $550226000 | $19476000 | $1651221000 | $1659414000 |
| Weighted average interest rate on maturing variable-rate debt (based on rates in effect as of December 31, 2022) | 7.03% | 6.97% | 6.31% | 6.10% | 6.05% | 6.58% | 6.44% |  |

---

***Debt Security Investment, Net***

As of December 31, 2022, the net carrying value of our debt security investment was $83,000,000. As we expect to hold our debt security investment to maturity and the amounts due under such debt security investment would be limited to the outstanding principal balance and any accrued and unpaid interest, we do not expect that fluctuations in interest rates, and the resulting change in fair value of our debt security investment, would have a significant impact on our operations. See Note 16, Fair Value Measurements, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a discussion of the fair value of our investment in a held-to-maturity debt security. The effective interest rate on our debt security investment was 4.24% per annum as of December 31, 2022.

***Mortgage Loans Payable, Net and Lines of Credit and Term Loan****s*

Mortgage loans payable were $1,254,479,000 ($1,229,847,000, net of discount/premium and deferred financing costs) as of December 31, 2022. As of December 31, 2022, we had 68 fixed-rate mortgage loans payable and 11 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 7.26% per annum and a weighted average effective interest rate of 5.29%. In addition, as of December 31, 2022, we had $1,282,634,000 ($1,281,794,000, net of deferred financing fees) outstanding under our lines of credit and term loans, at a weighted-average interest rate of 6.34% per annum.

As of December 31, 2022, the weighted average effective interest rate on our outstanding debt was 5.82% per annum. An increase in the variable interest rate on our variable-rate mortgage loans payable and lines of credit and term loans constitutes a market risk. As of December 31, 2022, a 0.50% increase in the market rates of interest would have increased our overall annualized interest expense on all of our other variable-rate mortgage loans payable and lines of credit and term loans by $8,371,000, or 7.76% of total annualized interest expense on our mortgage loans payable and lines of credit and term loans. See Note 8, Mortgage Loans Payable, Net, and Note 9, Lines of Credit and Term Loans, to the Consolidated Financial Statements that are a part of this Annual Report on Form 10-K, for a further discussion.

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**<u>[Table of](#if3ea478aad1243998fd851f05f33f584_10)[Contents](#if3ea478aad1243998fd851f05f33f584_10)</u>**

***Other Market Risk***

In addition to changes in interest rates and foreign currency exchange rates, the value of our future investments is subject to fluctuations based on changes in local and regional economic conditions and changes in the creditworthiness of tenants, which may affect our ability to refinance our debt if necessary.

**Item 8. Financial Statements and Supplementary Data.**

See Part IV, Item 15, Exhibits, Financial Statement Schedules.

**Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.**

None.

**Item 9A. Controls and Procedures.**

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(a) *Evaluation of disclosure controls and procedures.* We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our reports under the Securities Exchange Act of 1934, as amended, or the Exchange Act, is recorded, processed, summarized and reported within the time periods specified in the rules and forms, and that such information is accumulated and communicated to us, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, we recognize that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives, as ours are designed to do, and we necessarily are required to apply our judgment in evaluating whether the benefits of the controls and procedures that we adopt outweigh their costs.

As required by Rules 13a-15(b) and 15d-15(b) of the Exchange Act, an evaluation as of December 31, 2022 was conducted under the supervision and with the participation of our management, including our Chief Executive Officer and Chief Financial Officer, of the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act). Based on this evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures, as of December 31, 2022, were effective at the reasonable assurance level.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) *Management's Annual Report on Internal Control over Financial Reporting.* Our management is responsible for establishing and maintaining adequate internal control over our financial reporting, as such term is defined in Exchange Act Rules 13a-15(f) and 15d-15(f). Under the supervision, and with the participation, of our management, including our Chief Executive Officer and Chief Financial Officer, we conducted an evaluation of the effectiveness of our internal control over financial reporting based on the framework in Internal Control-Integrated Framework issued in 2013 by the Committee of Sponsoring Organizations of the Treadway Commission.

Based on our evaluation under the Internal Control-Integrated Framework issued in 2013, our management concluded that our internal control over financial reporting was effective as of December 31, 2022.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(c) *Changes in internal control over financial reporting.* There were no changes in internal control over financial reporting that occurred during the fiscal quarter ended December 31, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

**Item 9B. Other Information.**

None.

**Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.**

None.

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**<u>[Table of](#if3ea478aad1243998fd851f05f33f584_10)[Contents](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**PART III**

**Item 10. Directors, Executive Officers and Corporate Governance.**

The information required by this item is incorporated by reference to our definitive proxy statement to be filed within 120 days after the end of fiscal year 2022 with respect to our 2023 annual meeting of stockholders.

**Item 11. Executive Compensation.**

The information required by this item is incorporated by reference to our definitive proxy statement to be filed within 120 days after the end of fiscal year 2022 with respect to our 2023 annual meeting of stockholders.

**Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.**

The information required by this item is incorporated by reference to our definitive proxy statement to be filed within 120 days after the end of fiscal year 2022 with respect to our 2023 annual meeting of stockholders.

**Item 13. Certain Relationships and Related Transactions, and Director Independence.**

The information required by this item is incorporated by reference to our definitive proxy statement to be filed within 120 days after the end of fiscal year 2022 with respect to our 2023 annual meeting of stockholders.

**Item 14. Principal Accountant Fees and Services.**

The information required by this item is incorporated by reference to our definitive proxy statement to be filed within 120 days after the end of fiscal year 2022 with respect to our 2023 annual meeting of stockholders.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**PART IV**

**Item 15. Exhibits, Financial Statement Schedules.**

(a)(1) *Financial Statements:*

**INDEX TO CONSOLIDATED FINANCIAL STATEMENTS**

---

| | |
|:---|:---|
| | **<u>Page</u>** |
| <u>[Report of Independent Registered Public Accounting Firm (PCAOB ID No.](#if3ea478aad1243998fd851f05f33f584_100)</u> 34) | <u>[82](#if3ea478aad1243998fd851f05f33f584_100)</u> |
| <u>[Consolidated Balance Sheets as of December 31, 2022 and 2021](#if3ea478aad1243998fd851f05f33f584_103)</u> | <u>[84](#if3ea478aad1243998fd851f05f33f584_103)</u> |
| <u>[Consolidated Statements of Operations and Comprehensive Income (Loss) for the Years Ended December 31, 2022, 2021 and 2020](#if3ea478aad1243998fd851f05f33f584_106)</u> | <u>[86](#if3ea478aad1243998fd851f05f33f584_106)</u> |
| <u>[Consolidated Statements of Equity for the Years Ended December 31, 2022, 2021 and 2020](#if3ea478aad1243998fd851f05f33f584_109)</u> | <u>[87](#if3ea478aad1243998fd851f05f33f584_109)</u> |
| <u>[Consolidated Statements of Cash Flows for the Years Ended December 31, 2022, 2021 and 2020](#if3ea478aad1243998fd851f05f33f584_112)</u> | <u>[89](#if3ea478aad1243998fd851f05f33f584_112)</u> |
| <u>[Notes to Consolidated Financial Statements](#if3ea478aad1243998fd851f05f33f584_115)</u> | <u>[92](#if3ea478aad1243998fd851f05f33f584_115)</u> |

---

(a)(2) *Financial Statement Schedule:*

The following financial statement schedule for the year ended December 31, 2022 is submitted herewith:

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| | |
|:---|:---|
| | **<u>Page</u>** |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <u>[Real Estate and Accumulated Depreciation (Schedule III)](#if3ea478aad1243998fd851f05f33f584_196)</u> | <u>[142](#if3ea478aad1243998fd851f05f33f584_196)</u> |

---

All schedules other than the one listed above have been omitted as the required information is inapplicable or the information is presented in our consolidated financial statements or related notes.

(a)(3) *Exhibits:*

---

| | |
|:---|:---|
| | **<u>Page</u>** |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <u>[The exhibits listed in this section are included, or incorporated by reference, in this annual report.](#if3ea478aad1243998fd851f05f33f584_202)</u> | <u>[157](#if3ea478aad1243998fd851f05f33f584_202)</u> |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) *Exhibits:*

See Item 15(a)(3) above.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(c) *Financial Statement Schedule:* 

See Item 15(a)(2) above.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM**

To the Stockholders and the Board of Directors of American Healthcare REIT, Inc.

**Opinion on the Financial Statements**

We have audited the accompanying consolidated balance sheets of American Healthcare REIT, Inc. and subsidiaries (the "Company") as of December 31, 2022 and 2021, the related consolidated statements of operations and comprehensive income (loss), equity, and cash flows, for each of the three years in the period ended December 31, 2022, and the related notes and the schedule listed in the Index at Item 15 (collectively referred to as the "financial statements"). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2022 and 2021, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2022, in conformity with accounting principles generally accepted in the United States of America.

**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 Public Company Accounting Oversight Board (United States) (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. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits, we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company's internal control over financial reporting. Accordingly, we express no such opinion.

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 critical audit matters does not alter in any way our opinion on the 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 Long-Lived Assets relating to real estate investments — Refer to Note 2 to the financial statements***

*Critical Audit Matter Description*

The Company periodically evaluates long-lived assets, primarily consisting of investments in real estate that are carried at historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that the carrying value may not be recoverable. The Company considers the following indicators, among others, in its evaluation of impairment:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Significant negative industry or economic trends;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• A significant underperformance relative to historical or projected future operating results; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• A significant change in the extent or manner in which the asset is used or significant physical change in the asset.

If indicators of impairment of long-lived assets are present, the Company evaluates the carrying value of the related real estate investment in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, the Company considers market conditions and the Company's current intentions with respect to holding or disposing of the asset. The Company adjusts the net book value of properties it leases to others and other long-lived assets to fair value if the sum of

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

the expected future undiscounted cash flows, including sales proceeds, is less than carrying value. The Company recognizes an impairment loss at the time any such determination is made.

We identified the determination of impairment indicators for real estate investments as a critical audit matter because of the significant assumptions management makes when determining whether events or changes in circumstances have occurred indicating that the carrying amounts of real estate assets may not be recoverable. This required a high degree of auditor judgment when performing audit procedures to evaluate whether management appropriately identified impairment indicators.

*How the Critical Audit Matter Was Addressed in the Audit*

Our audit procedures related to the evaluation of real estate investments for possible indications of impairment included the following, among others:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Obtained independent market data to determine if there were indicators of impairment not identified by management.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Determined whether there are adverse qualitative or quantitative asset-specific conditions, which may indicate that an other than temporary impairment exists.

/s/ Deloitte & Touche LLP

Costa Mesa, California

March 17, 2023

We have served as the Company's auditor since 2013.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED BALANCE SHEETS**

**As of December 31, 2022 and 2021**

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| **ASSETS** | **ASSETS** | **ASSETS** |
| Real estate investments, net | $3581609000 | $3514686000 |
| Debt security investment, net | 83000000 | 79315000 |
| Cash and cash equivalents | 65052000 | 81597000 |
| Restricted cash | 46854000 | 43889000 |
| Accounts and other receivables, net | 137501000 | 122778000 |
| Identified intangible assets, net | 236283000 | 248871000 |
| Goodwill | 231611000 | 209898000 |
| Operating lease right-of-use assets, net | 276342000 | 158157000 |
| Other assets, net | 128446000 | 121148000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets | $4786698000 | $4580339000 |
| **LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY** | **LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY** | **LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND EQUITY** |
| Liabilities: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mortgage loans payable, net(1) | $1229847000 | $1095594000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Lines of credit and term loans(1) | 1281794000 | 1226634000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable and accrued liabilities(1) | 243831000 | 187254000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable due to affiliates(1) |  | 866000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Identified intangible liabilities, net | 10837000 | 12715000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Financing obligations(1) | 48406000 | 33653000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating lease liabilities(1) | 273075000 | 145485000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Security deposits, prepaid rent and other liabilities(1)  | 49545000 | 48567000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities | 3137335000 | 2750768000 |
| Commitments and contingencies (Note 12) |  |  |
| Redeemable noncontrolling interests (Note 13) | 81598000 | 72725000 |
| Equity: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Stockholders' equity: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Class T common stock, $0.01 par value per share; 200,000,000 shares authorized; 19,535,095 and 19,294,102 shares issued and outstanding as of December 31, 2022 and 2021, respectively | 194000 | 193000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Class I common stock, $0.01 par value per share; 800,000,000 shares authorized; 46,675,367 and 46,463,902 shares issued and outstanding as of December 31, 2022 and 2021, respectively | 467000 | 465000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Additional paid-in capital | 2540424000 | 2533904000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accumulated deficit | (1138304000) | (951303000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accumulated other comprehensive loss | (2690000) | (1966000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total stockholders' equity | 1400091000 | 1581293000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Noncontrolling interests (Note 14) | 167674000 | 175553000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total equity | 1567765000 | 1756846000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities, redeemable noncontrolling interests and equity | $4786698000 | $4580339000 |

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED BALANCE SHEETS — (Continued)**

**As of December 31, 2022 and 2021**

___________

(1)Such liabilities of American Healthcare REIT, Inc., represented liabilities of American Healthcare REIT Holdings, LP or its consolidated subsidiaries as of December 31, 2022 and 2021. American Healthcare REIT Holdings, LP is a variable interest entity, or VIE, and a consolidated subsidiary of American Healthcare REIT, Inc. The creditors of American Healthcare REIT Holdings, LP or its consolidated subsidiaries do not have recourse against American Healthcare REIT, Inc., except for the 2022 Credit Facility, as defined in Note 9, held by American Healthcare REIT Holdings, LP in the amount of $965,900,000 as of December 31, 2022 and the 2018 Credit Facility and 2019 Credit Facility, each as defined in Note 9, held by American Healthcare REIT Holdings, LP in the amount of $441,900,000 and $480,000,000, respectively, as of December 31, 2021, which were guaranteed by American Healthcare REIT, Inc.

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

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS)**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** | **2020** |
| **Revenues and grant income:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Resident fees and services | $1412156000 | $1123935000 | $1069073000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Real estate revenue | 205344000 | 141368000 | 120047000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Grant income | 25675000 | 16951000 | 55181000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenues and grant income | 1643175000 | 1282254000 | 1244301000 |
| **Expenses:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Property operating expenses | 1281526000 | 1030193000 | 993727000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rental expenses | 59684000 | 38725000 | 32298000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | 43418000 | 43199000 | 27007000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | 4388000 | 13022000 | 290000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | 167957000 | 133191000 | 98858000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total expenses | 1556973000 | 1258330000 | 1152180000 |
| **Other income (expense):** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | (105956000) | (80937000) | (71278000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain (loss) in fair value of derivative financial instruments | 500000 | 8200000 | (3906000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain (loss) on dispositions of real estate investments | 5481000 | (100000) | 1395000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | (54579000) | (3335000) | (11069000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill | (23277000) |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income (loss) from unconsolidated entities | 1407000 | (1355000) | (4517000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest | 19567000 |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency (loss) gain | (5206000) | (564000) | 1469000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | 3064000 | 1854000 | 1570000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | (158999000) | (76237000) | (86336000) |
| **(Loss) income before income taxes** | (72797000) | (52313000) | 5785000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax (expense) benefit | (586000) | (956000) | 3078000 |
| **Net (loss) income** | (73383000) | (53269000) | 8863000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net (income) loss attributable to noncontrolling interests | (7919000) | 5475000 | (6700000) |
| **Net (loss) income attributable to controlling interest** | $(81302000) | $(47794000) | $2163000 |
| **Net (loss) income per Class T and Class I common share attributable to controlling interest — basic and diluted** | $(1.24) | $(0.95) | $0.05 |
| **Weighted average number of Class T and Class I common shares outstanding — basic and diluted** | 65807868 | 50081140 | 44979210 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net (loss) income | $(73383000) | $(53269000) | $8863000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other comprehensive (loss) income: |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency translation adjustments | (724000) | (65000) | 247000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total other comprehensive (loss) income | (724000) | (65000) | 247000 |
| **Comprehensive (loss) income** | (74107000) | (53334000) | 9110000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Comprehensive (income) loss attributable to noncontrolling interests | (7919000) | 5582000 | (6700000) |
| **Comprehensive (loss) income attributable to controlling interest** | $(82026000) | $(47752000) | $2410000 |

---

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

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF EQUITY**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | | | |
| | **Class T and Class I<br>Common Stock** | **Class T and Class I<br>Common Stock** | | | | | | | |
| | **Number<br>of<br>Shares** | **Amount** |<br>**Additional<br>Paid-In Capital** |<br>**Accumulated<br>Deficit** |<br>**Accumulated <br>Other <br>Comprehensive <br>Loss** |<br>**Total<br>Stockholders'<br>Equity** |<br>**Noncontrolling<br>Interests** |<br>**Total Equity** | |
| BALANCE — December 31, 2019 | 44932564 | $449000 | $1729911000 | $(827550000) | $(2255000) | $900555000 | $158108000 | $1058663000 |  |
| Offering costs — common stock |  |  | (9000) |  |  | (9000) |  | (9000) |  |
| Issuance of common stock under the DRIP | 538763 | 5000 | 21857000 |  |  | 21862000 |  | 21862000 |  |
| Issuance of vested and nonvested restricted common stock | 1737 |  | 14000 |  |  | 14000 |  | 14000 |  |
| Amortization of nonvested common stock compensation |  |  | 141000 |  |  | 141000 |  | 141000 |  |
| Stock based compensation |  |  |  |  |  |  | (1188000) | (1188000) |  |
| Repurchase of common stock | (558476) | (5000) | (23102000) |  |  | (23107000) |  | (23107000) |  |
| Issuance of noncontrolling interest |  |  | 515000 |  |  | 515000 | 10485000 | 11000000 |  |
| Distributions to noncontrolling interests |  |  |  |  |  |  | (5463000) | (5463000) |  |
| Reclassification of noncontrolling interests to mezzanine equity |  |  |  |  |  |  | (715000) | (715000) |  |
| Adjustment to value of redeemable noncontrolling interests |  |  | 2611000 |  |  | 2611000 | 1103000 | 3714000 |  |
| Distributions declared ($0.86 per share) |  |  |  | (38884000) |  | (38884000) |  | (38884000) |  |
| Net income |  |  |  | 2163000 |  | 2163000 | 6045000 | 8208000 | (1) |
| Other comprehensive income |  |  |  |  | 247000 | 247000 |  | 247000 |  |
| BALANCE — December 31, 2020 | 44914588 | $449000 | $1731938000 | $(864271000) | $(2008000) | $866108000 | $168375000 | $1034483000 |  |
| Offering costs — common stock |  |  | (14000) |  |  | (14000) |  | (14000) |  |
| Issuance of common stock and purchase of noncontrolling interest in connection with the Merger | 20432815 | 204000 | 764944000 |  |  | 765148000 | (43203000) | 721945000 | (2) |
| Issuance of operating partnership units to acquire AHI |  |  | 36449000 |  | 107000 | 36556000 | 75727000 | 112283000 |  |
| Issuance of common stock under the DRIP | 207866 | 2000 | 7664000 |  |  | 7666000 |  | 7666000 |  |
| Issuance of vested and nonvested restricted common stock | 213091 | 3000 | 38000 |  |  | 41000 |  | 41000 |  |
| Amortization of nonvested common stock compensation |  |  | 816000 |  |  | 816000 |  | 816000 |  |
| Stock based compensation |  |  |  |  |  |  | (14000) | (14000) |  |
| Repurchase of common stock | (10356) |  | (382000) |  |  | (382000) |  | (382000) | (3) |
| Distributions to noncontrolling interests |  |  |  |  |  |  | (15247000) | (15247000) |  |
| Reclassification of noncontrolling interests to mezzanine equity |  |  |  |  |  |  | (5923000) | (5923000) |  |
| Adjustment to value of redeemable noncontrolling interests |  |  | (7549000) |  |  | (7549000) | 169000 | (7380000) |  |
| Distributions declared ($0.69 per share) |  |  |  | (39238000) |  | (39238000) |  | (39238000) |  |
| Net loss |  |  |  | (47794000) |  | (47794000) | (4331000) | (52125000) | (1) |
| Other comprehensive loss |  |  |  |  | (65000) | (65000) |  | (65000) |  |
| BALANCE — December 31, 2021 | 65758004 | $658000 | $2533904000 | $(951303000) | $(1966000) | $1581293000 | $175553000 | $1756846000 |  |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF EQUITY — (Continued)**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | **Stockholders' Equity** | | | |
| | **Class T and Class I<br>Common Stock** | **Class T and Class I<br>Common Stock** | | | | | | | |
| | **Number<br>of<br>Shares** | **Amount** |<br>**Additional<br>Paid-In Capital** |<br>**Accumulated<br>Deficit** |<br>**Accumulated <br>Other <br>Comprehensive <br>Loss** |<br>**Total<br>Stockholders'<br>Equity** |<br>**Noncontrolling<br>Interests** |<br>**Total Equity** | |
| Offering costs — common stock |  | $— | $(2000) | $— | $— | $(2000) | $— | $(2000) |  |
| Issuance of common stock under the DRIP | 992964 | 8000 | 36804000 |  |  | 36812000 |  | 36812000 |  |
| Issuance of nonvested restricted common stock | 18689 | 1000 | (1000) |  |  |  |  |  |  |
| Amortization of nonvested restricted common stock and stock units |  |  | 3935000 |  |  | 3935000 |  | 3935000 |  |
| Stock based compensation |  |  |  |  |  |  | 83000 | 83000 |  |
| Repurchase of common stock | (559195) | (6000) | (20693000) |  |  | (20699000) |  | (20699000) |  |
| Distributions to noncontrolling interests |  |  |  |  |  |  | (13985000) | (13985000) |  |
| Adjustment to noncontrolling interest in connection with the Merger |  |  | (1173000) |  |  | (1173000) | 1173000 |  | (2) |
| Reclassification of noncontrolling interests to mezzanine equity |  |  |  |  |  |  | (83000) | (83000) |  |
| Adjustment to value of redeemable noncontrolling interests |  |  | (13353000) |  |  | (13353000) | (3391000) | (16744000) |  |
| Purchase of redeemable noncontrolling interest |  |  | 1003000 |  |  | 1003000 |  | 1003000 |  |
| Distributions declared ($1.60 per share) |  |  |  | (105699000) |  | (105699000) |  | (105699000) |  |
| Net (loss) income |  |  |  | (81302000) |  | (81302000) | 8324000 | (72978000) | (1) |
| Other comprehensive loss |  |  |  |  | (724000) | (724000) |  | (724000) |  |
| BALANCE — December 31, 2022 | 66210462 | $661000 | $2540424000 | $(1138304000) | $(2690000) | $1400091000 | $167674000 | $1567765000 |  |

---

___________

(1)For the years ended December 31, 2022, 2021 and 2020, amounts exclude $(405,000), $(1,144,000) and $655,000, respectively, of net (loss) income attributable to redeemable noncontrolling interests. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.

(2)In connection with the Merger, as defined in Note 1, on October 1, 2021, a wholly owned subsidiary of Griffin-American Healthcare REIT IV Holdings, LP sold its 6.0% interest in Trilogy REIT Holdings, LLC to GAHR III, as defined in Note 1. See Note 14, Equity — Noncontrolling Interests in Total Equity, for a further discussion.

(3)Prior to the Merger, but upon the closing of the AHI Acquisition, as defined in Note 1, GAHR III redeemed all 5,148 shares of its common stock held by GAHR III's former advisor as well as all 5,208 shares of GAHR IV Class T common stock held by the former advisor of GAHR IV, as defined in Note 1.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF CASH FLOWS**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** | **2020** |
| **CASH FLOWS FROM OPERATING ACTIVITIES** |  |  |  |
| Net (loss) income | $(73383000) | $(53269000) | $8863000 |
| Adjustments to reconcile net (loss) income to net cash provided by operating activities: |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | 167957000 | 133191000 | 98858000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other amortization  | 32643000 | 24189000 | 30789000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred rent | (6520000) | (2673000) | (5606000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Stock based compensation | 3909000 | 9658000 | (1187000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(Gain) loss on dispositions of real estate investments | (5481000) | 100000 | (1395000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | 54579000 | 3335000 | 11069000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill | 23277000 |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(Income) loss from unconsolidated entities | (1407000) | 1355000 | 4517000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest | (19567000) |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss (gain) | 4893000 | 573000 | (1522000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss on extinguishments of debt | 5166000 | 2655000 |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Change in fair value of derivative financial instruments | (500000) | (8200000) | 3906000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred income taxes |  |  | (3329000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other adjustments |  | 466000 |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Changes in operating assets and liabilities: |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts and other receivables | (4457000) | 3691000 | 20318000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other assets | (8303000) | (2775000) | (7357000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable and accrued liabilities | 14062000 | (32571000) | 30290000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable due to affiliates | (184000) | (7140000) | 5162000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating lease liabilities | (24699000) | (16793000) | (23790000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Security deposits, prepaid rent and other liabilities | (14217000) | (37879000) | 49570000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash provided by operating activities | 147768000 | 17913000 | 219156000 |
| **CASH FLOWS FROM INVESTING ACTIVITIES** |  |  |  |
| Acquisitions of real estate investments | (73229000) | (80109000) | (30552000) |
| Developments and capital expenditures | (71520000) | (79695000) | (128302000) |
| Acquisition of previously held equity interest | (13714000) |  |  |
| Cash, cash equivalents and restricted cash acquired in connection with the Merger and the AHI Acquisition |  | 17852000 |  |
| Proceeds from dispositions of real estate investments | 48297000 | 4499000 | 12525000 |
| Investments in unconsolidated entities | (4858000) | (650000) | (960000) |
| Issuance of note receivable | (3000000) |  |  |
| Real estate and other deposits | (554000) | (549000) | (656000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash used in investing activities | (118578000) | (138652000) | (147945000) |
| **CASH FLOWS FROM FINANCING ACTIVITIES** |  |  |  |
| Borrowings under mortgage loans payable | 120057000 | 298515000 | 92399000 |
| Payments on mortgage loans payable | (125454000) | (34616000) | (71990000) |
| Early payoff of mortgage loans payable |  |  | (2601000) |
| Borrowings under the lines of credit and term loans | 1160400000 | 51100000 | 121755000 |
| Payments on the lines of credit and term loans | (1104400000) | (157000000) | (94000000) |
| Borrowings under financing obligations | 25900000 |  | 1907000 |
| Payments on financing obligations | (13677000) | (11685000) | (5453000) |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF CASH FLOWS — (Continued)**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** | **2020** |
| Deferred financing costs | $(7550000) | $(3854000) | $(4890000) |
| Debt extinguishment costs | (3243000) | (127000) |  |
| Distributions paid to common stockholders | (51122000) | (22788000) | (26997000) |
| Repurchase of common stock | (20699000) | (382000) | (23107000) |
| Issuance of noncontrolling interest |  |  | 11000000 |
| Distributions to noncontrolling interests in total equity | (13242000) | (14875000) | (5463000) |
| Contributions from redeemable noncontrolling interests | 273000 | 152000 |  |
| Distributions to redeemable noncontrolling interests | (2627000) | (1483000) | (1271000) |
| Repurchase of redeemable noncontrolling interests and stock warrants | (4679000) | (8933000) | (150000) |
| Payment of offering costs | (2084000) | (10000) | (10000) |
| Security deposits | (777000) | 95000 | 60000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net cash (used in) provided by financing activities | (42924000) | 94109000 | (8811000) |
| **NET CHANGE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH** | $(13734000) | $(26630000) | $62400000 |
| EFFECT OF FOREIGN CURRENCY TRANSLATION ON CASH, CASH EQUIVALENTS AND RESTRICTED CASH | 154000 | (74000) | (90000) |
| CASH, CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period | 125486000 | 152190000 | 89880000 |
| CASH, CASH EQUIVALENTS AND RESTRICTED CASH — End of period | $111906000 | $125486000 | $152190000 |
| **RECONCILIATION OF CASH, CASH EQUIVALENTS AND RESTRICTED CASH** |  |  |  |
| **Beginning of period:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents | $81597000 | $113212000 | $53149000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Restricted cash | 43889000 | 38978000 | 36731000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash, cash equivalents and restricted cash | $125486000 | $152190000 | $89880000 |
| **End of period:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash and cash equivalents | $65052000 | $81597000 | $113212000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Restricted cash | 46854000 | 43889000 | 38978000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Cash, cash equivalents and restricted cash | $111906000 | $125486000 | $152190000 |
| **SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION** |  |  |  |
| **Cash paid for:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest  | $88682000 | $70212000 | $65771000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income taxes | $1131000 | $1239000 | $753000 |
| **SUPPLEMENTAL DISCLOSURE OF NONCASH INVESTING AND FINANCING ACTIVITIES** |  |  |  |
| Accrued developments and capital expenditures | $30211000 | $19546000 | $22342000 |
| Capital expenditures from financing obligations | $2465000 | $1409000 | $1053000 |
| Tenant improvement overage | $1408000 | $1598000 | $4482000 |
| Acquisition of real estate investments with assumed mortgage loans payable, net | $104561000 | $— | $— |
| Acquisition of real estate investment with financing obligation | $— | $15504000 | $— |
| Accrued offering costs | $1256000 | $— | $— |
| Issuance of common stock under the DRIP | $36812000 | $7666000 | $21861000 |
| Distributions declared but not paid — common stockholders | $26484000 | $8768000 | $— |
| Distributions declared but not paid — limited partnership units | $1401000 | $467000 | $— |
| Distributions declared but not paid — restricted stock units | $65000 | $— | $— |
| Reclassification of noncontrolling interests to mezzanine equity | $83000 | $5923000 | $715000 |
| Issuance of redeemable noncontrolling interests | $— | $7999000 | $— |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**CONSOLIDATED STATEMENTS OF CASH FLOWS — (Continued)**

**For the Years Ended December 31, 2022, 2021 and 2020**

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** | **2020** |
| **The following represents the net increase (decrease) in certain assets and liabilities in connection with our acquisitions and dispositions of investments:** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts and other receivables | $2410000 | $(153000) | $(11000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Issuance of note receivable | $5000000 | $— | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other assets | $(12337000) | $(4036000) | $(253000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mortgage loans payable, net | $33241000 | $— | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Due to affiliates | $— | $6000 | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Financing obligations | $65000 | $— | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Accounts payable and accrued liabilities | $15674000 | $(161000) | $(110000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Security deposits and other liabilities | $15919000 | $— | $(459000) |
| **Merger and AHI Acquisition (Note 1):** |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Issuance of limited partnership units in the AHI Acquisition | $— | $131674000 | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Implied issuance of GAHR III common stock in exchange for net assets acquired and purchase of noncontrolling interests in connection with the Merger | $— | $722169000 | $— |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Fair value of mortgage loans payable and lines of credit and term loans assumed in the Merger | $— | $507503000 | $— |

---

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

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS**

**For the Years Ended December 31, 2022, 2021 and 2020**

*The use of the words "we," "us" or "our" refers to Griffin-American Healthcare REIT III, Inc., or GAHR III, and its subsidiaries, including Griffin-American Healthcare REIT III Holdings, LP, for periods prior to the Merger, as defined below, and American Healthcare REIT, Inc. (formerly known as Griffin-American Healthcare REIT IV, Inc., or GAHR IV) and its subsidiaries, including American Healthcare REIT Holdings, LP (formerly known as Griffin-American Healthcare REIT III Holdings, LP), for periods following the Merger, except where otherwise noted. Certain historical information of GAHR IV is included for background purposes.*

**1. Organization and Description of Business** 

***Overview and Background***

American Healthcare REIT, Inc., a Maryland corporation, is a self-managed real estate investment trust, or REIT, that owns a diversified portfolio of clinical healthcare real estate properties, focusing primarily on medical office buildings, or MOBs, senior housing, skilled nursing facilities, or SNFs, hospitals and other healthcare-related facilities. We also operate healthcare-related facilities utilizing the structure permitted 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 of 1986, as amended, or the Code, authorizing the RIDEA structure were enacted as part of the Housing and Economic Recovery Act of 2008). Our healthcare facilities operated under a RIDEA structure include our senior housing operating properties, or SHOP, and our integrated senior health campuses. We have originated and acquired secured loans and may also originate and acquire other real estate-related investments on an infrequent and opportunistic basis. We generally seek investments that produce current income; however, we have selectively developed, and may continue to selectively develop, healthcare real estate properties. We have elected to be taxed as a REIT for U.S. federal income tax purposes. We believe that we have been organized and operated, and we intend to continue to operate, in conformity with the requirements for qualification and taxation as a REIT under the Code.

***Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc.***

On October 1, 2021, pursuant to an Agreement and Plan of Merger dated June 23, 2021, or the Merger Agreement, GAHR III merged with and into Continental Merger Sub, LLC, a Maryland limited liability company and newly formed wholly owned subsidiary of GAHR IV, or Merger Sub, with Merger Sub being the surviving company, or the REIT Merger. On October 1, 2021, also pursuant to the Merger Agreement, Griffin-American Healthcare REIT IV Holdings, LP, a Delaware limited partnership and subsidiary and operating partnership of GAHR IV, or GAHR IV Operating Partnership, merged with and into Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership, or our operating partnership, with our operating partnership being the surviving entity, or the Partnership Merger. We collectively refer to the REIT Merger and the Partnership Merger as the Merger. Following the Merger on October 1, 2021, our company, or the Combined Company, was renamed American Healthcare REIT, Inc. and our operating partnership, also referred to as the surviving partnership, was renamed American Healthcare REIT Holdings, LP. The REIT Merger was intended to qualify as a reorganization under, and within the meaning of, Section 368(a) of the Code. As a result of and at the effective time of the Merger, the separate corporate existence of GAHR III and GAHR IV Operating Partnership ceased.

***AHI Acquisition***

Also on October 1, 2021, immediately prior to the consummation of the Merger, GAHR III acquired a newly formed entity, American Healthcare Opps Holdings, LLC, or NewCo, which we refer to as the AHI Acquisition, pursuant to a contribution and exchange agreement dated June 23, 2021, or the Contribution Agreement, between GAHR III; our operating partnership; American Healthcare Investors, LLC, or AHI; Griffin Capital Company, LLC, or Griffin Capital; Platform Healthcare Investor T-II, LLC; Flaherty Trust; and Jeffrey T. Hanson, the non-executive Chairman of our board of directors, or our board, Danny Prosky, our Chief Executive Officer and President, and Mathieu B. Streiff, one of our directors, or collectively, the AHI Principals. NewCo owned substantially all of the business and operations of AHI, as well as all of the equity interests in (i) Griffin-American Healthcare REIT IV Advisor, LLC, or GAHR IV Advisor, a subsidiary of AHI that served as the external advisor of GAHR IV, and (ii) Griffin-American Healthcare REIT III Advisor, LLC, or GAHR III Advisor, also referred to as our former advisor, a subsidiary of AHI that served as the external advisor of GAHR III.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Pursuant to the Contribution Agreement, AHI contributed substantially all of its business and operations to the surviving partnership, including its interest in GAHR III Advisor and GAHR IV Advisor, and Griffin Capital contributed its then-current ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for these contributions, the surviving partnership issued limited partnership units, or OP units. Subject to working capital and other customary adjustments, the total approximate value of these OP units at the time of consummation of the transactions contemplated by the Contribution Agreement, and prior to the reverse stock split, was approximately $131,674,000, with a reference value for purposes thereof of $8.71 per OP unit, such that the surviving partnership issued 15,117,529 OP units as consideration, or the Closing Date Consideration. Following the consummation of the Merger and the AHI Acquisition, the Combined Company became self-managed. See "Operating Partnership and Former Advisor" below for a further discussion. Such OP units were owned by AHI Group Holdings, LLC, or AHI Group Holdings, which is owned and controlled by the AHI Principals, Platform Healthcare Investor TII, LLC, Flaherty Trust and a wholly owned subsidiary of Griffin Capital, or collectively, the NewCo Sellers.

The AHI Acquisition was treated as a business combination for accounting purposes, with GAHR III as both the legal and accounting acquiror of NewCo. While GAHR IV was the legal acquiror of GAHR III in the REIT Merger, GAHR III was determined to be the accounting acquiror in the REIT Merger in accordance with Financial Accounting Standards Board, or FASB, Accounting Standards Codification, or ASC, Topic 805, *Business Combinations*, or ASC Topic 805 after considering the relative share ownership and the composition of the governing body of the Combined Company. Thus, the financial information set forth herein subsequent to the consummation of the Merger and the AHI Acquisition reflects results of the Combined Company, and the financial information set forth herein prior to the Merger and the AHI Acquisition reflects GAHR III's results. For this reason, period to period comparisons may not be meaningful.

See Note 4, Business Combinations — 2021 Business Combinations, for a further discussion of the Merger and the AHI Acquisition.

***Operating Partnership and Former Advisor***

We conduct substantially all of our operations through our operating partnership and we are the sole general partner of our operating partnership. As of December 31, 2022 and 2021, we owned an approximately 95.0% and 94.9% general partnership interest therein, respectively, and the remaining 5.0% and 5.1%, respectively, was owned by the NewCo Sellers.

Through September 30, 2021, we were externally advised by our former advisor pursuant to an advisory agreement, as amended, or the Advisory Agreement, between us and our former advisor. Our former advisor, subject to the oversight and review of our board, provided asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Following the Merger and the AHI Acquisition, we became self-managed and are no longer externally advised. As a result, any fees that would have otherwise been payable to our former advisor are no longer being paid to a third party. Upon consummation of the AHI Acquisition, we redeemed all 51 limited partnership units that our former advisor held in our operating partnership, as well as all 52 limited partnership units held by GAHR IV Advisor in GAHR IV Operating Partnership. Also, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership redeemed all 5,148 shares of our common stock owned by our former advisor and all 5,208 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV.

Prior to the Merger and the AHI Acquisition, our former advisor was 75.0% owned and managed by wholly owned subsidiaries of AHI, and 25.0% owned by a wholly owned subsidiary of Griffin Capital, or collectively, our former co-sponsors. Prior to the AHI Acquisition, AHI was 47.1% owned by AHI Group Holdings, 45.1% indirectly owned by DigitalBridge Group, Inc. (NYSE: DBRG), or DigitalBridge, and 7.8% owned by James F. Flaherty III. We were not affiliated with Griffin Capital, DigitalBridge or Mr. Flaherty; however, we were affiliated with our former advisor, AHI and AHI Group Holdings.

See the "Merger of Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT IV, Inc." and "AHI Acquisition" sections above for a further discussion. See Note 13, Redeemable Noncontrolling Interests, and Note 14, Equity — Noncontrolling Interests in Total Equity, for a further discussion of the ownership in our operating partnership.

***Public Offerings***

Prior to the Merger, we raised $1,842,618,000 through a best efforts initial public offering that commenced on February 26, 2014, or the GAHR III initial offering, and issued 42,839,173 shares of our common stock. In addition, during the GAHR III initial offering, we issued 451,385 shares of our common stock pursuant to our initial distribution reinvestment plan, or the Initial DRIP, for a total of $18,511,000 in distributions reinvested. Following the deregistration of the GAHR III initial offering

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

on April 22, 2015, we continued issuing shares of our common stock pursuant to subsequent distribution reinvestment plan offerings.

On September 16, 2022, we filed with the United States Securities and Exchange Commission, or the SEC, a Registration Statement on Form S-11 (File No. 333-267464), with respect to a proposed public offering by us, or the Proposed Listing, of our shares of common stock in conjunction with a contemplated listing of our common stock on the New York Stock Exchange. Such registration statement and contemplated listing are not yet effective.

On November 10, 2022, our board approved charter amendments to effect on November 15, 2022 a one-for-four reverse stock split of our common stock and a corresponding reverse split of the partnership units in our operating partnership, or the Reverse Splits. All numbers of common shares and per share data, as well as the partnership units in our operating partnership, in our accompanying consolidated financial statements and related notes have been retroactively adjusted for all periods presented to give effect to the Reverse Splits.

See Note 14, Equity — Common Stock, and Note 14, Equity — Distribution Reinvestment Plan, for a further discussion of our public offerings.

***Our Real Estate Investments Portfolio***

We currently operate through six reportable business segments: integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals. As of December 31, 2022, we owned and/or operated 314 buildings and integrated senior health campuses including completed development and expansion projects, or approximately 19,897,000 square feet of gross leasable area, or GLA, for an aggregate contract purchase price of $4,624,249,000. In addition, as of December 31, 2022, we also owned a real estate-related debt investment purchased for $60,429,000.

***COVID-19***

Our residents, tenants, operating partners and managers, our industry and the U.S. economy continue to be adversely affected by the COVID-19 pandemic and related supply chain disruptions and labor shortages. While the COVID 19 pandemic is subsiding, the timing and extent of the economic recovery from the COVID-19 pandemic is dependent upon many factors, including the emergence and severity of COVID-19 variants, the effectiveness and frequency of booster vaccinations and the duration and implications of restrictions and safety measures. As the lasting effects of the COVID-19 pandemic is still impacting the healthcare system to a certain extent, it continues to present challenges for us as an owner and operator of healthcare facilities, making it difficult to ascertain the long-term impact the COVID-19 pandemic will have on real estate markets in which we own and/or operate properties and our portfolio of investments.

We have evaluated the impacts of the COVID-19 pandemic on our business thus far and incorporated information concerning such impacts into our assessments of liquidity, impairment and collectability from tenants and residents as of December 31, 2022. We will continue to monitor such impacts and will adjust our estimates and assumptions based on the best available information.

**2. Summary of Significant Accounting Policies** 

The summary of significant accounting policies presented below is designed to assist in understanding our accompanying consolidated financial statements. Such consolidated financial statements and the accompanying notes thereto are the representations of our management, who are responsible for their integrity and objectivity. These accounting policies conform to accounting principles generally accepted in the United States of America, or GAAP, in all material respects, and have been consistently applied in preparing our accompanying consolidated financial statements.

***Basis of Presentation***

Our accompanying consolidated financial statements include our accounts and those of our operating partnership, the wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries in which we have control, as well as any VIEs, in which we are the primary beneficiary. The portion of equity in any subsidiary that is not wholly owned by us is presented in our accompanying consolidated financial statements as a noncontrolling interest. We evaluate our ability to control an entity, and whether the entity is a VIE and we are the primary beneficiary, by considering substantive terms of the arrangement and identifying which enterprise has the power to direct the activities of the entity that most significantly impacts the entity's economic performance.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

We operate and intend to continue to operate in an umbrella partnership REIT structure in which our operating partnership, or wholly owned subsidiaries of our operating partnership and all non-wholly owned subsidiaries of which we have control, will own substantially all of the interests in properties acquired on our behalf. We are the sole general partner of our operating partnership and as of December 31, 2022 and 2021, we owned an approximately 95.0% and 94.9% general partnership interest therein, respectively, and the remaining 5.0% and 5.1%, respectively, was owned by the NewCo Sellers. Prior to the Merger, we owned greater than a 99.99% general partnership interest in our operating partnership and our former advisor was a limited partner that owned less than a 0.01% noncontrolling limited partnership interest in our operating partnership.

The accounts of our operating partnership are consolidated in our accompanying consolidated financial statements because we are the sole general partner of our operating partnership and have unilateral control over its management and major operating decisions (even if additional limited partners are admitted to our operating partnership). All intercompany accounts and transactions are eliminated in consolidation.

***Use of Estimates***

The preparation of our accompanying consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, as well as the disclosure of contingent assets and liabilities, at the date of our consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates and assumptions include, but are not limited to, the initial and recurring valuation of certain assets acquired and liabilities assumed through property acquisitions including through business combinations, goodwill and its impairment, revenues and grant income, allowance for credit losses, impairment of long-lived and intangible assets and contingencies. These estimates are made and evaluated on an on-going basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in material adverse ways, and those estimates could be different under different assumptions or conditions.

***Cash, Cash Equivalents and Restricted Cash***

Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash primarily comprises lender required accounts for property taxes, tenant improvements, capital improvements and insurance, which are restricted as to use or withdrawal.

***Leases***

*Lessee*: We determine if a contract is a lease upon inception of the lease and maintain a distinction between finance and operating leases. Pursuant to ASC Topic 842, *Leases*, or ASC Topic 842, lessees are required to recognize the following for all leases with terms greater than 12 months at the commencement date: (i) a lease liability, which is a lessee's obligation to make lease payments arising from a lease; and (ii) a right-of-use asset, which is an asset that represents the lessee's right to use, or control the use of, a specified asset for the lease term. The lease liability is calculated by using either the implicit rate of the lease or the incremental borrowing rate. The accretion of lease liabilities and amortization expense on right-of-use assets for our operating leases are included in rental expenses, property operating expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive income (loss). Operating lease liabilities are calculated using our incremental borrowing rate based on the information available as of the lease commencement date.

For our finance leases, the accretion of lease liabilities are included in interest expense and the amortization expense on right-of-use assets are included in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive income (loss). Further, finance lease assets are included within real estate investments, net and finance lease liabilities are included within financing obligations in our accompanying consolidated balance sheets.

*Lessor*: Pursuant to ASC Topic 842, lessors bifurcate lease revenues into lease components and non-lease components and separately recognize and disclose non-lease components that are executory in nature. Lease components continue to be recognized on a straight-line basis over the lease term and certain non-lease components may be accounted for under the revenue recognition guidance in ASC Topic 606, *Revenue from Contracts with Customers,* or ASC Topic 606. See the "Revenue Recognition" section below. ASC Topic 842 also provides for a practical expedient package that permits lessors to not separate non-lease components from the associated lease component if certain conditions are met. In addition, such practical expedient causes an entity to assess whether a contract is predominately lease or service based, and recognize the revenue from the entire contract under the relevant accounting guidance. We recognize revenue for our MOBs, senior housing, SNFs and hospitals segments as real estate revenue. Minimum annual rental revenue is recognized on a straight-line basis over the term of

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

the related lease (including rent holidays). Differences between real estate revenue recognized and cash amounts contractually due from tenants under the lease agreements are recorded to deferred rent receivable, which is included in other assets, net in our accompanying consolidated balance sheets. Tenant reimbursement revenue, which comprises additional amounts recoverable from tenants for common area maintenance expenses and certain other recoverable expenses, are considered non-lease components and variable lease payments. We qualified for and elected the practical expedient as outlined above to combine the non-lease component with the lease component, which is the predominant component, and therefore the non-lease component is recognized as part of real estate revenue. In addition, as lessors, we exclude certain lessor costs (i.e., property taxes and insurance) paid directly by a lessee to third parties on our behalf from our measurement of variable lease revenue and associated expense (i.e., no gross up of revenue and expense for these costs); and include lessor costs that we paid and are reimbursed by the lessee in our measurement of variable lease revenue and associated expense (i.e., gross up revenue and expense for these costs).

At our RIDEA facilities, we offer residents room and board (lease component), standard meals and healthcare services (non-lease component) and certain ancillary services that are not contemplated in the lease with each resident (i.e., laundry, guest meals, etc.). For our RIDEA facilities, we recognize revenue under ASC Topic 606 as resident fees and services, based on our predominance assessment from electing the practical expedient outlined above. See the "Revenue Recognition" section below.

See Note 18, Leases, for a further discussion.

***Revenue Recognition***

*Real Estate Revenue*

We recognize real estate revenue in accordance with ASC Topic 842. See the "Leases" section above.

*Resident Fees and Services Revenue* 

We recognize resident fees and services revenue in accordance with ASC Topic 606. A significant portion of resident fees and services revenue represents healthcare service revenue that is reported at the amount that we expect to be entitled to in exchange for providing patient care. These amounts are due from patients, third-party payors (including health insurers and government programs), other healthcare facilities, and others and includes variable consideration for retroactive revenue adjustments due to settlement of audits, reviews, and investigations. Generally, we bill the patients, third-party payors and other healthcare facilities several days after the services are performed. Revenue is recognized as performance obligations are satisfied. Consistent with healthcare industry accounting practices, any changes to these governmental revenue estimates are recorded in the period the change or adjustment becomes known based on final settlement. Any differences between recorded revenues and subsequent adjustments are reflected in operations in the year finalized.

Performance obligations are determined based on the nature of the services provided by us. Revenue for performance obligations satisfied over time is recognized based on actual charges incurred in relation to total expected (or actual) charges. This method provides a depiction of the transfer of services over the term of the performance obligation based on the inputs needed to satisfy the obligation. Generally, performance obligations satisfied over time relate to patients receiving long-term healthcare services, including rehabilitation services. We measure the performance obligation from admission into the facility to the point when we are no longer required to provide services to that patient. Revenue for performance obligations satisfied at a point in time is recognized when goods or services are provided and we do not believe we are required to provide additional goods or services to the patient. Generally, performance obligations satisfied at a point in time relate to sales of our pharmaceuticals business or to sales of ancillary supplies.

Because all of our performance obligations relate to contracts with a duration of less than one year, we have elected to apply the optional exemption provided in ASC Topic 606 and, therefore, are not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period. The performance obligations for these contracts are generally completed within months of the end of the reporting period.

We determine the transaction price based on standard charges for goods and services provided, reduced, where applicable, by contractual adjustments provided to third-party payors, implicit price concessions provided to uninsured patients, and estimates of goods to be returned. We also determine the estimates of contractual adjustments based on Medicare and Medicaid pricing tables and historical experience. We determine the estimate of implicit price concessions based on the historical collection experience with each class of payor.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Agreements with third-party payors typically provide for payments at amounts less than established charges. The following is a summary of the payment arrangements with major third-party payors:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• **Medicare:** Certain healthcare services are paid at prospectively determined rates based on cost-reimbursement methodologies subject to certain limits.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• **Medicaid:** Reimbursements for Medicaid services are generally paid at prospectively determined rates. In the state of Indiana, we participate in an Upper Payment Limit program, or IGT, with various county hospital partners, which provides supplemental Medicaid payments to SNFs that are licensed to non-state, government-owned entities such as county hospital districts. We have operational responsibility through management agreements for facilities retained by the county hospital districts including this IGT. The licenses and management agreements between the nursing center division and hospital districts are terminable by either party to restore the previous licensed status.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• **Other:** Payment agreements with certain commercial insurance carriers, health maintenance organizations and preferred provider organizations provide for payment using prospectively determined rates per discharge, discounts from established charges and prospectively determined periodic rates.

Laws and regulations concerning government programs, including Medicare and Medicaid, are complex and subject to varying interpretation. As a result of investigations by governmental agencies, various healthcare organizations have received requests for information and notices regarding alleged noncompliance with those laws and regulations, which, in some instances, have resulted in organizations entering into significant settlement agreements. Compliance with such laws and regulations may also be subject to future government review and interpretation as well as significant regulatory action, including fines, penalties and potential exclusion from the related programs. There can be no assurance that regulatory authorities will not challenge our compliance with these laws and regulations, and it is not possible to determine the impact such claims or penalties would have upon us, if any.

Settlements with third-party payors for retroactive adjustments due to audits, reviews or investigations are considered variable consideration and are included in the determination of the estimated transaction price for providing patient care. These settlements are estimated based on the terms of the payment agreement with the payor, correspondence from the payor and our historical settlement activity, including an assessment to ensure that it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainty associated with the retroactive adjustment is subsequently resolved. Estimated settlements are adjusted in future periods as adjustments become known (that is, new information becomes available), or as years are settled or are no longer subject to such audits, reviews and investigations. Adjustments arising from a change in the transaction price were not significant for the years ended December 31, 2022, 2021 and 2020.

Disaggregation of Resident Fees and Services Revenue

We disaggregate revenue from contracts with customers according to lines of business and payor classes. The transfer of goods and services may occur at a point in time or over time; in other words, revenue may be recognized over the course of the underlying contract, or may occur at a single point in time based upon a single transfer of control. This distinction is discussed in further detail below. We determine that disaggregating revenue into these categories achieves the disclosure objective to depict how the nature, amount, timing and uncertainty of revenue and cash flows are affected by economic factors.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

The following tables disaggregate our resident fees and services revenue by line of business, according to whether such revenue is recognized at a point in time or over time, for the years then ended:

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| | | | |
|:---|:---|:---|:---|
| | **Integrated <br>Senior Health<br>Campuses** | **SHOP(1)** | **Total** |
| **2022:** | | | |
| &nbsp;&nbsp;&nbsp;Over time | $1019198000 | $154268000 | $1173466000 |
| &nbsp;&nbsp;&nbsp;Point in time | 235467000 | 3223000 | 238690000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $1254665000 | $157491000 | $1412156000 |
| **2021:** |  |  |  |
| &nbsp;&nbsp;&nbsp;Over time | $824991000 | $96000000 | $920991000 |
| &nbsp;&nbsp;&nbsp;Point in time | 200708000 | 2236000 | 202944000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $1025699000 | $98236000 | $1123935000 |
| **2020:** |  |  |  |
| &nbsp;&nbsp;&nbsp;Over time | $787116000 | $83043000 | $870159000 |
| &nbsp;&nbsp;&nbsp;Point in time | 196053000 | 2861000 | 198914000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $983169000 | $85904000 | $1069073000 |

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The following tables disaggregate our resident fees and services revenue by payor class for the years then ended:

---

| | | | |
|:---|:---|:---|:---|
| | **Integrated <br>Senior Health<br>Campuses** | **SHOP(1)** | **Total** |
| **2022:** | | | |
| &nbsp;&nbsp;&nbsp;Private and other payors | $582448000 | $144771000 | $727219000 |
| &nbsp;&nbsp;&nbsp;Medicare | 429129000 |  | 429129000 |
| &nbsp;&nbsp;&nbsp;Medicaid | 243088000 | 12720000 | 255808000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $1254665000 | $157491000 | $1412156000 |
| **2021:** |  |  |  |
| &nbsp;&nbsp;&nbsp;Private and other payors | $462828000 | $94673000 | $557501000 |
| &nbsp;&nbsp;&nbsp;Medicare | 349876000 |  | 349876000 |
| &nbsp;&nbsp;&nbsp;Medicaid | 212995000 | 3563000 | 216558000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $1025699000 | $98236000 | $1123935000 |
| **2020:** |  |  |  |
| &nbsp;&nbsp;&nbsp;Private and other payors | $437133000 | $84308000 | $521441000 |
| &nbsp;&nbsp;&nbsp;Medicare | 356350000 |  | 356350000 |
| &nbsp;&nbsp;&nbsp;Medicaid | 189686000 | 1596000 | 191282000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total resident fees and services | $983169000 | $85904000 | $1069073000 |

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___________

(1)Includes fees for basic housing and assisted living care. We record revenue when services are rendered at amounts billable to individual residents. Residency agreements are generally for a term of 30 days, with resident fees billed monthly in advance. For patients under reimbursement arrangements with Medicaid, revenue is recorded based on contractually agreed-upon amounts or rates on a per resident, daily basis or as services are rendered.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Accounts Receivable, Net — Resident Fees and Services Revenue

The beginning and ending balances of accounts receivable, net **—** resident fees and services are as follows:

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| | | | | |
|:---|:---|:---|:---|:---|
| | **Private <br>and <br>Other Payors** | **Medicare** | **Medicaid** | **Total** |
| Beginning balance **—** January 1, 2022 | $42056000 | $35953000 | $16922000 | $94931000 |
| Ending balance **—** December 31, 2022 | 55484000 | 45669000 | 20832000 | 121985000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Increase | $13428000 | $9716000 | $3910000 | $27054000 |

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Deferred Revenue — Resident Fees and Services Revenue

The beginning and ending balances of deferred revenue **—** resident fees and services, almost all of which relates to private and other payors, are as follows:

---

| | |
|:---|:---|
| | **Total** |
| Beginning balance **—** January 1, 2022 | $14673000 |
| Ending balance **—** December 31, 2022 | 17901000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Increase | $3228000 |

---

In addition to the deferred revenue above, as of December 31, 2021, we had approximately $12,969,000 remaining in Medicare advance payments that were received during 2020 through an expanded program of the Centers for Medicare & Medicaid Services. Such amounts were included in security deposits, prepaid rent and other liabilities in our accompanying condensed consolidated balance sheet as of December 31, 2021, and were fully applied to Medicare claims and recognized as resident fees and services revenue for the year ended December 31, 2022.

Financing Component

We have elected a practical expedient allowed under ASC Topic 606 and, therefore, we do not adjust the promised amount of consideration from patients and third-party payors for the effects of a significant financing component due to our expectation that the period between the time the service is provided to a patient and the time that the patient or a third-party payor pays for that service will be one year or less.

Contract Costs

We have applied the practical expedient provided by FASB ASC Topic 340, *Other Assets and Deferred Costs*, and, therefore, all incremental customer contract acquisition costs are expensed as they are incurred since the amortization period of the asset that we otherwise would have recognized is one year or less in duration.

***Resident and Tenant Receivables and Allowances***

Resident receivables, which are related to resident fees and services revenue, are carried net of an allowance for credit losses. An allowance is maintained for estimated losses resulting from the inability of residents and payors to meet the contractual obligations under their lease or service agreements. Substantially all of such allowances are recorded as direct reductions of resident fees and services revenue as contractual adjustments provided to third-party payors or implicit price concessions in our accompanying consolidated statements of operations and comprehensive income (loss). Our determination of the adequacy of these allowances is based primarily upon evaluations of historical loss experience, the residents' financial condition, security deposits, cash collection patterns by payor and by state, current economic conditions, future expectations in estimating credit losses and other relevant factors. Tenant receivables, which are related to real estate revenue, and unbilled deferred rent receivables are reduced for uncollectible amounts, which are recognized as direct reductions of real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss).

As of December 31, 2022 and 2021, we had $14,071,000 and $12,378,000, respectively, in allowances, which were determined necessary to reduce receivables by our expected future credit losses. For the years ended December 31, 2022, 2021 and 2020, we increased allowances by $21,538,000, $10,779,000 and $12,494,000, respectively, and reduced allowances for collections or adjustments by $9,161,000, $5,624,000 and $7,697,000, respectively. For the years ended December 31, 2022, 2021 and 2020, $10,684,000, $4,353,000 and $6,766,000, respectively, of our receivables were written off against the related allowances. For the year ended December 31, 2021, the allowance also included an increase of $2,110,000 as a result of the Merger.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Real Estate Investments Purchase Price Allocation***

Upon the acquisition of real estate properties or entities owning real estate properties, we determine whether the transaction is a business combination, which requires that the assets acquired and liabilities assumed constitute a business. If the assets acquired and liabilities assumed are not a business, we account for the transaction as an asset acquisition. Under both methods, we recognize the identifiable assets acquired and liabilities assumed; however, for a transaction accounted for as an asset acquisition, we capitalize transaction costs and allocate the purchase price using a relative fair value method allocating all accumulated costs, whereas for a transaction accounted for as a business combination, we immediately expense transaction costs incurred associated with the business combination and allocate the purchase price based on the estimated fair value of each separately identifiable asset and liability. For the years ended December 31, 2022 and 2021, our investment transactions were accounted for as asset acquisitions or as business combinations, as applicable. For the year ended December 31, 2020, all of our investment transactions were accounted for as asset acquisitions. See Note 3, Real Estate Investments, Net — Acquisition of Real Estate Investments, and Note 4, Business Combinations, for a further discussion.

We, with assistance from independent valuation specialists, measure the fair value of tangible and identified intangible assets and liabilities, as applicable, based on their respective fair values for acquired properties. Our method for allocating the purchase price to acquired investments in real estate requires us to make subjective assessments for determining fair value of the assets acquired and liabilities assumed. This includes determining the value of the buildings, land, leasehold interests, furniture, fixtures and equipment, above- or below-market rent, in-place leases, master leases, tenant improvements, above- or below-market debt assumed, derivative financial instruments assumed, and noncontrolling interest in the acquiree, if any. These estimates require significant judgment and in some cases involve complex calculations. These allocation assessments directly impact our results of operations, as amounts allocated to certain assets and liabilities have different depreciation or amortization lives. In addition, we amortize the value assigned to above- or below-market rent as a component of revenue, unlike in-place leases and other intangibles, which we include in depreciation and amortization in our accompanying consolidated statements of operations and comprehensive income (loss).

The determination of the fair value of land is based upon comparable sales data. In cases where a leasehold interest in the land is acquired, only the above/below market consideration is necessary where the value of the leasehold interest is determined by discounting the difference between the contract ground lease payments and a market ground lease payment back to a present value as of the acquisition date. The fair value of buildings is based upon our determination of the value under two methods: one, as if it were to be replaced and vacant using cost data and, two, also using a residual technique based on discounted cash flow models, as vacant. Factors considered by us include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. We also recognize the fair value of furniture, fixtures and equipment on the premises, as well as the above- or below-market rent, the value of in-place leases, master leases, above- or below-market debt and derivative financial instruments assumed.

The value of the above- or below-market component of the acquired in-place leases is determined based upon the present value (using a discount rate that reflects the risks associated with the acquired leases) of the difference between: (i) the level payment equivalent of the contract rent paid pursuant to the lease; and (ii) our estimate of market rent payments taking into account the expected market rent growth. In the case of leases with options, a case-by-case analysis is performed based on all facts and circumstances of the specific lease to determine whether the option will be assumed to be exercised. The amounts related to above-market leases are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as a decrease to real estate revenue over the remaining non-cancelable lease term of the acquired leases with each property. The amounts related to below-market leases are included in identified intangible liabilities, net in our accompanying consolidated balance sheets and are amortized as an increase to real estate revenue over the remaining non-cancelable lease term plus any below-market renewal options of the acquired leases with each property.

The value of in-place lease costs are based on management's evaluation of the specific characteristics of the tenant's lease and our overall relationship with the tenants. Characteristics considered by us in allocating these values include the nature and extent of the credit quality and expectations of lease renewals, among other factors. The in-place lease intangible represents the value related to the economic benefit for acquiring a property with in-place leases as opposed to a vacant property, which is evaluated based on a review of comparable leases for a similar property, terms and conditions for marketing and executing new leases, and implied in the difference between the value of the whole property "as is" and "as vacant." The net amounts related to in-place lease costs are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over the average downtime of the acquired leases with each property. The net amounts related to the value of tenant relationships, if any, are included in identified intangible assets, net in our accompanying consolidated balance sheets and are amortized as an increase to depreciation and amortization expense over

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

the average remaining non-cancelable lease term of the acquired leases plus the market renewal lease term. The value of a master lease, if any, in which a previous owner or a tenant is relieved of specific rental obligations as additional space is leased, is determined by discounting the expected real estate revenue associated with the master lease space over the assumed lease-up period.

The value of above- or below-market debt is determined based upon the present value of the difference between the cash flow stream of the assumed mortgage and the cash flow stream of a market rate mortgage at the time of assumption. The net value of above- or below-market debt is included in mortgage loans payable, net in our accompanying consolidated balance sheets and is amortized as an increase or decrease to interest expense, as applicable, over the remaining term of the assumed mortgage.

The values of contingent consideration assets and liabilities are analyzed at the time of acquisition. For contingent purchase options, the fair market value of the acquired asset is compared to the specified option price at the exercise date. If the option price is below market, it is assumed to be exercised and the difference between the fair market value and the option price is discounted to the present value at the time of acquisition.

The values of the redeemable and nonredeemable noncontrolling interests are estimated by applying the income approach based on a discounted cash flow analysis. The fair value measurement may apply significant inputs that are not observable in the market. See Note 4, Business Combinations — 2021 Business Combinations — Fair Value of Noncontrolling Interests, for a further discussion of our fair value measurement approach and the significant inputs used in the values of redeemable and nonredeemable noncontrolling interests in GAHR IV.

***Real Estate Investments, Net***

We carry our operating properties at our historical cost less accumulated depreciation. The cost of operating properties includes the cost of land and completed buildings and related improvements, including those related to financing obligations. Expenditures that increase the service life of properties are capitalized and the cost of maintenance and repairs is charged to expense as incurred. The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost for tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years. When depreciable property is retired, replaced or disposed of, the related cost and accumulated depreciation is removed from the accounts and any gain or loss is reflected in earnings.

As part of the leasing process, we may provide the lessee with an allowance for the construction of leasehold improvements. These leasehold improvements are capitalized and recorded as tenant improvements and depreciated over the shorter of the useful life of the improvements or the lease term. If the allowance represents a payment for a purpose other than funding leasehold improvements, or in the event we are not considered the owner of the improvements, the allowance is considered to be a lease inducement and is included in other assets, net in our accompanying consolidated balance sheets. Lease inducement is amortized over the lease term as a reduction of real estate revenue on a straight-line basis. Factors considered during this evaluation include, among other things, who holds legal title to the improvements as well as other controlling rights provided by the lease agreement and provisions for substantiation of such costs (e.g*.,* unilateral control of the tenant space during the build-out process). Determination of the appropriate accounting for the payment of a tenant allowance is made on a lease-by-lease basis, considering the facts and circumstances of the individual tenant lease. Recognition of lease revenue commences when the lessee is given possession of the leased space upon completion of tenant improvements when we are the owner of the leasehold improvements. However, when the leasehold improvements are owned by the tenant, the lease inception date (and the date on which recognition of lease revenue commences) is the date the tenant obtains possession of the leased space for purposes of constructing its leasehold improvements.

***Goodwill***

Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of a business acquired in a business combination. Our goodwill has an indeterminate life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or changes in circumstances indicate that the asset might be impaired. We compare the fair value of a reporting unit with its carrying amount. We recognize an impairment loss to the extent the carrying value of goodwill exceeds the implied value in the current period. We take a qualitative approach, as applicable, to consider whether an impairment of goodwill exists prior to quantitatively determining the fair value of the reporting unit in step one of the impairment test.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

See Note 4, Business Combinations, for a further discussion of goodwill recognized in connection with our business combinations, and Note 19, Segment Reporting, for a further discussion of goodwill allocation by segment and impairment of goodwill.

***Impairment of Long-Lived Assets and Intangible Assets***

We periodically evaluate our long-lived assets, primarily consisting of investments in real estate that we carry at our historical cost less accumulated depreciation, for impairment when events or changes in circumstances indicate that its carrying value may not be recoverable. We consider the following indicators, among others, in our evaluation of impairment:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• significant negative industry or economic trends;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a significant underperformance relative to historical or projected future operating results; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a significant change in the extent or manner in which the asset is used or significant physical change in the asset.

If indicators of impairment of our long-lived assets are present, we evaluate the carrying value of the related real estate investments in relation to the future undiscounted cash flows of the underlying operations. In performing this evaluation, we consider market conditions and our current intentions with respect to holding or disposing of the asset. We adjust the net book value of properties we lease to others and other long-lived assets to fair value if the sum of the expected future undiscounted cash flows, including sales proceeds, is less than carrying value. We recognize an impairment loss at the time we make any such determination.

We test indefinite-lived intangible assets, other than goodwill, for impairment at least annually, and more frequently if indicators arise. We first assess qualitative factors to determine the likelihood that the fair value of the reporting group is less than its carrying value. If the carrying amount of an indefinite-lived intangible asset exceeds its fair value, an impairment loss is recognized. Fair values of other indefinite-lived intangible assets are usually determined based on discounted cash flows or appraised values, as appropriate.

If impairment indicators arise with respect to intangible assets with finite useful lives, we evaluate impairment by comparing the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated by the asset. If the estimated future undiscounted net cash flows are less than the carrying amount of the asset, then we estimate the fair value of the asset and compare the estimated fair value to the intangible asset's carrying value. For all of our reporting units, we recognize any shortfall from carrying value as an impairment loss in the current period.

See Note 3, Real Estate Investments, Net, for a further discussion of impairment of long-lived assets. See Note 6, Identified Intangible Assets, Net, for a further discussion.

***Properties Held for Sale***

A property or a group of properties is reported in discontinued operations in our consolidated statements of operations and comprehensive income (loss) for current and prior periods if the disposal represents a strategic shift that has (or will have) a major effect on an entity's operations and financial results when either: (i) the component has been disposed of or (ii) is classified as held for sale. At such time as a property is held for sale, such property is carried at the lower of: (i) its carrying amount or (ii) fair value less costs to sell. In addition, a property being held for sale ceases to be depreciated. We classify operating properties as property held for sale in the period in which all of the following criteria are met:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• management, having the authority to approve the action, commits to a plan to sell the asset;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the asset is available for immediate sale in its present condition subject only to terms that are usual and customary for sales of such assets;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an active program to locate a buyer or buyers and other actions required to complete the plan to sell the asset has been initiated;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the sale of the asset is probable and the transfer of the asset is expected to qualify for recognition as a completed sale within one year;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the asset is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• given the actions required to complete the plan to sell the asset, it is unlikely that significant changes to the plan would be made or that the plan would be withdrawn.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Our properties held for sale are included in other assets, net in our accompanying consolidated balance sheets. We did not recognize impairment charges on properties held for sale for the years ended December 31, 2022 and 2021. For the year ended December 31, 2020, we determined that the fair values of two integrated senior health campuses that were held for sale were lower than their carrying amounts, and as such, we recognized an aggregate impairment charge of $2,719,000, which reduced the total aggregate carrying value of such assets to $807,000. The fair values of such properties were determined by the sales prices from executed purchase and sales agreements with third-party buyers, and adjusted for anticipated selling costs, which were considered Level 2 measurements within the fair value hierarchy.

For the year ended December 31, 2022, we disposed of two integrated senior health campuses included in properties held for sale for an aggregate contract sales price of $18,700,000 and recognized an aggregated net gain on sale of $3,421,000. For the year ended December 31, 2021, we disposed of two integrated senior health campuses included in properties held for sale for an aggregate contract sales price of $500,000 and recognized an aggregate net loss on sale of $114,000. For the year ended December 31, 2020, we disposed of two integrated senior health campuses included in properties held for sale for an aggregate contract sales price of $10,457,000 and recognized an aggregate net gain on sale of $1,380,000.

For the years ended December 31, 2021 and 2020, our former advisor agreed to waive $93,000 and $431,000, respectively, of disposition fees that may otherwise have been due to our former advisor pursuant to the Advisory Agreement. Our former advisor did not receive any additional securities, shares of stock or any other form of consideration or any repayment as a result of the waiver of such disposition fees. See Note 3, Real Estate Investments, Net, for a further discussion of our property dispositions, as well as Note 14, Equity — Noncontrolling Interests in Total Equity, for a discussion of the disposition of membership interests in a consolidated limited liability company.

***Debt Security Investment, Net***

We classify our marketable debt security investment as held-to-maturity because we have the positive intent and ability to hold the security to maturity, and we have not recorded any unrealized holding gains or losses on such investment. Our held-to-maturity security is recorded at amortized cost and adjusted for the amortization of premiums or discounts through maturity.

See Note 5, Debt Security Investment, Net, for a further discussion.

***Derivative Financial Instruments***

We are exposed to the effect of interest rate changes in the normal course of business. We seek to mitigate these risks by following established risk management policies and procedures, which include the occasional use of derivatives. Our primary strategy in entering into derivative contracts, such as fixed-rate interest rate swaps and interest rate caps, is to add stability to interest expense and to manage our exposure to interest rate movements by effectively converting a portion of our variable-rate debt to fixed-rate debt. We do not enter into derivative instruments for speculative purposes.

Derivatives are recognized as either other assets or other liabilities in our accompanying consolidated balance sheets and are measured at fair value. We do not designate our derivative instruments as hedge instruments as defined by guidance under ASC Topic 815, *Derivatives and Hedges*, or ASC Topic 815, which allows for gains and losses on derivatives designated as hedges to be offset by the change in value of the hedged items or to be deferred in other comprehensive income (loss). Changes in the fair value of our derivative financial instruments are recorded as a component of interest expense in gain or loss in fair value of derivative financial instruments in our accompanying consolidated statements of operations and comprehensive income (loss).

See Note 10, Derivative Financial Instruments, and Note 16, Fair Value Measurements, for a further discussion of our derivative financial instruments.

***Fair Value Measurements***

The fair value of certain assets and liabilities is a market-based measurement, not an entity-specific measurement. Therefore, a fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, we follow a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of our reporting entity (observable inputs that are classified within Levels 1 and 2 of the hierarchy) and our reporting entity's own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy).

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that we have the ability to access. An active market is defined as a market in which transactions for the assets or liabilities occur with sufficient frequency and volume to provide pricing information on an ongoing basis. Level 2 inputs are inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs may include quoted prices for similar assets and liabilities in active markets, as well as inputs that are observable for the asset or liability (other than quoted prices), such as interest rates, foreign exchange rates and yield curves that are observable at commonly quoted intervals. Level 3 inputs are unobservable inputs for the asset or liability, which are typically based on an entity's own assumptions, as there is little, if any, related market activity. In instances where the determination of the fair value measurement is based on inputs from different levels of the fair value hierarchy, the level in the fair value hierarchy within which the entire fair value measurement falls is based on the lowest level input that is significant to the fair value measurement in its entirety. Our assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability.

See Note 16, Fair Value Measurements, for a further discussion.

***Other Assets, Net***

Other assets, net primarily consists of inventory, prepaid expenses and deposits, certain deferred financing costs related to our lines of credit and term loans, deferred rent receivables, deferred tax assets, investments in unconsolidated entities, lease inducements and lease commissions. Inventory consists primarily of pharmaceutical and medical supplies and is stated at the lower of cost (first-in, first-out) or market. Deferred financing costs related to our lines of credit and term loans include amounts paid to lenders and others to obtain such financing. Such costs are amortized using the straight-line method over the term of the related loan, which approximates the effective interest rate method. Amortization of deferred financing costs related to our lines of credit and term loans is included in interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Lease commissions are amortized using the straight-line method over the term of the related lease. Prepaid expenses are amortized over the related contract periods.

We report investments in unconsolidated entities using the equity method of accounting when we have the ability to exercise significant influence over the operating and financial policies. Under the equity method, our share of the investee's earnings or losses is included in our accompanying consolidated statements of operations and comprehensive income (loss). We generally do not recognize equity method losses when such losses exceed our net equity method investment balance unless we have committed to provide such investee additional financial support or guaranteed its obligations. 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. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the entity interest or the estimated fair value of the assets prior to the sale of interests in the entity. We have elected to follow the cumulative earnings approach when classifying distributions received from equity method investments in our consolidated statements of cash flows, whereby any distributions received up to the amount of cumulative equity earnings will be considered a return on investment and classified in operating activities and any excess distributions would be considered a return of investment and classified in investing activities. 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.

See Note 7, Other Assets, Net, for a further discussion.

***Accounts Payable and Accrued Liabilities***

As of December 31, 2022 and 2021, accounts payable and accrued liabilities primarily include insurance reserves of $39,893,000 and $36,440,000, respectively, reimbursement of payroll-related costs to the managers of our SHOP and integrated senior health campuses of $38,624,000 and $31,101,000, respectively, accrued property taxes of $24,926,000 and $22,102,000, respectively, accrued developments and capital expenditures to unaffiliated third parties of $30,211,000 and $22,852,000, respectively, and accrued distributions to common stockholders of $26,484,000 and $8,768,000, respectively.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Stock Based Compensation***

We follow ASC Topic 718, *Compensation — Stock Compensation*, or ASC Topic 718, to account for our stock compensation pursuant to the 2015 Incentive Plan, or the AHR Incentive Plan, using the fair value method, which requires an estimate of fair value of the award at the time of grant and recognition of compensation expense on a straight-line basis over the requisite service period of the awards. The compensation expense is adjusted for actual forfeitures upon occurrence. Awards granted under the AHR Incentive Plan consist of restricted stock or units issued to our executive officers and employees, in addition to restricted stock issued to our directors. See Note 14, Equity — AHR 2015 Incentive Plan, for a further discussion of awards granted under the AHR Incentive Plan.

***Foreign Currency***

We have real estate investments in the United Kingdom, or UK, and Isle of Man for which the functional currency is the UK Pound Sterling, or GBP. We translate the results of operations of our foreign real estate investments into United States Dollars, or USD, using the average currency rates of exchange in effect during the period, and we translate assets and liabilities using the currency exchange rate in effect at the end of the period. The resulting foreign currency translation adjustments are included in accumulated other comprehensive loss, a component of stockholders' equity, in our accompanying consolidated balance sheets. Certain balance sheet items, primarily equity and capital-related accounts, are reflected at the historical currency exchange rates. We also have intercompany notes and payables denominated in GBP with our UK subsidiaries. Gains or losses resulting from remeasuring such intercompany notes and payables into USD at the end of each reporting period are reflected in our accompanying consolidated statements of operations and comprehensive income (loss). When such intercompany notes and payables are deemed to be of a long-term investment nature, they will be reflected in accumulated other comprehensive loss in our accompanying consolidated balance sheets.

Gains or losses resulting from foreign currency transactions are remeasured into USD at the rates of exchange prevailing on the date of the transactions. The effects of transaction gains or losses are included in our accompanying consolidated statements of operations and comprehensive income (loss).

***Income Taxes***

We qualified, and elected to be taxed, as a REIT under the Code, and we intend to continue to qualify to be taxed as a REIT. To maintain our qualification as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to our stockholders a minimum of 90.0% of our annual taxable income, excluding net capital gains. We generally will not be subject to U.S. federal income taxes if we distribute 100% of our taxable income each year to our stockholders.

If we fail to maintain our qualification as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could have a material adverse effect on our net income and net cash available for distribution to our stockholders.

We may be subject to certain state and local income taxes on our income, property or net worth in some jurisdictions, and in certain circumstances we may also be subject to federal excise taxes on undistributed income. In addition, certain activities that we undertake are conducted by subsidiaries, which we elected to be treated as taxable REIT subsidiaries, or TRS, to allow us to provide services that would otherwise be considered impermissible for REITs. Also, we have real estate investments in the UK and Isle of Man, which do not accord REIT status to United States REITs under their tax laws. Accordingly, we recognize an income tax benefit or expense for the federal, state and local income taxes incurred by our TRS and foreign income taxes on our real estate investments in the UK and Isle of Man.

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 financial statements or tax returns. Under this method, we determine deferred tax assets and liabilities based on the temporary differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases using enacted tax rates in effect for the year in which the differences are expected to reverse. Deferred tax assets reflect the impact of the future deductibility of operating loss 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 us to change our judgment about the realizability of the related deferred tax asset, is included in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive income (loss)

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

when such changes occur. Any increase or decrease in the deferred tax liability that results from a change in circumstances, and that causes us to change our judgment about expected future tax consequences of events, is recorded in income tax benefit or expense in our accompanying consolidated statements of operations and comprehensive income (loss).

Net deferred tax assets are included in other assets, or net deferred tax liabilities are included in security deposits, prepaid rent and other liabilities, in our accompanying consolidated balance sheets.

See Note 17, Income Taxes, for a further discussion.

***Segment Disclosure***

We segregate our operations into reporting segments in order to assess the performance of our business in the same way that management reviews our performance and makes operating decisions. Accordingly, when we acquired our first MOB in June 2014; SNF in September 2014; hospital in December 2014; SHOP in May 2015; skilled nursing facility in October 2015; and integrated senior health campus in December 2015, we established a new reportable segment at such time. As of December 31, 2022, we operated through six reportable business segments, with activities related to investing in integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals.

See Note 19, Segment Reporting, for a further discussion.

***GLA and Other Measures***

GLA and other measures used to describe real estate investments included in our accompanying consolidated financial statements are presented on an unaudited basis.

***Recently Issued Accounting Pronouncements***

In March 2020, the FASB issued Accounting Standards Update, or ASU, 2020-04, *Facilitation of the Effects of Reference Rate Reform of Financial Reporting*, or ASU 2020-04, which provides optional expedients and exceptions for applying GAAP to contract modifications, hedging relationships and other transactions, subject to meeting certain criteria. ASU 2020-04 applies to the aforementioned transactions that reference the London Inter-bank Offered Rate, or LIBOR, or another reference rate expected to be discontinued because of the reference rate reform. In January 2021, the FASB issued ASU 2021-01, *Reference Rate Reform (Topic 848),* or ASU 2021-01, which clarifies that certain optional expedients and exceptions for contract modification and hedge accounting apply to derivative instruments that use an interest rate for margining, discounting, or contract price alignment that is modified as a result of the discontinuation of the use of LIBOR as a benchmark interest rate due to reference rate reform. In December 2022, the FASB issued ASU 2022-06, *Reference Rate Reform* (Topic 848): *Deferral of the Sunset Date of Topic 848,* or ASU 2022-06, which extends the period of time entities can utilize the reference rate reform relief guidance under ASU 2020-04 from December 31, 2022 to December 31, 2024. ASU 2020-04, ASU 2021-01 and ASU 2022-06 are effective for fiscal years and interim periods beginning after March 12, 2020 and through the effective date December 31, 2024, as extended by ASU 2022-06. We are currently evaluating the impact this guidance has on our variable-rate debt and lease contracts to determine the impact on our disclosures.

In July 2021, the FASB issued ASU 2021-05, *Leases (Topic 842): Lessors* — *Certain Leases with Variable Lease Payments,* or ASU 2021-05, which amends the lease classification requirements for lessors to align them with practice under the previous lease accounting standard, ASC Topic 840, *Leases*. Lessors should classify and account for a lease with variable lease payments that do not depend on a reference index or a rate as an operating lease, if both of the following criteria are met: (1) the lease would have been classified as a sales-type lease or a direct financing lease; and (2) the lessor would have otherwise recognized a day-one loss. ASU 2021-05 was effective for fiscal years beginning after December 15, 2021. Early adoption was permitted. We adopted such accounting pronouncement on January 1, 2022, which did not have a material impact to our consolidated financial statements and disclosures as we have no material sales-type or direct financing leases.

In October 2021, the FASB issued ASU 2021-08, *Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers*, or ASU 2021-08, which requires contract assets and contract liabilities acquired in a business combination to be recognized and measured by the acquiror on the acquisition date in accordance with ASC Topic 606 as if it had originated the contracts. Under the current business combination guidance, such assets and liabilities were recognized by the acquiror as fair value on the acquisition date. ASU 2021-08 is effective for fiscal years beginning after December 15, 2022. Early adoption is permitted. We adopted such accounting pronouncements on January 1, 2023, which did not have a material impact to our consolidated financial statements and disclosures.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

In March 2022, the FASB issued ASU 2022-02, *Financial Instruments — Credit Losses (Topic 326): Troubled Debt Restructuring and Vintage Disclosures,* or ASU 2022-02, which eliminates certain previously issued accounting guidance for troubled debt restructurings, or TDRs, and enhances disclosure requirements surrounding refinancing, restructurings, and write-offs. Current GAAP provides an exception to general recognition and measurement guidance for loan restructurings if they meet specific criteria to be considered TDRs. If a modification is a TDR, incremental expected losses are recorded in the allowance for credit losses upon modification and specific disclosures are required. The new amendment eliminates the TDR recognition and measurement guidance and requires the reporting entity to evaluate whether the modification represents a new loan or a continuation of an existing loan, consistent with accounting for other loan modifications. The amendment also requires public business entities to disclose current-period gross write-offs by year of origination for certain financing receivables and net investments in leases. For entities that have adopted the previously issued guidance amended by this update, ASU 2016-13, *Measurement of Credit Losses on Financial Instruments*, which we adopted during the year ended December 31, 2020, this update is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted for entities that have adopted the previously issued guidance amended by this update. We adopted such accounting pronouncements on January 1, 2023, which did not have a material impact to our consolidated financial statements and disclosures.

**3. Real Estate Investments, Net** 

Our real estate investments, net consisted of the following as of December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| Building, improvements and construction in process | $3670361000 | $3505786000 |
| Land and improvements | 344359000 | 334562000 |
| Furniture, fixtures and equipment | 221727000 | 198224000 |
|  | 4236447000 | 4038572000 |
| Less: accumulated depreciation | (654838000) | (523886000) |
|  | $3581609000 | $3514686000 |

---

Depreciation expense for the years ended December 31, 2022, 2021 and 2020 was $141,257,000, $109,036,000 and $90,997,000, respectively. In addition to the acquisitions and dispositions discussed below, for the years ended December 31, 2022, 2021 and 2020, we incurred capital expenditures of $32,373,000, $21,605,000 and $17,854,000, respectively, for our MOBs, $30,926,000, $62,596,000 and $111,286,000, respectively, for our integrated senior health campuses, $9,280,000, $3,539,000 and $1,232,000, respectively, for our SHOP, $4,000, $0 and $47,000, respectively, for our hospitals and $0, $31,000 and $0, respectively, for our SNFs. We did not incur any capital expenditures for our senior housing — leased segment for the years ended December 31, 2022, 2021 and 2020.

Included in the capital expenditure amounts above are costs for the development and expansion of our integrated senior health campuses. For the year ended December 31, 2022, we exercised our right to purchase a leased property that cost $15,462,000 to develop and incurred $7,543,000 to expand three of our existing integrated senior health campuses. For the year ended December 31, 2021, we completed the development of three integrated senior health campuses for $50,435,000 and incurred $22,720,000 to expand two of our existing integrated senior health campuses. We also exercised our right to purchase a leased property that cost $11,004,000. For the year ended December 31, 2020, we completed the development of six integrated senior health campuses for $64,409,000 and incurred $2,573,000 to expand two of our existing integrated senior health campuses.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Acquisitions of Real Estate Investments***

*2022 Acquisitions of Real Estate Investments*

For the year ended December 31, 2022, we, through a majority-owned subsidiary of Trilogy Investors, LLC, or Trilogy, of which we own 73.1%, exercised purchase options to acquire four previously leased real estate investments located in Indiana and Kentucky for an aggregate contract purchase price of $54,805,000, which investments are included in our integrated senior health campus segment. We financed such acquisitions with cash on hand and a mortgage loan payable with a principal balance of $52,725,000. In addition, for the year ended December 31, 2022, we, through a majority-owned subsidiary of Trilogy, acquired land parcels in Indiana and Kentucky for the future development and expansion of our integrated senior health campuses for an aggregate contract purchase price of $1,020,000, plus closing costs.

We accounted for our acquisitions of land and previously leased real estate investments completed during the year ended December 31, 2022 described above as asset acquisitions. For the year ended December 31, 2022, we incurred and capitalized closing costs and direct acquisition related expenses of $303,000. The following table summarizes the purchase price of such assets acquired, adjusted for $37,464,000 operating lease right-of-use assets and $36,326,000 operating lease liabilities, and based on their relative fair values:

---

| | |
|:---|:---|
| | **2022 <br>Acquisitions** |
| Building and improvements | $49645000 |
| Land and improvements | 8885000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets acquired | $58530000 |

---

*2021 Acquisitions of Real Estate Investments*

For the year ended December 31, 2021, we, through a majority-owned subsidiary of Trilogy, acquired a portfolio of six previously leased real estate investments located in Indiana and Ohio. The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment:

---

| | | | | |
|:---|:---|:---|:---|:---|
| **Location** | **Date <br>Acquired** | **Contract<br>Purchase Price** | **Mortgage<br>Loan Payable(1)** | **Acquisition <br>Fee(2)** |
| Kendallville, IN; and Delphos, Lima, Springfield, Sylvania and Union Township, OH | 01/19/21 | $76549000 | $78587000 | $1164000 |

---

___________

(1)Represents the principal balance of the mortgage loan payable placed on the properties at the time of acquisition.

(2)Our former advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest in the Trilogy subsidiary that acquired the properties.

For the year ended December 31, 2021, and prior to the Merger, we, through a majority-owned subsidiary of Trilogy, acquired land parcels in Indiana and Ohio for the future development and expansion of our integrated senior health campuses for an aggregate contract purchase price of $1,459,000 plus closing costs. We paid to our former advisor an acquisition fee of 2.25% of the portion of the contract purchase price of each land parcel attributed to our ownership interest. On October 15, 2021, we, through a majority-owned subsidiary of Trilogy, acquired a land parcel in Ohio for a contract purchase price of $249,000, plus closing costs.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

We accounted for our acquisitions of land and previously leased real estate investments completed during the year ended December 31, 2021 described above as asset acquisitions. For the year ended December 31, 2021, we incurred and capitalized closing costs and direct acquisition related expenses of $1,855,000. The following table summarizes the purchase price of such assets acquired at the time of acquisition, adjusted for $57,647,000 operating lease right-of-use assets and $54,564,000 operating lease liabilities, and based on their relative fair values:

---

| | |
|:---|:---|
| | **2021 <br>Acquisitions** |
| Building and improvements | $66167000 |
| Land | 17612000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets acquired | $83779000 |

---

*2020 Acquisitions of Real Estate Investments*

For the year ended December 31, 2020, we, through a majority-owned subsidiary of Trilogy, of which we owned 67.6% at the time of property acquisition, acquired two previously leased real estate investments located in Indiana and Kentucky. The following is a summary of such property acquisitions, which are included in our integrated senior health campuses segment:

---

| | | | | |
|:---|:---|:---|:---|:---|
| **Location** | **Date <br>Acquired** | **Contract<br>Purchase Price** | **Line of Credit(1)** | **Acquisition <br>Fee(2)** |
| Monticello, IN | 07/30/20 | $10600000 | $13200000 | $161000 |
| Louisville, KY | 07/30/20 | 16719000 | 15055000 | 254000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total |  | $27319000 | $28255000 | $415000 |

---

___________

(1)Represents borrowings under the 2019 Trilogy Credit Facility, as defined in Note 9, Lines of Credit and Term Loans, at the time of acquisition.

(2)Our former advisor was paid, as compensation for services rendered in connection with the investigation, selection and acquisition of our properties, an acquisition fee of 2.25% of the portion of the contract purchase price of the properties attributed to our ownership interest at the time of acquisition in the Trilogy subsidiary that acquired the properties.

In addition to the property acquisitions discussed above, for the year ended December 31, 2020, we, through a majority-owned subsidiary of Trilogy, acquired land in Ohio for an aggregate contract purchase price of $2,833,000 plus closing costs and paid to our former advisor an acquisition fee of 2.25% of the portion of the contract purchase price of such land parcel attributed to our ownership interest.

We accounted for our acquisitions of land and previously leased real estate investments completed during the year ended December 31, 2020 described above as asset acquisitions. For the year ended December 31, 2020, we incurred and capitalized closing costs and direct acquisition related expenses of $709,000. The following table summarizes the purchase price of the assets acquired at the time of acquisition, adjusted for $14,281,000 of operating lease right-of-use assets and $15,530,000 of operating lease liabilities, and based on their relative fair values:

---

| | |
|:---|:---|
| | **2020<br>Acquisitions** |
| Building and improvements | $26311000 |
| Land | 4563000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets acquired | $30874000 |

---

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Dispositions of Real Estate Investments***

Below is a summary of dispositions of real estate investments for the years ended December 31, 2022 and 2021. We did not dispose of any real estate investments for the year ended December 31, 2020.

*2022 Dispositions of Real Estate Investments*

For the year ended December 31, 2022, we disposed of one MOB in Tennessee and three facilities in Florida within our Central Florida Senior Housing Portfolio. We recognized a total aggregate gain on such dispositions of $1,370,000. The following is a summary of such dispositions, which were included in our MOBs and SHOP segments, as applicable:

---

| | | |
|:---|:---|:---|
| **Location** | **Date <br>Disposed** | **Contract<br>Sales Price** |
| Brooksville, FL(1) | 11/15/22 | $2640000 |
| Sanford, FL(1) | 12/15/22 | 3750000 |
| Memphis, TN | 12/20/22 | 9600000 |
| Bradenton FL(1) | 12/30/22 | 7215000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total |  | $23205000 |

---

___________

(1)See Note 13, Redeemable Noncontrolling Interests, for information about the ownership of the Central Florida Senior Housing Portfolio.

*2021 Disposition of Real Estate Investments*

In July 2021, we, through a majority-owned subsidiary of Trilogy, sold an integrated senior health campus, or the Sold Property, to an unaffiliated third party, or the Buyer, and leased it back, while retaining control of the Sold Property. This transaction did not meet the criteria for a sale and leaseback under GAAP. The lease agreement includes a finance obligation with a present value of $15,504,000 representing our obligation to purchase the Sold Property between 2028 and 2029. Simultaneously, we, through a majority-owned subsidiary of Trilogy, purchased a previously leased integrated senior health campus, or the Purchased Property, from the Buyer which was in exchange for the Sold Property. No cash consideration was exchanged as part of the transactions explained above. As of the transaction date, the carrying value of the Purchased Property of $14,807,000 was recorded to real estate investments, net, in our accompanying consolidated balance sheet and the carrying value of the finance obligation of $15,504,000 was recorded to financing obligations in our accompanying consolidated balance sheet.

***Sale of Controlling Interests in Developments***

On February 8, 2022, we sold approximately 74.0% of our ownership interests in several real estate development assets within our integrated senior health campuses segment for an aggregate sales price of $19,622,000 and we recognized an aggregate gain on sale of $683,000 for the year ended December 31, 2022. At the time of sale, we retained approximately 26.0% ownership interests in such real estate development assets. As of December 31, 2022, we own approximately 31.6% ownership interests in such real estate development assets, which interests are accounted for as investments in unconsolidated entities within other assets, net in our accompanying consolidated balance sheet as of December 31, 2022. From February 8, 2022 through December 31, 2022, our interests in the net earnings or losses of such unconsolidated entities were included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive income (loss).

See Note 4, Business Combinations, for a discussion of real estate investment acquisitions accounted for business combinations for the years ended December 31, 2022 and 2021. We did not have any business combinations for the year ended December 31, 2020.

***Impairment of Real Estate Investments***

For the year ended December 31, 2022, we determined that 12 facilities within our SHOP segment were impaired and recognized an aggregate impairment charge of $54,579,000, which reduced the total aggregate carrying value of such facilities to $81,149,000. We disposed of three of such impaired facilities during the fourth quarter of 2022, as discussed in the "Dispositions of Real Estate Investments" section above. The fair value of one of our impaired facilities was determined by the

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

sales price from an executed purchase and sale agreement with a third-party buyer, which was considered a Level 2 measurement within the fair value hierarchy. The fair value of our remaining 11 impaired facilities were based on their projected sales prices, which were considered Level 2 measurements within the fair value hierarchy.

For the year ended December 31, 2021, we determined that one MOB was impaired and recognized an impairment charge of $3,335,000, which reduced the carrying value of such asset to $2,880,000. The fair value of such property was determined by the sales price from an executed purchase and sale agreement with third-party buyer, and adjusted for anticipated selling costs, which was considered a Level 2 measurement within the fair value hierarchy. We disposed of such impaired MOB in July 2021 for a contract sales price of $3,000,000 and recognized a net gain on sale of $346,000.

For the year ended December 31, 2020, we determined that one SNF and one MOB were impaired and recognized an aggregate impairment charge of $8,350,000, which reduced the total carrying value of such assets to $4,256,000. The fair values of such properties were determined by the sales price from executed purchase and sales agreements with third-party buyers, and adjusted for anticipated selling costs, which were considered Level 2 measurements within the fair value hierarchy. We disposed of such impaired MOB in July 2020 for a contract sales price of $3,500,000 and recognized a net gain on sale of $15,000. As of December 31, 2020, the remaining $1,056,000 carrying value of such SNF was classified in properties held for sale, and we subsequently disposed of such property in February 2021 for a contract sales price of $1,300,000 and recognized a net loss on sale of $332,000.

**4. Business Combinations** 

***2022 Business Combinations***

For the year ended December 31, 2022, we accounted for four acquisitions as business combinations, as discussed below, the first three of which are included within our integrated senior health campuses segment. Based on quantitative and qualitative considerations, such four business combinations were not material to us individually or in the aggregate and, therefore, pro forma financial information is not provided.

On January 3, 2022, we, through a majority-owned subsidiary of Trilogy, acquired an integrated senior health campus in Kentucky from an unaffiliated third party. The contract purchase price for such property acquisition was $27,790,000 plus immaterial closing costs. We acquired such property using cash on hand and placed a mortgage loan payable of $20,800,000 on the property at the time of acquisition.

On April 1, 2022, we, through a majority-owned subsidiary of Trilogy, acquired a 50.0% interest in a pharmaceutical business in Florida from an unaffiliated third party and incurred transaction costs of $938,000. Prior to such pharmaceutical business acquisition, we, through a majority-owned subsidiary of Trilogy, owned the other 50.0% interest in such business, which investment was included in investments in unconsolidated entities within other assets, net in our accompanying consolidated balance sheet as of December 31, 2021. Therefore, through March 31, 2022, our 50.0% interest in the net earnings or losses of such unconsolidated entity was included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive income (loss).

On August 1, 2022, we, through a majority-owned subsidiary of Trilogy, acquired the 50.0% controlling interest in a privately held company, RHS Partners, LLC, or RHS, that owns and/or operates 16 integrated senior health campuses located in Indiana, from an unaffiliated third party. The contract purchase price for the acquisition of RHS was $36,661,000 plus immaterial closing costs, which was primarily acquired using cash on hand. Prior to such acquisition, we owned a 50.0% interest in RHS, which was accounted for as an equity method investment and was included in investments in unconsolidated entities within other assets, net in our accompanying consolidated balance sheet as of December 31, 2021. Therefore, through July 31, 2022, our 50.0% equity interest in the net earnings or losses of RHS was included in income or loss from unconsolidated entities in our accompanying consolidated statements of operations and comprehensive income (loss). In connection with the acquisition of RHS, we re-measured the fair value of our previously held equity interest in RHS and recognized a gain on re-measurement of $19,567,000 in our accompanying consolidated statements of operations and comprehensive income (loss).

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

On December 5, 2022, we acquired a portfolio of seven senior housing facilities in Texas from an unaffiliated third party, which facilities are included in our SHOP segment. These facilities are part of the underlying collateral pool of real estate assets securing our debt security investment, as defined and described at Note 5, Debt Security Investment, Net. We acquired the seven facilities by assuming the outstanding principal balance of each related mortgage loan payable from one of the borrowers as such borrower was in default on the required debt payments. The aggregated principal balance of such assumed mortgage loans payable was $110,627,000 at the time of acquisition. No cash consideration was exchanged as part of the transactions; however, we incurred transaction costs of $1,895,000 related to the acquisition of such facilities. See Note 5, Debt Security Investment, Net, for a further discussion.

The table below summarizes the acquisition date fair values of the assets acquired and liabilities assumed of our 2022 acquisitions accounted for as business combinations. The fair values of the assets acquired and liabilities assumed during 2022 were preliminary estimates. Any necessary adjustments will be finalized within one year from the date of acquisition.

---

| | |
|:---|:---|
| | **2022<br>Acquisitions** |
| Operating lease right-of-use assets | $153777000 |
| Building and improvements | 163166000 |
| Goodwill | 44990000 |
| Accounts receivable, net | 19472000 |
| In-place leases | 18834000 |
| Land | 20514000 |
| Cash and restricted cash | 12331000 |
| Certificates of need | 3567000 |
| Furniture, fixtures and equipment | 1936000 |
| Other assets | 1798000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets acquired | 440385000 |
| Operating lease liabilities | (161121000) |
| Mortgage loans payable (including debt discount of $6,066,000) | (149861000) |
| Security deposits and other liabilities | (15994000) |
| Accounts payable and accrued liabilities | (16012000) |
| Financing obligations | (65000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities assumed | (343053000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net assets acquired | $97332000 |

---

***2021 Business Combinations*** — ***Merger and the AHI Acquisition***

As discussed in Note 1, Organization and Description of Business, on October 1, 2021, pursuant to the Merger Agreement, we completed the REIT Merger and Partnership Merger. At the effective time of the REIT Merger and prior to the reverse stock split, each issued and outstanding share of GAHR III's common stock, $0.01 par value per share, converted into the right to receive 0.9266 shares of GAHR IV's Class I common stock, $0.01 par value per share. At the effective time of the Partnership Merger and prior to the reverse stock split, (i) each unit of limited partnership interest in our operating partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive 0.9266 of a Partnership Class I Unit, as defined in the agreement of limited partnership, as amended, of the surviving partnership and (ii) each unit of limited partnership interest in GAHR IV Operating Partnership outstanding as of immediately prior to the effective time of the Partnership Merger was converted automatically into the right to receive one unit of limited partnership interest of the surviving partnership of like class.

Additionally, on October 1, 2021, the AHI Acquisition closed immediately prior to the consummation of the Merger, and pursuant to the Contribution Agreement, AHI contributed substantially all of its business and operations to the surviving partnership, including its interest in GAHR III Advisor and GAHR IV Advisor, and Griffin Capital contributed its ownership interest in GAHR III Advisor and GAHR IV Advisor to the surviving partnership. In exchange for their contributions, the surviving partnership issued surviving partnership OP units to the NewCo Sellers.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

*Purchase Consideration*

REIT Merger

The fair value of the purchase consideration transferred was calculated as follows:

---

| | |
|:---|:---|
| Deemed equity consideration (1) | $768075000 |
| Consideration for acquisition of noncontrolling interest (2) | (53300000) |
| Repurchase of GAHR IV Class T common stock | 192000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total purchase consideration | $714967000 |

---

________________

(1)Represents the fair value of GAHR III common stock that is deemed to be issued for accounting purposes only. Taking into consideration the impact of the reverse stock split, the fair value of the purchase consideration is calculated based on 22,045,766 shares of common stock deemed to be issued by GAHR III at the fair value per share of $34.84.

(2)Represents the fair value of additional interest acquired in GAHR III's subsidiary, Trilogy REIT Holdings, LLC, or Trilogy REIT Holdings. The acquisition of additional interest in Trilogy is accounted for separately from the REIT Merger in accordance with ASC Topic 810, *Consolidation*, or ASC Topic 810. See Note 14, Equity — Noncontrolling Interests in Total Equity, for a discussion of the Trilogy transaction.

AHI Acquisition

The fair value of the purchase consideration transferred was calculated as follows:

---

| | |
|:---|:---|
| Equity consideration (1) | $131674000 |
| Post-closing cash payment to NewCo Sellers related to net working capital adjustments | 73000 |
| Contingent consideration (2) |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total purchase consideration | $131747000 |

---

________________

(1)Taking into consideration the impact of the reverse stock split, the amount represents the estimated fair value of the 3,779,382 surviving partnership OP units issued as consideration, with a reference value for purposes thereof of $34.84 per unit. The issuance of surviving partnership OP units was accounted for separately from the AHI Acquisition.

(2)Represents the estimated fair value of contingent consideration based on the performance of a possible private investment fund under consideration by AHI. We have no definitive plans to establish the investment fund and therefore the fair value of contingent consideration was estimated to be $0.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

*Purchase Price Allocation*

REIT Merger

The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date of GAHR IV, as well as the fair value at the acquisition date of the noncontrolling interests in GAHR IV:

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| | |
|:---|:---|
| Real estate investments | $1126641000 |
| Cash and cash equivalents | 16163000 |
| Accounts and other receivables, net | 2086000 |
| Restricted cash | 986000 |
| Identified intangible assets | 115824000 |
| Operating lease right-of-use assets | 11939000 |
| Other assets | 3938000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets | 1277577000 |
| Mortgage loans payable (including debt premium of $311,000) | (18602000) |
| Lines of credit and term loans | (488900000) |
| Accounts payable and accrued liabilities | (21882000) |
| Accounts payable due to affiliates | (324000) |
| Identified intangible liabilities | (12927000) |
| Operating lease liabilities | (7568000) |
| Security deposits, prepaid rent and other liabilities | (8354000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities | (558557000) |
| Net identifiable assets acquired | 719020000 |
| Redeemable noncontrolling interests | (2525000) |
| Noncontrolling interest in total equity | (1528000) |
| Total purchase consideration | $714967000 |

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

AHI Acquisition

The following table sets forth the allocation of the purchase consideration to the fair values of identifiable tangible and intangible assets acquired and liabilities assumed recognized at the acquisition date:

---

| | |
|:---|:---|
| Cash and cash equivalents | $706000 |
| Operating lease right-of-use assets | 3526000 |
| Other assets | 362000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets | 4594000 |
| Accounts payable and accrued liabilities | (3910000) |
| Operating lease liabilities | (3526000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities | (7436000) |
| Net identifiable liabilities assumed | (2842000) |
| Goodwill | 134589000 |
| Total purchase consideration | $131747000 |

---

*Acquisition-related Costs* 

The Merger and the AHI Acquisition were accounted for as business combinations and as a result, acquisition-related costs incurred in connection with these transactions of $13,987,000 were expensed and included in business acquisition expenses in our accompanying consolidated statement of operations and comprehensive income (loss). Acquisition-related costs of $6,753,000 were incurred by GAHR IV in the period before the consummation of the Merger and are therefore not reflected in our accompanying consolidated statements of operations and comprehensive income (loss) for the year ended December 31, 2021 as GAHR III was the accounting acquiror in the Merger under ASC Topic 805, as further explained above.

*Fair Value of Noncontrolling Interests* 

The fair value of the redeemable and nonredeemable noncontrolling interest in GAHR IV was estimated by applying the income approach based on a discounted cash flow analysis. This fair value measurement is based on significant inputs not observable in the market. The key assumptions applied in the income approach include the estimates of stabilized occupancy, market rents, capitalization rates, and discount rates.

*AHI Acquisition — Goodwill*

In connection with the AHI Acquisition, we recorded goodwill of $134,589,000 as a result of the consideration exceeding the fair value of the net assets acquired and liabilities assumed. Goodwill represents the estimated future benefits arising from other assets acquired that could not be individually identified and separately recognized. Goodwill recognized in this transaction is not deductible for tax purposes. See Note 19, Segment Reporting, for a further discussion.

The table below represents the allocation of goodwill in connection with the AHI Acquisition to our reporting segments:

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| | |
|:---|:---|
| MOBs | $47812000 |
| Integrated senior health campuses | 44547000 |
| SHOP | 23277000 |
| SNFs | 8640000 |
| Senior housing | 5924000 |
| Hospitals | 4389000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total | $134589000 |

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

*REIT Merger — Real Estate Investments, Intangible Assets and Intangible Liabilities*

Real estate investments consist of land, building improvements, site improvements, unamortized tenant improvement allowances and unamortized capital improvements. Intangibles assets consist of in-place leases, above-market leases and certificates of need. We amortize purchased real estate investments and intangible assets on a straight-line basis over their respective useful lives. The following tables present the approximate fair value and the weighted-average depreciation and amortization periods of each major type of asset and liability.

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| | | |
|:---|:---|:---|
| **Real Estate Investments** | **Approximate Fair <br>Value** | **Estimated** <br>**Useful Lives** <br>**(in years)** |
| Land | $114525000 | N/A |
| Building improvements | 930700000 | 39 |
| Site improvements | 33644000 | 7 |
| Unamortized tenant improvement allowances | 42407000 | 6 |
| Unamortized capital improvements | 5365000 | 11 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total real estate investments | $1126641000 |  |

---

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| | | |
|:---|:---|:---|
| **Intangible Assets** | **Approximate Fair <br>Value** | **Estimated** <br>**Useful Lives**<br>**(in years)** |
| In-place leases | $79887000 | 6 |
| Above-market leases | 35606000 | 10 |
| Certificates of need | 331000 | N/A |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total identified intangible assets | $115824000 |  |
| **Intangible Liabilities** | **Approximate Fair <br>Value** | **Estimated <br>Useful Life <br>(in years)** |
| Below-market leases | $12927000 | 10 |

---

The fair values of the assets acquired and liabilities assumed, as well as the fair value of the noncontrolling interests, on October 1, 2021 were estimates determined using the cost approach and direct capitalization method under the income approach, and in limited circumstances, the market approach. Any necessary adjustments were finalized within one year from the date of acquisition.

*Pro Forma Financial Information (Unaudited)*

The following unaudited pro forma operating information is presented as if the Merger and the AHI Acquisition occurred on January 1, 2020. Such unaudited pro forma information includes a nonrecurring adjustment to present acquisition related expenses incurred in the year ended December 31, 2021 in the 2020 pro forma results. The pro forma results are not necessarily indicative of the operating results that would have been obtained had the Merger and the AHI Acquisition occurred at the beginning of the periods presented, nor are they necessarily indicative of future operating results. Unaudited pro forma revenue, net loss and net loss attributable to controlling interest would have been as follows:

---

| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2021** | **2020** |
| Revenue | $1392884000 | $1397261000 |
| Net loss | $(45253000) | $(17116000) |
| Net loss attributable to controlling interest | $(35140000) | $(20642000) |

---

**5. Debt Security Investment, Net**

On October 15, 2015, we acquired a commercial mortgage-backed debt security, or debt security, from an unaffiliated third party. The debt security bears an interest rate on the stated principal amount thereof equal to 4.24% per annum, the terms of which security provide for monthly interest-only payments. The debt security matures on August 25, 2025 at a stated amount

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

of $93,433,000, resulting in an anticipated yield-to-maturity of 10.0% per annum. The debt security was issued by an unaffiliated mortgage trust and represents a 10.0% beneficial ownership interest in such mortgage trust. The debt security is subordinate to all other interests in the mortgage trust and is not guaranteed by a government-sponsored entity.

On December 5, 2022, we acquired a portfolio of seven senior housing facilities in Texas from an unaffiliated third party, which facilities are included in the underlying collateral pool securing our debt security investment. We acquired the seven facilities by assuming the outstanding principal balance of each related mortgage loan payable from one of the borrowers as such borrower was in default on the required debt payments. We did not grant any concessions to such borrowers and the carrying value of our debt security investment at the time of acquisition did not exceed the fair value of such facilities. See Note 4, Business Combinations — 2022 Business Combinations, for a further discussion of such acquisitions.

As of December 31, 2022 and 2021, the carrying amount of the debt security investment was $83,000,000 and $79,315,000, respectively, net of unamortized closing costs of $767,000 and $1,004,000, respectively. Accretion on the debt security for the years ended December 31, 2022, 2021 and 2020 was $3,922,000, $3,665,000 and $3,304,000, respectively, which is recorded as an increase to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). Amortization expense of closing costs for the years ended December 31, 2022, 2021 and 2020 was $237,000, $201,000 and $170,000, respectively, which is recorded as a decrease to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). We evaluated credit quality indicators such as the agency ratings and the underlying collateral of such investment in order to determine expected future credit loss. No credit loss was recorded for the years ended December 31, 2022, 2021 and 2020.

**6. Identified Intangible Assets, Net** 

Identified intangible assets, net consisted of the following as of December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| **Amortized intangible assets:** |  |  |
| In-place leases, net of accumulated amortization of $38,930,000 and $28,120,000 as of December 31, 2022 and 2021, respectively (with a weighted average remaining life of 7.0 years and 8.2 years as of December 31, 2022 and 2021, respectively) | $75580000 | $81538000 |
| Above-market leases, net of accumulated amortization of $6,360,000 and $2,082,000 as of December 31, 2022 and 2021, respectively (with a weighted average remaining life of 9.0 years and 9.7 years as of December 31, 2022 and 2021, respectively) | 30194000 | 35106000 |
| Customer relationships, net of accumulated amortization of $785,000 and $635,000 as of December 31, 2022 and 2021, respectively (with a weighted average remaining life of 13.7 years and 14.7 years as of December 31, 2022 and 2021, respectively) | 2055000 | 2205000 |
| Internally developed technology and software, net of accumulated amortization of $399,000 as of December 31, 2021 (with a weighted average remaining life of 0.7 years as of December 31, 2021) |  | 70000 |
| **Unamortized intangible assets:** |  |  |
| Certificates of need | 97667000 | 99165000 |
| Trade names | 30787000 | 30787000 |
|  | $236283000 | $248871000 |

---

Amortization expense on identified intangible assets for the years ended December 31, 2022, 2021 and 2020 was $28,378,000, $22,460,000 and $6,678,000, respectively, which included $4,444,000, $1,349,000 and $420,000, respectively, of amortization recorded as a decrease to real estate revenue for above-market leases in our accompanying consolidated statements of operations and comprehensive income (loss). For the years ended December 31, 2022, 2021 and 2020, we did not incur any impairment losses with respect to intangible assets.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

The aggregate weighted average remaining life of the identified intangible assets was 7.7 years and 8.8 years as of December 31, 2022 and 2021, respectively. As of December 31, 2022, estimated amortization expense on the identified intangible assets for each of the next five years ending December 31 and thereafter was as follows:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $29132000 |
| 2024 | 13735000 |
| 2025 | 10910000 |
| 2026 | 9740000 |
| 2027 | 9104000 |
| Thereafter | 35208000 |
|  | $107829000 |

---

**7. Other Assets, Net** 

Other assets, net consisted of the following as of December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| Deferred rent receivables | $46867000 | $41061000 |
| Prepaid expenses, deposits, other assets and deferred tax assets, net | 25866000 | 22484000 |
| Inventory | 19775000 | 18929000 |
| Lease commissions, net of accumulated amortization of $6,260,000 and $4,911,000 as of December 31, 2022 and 2021, respectively | 19217000 | 16120000 |
| Investments in unconsolidated entities | 9580000 | 15615000 |
| Deferred financing costs, net of accumulated amortization of $5,704,000 and $8,469,000 as of December 31, 2022 and 2021, respectively | 4334000 | 3781000 |
| Lease inducement, net of accumulated amortization of $2,193,000 and $1,842,000 as of December 31, 2022 and 2021, respectively (with a weighted average remaining life of 7.9 years and 8.9 years as of December 31, 2022 and 2021, respectively) | 2807000 | 3158000 |
|  | $128446000 | $121148000 |

---

Deferred financing costs included in other assets, net were related to the 2018 Credit Facility, 2019 Credit Facility, 2019 Trilogy Credit Facility and the senior unsecured revolving credit facility portion of the 2022 Credit Facility. See Note 9, Lines of Credit and Term Loans, for a further discussion. Amortization expense on lease inducement for the years ended December 31, 2022, 2021 and 2020 was $351,000, and is recorded as a decrease to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss). For the years ended December 31, 2022, 2021 and 2020, we did not incur any impairment losses with respect to our investments in unconsolidated entities.

**8. Mortgage Loans Payable, Net** 

As of December 31, 2022 and 2021, mortgage loans payable were $1,254,479,000 ($1,229,847,000, net of discount/premium and deferred financing costs) and $1,116,216,000 ($1,095,594,000, net of discount/premium and deferred financing costs), respectively. As of December 31, 2022, we had 68 fixed-rate mortgage loans payable and 11 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 7.26% per annum based on interest rates in effect as of December 31, 2022 and a weighted average effective interest rate of 5.29%. As of December 31, 2021, we had 66 fixed-rate mortgage loans payable and 12 variable-rate mortgage loans payable with effective interest rates ranging from 2.21% to 5.25% per annum based on interest rates in effect as of December 31, 2021 and a weighted average effective interest rate of 3.21%. We are required by the terms of certain loan documents to meet certain reporting requirements and covenants, such as net worth ratios, fixed charge coverage ratios and leverage ratios.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Mortgage loans payable, net consisted of the following as of December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| Total fixed-rate debt | $885892000 | $845504000 |
| Total variable-rate debt | 368587000 | 270712000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total fixed- and variable-rate debt | 1254479000 | 1116216000 |
| Less: deferred financing costs, net | (8845000) | (8680000) |
| Add: premium | 237000 | 397000 |
| Less: discount | (16024000) | (12339000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Mortgage loans payable, net | $1229847000 | $1095594000 |

---

&nbsp;&nbsp;&nbsp;&nbsp;

The following table reflects the changes in the carrying amount of mortgage loans payable, net for the years ended December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** |
| Beginning balance | $1095594000 | $810478000 |
| Additions: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Borrowings under mortgage loans payable | 186227000 | 407939000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Assumption of mortgage loans payable due to acquisitions of real estate investments, net | 149861000 | 18602000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Amortization of deferred financing costs | 2332000 | 4077000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Amortization of discount/premium on mortgage loans payable | 2242000 | 773000 |
| Deductions: |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Scheduled principal payments on mortgage loans payable | (104384000) | (34616000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Early payoff of mortgage loans payable | (90871000) | (109424000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Payoff of a mortgage loan payable due to disposition of real estate investment | (8637000) |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Deferred financing costs | (2517000) | (2235000) |
| Ending balance | $1229847000 | $1095594000 |

---

For the year ended December 31, 2022, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $2,005,000, which is recorded as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). For the year ended December 31, 2022, such aggregate loss on debt extinguishments was primarily related to the payoff of a mortgage loan payable due to the disposition of a real estate investment, the payoff of a construction loan and the write-off of unamortized loan discount related to eight mortgage loans payable that we refinanced on January 1, 2022 that were due to mature in 2044 through 2052.

For the year ended December 31, 2021, we incurred an aggregate loss on the extinguishment of mortgage loans payable of $2,425,000, which is recorded as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Such loss was primarily related to the write-off of unamortized deferred financing costs of 10 mortgage loans payable that we refinanced on January 29, 2021 and one mortgage loan payable that we refinanced on December 1, 2021 that were due to mature in 2053 and 2049, respectively. For the year ended December 31, 2020, we did not incur any gain or loss on the extinguishment of mortgage loans payable.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

As of December 31, 2022, the principal payments due on our mortgage loans payable for each of the next five years ending December 31 and thereafter were as follows:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $193089000 |
| 2024 | 217952000 |
| 2025 | 165554000 |
| 2026 | 155168000 |
| 2027 | 34423000 |
| Thereafter | 488293000 |
|  | $1254479000 |

---

**9. Lines of Credit and Term Loans**

***2018 Credit Facility***

In order to accommodate the Merger, we amended GAHR IV and its operating partnership's credit agreement, as amended, or the 2018 Credit Agreement, with Bank of America, N.A., or Bank of America; KeyBank, National Association, or KeyBank; Citizens Bank, National Association, or Citizens Bank; Merrill Lynch, Pierce, Fenner & Smith Incorporated; KeyBanc Capital Markets, Inc., or KeyBanc Capital Markets; and the lenders named therein, for a credit facility with an aggregate maximum principal amount of $530,000,000, or the 2018 Credit Facility. The 2018 Credit Facility, which was further amended on October 1, 2021 to provide for updates regarding the Combined Company subsequent to the Merger, consisted of a senior unsecured revolving credit facility in the amount of $235,000,000 and senior unsecured term loan facilities in the aggregate amount of $295,000,000. Unless defined herein, all capitalized terms under this "2018 Credit Facility" subsection are as defined in the 2018 Credit Agreement.

At our option, the 2018 Credit Facility bore interest at per annum rates equal to (a)(i) the Eurodollar Rate, plus (ii) a margin ranging from 1.70% to 2.20% based on our Consolidated Leverage Ratio, or (b)(i) the greater of: (1) the prime rate publicly announced by Bank of America (2) the Federal Funds Rate, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.70% to 1.20% based on our Consolidated Leverage Ratio.

The 2018 Credit Facility was due to mature on November 19, 2021; however, pursuant to the terms of the 2018 Credit Agreement, at such time we extended the maturity date for an additional 12 months and paid an extension fee of $795,000. As of December 31, 2021, borrowings outstanding totaled $441,900,000 and the weighted average interest rate on such borrowings outstanding was 2.27% per annum. On January 19, 2022, we terminated the 2018 Credit Agreement and entered into the 2022 Credit Agreement, as defined and discussed below.

***2019 Credit Facility***

Upon consummation of the Merger, we, through the surviving partnership, were subject to GAHR III's credit agreement, as amended, or the 2019 Credit Agreement, with Bank of America; KeyBank; Citizens Bank; and a syndicate of other banks, as lenders, for a credit facility with an aggregate maximum principal amount of $630,000,000, or the 2019 Credit Facility. The 2019 Credit Facility consisted of a senior unsecured revolving credit facility in an aggregate amount of $150,000,000 and a senior unsecured term loan facility in an aggregate amount of $480,000,000. Further, upon consummation of the Merger, the previously available $150,000,000 senior unsecured revolving credit facility was cancelled and a ratable amendment to certain financial covenants was made to account for the Combined Company. Unless defined herein, all capitalized terms under this "2019 Credit Facility" subsection are as defined in the 2019 Credit Agreement.

At our option, the 2019 Credit Facility bore interest at per annum rates equal to (a) (i) the Eurodollar Rate, plus (ii) a margin ranging from 1.85% to 2.80% based on our Consolidated Leverage Ratio, or (b) (i) the greater of: (1) the prime rate publicly announced by Bank of America, (2) the Federal Funds Rate, plus 0.50%, (3) the one-month Eurodollar Rate plus 1.00%, and (4) 0.00%, plus (ii) a margin ranging from 0.85% to 1.80% based on our Consolidated Leverage Ratio.

As of December 31, 2021, borrowings outstanding under the 2019 Credit Facility totaled $480,000,000 and the weighted average interest rate on such borrowings outstanding was 2.60% per annum. The 2019 Credit Agreement was due to mature on January 25, 2022. On January 19, 2022, we, through our operating partnership, entered into an agreement that amended and restated the 2019 Credit Agreement in its entirety, or the 2022 Credit Agreement. See below for a further discussion.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***2022 Credit Facility***

On January 19, 2022, we, through our operating partnership, as borrower, and certain of our subsidiaries, or the subsidiary guarantors, collectively as guarantors, entered into the 2022 Credit Agreement that amended, restated, superseded and replaced the 2019 Credit Agreement and the 2018 Credit Agreement for a credit facility with an aggregate maximum principal amount up to $1,050,000,000, or the 2022 Credit Facility. The 2022 Credit Facility consists of a senior unsecured revolving credit facility in the initial aggregate amount of $500,000,000 and a senior unsecured term loan facility in the initial aggregate amount of $550,000,000. The proceeds of loans made under the 2022 Credit Facility may be used for refinancing existing indebtedness and for general corporate purposes including for working capital, capital expenditures and other corporate purposes not inconsistent with obligations under the 2022 Credit Agreement. We may also obtain up to $25,000,000 in the form of standby letters of credit pursuant to the 2022 Credit Facility. Unless defined herein, all capitalized terms under this "2022 Credit Facility" subsection are as defined in the 2022 Credit Agreement.

Under the terms of the 2022 Credit Agreement, the revolving loans mature on January 19, 2026, and may be extended for one 12-month period, subject to the satisfaction of certain conditions, including payment of an extension fee. The term loan matures on January 19, 2027, and may not be extended. The maximum principal amount of the 2022 Credit Facility may be increased by an aggregate incremental amount of $700,000,000, subject to: (i) the terms of the 2022 Credit Agreement; and (ii) at least five business days' prior written notice to Bank of America.

The 2022 Credit Facility bears interest at varying rates based upon, at our option, (i) Daily SOFR, plus the Applicable Rate for Daily SOFR Rate Loans or (ii) the Term SOFR, plus the Applicable Rate for Term SOFR Rate Loans. If, under the terms of the 2022 Credit Agreement, there is an inability to determine the Daily SOFR or the Term SOFR then the 2022 Credit Facility will bear interest at a rate per annum equal to the Base Rate plus the Applicable Rate for Base Rate Loans. The loans may be repaid in whole or in part without prepayment premium or penalty, subject to certain conditions.

The 2022 Credit Agreement requires us to add additional subsidiaries as guarantors in the event the value of the assets owned by the subsidiary guarantors falls below a certain threshold as set forth in the 2022 Credit Agreement. In the event of default, Bank of America has the right to terminate the commitment of each Lender to make Loans and any obligation of the L/C Issuer to make L/C Credit Extensions under the 2022 Credit Agreement, and to accelerate the payment on any unpaid principal amount of all outstanding loans and interest thereon.

As of December 31, 2022, our aggregate borrowing capacity under the 2022 Credit Facility was $1,050,000,000, excluding the $25,000,000 in standby letters of credit described above. As of December 31, 2022, borrowings outstanding under the 2022 Credit Facility totaled $965,900,000 ($965,060,000, net of deferred financing costs related to the senior unsecured term loan facility portion of the 2022 Credit Facility) and the weighted average interest rate on such borrowings outstanding was 6.07% per annum.

In January 2022, in connection with the 2022 Credit Agreement, we incurred an aggregate $3,161,000 loss on the extinguishment of a portion of senior unsecured term loans which formed part of the 2018 Credit Facility and the 2019 Credit Facility. Such loss on extinguishment of debt is recorded as an increase to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss), and primarily consisted of lender fees we paid to obtain the 2022 Credit Facility.

***2019 Trilogy Credit Facility***

Upon consummation of the Merger, through Trilogy RER, LLC, we became subject to an amended and restated loan agreement, or the 2019 Trilogy Credit Agreement, among certain subsidiaries of Trilogy OpCo, LLC, Trilogy RER, LLC, and Trilogy Pro Services, LLC; KeyBank; CIT Bank, N.A.; Regions Bank; KeyBanc Capital Markets, Inc.; Regions Capital Markets; Bank of America; The Huntington National Bank; and a syndicate of other banks, as lenders named therein, with respect to a senior secured revolving credit facility that had an aggregate maximum principal amount of $360,000,000, consisting of: (i) a $325,000,000 secured revolver supported by real estate assets and ancillary business cash flow and (ii) a $35,000,000 accounts receivable revolving credit facility supported by eligible accounts receivable, or the 2019 Trilogy Credit Facility. The proceeds of the 2019 Trilogy Credit Facility may be used for acquisitions, debt repayment and general corporate purposes. The maximum principal amount of the 2019 Trilogy Credit Facility may have been increased by up to $140,000,000, for a total principal amount of $500,000,000, subject to certain conditions.

On December 20, 2022, we entered into an amendment to the 2019 Trilogy Credit Agreement, or the 2019 Trilogy Credit Amendment. The material terms of the 2019 Trilogy Credit Amendment provided for an increase to the secured revolver amount from $325,000,000 to $365,000,000, thereby increasing our aggregate maximum principal amount from $360,000,000

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

to $400,000,000. As a result, the maximum principal amount of the 2019 Trilogy Credit Facility may be increased by up to $100,000,000. In addition, all references to the London Inter-bank Offered Rate, or LIBOR, were replaced with the Secured Overnight Financing Rate, or SOFR. Unless defined herein, all capitalized terms under this "2019 Trilogy Credit Facility" subsection are defined in the 2019 Trilogy Credit Amendment.

The 2019 Trilogy Credit Facility matures on September 5, 2023 and may be extended for one 12-month period during the term of the 2019 Trilogy Credit Amendment, subject to the satisfaction of certain conditions, including payment of an extension fee. At our option, the 2019 Trilogy Credit Facility bears interest at per annum rates equal to (a) SOFR, plus 2.75% for SOFR Rate Loans, as defined in the 2019 Trilogy Credit Amendment, and (b) for Base Rate Loans, as defined in the 2019 Trilogy Credit Amendment, 1.75% plus the highest of: (i) the fluctuating rate per annum of interest in effect for such day as established from time to time by KeyBank as its prime rate, (ii) 0.50% above the Federal Funds Effective Rate, as defined in the 2019 Trilogy Credit Amendment, and (iii) 1.00% above one-month Adjusted Term SOFR.

As of December 31, 2022 and 2021, our aggregate borrowing capacity under the 2019 Trilogy Credit Facility was $400,000,000 and $360,000,000, respectively. As of December 31, 2022 and 2021, borrowings outstanding under the 2019 Trilogy Credit Facility totaled $316,734,000 and $304,734,000, respectively, and the weighted average interest rate on such borrowings outstanding was 7.17% and 2.85% per annum, respectively.

**10. Derivative Financial Instruments**

We have used derivative financial instruments to manage interest rate risk associated with variable-rate debt. We recorded such derivative financial instruments in our accompanying consolidated balance sheets as either an asset or a liability measured at fair value. We did not have any derivative financial instruments as of December 31, 2022. The following table lists the derivative financial instruments held by us as of December 31, 2021, which were included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets:

---

| | | | | | |
|:---|:---|:---|:---|:---|:---|
| **Instrument** | **Notional Amount** | **Index** | **Interest Rate** | **Maturity Date** | **Fair Value<br>December 31, 2021** |
| Swap | $250000000 | one month LIBOR | 2.10% | 01/25/22 | $332000 |
| Swap | $130000000 | one month LIBOR | 1.98% | 01/25/22 | 162000 |
| Swap | $100000000 | one month LIBOR | 0.20% | 01/25/22 | 6000 |
|  |  |  |  |  | $500000 |

---

As of December 31, 2021, none of our derivative financial instruments were designated as hedges. Derivative financial instruments not designated as hedges are not speculative and are used to manage our exposure to interest rate movements, but do not meet the strict hedge accounting requirements. On January 25, 2022, our interest rate swap contracts matured. For the years ended December 31, 2022, 2021 and 2020, we recorded a gain (loss) in the fair value of derivative financial instruments of $500,000, $8,200,000 and $(3,906,000), respectively, which is included as a decrease/(increase) to interest expense in our accompanying consolidated statements of operations and comprehensive income (loss). Included in the gain in the fair value of derivative instruments recognized for the year ended December 31, 2021 is $823,000 related to the fair value of an interest rate swap entered into by GAHR IV, which matured on November 19, 2021.

See Note 16, Fair Value Measurements, for a further discussion of the fair value of our derivative financial instruments, and Note 22, Subsequent Events — Interest Rate Swap, regarding a derivative instrument contract we entered into in January 2023.

**11. Identified Intangible Liabilities, Net** 

As of December 31, 2022 and 2021, identified intangible liabilities, net consisted of below-market leases of $10,837,000 and $12,715,000, respectively, net of accumulated amortization of $2,508,000 and $1,047,000, respectively. Amortization expense on below-market leases for the years ended December 31, 2022, 2021 and 2020 was $1,848,000, $396,000 and $296,000, respectively, which is recorded as an increase to real estate revenue in our accompanying consolidated statements of operations and comprehensive income (loss).

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

The weighted average remaining life of below-market leases was 8.4 years and 9.1 years as of December 31, 2022 and 2021, respectively. As of December 31, 2022, estimated amortization expense on below-market leases for each of the next five years ending December 31 and thereafter was as follows:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $1596000 |
| 2024 | 1475000 |
| 2025 | 1347000 |
| 2026 | 1198000 |
| 2027 | 1162000 |
| Thereafter | 4059000 |
|  | $10837000 |

---

**12. Commitments and Contingencies** 

***Litigation***

We are not presently subject to any material litigation nor, to our knowledge, is any material litigation threatened against us, which if determined unfavorably to us, would have a material adverse effect on our consolidated financial position, results of operations or cash flows.

***Environmental Matters***

We follow a policy of monitoring our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material effect on our consolidated financial position, results of operations or cash flows. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that we believe would require additional disclosure or the recording of a loss contingency.

***Other***

Our other commitments and contingencies include the usual obligations of real estate owners and operators in the normal course of business, which include calls/puts to sell/acquire properties. In our view, these matters are not expected to have a material adverse effect on our consolidated financial position, results of operations or cash flows.

**13. Redeemable Noncontrolling Interests** 

As a result of the Merger and the AHI Acquisition, as of December 31, 2022 and 2021, we, through our direct and indirect subsidiaries, owned an approximately 95.0% and 94.9% general partnership interest, respectively, in our operating partnership and the remaining approximate 5.0% and 5.1% limited partnership interest, respectively, in our operating partnership is owned by the NewCo Sellers. Some of the limited partnership units outstanding, which account for approximately 1.0% of our total operating partnership units outstanding, have redemption features outside of our control and are accounted for as redeemable noncontrolling interests presented outside of permanent equity in our accompanying consolidated balance sheets. The issuance of our surviving operating partnership units in connection with the AHI acquisition was accounted for separately from the business combination as an equity transaction under ASC Topic 810. The transaction resulted in an increase in redeemable noncontrolling interests of $19,392,000 offset to additional paid-in capital for the year ended December 31, 2021. The adjustment to accumulated other comprehensive income was nominal.

Prior to the Merger, our former advisor owned all 51 limited partnership units outstanding in our operating partnership, and, therefore, we owned greater than a 99.99% general partnership interest in our operating partnership, and our former advisor owned less than a 0.01% limited partnership interest in our operating partnership. Our former advisor was entitled to special redemption rights of its limited partnership units. The noncontrolling interest of our former advisor in our operating partnership that had redemption features outside of our control was accounted for as a redeemable noncontrolling interest and was presented outside of permanent equity in our accompanying consolidated balance sheets. In connection with the AHI Acquisition, on October 1, 2021, we redeemed all 51 limited partnership units in our operating partnership owned by our former advisor for approximately $2,000.

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

As of both December 31, 2022 and 2021, we, through Trilogy REIT Holdings, in which we indirectly hold a 76.0% ownership interest, owned 96.2% and 95.9%, respectively, of the outstanding equity interests of Trilogy. As of December 31, 2022 and 2021, certain members of Trilogy's management and certain members of an advisory committee to Trilogy's board of directors owned approximately 3.8% and 4.1%, respectively, of the outstanding equity interests of Trilogy. The noncontrolling interests held by such members have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying consolidated balance sheets. In October 2022, we redeemed a portion of the equity interests owned by certain previous or current members of Trilogy's management and advisory committee for cash of $3,707,000.

As a result of the Merger and through our operating partnership, as of December 31, 2022 and 2021, we own approximately 98.0% of the joint ventures with an affiliate of Meridian, that own Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF and Pinnacle Warrenton ALF. The noncontrolling interests held by Meridian have redemption features outside of our control and are accounted for as redeemable noncontrolling interests in our accompanying consolidated balance sheets. See Note 3, Real Estate Investments, Net — Disposition of Real Estate, for dispositions within our Central Florida Senior Housing Portfolio.

Also as a result of the Merger, we acquired approximately 90.0% of the joint venture with Avalon Health Care, Inc., or Avalon, that owned Catalina West Haven ALF and Catalina Madera ALF. The noncontrolling interests held by Avalon had redemption features outside of our control and were accounted for as redeemable noncontrolling interests in our accompanying consolidated balance sheets. As of December 31, 2021, we owned 90.0% of the joint venture with Avalon. On December 1, 2022, we exercised our right to purchase the remaining 10.0% of the joint venture with Avalon for a contract purchase price of $295,000. As such, 10.0% of the net earnings of such joint venture were allocated to redeemable noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss) following the Merger and through November 30, 2022.

We record the carrying amount of redeemable noncontrolling interests at the greater of: (i) the initial carrying amount, increased or decreased for the noncontrolling interests' share of net income or loss and distributions or (ii) the redemption value. The changes in the carrying amount of redeemable noncontrolling interests consisted of the following for the years ended December 31, 2022 and 2021:

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| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| Beginning balance | $72725000 | $40340000 |
| Additional redeemable noncontrolling interests | 273000 | 30236000 |
| Reclassification from equity | 83000 | 5923000 |
| Distributions | (2817000) | (1579000) |
| Repurchase of redeemable noncontrolling interests | (4034000) | (8431000) |
| Adjustment to redemption value | 15773000 | 7380000 |
| Net loss attributable to redeemable noncontrolling interests | (405000) | (1144000) |
| Ending balance | $81598000 | $72725000 |

---

**14. Equity** 

***Preferred Stock***

Pursuant to our charter, we are authorized to issue 200,000,000 shares of our preferred stock, par value $0.01 per share. As of both December 31, 2022 and 2021, no shares of preferred stock were issued and outstanding.

***Common Stock*** 

Pursuant to our charter, as amended, we are authorized to issue 1,000,000,000 shares of our common stock, par value $0.01 per share, whereby 200,000,000 shares are classified as Class T common stock and 800,000,000 shares are classified as Class I common stock. Prior to the Merger, GAHR III issued 42,839,173 shares of its common stock in connection with the GAHR III initial offering and our former advisor owned 5,148 shares of our common stock. In connection with the AHI Acquisition, on October 1, 2021, all 5,148 shares of our common stock owned by our former advisor were redeemed by our operating partnership for $190,000. In addition, on October 1, 2021 and in connection with the AHI Acquisition, our operating partnership also redeemed all 5,208 shares of our Class T common stock owned by GAHR IV Advisor in GAHR IV for

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

approximately $192,000. At the effective time of the REIT Merger and prior to the reverse stock split, each issued and outstanding share of GAHR III's common stock, $0.01 par value per share, was converted into the right to receive 0.9266 shares of GAHR IV's Class I common stock, $0.01 par value per share, resulting in the issuance of 44,909,444 shares, after the effect of the reverse stock split, of Class I common stock to GAHR III's stockholders.

On March 12, 2015, we terminated the primary portion of our initial public offering. We continued to offer shares of our common stock in the GAHR III initial offering pursuant to the Initial DRIP, until the termination of the distribution reinvestment plan portion of the GAHR III initial offering and deregistration of the GAHR III initial offering on April 22, 2015. We continued to issue shares of our common stock pursuant to subsequent distribution reinvestment plan offerings effective on each of March 25, 2015, or the 2015 GAHR III DRIP Offering, and on January 30, 2019, or the 2019 GAHR III DRIP Offering, pursuant to Registration Statements on Form S-3 under the Securities Act of 1933, as amended, or the Securities Act, filed with the SEC. The 2015 GAHR III DRIP Offering was terminated and deregistered on March 29, 2019.

On May 29, 2020, our board authorized the suspension of the 2019 GAHR III DRIP Offering, and consequently, ceased issuing shares pursuant to such offering following the distributions paid in June 2020 to stockholders of record on or prior to the close of business on May 31, 2020. As a result of the Merger, we deregistered the 2019 GAHR III DRIP Offering on October 4, 2021. Further, on October 4, 2021, our board authorized the reinstatement of our distribution reinvestment plan, as amended, or the AHR DRIP, to offer up to $100,000,000 of shares of our common stock pursuant to a Registration Statement on Form S-3 under the Securities Act filed by GAHR IV, or the AHR DRIP Offering. On November 14, 2022, our board suspended the AHR DRIP Offering beginning with the distributions declared, if any, for the quarter ending December 31, 2022. As a result of the suspension of the AHR DRIP, unless and until our board reinstates the AHR DRIP Offering, stockholders who are current participants in the AHR DRIP will be paid future distributions in cash.

We collectively refer to the Initial DRIP portion of the GAHR III initial offering, the 2015 GAHR III DRIP Offering, the 2019 GAHR III DRIP Offering and the AHR DRIP Offering as our DRIP Offerings. See Note 1, Organization and Description of Business — Public Offering, and the "Distribution Reinvestment Plan" section below for a further discussion.

We effected a one-for-four reverse split of our common stock on November 15, 2022 and a corresponding reverse split of the partnership units in our operating partnership. As a result of the Reverse Splits, every four shares of our common stock or four partnership units in our operating partnership were automatically combined and converted into one issued and outstanding share of our common stock of like class, or one partnership unit of like class, as applicable, rounded to the nearest 1/100th share or unit. The Reverse Splits impacted all classes of common stock and partnership units proportionately and had no impact on any stockholder's or partner's ownership percentage. Neither the number of authorized shares nor the par value of the Class T common stock and Class I common stock were ultimately impacted. All numbers of common shares and per share data, as well as partnership units in our operating partnership, in our accompanying consolidated financial statements and related notes have been retroactively adjusted for all periods presented to give effect to the Reverse Splits.

***Distribution Reinvestment Plan***

Prior to the Merger, GAHR III issued 451,385 shares of our common stock pursuant to the Initial DRIP. Following the deregistration of the Initial DRIP on April 22, 2015 as discussed above, we continued to offer shares of our common stock pursuant to the 2015 GAHR III DRIP Offering and 2019 GAHR III DRIP Offering which resulted in a total of $308,501,000 in distributions being reinvested and 7,670,138 shares of common stock being issued. As of December 31, 2022, a total of $91,448,000 in distributions were reinvested that resulted in 2,431,695 shares of common stock being issued pursuant to the AHR DRIP Offering.

Since October 5, 2016, our board had approved and established an estimated per share net asset value, or NAV, annually. Commencing with the distribution payment to stockholders paid in the month following such board approval, shares of our common stock issued pursuant to our distribution reinvestment plan are issued at the current estimated per share NAV until such time as our board determined an updated estimated per share NAV. The following is a summary of the historical estimated

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

per share NAV for GAHR III and the Combined Company, as applicable:

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| | |
|:---|:---|
| **Approval Date by our Board** | **Estimated Per Share NAV<br>(Unaudited)** |
| 10/03/19 | $37.60 |
| 03/18/21 | $34.20 |
| 03/24/22 | $37.16 |
| 03/15/23 | $31.40 |

---

For the years ended December 31, 2022, 2021 and 2020, $36,812,000, $7,666,000 and $21,861,000, respectively, in distributions were reinvested and 992,964, 207,866 and 538,763 shares of our common stock, respectively, were issued pursuant to our DRIP Offerings.

***Share Repurchase Plan***

Our share repurchase plan allowed for repurchases of shares of our common stock by us when certain criteria are met. Share repurchases were made at the sole discretion of our board. Subject to the availability of the funds for share repurchases and other certain conditions, we generally limited the number of shares of our common stock repurchased during any calendar year to 5.0% of the weighted average number of shares of our common stock outstanding during the prior calendar year; provided however, that shares subject to a repurchase requested upon the death or "qualifying disability," as defined in our share repurchase plan, of a stockholder were not subject to this cap. Funds for the repurchase of shares of our common stock came from the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP Offerings.

Pursuant to our share repurchase plan, the repurchase price is equal to the lesser of (i) the amount per share that a stockholder paid for their shares of our common stock, or (ii) the most recent estimated value of one share of our common stock, as determined by our board, except that the repurchase price with respect to repurchases resulting from the death or qualifying disability of stockholders was equal to the most recently published estimated per share NAV. On October 4, 2021, as a result of the Merger, our board authorized the partial reinstatement of our share repurchase plan with respect to requests to repurchase shares resulting from the death or qualifying disability of stockholders, effective with respect to qualifying repurchases for the fiscal quarter ending December 31, 2021. All share repurchase requests other than those requests resulting from the death or qualifying disability of stockholders were rejected. On November 14, 2022, our board suspended our share repurchase plan beginning with share repurchase requests for the quarter ending December 31, 2022. All share repurchase requests, including requests resulting from the death or qualifying disability of stockholders, commencing with the quarter ended December 31, 2022, will not be processed, will be considered canceled in full and will not be considered outstanding repurchase requests.

For the years ended December 31, 2022, 2021 and 2020, we repurchased 559,195, 10,356 and 558,476 shares of our common stock, respectively, for an aggregate of $20,699,000, $382,000 and $23,107,000, respectively, at an average repurchase price of $37.02, $36.88 and $38.32 per share, respectively, pursuant to our share repurchase plan. All shares were repurchased using the cumulative proceeds we received from the sale of shares of our common stock pursuant to our DRIP Offerings.

***Noncontrolling Interests in Total Equity***

As of December 31, 2022 and 2021, Trilogy REIT Holdings owned approximately 96.2% and 95.9%, respectively, of Trilogy. Prior to October 1, 2021, we were the indirect owner of a 70.0% interest in Trilogy REIT Holdings pursuant to an amended joint venture agreement with an indirect, wholly owned subsidiary of NorthStar Healthcare Income, Inc., or NHI, and a wholly owned subsidiary of GAHR IV Operating Partnership. We serve as the managing member of Trilogy REIT Holdings. As part of the Merger, the wholly owned subsidiary of GAHR IV Operating Partnership sold its 6.0% interest in Trilogy REIT Holdings to GAHR III, thereby increasing our indirect ownership in Trilogy REIT Holdings to 76.0%. Through September 30, 2021, 30.0% of the net earnings of Trilogy REIT Holdings were allocated to noncontrolling interests, and since October 1, 2021, 24.0% of the net earnings of Trilogy REIT Holdings were allocated to a noncontrolling interest.

In connection with our acquisition and operation of Trilogy, profit interest units in Trilogy, or the Profit Interests, were issued to Trilogy Management Services, LLC and an independent director of Trilogy, both unaffiliated third parties that manage or direct the day-to-day operations of Trilogy. The Profit Interests consisted of time-based or performance-based commitments. The time-based Profit Interests were measured at their grant date fair value and vest in increments of 20.0% on each anniversary of the respective grant date over a five year period. We amortized the time-based Profit Interests on a straight-line basis over the

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

vesting periods, which are recorded to general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss). The performance-based Profit Interests were subject to a performance commitment and would have vested upon liquidity events as defined in the Profit Interests agreements. The performance-based Profit Interests were measured at their fair value on the adoption date of ASU 2018-07, *Improvements to Nonemployee Share-Based Payment Accounting*, using a modified retrospective approach. The nonvested awards are presented as noncontrolling interests in total equity in our accompanying consolidated balance sheets, and are re-classified to redeemable noncontrolling interests upon vesting as they had redemption features outside of our control similar to the common stock units held by Trilogy's management. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.

In December 2021, we redeemed a part of the time-based Profit Interests, and all of the performance-based Profit Interests that were included in noncontrolling interests in total equity. We redeemed such Profit Interests for $16,517,000, which was paid $8,650,000 in cash and $7,867,000 through the issuance of additional equity interests in Trilogy that are classified as redeemable noncontrolling interests in our consolidated balance sheets. There were no canceled, expired or exercised Profit Interests during the years ended December 31, 2022 and 2020. For the years ended December 31, 2022, 2021 and 2020, we recognized stock compensation expense related to the Profit Interests of $83,000, $8,801,000 and $(1,342,000), respectively.

One of our consolidated subsidiaries issued non-voting preferred shares of beneficial interests to qualified investors for total proceeds of $125,000. These preferred shares of beneficial interests are entitled to receive cumulative preferential cash dividends at the rate of 12.5% per annum. We classify the value of the subsidiary's preferred shares of beneficial interests as noncontrolling interests in our accompanying consolidated balance sheets and the dividends of the preferred shares of beneficial interests in net income or loss attributable to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss).

As of both December 31, 2022 and 2021, we owned an 86.0% interest in a consolidated limited liability company that owns Lakeview IN Medical Plaza. As such, 14.0% of the net earnings of Lakeview IN Medical Plaza were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss) for the years ended December 31, 2022, 2021 and 2020.

As of both December 31, 2022 and 2021, we owned a 90.6% membership interest in a consolidated limited liability company that owns Southlake TX Hospital. On April 7, 2020, we sold a 9.4% membership interest in a consolidated limited liability company that owns Southlake TX Hospital to an unaffiliated third party for a contract purchase price of $11,000,000. For the year ended December 31, 2020, our former advisor agreed to waive the $220,000 disposition fee that may have otherwise been due to our former advisor pursuant to the Advisory Agreement. As such, 9.4% of the net earnings of Southlake TX Hospital were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss) since April 7, 2020.

Upon consummation of the Merger, through our operating partnership, we acquired an approximate 90.0% interest in a joint venture that owns the Louisiana Senior Housing Portfolio. As such, 10.0% of the net earnings of the joint venture were allocated to noncontrolling interests in our accompanying consolidated statements of operations and comprehensive income (loss) since October 1, 2021.

As discussed in Note 1, Organization and Description of Business, as a result of the Merger and the AHI Acquisition, as of December 31, 2022 and 2021, we, through our direct and indirect subsidiaries, own an approximately 95.0% and 94.9% general partnership interest, respectively, in our operating partnership and the remaining approximate 5.0% and 5.1% limited partnership interests, respectively, in our operating partnership are owned by the NewCo Sellers. As of December 31, 2022 and 2021, approximately 4.0% and 4.1% of our total operating partnership units outstanding, respectively, is presented in total equity in our accompanying consolidated balance sheets. See Note 13, Redeemable Noncontrolling Interests, for a further discussion.

***Equity Compensation Plans***

*GAHR III 2013 Incentive Plan*

Prior to the REIT Merger, GAHR III adopted the Griffin-American Healthcare REIT III, Inc. Incentive Plan, or the 2013 Incentive Plan, pursuant to which its board, or a committee of its independent directors, could grant options, shares of our common stock, stock purchase rights, stock appreciation rights or other awards to its independent directors, employees and consultants. The maximum number of shares of common stock that could have been issued pursuant to the 2013 Incentive Plan was 463,300 shares.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Under the 2013 Incentive Plan, GAHR III granted an aggregate of 33,750 shares of its restricted common stock, or I RSAs as defined below, which is equal to 31,273 shares of restricted Class I common stock, using the conversion ratio of 0.9266 shares of GAHR IV Class I common stock for each share of GAHR III restricted common stock, as determined in the Merger. Such restricted shares vest as to 20.0% of the shares on the date of grant and on each anniversary thereafter over four years from the date of grant, and are subject to continuous service through the vesting dates. For the year ended December 31, 2020, under the 2013 Incentive Plan, GAHR III granted an aggregate of 1,737 I RSAs at a weighted average grant date fair value of $40.58 per share to its independent directors in connection with their re-election to its board. As of the Merger date, 4,170 shares such I RSAs remained unvested with a weighted average grant date fair value of $40.38. For the year ended December 31, 2020, GAHR III recognized stock compensation expense related to its independent director grants of $155,000.

*AHR 2015 Incentive Plan*

Upon consummation of the Merger, we adopted the Amended and Restated 2015 Incentive Plan, or the AHR Incentive Plan, pursuant to which our board (with respect to options and restricted shares of common stock granted to independent directors), or our compensation committee (with respect to any other award), may make grants of options, restricted shares of common stock, stock purchase rights, stock appreciation rights or other awards to our independent directors, officers, employees and consultants. The maximum number of shares of our common stock that may be issued pursuant to the AHR Incentive Plan is 1,000,000 shares.

Restricted common stock

Pursuant to the AHR Incentive Plan, through December 31, 2022, we granted an aggregate of 289,303 shares of our restricted common stock, or RSAs. Shares of our restricted common stock include restricted Class T common stock, or T RSAs, and restricted Class I common stock, or I RSAs. RSAs were granted to our independent directors in connection with their initial election or re-election to our board or in consideration of their past services rendered. In addition, certain executive officers and key employees received grants of T RSAs, as defined in the AHR Incentive Plan. RSAs generally have a vesting period ranging from one to four years and are subject to continuous service through the vesting dates.

Restricted stock units

Pursuant to the AHR Incentive Plan, through December 31, 2022, we granted to our executive officers an aggregate 29,352 of performance-based restricted stock units, or PBUs, representing the right to receive shares of our Class T common stock upon vesting. We also granted to certain employees 19,200 time-based restricted stock units, or TBUs, representing the right to receive shares of our Class T common stock upon vesting. PBUs and TBUs are collectively referred to as RSUs. RSUs granted to executive officers and employees, generally have a vesting period of up to three years and are subject to continuous service through the vesting dates, and any performance conditions, as applicable.

A summary of the status of our nonvested RSAs and RSUs as of December 31, 2022 and 2021 and the changes for the year ended December 31, 2022 is presented below:

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| | | | | |
|:---|:---|:---|:---|:---|
| | **Number of <br>Nonvested<br>RSAs** | **Weighted <br>Average<br>Grant Date<br>Fair Value** | **Number of <br>Nonvested<br>RSUs** | **Weighted <br>Average<br>Grant Date<br>Fair Value** |
| Balance — December 31, 2021 | 222886 | $36.99 |  | $— |
| Granted | 18689 | 37.16 | 60077 | 37.16 |
| Vested | (58335) | 37.14 |  |  |
| Forfeited |  |  | (11524) | 37.16 |
| Balance — December 31, 2022 | 183240 | $36.97 | 48553 | $37.16 |

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For the years ended December 31, 2022 and 2021, pursuant to the AHR Incentive Plan, we granted 18,689 and 213,091 shares of our restricted common stock, respectively, at a weighted average grant date fair value of $37.16 and $36.88 per share, respectively, to our executives and to our independent directors in connection with their election or re-election to our board. For the years ended December 31, 2022 and 2021, we recognized stock compensation expense related to awards granted pursuant to the AHR Incentive Plan of $3,935,000 and $816,000, respectively, based on the grant date fair value, which is equal to the most recently published estimated per share NAV. As of December 31, 2022 and 2021, there was $6,888,000 and $7,233,000, respectively, of total unrecognized compensation expense, net of estimated forfeitures, related to nonvested RSAs and RSUs.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

As of December 31, 2022, this expense is expected to be recognized over a remaining weighted average period of 1.9 years. In addition, in October 2022, we repurchased 11,679 shares of our common stock, for an aggregate of $434,000, at a repurchase price of $37.16 per share in order to satisfy minimum statutory withholding tax obligations associated with the vesting of restricted stock awards issued pursuant to the AHR Incentive Plan.

***Stockholder Servicing Fee***

Upon consummation of the Merger, we assumed GAHR IV's obligations related to stockholder servicing fees. Such fees are paid quarterly with respect to our Class T shares sold in GAHR IV's initial public offering as additional compensation to participating broker-dealers. No stockholder servicing fee is paid with respect to Class I shares or shares of our common stock sold pursuant to our DRIP Offerings. The stockholder servicing fee accrued daily in an amount equal to 1/365th of 1.0% of the purchase price per share of our Class T shares sold in the primary portion of GAHR IV's public offering. We will cease paying the stockholder servicing fee upon the occurrence of certain defined events, such as our redemption of such Class T shares. By agreement with participating broker-dealers, such stockholder servicing fee may have been reduced or limited.

Following the termination of GAHR IV's public offering on February 15, 2019, we no longer incur additional stockholder servicing fees. As of December 31, 2022 and 2021, we accrued $339,000 and $1,583,000, respectively, in connection with the stockholder servicing fee payable, which is included in accounts payable and accrued liabilities in our accompanying consolidated balance sheet.

**15. Related Party Transactions** 

***Fees and Expenses Paid to Affiliates***

Prior to the closing of the AHI Acquisition, our former advisor used its best efforts, subject to the oversight and review of our board, to, among other things, provide asset management, property management, acquisition, disposition and other advisory services on our behalf consistent with our investment policies and objectives. Our former advisor performed its duties and responsibilities under the Advisory Agreement as our fiduciary. Until September 30, 2021, all of our executive officers were officers of our former advisor and officers, limited partners and/or members of one of our former co-sponsors and other affiliates of our former advisor.

On December 20, 2021, the Advisory Agreement was assigned to NewCo and as a result, any fees that would have otherwise been payable to our former advisor are no longer being paid to a third party. Following the consummation of the Merger in October 2021, we became self-managed and as a result we no longer incur any fees or expense reimbursements to our former advisor and its affiliates arising from the Advisory Agreement.

We did not incur any fees and expenses to our third-party affiliates for the year ended December 31, 2022. Fees and expenses incurred to our former advisor or its affiliates for the years ended December 31, 2021 and 2020 were as follows:

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| | | |
|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2021** | **2020** |
| Asset management fees(1) | $16187000 | $20693000 |
| Property management fees(2) | 1993000 | 2632000 |
| Acquisition fees(3) | 1363000 | 480000 |
| Development fees(4) | 856000 | 1073000 |
| Lease fees(5) | 410000 | 579000 |
| Operating expenses(6) | 160000 | 235000 |
| Construction management fees(7) | 144000 | 183000 |
|  | $21113000 | $25875000 |

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___________

(1)Asset management fees were included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss).

(2)Property management fees were included in rental expenses or general and administrative expenses in our accompanying consolidated statements of operations and comprehensive income (loss), depending on the property type from which the fee was incurred.

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**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

(3)Acquisition fees in connection with the acquisition of properties accounted for as asset acquisitions or the acquisition of real estate-related investments were capitalized as part of the associated investments in our accompanying consolidated balance sheets.

(4)Development fees were capitalized as part of the associated investments in our accompanying consolidated balance sheets.

(5)Lease fees were capitalized as costs of entering into new leases and included in other assets, net in our accompanying consolidated balance sheets.

(6)We reimbursed our former advisor or its affiliates for operating expenses incurred in rendering services to us, subject to certain limitations. For the 12 months ended December 31, 2021 and 2020, our operating expenses did not exceed such limitations. Operating expenses were generally included in general and administrative in our accompanying consolidated statements of operations and comprehensive income (loss).

(7)Construction management fees were capitalized as part of the associated asset and included in real estate investments, net in our accompanying consolidated balance sheets.

***Registration Rights Agreement***

Upon consummation of the AHI Acquisition, GAHR III and the surviving partnership entered into a registration rights agreement, or the Registration Rights Agreement, with Griffin-American Strategic Holdings, LLC, or HoldCo, pursuant to which, subject to certain limitations therein, as promptly as practicable following the later of the expiration of (i) the period commencing on the closing of the AHI Acquisition and ending upon the earliest to occur of (a) the second anniversary date of the issuance of the surviving partnership OP units issued in connection with the AHI Acquisition, (b) a change of control of Merger Sub, and (c) the listing of shares of our common stock on a national securities exchange, or the Lock-Up Period; and (ii) the date on which we are eligible to file a registration statement (but in any event no later than 180 days after such date), we, as the indirect parent company of the surviving partnership, are required to file a shelf registration statement with the SEC under the Securities Act covering the resale of the shares of our Class I common stock issued or issuable in redemption of the surviving partnership OP units that the surviving partnership issued as consideration in the AHI Acquisition. The Registration Rights Agreement also grants HoldCo (or any successor holder of such shares) demand rights to request additional registration statement filings as well as "piggyback" registration rights, in each case on or after the expiration of the Lock-Up Period. In connection with the Merger, we assumed from GAHR III the Registration Rights Agreement and GAHR III's obligations thereunder in their entirety.

***Accounts Payable Due to Affiliates***

We did not have any amounts outstanding to our third-party affiliates as of December 31, 2022. The following amounts were outstanding to our affiliates as of December 31, 2021:

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| | |
|:---|:---|
| **Fee** | **Amount** |
| Lease commissions | $245000 |
| Development fees | 229000 |
| Construction management fees | 152000 |
| Operating expenses | 100000 |
| Asset and property management fees | 83000 |
| Acquisition fees | 57000 |
|  | $866000 |

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**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

**16. Fair Value Measurements**

***Assets and Liabilities Reported at Fair Value***

We did not have any assets and liabilities measured at fair value on a recurring basis as of December 31, 2022. The table below presents our assets and liabilities measured at fair value on a recurring basis as of December 31, 2021, aggregated by the level in the fair value hierarchy within which those measurements fall:

---

| | | | | |
|:---|:---|:---|:---|:---|
| | **Quoted Prices in<br>Active Markets for<br>Identical Assets<br>and Liabilities<br>(Level 1)** | **Significant Other<br>Observable Inputs<br>(Level 2)** | **Significant<br>Unobservable<br>Inputs<br>(Level 3)** | **Total** |
| **<u>Liabilities:</u>** | | | | |
| Derivative financial instruments | $— | $500000 | $— | $500000 |
| Warrants |  |  | 786000 | 786000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total liabilities at fair value | $— | $500000 | $786000 | $1286000 |

---

There were no transfers into and out of fair value measurement levels during the years ended December 31, 2022 and 2021.

*Warr*ants

During the fourth quarter of 2022, we redeemed all the warrants in common units held by certain members of Trilogy's management for $678,000 in cash and as a result, we did not have any warrants outstanding as of December 31, 2022. As of December 31, 2021, we recorded $786,000 related to warrants in Trilogy common units held by certain members of Trilogy's management, which was included in security deposits, prepaid rent and other liabilities in our accompanying consolidated balance sheets. Such warrants had redemption features similar to the common units held by members of Trilogy's management. See Note 13, Redeemable Noncontrolling Interests, for a further discussion. As of December 31, 2021, the carrying value was a reasonable estimate of fair value.

*Derivative Financial Instruments*

On January 25, 2022, our interest rate swap contracts matured and as of December 31, 2022, we did not have any derivative financial instruments. We used interest rate swaps or interest rate caps to manage interest rate risk associated with variable-rate debt. The valuation of these instruments was determined using widely accepted valuation techniques including a discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflected the contractual terms of the derivatives, including the period to maturity, and used observable market-based inputs, including interest rate curves, as well as option volatility. The fair values of interest rate swaps were determined by netting the discounted future fixed cash payments and the discounted expected variable cash receipts. The variable cash receipts were based on an expectation of future interest rates derived from observable market interest rate curves.

We incorporated credit valuation adjustments to appropriately reflect both our own nonperformance risk and the respective counterparty's nonperformance risk in the fair value measurements. In adjusting the fair value of our derivative contracts for the effect of nonperformance risk, we considered the impact of netting and any applicable credit enhancements, such as collateral postings, thresholds, mutual puts and guarantees.

Although we determined that the majority of the inputs used to value our derivative financial instruments fell within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments utilized Level 3 inputs, such as estimates of current credit spreads, to evaluate the likelihood of default by us and our counterparty. However, as of December 31, 2021, we assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our derivative positions and determined that the credit valuation adjustments were not significant to the overall valuation of our derivatives. As a result, we determined that our derivative valuations in their entirety were classified in Level 2 of the fair value hierarchy.

***Financial Instruments Disclosed at Fair Value***

Our accompanying consolidated balance sheets include the following financial instruments: debt security investment, cash and cash equivalents, restricted cash, accounts and other receivables, accounts payable and accrued liabilities, accounts payable due to affiliates, mortgage loans payable and borrowings under our lines of credit and term loans.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

We consider the carrying values of cash and cash equivalents, restricted cash, accounts and other receivables and accounts payable and accrued liabilities to approximate the fair value for these financial instruments based upon an evaluation of the underlying characteristics, market data and because of the short period of time between origination of the instruments and their expected realization. The fair value of accounts payable due to affiliates is not determinable due to the related party nature of the accounts payable. The fair values of the other financial instruments are classified in Level 2 of the fair value hierarchy.

The fair value of our debt security investment is estimated using a discounted cash flow analysis using interest rates available to us for investments with similar terms and maturities. The fair values of our mortgage loans payable and our lines of credit and term loans are estimated using discounted cash flow analyses using borrowing rates available to us for debt instruments with similar terms and maturities. We have determined that the valuations of our debt security investment, mortgage loans payable and lines of credit and term loans are classified in Level 2 within the fair value hierarchy. The carrying amounts and estimated fair values of such financial instruments as of December 31, 2022 and 2021 were as follows:

---

| | | | | |
|:---|:---|:---|:---|:---|
| | **December 31,** | **December 31,** | **December 31,** | **December 31,** |
| | **2022** | **2022** | **2021** | **2021** |
| | **Carrying<br>Amount(1)** | **Fair<br>Value** | **Carrying<br>Amount(1)** | **Fair<br>Value** |
| **Financial Assets:** |  |  |  |  |
| Debt security investment | $83000000 | $93230000 | $79315000 | $93920000 |
| **Financial Liabilities:** |  |  |  |  |
| Mortgage loans payable | $1229847000 | $1091667000 | $1095594000 | $1075729000 |
| Lines of credit and term loans | $1277460000 | $1285205000 | $1222853000 | $1226636000 |

---

___________

(1)Carrying amount is net of any discount/premium and unamortized deferred financing costs.

**17. Income Taxes** 

As a REIT, we generally will not be subject to U.S. federal income tax on taxable income that we distribute to our stockholders. We have elected to treat certain of our consolidated subsidiaries as TRS pursuant to the Code. TRS may participate in services that would otherwise be considered impermissible for REITs and are subject to federal and state income tax at regular corporate tax rates.

The components of income or loss before taxes for the years ended December 31, 2022, 2021 and 2020, were as follows:

---

| | | | |
|:---|:---|:---|:---|
| | **December 31,** | **December 31,** | **December 31,** |
| | **2022** | **2021** | **2020** |
| Domestic | $(72510000) | $(52001000) | $6171000 |
| Foreign | (287000) | (312000) | (386000) |
| (Loss) income before income taxes | $(72797000) | $(52313000) | $5785000 |

---

The components of income tax benefit or expense for the years ended December 31, 2022, 2021 and 2020 were as follows:

---

| | | | |
|:---|:---|:---|:---|
| | **December 31,** | **December 31,** | **December 31,** |
| | **2022** | **2021** | **2020** |
| Federal deferred | $(8176000) | $(12033000) | $(4818000) |
| State deferred | (2099000) | (2908000) | (932000) |
| Federal current |  |  | (361000) |
| State current |  | 329000 |  |
| Foreign current | 586000 | 627000 | 612000 |
| Valuation allowances | 10275000 | 14941000 | 2421000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total income tax expense (benefit) | $586000 | $956000 | $(3078000) |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Current Income Tax*** 

Federal and state income taxes are generally a function of the level of income recognized by our TRS. Foreign income taxes are generally a function of our income on our real estate located in the UK and Isle of Man.

***Deferred Taxes***

Deferred income tax is generally a function of the period's temporary differences (primarily basis differences between tax and financial reporting for real estate assets and equity investments) and generation of tax NOL that may be realized in future periods depending on sufficient taxable income.

We recognize the financial statement effects of an uncertain tax position when it is more likely than not, based on the technical merits of the tax position, that such a position will be sustained upon examination by the relevant tax authorities. If the tax benefit meets the "more likely than not" threshold, the measurement of the tax benefit will be based on our estimate of the ultimate tax benefit to be sustained if audited by the taxing authority. As of both December 31, 2022 and 2021, we did not have any tax benefits or liabilities for uncertain tax positions that we believe should be recognized in our accompanying consolidated financial statements.

We assess the available positive and negative evidence to estimate if sufficient future taxable income will be generated to use the existing deferred tax assets. A valuation allowance is established if we believe it is more likely than not that all or a portion of the deferred tax assets are not realizable. As of both December 31, 2022 and 2021, our valuation allowance fully reserves the net deferred tax assets due to historical losses and inherent uncertainty of future income. We will continue to monitor industry and economic conditions, and our ability to generate taxable income based on our business plan and available tax planning strategies, which would allow us to utilize the tax benefits of the net deferred tax assets and thereby allow us to reverse all, or a portion of, our valuation allowance in the future.

Any increases or decreases to the deferred income tax assets or liabilities are reflected in income tax (expense) benefit in our accompanying consolidated statements of operations and comprehensive income (loss). The components of deferred tax assets and liabilities as of December 31, 2022 and 2021 were as follows:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| **<u>Deferred income tax assets:</u>** |  |  |
| Fixed assets and intangibles | $8271000 | $9870000 |
| Expense accruals and other | 18189000 | 17804000 |
| Net operating loss and other carry forwards | 50101000 | 41164000 |
| Reserves and accruals | 7487000 | 7375000 |
| Allowances for accounts receivable | 2224000 | 1951000 |
| Investments in unconsolidated entities |  | 2611000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total deferred income tax assets | $86272000 | $80775000 |
| **<u>Deferred income tax liabilities:</u>** |  |  |
| Fixed assets and intangibles | $(13626000) | $(18689000) |
| Other — temporary differences | (2676000) | (2467000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total deferred income tax liabilities | $(16302000) | $(21156000) |
| Net deferred income tax assets before valuation allowance | $69970000 | $59619000 |
| Valuation allowances | (69970000) | (59619000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Net deferred income tax assets (liabilities) | $— | $— |

---

At December 31, 2022 and 2021, we had a NOL carryforward of $196,779,000 and $165,321,000, respectively, related to our TRS. These amounts can be used to offset future taxable income, if any. The NOL carryforwards incurred before January 1, 2018 will begin to expire starting 2035, and NOL carryforwards incurred after December 31, 2017 will be carried forward indefinitely.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

***Tax Treatment of Distributions (Unaudited)***

For U.S. federal income tax purposes, distributions to stockholders are characterized as ordinary income, capital gain distributions or nontaxable distributions. Nontaxable distributions will reduce United States stockholders' basis (but not below zero) in their shares. The income tax treatment for distributions reportable for the years ended December 31, 2022, 2021 and 2020 was as follows:

---

| | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2022** | **2021** | **2021** | **2020** | **2020** |
| Ordinary income | $40745000 | 46.5% | $7989000 | 26.3% | $— | —% |
| Capital gain |  |  |  |  |  |  |
| Return of capital | 46890000 | 53.5 | 22406000 | 73.7 | 48842000 | 100 |
|  | $87635000 | 100% | $30395000 | 100% | $48842000 | 100% |

---

Amounts listed above do not include distributions paid on nonvested shares of our restricted common stock which have been separately reported.

**18. Leases** 

***Lessor***

We have operating leases with tenants that expire at various dates through 2050. For the years ended December 31, 2022, 2021 and 2020, we recognized $200,526,000, $136,294,000 and $114,770,000, respectively, of revenues related to operating lease payments, of which $39,278,000 and $23,340,000, $18,452,000, respectively, was for variable lease payments. As of December 31, 2022, the following table sets forth the undiscounted cash flows for future minimum base rents due under operating leases for each of the next five years ending December 31 and thereafter for properties that we wholly own:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $152100000 |
| 2024 | 143219000 |
| 2025 | 130134000 |
| 2026 | 119280000 |
| 2027 | 113207000 |
| Thereafter | 577498000 |
| Total | $1235438000 |

---

***Lessee***

We lease certain land, buildings, furniture, fixtures, campus equipment, office equipment and automobiles. We have lease agreements with lease and non-lease components, which are generally accounted for separately. Most leases include one or more options to renew, with renewal terms that generally can extend at various dates through 2107, excluding extension options. The exercise of lease renewal options is at our sole discretion. Certain leases also include options to purchase the leased property. As of December 31, 2022, we had future lease payments of $144,000 for an operating lease that had not yet commenced. Such operating lease will commence in fiscal year 2023 with a lease term of 8 years.

The depreciable life of assets and leasehold improvements are limited by the expected lease term, unless there is a transfer of title or purchase option reasonably certain of exercise. Certain of our lease agreements include rental payments that are adjusted periodically based on the United States Bureau of Labor Statistics' Consumer Price Index, and may also include other variable lease costs (i.e., common area maintenance, property taxes and insurance). Our lease agreements do not contain any material residual value guarantees or material restrictive covenants.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

The components of lease costs were as follows:

---

| | | | | |
|:---|:---|:---|:---|:---|
| | | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
|<br>**Lease Cost** |<br>**Classification** | **2022** | **2021** | **2020** |
| Operating lease cost(1) | Property operating expenses, rental expenses or general and administrative expenses | $30566000 | $23774000 | $32441000 |
| Finance lease cost |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Amortization of leased assets | Depreciation and amortization | 1249000 | 1447000 | 1891000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest on lease liabilities | Interest expense | 261000 | 384000 | 609000 |
| Sublease income | Resident fees and services revenue or other income | (693000) | (210000) |  |
| Total lease cost |  | $31383000 | $25395000 | $34941000 |

---

___________

(1)Includes short-term leases and variable lease costs, which are immaterial.

Additional information related to our leases for the periods presented below was as follows:

---

| | | | |
|:---|:---|:---|:---|
| | **December 31,** | **December 31,** | **December 31,** |
|<br>**Lease Term and Discount Rate** | **2022** | **2021** | **2020** |
| Weighted average remaining lease term (in years) |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating leases | 12.8 | 16.9 | 13.3 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Finance leases | 2.3 | 3.6 | 1.3 |
| Weighted average discount rate |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Operating leases | 5.69% | 5.52% | 5.77% |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Finance leases | 7.66% | 7.68% | 5.62% |

---

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
|<br>**Supplemental Disclosure of Cash Flows Information** | **2022** | **2021** | **2020** |
| Operating cash outflows related to finance leases | $262000 | $384000 | $609000 |
| Financing cash outflows related to finance leases | $54000 | $170000 | $1235000 |
| Right-of-use assets obtained in exchange for operating lease liabilities | $173832000 | $29523000 | $14302000 |

---

*Operating Leases*

As of December 31, 2022, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as the reconciliation of those cash flows to operating lease liabilities on our accompanying consolidated balance sheet:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $38163000 |
| 2024 | 37621000 |
| 2025 | 37004000 |
| 2026 | 37044000 |
| 2027 | 37673000 |
| Thereafter | 228550000 |
| Total undiscounted operating lease payments | 416055000 |
| Less: interest | 142980000 |
| Present value of operating lease liabilities | $273075000 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

*Finance Leases*

As of December 31, 2022, the following table sets forth the undiscounted cash flows of our scheduled obligations for future minimum payments for each of the next five years ending December 31 and thereafter, as well as a reconciliation of those cash flows to finance lease liabilities:

---

| | |
|:---|:---|
| **Year** | **Amount** |
| 2023 | $61000 |
| 2024 | 75000 |
| 2025 | 31000 |
| 2026 |  |
| 2027 |  |
| Thereafter |  |
| Total undiscounted finance lease payments | 167000 |
| Less: interest | 17000 |
| Present value of finance lease liabilities | $150000 |

---

**19. Segment Reporting** 

As of December 31, 2022, we evaluated our business and made resource allocations based on six reportable business segments: integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals. Our MOBs are typically leased to multiple tenants under separate leases, thus requiring active management and responsibility for many of the associated operating expenses (much of which are, or can effectively be, passed through to the tenants). Our integrated senior health campuses include a range of independent living, assisted living, memory care, skilled nursing services and certain ancillary businesses that are owned and operated utilizing a RIDEA structure. Our skilled nursing and senior housing facilities are single-tenant properties for which we lease the facilities to unaffiliated tenants under triple-net and generally master leases that transfer the obligation for all facility operating costs (including maintenance, repairs, taxes, insurance and capital expenditures) to the tenant. In addition, our senior housing — leased segment includes our debt security investment. Our hospital investments are similarly structured to our leased skilled nursing and senior housing facilities. Our SHOP segment includes senior housing facilities that are owned and operated utilizing a RIDEA structure.

While we believe that net income (loss), as defined by GAAP, is the most appropriate earnings measurement, we evaluate our segments' performance based upon segment net operating income, or NOI. We define segment NOI as total revenues and grant income, less property operating expenses and rental expenses, which excludes depreciation and amortization, general and administrative expenses, business acquisition expenses, interest expense, gain or loss on dispositions of real estate investments, impairment of real estate investments, impairment of goodwill, income or loss from unconsolidated entities, gain on re-measurement of previously held equity interest, foreign currency gain or loss, other income and income tax benefit or expense for each segment. We believe that segment NOI serves as an appropriate supplemental performance measure to net income (loss) because it allows investors and our management to measure unlevered property-level operating results and to compare our operating results to the operating results of other real estate companies and between periods on a consistent basis.

Interest expense, depreciation and amortization and other expenses not attributable to individual properties are not allocated to individual segments for purposes of assessing segment performance. Non-segment assets primarily consist of corporate assets including cash and cash equivalents, other receivables, deferred financing costs and other assets not attributable to individual properties.

Effective upon the Merger, we acquired 92 buildings, or approximately 4,799,000 square feet of GLA, which expanded our portfolio of real estate properties and SHOP within the segments as outlined above.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Summary information for the reportable segments during the years ended December 31, 2022, 2021 and 2020 was as follows:

---

| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Integrated <br>Senior Health <br>Campuses** | **SHOP** | **MOBs** | **Senior <br>Housing — <br>Leased** | **SNFs** | **Hospitals** | **Year Ended** <br>**December 31,** <br>**2022** |
| Revenues and grant income: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Resident fees and services | $1254665000 | $157491000 | $— | $— | $— | $— | $1412156000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Real estate revenue |  |  | 148717000 | 20802000 | 26159000 | 9666000 | 205344000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Grant income | 24820000 | 855000 |  |  |  |  | 25675000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenues and grant income | 1279485000 | 158346000 | 148717000 | 20802000 | 26159000 | 9666000 | 1643175000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Property operating expenses | 1133480000 | 148046000 |  |  |  |  | 1281526000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rental expenses |  |  | 56390000 | 682000 | 2179000 | 433000 | 59684000 |
| Segment net operating income | $146005000 | $10300000 | $92327000 | $20120000 | $23980000 | $9233000 | $301965000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative |  |  |  | $43418000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses |  |  |  | 4388000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization |  | 167957000 |
| Other income (expense): | Other income (expense): | Other income (expense): | Other income (expense): |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | (105956000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | 500000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments |  |  |  | 5481000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | (54579000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of goodwill |  |  |  | (23277000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income from unconsolidated entities | 1407000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on re-measurement of previously held equity interest |  |  |  | 19567000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | (5206000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income |  |  |  | 3064000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | (158999000) |
| Loss before income taxes | Loss before income taxes | Loss before income taxes | Loss before income taxes |  |  |  | (72797000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense |  |  |  | (586000) |
| Net loss |  |  |  |  |  |  | $(73383000) |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

---

| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Integrated <br>Senior Health <br>Campuses** | **SHOP** | **MOBs** | **Senior <br>Housing — <br>Leased** | **SNFs** | **Hospitals** | **Year Ended** <br>**December 31,** <br>**2021** |
| Revenues and grant income: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Resident fees and services | $1025699000 | $98236000 | $— | $— | $— | $— | $1123935000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Real estate revenue |  |  | 97297000 | 16530000 | 17309000 | 10232000 | 141368000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Grant income | 13911000 | 3040000 |  |  |  |  | 16951000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenues and grant income | 1039610000 | 101276000 | 97297000 | 16530000 | 17309000 | 10232000 | 1282254000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Property operating expenses | 943743000 | 86450000 |  |  |  |  | 1030193000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rental expenses |  |  | 36375000 | 366000 | 1507000 | 477000 | 38725000 |
| Segment net operating income | $95867000 | $14826000 | $60922000 | $16164000 | $15802000 | $9755000 | $213336000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative |  |  |  | $43199000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses |  |  |  | 13022000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization |  | 133191000 |
| Other income (expense): | Other income (expense): | Other income (expense): | Other income (expense): |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs, debt discount/premium and loss on debt extinguishments) | (80937000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain in fair value of derivative financial instruments | 8200000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss on dispositions of real estate investments |  |  |  | (100000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investments |  |  |  | (3335000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities |  |  |  | (1355000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency loss |  |  |  | (564000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income |  |  |  | 1854000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | (76237000) |
| Loss before income taxes | Loss before income taxes | Loss before income taxes | Loss before income taxes |  |  |  | (52313000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax expense |  |  |  | (956000) |
| Net loss |  |  |  |  |  |  | $(53269000) |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

---

| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Integrated <br>Senior Health <br>Campuses** | **SHOP** | **MOBs** | **Senior <br>Housing — <br>Leased** | **SNFs** | **Hospitals** | **Year Ended** <br>**December 31,** <br>**2020** |
| Revenues and grant income: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Resident fees and services | $983169000 | $85904000 | $— | $— | $— | $— | $1069073000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Real estate revenue |  |  | 78424000 | 14524000 | 16107000 | 10992000 | 120047000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Grant income | 53855000 | 1326000 |  |  |  |  | 55181000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total revenues and grant income | 1037024000 | 87230000 | 78424000 | 14524000 | 16107000 | 10992000 | 1244301000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Property operating expenses | 929897000 | 63830000 |  |  |  |  | 993727000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rental expenses |  |  | 30216000 | 64000 | 1572000 | 446000 | 32298000 |
| Segment net operating income | $107127000 | $23400000 | $48208000 | $14460000 | $14535000 | $10546000 | $218276000 |
| Expenses: |  |  |  |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;General and administrative |  |  |  | $27007000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Business acquisition expenses |  |  |  | 290000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Depreciation and amortization |  |  |  | 98858000 |
| Other income (expense): | Other income (expense): | Other income (expense): | Other income (expense): |  |  |  |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense: |  |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Interest expense (including amortization of deferred financing costs and debt discount/premium) | (71278000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss in fair value of derivative financial instruments | (3906000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Gain on dispositions of real estate investments |  |  |  | 1395000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investment | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investment | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investment | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Impairment of real estate investment |  |  |  | (11069000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Loss from unconsolidated entities |  |  |  | (4517000) |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency gain | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency gain | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency gain | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Foreign currency gain |  |  |  | 1469000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Other income |  |  |  | 1570000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total net other expense | (86336000) |
| Income before income taxes | Income before income taxes | Income before income taxes | Income before income taxes |  |  |  | 5785000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax benefit | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax benefit | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax benefit | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Income tax benefit |  |  |  | 3078000 |
| Net income |  |  |  |  |  |  | $8863000 |

---

Total assets by reportable segment as of December 31, 2022 and 2021 were as follows:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| Integrated senior health campuses | $2157748000 | $1896608000 |
| MOBs | 1379502000 | 1412247000 |
| SHOP | 635190000 | 625164000 |
| Senior housing — leased | 249576000 | 255555000 |
| SNFs | 245717000 | 252869000 |
| Hospitals | 106067000 | 109834000 |
| Other | 12898000 | 28062000 |
| &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Total assets | $4786698000 | $4580339000 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

As of and for the years ended December 31, 2022 and 2021, goodwill by reportable segment was as follows:

---

| | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|
| | **Integrated <br>Senior Health <br>Campuses** | **MOBs** | **SHOP** | **SNFs** | **Senior <br>Housing — <br>Leased** | **Hospitals** | **Total** |
| Balance **—** December 31, 2020 | $75309000 | $— | $— | $— | $— | $— | $75309000 |
| Goodwill acquired | 44547000 | 47812000 | 23277000 | 8640000 | 5924000 | 4389000 | 134589000 |
| Balance **—** December 31, 2021 | $119856000 | $47812000 | $23277000 | $8640000 | $5924000 | $4389000 | $209898000 |
| Goodwill acquired | 44990000 |  |  |  |  |  | 44990000 |
| Impairment loss |  |  | (23277000) |  |  |  | (23277000) |
| Balance **—** December 31, 2022 | $164846000 | $47812000 | $— | $8640000 | $5924000 | $4389000 | $231611000 |

---

See Note 4, Business Combinations, for a further discussion of goodwill recognized in connection with our business combinations. In connection with our annual assessments of goodwill, we performed the quantitative step one test of the goodwill impairment guidance for each of our reporting units. The fair value of each reporting unit was determined based on various methodologies, including the income approach and the market approach models. We determined that the fair value of the reporting unit under the SHOP reporting segment compared to its carrying value, including goodwill, was lower than its carrying value. As a result, goodwill pertaining to our SHOP reporting segment was fully impaired and we recognized an impairment loss of $23,277,000 in our accompanying consolidated statements of operations and comprehensive income (loss). Therefore, as of December 31, 2022, we did not have any remaining goodwill associated with our SHOP reporting segment.

Our portfolio of properties and other investments are located in the United States, the UK and Isle of Man. Revenues and grant income and assets are attributed to the country in which the property is physically located. The following is a summary of geographic information for our operations for the periods presented:

---

| | | | |
|:---|:---|:---|:---|
| | **Years Ended December 31,** | **Years Ended December 31,** | **Years Ended December 31,** |
| | **2022** | **2021** | **2020** |
| **<u>Revenues and grant income:</u>** |  |  |  |
| United States | $1638557000 | $1277095000 | $1239509000 |
| International | 4618000 | 5159000 | 4792000 |
|  | $1643175000 | $1282254000 | $1244301000 |

---

The following is a summary of real estate investments, net by geographic regions as of December 31, 2022 and 2021:

---

| | | |
|:---|:---|:---|
| | **December 31,** | **December 31,** |
| | **2022** | **2021** |
| **<u>Real estate investments, net:</u>** |  |  |
| United States | $3539453000 | $3466019000 |
| International | 42156000 | 48667000 |
|  | $3581609000 | $3514686000 |

---

**20. Concentration of Credit Risk** 

Financial instruments that potentially subject us to a concentration of credit risk are primarily our debt security investment, cash and cash equivalents, restricted cash and accounts and other receivables. We are exposed to credit risk with respect to our debt security investment, but we believe collection of the outstanding amount is probable. Cash and cash equivalents are generally invested in investment-grade, short-term instruments with a maturity of three months or less when purchased. We have cash and cash equivalents in financial institutions that are insured by the Federal Deposit Insurance Corporation, or FDIC. As of December 31, 2022 and 2021, we had cash and cash equivalents in excess of FDIC insured limits. We believe this risk is not significant. Concentration of credit risk with respect to accounts receivable from tenants and residents is limited. We perform credit evaluations of prospective tenants and security deposits are obtained at the time of property acquisition and upon lease execution.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)**

Based on leases as of December 31, 2022, properties in one state in the United States accounted for 10.0% or more of our total property portfolio's annualized base rent or annualized NOI, which is based on contractual base rent from leases in effect for our non-RIDEA properties and annualized NOI for our SHOP and integrated senior health campuses as of December 31, 2022. Properties located in Indiana accounted for 36.2% of our total property portfolio's annualized base rent or annualized NOI. Accordingly, there is a geographic concentration of risk subject to fluctuations in such state's economy.

Based on leases as of December 31, 2022, our six reportable business segments, integrated senior health campuses, MOBs, SNFs, SHOP, senior housing — leased and hospitals accounted for 46.8%, 33.4%, 7.3%, 6.0%, 3.7% and 2.8%, respectively, of our total property portfolio's annualized base rent or annualized NOI. As of December 31, 2022, none of our tenants at our properties accounted for 10.0% or more of our total property portfolio's annualized base rent or annualized NOI.

**21. Per Share Data** 

Basic earnings (loss) per share for all periods presented are computed by dividing net income (loss) applicable to common stock by the weighted average number of shares of our common stock outstanding during the period. Net income (loss) applicable to common stock is calculated as net income (loss) attributable to controlling interest less distributions allocated to participating securities of $5,967,000, $1,440,000 and $9,000, respectively, for the years ended December 31, 2022, 2021 and 2020. Diluted earnings (loss) per share are computed based on the weighted average number of shares of our common stock and all potentially dilutive securities, if any. TBUs, nonvested shares of our RSAs and limited partnership units of our operating partnership are participating securities and give rise to potentially dilutive shares of our common stock.

As of December 31, 2022 and 2021, there were 183,240 and 891,543 nonvested shares, respectively, of our RSAs outstanding, but such shares were excluded from the computation of diluted earnings per share because such shares were anti-dilutive during these periods. As of both December 31, 2022 and 2021, there were 3,501,976 limited partnership units of our operating partnership outstanding, but such units were also excluded from the computation of diluted earnings per share because such units were anti-dilutive during these periods. As of December 31, 2022, there were 19,200 nonvested TBUs outstanding, which were granted on April 1, 2022, but such units were excluded from the computation of diluted earnings (loss) per share because such restricted stock units were anti-dilutive during the period.

As of December 31, 2022, there were 29,352 nonvested PBUs outstanding, of which 28,301 were awarded in October 2021 and 1,051 were awarded in August 2022, with a grant date in April 2022 and August 2022, respectively, which were treated as contingently issuable shares pursuant to ASC Topic 718, *Compensation — Stock Compensation*. Such contingently issuable shares were excluded from the computation of diluted earnings (loss) per share because they were anti-dilutive during the period.

**22. Subsequent Events**

***Interest Rate Swap***

We, through our operating partnership, entered into an interest rate swap transaction, or the Swap, with Fifth Third Financial Risk Solutions, a division of Fifth Third Bank, an Ohio banking corporation, or Fifth Third, with an effective date of February 1, 2023 and a maturity date of January 19, 2026. We entered into the Swap to mitigate the risk associated with $275,000,000 of our floating rate term loan (without incurring substantial prepayment penalties or defeasance costs typically associated with fixed-rate indebtedness) under our existing 2022 Credit Facility. Beginning on March 1, 2023, we are required to make monthly fixed-rate payments at a rate of 3.74% while the counterparty is obligated to make monthly floating rate payments based on Term SOFR, as defined in the swap agreement.

***2022 Credit Agreement Amendment***

On March 1, 2023, we entered into an amendment to the 2022 Credit Agreement, or the Credit Amendment. The material terms of the Credit Amendment provided for revisions to certain financial covenants for a limited period of time. Except as modified by the terms of the Credit Amendment, the material terms of the 2022 Credit Agreement remain in full force and effect.

***Distributions Declared***

On March 15, 2023, our board authorized a reduced quarterly distribution from $0.40 per share to $0.25 per share to our Class T common stockholders and Class I common stockholders of record as of the close of business on April 4, 2023. The distribution for the quarter commencing January 1, 2023 to March 31, 2023, which will be paid on or about April 18, 2023, represents an annualized distribution rate of $1.00 per share.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| DeKalb Professional Center (Medical Office) | Lithonia, GA | $— | $479000 | $2871000 | $355000 | $479000 | $3226000 | $3705000 | $(921000) | 2008 | 06/06/14 |
| Country Club MOB (Medical Office) | Stockbridge, GA |  | 240000 | 2306000 | 542000 | 240000 | 2848000 | 3088000 | (842000) | 2002 | 06/26/14 |
| Acworth Medical Complex (Medical Office) | Acworth, GA |  | 216000 | 3135000 | 211000 | 216000 | 3346000 | 3562000 | (843000) | 1976/2009 | 07/02/14 |
|  | Acworth, GA |  | 250000 | 2214000 | 187000 | 250000 | 2401000 | 2651000 | (613000) | 1976/2009 | 07/02/14 |
|  | Acworth, GA |  | 104000 | 774000 | 54000 | 104000 | 828000 | 932000 | (251000) | 1976/2009 | 07/02/14 |
| Wichita KS MOB (Medical Office) | Wichita, KS |  | 943000 | 6288000 | 662000 | 943000 | 6950000 | 7893000 | (2055000) | 1980/1996 | 09/04/14 |
| Delta Valley ALF Portfolio (SHOP) | Batesville, MS |  | 331000 | 5103000 | (489000) | 331000 | 4614000 | 4945000 | (1132000) | 1999/2005 | 09/11/14 |
|  | Cleveland, MS |  | 348000 | 6369000 | (953000) | 348000 | 5416000 | 5764000 | (1316000) | 2004 | 09/11/14 |
|  | Springdale, AR |  | 891000 | 6538000 | (769000) | 891000 | 5769000 | 6660000 | (1337000) | 1998/2005 | 01/08/15 |
| Lee's Summit MO MOB (Medical Office) | Lee's Summit, MO |  | 1045000 | 5068000 | 962000 | 1045000 | 6030000 | 7075000 | (1998000) | 2006 | 09/18/14 |
| Carolina Commons MOB (Medical Office) | Indian Land, SC |  | 1028000 | 9430000 | 4379000 | 1028000 | 13809000 | 14837000 | (3594000) | 2009 | 10/15/14 |
| Mount Olympia MOB Portfolio (Medical Office) | Mount Dora, FL |  | 393000 | 5633000 |  | 393000 | 5633000 | 6026000 | (1403000) | 2009 | 12/04/14 |
|  | Olympia Fields, IL |  | 298000 | 2726000 | 92000 | 298000 | 2818000 | 3116000 | (778000) | 2005 | 12/04/14 |
| Southlake TX Hospital (Hospital) | Southlake, TX | 94328000 | 5089000 | 108517000 |  | 5089000 | 108517000 | 113606000 | (23515000) | 2013 | 12/04/14 |
| East Texas MOB Portfolio (Medical Office) | Longview, TX |  |  | 19942000 | 9079000 |  | 29021000 | 29021000 | (5405000) | 2008 | 12/12/14 |
|  | Longview, TX |  | 228000 | 965000 | 187000 | 228000 | 1152000 | 1380000 | (404000) | 1979/1997 | 12/12/14 |
|  | Longview, TX |  | 759000 | 1696000 | 98000 | 759000 | 1794000 | 2553000 | (806000) | 1998 | 12/12/14 |
|  | Longview, TX |  |  | 8027000 |  |  | 8027000 | 8027000 | (2215000) | 2004 | 12/12/14 |
|  | Longview, TX |  |  | 696000 | 40000 |  | 736000 | 736000 | (302000) | 1956 | 12/12/14 |
|  | Longview, TX |  |  | 27601000 | 5373000 |  | 32974000 | 32974000 | (9081000) | 1985/1993/ 2004 | 12/12/14 |
|  | Marshall, TX |  | 368000 | 1711000 | 110000 | 368000 | 1821000 | 2189000 | (780000) | 1970 | 12/12/14 |
| Premier MOB (Medical Office) | Novi, MI |  | 644000 | 10420000 | 1446000 | 644000 | 11866000 | 12510000 | (3367000) | 2006 | 12/19/14 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Independence MOB Portfolio (Medical Office) | Southgate, KY | $— | $411000 | $11005000 | $2436000 | $411000 | $13441000 | $13852000 | $(3561000) | 1988 | 01/13/15 |
|  | Somerville, MA | 29116000 | 1509000 | 46775000 | 6328000 | 1509000 | 53103000 | 54612000 | (11202000) | 1985 | 01/13/15 |
|  | Morristown, NJ | 27209000 | 3763000 | 26957000 | 5158000 | 3764000 | 32114000 | 35878000 | (8864000) | 1980 | 01/13/15 |
|  | Verona, NJ |  | 1683000 | 9405000 | 1969000 | 1683000 | 11374000 | 13057000 | (2741000) | 1970 | 01/13/15 |
|  | Bronx, NY |  |  | 19593000 | 3253000 |  | 22846000 | 22846000 | (5262000) | 1987/1988 | 01/26/15 |
| King of Prussia PA MOB (Medical Office) | King of Prussia, PA |  | 3427000 | 13849000 | 6550000 | 3427000 | 20399000 | 23826000 | (6167000) | 1946/2000 | 01/21/15 |
| North Carolina ALF Portfolio (SHOP) | Clemmons, NC |  | 596000 | 13237000 | (513000) | 596000 | 12724000 | 13320000 | (2880000) | 2014 | 06/29/15 |
|  | Garner, NC |  | 1723000 | 11517000 | 89000 | 1723000 | 11606000 | 13329000 | (1558000) | 2014 | 03/27/19 |
|  | Huntersville, NC |  | 2033000 | 11494000 | (45000) | 2033000 | 11449000 | 13482000 | (2177000) | 2015 | 01/18/17 |
|  | Matthews, NC |  | 949000 | 12537000 | (108000) | 949000 | 12429000 | 13378000 | (1815000) | 2017 | 08/30/18 |
|  | Mooresville, NC |  | 835000 | 15894000 | (571000) | 835000 | 15323000 | 16158000 | (3469000) | 2012 | 01/28/15 |
|  | Raleigh, NC |  | 1069000 | 21235000 | (580000) | 1069000 | 20655000 | 21724000 | (4439000) | 2013 | 01/28/15 |
|  | Wake Forest, NC |  | 772000 | 13596000 | (688000) | 772000 | 12908000 | 13680000 | (2747000) | 2014 | 06/29/15 |
| Orange Star Medical Portfolio (Medical Office and Hospital) | Durango, CO |  | 623000 | 14166000 | 433000 | 623000 | 14599000 | 15222000 | (3245000) | 2004 | 02/26/15 |
|  | Durango, CO |  | 788000 | 10467000 | 1063000 | 788000 | 11530000 | 12318000 | (2653000) | 2004 | 02/26/15 |
|  | Friendswood, TX |  | 500000 | 7664000 | 944000 | 500000 | 8608000 | 9108000 | (2027000) | 2008 | 02/26/15 |
|  | Keller, TX |  | 1604000 | 7912000 | 609000 | 1604000 | 8521000 | 10125000 | (2114000) | 2011 | 02/26/15 |
|  | Wharton, TX |  | 259000 | 10590000 | 1366000 | 259000 | 11956000 | 12215000 | (2532000) | 1987 | 02/26/15 |
| Kingwood MOB Portfolio (Medical Office) | Kingwood, TX |  | 820000 | 8589000 | 463000 | 820000 | 9052000 | 9872000 | (2192000) | 2005 | 03/11/15 |
|  | Kingwood, TX |  | 781000 | 3943000 | 64000 | 781000 | 4007000 | 4788000 | (1025000) | 2008 | 03/11/15 |
| Mt Juliet TN MOB (Medical Office) | Mount Juliet, TN |  | 1188000 | 10720000 | 547000 | 1188000 | 11267000 | 12455000 | (2630000) | 2012 | 03/17/15 |
| Homewood AL MOB (Medical Office) | Homewood, AL |  | 405000 | 6590000 | 34000 | 405000 | 6624000 | 7029000 | (1738000) | 2010 | 03/27/15 |
| Paoli PA Medical Plaza (Medical Office) | Paoli, PA |  | 2313000 | 12447000 | 8469000 | 2313000 | 20916000 | 23229000 | (5034000) | 1951 | 04/10/15 |
|  | Paoli, PA |  | 1668000 | 7357000 | 1883000 | 1668000 | 9240000 | 10908000 | (2712000) | 1975 | 04/10/15 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Glen Burnie MD MOB (Medical Office) | Glen Burnie, MD | $— | $2692000 | $14095000 | $3829000 | $2692000 | $17924000 | $20616000 | $(4831000) | 1981 | 05/06/15 |
| Marietta GA MOB (Medical Office) | Marietta, GA |  | 1347000 | 10947000 | 620000 | 1347000 | 11567000 | 12914000 | (2635000) | 2002 | 05/07/15 |
| Mountain Crest Senior Housing Portfolio (SHOP) | Elkhart, IN |  | 793000 | 6009000 | 529000 | 793000 | 6538000 | 7331000 | (1756000) | 1997 | 05/14/15 |
|  | Elkhart, IN |  | 782000 | 6760000 | 708000 | 782000 | 7468000 | 8250000 | (2114000) | 2000 | 05/14/15 |
|  | Hobart, IN |  | 604000 | 11529000 | (826000) |  | 11307000 | 11307000 | (2807000) | 2008 | 05/14/15 |
|  | LaPorte, IN |  | 392000 | 14894000 | (6187000) |  | 9099000 | 9099000 | (3589000) | 2008 | 05/14/15 |
|  | Mishawaka, IN |  | 3670000 | 14416000 | 1052000 | 3670000 | 15468000 | 19138000 | (3888000) | 1978 | 07/14/15 |
|  | Niles, MI |  | 404000 | 5050000 | 759000 | 404000 | 5809000 | 6213000 | (1557000) | 2000 | 06/11/15 <br>and <br>11/20/15 |
| Nebraska Senior Housing Portfolio (SHOP) | Bennington, NE |  | 981000 | 20427000 | 915000 | 981000 | 21342000 | 22323000 | (4784000) | 2009 | 05/29/15 |
|  | Omaha, NE |  | 1274000 | 38619000 | 1505000 | 1274000 | 40124000 | 41398000 | (8473000) | 2000 | 05/29/15 |
| Pennsylvania Senior Housing Portfolio (SHOP) | Bethlehem, PA |  | 1542000 | 22249000 | 786000 | 1542000 | 23035000 | 24577000 | (5697000) | 2005 | 06/30/15 |
|  | Boyertown, PA | 22932000 | 480000 | 25544000 | 763000 | 480000 | 26307000 | 26787000 | (5766000) | 2000 | 06/30/15 |
|  | York, PA | 12432000 | 972000 | 29860000 | 517000 | 972000 | 30377000 | 31349000 | (6589000) | 1986 | 06/30/15 |
| Southern Illinois MOB Portfolio (Medical Office) | Waterloo, IL |  | 94000 | 1977000 |  | 94000 | 1977000 | 2071000 | (525000) | 2015 | 07/01/15 |
|  | Waterloo, IL |  | 738000 | 6332000 | 583000 | 738000 | 6915000 | 7653000 | (1787000) | 1995 | 07/01/15, <br>12/19/17 <br>and <br>04/17/18 |
|  | Waterloo, IL |  | 200000 | 2648000 | (69000) | 200000 | 2579000 | 2779000 | (621000) | 2011 | 07/01/15 |
| Napa Medical Center (Medical Office) | Napa, CA |  | 1176000 | 13328000 | 2014000 | 1176000 | 15342000 | 16518000 | (4113000) | 1980 | 07/02/15 |
| Chesterfield Corporate Plaza (Medical Office) | Chesterfield, MO |  | 8030000 | 24533000 | 3466000 | 8030000 | 27999000 | 36029000 | (8002000) | 1989 | 08/14/15 |
| Richmond VA ALF (SHOP) | North Chesterfield, VA |  | 2146000 | 56671000 | 826000 | 2146000 | 57497000 | 59643000 | (11349000) | 2009 | 09/11/15 |
| Crown Senior Care Portfolio (Senior Housing) | Peel, Isle of Man |  | 1106000 | 6602000 |  | 1106000 | 6602000 | 7708000 | (1448000) | 2015 | 09/15/15 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
|  | St. Albans, UK | $— | $1115000 | $11723000 | $647000 | $1115000 | $12370000 | $13485000 | $(2669000) | 2015 | 10/08/15 |
|  | Salisbury, UK |  | 1185000 | 11383000 | 37000 | 1185000 | 11420000 | 12605000 | (2461000) | 2015 | 12/08/15 |
|  | Aberdeen, UK |  | 1923000 | 5734000 |  | 1923000 | 5734000 | 7657000 | (1014000) | 1986 | 11/15/16 |
|  | Felixstowe, UK |  | 668000 | 5508000 | 488000 | 668000 | 5996000 | 6664000 | (1070000) | 2010/2011 | 11/15/16 |
|  | Felixstowe, UK |  | 504000 | 2414000 | 326000 | 504000 | 2740000 | 3244000 | (546000) | 2010/2011 | 11/15/16 |
| Washington DC SNF (Skilled Nursing) | Washington, DC | 60100000 | 1194000 | 34200000 |  | 1194000 | 34200000 | 35394000 | (8025000) | 1983 | 10/29/15 |
| Stockbridge GA MOB II (Medical Office) | Stockbridge, GA |  | 499000 | 8353000 | 1540000 | 485000 | 9907000 | 10392000 | (2084000) | 2006 | 12/03/15 |
| Marietta GA MOB II (Medical Office) | Marietta, GA |  | 661000 | 4783000 | 249000 | 661000 | 5032000 | 5693000 | (1160000) | 2007 | 12/09/15 |
| Naperville MOB (Medical Office) | Naperville, IL |  | 392000 | 3765000 | 792000 | 392000 | 4557000 | 4949000 | (1031000) | 1999 | 01/12/16 |
|  | Naperville, IL |  | 548000 | 11815000 | 1536000 | 548000 | 13351000 | 13899000 | (2971000) | 1989 | 01/12/16 |
| Lakeview IN Medical Plaza (Medical Office) | Indianapolis, IN | 20155000 | 2375000 | 15911000 | 9018000 | 2375000 | 24929000 | 27304000 | (6369000) | 1987 | 01/21/16 |
| Pennsylvania Senior Housing Portfolio II (SHOP) | Palmyra, PA | 19114000 | 835000 | 24424000 | 526000 | 835000 | 24950000 | 25785000 | (5870000) | 2007 | 02/01/16 |
| Snellville GA MOB (Medical Office) | Snellville, GA |  | 332000 | 7781000 | 1251000 | 332000 | 9032000 | 9364000 | (1783000) | 2005 | 02/05/16 |
| Lakebrook Medical Center (Medical Office) | Westbrook, CT |  | 653000 | 4855000 | 818000 | 653000 | 5673000 | 6326000 | (1299000) | 2007 | 02/19/16 |
| Stockbridge GA MOB III (Medical Office) | Stockbridge, GA |  | 606000 | 7924000 | 1863000 | 606000 | 9787000 | 10393000 | (2015000) | 2007 | 03/29/16 |
| Joplin MO MOB (Medical Office) | Joplin, MO |  | 1245000 | 9860000 | 54000 | 1245000 | 9914000 | 11159000 | (2409000) | 2000 | 05/10/16 |
| Austell GA MOB (Medical Office) | Austell, GA |  | 663000 | 10547000 | 167000 | 663000 | 10714000 | 11377000 | (2135000) | 2008 | 05/25/16 |
| Middletown OH MOB (Medical Office) | Middletown, OH |  |  | 17389000 | 898000 |  | 18287000 | 18287000 | (3659000) | 2007 | 06/16/16 |
| Fox Grape SNF Portfolio (Skilled Nursing) | Braintree, MA |  | 1844000 | 10847000 | 31000 | 1844000 | 10878000 | 12722000 | (2017000) | 2015 | 07/01/16 |
|  | Brighton, MA |  | 779000 | 2661000 | 334000 | 779000 | 2995000 | 3774000 | (612000) | 1982 | 07/01/16 |
|  | Duxbury, MA |  | 2921000 | 11244000 | 1933000 | 2921000 | 13177000 | 16098000 | (2675000) | 1983 | 07/01/16 |
|  | Hingham, MA |  | 2316000 | 17390000 | (166000) | 2316000 | 17224000 | 19540000 | (3181000) | 1990 | 07/01/16 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
|  | Quincy, MA | $13758000 | $3537000 | $13697000 | $365000 | $3537000 | $14062000 | $17599000 | $(2507000) | 1995 | 11/01/16 |
| Voorhees NJ MOB (Medical Office) | Voorhees, NJ |  | 1727000 | 8451000 | 1695000 | 1727000 | 10146000 | 11873000 | (2358000) | 2008 | 07/08/16 |
| Norwich CT MOB Portfolio (Medical Office) | Norwich, CT |  | 403000 | 1601000 | 1234000 | 403000 | 2835000 | 3238000 | (838000) | 2014 | 12/16/16 |
|  | Norwich, CT |  | 804000 | 12094000 | 834000 | 804000 | 12928000 | 13732000 | (2411000) | 1999 | 12/16/16 |
| New London CT MOB (Medical Office) | New London, CT |  | 669000 | 3479000 | 647000 | 670000 | 4125000 | 4795000 | (1052000) | 1987 | 05/03/17 |
| Middletown OH MOB II (Medical Office) | Middletown, OH |  |  | 3949000 | 592000 |  | 4541000 | 4541000 | (763000) | 2007 | 12/20/17 |
| Homewood Health Campus | Lebanon, IN | 8577000 | 973000 | 9702000 | 1094000 | 1044000 | 10725000 | 11769000 | (2002000) | 2000 | 12/01/15 |
| Ashford Place Health Campus | Shelbyville, IN | 5835000 | 664000 | 12662000 | 1297000 | 854000 | 13769000 | 14623000 | (2656000) | 2004 | 12/01/15 |
| Mill Pond Health Campus | Greencastle, IN | 6905000 | 1576000 | 8124000 | 580000 | 1629000 | 8651000 | 10280000 | (1651000) | 2005 | 12/01/15 |
| St. Andrews Health Campus | Batesville, IN | 4356000 | 552000 | 8213000 | 669000 | 758000 | 8676000 | 9434000 | (1680000) | 2005 | 12/01/15 |
| Hampton Oaks Health Campus | Scottsburg, IN | 6133000 | 720000 | 8145000 | 753000 | 845000 | 8773000 | 9618000 | (1751000) | 2006 | 12/01/15 |
| Forest Park Health Campus | Richmond, IN | 6697000 | 535000 | 9399000 | 607000 | 639000 | 9902000 | 10541000 | (1964000) | 2007 | 12/01/15 |
| The Maples at Waterford Crossing | Goshen, IN | 5681000 | 344000 | 8027000 | 689000 | 350000 | 8710000 | 9060000 | (1521000) | 2006 | 12/01/15 |
| Morrison Woods Health Campus | Muncie, IN | (c) | 1903000 | 21806000 | 1279000 | 1922000 | 23066000 | 24988000 | (3311000) | 2008/2022 | 12/01/15, <br>09/14/16 <br>and <br>03/03/21 |
| Woodbridge Health Campus | Logansport, IN | 8122000 | 228000 | 11812000 | 385000 | 262000 | 12163000 | 12425000 | (2333000) | 2003 | 12/01/15 |
| Bridgepointe Health Campus | Vincennes, IN | 6955000 | 747000 | 7469000 | 1968000 | 901000 | 9283000 | 10184000 | (1594000) | 2002/2022 | 12/01/15 |
| Greenleaf Living Center | Elkhart, IN | 11134000 | 492000 | 12157000 | 1022000 | 521000 | 13150000 | 13671000 | (2432000) | 2000 | 12/01/15 |
| Forest Glen Health Campus | Springfield, OH | 9712000 | 846000 | 12754000 | 928000 | 921000 | 13607000 | 14528000 | (2618000) | 2007 | 12/01/15 |
| The Meadows of Kalida Health Campus | Kalida, OH | 7691000 | 298000 | 7628000 | 291000 | 308000 | 7909000 | 8217000 | (1493000) | 2007 | 12/01/15 |
| The Heritage | Findlay, OH | 12701000 | 1312000 | 13475000 | 539000 | 1440000 | 13886000 | 15326000 | (2695000) | 1975 | 12/01/15 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Genoa Retirement Village | Genoa, OH | $8093000 | $881000 | $8113000 | $760000 | $926000 | $8828000 | $9754000 | $(1736000) | 1985 | 12/01/15 |
| Waterford Crossing | Goshen, IN | 7852000 | 344000 | 4381000 | 959000 | 349000 | 5335000 | 5684000 | (1037000) | 2004 | 12/01/15 |
| St. Elizabeth Healthcare | Delphi, IN | 8644000 | 522000 | 5463000 | 5413000 | 643000 | 10755000 | 11398000 | (1901000) | 1986 | 12/01/15 |
| Cumberland Pointe | West Lafayette, IN | 9160000 | 1645000 | 13696000 | 726000 | 1905000 | 14162000 | 16067000 | (3013000) | 1980 | 12/01/15 |
| Franciscan Healthcare Center | Louisville, KY | 10273000 | 808000 | 8439000 | 1855000 | 910000 | 10192000 | 11102000 | (2117000) | 1975 | 12/01/15 |
| Blair Ridge Health Campus | Peru, IN | 7503000 | 734000 | 11648000 | 738000 | 773000 | 12347000 | 13120000 | (2696000) | 2001 | 12/01/15 |
| Glen Oaks Health Campus | New Castle, IN | 5002000 | 384000 | 8189000 | 247000 | 413000 | 8407000 | 8820000 | (1547000) | 2011 | 12/01/15 |
| Covered Bridge Health Campus | Seymour, IN | (c) | 386000 | 9699000 | 831000 | 45000 | 10871000 | 10916000 | (2055000) | 2002 | 12/01/15 |
| Stonebridge Health Campus | Bedford, IN | 9615000 | 1087000 | 7965000 | 679000 | 1144000 | 8587000 | 9731000 | (1684000) | 2004 | 12/01/15 |
| RiverOaks Health Campus | Princeton, IN | 14330000 | 440000 | 8953000 | 1450000 | 472000 | 10371000 | 10843000 | (1835000) | 2004 | 12/01/15 |
| Park Terrace Health Campus | Louisville, KY | (c) | 2177000 | 7626000 | 1298000 | 2177000 | 8924000 | 11101000 | (1850000) | 1977 | 12/01/15 |
| Cobblestone Crossing | Terre Haute, IN | (c) | 1462000 | 13860000 | 5722000 | 1510000 | 19534000 | 21044000 | (3615000) | 2008 | 12/01/15 |
| Creasy Springs Health Campus | Lafayette, IN | 15871000 | 2111000 | 14337000 | 6073000 | 2431000 | 20090000 | 22521000 | (3724000) | 2010 | 12/01/15 |
| Avalon Springs Health Campus | Valparaiso, IN | 17263000 | 1542000 | 14107000 | 180000 | 1575000 | 14254000 | 15829000 | (2696000) | 2012 | 12/01/15 |
| Prairie Lakes Health Campus | Noblesville, IN | 8716000 | 2204000 | 13227000 | 492000 | 2342000 | 13581000 | 15923000 | (2612000) | 2010 | 12/01/15 |
| RidgeWood Health Campus | Lawrenceburg, IN | 13545000 | 1240000 | 16118000 | 353000 | 1261000 | 16450000 | 17711000 | (3023000) | 2009 | 12/01/15 |
| Westport Place Health Campus | Louisville, KY | (c) | 1245000 | 9946000 | 445000 | 1262000 | 10374000 | 11636000 | (1867000) | 2011 | 12/01/15 |
| Paddock Springs | Warsaw, IN | 13195000 | 488000 |  | 10602000 | 654000 | 10436000 | 11090000 | (1140000) | 2019 | 02/14/19 |
| Amber Manor Care Center | Petersburg, IN | 5508000 | 446000 | 6063000 | 516000 | 515000 | 6510000 | 7025000 | (1300000) | 1990 | 12/01/15 |
| The Meadows of Leipsic Health Campus | Leipsic, OH | (c) | 1242000 | 6988000 | 779000 | 1317000 | 7692000 | 9009000 | (1541000) | 1986 | 12/01/15 |
| Springview Manor | Lima, OH | (c) | 260000 | 3968000 | 502000 | 300000 | 4430000 | 4730000 | (831000) | 1978 | 12/01/15 |
| Willows at Bellevue | Bellevue, OH | 16169000 | 587000 | 15575000 | 1214000 | 790000 | 16586000 | 17376000 | (3197000) | 2008 | 12/01/15 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Briar Hill Health Campus | North Baltimore, OH | (c) | $673000 | $2688000 | $484000 | $752000 | $3093000 | $3845000 | $(676000) | 1977 | 12/01/15 |
| Cypress Pointe Health Campus | Englewood, OH | (c) | 921000 | 10291000 | 10372000 | 1690000 | 19894000 | 21584000 | (2657000) | 2010 | 12/01/15 |
| The Oaks at NorthPointe Woods | Battle Creek, MI | (c) | 567000 | 12716000 | 164000 | 567000 | 12880000 | 13447000 | (2393000) | 2008 | 12/01/15 |
| Westlake Health Campus | Commerce, MI | 14113000 | 815000 | 13502000 | (9000) | 547000 | 13761000 | 14308000 | (2543000) | 2011 | 12/01/15 |
| Springhurst Health Campus | Greenfield, IN | 19614000 | 931000 | 14114000 | 3464000 | 2299000 | 16210000 | 18509000 | (3665000) | 2007 | 12/01/15 and 05/16/17 |
| Glen Ridge Health Campus | Louisville, KY | (c) | 1208000 | 9771000 | 2469000 | 1333000 | 12115000 | 13448000 | (2325000) | 2006 | 12/01/15 |
| St. Mary Healthcare | Lafayette, IN | 5171000 | 348000 | 2710000 | 283000 | 393000 | 2948000 | 3341000 | (586000) | 1969 | 12/01/15 |
| The Oaks at Woodfield | Grand Blanc, MI | (c) | 897000 | 12270000 | 379000 | 1128000 | 12418000 | 13546000 | (2407000) | 2012 | 12/01/15 |
| Stonegate Health Campus | Lapeer, MI | (c) | 538000 | 13159000 | 308000 | 702000 | 13303000 | 14005000 | (2544000) | 2012 | 12/01/15 |
| Senior Living at Forest Ridge | New Castle, IN | (c) | 204000 | 5470000 | 278000 | 325000 | 5627000 | 5952000 | (1079000) | 2005 | 12/01/15 |
| River Terrace Health Campus | Madison, IN | (c) |  | 13378000 | 4272000 | 76000 | 17574000 | 17650000 | (3382000) | 2016 | 03/28/16 |
| St. Charles Health Campus | Jasper, IN | 11295000 | 467000 | 14532000 | 2215000 | 558000 | 16656000 | 17214000 | (3102000) | 2000 | 06/24/16 and 06/30/16 |
| Bethany Pointe Health Campus | Anderson, IN | 19357000 | 2337000 | 26524000 | 2717000 | 2539000 | 29039000 | 31578000 | (5579000) | 1999 | 06/30/16 |
| River Pointe Health Campus | Evansville, IN | 13905000 | 1118000 | 14736000 | 1485000 | 1131000 | 16208000 | 17339000 | (3247000) | 1999 | 06/30/16 |
| Waterford Place Health Campus | Kokomo, IN | 14720000 | 1219000 | 18557000 | 2277000 | 1772000 | 20281000 | 22053000 | (3968000) | 2000/2022 | 06/30/16 |
| Autumn Woods Health Campus | New Albany, IN | (c) | 1016000 | 13414000 | 1862000 | 1048000 | 15244000 | 16292000 | (3219000) | 2000 | 06/30/16 |
| Oakwood Health Campus | Tell City, IN | 9036000 | 783000 | 11880000 | 1187000 | 874000 | 12976000 | 13850000 | (2768000) | 2000 | 06/30/16 |
| Cedar Ridge Health Campus | Cynthiana, KY | (c) | 102000 | 8435000 | 3608000 | 205000 | 11940000 | 12145000 | (2794000) | 2005 | 06/30/16 |
| Aspen Place Health Campus | Greensburg, IN | 9367000 | 980000 | 10970000 | 896000 | 1212000 | 11634000 | 12846000 | (2278000) | 2012 | 08/16/16 |
| The Willows at East Lansing | East Lansing, MI | 16186000 | 1449000 | 15161000 | 1495000 | 1496000 | 16609000 | 18105000 | (3386000) | 2014 | 08/16/16 |
| The Willows at Howell | Howell, MI | (c) | 1051000 | 12099000 | 6677000 | 1158000 | 18669000 | 19827000 | (2881000) | 2015 | 08/16/16 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| The Willows at Okemos | Okemos, MI | $7419000 | $1171000 | $12326000 | $799000 | $1210000 | $13086000 | $14296000 | $(2722000) | 2014 | 08/16/16 |
| Shelby Crossing Health Campus | Macomb, MI | 17010000 | 2533000 | 18440000 | 2224000 | 2614000 | 20583000 | 23197000 | (4428000) | 2013 | 08/16/16 |
| Village Green Healthcare Center | Greenville, OH | 6894000 | 355000 | 9696000 | 770000 | 405000 | 10416000 | 10821000 | (1956000) | 2014 | 08/16/16 |
| The Oaks at Northpointe | Zanesville, OH | (c) | 624000 | 11665000 | 1079000 | 722000 | 12646000 | 13368000 | (2559000) | 2013 | 08/16/16 |
| The Oaks at Bethesda | Zanesville, OH | 4502000 | 714000 | 10791000 | 834000 | 812000 | 11527000 | 12339000 | (2252000) | 2013 | 08/16/16 |
| White Oak Health Campus | Monticello, IN | (c) | 1005000 | 13207000 | 24000 | 1005000 | 13231000 | 14236000 | (1711000) | 2010 | 09/23/16 and 07/30/20 |
| Woodmont Health Campus | Boonville, IN | 7731000 | 790000 | 9633000 | 1096000 | 1010000 | 10509000 | 11519000 | (2194000) | 2000 | 02/01/17 |
| Silver Oaks Health Campus | Columbus, IN | (c) | 1776000 | 21420000 | 1457000 | 1000 | 24652000 | 24653000 | (4795000) | 2001 | 02/01/17 |
| Thornton Terrace Health Campus | Hanover, IN | 5479000 | 764000 | 9209000 | 1149000 | 845000 | 10277000 | 11122000 | (2025000) | 2003 | 02/01/17 |
| The Willows at Hamburg | Lexington, KY | 11409000 | 1740000 | 13422000 | 715000 | 1775000 | 14102000 | 15877000 | (2437000) | 2012 | 02/01/17 |
| The Lakes at Monclova | Monclova, OH | 19442000 | 2869000 | 12855000 | 10250000 | 3186000 | 22788000 | 25974000 | (3163000) | 2013 | 12/01/17 |
| The Willows at Willard | Willard, OH | (c) | 610000 | 12256000 | 9734000 | 213000 | 22387000 | 22600000 | (3537000) | 2012 | 02/01/17 |
| Westlake Health Campus — Commerce Villa | Commerce, MI | (c) | 261000 | 6610000 | 1230000 | 553000 | 7548000 | 8101000 | (1209000) | 2017 | 11/17/17 |
| Orchard Grove Health Campus | Romeo, MI | 27814000 | 2065000 | 11510000 | 17997000 | 3454000 | 28118000 | 31572000 | (2997000) | 2016 | 07/20/18 and 11/30/17 |
| The Meadows of Ottawa | Ottawa, OH |  | 695000 | 7752000 | 984000 | 728000 | 8703000 | 9431000 | (1421000) | 2014 | 12/15/17 |
| Valley View Healthcare Center | Fremont, OH | 10453000 | 930000 | 7635000 | 1508000 | 1089000 | 8984000 | 10073000 | (1100000) | 2017 | 07/20/18 |
| Novi Lakes Health Campus | Novi, MI | 12395000 | 1654000 | 7494000 | 2704000 | 1702000 | 10150000 | 11852000 | (2026000) | 2016 | 07/20/18 |
| The Willows at Fritz Farm | Lexington, KY | 9101000 | 1538000 | 8637000 | 434000 | 1563000 | 9046000 | 10609000 | (1069000) | 2017 | 07/20/18 |
| Trilogy Real Estate Gahanna | Gahanna, OH | (c) | 1146000 |  | 16757000 | 1202000 | 16701000 | 17903000 | (932000) | 2020 | 11/13/20 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Oaks at Byron Center | Byron Center, MI | $14343000 | $2000000 | $— | $15854000 | $2193000 | $15661000 | $17854000 | $(1079000) | 2020 | 07/08/20 |
| Harrison Springs Health Campus | Corydon, IN | (c) | 2017000 | 11487000 | 5789000 | 2301000 | 16992000 | 19293000 | (1236000) | 2016/2022 | 09/05/19 |
| The Cloister at Silvercrest | New Albany, IN | (c) | 139000 | 634000 | 1000 | 139000 | 635000 | 774000 | (53000) | 1940 | 10/01/19 |
| Trilogy Healthcare of Ferdinand II | Ferdinand, IN | 16805000 |  |  | 14602000 |  | 14602000 | 14602000 | (1161000) | 2019 | 11/19/19 |
| Forest Springs Health Campus | Louisville, KY | (c) | 964000 | 16691000 | 308000 | 997000 | 16966000 | 17963000 | (1154000) | 2015 | 07/30/20 |
| Gateway Springs Health Campus | Hamilton, OH | 11505000 | 1277000 | 10923000 | 1596000 | 1417000 | 12379000 | 13796000 | (675000) | 2020 | 12/28/20 |
| Orchard Pointe Health Campus | Kendallville, IN | 10884000 | 1806000 | 9243000 | 6000 | 1806000 | 9249000 | 11055000 | (657000) | 2016 | 01/19/21 |
| The Meadows of Delphos | Delphos, OH | 9184000 | 2345000 | 8150000 | 49000 | 2345000 | 8199000 | 10544000 | (740000) | 2018 | 01/19/21 |
| The Springs of Lima | Lima, OH | 10598000 | 2397000 | 9638000 | 18000 | 2397000 | 9656000 | 12053000 | (798000) | 2018 | 01/19/21 |
| Wooded Glen | Springfield, OH | 14224000 | 2803000 | 11928000 | 9000 | 2803000 | 11937000 | 14740000 | (944000) | 2018 | 01/19/21 |
| The Lakes of Sylvania | Sylvania, OH | 19190000 | 2548000 | 15059000 | 47000 | 2566000 | 15088000 | 17654000 | (1223000) | 2017 | 01/19/21 |
| The Glen | Union Township, OH | 14512000 | 2789000 | 12343000 | 21000 | 2789000 | 12364000 | 15153000 | (940000) | 2018 | 01/19/21 |
| Harrison Trial Health Campus | Harrison, OH | 15632000 | 1750000 | 17114000 | 76000 | 2048000 | 16892000 | 18940000 | (787000) | 2021 | 04/28/21 |
| The Oaks of Belmont | Grand Rapids, MI | 14795000 | 767000 | 17043000 | 55000 | 1058000 | 16807000 | 17865000 | (866000) | 2021 | 03/13/21 |
| Cedar Creek Health Campus | Lowell, IN | (c) | 2326000 | 12650000 | 94000 | 2331000 | 12739000 | 15070000 | (486000) | 2014 | 07/07/21 |
| Auburn MOB (Medical Office) | Auburn, CA |  | 567000 | 6472000 | 486000 | 567000 | 6958000 | 7525000 | (357000) | 1997 | 10/01/21 |
| Pottsville MOB (Medical Office) | Pottsville, PA |  | 1478000 | 8854000 | 55000 | 1478000 | 8909000 | 10387000 | (422000) | 2004 | 10/01/21 |
| Charlottesville MOB (Medical Office) | Charlottesville, VA |  | 4902000 | 19741000 | 741000 | 4902000 | 20482000 | 25384000 | (989000) | 2001 | 10/01/21 |
| Rochester Hills MOB (Medical Office) | Rochester Hills, MI | 2162000 | 2218000 | 8380000 | 685000 | 2218000 | 9065000 | 11283000 | (503000) | 1990 | 10/01/21 |
| Cullman MOB III (Medical Office) | Cullman, AL |  |  | 19224000 | 201000 |  | 19425000 | 19425000 | (765000) | 2010 | 10/01/21 |
| Iron MOB Portfolio (Medical Office) | Cullman, AL |  |  | 14799000 | 1252000 |  | 16051000 | 16051000 | (781000) | 1994 | 10/01/21 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
|  | Cullman, AL | $— | $— | $12287000 | $330000 | $— | $12617000 | $12617000 | $(588000) | 1998 | 10/01/21 |
|  | Sylacauga, AL |  |  | 11273000 | 55000 |  | 11328000 | 11328000 | (542000) | 1997 | 10/01/21 |
| Mint Hill MOB (Medical Office) | Mint Hill, NC |  |  | 24110000 | 64000 |  | 24174000 | 24174000 | (1189000) | 2007 | 10/01/21 |
| Lafayette Assisted Living Portfolio (SHOP) | Lafayette, LA |  | 1206000 | 9076000 | 98000 | 1206000 | 9174000 | 10380000 | (303000) | 1996 | 10/01/21 |
|  | Lafayette, LA |  | 1039000 | 4684000 | 68000 | 1039000 | 4752000 | 5791000 | (170000) | 2014 | 10/01/21 |
| Evendale MOB (Medical Office) | Evendale, OH |  | 1776000 | 11695000 | 212000 | 1776000 | 11907000 | 13683000 | (741000) | 1988 | 10/01/21 |
| Battle Creek MOB (Medical Office) | Battle Creek, MI |  | 1156000 | 7910000 | (46000) | 1156000 | 7864000 | 9020000 | (478000) | 1996 | 10/01/21 |
| Reno MOB (Medical Office) | Reno, NV |  |  | 82515000 | 446000 |  | 82961000 | 82961000 | (3428000) | 2005 | 10/01/21 |
| Athens MOB Portfolio (Medical Office) | Athens, GA |  | 860000 | 7989000 | (14000) | 860000 | 7975000 | 8835000 | (412000) | 2006 | 10/01/21 |
|  | Athens, GA |  | 1106000 | 11531000 | 500000 | 1106000 | 12031000 | 13137000 | (508000) | 2006 | 10/01/21 |
| SW Illinois Senior Housing Portfolio (Senior Housing) | Columbia, IL |  | 1117000 | 9700000 |  | 1117000 | 9700000 | 10817000 | (356000) | 2007 | 10/01/21 |
|  | Columbia, IL |  | 147000 | 2106000 |  | 147000 | 2106000 | 2253000 | (75000) | 1999 | 10/01/21 |
|  | Millstadt, IL |  | 259000 | 3980000 |  | 259000 | 3980000 | 4239000 | (142000) | 2004 | 10/01/21 |
|  | Red Bud, IL |  | 690000 | 5175000 |  | 690000 | 5175000 | 5865000 | (184000) | 2006 | 10/01/21 |
|  | Waterloo, IL |  | 934000 | 8932000 |  | 934000 | 8932000 | 9866000 | (320000) | 2012 | 10/01/21 |
| Lawrenceville MOB (Medical Office) | Lawrenceville, GA |  | 1663000 | 12019000 | 250000 | 1663000 | 12269000 | 13932000 | (618000) | 2005 | 10/01/21 |
| Northern California Senior Housing Portfolio (SHOP) | Belmont, CA |  | 10491000 | 9650000 | 601000 | 10491000 | 10251000 | 20742000 | (335000) | 1958/2000 | 10/01/21 |
|  | Menlo Park, CA |  | 3730000 | 3018000 | 106000 | 3730000 | 3124000 | 6854000 | (103000) | 1945 | 10/01/21 |
| Roseburg MOB (Medical Office) | Roseburg, OR |  |  | 28140000 | 98000 |  | 28238000 | 28238000 | (1211000) | 2003 | 10/01/21 |
| Fairfield County MOB Portfolio (Medical Office) | Stratford, CT |  | 1209000 | 4272000 | 348000 | 1209000 | 4620000 | 5829000 | (276000) | 1963 | 10/01/21 |
|  | Trumbull, CT |  | 2797000 | 10400000 | 52000 | 2797000 | 10452000 | 13249000 | (644000) | 1987 | 10/01/21 |
| Central Florida Senior Housing Portfolio (SHOP) | Brooksville, FL |  | 1545000 | 11107000 | (4421000) |  | 8231000 | 8231000 | (432000) | 1960/2007 | 10/01/21 |
|  | Lake Placid, FL |  | 590000 | 2847000 | (106000) | 279000 | 3052000 | 3331000 | (99000) | 2008 | 10/01/21 |
|  | Lakeland, FL |  | 383000 | 15622000 | (7986000) |  | 8019000 | 8019000 | (518000) | 1985 | 10/01/21 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
|  | Pinellas Park, FL | $— | $1065000 | $7610000 | $(1387000) | $— | $7288000 | $7288000 | $(278000) | 2016 | 10/01/21 |
|  | Spring Hill, FL |  | 2623000 | 12200000 | (7639000) |  | 7184000 | 7184000 | (450000) | 1988 | 10/01/21 |
|  | Winter Haven, FL |  | 2654000 | 19811000 | (2749000) |  | 19716000 | 19716000 | (727000) | 1984 | 10/01/21 |
| Central Wisconsin Senior Care Portfolio (Skilled Nursing) | Sun Prairie, WI |  | 543000 | 2587000 |  | 543000 | 2587000 | 3130000 | (111000) | 1960/2006 | 10/01/21 |
|  | Waunakee, WI |  | 2171000 | 10198000 | 30000 | 2171000 | 10228000 | 12399000 | (434000) | 1974/2005 | 10/01/21 |
| Sauk Prairie MOB (Medical Office) | Prairie du Sac, WI |  | 2044000 | 19669000 | 366000 | 2044000 | 20035000 | 22079000 | (866000) | 2014 | 10/01/21 |
| Surprise MOB (Medical Office) | Surprise, AZ |  | 1827000 | 10968000 | 494000 | 1827000 | 11462000 | 13289000 | (533000) | 2012 | 10/01/21 |
| Southfield MOB (Medical Office) | Southfield, MI | 5538000 | 1634000 | 16550000 | 877000 | 1634000 | 17427000 | 19061000 | (989000) | 1975/2014 | 10/01/21 |
| Pinnacle Beaumont ALF (SHOP) | Beaumont, TX |  | 1775000 | 17541000 | 19000 | 1775000 | 17560000 | 19335000 | (589000) | 2012 | 10/01/21 |
| Grand Junction MOB (Medical Office) | Grand Junction, CO |  | 2460000 | 34188000 | 22000 | 2460000 | 34210000 | 36670000 | (1527000) | 2013 | 10/01/21 |
| Edmonds MOB (Medical Office) | Edmonds, WA |  | 4523000 | 22414000 | 301000 | 4523000 | 22715000 | 27238000 | (1015000) | 1991/2008 | 10/01/21 |
| Pinnacle Warrenton ALF (SHOP) | Warrenton, MO |  | 514000 | 7059000 | (2405000) |  | 5168000 | 5168000 | (249000) | 1986 | 10/01/21 |
| Glendale MOB (Medical Office) | Glendale, WI |  | 665000 | 6782000 | 281000 | 665000 | 7063000 | 7728000 | (382000) | 2004 | 10/01/21 |
| Missouri SNF Portfolio (Skilled Nursing) | Florissant, MO |  | 800000 | 10363000 |  | 800000 | 10363000 | 11163000 | (384000) | 1987 | 10/01/21 |
|  | Kansas City, MO |  | 2090000 | 10527000 |  | 2090000 | 10527000 | 12617000 | (456000) | 1974 | 10/01/21 |
|  | Milan, MO |  | 493000 | 7057000 |  | 493000 | 7057000 | 7550000 | (258000) | 1980 | 10/01/21 |
|  | Missouri, MO |  | 729000 | 10187000 |  | 729000 | 10187000 | 10916000 | (365000) | 1963 | 10/01/21 |
|  | Salisbury, MO |  | 515000 | 8852000 |  | 515000 | 8852000 | 9367000 | (324000) | 1970 | 10/01/21 |
|  | Sedalia, MO |  | 631000 | 24172000 |  | 631000 | 24172000 | 24803000 | (814000) | 1975 | 10/01/21 |
|  | St. Elizabeth, MO |  | 437000 | 4561000 |  | 437000 | 4561000 | 4998000 | (171000) | 1981 | 10/01/21 |
|  | Trenton, MO |  | 310000 | 4875000 |  | 310000 | 4875000 | 5185000 | (176000) | 1967 | 10/01/21 |
| Flemington MOB Portfolio (Medical Office) | Flemington, NJ |  | 1419000 | 11110000 | 518000 | 1419000 | 11628000 | 13047000 | (612000) | 2002 | 10/01/21 |
|  | Flemington, NJ |  | 578000 | 3340000 | 209000 | 578000 | 3549000 | 4127000 | (195000) | 1993 | 10/01/21 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Lawrenceville MOB II (Medical Office) | Lawrenceville, GA | $— | $1058000 | $9709000 | $278000 | $1058000 | $9987000 | $11045000 | $(567000) | 1990 | 10/01/21 |
| Mill Creek MOB (Medical Office) | Mill Creek, WA |  | 1344000 | 7516000 | 462000 | 1344000 | 7978000 | 9322000 | (327000) | 1991 | 10/01/21 |
| Modesto MOB (Medical Office) | Modesto, CA |  |  | 16065000 | 270000 |  | 16335000 | 16335000 | (713000) | 1991/2016 | 10/01/21 |
| Michigan ALF Portfolio (Senior Housing) | Grand Rapids, MI |  | 1196000 | 8955000 |  | 1196000 | 8955000 | 10151000 | (344000) | 1953/2016 | 10/01/21 |
|  | Grand Rapids, MI | 9810000 | 1291000 | 11308000 |  | 1291000 | 11308000 | 12599000 | (433000) | 1989 | 10/01/21 |
|  | Holland, MI |  | 716000 | 6534000 |  | 716000 | 6534000 | 7250000 | (288000) | 2007/2017 | 10/01/21 |
|  | Howell, MI |  | 836000 | 4202000 |  | 836000 | 4202000 | 5038000 | (161000) | 2003 | 10/01/21 |
|  | Lansing, MI |  | 1300000 | 11629000 |  | 1300000 | 11629000 | 12929000 | (426000) | 1988/2015 | 10/01/21 |
|  | Wyoming, MI |  | 1343000 | 13347000 |  | 1343000 | 13347000 | 14690000 | (490000) | 1964/2016 | 10/01/21 |
| Lithonia MOB (Medical Office) | Lithonia, GA |  | 1676000 | 10871000 | 329000 | 1676000 | 11200000 | 12876000 | (556000) | 2015 | 10/01/21 |
| West Des Moines SNF (Skilled Nursing) | West Des Moines, IA |  | 509000 | 3813000 |  | 509000 | 3813000 | 4322000 | (144000) | 2004 | 10/01/21 |
| Great Nord MOB Portfolio (Medical Office) | Tinley Park, IL |  |  | 15423000 | 761000 |  | 16184000 | 16184000 | (790000) | 2002 | 10/01/21 |
|  | Chesterton, IN |  | 743000 | 9070000 | 266000 | 743000 | 9336000 | 10079000 | (499000) | 2007 | 10/01/21 |
|  | Crown Point, IN |  | 265000 | 5467000 |  | 265000 | 5467000 | 5732000 | (251000) | 2005 | 10/01/21 |
|  | Plymouth, MN |  | 1491000 | 12994000 | 18000 | 1491000 | 13012000 | 14503000 | (612000) | 2014 | 10/01/21 |
| Overland Park MOB (Medical Office) | Overland Park, KS |  | 2803000 | 23639000 | 548000 | 2803000 | 24187000 | 26990000 | (1079000) | 2017 | 10/01/21 |
| Blue Badger MOB (Medical Office) | Marysville, OH |  | 1518000 | 12543000 | 9000 | 1518000 | 12552000 | 14070000 | (525000) | 2014 | 10/01/21 |
| Bloomington MOB (Medical Office) | Bloomington, IL |  | 2114000 | 17363000 |  | 2114000 | 17363000 | 19477000 | (612000) | 1990 | 10/01/21 |
| Haverhill MOB (Medical Office) | Haverhill, MA |  | 1393000 | 15477000 | 51000 | 1393000 | 15528000 | 16921000 | (832000) | 1987 | 10/01/21 |
| Fresno MOB (Medical Office) | Fresno, CA |  | 1536000 | 8964000 | 5000 | 1536000 | 8969000 | 10505000 | (466000) | 2007 | 10/01/21 |
| Colorado Foothills MOB Portfolio (Medical Office) | Arvada, CO |  | 695000 | 6369000 | 146000 | 695000 | 6515000 | 7210000 | (467000) | 1979 | 10/01/21 |
|  | Centennial, CO |  | 873000 | 11233000 | 196000 | 873000 | 11429000 | 12302000 | (577000) | 1979 | 10/01/21 |
|  | Colorado Springs, CO |  | 2225000 | 12520000 | 804000 | 2225000 | 13324000 | 15549000 | (601000) | 1999 | 10/01/21 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
| Catalina West Haven ALF (SHOP) | West Haven, UT | $— | $1936000 | $10415000 | $142000 | $1936000 | $10557000 | $12493000 | $(379000) | 2012 | 10/01/21 |
| Louisiana Senior Housing Portfolio (SHOP) | Gonzales, LA |  | 1123000 | 5668000 | 87000 | 1123000 | 5755000 | 6878000 | (220000) | 1996 | 10/01/21 |
|  | Monroe, LA |  | 834000 | 4037000 | 85000 | 834000 | 4122000 | 4956000 | (157000) | 1994 | 10/01/21 |
|  | New Iberia, LA |  | 952000 | 5257000 | 34000 | 952000 | 5291000 | 6243000 | (196000) | 1996 | 10/01/21 |
|  | Shreveport, LA |  | 1177000 | 6810000 | 15000 | 1177000 | 6825000 | 8002000 | (241000) | 1996 | 10/01/21 |
|  | Slidell, LA |  | 801000 | 4348000 | 115000 | 801000 | 4463000 | 5264000 | (172000) | 1996 | 10/01/21 |
| Catalina Madera ALF (SHOP) | Madera, CA |  | 1312000 | 15299000 | 208000 | 1312000 | 15507000 | 16819000 | (546000) | 2005 | 10/01/21 |
| The Willows at Springhurst | Louisville, KY | 20800000 | 1876000 | 12595000 | (649000) | 1946000 | 11876000 | 13822000 | (335000) | 1979 | 01/03/22 |
|  | Louisville, KY | (c) | 1184000 | 6483000 | (190000) | 1184000 | 6293000 | 7477000 | (181000) | 1979 | 01/03/22 |
| The Willows at Harrodsburg | Harrodsburg, KY | 7125000 | 918000 | 10181000 | 956000 | 1571000 | 10484000 | 12055000 | (220000) | 2018 | 04/29/22 |
| North River Health Campus | Evansville, IN | 17100000 | 2614000 | 15031000 | 56000 | 2614000 | 15087000 | 17701000 | (321000) | 2017 | 05/20/22 |
| Trilogy Healthcare of Jefferson II | Louisville, KY | 14175000 | 2265000 | 14077000 | 44000 | 2265000 | 14121000 | 16386000 | (265000) | 2018 | 05/20/22 |
| Pickerington Health Campus | Pickerington, OH | 13050000 | 860000 | 15575000 |  | 860000 | 15575000 | 16435000 | (1296000) | 2019 | 05/20/22 |
| Mt. Washington Development Project | Mt. Washington | 14325000 | 2054000 | 10225000 | 14000 | 2054000 | 10239000 | 12293000 | (213000) | 2020 | 05/20/22 |
| Silvercrest Health Center | New Albany, IN | 21626000 | 1920000 | 24965000 | 127000 | 1920000 | 25092000 | 27012000 | (292000) | 2013 | 08/01/22 |
| The Springs of Mooresville | Mooresville, IN | 9813000 | 1460000 | 12617000 | 15000 | 1460000 | 12632000 | 14092000 | (148000) | 2016 | 08/01/22 |
| Hearthstone Health Campus | Bloomington, IN | 13861000 | 2140000 | 16928000 | 144000 | 2140000 | 17072000 | 19212000 | (211000) | 2014 | 08/01/22 |
| AHR Texas ALF Portfolio (SHOP) | Bell County, TX | 14835000 | 1819000 | 11090000 | 12000 | 1819000 | 11102000 | 12921000 | (31000) | 1998 | 12/05/22 |
|  | Cedar Park, TX | 5852000 | 1347000 | 5250000 | 3000 | 1347000 | 5253000 | 6600000 | (15000) | 1998 | 12/05/22 |
|  | Corpus Christi, TX | 14440000 | 1229000 | 12663000 | 1000 | 1229000 | 12664000 | 13893000 | (35000) | 1997 | 12/05/22 |
|  | League City, TX | 15829000 | 1435000 | 15475000 | 1000 | 1435000 | 15476000 | 16911000 | (38000) | 1999 | 12/05/22 |
|  | Round Rock, TX | 21520000 | 2124000 | 14895000 | 7000 | 2124000 | 14902000 | 17026000 | (38000) | 1997 | 12/05/22 |
|  | Sugarland, TX | 28302000 | 2674000 | 12751000 | 2000 | 2674000 | 12753000 | 15427000 | (34000) | 1999 | 12/05/22 |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

---

| | | | | | | | | | | | |
|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|:---|
| | | | **Initial Cost to Company** | **Initial Cost to Company** | | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | **Gross Amount of Which Carried at Close of Period(f)** | | |
| **Description(a)** | **Description(a)** |<br>**Encumbrances** | **Land** | **Buildings and<br>Improvements** |<br>**Cost <br>Capitalized<br>Subsequent to<br>Acquisition(b)** | **Land** | **Buildings and<br>Improvements** | **Total(e)** | **Accumulated<br>Depreciation<br>(g)(h)** |<br>**Date of<br>Construction** |<br>**Date <br>Acquired** |
|  | Tyler, TX | $9849000 | $1131000 | $10510000 | $1000 | $1131000 | $10511000 | $11642000 | $(30000) | 1998 | 12/05/22 |
|  |  | $1254479000 | $341884000 | $3353698000 | $299691000 | $341479000 | $3653794000 | $3995273000 | $(535354000) |  |  |
| Leased properties(d) |  | $— | $1130000 | $84944000 | $148149000 | $2304000 | $231920000 | $234224000 | $(118842000) |  |  |
| Construction in progress |  |  |  |  | 6950000 | 576000 | 6374000 | 6950000 | (642000) |  |  |
|  |  | $1254479000 | $343014000 | $3438642000 | $454790000 | $344359000 | $3892088000 | $4236447000 | $(654838000) |  |  |

---

___________

(a)We own 100% of our properties as of December 31, 2022, with the exception of Trilogy, Lakeview IN Medical Plaza, Southlake TX Hospital, Central Florida Senior Housing Portfolio, Pinnacle Beaumont ALF, Pinnacle Warrenton ALF and Louisiana Senior Housing Portfolio.

(b)The cost capitalized subsequent to acquisition is shown net of dispositions and impairments.

(c)These properties are used as collateral for the secured revolver portion of the 2019 Trilogy Credit Facility, which had an outstanding balance of $316,734,000 as of December 31, 2022. See Note 9, Lines of Credit and Term Loans — 2019 Trilogy Credit Facility, for a further discussion.

(d)Represents furniture, fixtures, equipment, land and improvements associated with properties under operating leases.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**SCHEDULE III — REAL ESTATE AND** 

**ACCUMULATED DEPRECIATION — (Continued)**

**December 31, 2022**

(e) &nbsp;&nbsp;&nbsp;&nbsp;The changes in total real estate for the years ended December 31, 2022, 2021 and 2020 are as follows:

---

| | |
|:---|:---|
| | **Amount** |
| Balance — December 31, 2019 | $2618608000 |
| Acquisitions | 31157000 |
| Additions | 129254000 |
| Dispositions and impairments | (18718000) |
| Foreign currency translation adjustment | 1971000 |
| Balance — December 31, 2020 | $2762272000 |
| Acquisitions | $1225626000 |
| Additions | 87909000 |
| Dispositions and impairments | (36645000) |
| Foreign currency translation adjustment | (590000) |
| Balance — December 31, 2021 | $4038572000 |
| Acquisitions | $254947000 |
| Additions | 72802000 |
| Dispositions and impairments | (123841000) |
| Foreign currency translation adjustment | (6033000) |
| Balance — December 31, 2022 | $4236447000 |

---

(f) &nbsp;&nbsp;&nbsp;&nbsp;As of December 31, 2022, the unaudited aggregate cost of our properties was $4,085,863,000 for U.S. federal income tax purposes.

(g) &nbsp;&nbsp;&nbsp;&nbsp;The changes in accumulated depreciation for the years ended December 31, 2022, 2021 and 2020 are as follows:

---

| | |
|:---|:---|
| | **Amount** |
| Balance — December 31, 2019 | $337898000 |
| Additions | 91617000 |
| Dispositions and impairments | (4530000) |
| Foreign currency translation adjustment | 287000 |
| Balance — December 31, 2020 | $425272000 |
| Additions | $109036000 |
| Dispositions and impairments | (10320000) |
| Foreign currency translation adjustment | (102000) |
| Balance — December 31, 2021 | $523886000 |
| Additions | $141257000 |
| Dispositions and impairments | (9355000) |
| Foreign currency translation adjustment | (950000) |
| Balance — December 31, 2022 | $654838000 |

---

(h) &nbsp;&nbsp;&nbsp;&nbsp;The cost of buildings and capital improvements is depreciated on a straight-line basis over the estimated useful lives of the buildings and capital improvements, up to 39 years, and the cost of tenant improvements is depreciated over the shorter of the lease term or useful life, up to 34 years. The cost of furniture, fixtures and equipment is depreciated over the estimated useful life, up to 28 years.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**EXHIBITS LIST**

**December 31, 2022**

The following exhibits are included, or incorporated by reference, in this Annual Report on Form 10-K for the period ended December 31, 2022 (and are numbered in accordance with Item 601 of Regulation S-K).

---

| | |
|:---|:---|
| <u>[2.1](https://www.sec.gov/Archives/edgar/data/1632970/000119312521198339/d153975dex21.htm)</u> | <u>[Agreement and Plan of Merger, dated June 23, 2021, by and among Griffin-American Healthcare REIT IV, Inc., Griffin-American Healthcare REIT IV Holdings, LP, Continental Merger Sub, LLC, Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT III Holdings, LP (included as Exhibit 2.1 to our Current Report on Form 8-K (File No. 000-55775) filed June 24, 2021 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000119312521198339/d153975dex21.htm)</u> |
| <u>[3.1\*](ex31fourtharticlesofamendm.htm)</u> | <u>[Fourth Articles of Amendment and Restatement of Griffin-American Healthcare REIT IV, Inc., dated October 1, 2021](ex31fourtharticlesofamendm.htm)</u> |
| <u>[3.](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex31articlesofamendment-re.htm)[2](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex31articlesofamendment-re.htm)</u> | <u>[Articles of Amendment (Reverse Stock Split) of American Healthcare REIT, Inc., dated November 15 2022 (included as Exhibit 3.1 to our Current Report on Form 8-K (File No. 000-55775) filed November 16. 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex31articlesofamendment-re.htm)</u> |
| <u>[3.](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex32articlesofamendment-pa.htm)[3](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex32articlesofamendment-pa.htm)</u> | <u>[Articles of Amendment (Par Value Decrease) of American Healthcare REIT, Inc., dated November 15 2022 (included as Exhibit 3.2 to our Current Report on Form 8-K (File No. 000-55775) filed November 16. 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000088/ex32articlesofamendment-pa.htm)</u> |
| <u>[3.4](http://www.sec.gov/Archives/edgar/data/1632970/000163297023000006/ex31-ahrxamendedandrestate.htm)</u> | <u>[Amended and Restated Bylaws of American Healthcare REIT, Inc. (included as Exhibit 3.1 to our Current Report on Form 8-K (File No. 000-55775) filed February](http://www.sec.gov/Archives/edgar/data/1632970/000163297023000006/ex31-ahrxamendedandrestate.htm)[1](http://www.sec.gov/Archives/edgar/data/1632970/000163297023000006/ex31-ahrxamendedandrestate.htm)[7](http://www.sec.gov/Archives/edgar/data/1632970/000163297023000006/ex31-ahrxamendedandrestate.htm)[, 2023 and incorporated herein by reference)](http://www.sec.gov/Archives/edgar/data/1632970/000163297023000006/ex31-ahrxamendedandrestate.htm)</u> |
| <u>[4.1](https://www.sec.gov/Archives/edgar/data/1632970/000163297019000019/gahr4forms-3drip.htm#s1992693DF88150049C808945212EE540)</u> | <u>[Amended and Restated Distribution Reinvestment Plan of Griffin-American Healthcare REIT IV, Inc. (included as Exhibit 4.6 to our Registration Statement on Form S-3 (File No. 333-229301) filed January 18, 2019 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297019000019/gahr4forms-3drip.htm#s1992693DF88150049C808945212EE540)</u> |
| <u>[4.2\*](ex42-2022xq410xkahr.htm)</u> | <u>[Description of Registrant's Securities](ex42-2022xq410xkahr.htm)</u> |
| <u>[10.1†](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex101ahr2021ahrincentivepl.htm)</u> | <u>[American Healthcare REIT, Inc. Amended and Restated 2015 Incentive Plan, effective as of November 18, 2021](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex101ahr2021ahrincentivepl.htm)[(included as Exhibit 10.13 to our Annual Report on Form 10-K (File No. 000-55775) filed March 25, 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex101ahr2021ahrincentivepl.htm)</u> |
| <u>[10.2](https://www.sec.gov/Archives/edgar/data/1566912/000156691219000059/gahr38-kre919trilogyexh101.htm)</u> | <u>[First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, among Trilogy RER, LLC, and certain subsidiaries of Trilogy RER, LLC, Trilogy OpCo, LLC and Trilogy Pro Services, LLC, KeyBank National Association and the other lenders which are parties thereto from time to time, CIT Bank, N.A., Regions Bank, KeyBanc Capital Markets, Inc., Regions Capital Markets, Bank of America, N.A. and The Huntington National Bank (included as Exhibit 10.1 to Griffin-American Healthcare REIT III, Inc.'s Current Report on Form 8-K (File No. 000-55434) filed September 11, 2019 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1566912/000156691219000059/gahr38-kre919trilogyexh101.htm)</u>  |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1566912/000156691219000059/gahr38-kre919trilogyexh102.htm)[3](https://www.sec.gov/Archives/edgar/data/1566912/000156691219000059/gahr38-kre919trilogyexh102.htm)</u> | <u>[Unconditional Guaranty of Payment dated as of September 5, 2019, by Trilogy Investors, LLC, Trilogy Healthcare Holdings, Inc., Trilogy Pro Services, LLC and Trilogy OpCo, LLC for the benefit of KeyBank National Association and the other lenders which are parties thereto from time to time, CIT Bank, N.A., Regions Bank, KeyBanc Capital Markets, Inc., Regions Capital Markets, Bank of America, N.A. and The Huntington National Bank (included as Exhibit 10.2 to Griffin-American Healthcare REIT III, Inc.'s Current Report on Form 8-K (File No. 000-55434) filed September 11, 2019 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1566912/000156691219000059/gahr38-kre919trilogyexh102.htm)</u>  |
| <u>[10.4\*](keybank_trilogy-firstame.htm)</u> | <u>[First Amendment to the First Amended and Restated Senior Secured Credit Agreement and dated as of April 30, 2021, among Trilogy RER, LLC, and certain subsidiaries of Trilogy RER, LLC, Trilogy OpCo, LLC and Trilogy Pro Services, LLC, KeyBank National Association and the other lenders which are parties thereto from time to time, CIT Bank, N.A., Regions Bank, KeyBanc Capital Markets, Inc., Regions Capital Markets, Bank of America, N.A. and The Huntington National Bank](keybank_trilogy-firstame.htm)</u> |
| <u>[10.5\*](keybank_trilogy-secondam.htm)</u> | <u>[Second](keybank_trilogy-secondam.htm)[Amendment to the First Amended and Restated Senior Secured Credit Agreement and](keybank_trilogy-secondam.htm)[dated as of](keybank_trilogy-secondam.htm)[September](keybank_trilogy-secondam.htm)[29](keybank_trilogy-secondam.htm)[, 202](keybank_trilogy-secondam.htm)[1](keybank_trilogy-secondam.htm)[, among](keybank_trilogy-secondam.htm)[Trilogy RER, LLC, and certain subsidiaries of Trilogy RER, LLC, Trilogy OpCo, LLC and Trilogy Pro Services, LLC, KeyBank National Association and the other lenders which are parties thereto from time to time, CIT Bank, N.A., Regions Bank, KeyBanc Capital Markets, Inc., Regions Capital Markets, Bank of America, N.A. and The Huntington National Bank](keybank_trilogy-secondam.htm)</u> |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**EXHIBITS LIST — (Continued)**

**December 31, 2022**

---

| | |
|:---|:---|
| <u>[10.6\*](keybank_trilogy-thirdame.htm)</u> | <u>[Third Amendment to the First Amended and Restated Senior Secured Credit Agreement and Amendment to Unconditional Guaranty of Payment and Performance dated as of December 20, 2022, among Trilogy RER, LLC, and certain subsidiaries of Trilogy RER, LLC, Trilogy OpCo, LLC and Trilogy Pro Services, LLC, KeyBank National Association and the other lenders which are parties thereto from time to time, CIT Bank, N.A., Regions Bank, KeyBanc Capital Markets, Inc., Regions Capital Markets, Bank of America, N.A. and The Huntington National Bank](keybank_trilogy-thirdame.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000095/exh101ahrmergerclosinginde.htm)[7](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000095/exh101ahrmergerclosinginde.htm)[†](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000095/exh101ahrmergerclosinginde.htm)</u> | <u>[Form of Indemnification Agreement (included as Exhibit 10.1 to our Current Report on Form 8-K (File No. 000-55775) filed October 1, 2021 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000095/exh101ahrmergerclosinginde.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit101ahrformpostmerge.htm)[8](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit101ahrformpostmerge.htm)</u> | <u>[Second Amended and Restated Agreement of Limited Partnership of American Healthcare REIT Holdings, LP, dated October 1, 2021 (included as Exhibit 10.1 to our Current Report on Form 8-K (File No. 000-55775) filed October 5, 2021 and incorporated by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit101ahrformpostmerge.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit102ahrformpostmerge.htm)[9](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit102ahrformpostmerge.htm)</u> | <u>[Amended and Restated Share Repurchase Plan (included as Exhibit 10.2 to our Current Report on Form 8-K (File No. 000-55775) filed October 5, 2021 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297021000099/exhibit102ahrformpostmerge.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1566912/000156691221000075/exh101gahriiiformregistrat.htm)[10](https://www.sec.gov/Archives/edgar/data/1566912/000156691221000075/exh101gahriiiformregistrat.htm)</u> | <u>[Registration Rights Agreement, dated October 1, 2021, by and between Griffin-American Healthcare REIT III, Inc. and Griffin-American Healthcare REIT III Holdings, LP (included as Exhibit 10.1 to Griffin-American Healthcare REIT III, Inc's Current Report on Form 8-K (File No. 000-55434) filed October 1, 2021 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1566912/000156691221000075/exh101gahriiiformregistrat.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1012-2021xq410xkahr.htm)[11](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1012-2021xq410xkahr.htm)[†](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1012-2021xq410xkahr.htm)</u> | <u>[American Healthcare Opps Holdings, LLC Executive Severance and Change in Control Plan, effective as of November 18, 2021 (included as Exhibit 10.12 to our Annual Report on Form 10-K (File No. 000-55775) filed March 25, 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1012-2021xq410xkahr.htm)</u> |
| <u>[10.](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)[1](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)[2](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)</u> | <u>[Eighth Amended and Restated Limited Liability Company Agreement of Trilogy REIT Holdings, LLC dated as of December 31, 2021, entered into by and among Trilogy Real Estate Investment Trust, Trilogy Management Services, LLC and Members, effective as of December 31, 2021](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)[(included as Exhibit 10.1](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)[3](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)[to our Annual Report on Form 10-K (File No. 000-55775) filed March 25, 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000020/ex1013-2021xq410xkahr.htm)</u> |
| <u>[10.1](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000004/ex101ahrformreamendedandre.htm)[3](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000004/ex101ahrformreamendedandre.htm)</u> | <u>[Amended and Restated Credit Agreement by and among American Healthcare REIT Holdings, L.P., American Healthcare REIT, Inc. and certain subsidiaries, Bank of America, N.A., KeyBank, National Association, Citizens Bank, National Association, Bank of the West, Fifth Third Bank, National Association, Truist Bank, Regions Bank, KeyBanc Capital Markets and BofA Securities, Inc. dated January 19, 2022 (included as Exhibit 10.1 to our Current Report on Form 8-K (File No. 000-055775) filed January 25, 2022 and incorporated herein by reference)](https://www.sec.gov/Archives/edgar/data/1632970/000163297022000004/ex101ahrformreamendedandre.htm)</u> |
| <u>[21.1\*](ex211-2022xq410xkahr.htm)</u> | <u>[Subsidiaries of American Healthcare REIT, Inc.](ex211-2022xq410xkahr.htm)</u> |
| <u>[23.1\*](ex231-2022xq410xkahr.htm)</u> | <u>[Consent of Deloitte & Touche LLP](ex231-2022xq410xkahr.htm)</u> |
| <u>[31.1\*](ex311-2022xq410xqahr.htm)</u> | <u>[Certification of Chief Executive Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002](ex311-2022xq410xqahr.htm)</u> |
| <u>[31.2\*](ex312-2022xq410xqahr.htm)</u> | <u>[Certification of Chief Financial Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002](ex312-2022xq410xqahr.htm)</u> |

| 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.DEF\* | Inline XBRL Taxonomy Extension Definition Linkbase Document |
| 101.LAB\* | Inline XBRL Taxonomy Extension Label Linkbase Document |
| 101.PRE\* | Inline XBRL Taxonomy Extension Presentation Linkbase Document |
| 104\* | Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101) |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**AMERICAN HEALTHCARE REIT, INC.**

**EXHIBITS LIST — (Continued)**

**December 31, 2022**

_________

---

| | |
|:---|:---|
| \* | Filed herewith. |
| \*\* | Furnished herewith. In accordance with Item 601(b)(32) of Regulation S-K, this Exhibit is not deemed "filed" for purposes of Section 18 of the Exchange Act or otherwise subject to the liabilities of that section. Such certifications will not be deemed incorporated by reference into any filing under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, except to the extent that the registrant specifically incorporates it by reference. |
| † | Management contract or compensatory plan or arrangement. |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**Item 16. Form 10-K Summary.**

None.

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

**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.

---

| | | |
|:---|:---|:---|
| | <u>American Healthcare REIT, Inc.</u><br>*(Registrant)* | |
| By | /s/ DANNY PROSKY | Chief Executive Officer and President |
| | Danny Prosky | |
| Date: March 17, 2023 | Date: March 17, 2023 | |

---

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.

---

| | | |
|:---|:---|:---|
| By | /s/ DANNY PROSKY | Chief Executive Officer, President and Director |
|  | Danny Prosky | (Principal Executive Officer) |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ BRIAN S. PEAY | Chief Financial Officer |
|  | Brian S. Peay | (Principal Financial Officer and Principal Accounting Officer) |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ JEFFREY T. HANSON | Non-Executive Chairman of the Board of Directors |
|  | Jeffrey T. Hanson |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ MATHIEU B. STREIFF | Director |
|  | Mathieu B. Streiff |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ SCOTT ESTES | Independent Director |
|  | Scott Estes |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ BRIAN J. FLORNES | Independent Director |
|  | Brian J. Flornes |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |

---

------

**<u>[**Table of Contents**](#if3ea478aad1243998fd851f05f33f584_10)</u>**

---

| | | |
|:---|:---|:---|
| By | /s/ HAROLD H. GREENE | Independent Director |
|  | Harold H. Greene |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ DIANNE HURLEY | Independent Director |
|  | Dianne Hurley |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ MARVIN R. O'QUINN | Independent Director |
|  | Marvin R. O'Quinn |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ VALERIE RICHARDSON | Independent Director |
|  | Valerie Richardson |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ GERALD W. ROBINSON | Independent Director |
|  | Gerald W. Robinson |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ J. GRAYSON SANDERS | Independent Director |
|  | J. Grayson Sanders |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |
| By | /s/ WILBUR H. SMITH III | Independent Director |
|  | Wilbur H. Smith III |  |
| Date: March 17, 2023 | Date: March 17, 2023 |  |

---

## Exhibit 3.1

**<u>EXHIBIT 3.1</u>**

**<u>GRIFFIN-AMERICAN HEALTHCARE REIT IV, INC.</u>**

**FOURTH ARTICLES OF AMENDMENT AND RESTATEMENT**

<u>FIRST</u>: Griffin-American Healthcare REIT IV, Inc., a Maryland corporation (the "Corporation"), desires to amend and restate its charter as currently in effect and as hereinafter amended.

<u>SECOND</u>: The following provisions are all the provisions of the charter currently in effect and as hereinafter amended:

**ARTICLE I**

**INCORPORATOR**

Jeffrey T. Hanson, whose address is 18191 Von Karman Avenue, Suite 300, Irvine, California 92612, being at least 18 years of age, formed a corporation under the general laws of the State of Maryland on January 23, 2015.

**ARTICLE II**

**NAME**

The name of the corporation (which is hereinafter called the "Corporation") is:

American Healthcare REIT, Inc.

**ARTICLE III**

**PURPOSES AND POWERS**

The purposes for which the Corporation is formed are to engage in any lawful act or activity (including, without limitation or obligation, engaging in business as a real estate investment trust under the Internal Revenue Code of 1986, as amended, or any successor statute (the "Code")) for which corporations may be organized under the general laws of the State of Maryland as now or hereafter in force.

**ARTICLE IV**

**PRINCIPAL OFFICE IN STATE AND RESIDENT AGENT**

The address of the principal office of the Corporation in the State of Maryland is c/o CSC-Lawyers Incorporating Service Company, 7 Saint Paul Street, Suite 820, Baltimore, Maryland 21202. The name and address of the resident agent of the Corporation are CSC-Lawyers Incorporating Service Company, 7 Saint Paul Street, Suite 820, Baltimore, Maryland 21202. The resident agent is a Maryland corporation.

------

**ARTICLE V**

**DEFINITIONS**

As used in the Charter, the following terms shall have the following meanings unless the context otherwise requires:

<u>Aggregate Share Ownership Limit</u>. The term "Aggregate Share Ownership Limit" shall mean 9.9% in value of the aggregate of the outstanding Shares, or such other percentage determined by the Board of Directors in accordance with Section 7.1.8 of the Charter.

<u>Beneficial Ownership</u>. The term "Beneficial Ownership" shall mean ownership of Shares by a Person, whether the interest in Shares is held directly or indirectly (including by a nominee), and shall include interests that would be treated as owned through the application of Section 544 of the Code, as modified by Section 856(h)(1)(B) of the Code. The terms "Beneficial Owner," "Beneficially Owns" and "Beneficially Owned" shall have the correlative meanings.

<u>Board or Board of Directors</u>. The term "Board" or "Board of Directors" shall mean the Board of Directors of the Corporation.

<u>Business Day</u>. The term "Business Day" shall mean any day, other than a Saturday or Sunday, that is neither a legal holiday nor a day on which banking institutions in New York City are authorized or required by law, regulation or executive order to close.

<u>Bylaws</u>. The term "Bylaws" shall mean the Bylaws of the Corporation, as amended from time to time.

<u>Charitable Beneficiary</u>. The term "Charitable Beneficiary" shall mean one or more beneficiaries of the Charitable Trust as determined pursuant to Section 7.2.6 of the Charter, provided that each such organization must be described in Section 501(c)(3) of the Code and contributions to each such organization must be eligible for deduction under each of Sections 170(b)(1)(A), 2055 and 2522 of the Code.

<u>Charitable Trust</u>. The term "Charitable Trust" shall mean any trust provided for in Section 7.2.1 of the Charter.

<u>Charitable Trustee</u>. The term "Charitable Trustee" shall mean the Person unaffiliated with the Corporation and a Prohibited Owner, that is appointed by the Corporation to serve as Trustee of the Charitable Trust.

<u>Charter</u>. The term "Charter" shall mean the charter of the Corporation.

<u>Class I Common Stock</u>. The term "Class I Common Stock" shall have the meaning as provided in Section 6.1 of the Charter.

<u>Class T Common Stock</u>. The term "Class T Common Stock" shall have the meaning as provided in Section 6.1 of the Charter.

------

<u>Code</u>. The term "Code" shall have the meaning as provided in Article III herein.

<u>Common Share Ownership Limit</u>. The term "Common Share Ownership Limit" shall mean 9.9% (in value or in number of Common Shares, whichever is more restrictive) of the aggregate of the outstanding Common Shares, or such other percentage determined by the Board of Directors in accordance with Section 7.1.8 of the Charter.

<u>Common Shares</u>. The term "Common Shares" shall have the meaning as provided in Section 6.1 of the Charter.

<u>Constructive Ownership</u>. The term "Constructive Ownership" shall mean ownership of Shares by a Person, whether the interest in Shares is held directly or indirectly (including by a nominee), and shall include interests that would be treated as owned through the application of Section 318(a) of the Code, as modified by Section 856(d)(5) of the Code. The terms "Constructive Owner," "Constructively Owns" and "Constructively Owned" shall have the correlative meanings.

<u>Corporation</u>. The term "Corporation" shall have the meaning as provided in Article II herein.

<u>Director</u>. The term "Director" shall have the meaning as provided in Section 8.1 of the Charter.

<u>Distributions</u>. The term "Distributions" shall mean any distributions (as such term is defined in Section 2-301 of the MGCL) by the Corporation to owners of Shares, including distributions that may constitute a return of capital for federal income tax purposes.

<u>Excepted Holder Limit</u>. The term "Excepted Holder Limit" shall mean, provided that the affected Excepted Holder agrees in writing to comply with the requirements established by the Board of Directors pursuant to Section 7.1.7 of the Charter and subject to adjustment pursuant to Section 7.1.8 of the Charter, the percentage limit established by the Board of Directors pursuant to Section 7.1.7 of the Charter.

<u>Exchange Act</u>. The term "Exchange Act" shall mean the Securities Exchange Act of 1934, as amended from time to time, or any successor statute thereto.

<u>Listing</u>. The term "Listing" shall mean the listing of Common Shares on a national securities exchange. Upon a Listing, such Common Shares shall be deemed Listed.

<u>Market Price</u>. The term "Market Price" on any date shall mean, with respect to any class or series of outstanding Shares, the Closing Price for such Shares on such date. The "Closing Price" on any date shall mean the last sale price for such Shares, regular way, or, in case no such sale takes place on such day, the average of the closing bid and asked prices, regular way, for such Shares, in either case as reported in the principal consolidated transaction

------

reporting system with respect to securities listed or admitted to trading on the NYSE or, if such Shares are not listed or admitted to trading on the NYSE, as reported on the principal consolidated transaction reporting system with respect to securities listed on the principal national securities exchange on which such Shares are listed or admitted to trading or, if such Shares are not listed or admitted to trading on any national securities exchange, the last quoted price or, if not so quoted, the average of the high bid and low asked prices in the over-the-counter market, as reported by the principal automated quotation system that may then be in use or, if such Shares are not quoted by any such system, the average of the closing bid and asked prices as furnished by a professional market maker making a market in such Shares selected by the Board of Directors or, in the event that no trading price is available for such Shares, the fair market value of Shares, as determined by the Board of Directors.

<u>MGCL</u>. The term "MGCL" shall mean the Maryland General Corporation Law, as amended from time to time.

<u>Net Asset Value Per Share of Class I Common Stock</u>. The term "Net Asset Value Per Share of Class I Common Stock" shall mean the net asset value of the Corporation allocable to the Class I Common Stock, calculated as described in the Corporation's most recent Prospectus for an offering of Class I Common Stock (or, if the Corporation is not then engaged in an offering of Class I Common Stock and the calculation methodology has been amended by the Board of Directors, then as described in the Corporation's periodic filings with the Securities and Exchange Commission), divided by the number of outstanding shares of Class I Common Stock.

<u>Net Asset Value Per Share of Class T Common Stock</u>. The term "Net Asset Value Per Share of Class T Common Stock" shall mean the net asset value of the Corporation allocable to the Class T Common Stock, calculated as described in the Corporation's most recent Prospectus for an offering of Class T Common Stock (or, if the Corporation is not then engaged in an offering of Class T Common Stock and the calculation methodology has been amended by the Board of Directors, then as described in the Corporation's periodic filings with the Securities and Exchange Commission), divided by the number of outstanding shares of Class T Common Stock.

<u>Non-Compliant Tender Offer</u>. The term "Non-Compliant Tender Offer" shall have the meaning as provided in Article IX herein.

<u>NYSE</u>. The term "NYSE" shall mean the New York Stock Exchange.

<u>Person</u>. The term "Person" shall mean an individual, corporation, partnership, limited liability company, estate, trust (including a trust qualified under Sections 401(a) or 501(c)(17) of the Code), a portion of a trust permanently set aside for or to be used exclusively for the purposes described in Section 642(c) of the Code, association, private foundation within the meaning of Section 509(a) of the Code, joint stock company or other entity and also includes a group as that term is used for purposes of Section 13(d)(3) of the Exchange Act and a group to which an Excepted Holder Limit applies.

------

<u>Preferred Shares</u>. The term "Preferred Shares" shall have the meaning as provided in Section 6.1 of the Charter.

<u>Prohibited Owner</u>. The term "Prohibited Owner" shall mean, with respect to any purported Transfer, any Person who, but for the provisions of Article VII herein, would Beneficially Own or Constructively Own Shares in violation of Section 7.1.1 of the Charter, and, if appropriate in the context, shall also mean any Person who would have been the record owner of Shares that the Prohibited Owner would have so owned.

<u>Prospectus</u>. The term "Prospectus" shall mean the same as that term is defined in Section 2(10) of the Securities Act, including a preliminary prospectus, an offering circular as described in Rule 256 of the General Rules and Regulations under the Securities Act or, in the case of an intrastate offering, any document by whatever name known, utilized for the purpose of offering and selling Securities to the public.

<u>REIT</u>. The term "REIT" shall mean a corporation, trust, association or other legal entity (other than a real estate syndication) that is engaged primarily in investing in equity interests in real estate (including fee ownership and leasehold interests) or in loans secured by real estate or both, as defined pursuant to the REIT Provisions of the Code.

<u>REIT Provisions of the Code</u>. The term "REIT Provisions of the Code" shall mean Sections 856 through 860 of the Code and any successor or other provisions of the Code relating to real estate investment trusts (including provisions as to the attribution of ownership of beneficial interests therein) and the regulations promulgated thereunder.

<u>Restriction Termination Date</u>. The term "Restriction Termination Date" shall mean the first day on which the Board of Directors determines pursuant to Section 8.6 of the Charter that it is no longer in the best interests of the Corporation to attempt to, or continue to, qualify as a REIT or that compliance with the restrictions and limitations on Beneficial Ownership, Constructive Ownership and Transfers of Shares set forth herein is no longer required in order for the Corporation to qualify as a REIT.

<u>SDAT</u>. The term "SDAT" shall have the meaning as provided in Section 6.4 of the Charter.

<u>Securities</u>. The term "Securities" shall mean any of the following issued by the Corporation, as the text requires: Shares, any other stock, shares or other evidences of equity or beneficial or other interests, voting trust certificates, bonds, debentures, notes or other evidences of indebtedness, secured or unsecured, convertible, subordinated or otherwise, or in general any instruments commonly known as "securities" or any certificates of interest, shares or participations in, temporary or interim certificates for, receipts for, guarantees of or warrants, options or rights to subscribe to, purchase or acquire any of the foregoing.

<u>Securities Act</u>. The term "Securities Act" shall mean the Securities Act of 1933, as amended from time to time, or any successor statute thereto. Reference to any provision of the Securities Act shall mean such provision as in effect from time to time, as the same may be

------

amended, and any successor provision thereto, as interpreted by any applicable regulations as in effect from time to time.

<u>Shares</u>. The term "Shares" shall mean shares of stock of the Corporation of any class or series, including Common Shares or Preferred Shares.

<u>Stockholders</u>. The term "Stockholders" shall mean the holders of record of the Shares as maintained in the books and records of the Corporation or its transfer agent.

<u>Transfer</u>. The term "Transfer" shall mean any issuance, sale, transfer, gift, assignment, devise or other disposition, as well as any other event that causes any Person to acquire Beneficial Ownership or Constructive Ownership of Shares or the right to vote or receive dividends on Shares, or any agreement to take any such action or cause any such event, including (i) the granting or exercise of any option (or any disposition of any option), (ii) any disposition of any securities or rights convertible into or exchangeable for Shares or any interest in Shares or any exercise of any such conversion or exchange right and (iii) Transfers of interests in other entities that result in changes in Beneficial or Constructive Ownership of Shares; in each case, whether voluntary or involuntary, whether owned of record, Constructively Owned or Beneficially Owned and whether by operation of law or otherwise. The terms "Transferring" and "Transferred" shall have the correlative meanings.

**ARTICLE VI**

**STOCK**

Section 6.1 <u>Authorized Shares</u>. The Corporation has authority to issue 1,200,000,000 Shares, of which (i) 1,000,000,000 shares shall be classified as common stock, $0.01 par value per share ("Common Shares"), 200,000,000 of which shall be classified as Class T Common Stock (the "Class T Common Stock") and 800,000,000 of which shall be classified as Class I Common Stock (the "Class I Common Stock"), and (ii) 200,000,000 shares shall be classified as preferred stock, $0.01 par value per share ("Preferred Shares"). The aggregate par value of all authorized Shares having par value is $12,000,000. If Shares of one class are classified or reclassified into Shares of another class pursuant to this Article VI, the number of authorized Shares of the former class shall be automatically decreased and the number of Shares of the latter class shall be automatically increased, in each case by the number of Shares so classified or reclassified, so that the aggregate number of Shares of all classes that the Corporation has authority to issue shall not be more than the total number of Shares set forth in the first sentence of this paragraph. The Board of Directors, with the approval of a majority of the entire Board and without any action by the Stockholders, may amend the Charter from time to time to increase or decrease the aggregate number of Shares or the number of Shares of any class or series that the Corporation has authority to issue.

Section 6.2 <u>Common Shares</u>.

Section 6.2.1 <u>Common Shares Subject to Terms of Preferred Shares</u>. The Common Shares shall be subject to the express terms of any class or series of Preferred Shares.

------

Section 6.2.2 <u>Description</u>. Subject to the provisions of Article VII and except as may otherwise be specified in the Charter, each Common Share shall entitle the holder thereof to one vote. The Board may classify or reclassify any unissued Common Shares from time to time into one or more classes or series of Shares.

Section 6.2.3 <u>Rights Upon Liquidation</u>. In the event of any voluntary or involuntary liquidation, dissolution or winding up, or any Distribution of the assets of the Corporation, the holder of each share of Class T Common Stock shall be entitled to be paid, out of the assets of the Corporation that are legally available for Distribution to the Stockholders, a liquidation payment equal to the Net Asset Value Per Share of Class T Common Stock and the holder of each share of Class I Common Stock shall be entitled to be paid, out of the assets of the Corporation that are legally available for Distribution to the Stockholders, a liquidation payment equal to the Net Asset Value Per Share of Class I Common Stock.

Section 6.2.4 <u>Voting Rights</u>. Except as may be provided otherwise in the Charter, and subject to the express terms of any series of Preferred Shares, the holders of the Common Shares shall have the exclusive right to vote on all matters (as to which a common stockholder shall be entitled to vote pursuant to applicable law) at all meetings of the Stockholders. The shares of Class I Common Stock shall vote together with the shares of Class T Common Stock as a single class on all actions to be taken by the Stockholders; <u>provided</u>, <u>however</u>, that the holders of Class I Common Stock shall have exclusive voting rights on any amendment of the Charter (including the terms of the Class I Common Stock set forth herein) that would alter only the contract rights of the Class I Common Stock and no holders of any other class or series of Shares shall be entitled to vote thereon; and <u>provided</u> <u>further</u> that the holders of Class I Common Stock shall have no voting rights on any amendment of the Charter that would alter only the contract rights of any other class or series of Common Shares, including, without limitation, the Class T Common Stock.

Section 6.2.5 <u>Conversion Upon Listing</u>. Upon the Listing of a class of Common Shares or such later date not to exceed twelve months from the date of Listing as shall be approved by the Board of Directors, each Share of the class or classes of Common Shares that are not so Listed shall automatically and without any action on the part of the holder thereof convert into a number of Shares of the class of Common Shares that is Listed equal to a fraction, the numerator of which is the net asset value of the Corporation allocable to the Shares of the applicable class of Common Shares that is not Listed and the denominator of which is the net asset value of the Corporation allocable to the Shares of the class of Common Shares that is Listed.

Section 6.3 <u>Preferred Shares</u>. The Board may classify any unissued Preferred Shares and reclassify any previously classified but unissued Preferred Shares of any series from time to time, into one or more classes or series of Shares.

Section 6.4 <u>Classified or Reclassified Shares</u>. Prior to issuance of classified or reclassified Shares of any class or series, the Board by resolution shall: (a) designate that class or series to distinguish it from all other classes and series of Shares; (b) specify the number of Shares to be included in the class or series; (c) set or change, subject to the provisions of Article VII and subject to the express terms of any class or series of Shares outstanding at the time, the

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preferences, conversion or other rights, voting powers, restrictions, limitations as to dividends or other Distributions, qualifications and terms and conditions of redemption for each class or series; and (d) cause the Corporation to file articles supplementary with the State Department of Assessments and Taxation of Maryland ("SDAT"). Any of the terms of any class or series of Shares set or changed pursuant to clause (c) of this Section 6.4 may be made dependent upon facts or events ascertainable outside the Charter (including determinations by the Board or other facts or events within the control of the Corporation) and may vary among holders thereof, provided that the manner in which such facts, events or variations shall operate upon the terms of such class or series of Shares is clearly and expressly set forth in the articles supplementary or other charter document.

Section 6.5 <u>Distributions</u>. The Board of Directors may from time to time authorize the Corporation to declare and pay to Stockholders such dividends or other Distributions, in cash or other assets of the Corporation or in securities of the Corporation, including in Shares of one class payable to holders of Shares of another class, or from any other source as the Board of Directors in its sole and absolute discretion shall determine. The exercise of the powers and rights of the Board of Directors pursuant to this Section 6.5 shall be subject to the provisions of any class or series of Shares at the time outstanding.

Section 6.6 <u>Charter and Bylaws</u>. The rights of all Stockholders and the terms of all Shares are subject to the provisions of the Charter and the Bylaws.

**ARTICLE VII**

**RESTRICTION ON TRANSFER AND OWNERSHIP OF SHARES**

Section 7.1 <u>Shares</u>.

Section 7.1.1 <u>Ownership Limitations</u>. Prior to the Restriction Termination Date, but subject to Section 7.3 of the Charter:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(a) <u>Basic Restrictions</u>.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(i) (1) No Person, other than an Excepted Holder, shall

Beneficially Own or Constructively Own Shares in excess of the Aggregate Share Ownership Limit, (2) no Person, other than an Excepted Holder, shall Beneficially Own or Constructively Own Common Shares in excess of the Common Share Ownership Limit and (3) no Excepted Holder shall Beneficially Own or Constructively Own Shares in excess of the Excepted Holder Limit for such Excepted Holder.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(ii) No Person shall Beneficially or Constructively Own

Shares to the extent that such Beneficial or Constructive Ownership of Shares would result in the Corporation being "closely held" within the meaning of Section 856(h) of the Code (without regard to whether the ownership interest is held during the last half of a taxable year), or otherwise failing to qualify as a REIT (including, but not limited to, Beneficial or Constructive Ownership that would result in the Corporation owning (actually or Constructively) an interest in a tenant that is described in Section 856(d)(2)(B) of the Code if the income derived by the

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Corporation from such tenant would cause the Corporation to fail to satisfy any of the gross income requirements of Section 856(c) of the Code).

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(iii) Any Transfer of Shares that, if effective, would result in Shares being beneficially owned by fewer than 100 Persons (determined under the principles of Section 856(a)(5) of the Code) shall be void <u>ab</u> <u>initio</u>, and the intended transferee shall acquire no rights in such Shares.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) <u>Transfer in Trust</u>. If any Transfer of Shares occurs which, if effective, would result in any Person Beneficially Owning or Constructively Owning Shares in violation of Section 7.1.1(a)(i) or (ii) of the Charter,

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(i) then that number of Shares the Beneficial or Constructive Ownership of which otherwise would cause such Person to violate Section 7.1.1(a)(i) or (ii) of the Charter (rounded up to the nearest whole share) shall be automatically Transferred to a Charitable Trust for the benefit of a Charitable Beneficiary, as described in Section 7.2 of the Charter, effective as of the close of business on the Business Day prior to the date of such Transfer, and such Person shall acquire no rights in such Shares; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(ii) if the Transfer to the Charitable Trust described in clause (i) of this sentence would not be effective for any reason to prevent the violation of Section 7.1.1(a)(i) or (ii) of the Charter, then the Transfer of that number of Shares that otherwise would cause any Person to violate Section 7.1.1(a)(i) or (ii) of the Charter shall be void <u>ab</u> <u>initio</u>, and the intended transferee shall acquire no rights in such Shares.

To the extent that, upon a transfer of Shares pursuant to this Section 7.1.1(b), a violation of any provision of this Article VII would nonetheless be continuing (for example where the ownership of Shares by a single Charitable Trust would violate the 100 stockholder requirement applicable to REITs), then Shares shall be transferred to that number of Charitable Trusts, each having a distinct Charitable Trustee and a Charitable Beneficiary or Beneficiaries that are distinct from those of each other Charitable Trust, such that there is no violation of any provision of this Article VII.

Section 7.1.2 <u>Remedies for Breach</u>. If the Board of Directors or its designee (including any duly authorized committee of the Board) shall at any time determine that a Transfer or other event has taken place that results in a violation of Section 7.1.1 of the Charter or that a Person intends to acquire or has attempted to acquire Beneficial or Constructive Ownership of any Shares in violation of Section 7.1.1 of the Charter (whether or not such violation is intended), the Board of Directors or its designee shall take such action as it deems advisable to refuse to give effect to or to prevent such Transfer or other event, including, without limitation, causing the Corporation to redeem Shares, refusing to give effect to such Transfer on the books of the Corporation or instituting proceedings to enjoin such Transfer or other event; provided, however, that any Transfers or attempted Transfers or other events in violation of Section 7.1.1 of the Charter shall automatically result in the Transfer to the Charitable Trust described above, and, where applicable, such Transfer (or other event) shall be void <u>ab</u> <u>initio</u> as provided above irrespective of any action (or non-action) by the Board of Directors or its designee.

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Section 7.1.3 <u>Notice of Restricted Transfer</u>. Any Person who acquires or attempts or intends to acquire Beneficial Ownership or Constructive Ownership of Shares that will or may violate Section 7.1.1(a) of the Charter, or any Person who would have owned Shares that resulted in a Transfer to the Charitable Trust pursuant to the provisions of Section 7.1.1(b) of the Charter, shall immediately give written notice to the Corporation of such event, or in the case of such a proposed or attempted transaction, give at least 15 days prior written notice, and shall provide to the Corporation such other information as the Corporation may request in order to determine the effect, if any, of such Transfer on the Corporation's status as a REIT.

Section 7.1.4 <u>Owners Required To Provide Information</u>. Prior to the Restriction Termination Date:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(a) every owner of more than five percent (or such lower percentage as required by the Code or the Treasury Regulations promulgated thereunder) of the outstanding Shares, within 30 days after the end of each taxable year, shall give written notice to the Corporation stating the name and address of such owner, the number of Shares Beneficially Owned and a description of the manner in which such Shares are held. Each such owner shall provide to the Corporation such additional information as the Corporation may request in order to determine the effect, if any, of such Beneficial Ownership on the Corporation's status as a REIT and to ensure compliance with the Aggregate Share Ownership Limit, the Common Share Ownership Limit and the other restrictions set forth herein; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) each Person who is a Beneficial or Constructive Owner of Shares and each Person (including the Stockholder of record) who is holding Shares for a Beneficial or Constructive Owner shall provide to the Corporation such information as the Corporation may request in order to determine the Corporation's status as a REIT and to comply with requirements of any taxing authority or governmental authority or to determine such compliance.

Section 7.1.5 <u>Remedies Not Limited</u>. Subject to Section 8.10 of the Charter, nothing contained in this Section 7.1 shall limit the authority of the Board of Directors to take such other action as it deems necessary or advisable to protect the Corporation and the interests of its Stockholders in preserving the Corporation's status as a REIT.

Section 7.1.6 <u>Ambiguity</u>. In the case of an ambiguity in the application of any of the provisions of this Section 7.1, Section 7.2 of the Charter or any definition contained in Article V, the Board of Directors may determine the application of the provisions of this Section 7.1 or Section 7.2 of the Charter with respect to any situation based on the facts known to it. In the event this Section 7.1 or 7.2 of the Charter requires an action by the Board of Directors and the Charter fails to provide specific guidance with respect to such action, the Board of Directors may determine the action to be taken so long as such action is not contrary to the provisions of Article V or this Section 7.1 or Section 7.2 of the Charter. Absent a decision to the contrary by the Board of Directors (which the Board may make in its sole and absolute discretion), if a Person would have (but for the remedies set forth in Section 7.1.2 of the Charter) acquired Beneficial or Constructive Ownership of Shares in violation of Section 7.1.1 of the Charter, such remedies (as applicable) shall apply first to the Shares which, but for such remedies, would have been Beneficially Owned or Constructively Owned (but not actually

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owned) by such Person, pro rata among the Persons who actually own such Shares based upon the relative number of the Shares held by each such Person.

Section 7.1.7 <u>Exceptions</u>.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(a) Subject to Section 7.1.1(a)(ii) of the Charter, the Board of Directors may exempt (prospectively or retroactively) a Person from the Aggregate Share Ownership Limit and the Common Share Ownership Limit, as the case may be, and may establish or increase an Excepted Holder Limit for such Person if:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(i) the Board of Directors obtains such representations and undertakings from such Person as are reasonably necessary for the Board to ascertain that no individual's Beneficial or Constructive Ownership of such Shares will violate Section 7.1.1(a)(ii) of the Charter;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(ii) such Person does not and represents that it will not own, actually or Constructively, an interest in a tenant of the Corporation (or a tenant of any entity owned or controlled by the Corporation) that would cause the Corporation to own, actually or Constructively, more than a 9.9% interest (as set forth in Section 856(d)(2)(B) of the Code) in such tenant and the Board of Directors obtains such representations and undertakings from such Person as are reasonably necessary to ascertain this fact (for this purpose, a tenant from whom the Corporation (or an entity owned or controlled by the Corporation) derives (and is expected to continue to derive) a sufficiently small amount of revenue such that, in the judgment of the Board of Directors, rent from such tenant would not adversely affect the Corporation's ability to qualify as a REIT, shall not be treated as a tenant of the Corporation); and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(iii) such Person agrees that any violation or attempted violation of such representations or undertakings (or other action which is contrary to the restrictions contained in Sections 7.1.1 through 7.1.6 of the Charter) will result in such Shares being automatically Transferred to a Charitable Trust in accordance with Sections 7.1.1(b) and 7.2 of the Charter.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(b) Prior to granting any exception pursuant to Section 7.1.7(a), the Board of Directors may require a ruling from the Internal Revenue Service, or an opinion of counsel, in either case in form and substance satisfactory to the Board of Directors in its sole and absolute discretion, as it may deem necessary or advisable in order to determine or ensure the Corporation's status as a REIT. Notwithstanding the receipt of any ruling or opinion, the Board of Directors may impose such conditions or restrictions as it deems appropriate in connection with granting such exception.

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(c) Subject to Section 7.1.1(a)(ii) of the Charter, an underwriter which participates in a public offering or a private placement of Shares (or securities convertible into or exchangeable or exercisable for Shares) may Beneficially Own or Constructively Own Shares (or securities convertible into or exchangeable or exercisable for Shares) in excess of the Aggregate Share Ownership Limit, the Common Share Ownership Limit or both such limits, but only to the extent necessary to facilitate such public offering or private placement.

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(d) The Board of Directors may only reduce the Excepted Holder Limit for an Excepted Holder: (i) with the written consent of such Excepted Holder at any time, (ii) unless the terms and conditions of the agreements and undertakings entered into with such Excepted Holder in connection with the establishment of the Excepted Holder Limit for that Excepted Holder provide otherwise, at any time after the Excepted Holder no longer Beneficially Owns or Constructively Owns Shares in excess of the Aggregate Share Ownership Limit or the Common Share Ownership Limit or (iii) pursuant to the terms and conditions of the agreements and undertakings entered into with such Excepted Holder in connection with the establishment of the Excepted Holder Limit for that Excepted Holder. No Excepted Holder Limit shall be reduced to a percentage that is less than the Common Share Ownership Limit.

Section 7.1.8 <u>Increase or Decrease in Aggregate Share Ownership and Common Share Ownership Limits</u>. Subject to Section 7.1.1(a)(ii) of the Charter, the Board of Directors may from time to time increase or decrease the Common Share Ownership Limit and the Aggregate Share Ownership Limit for one or more Persons and increase or decrease the Common Share Ownership Limit and the Aggregate Share Ownership Limit for all other Persons. No decreased Common Share Ownership Limit and/or Aggregate Share Ownership Limit will be effective for any Person whose percentage of ownership in Shares is in excess of such decreased Common Share Ownership Limit and/or Aggregate Share Ownership Limit, as applicable, until such time as such Person's percentage of ownership in Shares equals or falls below the decreased Common Share Ownership Limit and/or Aggregate Share Ownership Limit, but any further acquisition of Shares in excess of such percentage of ownership in Shares will be in violation of the Common Share Ownership Limit and/or Aggregate Share Ownership Limit and, provided further, that the new Common Share Ownership Limit and/or Aggregate Share Ownership Limit would not allow five or fewer Persons to Beneficially Own more than 49.9% in value of the outstanding Shares.

Section 7.1.9 <u>Legend</u>. Any certificate representing Shares shall bear substantially the following legend:

The Shares represented by this certificate are subject to restrictions on Beneficial and Constructive Ownership and Transfer for the purpose, among others, of the Corporation's maintenance of its status as a real estate investment trust (a "REIT") under the Internal Revenue Code of 1986, as amended (the "Code"). Subject to certain further restrictions and except as expressly provided in the Corporation's charter, (i) no Person may Beneficially or Constructively Own Common Shares in excess of 9.9% (in value or number of Common Shares) of the outstanding Common Shares unless such Person is an Excepted Holder (in which case the Excepted Holder Limit shall be applicable); (ii) no Person may Beneficially or Constructively Own Shares in excess of 9.9% of the value of the total outstanding Shares, unless such Person is an Excepted Holder (in which case the Excepted Holder Limit shall be applicable); (iii) no Person may Beneficially or Constructively Own Shares that would result in the Corporation being "closely held" under Section 856(h) of the Code or otherwise cause the

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Corporation to fail to qualify as a REIT; and (iv) any Transfer of Shares that, if effective, would result in Shares being beneficially owned by fewer than 100 Persons (as determined under the principles of Section 856(a)(5) of the Code) shall be void <u>ab</u> <u>initio</u>, and the intended transferee shall acquire no rights in such Shares. Any Person who Beneficially or Constructively Owns or attempts to Beneficially or Constructively Own Shares which cause or will cause a Person to Beneficially or Constructively Own Shares in excess or in violation of the above limitations must immediately notify the Corporation in writing (or, in the case of an attempted transaction, give at least 15 days prior written notice). If any of the restrictions on Transfer or ownership as set forth in (i), (ii) or (iii) above are violated, the Shares in excess or in violation of the above limitations will be automatically Transferred to a Charitable Trust for the benefit of one or more Charitable Beneficiaries. In addition, the Corporation may redeem Shares upon the terms and conditions specified by the Board of Directors in its sole discretion if the Board of Directors determines that ownership or a Transfer or other event may violate the restrictions described above. Furthermore, upon the occurrence of certain events, attempted Transfers in violation of the restrictions described in (i), (ii) or (iii) above may be void <u>ab</u> <u>initio</u>. All capitalized terms in this legend have the meanings defined in the Corporation's charter, as the same may be amended from time to time, a copy of which, including the restrictions on Transfer and ownership, will be furnished to each holder of Shares on request and without charge. Requests for such a copy may be directed to the Secretary of the Corporation at its principal office.

Instead of the foregoing legend, the certificate may state that the Corporation will furnish a full statement about certain restrictions on transferability to a Stockholder on request and without charge. In the case of uncertificated Shares, the Corporation will send the holder of such Shares, on request and without charge, a written statement of the information otherwise required on certificates.

Section 7.2 <u>Transfer of Shares in Trust</u>.

Section 7.2.1 <u>Ownership in Trust</u>. Upon any purported Transfer or other event described in Section 7.1.1(b) of the Charter that would result in a Transfer of Shares to a Charitable Trust, such Shares shall be deemed to have been Transferred to the Charitable Trustee as trustee of a Charitable Trust for the exclusive benefit of one or more Charitable Beneficiaries. Such Transfer to the Charitable Trustee shall be deemed to be effective as of the close of business on the Business Day prior to the purported Transfer or other event that results in the Transfer to the Charitable Trust pursuant to Section 7.1.1(b) of the Charter. The Charitable Trustee shall be appointed by the Corporation and shall be a Person unaffiliated with the Corporation and any Prohibited Owner. Each Charitable Beneficiary shall be designated by the Corporation as provided in Section 7.2.6 of the Charter.

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Section 7.2.2 <u>Status of Shares Held by the Charitable Trustee</u>. Shares held by the Charitable Trustee shall continue to be issued and outstanding Shares. The Prohibited Owner shall have no rights in the Shares held by the Charitable Trustee. The Prohibited Owner shall not benefit economically from ownership of any Shares held in trust by the Charitable Trustee, shall have no rights to dividends or other Distributions and shall not possess any rights to vote or other rights attributable to the Shares held in the Charitable Trust.

Section 7.2.3 <u>Dividend and Voting Rights</u>. The Charitable Trustee shall have all voting rights and rights to dividends or other Distributions with respect to Shares held in the Charitable Trust, which rights shall be exercised for the exclusive benefit of the Charitable Beneficiary. Any dividend or other Distribution paid prior to the discovery by the Corporation that Shares have been Transferred to the Charitable Trustee shall be paid by the recipient of such dividend or other Distribution to the Charitable Trustee upon demand and any dividend or other Distribution authorized but unpaid shall be paid when due to the Charitable Trustee. Any dividends or other Distributions so paid over to the Charitable Trustee shall be held in trust for the Charitable Beneficiary. The Prohibited Owner shall have no voting rights with respect to Shares held in the Charitable Trust and, subject to Maryland law, effective as of the date that Shares have been Transferred to the Charitable Trustee, the Charitable Trustee shall have the authority (at the Charitable Trustee's sole and absolute discretion) (a) to rescind as void any vote cast by a Prohibited Owner prior to the discovery by the Corporation that Shares have been Transferred to the Charitable Trustee and (b) to recast such vote in accordance with the desires of the Charitable Trustee acting for the benefit of the Charitable Beneficiary; provided, however, that if the Corporation has already taken irreversible corporate action, then the Charitable Trustee shall not have the authority to rescind and recast such vote. Notwithstanding the provisions of this Article VII, until the Corporation has received notification that Shares have been Transferred into a Charitable Trust, the Corporation shall be entitled to rely on its share transfer and other Stockholder records for purposes of preparing lists of Stockholders entitled to vote at meetings, determining the validity and authority of proxies and otherwise conducting votes and determining the other rights of Stockholders.

Section 7.2.4 <u>Sale of Shares by Charitable Trustee</u>. Within 20 days of receiving notice from the Corporation that Shares have been Transferred to the Charitable Trust, the Charitable Trustee shall sell the Shares held in the Charitable Trust to a Person, designated by the Charitable Trustee, whose ownership of the Shares will not violate the ownership limitations set forth in Section 7.1.1(a) of the Charter. Upon such sale, the interest of the Charitable Beneficiary in the Shares sold shall terminate and the Charitable Trustee shall distribute the net proceeds of the sale to the Prohibited Owner and to the Charitable Beneficiary as provided in this Section 7.2.4. The Charitable Trustee may reduce the amount payable to the Prohibited Owner by the amount of dividends and other Distributions which have been paid to the Prohibited Owner and are owed by the Prohibited

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Owner to the Charitable Trustee pursuant to Section 7.2.3 of the Charter. Any net sales proceeds in excess of the amount payable to the Prohibited Owner shall be immediately paid to the Charitable Beneficiary. If, prior to the discovery by the Corporation that Shares have been Transferred to the Charitable Trustee, such Shares are sold by a Prohibited Owner, then (i) such Shares shall be deemed to have been sold on behalf of the Charitable Trust and (ii) to the extent that the Prohibited Owner received an amount for such Shares that exceeds the amount that such Prohibited Owner was entitled to receive pursuant to this Section 7.2.4, such excess shall be paid to the Charitable Trustee upon demand.

Section 7.2.5 <u>Purchase Right in Shares Transferred to the Charitable Trustee</u>. Shares Transferred to the Charitable Trustee shall be deemed to have been offered for sale to the Corporation, or its designee, at a price per Share equal to the lesser of (a) the price per Share in the transaction that resulted in such Transfer to the Charitable Trust (or, in the case of a devise or gift, the Market Price at the time of such devise or gift) and (b) the Market Price on the date the Corporation, or its designee, accepts such offer. The Corporation shall have the right to accept such offer until the Charitable Trustee has sold the Shares held in the Charitable Trust pursuant to Section 7.2.4 of the Charter. Upon such a sale to the Corporation, the interest of the Charitable Beneficiary in the Shares sold shall terminate and the Charitable Trustee shall distribute the net proceeds of the sale to the Prohibited Owner. The Corporation may reduce the amount payable to the Prohibited Owner by the amount of dividends and other Distributions which have been paid to the Prohibited Owner and are owed by the Prohibited Owner to the Charitable Trustee pursuant to Section 7.2.3 of the Charter. The Corporation may pay the amount of such reduction to the Charitable Trustee for the benefit of the Charitable Beneficiary.

Section 7.2.6 <u>Designation of Charitable Beneficiaries</u>. By written notice to the Charitable Trustee, the Corporation shall designate one or more nonprofit organizations to be the Charitable Beneficiary of the interest in the Charitable Trust such that (a) Shares held in the Charitable Trust would not violate the restrictions set forth in Section 7.1.1(a) of the Charter in the hands of such Charitable Beneficiary and (b) each such organization must be described in Section 501(c)(3) of the Code and contributions to each such organization must be eligible for deduction under each of Sections 170(b)(1)(A), 2055 and 2522 of the Code. Neither the failure of the Corporation to make such designation nor the failure of the Corporation to appoint the Charitable Trustee before the automatic transfer provided in Section 7.1.1(b) of the Charter shall make such transfer ineffective, provided that the Corporation thereafter makes such designation and appointment.

Section 7.3 <u>Settlement</u>. Nothing in this Article VII shall preclude the settlement of any transaction entered into through the facilities of the NYSE or any other national securities exchange or automated inter-dealer quotation system. The fact that the settlement of any transaction occurs shall not negate the effect of any other provision of this Article VII and any transferee in such a transaction shall be subject to all of the provisions and limitations set forth in this Article VII.

Section 7.4 <u>Enforcement</u>. The Corporation is authorized specifically to seek equitable relief, including injunctive relief, to enforce the provisions of this Article VII.

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Section 7.5 <u>Non-Waiver</u>. No delay or failure on the part of the Corporation or the Board of Directors in exercising any right hereunder shall operate as a waiver of any right of the Corporation or the Board of Directors, as the case may be, except to the extent specifically waived in writing.

Section 7.6 <u>Severability</u>. If any provision of this Article VII or any application of any such provision is determined to be invalid by any federal or state court having jurisdiction over the issues, the validity of the remaining provisions shall not be affected and other applications of such provisions shall be affected only to the extent necessary to comply with the determination of such court.

**ARTICLE VIII**

**PROVISIONS FOR DEFINING, LIMITING** 

**AND REGULATING CERTAIN POWERS OF THE** 

**CORPORATION AND OF THE STOCKHOLDERS AND DIRECTORS**

Section 8.1 <u>Number of Directors</u>. The business and affairs of the Corporation shall be managed under the direction of the Board of Directors. The number of Directors of the Corporation (the "Directors") shall be five, which number may be increased or decreased from time to time pursuant to the Bylaws; provided, however, that the total number of Directors shall not be fewer than the minimum number required by the MGCL. The names of the Directors who shall serve until the next annual meeting of Stockholders and until their successors are duly elected and qualify are:

Jeffrey T. Hanson

Richard S. Welch

Brian J. Flornes

Dianne Hurley

Wilbur H. Smith III

Any vacancy on the Board of Directors may be filled in the manner provided in the Bylaws.

The Corporation elects, pursuant to Section 3-804(c) of the MGCL, that, except as may be provided by the Board of Directors in setting the terms of any class or series of Preferred Shares, any and all vacancies on the Board of Directors may be filled only by the affirmative vote of a majority of the remaining Directors in office, even if the remaining Directors do not constitute a quorum, and any Director elected to fill a vacancy shall serve for the remainder of the full term of the directorship in which such vacancy occurred and until a successor is elected and qualifies.

Section 8.2 <u>Extraordinary Actions</u>. Except as specifically provided in Section 8.7 of the Charter (relating to removal of Directors) and in Article XI, notwithstanding any provision of law permitting or requiring any action to be taken or approved by the affirmative vote of Stockholders entitled to cast a greater number of votes, any such action shall be effective and valid if declared advisable by the Board of Directors and taken or approved by the

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affirmative vote of Stockholders entitled to cast a majority of all the votes entitled to be cast on the matter.

Section 8.3 <u>Authorization by Board of Stock Issuance</u>. The Board of Directors may authorize the issuance from time to time of Shares of any class or series, whether now or hereafter authorized, or securities or rights convertible into Shares of any class or series, whether now or hereafter authorized, for such consideration as the Board of Directors may deem advisable (or without consideration in the case of a stock split or stock dividend), subject to such restrictions or limitations, if any, as may be set forth in the Charter or the Bylaws.

Section 8.4 <u>Preemptive Rights and Appraisal Rights</u>. Except as may be provided by the Board of Directors in setting the terms of classified or reclassified Shares pursuant to Section 6.4 of the Charter or as may otherwise be provided by contract approved by the Board of Directors, no holder of Shares shall, as such holder, have any preemptive right to purchase or subscribe for any additional Shares or any other Security which the Corporation may issue or sell. Holders of Shares shall not be entitled to exercise any rights of an objecting stockholder provided for under Title 3, Subtitle 2 of the MGCL or any successor statute unless the Board of Directors, upon such terms and conditions as may be specified by the Board of Directors, shall determine that such rights apply, with respect to all or any classes or series of Shares, to one or more transactions occurring after the date of such determination in connection with which holders of such Shares would otherwise be entitled to exercise such rights.

Section 8.5 <u>Determinations by Board</u>. The determination as to any of the following matters, made by or pursuant to the direction of the Board of Directors consistent with the Charter, shall be final and conclusive and shall be binding upon the Corporation and every holder of Shares: the amount of the net income of the Corporation for any period and the amount of assets at any time legally available for the payment of dividends, redemption of Shares or the payment of other Distributions on Shares; the amount of paid-in surplus, net assets, other surplus, annual or other cash flow, funds from operations, net profit, net assets in excess of capital, undivided profits or excess of profits over losses on sales of assets; the amount, purpose, time of creation, increase or decrease, alteration or cancellation of any reserves or charges and the propriety thereof (whether or not any obligation or liability for which such reserves or charges shall have been created shall have been paid or discharged); any interpretation or resolution of any ambiguity with respect to any provision of the Charter (including any of the terms, preferences, conversion or other rights, voting powers or rights, restrictions, limitations as to dividends or other Distributions, qualifications or terms or conditions of redemption of any class or series of Shares) or of the Bylaws; the fair value, or any sale, bid or asked price to be applied in determining the fair value, of any asset owned or held by the Corporation or of any Shares; the number of Shares of any class of the Corporation; any interpretation of the terms and conditions of one or more agreements with any Person; the compensation of Directors, officers, employees or agents of the Corporation; or any other matter relating to the business and affairs of the Corporation or required or permitted by applicable law, the Charter or Bylaws or otherwise to be determined by the Board of Directors; provided, however, that any determination by the Board of Directors as to any of the preceding matters shall not render invalid or improper any action taken or omitted prior to such determination and no Director shall be liable for making or failing to make such a determination.

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Section 8.6 <u>REIT Qualification</u>. If the Corporation elects to qualify for federal income tax treatment as a REIT, the Board of Directors shall use its reasonable best efforts to take such actions as are necessary or appropriate to preserve the status of the Corporation as a REIT; provided, however, if the Board of Directors determines that it is no longer in the best interests of the Corporation to attempt to, or continue to, qualify as a REIT, the Board of Directors may revoke or otherwise terminate the Corporation's REIT election pursuant to Section 856(g) of the Code. The Board of Directors also may determine that compliance with any restriction or limitation on stock ownership and Transfers set forth in Article VII is no longer required for REIT qualification. No Director or officer, employee or agent of the Corporation shall be liable for any act or omission resulting in the loss of tax benefits under the Code, except to the extent provided in Section 10.2 of the Charter.

Section 8.7 <u>Removal of Directors</u>. Subject to the rights of holders of one or more classes or series of Preferred Shares to elect or remove one or more Directors, any Director, or the entire Board of Directors, may be removed from office at any time, but only by the affirmative vote of Stockholders entitled to cast at least two-thirds of the votes entitled to be cast generally in the election of Directors.

Section 8.8 <u>Advisor Agreements</u>. Subject to such approval of Stockholders and other conditions, if any, as may be required by any applicable statute, rule or regulation, the Board of Directors may authorize the execution and performance by the Corporation of one or more agreements with any Person whereby, subject to the supervision and control of the Board of Directors, any such other Person shall render or make available to the Corporation managerial, investment, advisory and/or related services, office space and other services and facilities (including, if deemed advisable by the Board of Directors, the management or supervision of the investments of the Corporation) upon such terms and conditions as may be provided in such agreement or agreements (including, if deemed fair and equitable by the Board of Directors, the compensation payable thereunder by the Corporation).

Section 8.9 <u>Corporate Opportunities</u>. The Corporation shall have the power, by resolution of the Board of Directors, to renounce any interest or expectancy of the Corporation in, or in being offered an opportunity to participate in, business opportunities or classes or categories of business opportunities that are presented to the Corporation or developed by or presented to one or more Directors or officers of the Corporation.

**ARTICLE IX**

**TENDER OFFERS**

If any Person makes a tender offer, including, without limitation, a "mini-tender" offer, such Person must comply with all of the provisions set forth in Regulation 14D of the Exchange Act, including, without limitation, disclosure and notice requirements, that would be applicable if the tender offer was for more than five percent of the outstanding Shares; <u>provided</u>, <u>however</u>, that, unless otherwise required by the Exchange Act, such documents are not required to be filed with the Securities and Exchange Commission. In addition, any such Person must provide notice to the Corporation at least ten business days prior to initiating any such tender offer. No Stockholder may Transfer any Shares held by such Stockholder to any Person who

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initiates a tender offer without complying with the provisions set forth above (a "Non-Compliant Tender Offer") unless such Stockholder shall have first offered such Shares to the Corporation at the tender offer price offered in such Non-Compliant Tender Offer. In addition, any Person who makes a Non-Compliant Tender Offer shall be responsible for all expenses incurred by the Corporation in connection with the enforcement of the provisions of this Article IX, including, without limitation, expenses incurred in connection with the review of all documents related to such tender offer. In addition to the remedies provided herein, the Corporation may seek injunctive relief, including, without limitation, a temporary or permanent restraining order, in connection with any Non-Compliant Tender Offer. This Article IX shall be of no force or effect with respect to any Shares that are then Listed.

**ARTICLE X**

**LIABILITY LIMITATION AND INDEMNIFICATION**

Section 10.1 <u>Limitation of Stockholder Liability</u>. No Stockholder shall be liable for any debt, claim, demand, judgment or obligation of any kind of, against or with respect to the Corporation by reason of being a Stockholder, nor shall any Stockholder be subject to any personal liability whatsoever, in tort, contract or otherwise, to any Person in connection with the assets or the affairs of the Corporation by reason of being a Stockholder.

Section 10.2 <u>Limitation of Director and Officer Liability</u>. To the maximum extent that Maryland law in effect from time to time permits limitation of the liability of directors and officers of a corporation, no present or former Director or officer of the Corporation shall be liable to the Corporation or its Stockholders for money damages. Neither the amendment nor repeal of this Section 10.2, nor the adoption or amendment of any other provision of the Charter or Bylaws inconsistent with this Section 10.2, shall apply to or affect in any respect the applicability of the preceding sentence with respect to any act or failure to act which occurred prior to such amendment, repeal or adoption.

Section 10.3 <u>Indemnification</u>. To the maximum extent permitted by Maryland law in effect from time to time, the Corporation shall indemnify and, without requiring a preliminary determination of the ultimate entitlement to indemnification, shall pay or reimburse reasonable expenses in advance of final disposition of a proceeding to (a) any individual who is a present or former director or officer of the Corporation or any of its subsidiaries and who is made or threatened to be made a party to, or witness in, the proceeding by reason of his or her service in that capacity or (b) any individual who, while a director or officer of the Corporation or any of its subsidiaries, and at the request of the Corporation or any of its subsidiaries, serves or has served as a director, officer, partner, manager, member or trustee of another corporation, real estate investment trust, partnership, joint venture, limited liability company, trust, employee benefit plan or other enterprise and who is made or threatened to be made a party to, or witness in, the proceeding by reason of his or her service in that capacity. The rights to indemnification and advance of expenses provided by the Charter shall vest immediately upon the election of a director or officer. The indemnification and payment or reimbursement of expenses provided in the Charter shall not be deemed exclusive of or limit in any way other rights to which any person seeking indemnification or payment or reimbursement of expenses may be or may become entitled under any bylaw, resolution, insurance or agreement or otherwise.

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Neither the amendment nor repeal of this Section 10.3, nor the adoption or amendment of any other provision of the Charter or Bylaws inconsistent with this Section 10.3, shall apply to or affect in any respect the applicability of the preceding paragraph with respect to any act or failure to act which occurred prior to such amendment, repeal or adoption.

Section 10.4 <u>Express Exculpatory Clauses in Instruments</u>. Neither the Stockholders nor the Directors, officers, employees or agents of the Corporation shall be liable under any written instrument creating an obligation of the Corporation by reason of their being Stockholders, Directors, officers, employees or agents of the Corporation, and all Persons shall look solely to the Corporation's assets for the payment of any claim under or for the performance of that instrument. The omission of the foregoing exculpatory language from any instrument shall not affect the validity or enforceability of such instrument and shall not render any Stockholder, Director, officer, employee or agent liable thereunder to any third party, nor shall the Directors or any officer, employee or agent of the Corporation be liable to anyone as a result of such omission.

**ARTICLE XI**

**AMENDMENTS**

The Corporation reserves the right from time to time to make any amendment to the Charter, now or hereafter authorized by law, including any amendment altering the terms or contract rights, as expressly set forth in the Charter, of any Shares. All rights and powers conferred by the Charter on Stockholders, Directors and officers are granted subject to this reservation. Except as set forth in the next sentence and except for those amendments permitted to be made without Stockholder approval under Maryland law or by specific provision in the Charter, any amendment to the Charter shall be valid only if declared advisable by the Board of Directors and approved by the affirmative vote of Stockholders entitled to cast a majority of all the votes entitled to be cast on the matter. Any amendment to Section 8.7 of the Charter or this sentence of the Charter shall be valid only if declared advisable by the Board of Directors and approved by the affirmative vote of Stockholders entitled to cast two-thirds of all the votes entitled to be cast on the matter.

<u>THIRD</u>: The amendment and restatement of the charter of the Corporation as hereinabove set forth has been duly advised by the Board of Directors and approved by the Stockholders of the Corporation as required by law.

<u>FOURTH</u>: The current address of the principal office of the Corporation in the State of Maryland is as set forth in Article IV of the foregoing amendment and restatement of the charter.

<u>FIFTH</u>: The name and address of the Corporation's current resident agent are as set forth in Article IV of the foregoing amendment and restatement of the charter.

<u>SIXTH</u>: The number of Directors of the Corporation and the names of those currently in office are as set forth in Section 8.1 of the foregoing amendment and restatement of the charter.

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<u>SEVENTH</u>: The total number of shares of stock which the Corporation had authority to issue immediately prior to the foregoing amendment and restatement of the charter was 1,200,000,000, consisting of 1,000,000,000 shares of common stock, $0.01 par value per share, 900,000,000 of which were classified as Class T Common Stock and 100,000,000 of which were classified as Class I Common Stock, and 200,000,000 shares of preferred stock, $0.01 par value per share. The aggregate par value of all shares of stock having par value was $12,000,000.

<u>EIGHTH</u>: The total number of shares of stock which the Corporation has authority to issue pursuant to the foregoing amendment and restatement of the charter is 1,200,000,000, consisting of 1,000,000,000 shares of common stock, $0.01 par value per share, 200,000,000 of which are classified as Class T Common Stock and 800,000,000 of which are classified as Class I Common Stock, and 200,000,000 shares of preferred stock, $0.01 par value per share. The aggregate par value of all authorized shares of stock having par value is $12,000,000.

<u>NINTH</u>: The undersigned acknowledges the foregoing amendment and restatement of the charter to be the corporate act of the Corporation and as to all matters and facts required to be verified under oath, the undersigned acknowledges that to the best of his knowledge, information and belief, these matters and facts are true in all material respects and that this statement is made under the penalties for perjury.

[SIGNATURE PAGE FOLLOWS]

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IN WITNESS WHEREOF, the Corporation has caused these Fourth Articles of Amendment and Restatement to be signed in its name and on its behalf by its Chief Executive Officer and attested to by its Secretary on this 1st day of October 2021.

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| | |
|:---|:---|
| ATTEST: | GRIFFIN-AMERICAN HEALTHCARE |
| | REIT IV, INC. |
| /s/ Cora Lo | /s/ Jeffery T. Hanson |
| Name: Cora Lo | Name: Jeffrey T. Hanson |
| Title: Secretary | Title: Chief Executive Officer |

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## Exhibit 4.2

**<u>EXHIBIT 4.2</u>**

**DESCRIPTION OF REGISTRANT'S SECURITIES**

**REGISTERED PURSUANT TO SECTION 12 OF THE** 

**SECURITIES EXCHANGE ACT OF 1934** 

The following is a description of American Healthcare REIT, Inc.'s securities registered under Section 12 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), as of December 31, 2022 and certain provisions of the Maryland General Corporation Law (the "MGCL"), and our charter and amended and restated bylaws (the "bylaws"). The description is a summary, does not purport to be complete and is subject to and qualified by reference to Maryland law and to our charter and bylaws, copies of which are filed as exhibits to our Annual Report on Form 10-K for the fiscal year ended December 31, 2022 and are incorporated by reference herein. As used herein, the terms "we," "our" and "us" refer to American Healthcare REIT, Inc., a Maryland corporation.

Under our charter, we have authority to issue a total of 1,200,000,000 shares of capital stock, of which (i) 1,000,000,000 shares are designated common stock, $0.01 par value per share, and (ii) 200,000,000 shares are designated as preferred stock, $0.01 par value per share. Of the 1,000,000,000 shares of common stock authorized, 200,000,000 shares are classified as Class T common stock and 800,000,000 shares are classified as Class I common stock. In addition, our board of directors may amend our charter from time to time, without stockholder approval, to increase or decrease the aggregate number of shares of stock or the number of shares of stock of any class or series that we have authority to issue.

**Common Stock**

Subject to the restrictions on ownership and transfer of stock set forth in our charter and except as may otherwise be specified in our charter, the holders of common stock are entitled to one vote per share on all matters voted on by stockholders, including election of our directors; provided, however, that holders of Class I common stock have exclusive voting rights on any amendment to our charter that would alter only the contract rights of Class I common stock and no holders of any other class or series of stock will be entitled to vote thereon, and holders of Class I common stock have no voting rights on any amendment to our charter that would alter only the contract rights of any other class or series of common stock. Our charter does not provide for cumulative voting in the election of our directors. Therefore, the holders of a majority of the outstanding shares of our common stock can elect our entire board of directors. Subject to any preferential rights of any outstanding class or series of shares of stock and to the provisions in our charter regarding the restrictions on ownership and transfer of stock, the holders of common stock are entitled to such distributions as may be authorized from time to time by our board of directors and declared by us out of legally available funds and, upon liquidation, are entitled to receive all assets available for distribution to our stockholders. Our charter also provides that upon the listing of a class of common stock for trading on a national securities exchange or such later date not to exceed 12 months from the date of listing as approved by our board of directors, each share of the class or classes of common stock that are not so listed will automatically and without any action on the part of the holder thereof convert into a number of shares of the listed class of common stock equal to a fraction, the numerator of which is the net asset value allocable to the shares of the applicable non-listed class of common stock and the denominator of which is the net asset value allocable to the shares of the listed class of common stock.

*Class T Shares*

Each share of our Class T common stock sold in the primary portion of our initial public offering (the "primary offering") was subject to a selling commission of up to 3.0% of the gross offering proceeds per share and a dealer manager fee of up to 3.0% of the gross offering proceeds per share. To the extent that selling commissions were less than 3.0% of the gross offering proceeds for any shares of Class T common stock sold, such reduction in selling commissions was accompanied by a corresponding reduction in the applicable per share purchase price for purchases of such shares. With respect to the dealer manager fee, our advisor funded up to an amount equal to 2.0% of the gross offering proceeds, which reduced the amount we paid for such fee, and we funded the remaining 1.0% of the gross offering proceeds. To the extent that any reduction in dealer manager fees exceeded the portion of the dealer manager fees funded by our advisor, such excess reduction was accompanied by a corresponding reduction in the applicable per share purchase price for purchases of such shares. In addition, we pay an ongoing stockholder servicing fee to our dealer manager with respect to shares of our Class T common stock sold in our primary offering. The stockholder servicing fee accrues daily in an amount equal to 1/365th of 1.0% of the purchase price per share of our Class T common stock sold in our primary offering, will not exceed an amount equal to 4.0% in the aggregate and is paid quarterly in arrears. By agreement with participating broker-dealers, such stockholder servicing fee may have been reduced or limited. We will cease paying the stockholder servicing fee with respect to the shares of our Class T common stock sold in our primary offering at the earliest of (i) the date at which the aggregate underwriting compensation from all sources equals 10.0% of the gross proceeds from the sale of shares of our common stock in our primary offering (*i.e.*, excluding proceeds from sales pursuant to our Distribution Reinvestment Plan (the "DRIP")); (ii) the fourth anniversary of the last day of the fiscal quarter in which our initial public offering (excluding the DRIP

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offering) terminates; (iii) the date that such shares are redeemed or are no longer outstanding; or (iv) the occurrence of a merger, listing on a national securities exchange, or an extraordinary transaction. We cannot predict if or when this will occur. Our dealer manager may reallow 100% of the stockholder servicing fee to participating broker-dealers. We do not pay selling commissions, dealer manager fees or stockholder servicing fees on shares of Class T common stock sold pursuant to the DRIP.

*Class I Shares*

Each share of our Class I common stock sold in our primary offering was not subject to up-front selling commissions or a stockholder servicing fee but was subject to a dealer manager fee. Prior to March 1, 2017, shares of Class I common stock were subject to a dealer manager fee of up to 3.0% of the gross offering proceeds in our primary offering, of which an amount equal to 2.0% of the gross offering proceeds was funded by our advisor and 1.0% of the gross offering proceeds was funded by us. Effective March 1, 2017, shares of Class I common stock were subject to a dealer manager fee of up to an amount equal to 1.5% of the gross offering proceeds in our primary offering, all of which was funded by our advisor.

Our board of directors may, without common stockholder approval, classify any unissued shares of our preferred stock and reclassify any unissued shares of our common stock or previously classified shares of our preferred stock into other classes or series of stock. Before authorizing the issuance of shares of any new class or series, our board of directors must set, subject to the provisions of our charter relating to the restrictions on ownership and transfer of our stock, the preferences, conversion and other rights, voting powers, restrictions, limitations as to dividends and other distributions, qualifications and terms or conditions of redemption for each class class or series of stock.In addition, our charter authorizes our board of directors, with the approval of a majority of the entire board of directors and without stockholder approval, to amend our charter from time to time to increase or decrease the aggregate number of shares of stock, or the number of shares of any class or series of stock, that we are authorized to issue. These actions can be taken without common stockholder approval, unless stockholder approval is required by applicable law, the terms of any other class or series of our stock, or the rules of any stock exchange or automated quotation system on which our securities may be listed or traded.

Computershare Trust Company, N.A. acts as our registrar and as the transfer agent for our shares.

**Preferred Stock**

Our charter authorizes our board of directors to designate and issue one or more classes or series of preferred stock without stockholder approval, and to establish the preferences, conversion or other rights, voting powers, restrictions, limitations as to dividends and other distributions, qualifications and terms or conditions of redemption of each class or series of preferred stock so issued.

**Meetings and Special Voting Requirements**

Special meetings of stockholders may be called by the chairman of the board of directors, the chief executive officer, the president and the board of directors and must also be called by our secretary to act on any matter that may properly be considered at a meeting of stockholders upon the written request of stockholders entitled to cast not less than a majority of all the votes entitled to be cast on such matter at the meeting. The presence either in person or by proxy of stockholders entitled to cast a majority of all the votes entitled to be cast at the meeting will constitute a quorum. Generally, the affirmative vote of a majority of all votes cast is necessary to take stockholder action, except as described in the next paragraph and except that a plurality of all the votes cast at a meeting of stockholders duly called and at which a quorum is present is sufficient to elect a director.

Under the MGCL, a Maryland corporation generally cannot dissolve, amend its charter, merge with another entity, convert into another entity, consolidate with one or more other corporations, sell or transfer all or substantially all of its assets or engage in a statutory share exchange unless declared advisable by our board and approved by the affirmative vote of stockholders entitled to cast at least two-thirds of the votes entitled to be cast on the matter unless a lesser percentage (but not less than a majority of all of the votes entitled to be cast on the matter) is set forth in the corporation's charter. Our charter provides that these matters (other than certain amendments to the provisions of our charter related to the removal of directors and the vote required for certain amendments) may be approved by stockholders entitled to cast a majority of all of the votes entitled to be cast on the matter. Stockholders are not entitled to exercise any of the rights of an objecting stockholder provided for in Title 3, Subtitle 2 of the MGCL unless our board of directors determines that such rights apply, with respect to all or any classes or series of stock, to one or more transactions occurring after the date of the determination in connection with which stockholders would otherwise be entitled to exercise such rights. Subject to the rights of holders of one or more classes or series of preferred stock, any director may be removed from office at any time, but only by the affirmative vote of stockholders entitled to cast at least two-thirds of the votes entitled to be cast generally in the election of directors.

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**Restrictions on Ownership and Transfer**

In order for us to maintain our qualification as a real estate investment trust ("REIT") under the Internal Revenue Codes of 1986, as amended (the "Code"), we must meet several requirements concerning the ownership of our outstanding capital stock. Specifically, no more than 49.9% in value of our outstanding capital stock may be owned, directly or indirectly, by five or fewer individuals (as defined in the Code to include specified private foundations, employee benefit plans and trusts, and charitable trusts) during the last half of any taxable year beginning with the second taxable year in which we qualified as a REIT. In addition, the outstanding shares of stock must be owned by 100 or more persons during at least 335 days of a 12-month taxable year or during a proportionate part of a shorter taxable year beginning with the second taxable year in which we qualified as a REIT. We may prohibit certain acquisitions and transfers of shares of our stock so as to ensure our qualification as a REIT under the Internal Revenue Code of 1986, as amended (the "Internal Revenue Code"). However, we cannot assure you that this prohibition will be effective.

Our charter contains a limitation on ownership that prohibits any individual or entity from directly acquiring beneficial ownership of more than 9.9% in value of our then outstanding shares of capital stock (which includes common stock and any preferred stock we may issue) or more than 9.9% (by value or number of shares, whichever is more restrictive) of our the aggregate of our then outstanding shares of common stock.

Any attempted transfer of our stock which, if effective, would result in our stock being beneficially owned by fewer than 100 persons will be null and void and the proposed transferee will acquire no rights in such stock. Any attempted transfer of our stock which, if effective, would result in violation of the ownership limits discussed above or in our being "closely held" under Section 856(h) of the Code (without regard to whether the ownership interest is held during the last half of a taxable year) or otherwise failing to maintain our qualification as a REIT, (including, but not limited to, any attempted transfer that would result in us owning an interest in a tenant that is described in Section 856(d)(2)(B) of the Code if the income derived by us from such tenant would cause us to fail to satisfy any gross income requirement described in Section 856(c) of the Code), will cause the number of shares of our stock causing the violation (rounded up to the nearest whole share) to be automatically transferred to a trust for the exclusive benefit of one or more charitable beneficiaries, and the proposed transferee will not acquire any rights in the shares of our stock. If the transfer to the trust would not be effective for any reason to prevent any of the foregoing, the transfer of that number of shares that otherwise would cause a person to violate any of the restrictions described above will be null and void and the proposed transferee will acquire no rights in such shares of our stock. The automatic transfer will be deemed to be effective as of the close of business on the business day prior to the date of the transfer. We will designate a trustee of the trust that will not be affiliated with us. We will also name one or more charitable organizations as a beneficiary of the trust. Shares-in-trust will remain issued and outstanding shares of stock and will be entitled to the same rights and privileges as all other shares of the same class or series of stock. The trustee will receive all distributions on the shares-in-trust and will hold such distributions in trust for the benefit of the beneficiary. The trustee will vote all shares-in-trust during the period they are held in trust and, subject to Maryland law, will have the authority (i) to rescind as void any vote cast by the proposed transferee prior to our discovery that the shares have been transferred to the trust and (ii) to recast the vote in accordance with the desires of the trustee acting for the benefit of the charitable beneficiary. However, if we have already taken irreversible corporate action, then the trustee will not have the authority to rescind and recast the vote.

Within 20 days of receiving notice from us that shares have been transferred to the trust, the trustee of the trust will sell the shares-in-trust to a person, selected by the trustee, whose ownership of the shares will not violate the ownership limits discussed above and distribute to the applicable prohibited owner an amount equal to the lesser of (i) the sales proceeds received by the trust for such shares-in-trust (net of any commissions and other expenses of sale) and (ii) (a) if the prohibited owner gave value for the shares in connection with the event causing the shares to be held in trust, the price paid by the prohibited owner for such shares-in-trust or (b) if the prohibited owner did not give value for the shares in connection with the event causing the shares to be held in trust (e.g., in the case of a gift, devise or other such transaction), the market price, or, in the event no market price is available for such shares, the fair market value, of such shares-in-trust on the day of the event causing the shares to be held in trust. The trustee may reduce the amount payable to the prohibited owner by the amount of dividends and other distributions which have been paid to the prohibited owner and are owed by the prohibited owner to the trustee. Any amount received by the trustee in excess of the amount to be paid to the prohibited owner will be distributed to the beneficiary of the trust.

If, prior to our discovery that shares have been transferred to the trustee, such shares are sold by the prohibited owner, then such shares will be deemed to have been sold on behalf of the trust and, to the extent that the prohibited owner received an amount for such shares that exceeds the amount that the prohibited owner was entitled to receive, such excess must be paid to the trustee upon demand. In addition, all shares-in-trust will be deemed to have been offered for sale to us or our designee, at a price per share equal to the lesser of (i) the price per share in the transaction that created such shares-in-trust (or, in the case of devise, gift, or other event other than a transfer for value, the market price or, in the event no market price is available for such shares, the fair market value, of such shares of stock at the time of such devise, gift, or other event) and (ii) the

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market price or, in the event no market price is available for such shares, the fair market value, of such shares of stock on the date we, or our designee, accepts such offer. We will have the right to accept the offer until the trustee has sold the shares. Upon a sale to us, the interest of the charitable beneficiary in the shares sold will terminate and the trustee will distribute the net proceeds of the sale to the prohibited owner. We may reduce the amount payable to the prohibited owner by the amount of dividends and other distributions which have been paid to the prohibited owner and are owed by the prohibited owner to the trustee. We may pay the amount of such reduction to the trustee for the benefit of the charitable beneficiary.

Any person who acquires or attempts or intends to acquire shares of our stock in violation of the foregoing restrictions or who would have owned shares of our stock that resulted in a transfer to the charitable trust is required to give immediate written notice to us of such event or, in the case of a proposed or attempted transaction, at least 15 days prior written notice. Such person shall provide to us such other information as we may request in order to determine the effect, if any, of such transfer on our status as a REIT.

The foregoing restrictions continue to apply until our board of directors determines it is no longer in our best interest to continue to qualify as a REIT or that compliance with the foregoing restrictions is no longer required for REIT qualification.

Our board of directors, in its sole discretion, may exempt a person (prospectively or retroactively) from the limitation on ownership of more than 9.9% in value of our then outstanding shares of capital stock (which includes common stock and any preferred stock we may issue) or more than 9.9% (by value or number of shares, whichever is more restrictive) of the aggregate of our then outstanding shares of common stock. However, our board of directors may not exempt any person whose ownership of our outstanding stock would result in our being "closely held" within the meaning of Section 856(h) of the Code or otherwise would result in our failure to maintain our qualification as a REIT. In order to be considered by our board of directors for exemption, a person also must not own, directly or indirectly, an interest in our tenant (or a tenant of any entity which we own or control) that would cause us to own, directly or indirectly, more than a 9.9% interest in the tenant within the meaning of Section 856(d)(2)(B) of the Code. The person seeking an exemption must represent to the satisfaction of our board of directors that it will not violate these two restrictions. The person also must agree that any violation or attempted violation of these restrictions will result in the automatic transfer of the shares of stock causing the violation to the trust.

Any stockholder of record who owns more than 5.0% (or such lower level as required by the Code and the regulations thereunder) of the outstanding shares of our stock during any taxable year, within 30 days after the end of such taxable year, will be asked to deliver a statement or affidavit setting forth the name and address of such record owner, the number of shares of our stock actually owned by such stockholder, and such information regarding the beneficial ownership of the shares of our stock as we may request in order to determine the effect, if any, of such actual or beneficial ownership on our status as a REIT and to ensure compliance with the ownership limits.

**Business Combinations**

Under the MGCL, business combinations between a Maryland corporation and an interested stockholder or an affiliate of an interested stockholder are prohibited for five years after the most recent date on which the interested stockholder becomes an interested stockholder. These business combinations include a merger, consolidation, share exchange, or, in circumstances specified in the statute, an asset transfer or issuance or reclassification of equity securities. An interested stockholder is defined as:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• Any person who beneficially owns, directly or indirectly, 10.0% or more of the voting power of the corporation's outstanding voting stock; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• An affiliate or associate of the corporation who, at any time within the two-year period prior to the date in question, was the beneficial owner, directly or indirectly, of 10.0% or more of the voting power of the then outstanding stock of the corporation.

A person is not an interested stockholder under the statute if the board of directors approved in advance the transaction by which such person otherwise would have become an interested stockholder. However, in approving a transaction, the board of directors may provide that its approval is subject to compliance, at or after the time of approval, with any terms and conditions determined by the board of directors.

After the five-year prohibition, any business combination between the Maryland corporation and an interested stockholder generally must be recommended by the board of directors of the corporation and approved by the affirmative vote of at least:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• 80.0% of the votes entitled to be cast by holders of outstanding shares of voting stock of the corporation; and

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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• two-thirds of the votes entitled to be cast by holders of voting stock of the corporation other than shares of stock held by the interested stockholder with whom or with whose affiliate the business combination is to be effected or held by an affiliate or associate of the interested stockholder.

These super-majority vote requirements do not apply if the corporation's common stockholders receive a minimum price, as defined under Maryland law, for their shares of our common stock in the form of cash or other consideration in the same form as previously paid by the interested stockholder for its shares of our common stock.

The statute permits various exemptions from its provisions, including business combinations that are exempted by the board of directors before the time that the interested stockholder becomes an interested stockholder. Our board of directors has adopted a resolution providing that any business combination between us and any other person is exempted from this statute, provided that such business combination is first approved by our board of directors. This resolution, however, may be altered or repealed in whole or in part at any time.

**Control Share Acquisitions**

The MGCL provides that control shares of a Maryland corporation acquired in a control share acquisition have no voting rights except to the extent approved by a vote of stockholders entitled to cast two-thirds of the votes entitled to be cast on the matter. Shares of stock owned by the acquiror, by officers or by employees who are directors of the corporation are excluded from shares of stock entitled to vote on the matter. Control shares are voting shares of stock which, if aggregated with all other shares of stock owned by the acquiror or in respect of which the acquiror is able to exercise or direct the exercise of voting power (except solely by virtue of a revocable proxy), would entitle the acquiror to exercise voting power in electing directors within one of the following ranges of voting power:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• one-tenth or more but less than one-third;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• one-third or more but less than a majority; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a majority or more of all voting power.

Control shares do not include shares of stock the acquiring person is then entitled to vote as a result of having previously obtained stockholder approval or shares acquired directly from the corporation. A control share acquisition means the acquisition of issued and outstanding control shares, subject to certain exceptions.

A person who has made or proposes to make a control share acquisition may compel our board of directors to call a special meeting of stockholders to be held within 50 days of demand to consider the voting rights of the shares of stock. The right to compel the calling of a special meeting is subject to the satisfaction of certain conditions, including an undertaking to pay the expenses of the meeting. If no request for a meeting is made, the corporation may itself present the question at any stockholders' meeting.

If voting rights are not approved at the meeting or if the acquiring person does not deliver an acquiring person statement as required by the statute, then the corporation may redeem for fair value any or all of the control shares, except those for which voting rights have previously been approved. The right of the corporation to redeem control shares is subject to certain conditions and limitations. Fair value is determined, without regard to the absence of voting rights for the control shares, as of the date of any meeting of stockholders at which the voting rights of the shares of stock are considered and not approved or, if no such meeting is held, as of the date of the last control share acquisition by the acquiror. If voting rights for control shares are approved at a stockholders' meeting and the acquiror becomes entitled to vote a majority of the shares of stock entitled to vote, all other stockholders may exercise appraisal rights. The fair value of the shares of stock as determined for purposes of appraisal rights may not be less than the highest price per share paid by the acquiror in the control share acquisition.

The control share acquisition statute does not apply (i) to shares of stock acquired in a merger, consolidation or share exchange if the corporation is a party to the transaction, or (ii) to acquisitions approved or exempted by the charter or bylaws of the corporation.

Our bylaws contain a provision exempting from the control share acquisition statute any and all acquisitions of shares of our stock by any person. This bylaw provision may be amended or eliminated at any time in the future.

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**Subtitle 8**

Subtitle 8 of Title 3 of the MGCL permits a Maryland corporation with a class of equity securities registered under the Exchange Act and at least three independent directors to elect to be subject, by provision in its charter or bylaws or a resolution of its board of directors and notwithstanding any contrary provision in the charter or bylaws, to any or all of five

provisions:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a classified board of directors;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a two-thirds vote requirement for removing a director;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a requirement that the number of directors be fixed only by vote of the directors;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a requirement that a vacancy on the board of directors be filled only by the remaining directors and for the remainder of the full term of the class of directors in which the vacancy occurred; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• a majority requirement for the calling of a stockholder-requested special meeting of stockholders.

In our charter, we have elected that, except as may be provided by the board of directors in setting the terms of any class or series of preferred stock, vacancies on our board of directors be filled only by the remaining directors in office, even if the remaining directors do not constitute a quorum, and for the remainder of the full term of the directorship in which the vacancy occurred. Through provisions in our charter and bylaws unrelated to Subtitle 8, we require the affirmative vote of stockholders entitled to cast at least two-thirds of the votes entitled to be cast generally in the election of directors in order to remove a director, vest in our board of directors the exclusive power to fix the number of directorships and require the written request of stockholders entitled to cast not less than a majority of all the votes entitled to be cast on any matter that may properly be considered at a meeting of stockholders in order to call a special meeting to act on such matter. We have not elected to be subject to any of the other provisions of Subtitle 8.

**Vacancies on Board of Directors; Removal of Directors**

Any director may resign at any time and, subject to the rights of holders of one or more classes or series of preferred stock to elect or remove directors, may be removed at any time with or without cause upon the affirmative vote of stockholders entitled to cast at least two-thirds of the votes entitled to be cast generally in the election of directors. The notice of any special meeting called for the purpose of the proposed removal shall indicate that the purpose, or one of the purposes, of the meeting is to determine if the director shall be removed.

**Advance Notice of Director Nominations and New Business**

Our bylaws provide that with respect to an annual meeting of stockholders, nominations of individuals for election to the board of directors and the proposal of business to be considered by our stockholders may be made only (i) pursuant to our notice of the meeting, (ii) by or at the direction of our board of directors or (iii) by a stockholder who is a stockholder of record at the record date set by our board of directors for the purpose of determining stockholders entitled to vote at the annual meeting, at the time of giving the advance notice required by the bylaws and at the time of the meeting (and any postponement or adjournment thereof), who is entitled to vote at the meeting in the election of each individual nominated or on such other business and who has complied with the advance notice procedures of the bylaws. With respect to special meetings of stockholders, only the business specified in our notice of the meeting may be brought before the meeting. Nominations of individuals for election to our board of directors at a special meeting may be made only (i) by or at the direction of our board of directors or (ii) provided that the meeting has been called for the purpose of electing directors, by a stockholder who is a stockholder of record at the record date set by our board of directors for the purpose of determining stockholders entitled to vote at the special meeting, at the time of giving the advance notice required by the bylaws and at the time of the meeting (and any postponement or adjournment thereof), who is entitled to vote at the meeting in the election of each individual nominated and who has complied with the advance notice provisions of the bylaws.

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**Limited Liability and Indemnification of Directors, Officers and Others**

Maryland law permits a Maryland corporation to include in its charter a provision eliminating the liability of its directors and officers to the corporation and its stockholders for money damages except for liability resulting from (i) actual receipt of an improper benefit or profit in money, property or services or (ii) active and deliberate dishonesty established by a final judgment as being material to the cause of action. Our charter contains such a provision that eliminates such liability to the maximum extent permitted by Maryland law.

The MGCL requires a corporation (unless its charter provides otherwise, which our charter does not) to indemnify a director or officer who has been successful, on the merits or otherwise, in the defense of any proceeding to which he or she is made or threatened to be made a party by reason of his or her service in that capacity against reasonable expenses actually incurred in connection with such proceeding. The MGCL permits a corporation to indemnify its present and former directors and officers, among others, against judgments, penalties, fines, settlements and reasonable expenses actually incurred by them in connection with any proceeding to which they may be made or threatened to be made a party by reason of their service in those or other capacities unless the following can be established:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• an act or omission of the director or officer was material to the matter giving rise to the proceeding, and was committed in bad faith or was the result of active and deliberate dishonesty;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• the director or officer received an improper personal benefit in money, property or services; or

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;• with respect to any criminal proceeding, the director or officer had reasonable cause to believe his or her act or omission was unlawful.

Under the MGCL, a court may order indemnification if it determines that the director or officer is fairly and reasonably entitled to indemnification, even though the director or officer did not meet the prescribed standard of conduct or was adjudged liable on the basis that personal benefit was improperly received. However, indemnification for an adverse judgment in a suit by the corporation or in its right, or for a judgment of liability on the basis that personal benefit was improperly received, is limited to expenses.

The MGCL also permits a corporation to advance reasonable expenses to a director or officer upon receipt of a written affirmation by the director or officer of his or her good faith belief that he or she has met the standard of conduct necessary for indemnification and a written undertaking by him or her or on his or her behalf to repay the amount paid or reimbursed by the corporation if it is ultimately determined that the standard of conduct was not met.

Our charter requires us, to the maximum extent permitted by Maryland law in effect from time to time, to indemnify and, without requiring a preliminary determination of the ultimate entitlement to indemnification, pay or reimburse reasonable expenses in advance of final disposition of a proceeding to any present or former director or officer of us or any of our subsidiaries who is made or threatened to be made a party to, or witness in, the proceeding by reason of his or her service in that capacity or any individual who, while a director or officer of us or any of our subsidiaries and at our request or any of our subsidiaries, serves or has served another corporation, real estate investment trust, partnership, joint venture, limited liability company, trust, employee benefit plan or other enterprise as a director, officer, partner, manager, member or trustee and who is made or threatened to be made a party to, or witness in, the proceeding by reason of his or her service in that capacity.

We have also entered into indemnification agreements with each of our directors and officers that provide for indemnification to the maximum extent permitted by Maryland law.

**Exclusive Forum For Certain Litigation**

Our bylaws provide that unless we consent in writing to the selection of an alternative forum, the Circuit Court for Baltimore City, Maryland, or, if that Court does not have jurisdiction, the United States District Court for the District of Maryland, Northern Division, shall be the sole and exclusive forum for (i) any internal corporate claim, as such term is defined in the MGCL (other than any action arising under federal securities laws), including, without limitation, (a) any derivative action or proceeding brought on our behalf, (b) any action asserting a claim of breach of any duty owed by any of our directors or officers or other employees to us or to our stockholders or (c) any action asserting a claim against us or any of our directors or officers or other employees arising pursuant to any provision of the MGCL, our charter or our bylaws, or (ii) any other action asserting a claim against us or any of our directors or officers or other employees that is governed by the internal affairs doctrine. None of the foregoing actions, claims or proceedings may be brought in any court sitting outside the State of Maryland unless we consent in writing to such court.

## Exhibit 10.4

![](keybank_trilogy-firstame001.jpg)

1 US_Active\118084400\V-1 FIRST AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT THIS FIRST AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT (this "Amendment"), dated as of April 30, 2021, by and among the undersigned parties executing this Amendment as "Borrowers" (collectively, "Borrowers"), the undersigned parties executing this Amendment as "Guarantors" (collectively, "Guarantors"), KEYBANK NATIONAL ASSOCIATION ("KeyBank") and the other Lenders party hereto (collectively, the "Lenders"), and KeyBank as Administrative Agent for itself and the other Lenders from time to time a party to the Credit Agreement (as hereinafter defined) (KeyBank, in its capacity as Administrative Agent, is hereinafter referred to as "Administrative Agent"). W I T N E S S E T H: WHEREAS, Borrowers, Administrative Agent and the Lenders are parties to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may be varied, extended, supplemented, consolidated, replaced, increased, renewed, modified or amended from time to time, the "Credit Agreement"); WHEREAS, Borrowers have requested that Administrative Agent and the Lenders make certain modifications to the Credit Agreement, and Administrative Agent and the Lenders have consented to such modifications, subject to the execution and delivery of this Amendment. NOW, THEREFORE, for and in consideration of the sum of TEN and NO/100 DOLLARS ($10.00), and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto do hereby covenant and agree as follows: 1. Definitions. Capitalized terms used in this Amendment, but which are not otherwise expressly defined in this Amendment, shall have the respective meanings given thereto in the Credit Agreement. 2. Modification of the Credit Agreement. Borrowers, Administrative Agent and the Lenders do hereby modify and amend the Credit Agreement as follows: (a) By deleting in its entirety the definition of GAHR appearing in Section 1.1 of the Credit Agreement, and inserting in lieu thereof the following new definition: ""GAHR" means, (a) at all times prior to the satisfaction of the Transaction Requirements, Griffin-American Healthcare REIT III Inc., a Maryland corporation, and (b) at all times after the satisfaction of the Transaction Requirements, Griffin-American Healthcare REIT IV, Inc., a Maryland corporation."; (b) By inserting the following new definitions in Section 1.1 of the Credit Agreement, in the appropriate alphabetical order: ""Erroneous Payment" has the meaning assigned to it in Section 14.9(a). "Erroneous Payment Deficiency Assignment" has the meaning assigned to it in Section 14.9(d). 2 US_Active\118084400\V-1 "Erroneous Payment Impacted Class" has the meaning assigned to it in Section 14.9(d). "Erroneous Payment Return Deficiency" has the meaning assigned to it in Section 14.9(d). "Erroneous Payment Subrogation Rights" has the meaning assigned to it in Section 14.9(d). "Payment Recipient" has the meaning assigned to it in Section 14.9(a). "Transaction Requirements" means, receipt and/or confirmation, as applicable, by the Administrative Agent of the following: (a) Receipt by Administrative Agent of a certification by the chief executive officer, president, chief financial officer or treasurer or controller of Parent certifying that (A) the Transaction (as defined in that certain letter dated April 22, 2021 from Trilogy RER, LLC to the Administrative Agent) has been consummated in accordance with the terms of said letter and that the resulting organizational structure of Trilogy Investors is the same as the "Post-Merger Structure" attached as Attachment I thereto, (B) that any consents, licenses or approvals required in connection with the Transaction have been obtained (except for such consents, licenses or approvals, the failure of which to obtain would not be reasonably expected to result in a Material Adverse Effect), (C) that no litigation, regulatory action or other proceeding or order (whether temporary, preliminary or permanent) of a court of competent jurisdiction has been filed or threated in writing that could reasonably be expected to prevent, restrain or enjoin the consummation of the Transaction or have a Material Adverse Effect; and (D) that no Default or Event of Default has occurred and is continuing, together with such other evidence as may be reasonably requested by Administrative Agent evidencing the consummation of the Transaction in accordance with the terms of said letter, such as copies of filed documents effectuating the Transaction from the appropriate Governmental Authorities; and (b) No Default or Event of Default shall have occurred and be continuing as a result of such Transaction or otherwise. For the avoidance of doubt, subject to the satisfaction of the Transaction Requirements, the Transaction shall not constitute a Change of Control under this Agreement."; (c) By deleting in its entirety the definition of LIBOR Termination Date appearing in Section 1.1 of the Credit Agreement; (d) By inserting the following parenthetical at the end of clause (a) of the definition of Obligations appearing in Section 1.1 of the Credit Agreement: "(including, without limitation, Erroneous Payment Subrogation Rights)"; (e) By inserting the following new Section 1.2(q) into the Credit Agreement: 3 US_Active\118084400\V-1 "(q) Administrative Agent does not warrant or accept any responsibility for, and shall not have any liability with respect to, the administration, submission or any other matter related to USD LIBOR (as defined in Section 4.15) or with respect to any alternative or successor benchmark thereto, or replacement rate therefor or thereof, including, without limitation, whether the composition or characteristics of any such alternative, successor or replacement reference rate, as it may or may not be adjusted pursuant to Section 4.15, will be similar to, or produce the same value or economic equivalence of, USD LIBOR or any other benchmark or have the same volume or liquidity as did USD LIBOR or any other benchmark prior to its discontinuance or unavailability."; (f) By deleting the word "In" appearing at the beginning of Section 4.5 of the Credit Agreement and inserting in lieu thereof the words "Subject to Section 4.15 below, in"; (g) By deleting in its entirety Section 4.15 of the Credit Agreement and inserting in lieu thereof the following new Section 4.15: "Section 4.15 Successor LIBOR Rate Index. Notwithstanding anything to the contrary herein or in any other Loan Document: (a) Replacing USD LIBOR. On March 5, 2021, the Financial Conduct Authority ("FCA"), the regulatory supervisor of USD LIBOR's administrator ("IBA"), announced in a public statement the future cessation or loss of representativeness of overnight/Spot Next, 1-month, 3-month, 6-month and 12- month USD LIBOR tenor settings. On the earliest of (i) July 1, 2023, (ii) the date that all Available Tenors of USD LIBOR have either permanently or indefinitely ceased to be provided by IBA or have been announced by the FCA pursuant to public statement or publication of information to be no longer representative and (iii) the Early Opt-in Effective Date, if the then-current Benchmark is USD LIBOR, the Benchmark Replacement will replace such Benchmark for all purposes hereunder and under any Loan Document in respect of any setting of such Benchmark on such day and all subsequent settings without any amendment to, or further action by or consent of any other party to, this Agreement or any other Loan Document. If the Benchmark Replacement is Daily Simple SOFR, all interest payments will be payable on a monthly basis. (b) Replacement Future Benchmarks. If any Benchmark Transition Event occurs after the date hereof (other than as described above with respect to USD LIBOR), the then-current Benchmark will be replaced with the Benchmark Replacement for all purposes hereunder and under any Loan Document in respect of any Benchmark setting on the later of (i) as of 5:00 p.m. (New York City time) on the fifth (5th) Business Day after the date notice of such Benchmark Replacement is provided to the Lenders and the Borrower or (ii) such other date as may be determined by the Administrative Agent, in each case, without any further action or consent of any other party to this Agreement or any other Loan Document, so long as the Administrative Agent has not received, by such time (or, in the case of clause (ii) above, such time as may be specified by the Administrative Agent as a deadline to receive objections, but in any case, no less than five (5) Business Days after the date such notice is provided to the Lenders and the Borrower), written notice of objection to such Benchmark Replacement from Lenders comprising the Majority Lenders. At any time that the 4 US_Active\118084400\V-1 administrator of the then-current Benchmark has permanently or indefinitely ceased to provide such Benchmark or such Benchmark has been announced by the regulatory supervisor for the administrator of such Benchmark pursuant to public statement or publication of information to be no longer representative of the underlying market and economic reality that such Benchmark is intended to measure and that representativeness will not be restored, the Borrower may revoke any request for a borrowing of, conversion to or continuation of Loans to be made, converted or continued that would bear interest by reference to such Benchmark until the Borrower's receipt of notice from the Administrative Agent that a Benchmark Replacement has replaced such Benchmark, and, failing that, the Borrower will be deemed to have converted any such request into a request for a borrowing of or conversion to Base Rate Loans. During the period referenced in the foregoing sentence, the component of the Base Rate based upon the Benchmark will not be used in any determination of the Base Rate. (c) Benchmark Replacement Conforming Changes. In connection with the implementation and administration of a Benchmark Replacement (whether in connection with the replacement of USD LIBOR or any future Benchmark), the Administrative Agent will have the right to make Benchmark Replacement Conforming Changes from time to time and, notwithstanding anything to the contrary herein or in any other Loan Document, any amendments implementing such Benchmark Replacement Conforming Changes will become effective without any further action or consent of any other party to this Agreement or any other Loan Document. (d) Notices; Standards for Decisions and Determinations. The Administrative Agent will promptly notify the Borrower and the Lenders of (i) the implementation of any Benchmark Replacement and (ii) the effectiveness of any Benchmark Replacement Conforming Changes. Any determination, decision or election that may be made by the Administrative Agent pursuant to this Section 4.15 including, without limitation, any determination with respect to a tenor, rate or adjustment, or implementation of any Benchmark Replacement Conforming Changes, the timing of implementation of any Benchmark Replacement or of the occurrence or non-occurrence of an event, circumstance or date and any decision to take or refrain from taking any action, will be conclusive and binding on all parties hereto absent manifest error and may be made in its sole discretion and without consent from any other party to this Agreement or any other Loan Document, except, in each case, as expressly required pursuant to this Section 4.15, and shall not be a basis of any claim of liability of any kind or nature by any party hereto, all such claims being hereby waived individually by each party hereto. (e) Unavailability of Tenor of Benchmark. At any time (including in connection with the implementation of a Benchmark Replacement), (i) if the then-current Benchmark is a term rate (including Term SOFR or USD LIBOR), then the Administrative Agent may remove any tenor of such Benchmark that is unavailable or non-representative for such Benchmark (including any Benchmark Replacement) settings and (ii) if such tenor becomes available or representative, the Administrative Agent may reinstate any previously removed tenor for such Benchmark (including any Benchmark Replacement) settings.

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5 US_Active\118084400\V-1 (f) Certain Defined Terms. As used in this Section 4.15: "Available Tenor" means, as of any date of determination and with respect to the then-current Benchmark, as applicable, (x) if the then-current Benchmark is a term rate, any tenor for such Benchmark that is or may be used for determining the length of an Interest Period or (y) otherwise, any payment period for interest calculated with reference to such Benchmark, as applicable, pursuant to this Agreement as of such date. "Benchmark" means, initially, USD LIBOR; provided that if a replacement for the Benchmark has occurred pursuant to this Section 4.15, then "Benchmark" means the applicable Benchmark Replacement to the extent that such Benchmark Replacement has replaced such prior benchmark rate. Any reference to "Benchmark" shall include, as applicable, the published component used in the calculation thereof. "Benchmark Replacement" means, for any Available Tenor: (1) for purposes of clause (a) of this Section 4.15, the first alternative set forth below that can be determined by the Administrative Agent (a) the sum of: (i) Term SOFR and (ii) 0.11448% (11.448 basis points) for an Available Tenor of one-month's duration, 0.26161% (26.161 basis points) for an Available Tenor of three-months' duration, and 0.42826% (42.826 basis points) for an Available Tenor of six- months' duration; or (b) the sum of: (i) Daily Simple SOFR and (ii) the spread adjustment for an Available Tenor of one-month's duration (0.11448% (11.448 basis points)); and (2) for purposes of clause (b) of this Section 4.15, the sum of: (a) the alternate benchmark rate and (b) an adjustment (which may be a positive or negative value, or zero), in each case, that has been selected pursuant to this clause (2) by the Administrative Agent and the Borrower as the replacement for such Available Tenor of such Benchmark giving due consideration to any evolving or then-prevailing market convention, including any applicable recommendations made by the Relevant Governmental Body, for U.S. dollar- denominated syndicated credit facilities at such time; provided that, if the Benchmark Replacement as determined pursuant to clause (1) or (2) above would be less than the Floor, the Benchmark Replacement will be deemed to be the Floor for all purposes of this Agreement and the other Loan Documents. "Benchmark Replacement Conforming Changes" means, with respect to any Benchmark Replacement, any technical, administrative or operational changes (including changes to the definition of "Base Rate," the definition of "Business Day," the definition of "Interest Period," timing and frequency of determining rates and making payments of interest, timing of borrowing requests or prepayment, conversion or continuation notices, the applicability and length of 6 US_Active\118084400\V-1 lookback periods, the applicability of breakage provisions, and other technical, administrative or operational matters) that the Administrative Agent decides may be appropriate to reflect the adoption and implementation of such Benchmark Replacement and to permit the administration thereof by the Administrative Agent in a manner substantially consistent with market practice (or, if the Administrative Agent decides that adoption of any portion of such market practice is not administratively feasible or if the Administrative Agent determines that no market practice for the administration of such Benchmark Replacement exists, in such other manner of administration as the Administrative Agent decides is reasonably necessary in connection with the administration of this Agreement and the other Loan Documents). "Benchmark Transition Event" means, with respect to any then-current Benchmark (other than USD LIBOR), the occurrence of a public statement or publication of information by or on behalf of the administrator of the then-current Benchmark, the regulatory supervisor for the administrator of such Benchmark, the Board of Governors of the Federal Reserve System, the Federal Reserve Bank of New York, an insolvency official with jurisdiction over the administrator for such Benchmark, a resolution authority with jurisdiction over the administrator for such Benchmark or a court or an entity with similar insolvency or resolution authority over the administrator for such Benchmark, announcing or stating that (a) such administrator has ceased or will cease on a specified date to provide all Available Tenors of such Benchmark, permanently or indefinitely, provided that, at the time of such statement or publication, there is no successor administrator that will continue to provide any Available Tenor of such Benchmark or (b) all Available Tenors of such Benchmark are or will no longer be representative of the underlying market and economic reality that such Benchmark is intended to measure and that representativeness will not be restored. "Daily Simple SOFR" means, for any day, SOFR, with the conventions for this rate (which will include a lookback) being established by the Administrative Agent in accordance with the conventions for this rate recommended by the Relevant Governmental Body for determining "Daily Simple SOFR" for syndicated business loans; provided, that if the Administrative Agent decides that any such convention is not administratively feasible for the Administrative Agent, then the Administrative Agent may establish another convention in its reasonable discretion. "Early Opt-in Effective Date" means, with respect to any Early Opt-in Election, the sixth (6th) Business Day after the date notice of such Early Opt-in Election is provided to the Lenders, so long as the Administrative Agent has not received, by 5:00 p.m. (New York City time) on the fifth (5th) Business Day after the date notice of such Early Opt-in Election is provided to the Lenders, written notice of objection to such Early Opt-in Election from Lenders comprising the Majority Lenders. "Early Opt-in Election" means the occurrence of: (1) a notification by the Administrative Agent to each of the other parties hereto that at least five (5) currently outstanding U.S. dollar-denominated 7 US_Active\118084400\V-1 syndicated credit facilities at such time contain (as a result of amendment or as originally executed) a SOFR-based rate (including SOFR, a term SOFR or any other rate based upon SOFR) as a benchmark rate (and such syndicated credit facilities are identified in such notice and are publicly available for review), and (2) the joint election by the Administrative Agent and the Borrower to trigger a fallback from USD LIBOR and the provision by the Administrative Agent of written notice of such election to the Lenders. "Floor" means the benchmark rate floor, if any, provided in this Agreement initially (as of the execution of this Agreement, the modification, amendment or renewal of this Agreement or otherwise) with respect to USD LIBOR. "Relevant Governmental Body" means the Board of Governors of the Federal Reserve System or the Federal Reserve Bank of New York, or a committee officially endorsed or convened by the Board of Governors of the Federal Reserve System or the Federal Reserve Bank of New York, or any successor thereto. "SOFR" means, for any Business Day, a rate per annum equal to the secured overnight financing rate for such Business Day published by the Federal Reserve Bank of New York (or a successor administrator of the secured overnight financing rate) on the website of the Federal Reserve Bank of New York, currently at http://www.newyorkfed.org. (or any successor source for the secured overnight financing rate identified as such by the administrator of the secured overnight financing rate from time to time), on the immediately succeeding Business Day. "Term SOFR" means, for the applicable corresponding tenor, the forward-looking term rate based on SOFR that has been selected or recommended by the Relevant Governmental Body. "USD LIBOR" means the London interbank offered rate for U.S. dollars." (h) By inserting the following new Section 14.19 into the Credit Agreement: "Section 14.19 Erroneous Payments. (a) If the Administrative Agent notifies a Lender, Issuing Lender or Secured Party, or any Person who has received funds on behalf of a Lender, Issuing Lender or Secured Party such Lender or Issuing Lender (any such Lender, Issuing Lender, Secured Party or other recipient, a "Payment Recipient") that the Administrative Agent has determined in its sole discretion (whether or not after receipt of any notice under immediately succeeding clause (b)) that any funds received by such Payment Recipient from the Administrative Agent or any of its Affiliates were erroneously transmitted to, or otherwise erroneously or mistakenly received by, such Payment Recipient (whether or not known to such Lender, Issuing Lender, Secured Party or other Payment Recipient on its behalf) (any such funds, whether received as a payment, prepayment or repayment of 8 US_Active\118084400\V-1 principal, interest, fees, distribution or otherwise, individually and collectively, an "Erroneous Payment") and demands the return of such Erroneous Payment (or a portion thereof), such Erroneous Payment shall at all times remain the property of the Administrative Agent and shall be segregated by the Payment Recipient and held in trust for the benefit of the Administrative Agent, and such Lender, Issuing Lender or Secured Party shall (or, with respect to any Payment Recipient who received such funds on its behalf, shall cause such Payment Recipient to) promptly, but in no event later than two (2) Business Days thereafter, return to the Administrative Agent the amount of any such Erroneous Payment (or portion thereof) as to which such a demand was made, in same day funds (in the currency so received), together with interest thereon in respect of each day from and including the date such Erroneous Payment (or portion thereof) was received by such Payment Recipient to the date such amount is repaid to the Administrative Agent in same day funds at the greater of the Federal Funds Effective Rate and a rate determined by the Administrative Agent in accordance with banking industry rules on interbank compensation from time to time in effect. A notice of the Administrative Agent to any Payment Recipient under this clause (a) shall be conclusive, absent manifest error. (b) Without limiting immediately preceding clause (a), each Lender, Issuing Lender or Secured Party, or any Person who has received funds on behalf of a Lender, Issuing Lender or Secured Party such Lender or Issuing Lender, hereby further agrees that if it receives a payment, prepayment or repayment (whether received as a payment, prepayment or repayment of principal, interest, fees, distribution or otherwise) from the Administrative Agent (or any of its Affiliates) (x) that is in a different amount than, or on a different date from, that specified in a notice of payment, prepayment or repayment sent by the Administrative Agent (or any of its Affiliates) with respect to such payment, prepayment or repayment, (y) that was not preceded or accompanied by a notice of payment, prepayment or repayment sent by the Administrative Agent (or any of its Affiliates), or (z) that such Lender, Issuing Lender or Secured Party, or other such recipient, otherwise becomes aware was transmitted, or received, in error or by mistake (in whole or in part) in each case: (i) (A) in the case of immediately preceding clauses (x) or (y), an error shall be presumed to have been made (absent written confirmation from the Administrative Agent to the contrary) or (B) an error has been made (in the case of immediately preceding clause (z)), in each case, with respect to such payment, prepayment or repayment; and (ii) such Lender, Issuing Lender or Secured Party shall (and shall cause any other recipient that receives funds on its respective behalf to) promptly (and, in all events, within one Business Day of its knowledge of such error) notify the Administrative Agent of its receipt of such payment, prepayment or repayment, the details thereof (in reasonable detail) and that it is so notifying the Administrative Agent pursuant to this Section 14.19(b). (c) Each Lender, Issuing Lender or Secured Party hereby authorizes the Administrative Agent to set off, net and apply any and all amounts at any time owing to such Lender, Issuing Lender or Secured Party under any Loan

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9 US_Active\118084400\V-1 Document, or otherwise payable or distributable by the Administrative Agent to such Lender, Issuing Lender or Secured Party from any source, against any amount due to the Administrative Agent under immediately preceding clause (a) or under the indemnification provisions of this Agreement. (d) In the event that an Erroneous Payment (or portion thereof) is not recovered by the Administrative Agent for any reason, after demand therefor by the Administrative Agent in accordance with immediately preceding clause (a), from any Lender or Issuing Lender that has received such Erroneous Payment (or portion thereof) (and/or from any Payment Recipient who received such Erroneous Payment (or portion thereof) on its respective behalf) (such unrecovered amount, an "Erroneous Payment Return Deficiency"), upon the Administrative Agent's notice to such Lender or Issuing Lender at any time, (i) such Lender or Issuing Lender shall be deemed to have assigned its Loans (but not its Commitments) of the relevant class of Loans with respect to which such Erroneous Payment was made (the "Erroneous Payment Impacted Class") in an amount equal to the Erroneous Payment Return Deficiency (or such lesser amount as the Administrative Agent may specify) (such assignment of the Loans (but not Commitments) of the Erroneous Payment Impacted Class, the "Erroneous Payment Deficiency Assignment") at par plus any accrued and unpaid interest (with the assignment fee to be waived by the Administrative Agent in such instance), and is hereby (together with the Borrower) deemed to execute and deliver an Assignment and Acceptance Agreement (or, to the extent applicable, an agreement incorporating an Assignment and Acceptance Agreement by reference pursuant to an approved electronic platform as to which the Administrative Agent and such parties are participants) with respect to such Erroneous Payment Deficiency Assignment, and such Lender or Issuing Lender shall deliver any Notes evidencing such Loans to the Borrower or the Administrative Agent, (ii) the Administrative Agent as the assignee Lender shall be deemed to acquire the Erroneous Payment Deficiency Assignment, (iii) upon such deemed acquisition, the Administrative Agent as the assignee Lender shall become a Lender or Issuing Lender, as applicable, hereunder with respect to such Erroneous Payment Deficiency Assignment and the assigning Lender or assigning Issuing Lender shall cease to be a Lender or Issuing Lender, as applicable, hereunder with respect to such Erroneous Payment Deficiency Assignment, excluding, for the avoidance of doubt, its obligations under the indemnification provisions of this Agreement and its applicable Commitments which shall survive as to such assigning Lender or assigning Issuing Lender and (iv) the Administrative Agent may reflect in the Register its ownership interest in the Loans subject to the Erroneous Payment Deficiency Assignment. The Administrative Agent may, in its discretion, sell any Loans acquired pursuant to an Erroneous Payment Deficiency Assignment and upon receipt of the proceeds of such sale, the Erroneous Payment Return Deficiency owing by the applicable Lender or Issuing Lender shall be reduced by the net proceeds of the sale of such Loan (or portion thereof), and the Administrative Agent shall retain all other rights, remedies and claims against such Lender or Issuing Lender (and/or against any recipient that receives funds on its respective behalf). For the avoidance of doubt, no Erroneous Payment Deficiency Assignment will reduce the Commitments of any Lender or Issuing Lender and such Commitments shall remain available in accordance with the terms of this Agreement. In addition, each party hereto agrees that, except to the extent that the Administrative Agent 10 US_Active\118084400\V-1 has sold a Loan (or portion thereof) acquired pursuant to an Erroneous Payment Deficiency Assignment, and irrespective of whether the Administrative Agent may be equitably subrogated, the Administrative Agent shall be contractually subrogated to all the rights and interests of the applicable Lender, Issuing Lender or Secured Party under the Loan Documents with respect to each Erroneous Payment Return Deficiency (the "Erroneous Payment Subrogation Rights"). (e) The parties hereto agree that an Erroneous Payment shall not pay, prepay, repay, discharge or otherwise satisfy any Obligations owed by the Borrower or any other Loan Party, except, in each case, to the extent such Erroneous Payment is, and solely with respect to the amount of such Erroneous Payment that is, comprised of funds received by the Administrative Agent from the Borrower or any other Loan Party for the purpose of making such Erroneous Payment. (f) To the extent permitted by applicable law, no Payment Recipient shall assert any right or claim to an Erroneous Payment, and hereby waives, and is deemed to waive, any claim, counterclaim, defense or right of set-off or recoupment with respect to any demand, claim or counterclaim by the Administrative Agent for the return of any Erroneous Payment received, including without limitation waiver of any defense based on "discharge for value" or any similar doctrine. (g) Each party's obligations, agreements and waivers under this Section 14.19 shall survive the resignation or replacement of the Administrative Agent, any transfer of rights or obligations by, or the replacement of, a Lender or Issuing Lender, the termination of the Commitments and/or the repayment, satisfaction or discharge of all Obligations (or any portion thereof) under any Loan Document." 3. References to Credit Agreement. All references in the Loan Documents to the Credit Agreement shall be deemed a reference to the Credit Agreement as modified and amended herein. 4. Representations. Borrowers and Guarantors represent and warrant to Administrative Agent and the Lenders as follows: (a) Authorization. The execution, delivery and performance of this Amendment and the transactions contemplated hereby (i) are within the authority of Borrowers and Guarantors, (ii) have been duly authorized by all necessary proceedings on the part of such Persons, (iii) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which any of such Persons is subject or any judgment, order, writ, injunction, license or permit applicable to such Persons, (iv) do not and will not conflict with or constitute a default under any provision of the partnership agreement, articles of incorporation or other charter documents or bylaws of such Person, (v) do not and will not conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of any material agreement or other instrument binding upon, such Person or any of its properties, and (vi) do not and will not result in or require the imposition of any lien or other encumbrance on any of the properties, assets or rights of such Person other than the liens and encumbrances in favor of Administrative Agent contemplated by the Credit Agreement and the other Loan Documents. 11 US_Active\118084400\V-1 (b) Enforceability. This Amendment and any other agreements or instruments executed in connection herewith to which any of Borrowers or Guarantors is a party are the valid and legally binding obligations of such Person enforceable in accordance with the respective terms and provisions hereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and the effect of general principles of equity. (c) Approvals. The execution, delivery and performance of this Amendment and the transactions contemplated hereby do not require the approval or consent of or approval of any Person or the authorization, consent, approval of or any license or permit issued by, or any filing or registration with, or the giving of any notice to, any court, department, board, commission or other governmental agency or authority other than those already obtained and delivered to Administrative Agent. (d) Reaffirmation. Borrowers and Guarantors reaffirm and restate as of the date hereof each and every representation and warranty made by such Persons in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith except for representations or warranties that expressly relate to an earlier date. The representations and warranties made by Borrowers, Guarantors or their respective Subsidiaries in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith or after the date of the Credit Agreement were true and correct in all material respects when made and are true and correct in all material respects as of the hereof, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date). (e) No Default. By execution hereof, Borrowers and Guarantors certify that such Persons are and will be in compliance with all covenants under the Loan Documents after the execution and delivery of this Amendment and the other documents executed in connection herewith, and that no Default or Event of Default has occurred and is continuing. 5. Waiver of Claims. Borrowers and Guarantors acknowledge, represent and agree that such Persons as of the date hereof have no defenses, setoffs, claims, counterclaims or causes of action of any kind or nature whatsoever with respect to the Loan Documents, the administration or funding of the Loans or with respect to any acts or omissions of Administrative Agent or any Lender, or any past or present officers, agents or employees of Administrative Agent or any Lender, and each of Borrowers and Guarantors does hereby expressly waive, release and relinquish any and all such defenses, setoffs, claims, counterclaims and causes of action, if any. 6. Ratification. Except as hereinabove set forth or in any other document previously executed or executed in connection herewith, all terms, covenants and provisions of the Credit Agreement and the other Loan Documents remain unaltered and in full force and effect, and the parties hereto do hereby expressly ratify and confirm the Credit Agreement and the other Loan Documents. Nothing in this Amendment shall be deemed or construed to constitute, and there has not otherwise occurred, a novation, cancellation, satisfaction, release, extinguishment or substitution of the indebtedness evidenced by the Notes or the other obligations of Borrowers and Guarantors under the Loan Documents. 7. Counterparts. This Amendment may be executed in any number of counterparts which shall together constitute but one and the same agreement. 8. Miscellaneous. THIS AMENDMENT SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5-1401, BE GOVERNED BY AND CONSTRUED IN 12 US_Active\118084400\V-1 ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. This Amendment shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted successors, successors-in-title and assigns as provided in the Credit Agreement. This Amendment shall constitute a Loan Document. 9. Effective Date. The effectiveness of this Amendment is subject to confirmation by the Administrative Agent of the satisfaction of the following conditions: (a) Execution and delivery of this Amendment by Borrowers, Guarantors, Administrative Agent and the Majority Lenders; (b) Receipt by Administrative Agent of copies of such agreements, instruments, documents, financial statements and other diligence materials reasonably requested by Agent and the Lenders on or prior to the date of this Amendment in connection with the "Transaction" (as defined in that certain letter dated April 22, 2021 from Trilogy RER, LLC to the Administrative Agent); (c) Absence of any litigation, regulatory action or other proceeding or order (whether temporary, preliminary or permanent) of a court of competent jurisdiction that could reasonably be expected to prevent, restrain or enjoin the consummation of the Transaction or have a Material Adverse Effect; (d) Borrowers, Guarantors and any other Person reasonably requested by any Lender shall have complied with all know-your-customer and anti-money laundering requirements of the Lenders, including the Patriot Act and, if required, the provision of a Beneficial Ownership Certification; (e) Receipt by Administrative Agent of evidence that the Borrower shall have paid all fees due and payable with respect to this Amendment; and (f) Receipt by Administrative Agent of such other resolutions, certificates, documents, customary searches (credit, judgment, lien, bankruptcy, etc.), instruments and agreements as the Agent may reasonably request on or prior to the date of this Amendment. 10. Fees and Expenses. Borrowers will pay the reasonable fees and expenses of Administrative Agent in connection with this Amendment and the transactions contemplated hereby in accordance with Section 15 of the Credit Agreement. 11. Electronic Signatures. Delivery of an executed counterpart of a signature page to this Amendment by facsimile or as an attachment to an electronic mail message in .pdf, .jpeg, .TIFF or similar electronic format shall be effective as delivery of a manually executed counterpart of this Amendment for all purposes. The words "execution," "signed," "signature," "delivery," and words of like import in or relating to this Amendment and any other Loan Document to be signed in connection with this Amendment, the other Loan Documents and the transactions contemplated hereby and thereby shall be deemed to include Electronic Signatures, deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as manually executed signature, physical delivery thereof or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any Applicable Law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any other similar state laws based on the Uniform Electronic Transactions Act; provided that nothing herein shall require the Agent to accept electronic signatures in any form or format without its prior written consent. For the purposes hereof, "Electronic Signatures" means an electronic sound, symbol, or process attached to, or associated with, a contract or other record and adopted by a Person with the intent to sign, authenticate or

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13 US_Active\118084400\V-1 accept such contract or record. Each of the parties hereto represents and warrants to the other parties hereto that it has the corporate capacity and authority to execute the Amendment through electronic means and there are no restrictions for doing so in that party's constitutive documents. Without limiting the generality of the foregoing, each Borrower and Guarantor hereby (i) agrees that, for all purposes, including without limitation, in connection with any workout, restructuring, enforcement of remedies, bankruptcy proceedings or litigation among any of the Agent or the Lenders and any of the Borrowers or Guarantors, electronic images of this Agreement or any other Loan Document (in each case, including with respect to any signature pages thereto) shall have the same legal effect, validity and enforceability as any paper original, and (ii) waives any argument, defense or right to contest the validity or enforceability of any Loan Document based solely on the lack of paper original copies of such Loan Document, including with respect to any signature pages thereto. [CONTINUED ON NEXT PAGE]

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to First Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) ADMINISTRATIVE AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Laura Conway Title: Senior Vice President CIT BANK, N.A., as a Lender By: Name: Title: REGIONS BANK, as a Lender By: Name: Title: BANK OF AMERICA, N.A., as a Lender By: Name: Title: THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: [SIGNATURES CONTINUED ON NEXT PAGE] VP Eli Plotkin

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Signature Page to First Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) Internal Use ADMINISTRATIVE AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Laura Conway Title: Senior Vice President CIT BANK, N.A., as a Lender By: Name: Title: REGIONS BANK, as a Lender By: Name: John E. Boudler Title: Senior Vice President BANK OF AMERICA, N.A., as a Lender By: Name: Title: THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: [SIGNATURES CONTINUED ON NEXT PAGE] Signature Page to First Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) ADMINISTRATIVE AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Laura Conway Title: Senior Vice President CIT BANK, N.A., as a Lender By: Name: Title: REGIONS BANK, as a Lender By: Name: Title: BANK OF AMERICA, N.A., as a Lender By: Name: H. Hope Walker Title: Senior Vice President THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: [SIGNATURES CONTINUED ON NEXT PAGE]

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to First Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: CIBC BANK USA, as a Lender By: Name: Title: BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: BANK OF THE WEST, as a Lender By: Name: Mary Smith Title: Managing Director

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## Exhibit 10.5

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1 US_Active\119172305\V-3 SECOND AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT THIS SECOND AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT (this "Amendment"), dated as of September 29, 2021, by and among the undersigned parties executing this Amendment as "Borrowers" (collectively, "Borrowers"), the undersigned parties executing this Amendment as "Guarantors" (collectively, "Guarantors"), KEYBANK NATIONAL ASSOCIATION ("KeyBank") and the other Lenders party hereto (collectively, the "Lenders"), and KeyBank as Administrative Agent for itself and the other Lenders from time to time a party to the Credit Agreement (as hereinafter defined) (KeyBank, in its capacity as Administrative Agent, is hereinafter referred to as "Administrative Agent"). W I T N E S S E T H: WHEREAS, Borrowers, Administrative Agent and the Lenders are parties to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, as amended by that certain First Amendment to First Amended and Restated Senior Secured Credit Agreement dated as of April 30, 2021 (as the same may be further varied, extended, supplemented, consolidated, replaced, increased, renewed, modified or amended from time to time, the "Credit Agreement"); WHEREAS, Borrowers have requested that Administrative Agent and the Lenders make certain modifications to the Credit Agreement, and Administrative Agent and the Lenders have consented to such modifications, subject to the execution and delivery of this Amendment. NOW, THEREFORE, for and in consideration of the sum of TEN and NO/100 DOLLARS ($10.00), and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto do hereby covenant and agree as follows: 1. Definitions. Capitalized terms used in this Amendment, but which are not otherwise expressly defined in this Amendment, shall have the respective meanings given thereto in the Credit Agreement. 2. Modification of the Credit Agreement. Borrowers, Administrative Agent and the Lenders do hereby modify and amend the Credit Agreement as follows: (a) By inserting the following new definitions in Section 1.1 of the Credit Agreement, in the appropriate alphabetical order: ""Covenant Relief Period" means the period commencing on September 29, 2021, and ending on (and including) the Covenant Relief Period Termination Date."; "Covenant Relief Period Termination Date" means the earlier of (a) June 30, 2022 and (b) the date specified in the Covenant Relief Period Termination Notice on which the Borrowers irrevocably elect to terminate the Covenant Relief Period."; 2 US_Active\119172305\V-3 "Covenant Relief Period Termination Notice" means a notice executed by the chief executive officer, president, chief financial officer or treasurer or controller of Parent (a) stating that Borrowers irrevocably elect to terminate the Covenant Relief Period effective as of the last day of the fiscal quarter specified in such notice (provided, that such notice shall have been delivered to the Administrative Agent not later than the date of delivery of the Compliance Certificate for such specified fiscal quarter pursuant to Section 7.4(a)(iii)), (b) reserved, and (c) enclosing a Compliance Certificate for such specified fiscal quarter demonstrating compliance with the covenants contained in Section 9 of the Credit Agreement and the other covenants set forth in such Compliance Certificate, in each case, after giving effect to the termination of the Covenant Relief Period."; "Covenant Relief Period Permitted Recourse Indebtedness" means (x) the obligations of Trilogy Investors and/or one or more of its Subsidiaries in connection with that certain purchase option with respect to the real property located at 3001- 3101 N Hurstbourne Parkway, Louisville, Kentucky 40241, not to exceed $20,000,000.00 in the aggregate, and (y) Obligations under the Credit Agreement and the other Loan Documents."; (b) By deleting in its entirety the definition of Implied Debt Service appearing in Section 1.1 of the Credit Agreement, and inserting in lieu thereof the following new definition: ""Implied Debt Service" means, on any date of determination, an amount equal to the annual principal and interest payment sufficient to amortize in full during a thirty (30) year period, a loan in an amount equal to the sum of the aggregate outstanding principal balance of the Real Estate Revolving Loans, Letter of Credit Liabilities and Real Estate Swing Loans obtained pursuant to clause (a) or clause (b) of the definition of Real Estate Borrowing Base Availability, as applicable, as of such date, calculated using an interest rate equal to the greater of (a) the then current annual yield on ten (10) year obligations issued by the United States Treasury most recently prior to the date of determination as determined by Administrative Agent plus two and one-half percent (2.50%), (b) six percent (6.00%) per annum (provided that during the Covenant Relief Period, such rate shall be five percent (5.00%) per annum), and (c) the blended current effective interest rate (including any spread or margin) applicable to the Real Estate Revolving Loans."; (c) By deleting the period at the end of Section 9.2 of the Credit Agreement and inserting in lieu thereof the following: "; provided, however, that notwithstanding the foregoing, during the Covenant Relief Period, Borrowers shall not permit at any time the ratio of Total Adjusted EBITDAR to Consolidated Fixed Charges to be less than the applicable ratio set forth below with respect to each applicable fiscal quarter set forth below: Fiscal Quarter Ending Total Adjusted EBITDAR to Consolidated Fixed Charges September 30, 2021 1.40 to 1.00 3 US_Active\119172305\V-3 December 31, 2021 1.40 to 1.00 March 31, 2022 1.45 to 1.00 June 30, 2022 1.45 to 1.00 (d) By inserting the following at the end of Section 9.4 of the Credit Agreement: "(d) Notwithstanding anything to the contrary contained herein, during the Covenant Relief Period, Borrowers shall not permit Trilogy Investors to create, incur, assume, guarantee or become liable under any additional Recourse Indebtedness not existing immediately prior to the commencement of the Covenant Relief Period, other than the Covenant Relief Period Permitted Recourse Indebtedness subject to compliance with the terms and conditions of this Agreement, including, without limitation, this Section 9.4."; and (e) By inserting the following new Section 9.5(d) into the Credit Agreement: "(d) Notwithstanding anything to the contrary contained herein, during the Covenant Relief Period, Borrowers shall not (x) make any Distributions to their respective partners, shareholders, members or other owners except in the minimum amount necessary to permit Trilogy Investors to make Distributions in an amount equal to the Minimum REIT Distributions, and (y) permit Trilogy Investors to make any Distributions to its partners, shareholders, members or other owners, other than Distributions in an amount equal to the Minimum REIT Distributions, in each case of the foregoing clauses (x) and (y), as evidenced by a certification of the principal financial officer of Trilogy Investors containing reasonably detailed proforma calculations satisfactory in form and substance to Administrative Agent." 3. References to Credit Agreement. All references in the Loan Documents to the Credit Agreement shall be deemed a reference to the Credit Agreement as modified and amended herein. 4. Representations. Borrowers and Guarantors represent and warrant to Administrative Agent and the Lenders as follows: (a) Authorization. The execution, delivery and performance of this Amendment and the transactions contemplated hereby (i) are within the authority of Borrowers and Guarantors, (ii) have been duly authorized by all necessary proceedings on the part of such Persons, (iii) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which any of such Persons is subject or any judgment, order, writ, injunction, license or permit applicable to such Persons, (iv) do not and will not conflict with or constitute a default under any provision of the partnership agreement, articles of incorporation or other charter documents or bylaws of such Person, (v) do not and will not conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of any material agreement or other instrument binding upon, such Person or any of its properties, and (vi) do not and will not result in or require the imposition of any lien or other encumbrance on any of the properties, assets or rights of such Person other than the liens and encumbrances in favor of Administrative Agent contemplated by the Credit Agreement and the other Loan Documents. 4 US_Active\119172305\V-3 (b) Enforceability. This Amendment and any other agreements or instruments executed in connection herewith to which any of Borrowers or Guarantors is a party are the valid and legally binding obligations of such Person enforceable in accordance with the respective terms and provisions hereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and the effect of general principles of equity. (c) Approvals. The execution, delivery and performance of this Amendment and the transactions contemplated hereby do not require the approval or consent of or approval of any Person or the authorization, consent, approval of or any license or permit issued by, or any filing or registration with, or the giving of any notice to, any court, department, board, commission or other governmental agency or authority other than those already obtained and delivered to Administrative Agent. (d) Reaffirmation. Borrowers and Guarantors reaffirm and restate as of the date hereof each and every representation and warranty made by such Persons in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith except for representations or warranties that expressly relate to an earlier date. The representations and warranties made by Borrowers, Guarantors or their respective Subsidiaries in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith or after the date of the Credit Agreement were true and correct in all material respects when made and are true and correct in all material respects as of the hereof, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date). (e) No Default. By execution hereof, Borrowers and Guarantors certify that such Persons are and will be in compliance with all covenants under the Loan Documents after the execution and delivery of this Amendment and the other documents executed in connection herewith, and that no Default or Event of Default has occurred and is continuing. 5. Waiver of Claims. Borrowers and Guarantors acknowledge, represent and agree that such Persons as of the date hereof have no defenses, setoffs, claims, counterclaims or causes of action of any kind or nature whatsoever with respect to the Loan Documents, the administration or funding of the Loans or with respect to any acts or omissions of Administrative Agent or any Lender, or any past or present officers, agents or employees of Administrative Agent or any Lender, and each of Borrowers and Guarantors does hereby expressly waive, release and relinquish any and all such defenses, setoffs, claims, counterclaims and causes of action, if any. 6. Ratification. Except as hereinabove set forth or in any other document previously executed or executed in connection herewith, all terms, covenants and provisions of the Credit Agreement and the other Loan Documents remain unaltered and in full force and effect, and the parties hereto do hereby expressly ratify and confirm the Credit Agreement and the other Loan Documents. Nothing in this Amendment shall be deemed or construed to constitute, and there has not otherwise occurred, a novation, cancellation, satisfaction, release, extinguishment or substitution of the indebtedness evidenced by the Notes or the other obligations of Borrowers and Guarantors under the Loan Documents. 7. Counterparts. This Amendment may be executed in any number of counterparts which shall together constitute but one and the same agreement. 8. Miscellaneous. THIS AMENDMENT SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5-1401, BE GOVERNED BY AND CONSTRUED IN

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5 US_Active\119172305\V-3 ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. This Amendment shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted successors, successors-in-title and assigns as provided in the Credit Agreement. This Amendment shall constitute a Loan Document. 9. Effective Date. The effectiveness of this Amendment is subject to confirmation by the Administrative Agent of the satisfaction of the following conditions: (a) Execution and delivery of this Amendment by Borrowers, Guarantors, Administrative Agent and the Majority Lenders; (b) Borrowers shall have paid to the Administrative Agent a modification fee in the amount of 7.5 basis points on the aggregate Real Estate Revolving Loan Commitments, which fee shall be for the pro rata account of each of the Lenders based on such Lender's Real Estate Revolving Loan Commitment; (c) Receipt by Administrative Agent of evidence that the Borrower shall have paid all fees due and payable with respect to this Amendment; and (d) Receipt by Administrative Agent of such other resolutions, certificates, documents, customary searches (credit, judgment, lien, bankruptcy, etc.), instruments and agreements as the Agent may reasonably request on or prior to the date of this Amendment. 10. Fees and Expenses. Borrowers will pay the reasonable fees and expenses of Administrative Agent in connection with this Amendment and the transactions contemplated hereby in accordance with Section 15 of the Credit Agreement. 11. Electronic Signatures. Delivery of an executed counterpart of a signature page to this Amendment by facsimile or as an attachment to an electronic mail message in .pdf, .jpeg, .TIFF or similar electronic format shall be effective as delivery of a manually executed counterpart of this Amendment for all purposes. The words "execution," "signed," "signature," "delivery," and words of like import in or relating to this Amendment and any other Loan Document to be signed in connection with this Amendment, the other Loan Documents and the transactions contemplated hereby and thereby shall be deemed to include Electronic Signatures, deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as manually executed signature, physical delivery thereof or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any Applicable Law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any other similar state laws based on the Uniform Electronic Transactions Act; provided that nothing herein shall require the Agent to accept electronic signatures in any form or format without its prior written consent. For the purposes hereof, "Electronic Signatures" means an electronic sound, symbol, or process attached to, or associated with, a contract or other record and adopted by a Person with the intent to sign, authenticate or accept such contract or record. Each of the parties hereto represents and warrants to the other parties hereto that it has the corporate capacity and authority to execute the Amendment through electronic means and there are no restrictions for doing so in that party's constitutive documents. Without limiting the generality of the foregoing, each Borrower and Guarantor hereby (i) agrees that, for all purposes, including without limitation, in connection with any workout, restructuring, enforcement of remedies, bankruptcy proceedings or litigation among any of the Agent or the Lenders and any of the Borrowers or Guarantors, electronic images of this Agreement or any other Loan Document (in each case, including with respect to any signature pages thereto) shall have the same legal effect, validity and enforceability as any paper original, and (ii) waives any argument, defense or right to contest the validity or enforceability of any Loan 6 US_Active\119172305\V-3 Document based solely on the lack of paper original copies of such Loan Document, including with respect to any signature pages thereto. [CONTINUED ON NEXT PAGE]

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to Second Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) ADMINISTRATIVE AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Laura Conway Title: Senior Vice President CIT BANK, N.A., as a Lender By: Name: Eli Plotkin Title: Vice President REGIONS BANK, as a Lender By: Name: Title: BANK OF AMERICA, N.A., as a Lender By: Name: Title: THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: [SIGNATURES CONTINUED ON NEXT PAGE]

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to Second Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: CIBC BANK USA, as a Lender By: Name: Michael Velazquez Title: Managing Director BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: BANK OF THE WEST, as a Lender By: Name: Title: Signature Page to Second Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: CIBC BANK USA, as a Lender By: Name: Title: BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: BANK OF THE WEST, as a Lender By: Name: Shikha Rehman Title: Director

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## Exhibit 10.6

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1 US_ACTIVE\122519180\V-5 THIRD AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT AND AMENDMENT TO UNCONDITIONAL GUARANTY OF PAYMENT AND PERFORMANCE THIS THIRD AMENDMENT TO FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT AND AMENDMENT TO UNCONDITIONAL GUARANTY OF PAYMENT AND PERFORMANCE (this "Amendment"), dated as of December 20, 2022, by and among the undersigned parties executing this Amendment as "Borrowers" (collectively, "Borrowers"), the undersigned parties executing this Amendment as "Guarantors" (collectively, "Guarantors"), KEYBANK NATIONAL ASSOCIATION ("KeyBank") and the other Lenders party hereto (collectively, the "Lenders"), and KeyBank as Administrative Agent for itself and the other Lenders from time to time a party to the Credit Agreement (as hereinafter defined) (KeyBank, in its capacity as Administrative Agent, is hereinafter referred to as "Administrative Agent"). W I T N E S S E T H: WHEREAS, Borrowers, Administrative Agent and the Lenders are parties to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, as amended by that certain First Amendment to First Amended and Restated Senior Secured Credit Agreement dated as of April 30, 2021 and that certain Second Amendment to First Amended and Restated Senior Secured Credit Agreement dated as of September 29, 2021 (as varied, extended, supplemented, consolidated, replaced, increased, renewed, modified or amended from time to time prior to the effectiveness of this Amendment, the "Existing Credit Agreement", and the Existing Credit Agreement, as amended by this Amendment is referred to herein as the "Credit Agreement"); WHEREAS, in connection with the Credit Agreement, the Guarantors executed and delivered to Agent and Lenders that certain Unconditional Guaranty of Payment and Performance dated as of September 5, 2019 (as varied, extended, supplemented, consolidated, replaced, increased, renewed, modified or amended from time to time prior to the effectiveness of this Amendment, the "Existing Guaranty", and the Existing Guaranty, as amended by this Amendment is referred to herein as the "Guaranty") WHEREAS, Borrowers and the Guarantors have requested that Administrative Agent and the Lenders make certain modifications to the Existing Credit Agreement and the Existing Guaranty, and Administrative Agent and the Lenders have consented to such modifications, subject to the execution and delivery of this Amendment. NOW, THEREFORE, for and in consideration of the sum of TEN and NO/100 DOLLARS ($10.00), and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto do hereby covenant and agree as follows: 1. Definitions. Capitalized terms used in this Amendment, but which are not otherwise expressly defined in this Amendment, shall have the respective meanings given thereto in the Credit Agreement. 2. Amendment of the Credit Agreement. Subject to all of the terms and conditions set forth in this Amendment, Borrowers, Guarantors, the Lenders and the Administrative Agent hereby agree that the Existing Credit Agreement (other than the schedules and exhibits thereto, except as expressly provided herein) is amended to incorporate the changes marked to delete the stricken text (indicated textually in the same manner as the following example: stricken text) and to add the underlined text (indicated textually in the same manner as the following example: underlined text) as set forth on the copy of the Credit Agreement attached as Annex I. Schedule 1.1(a) to the Existing Credit Agreement is hereby deleted in its 2 US_ACTIVE\122519180\V-5 entirety and replaced with Schedule 1.1(a) attached hereto and made a part hereof. Exhibit F attached to the Existing Credit Agreement is hereby deleted in its entirety and replaced with Exhibit F attached hereto and made a part hereof. Each reference to a "LIBOR Rate Loan" appearing in Section 7(d) of Exhibit M attached to the Credit Agreement shall be deemed to be a reference to a "Term SOFR Loan". None of the other Schedules or Exhibits to the Existing Credit Agreement shall be revised pursuant to this Amendment. 3. Amendment of Guaranty. Administrative Agent and Guarantors do hereby modify and amend the Existing Guaranty by deleting the figure "$325,000,000.00" appearing in paragraph (a) of the Existing Guaranty, appearing on page 1 thereof, and inserting in lieu thereof the figure "$365,000,000.00". 4. Commitment Increase. (a) Borrowers and Guarantors hereby acknowledge and agree that as of the Effective Date (as hereinafter defined) and following satisfaction of all conditions thereto as provided herein, the amount of each Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment shall be the amount set forth on Schedule 1.1(a) attached hereto (the amount by which the Total Real Estate Revolving Loan Commitment is being increased hereby being referred to herein as the "Commitment Increase"). In connection with the Commitment Increase, each Real Estate Revolving Loan Lender which is increasing its Real Estate Revolving Loan Commitment shall be issued a new Real Estate Revolving Loan Note in the principal face amount of its Real Estate Revolving Loan Commitment, which will be a "Real Estate Revolving Loan Note" under the Credit Agreement, and each such increasing Lender will promptly after receipt of such new Real Estate Revolving Loan Note return to Borrower its existing Real Estate Revolving Loan Note, marked "Replaced." (b) On the Effective Date, the outstanding principal balance of the Real Estate Revolving Loans shall be reallocated among the Real Estate Revolving Loan Lenders such that the outstanding principal amount of Real Estate Revolving Loans owed to each Real Estate Revolving Loan Lender shall be equal to such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment Percentage of the outstanding principal amount of all Real Estate Revolving Loans. The participation interests of the Real Estate Revolving Loan Lenders in Swing Loans and Letters of Credit shall be similarly adjusted. Each of those Real Estate Revolving Loan Lenders whose Real Estate Revolving Loan Commitment Percentage is increasing shall advance the funds to the Administrative Agent and the funds so advanced shall be distributed among the Real Estate Revolving Loan Lenders whose Real Estate Revolving Loan Commitment Percentage is decreasing as necessary to accomplish the required reallocation of the outstanding Real Estate Revolving Loans, as necessary to accomplish the required reallocation of the outstanding principal balance of the Real Estate Revolving Loans. 5. References to Credit Agreement and the Guaranty. All references in the Loan Documents to the Credit Agreement and the Guaranty shall be deemed a reference to the Credit Agreement and the Guaranty, as applicable, as modified and amended herein. 6. Consent and Acknowledgment of Borrowers and Guarantors. By execution of this Amendment, Guarantors hereby expressly consents to the modifications and amendments relating to the Credit Agreement as set forth herein and any other agreements or instruments executed in connection herewith, and Borrowers and Guarantors hereby acknowledge, represent and agree that (a) the Credit Agreement, as modified and amended herein, and the other Loan Documents remain in full force and effect and constitute the valid and legally binding obligation of Borrowers and Guarantors, as applicable, enforceable against such Persons in accordance with their respective terms, (b) that the Guaranty extends to and applies to the Credit Agreement as modified and amended herein, and (c) that the execution and delivery of this Amendment and any other agreements or instruments executed in connection herewith does 3 US_ACTIVE\122519180\V-5 not constitute, and shall not be deemed to constitute, a release, waiver or satisfaction of any Borrower's or any Guarantor's obligations under the Loan Documents. 7. Representations. Borrowers and Guarantors represent and warrant to Administrative Agent and the Lenders as follows: (a) Authorization. The execution, delivery and performance of this Amendment and the transactions contemplated hereby (i) are within the authority of Borrowers and Guarantors, (ii) have been duly authorized by all necessary proceedings on the part of such Persons, (iii) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which any of such Persons is subject or any judgment, order, writ, injunction, license or permit applicable to such Persons, (iv) do not and will not conflict with or constitute a default under any provision of the partnership agreement, articles of incorporation or other charter documents or bylaws of such Person, (v) do not and will not conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of any material agreement or other instrument binding upon, such Person or any of its properties, and (vi) do not and will not result in or require the imposition of any lien or other encumbrance on any of the properties, assets or rights of such Person other than the liens and encumbrances in favor of Administrative Agent contemplated by the Credit Agreement and the other Loan Documents. (b) Enforceability. This Amendment and any other agreements or instruments executed in connection herewith to which any of Borrowers or Guarantors is a party are the valid and legally binding obligations of such Person enforceable in accordance with the respective terms and provisions hereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and the effect of general principles of equity. (c) Approvals. The execution, delivery and performance of this Amendment and the transactions contemplated hereby do not require the approval or consent of or approval of any Person or the authorization, consent, approval of or any license or permit issued by, or any filing or registration with, or the giving of any notice to, any court, department, board, commission or other governmental agency or authority other than those already obtained and delivered to Administrative Agent. (d) Reaffirmation. Borrowers and Guarantors reaffirm and restate as of the date hereof each and every representation and warranty made by such Persons in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith except for representations or warranties that expressly relate to an earlier date. The representations and warranties made by Borrowers, Guarantors or their respective Subsidiaries in the Loan Documents or otherwise made by or on behalf of such Persons in connection therewith or after the date of the Credit Agreement were true and correct in all material respects when made and are true and correct in all material respects as of the hereof, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date). (e) No Default. By execution hereof, Borrowers and Guarantors certify that such Persons are and will be in compliance with all covenants under the Loan Documents after the execution and delivery of this Amendment and the other documents executed in connection herewith, and that no Default or Event of Default has occurred and is continuing. 4 US_ACTIVE\122519180\V-5 8. Waiver of Claims. Borrowers and Guarantors acknowledge, represent and agree that such Persons as of the date hereof have no defenses, setoffs, claims, counterclaims or causes of action of any kind or nature whatsoever with respect to the Loan Documents, the administration or funding of the Loans or with respect to any acts or omissions of Administrative Agent or any Lender, or any past or present officers, agents or employees of Administrative Agent or any Lender, and each of Borrowers and Guarantors does hereby expressly waive, release and relinquish any and all such defenses, setoffs, claims, counterclaims and causes of action, if any. 9. Ratification. Except as hereinabove set forth or in any other document previously executed or executed in connection herewith, all terms, covenants and provisions of the Credit Agreement and the other Loan Documents remain unaltered and in full force and effect, and the parties hereto do hereby expressly ratify and confirm the Credit Agreement, the Guaranty and the other Loan Documents. Nothing in this Amendment shall be deemed or construed to constitute, and there has not otherwise occurred, a novation, cancellation, satisfaction, release, extinguishment or substitution of the indebtedness evidenced by the Notes or the other obligations of Borrowers and Guarantors under the Loan Documents. 10. Counterparts. This Amendment may be executed in any number of counterparts which shall together constitute but one and the same agreement. 11. Miscellaneous. THIS AMENDMENT SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5-1401, BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. This Amendment shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted successors, successors-in-title and assigns as provided in the Credit Agreement. This Amendment shall constitute a Loan Document. 12. Effective Date. The effectiveness of this Amendment is subject to confirmation by the Administrative Agent of the satisfaction of the following conditions: (a) Execution and delivery of this Amendment by Borrowers, Guarantors, Administrative Agent and all of the Lenders; (b) Receipt by Administrative Agent of evidence that the Borrower shall have paid all fees due and payable with respect to this Amendment and the Commitment Increase; and I Receipt by Administrative Agent of such other resolutions, certificates, documents, customary searches (credit, judgment, lien, bankruptcy, etc.), instruments and agreements as the Agent may reasonably request on or prior to the date of this Amendment. 13. Fees and Expenses. Borrowers will pay the reasonable fees and expenses of Administrative Agent in connection with this Amendment and the transactions contemplated hereby in accordance with Section 15 of the Credit Agreement. 14. Electronic Signatures. Delivery of an executed counterpart of a signature page to this Amendment by facsimile or as an attachment to an electronic mail message in .pdf, .jpeg, .TIFF or similar electronic format shall be effective as delivery of a manually executed counterpart of this Amendment for all purposes. The words "execution," "signed," "signature," "delivery," and words of like import in or relating to this Amendment and any other Loan Document to be signed in connection with this Amendment, the other Loan Documents and the transactions contemplated hereby and thereby shall be deemed to include Electronic Signatures, deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as manually executed signature, physical delivery thereof or the

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5 US_ACTIVE\122519180\V-5 use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any Applicable Law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any other similar state laws based on the Uniform Electronic Transactions Act; provided that nothing herein shall require the Agent to accept electronic signatures in any form or format without its prior written consent. For the purposes hereof, "Electronic Signatures" means an electronic sound, symbol, or process attached to, or associated with, a contract or other record and adopted by a Person with the intent to sign, authenticate or accept such contract or record. Each of the parties hereto represents and warrants to the other parties hereto that it has the corporate capacity and authority to execute the Amendment through electronic means and there are no restrictions for doing so in that party's constitutive documents. Without limiting the generality of the foregoing, each Borrower and Guarantor hereby (i) agrees that, for all purposes, including without limitation, in connection with any workout, restructuring, enforcement of remedies, bankruptcy proceedings or litigation among any of the Agent or the Lenders and any of the Borrowers or Guarantors, electronic images of this Amendment or any other Loan Document (in each case, including with respect to any signature pages thereto) shall have the same legal effect, validity and enforceability as any paper original, and (ii) waives any argument, defense or right to contest the validity or enforceability of any Loan Document based solely on the lack of paper original copies of such Loan Document, including with respect to any signature pages thereto. [CONTINUED ON NEXT PAGE]

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to Third Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) Confidential ADMINISTRATIVE AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Laura Conway Title: Senior Vice President CIT BANK, N.A., as a Lender By: Name: Title: REGIONS BANK, as a Lender By: Name: John E. Boudler Title: Senior Vice President BANK OF AMERICA, N.A., as a Lender By: Name: Title: THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: [SIGNATURES CONTINUED ON NEXT PAGE] Type text here

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&nbsp;&nbsp;&nbsp;&nbsp;Signature Page to Third Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: CIBC BANK USA, as a Lender By: Name: Adam D. Panos Title: Managing Director BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: BANK OF THE WEST, as a Lender By: Name: Title:

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Signature Page to Third Amendment to First Amended and Restated Senior Secured Credit Agreement (KeyBank/Trilogy) SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: CIBC BANK USA, as a Lender By: Name: Title: BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: BANK OF THE WEST, as a Lender By: Name: Adam Shifrin Title: 11/18/22 US_ACTIVE\122519180\V-5 SCHEDULE 1.1(a) LENDERS, COMMITMENTS AND COMMITMENT PERCENTAGES Name and Address A/R Revolving Loan Commitment A/R Revolving Loan Commitment Percentage Real Estate Revolving Loan Commitment Real Estate Revolving Loan Commitment Percentage Total Commitment Total Commitment Percentage KeyBank National Association Applicable Lending Office: KeyBank National Association Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields Notices: See Section 19 $5,347,000.00 15.277142857143 % $64,653,000.00 17.713150684932 % $70,000,000.00 17.500000000000 % Regions Bank Applicable Lending Office: Regions Bank One Indiana Square Indianapolis, Indiana 46204 Attn: Jack Boudler Notices: See Section 19 $5,347,000.00 15.277142857143 % $49,653,000.00 13.603561643836 % $55,000,000.00 13.750000000000 % US_ACTIVE\122519180\V-5 Name and Address A/R Revolving Loan Commitment A/R Revolving Loan Commitment Percentage Real Estate Revolving Loan Commitment Real Estate Revolving Loan Commitment Percentage Total Commitment Total Commitment Percentage The Huntington National Bank Applicable Lending Office: The Huntington National Bank 10200 Forest Green Boulevard, Suite 112 Louisville, Kentucky 40223 Attn: Michael Kinnick Notices: See Section 19 $3,889,000.00 11.111428571429 % $46,111,000.00 12.633150684932 % $50,000,000.00 12.500000000000 % Bank of America, N.A. Applicable Lending Office: Bank of America, N.A. 222 2nd Ave. S., Suite 2440 Nashville, Tennessee 37201 Attn: Hope Walker Notices: See Section 19 $3,889,000.00 11.111428571429 % $36,111,000.00 9.893424657534% $40,000,000.00 10.000000000000 % CIT Bank, N.A. Applicable Lending Office: CIT Bank, N.A. 11 w. 42ND Street, 12th Floor New York, New York 10036 Attn: Thomas Gatsios Notices: See Section 19 $3,403,000.00 9.722857142857% $31,597,000.00 8.656712328767% $35,000,000.00 8.750000000000% US_ACTIVE\122519180\V-5 Name and Address A/R Revolving Loan Commitment A/R Revolving Loan Commitment Percentage Real Estate Revolving Loan Commitment Real Estate Revolving Loan Commitment Percentage Total Commitment Total Commitment Percentage Synovus Financial Corporation Applicable Lending Office: Synovus Financial Corporation 800 Shades Creek Parkway, Suite 325 Birmingham, Alabama 35209 Attn: Kathyrn H. Buchanan Notices: See Section 19 $3,403,000.00 9.722857142857% $31,597,000.00 8.656712328767% $35,000,000.00 8.750000000000% BOKF, NA dba Bank of Oklahoma Applicable Lending Office: BOKF One Williams Center, 8th Floor Tulsa, Oklahoma 74172 Attn: Chris Rollman Notices: See Section 19 $1,944,000.00 5.554285714286% $33,056,000.00 9.056438356164% $35,000,000.00 8.750000000000% CIBC Bank USA Applicable Lending Office: CIBC Bank USA 120 S. LaSalle Street Chicago, Illinois 60603 Attn: Michael Velazquez Notices: See Section 19 $2,917,000.00 8.334285714286% $27,083,000.00 7.420000000000% $30,000,000.00 7.500000000000%

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US_ACTIVE\122519180\V-5 Name and Address A/R Revolving Loan Commitment A/R Revolving Loan Commitment Percentage Real Estate Revolving Loan Commitment Real Estate Revolving Loan Commitment Percentage Total Commitment Total Commitment Percentage Pacific Western Bank Applicable Lending Office: Pacific Western Bank 5404 Wisconsin Ave., 2nd Floor Chevy Chase, Maryland 20815 Attn: Jason Schwartz Notices: See Section 19 $2,917,000.00 8.334285714286% $27,083,000.00 7.420000000000% $30,000,000.00 7.500000000000% Bank of the West Applicable Lending Office: Bank of the West 2527 Camino Ramon San Ramon, California 94583 Attn: Adam Shifrin Notices: See Section 19 $1,944,000.00 5.554285714286% $18,056,000.00 4.946849315068% $20,000,000.00 5.000000000000% TOTAL $35,000,000.00 100%\* $365,000,000.00 100%\* $400,000,000.00 100%\* \* Percentages may not equal 100% due to rounding. US_ACTIVE\122519180\V-5 EXHIBIT F FORM OF REQUEST FOR LOAN/CONVERSION KeyBank National Association, as Administrative Agent Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields Ladies and Gentlemen: This request is delivered pursuant to the provisions of Section [2.6/4.1] of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among TRILOGY RER, LLC, a Delaware limited liability company, as a Borrower ("Parent") and the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto. Terms defined in the Credit Agreement and not otherwise defined herein are used herein as defined in the Credit Agreement. Parent hereby requests, on behalf of itself and the other Borrowers, and certifies as follows: 1. Loan. Borrowers hereby request a [Real Estate Revolving Loan under Section 2.1] [A/R Revolving Loan under Section 2.2] [A/R Swing Loan under Section 2.4] [Real Estate Swing Loan under Section 2.4] [conversion of a Loan under Section 4.1] of the Credit Agreement: Principal Amount: $__________ Type (Base Rate Loan; Daily Simple SOFR Loan; Term SOFR Loan): Drawdown/Conversion Date: Interest Period for Term SOFR Loans: [If a request of a Loan under Section 2.1 or Section 2.2 or a Swing Loan under Section 2.4, add the following: by credit to the general account of [designate Borrower] with Administrative Agent at Administrative Agent's Head Office.] [If the requested Loan is a Swing Loan and Borrowers desire for such Loan to be a Term SOFR Loan following its conversion as provided in Section 2.4(d), specify the Interest Period following conversion:_________________] 2. Use of Proceeds. Such Loan shall be used in accordance with the terms of Section 2.8 of the Credit Agreement. 3. No Default. The undersigned Authorized Officer of Parent certifies, on behalf of Borrowers, that Loan Parties are and will be in compliance with all covenants under the Loan Documents after giving effect to the making or conversion, as the case may be, of the Loan requested hereby and no Default or Event of Default has occurred and is continuing. 4. Borrowing Base Certificate. [If a request of an A/R Revolving Loan or Real Estate Revolving Loan under Section 2.1 or Section 2.2 or Swing Loan under Section 2.4, add the following: US_ACTIVE\122519180\V-5 Attached hereto is [an A/R] [a Real Estate] Borrowing Base Certificate setting forth a calculation of the [A/R/Real Estate] Borrowing Base Availability after giving effect to the [A/R/Real Estate] Revolving Loan requested hereby. After giving effect to the making of such Loan, (a) the Aggregate A/R Revolving Credit Obligations shall not be greater than the lesser of (i) the Total A/R Revolving Loan Commitment and (ii) the A/R Borrowing Base Availability, and (b) the Aggregate Real Estate Revolving Credit Obligations shall not be greater than the lesser of (i) the Total Real Estate Revolving Loan Commitment and (ii) the Real Estate Borrowing Base Availability.] [INCLUDE IF NOTICE IS DELIVERED IN CONNECTION WITH A DRAW: 5. Representations True. The undersigned certifies, represents and agrees, on behalf of Borrowers, that each of the representations and warranties made by any Loan Party contained in the Credit Agreement, the other Loan Documents or in any document or instrument delivered by or on behalf of any Loan Party to Administrative Agent, Revolving Agent or the Lenders pursuant to or in connection with the Credit Agreement shall be true and correct in all material respects both as of the date as of which they were made and shall also be true and correct in all material respects as of the time of the making of such Loan, with the same effect as if made at and as of that time, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing.] [5/6]. Other Conditions. The undersigned certifies, represents and agrees, on behalf of Borrowers, that all conditions to the making or conversion, as the case may be, of the Loan requested hereby set forth in the Credit Agreement have been satisfied or waived in writing. [6/7]. Definitions. Terms defined in the Credit Agreement are used herein with the meanings so defined. IN WITNESS WHEREOF, the undersigned has duly executed this request this _____ day of _____________, 20__. TRILOGY RER, LLC, a Delaware limited liability company, on behalf of Borrowers By: Name: Title: US_ACTIVE\122519180\V-5 ANNEX I Revised Credit Agreement [Attached]

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First Amended and Restated Senior Credit Agreement - 9/5/2019 First Amendment to First Amended and Restated Senior Credit Agreement - 4/30/2021 Second Amendment to First Amended and Restated Senior Credit Agreement - 9/29/2021 Third Amendment to First Amended and Restated Senior Credit Agreement – 12/20/2022 __________________________________________________________________________ FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT DATED AS OF SEPTEMBER 5, 2019 among THE INITIAL PARTIES HERETO EXECUTING AS BORROWERS, as Borrowers, KEYBANK NATIONAL ASSOCIATION, as a Lender, The other Lenders which are parties hereto from time to time, and KEYBANK NATIONAL ASSOCIATION, as Administrative Agent, CIT BANK, N.A., as Revolving Agent, REGIONS BANK, as Syndication Agent, KEYBANC CAPITAL MARKETS, INC. AND REGIONS CAPITAL MARKETS, as Co-Lead Arrangers and Co-Book Runners, and BANK OF AMERICA, N.A. and THE HUNTINGTON NATIONAL BANK, as Co-Documentation Agents US_Active\120558968\V-3US_ACTIVE\122519032\V-4 FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT THIS FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT (this "Agreement") is made as of September 5, 2019, among THE INITIAL PARTIES HERETO EXECUTING AS BORROWERS (collectively, the "Initial Borrowers"), KEYBANK NATIONAL ASSOCIATION ("KeyBank"), as a Lender, the other lending institutions which are parties to this Agreement as Lenders, the other lending institutions that may become parties hereto as Lenders pursuant to Sections 2.10 or 18, KEYBANK NATIONAL ASSOCIATION, as Administrative Agent, and CIT BANK, N.A., as Revolving Agent. R E C I T A L S Certain of the Initial Borrowers, KeyBank, certain of the Lenders and Administrative Agent have entered into that certain Senior Secured Credit Agreement dated as of December 1, 2015, as amended by that certain First Amendment to Senior Secured Credit Agreement dated March 21, 2016 (as so amended, the "Original Credit Agreement"). The parties hereto desire to enter into this Agreement to amend and restate the Original Credit Agreement in its entirety. In consideration of the mutual covenants and agreements contained herein, the parties hereto hereby amend and restate the Original Credit Agreement and covenant and agree as follows: SECTION 1. DEFINITIONS AND RULES OF INTERPRETATION. Section 1.1 Definitions. The following terms shall have the meanings set forth in this Section l or elsewhere in the provisions of this Agreement referred to below: "A/R Borrowing Base Availability" means, at any time, subject to adjustment as provided below, an amount equal to the sum of, without duplication: (a) up to 85% of the amount of Operating Company Eligible Accounts multiplied by the Expected Net Value, less the Credit and Unapplied Collection Account, plus (b) up to 75% of the amount of Ancillary Business Eligible Accounts multiplied by the Expected Net Value, less the Credit and Unapplied Collection Account, less (c) the aggregate amount of Reserves established by Revolving Agent as provided below; provided, that Revolving Agent may, in the exercise of its Permitted Discretion, reduce the percentages in clauses (a) and (b) above from time to time with at least three (3) Business Days' notice to Parent (which notice shall not be required during the existence of an Event of Default). Revolving Agent shall give prompt written notice to Administrative Agent and the A/R Revolving Loan Lenders of any adjustments effected pursuant to this proviso, but a non-willful failure of Revolving Agent to so notify shall not be a breach of this Agreement. Anything to the contrary in this definition notwithstanding, Revolving Agent shall have the right (but not the obligation), in the exercise of its Permitted Discretion, to establish and increase or decrease the Receivable Reserves, Bank Product Reserves and other Reserves against the A/R Borrowing Base Availability; provided that Revolving Agent shall endeavor to notify Borrowers at or before the US_Active\120558968\V-3US_ACTIVE\122519032\V-4 time any such reserve in a material amount is to be established or increased, but a non-willful failure of Revolving Agent to so notify Borrowers shall not be a breach of this Agreement and shall not cause such establishment or increase of a reserve to be ineffective. The amount of any Receivable Reserve, Bank Product Reserve or other Reserve established by Revolving Agent shall have a reasonable relationship to the event, condition, other circumstance or fact that is the basis for such reserve and shall not be duplicative of any other reserve established and currently maintained. "A/R Borrowing Base Certificate" has the meaning set forth in Section 7.4(a)(x). "A/R Borrowing Base Review" has the meaning set forth in Section 7.9(b). "A/R Revolving Loan Commitment" means, with respect to each A/R Revolving Loan Lender, the amount set forth on Schedule 1.1(a) as the amount of such A/R Revolving Loan Lender's A/R Revolving Loan Commitment to make or maintain A/R Revolving Loans to Borrowers or to participate in A/R Swing Loans, as the same may be changed from time to time in accordance with the terms of this Agreement. "A/R Revolving Loan Commitment Percentage" means, with respect to each A/R Revolving Loan Lender, the percentage set forth on Schedule 1.1(a) as such A/R Revolving Loan Lender's percentage of the aggregate A/R Revolving Loan Commitments of all of the A/R Revolving Loan Lenders, as the same may be changed from time to time in accordance with the terms of this Agreement; provided that if the A/R Revolving Loan Commitments of the A/R Revolving Loan Lenders have been terminated as provided in this Agreement, then the A/R Revolving Loan Commitment Percentage of each A/R Revolving Loan Lender shall be determined based on the A/R Revolving Loan Commitment Percentage of such A/R Revolving Loan Lender immediately prior to such termination and after giving effect to any subsequent assignments made pursuant to the terms thereof. "A/R Revolving Loan" or "A/R Revolving Loans" means an individual A/R Revolving Loan or the aggregate A/R Revolving Loans, as the case may be, made by A/R Revolving Loan Lenders hereunder to Borrowers, as more particularly described in Section 2.2. Those Borrowers as of the Closing Date providing Collateral included in the calculation of A/R Borrowing Base Availability are described on Schedule1.1(d) attached hereto. "A/R Revolving Loan Lenders" means, collectively, the Lenders which have an A/R Revolving Loan Commitment, the initial A/R Revolving Loan Lenders being identified on Schedule 1.1(a). "A/R Revolving Loan Note" means a promissory note made by Borrowers in favor of an A/R Revolving Loan Lender in the principal face amount equal to such A/R Revolving Loan Lender's A/R Revolving Loan Commitment, or if less, the outstanding amount of all A/R Revolving Loans made by such A/R Revolving Loan Lender, in substantially the form of Exhibit A. "A/R Swing Loan" means a Swing Loan made hereunder pursuant to the A/R Borrowing Base Availability. "A/R Unused Fee Percentage" means with respect to any day during a calendar quarter, (a) 0.15% per annum, if the sum of the Aggregate A/R Revolving Credit Obligations outstanding on such day is greater than 50% of the Total A/R Revolving Loan Commitment, or (b) 0.20% per annum if the sum of the Aggregate A/R Revolving Credit Obligations outstanding on such day is less than or equal to 50% of the Total A/R Revolving Loan Commitment. 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Account" means an account (as that term is defined in the UCC), including all health-care-insurance receivables (as that term is defined in the UCC). "Account Debtor" means any Person who is obligated on an Account, an IGT Account, chattel paper or a general intangible. "Acknowledgments" means, collectively, each of the Acknowledgments executed by a Borrower in favor of Administrative Agent, acknowledging the pledge of Equity Interests in such Borrower to Administrative Agent, such Acknowledgment to be in the form to which Administrative Agent agrees on the Closing Date. "Adjusted Daily Simple SOFR" means, with respect to a Daily Simple SOFR Loan, an interest rate per annum equal to the greater of (1) the sum of (a) Daily Simple SOFR and (b) the applicable SOFR Index Adjustment and (2) the Floor. "Adjusted Term SOFR" means, for any Available Tenor and Interest Period with respect to a Term SOFR Loan, an interest rate per annum equal to (a) Term SOFR for such Interest Period, plus (b) the applicable SOFR Index Adjustment; provided that if Adjusted Term SOFR as so determined would be less than the Floor, such rate shall be deemed to be equal to the Floor for the purposes of this Agreement. "Administrative Agent" means KeyBank National Association, acting as administrative agent for the Secured Parties, and its successors and assigns. "Administrative Agent Fee Letter" means that certain fee letter dated July 31, 2019, among KeyBank, KeyBanc Capital Markets, Inc., and Trilogy Investors. "Administrative Agent's Head Office" means Administrative Agent's head office located at 127 Public Square, Cleveland, Ohio 44114-1306, or at such other location as Administrative Agent may designate from time to time by notice to Parent, Revolving Agent and the Lenders. "Administrative Agent's Special Counsel" means Dentons US LLP or such other counsel selected by Administrative Agent. "Affected Financial Institution" means (a) any EEA Financial Institution or (b) any UK Financial Institution. "Affected Lender" has the meaning set forth in Section 4.14. "Affiliate" means, as applied to any Person, any other Person directly or indirectly controlling, controlled by, or under common control with, that Person. For purposes of this definition, "control" (including, with correlative meanings, the terms "controlling", "controlled by" and "under common control with"), as applied to any Person, means the power to direct, or cause the direction of, the management and policies of such Person, whether through the ownership of voting securities, common directors, trustees or officers, by contract or otherwise, and including the ownership of a general partnership interest or a managing member's or manager's interest in a limited liability company; provided, that, for purposes of the definition of Eligible Accounts and Section 8.12: (a) any Person which owns directly or indirectly ten percent (10%) or more of the Equity Interests having ordinary voting power for the election of directors or other members of the governing body of a Person or ten percent (10%) or more of the partnership or other ownership interests of a Person (other than as a limited partner of such Person) shall be deemed an Affiliate of such Person, (b) each director (or comparable manager) 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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of a Person shall be deemed to be an Affiliate of such Person, and (c) each partnership in which a Person is a general partner shall be deemed an Affiliate of such Person. For purposes hereof, neither Trilogy Management Services, LLC, Trilogy Management Profit Interests, LLC nor any of their wholly-owned Subsidiaries shall be deemed an Affiliate of any Loan Party. "Agents" means, collectively, Administrative Agent and Revolving Agent. "Aggregate A/R Revolving Credit Obligations" means, as of any particular time, the sum of (a) the aggregate principal amount of all A/R Revolving Loans then outstanding plus (b) the aggregate principal amount of all A/R Swing Loans then outstanding. "Aggregate Real Estate Revolving Credit Obligations" means, as of any particular time, the sum of (a) the aggregate principal amount of all Real Estate Revolving Loans then outstanding, plus (b) the aggregate principal amount of all Real Estate Swing Loans then outstanding, plus (c) the aggregate Letter of Credit Liabilities. "Agreement" means this First Amended and Restated Senior Secured Credit Agreement, including the Schedules and Exhibits. "Ancillary Business Eligible Accounts" means Eligible Accounts generated by Ancillary Services. "Ancillary Services" means pharmacy services and rehabilitation services. "Ancillary Services Borrowing Base Value" means, with respect to any date, an amount equal to (a) the sum of that portion of the EBITDA of each of Paragon and PCA (excluding their Subsidiaries for the purposes hereof) derived solely from its Ancillary Services provided at independent living facilities, assisted living facilities, skilled nursing facilities, memory care facilities or rehabilitation facilities that are neither owned, leased or operated by Trilogy Investors or any of its Subsidiaries or Unconsolidated Affiliates and without including any contribution from any Subsidiary of Paragon or PCA, in each case so long as such Person is a Borrower, for the four (4) fiscal quarters most recently ended as of such date, multiplied by (b) 3.00. "Applicable Law" means all applicable provisions of constitutions, statutes, rules, regulations, guidelines and orders of all Governmental Authorities and all orders and binding decrees of all applicable courts, tribunals and arbitrators. "Applicable Lending Office" means, with respect to each Lender, the office designated by such Lender to the Administrative Agent as such Lender's lending office for all purposes of this Agreement. A Lender may have a different Applicable Lending Office for Base Rate Loans and SOFR Rate Loans. "Applicable Margin" means, on any date, (a) for LIBORSOFR Rate Loans, two and three-quarter percent (2.75%) per annum, and (b) for Base Rate Loans, one and three-quarter percent (1.75%) per annum. "Appraisal" means an MAI appraisal of the value of a parcel of Real Estate, determined on, with respect to the Collateral Properties (other than Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability), an "as-is" value basis, and with respect to the Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability, an "as-stabilized" basis, performed by an independent appraiser selected by 4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Administrative Agent who is not an employee of Trilogy Investors, any of its Subsidiaries or Affiliates, Administrative Agent or a Lender, the form and substance of such appraisal and the identity of the appraiser to be in compliance with the Financial Institutions Reform, Recovery and Enforcement Act of 1989, the rules and regulations adopted pursuant thereto and all other regulatory laws and policies (both regulatory and internal) applicable to the Lenders and otherwise acceptable to Administrative Agent and Majority Real Estate Revolving Loan Lenders. "Appraised Value" means (a) with respect to the Collateral Properties (other than Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability), the "as-is" value of a parcel of Real Estate determined by the Appraisal of such Real Estate, unless otherwise expressly provided in this Agreement, most recently completed and (b) with respect to the Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability, the "as-stabilized" value of such Villa Units determined by the Appraisal of such Villa Units, unless otherwise expressly provided in this Agreement. "Assignment and Acceptance Agreement" has the meaning set forth in Section 18.1. "Assignment of Leases and Rents" means each of the assignments of leases and rents from a Borrower that is an owner or lessee of Real Estate to Administrative Agent in substantially the form delivered on the Closing Date with such changes thereto as Administrative Agent may reasonably require as a result of Applicable Law or practice, pursuant to which there shall be assigned to Administrative Agent for the benefit of the Secured Parties a security interest in the interest of such Borrower, as lessor with respect to all Leases of all or any part of such Real Estate. "Authorized Officer" means any of the following Persons: Randall J. Bufford, Leigh Ann Barney, David Davis, Brad Williamson, Robin Barber, and Michael Bryant and such other Persons as Parent shall designate in a written notice to Administrative Agent. "Available Tenor" means, as of any date of determination and with respect to the then-current Benchmark, (x) if such Benchmark is a term rate, any tenor for such Benchmark (or component thereof) that is or may be used for determining the length of an interest period pursuant to this Agreement, or (y) otherwise, any payment period for interest calculated with reference to such Benchmark (or component thereof) that is or may be used for determining any frequency of making payments of interest calculated with reference to such Benchmark, in each case, as of such date and not including, for the avoidance of doubt, any tenor for such Benchmark that is then-removed from the definition of "Interest Period" pursuant to Section 4.15(d). "Bail-In Action" means the exercise of any Write-Down and Conversion Powers by the applicable EEA Resolution Authority in respect of any liability of an EEAAffected Financial Institution. "Bail-In Legislation" means (a) with respect to any EEA Member Country implementing Article 55 of Directive 2014/59/EU of the European Parliament and of the Council of the European Union, the implementing law, regulation rule or requirement for such EEA Member Country from time to time which is described in the EU Bail-In Legislation Schedule and (b) with respect to the United Kingdom, Part I of the United Kingdom Banking Act 2009 (as amended from time to time) and any other law, regulation or rule applicable in the United Kingdom relating to the resolution of unsound or failing banks, investment firms or other financial institutions or their affiliates (other than through liquidation, administration or other insolvency proceedings). "Balance Sheet Date" means June 30, 2019. 5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Bank Account Address" has the meaning set forth in Section 7.19(d). "Bank Product Obligations" means, collectively, all obligations and other liabilities of any Loan Party to any Bank Product Provider arising out of any Bank Products relating to the Senior Care Properties. "Bank Product Provider" means KeyBank, any Affiliate thereof and any other Person that, at the time it provides any Bank Products to any Loan Party, is a Lender or an Affiliate of a Lender. "Bank Products" means any of the following services provided to any Loan Party by any Bank Product Provider: (a) any treasury or other cash management services, including deposit accounts, automated clearing house (ACH) origination and other funds transfer services, depository services (including cash vault and check deposit), zero balance accounts and sweeps, return items processing, controlled disbursement accounts, positive pay, lockboxes and lockbox accounts, account reconciliation and information reporting, payables outsourcing, payroll processing, trade finance services, investment accounts and securities accounts; and (b) card services, including credit cards (including purchasing cards and commercial cards), prepaid cards, payroll, stored value and gift cards, merchant services processing, and debit card services. "Bank Products Reserve" means a reserve which shall reduce availability under the A/R Borrowing Base Availability by, as of any date of determination, an amount equal to the aggregate amount that would be payable by any Loan Party to the Bank Product Providers in the event the Bank Product Obligations were terminated as of such date, as communicated by the Bank Product Providers to Revolving Agent or as otherwise determined by Revolving Agent in its Permitted Discretion. "Bankruptcy Code" means the United States Bankruptcy Code (11 U.S.C. Section 101 et seq.). "Base Rate" means the greatest of (a) the, for any day, a fluctuating annualrate per annum equal to the highest of (i) the Federal Funds Effective Rate in effect on such day plus 0.50%, (ii) the rate of interest announcedin effect for such day as established from time to time by Administrative Agent at Administrative Agent's Head Office as its "prime rate", (b) one half of one percent (0.5%) above the Federal Funds Effective Rate andwhether or not publicly announced, which interest rate may or may not be the lowest rate charged by it for commercial loans or other extensions of credit, (ciii) LIBOR for an Interest Period ofAdjusted Term SOFR for a one (1) month tenor in effect on such day (or if such day is not a Business Day, the immediately preceding Business Day) plus one percent (1.00%). The rate described in clause (a) of the preceding sentence is a reference rate and does not necessarily represent the lowest or best rate being charged to any customer. Any change in the rate of interest payable hereunder resulting fromBase Rate due to a change in the Baseprime rate, the Federal Funds Effective Rate or Adjusted Term SOFR shall becomebe effective as of 12:01 a.m. on the Business Day on whichfrom and including the effective date of such change in the Base Rate becomes effective, without notice or demand of any kindprime rate, the Federal Funds Effective Rate or Adjusted Term SOFR, respectively. "Base Rate Loans" means, collectively, (a) the A/R Revolving Loans bearing interest calculated by reference to the Base Rate, (b) the Swing Loans and (c) the Real Estate Revolving Loans bearing interest calculated by reference to the Base Rate. "Benchmark" means, initially, with respect to (a) any Daily Simple SOFR Loan, Daily Simple SOFR, and (b) any Term SOFR Loan, Term SOFR; provided that if a Benchmark Transition Event has occurred with respect to the then-current Benchmark, then "Benchmark" means the applicable 6 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Benchmark Replacement to the extent that such Benchmark Replacement has replaced such prior benchmark rate pursuant to Section 4.15. "Benchmark Replacement" means, with respect to any Benchmark Transition Event for the then-current Benchmark, the sum of: (i) the alternate benchmark rate that has been selected by the Administrative Agent as the replacement for such Benchmark giving due consideration to (A) any selection or recommendation of a replacement benchmark rate or the mechanism for determining such a rate by the Relevant Governmental Body or (B) any evolving or then-prevailing market convention for determining a benchmark rate as a replacement for such Benchmark for syndicated credit facilities denominated in U.S. Dollars at such time and (ii) the related Benchmark Replacement Adjustment, if any; provided that, if such Benchmark Replacement as so determined would be less than the Floor, such Benchmark Replacement will be deemed to be the Floor for the purposes of this Agreement and the other Loan Documents. "Benchmark Replacement Adjustment" means, with respect to any replacement of any then-current Benchmark with an Unadjusted Benchmark Replacement for any applicable Available Tenor, the spread adjustment, or method for calculating or determining such spread adjustment (which may be a positive or negative value or zero), if any, that has been selected by the Administrative Agent giving due consideration to (a) any selection or recommendation of a spread adjustment, or method for calculating or determining such spread adjustment, for the replacement of such Benchmark with the applicable Unadjusted Benchmark Replacement by the Relevant Governmental Body or (b) any evolving or then-prevailing market convention for determining a spread adjustment, or method for calculating or determining such spread adjustment, for the replacement of such Benchmark with the applicable Unadjusted Benchmark Replacement for U.S. Dollar denominated syndicated credit facilities. "Benchmark Replacement Date" means, the earlier to occur of the following events with respect to the then-current Benchmark: (a) in the case of clause (a) or (b) of the definition of "Benchmark Transition Event", the later of (i) the date of the public statement or publication of information referenced therein and (ii) the date on which the administrator of such Benchmark (or the published component used in the calculation thereof) permanently or indefinitely ceases to provide all Available Tenors of such Benchmark (or such component thereof); or (b) in the case of clause (c) of the definition of "Benchmark Transition Event," the first date on which such Benchmark (or the published component used in the calculation thereof) has been determined and announced by the regulatory supervisor for the administrator of such Benchmark (or such component thereof) to be non-representative; provided that such non-representativeness will be determined by reference to the most recent statement or publication referenced in such clause (c) and even if any Available Tenor of such Benchmark (or such component thereof) continues to be provided on such date. For the avoidance of doubt, the "Benchmark Replacement Date" will be deemed to have occurred in the case of clause (a) or (b) with respect to any Benchmark upon the occurrence of the applicable event or events set forth therein with respect to all then-current Available Tenors of such Benchmark (or the published component used in the calculation thereof). "Benchmark Transition Event" means, with respect to the then-current Benchmark, the occurrence of one or more of the following events with respect to such Benchmark: 7 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Replacement, any technical, administrative or operational changes (including changes to the definition of "Base Rate," the definition of "Business Day," the definition of "SOFR Business Day," the definition of "Interest Period" or any similar or analogous definition (or the addition of a concept of "interest period"), timing and frequency of determining rates and making payments of interest, timing of borrowing requests or prepayment, conversion or continuation notices, the applicability and length of lookback periods, the applicability of Section 4.7 and other technical, administrative or operational matters) that the Administrative Agent decides may be appropriate to reflect the adoption and implementation of any such rate or to permit the use and administration thereof by the Administrative Agent in a manner substantially consistent with market practice (or, if the Administrative Agent decides that adoption of any portion of such market practice is not administratively feasible or if the Administrative Agent determines that no market practice for the administration of any such rate exists, in such other manner of administration as the Administrative Agent decides is reasonably necessary in connection with the administration of this Agreement and the other Loan Documents). "Consolidated" means, with reference to any term defined herein, that term as applied to the accounts of a Person and its Subsidiaries, determined on a consolidated basis in accordance with GAAP. "Consolidated Fixed Charges" means, with respect to any period, the sum of (a) Debt Service for such period, plus all (b) Preferred Distributions of Trilogy Investors and its Subsidiaries, if any, made during such period, plus (c) cash income tax payments, and cash Distributions, in respect of income taxes of Trilogy Investors and its Subsidiaries, plus (d) rental payments made under any ground lease of Trilogy Investors and its Subsidiaries, in each case, if any, made during such period plus (e) all base rent and additional rent due and payable by Trilogy Investors and its Subsidiaries during such period. Such Person's Equity Percentage in the fixed charges referred to above of its Unconsolidated Affiliates shall be included in the determination of Consolidated Fixed Charges. "Consolidated Interest Expense" means, with respect to any period, without duplication, total Interest Expense of Trilogy Investors and its Subsidiaries, determined on a Consolidated basis in accordance with GAAP for such period, plus Trilogy Investor's Equity Percentage of the Interest Expense of its Unconsolidated Subsidiaries. "Consolidated Net Worth" means, as of any date of determination, the result of (a) Consolidated Total Asset Value minus (b) Consolidated Total Indebtedness minus (c) Indebtedness of any Unconsolidated Affiliate of Trilogy Investors as to which the undepreciated book value, determined in accordance with GAAP, of Trilogy Investors in such Unconsolidated Affiliate is not greater than zero. "Consolidated Total Asset Value" means the sum of (a) the total undepreciated book value, determined in accordance with GAAP, of Trilogy Investors and its Subsidiaries on a Consolidated basis, less (b) those assets identified on the balance sheet of Trilogy Investors as "right of use assets". "Consolidated Total Indebtedness" means all Indebtedness of Trilogy Investors and its Subsidiaries determined on a Consolidated basis. "Construction Budget" means each budget for the construction of Villa Units on a Collateral Property through the completion date therefor delivered by Parent pursuant to Section 5.4, in form and substance reasonably satisfactory to Administrative Agent. "Construction Costs" means the costs, fees and expenses for the construction of Villa Units on a Collateral Property set forth on the Construction Budget for such Villa Units. Construction 12 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Costs shall not include costs associated with the acquisition of land unless the applicable Villa Units are to be constructed on newly-acquired land. "Contribution Agreement" means that certain First Amended and Restated Contribution Agreement dated as of the Closing Date among the Loan Parties. "Continue, Continuation and Continued" refers to a continuation of a SOFR Rate Loan for an additional Interest Period as provided in Section 4.1. "Conversion/Continuation Request" means a written notice given by Parent to Administrative Agent of Borrowers' election to convert a Loan in accordance with Section 4.1, which notice shall specify (A) the Loan (or portion thereof) to be continued or converted, (B) the requested effective date of the continuation or conversion (which shall be a Business Day), (C) whether the resulting Loan is to be a Base Rate Loan or a SOFR Rate Loan, and (D) in the case of a continuation or conversion resulting in a SOFR Rate Loan, the Interest Period applicable thereto. "Covenant Relief Period" means the period commencing on September 29, 2021, and ending on (and including) the Covenant Relief Period Termination Date. "Covenant Relief Period Termination Date" means the earlier of (a) June 30, 2022 and (b) the date specified in the Covenant Relief Period Termination Notice on which the Borrowers irrevocably elect to terminate the Covenant Relief Period. "Covenant Relief Period Termination Notice" means a notice executed by the chief executive officer, president, chief financial officer or treasurer or controller of Parent (a) stating that Borrowers irrevocably elect to terminate the Covenant Relief Period effective as of the last day of the fiscal quarter specified in such notice (provided, that such notice shall have been delivered to the Administrative Agent not later than the date of delivery of the Compliance Certificate for such specified fiscal quarter pursuant to Section 7.4(a)(iii)), (b) reserved, and (c) enclosing a Compliance Certificate for such specified fiscal quarter demonstrating compliance with the covenants contained in Section 9 of the Credit Agreement and the other covenants set forth in such Compliance Certificate, in each case, after giving effect to the termination of the Covenant Relief Period. "Covenant Relief Period Permitted Recourse Indebtedness" means (x) the obligations of Trilogy Investors and/or one or more of its Subsidiaries in connection with that certain purchase option with respect to the real property located at 3001- 3101 N Hurstbourne Parkway, Louisville, Kentucky 40241, not to exceed $20,000,000.00 in the aggregate, and (y) Obligations under the Credit Agreement and the other Loan Documents. "Covered Entity" shall mean any of the following: (i) a "covered entity" as that term is defined in, and interpreted in accordance with, 12 C.F.R. §252.82(b); (ii) a "covered bank" as that term is defined in, and interpreted in accordance with, 12 C.F.R. §47.3(b); or (iii) a "covered FSI" as that term is defined in, and interpreted in accordance with, 12 C.F.R. §382.2(b). "Covered Party" shall have the meaning set forth in Section 38. "Credit and Unapplied Collection Amount" means, at any time, the sum of (a) any credit charges of any Account Debtors of Eligible Accounts that are aged greater than (i) if such Eligible Account is for Ancillary Services, one hundred twenty (120) days from the invoice date, and (ii) if such 13 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Eligible Account is for other Medical Services, one hundred fifty (150) days from the invoice date and (b) any collections that have been received by a Borrower but have not yet been applied to the invoice. "Daily Simple SOFR" means, for any day (a "SOFR Rate Day"), a rate per annum (rounded in accordance with Administrative Agent's customary practice) equal to SOFR for the day (such day, the "SOFR Determination Day") that is five (5) SOFR Business Days prior to (i) if such SOFR Rate Day is a SOFR Business Day, such SOFR Rate Day or (ii) if such SOFR Rate Day is not a SOFR Business Day, the SOFR Business Day immediately preceding such SOFR Rate Day, in each case, as and when SOFR for such SOFR Rate Day is published by the SOFR Administrator on the SOFR Administrator's Website. If by 5:00 pm (New York City time) on the second (2nd) SOFR Business Day immediately following any SOFR Determination Day, SOFR in respect of such SOFR Determination Day has not been published on the SOFR Administrator's Website and a Benchmark Replacement Date with respect to Daily Simple SOFR has not occurred, then SOFR for such SOFR Determination Day will be SOFR as published in respect of the first preceding SOFR Business Day for which such SOFR was published on the SOFR Administrator's Website; provided, that any SOFR determined pursuant to this sentence shall be utilized for purposes of calculation of Daily Simple SOFR for no more than three (3) consecutive SOFR Rate Days. Any change in Daily Simple SOFR due to a change in SOFR shall be effective from and including the effective date of such change in SOFR without notice to Borrowers. "Daily Simple SOFR Loan" means each Loan bearing interest at a rate based upon Daily Simple SOFR. "Debt Service" means (a) Consolidated Interest Expense including interest expense attributable to Deferred Financing Leases of Trilogy Investors and its Subsidiaries (net of deferred financing fees), plus (b) all regularly-scheduled principal payments paid with respect to Indebtedness (including payments made with respect to Deferred Financing Leases) of Trilogy Investors and its Subsidiaries during such period, other than any balloon, bullet or similar principal payment which repays or defeases such Indebtedness in full and any related defeasance premiums, plus (c) each such Person's Equity Percentage of such scheduled principal payments of its Unconsolidated Affiliates for such period. "Default" means the occurrence of an event, which, if the giving of notice or the lapse of time or both is required, would constitute an Event of Default following such notice or lapse of time, as applicable. "Default Rate" has the meaning set forth in Section 4.11. "Default Right" shall have the meaning assigned to that term in, and shall be interpreted in accordance with, 12 C.F.R. §§ 252.81, 47.2 or 382.1, as applicable. "Defaulting Lender" means any Lender that, as reasonably determined by Administrative Agent, (a) has failed to perform any of its funding obligations hereunder, including in respect of its Loans or participations in respect of Letters of Credit or Swing Loans, within two (2) Business Days of the date required to be funded by it hereunder and such failure is continuing, unless such failure arises out of a good faith dispute between such Lender and either any Borrower or Administrative Agent, (b) (i) has notified any Borrower, Administrative Agent or any Lender that it does not intend to comply with its funding obligations hereunder or (ii) has made a public statement to that effect with respect to its funding obligations under other agreements generally in which it commits to extend credit, unless with respect to this clause (b), such failure is subject to a good faith dispute, (c) has failed, within two (2) Business Days after request by Administrative Agent, to confirm in a manner reasonably satisfactory to Administrative Agent that it will comply with its funding obligations; provided that, notwithstanding the provisions of Section 2.12, such Lender shall cease to be a Defaulting Lender upon Administrative Agent's receipt of 14 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 confirmation that such Defaulting Lender will comply with its funding obligations, or (d) has, or has a direct or indirect parent company that has, (i) become the subject of a proceeding under any bankruptcy, insolvency, reorganization, liquidation, conservatorship, assignment for the benefit of creditors, moratorium, receivership, rearrangement or similar debtor relief law of the United States or other applicable jurisdiction from time to time in effect, including any law for the appointment of the Federal Deposit Insurance Corporation or any other state or federal regulatory authority as receiver, conservator, trustee, administrator or any similar capacity, (ii) had appointed for it a receiver, custodian, conservator, trustee, administrator, assignee for the benefit of creditors or similar Person, including the Federal Deposit Insurance Corporation or any other state or federal regulatory authority acting in such capacity, charged with reorganization or liquidation of its business or assets, (iii) taken any action in furtherance of, or indicated its consent to, approval of or acquiescence in any such proceeding or appointment; provided that a Lender shall not be a Defaulting Lender solely by virtue of the ownership or acquisition of any equity interest in that Lender or any direct or indirect parent company thereof by a Governmental Authority (including any agency, instrumentality, regulatory body, central bank or other authority) so long as such ownership interest does not result in or provide such Lender with immunity from the jurisdiction of courts of the United States or from the enforcement of judgments or writs of attachment of its assets or permit such Lender (or such Governmental Authority) to reject, repudiate, disavow, or disaffirm any contracts or agreements made with such Person), or (iv) is the subject of a Bail-In Action. Any determination by Administrative Agent that a Lender is a Defaulting Lender under any one or more of clauses (a) through (d) above shall be conclusive and binding absent manifest error, and such Lender shall be deemed to be a Defaulting Lender (subject to Section 2.12(g)) upon delivery of written notice of such determination to Parent and each Lender. "Deferred Financing Lease" means a lease under which the discounted future rental payment obligations of the lessee or the obligor are required to be capitalized on the balance sheet of such Person in accordance with GAAP (excluding any Leases between Wholly-Owned Subsidiaries of Trilogy Investors). "Deposit Account" means a deposit account (as that term is defined in the UCC). "Derivatives Contract" means any and all rate swap transactions, basis swaps, credit derivative transactions, forward rate transactions, commodity swaps, commodity options, forward commodity contracts, equity or equity index swaps or options, bond or bond price or bond index swaps or options or forward bond or forward bond price or forward bond index transactions, interest rate options, forward foreign exchange transactions, cap transactions, floor transactions, collar transactions, currency swap transactions, cross-currency rate swap transactions, currency options, spot contracts, or any other similar transactions or any combination of any of the foregoing (including any options to enter into any of the foregoing), whether or not any such transaction is governed by or subject to any master agreement. Not in limitation of the foregoing, the term "Derivatives Contract" includes any and all transactions of any kind, and the related confirmations, which are subject to the terms and conditions of, or governed by, any form of master agreement published by the International Swaps and Derivatives Association, Inc., any International Foreign Exchange Master Agreement, or any other master agreement of similar type, including any such obligations or liabilities under any such master agreement. "Derivatives Termination Value" means, in respect of any one or more Derivatives Contracts, after taking into account the effect of any legally enforceable netting agreement relating to such Derivatives Contracts, (a) for any date on or after the date such Derivatives Contracts have been closed out and termination value(s) determined in accordance therewith, such termination value(s), and (b) for any date prior to the date referenced in clause (a) above, the amount(s) determined as the mark-to-market value(s) for such Derivatives Contracts, as determined based upon one or more 15 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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herein, Administrative Agent and the Majority Real Estate Revolving Loan Lenders have approved for inclusion in the Real Estate Borrowing Base Availability. "Eligible Owned Real Estate Qualification Documents" means the items set forth on Schedule 10.10. "Eligible Villa Unit" means a Villa Unit one hundred percent (100%) directly owned by a Borrower: (a) located on Eligible Owned Real Estate that is a Collateral Property; (b) that will be, upon completion of construction thereof, (i) leased by such Borrower to another Borrower that is an OpCo Affiliate, (ii) operated and managed by EIK Manager and (iii) not a "special focus facility" as determined by CMS; (c) as to which all of the representations set forth in this Agreement and the other Loan Documents concerning the subject Villa Unit are true and correct in all material respects; (d) as to which Administrative Agent has received and approved all Eligible Villa Unit Qualification Documents, or will receive and approve them prior to inclusion of such Villa Units in the calculation of Real Estate Borrowing Base Availability; and (e) with respect to any Villa Units acquired by a Borrower after the Closing Date that are not listed on Schedule 1.1(c), as to which, notwithstanding anything to the contrary contained herein, Administrative Agent and the Majority Real Estate Revolving Loan Lenders have approved for inclusion in the Real Estate Borrowing Base Availability. "Eligible Villa Unit Qualification Documents" means the items set forth on Schedule 10.11. "Employee Benefit Plan" means any employee benefit plan within the meaning of Section 3(3) of ERISA maintained or contributed to by any Loan Party or any ERISA Affiliate, other than a Multiemployer Plan. "Environmental Engineer" means any firm of independent professional engineers or other professionals experienced in the detection, analysis and remediation of Hazardous Substances and related environmental matters and acceptable to Administrative Agent in its reasonable discretion. "Environmental Laws" means as defined in the Indemnity Agreement. "Environmental Reports" has the meaning set forth in Section 6.19. "EPA" has the meaning set forth in Section 6.19(b). "Equity Interests" means, with respect to any Person, (a) any share of capital stock of (or other ownership or profit interests in) such Person, (b) any warrant, option or other right for the purchase or other acquisition from such Person of (i) any share of capital stock of (or other ownership or profit interests in) such Person, or (ii) any security convertible into or exchangeable for any share of capital stock of (or other ownership or profit interests in) such Person or warrant, right or option for the purchase or other acquisition from such Person of such shares (or such other interests) and whether or not such share, warrant, option, right or other interest is authorized or otherwise existing on any date of 20 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 determination, and (c) any other ownership or profit interest in such Person (including partnership, member or trust interests therein), whether, in each case of clauses (a), (b) and (c), voting or nonvoting. "Equity Offering" means the issuance and sale after the Closing Date by Trilogy Investors or its Subsidiaries of any equity securities of such Person (other than equity securities issued to Trilogy Investors or any one or more of its Subsidiaries in their respective Subsidiaries). "Equity Percentage" means the aggregate ownership percentage of any Person or its Subsidiaries in each Unconsolidated Affiliate, which shall be calculated as the greater of (a) such Person's direct or indirect nominal capital ownership interest in the Unconsolidated Affiliate as set forth in the Unconsolidated Affiliate's organizational documents, and (b) such Person's direct or indirect economic ownership interest in the Unconsolidated Affiliate reflecting such Person's current allocable share of income and expenses of the Unconsolidated Affiliate. "ERISA" means the Employee Retirement Income Security Act of 1974 and all federal regulations and formal guidelines issued by a Governmental Authority thereunder. "ERISA Affiliate" means any Person which is treated as a single employer with any Loan Party and its Subsidiaries under Section 414 of the Code or Section 4001 of ERISA and any predecessor entity of any of them. "ERISA Reportable Event" means a reportable event with respect to a Guaranteed Pension Plan within the meaning of Section 4043 of ERISA and the regulations promulgated thereunder as to which the requirement of notice has not been waived or any other event with respect to which a Loan Party or an ERISA Affiliate could have liability under Section 4062(e) or Section 4063 of ERISA. "Erroneous Payment" has the meaning assigned to it in Section 14.9(a). "Erroneous Payment Deficiency Assignment" has the meaning assigned to it in Section 14.9(d). "Erroneous Payment Impacted Class" has the meaning assigned to it in Section 14.9(d). "Erroneous Payment Return Deficiency" has the meaning assigned to it in Section 14.9(d). "Erroneous Payment Subrogation Rights" has the meaning assigned to it in Section 14.9(d). "EU Bail-In Legislation Schedule" means the EU Bail-In Legislation Schedule published by the Loan Market Association (or any successor person), as in effect from time to time. "Event of Default" has the meaning set forth in Section 12.1. "Exchange Act" means the Securities and Exchange Act of 1934, as amended. "Excluded Hedge Obligation" means, with respect to any Borrower or any Guarantor, any Hedge Obligation, if, and to the extent that, all or a portion of the guarantee of such Borrower or such Guarantor of, or the grant by such Borrower or such Guarantor of a security interest to secure, such Hedge Obligation (or any guarantee thereof) is or becomes illegal under the Commodity Exchange Act or any rule regulation or order of the Commodity Futures Trading Commission (or the application or 21 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 official interpretation of any thereof) by virtue of such Borrower or such Guarantor's failure for any reason to constitute an Eligible Contract Participant at the time the guarantee of such Borrower or such Guarantor or the grant of such security interest becomes effective with respect to such Hedge Obligation. If a Hedge Obligation arises under a master agreement governing more than one (1) swap, such exclusion shall apply only to the portion of such Hedge Obligation that is attributable to swaps for which such guarantee or security interest is or becomes illegal. "Excluded Taxes" means any of the following Taxes imposed on or with respect to a Recipient or required to be withheld or deducted from a payment to a Recipient, (a) Taxes imposed on or measured by net income (however denominated), franchise Taxes, and branch profits Taxes, in each case, (i) imposed as a result of such Recipient being organized under the laws of, or having its principal office or, in the case of any Lender, its applicable lending officeApplicable Lending Office located in, the jurisdiction imposing such Tax (or any political subdivision thereof) or (ii) that are Other Connection Taxes, (b) in the case of a Lender, U.S. federal withholding Taxes imposed on amounts payable to or for the account of such Lender with respect to an applicable interest in a Loan or its Commitment pursuant to an Applicable Law in effect on the date on which (i) such Lender acquires such interest in the Loan or its Commitment (other than pursuant to an assignment request by Borrowers under Section 4.14 as a result of costs sought to be reimbursed pursuant to Section 4.3) or (ii) such Lender changes its lending office, except in each case to the extent that, pursuant to Section 4.3, amounts with respect to such Taxes were payable either to such Lender's assignor immediately before such Lender became a party hereto or to such Lender immediately before it changed its lending office, (c) Taxes attributable to such Recipient's failure to comply with Section 4.3(f) and (d) any U.S. federal withholding Taxes imposed under FATCA. "Exiting Lenders" has the meaning set forth on the signature pages hereto. "Expected Net Value" means percentages that Revolving Agent deems necessary or appropriate, in its Permitted Discretion, adjusted from time to time to reduce Eligible Accounts by payor class (e.g., Medicare, Medicaid, commercial insurance, etc.) based upon Borrowers' historical collection history, contractual allowances, returns, rebates, discounts, credits and other allowances that may result in the non-payment or diminution in value of Eligible Accounts. "Extension Request" has the meaning set forth in Section 2.11(a). "Facility Occupancy Report" means a monthly report prepared by EIK Manager or Borrowers showing each Senior Care Property's average daily census, number of days billed and average rate billed for patients or residents under each payor type (Medicare, Medicaid, private pay, etc.), in substantially the form presented to Administrative Agent on or immediately prior to the Closing Date or in such other form as may be reasonably acceptable to Administrative Agent. "FATCA" means Sections 1471 through 1474 of the Code, as of the date of this Agreement (or any amended or successor version that is substantively comparable and not materially more onerous to comply with), any current or future federal regulations or official governmental interpretations thereof and any agreements entered into pursuant to Section 1471(b)(1) of the Code and any intergovernmental agreements to implement such Sections of the Code entered into between any relevant Governmental Authorities on behalf of the United States and such jurisdiction. "FDA" means the U.S. Food and Drug Administration and any Governmental Authority successor thereto. "Federal Funds Effective Rate" means, for any day, the rate per annum (rounded upward to the nearest one-hundredth of one percent (1/100 of 1%)) announced by the Federal Reserve Bank of 22 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Cleveland on such day as being the weighted average of the rates on overnight federal funds transactions arranged by federal funds brokers on the previous trading day, as computed and announced by such Federal Reserve Bank in substantially the same manner as such Federal Reserve Bank computes and announces the weighted average it refers to as the "Federal Funds Effective Rate", or, if such rate is not so published for any day that is a Business Day, the average of the quotations for such day on such transactions received by Administrative Agent from three (3) Federal funds brokers of recognized standing selected by Administrative Agent; provided that if the Federal Funds Effective Rate as so determined would be less than the Floor, such rate shall be deemed to be equal to the Floor for the purposes of this Agreement. "FF&E Leases" has the meaning set forth in Section 8.1. "Floor" means a rate of interest equal to zero percent (0.00%) per annum. "Foreign Lender" means a Lender that is not a U.S. Person. "Fronting Exposure" means, at any time there is a Defaulting Lender, (a) with respect to the Issuing Lender, such Defaulting Lender's Real Estate Revolving Loan Commitment Percentage of the outstanding Letter of Credit Liabilities other than Letter of Credit Liabilities as to which such Defaulting Lender's participation obligation has been reallocated to other Real Estate Revolving Loan Lenders or cash collateral or other credit support acceptable to the Issuing Lender shall have been provided in accordance with the terms hereof, and (b) with respect to the Swing Loan Lender, such Defaulting Lender's Real Estate Revolving Loan Commitment Percentage of the outstanding Real Estate Swing Loans and such Defaulting Lender's A/R Revolving Loan Commitment Percentage of the outstanding A/R Swing Loans, as applicable, other than Swing Loans as to which such Defaulting Lender's participation obligation has been reallocated to other Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as applicable, repaid by Borrowers or for which cash collateral or other credit support acceptable to the Swing Loan Lender shall have been provided in accordance with the terms hereof. "Funds from Operations" means, with respect to any Person for any period, on a Consolidated basis, an amount equal to (a) the Net Income of such Person computed in accordance with GAAP, calculated without regard to gains (or losses) from debt restructuring and sales of property during such period, plus (b) depreciation with respect to such Person's real estate assets and amortization (other than amortization of deferred financing costs) of such Person for such period, all after adjustment for unconsolidated partnerships and joint ventures, plus (c) expenses (not otherwise capitalized) associated with upfront costs of acquisitions. Adjustments for Unconsolidated Affiliates will be calculated to reflect funds from operations on the same basis. Without limiting the foregoing, Funds from Operations shall be calculated in accordance with NAREIT policies. "GAAP" means principles that are (a) consistent with the principles promulgated or adopted by the Financial Accounting Standards Board and its predecessors, as in effect from time to time, and (b) consistently applied. "GAHR" means, (a) at all times prior to the satisfaction of the Transaction Requirements, Griffin-American Healthcare REIT III Inc., a Maryland corporation, and (b) at all times after the satisfaction of the Transaction Requirements, Griffin-American Healthcare REIT IV, Inc., a Maryland corporation. 23 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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"GAHR Operating Partnership" means Griffin-American Healthcare REIT III Holdings, LP, a Delaware limited partnership. "Government Receivables" means, collectively, any and all Accounts which are (a) Medicare Receivables, (b) Medicaid Receivables, (c) TRICARE Receivables, (d) CHAMPUS Receivables or (e) any other Accounts payable by a Governmental Authority approved by Revolving Agent in its Permitted Discretion. "Governmental Authority" means any federal, state, county or municipal government, or political subdivision thereof, any governmental or quasi-governmental agency, authority, board, bureau, commission, department, instrumentality, or public body, or any court, administrative tribunal, or public utility, including any agency, branch or other governmental body charged with the responsibility or vested with the authority to administer or enforce any Healthcare Laws. "Ground Lease" means a ground lease of a Collateral Property pursuant to which a Borrower has a leasehold interest in a Collateral Property, each such Ground Lease, other than that certain Ground Lease dated December 27, 1999, by and between Schleters', LLC, an Indiana limited liability company, as ground lessor, and Trilogy Real Estate of Seymour, LLC, a Delaware limited liability company, as tenant, demising the real property located at 1675 West Tipton Street, Seymore, Indiana 47274-8659, consisting of approximately 5.913 acres, to be in form and substance reasonably satisfactory to Agent. "Ground Lessor" means the applicable owner of the fee interest in a Collateral Property that is subject to a Ground Lease. "Guaranteed Pension Plan" means any employee pension benefit plan within the meaning of Section 3(2) of ERISA maintained or contributed to by any Loan Party or any ERISA Affiliate, the benefits of which are guaranteed on termination in full or in part by the PBGC pursuant to Title IV of ERISA, other than a Multiemployer Plan. "Guarantor" means Trilogy Investors, Trilogy Healthcare Holdings, Trilogy Pro Services and OpCo, and collectively all of them. "Guaranty" means the Unconditional Guaranty of Payment and Performance dated as of the Closing Date executed by Guarantor in favor of Administrative Agent for the benefit of the Secured Parties. "Hazardous Substances" has the meaning set forth in the Indemnity Agreement. "Healthcare Investigations" means any written inquiries, investigations, probes, audits, reviews or proceedings concerning the business affairs, practices, licensing or reimbursement entitlements of any Borrower, EIK Manager or any other Operator to the extent relating to the Collateral Properties or the operations of a Senior Care Property by any Governmental Authority or third party Person engaged thereby (including written inquiries involving the Comprehensive Error Rate Testing and any written inquiries, investigations, probes, audits, reviews or proceedings initiated by any Fiscal Intermediary/Medicare Administrator Contractor, any Medicaid Integrity Contractor, any Recovery Audit Contractor, any Program Safeguard Contractor, any Zone Program Integrity Contractor, any Medicaid Fraud Control Unit, any Attorney General, any Department of Insurance, the Office of Inspector General, the Department of Justice, the CMS or any similar governmental agency or contractor for such agency). 24 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Healthcare Laws" means all applicable state and federal statutes, codes, ordinances, orders, rules and regulations relating to (a) patient healthcare or patient healthcare information, including HIPAA, the Health Information Technology for Economic Clinical Health Act provisions of the American Recovery and Investment Act of 2009 and the respective rules and regulations promulgated thereunder by any Governmental Authority, and all other applicable state and federal laws regarding the privacy and security of protected health information and other confidential patient information, (b) the establishment, construction, ownership, operation, licensure, use or occupancy of any Collateral Property or any part thereof as a healthcare facility, as the case may be, (c) Medicaid Regulations and Medicare Regulations including all conditions of participation pursuant to Medicare or Medicaid certification, and (d) all applicable state and federal statutes, codes, ordinances, orders, rules, and regulations relating to fraud and abuse, including Public Law No. 111-148 (2010) (Patient Protection and Affordable Care Act, as amended, commonly referred to as the "PPACA"), Section 1128B(b) of the Social Security Act, 42 U.S.C. Sections 1320a-7, 1320a-7(a) and 1320a-7(b) (Criminal Penalties Involving Medicare or State Health Care Programs), commonly referred to as the "Federal Anti-Kickback Statute," and Section 1877 of the Social Security Act, 42 U.S.C. Section 1395nn (Prohibition Against Certain Referrals), commonly referred to as the "Stark Law," Section 1128A of the Social Security Act, as amended, 42 U.S.C. Section 1320q-7(a) (Civil Monetary Penalties), commonly referred to as the "Civil Monetary Penalties Law," and 31 U.S.C. Section 3729-33, commonly referred to as the "False Claims Act". "Hedge Obligations" means all obligations of any Borrower thereof to any Lender Hedge Provider under any agreement with respect to a Derivatives Contract, any agreement with respect to an interest rate swap, collar, cap or floor or a forward rate agreement or other agreement regarding the hedging of interest rate risk exposure relating to the Obligations, and any confirming letter executed pursuant to such hedging agreement and which shall include any obligation to pay or perform under any agreement, contract or transaction that constitutes a "swap" within the meaning of section 1a(47) of the Commodity Exchange Act, all as amended, restated or otherwise modified. Under no circumstances shall any of the Hedge Obligations secured or guaranteed by any Loan Document as to a Borrower or a Guarantor include any obligation that constitutes an Excluded Hedge Obligation of such Borrower or such Guarantor or that relates to obligations unrelated to the Loans. "HHS" has the meaning set forth in the definition of Medicare Regulations. "HIPAA" means the Health Insurance Portability and Accountability Act of 1996 and any and all rules or regulations promulgated by any Governmental Authority from time to time thereunder. "IGT Accounts" means the Accounts of an IGT Hospital generated by the IGT Facility leased to such IGT Hospital and operated by an IGT Borrower pursuant to the IGT Documents to which such IGT Hospital and such IGT Borrower are a party. "IGT Borrowers" means, collectively, (a) Borrowers party to IGT Transactions as of the Closing Date that have complied with the requirements of Section 7.30(a) and (b) the Borrowers that enter into IGT Transactions after the Closing Date in accordance with the terms and conditions of Section 7.30(b). "IGT Documents" means, collectively, those certain sublease agreements, management agreements, intangible property license agreements, security agreements, operations transfer agreements and assignment and assumption of admission agreements, authorization to occupy/licenses to which the IGT Borrowers and the IGT Hospitals are parties, and all other agreements, instruments, licenses, valuations and other documents executed in connection therewith, each of which, to the extent executed 25 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 after the Closing Date, comply with the terms of Section 7.30 applicable thereto and are otherwise in form and substance reasonably satisfactory to Administrative Agent. "IGT Facilities" means, collectively, (a) the Senior Care Properties subject to IGT Transactions as of the Closing Date so long as the requirements of Section 7.30(a) have been satisfied with respect to such Senior Care Properties and (b) any additional Senior Care Properties subject to IGT Transactions after the Closing Date in accordance with the terms and conditions of Section 7.30(b). "IGT Fees" means, collectively, the management fees, rent and royalty fees due to the IGT Borrowers in connection with the IGT Transactions. "IGT Hospital" means a government-owned hospital party to an IGT Transaction that complies with the requirements of Section 7.30. "IGT Lien" means the first priority Liens granted by an IGT Hospital under an IGT Security Agreement to (a) the applicable IGT Borrowers (and assigned to Administrative Agent) and (b) Administrative Agent, in each case on the IGT Accounts (other than IGT UPL Payments) of such IGT Hospital, the Deposit Accounts into which payments of such IGT Accounts are deposited and certain other collateral described in the IGT Documents to which such IGT Hospital is a party. "IGT Obligations" means all of the obligations, liabilities and duties of an IGT Hospital under the IGT Documents to which such IGT Hospital is a party, including the management fees, rent and royalty fees due to the IGT Borrowers party to such IGT Documents. "IGT Security Agreement" means, with respect to each IGT Hospital, the security agreement, by and among such IGT Hospital, as grantor, and Administrative Agent and the applicable IGT Borrower, as secured parties. "IGT Transaction" means the following transactions: (a) lease of an IGT Facility by an IGT Borrower to an IGT Hospital; (b) the license of certain government permits and approvals and intellectual property relating to such IGT Facility from an IGT Borrower to such IGT Hospital; (c) the management of such IGT Facility by an IGT Borrower on behalf of such IGT Hospital, and the submanagement of such IGT Facility by EIK Manager; (d) the advance of Permitted IGT Loans; and (e) the granting of a first priority IGT Lien by such IGT Hospital to Administrative Agent and to the applicable IGT Borrower in connection with the obligations of such IGT Hospital under the foregoing transactions. "IGT UPL Accounts" means the Accounts of an IGT Hospital representing IGT UPL Payments. "IGT UPL Payment" means any "upper payment limit" (as defined by CMS or Medicaid regulations) payment received or accrued by an IGT Hospital in connection with an IGT Facility or an IGT Transaction. "Implied Debt Service" means, on any date of determination, an amount equal to the annual principal and interest payment sufficient to amortize in full during a thirty (30) year period, a loan in an amount equal to the sum of the aggregate outstanding principal balance of the Real Estate Revolving Loans, Letter of Credit Liabilities and Real Estate Swing Loans obtained pursuant to clause (a) or clause (b) of the definition of Real Estate Borrowing Base Availability, as applicable, as of such date, calculated using an interest rate equal to the greater of (a) the then current annual yield on ten (10) year obligations issued by the United States Treasury most recently prior to the date of determination as 26 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 determined by Administrative Agent plus two and one-half percent (2.50%), (b) six percent (6.00%) per annum (provided that during the Covenant Relief Period, such rate shall be five percent (5.00%) per annum), and (c) the blended current effective interest rate (including any spread or margin) applicable to the Real Estate Revolving Loans. "Increase Effective Date" has the meaning set forth in Section 2.10(a). "Increase Joinder" has the meaning set forth in Section 2.10(c)(i). "Increase Notice" has the meaning set forth in Section 2.10(a). "Indebtedness" means, with respect to a Person, at the time of computation thereof, all of the following (without duplication), if any: (a) all obligations of such Person in respect of money borrowed (other than trade debt incurred in the ordinary course of business which is not more than one hundred twenty (120) days past due); (b) all obligations of such Person, whether or not for money borrowed (i) represented by notes payable, or drafts accepted, in each case representing extensions of credit, (ii) evidenced by bonds, debentures, notes or similar instruments, or (iii) constituting purchase money indebtedness, conditional sales contracts, title retention debt instruments or other similar instruments, upon which interest charges are customarily paid or that are issued or assumed as full or partial payment for property or services rendered; (c) obligations of such Person as a lessee or obligor under a Deferred Financing Lease and guaranties thereof; (d) all reimbursement obligations of such Person under any letters of credit or acceptances (whether or not the same have been presented for payment); (e) all obligations of such Person in respect of Synthetic Leases; (f) all obligations of such Person in respect of any purchase obligation, repurchase obligation, takeout commitment or forward equity commitment, in each case evidenced by a binding agreement (excluding any such obligation to the extent the obligation can be satisfied solely by the issuance of Equity Interests); (g) net obligations under any Derivatives Contract, in an amount equal to the Derivatives Termination Value thereof; (h) all Indebtedness of other Persons which such Person has guaranteed or is otherwise recourse to such Person (except for guaranties of customary exceptions for fraud, misapplication of funds, environmental indemnities, violations of "special purpose entity" covenants, voluntary or involuntary bankruptcies and other similar exceptions to recourse liability until a claim is made with respect thereto, and then shall be included only to the extent of the amount of such claim), including liability of a general partner in respect of liabilities of a partnership in which it is a general partner which would constitute "Indebtedness" hereunder, any obligation to supply funds to or in any manner to invest directly or indirectly in a Person, to maintain working capital or equity capital of a Person or otherwise to maintain net worth, solvency or other financial condition of a Person, to purchase indebtedness, or to assure the owner of indebtedness against loss, including through an agreement to purchase property, securities, goods, supplies or services for the purpose of enabling the debtor to make payment of the indebtedness held by such owner or otherwise; (i) all Indebtedness of another Person secured by (or for which the holder of such Indebtedness has an existing right, contingent or otherwise, to be secured by) any Lien on property or assets owned by such Person, even though such Person has not assumed or become liable for the payment of such Indebtedness or other payment obligation; and (j) such Person's pro rata share of the Indebtedness (based upon its Equity Percentage) of any Unconsolidated Affiliate of such Person. "Indebtedness" shall be adjusted to remove any impact of intangibles pursuant to FAS 141, as issued by the Financial Accounting Standards Board in June of 2001 and shall not include intercompany liabilities arising in the ordinary course of business, including for cash management purposes. Indebtedness of any Person shall include Indebtedness of any partnership or joint venture in which such Person is a general partner or joint venture only to the extent of such Person's pro rata share of the ownership of such partnership or joint venture (except if such Indebtedness, or portion thereof, is recourse to such Person, in 27 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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which case the greater of such Person's pro rata portion of such Indebtedness or the amount of the recourse portion of the Indebtedness, shall be included as Indebtedness of such Person). "Indemnified Taxes" means (a) Taxes, other than Excluded Taxes, imposed on or with respect to any payment made by or on account of any obligation of any Borrower or any Guarantor under any Loan Document to which it is a party and (b) to the extent not otherwise described in the immediately preceding clause (a), Other Taxes. "Indemnity Agreement" means that certain First Amended and Restated Indemnity Agreement Regarding Hazardous Materials dated as of the Closing Date made by Borrowers and Guarantors in favor of Administrative Agent and the Lenders. "Initial Borrowers" has the meaning set forth in the Preamble. "Insolvency Laws" means the Bankruptcy Code and all other applicable liquidation, conservatorship, bankruptcy, moratorium, rearrangement, receivership, insolvency, reorganization, suspension of payments, or similar debtor relief laws from time to time in effect affecting the rights of creditors generally. "Insolvency Proceeding" means any proceeding commenced by or against any Person under any provision of any Insolvency Law, assignments for the benefit of creditors, formal or informal moratoria, compositions, extensions generally with creditors, or proceedings seeking reorganization, arrangement, or other similar relief. "Insurer" means any non-individual Person, other than a Governmental Authority (including Medicare, Medicaid and TRICARE), located in the United States which, in the ordinary course of its business or activities, agrees to pay for healthcare goods and services received by individuals at a Collateral Property, including a commercial insurance company, a nonprofit insurance company (such as a Blue Cross/Blue Shield entity), an employer or union who self-insures for employee or member health insurance, an HMO and a PPO. "Intercreditor Agreements" means any intercreditor agreement or subordination agreement to which Administrative Agent is a party in connection with the Real Estate, the Accounts or the Obligations. "Interest Expense" means, with respect to any period, with respect to any Person and its Subsidiaries or any Real Estate, as applicable, without duplication, total interest expense accruing or paid on Indebtedness of such Person and its Subsidiaries or such Real Estate, as applicable, on a Consolidated basis, during such period (including interest expense attributable to Deferred Financing Leases and amounts attributable to interest incurred under Derivatives Contracts, but excluding, to the extent non-cash, amortization of defeasance financing costs and charges, and non-cash charges relating to Hedge Obligations), determined in accordance with GAAP, and including (without duplication) the Equity Percentage of Interest Expense for the Unconsolidated Affiliates of such Person and its Subsidiaries. Interest Expense shall not include capitalized interest funded under a construction loan by an interest reserve. "Interest Payment Date" means, (a) as to each Base Rate Loan (other than a Swing Loan) or any Daily Simple SOFR Loan, to the extent applicable, the first day of each calendar month during the term of such Loan, the date of any prepayment of such Loan or portion thereof and on the Maturity Date, and (b) as to each LIBOR RateTerm SOFR Loan, to the extent applicable, the last day of each Interest Period therefor, the date of any prepayment of such Loan or portion thereof and on the Maturity Date; 28 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 provided, however, in the case of clause (b) above, if any Interest Period for a LIBOR RateTerm SOFR Loan exceeds one (1) month, interest shall also be payable with respect to such LIBOR Rate LoansTerm SOFR Loan in arrears in one-month intervals on the first day of each calendar such one-month interval during the term of such Loan, the date of any prepayment of such Loan or portion thereof and on the Maturity Date, and (c) with respect to any Swing Loan, the day that such Loan is required to be repaid. "Interest Period" means, with respect to each LIBOR RateTerm SOFR Loan, (a) initially, the period commencing on the Drawdown Date of such LIBOR Rate Loan and endingof one (1), two (2), three (3) or six (6) months thereafter, and (b) thereafter, each period commencing on the day following the last day of the next precedingas selected by the Borrowers; provided, however, that (i) the initial Interest Period applicable to suchfor any borrowing of a Term SOFR Loan and endingshall commence on the last daydate of one (1) of the periods set forth above, as selected by Parent on behalfsuch borrowing (the date of Borrowers in a Loan Request or, to the extent applicable,borrowing resulting from a Conversion or Continuation shall be the date of such Conversion/ or Continuation Request; provided that all of the foregoing provisions relating to Interest Periods are subject to the following: (a) and each Interest Period occurring thereafter in respect of such borrowing shall commence on the first day after the last day of the next preceding Interest Period; (ii) if any Interest Period with respect to a LIBOR Rate Loanbegins on a day for which there is no numerically corresponding day in the calendar month at the end of such Interest Period, such Interest Period shall end on the last Business Day of such calendar month; (iii) if any Interest Period would otherwise endexpire on a day that is not a LIBOR Business Day, such Interest Period shall endexpire on the next succeeding LIBOR Business Day, unless such next succeeding LIBOR; provided, however, that if any Interest Period would otherwise expire on a day that is not a Business Day but is a day of the month after which no further Business Day occurs in the next calendarsuch month, in which case such Interest Period shall endexpire on the next preceding LIBOR Business Day; (b) if Borrowers shall fail to give notice of conversion as provided in Section 4.1, Borrowers shall be deemed to have requested a continuation of an affected LIBOR Rate Loan that has an Interest Period of (i) one (1), two (2) or three (3) months as a LIBOR Rate Loan with an Interest Period the same as the expiring LIBOR Rate Loan, and (ii) six (6) months as a LIBOR Rate Loan with an Interest Period of one (1) month, in each case, on the last day of the then (iv) no Interest Period for any Term SOFR Loan may be selected that would end after the Maturity Date; and (v) if, upon the expiration of any Interest Period, the Borrowers have failed to (or may not) elect a new Interest Period to be applicable to the respective borrowing of Term SOFR Loans as provided above, the Borrowers shall be deemed to have elected to convert such borrowing to Base Rate Loans effective as of the expiration date of such current Interest Period with respect thereto; (c) any Interest Period pertaining to a LIBOR Rate Loan that begins on the last Business Day of a calendar month (or on a day for which there is no numerically corresponding day in the calendar month at the end of such Interest Period) shall end on the last Business Day of the applicable calendar month; and(d) no Interest Period relating to any LIBOR Rate Loan shall extend beyond the Maturity Date. "Investments" means, with respect to any Person, all shares of capital stock, evidences of Indebtedness and other securities issued by any other Person and owned by such Person, all loans, advances (other than advances to employees for moving, entertainment and travel expenses, drawing accounts and similar expenditures in the ordinary course of business), or extensions of credit to, or contributions to the capital of, any other Person (other than any other Borrower), all purchases of the securities or business or integral part of the business of any other Person and commitments and options to make such purchases, all interests in real property; provided, however, that the term "Investment" shall 29 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 not include (x) equipment, inventory and other tangible personal property acquired for use in Borrowers' business, or (y) current trade and customer accounts receivable for services rendered in the ordinary course of business and payable in accordance with customary trade terms. In determining the aggregate amount of Investments outstanding at any particular time: (a) the amount of any Investment represented as a guaranty shall be taken at not less than the principal amount of the obligations guaranteed and still outstanding; (b) there shall be included as an Investment all interest accrued with respect to Indebtedness constituting an Investment unless and until such interest is paid; (c) there shall be deducted in respect of each such Investment any amount received as a return of capital; and (d) there shall not be deducted in respect of any Investment any decrease in the value thereof. "IRS" means the United States Internal Revenue Service. "Issuing Lender" means KeyBank in its capacity as the Real Estate Revolving Loan Lender issuing the Letters of Credit and any successor thereto. "Joinder" means a joinder and supplement with respect to this Agreement, the Notes, the Contribution Agreement and the Indemnity Agreement to be executed and delivered pursuant to Section 7.20 by a Subsidiary of any Borrower or by any new Borrower pursuant to Section 5.5(a) or Section 5.5(b), such Joinder to be in the form of Exhibit D. "Key Principal" means Randall J. Bufford or Leigh Ann Barney and any other Person approved after the Closing Date by Majority Lenders as provided in Section 7.22. "KeyBank" has the meaning set forth in the Preamble. "KeyBanc" means KeyBanc Capital Markets, Inc., in its capacity as a Co-Lead Arranger, and any successor thereof. "Lease Default" has the meaning set forth in Section 6.35. "Leasehold Property" means a property that is leased by a Borrower from a third party who is not also a Borrower. "Leases" means leases, licenses, subleases, sublicenses and occupancy agreements (other than occupancy agreements with patients or residents and Permitted Subleases), whether written or oral, relating to the use or occupation of space in any Building or of any Real Estate, including all leases between one or more Borrowers and one or more OpCo Affiliates, which leases shall be in a form approved by Administrative Agent with such changes thereto (i) permitted hereunder, (ii) requested by Borrowers that are reasonably satisfactory to Administrative Agent or (iii) as Administrative Agent may require as a result of Applicable Law. "Lender Hedge Provider" means, with respect to any Hedge Obligations, KeyBank, any Affiliate thereof and any other counterparty thereto that, at the time the applicable hedge agreement was entered into with Borrower, was a Lender or an Affiliate of a Lender. "Lenders" means KeyBank, the other lending institutions which are party hereto and any other Person which becomes an assignee of any rights of a Lender pursuant to Section 18 (but not including any participant as described in Section 18). Each of the Issuing Lender and the Swing Loan Lender (as to Real Estate Swing Loans) shall be a Real Estate Revolving Loan Lender, as applicable. The Swing Loan Lender, as to A/R Swing Loans, shall be an A/R Revolving Loan Lender, as applicable. 30 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Letter of Credit" means any standby letter of credit issued at the request of a Borrower and for the account of a Borrower in accordance with Section 2.9. "Letter of Credit Commitment" means an amount equal to Fifteen Million and No/100 Dollars ($15,000,000.00), as the same may be changed from time to time in accordance with the terms of this Agreement. "Letter of Credit Liabilities" means at any time and in respect of any Letter of Credit, the sum of (a) the maximum undrawn face amount of such Letter of Credit plus (b) the aggregate unpaid principal amount of all drawings made under such Letter of Credit which have not been repaid (including repayment by a Real Estate Revolving Loan). For purposes of this Agreement, a Real Estate Revolving Loan Lender (other than the Real Estate Revolving Loan Lender acting as the Issuing Lender) shall be deemed to hold a Letter of Credit Liability in an amount equal to its participation interest in the related Letter of Credit under Section 2.9, and the Real Estate Revolving Loan Lender acting as the Issuing Lender shall be deemed to hold a Letter of Credit Liability in an amount equal to its retained interest in the related Letter of Credit after giving effect to the acquisition by the Real Estate Revolving Loan Lenders other than the Real Estate Revolving Loan Lender acting as the Issuing Lender of their participation interests under Section 2.9. "Letter of Credit Request" has the meaning set forth in Section 2.9(a). "LIBOR" means, for any LIBOR Rate Loan for any Interest Period, the London interbank offered rate administered by ICE Benchmark Administration Limited (or any other Person which takes over the administration of that rate) or a comparable or successor rate which is approved by Administrative Agent as shown in Reuters Screen LIBOR 01 Page (or any successor service, or if such Person no longer reports such rate as determined by Administrative Agent, by another commercially available source providing such quotations approved by Administrative Agent) at which deposits in U.S. dollars are offered by first-class banks in the London Interbank Market at approximately 11:00 a.m. (London time) on the day that is two (2) LIBOR Business Days prior to the first day of such Interest Period with a maturity approximately equal to such Interest Period and in an amount approximately equal to the amount to which such Interest Period relates, adjusted for reserves and taxes if required by future regulations. If such service or such other Person approved by Administrative Agent described above no longer reports such rate or Administrative Agent determines in good faith that the rate so reported no longer accurately reflects the rate available to Administrative Agent in the London Interbank Market, Loans shall accrue interest at the Base Rate plus the Applicable Margin for such Loan. For any period during which a Reserve Percentage shall apply, LIBOR with respect to LIBOR Rate Loans shall be equal to the amount determined above divided by an amount equal to one (1) minus the Reserve Percentage. Notwithstanding the foregoing, if the rate shown on Reuters Screen LIBOR01 Page (or any successor service designated pursuant to this definition) shall be less than zero, such rate shall be deemed to be zero for the purposes of this Agreement. "LIBOR Business Day" means any day on which commercial banks are open for international business (including dealings in Dollar deposits) in London, England. "LIBOR Lending Office" means, initially, the office of each Lender designated as such on Schedule 1.1(a); thereafter, such other office of such Lender, if any, that shall be making or maintaining LIBOR Rate Loans. "LIBOR Rate Loans" means those Loans bearing interest calculated by reference to LIBOR. 31 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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"Lien" has the meaning set forth in Section 8.2. "LLC Division" means in the event any Borrower or any Guarantor is a limited liability company, (i) the division of any such Borrower or any such Guarantor into two or more newly formed limited liability companies (whether or not any such Borrower or any such Guarantor is a surviving entity following any such division) pursuant to, in the event any such Borrower or any such Guarantor is organized under the laws of the State of Delaware, Section 18-217 of the Delaware Limited Liability Company Act or, in the event any such Borrower or any such Guarantor is organized under the laws of a State or Commonwealth of the United States (other than Delaware) or of the District of Columbia, any similar provision under any similar act governing limited liability companies organized under the laws of such State or Commonwealth or of the District of Columbia, or (ii) the adoption of a plan contemplating, or the filing of any certificate with any applicable Governmental Authority that results or may result in, any such division. "Loan" and "Loans" means an individual loan or the aggregate loans (including a Swing Loan, a Real Estate Revolving Loan and an A/R Revolving Loan (or Loans)), as the case may be, in the maximum principal amount of the Total Commitment. All Loans shall be made in Dollars. Amounts drawn under a Letter of Credit shall also be considered Real Estate Revolving Loans as provided in Section 2.9. "Loan Documents" means this Agreement, the Notes, the Guaranty, the Security Documents, the Administrative Agent Fee Letter, the Revolving Agent Fee Letter, each Subordination of Management Agreement, each Letter of Credit Request, each A/R Borrowing Base Certificate, each Real Estate Borrowing Base Certificate, the Intercreditor Agreements and all other documents, instruments or agreements now or hereafter executed by any Loan Party or delivered to Administrative Agent or any Lender by any Loan Party in connection with any of the foregoing or the Loans. "Loan Parties" means, collectively, Borrowers and Guarantors. "Loan Request" has the meaning set forth in Section 2.6. "Majority A/R Revolving Loan Lenders" means as of any date, the A/R Revolving Loan Lender or A/R Revolving Loan Lenders whose aggregate A/R Revolving Loan Commitment Percentage is greater than fifty percent (50%); provided that in determining said percentage at any given time, all then existing Defaulting Lenders will be disregarded and excluded and the A/R Revolving Loan Commitment Percentages of the A/R Revolving Loan Lenders shall be re-determined for voting purposes only to exclude the A/R Revolving Loan Commitment Percentages of such Defaulting Lenders. "Majority Lenders" means as of any date, the Lender or Lenders whose aggregate Commitment Percentage is greater than fifty percent (50%); provided that in determining said percentage at any given time, all then existing Defaulting Lenders will be disregarded and excluded and the Commitment Percentages of the Lenders shall be re-determined for voting purposes only to exclude the Commitment Percentages of such Defaulting Lenders. "Majority Real Estate Revolving Loan Lenders" means as of any date, the Real Estate Revolving Loan Lender or Real Estate Revolving Loan Lenders whose aggregate Real Estate Revolving Loan Commitment Percentage is greater than fifty percent (50%); provided that in determining said percentage at any given time, all then existing Defaulting Lenders will be disregarded and excluded and the Real Estate Revolving Loan Commitment Percentages of the Real Estate Revolving Loan Lenders 32 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 shall be re-determined for voting purposes only to exclude the Real Estate Revolving Loan Commitment Percentages of such Defaulting Lenders. "Management Agreements" means agreements to which any Person, including EIK Manager, is a party, whether written or oral, providing for the management of Real Estate or any portion thereof with a Borrower (including relating to the IGT Hospitals in connection with IGT Transactions). "Mandatorily Redeemable Stock" means, with respect to any Person, any Equity Interest of such Person which by the terms of such Equity Interest (or by the terms of any security into which it is convertible or for which it is exchangeable or exercisable), upon the happening of any event or otherwise (but prior to the date 180 days after the Maturity Date (after giving effect to all potential extensions thereof as provided in Section 2.11)) (a) matures or is mandatorily redeemable, pursuant to a sinking fund obligation or otherwise (other than an Equity Interest to the extent redeemable in exchange for common stock or other equivalent common Equity Interests), (b) is convertible into or exchangeable or exercisable for Indebtedness or Mandatorily Redeemable Stock at the option of the holder thereof, or (c) is redeemable at the option of the holder thereof, in whole or in part (other than an Equity Interest which is redeemable solely in exchange for common stock or other equivalent common Equity Interests). "Material Acquisition" means the acquisition by Borrowers or their Subsidiaries of Leasehold Properties from Conficare, DMK and Ramsey for a gross purchase price equal to or in excess of $150,000,000.00. "Material Adverse Effect" means (a) a material adverse effect on (i) the business, properties, assets, condition (financial or otherwise) or results of operations of Borrowers, taken as a whole, or Guarantors, taken as a whole, (ii) the ability of any Guarantor or three (3) or more Borrowers to perform any of its or their material obligations under the Loan Documents, (iii) the validity or enforceability of any of the Loan Documents or the creation, perfection and priority of any Liens of Administrative Agent in the Collateral, or (iv) the rights or remedies of Administrative Agent, Revolving Agent or the Lenders thereunder; and (b) with respect to a Senior Care Property, a material adverse effect on the business, properties, assets, condition (financial or otherwise) or results of operations of such Senior Care Property. "Maturity Date" means September 5, 2023, as such date may be extended as provided in Section 2.11, or such earlier date on which the Loans shall become due and payable pursuant to the terms hereof. "Medicaid" means the medical assistance program established by Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.) and any statutes succeeding thereto. "Medicaid Provider Agreement" means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier, under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations. "Medicaid Receivable" means any Account with respect to which the obligor is a state or, to the extent provided by law, the United States acting through a state's Medicaid agency that arises out of charges reimbursable to any Borrower or, with respect to an IGT Facility, an IGT Hospital under Medicaid. "Medicaid Regulations" means, collectively, (a) all federal statutes set forth in Title XIX of the Social Security Act affecting Medicaid, (b) all applicable provisions of all federal rules, 33 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 regulations, and orders of all Governmental Authorities promulgated pursuant to or in connection with the statutes described in clause (a) above having the force of law promulgated pursuant to or in connection with the statutes described in clause (a) above, (c) all state statutes for medical assistance enacted in connection with the statutes and provisions described in clauses (a) and (b) above, and (d) all applicable provisions of all rules, regulations, and orders of all Governmental Authorities having the force of law promulgated pursuant to or in connection with the statutes described in clause (c) above. "Medicare" means the health insurance program for the aged and disabled established by Title XVIII of the Social Security Act (42 U.S.C. § 1995 et seq.) and any statutes succeeding thereto. "Medical Services" means (a) Ancillary Services and (b) medical and health care items, services or supplies provided to a patient, including physician services, nurse and therapist services, dental services, hospital services, skilled nursing facility services, comprehensive outpatient rehabilitation services, home health care services, residential and out-patient behavioral healthcare services, and medicine or health care equipment provided by Borrower to a patient for a valid and proper medical or health purpose. "Medicare Provider Agreement" means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations. "Medicare Receivable" means any Account with respect to which the obligor is the United States that arises out of charges reimbursable to any Borrower or, with respect to an IGT Facility, an IGT Hospital under Medicare. "Medicare Regulations" means, collectively, all federal statutes set forth in Title XVIII of the Social Security Act affecting Medicare, together with all applicable provisions of all rules, regulations, and orders having the force of law of all applicable Governmental Authorities (including Health and Human Services ("HHS"), CMS, the Office of the Inspector General for HHS, or any Person succeeding to the functions of any of the foregoing) promulgated pursuant to or in connection with any of the foregoing having the force of law. "Michigan Lessee" means each OpCo Affiliate that is a lessee of a Collateral Property located in the State of Michigan. "Minimum REIT Distributions" has the meaning set forth in Section 9.5. "Moody's" means Moody's Investor Service, Inc. "Mortgages" means the mortgages, deeds to secure debt or deeds of trust from one or more Borrowers to Administrative Agent for the benefit of Administrative Agent and the other Secured Parties (or to trustees named therein acting on behalf of Administrative Agent for the benefit of Administrative Agent and the other Secured Parties) in substantially the form as delivered to Administrative Agent on the Closing Date with such changes thereto as Administrative Agent may reasonably require as a result of Applicable Law or practice, pursuant to which such Borrower or Borrowers has conveyed or granted a mortgage lien upon or a conveyance in fee simple (or of a leasehold, if applicable) of any Collateral Property and the OpCo Affiliate's leasehold interest, as security for the Obligations. 34 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Multiemployer Plan" means any multiemployer plan within the meaning of Section 3(37) of ERISA maintained or contributed to by any Loan Party or any ERISA Affiliate. "Net Income" means, with respect to any Person (or any asset of any Person) with respect to any period, the net income (or loss) of such Person (or attributable to such asset), determined in accordance with GAAP. "Net Offering Proceeds" means the gross cash proceeds received by Trilogy Investors or any of its Subsidiaries as a result of an Equity Offering less the customary and reasonable costs and expenses paid by Trilogy Investors or such Subsidiary in connection therewith. Net Offering Proceeds shall not include cash proceeds received by Trilogy Investors as a result of an investment by a joint venture partner. "Non-Consenting Lender" has the meaning set forth in Section 18.8. "Non-Defaulting Lender" means, at any time, any Lender that is not a Defaulting Lender at such time. "Non-Recourse Exclusions" means, with respect to any Non-Recourse Indebtedness of any Person, any usual and customary exclusions from the non-recourse limitations governing such Indebtedness, including exclusions for claims that (a) are based on fraud, intentional or material misrepresentation, misapplication of funds, gross negligence or willful misconduct, (b) result from intentional mismanagement of or waste at the Real Estate securing such Non-Recourse Indebtedness, (c) arise from the presence of Hazardous Substances on the Real Estate securing such Non-Recourse Indebtedness, (d) are the result of any unpaid real estate taxes and assessments (whether contained in a loan agreement, promissory note, indemnity agreement or other document) or (e) result from such Person or its assets becoming the subject of a voluntary or involuntary bankruptcy, insolvency or similar proceeding. "Non-Recourse Indebtedness" means, with respect to a Person, (a) Indebtedness owed to a financial institution with respect to Real Estate (and assets used in connection with such Real Estate) and in respect of which recourse for payment (except for Non-Recourse Exclusions until a claim is made with respect thereto, and then such Indebtedness shall not constitute Non-Recourse Indebtedness only to the extent of the amount of such claim) is contractually limited to specific assets of such Person encumbered by a Lien securing such Indebtedness or (b) if such Person is a Single Asset Entity, any Indebtedness of such Person. "Notes" means, collectively, the A/R Revolving Loan Notes, the Real Estate Revolving Loan Notes and the Swing Loan Note. "Notice" has the meaning set forth in Section 19. "Obligations" means (a) all indebtedness, obligations and liabilities of any Loan Party to any of the Secured Parties, individually or collectively, under this Agreement or any of the other Loan Documents or in respect of any of the Loans, the Notes or the Letters of Credit, or other instruments at any time evidencing any of the foregoing, whether existing on the Closing Date or arising or incurred thereafter, direct or indirect, joint or several, absolute or contingent, matured or unmatured, liquidated or unliquidated, secured or unsecured, arising by contract, operation of law or otherwise (including, without limitation, Erroneous Payment Subrogation Rights), (b) Bank Product Obligations and (c) Hedge Obligations. 35 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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"Preferred Securities" means, with respect to any Person, Equity Interests in such Person which are entitled to preference or priority over any other Equity Interest in such Person in respect of the payment of dividends or distribution of assets upon liquidation, or both. "Primary Licenses" means (a) with respect to any Senior Care Property or Person operating all or a portion of such Senior Care Property, as the case may be, the CON, permit or license to operate as a Senior Care Property, as the case may be, and each Medicaid Provider Agreement, Medicare Provider Agreement, TRICARE provider agreement or any other Third Party Payor Program provider agreement or similar agreement, each as applicable, (b) with respect to any Person performing an Ancillary Service at any Senior Care Property or whose Accounts are included in the calculation of A/R Borrowing Base Availability, the permit or license to provide such Ancillary Service and each Medicaid Provider Agreement, Medicare Provider Agreement, TRICARE provider agreement or any other Third Party Payor Program provider agreement or similar agreement, each as applicable, and (c) all other Permits necessary for the proper and lawful operation of a Senior Care Property, the business of any Borrower and the business of EIK Manager or any IGT Hospital with respect to any Senior Care Property, including provider identification numbers. "Private Payor" means any Account Debtor that is a natural person. "Private REIT" means Trilogy Real Estate Investment Trust, a Maryland statutory trust. "Public Health Laws" means all applicable laws, regulations and other requirements relating to the procurement, development, manufacture, production, analysis, distribution, dispensing, importation, exportation, use, handling, quality, sale, or promotion of any drug, medical device, food, dietary supplement, or other product subject to regulation under the Federal Food, Drug, and Cosmetic Act (21 U.S.C. §§ 301 et seq.) and similar state laws, controlled substances laws, pharmacy laws, or consumer product safety laws. "QFC" shall have the meaning assigned to the term "qualified financial contract" in, and shall be interpreted in accordance with, 12 U.S.C. 5390(c)(8)(D). "QFC Credit Support" shall have the meaning set forth in Section 38. "RCP" has the meaning set forth in Section 7.14(g). "Real Estate" means all real property at the time of determination then owned or leased (as lessee or sublessee) in whole or in part, or operated, by any Borrower. "Real Estate Borrowing Base Availability" means the amount which is the sum of (a) the lesser of (i) the Owned Real Estate Borrowing Base Value of the Collateral Properties (other than Villa Units that are included in the calculation of clause (b) below) and (ii) the maximum principal amount (including Letter of Credit Liabilities) which would not cause the Owned Real Estate Borrowing Base Debt Service Coverage Ratio with respect to the Collateral Properties to be less than 1.75 to 1.0 plus (b) the least of (i) $25,000,000.00, (ii) with respect to each Villa Unit complex included as Eligible Villa Units (which shall not be eligible for more than eighteen (18) months), the Villa Unit Borrowing Base Value and (iii) with respect to each Villa Unit complex included as Eligible Villa Units (which shall not be eligible for more than eighteen (18) months), the maximum principal amount (including Letter of Credit Liabilities) which would not cause the Villa Unit Borrowing Base Debt Service Coverage Ratio with respect to the Villa Units to be less than 1.75 to 1.0; provided, however, that the availability under this clause (b) shall (i) only be used to pay Construction Costs for Villa Units on a Collateral Property and (ii) shall only be created and available for Villa Units on a particular Collateral Property after 40 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Borrowers have evidenced to Administrative Agent the contribution of cash equity towards such Construction Costs of such Villa Units of not less than thirty percent (30%) of the total Construction Costs for such Villa Units and the use of such contribution, in its entirety, for Construction Costs, plus (c) the Ancillary Services Borrowing Base Value. Notwithstanding the foregoing, in no event shall the sum of (x) Ancillary Services Borrowing Base Value plus (y) the A/R Borrowing Base Availability attributable to clause (b) of the definition of A/R Borrowing Base Availability exceed twenty percent (20%) of the Real Estate Borrowing Base Availability, and any excess shall be excluded from the Real Estate Borrowing Base Availability. For the avoidance of doubt, the Real Estate Borrowing Base Availability created under clause (b) above shall only be included in the calculation of Real Estate Borrowing Base Availability with respect to any Real Estate Revolving Loan (or Loans) requested for Construction Costs at such Villa Unit and shall not be available to support other Real Estate Revolving Loans. Notwithstanding the foregoing, if the Appraised Value for a Collateral Property increases after such property first becomes a Collateral Property, such increased value shall not be included in the calculation of Real Estate Borrowing Base Availability until Borrowers increase the coverage under the Title Policy for such Collateral Property (and any tie-in endorsements included in the Title Policies for the other Collateral Properties) to an amount not less than such increased Appraised Value (unless the allocable title insurance amount under such Title Policy allocable to such Collateral Property is already in such amount or a greater amount). "Real Estate Borrowing Base Certificate" has the meaning set forth in Section 7.4(a)(iii)(A). "Real Estate Revolving Loan Commitment" means, with respect to each Real Estate Revolving Loan Lender, the amount set forth on Schedule 1.1(a) as the amount of such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment to make or maintain Real Estate Revolving Loans to Borrowers or to participate in Letters of Credit or Real Estate Swing Loans, as the same may be changed from time to time in accordance with the terms of this Agreement. "Real Estate Revolving Loan Commitment Percentage" means, with respect to each Real Estate Revolving Loan Lender, the percentage set forth on Schedule 1.1(a) as such Real Estate Revolving Loan Lender's percentage of the aggregate Real Estate Revolving Loan Commitments of all of the Real Estate Revolving Loan Lenders, as the same may be changed from time to time in accordance with the terms of this Agreement; provided that if the Real Estate Revolving Loan Commitments of the Real Estate Revolving Loan Lenders have been terminated as provided in this Agreement, then the Real Estate Revolving Loan Commitment Percentage of each Real Estate Revolving Loan Lender shall be determined based on the Real Estate Revolving Loan Commitment Percentage of such Real Estate Revolving Loan Lender immediately prior to such termination and after giving effect to any subsequent assignments made pursuant to the terms thereof. "Real Estate Revolving Loan" or "Real Estate Revolving Loans" means an individual Real Estate Revolving Loan or the aggregate Real Estate Revolving Loans, as the case may be, made by Real Estate Revolving Loan Lenders hereunder to Borrowers, as more particularly described in Section 2.1. Amounts drawn under a Letter of Credit shall also be considering Real Estate Revolving Loans as provided in Section 2.9(f). The Borrowers as of the Closing Date that own or lease a Collateral Property are described on Schedule 1.1(e) attached hereto. 41 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Real Estate Revolving Loan Lenders" means, collectively, the Lenders which have a Real Estate Revolving Loan Commitment, the initial Real Estate Revolving Loan Lenders being identified on Schedule 1.1(a). "Real Estate Revolving Loan Note" means a promissory note made by Borrowers in favor of a Real Estate Revolving Loan Lender in the principal face amount equal to such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment, or if less, the outstanding amount of all Real Estate Revolving Loans made by such Real Estate Revolving Loan Lender, in substantially the form of Exhibit B. "Real Estate Swing Loan" means a Swing Loan made hereunder pursuant to the Real Estate Borrowing Base Availability. "Real Estate Unused Fee Percentage". With respect to any day during a calendar quarter, (a) 0.15% per annum, if the sum of the Aggregate Real Estate Revolving Credit Obligations outstanding on such day is greater than 50% of the Total Real Estate Revolving Loan Commitment, or (b) 0.20% per annum if the sum of the Aggregate Real Estate Revolving Credit Obligations outstanding on such day is less than or equal to 50% of the Total Real Estate Revolving Loan Commitment. "Receivable Reserves" means, as of any date of determination, (a) those reserves that Revolving Agent deems necessary or appropriate, in its Permitted Discretion and subject to the proviso in the definition of A/R Borrowing Base Availability, to establish and maintain (including reserves for rebates, discounts, warranty claims, and returns) with respect to the Eligible Accounts and (b) reserves equal to the sum of (i) the amount of retroactive settlements estimated to be due and owing to a Governmental Authority and (ii) without duplication, one hundred percent (100%) of those amounts for which payment plans have been established with the appropriate Governmental Authority. "Recipient" means any Agent and any Lender. "Record" means the grid attached to any Note, or the continuation of such grid, or any other similar record, including computer records, maintained by Administrative Agent with respect to any Loan referred to in such Note. "Recourse Indebtedness" means, with respect to any Person, as of any date of determination, any Indebtedness (whether secured or unsecured) which is recourse to such Person, including Deferred Financing Leases, guaranties of Deferred Financing Leases and equipment financings. Recourse Indebtedness shall not include Non-Recourse Indebtedness, but shall include any Non-Recourse Exclusions at such time a written claim is made with respect thereto, unless such claim is paid in full in cash or otherwise finally resolved with no further obligation on the part of such Person. "Register" has the meaning set forth in Section 18.2. "Registrations" has the meaning set forth in Section 6.33(a). "REIT Status" means with respect to a Person, its status as a real estate investment trust as defined in Section 856(a) of the Code. "Related Fund" means, with respect to any Lender which is a fund that invests in loans, any Affiliate of such Lender or any other fund that invests in loans that is managed by the same investment advisor as such Lender or by an Affiliate of such Lender or such investment advisor. 42 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Release" means any releasing, spilling, leaking, pumping, pouring, emitting, emptying, discharging, injecting, escaping, disposing or dumping (other than the storing of materials in reasonable quantities to the extent necessary for the operation of property in the ordinary course of business, and in any event in compliance with all Environmental Laws) of Hazardous Substances. "Relevant Governmental Body" means the Federal Reserve Board or the Federal Reserve Bank of New York, or a committee officially endorsed or convened by the Federal Reserve Board or the Federal Reserve Bank of New York, or any successor thereto. "Reserve Percentage" means, for any Interest Period, that percentage which is specified three (3) Business Days before the first day of such Interest Period by the Board of Governors of the Federal Reserve System (or any successor) or any other Governmental Authority with jurisdiction over Administrative Agent or any Lender for determining the maximum reserve requirement (including any marginal reserve requirement) for Administrative Agent or any Lender with respect to liabilities constituting of or including (among other liabilities) Eurocurrency liabilities in an amount equal to that portion of the Loan affected by such Interest Period and with a maturity equal to such Interest Period. "Reserves" means (a) the Bank Products Reserve, (b) the Receivables Reserve and (c) as of any date of determination, those other reserves that Revolving Agent deems necessary or appropriate, in its Permitted Discretion and subject to the proviso in the definition of A/R Borrowing Base Availability, to establish and maintain (including reserves with respect to (x) sums that any Loan Party is required to pay under any Section of this Agreement or any other Loan Document (such as taxes, assessments, insurance premiums, or, in the case of leased assets, rents or other amounts payable under such leases) and has failed to pay, and (y) amounts owing by a Loan Party to any Person to the extent secured by a Lien on, or trust over, any of the Collateral (other than a Permitted Lien), which Lien or trust, in the Permitted Discretion of Administrative Agent likely would have a priority superior to Administrative Agent's Liens (such as Liens or trusts in favor of landlords, warehousemen, carriers, mechanics, materialmen, laborers, or suppliers, or Liens or trusts for ad valorem, excise, sales, or other taxes where given priority under applicable law) in and to such item of the Collateral) with respect to A/R Borrowing Base Availability. "Resolution Authority" means an EEA Resolution Authority or, with respect to any UK Financial Institution, a UK Resolution Authority. "Revolving Agent" means CIT Bank, N.A., acting as revolving agent for the Secured Parties, and its successors and assigns. "Revolving Agent Fee Letter" means that certain fee letter between Borrowers and Revolving Agent dated August 28, 2019. "RHS Entities" means RHS PropCo Mooresville, LLC, Trilogy Real Estate Bloomington, LLC, Trilogy Real Estate Floyd, LLC, RHS Partners of Mooresville, LLC, Trilogy Healthcare of Bloomington, LLC, Trilogy Healthcare of Floyd, LLC, LCS Avon, LLC, RHS Partners of Bloomington, LLC, RHS Partners of Carmel, LLC, LCS Crawfordsville, LLC, RHS Partners of Arlington, LLC, RHS Partners of Castleton, LLC, LCS Kokomo, LLC, RHS Partners of Lafayette, LLC, RHS Partners of Richmond, LLC, LCS South Bend LLC, RHS Partners of Terre Haute, LLC, LCS Wabash LLC, and LCS Westfield LLC. "Sanctioned Entity" means (a) a country or a government of a country, (b) an agency of the government of a country, (c) an organization directly or indirectly controlled by a country or its government or (d) a Person resident in or determined to be resident in a country, in each case of clauses 43 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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(a) through (d) that is a target of Sanctions, including a target of any country sanctions program administered and enforced by OFAC. "Sanctioned Person" means, at any time (a) any Person named on the list of Specially Designated Nationals and Blocked Persons maintained by OFAC, OFAC's consolidated Non-SDN list or any other Sanctions-related list maintained by any Governmental Authority, (b) a Person or legal entity that is a target of Sanctions, (c) any Person operating, organized or resident in a Sanctioned Entity or (d) any Person directly or indirectly owned or controlled (individually or in the aggregate) by or acting on behalf of any such Person or Persons described in clauses (a) through (c) above. "Sanctions" means individually and collectively, respectively, any and all economic sanctions, trade sanctions, financial sanctions, sectoral sanctions, secondary sanctions, trade embargoes anti-terrorism laws and other sanctions laws, regulations or embargoes, including those imposed, administered or enforced from time to time by: (a) the United States, including those administered by OFAC, the U.S. Department of State, the U.S. Department of Commerce, or through any existing or future executive order, (b) the United Nations Security Council, (c) the European Union or any European Union member state, (d) Her Majesty's Treasury of the United Kingdom, or (d) any other Governmental Authority with jurisdiction over any Agent, any Lender or any Loan Party or any of their respective Subsidiaries or Affiliates. Sanctions shall not include civil monetary penalties under Healthcare Laws. "S&P" means S&P Global, Inc. "SEC" means the federal Securities and Exchange Commission. "Secured Parties" means Administrative Agent, Revolving Agent, the Lenders, Issuing Lender, the Bank Product Providers and the Lender Hedge Providers. "Security Agreement" means that certain Pledge and Security Agreement dated as of the date hereof among Administrative Agent and Borrowers. "Security Documents" means, collectively, the Security Agreement, the Pledge Agreement, the Acknowledgments, any Mortgages, any Assignments of Leases and Rents, the Indemnity Agreement, each IGT Security Agreement, any UCC-1 financing statements contemplated by any other Security Document, any Joinder, any other joinder agreements relating to any of the foregoing, any control agreements, any other security agreement or instrument and any further collateral assignments to Administrative Agent for the benefit of the Secured Parties as security for the Obligations. "Senior Care Property" means single owned facilities consisting of independent living facilities and residences, assisted living facilities, skilled nursing facilities, memory care facilities and rehabilitation facilities, or any combination of the foregoing, and the medical office building located at 9702 Stonestreet Road, Louisville, Kentucky, which is owned, leased or operated by or on behalf of a Borrower. "Single Asset Entity" means a bankruptcy remote, single purpose entity that (a) is a Subsidiary of a Borrower, (b) is not a Borrower or a Guarantor or an owner of a direct or indirect interest in a Borrower or a Guarantor and (c) owns Real Estate and related assets which are security for Indebtedness of such Person, and which Indebtedness does not constitute Indebtedness of any other Person except as provided in the definition of Non-Recourse Indebtedness (except for Non-Recourse Exclusions). 44 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "SOFR" means a rate equal to the secured overnight financing rate as administered by the SOFR Administrator. "SOFR Administrator" means the Federal Reserve Bank of New York (or a successor administrator of the secured overnight financing rate). "SOFR Administrator's Website" means the website of the Federal Reserve Bank of New York, currently at http://www.newyorkfed.org, or any successor source for the secured overnight financing rate identified as such by the SOFR Administrator from time to time. "SOFR Business Day" means any day except for (i) a Saturday, (ii) a Sunday or (iii) a day on which the Securities Industry and Financial Markets Association recommends that the fixed income departments of its members be closed for the entire day for purposes of trading in United States government securities. "SOFR Determination Day" has the meaning specified in the definition of "Daily Simple SOFR". "SOFR Index Adjustment" means, for any calculation with respect to a SOFR Rate Loan and for any applicable Interest Period, 0.10% per annum. "SOFR Rate Day" has the meaning specified in the definition of "Daily Simple SOFR". "SOFR Rate Loan" means each Loan bearing interest at a rate based upon (a) Adjusted Term SOFR (other than pursuant to clause (iii) of the definition of "Base Rate") or (b) Adjusted Daily Simple SOFR. "Solvent" means, with respect to any Person as of any date of determination, that (a) at fair valuations, the sum of such Person's debts (including contingent liabilities) is less than all of such Person's assets, (b) such Person is not engaged or about to engage in a business or transaction for which the remaining assets of such Person are unreasonably small in relation to the business or transaction or for which the property remaining with such Person is an unreasonably small capital and (c) such Person has not incurred and does not intend to incur, or reasonably believe that it will incur, debts beyond its ability to pay such debts as they become due (whether at maturity or otherwise), and (d) such Person is "solvent" or not "insolvent", as applicable within the meaning given those terms and similar terms under applicable laws relating to fraudulent transfers and conveyances. For purposes of this definition, the amount of any contingent liability at any time shall be computed as the amount that, in light of all of the facts and circumstances existing at such time, represents the amount that can reasonably be expected to become an actual or matured liability (irrespective of whether such contingent liabilities meet the criteria for accrual under Statement of Financial Accounting Standard No. 5). "State" means a state of the United States and the District of Columbia. "Subordination and Attornment Agreement" means any agreement among Administrative Agent, one or more Borrowers that is the fee owner or ground lessee of a Collateral Property and one or more Borrowers that is the tenant under a Lease pursuant to which such tenant agrees to subordinate its rights under the Lease to the lien or security title of the applicable Mortgage and agrees to recognize the Agent or its successor in interest as landlord under the Lease in the event of a foreclosure under such Mortgage, such agreement to be in form and substance reasonably satisfactory to Administrative Agent. 45 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Subordination of Management Agreement" means an agreement pursuant to which a manager of a Collateral Property subordinated certain of its rights under a Management Agreement to the Loan Documents and agrees to cooperate with Administrative Agent and the Lenders in connection with any transition of management of the Collateral Properties, in form and substance reasonably satisfactory to Administrative Agent. "Subsidiary" means, subject to Section 5.3, for any Person, any corporation, partnership, limited liability company or other entity of which at least a majority of the securities or other ownership interests having by the terms thereof ordinary voting power to elect a majority of the board of directors or other persons performing similar functions of such corporation, partnership, limited liability company or other entity (without regard to the occurrence of any contingency) is at the time directly or indirectly owned or controlled by such Person or one or more Subsidiaries of such Person, and shall include all Persons the accounts of which are consolidated with those of such Person pursuant to GAAP. Based upon its ownership as of the Closing Date, PCA Iowa, LLC is not a Subsidiary of Trilogy Pro Services as of the Closing Date. "Subsidiary Borrower" means each Wholly-Owned Domestic Subsidiary of Parent, OpCo or Trilogy Pro Services which becomes a Borrower pursuant to Section 5.5(a) or (b) or Section 7.20. "Supported QFC" shall have the meaning set forth in in Section 38. "Survey" means an instrument survey of each parcel of Real Estate comprising a Collateral Property or Villa Units prepared by a registered land surveyor which shall show the location of all buildings, structures, easements and utility lines on such property, shall be sufficient to remove the standard survey exception from the relevant Title Policy, shall show that all buildings and structures are within the lot lines of such Real Estate and shall not show any encroachments by others (or to the extent any encroachments are shown, such encroachments shall be acceptable to Administrative Agent in its reasonable discretion), and shall show whether or not such Real Estate is located in a flood hazard district as established by the Federal Emergency Management Agency or any successor agency or is located in any flood plain, flood hazard or wetland protection district established under federal, state or local law and shall otherwise be in form and substance reasonably satisfactory to Administrative Agent. "Surveyor Certification" means, with respect to each parcel of Real Estate, a certificate executed by the surveyor who prepared the Survey with respect thereto, dated as of a recent date prior to inclusion of such Real Estate as Collateral and containing such information relating to such parcel as Administrative Agent or, as applicable, the Title Insurance Company may reasonably require, such certificate to be in form and substance reasonably satisfactory to Administrative Agent. "Swing Loan" has the meaning set forth in Section 2.4(a). Swing Loans include the A/R Swing Loans and the Real Estate Swing Loans. "Swing Loan Commitment" means an amount equal to $35,000,000.00, as the same may be changed from time to time in accordance with the terms of this Agreement. "Swing Loan Lender" means KeyBank, in its capacity as the Real Estate Revolving Loan Lender making Swing Loans, and any successor thereof. "Swing Loan Note" has the meaning set forth in Section 2.4(b). 46 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Syndication Agent" means Regions Bank, or any successor thereof. "Synthetic Lease" means any synthetic lease, tax retention operating lease, off-balance sheet loan or similar off-balance sheet financing arrangement whereby the arrangement is considered borrowed money indebtedness for tax purposes but is classified as an operating lease or does not otherwise appear on a balance sheet under GAAP. "Taking" means the taking or appropriation (including by deed in lieu of condemnation) of any Collateral Property, or any part thereof or interest therein, whether permanently or temporarily, for public or quasi-public use under the power of eminent domain, by reason of any public improvement or condemnation proceeding, or in any other manner or any damage or injury or diminution in value through condemnation, inverse condemnation or other exercise of the power of eminent domain. "Taxes" means all present or future taxes, levies, imposts, duties, deductions, withholdings (including backup withholding), assessments, fees or other charges imposed by any Governmental Authority, including any interest, additions to tax or penalties applicable thereto. "Term SOFR" means (a) for any calculation with respect to a Term SOFR Loan, the Term SOFR Reference Rate for a tenor comparable to the applicable Interest Period on the day (such day, the "Lookback Day") that is two SOFR Business Days prior to the first day of such Interest Period (and rounded in accordance with the Administrative Agent's customary practice), as such rate is published by the Term SOFR Administrator; provided, however, that if as of 5:00 p.m. (New York City time) on any Lookback Day the Term SOFR Reference Rate for the applicable tenor has not been published by the Term SOFR Administrator and a Benchmark Replacement Date with respect to the Term SOFR Reference Rate has not occurred, then Term SOFR will be the Term SOFR Reference Rate for such tenor as published by the Term SOFR Administrator on the first preceding SOFR Business Day for which such Term SOFR Reference Rate for such tenor was published by the Term SOFR Administrator so long as such first preceding SOFR Business Day is not more than three SOFR Business Days prior to such Lookback Day, and (b) for any calculation with respect to a Base Rate Loan, the Term SOFR Reference Rate for a tenor of one month on the day that is two SOFR Business Days prior to the date the Base Rate is determined, subject to the proviso provided above. "Term SOFR Administrator" means CME (or a successor administrator of the Term SOFR Reference Rate, as selected by the Administrative Agent in its reasonable discretion). "Term SOFR Loan" means each Loan bearing interest at a rate based upon Adjusted Term SOFR (other than pursuant to clause (iii) of the definition of Base Rate). "Term SOFR Reference Rate" means the forward-looking term rate based on SOFR. "Third Party Insurance Accounts" means, collectively, any and all Accounts that are not Government Receivables. "Third Party Payor" means any governmental entity, insurance company, health maintenance organization, professional provider organization or similar entity that is obligated to make payments on any account receivable in connection with healthcare services rendered at a Collateral Property or with respect to any Accounts relating to or arising at or from a Senior Care Property or Medical Services. "Third Party Payor Programs" means any participation or provider agreements with any Third Party Payor, including Medicare, Medicaid, TRICARE, any non-individual Person, other than a 47 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Governmental Authority, located in the United States which, in the ordinary course of its business or activities, agrees to pay for healthcare goods and services received by individuals, including a commercial insurance company, a nonprofit insurance company (such as a Blue Cross/Blue Shield entity), an employer or union who self-insures for employee or member health insurance, an HMO, a PPO, and any other insurance company issuing health, personal injury, workmen's compensation or other types of insurance, and any other private commercial insurance managed care and employee assistance program, to which any Borrower or any Operator may be subject with respect to a Collateral Property or with respect to any Accounts relating to or arising at or from a Senior Care Property or Medical Services. "Titled Agents" means, collectively, Co-Lead Arrangers and the Syndication Agent. "Title Insurance Company" means First American Title Company and any other title insurance company or companies approved by Administrative Agent and Parent, such approval not to be unreasonably withheld, conditioned or delayed. "Title Policy" means, with respect to each parcel of Collateral Property, an ALTA standard form title insurance policy (or, if such form is not available, an equivalent, legally promulgated form of mortgagee title insurance policy reasonably acceptable to Administrative Agent) issued by a Title Insurance Company (with such reinsurance as Administrative Agent may reasonably require, any such reinsurance to be with direct access endorsements to the extent available under applicable law) in an amount as Administrative Agent may reasonably require based upon the fair market value of such Collateral Property insuring the priority of the Mortgage thereon and that the Loan Party executing such Mortgage holds marketable or indefeasible fee simple title or a valid and subsisting leasehold interest to such parcel, subject only to the encumbrances acceptable to Administrative Agent in its reasonable discretion and which shall not contain standard exceptions for mechanics liens, persons in occupancy (other than tenants as tenants only under Leases and residents and patients under unrecorded move-in agreements) or matters which would be shown by a Survey, shall not insure over any matter except to the extent that any such affirmative insurance is acceptable to Administrative Agent in its reasonable discretion, and shall contain, to the extent available in the state or jurisdiction of the Collateral Property (a) a revolving credit endorsement and (b) such other endorsements and affirmative insurance as Administrative Agent may reasonably require and is available in the State in which such Collateral Property is located, including, to the extent available in the state or jurisdiction of the Collateral Property, (i) a comprehensive endorsement, (ii) a variable rate of interest endorsement, (iii) a usury endorsement, (iv) a doing business endorsement, (v) an ALTA form 3.1 zoning endorsement, (vi) a "tie-in" endorsement relating to all Title Policies issued by such Title Insurance Company in respect of other Collateral Properties, (vii) "first loss" and "last dollar" endorsements, and (viii) a utility location endorsement. "Total Adjusted EBITDA" means, with respect to any period, an amount equal to (a) the EBITDA of Trilogy Investors and its Subsidiaries plus (b) each such Person's pro rata share of EBITDA of its Unconsolidated Affiliates as provided below. With respect to Unconsolidated Affiliates, EBITDA attributable to such entities shall be excluded but EBITDA shall include a Person's Equity Percentage of Net Income from such Unconsolidated Affiliates plus its Equity Percentage of, only to the extent deducted in determination of such Net Income: (a) depreciation and amortization expense; (b) interest expense; (c) income tax expense; and (d) extraordinary or non-recurring losses and costs (including losses on the sale of assets or payment of Indebtedness); and minus (e) only to the extent included in determination of such Net Income, extraordinary or non-recurring gains (including gains on the sale of assets); provided, however, that straight line leveling adjustments required under GAAP and amortization of intangibles pursuant to FAS 141R shall be excluded from such calculation. 48 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "Total Adjusted EBITDA (Real Estate)" means, with respect to the Collateral Properties (other than Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability), with respect to any period (without duplication), (a) Net Income of the OpCo Affiliates leasing such Collateral Properties on a Consolidated basis, in accordance with GAAP plus (b) only to the extent deducted in determination of such Net Income: (i) depreciation and amortization expense; (ii) total Interest Expense of such OpCo Affiliates; (iii) income tax expense; and (iv) management fee expense minus: (b)(i) the amount equal to Capital Reserves for such period; (ii) the aggregate amount of IGT UPL Payments received and (iii) an amount equal to five percent (5%) of the gross revenues generated by the Collateral Properties during such period and net of (c) intercompany profits and losses; provided, however, that straight line leveling adjustments required under GAAP and amortization of intangibles pursuant to FAS 141R shall be excluded from such calculation. "Total Adjusted EBITDAR" means the sum of (a) Total Adjusted EBITDA plus (b) all base rent and additional rent due and payable by Trilogy Investors and its Subsidiaries during such period. "Total Adjusted EBITDAR (Real Estate)" means Total Adjusted EBITDA (Real Estate) plus Total Rental Expense during the applicable period calculated on a Consolidated basis. "Total A/R Revolving Loan Commitment" means the sum of the A/R Revolving Loan Commitments of the A/R Revolving Loan Lenders, as in effect from time to time. As of the date of this Agreement, the Total A/R Revolving Loan Commitment is $35,000,000.00. The Total A/R Revolving Loan Commitment may increase in accordance with Section 2.10. "Total Commitment" means the sum of the Commitments of the Lenders, as in effect from time to time in accordance with the terms hereof. As of the date of this AgreementDecember 20, 2022, the Total Commitment is $360,000,000.00400,000,000.00. The Total Commitment may increase in accordance with Section 2.10 or decrease in accordance with Section 2.14. "Total Real Estate Revolving Loan Commitment" means the sum of the Real Estate Revolving Loan Commitments of the Real Estate Revolving Loan Lenders, as in effect from time to time. As of the date of this AgreementDecember 20, 2022, the Total Real Estate Revolving Loan Commitment is $325,000,000.00365,000,000.00. The Total Real Estate Revolving Loan Commitment may increase in accordance with Section 2.10 or decrease in accordance with Section 2.14. "Total Rental Expense" means, for any period, all base rent and additional rent due and payable to Borrowers that are the owners or lessees under a Ground Lease with respect to the Collateral Properties (other than Villa Units that are included in the calculation of clause (b) of the definition of Real Estate Borrowing Base Availability) during such period. "Transaction Requirements" means, receipt and/or confirmation, as applicable, by the Administrative Agent of the following: (a) Receipt by Administrative Agent of a certification by the chief executive officer, president, chief financial officer or treasurer or controller of Parent certifying that (A) the Transaction (as defined in that certain letter dated April 22, 2021 from Trilogy RER, LLC to the Administrative Agent) has been consummated in accordance with the terms of said letter and that the resulting organizational structure of Trilogy Investors is the same as the "Post-Merger Structure" attached as Attachment I thereto, (B) that any consents, licenses or approvals required in connection with the Transaction have been obtained 49 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (except for such consents, licenses or approvals, the failure of which to obtain would not be reasonably expected to result in a Material Adverse Effect), (C) that no litigation, regulatory action or other proceeding or order (whether temporary, preliminary or permanent) of a court of competent jurisdiction has been filed or threated in writing that could reasonably be expected to prevent, restrain or enjoin the consummation of the Transaction or have a Material Adverse Effect; and (D) that no Default or Event of Default has occurred and is continuing, together with such other evidence as may be reasonably requested by Administrative Agent evidencing the consummation of the Transaction in accordance with the terms of said letter, such as copies of filed documents effectuating the Transaction from the appropriate Governmental Authorities; and (b) No Default or Event of Default shall have occurred and be continuing as a result of such Transaction or otherwise. For the avoidance of doubt, subject to the satisfaction of the Transaction Requirements, the Transaction shall not constitute a Change of Control under this Agreement. "TRICARE" means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, which program was formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and all laws, rules, regulations, and orders of all applicable Governmental Authorities promulgated in connection with such program and having the force of law. "TRICARE Receivable" means any Account payable pursuant to TRICARE. "Trilogy Investors" means Trilogy Investors, LLC, a Delaware limited liability company. "Trilogy REIT JV" means Trilogy REIT Holdings, LLC, a Delaware limited liability company. "Trilogy Healthcare Holdings" means Trilogy Healthcare Holdings, Inc., a Delaware corporation. "Trilogy Pharmacy Company" means each and any of Trilogy Mission RX, LLC, a Delaware limited liability company, PCA, Trilogy NuScriptRx, LLC, a Delaware limited liability company, and any other Borrower formed or acquired after the Closing Date that operates a business of providing pharmacy services. "Trilogy Pro Services" means Trilogy Pro Services, LLC, a Delaware limited liability company. "Trilogy Rehab Company" means each and any of Trilogy Rehab Services, LLC, a Delaware limited liability company, Paragon, and any other Borrower formed or acquired after the Closing Date that operates a business of providing rehabilitative services. "Type" means as to any type of Loan, its nature as determined with respect to the interest option applicable thereto, which in each case shall be a Base Rate Loan, a Daily Simple SOFR Loan or a LIBOR RateTerm SOFR Loan. 50 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 "UCC" means the Uniform Commercial Code as in effect in the State of New York. "UK Financial Institutions" means any BRRD Undertaking (as such term is defined under the PRA Rulebook (as amended from time to time) promulgated by the United Kingdom Prudential Regulation Authority) or any person falling within IFPRU 11.6 of the FCA Handbook (as amended from time to time) promulgated by the United Kingdom Financial Conduct Authority, which includes certain credit institutions and investment firms, and certain affiliates of such credit institutions or investment firms. "UK Resolution Authority" means the Bank of England or any other public administrative authority having responsibility for the resolution of any UK Financial Institution. "Unadjusted Benchmark Replacement" means the applicable Benchmark Replacement excluding the related Benchmark Replacement Adjustment. "Unconsolidated Affiliate" means in respect of any Person, any other Person in whom such Person holds an Investment, which Investment is accounted for in the financial statements of such Person on an equity basis of accounting and whose financial results would not be consolidated under GAAP with the financial results of such first Person on the consolidated financial statements of such first Person if such financial statements were prepared in accordance with the full consolidation method of GAAP as of such date. "U.S. Person" means any Person that is a "United States Person" as defined in Section 7701(a)(30) of the Code. "U.S. Special Resolution Regimes" shall have the meaning set forth in Section 38. "United States" means the United States of America. "Villa Unit" means (a) independent senior living residences within a Borrower campus setting and (b) an expansion of an existing Building on a Collateral Property. "Villa Unit Borrowing Base Debt Service Coverage Ratio" means the ratio of the aggregate adjusted "EBITDAR" for the Eligible Villa Units (based on a pro forma, as-stabilized basis as shown on the Appraisals for such Villa Units), divided by, in each case, the Implied Debt Service. "Villa Unit Borrowing Base Value" means, for the Eligible Villa Units owned by Borrowers included in the Villa Units, the amount which is the lesser of (a) seventy percent (70%) of the sum of the Collateral Pool Value of the Villa Units and (b) seventy percent (70%) of the sum of the Construction Costs of the Villa Units, in each case, as most recently determined under this Agreement. "Wholly-Owned Domestic Subsidiary" means as to any Borrower, any Domestic Subsidiary of any Borrower that is directly or indirectly owned one hundred percent (100%) by such Borrower. "Withholding Agent" means Parent, any Guarantor and Administrative Agent, as applicable. "Write-Down and Conversion Powers" means, (a) with respect to any EEA Resolution Authority, the write-down and conversion powers of such EEA Resolution Authority from time to time under the Bail-In Legislation for the applicable EEA Member Country, which write-down and conversion powers are described in the EU Bail-In Legislation Schedule, and (b) with respect to the United 51 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Kingdom, any powers of the applicable Resolution Authority under the Bail-In Legislation to cancel, reduce, modify or change the form of a liability of any UK Financial Institution or any contract or instrument under which that liability arises, to convert all or part of that liability into shares, securities or obligations of that person or any other person, to provide that any such contract or instrument is to have effect as if a right had been exercised under it or to suspend any obligation in respect of that liability or any of the powers under that Bail-In Legislation that are related to or ancillary to any of those powers. Section 1.2 Rules of Interpretation. (a) A reference to any formation document, governing document, agreement or other contractual instrument, including the Loan Documents, shall include such document, agreement or instrument as amended, restated, modified or supplemented from time to time in accordance with its terms and the terms of this Agreement. (b) The singular includes the plural and the plural includes the singular. (c) Unless otherwise expressly provided herein, references to any constitutions, laws, statutes, ordinances, rules, treaties, regulations, permits, licenses, approvals, interpretations and orders shall include all statutory and regulatory provisions consolidating, amending, replacing, supplementing or interpreting such constitution, law, statute, ordinance, rules, treaty, regulation, permit, license, approval, interpretation and order. (d) A reference to any Person includes its permitted successors and permitted assigns and in the event any Borrower or a Guarantor is a limited liability company and shall undertake an LLC Division (any such LLC Division being a violation of this Agreement), shall be deemed to include each limited liability company resulting from any such LLC Division. (e) Accounting terms not otherwise defined herein have the meanings assigned to them by GAAP applied on a consistent basis by the accounting entity to which they refer. (f) The words "include", "includes" and "including" are not limiting, and the term "or" has, except where otherwise indicated, the inclusive meaning represented by the phrase "and/or". (g) The words "approval" and "approved", as the context requires, means an approval in writing given to the party seeking approval after full and fair disclosure to the party giving approval of all material facts necessary in order to determine whether approval should be granted. (h) All terms not specifically defined herein or by GAAP, which terms are defined in the Uniform Commercial Code as in effect in the State of New York, have the meanings assigned to them therein. (i) "Section", "Annex", "clause", "Schedule" and "Exhibit" references are to this Agreement unless otherwise specified. (j) The words "herein", "hereof", "hereunder" and words of like import shall refer to this Agreement as a whole and not to any particular section or subdivision of this Agreement. (k) In the event of any change in GAAP after the date hereof or any other change in accounting procedures pursuant to Section 7.3 which would affect the computation of any financial covenant, ratio or other requirement set forth in any Loan Document, then upon the request of Parent or Administrative Agent, Borrowers, Guarantors, Administrative Agent and the Lenders shall negotiate promptly, diligently and in good faith in order to amend the provisions of the Loan Documents such that 52 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 such financial covenant, ratio or other requirement shall continue to provide substantially the same financial tests or restrictions of the Loan Parties as in effect prior to such accounting change, as determined by the Majority Lenders in their good faith judgment. Until such time as such amendment shall have been executed and delivered by Borrowers, Administrative Agent and the Majority Lenders, such financial covenants, ratio and other requirements, and all financial statements and other documents required to be delivered under the Loan Documents, shall be calculated and reported as if such change had not occurred and no Event of Default shall be deemed to have occurred solely as a result of such change. (l) Notwithstanding any other provision contained herein, all terms of an accounting or financial nature used herein shall be construed, and all computations of amounts and ratios referred to herein shall be made (i) without giving effect to any election under Accounting Standards Codification 825-10-25 (or any other Accounting Standards Codification or Financial Accounting Standard having a similar result or effect) to value any Indebtedness or other liabilities of a Person or any of its Subsidiaries at "fair value", as defined therein, and (ii) without giving effect to any treatment of Indebtedness in respect of convertible debt instruments under Accounting Standards Codification 470-20 (or any other Accounting Standards Codification or Financial Accounting Standard having a similar result or effect) to value any such Indebtedness in a reduced or bifurcated manner as described therein, and such Indebtedness shall at all times be valued at the full stated principal amount thereof. (m) To the extent that any of the representations and warranties contained in this Agreement or any other Loan Document is qualified by "Material Adverse Effect" or any other materiality qualifier, then the qualifier "in all material respects" contained in Sections 2.10(d)(iv), 2.12(c)(iii), 10.1(g) and 11.1 shall not apply with respect to any such representations and warranties. (n) Unless otherwise specified, all references herein to times of day shall be references to Eastern time (daylight or standard, as applicable). (o) Any Person referred to herein in respect of, or in connection with, any document, agreement or instrument shall include such Person's successors and assigns in such capacity thereunder, to the extent such succession or assignment is permitted hereunder. (p) For all purposes under the Loan Documents, in connection with any LLC Division: (a) if any asset, right, obligation or liability of any Person becomes the asset, right, obligation or liability of a different Person, then it shall be deemed to have been transferred from the original Person to the subsequent Person, and (b) if any new Person comes into existence, such new Person shall be deemed to have been organized on the first date of its existence by the holders of its Equity Interests at such time. (q) The interest rate on Loans denominated in Dollars may be determined by reference to a benchmark rate that is, or may in the future become, the subject of regulatory reform or cessation. Administrative Agent does not warrant or accept any responsibility for, and shall not have any liability with respect to, (a) the continuation of, administration of, submission of, calculation of or any other matter related to USD LIBOR (as defined in Section 4.15) or with respect tothe Base Rate, Daily Simple SOFR, Adjusted Daily Simple SOFR, the Term SOFR Reference Rate, Adjusted Term SOFR or Term SOFR, or any component definition thereof or rates referred to in the definition thereof, or any alternative or, successor benchmark thereto, or replacement rate therefor or thereofthereto (including any Benchmark Replacement), including, without limitation, whether the composition or characteristics of any such alternative, successor or replacement reference rate, as it may or may not be adjusted pursuant to Section 4.15, (including any Benchmark Replacement) will be similar to, or produce the same value or economic equivalence of, USD LIBOR or any other benchmark or have the same volume or liquidity as 53 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 did USD LIBOR, the Base Rate, Daily Simple SOFR, Adjusted Daily Simple SOFR, the Term SOFR Reference Rate, Adjusted Term SOFR or Term SOFR or any other benchmarkBenchmark prior to its discontinuance or unavailability, or (b) the effect, implementation or composition of any Conforming Changes. Administrative Agent and its affiliates or other related entities may engage in transactions that affect the calculation of the Base Rate, Daily Simple SOFR, Adjusted Daily Simple SOFR, the Term SOFR Reference Rate, Adjusted Term SOFR or Term SOFR, any alternative, successor or replacement rate (including any Benchmark Replacement) or any relevant adjustments thereto, in each case, in a manner adverse to the Borrowers. Administrative Agent may select information sources or services in its reasonable good faith discretion to ascertain the Base Rate, Daily Simple SOFR, Adjusted Daily Simple SOFR, the Term SOFR Reference Rate, Adjusted Term SOFR or Term SOFR or any other Benchmark, in each case pursuant to the terms of this Agreement, and shall have no liability to the Borrowers, any Lender or any other person or entity for damages of any kind, including direct or indirect, special, punitive, incidental or consequential damages, costs, losses or expenses (whether in tort, contract or otherwise and whether at law or in equity), for any error or calculation of any such rate (or component thereof) provided by any such information source or service. Administrative Agent will, in keeping with industry practice, continue using its current rounding practices in connection with the Base Rate, Daily Simple SOFR, Adjusted Daily Simple SOFR, the Term SOFR Reference Rate, Adjusted Term SOFR or Term SOFR. In connection with the use or administration of Daily Simple SOFR and Term SOFR, Administrative Agent will have the right to make Conforming Changes from time to time and, notwithstanding anything to the contrary herein or in any other Loan Document, any amendments implementing such Conforming Changes will become effective without any further action or consent of any other party to this Agreement or any other Loan Document. Administrative Agent will promptly notify the Borrowers and the Lenders of the effectiveness of any Conforming Changes in connection with the use or administration of Daily Simple SOFR and Term SOFR. Section 1.3 Rates. Administrative Agent does not warrant or accept responsibility for and shall not have any liability with respect to, the administration, submission or any other matter related to the rates in the definition of "LIBORSOFR". SECTION 2. THE CREDIT FACILITY. Section 2.1 Real Estate Revolving Loans. (a) Subject to the terms and conditions set forth in this Agreement, each of the Real Estate Revolving Loan Lenders severally agrees to lend to Borrowers, and Borrowers may borrow (and repay and reborrow) from time to time between the Closing Date and the Maturity Date upon notice by Borrowers to Administrative Agent given in accordance with Section 2.6, such sums as are requested by Borrowers for the purposes set forth in Section 2.8 up to a maximum aggregate principal amount outstanding (after giving effect to all amounts requested) at any one time equal to the lesser of (i) the sum of such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment and (ii) such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment Percentage of the Real Estate Borrowing Base Availability (after giving pro forma effect to the addition of any assets increasing the Real Estate Borrowing Base Availability as set forth in the applicable updated Real Estate Borrowing Base Certificate); provided, that in all events no Default or Event of Default shall have occurred and be continuing; and provided, further, that the Aggregate Real Estate Revolving Credit Obligations shall not at any time (i) exceed the lesser of (A) the Real Estate Borrowing Base Availability (after giving pro forma effect to the addition of any assets increasing the Real Estate Borrowing Base Availability as set forth in the applicable updated Real Estate Borrowing Base Certificate) and (B) the Total Real Estate Revolving Loan Commitment or (ii) cause a violation of the covenant set forth in Section 9.1. The Real 54 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Estate Revolving Loans shall be made pro rata in accordance with each Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment Percentage. Each request for a Real Estate Revolving Loan hereunder shall constitute a representation and warranty by Borrowers that all of the conditions required of Borrowers set forth in Sections 10 and 11 have been satisfied on the date of such request. Administrative Agent may assume that the conditions in Sections 10 and 11 have been satisfied unless it receives prior written notice from a Real Estate Revolving Loan Lender that such conditions have not been satisfied. No Real Estate Revolving Loan Lender shall have any obligation to make Real Estate Revolving Loans to Borrowers or participate in Letter of Credit Liabilities in an aggregate principal outstanding amount of more than its Real Estate Revolving Loan Commitment Percentage of the Total Real Estate Revolving Loan Commitment. (b) The Real Estate Revolving Loans shall be evidenced by separate Real Estate Revolving Loan Notes for each Real Estate Revolving Loan Lender based on its Real Estate Revolving Loan Commitment. One Real Estate Revolving Loan Note shall be payable to the order of each Real Estate Revolving Loan Lender in the principal amount equal to such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment or, if less, the outstanding amount of all Real Estate Revolving Loans made by such Real Estate Revolving Loan Lender, plus interest accrued thereon, as set forth below. Each Borrower irrevocably authorizes Administrative Agent to make or cause to be made, at or about the time of the Drawdown Date of any Real Estate Revolving Loan or the time of receipt of any payment of principal thereof, an appropriate notation on Administrative Agent's Record reflecting the making of such Real Estate Revolving Loan or (as the case may be) the receipt of such payment. The outstanding amount of the Real Estate Revolving Loans set forth on Administrative Agent's Record shall be, absent manifest error, prima facie evidence of the principal amount thereof owing and unpaid to each Real Estate Revolving Loan Lender, but the failure to record, or any error in so recording, any such amount on Administrative Agent's Record shall not limit or otherwise affect the obligations of Borrowers hereunder or under any Real Estate Revolving Loan Note to make payments of principal of or interest on any Real Estate Revolving Loan Note when due. Section 2.2 A/R Revolving Loans. (a) Subject to the terms and conditions set forth in this Agreement, each of the A/R Revolving Loan Lenders severally agrees to lend to Borrowers, and Borrowers may borrow (and repay and reborrow) from time to time between the Closing Date and the Maturity Date upon notice by Borrowers to Administrative Agent given in accordance with Section 2.6, such sums as are requested by Borrowers for the purposes set forth in Section 2.8 up to a maximum aggregate principal amount outstanding (after giving effect to all amounts requested) at any one time equal to the lesser of (i) the sum of such A/R Revolving Loan Lender's A/R Revolving Loan Commitment and (ii) such A/R Revolving Loan Lender's A/R Revolving Loan Commitment Percentage of the sum of the A/R Borrowing Base Availability; provided, that in all events no Default or Event of Default shall have occurred and be continuing; and provided, further, that the Aggregate A/R Revolving Credit Obligations shall not at any time (i) exceed the lesser of (A) the A/R Borrowing Base Availability and (B) the Total A/R Revolving Loan Commitment or (ii) cause a violation of the covenant set forth in Section 9.1. The A/R Revolving Loans shall be made pro rata in accordance with each A/R Revolving Loan Lender's A/R Revolving Loan Commitment Percentage. Each request for an A/R Revolving Loan hereunder shall constitute a representation and warranty by Borrowers that all of the conditions required of Borrowers set forth in Sections 10 and 11 have been satisfied on the date of such request. Administrative Agent may assume that the conditions in Sections 10 and 11 have been satisfied unless it receives prior written notice from an A/R Revolving Loan Lender that such conditions have not been satisfied. No A/R Revolving Loan Lender shall have any obligation to make A/R Revolving Loans to Borrowers in the maximum aggregate 55 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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principal outstanding balance of more than the amount equal to its A/R Revolving Loan Commitment Percentage of the Total A/R Revolving Loan Commitments. (b) The A/R Revolving Loans shall be evidenced by separate A/R Revolving Loan Notes for each A/R Revolving Loan Lender based on its A/R Revolving Loan Commitment. One A/R Revolving Loan Note shall be payable to the order of each A/R Revolving Loan Lender in the principal amount equal to such A/R Revolving Loan Lender's A/R Revolving Loan Commitment or, if less, the outstanding amount of all A/R Revolving Loans made by such A/R Revolving Loan Lender, plus interest accrued thereon, as set forth below. Each Borrower irrevocably authorizes Administrative Agent to make or cause to be made, at or about the time of the Drawdown Date of any A/R Revolving Loan or the time of receipt of any payment of principal thereof, an appropriate notation on Administrative Agent's Record reflecting the making of such A/R Revolving Loan or (as the case may be) the receipt of such payment. The outstanding amount of the A/R Revolving Loans set forth on Administrative Agent's Record shall be, absent manifest error, prima facie evidence of the principal amount thereof owing and unpaid to each A/R Revolving Loan Lender, but the failure to record, or any error in so recording, any such amount on Administrative Agent's Record shall not limit or otherwise affect the obligations of Borrowers hereunder or under any A/R Revolving Loan Note to make payments of principal of or interest on any A/R Revolving Loan Note when due. (c) Revolving Agent's determination of the Expected Net Value of the Eligible Accounts and other amounts to be determined or calculated under this Agreement shall, if determined in its Permitted Discretion in the absence of manifest error, be binding and conclusive. Section 2.3 Facility Unused Fees. (a) Each Borrower agrees to pay to Administrative Agent, for the account and ratable benefit of the Real Estate Revolving Loan Lenders (other than a Defaulting Lender for such period of time as such Real Estate Revolving Loan Lender is a Defaulting Lender) in accordance with their respective Real Estate Revolving Loan Commitment Percentages a facility unused fee calculated by multiplying the Real Estate Unused Fee Percentage applicable to such day, calculated as a per diem rate, times the excess of the Total Real Estate Revolving Loan Commitment over the Aggregate Real Estate Revolving Credit Obligations outstanding on such day, commencing on the Closing Date and ending on the Maturity Date. The facility unused fee pursuant to this Section 2.3(a) shall be payable quarterly in arrears on the first day of each calendar quarter for the immediately preceding calendar quarter or portion thereof, with a final payment on the Maturity Date. (b) Each Borrower agrees to pay to Administrative Agent for the account and ratable benefit of the A/R Revolving Loan Lenders (other than a Defaulting Lender for such period of time as such A/R Revolving Loan Lender is a Defaulting Lender) in accordance with their respective A/R Revolving Loan Commitment Percentages a facility unused fee calculated by multiplying the A/R Unused Fee Percentage applicable to such day, calculated as a per diem rate, times the excess of the Total A/R Revolving Loan Commitment over the Aggregate A/R Revolving Credit Obligations outstanding on such day commencing on the Closing Date and ending on the Maturity Date. The facility unused fee pursuant to this Section 2.3(b) shall be payable quarterly in arrears on the first day of each calendar quarter for the immediately preceding calendar quarter or portion thereof, with a final payment on the Maturity Date. Section 2.4 Swing Loan Commitment. (a) Subject to the terms and conditions set forth in this Agreement, the Swing Loan Lender agrees to lend to Borrowers (the "Swing Loans"), and Borrowers may borrow (and repay and 56 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 reborrow) from time to time between the Closing Date and the date which is five (5) Business Days prior to the Maturity Date upon notice by Borrowers to the Swing Loan Lender given in accordance with this Section 2.4, such sums as are requested by Borrowers for the purposes set forth in Section 2.8 in an aggregate principal amount at any one time outstanding not exceeding the Swing Loan Commitment; provided that in all events (i) no Default or Event of Default shall have occurred and be continuing; (ii) the Aggregate Real Estate Revolving Credit Obligations (after giving effect to all amounts requested) shall not at any time exceed the lesser of (A) the Total Real Estate Revolving Loan Commitment and (B) the Real Estate Borrowing Base Availability (after giving pro forma effect to the addition of any assets increasing the Real Estate Borrowing Base Availability as set forth in the applicable updated Real Estate Borrowing Base Certificate), or cause a violation of the covenant set forth in Section 9.1; (iii) the Aggregate A/R Revolving Credit Obligations (after giving effect to all amounts requested) shall not at any time exceed the lesser of (A) the Total A/R Revolving Loan Commitment and (B) the A/R Borrowing Base Availability; and (iv) the aggregate A/R Swing Loans and Real Estate Swing Loans shall not exceed the Swing Loan Commitment. Subject to the terms hereof, the Swing Loan Lender shall make Swing Loans available to Borrowers based on the Swing Loan Commitment regardless of amounts advanced by the Swing Loan Lender individually in its capacity as a Real Estate Revolving Loan Lender or an A/R Revolving Loan Lender or amounts remaining to be funded by it individually as a Lender under its Real Estate Revolving Loan Commitment or its A/R Revolving Loan Commitment, as applicable. Notwithstanding anything to the contrary contained in this Section 2.4, the Swing Loan Lender shall not be obligated to make any A/R Swing Loan or Real Estate Swing Loan at a time when any other A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, is a Defaulting Lender, unless the Swing Loan Lender is satisfied that the participation therein will otherwise be fully allocated to the A/R Revolving Loan Lenders or Real Estate Revolving Loan Lenders, as applicable, that are Non-Defaulting Lenders consistent with Section 2.12(c) and the Defaulting Lender shall not participate therein, except to the extent the Swing Loan Lender has entered into arrangements with Borrowers or such Defaulting Lender that are satisfactory to the Swing Loan Lender in its good faith determination to eliminate the Swing Loan Lender's Fronting Exposure with respect to any such Defaulting Lender, including the delivery of cash collateral. A/R Swing Loans shall constitute "A/R Revolving Loans" for all purposes hereunder, and Real Estate Swing Loans shall constitute "Real Estate Revolving Loans" for all purposes hereunder. The funding of a Swing Loan hereunder shall constitute a representation and warranty by Borrowers that all of the conditions set forth in Sections 10 and 11 have been satisfied on the date of such funding. The Swing Loan Lender may assume that the conditions in Sections 10 and 11 have been satisfied unless the Swing Loan Lender has received written notice from an A/R Revolving Loan Lender or a Real Estate Revolving Loan Lender, as applicable, that such conditions have not been satisfied. Each Swing Loan shall be due and payable within five (5) Business Days of the date such Swing Loan was provided and each Borrower hereby agrees (to the extent not repaid as contemplated by Section 2.4(d)) to repay each Swing Loan on or before the date that is five (5) Business Days from the date such Swing Loan was provided. A Swing Loan may not be refinanced with another Swing Loan. (b) The Swing Loans shall be evidenced by a separate promissory note of Borrowers in substantially the form of Exhibit C (the "Swing Loan Note"), dated the date of this Agreement for the Swing Loan Lender based on its Swing Loan Commitment. The Swing Loan Note shall be payable to the order of the Swing Loan Lender in the principal face amount equal to the Swing Loan Commitment and shall be payable as set forth below. Each Borrower irrevocably authorizes the Swing Loan Lender to make or cause to be made, at or about the time of the Drawdown Date of any Swing Loan or at the time of receipt of any payment of principal thereof, an appropriate notation on the Swing Loan Lender's Record reflecting the making of such Swing Loan, whether such Swing Loan is an A/R Swing Loan or a Real Estate Swing Loan, or (as the case may be) the receipt of such payment. The outstanding amount of the Swing Loans (and A/R Swing Loans and Real Estate Swing Loans) set forth on the Swing Loan Lender's Record shall be, absent manifest error, prima facie evidence of the principal amount thereof 57 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 owing and unpaid to the Swing Loan Lender, but the failure to record, or any error in so recording, any such amount on the Swing Loan Lender's Record shall not limit or otherwise affect the obligations of Borrowers hereunder or under the Swing Loan Note to make payments of principal of or interest on any Swing Loan Note when due. (c) Parent shall request a Swing Loan on behalf of Borrowers by delivering to the Swing Loan Lender a Loan Request executed by an Authorized Officer of Parent no later than 11:00 a.m. (Cleveland time) on the requested Drawdown Date specifying the amount of the requested Swing Loan (which shall be in the minimum amount of $1,000,000.00 or an integral multiple of $100,000.00 in excess thereof), specifying whether such Swing Loan shall be an A/R Swing Loan or a Real Estate Swing Loan and providing the wire instructions for the delivery of the Swing Loan proceeds. The Loan Request shall also contain the statements and certifications required by Sections 2.6(a) and 2.6(b). Each such Loan Request shall be irrevocable and binding on Borrowers and shall obligate Borrowers to accept such Swing Loan on the Drawdown Date. Notwithstanding anything herein to the contrary, a Swing Loan shall be a Base Rate Loan and shall bear interest at the Base Rate plus the Applicable Margin. The proceeds of the Swing Loan will be disbursed by wire by the Swing Loan Lender to Borrowers no later than 1:00 p.m. (Cleveland time). (d) The Swing Loan Lender shall, within five (5) Business Days after the Drawdown Date with respect to such Swing Loan, other than a Swing Loan made pursuant to Section 2.4(h), request each A/R Revolving Loan Lender (with respect to A/R Swing Loans) or Real Estate Revolving Loan Lender (with respect to Real Estate Swing Loans) to make an A/R Revolving Loan or Real Estate Revolving Loan, as applicable, pursuant to Section 2.1 in an amount equal to such A/R Revolving Loan Lenders A/R Revolving Loan Commitment Percentage or such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment Percentage, as applicable, of the amount of the A/R Swing Loan or Real Estate Swing Loan, as applicable, outstanding on the date such notice is given. In the event that Borrowers do not notify Administrative Agent in writing otherwise on or before noon on the Business Day of the Drawdown Date with respect to such Swing Loan, Administrative Agent shall notify the applicable A/R Revolving Loan Lenders or Real Estate Revolving Loan Lenders that such A/R Revolving Loan or Real Estate Revolving Loan shall be a LIBOR RateTerm SOFR Loan with an Interest Period of one (1) month, provided that the making of such LIBOR RateTerm SOFR Loan will not be in contravention of any other provision of this Agreement, or if the making of a LIBOR RateTerm SOFR Loan would be in contravention of this Agreement, then such notice shall indicate that such A/R Revolving Loan or Real Estate Revolving Loan, as applicable, shall be a Base Rate Loan. Each Borrower hereby irrevocably authorizes and directs the Swing Loan Lender to so act on its behalf, and agrees that any amount advanced to Administrative Agent for the benefit of the Swing Loan Lender pursuant to this Section 2.4(d) shall be considered an A/R Revolving Loan or a Real Estate Revolving Loan pursuant to Section 2.1. Unless any of the events described in Section 12.1(h), 12.1(i) or 12.1(j) shall have occurred (in which event the procedures of Section 2.4(e) shall apply), each A/R Revolving Loan Lender (with respect to A/R Swing Loans) or Real Estate Revolving Loan Lender (with respect to Real Estate Swing Loans) shall make the proceeds of its A/R Revolving Loan or Real Estate Revolving Loan available to the Swing Loan Lender for the account of the Swing Loan Lender at Administrative Agent's Head Office prior to 12:00 noon in funds immediately available no later than one (1) Business Day after the date such request was made by the Swing Line Lender just as if the A/R Revolving Loan Lenders or the Real Estate Revolving Loan Lenders, as applicable, were funding directly to Borrowers, so that thereafter such Obligations shall be evidenced by the A/R Revolving Loan Notes or the Real Estate Revolving Loan Notes, as applicable. The proceeds of such A/R Revolving Loan or Real Estate Revolving Loan, as applicable, shall be immediately applied to repay the applicable Swing Loans. (e) If for any reason a Swing Loan cannot be refinanced by an A/R Revolving Loan or a Real Estate Revolving Loan, as applicable, pursuant to Section 2.4(d) or if such Swing Loan was 58 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 made pursuant to Section 2.4(h), each A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, will, on the date such A/R Revolving Loan or Real Estate Revolving Loan pursuant to Section 2.4(d) was to have been made (or automatically and without any action on the part of the Swing Loan Lender, if such Swing Loan was made pursuant to Section 2.4(h) or any of the events described in any of the events described in Section 12.1(h), 12.1(i) or 12.1(j) shall have occurred), purchase an undivided participation interest in the Swing Loan in an amount equal to its A/R Revolving Loan Commitment Percentage or Real Estate Revolving Loan Commitment Percentage, as applicable, of such Swing Loan. Each A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, will immediately transfer to the Swing Loan Lender in immediately available funds the amount of its participation and upon receipt thereof the Swing Loan Lender will deliver to such A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, a Swing Loan participation certificate dated the date of receipt of such funds and in such amount. (f) Whenever at any time after the Swing Loan Lender has received from any A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, such A/R Revolving Loan Lender's or Real Estate Revolving Loan Lender's participation interest in a Swing Loan, the Swing Loan Lender receives any payment on account thereof, the Swing Loan Lender will distribute to such A/R Revolving Loan Lender or Real Estate Revolving Loan Lender its participation interest in such amount (appropriately adjusted in the case of interest payments to reflect the period of time during which such A/R Revolving Loan Lender's or Real Estate Revolving Loan Lender's participating interest was outstanding and funded); provided, however, that in the event that such payment received by the Swing Loan Lender is required to be returned, such A/R Revolving Loan Lender or Real Estate Revolving Loan Lender will return to the Swing Loan Lender any portion thereof previously distributed by the Swing Loan Lender to it. (g) Each A/R Revolving Loan Lender's obligation to fund an A/R Revolving Loan and Real Estate Revolving Loan Lender's obligation to fund a Real Estate Revolving Loan as provided in Section 2.4(d) or to purchase participation interests pursuant to Section 2.4(e) shall be absolute and unconditional and shall not be affected by any circumstance, including (a) any setoff, counterclaim, recoupment, defense or other right which such A/R Revolving Loan Lender or Real Estate Revolving Loan Lender or any Borrower may have against the Swing Loan Lender, any Borrower or anyone else for any reason whatsoever; (b) the occurrence or continuance of a Default or an Event of Default; (c) any adverse change in the condition (financial or otherwise) of any Loan Party or any of their Subsidiaries; (d) any breach of this Agreement or any of the other Loan Documents by any Loan Party or any Lender; or (e) any other circumstance, happening or event whatsoever, whether or not similar to any of the foregoing. Any portions of a Swing Loan not so purchased or converted may be treated by Administrative Agent and the Swing Loan Lender as against such applicable A/R Revolving Loan Lender as an A/R Revolving Loan or against such Real Estate Revolving Loan Lender as a Real Estate Revolving Loan which was not funded by the non-purchasing A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, thereby making such A/R Revolving Loan Lender or Real Estate Revolving Loan Lender, as applicable, a Defaulting Lender. Each Swing Loan, once so sold or converted, shall cease to be a Swing Loan for the purposes of this Agreement, but shall be an A/R Revolving Loan made by such A/R Revolving Loan Lender under its A/R Revolving Loan Commitment or a Real Estate Revolving Loan made by each Real Estate Revolving Loan Lender under its Real Estate Revolving Loan Commitment, as applicable. (h) Notwithstanding the foregoing or any other contrary provision of this Agreement, the Lenders hereby authorize the Swing Loan Lender, at the direction of Administrative Agent in Administrative Agent's reasonable discretion, and Swing Loan Lender shall, at the direction of Administrative Agent, knowingly and intentionally, continue to make Real Estate Swing Loans to Borrowers, notwithstanding that the Aggregate Real Estate Revolving Credit Obligations (after giving 59 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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effect to all amounts requested) exceed, or would exceed after the making of such Real Estate Swing Loan, the lesser of (A) the Total Real Estate Revolving Loan Commitment and (B) the Real Estate Borrowing Base Availability, in an aggregate amount outstanding at any time not to exceed $10,000,000.00, so long as (i) after giving effect to each such Real Estate Swing Loan, the outstanding Aggregate Real Estate Revolving Credit Obligations do not exceed the Total Real Estate Revolving Loan Commitment, and (ii) Administrative Agent, in its reasonable business judgment, deems such Real Estate Swing Loan necessary or desirable (1) to preserve or protect the Collateral, or any portion thereof or (2) to enhance the likelihood of, or maximize the amount of, repayment of the Loans and other Obligations. The foregoing sentence is for the exclusive benefit of Administrative Agent, the Swing Loan Lender, and the Lenders and is not intended to benefit Borrowers in any way. The Majority Real Estate Revolving Loan Lenders may at any time revoke Administrative Agent's authority to direct the Swing Loan Lender to make Real Estate Swing Loans pursuant to the preceding sentence of this Section 2.4(h). Any such revocation must be in writing and shall become effective prospectively upon Administrative Agent's receipt thereof. (i) The obligations of Borrowers to the A/R Revolving Loan Lenders and the Real Estate Revolving Loan Lenders under this Agreement with respect to Swing Loans (and of the A/R Revolving Loan Lenders and the Real Estate Revolving Loan Lenders to make payments to the Swing Loan Lender with respect to Swing Loans) shall be absolute, unconditional and irrevocable, and shall be paid and performed strictly in accordance with the terms of this Agreement, under all circumstances whatsoever, including the following circumstances: (i) any lack of validity or enforceability of this Agreement or any of the other Loan Documents; (ii) the existence of any claim, set-off, defense or any right which any Borrower or any of its Subsidiaries or Affiliates may have at any time against any Lender (other than the defense of payment to the Lenders in accordance with the terms of this Agreement) or any other person, whether in connection with this Agreement, any other Loan Document, or any unrelated transaction; (iii) the surrender or impairment of any security for the performance or observance of any of the terms of any of the Loan Documents; (iv) the occurrence of any Default or Event of Default; and (v) any other circumstance or happening whatsoever, whether or not similar to any of the foregoing. Section 2.5 Interest on Loans. (a) Subject to Section 4.11, each Base Rate Loan shall bear interest for the period commencing with (and including) the Drawdown Date thereof and ending on (and excluding, with respect to repayment, if such repayment is received by Administrative Agent no later than 2:00 pm as required by Section 4.3(a)) the date on which such Base Rate Loan is repaid or converted to a LIBORSOFR Rate Loan at the rate per annum equal to the sum of the Base Rate plus the Applicable Margin. (b) Subject to Section 4.11, each LIBOR Rate(i) Daily Simple SOFR Loan shall bear interest for the period commencing with (and including) the Drawdown Date thereof and ending on (and excluding, with respect to repayment, if such repayment is received by Administrative Agent no later than 2:00 pm as required by Section 4.3(a)) the last day of each Interest Period with respect thereto or, if earlier, the date on which such LIBOR Rate Loan is repaid or converted to a Base Rate Loan,the date on which such Daily Simple SOFR Loan is repaid or is converted to a Loan of another Type at the rate per annum equal to the sum of Adjusted Daily Simple SOFR plus the Applicable Margin for SOFR Rate Loans, and (ii) Term SOFR Loan shall bear interest for the period commencing with the Drawdown Date thereof and ending on the last day of each Interest Period with respect thereto at the rate per annum equal to the sum of LIBORAdjusted Term SOFR determined for such Interest Period plus the Applicable Margin for SOFR Rate Loans. 60 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (c) Borrowers promise to pay interest on each Loan in arrears on each Interest Payment Date with respect thereto. (d) Base Rate Loans and LIBORSOFR Rate Loans may be converted to Loans of the other Type as provided in Section 4.1. Section 2.6 Requests for Loans. Parent, on behalf of the applicable Borrowers, shall give to Administrative Agent written notice executed by an Authorized Officer of Parent in the form of Exhibit F (or telephonic notice confirmed in writing in the form of Exhibit F) of each Loan requested hereunder (a "Loan Request") by 11:00 a.m. (X) one (1) Business Day prior to the proposed Drawdown Date with respect to Base Rate Loans and, (Y) on the same Business Day as the proposed Drawdown Date with respect to Daily Simple SOFR Loans, or (Z) three (3) Business Days prior to the proposed Drawdown Date with respect to LIBOR RateTerm SOFR Loans. Each such notice shall specify with respect to the requested Loan the proposed principal amount of such Loan, whether the Loan is a Real Estate Revolving Loan or an A/R Revolving Loan, the Type of Loan, the initial Interest Period (if applicable) for such Loan and the Drawdown Date. Each such notice shall also contain (a) a statement that the proceeds of such Loan shall be used in accordance with the terms of Section 2.8 and (b) a certification by the chief executive officer, president, chief financial officer or treasurer or controller of Parent that the Loan Parties are and will be in compliance with all covenants under the Loan Documents after giving effect to the making of such Loan. Promptly upon receipt of any such notice, Administrative Agent shall notify each of the applicable Lenders thereof. Each such Loan Request shall be irrevocable and binding on Borrowers and shall obligate Borrowers to accept the Loan requested from the applicable Lenders on the proposed Drawdown Date. Nothing herein shall prevent Borrowers from seeking recourse against any Lender that fails to advance its proportionate share of a requested Loan as required by this Agreement. Each Loan Request shall be in a minimum aggregate amount of $500,000.00 or an integral multiple of $100,000.00 in excess thereof; provided, however, that there shall be no more than ten (10) LIBORSOFR Rate Loans outstanding at any one time. At Revolving Agent's reasonable request, Administrative Agent shall provide information with respect to A/R Revolving Loan balances. Section 2.7 Funds for Loans. (a) Not later than (i) the time specified by Administrative Agent to the Lenders with respect to the initial advance of the Loans on the Closing Date, and (ii) 1:00 p.m. on the proposed Drawdown Date of any Loans, each of the applicable Lenders will make available to Administrative Agent, at Administrative Agent's Head Office, in immediately available funds, the amount of such Lender's A/R Revolving Loan Commitment Percentage or Real Estate Revolving Loan Commitment Percentage, as applicable, of the amount of the requested Loans which may be disbursed pursuant to Section 2.1 or 2.2. Upon receipt from each such Lender of such amount, and upon receipt of the documents required by Sections 10 and 11 and the satisfaction of the other conditions set forth therein, to the extent applicable, Administrative Agent will make available to Borrowers the aggregate amount of such Loans made available to Administrative Agent by the applicable Lenders by crediting such amount to the account of Borrowers maintained at Administrative Agent's Head Office or wiring such funds in accordance with Borrowers' written instructions. The failure or refusal of any Lender to make available to Administrative Agent at the aforesaid time and place on any Drawdown Date the amount of its Commitment Percentage of the requested Loans shall not relieve any other Lender from its several obligation hereunder to make available to Administrative Agent the amount of such other Lender's Commitment Percentage of any requested Loans, including any additional A/R Revolving Loans or Real Estate Revolving Loans that may be requested subject to the terms and conditions hereof to provide funds to replace those not advanced by the Lender so failing or refusing. 61 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (b) Unless Administrative Agent shall have been notified by any Lender prior to the applicable Drawdown Date that such Lender will not make available to Administrative Agent such Lender's Commitment Percentage of a proposed Loan, Administrative Agent may in its discretion assume that such Lender has made such Loan available to Administrative Agent in accordance with the provisions of this Agreement and Administrative Agent may, if it chooses, in reliance upon such assumption make such Loan available to Borrowers, and such Lender shall be liable to Administrative Agent for the amount of such advance. If such Lender does not pay such corresponding amount upon Administrative Agent's demand therefor, Administrative Agent will promptly notify Parent, and Borrowers shall promptly pay such corresponding amount to Administrative Agent. Administrative Agent shall also be entitled to recover from the Lender or Borrowers, as the case may be, interest on such corresponding amount in respect of each day from the date such corresponding amount was made available by Administrative Agent to Borrowers to the date such corresponding amount is recovered by Administrative Agent at a per annum rate equal to (i) from Borrowers at the applicable rate for such Loan or (ii) from a Lender at the Federal Funds Effective Rate. Section 2.8 Use of Proceeds. Borrowers will use (a) the proceeds of Real Estate Revolving Loans available pursuant to clause (b) of the definition of Real Estate Borrowing Base Availability only as expressly permitted by such clause (b), and (b) the proceeds of all other Loans for acquisitions, debt repayment, general corporate and working capital purposes, including Construction Costs for Eligible Villa Units, Investments permitted under Section 8.3 and Permitted Distributions, in each case to the extent otherwise consistent with the terms of this Agreement. Section 2.9 Letters of Credit. (a) Subject to the terms and conditions set forth in this Agreement, at any time and from time to time from the Closing Date through the day that is ninety (90) days prior to the Maturity Date, the Issuing Lender shall issue such Letters of Credit as Borrowers may request upon the delivery of a written request in the form of Exhibit G (a "Letter of Credit Request") to the Issuing Lender, provided that (i) no Default or Event of Default shall have occurred and be continuing, (ii) upon issuance of such Letter of Credit, the aggregate Letter of Credit Liabilities shall not exceed the Letter of Credit Commitment, (iii) in no event shall the Aggregate Real Estate Revolving Credit Obligations (after giving effect to any requested Letters of Credit) exceed the lesser of the Total Real Estate Revolving Loan Commitment and the Real Estate Borrowing Base Availability or cause a violation of the covenant set forth in Section 9.1, (iv) the conditions set forth in Sections 10 and 11 shall have been satisfied, and (v) in no event shall any amount drawn under a Letter of Credit be available for reinstatement or a subsequent drawing under such Letter of Credit. Notwithstanding anything to the contrary contained in this Section 2.9, the Issuing Lender shall not be obligated to issue, amend, extend, renew or increase any Letter of Credit at a time when any other Real Estate Revolving Loan Lender is a Defaulting Lender, unless the Issuing Lender is satisfied that the participation therein will otherwise be fully allocated to the Real Estate Revolving Loan Lenders that are Non-Defaulting Lenders consistent with Section 2.12(c) and the Defaulting Lender shall have no participation therein, except to the extent the Issuing Lender has entered into arrangements with Borrowers or such Defaulting Lender which are satisfactory to the Issuing Lender in its good faith determination to eliminate the Issuing Lender's Fronting Exposure with respect to any such Defaulting Lender, including the delivery of cash collateral. The Issuing Lender may assume that the conditions in Sections 10 and 11 have been satisfied unless it receives written notice from a Real Estate Revolving Loan Lender that such conditions have not been satisfied. Each Letter of Credit Request shall be executed by an Authorized Officer of Parent. The Issuing Lender shall be entitled to conclusively rely on such Person's authority to request a Letter of Credit on behalf of Borrowers. The Issuing Lender shall have no duty to verify the authenticity of any signature appearing on a Letter of Credit Request. Each Borrower assumes all risks with respect to the use of the Letters of Credit. Unless the Issuing Lender and the Majority Real Estate Revolving Loan Lenders otherwise 62 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 consent, the term of any Letter of Credit shall not exceed a period of time commencing on the issuance of the Letter of Credit and ending one (1) year after the date of issuance thereof, subject to extension pursuant to an "evergreen" clause acceptable to Administrative Agent and the Issuing Lender (but in any event the term shall not extend beyond five (5) Business Days prior to the Maturity Date). The amount available to be drawn under any Letter of Credit shall reduce on a dollar-for-dollar basis the amount available to be drawn under the Total Real Estate Revolving Loan Commitment as a Real Estate Revolving Loan. (b) Each Letter of Credit Request shall be submitted to the Issuing Lender at least five (5) Business Days (or such shorter period as the Issuing Lender may approve) prior to the date upon which the requested Letter of Credit is to be issued. Each such Letter of Credit Request shall contain (i) a statement as to the purpose for which such Letter of Credit shall be used (which purpose shall be in accordance with the terms of this Agreement), and (ii) a certification by the chief financial officer of Parent that the Loan Parties are and will be in compliance with all covenants under the Loan Documents after giving effect to the issuance of such Letter of Credit. Borrowers shall further deliver to the Issuing Lender such additional applications (the form of application as of the date hereof being attached hereto as Exhibit H) and documents as the Issuing Lender may require, in conformity with the then standard practices of its letter of credit department, in connection with the issuance of such Letter of Credit; provided that in the event of any conflict, the terms of this Agreement shall control. (c) The Issuing Lender shall, subject to the conditions set forth in this Agreement, issue the Letter of Credit on or before five (5) Business Days following receipt of the documents last due pursuant to Section 2.9(b). Each Letter of Credit shall be in form and substance reasonably satisfactory to the Issuing Lender in its reasonable discretion. (d) Upon the issuance of a Letter of Credit, each Real Estate Revolving Loan Lender shall be deemed to have purchased a participation therein from the Issuing Lender in an amount equal to its respective Real Estate Revolving Loan Commitment Percentage of the amount of such Letter of Credit. No Real Estate Revolving Loan Lender's obligation to participate in a Letter of Credit shall be affected by any other Real Estate Revolving Loan Lender's failure to perform as required herein with respect to such Letter of Credit or any other Letter of Credit. (e) Upon the issuance of each Letter of Credit, Borrowers shall pay to the Issuing Lender (i) for its own account, a Letter of Credit fronting fee calculated at the rate equal to one-eighth of one percent (0.125%) of the face amount of such Letter of Credit (which fee shall not be less than $1,500 in any event) and an administrative charge of $250, and (ii) for the accounts of the Real Estate Revolving Loan Lenders that are Non-Defaulting Lenders (including the Issuing Lender) in accordance with their respective percentage shares of participation in such Letter of Credit, a Letter of Credit fee calculated at the rate per annum equal to the sum of Adjusted Term SOFR plus Applicable Margin then applicable to LIBORSOFR Rate Loans on the face amount of such Letter of Credit. Such fees shall be payable in quarterly installments in arrears with respect to each Letter of Credit on the first day of each calendar quarter following the date of issuance and continuing on each quarter or portion thereof thereafter, as applicable, or on any earlier date on which the Real Estate Revolving Loan Commitments shall terminate and on the expiration or return of any Letter of Credit. In addition, Borrowers shall pay to the Issuing Lender for its own account within five (5) days of demand of the Issuing Lender the standard issuance, documentation and service charges for Letters of Credit issued from time to time by the Issuing Lender. (f) In the event that any amount is drawn under a Letter of Credit by the beneficiary thereof, Borrowers shall reimburse the Issuing Lender by having such amount drawn treated as an outstanding Real Estate Revolving Loan that is a Base Rate Loan under this Agreement (Borrowers being deemed to have requested a Base Rate Loan on such date in an amount equal to the amount of such 63 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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drawing and such amount drawn shall be a Real Estate Revolving Loan that is a Base Rate Loan under this Agreement) and Administrative Agent shall promptly notify each Real Estate Revolving Loan Lender by telecopy, telephone (confirmed in writing) or other similar means of transmission, and each Real Estate Revolving Loan Lender shall promptly and unconditionally pay to Administrative Agent, for the Issuing Lender's own account, an amount equal to such Real Estate Revolving Loan Lender's Real Estate Revolving Loan Commitment Percentage of such Letter of Credit (to the extent of the amount drawn). If and to the extent any Real Estate Revolving Loan Lender shall not make such amount available on the Business Day on which such draw is funded, such Real Estate Revolving Loan Lender agrees to pay such amount to Administrative Agent forthwith on demand, together with interest thereon, for each day from the date on which such draw was funded until the date on which such amount is paid to Administrative Agent, at the Federal Funds Effective Rate until three (3) days after the date on which Administrative Agent gives notice of such draw and at the Federal Funds Effective Rate plus one percent (1%) for each day thereafter. Further, such Real Estate Revolving Loan Lender shall be deemed to have assigned any and all payments made of principal and interest on its Real Estate Revolving Loans, amounts due with respect to its participations in Letters of Credit and any other amounts due to it hereunder to Administrative Agent to fund the amount of any drawn Letter of Credit which such Real Estate Revolving Loan Lender was required to fund pursuant to this Section 2.9(f) until such amount has been funded (as a result of such assignment or otherwise). In the event of any such failure or refusal, the Real Estate Revolving Loan Lenders not so failing or refusing shall be entitled to a priority secured position for such amounts as provided in Section 3.6. The failure of any Real Estate Revolving Loan Lender to make funds available to Administrative Agent in such amount shall not relieve any other Real Estate Revolving Loan Lender of its obligation hereunder to make funds available to Administrative Agent pursuant to this Section 2.9(f). (g) If after the issuance of a Letter of Credit pursuant to Section 2.9(c) by the Issuing Lender, but prior to the funding of any portion thereof by a Real Estate Revolving Loan Lender, for any reason a drawing under a Letter of Credit cannot be refinanced as an Real Estate Revolving Loan, each Real Estate Revolving Loan Lender will, on the date such Real Estate Revolving Loan pursuant to Section 2.9(f) was to have been made, purchase an undivided participation interest in the Letter of Credit in an amount equal to its Real Estate Revolving Loan Commitment Percentage of the amount of such Letter of Credit. Each Real Estate Revolving Loan Lender will immediately transfer to the Issuing Lender in immediately available funds the amount of its participation and upon receipt thereof the Issuing Lender will deliver to such Real Estate Revolving Loan Lender a Letter of Credit participation certificate dated the date of receipt of such funds and in such amount. (h) Whenever at any time after the Issuing Lender has received from any Real Estate Revolving Loan Lender any such Real Estate Revolving Loan Lender's payment of funds under a Letter of Credit and thereafter the Issuing Lender receives any payment on account thereof, then the Issuing Lender will distribute to such Real Estate Revolving Loan Lender its participation interest in such amount (appropriately adjusted in the case of interest payments to reflect the period of time during which such Real Estate Revolving Loan Lender's participation interest was outstanding and funded); provided, however, that in the event that such payment received by the Issuing Lender is required to be returned, such Real Estate Revolving Loan Lender will return to the Issuing Lender any portion thereof previously distributed by the Issuing Lender to it. (i) The issuance of any supplement, modification, amendment, renewal or extension to or of any Letter of Credit shall be treated in all respects the same as the issuance of a new Letter of Credit. (j) Each Borrower assumes all risks of the acts, omissions, or misuse of any Letter of Credit by the beneficiary thereof. Neither Administrative Agent, the Issuing Lender nor any Real 64 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Estate Revolving Loan Lender will be responsible for (i) the form, validity, sufficiency, accuracy, genuineness or legal effect of any Letter of Credit or any document submitted by any party in connection with the issuance of any Letter of Credit, even if such document should in fact prove to be in any or all respects invalid, insufficient, inaccurate, fraudulent or forged; (ii) the form, validity, sufficiency, accuracy, genuineness or legal effect of any instrument transferring or assigning or purporting to transfer or assign any Letter of Credit or the rights or benefits thereunder or proceeds thereof in whole or in part, which may prove to be invalid or ineffective for any reason; (iii) failure of any beneficiary of any Letter of Credit to comply fully with the conditions required in order to demand payment under a Letter of Credit; (iv) errors, omissions, interruptions or delays in transmission or delivery of any messages, by mail, cable, telegraph, telex or otherwise; (v) errors in interpretation of technical terms; (vi) any loss or delay in the transmission or otherwise of any document or draft required by or from a beneficiary in order to make a disbursement under a Letter of Credit or the proceeds thereof; (vii) for the misapplication by the beneficiary of any Letter of Credit of the proceeds of any drawing under such Letter of Credit; and (viii) for any consequences arising from causes beyond the control of Administrative Agent or any Real Estate Revolving Loan Lender. None of the foregoing will affect, impair or prevent the vesting of any of the rights or powers granted to Administrative Agent, the Issuing Lender or the Real Estate Revolving Loan Lenders hereunder. In furtherance and extension and not in limitation or derogation of any of the foregoing, any act taken or omitted to be taken by Administrative Agent, the Issuing Lender or the other Real Estate Revolving Loan Lenders in good faith will be binding on Borrowers and will not put Administrative Agent, the Issuing Lender or the other Real Estate Revolving Loan Lenders under any resulting liability to Borrowers; provided nothing contained herein shall relieve the Issuing Lender for liability to Borrowers arising as a result of the gross negligence or willful misconduct of the Issuing Lender as determined by a court of competent jurisdiction after the exhaustion of all applicable appeal periods. Section 2.10 Increase in Commitments. (a) Provided that no Default or Event of Default has occurred and is continuing, subject to the terms and conditions set forth in this Section 2.10 and with the approval of Administrative Agent, Borrowers shall have the option, at any time and from time to time, before the Maturity Date to request the increase of the Total Real Estate Revolving Loan Commitment or the increase of the Total A/R Revolving Loan Commitment (each, a "Commitment Increase"), in an aggregate amount not to exceed $140,000,000.00100,000,000.00 (such that the Total Commitment shall not exceed $500,000,000.00), by giving written notice to Administrative Agent (each, an "Increase Notice"), each of which shall specify the date (each, an "Increase Effective Date") on which Borrowers propose that the applicable Commitment Increase shall be effective, which shall be a date not less than ten (10) Business Days after the date on which such notice is delivered to Administrative Agent, and the Commitment to be increased; provided that any such individual increase of the Real Estate Revolving Loan Commitment or the A/R Revolving Loan Commitment must be in a minimum amount of $5,000,000.00 and increments of $5,000,000.00 in excess thereof unless otherwise approved by Administrative Agent in its sole discretion. Upon receipt of any Increase Notice, Administrative Agent shall consult with KeyBanc and shall notify Parent of the amount of the facility fees to be paid to any Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be, who provide a portion of the Commitment Increase pursuant to such Increase Notice in connection with such increase in the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be (which shall be in addition to the fees to be paid to Administrative Agent and KeyBanc pursuant to the Administrative Agent Fee Letter). If Borrowers agree to pay the facility fees so determined, Administrative Agent shall send a notice to all Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be (each, a "Commitment Increase Request Notice"), informing them of Borrowers' request to increase the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, and of the facility fees to be paid with respect thereto. Each Real Estate Revolving 65 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Loan Lender or A/R Revolving Loan Lender, as the case may be, who desires to provide a portion of the Commitment Increase upon such terms shall provide Administrative Agent with a written commitment letter specifying the portion of the Commitment Increase which it is willing to provide prior to such deadline as may be specified in the Commitment Increase Request Notice. If the requested increase is oversubscribed, Administrative Agent and KeyBanc shall allocate the Commitment Increase among the Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be, who provide such commitment letters on such basis as Administrative Agent and KeyBanc shall determine in their sole discretion. If the increases to the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, so provided are not sufficient to provide the full amount of the Commitment Increase requested by Borrowers, then Administrative Agent, KeyBanc or Borrowers may, but shall not be obligated to, invite one or more banks or lending institutions (which banks or lending institutions shall be acceptable to Administrative Agent, KeyBanc and Parent) to become a Real Estate Revolving Loan Lender or an A/R Revolving Loan Lenders, as the case may be, and provide a portion of the Commitment Increase. Administrative Agent shall provide all Lenders with a notice setting forth the amount, if any, of the Commitment Increase to be provided by each Real Estate Revolving Loan Lender or A/R Revolving Loan Lender, as the case may be, and the revised Real Estate Revolving Loan Commitment Percentages or A/R Revolving Loan Commitment Percentages, as the case may be, which shall be applicable after the Increase Effective Date. In no event shall any Lender be obligated to increase its Real Estate Revolving Loan Commitment or A/R Revolving Loan Commitment, as the case may be. (b) The terms and provisions of the Real Estate Revolving Loans or A/R Revolving Loans, as the case may be, made pursuant to the Commitment Increases shall be as follows: (i) terms and provisions of Loans made pursuant to the Commitment Increases shall be identical to the existing Real Estate Revolving Loans or A/R Revolving Loans, as the case may be (except as otherwise set forth in Section 2.10(a) with respect to the facility fees paid in connection therewith), it being understood that the Loans made pursuant to the Commitment Increases will be, for all intents and purposes, Real Estate Revolving Loans or A/R Revolving Loans, as the case may be, and all references in the Loan Documents to Real Estate Revolving Loans or A/R Revolving Loans, as the case may be, shall be deemed, unless the context otherwise requires, to include references to Loans made pursuant to the Commitment Increases that are Real Estate Revolving Loans or A/R Revolving Loans, as the case may be, made pursuant to this Agreement; and (ii) the maturity date of Real Estate Revolving Loans or A/R Revolving Loans, as the case may be, shall be the Maturity Date. (c) Upon each Increase Effective Date of each increase in the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, pursuant to this Section 2.10, (i) the applicable Commitment Increase shall be effected by a joinder agreement (the "Increase Joinder") executed by Borrowers, Guarantors, Administrative Agent and each Lender making a portion of such Commitment Increase, in form and substance reasonably satisfactory to each of them, and the Increase Joinder may, without the consent of any other Lenders, effect such amendments to this Agreement and the other Loan Documents as may be necessary or appropriate, in the opinion of Administrative Agent, to effect the provisions of this Section 2.10, (ii) Administrative Agent may unilaterally revise Schedule 1.1(a) to reflect the name and address, Real Estate Revolving Loan Commitment or A/R Revolving Loan Commitment, as the case may be, and Real Estate Revolving Loan Commitment Percentage or A/R Revolving Loan Commitment Percentage, as the case may be, of each Lender following such increase and (iii) Borrowers shall execute and deliver to Administrative Agent a new Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, for each Real Estate Revolving Loan Lender or A/R Revolving Loan Lender, as the case may be, whose Real Estate 66 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Revolving Loan Commitment or A/R Revolving Loan Commitment, as the case may be, has changed so that the principal amount of such Real Estate Revolving Loan Lender's or A/R Revolving Loan Lender's, as the case may be, Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, shall equal its Real Estate Revolving Loan Commitment or A/R Revolving Loan Commitment, as the case may be. Administrative Agent shall deliver such replacement Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, to the respective Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be, in exchange for the Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, replaced thereby which shall be surrendered by such Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be. Each such new Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, shall provide that it is a replacement for the applicable surrendered Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, and that it does not constitute a novation, shall be dated as of the applicable Increase Effective Date and shall otherwise be in substantially the form of the replaced Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be. Concurrently with the issuance of any new Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, pursuant to this Section 2.10(c), Borrowers shall deliver an opinion of counsel, addressed to the Lenders and Administrative Agent, relating to the due authorization, execution and delivery of such new Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, and the enforceability thereof, in form and substance substantially similar to the opinion delivered in connection with the first disbursement under this Agreement. The surrendered Real Estate Revolving Loan Note or A/R Revolving Loan Note, as the case may be, shall be canceled and returned to Borrowers. (d) Notwithstanding anything to the contrary contained herein, Borrowers may not request any Commitment Increase unless the following conditions precedent are satisfied prior to the effectiveness of thereof, which conditions cannot be waived without the consent of all of the Lenders: (i) Payment of Activation Fee. Borrowers shall pay (A) to Administrative Agent and KeyBanc those fees described in and contemplated by the Administrative Agent Fee Letter with respect to the applicable Commitment Increase, and (B) to KeyBanc such facility fees as the Real Estate Revolving Loan Lenders or A/R Revolving Loan Lenders, as the case may be, who are providing a portion of such Commitment Increase may require to fund such increase, which fees shall, when paid, be fully earned and non-refundable under any circumstances. KeyBanc shall pay to the Lenders providing a portion of such Commitment Increase such facility fees pursuant to their separate agreement; (ii) [Intentionally Omitted]; (iii) Sections 10 and 11. On the date any Increase Notice is given and on the Increase Effective Date, both immediately before and after the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, is increased, the conditions set forth in Sections 10 and 11 are satisfied at the time of such reallocation; (iv) Representations True. The representations and warranties made by the Loan Parties in the Loan Documents or otherwise made by or on behalf of the Loan Parties in connection therewith or after the date thereof shall have been true and correct in all material respects when made and shall also be true and correct in all material respects (except on account of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by this Agreement) on the date of such Increase Notice and on the date the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, is increased, both immediately before and after the Total Real Estate Revolving Loan Commitment or Total A/R Revolving Loan Commitment, as the case may be, is increased; 67 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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consents hereto, and to the extent allocated to the repayment of principal of the Loans, shall not be considered outstanding principal under this Agreement. (e) Within five (5) Business Days of demand by the Issuing Lender or the Swing Loan Lender from time to time, Borrowers shall deliver to Administrative Agent for the benefit of the Issuing Lender and the Swing Loan Lender cash collateral in an amount sufficient to cover all Fronting Exposure (after giving effect to Sections 2.4(a), 2.9(a) and 2.12(c)) on terms satisfactory to the Issuing Lender and/or the Swing Loan Lender in its good faith determination (and such cash collateral shall be in Dollars). Any such cash collateral shall be deposited in the Collateral Account as collateral (solely for the benefit of the Issuing Lender and/or the Swing Loan Lender) for the payment and performance of each Defaulting Lender's pro rata portion in accordance with their respective Real Estate Revolving Loan Commitment Percentages of outstanding Letter of Credit Liabilities and Real Estate Swing Loans and A/R Revolving Loan Commitment Percentages of outstanding A/R Swing Loans. Moneys in the Collateral Account deposited pursuant to this Section 2.12(e) shall be applied by Administrative Agent to reimburse the Issuing Lender and/or the Swing Loan Lender immediately for each Defaulting Lender's pro rata portion in accordance with their respective Real Estate Revolving Loan Commitment Percentages or A/R Revolving Loan Commitment Percentages, as applicable, of any funding obligation with respect to a Letter of Credit or Swing Loan which has not otherwise been reimbursed by Borrowers or such Defaulting Lender. (f) (i) Each Lender that is a Defaulting Lender shall not be entitled to receive any facility unused fee pursuant to Section 2.3 for any period during which such Lender is a Defaulting Lender. (ii) Each Lender that is a Defaulting Lender shall not be entitled to receive Letter of Credit fees pursuant to Section 2.9(e) due to it for any period during which such Lender is a Defaulting Lender. (iii) With respect to any facility unused fee or Letter of Credit fee not required to be paid to any Defaulting Lender pursuant to clause (i) or (ii) above, Borrowers shall (A) pay to each Non-Defaulting Lender that portion of any such fee otherwise payable to such Defaulting Lender with respect to such Defaulting Lender's participation in Letter of Credit Liabilities or Swing Loans that has been reallocated to such Non-Defaulting Lender pursuant to Section 2.12(c), (B) pay to the Issuing Lender and the Swing Loan Lender the amount of any such fee otherwise payable to such Defaulting Lender to the extent allocable to the Issuing Lender's or the Swing Loan Lender's Fronting Exposure to such Defaulting Lender and (C) not be required to pay any remaining amount of any such fee. (g) If Parent (so long as no Default or Event of Default exists) and Administrative Agent agree in writing in their sole discretion that a Defaulting Lender should no longer be deemed to be a Defaulting Lender, Administrative Agent will so notify the parties hereto, whereupon as of the date specified in such notice and subject to any conditions set forth therein (which may include arrangements with respect to any cash collateral), that Lender will, to the extent applicable, purchase that portion of outstanding Loans of the other Lenders or take such other actions as Administrative Agent may determine to be necessary to cause the Loans and funded and unfunded participations in Letters of Credit and Swing Loans to be held on a pro rata basis by the Lenders in accordance with their Commitments (without giving effect to Section 2.12(c)), whereupon such Lender will cease to be a Defaulting Lender; provided that no adjustments will be made retroactively with respect to fees accrued or payments made by or on behalf of Borrowers while such Lender was a Defaulting Lender; and provided, further, that except to the extent otherwise expressly agreed by the affected parties, no change hereunder from 72 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Defaulting Lender to Lender will constitute a waiver or release of any claim of any party hereunder arising from such Lender having been a Defaulting Lender. Section 2.13 Borrowing Agency Provisions; Joint and Several Liability; Waivers; Subrogation; Subordination. (a) Each Borrower hereby irrevocably appoints Parent, and Parent hereby irrevocably agrees, to act under this Agreement and the other Loan Documents, as the agent and representative of itself and each other Borrower for all purposes under this Agreement and the other Loan Documents, including requesting Loans and Letters of Credit, selecting whether any Loan or portion thereof is to bear interest as a Base Rate Loan or a LIBORSOFR Rate Loan, and receiving account statements and other notices and communications to Borrowers (or any of them) from Administrative Agent or Revolving Agent. Administrative Agent and Revolving Agent may rely, and shall be fully protected in relying, on any Loan Request, Letter of Credit Request, Increase Notice, Conversion/Continuation Request, Real Estate Borrowing Base Certificate, A/R Borrowing Base Certificate, Compliance Certificate, disbursement instructions, reports, information, or any other notice or communication made or given by Parent, whether in its own name, on behalf of any Borrower or on behalf of "Borrowers", and neither Administrative Agent nor Revolving Agent shall have any obligation to make any inquiry or request any confirmation from or on behalf of any other Borrower as to the binding effect on such Borrower of any such Loan Request, Letter of Credit Request, Increase Notice, Conversion/Continuation Request, Real Estate Borrowing Base Certificate, A/R Borrowing Base Certificate, Compliance Certificate, instruction, report, information or other notice or communication, nor shall the joint and several character of Borrowers' liability for the Obligations be affected. Each Borrower hereby irrevocably authorizes Administrative Agent to pay over or credit all loan proceeds hereunder in accordance with the request of Parent. (b) The handling of this credit facility as a co-borrowing facility with a borrowing agent in the manner set forth in this Agreement is solely as an accommodation to Borrowers and at their request. None of Administrative Agent, Revolving Agent nor any Lender shall incur liability to Borrowers as a result of structuring the facility as a co-borrowing facility. To induce Administrative Agent, Revolving Agent and the Lenders to do so and in consideration thereof, each Borrower hereby indemnifies Administrative Agent, Revolving Agent and each Lender and holds Administrative Agent, Revolving Agent and each Lender harmless from and against any and all liabilities and claims of damage or injury asserted and actual out-of-pocket expenses, losses and damages against or of Administrative Agent, Revolving Agent or any Lender by any Person arising from or incurred by reason of the handling of the financing arrangements of Borrowers as provided herein, reliance by Administrative Agent, Revolving Agent or any Lender on any request or instruction from Parent or any other action taken by Administrative Agent, Revolving Agent or any Lender with respect to this Section 2.13 except due to willful misconduct or gross (not mere) negligence by the indemnified party (as determined by a court of competent jurisdiction in a final and non-appealable judgment). (c) All Obligations shall constitute joint and several obligations of Borrowers and shall be secured by Administrative Agent's security interest (on behalf of the Secured Parties) and Lien upon all of the Collateral, and by all other security interests and Liens heretofore, now or at any time hereafter granted by each Loan Party to the Secured Parties, or any of them, to the extent provided in the Security Documents under which such Lien arises. Each Borrower expressly represents and acknowledges that it is part of a common enterprise with the other Borrowers and that any financial accommodations by the Secured Parties, or any of them, to any other Borrower hereunder and under the other Loan Documents are and will be of direct and indirect interest, benefit and advantage to all Borrowers. Each Borrower acknowledges that any Loan Request, Letter of Credit Request, Conversion or other notice given by any Borrower to Administrative Agent, Revolving Agent or any Lender shall bind 73 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 all Borrowers, and that any notice given by Administrative Agent, Revolving Agent or any Lender to any Borrower shall be effective with respect to all Borrowers. Each Borrower acknowledges and agrees that each Borrower shall be liable, on a joint and several basis, for all of the Loans and other Obligations, regardless of which Borrower actually may have received the proceeds of any of the Loans or other extensions of credit or the amount of such Loans or other extensions of credit received or the manner in which Administrative Agent or any Lender accounts among Borrowers for such Loans or the other Obligations on its books and records, and further acknowledges and agrees that Loans and other extensions of credit to any Borrower inure to the mutual benefit of all of Borrowers and that the Secured Parties are relying on the joint and several liability of Borrowers in extending the Loans and other financial accommodations under the Loan Documents, the Bank Products Documents and the documents evidencing Hedge Obligations. (d) Each of Borrowers represents, warrants and covenants to the Lenders and Agents that in the event of the filing of any voluntary or involuntary petition in bankruptcy by or against any of the other Borrowers at any time following the execution and delivery of this Agreement, none of Borrowers shall seek a supplemental stay or any other relief in any bankruptcy case of any of such other Borrowers, whether injunctive or otherwise, pursuant to Section 105 of the Bankruptcy Code or any other provision of the Bankruptcy Code, to stay, interdict, condition, reduce or inhibit the ability of the Lenders or any Agent to enforce any rights it has by virtue of this Agreement, the other Loan Documents, or at law or in equity, or any other rights the Lenders or any Agent has, whether now or hereafter acquired, against the other Borrowers or against any property owned by such other Borrowers. (e) Each of Borrowers hereby waives and agrees not to assert or take advantage of any defense based upon: (i) Any right to require any Agent or the Lenders to proceed against the other Borrowers or any other Person or to proceed against or exhaust any security held by any Agent or the Lenders at any time or to pursue any other remedy in any Agent's or any Lender's power or under any other agreement before proceeding against a Borrower hereunder or under any other Loan Document; (ii) The defense of the statute of limitations in any action hereunder or the payment or performance of any of the Hedge Obligations, the Bank Product Obligations or the other Obligations; (iii) Any defense that may arise by reason of the incapacity, lack of authority, death or disability of any other Person or Persons or the failure of any Agent or any Lender to file or enforce a claim against the estate (in administration, bankruptcy or any other proceeding) of any other Person or Persons; (iv) Any failure on the part of Administrative Agent, Revolving Agent or any Lender to ascertain the extent or nature of any Collateral or any insurance or other rights with respect thereto, or the liability of any party liable under the Loan Documents or the obligations evidenced or secured thereby; (v) Demand, presentment for payment, notice of nonpayment, protest, notice of protest and all other notices of any kind (except for such notices as are specifically required to be provided to Borrowers pursuant to the Loan Documents), or the lack of any thereof, including, without limiting the generality of the foregoing, notice of the existence, creation or incurring of any new or additional indebtedness or obligation or of any action or non-action on the part of any Borrower, Administrative Agent, Revolving Agent, any Lender, any endorser or creditor of Borrowers or on the part 74 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 of any other Person whomsoever under this or any other instrument in connection with any obligation or evidence of indebtedness held by any Agent or any Lender; (vi) Any defense based upon an election of remedies by any Agent or any Lender, including any election to proceed by judicial or nonjudicial foreclosure of any security, whether real property or personal property security, or by deed in lieu thereof, and whether or not every aspect of any foreclosure sale is commercially reasonable, or any election of remedies, including remedies relating to real property or personal property security, which destroys or otherwise impairs the subrogation rights of a Borrower or the rights of a Borrower to proceed against the other Borrowers for reimbursement, or both; (vii) Any right or claim of right to cause a marshaling of the assets of any other Borrower or any Guarantor; (viii) Any principle or provision of law, statutory or otherwise, which is or might be in conflict with the terms and provisions of this Agreement; (ix) Any duty on the part of Administrative Agent, Revolving Agent or any Lender to disclose to Borrowers any facts any Agent or any Lender may now or hereafter know about Borrowers, any Guarantor or the Collateral, regardless of whether Administrative Agent, Revolving Agent or any Lender has reason to believe that any such facts materially increase the risk beyond that which each Borrower intends to assume or has reason to believe that such facts are unknown to Borrowers or has a reasonable opportunity to communicate such facts to Borrowers, it being understood and agreed that each Borrower is fully responsible for being and keeping informed of the financial condition of the other Borrowers, of the condition of the Collateral Properties or the other Collateral and of any and all circumstances bearing on the risk that liability may be incurred by Borrowers hereunder and under the other Loan Documents; (x) Any lack of notice of disposition or of manner of disposition of any Collateral; (xi) Any inaccuracy of any representation or other provision contained in any Loan Document; (xii) Any sale or assignment of the Loan Documents, or any interest therein; (xiii) Any sale or assignment by a Borrower or any other Person of any Collateral, or any portion thereof or interest therein, whether or not consented to by any Agent or any Lender; (xiv) Any invalidity, irregularity or unenforceability, in whole or in part, of any one or more of the Loan Documents; (xv) Any lack of commercial reasonableness in dealing with the Collateral; (xvi) Any deficiencies in the Collateral, the nonperfection or impairment of any security interest or other Lien on any Collateral, or any deficiency in the ability of Administrative Agent, Revolving Agent or any Lender to collect or to obtain performance from any Persons now or hereafter liable for the payment and performance of any obligation hereby guaranteed; 75 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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expenses hereunder or payments made pursuant to Section 3.2 (which shall be applied as earmarked or, with respect to payments under Section 3.2, as set forth in Section 3.2)), shall be distributed by Administrative Agent in the following order of priority: FIRST, to payment of that portion of the Obligations constituting fees, indemnities, actual out-of-pocket costs and expenses and other amounts (including reasonable, out-of-pocket fees, charges and disbursements of legal counsel to Administrative Agent) due and payable to Administrative Agent in its capacity as such; SECOND, pro rata, to the payment of that portion of the Obligations constituting fees, indemnities, actual out-of-pocket costs and expenses and other amounts due and payable to Revolving Agent and payment of any fees due and payable to the Issuing Lender and the Swing Loan Lender hereunder or under any other Loan Documents; THIRD, pro rata, to the payment of accrued fees and interest then due and payable to the Lenders hereunder; FOURTH, to the payment of principal then due and payable on the Swing Loans; FIFTH, pro rata, to (i) the payment of principal on the A/R Revolving Loans then outstanding, (ii) the payment of principal on the Real Estate Revolving Loans and Letter of Credit Liabilities then outstanding and (iii) the payment of the Bank Product Obligations and Hedge Obligations then due and payable; and SIXTH, to the payment of all other Obligations under any other Loan Document not otherwise referred to in this Section 3.6(a) then due and payable. (b) Payments Subsequent to Event of Default. During the continuance of an Event of Default, Administrative Agent may, and upon the direction of Majority Lenders shall, apply any and all payments received by Administrative Agent in respect of any Obligation (including payments by any IGT Hospital under any IGT Security Agreement) in accordance with clauses first through eighth below. Notwithstanding any provision herein to the contrary, all payments made after the Obligations have been accelerated (so long as such acceleration has not been rescinded), including proceeds of Collateral, shall be applied as follows: FIRST, to payment of that portion of the Obligations constituting fees, indemnities, actual out-of-pocket costs and expenses and other amounts (including fees, charges and disbursements of legal counsel to Administrative Agent) due and payable to Administrative Agent in its capacity as such; SECOND, pro rata, to the payment of that portion of the Obligations constituting fees, indemnities, actual out-of-pocket costs and expenses and other amounts payable to Revolving Agent and payment of any fees payable to the Issuing Lender and the Swing Loan Lender hereunder or under any other Loan Documents; THIRD, to the payment of out-of-pocket costs and expenses (including reasonable attorneys' fees) of the Lenders incurred in connection with the enforcement of their respective rights under the Loan Documents; FOURTH, to the payment of all obligations consisting of accrued fees and interest payable to the Lenders hereunder; 80 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 FIFTH, to the payment of the principal of the Swing Loans then outstanding; SIXTH, pro rata, to (i) the payment of principal on the A/R Revolving Loans then outstanding, (ii) the Collateral Account to the extent of one hundred five percent (105%) of any Letter of Credit Liabilities then outstanding, (iii) the payment of principal on the Real Estate Revolving Loans then outstanding and (iv) the payment of the Bank Product Obligations and Hedge Obligations then due and payable; SEVENTH, to any other Obligations not otherwise referred to in this Section 3.6(b); and EIGHTH, upon satisfaction in full of all Obligations, to Borrowers or as otherwise required by law. SECTION 4. CERTAIN GENERAL PROVISIONS. Section 4.1 Conversion/Continuation Options. (a) Borrowers may elect from time to time to convert any of their outstanding Loans to a Loan of another Type and such Loan shall thereafter bear interest as a Base Rate Loan or a LIBORSOFR Rate Loan, as applicable; provided that (i) with respect to any such conversion of a LIBORSOFR Rate Loan to a Base Rate Loan or, if applicable, any such conversion of a SOFR Rate Loan that is a Term SOFR Loan to a Daily Simple SOFR Loan, an Authorized Officer of Parent, on behalf of Borrowers, shall give Administrative Agent a Conversion/Continuation Request with respect to such election at least two (2) Business Days prior written noticeto the requested date of such electionconversion, in the form of Exhibit F, and such conversion shall only be made on (X) the last day of the Interest Period with respect to any SOFR Rate Loan that is a Term SOFR Loan, or (Y) the applicable Interest Payment Date with respect to any such LIBORSOFR Rate Loan that is a Daily Simple SOFR Loan; (ii) with respect to any such conversion of a Base Rate Loan to a LIBORSOFR Rate Loan of any Type or, if applicable, any such conversion of a SOFR Rate Loan that is a Daily Simple SOFR Loan to a Term SOFR Loan (provided that such conversion shall only be made on the applicable Interest Payment Date with respect to such Daily Simple SOFR Loan), an Authorized Officer of Parent, on behalf of Borrowers, shall give Administrative Agent a Conversion/Continuation Request with respect to such election at least three (3) LIBORSOFR Business Days prior written notice ofto the requested date such electionconversion, in the form of Exhibit F, and the Interest Period requested for such Loan, the principal amount of the Loan so converted shall be in a minimum aggregate amount of $500,000.00 or an integral multiple of $100,000.00 in excess thereof and, after giving effect to the making of such Loan, there shall be no more than ten (10) LIBORSOFR Rate Loans outstanding at any one time; and (iii) no Loan may be converted into a LIBORSOFR Rate Loan when any Default or Event of Default has occurred and is continuing. All or any part of the outstanding Loans of any Type may be converted as provided herein, provided that each partial conversion shall result in a Base Rate Loan in a principal amount of not less than $500,000.00 or an integral multiple of $100,000.00 in excess thereof or a LIBORSOFR Rate Loan in a principal amount of not less than $500,000.00 or an integral multiple of $100,000.00 in excess thereof. On the date on which such conversion is being made, each Lender shall take such action as is necessary to transfer its Commitment Percentages of such Loans to its DomesticApplicable Lending Office or its LIBOR Lending Office, as the case may be. Each Conversion/Continuation Request relating to the conversion of a Base Rate Loan to a LIBORSOFR Rate Loan shall be irrevocable by Borrowers. (b) Subject to the other termterms of this Agreement, any LIBORSOFR Rate Loan shall be continued as such Type upon the expiration of an Interest Period with respect thereto (for a Term SOFR Loan) or following the Interest Payment Date with respect thereto (for a Daily Simple SOFR 81 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Loan) until such time as Parent delivers a Conversion/Continuation Request in compliance with the terms of this Section 4.1; provided that no LIBORSOFR Rate Loan may be continued as such when any Default or Event of Default has occurred and is continuing, but shall be automatically converted to a Base Rate Loan on the last day of the Interest Period relating thereto ending during the continuance of any Default or Event of Default. Section 4.2 Fees. (a) Each Borrower agrees to pay to (a) Administrative Agent and KeyBanc such fees to be paid pursuant to the Administrative Agent Fee Letter and (b) Revolving Agent such fees as are set forth in the Revolving Agent Fee Letter, and each Borrower assumes all obligations of Trilogy Investors under the Administrative Agent Fee Letter, notwithstanding that such Borrower is not a signatory thereto. All such fees shall be fully earned when paid and nonrefundable under any circumstances. (b) Borrowers shall pay to Revolving Agent reasonable and documented fees, costs, expenses and charges incurred by Revolving Agent in connection with field examinations, appraisals and valuations, as and when incurred or chargeable, including, without limitation, fees and reasonable and documented out-of-pocket costs and expenses (including travel, meals, and lodging) of one or more third Persons to perform field examinations of the Borrowers; provided that, so long as no Event of Default shall have occurred and be continuing, Borrowers shall not be obligated to reimburse Revolving Agent for more than two (2) field examinations during any calendar year. Section 4.3 Funds for Payments. (a) All payments of principal, interest, facility fees, Letter of Credit fees, closing fees and any other amounts due hereunder or under any of the other Loan Documents shall be made to Administrative Agent, for the respective accounts of the Lenders, Administrative Agent and Revolving Agent, as the case may be, at Administrative Agent's Head Office, not later than 2:00 p.m. on the day when due (or such later time on such day as is acceptable to the Administrative Agent in the event of a payment in full of all Loans, return of all Letters of Credit, and a termination of Commitments hereunder), in each case in lawful money of the United States in immediately available funds. To the extent not already timely paid pursuant to the preceding sentence, the Administrative Agent is hereby authorized to charge any accounts of any Borrower with KeyBank set forth on Schedule 4.3, on the dates when the amount thereof shall become due and payable, with the amounts of the principal of and interest on the Loans and all fees, charges, actual out-of-pocket expenses and other amounts owing to Administrative Agent, Revolving Agent or the Lenders (including the Swing Loan Lender) under the Loan Documents. Subject to the foregoing, all payments made to Administrative Agent on behalf of the Lenders, and actually received by Administrative Agent, shall be deemed received by the Lenders on the date actually received by Administrative Agent. (b) All payments by Borrowers or the Guarantors hereunder and under any of the other Loan Documents shall be made without setoff or counterclaim, and free and clear of and without deduction or withholding for any Taxes, except as required by Applicable Law. If any Applicable Law (as determined in the good faith discretion of an applicable Withholding Agent) requires the deduction or withholding of any Tax from any such payment by a Withholding Agent, then the applicable Withholding Agent shall be entitled to make such deduction or withholding and shall timely pay the full amount deducted or withheld to the relevant Governmental Authority in accordance with Applicable Law and, if such Tax is an Indemnified Tax, then the sum payable by Borrowers or any applicable Guarantor shall be increased as necessary so that after such deduction or withholding has been made (including such deductions and withholdings applicable to additional sums payable under this Section 4.3) the 82 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 applicable Recipient receives an amount equal to the sum it would have received had no such deduction or withholding been made. (c) Borrowers shall timely pay to the relevant Governmental Authority in accordance with Applicable Law, or at the option of Administrative Agent, timely reimburse it for the payment of, any Other Taxes. (d) Borrowers shall jointly and severally indemnify each Recipient, within ten (10) Business Days after demand therefor, for the full amount of any Indemnified Taxes (including Indemnified Taxes imposed or asserted on or attributable to amounts payable under this Section 4.3) payable or paid by such Recipient or required to be withheld or deducted from a payment to such Recipient and any reasonable out-of-pocket expenses arising therefrom or with respect thereto, whether or not such Indemnified Taxes were correctly or legally imposed or asserted by the relevant Governmental Authority. A certificate as to the amount of such payment or liability delivered to Parent by a Lender or Revolving Agent (with a copy to Administrative Agent), or by Administrative Agent on its own behalf or on behalf of a Lender, shall be conclusive absent manifest error; provided that the determinations in such statement are made on a reasonable basis and in good faith. (e) Each Lender shall severally indemnify Administrative Agent, within ten (10) days after demand therefor, for (i) any Indemnified Taxes attributable to such Lender (but only to the extent that any Borrower has not already indemnified Administrative Agent for such Indemnified Taxes and without limiting the obligation of Borrowers to do so), (ii) any Taxes attributable to such Lender's failure to comply with the provisions of Section 18.4 relating to the maintenance of a Participant Register and (iii) any Excluded Taxes attributable to such Lender, in each case, that are payable or paid by Administrative Agent in connection with any Loan Document, and any reasonable expenses arising therefrom or with respect thereto, whether or not such Taxes were correctly or legally imposed or asserted by the relevant Governmental Authority. A certificate as to the amount of such payment or liability delivered to any Lender by Administrative Agent shall be conclusive absent manifest error. Each Lender hereby authorizes Administrative Agent to set off and apply any and all amounts at any time owing to such Lender under any Loan Document or otherwise payable by Administrative Agent to the Lender from any other source against any amount due to Administrative Agent under this Section 4.3(e). (f) As soon as practicable after any payment of Taxes by any Borrower to a Governmental Authority pursuant to this Section 4.3, such Borrower shall deliver to Administrative Agent the original or a certified copy of a receipt issued by such Governmental Authority evidencing such payment, a copy of the return reporting such payment or other evidence of such payment reasonably satisfactory to Administrative Agent. (i) Any Lender that is entitled to an exemption from or reduction of withholding Tax with respect to payments made under any Loan Document shall deliver to Parent and Administrative Agent, at the time or times reasonably requested by Parent or Administrative Agent, such properly completed and executed documentation reasonably requested by Parent or Administrative Agent as will permit such payments to be made without withholding or at a reduced rate of withholding. In addition, any Lender, if reasonably requested by Parent or Administrative Agent, shall deliver such other documentation prescribed by Applicable Law or reasonably requested by Parent or Administrative Agent as will enable Parent or Administrative Agent to determine whether or not such Lender is subject to backup withholding or information reporting requirements. Notwithstanding anything to the contrary in the preceding two (2) sentences, the completion, execution and submission of such documentation (other than such documentation set forth in the immediately following clauses (ii)(A), (ii)(B) and (ii)(D)) shall not be required if in the applicable Lender's reasonable judgment such completion, execution or 83 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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submission would subject such Lender to any material unreimbursed cost or expense or would materially prejudice the legal or commercial position of such Lender. (ii) Without limiting the generality of the foregoing, in the event that any Borrower is a U.S. Person: (A) any Lender that is a U.S. Person shall deliver to Parent and Administrative Agent on or prior to the date on which such Lender becomes a Lender under this Agreement (and from time to time thereafter upon the reasonable request of Parent or Administrative Agent), an electronic copy (or an original if requested by Parent or Administrative Agent) of an executed IRS Form W-9 (or any successor form) certifying that such Lender is exempt from U.S. federal backup withholding tax; (B) any Foreign Lender shall, to the extent it is legally entitled to do so, deliver to Parent and Administrative Agent (in such number of copies as shall be requested by the recipient) on or prior to the date on which such Foreign Lender becomes a Lender under this Agreement (and from time to time thereafter upon the reasonable request of Parent or Administrative Agent), whichever of the following is applicable: (1) in the case of a Foreign Lender claiming the benefits of an income tax treaty to which the United States is a party (x) with respect to payments of interest under any Loan Document, an electronic copy (or an original if requested by Parent or Administrative Agent) of an executed an appropriate IRS Form W-8BEN establishing an exemption from, or reduction of, U.S. federal withholding Tax pursuant to the "interest" article of such tax treaty and (y) with respect to any other applicable payments under any Loan Document, an appropriate IRS Form W 8BEN establishing an exemption from, or reduction of, U.S. federal withholding Tax pursuant to the "business profits" or "other income" article of such tax treaty; (2) an electronic copy (or an original if requested by Parent or Administrative Agent) of an executed IRS Form W-8ECI; (3) in the case of a Foreign Lender claiming the benefits of the exemption for portfolio interest under Section 881(c) of the Code, (x) a certificate substantially in the form of Exhibit I-1 to the effect that such Foreign Lender is not a "bank" within the meaning of Section 881(c)(3)(A) of the Code, a "10 percent shareholder" of a Borrower within the meaning of Section 871(h)(3)(B) of the Code, or a "controlled foreign corporation" described in Section 881(c)(3)(C) of the Code (a "U.S. Tax Compliance Certificate") and (y) executed originals of an appropriate IRS Form W-8BEN; or (4) to the extent a Foreign Lender is not the beneficial owner, an electronic copy (or an original if requested by Parent or Administrative Agent) of an executed IRS Form W-8IMY, accompanied by IRS Form W-8ECI, an appropriate IRS Form W-8BEN, a U.S. Tax Compliance Certificate substantially in the form of Exhibit I-2 or Exhibit I-3, IRS Form W-9, or other certification documents from each beneficial owner, as applicable; provided that if the Foreign Lender is a partnership and one or more direct or indirect partners of such Foreign Lender are claiming the portfolio interest exemption, such Foreign Lender may provide a U.S. Tax Compliance Certificate substantially in the form of Exhibit I-4 on behalf of each such direct and indirect partner; (C) any Foreign Lender shall, to the extent it is legally entitled to do so, deliver to Parent and Administrative Agent (in such number of copies as shall be requested by the recipient) on or prior to the date on which such Foreign Lender becomes a Lender under this Agreement 84 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (and from time to time thereafter upon the reasonable request of Parent or Administrative Agent), an electronic copy (or an original if requested by Parent or Administrative Agent) of any other form prescribed by Applicable Law as a basis for claiming exemption from or a reduction in U.S. federal withholding Tax, duly completed, together with such supplementary documentation as may be prescribed by Applicable Law to permit Parent or Administrative Agent to determine the withholding or deduction required to be made; and (D) if a payment made to a Lender under any Loan Document would be subject to U.S. federal withholding Tax imposed by FATCA if such Lender were to fail to comply with the applicable reporting requirements of FATCA (including those contained in Section 1471(b) or 1472(b) of the Code, as applicable), such Lender shall deliver to Parent and Administrative Agent at the time or times prescribed by Applicable Law and at such time or times reasonably requested by Parent or Administrative Agent such documentation prescribed by Applicable Law (including as prescribed by Section 1471(b)(3)(C)(i) of the Code) and such additional documentation reasonably requested by Parent or Administrative Agent as may be necessary for Parent and Administrative Agent to comply with their obligations under FATCA and to determine that such Lender has complied with such Lender's obligations under FATCA or to determine the amount to deduct and withhold from such payment. Solely for purposes of this clause (D), "FATCA" shall include any amendments made to FATCA after the date of this Agreement. Each Lender agrees that if any form or certification it previously delivered expires or becomes obsolete or inaccurate in any respect, it shall update such form or certification or promptly notify Parent and Administrative Agent in writing of its legal inability to do so. (g) If any party determines, in its sole discretion exercised in good faith, that it has received a refund of any Taxes as to which it has been indemnified pursuant to this Section 4.3 (including by the payment of additional amounts pursuant to this Section 4.3), it shall pay to the indemnifying party an amount equal to such refund (but only to the extent of indemnity payments made under this Section 4.3 with respect to the Taxes giving rise to such refund), net of all out-of-pocket expenses (including Taxes) of such indemnified party and without interest (other than any interest paid by the relevant Governmental Authority with respect to such refund). Such indemnifying party, upon the request of such indemnified party, shall repay to such indemnified party the amount paid over pursuant to this Section 4.3(g) (plus any penalties, interest or other charges imposed by the relevant Governmental Authority) in the event that such indemnified party is required to repay such refund to such Governmental Authority. Notwithstanding anything to the contrary in this Section 4.3(g), in no event will the indemnified party be required to pay any amount to an indemnifying party pursuant to this Section 4.3(g) the payment of which would place the indemnified party in a less favorable net after-Tax position than the indemnified party would have been in if the Tax subject to indemnification and giving rise to such refund has not been deducted, withheld or otherwise imposed and the indemnification payments or additional amounts with respect to such Tax had never been paid. This Section 4.3(g) shall not be construed to require any indemnified party to make available its Tax returns (or any other information relating to its Taxes that it reasonably deems confidential) to the indemnifying party or any other Person. (h) Each party's obligations under this Section 4.3 shall survive the resignation or replacement of Administrative Agent or any assignment of rights by, or the replacement of, a Lender, the termination of the Commitments and the repayment, satisfaction or discharge of all obligations under any Loan Document. (i) The obligations of Borrowers to the Lenders under this Agreement with respect to Letters of Credit (and of the Real Estate Revolving Loan Lenders to make payments to the Issuing Lender with respect to Letters of Credit and of the Lenders to the Swing Loan Lender with respect to 85 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Swing Loans) shall be absolute, unconditional and irrevocable, and shall be paid and performed strictly in accordance with the terms of this Agreement, under all circumstances whatsoever, including, without limitation, the following circumstances: (i) any lack of validity or enforceability of this Agreement, any Letter of Credit or any of the other Loan Documents; (ii) any improper use which may be made of any Letter of Credit or any improper acts or omissions of any beneficiary or transferee of any Letter of Credit in connection therewith; (iii) the existence of any claim, set-off, defense or any right which any Borrower or any of its Subsidiaries or Affiliates may have at any time against any beneficiary or any transferee of any Letter of Credit (or persons or entities for whom any such beneficiary or any such transferee may be acting) or the Lenders (other than the defense of payment to the Lenders in accordance with the terms of this Agreement) or any other person, whether in connection with any Letter of Credit, this Agreement, any other Loan Document, or any unrelated transaction; (iv) any draft, demand, certificate, statement or any other documents presented under any Letter of Credit proving to be insufficient, forged, fraudulent or invalid in any respect or any statement therein being untrue or inaccurate in any respect whatsoever; (v) any breach of any agreement between any Borrower or any of its Subsidiaries or Affiliates or any Guarantor and any beneficiary or transferee of any Letter of Credit; (vi) any irregularity in the transaction with respect to which any Letter of Credit is issued, including any fraud by the beneficiary or any transferee of such Letter of Credit; (vii) payment by the Issuing Lender under any Letter of Credit against presentation of a sight draft, demand, certificate or other document which does not comply with the terms of such Letter of Credit, provided that such payment shall not have constituted gross negligence or willful misconduct on the part of the Issuing Lender as determined by a court of competent jurisdiction after the exhaustion of all applicable appeal periods; (viii) any non-application or misapplication by the beneficiary of a Letter of Credit of the proceeds of such Letter of Credit; (ix) the legality, validity, form, regularity or enforceability of the Letter of Credit; (x) the failure of any payment by the Issuing Lender to conform to the terms of a Letter of Credit (if, in the Issuing Lender's good faith judgment, such payment is determined to be appropriate); (xi) the surrender or impairment of any security for the performance or observance of any of the terms of any of the Loan Documents; (xii) the occurrence of any Default or Event of Default; and (xiii) any other circumstance or happening whatsoever, whether or not similar to any of the foregoing. Section 4.4 Computations. All computations of interest on the Loans and of other fees to the extent applicable shall be based on a 360-day year and paid for the actual number of days elapsed. Except as otherwise provided in the definition of the term "Interest Period" with respect to LIBOR RateTerm SOFR Loans, whenever a payment hereunder or under any of the other Loan Documents becomes due on a day that is not a Business Day, the due date for such payment shall be extended to the next succeeding Business Day, and interest shall accrue during such extension; provided, however, that if such due date is the Maturity Date, such payment shall be due on the immediately preceding Business Day. The outstanding Loans and Letter of Credit Liabilities as reflected on the records of Administrative Agent from time to time shall be considered prima facie evidence of such amount absent manifest error. Section 4.5 Suspension of LIBOR Rate LoansTemporary Inability to Determine Rates. Subject to Section 4.15 below, in the event that, prior to the commencement of any Interest Period relating to any LIBOR Rate Loan, Administrative Agent shall determine that adequate and reasonable methods do not exist for ascertaining LIBOR for suchIf (A) the Administrative Agent reasonably and in good faith determines (which determination shall be conclusive and binding absent manifest error) that Adjusted Daily Simple SOFR or Adjusted Term SOFR cannot be determined pursuant to the definition thereof or (B) the Majority Lenders determine that for any reason in connection with any request for a SOFR Rate Loan or a conversion thereto or a continuation thereof that Adjusted Daily Simple SOFR or Adjusted Term SOFR for any requested Interest Period with respect to a proposed Term SOFR Loan does not adequately and fairly reflect the cost to such Lenders of funding such Loan, and the Majority Lenders have provided notice of such determination to the Administrative Agent, in each case of (A) and (B), on or prior to the first day of any Interest Period, orthe Administrative Agent shall reasonably and in 86 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 good faith determine that LIBOR will not accurately and fairly reflect the cost to the Lenders of making or maintaining LIBOR Rate Loans for suchwill promptly so notify the Borrowers and each Lender. Upon notice thereof by the Administrative Agent to the Borrowers, (i) any obligation of the Lenders to make or continue the applicable SOFR Rate Loans or to convert Base Rate Loans to SOFR Rate Loans shall be suspended (to the extent of the affected Interest Period,Periods) until the Administrative Agent shall forthwith giverevokes such notice ofand (ii) if such determination (which shall be conclusive and binding on Borrowers and the Lenders) to Parent and the Lenders. In such event (a) any Loan Request with respect to a LIBOR Rate Loan shall be automatically withdrawn and shallaffects the calculation of the Base Rate, the Administrative Agent shall during the period of such suspension compute the Base Rate without reference to clause (iii) of the definition of "Base Rate" until the Administrative Agent revokes such notice. Upon receipt of such notice, (i) the Borrowers may revoke any pending request for a borrowing of, conversion to or continuation of any applicable SOFR Rate Loans (to the extent of the affected SOFR Rate Loans or affected Interest Periods) or, failing that, the Borrowers will be deemed to have converted any such request into a request for a borrowing of or conversion to Base Rate LoanLoans in the amount specified therein and (bii) each LIBORany outstanding affected SOFR Rate LoanLoans will automatically, onbe deemed to have been converted into Base Rate Loans at the last dayend of the then currentapplicable Interest Period applicable thereto, become a Base Rate Loan, and the obligations of the Lenders to make LIBOR Rate Loans shall be suspended until. Upon any such conversion, the Borrowers shall also pay accrued interest on the amount so converted, together with any additional amounts required pursuant to Section 4.7. If the Administrative Agent determines in its good faith discretion that the circumstances giving rise to such suspension no longer exist, whereupon Administrative Agent shall so notify Parent and the Lenders(which determination shall be conclusive and binding absent manifest error) that "Adjusted Term SOFR" cannot be determined pursuant to the definition thereof on any given day, the interest rate on Base Rate Loans shall be determined by the Administrative Agent without reference to clause (iii) of the definition of "Base Rate" until the Administrative Agent revokes such determination. Section 4.6 Illegality. Notwithstanding any other provisions herein, if any present or future law, regulation, treaty or directive or the interpretation or application thereof shall make it unlawful, or any central bank or other Governmental Authority having jurisdiction over a Lender or its LIBORApplicable Lending Office shall assert that it is unlawful, for any Lender, in such Lender's good faith discretion, to make or maintain LIBORSOFR Rate Loans, such Lender shall forthwith give notice of such circumstances to Administrative Agent and Parent and thereupon (a) the commitment of the Lenders to make LIBORSOFR Rate Loans or convert Loans of another Type to LIBORSOFR Rate Loans shall forthwith be suspended and (b) the LIBOR Rate Loans(i) any such Term SOFR Loan then outstanding shall be converted automatically to Base Rate Loansinto (X) a Daily Simple SOFR Loan so long as the Adjusted Daily Simple SOFR is not also the subject of this Section 4.6 or (Y) a Base Rate Loan if the Adjusted Daily Simple SOFR also is the subject of this Section 4.6, in each case, on the last day of each Interest Period applicable to such LIBOR Rate LoansTerm SOFR Loan (or the next succeeding Business Day if such day is not a Business Day) or within such earlier period as may be required by law, and (ii) any such Daily Simple SOFR Loan then outstanding shall be converted automatically into a Base Rate Loan upon the occurrence of such event or within such earlier period as may be required by law. Notwithstanding the foregoing, before giving such notice, the applicable Lender shall designate a different lending office if such designation will void the need for giving such notice and will not, in the judgment of such Lender, be otherwise materially disadvantageous to such Lender or increase any costs payable by Borrowers hereunder. Section 4.7 Additional InterestBreakage Compensation. If any LIBOR Rate Loan or any portion thereof is repaid or is converted to a Base Rate Loan for any reason on a date which is prior to the last day of the Interest Period applicable to such LIBOR Rate Loan, including as a result of an acceleration of the Loans pursuant to Section 12.1, or if Borrowers fail to draw down on the first day of 87 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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the applicable Interest Period any amount as to which Borrowers have elected a LIBOR Rate Loan, Borrowers will pay to Administrative Agent upon demand for the account of the applicable Lenders in accordance with their respective Commitment Percentages (or to the Swing Loan Lender with respect to a Swing Loan), in addition to any amounts of interest otherwise payable hereunder, the Breakage Costs. Each Borrower understands, agrees and acknowledges the following: (a) no Lender has any obligation to purchase, sell or match funds in connection with the use of LIBOR as a basis for calculating the rate of interest on a LIBOR Rate Loan; (b) LIBOR is used merely as a reference in determining such rate; and (c) such Borrower has accepted LIBOR as a reasonable and fair basis for calculating such rate and any Breakage Costs. Each Borrower further agrees to pay the Breakage Costs, if any, whether or not a Lender elects to purchase, sell or match funds. The Borrowers shall compensate each Lender upon its written request (which request shall set forth the detailed basis for requesting and the method of calculating such compensation), for all reasonable losses, costs, expenses and liabilities (including, without limitation, any loss, cost, expense or liability incurred by reason of the liquidation or reemployment of deposits or other funds required by such Lender to fund its SOFR Rate Loans but not including any lost profits) which such Lender may sustain in connection with any of the following: (i) if for any reason (other than a default by such Lender or the Administrative Agent) a borrowing of SOFR Rate Loans does not occur on a date specified therefor in a Notice of borrowing or a Notice of Continuation or Conversion; (ii) if any repayment, prepayment, Conversion or Continuation of any SOFR Rate Loan occurs on a date that is not the last day of an Interest Period applicable thereto; (iii) if any prepayment of any of its SOFR Rate Loans is not made on any date specified in a notice of prepayment given by the Borrowers; (iv) as a result of an assignment by a Lender of any SOFR Rate Loan other than on the last day of the Interest Period applicable thereto pursuant to a request by the Borrowers in accordance herewith or (v) as a consequence of (y) any other default by the Borrowers to repay or prepay any SOFR Rate Loans when required by the terms of this Agreement. The written request of any Lender setting forth any amount or amounts that such Lender is entitled to receive pursuant to this Section shall be delivered to the Borrowers and shall be conclusive absent manifest error. The Borrowers shall pay such Lender the amount shown as due on any such request within fifteen (15) days after receipt thereof. Section 4.8 Additional Costs, Etc. Notwithstanding anything herein to the contrary, if any present or future Applicable Law, which expression, as used herein, includes statutes, rules and regulations thereunder and interpretations thereof by any competent court or by any governmental or other regulatory body or official charged with the administration or the interpretation thereof and requests, directives, instructions and notices at any time (or from time to time) hereafter made upon or otherwise issued to any Lender or any Agent by any central bank or other fiscal, monetary or other authority (whether or not having the force of law), shall: (a) subject any Lender or any Agent to any Tax of any nature with respect to this Agreement, the other Loan Documents, such Lender's Commitments, a Letter of Credit or the Loans (other than any Indemnified Tax, any Tax described in clauses (b) through (d) of the definition of Excluded Taxes, and any Connection Income Tax), or (b) impose on any Lender or Issuing Lender or the London interbankrelevant local market for obtaining quotations for any Benchmark, any other condition, cost or expense (other than Taxes) affecting this Agreement or Loans made by such Lender or any Letter of Credit or participation therein, or (c) impose or increase or render applicable any special deposit, compulsory loan, insurance charge, reserve, assessment, liquidity, capital adequacy or other similar requirements (whether or not having the force of law and which are not already reflected in any amounts payable by Borrowers 88 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 hereunder) against assets held by, or deposits in or for the account of, or loans by, or commitments of an office of any Lender, or (d) impose on any Lender or any Agent any other conditions or requirements with respect to this Agreement, the other Loan Documents, the Loans, such Lender's Commitments, a Letter of Credit or any class of loans or commitments of which any of the Loans or such Lender's Commitments forms a part; and the result of any of the foregoing is: (i) to increase the cost to any Lender of making, continuing, converting to, funding, issuing, renewing, extending or maintaining any of the Loans, the Letters of Credit or such Lender's Commitments, or (ii) to reduce the amount of principal, interest or other amount payable to any Lender or any Agent hereunder on account of such Lender's Commitments or any of the Loans or the Letters of Credit, or (iii) to require any Lender or any Agent to make any payment or to forego any interest or other sum payable hereunder, the amount of which payment or foregone interest or other sum is calculated by reference to the gross amount of any sum receivable or deemed received by such Lender or any Agent from Borrowers hereunder, then, and in each such case, Borrowers will, within fifteen (15) days of demand made by such Lender or (as the case may be) Agent at any time and from time to time and as often as the occasion therefor may arise, pay to such Lender or Agent such additional amounts as such Lender or Agent shall determine in good faith to be sufficient to compensate such Lender or Agent for such additional cost, reduction, payment or foregone interest or other sum. Each Lender and Agent in determining such amounts may use any reasonable averaging and attribution methods generally applied by such Lender or Agent. Notwithstanding the foregoing, Borrowers shall not be required to compensate Lenders pursuant to this Section 4.8 for any increased costs incurred or reductions suffered more than six (6) months prior to the date that such Lender notifies Parent of the event giving rise to such increased costs or reductions and such Lender's intent to claim compensation therefor; provided, however, that if any such change giving rise to such increased costs or reduction is retroactive, then the six (6)-month period referred to above shall be extended to include the period of retroactive effect thereof. Section 4.9 Capital Adequacy. If after the date hereof any Lender determines that (a) the adoption of or change in any law, rule, regulation or guideline regarding capital or liquidity ratios or requirements for banks or bank holding companies or any change in the interpretation or application thereof by any Governmental Authority charged with the administration thereof, or (b) compliance by such Lender or its parent bank holding company with any guideline, request or directive of any such entity regarding capital adequacy or liquidity (whether or not having the force of law), has the effect of reducing the return on such Lender's or such holding company's capital or liquidity as a consequence of such Lender's commitment to make Loans or participate in Letters of Credit or Swing Loans hereunder to a level below that which such Lender or holding company could have achieved but for such adoption, change or compliance (taking into consideration such Lender's or such holding company's then existing policies with respect to capital adequacy or liquidity and assuming the full utilization of such entity's capital) by any amount deemed in good faith by such Lender to be material, then such Lender may notify Parent thereof. Borrowers agree to pay to such Lender the amount of such reduction in the return on capital as and when such reduction is reasonably determined, within thirty (30) days of presentation by such Lender of a statement of the amount setting forth such Lender's calculation thereof. In determining such amount, such Lender may use any reasonable averaging and attribution methods generally applied by such Lender. For purposes of Section 4.8 and this Section 4.9, the Dodd-Frank Wall Street Reform 89 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 and Consumer Protection Act and all requests, rules, publications, orders, guidelines and directives thereunder or issued in connection therewith and all requests, rules, guidelines or directives promulgated by the Bank for International Settlements, the Basel Committee on Banking Supervision (or any successor or similar authority) or the United States or foreign regulatory authorities, in each case pursuant to Basel III, shall be deemed to have been adopted and gone into effect after the date hereof regardless of when adopted, enacted or issued. Notwithstanding the foregoing, Borrowers shall not be required to compensate Lenders pursuant to this Section 4.9 for any in good faith reductions suffered more than six (6) months prior to the date that such Lender notifies Parent of the event giving rise to such increased costs or reductions and such Lender's intent to claim compensation therefor; provided, however, that if any such change giving rise to such increased costs or reduction is retroactive, then the six (6)-month period referred to above shall be extended to include the period of retroactive effect thereof. Section 4.10 Breakage CostsIntentionally Omitted. Borrowers shall pay all Breakage Costs required to be paid by it pursuant to this Agreement and incurred from time to time by any Lender upon demand within fifteen (15) days from receipt of written notice from Administrative Agent, or such earlier date as may be required by this Agreement.. Section 4.11 Default Interest; Late Charge. Following the occurrence and during the continuance of any Event of Default, and regardless of whether or not Administrative Agent or the Lenders shall have accelerated the maturity of the Loans, all Loans shall bear interest payable on demand at a rate per annum equal to the sum of the Base Rate plus the Applicable Margin plus four percent (4%) (the "Default Rate"), until such amount shall be paid in full (after as well as before judgment) and the fee payable with respect to Letters of Credit shall be increased to a rate equal to four percent (4%) above the Letter of Credit fee that would otherwise be applicable to such time, or if any of such amounts shall exceed the maximum rate permitted by law, then at the maximum rate permitted by law. In addition, Borrowers shall pay a late charge equal to four percent (4%) of any amount of interest or principal payable on the Loans or any other amounts payable hereunder or under the other Loan Documents, which is not paid by Borrowers within ten (10) days of the date when due; provided, however, that such late charge shall not be payable in connection with a payment of the Loans after the Maturity Date or in connection with an acceleration of the Loans. Section 4.12 Certificate. A certificate setting forth any amounts payable pursuant to Section 4.7, 4.8, 4.9, 4.10 or 4.11 and a reasonably detailed explanation of such amounts which are due, submitted by any Lender or any Agent to Parent, shall be conclusive in the absence of manifest error, and shall be promptly provided to any Agent and Parent upon their written request. Section 4.13 Limitation on Interest. Notwithstanding anything in this Agreement or the other Loan Documents to the contrary, all agreements between or among the Loan Parties, the Lenders and Administrative Agent, whether now existing or hereafter arising and whether written or oral, are hereby limited so that in no contingency, whether by reason of acceleration of the maturity of any of the Obligations or otherwise, shall the interest contracted for, charged or received by the Lenders exceed the maximum amount permissible under applicable law. If, from any circumstance whatsoever, interest would otherwise be payable to the Lenders in excess of the maximum lawful amount, the interest payable to the Lenders shall be reduced to the maximum amount permitted under applicable law; and if from any circumstance the Lenders shall ever receive anything of value deemed interest by applicable law in excess of the maximum lawful amount, an amount equal to any excessive interest shall be applied to the reduction of the principal balance of the Obligations and to the payment of interest or, if such excessive interest exceeds the unpaid balance of principal of the Obligations, such excess shall be refunded to Borrowers. All interest paid or agreed to be paid to the Lenders shall, to the extent permitted by applicable law, be amortized, prorated, allocated and spread throughout the full period until payment in 90 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 full of the principal of the Obligations (including the period of any renewal or extension thereof) so that the interest thereon for such full period shall not exceed the maximum amount permitted by applicable law. This Section 4.13 shall control all agreements between or among any or all of the Loan Parties, the Lenders and Administrative Agent relating to the Loans. Section 4.14 Certain Provisions Relating to Increased Costs. If a Lender gives notice of the existence of the circumstances set forth in Section 4.8 or any Lender requests compensation for any losses, costs or Taxes to be reimbursed or paid pursuant to any one or more of the provisions of Section 4.3, 4.8 or 4.9, then, upon request of Parent, such Lender, as applicable, shall use reasonable efforts in a manner consistent with such institution's practice in connection with loans like the Loan of such Lender to eliminate, mitigate or reduce amounts that would otherwise be payable by Borrowers under the foregoing provisions, including by designating another of such Lender's offices, branches or Affiliates; provided that such action would not be otherwise prejudicial to such Lender, and Borrowers hereby agree to pay all reasonably incurred out-of-pocket costs and expenses incurred by such Lender in connection with any such action. Notwithstanding anything to the contrary contained herein, if no Default or Event of Default shall have occurred and be continuing, if any Lender has given notice of the existence of the circumstances set forth in Section 4.8 or has requested payment or compensation for any losses, costs or Taxes to be reimbursed or paid pursuant to any one or more of the provisions of Section 4.3, 4.8 or 4.9 and following the request of Parent has been unable to take the steps described above to mitigate such amounts (each, an "Affected Lender"), then, within thirty (30) days after such notice or request for payment or compensation, Borrowers shall have the one-time right as to such Affected Lender, to be exercised by delivery of written notice delivered to Administrative Agent and the Affected Lender within thirty (30) days of receipt of such notice, to elect to cause the Affected Lender to transfer its Commitment to an assignee reasonably acceptable to Administrative Agent. Upon any such purchase of the Commitment of the Affected Lender, the Affected Lender's interest in the Obligations and its rights hereunder and under the Loan Documents shall terminate at the date of purchase, and the Affected Lender shall promptly execute all documents reasonably requested to surrender and transfer such interest. The purchase price for the Affected Lender's Commitment shall equal any and all amounts outstanding and owed by Borrowers to the Affected Lender including principal, prepayment premium or fee, and all accrued and unpaid interest or fees. Section 4.15 Successor LIBOR Rate Index. Permanent Ability to Determine Rate; Benchmark Replacement. (a) Replacing USD LIBOR. On March 5, 2021, the Financial Conduct Authority ("FCA"), the regulatory supervisor of USD LIBOR's administrator ("IBA"), announced in a public statement the future cessation or loss of representativeness of overnight/Spot Next, 1-month, 3-month, 6-month and 12-month USD LIBOR tenor settings. On the earliest of (i) July 1, 2023, (ii) the date that all Available Tenors of USD LIBOR have either permanently or indefinitely ceased to be provided by IBA or have been announced by the FCA pursuant to public statement or publication of information to be no longer representative and (iii) the Early Opt-in Effective Date, if the then-current Benchmark is USD LIBOR, the Benchmark Replacement will replace such Benchmark for all purposes hereunder and under any Loan Document in respect of any setting of such Benchmark on such day and all subsequent settings without any amendment to, or further action by or consent of any other party to, this Agreement or any other Loan Document. If the Benchmark Replacement is Daily Simple SOFR, all interest payments will be payable on a monthly basis. (a) (b) Benchmark Replacement Future Benchmarks. If any Benchmark Transition Event occurs after the date hereof (other than as described above with respect to USD LIBOR), the then-current Benchmark will be replaced with the Benchmark Replacement for all purposes hereunder and under any Loan Document in respect of any Benchmark setting on the later of (i) as of. 91 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Notwithstanding anything to the contrary herein or in any other Loan Document, upon the occurrence of a Benchmark Transition Event, the Administrative Agent and the Borrowers may amend this Agreement to replace the then-current Benchmark with a Benchmark Replacement. Any such amendment with respect to a Benchmark Transition Event will become effective at 5:00 p.m. (New York City time) on the fifth (5th) Business Day after the date notice of such Benchmark Replacement is provided to the Lenders and the Borrower or (ii) such other date as may be determined by the Administrative Agent, in each case, without any further action or consent of any other party to this Agreement or any other Loan Document,Administrative Agent has posted such proposed amendment to all Lenders and the Borrowers so long as the Administrative Agent has not received, by such time (or, in the case of clause (ii) above, such time as may be specified by the Administrative Agent as a deadline to receive objections, but in any case, no less than five (5) Business Days after the date such notice is provided to the Lenders and the Borrower), written notice of objection to such Benchmark Replacementamendment from Lenders comprising the Majority Lenders. At any time that the administratorNo replacement of the then-current Benchmark has permanently or indefinitely ceased to provide such Benchmark or such Benchmark has been announced by the regulatory supervisor for the administrator of such Benchmark pursuant to public statement or publication of information to be no longer representative of the underlying market and economic reality that such Benchmark is intended to measure and that representativeness will not be restored, the Borrower may revoke any request for a borrowing of, conversion to or continuation of Loans to be made, converted or continued that would bear interest by reference to suchwith a Benchmark Replacement pursuant to this Section 4.15 will occur prior to the applicable Benchmark Transition Start Date. Unless and until the Borrower's receipt of notice from the Administrative Agent that a Benchmark Replacement has replaced such Benchmark, and, failing that, the Borrower willis effective in accordance with this clause (a), all Loans shall be deemed to have converted any such request into a request for a borrowing of or conversion to Base Rate Loans. During the period referenced in accordance with the foregoing sentence, the component of the Base Rate based upon the Benchmark will not be used in any determination of the Base Rateprovisions of Section 4.5 above. (b) (c) Benchmark Replacement Conforming Changes. In connection with the use, administration, adoption or implementation and administration of a Benchmark Replacement (whether in connection with the replacement of USD LIBOR or any future Benchmark), the Administrative Agent will have the right to make Benchmark Replacement Conforming Changes from time to time and, notwithstanding anything to the contrary herein or in any other Loan Document, any amendments implementing such Benchmark Replacement Conforming Changes will become effective without any further action or consent of any other party to this Agreement or any other Loan Document. (c) (d) Notices; Standards for Decisions and Determinations. The Administrative Agent will promptly notify the BorrowerBorrowers and the Lenders of (i) the implementation of any Benchmark Replacement and (ii) the effectiveness of any Benchmark Replacement Conforming Changes. The Administrative Agent will notify the Borrowers and the removal or reinstatement of any tenor of a Benchmark. Any determination, decision or election that may be made by the Administrative Agent or Lenders pursuant to this Section 4.15, including, without limitation, any determination with respect to a tenor, rate or adjustment, or implementation of any Benchmark Replacement Conforming Changes, the timing of implementation of any Benchmark Replacement or of the occurrence or non-occurrence of an event, circumstance or date and any decision to take or refrain from taking any action, will be conclusive and binding on all parties hereto absent manifest error and may be made in its or their sole discretion and without consent from any other party to this Agreement or any other Loan Documenthereto, except, in each case, as expressly required pursuant to this Section 4.15, and shall not be a basis of any claim of liability of any kind or nature by any party hereto, all such claims being hereby waived individually by each party hereto. 92 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (d) (e) Unavailability of Tenor of Benchmark. AtNotwithstanding anything to the contrary herein or in any other Loan Document, at any time (including in connection with the implementation of a Benchmark Replacement), (i) if theany then-current Benchmark is a term rate (including the Term SOFR or USD LIBOR)Reference Rate) and either (A) any tenor for such Benchmark is not displayed on a screen or other information service that publishes such rate from time to time as selected by the Administrative Agent in its reasonable discretion or (B) the administrator of such Benchmark or the regulatory supervisor for the administrator of such Benchmark has provided a public statement or publication of information announcing that any tenor for such Benchmark is not or will not be representative or in compliance with or aligned with the International Organization of Securities Commissions (IOSCO) Principles for Financial Benchmarks, then the Administrative Agent may modify the definition of "Interest Period" (or any similar or analogous definition) for any Benchmark settings at or after such time to remove any tenor of such Benchmark that is unavailable or, non-representative for such Benchmark (including any Benchmark Replacement) settings, non-compliant or non-aligned tenor and (ii) if sucha tenor becomes available or representative,that was removed pursuant to clause (i) above either (A) is subsequently displayed on a screen or information service for a Benchmark (including a Benchmark Replacement) or (B) is not, or is no longer, subject to an announcement that it is not or will not be representative or in compliance with or aligned with the International Organization of Securities Commissions (IOSCO) Principles for Financial Benchmarks for a Benchmark (including a Benchmark Replacement), then the Administrative Agent may modify the definition of "Interest Period" (or any similar or analogous definition) for all Benchmark settings at or after such time to reinstate anysuch previously removed tenor for such Benchmark (including any Benchmark Replacement) settings. (f) Certain Defined Terms. As used in this Section 4.15: "Available Tenor" means, as of any date of determination and with respect to the then-current Benchmark, as applicable, (x) if the then-current Benchmark is a term rate, any tenor for such Benchmark that is or may be used for determining the length of an Interest Period or (y) otherwise, any payment period for interest calculated with reference to such Benchmark, as applicable, pursuant to this Agreement as of such date. "Benchmark" means, initially, USD LIBOR; provided that if a replacement for the Benchmark has occurred pursuant to this Section 4.15, then "Benchmark" means the applicable Benchmark Replacement to the extent that such Benchmark Replacement has replaced such prior benchmark rate. Any reference to "Benchmark" shall include, as applicable, the published component used in the calculation thereof. "Benchmark Replacement" means, for any Available Tenor: (1) for purposes of clause (a) of this Section 4.15, the first alternative set forth below that can be determined by the Administrative Agent (a) the sum of: (i) Term SOFR and (ii) 0.11448% (11.448 basis points) for an Available Tenor of one-month's duration, 0.26161% (26.161 basis points) for an Available Tenor of three-months' duration, and 0.42826% (42.826 basis points) for an Available Tenor of six-months' duration; or 93 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (b) the sum of: (i) Daily Simple SOFR and (ii) the spread adjustment for an Available Tenor of one-month's duration (0.11448% (11.448 basis points)); and (2) for purposes of clause (b) of this Section 4.15, the sum of: (a) the alternate benchmark rate and (b) an adjustment (which may be a positive or negative value, or zero), in each case, that has been selected pursuant to this clause (2) by the Administrative Agent and the Borrower as the replacement for such Available Tenor of such Benchmark giving due consideration to any evolving or then-prevailing market convention, including any applicable recommendations made by the Relevant Governmental Body, for U.S. dollar-denominated syndicated credit facilities at such time; provided that, if the Benchmark Replacement as determined pursuant to clause (1) or (2) above would be less than the Floor, the Benchmark Replacement will be deemed to be the Floor for all purposes of this Agreement and the other Loan Documents. "Benchmark Replacement Conforming Changes" means, with respect to any Benchmark Replacement, any technical, administrative or operational changes (including changes to the definition of "Base Rate," the definition of "Business Day," the definition of "Interest Period," timing and frequency of determining rates and making payments of interest, timing of borrowing requests or prepayment, conversion or continuation notices, the applicability and length of lookback periods, the applicability of breakage provisions, and other technical, administrative or operational matters) that the Administrative Agent decides may be appropriate to reflect the adoption and implementation of such Benchmark Replacement and to permit the administration thereof by the Administrative Agent in a manner substantially consistent with market practice (or, if the Administrative Agent decides that adoption of any portion of such market practice is not administratively feasible or if the Administrative Agent determines that no market practice for the administration of such Benchmark Replacement exists, in such other manner of administration as the Administrative Agent decides is reasonably necessary in connection with the administration of this Agreement and the other Loan Documents). "Benchmark Transition Event" means, with respect to any then-current Benchmark (other than USD LIBOR), the occurrence of a public statement or publication of information by or on behalf of the administrator of the then-current Benchmark, the regulatory supervisor for the administrator of such Benchmark, the Board of Governors of the Federal Reserve System, the Federal Reserve Bank of New York, an insolvency official with jurisdiction over the administrator for such Benchmark, a resolution authority with jurisdiction over the administrator for such Benchmark or a court or an entity with similar insolvency or resolution authority over the administrator for such Benchmark, announcing or stating that (a) such administrator has ceased or will cease on a specified date to provide all Available Tenors of such Benchmark, permanently or indefinitely, provided that, at the time of such statement or publication, there is no successor administrator that will continue to provide any Available Tenor of such Benchmark or (b) all Available Tenors of such Benchmark are or will no longer be representative of the underlying market and economic reality that such 94 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Benchmark is intended to measure and that representativeness will not be restored. "Daily Simple SOFR" means, for any day, SOFR, with the conventions for this rate (which will include a lookback) being established by the Administrative Agent in accordance with the conventions for this rate recommended by the Relevant Governmental Body for determining "Daily Simple SOFR" for syndicated business loans; provided, that if the Administrative Agent decides that any such convention is not administratively feasible for the Administrative Agent, then the Administrative Agent may establish another convention in its reasonable discretion. "Early Opt-in Effective Date" means, with respect to any Early Opt-in Election, the sixth (6th) Business Day after the date notice of such Early Opt-in Election is provided to the Lenders, so long as the Administrative Agent has not received, by 5:00 p.m. (New York City time) on the fifth (5th) Business Day after the date notice of such Early Opt-in Election is provided to the Lenders, written notice of objection to such Early Opt-in Election from Lenders comprising the Majority Lenders. "Early Opt-in Election" means the occurrence of: (1) a notification by the Administrative Agent to each of the other parties hereto that at least five (5) currently outstanding U.S. dollar-denominated syndicated credit facilities at such time contain (as a result of amendment or as originally executed) a SOFR-based rate (including SOFR, a term SOFR or any other rate based upon SOFR) as a benchmark rate (and such syndicated credit facilities are identified in such notice and are publicly available for review), and (2) the joint election by the Administrative Agent and the Borrower to trigger a fallback from USD LIBOR and the provision by the Administrative Agent of written notice of such election to the Lenders. "Floor" means the benchmark rate floor, if any, provided in this Agreement initially (as of the execution of this Agreement, the modification, amendment or renewal of this Agreement or otherwise) with respect to USD LIBOR. "Relevant Governmental Body" means the Board of Governors of the Federal Reserve System or the Federal Reserve Bank of New York, or a committee officially endorsed or convened by the Board of Governors of the Federal Reserve System or the Federal Reserve Bank of New York, or any successor thereto. "SOFR" means, for any Business Day, a rate per annum equal to the secured overnight financing rate for such Business Day published by the Federal Reserve Bank of New York (or a successor administrator of the secured overnight financing rate) on the website of the Federal Reserve Bank of New York, currently at http://www.newyorkfed.org. (or any successor source for the secured overnight financing rate identified as such by the administrator of the 95 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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secured overnight financing rate from time to time), on the immediately succeeding Business Day. "Term SOFR" means, for the applicable corresponding tenor, the forward-looking term rate based on SOFR that has been selected or recommended by the Relevant Governmental Body. "USD LIBOR" means the London interbank offered rate for U.S. dollars. (e) Benchmark Unavailability Period. Upon the Borrowers' receipt of notice of the commencement of a Benchmark Unavailability Period, the Borrowers may revoke any request for the applicable SOFR Rate Loan of, conversion to or continuation of SOFR Rate Loans to be made, converted or continued during any Benchmark Unavailability Period and, failing that, the Borrowers will be deemed to have converted any such request into a request for a Borrowing of or conversion to Base Rate Loans. During any Benchmark Unavailability Period or at any time that a tenor for the then-current Benchmark is not an Available Tenor, the component of Base Rate based upon Adjusted Term SOFR (or then-current Benchmark) will not be used in any determination of Base Rate. SECTION 5. COLLATERAL SECURITY. Section 5.1 Collateral. The Obligations shall be secured by a perfected first priority lien and security interest to be held by Administrative Agent for the benefit of the Lenders on the Collateral, pursuant to, and in accordance with, the terms of the Security Documents. Section 5.2 Appraisals. (a) At Borrowers' option (but as to any Collateral Property, not more than one time during the term of this Agreement and one time with respect to a Villa Unit complex becoming Eligible Owned Real Estate), Administrative Agent shall, on behalf of the Lenders, obtain current Appraisals of each of the Collateral Properties. Such Appraisals will be ordered by Administrative Agent, in order to determine the current Appraised Value of the Collateral Properties, and Borrowers shall pay to Administrative Agent within ten (10) days of demand all reasonable costs of such Appraisals. For the avoidance of doubt, the Appraisals must be acceptable to Administrative Agent. (b) Administrative Agent may obtain new Appraisals or an update to existing Appraisals with respect to the Real Estate, or any of them, as Administrative Agent shall determine (i) at any time that the regulatory requirements of any Lender generally applicable to real estate loans of the category made under this Agreement as reasonably interpreted by such Lender shall require that such Lender obtain a new or updated Appraisal in order to comply with such regulatory requirements, (ii) in connection with an expansion of a Collateral Property (but only with respect to such Collateral Property), (iii) at any time that a Default or Event of Default has occurred and is continuing, (iv) if Administrative Agent reasonably believes that there has been a casualty (which is not being restored in accordance with the terms of the Loan Documents), Taking or material adverse change or deterioration with respect to a Collateral Property itself (as opposed to a material adverse change in the market in which such Collateral Property is located or other changes in facts or circumstances that do not relate just to such Collateral Property), (v) in connection with a Commitment Increase, (vi) in connection with an extension of the Maturity Date as provided in Section 2.11, and (vii) at the request of the Majority Real Estate Revolving Loan Lenders, one (1) other time during the term of this Agreement. The expense of such Appraisals or updates performed pursuant to (x) Section 5.2(b)(i) and 5.2(b)(vii) shall be borne by Borrowers up to once per twelve (12) month period of the Loans (except upon and during the continuation of an Event of 96 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Default, in which event any and all Appraisals shall be at Borrowers' expense prior to any foreclosure or deed in lieu transaction) and (y) Section 5.2(b)(ii), 5.2(b)(iii), 5.2(b)(iv), 5.2(b)(v) and 5.2(b)(vi) shall be borne by Borrowers and, in each case, payable to Administrative Agent within thirty (30) days following demand. Notwithstanding the foregoing, no Collateral Property shall be appraised more than once in any twelve (12)-month period for purposes of determining Real Estate Borrowing Base Availability. (c) Each Borrower acknowledges that Administrative Agent has the right to approve any Appraisal performed pursuant to this Agreement. Each Borrower further agrees that the Lenders and Administrative Agent do not make any representations or warranties with respect to any such Appraisal and shall have no liability as a result of or in connection with any such Appraisal for statements contained in such Appraisal, including the accuracy and completeness of information, estimates, conclusions and opinions contained in such Appraisal, or variance of such Appraisal from the fair value of such property that is the subject of such Appraisal given by the local tax assessor's office, or such Borrower's idea of the value of such property. Section 5.3 Release of Collateral Properties. Provided no Default or Event of Default shall have occurred hereunder and be continuing (or would exist immediately after giving effect to the transactions contemplated by this Section 5.3), Administrative Agent shall release, upon the request of Parent, (x) from the lien or security title of the Security Documents a Collateral Property and the personal property solely used on or with respect to such Collateral Property and (y) if such Borrower is not an owner or lessee of any other Collateral Property or owner of other Collateral, such Borrower from its obligations as a Borrower under the Credit Agreement and the other Loan Documents, in each case, subject to and upon the following terms and conditions: (a) Parent shall deliver to Administrative Agent, no later than five (5) Business Days prior to the date on which such release is to be effected, written notice of Borrowers' desire to obtain such release; (b) Parent, on behalf of Borrowers shall submit to Administrative Agent with such request a Compliance Certificate prepared using the financial statements of Parent and Trilogy Investors most recently provided or required to be provided to Administrative Agent under Section 6.4 or 7.4 adjusted in the best good faith estimate of Borrowers to give effect to the proposed release and demonstrating that no Default or Event of Default with respect to the covenants set forth in Section 9 referred to therein shall exist after giving effect to such release; (c) If such release is in connection with a sale or refinancing, such sale or refinancing shall be with a Person that is not a Borrower or a Subsidiary thereof; (d) all release documents to be executed by Administrative Agent shall be in form and substance reasonably satisfactory to Administrative Agent; (e) Borrowers shall pay all reasonable, out-of-pocket costs and expenses of Administrative Agent in connection with such release, including reasonable attorney's fees; (f) Borrowers shall pay to Administrative Agent, for the account of the Lenders, a release price, which payment shall be applied, notwithstanding the provisions of Section 3.6, to reduce the outstanding principal balance of the Real Estate Revolving Loans in an amount equal to the amount, if any, necessary for the Aggregate Revolving Credit Obligations to equal or be less than the Real Estate Borrowing Base Availability; 97 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (g) Before and after giving effect to such release, there shall be no violation of the covenant set forth in Section 9.6; (h) Parent, on behalf of Borrowers, shall submit to Administrative Agent with such request a Real Estate Borrowing Base Certificate reflecting the release of such Loan Party's assets from the Lien of Administrative Agent; and (i) In connection with any release of a Collateral Property, Borrowers shall, as a condition to such release, pay any mortgage, recording, intangible, documentary stamp or other similar taxes that Administrative Agent reasonably determines to be payable to a Governmental Authority with respect to the remaining Collateral Properties as a consequence of said release. Notwithstanding the foregoing, in the event that any Collateral Property is to be released, Administrative Agent may condition such release upon the increase of the coverages under the Title Policies for the remaining Collateral Properties to an amount Administrative Agent may reasonably require based upon the fair market value of such remaining Collateral Properties. In the event that a Borrower that is an owner or lessee of a Collateral Property is released as provided in this Section 5.3, then such Person shall not be deemed, subject to the proviso below, a Subsidiary of a Borrower or otherwise bound by the terms of the Loan Documents, provided that for the avoidance of doubt such Person shall be subject to inclusion in the applicable financial covenants of Trilogy Investors and Sections 12.1(f), 12.1(h), 12.1(i), 12.1(j), 12.1(l) and 12.1(p). Section 5.4 Addition of Collateral Properties and Villa Units. (a) After the Closing Date, Borrowers may, upon satisfaction by Borrowers of the conditions set forth in this Section 5.4 and Section 5.5, add Potential Collateral to the Collateral. In the event Borrowers desire to or are required to add additional Potential Collateral as aforesaid, Borrowers shall provide written notice to Administrative Agent of such request (which Administrative Agent shall promptly furnish to the Lenders), together with all documentation and other information required to permit Administrative Agent to determine whether such Real Estate is Eligible Owned Real Estate or Eligible Villa Units, as the case may be. Thereafter, Administrative Agent shall have fifteen (15) Business Days from the date of the receipt of such documentation and other information to advise Borrowers whether Administrative Agent and the Majority Real Estate Revolving Loan Lenders consent to the acceptance of such Potential Collateral. If a Real Estate Revolving Loan Lender shall fail to respond to Administrative Agent within fifteen (15) Business Days from receipt of such documentation and information from Administrative Agent, such Real Estate Revolving Loan Lender shall be deemed to have approved such proposed Potential Collateral. Notwithstanding the foregoing, no Potential Collateral shall be included as Collateral unless and until the following conditions precedent shall have been satisfied: (i) such Potential Collateral shall be Eligible Owned Real Estate or Eligible Villa Units, as the case may be; (ii) if the owner or lessee of any Potential Collateral shall be a Subsidiary of a Borrower, each such Subsidiary shall have satisfied the conditions of Section 5.5; (iii) such Borrower or such Subsidiary, as applicable, shall have executed and delivered to Administrative Agent all Eligible Owned Real Estate Qualification Documents or 98 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Eligible Villa Unit Qualification Documents, as applicable, all of which instruments, documents or agreements shall be in form and substance reasonably satisfactory to Administrative Agent; (iv) after giving effect to the inclusion of such Potential Collateral, each of the representations and warranties made by or on behalf of Borrowers and Guarantors contained in this Agreement, the other Loan Documents or in any document or instrument delivered pursuant to or in connection with this Agreement shall be true in all material respects (except on account of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by this Agreement) both as of the date as of which it was made and shall also be true as of the time of the addition of Collateral Properties or Villa Units, with the same effect as if made at and as of that time (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing, and Administrative Agent shall have received a certificate of Borrowers and the Guarantors to such effect; and (v) other than with respect to any Real Estate listed on Schedule 1.1(b) or Schedule 1.1(c), Administrative Agent shall have consented, and Administrative Agent shall have received the prior written consent of the Majority Real Estate Revolving Loan Lenders to, the inclusion of such Real Estate as a Collateral Property or as Villa Units (or deemed consent as set forth above). (b) Borrowers may, at their option, obtain preliminary approval of the Majority Real Estate Revolving Loan Lenders of Potential Collateral by delivering to Administrative Agent (and Administrative Agent shall deliver the following to the Real Estate Revolving Loan Lenders within three (3) Business Days of receipt) the following with respect to such Potential Collateral: (i) a physical description of the Real Estate (including maps, photographs, market studies and information regarding the market and submarket in which such Real Estate is located); (ii) (A) two (2) years of annual operating statements for such Real Estate, a year-to-date operating statement for such Real Estate and monthly operating statements for such Real Estate for the twelve (12) months most recently completed and (B) a pro forma calculation of Collateral Pool Value and covenant compliance certificate showing the impact of such Real Estate, in each case, reasonably satisfactory to the Majority Real Estate Revolving Loan Lenders; and (iii) a certification to the knowledge of Borrowers that such Real Estate will satisfy (or is anticipated to satisfy upon the acceptance of such Real Estate as a Collateral Property) each of the other conditions to the acceptance of such Real Estate as a Collateral Property. The Majority Real Estate Revolving Loan Lenders shall have fifteen (15) Business Days following receipt of all of the foregoing items to grant or deny preliminary approval for such proposed Potential Collateral. If a Real Estate Revolving Loan Lender shall fail to respond within such fifteen (15) Business Day period, such Real Estate Revolving Loan Lender shall be deemed to have approved such proposed Potential Collateral. Administrative Agent shall notify Parent if and when the Majority Real Estate Revolving Loan Lenders have granted such preliminary approval. In the event that the Majority Real Estate Revolving Loan Lenders grant such preliminary approval, Borrowers and the Guarantors shall satisfy the remaining requirements to the acceptance of such Collateral as provided in Section 5.4(a). Such Real Estate shall not be included in the calculation of the Real Estate Borrowing Base Availability until the requirements of Section 5.4(a) are satisfied. 99 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Section 5.5 Additional Borrowers. (a) In the event that certain Real Estate of a Subsidiary of Parent which is leased to a Wholly-Owned Domestic Subsidiary of OpCo is to be included as a Collateral Property as contemplated by Section 5.4 and such Real Estate is approved for inclusion as a Collateral Property in accordance with the terms hereof, Borrowers shall cause each such Subsidiary that owns or leases such Collateral Property to execute and deliver to Administrative Agent the documents and other items required under Section 7.20, and such Subsidiary shall become a Borrower hereunder. Each such Subsidiary shall be specifically authorized, in accordance with its respective organizational documents, to be a Borrower hereunder and to comply with the requirements of Section 7.20. Borrowers shall further cause all representations, covenants and agreements in the Loan Documents with respect to Borrowers to be true and correct with respect to such Subsidiary. (b) After the Closing Date, Borrowers may, upon satisfaction by Borrowers of the conditions set forth in this Section 5.5(b), add an OpCo Affiliate that is the lessee of a Leasehold Property or a lessee under a Lease to this Agreement and the other Loan Documents as a Borrower. In the event Borrowers desire to or are required to add such OpCo Affiliate as aforesaid, Borrowers shall provide written notice to Administrative Agent and Revolving Agent of such request (which Administrative Agent shall promptly furnish to the Lenders), together with all documentation and other information required to permit Administrative Agent and Revolving Agent to evaluate such OpCo Affiliate as a potential Borrower, including a copy of the applicable Lease. Thereafter, Administrative Agent and Revolving Agent shall have fifteen (15) Business Days from the date of the receipt of such documentation and other information to advise Borrowers whether Administrative Agent, Revolving Agent and the Majority A/R Revolving Loan Lenders consent to the addition of such OpCo Affiliate as a Borrower. If an A/R Revolving Loan Lender shall fail to respond to Administrative Agent and Revolving Agent within fifteen (15) Business Days from receipt of such documentation and information, including a copy of the applicable Lease from Administrative Agent and Revolving Agent, such A/R Revolving Loan Lender shall be deemed to have approved such proposed addition. In the event such OpCo Affiliate is approved for inclusion as a Borrower in accordance with the terms hereof, Borrowers shall cause such OpCo Affiliate to execute or obtain and deliver to Administrative Agent the ground lessor estoppels and intercreditor agreements requested by Administrative Agent (in forms substantively identical to those provided by one or more OpCo Affiliates that are lessees of Leasehold Properties or under a Lease on the Closing Date) and the documents and other items required under Section 7.20, and such OpCo Affiliate shall become a Borrower hereunder. Each such OpCo Affiliate shall be specifically authorized, in accordance with its respective organizational documents, to be a Borrower hereunder and to comply with the requirements of Section 7.20. Borrowers shall further cause all representations, covenants and agreements in the Loan Documents with respect to Borrowers to be true and correct with respect to such OpCo Affiliate. Section 5.6 Release of Collateral. Upon the refinancing or repayment of the Obligations (excluding any contingent indemnification and reimbursement claims not then due) in full, the return of all Letters of Credit and termination of the obligation to provide additional Loans or issue Letters of Credit to Borrowers, Administrative Agent shall release the Collateral from the lien and security interest of the Security Documents and shall release Borrowers other than with respect to any indemnification or reimbursement obligations that expressly survive payment of the Obligations and termination of this Agreement or any of the other Loan Documents, provided that Administrative Agent either (a) has not received a notice from any Bank Product Provider or any Lender Hedge Provider as described in Section 34, or (b) has received notice from the holder of the Hedge Obligations that collateral or other credit support has been provided to such holder in form and substance satisfactory to such holder. 100 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SECTION 6. REPRESENTATIONS AND WARRANTIES. Each Borrower represents and warrants to Administrative Agent and the Lenders as follows. Section 6.1 Corporate Authority, Etc. (a) Formation; Good Standing. Each Borrower, each Guarantor and each of the Subsidiaries of each Borrower (i) is duly organized under the laws of its State of organization and is validly existing and in good standing under the laws thereof, (ii) has all requisite power to own its property and conduct its business as now conducted and as presently contemplated and (iii) is in good standing and is duly authorized to do business in each jurisdiction where it is organized and where, with respect to each Borrower, Real Estate owned or leased by it is located (to the extent required by applicable law) and in each other jurisdiction where a failure to be so qualified could have a Material Adverse Effect. (b) Authorization. The execution, delivery and performance of this Agreement and the other Loan Documents to which any Loan Party is a party and the transactions contemplated hereby and thereby (i) are within the authority of such Person, (ii) have been duly authorized by all necessary proceedings on the part of such Person, (iii) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which such Person is subject or any judgment, order, writ, injunction, license or permit applicable to such Person, (iv) do not and will not conflict with or constitute a default under any provision of the partnership agreement, articles of incorporation or other charter documents or bylaws of such Person, (v) do not and will not conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of any material agreement or other instrument binding upon, such Person or any of its properties, (vi) do not and will not result in or require the imposition of any lien or other encumbrance on any of the properties, assets or rights of such Person other than the Liens in favor of Administrative Agent contemplated by this Agreement and the other Loan Documents, and (vii) do not require the approval or consent of any Person other than those already obtained and delivered to Administrative Agent. (c) Enforceability. This Agreement and the other Loan Documents to which any Loan Party is a party are valid and legally binding obligations of such Loan Party enforceable in accordance with the respective terms and provisions hereof and thereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and general principles of equity. Section 6.2 Governmental Approvals. Other than ministerial notices to be filed with Medicare and Medicaid by the OpCo Affiliates that are Borrowers, if any, in connection with the liens granted to Borrowers pursuant to the Leases or to Administrative Agent pursuant to the Loan Documents, the execution, delivery and performance of this Agreement and the other Loan Documents to which any Borrower or any Guarantor is a party and the transactions contemplated hereby and thereby do not require the approval or consent of, or filing or registration with, or the giving of any notice to, any court, department, board, governmental agency or authority, including with respect to the Primary Licenses, other than those already obtained, the filing of the Security Documents in the appropriate office with respect thereto including any required UCC-1 financing statements, and filings of disclosures with the SEC, or as may be required hereafter with respect to tenant improvements, repairs or other work with respect to any Real Estate. 101 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 6.3 Title to Properties. Except as indicated on Schedule 6.3, Borrowers own all of the assets necessary for the operation of the business of Borrowers, subject only to the Permitted Liens. Section 6.4 Financial Statements. Borrowers have furnished to Administrative Agent: (a) the consolidated balance sheet of Trilogy Investors and its Subsidiaries as of the Balance Sheet Date and the related consolidated statement of income and cash flow for the calendar year then ended certified by the chief financial officer of Trilogy Investors, and (b) certain other financial information relating to the Loan Parties, their respective Subsidiaries and the Collateral, including the Real Estate, as required by Section 10.1. The balance sheet and statements referred to in clauses (a) and (b) above have been prepared in accordance with generally accepted accounting principles and fairly present the consolidated financial condition of Trilogy Investors and its Subsidiaries and Borrowers, respectively, as of such dates and the consolidated results of the operations of Trilogy Investors and its Subsidiaries and Borrowers, respectively, for such periods. There are no liabilities, contingent or otherwise, of Trilogy Investors, any of its Subsidiaries or Borrowers involving material amounts not disclosed in said financial statements and the related notes thereto. Section 6.5 No Material Changes. Since the Balance Sheet Date, no Material Adverse Effect has occurred. Section 6.6 Franchises, Patents, Copyrights, Etc. Borrowers, their respective Subsidiaries and the Guarantors possess all franchises, patents, copyrights, trademarks, trade names, service marks, licenses and permits, and rights in respect of the foregoing, adequate for the conduct of their business substantially as now conducted without known conflict with any rights of others. Except as set forth on Schedule 6.6 or in any Mortgage accepted after the Closing Date, none of the Collateral Properties is owned or operated by Borrowers or their respective Subsidiaries under or by reference to any trademark, trade name, service mark or logo, and none of such trademarks, trade names, service marks or logos set forth on Schedule 6.6 are registered or subject to any license or provision of law limiting their assignability or use except as specifically set forth on Schedule 6.6 or in any Mortgage accepted after the Closing Date. Section 6.7 Litigation. Except as stated on Schedule 6.7, there are no actions, suits, proceedings or investigations of any kind pending or, to the knowledge of any Borrower, threatened in writing against any Borrower or any Subsidiary thereof or any Guarantor before any court, tribunal, arbitrator, mediator or administrative agency or board which question the validity of this Agreement or any of the other Loan Documents, any action taken or to be taken pursuant hereto or thereto, the Collateral or any lien, security title or security interest created or intended to be created pursuant hereto or thereto, or which if adversely determined could reasonably be expected to have a Material Adverse Effect. Except as set forth on Schedule 6.7, there are no judgments, final orders or awards outstanding against or adversely affecting any Borrower, any of their respective Subsidiaries, any Guarantor, or any Collateral as of the Closing Date. No injunction, writ, temporary restraining order or any written order of any nature has been issued by any court or other Governmental Authority purporting to enjoin or restrain the execution, delivery or performance of this Agreement or any other Loan Document, or directing that the transactions provided for herein or therein not be consummated as herein or therein provided. As of the Closing Date, no Loan Party has received written notice that it is the subject of an audit (other than over payments in the ordinary course) by a Governmental Authority or, to any Borrower's knowledge, any investigation or review by a Governmental Authority concerning the violation or possible violation of any Applicable Law, including any Healthcare Law. Section 6.8 No Material Adverse Contracts, Etc. None of any Borrower, any of their respective Subsidiaries nor any Guarantor is subject to any charter, corporate or other legal restriction, or any judgment, decree, order, rule or regulation that has or could reasonably be expected to have a 102 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Material Adverse Effect. None of any Borrower, any of their respective Subsidiaries nor any Guarantor is a party to any contract or agreement that has or could reasonably be expected to have a Material Adverse Effect. Section 6.9 Compliance with Other Instruments, Laws, Etc. No Loan Party is in violation of any provision of its charter or other organizational documents, bylaws, or any agreement or instrument to which it is subject or by which it or any of its properties is bound or any decree, order, judgment, statute, license, law, rule or regulation (excluding Healthcare Laws and Public Health Laws, which laws are covered by Sections 6.32 and 6.33), in any of the foregoing cases in a manner that has had or could reasonably be expected to have a Material Adverse Effect. Section 6.10 Tax Status. Each Loan Party (a) has made or filed all federal and state income tax, property tax and all other material tax returns, reports and declarations required by any jurisdiction to which it is subject to be made or filed, or has obtained an extension for filing, (b) has paid prior to delinquency all real estate taxes and all other material taxes and other governmental assessments and charges shown or determined to be due on such returns, reports and declarations, (c) has paid prior to delinquency all real estate and other material taxes due or purported to be due with respect to the Real Estate and (d) has set aside on its books provisions reasonably adequate for the payment of all material amounts of taxes for periods subsequent to the periods to which such returns, reports or declarations apply or such taxes are due. Except as set forth on Schedule 6.10, there are no unpaid taxes in any material amount claimed in writing to be due from any Loan Party by the taxing authority of any jurisdiction having authority over such Loan Party. Except as set forth on Schedule 6.10, there are no audits pending or, to the knowledge of any Borrower, threatened in writing with respect to any federal and state income tax, property tax or other material tax returns filed by any Loan Party. The taxpayer identification number for each Loan Party is set forth on Schedule 6.10. Section 6.11 No Event of Default. No Default or Event of Default has occurred and is continuing. Section 6.12 Investment Company Act. No Loan Party is an "investment company", or an "affiliated company" or a "principal underwriter" of an "investment company", as such terms are defined in the Investment Company Act of 1940. Section 6.13 Setoff, Etc. The Collateral and the rights of Administrative Agent and the Lenders with respect to the Collateral are not subject to any setoff, claims (except Permitted Liens, to the extent such claims are considered Liens), withholdings or other defenses by any Borrower or any of their respective Subsidiaries and with respect to Accounts, any claims of CMS in the ordinary course which would not otherwise be a violation of the terms of the Loan Documents or, to the best knowledge of Borrowers, any other Person. Section 6.14 Certain Transactions. Except as disclosed on Schedule 6.14, none of the partners, officers, trustees, managers, direct members, directors, or employees of any Borrower, is, nor shall any such Person become, a party to any transaction with any Loan Party or any Affiliate thereof (other than for services as partners, managers, direct members, employees, officers and directors), including any agreement or other arrangement providing for the furnishing of services to or by, providing for rental of real or personal property to or from, or otherwise requiring payments to or from any partner, officer, trustee, director or such employee or, to the knowledge of Borrowers, any corporation, partnership, trust or other entity in which any partner, officer, trustee, director, or any such employee has a substantial interest or is an officer, director, trustee or partner which, with respect to any of the 103 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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foregoing, are on terms less favorable to any Loan Party than those that would be obtained in a comparable arms-length transaction. Section 6.15 Employee Benefit Plans. Each Borrower, each Guarantor and each ERISA Affiliate has fulfilled its obligation, if any, under the minimum funding standards of ERISA and the Code with respect to each Employee Benefit Plan, Multiemployer Plan or Guaranteed Pension Plan and is in compliance in all material respects with the presently applicable provisions of ERISA and the Code with respect to each Employee Benefit Plan, Multiemployer Plan or Guaranteed Pension Plan. Neither any Borrower, any Guarantor nor any ERISA Affiliate has (a) sought a waiver of the minimum funding standard under Section 412 of the Code in respect of any Employee Benefit Plan, Multiemployer Plan or Guaranteed Pension Plan, (b) failed to make any material contribution or payment to any Employee Benefit Plan or any contribution or payment to any Multiemployer Plan or Guaranteed Pension Plan, or made any amendment to any Employee Benefit Plan, Multiemployer Plan or Guaranteed Pension Plan, which has resulted or could result in the imposition of a Lien or the posting of a bond or other security under ERISA or the Code, or (c) incurred any liability under Title IV of ERISA other than a liability to the PBGC for premiums under Section 4007 of ERISA. None of the assets of any Borrower or any of their Subsidiaries, including any Collateral Property, constitutes a Plan Asset of any Employee Benefit Plan, Multiemployer Plan or Guaranteed Pension Plan. Section 6.16 Disclosure. All of the representations and warranties made by or on behalf of any Loan Party in this Agreement and the other Loan Documents or any document or instrument delivered to any Agent or the Lenders pursuant to or in connection with any of such Loan Documents are true and correct in all material respects, and no Loan Party has failed to disclose such information as is necessary to make such representations and warranties not misleading. All written information contained in this Agreement, the other Loan Documents or otherwise furnished to or made available to any Agent or the Lenders by or on behalf of any Loan Party, as supplemented to date, is and, when delivered, will be true and correct in all material respects and, as supplemented to date, does not, and when delivered will not, contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements contained therein not misleading. The written information, reports and other papers and data with respect to any Borrower, any Guarantor, any Subsidiary of any Borrower or any Guarantor or the Collateral, including the Collateral Properties (other than projections and estimates) furnished to any Agent or the Lenders in connection with this Agreement or the obtaining of the Commitments of the Lenders hereunder is correct in all material respects and does not, taken together with all written information furnished, contain any untrue statement of a material fact or omit a material fact necessary to make the statements not materially misleading in light of the circumstances under which such statements were made, or has been subsequently supplemented by other written information, reports or other papers or data, to the extent necessary to give in all material respects a true and accurate knowledge of the subject matter in all material respects; provided that such representation shall not apply to (a) the accuracy of any appraisal, title commitment, survey, or engineering and environmental reports prepared by third parties or legal conclusions or analysis provided by Borrowers' or the Guarantors' counsel (although Borrowers and the Guarantors have no reason to believe that any Agent and the Lenders may not rely on the accuracy thereof) or (b) budgets, projections and other forward-looking speculative information prepared in good faith by Borrowers. All financial projections concerning Borrowers or their Subsidiaries that have been furnished to any Agent or Lenders have been prepared in good faith based upon reasonable assumptions believed to be reasonable at the time made. Section 6.17 Trade Name; Place of Business. Except as disclosed on Schedule 6.17, neither any Borrower nor any Guarantor uses any trade name and conducts business under any name other than its actual name set forth in the Loan Documents. The principal place of business of the Loan Parties is Forum Office Park II, 303 N. Hurstbourne Parkway, Suite 200, Louisville, Kentucky 40222. 104 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 6.18 Regulations T, U and X. No portion of any Loan or Letter of Credit is to be used for the purpose of purchasing or carrying any "margin security" or "margin stock" as such terms are used in Regulations T, U and X of the Board of Governors of the Federal Reserve System, 12 C.F.R. Parts 220, 221 and 224. Neither any Borrower nor any Guarantor is engaged, nor will it engage, principally or as one of its important activities, in the business of extending credit for the purpose of purchasing or carrying any "margin security" or "margin stock" as such terms are used in Regulations T, U and X of the Board of Governors of the Federal Reserve System, 12 C.F.R. Parts 220, 221 and 224. Section 6.19 Environmental Compliance. Each Borrower has obtained and provided to Administrative Agent, or in the case of Collateral Properties acquired after the Closing Date will obtain and provide to Administrative Agent, written environmental site assessment reports of the Environmental Engineer, which reports shall be in form and substance satisfactory to Administrative Agent (collectively, the "Environmental Reports"). Except as set forth in the Environmental Reports with respect to the Collateral Properties, each Borrower makes the following representations and warranties: (a) None of Borrowers nor their respective Subsidiaries nor any Operator of the Real Estate, nor any tenant or operations thereon, is in violation, or alleged violation, of any judgment, decree, order, law, license, rule or regulation pertaining to environmental matters, including those arising under any Environmental Law, which violation involves any Collateral Property. (b) None of Borrowers nor any of their respective Subsidiaries has received notice from any third party including any Governmental Authority, (i) that it has been identified by the United States Environmental Protection Agency ("EPA") as a potentially responsible party under CERCLA with respect to a site listed on the National Priorities List, 40 C.F.R. Part 300 Appendix B (1986); (ii) that any Hazardous Substance(s) which it has generated, transported or disposed of have been found at any site at which a federal, state or local agency or other third party has conducted or has ordered that any Borrower or any of their respective Subsidiaries conduct a remedial investigation, removal or other response action pursuant to any Environmental Law; or (iii) that it is or shall be a named party to any claim, action, cause of action, complaint, or legal or administrative proceeding (in each case, contingent or otherwise) arising out of any third party's incurrence of costs, expenses, losses or damages of any kind whatsoever in connection with any Release, which in any case involves any Collateral Property and has not been fully remediated without any ongoing responsibilities (including monitoring) or liability. (c) (i) No portion of any Collateral Property has been used for the handling, processing, storage or disposal of Hazardous Substances except in accordance with applicable Environmental Laws, and no underground tank or other underground storage receptacle for Hazardous Substances is located on any portion of such Collateral Property except those which are being operated and maintained in compliance with Environmental Laws; (ii) in the course of any activities conducted by Borrowers, their respective Subsidiaries or the Operator of their properties, no Hazardous Substances have been generated or are being used on any Collateral Property except in the ordinary course of business of Borrowers and their respective Subsidiaries, or the Operator of such Collateral Property, and in accordance with applicable Environmental Laws; (iii) there has been no past or present Release or threatened Release of Hazardous Substances on, upon, into or from any Collateral Property which Release would have a material adverse effect on the value of such Collateral Property or adjacent properties; (iv) there have been no Releases on, upon, from or into any real property in the vicinity of any of the Collateral Properties which, through soil or groundwater contamination, may have come to be located on and which could be reasonably anticipated to have a material adverse effect on the value of, any Collateral Property; and (v) any Hazardous Substances that have been generated on any of the Collateral Properties have been transported off-site in accordance with all applicable Environmental Laws. 105 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (d) None of Borrowers, their respective Subsidiaries nor any Collateral Property is subject to any applicable Environmental Law requiring the performance of Hazardous Substances site assessments, or the removal or remediation of Hazardous Substances, or the giving of notice to any governmental agency or the recording or delivery to other Persons of an environmental disclosure document or statement in each case by virtue of the transactions set forth herein and contemplated hereby, or as a condition to the recording of the Mortgages or to the effectiveness of any other transactions contemplated hereby, except for such matters with which Borrowers and their respective Subsidiaries shall have complied of the Closing Date. (e) There are no existing or closed sanitary landfills, solid waste disposal sites, or hazardous waste treatment, storage or disposal facilities on or affecting any Collateral Property. (f) No Borrowers, nor to Borrower's knowledge, any other Operator has received a written claim by any party that any use, operation, or condition of any Collateral Property has caused any nuisance or any other liability or adverse condition on any other property, nor, to Borrower's knowledge, is there any basis for such a claim, which is reasonably likely to have a Material Adverse Effect. Section 6.20 Subsidiaries; Organizational Structure. Schedule 6.20(a) sets forth, as of the Closing Date, the ownership of Trilogy Investors (as reflected thereon but to no higher tiers), the direct subsidiaries of Trilogy Investors (including Parent and each other Guarantor), Borrowers and all of the Subsidiaries of Borrowers, the form and jurisdiction of organization of each of such Persons, and the direct and indirect ownership thereof (other than any higher tiers now shown thereon). Schedule 6.20(b) sets forth, as of the Closing Date, all of the Unconsolidated Affiliates of Borrowers and their Subsidiaries, the form and jurisdiction of organization of each of the Unconsolidated Affiliates, the applicable Borrower's or its Subsidiary's ownership interest therein and the other owners of the applicable Unconsolidated Affiliate. No Person owns any legal, equitable or beneficial interest in any of the Persons set forth on Schedules 6.20(a) and 6.20(b) except as set forth on such Schedules. Each lessee of a Collateral Property is an OpCo Affiliate that is a Borrower and all such Real Estate is operated and managed by EIK Manager. Section 6.21 Leases; Management Agreements; Key Principal. (a) An accurate and complete Lease and Facility Occupancy Report as of the most recent month ending prior to the acceptance of any Collateral Property or Villa Unit in the calculation of Real Estate Borrowing Base Availability with respect to each Collateral Property and the Villa Units on each Collateral Property has been provided to Administrative Agent. The Leases and the occupancy agreements reflected on such Facility Occupancy Report constitute as of the date thereof the sole agreements relating to leasing or use or occupancy licensing of such Senior Care Property relating thereto (other than subleases and sublicenses for providers of resident services, such as haircare, under immaterial subleases and sublicenses, and occupancy agreements with patients or residents). Except as reflected on such Facility Occupancy Report or on Schedule 6.21(a), no tenant under any Lease is entitled to any free rent, partial rent, rebate of rent payments, credit, offset or deduction in rent, including lease support payments, lease buy-outs or abatements or credits. The Leases and the occupancy agreements reflected in the Facility Occupancy Report are in full force and effect in accordance with their respective terms, without any payment default (beyond any applicable notice and cure period) or any other material default under such Leases (beyond any applicable notice and cure period), or any other default under such occupancy agreements (beyond any applicable notice and cure period), nor are there any defenses, counterclaims, offsets, concessions, rebates, tenant improvement allowances, contributions or landlord construction obligations available to any tenant thereunder, and, except as reflected in Schedule 6.21(a), no Loan Party has given or made any notice of any payment or other material default, or any claim, which remains uncured or unsatisfied, with respect to any of the Leases, and to the best of 106 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 the knowledge and belief of each Borrower, there is no basis for any such claim or notice of default by any tenant. Except as reflected in Schedule 6.21(a) as to the Collateral Properties as of the Closing Date or as approved by Administrative Agent for Collateral Properties added after the Closing Date, no property, other than the Collateral Property which is the subject of the applicable Lease under which a Borrower is a lessor, is necessary to comply with the requirements (including parking requirements) contained in such Lease. An OpCo Affiliate that is a Borrower is the lessee under each Lease of a Collateral Property by a Borrower. There is no sublease or sublicense at any Collateral Property except for subleases in connection with an IGT Transaction, Permitted Subleases and occupancy agreements with patients or residents. (b) Borrowers have delivered a true and correct copy of each Lease under which any Loan Party is a party with respect to a Collateral Property as lessee or lessor, as amended, to Administrative Agent as of the date the applicable property becomes a Collateral Property and no such Lease has been modified, amended or assigned after the Closing Date except as otherwise expressly provided herein. There are no rights of a Borrower as lessor under a Lease to terminate such Lease other than such lessor's right to terminate by reason of default, casualty, condemnation or other reasons, in each case as expressly set forth in the applicable Lease. Each such Lease is in full force and effect, except as otherwise expressly permitted under Section 8.16, and no payment or material breach or other material default or event that with the giving of notice or passage of time would constitute a breach or default under the applicable Lease exists or has occurred on the part of any Loan Party thereof or on the part of the lessor under any such Lease. No Borrower has received any written notice that a payment or other material default or event of default under any such Lease has occurred or exists, or that any lessor or lessee or any third party alleges the same to have occurred or exist. Except as reflected on Schedule 6.21(b), a Borrower is the exclusive owner of the lessee's interest under and pursuant to each Lease under which any Borrower is the lessee and has not assigned, sublet, transferred or encumbered its interest in, to, or under such Lease. (c) True and correct copies of all Management Agreements in place as of the Closing Date or later date upon which an applicable property becomes a Collateral Property have been delivered to Administrative Agent, and a list of all such Management Agreements as of the Closing Date is set forth on Schedule 6.21(c). All such Management Agreements are in full force and effect and no payment or other material default or event of default exists thereunder. (d) EIK Manager is managed by a Key Principal, and Randall J. Bufford and Leigh Ann Barney are each a Key Principal as of the Closing Date; provided Lenders acknowledge Randall J. Bufford may elect not to be a Key Principal following the Closing Date. Section 6.22 Real Estate. (a) All Real Estate owned or leased by Borrowers as of the Closing Date is listed on Schedule 6.22(a), including, for each parcel of Real Estate, its address, its Operator(s) and, to the extent not one of the foregoing, any lessor, lessee, sublessor and sublessee of the Real Estate (other than sublessees and sublicensees for providers of resident services, such as haircare, under immaterial subleases and sublicenses, patients and residents). (b) Except as set forth on Schedule 6.22(b) and the property condition reports and Surveys and Title Policies for the Collateral Properties delivered to Administrative Agent on or before the Closing Date, (i) all of the Buildings, and all major building systems located therein, are structurally sound, in good condition and working order and free from material defects, subject to ordinary wear and tear and repairs and replacement in the ordinary course, (ii) the Real Estate, and the use and operation thereof, is in material compliance with all applicable federal and state law and governmental regulations 107 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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and any applicable local ordinances, orders or regulations, including laws, regulations and ordinances relating to zoning, building codes, subdivision, fire protection, health, safety, handicapped access, historic preservation and protection, wetlands and tidelands (but excluding for purposes of this Section 6.22(b), Environmental Laws), (iv) all water, sewer, electric, gas, telephone and other utilities necessary for the use and operation of Collateral Properties are installed to the property lines of the Real Estate through dedicated public rights of way or through perpetual private easements approved by Administrative Agent with respect to which, as applicable, the applicable Mortgage creates a valid and enforceable first lien (subject to Liens permitted by Section 8.2(v)) and, except in the case of drainage facilities, are connected to the Building located thereon with valid permits and are adequate to service the Building in material compliance with applicable law, (v) the streets abutting each Collateral Property are dedicated and accepted public roads, to which such Collateral Property has direct access, or are perpetual private ways to which the Collateral Property has direct access approved by Administrative Agent and with respect to which, as applicable, the applicable Mortgage creates a valid and enforceable first lien, (vi) to the extent applicable, sufficient private ways providing access to each Collateral Property are zoned in a manner which will permit access to the Building on such Collateral Property over such ways, (vii) there are no unpaid or outstanding real estate or other taxes or assessments on or against any of the Real Estate which are payable by any Borrower or any of their respective Subsidiaries (except only real estate or other taxes or assessments, that are not yet delinquent or are being protested as expressly permitted by this Agreement), (viii) each Real Estate asset is separately assessed for purposes of real estate tax assessment and payment, (ix) there are no unpaid or outstanding real estate or other taxes or assessments on or against any other property of Borrowers or any of their respective Subsidiaries which are payable by any of such Persons in any material amount (except only real estate or other taxes or assessments, that are not yet delinquent or are being protested as expressly permitted by this Agreement), (x) there are no pending, or to the knowledge of Borrowers, threatened in writing, eminent domain proceedings against any Real Estate, (xi) none of the Buildings is now damaged as a result of any fire, explosion, accident, flood or other casualty, (xii) none of Borrowers or any of their respective Subsidiaries has received any outstanding notice from any insurer or its agent requiring performance of any work with respect to any of the Real Estate or canceling or threatening to cancel any policy of insurance, and each of the Real Estate assets complies with the material requirements of all of Borrowers' and their respective Subsidiaries' insurance carriers, (xiii) no person or entity has any right or option to acquire any Real Estate or any Building thereon or any portion thereof or interest therein, (xiv) no Collateral Property is subject to a Management Agreement that has not been delivered to Administrative Agent, (xv) no Collateral Property is subject to a Management Agreement that does not comply with the terms of this Agreement, (xvi) there are no material claims or any bases for material claims in respect of any Real Estate or its operation by any party to any service agreement or Management Agreement, and (xvii) there are no material agreements (excluding Leases or subleases permitted under this Agreement) not otherwise terminable upon thirty (30) days' notice pertaining to any Real Estate, any Building thereon or the operation or maintenance of either thereof other than as described in this Agreement (including the Schedules hereto) or, as applicable, the Title Policies. No default or event of default exists under any Management Agreement. (c) No change with respect to any Real Estate securing the obligations under the Original Credit Agreement and which is a Collateral Property under this Agreement that would be shown by a current Survey has occurred since the Survey obtained for such Real Estate in connection with the Original Credit Agreement. Section 6.23 Brokers. No Guarantor or Borrower has engaged or otherwise dealt with any broker, finder or similar entity in connection with this Agreement or the Loans contemplated hereunder. Section 6.24 Other Debt. As of the Closing Date, (a) no Loan Party is in default of the payment of any Indebtedness, the performance of any related agreement, mortgage, deed of trust, security 108 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 agreement, financing agreement, indenture or lease to which any of them is a party, (b) no Indebtedness of any Loan Party has been accelerated and (c) no Borrower has, directly or indirectly, any Investments in, or obligations owed to, any of its Affiliates (other than the Loan Documents and the joint and several obligations of the Loan Parties thereunder, and Leases, as landlord or tenant, by a Borrower with any of its OpCo Affiliates that are Borrowers that are in full force and effect as of the Closing Date). No Loan Party is a party to or bound by any agreement, instrument or indenture that may require the subordination in right or time or payment of any of the Obligations to any other indebtedness or obligation of any Borrower or Guarantor. Schedule 6.24 sets forth all agreements, mortgages, deeds of trust, financing agreements or other material agreements binding upon each Loan Party or the Collateral Properties and entered into by such Loan Party as of the Closing Date with respect to any Indebtedness of any Loan Party in an amount greater than $5,000,000.00, and Borrowers have notified Administrative Agent of such documents and provided Administrative Agent with such true, correct and complete copies thereof as requested by Administrative Agent. Section 6.25 Solvency. As of the Closing Date and after giving effect to the transactions contemplated by this Agreement and the other Loan Documents, including all Loans made or to be made hereunder, each Loan Party is Solvent. Section 6.26 No Bankruptcy Filing. No Loan Party is contemplating either the commencement of an Insolvency Proceeding or the liquidation of its assets or property, and no Borrower has any knowledge of three (3) or more Persons contemplating the commencement of an Insolvency Proceeding against it or any other Loan Party. Section 6.27 No Fraudulent Intent. Neither the execution and delivery of this Agreement or any of the other Loan Documents nor the performance of any actions required hereunder or thereunder is being undertaken by any Borrower or Guarantor with or as a result of any actual intent by any of such Persons to hinder, delay or defraud any entity to which any of such Persons is now or will hereafter become indebted. Section 6.28 Transaction in Best Interests of Borrowers and Guarantors; Consideration. The transaction evidenced by this Agreement and the other Loan Documents is in the best interests of each Borrower and Guarantor. Borrowers and Guarantors are engaged in common business enterprises and will derive substantial direct and indirect benefit from the effectiveness and existence of this Agreement. The direct and indirect benefits to inure to each Borrower and Guarantor pursuant to this Agreement and the other Loan Documents constitute substantially more than "reasonably equivalent value" (as such term is used in Section 548 of the Bankruptcy Code) and "valuable consideration," "fair value," and "fair consideration" (as such terms are used in any applicable state fraudulent conveyance law), in exchange for the benefits to be provided by Borrowers and Guarantors pursuant to this Agreement and the other Loan Documents, and but for the willingness of Guarantors to guaranty the Loans in accordance with the terms hereof and the other Loan Documents, Borrowers would be unable to obtain the financing contemplated hereunder which financing will enable each Borrower and Guarantor to have available financing to conduct and expand their business. Section 6.29 Contribution Agreement. Borrowers and Guarantors have executed and delivered the Contribution Agreement, and the Contribution Agreement constitutes the valid and legally binding obligations of such parties enforceable against them in accordance with the terms and provisions thereof, except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and except to the extent that availability of the remedy of specific performance or injunctive relief is subject to the discretion of the court before which any proceeding therefor may be brought. 109 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 6.30 Representations and Warranties of Borrowers. No Borrower has any knowledge that any of the representations or warranties of any other Loan Party contained in any Loan Document to which such other Loan Party is a party are untrue or inaccurate in any material respect. Section 6.31 OFAC. No Loan Party or, to the knowledge of Borrowers, any of their respective directors, officers, employees, agents, advisors or Affiliates (a) is (or will be) a Person: (i) that is, or is owned or controlled by Persons that are: (x) the subject or target of any Sanctions or (y) located, organized or resident in a country or territory that is, or whose government is, the subject of Sanctions, including, without limitation Crimea, Cuba, Iran, North Korea and Syria or (ii) with whom any Lender is restricted from doing business under OFAC (including, those Persons named on OFAC's Specially Designated and Blocked Persons list) or under any statute, executive order (including the September 24, 2001 Executive Order Blocking Property and Prohibiting Transactions With Persons Who Commit, Threaten to Commit, or Support Terrorism), or other governmental action and (b) is not and shall not engage in any dealings or transactions or otherwise be associated with any such Person (any such Person, a "Designated Person"). In addition, Borrowers hereby agree to provide to the Lenders any additional information that a Lender reasonably deems necessary from time to time in order to ensure compliance with all applicable Laws (including, without limitation, any Sanctions) concerning money laundering and similar activities. Neither any Loan Party nor any director or officer of Loan Party or, to the knowledge of Borrowers, any Affiliate, agent or employee of any Loan Party, has engaged in any activity or conduct which would violate any applicable anti-bribery, anti-corruption or anti-money laundering laws or regulations in any applicable jurisdiction, including without limitation, any Sanctions. Section 6.32 Healthcare Representations. (a) Except as set forth on Schedule 6.32, each Borrower, each Senior Care Property, each Operator and each Ancillary Service provided at any Senior Care Property by any Person, as applicable: (i) has and maintains in full force and effect all Primary Licenses required, in each case, to operate each Senior Care Property and provide each Ancillary Service at each Senior Care Property in compliance with applicable law, and no such Primary License is currently restricted, limited, placed in provisionary or probationary status, suspended, revoked or terminated; (ii) is in compliance with all applicable Healthcare Laws and all other laws and requirements of Governmental Authorities having jurisdiction over the Ancillary Services performed at any Senior Care Property or included in the Ancillary Services Borrowing Base Value or any Senior Care Property, as applicable, including: (A) licensure requirements; (B) minimum staffing requirements; (C) health and fire safety codes, including quality and safety standards; (D) accepted professional standards and principles that apply to professionals providing Ancillary Services at any Senior Care Property or included in the Ancillary Services Borrowing Base Value or other services at each Senior Care Property; (E) those relating to the prevention of fraud and abuse; (F) government payment program requirements, conditions of participation and disclosure of ownership and related information reporting requirements; (G) requirements relating to the Senior Care Properties' physical structure, environment, quality and adequacy of medical care and licensing, equipment, personnel, rate setting and fee splitting; and (H) those related to payment or reimbursement for any Ancillary Service performed at any Senior Care Property or for care or service provided by Operators with respect to the Senior Care Properties, except in any of the foregoing cases where the failure to comply is in process of remediation pursuant to a written plan of correction remitted to or accepted by the appropriate Governmental Authority and such failure to comply could not reasonably be expected, directly or indirectly, or with the passage of time (1) to have a Material Adverse Effect on any Senior Care Property or a material adverse effect on any Borrower's or any Operator's ability to accept or retain patients or residents, provide Ancillary Services 110 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 at any Senior Care Property or included in the Ancillary Services Borrowing Base Value or receive payment or reimbursement for care or services provided at, or operate, any Senior Care Property for its current use or result in a lower rate certification or a lower reimbursement rate for services rendered to eligible patients or residents, (2) to adversely modify, limit or result in the transfer, suspension, revocation, non-renewal or imposition of probationary use or other limitation of any of the Primary Licenses, (3) to adversely affect any Borrower's, or any Operator's continued participation in the Medicaid or Medicare programs or any other Third Party Payor Programs in which such Person participates in connection with any Senior Care Property, or any successor programs thereto, at then current rates, (4) to result in any material civil or criminal penalty or remedy, or (5) to result in the appointment of a receiver or manager for any Senior Care Property; or in any of the above cases, which has not otherwise been cured prior to the Closing Date; and (iii) has and maintains all records required to be maintained by it or with respect thereto under the Healthcare Laws and Public Health Laws for each Senior Care Property or the Ancillary Services provided thereon. (b) No waivers of any laws, rules, regulations or requirements (including minimum square foot requirements per bed) are required for the Real Estate, Borrowers, their Subsidiaries or the Operators to operate in compliance with applicable law, which have not already been obtained and delivered to Administrative Agent, and which waivers are reasonably satisfactory to Administrative Agent. (c) All Primary Licenses, and, unless Borrowers have elected, with respect to a Third Party Payor Program with an Insurer, to no longer participate in such program, all Medicaid Provider Agreements, Medicare Provider Agreements, TRICARE provider agreements and other Third Party Payor Program provider agreements or similar agreement, as the case may be, with respect to each Senior Care Property are in full force and effect and in the name of a Borrower or Operator, as appropriate, including approved provider status in any Third Party Payor Program in which any Borrower, any Subsidiary of any Borrower or any Operator participates. If and to the extent that any Borrower or any Operator have been or are required to make any filing, submission or notice with, or to take any other action to obtain approval from, any Governmental Authority or Third Party Payor Program in connection with the acquisition of any Primary License or Permit, all such filings, submissions, notices or actions have been fully made or taken. (d) Except as set forth on Schedule 6.32, there are no, and there have been no written notices with respect to, violations, statements of charges or deficiencies, penalties or fines, in each case by or against any Borrower, any Senior Care Property, any Ancillary Service performed at any Senior Care Property, any Operator with respect to such Senior Care Property or any officer, director, employee or agent of any of them, or any Healthcare Investigations or any other inquiries, reviews, investigations, probes, reviews, audits or proceedings by any Governmental Authority, Third Party Payor Program in which any such Person participates or any other third party or any patient, employee or resident (including whistleblower suits, or suits brought pursuant to federal or state "false claims acts" and Medicaid, Medicare or state fraud or abuse laws), that in any of the above cases is reasonably likely directly or indirectly, or with the passage of time (i) to have a Material Adverse Effect on any Senior Care Property or a material adverse effect on any Borrower's or any Operator's ability to accept or retain patients or residents, provide Ancillary Services at any Senior Care Property or included in the Ancillary Services Borrowing Base Value or receive payment or reimbursement for care or services provided at, or operate, any Senior Care Property for its current use or result in a lower rate certification or a lower reimbursement rate for services rendered to eligible patients or residents, (ii) to adversely modify, limit or result in the transfer, suspension, revocation, non-renewal or imposition of probationary use or other limitation of any of the Primary Licenses, (iii) to adversely affect any Borrower's, or any Operator's 111 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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thereto, including its governance responsibilities as Member of its Subsidiaries and granting a Lien on its property pursuant to the Security Agreement. Section 6.39 Michigan Lessees. As of the Closing Date, each Michigan Lessee is a holder of a certificate of need properly issued by the Michigan Department of Health and Human Services ("MDHHS") and is the holder of nursing home license properly issued by the Michigan Department of Licensing and Regulatory Affairs to operate the applicable Collateral Property as a Senior Care Property and with the number of beds approved as of the Closing Date under the Lease in effect as of the Closing Date. The transactions contemplated by the Loan Documents shall not cause the suspension, loss, termination or review of any such certificate of need or license held by a Michigan Lessee. SECTION 7. AFFIRMATIVE COVENANTS. Each Borrower covenants and agrees that, so long as any Obligation is outstanding or any Lender has any obligation to make any Loans or issue Letters of Credit: Section 7.1 Punctual Payment. Each Borrower will duly and punctually pay or cause to be paid the principal and interest on the Loans and all interest and fees provided for in this Agreement, all in accordance with the terms of this Agreement and the Notes, as well as all other sums owing pursuant to, and in accordance with, the Loan Documents. Section 7.2 Maintenance of Office. Each Borrower and each Guarantor will maintain their respective chief executive office at 303 N. Hurstbourne Parkway, Suite 200, Louisville, Kentucky 40222, or at such other place in the United States as any Borrower or any Guarantor shall designate, upon thirty (30) days prior written notice to Administrative Agent and the Lenders, where notices, presentations and demands to or upon such Borrower or such Guarantor in respect of the Loan Documents may be given or made. Section 7.3 Records and Accounts. Each Borrower and each Guarantor will (a) keep, and cause each of their respective Subsidiaries to keep, true and accurate records and books of account, including with respect to IGT Accounts, in which full, true and correct entries will be made in accordance with GAAP, subject to adjustments in accordance with GAAP, and (b) maintain adequate accounts and reserves for all taxes (including income taxes), depreciation and amortization of its properties, contingencies and other reserves, with respect to the Collateral Properties and business. Neither any Borrower, any Guarantor nor any of their respective Subsidiaries shall, without the prior written consent of Administrative Agent, (x) make any material change to the accounting policies/principles used by such Person in preparing the financial statements and other information described in Section 6.4 or 7.4, or (y) change its fiscal year. Administrative Agent and the Lenders acknowledge that Borrowers' and Guarantors' fiscal year is a calendar year. Section 7.4 Financial Statements; Borrowing Base Information; other Certificates and Information. (a) Borrowers will deliver or cause to be delivered to Administrative Agent (and Revolving Agent, as applicable), in form and substance satisfactory to Administrative Agent (and Revolving Agent, as applicable): (i) not later than one-hundred twenty (120) days after the end of each fiscal year of Trilogy Investors, (A) the audited consolidated balance sheet of Trilogy Investors and its Subsidiaries at the end of such year, and the related audited consolidated statements of income, shareholders' equity, changes in capital and cash flows for such year, setting forth in comparative form 116 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 the figures for the previous fiscal year and all such statements to be in reasonable detail, prepared in accordance with GAAP, together with a certification by the chief financial officer or chief accounting officer of Parent and Trilogy Investors that the information contained in such financial statements fairly presents the financial position of Trilogy Investors and its Subsidiaries, and accompanied by an auditor's report prepared without qualification (other than a qualification permitted by the Securities and Exchange Commission regarding the internal controls of a company acquired during such period pursuant to a material acquisition by a Borrower or any of its Subsidiaries) as to the scope of the audit by a nationally recognized accounting firm reasonably approved by Administrative Agent and who shall have authorized Trilogy Investors and Parent to deliver such financial statements and report thereof to Administrative Agent and the Lenders, and (B) within a reasonable period of time following request therefor, any other information the Lenders may reasonably request to complete a financial analysis of Trilogy Investors and its Subsidiaries; (ii) not later than forty-five (45) days after the end of each fiscal quarter of Trilogy Investors (including the fourth quarter of each fiscal year), copies of the unaudited consolidated balance sheet of Trilogy Investors and its Subsidiaries, at the end of such quarter, and the related unaudited consolidated statements of income, unaudited consolidated balance sheet and cash flows for the portion of Trilogy Investors' fiscal year then elapsed, each setting forth in comparative form the figures for the previous fiscal year and all in reasonable detail and prepared in accordance with GAAP, together with a certification by the chief financial officer or chief accounting officer of Trilogy Investors that the information contained in such financial statements fairly presents the financial position of Trilogy Investors and its Subsidiaries on the date thereof (subject to year-end adjustments) (it being understood that the delivery of quarterly reports on Form 10-Q or reports on Form 6-K (or any successor or comparable forms) of Trilogy Investors shall satisfy the requirements of this Section 7.4(a)(ii) to the extent such reports include the information specified herein); (iii) simultaneously with the delivery of the financial statements referred to in Sections 7.4(a)(i) and 7.4(a)(ii), (A) a Real Estate Borrowing Base Certificate in the form of Exhibit J (a "Real Estate Borrowing Base Certificate") pursuant to which Borrowers shall calculate the amount of the Real Estate Borrowing Base Availability as of the end of the immediately preceding calendar month and a statement (a "Compliance Certificate") certified by the chief financial officer or chief accounting officer of Parent, in the form of Exhibit L (or in such other form as Administrative Agent may approve from time to time) setting forth in reasonable detail computations evidencing compliance or non-compliance (as the case may be) with the covenants contained in Section 9 and the other covenants described in such certificate and (if applicable) setting forth reconciliations to reflect changes in GAAP since the Balance Sheet Date and with all necessary back-up calculations, including the lessee's and sublessee's property level operating statements, rent rolls, occupancy reports and any other information Agent may reasonably request relating to the Collateral Properties. All income, expense and value associated with Real Estate or other Investments or operations acquired or disposed of during any quarter will be adjusted, where applicable, (B) (1) the Total Adjusted EBITDA (Real Estate), Total Adjusted EBITDAR (Real Estate) and cash flow for the Senior Care Properties of Borrowers, on a property-by-property basis, and a summary thereof in form satisfactory to Administrative Agent as of the end of each calendar quarter (including the fourth calendar quarter in each year), (2) a copy of each Lease or amendment to any Lease entered into with respect to a Senior Care Property or any other Real Estate during such calendar quarter (including the fourth calendar quarter in each year), and (3) other 117 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 evidence reasonably required by Administrative Agent to determine compliance with the covenants contained in Section 9, (C) a statement listing (1) for each Senior Care Property owned by a Borrower as of the Closing Date, the net operating income and, if applicable, the IGT UPL Payments thereof, (2) for each parcel of Real Estate acquired after the Closing Date, the aggregate acquisition cost thereof, the location thereof, the date such parcel was acquired, the net operating income thereof and the appraised value thereof, and (3) the Indebtedness of Trilogy Investors and its Subsidiaries and Borrowers and their Subsidiaries (excluding Indebtedness of the type described in Sections 8.1(a) through 8.1(d), 8.1(f) and 8.1(k) through 8.1(p)), which statement shall include, if changed since the prior disclosure pursuant to this Section 7.4(a)(iii)(C) or Section 6.24, the current principal amount of such Indebtedness outstanding, the holder, the maturity date, any extension options, and the interest rate thereof, the collateral provided for such Indebtedness and whether such Indebtedness is Recourse Indebtedness or Non-Recourse Indebtedness, (D) a management discussion and analysis prepared by Trilogy Investors for the period covered by such financial statements, (E) financial statements for Borrowers' Senior Care Properties (other than balance sheets), including statements of income and expenses, utilization reports, quarterly census information of each separate parcel of Real Estate as of the end of such quarterly period in sufficient detail to show patient-mix, occupancy, payor mix and per diems (private pay, Medicare, Medicaid and other, and the Ancillary Services of Borrowers and their Subsidiaries), setting forth in each case in comparative form the figures for the corresponding periods in the previous fiscal year, all in reasonable detail, prepared in accordance with GAAP applicable to quarterly financial statements generally, to the extent applicable, and certified by an Authorized Officer as fairly presenting, in all material respects, the financial position of the operations at each separate Senior Care Property being reported on and their results of operations and cash flows, and (iv) not later than one-hundred twenty (120) days after the end of each fiscal year of Trilogy Investors, an internally-prepared schedule listing, on a property-by-property basis, all Real Estate of Trilogy Investors and its Subsidiaries; (v) within twenty (20) days after the end of each fiscal quarter, a Facility Occupancy Report, on a property-by-property basis, and a summary thereof in form satisfactory to Administrative Agent as of the end of each calendar quarter (including the fourth calendar quarter in each year); (vi) promptly following Administrative Agent's request, after they are filed with the Internal Revenue Service, copies of any annual federal income tax returns and amendments thereto of each Loan Party thereof; (vii) notice of any audits pending or threatened in writing with respect to any tax returns filed by any Guarantor, any Borrower or any of Borrowers' Subsidiaries promptly following notice of such audit; (viii) upon the written request of Administrative Agent, evidence of the timely payment of all real estate taxes for the Senior Care Properties and all sales taxes and payroll taxes of Borrowers; 118 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (ix) no later than sixty (60) days after the beginning of each fiscal year of Trilogy Investors, a quarter-by-quarter projected operating budget and cash flow of Trilogy Investors and its Subsidiaries and of Borrowers for such fiscal year (including an income statement for each month and a balance sheet as at the end of the last month in each fiscal quarter), such budget and cash flow to be accompanied by a certificate signed by the chief financial officer or chief accounting officer of Trilogy Investors to the effect that to his/her knowledge such budget and cash flow have been prepared on the basis of sound financial planning practice consistent with past budgets and financial statements and that such officer has no reason to question the reasonableness of any material assumptions on which such budget and cash flow were prepared; (x) no later than twenty (20) days after the end of each month (provided that if (i) an Event of Default exists or (ii) the Aggregate A/R Revolving Credit Obligations are equal to or greater than eighty percent (80%) of the A/R Borrowing Base Availability, such items shall be provided weekly (no later than the 3rd Business Day of such week)), (A) an executed A/R Borrowing Base Certificate in the form of Exhibit K (an "A/R Borrowing Base Certificate"), (B) a detailed aging, by total, of Borrowers' Accounts, together with a reconciliation and supporting documentation for any reconciling items noted (delivered electronically in an acceptable format, if Borrowers have implemented electronic reporting), (C) a detailed calculation of those Accounts that are not Eligible Accounts, if Borrowers have not implemented electronic reporting, (D) a summary aging, by vendor, of Borrowers' accounts payable and any book overdraft (delivered electronically in an acceptable format) and an aging, by vendor, of any held checks, (E) estimates of Accounts which are subject to offset by CMS or any other Governmental Authority and (F) a reconciliation of the Trilogy Investors, LLC consolidated Accounts and accounts payable, and Revolving Agent shall (x) confirm to Administrative Agent that the A/R Borrowing Base Certificate is acceptable, or notify Parent and Administrative Agent of any changes thereto, within five (5) Business Days after receipt thereof and (y) notify Administrative Agent promptly with respect to any changes in reserves and Eligible Account criteria that Revolving Agent implements that result in a change in A/R Borrowing Base Availability; (xi) not later than forty-five (45) days after the end of each quarter, a quarterly Account roll-forward with supporting details supplied from sales, journals, collection journals, credit registers and other records, in a format acceptable to Revolving Agent in its reasonable discretion, tied to the beginning and ending account receivable balances of each Borrower's general ledger; (xii) not later than forty-five (45) days after the end of each fiscal quarter of Trilogy Investors (including the fourth quarter of each fiscal year), copies of the unaudited and unconsolidated balance sheet of the Trilogy Pharmacy Companies and the Trilogy Rehab Companies, at the end of such quarter, and the related unaudited and unconsolidated statements of income, unaudited and unconsolidated balance sheet and cash flows for the portion of such Person's fiscal year then elapsed, each setting forth in comparative form the figures for the previous fiscal year and all in reasonable detail and prepared in accordance with GAAP, including, together with a certification by the chief financial officer or chief accounting officer of Paragon and PCA, respectively, that the information contained in such financial statements fairly presents the financial position of the Trilogy Pharmacy Companies and the Trilogy Rehab Companies respectively, on the date thereof (subject to year-end adjustments); (xiii) within five (5) Business Days of receipt, copies of any written claim made with respect to any Non-Recourse Exclusion; (xiv) without limiting the terms of Section 2.10 and Section 2.11, a completed and executed Beneficial Ownership Certification if requested by Administrative Agent or any Lender at 119 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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any time Administrative Agent or such Lender determines that it is required by law to obtain such certification; (xv) within five (5) Business Days of the occurrence of any of the following: (A) receipt of written notice by any Borrower or any Subsidiary of any Borrower that any Borrower or any Subsidiary of any Borrower, or any owner, officer, director or managing employee or Person with a "direct or indirect ownership interest" (as that phrase is defined in 42 C.F.R. §420.201) in any Borrower or any Subsidiary of any Borrower: (1) is subject to any investigations or audits (including cost reports or similar audits regarding the valuation of receivables payments) conducted by any federal, state or county Governmental Authority or its agents or designees, (2) has had a civil monetary penalty assessed pursuant to 42 U.S.C. §1320a-7a or is the subject of a proceeding seeking to assess such penalty; (3) has been excluded from participation in a Federal Health Care Program (as that term is defined in 42 U.S.C. §1320a-7b) or is the subject of a proceeding seeking to assess such penalty; (4) has been convicted (as that term is defined in 42 C.F.R. §1001.2) of any of those offenses described in 42 U.S.C. §1320a-7b or 18 U.S.C. §§669, 1035, 1347, 1518 or is the subject of a proceeding seeking to assess such penalty; or (5) has been named in a U.S. Attorney complaint made pursuant to the False Claims Act under 31 U.S.C. §§3729-3731 or in any qui tam action brought pursuant to 31 U.S.C. §3729 et seq.; (B) receipt of written notice by any Borrower or any Subsidiary of any Borrower of (1) any material reduction to any rate for reimbursement under any Third Party Payor Program, (2) any claim to recover any alleged overpayments with respect to any Accounts in excess of $250,000 and (3) any material validation review, program integrity review or material reimbursement audits related to any Borrower or any Subsidiary of any Borrower in connection with any material Third Party Payor Program; or the written disclosure by any Borrower or any Subsidiary of a Borrower to the Office of the Inspector General of the United States Department of Health and Human Services, or any Third Party Payor Program (including to any intermediary, carrier or contractor of such program), of an overpayment involving the submission of claims in an amount greater than $250,000; (C) receipt of written notice by any Borrower or any Subsidiary of any Borrower from an accrediting organization that any Borrower or any Subsidiary of any Borrower is (1) subject to or is required to file a plan of correction with respect to any accreditation survey, or (2) in danger of losing its accreditation due to a failure to comply with a plan of correction, to the extent that, in either case of clauses (1) and (2), any such loss of accreditation would, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect; (D) receipt of written notice by any Borrower or any Subsidiary of a Borrower of the pending or threatened imposition of any material fine or penalty by any Governmental Authority under any Healthcare Law against any Borrower or any Subsidiary of any Borrower that would, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect; (E) receipt of written notice by any Borrower or any Subsidiary of a Borrower of any pending or threatened revocation, suspension, termination, probation, restriction, denial, or non-renewal with respect to any Primary License or Third Party Payor Program, except as would not, individually or in the aggregate, reasonably be expected to have a Material Adverse Effect; (F) any non-routine and material inspection of any facility of any Borrower or any Subsidiary of any Borrower by any Governmental Authority; 120 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (G) submission of any insurance claim in an amount in excess of $250,000 by a Borrower to the applicable insurer, and (H) notice of entering into any settlement agreement or other extended payment agreement with CMS or any Account Debtor under a Government Receivable; (xvi) (A) within five (5) Business Days after the date that any Authorized Officer of any Borrower or any of their Affiliates determines that any proceeds of property or business interruption insurance or condemnation awards will be paid in connection with any Senior Care Property and (B) within one (1) Business Day after the date that any Borrower actually receives proceeds of property or business interruption insurance or condemnation awards in connection with any Senior Care Property or such proceeds were deposited into a Deposit Account of a Borrower, notice thereof; (xvii) promptly following a request by Revolving Agent, (A) such other reports as to the Collateral or the financial condition of Borrowers, (B) notice of all claims, offsets, or disputes asserted by Account Debtors with respect to Borrowers' Accounts in excess of $250,000 and (C) copies of invoices, and credit memos together with corresponding supporting documentation, with respect to invoices and credit memos in excess of an amount determined in the sole discretion of Revolving Agent, from time to time; (xviii) promptly following receipt by a Borrower, copies of all reports, financial information and other performance and census data received pursuant to the Management Agreements; and (xix) from time to time, such other financial data and information in the possession of Borrowers or any of their Subsidiaries or any Guarantor (including auditors' management letters, status of litigation or investigations against any Borrower or any of their Subsidiaries or any Guarantor and any settlement discussions relating thereto, property inspection and environmental reports and information as to zoning and other legal and regulatory changes affecting Borrower or any of their Subsidiaries or any Guarantor) as Administrative Agent may reasonably request. (b) Each Borrower shall use commercially reasonable efforts to deliver to Administrative Agent and, as applicable, Revolving Agent, upon the request of Administrative Agent or Revolving Agent, as applicable, materials or information provided by or on behalf of such Borrower or Guarantor in a format that allows Administrative Agent or Revolving Agent, as applicable to distribute materials or information through an Electronic System (as defined below). Documents required to be delivered pursuant to the Loan Documents shall be delivered by or on behalf of such Borrower or Guarantor to Administrative Agent and, as applicable, Revolving Agent, and the Lenders (collectively, "Information Materials") pursuant to this Section 7.4. Any material to be delivered pursuant to this Section 7.4 may be delivered electronically directly to Administrative Agent, Revolving Agent and the Lenders provided that such material is in a format reasonably acceptable to Administrative Agent, and as applicable, Revolving Agent, and such material shall be deemed to have been delivered to Administrative Agent, or as to materials to be delivered to Revolving Agent, to Revolving Agent, and the Lenders upon Administrative Agent's or Revolving Agent's receipt thereof, as applicable. Upon the request of Administrative Agent, and as applicable, Revolving Agent, Borrowers shall deliver paper copies thereof to Administrative Agent, Revolving Agent and the Lenders. Each Borrower authorizes Administrative Agent, Revolving Agent, and Co-Lead Arrangers to disseminate any such materials, including the Information Materials through the use of Intralinks, SyndTrak, Debtdomain or any other electronic information dissemination system (an "Electronic System") to the other Lenders and potential Lenders. Any such Electronic System is provided "as is" and "as available." Administrative Agent, Revolving Agent and Co-Lead Arrangers do not warrant the adequacy of any Electronic System and expressly 121 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 disclaim liability for errors or omissions in any notice, demand, communication, information or other material provided by or on behalf of any Borrower or any Guarantor that is distributed over or by any such Electronic System ("Communications") except to the extent solely caused by Administrative Agent's or Revolving Agent's or Co-Lead Arranger's gross negligence or willful misconduct (as determined in a final, non-appealable decision by a court having competent jurisdiction). No warranty of any kind, express, implied or statutory, including any warranty of merchantability, fitness for a particular purpose, non-infringement of third-party rights or freedom from viruses or other code defects, is made by Administrative Agent, Revolving Agent or Co-Lead Arrangers in connection with the Communications or the Electronic System. In no event shall Administrative Agent, Revolving Agent, Co-Lead Arrangers or any of their directors, officers, employees, agents or attorneys have any liability to any Borrower, any Guarantor, any Lender or any other Person for damages of any kind, including direct or indirect, special, incidental or consequential damages, losses or expenses (whether in tort, contract or otherwise) arising out of the any Borrower's, any Guarantor's, Administrative Agent's, Revolving Agent's or Co-Lead Arrangers' transmission of Communications through the Electronic System, and Borrowers and the Guarantors release Administrative Agent, Revolving Agent, Co-Lead Arrangers and the Lenders from any liability in connection therewith. Section 7.5 Notices. (a) Defaults. Borrowers will, within five (5) Business Days of becoming aware of same, notify Administrative Agent in writing of the occurrence of any Default or Event of Default, which notice shall describe such occurrence with reasonable specificity and shall state that such notice is a "notice of default". If any Person shall give any notice of the existence of a claimed default or take any other action in respect of a claimed default (whether or not constituting an Event of Default) under this Agreement or under any note, evidence of indebtedness, indenture or other obligation to which or with respect to which any Borrower, any Guarantor or any of their respective Subsidiaries is a party or obligor, whether as principal or surety, and such default would permit the holder of such note or obligation or other evidence of indebtedness to accelerate the maturity thereof, which acceleration would either cause an Event of Default or have a Material Adverse Effect, Borrowers shall forthwith give written notice thereof to Administrative Agent and each of the Lenders, describing the notice or action and the nature of the claimed default. (b) Environmental Events. Borrowers will give notice to Administrative Agent within five (5) Business Days of any Borrower becoming aware of (i) any potential or known Release, or threat of Release, of any Hazardous Substances in violation of any applicable Environmental Law at a Collateral Property; (ii) any violation of any Environmental Law that any Borrower or any of their respective Subsidiaries reports in writing or is reportable by such Person in writing (or for which any written report supplemental to any oral report is made) to any federal, state or local environmental agency relating to a Collateral Property or (iii) any inquiry, proceeding, investigation, or other action, including a notice from any agency of potential environmental liability, of any federal, state or local environmental agency or board, that in any case involves (A) a Collateral Property or (B) Administrative Agent's Liens on the Collateral pursuant to the Security Documents. (c) Notification of Claims Against Collateral. Borrowers will give notice to Administrative Agent in writing within five (5) Business Days of becoming aware of any material setoff, claims (including environmental claims), withholdings or other defenses to which any of the Collateral, or the rights of Administrative Agent or the Lenders with respect to the Collateral, are subject. (d) Notice of Litigation and Judgments. Borrowers will give notice to Administrative Agent in writing within five (5) Business Days of becoming aware of any litigation or proceedings threatened in writing or any pending litigation and proceedings affecting any Borrower, any 122 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Guarantor or any of their respective Subsidiaries or to which any Borrower, any Guarantor or any of their respective Subsidiaries is or is to become a party involving an uninsured claim against any Borrower, any Guarantor or any of their respective Subsidiaries that could either reasonably be expected to cause an Event of Default or could reasonably be expected to have a Material Adverse Effect and stating the nature and status of such litigation or proceedings. Borrowers will give notice to Administrative Agent, in writing, in form and detail reasonably satisfactory to Administrative Agent and each of the Lenders, within ten (10) days of any judgment not covered by insurance, whether final or otherwise, against any Borrower or any of its Subsidiaries in an amount in excess of $2,500,000.00. (e) ERISA. Borrowers will give notice to Administrative Agent within ten (10) Business Days after any Borrower, any Guarantor or any ERISA Affiliate (i) gives or is required to give notice to the PBGC of any "reportable event" (as defined in Section 4043 of ERISA) with respect to any Guaranteed Pension Plan, Multiemployer Plan or Employee Benefit Plan, or knows that the plan administrator of any such plan has given or is required to give notice of any such reportable event; (ii) gives a copy of any notice of complete or partial withdrawal liability under Title IV of ERISA; or (iii) receives any notice from the PBGC under Title IV of ERISA of an intent to terminate or appoint a trustee to administer any such plan. (f) Notices of Default Under Leases and Management Agreement. Borrowers will give notice to Administrative Agent in writing within five (5) Business Days after any Borrower (i) receives written notice from a Borrower or an OpCo Affiliate under a Lease of a Collateral Property of a default by a Borrower as the landlord or tenant under such Lease, (ii) delivers a written notice to any landlord or tenant under a Lease of a Collateral Property of a default by such landlord or tenant under its Lease, (iii) receives written notice from EIK Manager or any other Person a party to a Management Agreement of a default by a Borrower under such Management Agreement, or (iv) delivers a written notice to EIK Manager or any other Person under a Management Agreement of a default by such Person under such Management Agreement. (g) Governmental Authority Notices. (i) Borrowers will give prompt written notice to Administrative Agent (A) of the institution of any investigation, review or proceeding against any Borrower, any of its Subsidiaries or any Operator to suspend, revoke or terminate (or that could reasonably be expected to result in the suspension, revocation or termination of) any Medicare Provider Agreement, Medicaid Provider Agreement or any other agreement or participation with another Third Party Payor Program in which any such Person participates (unless Borrowers have elected, with respect to a Third Party Payor Program with an Insurer, to no longer participate in such program), (B) of the institution of any other investigation, review or proceeding against any Borrower or any of its Subsidiaries or any Operator under any Healthcare Law that could result in a Material Adverse Effect or a Material Adverse Effect on any Senior Care Property, (C) of any notice of loss or threatened (in writing) (other than relating to survey tags and plans of correction in the ordinary course) loss of (1) any material accreditation or certification or (2) any participation under any Third Party Payor Program (unless Borrowers have elected, with respect to a Third Party Payor Program with an Insurer, to no longer participate in such program), (D) if any Primary License becomes provisionary, probationary or is made subject to material restrictions or (E) of any other Healthcare Investigation that could reasonably be expected to result in a Material Adverse Effect or a Material Adverse Effect on any Senior Care Property, and, in each case, any non-privileged information reasonably requested by Administrative Agent in connection with the foregoing. (ii) Borrowers will give written notice to Administrative Agent within five (5) Business Days of any Operator of receiving any documents, correspondence or written notice from any Governmental Authority where such document, correspondence or notice relates to threatened or 123 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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actual change or development that could reasonably be expected to have a Material Adverse Effect or a Material Adverse Effect on any Senior Care Property. (iii) upon the written request of Administrative Agent, Borrowers will, and will cause each Operator to, give Administrative Agent copies of all Medicare and Medicaid cost reports with respect to the Senior Care Properties and the Ancillary Services provided at the Senior Care Properties or included in the Ancillary Services Borrowing Base Value that are subject to such request. (iv) upon the written request of Administrative Agent, Borrowers will, and will cause each Operator to, give Administrative Agent copies of the most recent Department of Health (or similar entity) surveys from the States in which the Senior Care Properties are operated with respect to the Senior Care Properties, including follow-up revisits, plans of corrective actions and letters indicating that the Senior Care Properties are in substantial compliance with the requirements of the Department of Health (or similar entity) of the applicable State. (h) Notification of Lenders. Within five (5) Business Days after receiving any notice under this Section 7.5, Administrative Agent will forward a copy thereof to each of the Lenders, together with copies of any certificates or other written information that accompanied such notice. Section 7.6 Existence; Maintenance of Properties. (a) Except as expressly permitted under Sections 8.4 and 8.8, each Borrower will preserve and keep in full force and effect their legal existence as a single purpose, bankruptcy remote entity in the jurisdiction of its incorporation or formation. Each Guarantor will preserve and keep in full force and effect its legal existence in the jurisdiction of its incorporation or formation. Each Borrower and each Guarantor will preserve and keep in full force all of their rights and franchises and those of their respective Subsidiaries, the preservation of which is necessary to the conduct of their business. (b) Each Borrower and each Guarantor (i) will cause all of its properties and those of the Subsidiaries of Borrowers used or useful in the conduct of its or their business to be maintained and kept in good condition, repair and working order (ordinary wear and tear excepted) and supplied with all necessary equipment, and (ii) will cause to be made all necessary repairs, renewals, replacements, betterments and improvements thereof, in each case, to the extent necessary to the conduct of its business. Section 7.7 Insurance; Condemnation. (a) Each Borrower will, and will cause each Operator to (to the extent not duplicative), at its expense, procure and maintain for the benefit of each Borrower, such Operator and Administrative Agent, insurance policies issued by such insurance companies, in such amounts, in such form and substance, and with such coverages, endorsements, deductibles and expiration dates as are reasonably acceptable to Administrative Agent, providing the following types of insurance covering each Collateral Property: (i) "Cause of Loss-Special Form" property insurance (including broad form flood, broad form earthquake, coverage from loss or damage arising from windstorm, hail and acts of terrorism, and comprehensive boiler and machinery coverages) on each Building and on the contents of each Building of Borrowers in an amount not less than one hundred percent (100%) of the full replacement cost of each Building and the contents therein of Borrowers, or such other amount as Administrative Agent may approve in its reasonable discretion, with deductibles not to exceed $55,000.00 for any one occurrence, with a replacement cost coverage endorsement, an agreed amount 124 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 endorsement, and, if reasonably requested by Administrative Agent, a contingent liability from operation of building laws endorsement in such amounts as Administrative Agent may reasonably require. Full replacement cost as used herein means the cost of replacing the Building (exclusive of the cost of excavations, foundations and footings below the lowest basement floor) and the contents therein of Borrowers without deduction for physical depreciation thereof; (ii) During the course of construction or repair of any Building, the insurance required by clause (i) above shall be written on a builders risk, completed value, non-reporting form, meeting all of the terms required by clause (i) above, covering the total value of work performed, materials, equipment, machinery and supplies furnished, existing structures, and temporary structures being erected on or near the Collateral Property, including coverage against collapse and damage during transit or while being stored off-site, and containing a soft costs (including loss of rents) coverage endorsement and a permission to occupy endorsement; (iii) Flood insurance if at any time any Building is located in any federally designated "special hazard area" (including any area having special flood, mudslide or flood-related erosion hazards, and shown on a Flood Hazard Boundary Map or a Flood Insurance Rate Map published by the Federal Emergency Management Agency as Zone A, AO, Al-30, AE, A99, AH, VO, V1-30, VE, V, M or E) and the broad form flood coverage required by clause (i) above is not available, in an amount equal to the full replacement cost or the maximum amount then available under the National Flood Insurance Program; (iv) (A) Rent loss insurance in an amount sufficient to recover at least the total estimated gross receipts from all sources of income, including rental income, for the Collateral Property for a twelve (12) month period, and (B) business interruption insurance in an amount sufficient to recover at least the total estimated gross receipts from all sources of income (less any avoided expenses) for each Borrower for a twelve (12) month period with an extended period of recovery provision covering at least 180 days following the resumption of operations; (v) Commercial general liability insurance against claims for personal injury (to include bodily injury and personal and advertising injury) and property damage liability, all on a claims-made basis, with such coverages as Administrative Agent may reasonably request (including contractual liability coverage, completed operations coverage for a period of two (2) years following completion of construction of any improvements on the Collateral Property, and coverages at least as broad as an ISO broad form endorsement or a substitute form providing equivalent coverage), coverage not less than $1,000,000 per occurrence, $3,000,000 general aggregate limit, $3,000,000 products-completed operations and $10,000 medical payments; (vi) During the course of construction or repair of any improvements on the Collateral Property, the general contractor selected to oversee such improvements shall provide commercial general liability insurance (including completed operations coverage) naming the applicable Borrower as an additional insured, or in lieu thereof, may provide for such coverage by way of an owner's contingent or protective liability insurance covering claims not covered by or under the terms or provisions of the insurance required by clause (v) above; (vii) Employer's liability insurance with respect to the employees of Borrowers and their Subsidiaries with limits of $1,000,000 each accident / $1,000,000 each employee / $1,000,000 policy limit; (viii) Umbrella/Excess liability insurance with limits of not less than $10,000,000.00 to be in excess of the limits of the insurance required by clauses (v) and (vii) above, with 125 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 coverage at least as broad as the underlying coverages of the insurance required by clauses (v), (vi) and (vii) above, with any excess liability insurance to be at least as broad as the coverages of the lead umbrella policy. All such policies shall be endorsed to provide defense coverage obligations; (ix) Statutory Workers' compensation insurance for all employees of Borrowers, their Subsidiaries and EIK Manager engaged on or with respect to the Collateral Property with limits as required by applicable law (or if such Person has no employees, for all employees of the managers under the Management Agreements); and (x) Such other insurance in such form and in such amounts as may from time to time be reasonably required by Administrative Agent against other insurable hazards and casualties which at the time are commonly insured against in the case of properties of similar character and location to the Collateral Property. (b) In addition to the foregoing, Borrowers will procure and maintain (or cause to be maintained) insurance covering Borrowers and the Collateral and their other assets in such amounts and against such risks and casualties as are customary for properties of similar character and location, due regard being given to the type of improvements thereon, their construction, location, use and occupancy, and shall: (i) keep all its insurable properties and properties in which such Borrower has an interest insured against the hazards of fire, flood, sprinkler leakage, those hazards covered by extended coverage insurance and such other hazards, and for such amounts, as is customary in the case of companies engaged in businesses similar to Borrowers, including business interruption insurance; (ii) maintain insurance coverage in such amounts as is customary in the case of companies engaged in businesses similar to Borrowers insuring against larceny, embezzlement or other criminal misappropriation of insured's officers and employees who may either singly or jointly with others at any time have access to the assets or funds of any Borrower either directly or through authority to draw upon such funds or to direct generally the disposition of such assets; (iii) maintain public and product liability insurance against claims for personal injury, death or property damage suffered by others; (iv) maintain all such worker's compensation or similar insurance as may be required under the laws of any state or jurisdiction in which any Borrower is engaged in business; and (v) furnish Administrative Agent with appropriate endorsements in form and substance reasonably satisfactory to Administrative Agent, naming Administrative Agent as a co-insured and lender loss payee as its interests may appear with respect to all insurance coverage referred to in Sections 7.7(a)(i) and 7.7(a)(iii) relating to the Collateral Properties, and providing (1) that all proceeds thereunder shall be payable to Administrative Agent, (2) no such insurance shall be affected by any act or neglect of the insured or owner of the property described in such policy, and (3) that such policy and lender loss payable clauses may not be cancelled, amended or terminated unless at least thirty (30) days (or ten (10) days in the case of nonpayment of premiums) prior written notice is given to Administrative Agent. The carriers named therein hereby are directed by Administrative Agent and Borrowers to make payment for such loss to Administrative Agent and not to Borrowers and Administrative Agent jointly. If any such insurance losses are paid by check, draft or other instrument payable to Borrowers and Administrative Agent jointly, Administrative Agent may endorse Borrowers' names thereon and do such other things as Administrative Agent may deem advisable to reduce the same to cash. Administrative Agent is hereby authorized to adjust and compromise claims under insurance coverage referred to in Section 7.7(a)(i) relating to the Collateral Properties. All loss recoveries received by Administrative Agent upon any such insurance may be applied to the Obligations, in such order as Administrative Agent in its sole discretion shall determine. Any surplus shall be paid by Administrative Agent to Borrowers or applied as may be otherwise required by applicable law. Any deficiency thereon shall be paid by Borrowers to Administrative Agent, on demand. Each Borrower shall bear the full risk of any loss of any nature whatsoever with respect to the Collateral. 126 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (c) Borrowers shall pay all premiums on insurance policies. The insurance policies with respect to all Collateral Property provided for in Sections 7.7(a)(v), 7.7(a)(vi) and 7.7(a)(viii) shall name Administrative Agent as an additional insured and shall contain a cross liability/severability endorsement as their interest may appear. The insurance policies provided for in Sections 7.7(a)(i), 7.7(a)(ii), 7.7(a)(iii) and 7.7(a)(iv) shall name Administrative Agent as mortgagee and loss payee, shall be first payable in case of loss to Administrative Agent, and shall contain mortgage clauses and lender's loss payable endorsements in form and substance reasonably acceptable to Administrative Agent. Borrowers shall deliver certificates of insurance evidencing all such policies to Administrative Agent, and Borrowers shall promptly furnish to Administrative Agent all renewal notices and evidence that all premiums or portions thereof then due and payable have been paid. Not less than ten (10) days prior to the expiration date of the policies, as the same may be reduced by Administrative Agent, Borrowers shall deliver to Administrative Agent evidence of continued coverage, as may be reasonably satisfactory to Administrative Agent, and within five (5) Business Days after the renewal date of such policies, Borrowers shall deliver a certificate of insurance to Administrative Agent, in form and substance reasonably satisfactory to Administrative Agent. (d) All policies of insurance required by this Agreement shall contain clauses or endorsements to the effect that (i) no act or omission of any Borrower, any of their respective Subsidiaries or any Operator or anyone acting for any Borrower, any of their respective Subsidiaries or any Operator (including any representations made in the procurement of such insurance), which might otherwise result in a forfeiture of such insurance or any part thereof, no occupancy or use of the Real Estate or the Collateral for purposes more hazardous than permitted by the terms of the policy, and no foreclosure or any other change in title to the Real Estate or the Collateral or any part thereof, shall affect the validity or enforceability of such insurance insofar as Administrative Agent is concerned, (ii) the insurer waives any subrogation in respect of any liability of any Borrower or any of their respective Subsidiaries and Administrative Agent, (iii) such insurance is primary and without right of contribution from any other insurance which may be available, (iv) such policies shall not be modified so as to reduce or in any way negatively affect insurance coverage on any Real Estate or any Collateral, canceled or terminated prior to the scheduled expiration date thereof without the Borrowers giving reasonable written notice to Administrative Agent by certified or registered mail; provided, however, that only ten (10) days prior written notice to Administrative Agent shall be required if such cancellation or termination is due to non-payment of any insurance premium, and (v) that no Agent or Lender shall be liable for any premiums thereon or subject to any assessments thereunder, and such policies of insurance shall in all events be in amounts sufficient to avoid any coinsurance liability. (e) The insurance required by this Agreement may be secured through a blanket policy or policies covering additional locations and property of Borrowers not included in the Real Estate or the Collateral, provided that such blanket policy or policies comply with all of the terms and provisions of this Section 7.7, including Administrative Agent's reasonable determination based on a review of the schedule of locations and values that the amount of such coverage is sufficient in light of the other risks and properties insured under the blanket policy. (f) All policies of insurance required by this Agreement shall be issued by companies licensed to do business in the State where the policy is issued and also in the States where the Real Estate is located and shall be issued by companies having a rating in Best's Key Rating Guide of at least "A" and a financial size category of at least "X". (g) None of Borrowers or any of their Subsidiaries shall carry separate insurance, concurrent in kind or form or contributing in the event of loss, with any insurance required under this Agreement unless such insurance complies with the terms and provisions of this Section 7.7. 127 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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(h) In the event of any loss or damage to any Collateral Property, the applicable Borrower shall give prompt written notice to the insurance carrier and Administrative Agent. Each Borrower hereby irrevocably authorizes and empowers, subject to the terms of this Section 7.7(h) and Section 7.7(i), Administrative Agent, at Administrative Agent's option and in Administrative Agent's reasonable discretion or at the request of the Majority Real Estate Revolving Loan Lenders in their reasonable discretion, as its attorney in fact, to make proof of such loss, to adjust and compromise any claim under insurance policies, to appear in and prosecute any action arising from such insurance policies, to collect and receive insurance proceeds and condemnation proceeds, and to deduct therefrom Administrative Agent's reasonable, out-of-pocket expenses incurred in the collection of such insurance proceeds; provided, however, that so long as no Default or Event of Default has occurred and is continuing and so long as any Borrower shall in good faith diligently pursue such claim, such Borrower may make proof of loss and appear in any proceedings or negotiations with respect to the adjustment of such claim and, subject to Administrative Agent's consent rights set forth below, make all decisions with respect thereto, except that neither any Borrower nor any other Person may settle, adjust or compromise any such claim without the prior written consent of Administrative Agent, which consent shall not be unreasonably withheld or delayed; provided, further, that such Borrower may make proof of loss and adjust and compromise any claim under casualty insurance policies which is in an amount less than $750,000.00 so long as no Default or Event of Default has occurred and is continuing and so long as such Borrower shall in good faith diligently pursue such claim. Each Borrower further authorizes Administrative Agent, at Administrative Agent's option, to (i) apply the excess balance of such insurance proceeds and condemnation proceeds following completion of the reconstruction or repair, if applicable, to the payment of the Obligations whether or not then due, or (ii) if Administrative Agent shall require the reconstruction or repair of the Collateral Property, to hold the balance of such proceeds as trustee to be used to pay taxes, charges, sewer use fees, water rates and assessments which may be imposed on the Collateral Property and the Obligations as they become due during the course of reconstruction or repair of the Collateral Property, and to reimburse such Borrower, in accordance with such terms and conditions as Administrative Agent may prescribe, for, or to pay directly, the costs of reconstruction or repair of the Collateral Property and upon completion of such reconstruction or repair to pay any excess insurance proceeds to Borrowers, provided that (i) upon completion of such reconstruction or repair, the Collateral Property is in compliance in all material respects with all applicable state, federal and local laws, ordinances and regulations, including all building and zoning laws, ordinances and regulations and (ii) no Defaults or Events of Default exist or are continuing under this Agreement on the date of such payment to Borrowers. (i) Notwithstanding the foregoing or anything to the contrary contained in the Mortgages, Administrative Agent shall make net insurance proceeds and condemnation proceeds available to such Borrower to reconstruct and repair the Collateral Property, in accordance with such terms and conditions as Administrative Agent may prescribe in Administrative Agent's good faith and reasonable discretion for the disbursement of the proceeds, provided that (i) no Default or Event of Default shall have occurred and be continuing, (ii) such Borrower shall have demonstrated to Administrative Agent's reasonable discretion the availability of funds to cover any additional cash security in an amount equal to the amount reasonably estimated by Administrative Agent to be the amount in excess of such proceeds which will be required to complete such repair or restoration and such Borrower does in fact expend such amount for such purpose, (iii) Administrative Agent shall have approved the plans and specifications, construction budget, construction contracts, and construction schedule for such repair or restoration, which approval shall not be unreasonably withheld, delayed or conditioned (provided that Administrative Agent shall not disapprove such plans and specifications if the Building is to be restored to substantially its condition immediately prior to such damage), (iv) such Borrower shall have delivered to Administrative Agent written agreements binding upon each Operator, agreeing upon a date for delivery of possession of the Collateral Property or their respective portions thereof, to permit time which is sufficient in the reasonable judgment of Administrative Agent for such 128 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 repair or restoration and approving the plans and specifications for such repair or restoration, or other evidence reasonably satisfactory to Administrative Agent that none of such Operators may terminate their Leases or other agreements as a result of such casualty or as a result of having a right to approve the plans and specifications for such repair or restoration and prior to the exhaustion of expiration of any rental loss insurance coverage, (v) Administrative Agent shall reasonably determine that such repair or reconstruction can be completed prior to the Maturity Date and prior to the exhaustion of the benefits provided by the insurance described in Section 7.7(a)(iv), (vi) Administrative Agent shall receive evidence reasonably satisfactory to it that any such restoration, repair or rebuilding will comply in all material respects with any and all applicable state, federal and local laws, ordinances and regulations, including zoning laws, ordinances and regulations, and that all required permits, licenses and approvals relative thereto have been or will be issued in a manner so as not to materially impede the progress of restoration, (vii) Administrative Agent shall receive evidence reasonably satisfactory to it that the insurer under such policies of fire or other casualty insurance does not assert any defense to any payment under such policies with respect to such damage against any Borrower or Administrative Agent, unless such assertion is made prior to the commencement of restoration and Borrowers shall have demonstrated to Administrative Agent's reasonable discretion the availability of funds to cover any payment amount at issue prior to such commencement, and such Borrower does in fact expend such amount for such purpose, and (viii) with respect to any Taking, Administrative Agent shall determine that following such repair or restoration there shall be no non-de minimis reduction in occupancy or rental income from the Collateral Property so affected by such specific condemnation or taking and that, in the reasonable, good faith judgment of Administrative Agent, determined after consultation in good faith with the applicable Borrower and giving special consideration to such Borrower's provision of care to residents, compliance with applicable law and prudent standards of care with respect to the operation of the affected Collateral Property, such Taking does not render the affected Collateral Property unsuitable for continued use as a skilled nursing facility or assisted living facility, as the case may be. Any excess insurance proceeds shall be paid to Borrowers, or if a Default or Event of Default has occurred and is continuing, such proceeds shall be applied to the payment of the Obligations, unless in either case by the terms of the applicable insurance policy the excess proceeds are required to be returned to such insurer. Any excess condemnation proceeds shall be applied to the payment of the Obligations, with the remainder to Borrowers. In no event shall the provisions of this Section 7.7(i) be construed to extend the Maturity Date or to limit in any way any right or remedy of Administrative Agent upon the occurrence of an Event of Default hereunder. If the Collateral Property is sold or the Collateral Property is acquired by Administrative Agent following an Event of Default, all right, title and interest of any Borrower in and to any insurance policies to the extent that they relate to Collateral Properties and unearned premiums thereon and in and to the proceeds thereof resulting from loss or damage to the Collateral Property prior to the sale or acquisition shall pass to Administrative Agent or any other successor in interest to the applicable Borrower or purchaser of the Collateral Property. Section 7.8 Taxes; Liens. Borrowers and Guarantors will duly pay and discharge, or cause to be paid and discharged, before the same shall become delinquent, all property taxes and all other material taxes, assessments and other governmental charges imposed upon them or upon the Collateral Properties or the other Real Estate, sales and activities, or any part thereof, or upon the income or profits therefrom as well as all claims for labor, materials or supplies that if unpaid might by law become a lien or charge upon any of its property or other Liens affecting any of the Collateral or other property of Borrowers and all non-governmental assessments, levies, maintenance and other charges, whether resulting from covenants, conditions and restrictions or otherwise, water and sewer rents and charges assessments on any water stock, utility charges and assessments and owner association dues, fees and levies, provided that any such tax, assessment, charge or levy or claim need not be paid if the validity or amount thereof shall currently be contested in good faith by appropriate proceedings which shall suspend the collection thereof with respect to such property and the applicable Loan Party shall not be subject to any fine, suspension or loss of privileges or rights by reason of such proceeding, neither such property 129 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 nor any portion thereof or interest therein would be in any danger of sale, forfeiture, loss or suspension of operation by reason of such proceeding and such Loan Party shall have set aside on its books adequate reserves in accordance with GAAP; and provided, further, that forthwith upon the commencement of proceedings to foreclose any lien that may have attached as security therefor, such Loan Party either (i) will provide a bond issued by a surety reasonably acceptable to Administrative Agent and sufficient to stay all such proceedings or (ii) if no such bond is provided, will pay each such tax, assessment, charge or levy. Section 7.9 Inspection of Properties and Books. (a) Borrowers, Borrowers' respective Subsidiaries and Guarantors will permit Administrative Agent and the Lenders, at Borrowers' expense, upon reasonable prior notice and, if no Event of Default exists, during business hours, to visit and inspect, subject to HIPAA and all other applicable privacy laws, any of the properties of each Borrower (including with respect to any IGT Facility), to examine the books of account of any Borrower, any Guarantor and Borrower's respective Subsidiaries (including with respect to any IGT Facility) (and to make copies thereof and extracts therefrom) and to discuss the affairs, finances and accounts of any Borrower, any Guarantor and Borrower's respective Subsidiaries (including with respect to any IGT Facility) with, and to be advised as to the same by, their respective officers, partners or members, all at such reasonable times and intervals as Administrative Agent or any Lender may reasonably request; provided, however, that such visits and inspections shall be limited to one (1) time per year unless an Event of Default exists. The Lenders shall use good faith efforts to coordinate such visits and inspections so as to minimize the interference with and disruption to the normal business operations of such Persons. (b) Each Loan Party will permit Revolving Agent and each of its duly authorized representatives or agents to conduct field examinations, appraisals and valuations (including audits of the Accounts) at such reasonable times (during regular business hours) and intervals as Revolving Agent may designate, provided that the obligation of Borrowers to reimburse Revolving Agent for the costs of any such field examinations, appraisals and valuations shall be subject to the provisions of Section 4.2(b). Section 7.10 Compliance with Laws, Contracts, Licenses, and Permits. Borrowers will, and will cause the Operators of the Real Estate to, comply with (a) all applicable laws and regulations now or hereafter in effect wherever its business is conducted, including all Environmental Laws, in all material respects, (b) the provisions of its corporate charter, partnership agreement, limited liability company agreement or declaration of trust, as the case may be, and other charter documents and bylaws, (c) all agreements and instruments to which it is a party or by which it or any of the Real Estate may be bound, (d) all applicable decrees, orders, and judgments affecting the Real Estate, and (e) all Permits required by applicable laws and regulations for the conduct of its business or the ownership, use or operation of the Collateral Properties or other Senior Care Properties; except where failure to so comply with any of clause (a) through (e) would not result in the material non-compliance with the items described in such clauses. If any Permit from any officer, agency or instrumentality of any government shall become necessary or required in order that any Borrower may fulfill any of its obligations hereunder, such Borrower will promptly take or cause to be taken all steps necessary to obtain such Permit and, following a request by Administrative Agent, furnish Administrative Agent and the Lenders with evidence thereof. Each Borrower shall, and shall cause each of its Subsidiaries to, develop and implement such programs, policies and procedures as are necessary to comply with the Patriot Act and shall promptly advise Administrative Agent in writing in the event that such Borrower shall determine that any investors in such Borrower are in violation of such act. 130 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 7.11 Further Assurances. Each Borrower and each Guarantor will cooperate with Administrative Agent and the Lenders and execute such further instruments and documents as Administrative Agent shall reasonably request to carry out to their reasonable satisfaction the transactions contemplated by this Agreement and the other Loan Documents; provided that no such instruments or documents shall create any new obligations of Borrower or Guarantor or reduce any of their rights. In furtherance of, and not in limitation of, the foregoing, each Borrower shall take such actions as Administrative Agent may reasonably request from time to time to ensure that the Obligations are secured by IGT Liens. Section 7.12 Collateral Properties. (a) Borrowers shall cause the Eligible Owned Real Estate and Eligible Villa Units included in the calculation of the Real Estate Borrowing Base Availability and inclusion as Collateral Properties or Villa Units, as the case may be, to at all times satisfy all of the following conditions: (i) the Eligible Owned Real Estate or Eligible Villa Units, as the case may be, shall be Senior Care Properties that are owned one hundred percent (100%) in fee simple (or, if applicable, leasehold) by a Borrower, free and clear of all Liens other than the Liens expressly permitted in Section 8.2(v) as to the Collateral Properties, and such Eligible Owned Real Estate or Eligible Villa Units, as the case may be, shall not have applicable to it any restriction on the sale, pledge, transfer, mortgage or assignment of such property (including any restrictions contained in the above-described Permitted Liens, Applicable Law and any applicable organizational documents); (ii) none of the Eligible Owned Real Estate or Eligible Villa Units, as the case may be, shall be subject to any condemnation proceeding, that in any event would give rise to a materially adverse effect as to the value, use of, operation of or ability to sell or finance such Real Estate; (iii) no strike, lockout, labor dispute, embargo, injunction or other proceeding (but only to the extent within Borrowers' reasonable control to prevent) occurs which causes, for more than fifteen (15) consecutive days, the cessation or substantial curtailment of revenue producing activities of any Borrower or any Operator at such property; (iv) such Eligible Owned Real Estate or Eligible Villa Units, as the case may be, are (A) leased by a Borrower to a Borrower that is an OpCo Affiliate under a Lease approved by Administrative Agent and (B) operated and managed by EIK Manager under a Management Agreement reasonably satisfactory to Administrative Agent; (v) except with respect to Primary Licenses held by an IGT Hospital pursuant to an IGT Transaction, the applicable OpCo Affiliate is the holder of all Primary Licenses for such Eligible Owned Real Estate or Eligible Villa Units; and (vi) such Eligible Owned Real Estate or Eligible Villa Units, as the case may be, have not been removed from the calculation of the Real Estate Borrowing Base Availability pursuant to Section 5.3, Section 7.12(b), 7.12(c) or 7.12(d). (b) In the event that all or any material portion of any Eligible Owned Real Estate or Eligible Villa Units, as the case may be, included in the calculation of Real Estate Borrowing Base Availability shall be materially damaged or taken by condemnation, then such property shall no longer be included in the calculation of Real Estate Borrowing Base Availability unless and until Administrative Agent shall receive evidence satisfactory to Administrative Agent that (i) with respect to any repair or restoration, of material damage, (A) the applicable Lease with an OpCo Affiliate will remain in effect, 131 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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(B) adequate rent loss insurance will be in effect during the period of restoration and (C) Borrowers are otherwise in compliance with Section 7.7 in connection with such repair or restoration and (ii) with respect to any condemnation, (A) adequate condemnation proceeds have been received to replace the subject property and (B) Borrowers are otherwise in compliance with Section 7.7(i)(viii) with respect to such Taking. (c) Upon any asset ceasing to qualify to be included in the calculation of Real Estate Borrowing Base Availability, such asset shall no longer be included in the calculation of Real Estate Borrowing Base Availability. Within five (5) Business Days after any such disqualification, Borrowers shall deliver to Administrative Agent a certificate reflecting such disqualification, together with the identity of the disqualified asset, a statement as to whether any Default or Event of Default arises as a result of such disqualification, and a calculation of Real Estate Borrowing Base Availability attributable to such asset. Simultaneously with the delivery of the items required above, Borrowers shall deliver to Administrative Agent a pro forma Compliance Certificate and Real Estate Borrowing Base Certificate demonstrating, after giving effect to such removal or disqualification, compliance with the covenants contained in Section 9. (d) In addition, Borrowers may voluntarily remove any Real Estate from the calculation of the Real Estate Borrowing Base Availability in their sole discretion pursuant to Section 5.3. Section 7.13 Business Operations. Borrowers and their Subsidiaries shall operate their respective businesses (a) in substantially the same manner and in substantially the same fields and lines of business as such business is now conducted and such other lines of business that are reasonably related or incidental thereto and (b) in compliance with the terms and conditions of this Agreement and the Loan Documents. Neither Parent nor any other Borrower will, or permit any of their respective Subsidiaries to, directly or indirectly, engage in any line of business other than the ownership, operation and development of Senior Care Properties and the provision of Ancillary Services at Senior Care Properties or included in the calculation of Ancillary Services Borrowing Base Value. Each lessee of Real Estate (other than sublessees and sublicensees for providers of resident services, such as haircare, under immaterial subleases and sublicenses, patients and residents) shall be an OpCo Affiliate and such Real Estate shall be operated and managed by EIK Manager. Section 7.14 Healthcare Laws and Covenants. (a) Each Borrower shall cause, and shall cause each of the applicable Operators to cause, the operations of its Senior Care Properties and the provision of its Ancillary Services at any Senior Care Property or included in the calculation of Ancillary Services Borrowing Base Value to be conducted at all times in material compliance with the requirements of all applicable Healthcare Laws, Governmental Authorities and Third Party Payor Programs in which any such Person participates (unless Borrowers have elected, with respect to a Third Party Payor Program with an Insurer, to no longer participate in such program), in each case as are now in effect and which may be imposed upon any Borrower, any Subsidiary thereof or any Operator or the maintenance, use or operation of the Real Estate, the provision of Ancillary Services at any Senior Care Property or included in the calculation of Ancillary Services Borrowing Base Value or the care or services to the occupants of any Senior Care Property, except, with respect to any of the foregoing, where any such failure to comply is in process of remediation pursuant to a written plan of correction accepted by the appropriate Governmental Authority and such failure to comply, following remediation pursuant to such plan, could not reasonably be expected, directly or indirectly, or with the passage of time (i) to have a Material Adverse Effect on any Senior Care Property or a material adverse effect on any Borrower's or any Operator's ability to accept or retain patients or residents, provide Ancillary Services at any Senior Care Property or included in the 132 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 calculation of Ancillary Services Borrowing Base Value or receive payment or reimbursement for care or services provided at, or operate, any Senior Care Property for its current use with not less than the current number of licensed beds, (ii) to adversely modify, limit or result in the transfer, suspension, revocation, non-renewal or imposition of probationary use or other limitation of any of the Primary Licenses, (iii) to adversely affect any Borrower's, or any Operator's continued participation in the Medicaid or Medicare programs or any other Third Party Payor Programs in which such Person participates in connection with any Senior Care Property (unless Borrowers have elected, with respect to a Third Party Payor Program with an Insurer, to no longer participate in such program), or any successor programs thereto, at then current rates, (iv) to result in any material civil or criminal penalty or remedy, or (v) to result in the appointment of a receiver or manager for any Senior Care Property. Borrowers shall not permit any Collateral Property to be a "special focus facility" as determined by CMS. (b) Borrowers shall cause the Operators to maintain, and to take all necessary action to timely renew and otherwise maintain in full force and effect, all Primary Licenses necessary to operate the Senior Care Properties and to provide Ancillary Services therefrom, and no Primary License shall be permitted to become irrevocably provisionary, probationary or otherwise restricted. (c) Borrowers shall cause the Operators to maintain, and to take all necessary action to timely renew and otherwise maintain in full force and effect, all Medicaid Provider Agreements, Medicare Provider Agreements, TRICARE provider agreements or any other Third Party Payor Program provider agreements or similar agreements necessary to operate the Senior Care Properties and to provide Ancillary Services therefrom, and no such agreement shall be permitted to become irrevocably provisionary, probationary or otherwise restricted. (d) Each Borrower and each applicable Operator (i) does and shall maintain all records required to be maintained under the Healthcare Laws, (ii) is, and shall at all times remain in compliance in all material respects with the provisions of HIPAA, as amended and supplemented by HITECH and the regulations promulgated pursuant to each, including the Standards of Privacy of Individually Identifiable Health Information and the Security Standards for the Protection of Electronic Health Information at 45 C.F.R. part 160 and part 164, in each case as applicable, and (iii) has, and will maintain in full force and effect, all business associate agreements necessary for the conduct of their respective businesses in compliance with HIPAA. (e) Without Administrative Agent's prior written consent not to be unreasonably withheld, no Borrower shall (or suffer to be done), or shall permit any Operator to (or suffer to be done), any of the following: (i) transfer, terminate, relinquish, surrender or abandon any Primary License or any Medicaid Provider Agreement, Medicare Provider Agreement, TRICARE provider agreement or any other Third Party Payor Program provider agreement or similar agreement, in each case, necessary for the operation of any Senior Care Property; (ii) amend any Primary License or any Medicaid Provider Agreement, Medicare Provider Agreement, TRICARE provider agreement or any other Third Party Payor Program provider agreement or similar agreement necessary for the operation of any Senior Care Property, in each case, in such a manner that results in a material adverse effect on the rates charged, or otherwise diminishes or impairs the nature, tenor or scope of any Primary License or any such agreement; (iii) transfer all or any part of any Senior Care Property's beds to another site or location, take out of service any licensed or certified units or beds, or otherwise reduce the number of licensed or certified units or beds at any Senior Care Property; provided, however, that (A) so long as 133 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Administrative Agent receives an updated Appraisal reflecting such immediately succeeding action at least five (5) Business Days prior thereto, and Borrowers comply with Sections 5.3(f) and 5.3(g) in connection therewith, Trilogy Real Estate Ohio, LLC, or the OpCo Affiliate leasing its Cypress Pointe Health Campus from such Borrower may transfer nine (9) beds from such Senior Care Property to a new Senior Care Facility to be operated by an OpCo Affiliate, and (B) an OpCo Affiliate, in accordance with applicable law, shall be permitted to avail itself of permitted bed "banking" opportunities so long as such opportunities: (1) do not result in more than (I) a ten percent (10%) reduction in the number of licensed or certified beds or units in operation at any Senior Care Property (determined on an individual Senior Care Property basis and not in the aggregate) as of the Closing Date or (II) a five percent (5%) reduction in the aggregate number of licensed or certified beds or units in operation at the Senior Care Properties (determined on an aggregate basis) as of the Closing Date, and (2) do not result in the permanent de-licensing of any beds or units at any time; (iv) voluntarily transfer or encourage the transfer of any resident to any facility, except in accordance with applicable law and (A) at the request of the resident, (B) for reasons relating to the health, required level of medical care or safety of the resident to be transferred or the residents remaining at such parcel or (C) as a result of the disruptive behavior of the transferred resident, or (D) as a result of a resident's breach of, or failure to comply with such resident's occupancy agreement or the rules, policies and procedures of the Senior Care Property. (f) Each Trilogy Pharmacy Company will comply with all applicable Public Health Laws, except to the extent that any noncompliance, individually or in the aggregate, could not reasonably be expected to have a Material Adverse Effect. Each Trilogy Pharmacy Company will keep and maintain all records required to be maintained by any Governmental Authority or otherwise under any Healthcare Law and Public Health Law. All products prepared, assembled, packaged, labeled, distributed, sold or marketed by or on behalf of any Trilogy Pharmacy Company that are subject to the jurisdiction of the FDA shall be distributed, sold and marketed in material compliance with the Public Health Laws. (g) Each Borrower, to the extent applicable to such party under applicable Healthcare Laws, shall maintain a corporate and health care regulatory compliance program ("RCP") which addresses the requirements of Healthcare Laws, including HIPAA, and includes at least the following components: (i) standards of conduct and procedures that describe compliance policies regarding laws with an emphasis on prevention of fraud and abuse; (ii) a specific officer within high-level personnel identified as having overall responsibility for compliance with such standards and procedures; (iii) training and education programs which effectively communicate the compliance standards and procedures to employees and agents, including fraud and abuse laws and illegal billing practices; (iv) auditing and monitoring systems and reasonable steps for achieving compliance with such standards and procedures including publicizing a reporting system to allow employees and other agents to anonymously report criminal or suspect conduct and potential compliance problems; (v) disciplinary guidelines and consistent enforcement of compliance policies including discipline of individuals responsible for the failure to detect violations of the RCP; and (vi) mechanisms to promptly respond to detected violations of the RCP. Each Borrower shall modify such RCPs from time to time, as may be necessary to ensure continuing compliance with all applicable Healthcare Laws. Upon prior written request, Administrative Agent (and/or its consultants) shall be permitted to review such RCPs. Section 7.15 Registered Service Mark. Without prior written notice to Administrative Agent, except with respect to the trademarks, trade names, service marks or logos listed on Schedule 6.6 or in any Mortgage with respect to any Collateral Property other than the Initial Collateral Properties, none of the Collateral Properties shall be owned or operated by any Borrower under any trademark, trade name, service mark or logo. In the event any of the Collateral Properties shall be owned or operated by a Borrower under any trade name, trademark, service mark or logo, not listed on Schedule 6.6 or in any 134 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Mortgage with respect to any Collateral Property other than the Initial Collateral Properties, the applicable Borrower shall enter into such agreements with Administrative Agent in form and substance reasonably satisfactory to Administrative Agent, as Administrative Agent may reasonably require to grant Administrative Agent a perfected first priority security interest therein and to grant to Administrative Agent or any successful bidder at a foreclosure sale of such Collateral Property the right or license to continue operating such Collateral Property under such trade name, trademark, service mark or logo as determined by Administrative Agent. Section 7.16 Distributions of Income to Borrowers. Each Borrower shall cause all of its Subsidiaries (subject to the terms of any Non-Recourse Indebtedness permitted hereunder) to promptly distribute to such Borrower (but not less frequently than once each calendar quarter, unless otherwise approved by Administrative Agent), whether in the form of dividends, distributions or otherwise, all profits, proceeds or other income relating to or arising from its Subsidiaries' use, operation, financing, refinancing, sale or other disposition of their respective assets and properties after (a) the payment by each Subsidiary of its debt service, operating expenses, capital improvements and leasing commissions for such quarter and (b) the establishment of reasonable reserves for the payment of operating expenses not paid on at least a quarterly basis and capital improvements and tenant improvements to be made to such Subsidiary's assets and properties approved by such Subsidiary in the course of its business consistent with its past practices. Section 7.17 Plan Assets. Borrowers and each of their respective Subsidiaries will do, or cause to be done, all things necessary to ensure that none of its Real Estate will be deemed to be Plan Assets at any time. Section 7.18 Assignments and Records of Accounts; Verification of Accounts. If so requested by Administrative Agent during the existence of an Event of Default, each Borrower shall execute and deliver (with respect to IGT Accounts (other than IGT UPL Payments), in such Borrower's capacity as manager, as applicable), and, at the request of Administrative Agent, shall cause each IGT Hospital to execute and deliver, to Administrative Agent, for the benefit of Secured Parties, formal written assignments of all of the Accounts daily, which shall include all Accounts that have been created since the date of the last assignment, together with copies of invoices or invoice registers related thereto, subject, at all times, to the applicable provisions of applicable Healthcare Laws prohibiting the assignment of Medicaid and Medicare account receivables. Each Borrower shall keep accurate and complete records of the Accounts, including the IGT Accounts, and all payments and collections thereon. Whether or not an Event of Default has occurred, any of any Agent's officers, employees or agents shall have the right, at any time or times hereafter, in the name of such Agent, or any designee of the Lenders or Borrowers, to verify the validity, amount or other matter relating to any Accounts by mail, telephone, telegraph or otherwise. Borrowers shall cooperate fully with each Agent and the Lenders in an effort to facilitate and promptly conclude any such verification process. Section 7.19 Bank Accounts. (a) Subject, at all times, to the applicable provisions of applicable Healthcare Laws prohibiting the assignment of Medicaid and Medicare account receivables, Borrowers shall establish and maintain, and cause each IGT Hospital to establish and maintain with respect to each applicable IGT Facility, one or more deposit and control accounts pursuant to arrangements and agreements acceptable to Administrative Agent with KeyBank or any other bank(s) as may be selected by such Borrower and reasonably approved by Administrative Agent. Each such other bank, if any, shall agree to Administrative Agent's standard control account agreement or deposit account instructions and service agreement, as applicable, or such variation thereof as shall be mutually and reasonably satisfactory to Administrative Agent and such bank. All proceeds of Government Receivables shall be deposited into a 135 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Deposit Account subject to a deposit account instructions and service agreement substantially in the form of Administrative Agent's standard deposit account instructions and service agreement, and all other proceeds of Accounts shall be deposited into a Deposit Account subject to a control account agreement substantially in the form of Administrative Agent's standard control account agreement. As of the Closing Date, all Deposit Accounts, securities accounts and other bank accounts of Borrowers and the IGT Hospitals with respect to any IGT Facility (other than for IGT UPL Payments) are listed on Schedule 7.19 and such Schedule designates which such accounts are Deposit Accounts. No Borrower shall open, or permit any IGT Hospital (with respect to any IGT Facility (other than for IGT UPL Payments) to open, any Deposit Account, securities account or other bank account unless the institution at which such account is to be maintained is KeyBank or shall have entered into an agreement with Administrative Agent substantially in the form of Administrative Agent's standard control account agreement or deposit account instructions and service agreement, as applicable or variation thereof as shall be mutually and reasonably satisfactory to Administrative Agent and such institution. (b) Borrowers shall take all steps to ensure that all of their Account Debtors and all Account Debtors of each IGT Hospital with respect to each applicable IGT Facility, forward all items of payment (other than IGT UPL Payments) to a Collections Account or a Deposit Account maintained by a bank party to an agreement as provided in Section 7.19(a). No Borrower shall, or permit any IGT Hospital to, amend, waive, rescind, revoke, modify or terminate any funds transfer standing instructions or other instructions delivered to a bank party to an agreement as provided in Section 7.19(a) without the prior written consent of Administrative Agent. (c) In the event that any Borrower or any IGT Hospital (with respect to an applicable IGT Facility) shall at any time receive any remittances of any of the foregoing directly or shall receive any other funds representing proceeds of the Collateral, such Borrower shall hold, and shall cause such IGT Hospital to hold, the same as trustee for Administrative Agent, shall segregate such remittances from its other assets, and shall promptly deposit the same into the Collections Account or into a Deposit Account maintained by a bank party to an agreement as provided in Section 7.19(a). All cash, cash equivalents, checks, notes, drafts or similar items of payment (including from the sale of any assets or constituting insurance or condemnation proceeds) received by any Borrower or any IGT Hospital (with respect to an applicable IGT Facility, but excluding IGT UPL Payments) shall be deposited into the Collections Account or into a Deposit Account maintained by a bank party to an agreement as provided in Section 7.19(a), in each case, promptly upon (and in any event within one (1) Business Day of) receipt thereof by such Loan Party. (d) Without limiting the foregoing, each Borrower that is the owner or ground lessee of a Collateral Property shall promptly deposit or have deposited all rent and other amounts payable under each Lease for a Collateral Property into the Collections Account of Parent. Contemporaneously with the inclusion of any Eligible Owned Real Estate or Eligible Villa Unit as a Collateral Property, Borrowers shall, pursuant to a payment direction letter (a "Payment Direction Letter") substantially in the form of the payment direction letter delivered to Borrowers that are OpCo Affiliates by Borrowers that are owners or ground lessees of a Collateral Property on the Closing Date, notify and advise each Borrower that is an OpCo Affiliate under a Lease of a Collateral Property to send directly to KeyBank, as depository at an address at KeyBank (the "Bank Account Address"), promptly when due all payments, whether in the form of checks, cash, drafts, money orders or any other type of payment whatsoever, of rent, fees or any other item payable to Borrowers under such Leases. Without limiting any of the foregoing provisions, Borrowers shall deposit or will cause to be deposited with KeyBank within one (1) Business Day of receipt any and all such amounts received by them. Until such time as deposited into a Collections Account, each such Borrower agrees not to commingle or permit to be commingled any such 136 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 amounts received by them in respect of the Collateral Property, and agrees to hold all such amounts in trust for Administrative Agent until deposited into a Collections Account. (e) Without the prior written consent of Administrative Agent, no Borrower shall (i) terminate, amend, revoke, modify or contradict any Payment Direction Letter in any manner or (ii) direct or cause any lessee of a Collateral Property to pay any amount in any manner other than as provided specifically in such Payment Direction Letter. (f) KeyBank shall have unrestricted access to each Collections Account and have complete and exclusive authority to receive, pickup and open all regular, registered, certified or insured mail addressed to Borrowers at the Bank Account Address and may receive, open and dispose of mail sent to the Bank Account Address that is addressed to any Borrower, and remove and inspect the contents and apply and credit to or for deposit to a Collections Account all funds from time to time tendered by or on behalf of any Borrower, for deposit therein. Administrative Agent agrees that it will use reasonable efforts to forward to Borrowers any correspondence other than payments received at the Bank Account Address, provided that under no circumstances shall Agent be liable to any Borrower for any failure to do so. Section 7.20 Formation of Subsidiaries. On or before the earlier of (x) ten (10) Business Days after the date of the formation of any direct or indirect Subsidiary of a Borrower after the Closing Date as expressly permitted by Section 8.3(i) and (y) the date on which such Subsidiary of a Borrower obtains any assets (other than the minimum amount of capitalization required by Applicable Law to form such Subsidiary), Borrowers, as appropriate, shall (a) cause such new Domestic Subsidiary to provide to Administrative Agent, for the benefit of the Secured Parties, a Joinder, pursuant to which such new Domestic Subsidiary shall agree to join as a Borrower of the Obligations and a Loan Party under this Agreement and the Notes, (b) cause such new Domestic Subsidiary to provide to Administrative Agent, for the benefit of the Secured Parties, a joinder and supplement to the Security Agreement, and such other Security Documents (including Mortgages with respect to any real estate owned or leased pursuant to a ground lease by such Subsidiary), the Contribution Agreement and the Indemnity Agreement, together with appropriate Uniform Commercial Code financing statements, all in form and substance reasonably satisfactory to Administrative Agent, (c) provide to Administrative Agent, for the benefit of the Secured Parties, a pledge agreement or supplement to the Security Agreement and appropriate certificates and powers or Uniform Commercial Code financing statements, pledging all direct or beneficial ownership interest in such new Subsidiary, in form and substance satisfactory to Administrative Agent, and (d) provide to Administrative Agent, for the benefit of the Secured Parties, all other documentation, including one or more opinions of counsel satisfactory to Administrative Agent, which in its opinion is appropriate with respect to such formation and the execution and delivery of the applicable documentation referred to above. Nothing in this Section 7.20 shall authorize any Borrower or any Subsidiary thereof to acquire any Subsidiary absent express authorization to so form or acquire such Subsidiary pursuant to Section 8.3(i). Any document, agreement or instrument executed or issued pursuant to this Section 7.20 shall be a Loan Document for purposes of this Agreement. Section 7.21 Separateness. Each Borrower shall ensure the representations and warranties set forth in Section 6.37 are true and correct at all times and shall certify in each Compliance Certificate delivered to Administrative Agent as to each Borrower's continued compliance with the terms of Section 6.37 as of the date of such certificate and that the representations and warranties of each Borrower set forth in Section 6.37 are true and correct as of the date of such Compliance Certificate. In addition, each Borrower shall provide Administrative Agent with such other reasonable evidence of such Borrower's compliance with Section 6.37 as Administrative Agent may reasonably request from time to time. 137 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 7.22 EIK Manager. The Key Principal shall be the senior management of EIK Manager as of the Closing Date. No changes to the Key Principal of EIK Manager, shall be made without the approval of the Majority Lenders, which approval shall not be unreasonably withheld, delayed or conditioned, and any such senior management persons so approved shall then be the Key Principal. In the event the Majority Lenders approve a replacement EIK Manager (which approval shall not be unreasonably withheld, delayed or conditioned), the Majority Lenders shall also designate the Key Principal of such replacement manager that shall be subject to the terms of this Section 7.22. Any replacement EIK Manager and its Key Principal from and after the Closing Date must be approved by the Majority Lenders, which approval shall not be unreasonably withheld, delayed or conditioned (provided that with respect to the replacement of the Key Principal as a result of death or incapacitation, such approval by the Majority Lenders shall not be required for a temporary interim Key Principal (such period not to exceed six (6) months) approved by the board of directors of EIK Manager so long as any permanent Key Principal remains subject to Majority Lenders' approval (not to be unreasonably withheld, delayed or conditioned). At least one Key Principal (or replacement thereof after the Closing Date who is approved by Majority Lenders in their reasonable discretion) shall remain actively involved in EIK Manager's provision of services under the Management Agreements and shall devote sufficient time and attention (taking into account both magnitude and quality) thereto. Section 7.23 Construction of Villa Units. Borrowers shall cause the Villa Units included in Real Estate Borrowing Base Availability to be constructed and fully equipped in a good and workmanlike manner with materials of high quality, substantially in accordance with the Plans and Specifications (or in accordance with any changes therein that may be approved in writing by Administrative Agent, which consent shall not be unreasonably withheld, delayed or conditioned, or as to which Administrative Agent's approval is not required), and such construction and equipping will be prosecuted with due diligence and continuity; provided, however, that nothing herein shall limit the eighteen (18)-month duration set forth in clause (b) of the definition of Real Estate Borrowing Base Availability. Section 7.24 Inspection by Administrative Agent or any Lender of Construction at the Villa Units Complexes. Borrowers shall permit the Lenders, through Administrative Agent or any representative designated by Administrative Agent, and not more than one (1) consultant of Lender or Administrative Agent, at Borrowers' expense, to visit and inspect the Villa Units and all materials to be used in the construction thereof and will cooperate with Administrative Agent and any construction inspector during such inspections (including making available working drawings of the Plans and Specifications); provided that this provision shall not be deemed to impose on the Lender, Administrative Agent or such consultant of Administrative Agent or any Lender any obligation to undertake such inspections. Borrowers shall, upon the request of the consultant of Administrative Agent or any Lender, correct any material defect in the Villa Units or any failure of the Villa Units or the construction thereof to comply with the Plans and Specifications in any material respect. Section 7.25 Mechanics' Liens and Contest Thereof. Notwithstanding any provision in the Loan Documents to the contrary, Borrowers will not suffer or permit any mechanics' lien claims to be filed or otherwise asserted against the Villa Units, and will promptly discharge the same in case of the filing of any claims for lien or proceedings for the enforcement thereof, provided, however, that Borrowers shall have the right to contest in good faith and with reasonable diligence the validity of any such lien or claim so long as Borrowers post a statutory lien bond which removes such lien from title to the Villa Units within thirty (30) days of the filing of the lien. Section 7.26 Settlement of Mechanics' Lien Claims. If Borrowers shall, within thirty (30) days of the filing of a mechanics' lien on Villa Units included in the calculation of Real Estate Borrowing Base Availability, fail (i) to discharge any such lien, or (ii) post a statutory lien bond with respect thereto, Administrative Agent may, at its election (but shall not be required to), procure the 138 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 release and discharge of any such claim and any judgment or decree thereon and, further, may in its sole discretion effect any settlement or compromise of the same, or may furnish such security or indemnity to the Title Insurance Company, and any amounts so expended by Administrative Agent, including premiums paid or security furnished in connection with the issuance of any surety company bonds, shall be deemed to constitute disbursement of the proceeds of the Loans hereunder. In settling, compromising or discharging any claims for lien, Administrative Agent shall not be required to inquire into the validity or amount of any such claim. Section 7.27 Villa Unit Advances. (a) Notwithstanding anything herein to the contrary, advances under the Real Estate Revolving Loan Commitments for Villa Units are further subject to the following: not more frequently than one time each calendar month, Borrowers may submit to Administrative Agent evidence reasonably satisfactory to Administrative Agent of (i) costs expended to complete the Villa Units, and (ii) the remaining cost to complete the Villa Units (including the amount of any retainage), which evidence shall include executed lien waivers relating to previous payments, a certification from Borrowers regarding changes to the Plans and Specifications and the remaining cost to complete, and date down endorsements to the Title Policy for the applicable Villa Unit complex indicating the absence of liens. Following Administrative Agent's receipt and review of such items, Administrative Agent will request Real Estate Revolving Loans from the Real Estate Revolving Loan Lenders. If the costs to complete the Villa Unit complex exceeds Real Estate Borrowing Base Availability for such complex, Borrowers shall be required to fund such shortfall prior to further advances of the Real Estate Revolving Loans. (b) Borrowers shall provide Administrative Agent of evidence reasonably satisfactory to Administrative Agent of (i) completion of the applicable Villa Unit complex, (ii) issuance of a certificate of occupancy permitting the use and occupancy of such Villa Unit complex, (iii) payment in full of all sums due in connection with the construction of such Villa Unit complex, and that no party claims or has a right to claim any statutory or common law lien arising out of the construction of such Villa Unit complex (which evidence shall include final lien waivers from any general contractor and such major subcontractors as Administrative Agent may reasonably require), and (iv) issuance of an endorsement to the Title Policy for such Villa Unit complex removing any exception for mechanic's and materialmen's liens. Section 7.28 Sanctions. Borrowers shall not, directly or indirectly, use the proceeds of the Loans or any Letter of Credit or lend, contribute or otherwise make available such proceeds to any Guarantor, Subsidiary, Unconsolidated Affiliate or other Person (i) to fund any activities or business of or with any Designated Person, or in any country or territory, that at the time of such funding is itself the subject of territorial sanctions under applicable Sanctions, (ii) in any manner that would result in a violation of applicable Sanctions by any party to this Agreement, or (iii) in any manner that would cause any Borrower, any Guarantor or any of their respective Subsidiaries to violate the United States Foreign Corrupt Practices Act. None of the funds or assets of Borrowers or Guarantors that are used to pay any amount due pursuant to this Agreement shall constitute funds obtained from transactions with or relating to Designated Persons or countries which are themselves the subject of territorial sanctions under applicable Sanctions. Borrower shall maintain policies and procedures designed to promote and achieve compliance with Sanctions. Section 7.29 KYC. In the event that there shall be a transfer of direct or indirect ownership interests in the aggregate in excess of 20% (or 10% if the transferee is domiciled or organized under the laws of any jurisdiction other than any State or is not a citizen of the United States) of the ownership interests of Trilogy Investors and which does not result in a Change of Control, Parent shall give prompt 139 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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written notice thereof to Administrative Agent and shall cause such transferee to comply with the Patriot Act/OFAC and other know your customer requests of Administrative Agent and the Lenders. Section 7.30 Existing and Future IGT Transactions. (a) Notwithstanding any provision herein to the contrary, "Eligible Accounts" shall not include (x) any Accounts of a Borrower who, as of the Closing Date, is an IGT Borrower party to an existing IGT Transaction with an IGT Hospital, or (y) Accounts of the applicable IGT Hospital with respect to such IGT Borrower, unless and until such IGT Borrower satisfies each of the conditions set forth in this Section 7.30(a): (i) such IGT Borrower shall have delivered to Administrative Agent copies of the executed IGT Documents (including an amended and restated or replacement IGT Security Agreement) for such IGT Transaction which shall be in form and substance acceptable to Administrative Agent; (ii) the applicable IGT Facility and the parties to such IGT Transaction are listed on Schedule 7.30; (iii) Administrative Agent and the applicable IGT Borrower have each been granted an IGT Lien from the applicable IGT Hospital pursuant to the IGT Documents executed in connection with such IGT Transaction, and such IGT Lien will be a first priority Lien and will secure all of the Obligations and all of the IGT Obligations under such IGT Documents; (iv) (A) a Uniform Commercial Code financing statement describing the assets subject to such IGT Lien and naming the applicable IGT Hospital as debtor, such IGT Borrower as secured party and Administrative Agent as assignee has been filed and (B) a Uniform Commercial Code financing statement describing the assets subject to such IGT Lien and naming the applicable IGT Hospital as debtor and Administrative Agent as secured party has been filed; (v) all Deposit Accounts maintained in connection with such IGT Transaction (other than any Deposit Account of the applicable IGT Hospital that is dedicated exclusively to the receipt of IGT UPL Payments), including all Deposit Accounts of the applicable IGT Hospital into which IGT Accounts (other than IGT UPL Payments) are deposited, are maintained in accordance with the terms and conditions of Section 7.19; (vi) Administrative Agent, the applicable IGT Hospital and the applicable bank have executed all standard control account agreement or deposit account instructions and service agreement required pursuant to the terms and conditions of Section 7.19; and (vii) Administrative Agent shall have received (A) copies of the applicable IGT Hospital's organizational documents, as amended, modified, or supplemented to the date of the consummation of such IGT Transaction, which organizational documents shall be (1) certified by the Secretary of the applicable IGT Hospital, and (2) with respect to organizational documents that are charter documents, certified as of a recent date by the appropriate governmental official, (B) a certificate from the Secretary or other appropriate officer of the applicable IGT Hospital attesting to the resolutions of such IGT Hospital's board of directors (or equivalent governing body), authorizing its execution, delivery, and performance of the IGT Documents and (C) an opinion of the applicable IGT Hospital's outside counsel relating to the IGT Documents and the IGT Transaction, in form and substance satisfactory to Administrative Agent. 140 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (b) After the Closing Date, a Borrower that is not subject to an existing IGT Transaction may, upon satisfaction by such Borrower of the conditions set forth in this Section 7.30(b), enter into an IGT Transaction with an IGT Hospital: (i) such Borrower shall provide written notice to Administrative Agent of such Borrower's intention to enter into such IGT Transaction, together with all proposed IGT Documents and all other documentation and information required to permit Administrative Agent to determine whether such IGT Transaction complies with this Section 7.30(b), at least fifteen (15) Business Days prior to such Borrower's proposed closing date for such IGT Transaction; (ii) the IGT Hospital to be a party to such IGT Transaction is reasonably acceptable to Administrative Agent; (iii) Administrative Agent and such Borrower will each receive an IGT Lien from the applicable IGT Hospital pursuant to the IGT Documents executed in connection with such IGT Transaction, and such IGT Lien will be a first priority Lien and will secure both all of the Obligations hereunder and all of the IGT Obligations under any IGT Documents; (iv) (A) a Uniform Commercial Code financing statement describing the assets subject to such IGT Lien and naming the applicable IGT Hospital as debtor, such Borrower as secured party and Administrative Agent as assignee will be filed and (B) a Uniform Commercial Code financing statement describing the assets subject to such IGT Lien and naming the applicable IGT Hospital as debtor and Administrative Agent as secured party will be filed; (v) all Deposit Accounts maintained in connection with such IGT Transaction (other than any Deposit Account of the applicable IGT Hospital that is dedicated exclusively to the receipt of IGT UPL Payments), including all Deposit Accounts of the applicable IGT Hospital into which IGT Accounts (other than IGT UPL Payments) are deposited, are maintained in accordance with the terms and conditions of Section 7.19; (vi) Administrative Agent, the applicable IGT Hospital and the applicable bank have executed all standard control account agreement or deposit account instructions and service agreement required pursuant to the terms and conditions of Section 7.19; (vii) after giving effect to such IGT Transaction, each of the representations and warranties made by or on behalf of Borrowers and Guarantors contained in this Agreement, the other Loan Documents or in any document or instrument delivered pursuant to or in connection with this Agreement shall be true in all material respects both as of the date as of which it was made and shall also be true as of the time of such IGT Transaction, with the same effect as if made at and as of that time (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing, and Administrative Agent shall have received a certificate of Borrowers and the Guarantors to such effect; (viii) Administrative Agent shall have reviewed and approved the forms of the IGT Documents delivered by such Borrower to Administrative Agent; (ix) Administrative Agent shall have consented to such IGT Transaction and approved such IGT Documents; and 141 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (x) Administrative Agent shall have received (A) copies of the applicable IGT Hospital's organizational documents, as amended, modified, or supplemented to the date of the consummation of such IGT Transaction, which organizational documents shall be (1) certified by the Secretary or other appropriate officer of the applicable IGT Hospital, and (2) with respect to organizational documents that are charter documents, certified as of a recent date by the appropriate governmental official, (B) a certificate from the Secretary of the applicable IGT Hospital attesting to the resolutions of such IGT Hospital's board of directors (or equivalent governing body), authorizing its execution, delivery, and performance of the IGT Documents and (C) an opinion of the applicable IGT Hospital's outside counsel relating to the IGT Documents and the IGT Transaction, in form and substance satisfactory to Administrative Agent. Section 7.31 Post-Closing Obligations. Borrowers shall use commercially reasonable efforts to deliver to Administrative Agent on or before the date that is 180 days after the date of this Agreement (the "Updated Opinion Deadline"), a legal opinion in form and substance reasonably satisfactory to Administrative Agent (the "Updated Opinion") that Trilogy Healthcare of Kent, LLC has the requisite certificate of need necessary to operate the Facility located at 1157 Medical Parks Drive, Grand Rapids, Michigan. If the Borrowers fail to deliver the Updated Opinion on before the Updated Opinion Deadline, then the assets of Trilogy Healthcare of Kent, LLC shall no longer be included in the A/R Borrowing Base Availability. SECTION 8. NEGATIVE COVENANTS. Each Borrower covenants and agrees that, so long as any Obligation is outstanding or any of the Lenders has any obligation to make any Loans or issue Letters of Credit: Section 8.1 Restrictions on Indebtedness. Borrowers will not, and will not permit any of their respective Subsidiaries to, create, incur, assume, guarantee or be or remain liable, contingently or otherwise, with respect to any Indebtedness other than: (a) Indebtedness to the Lenders arising under any of the Loan Documents; (b) Indebtedness to the Lender Hedge Providers in respect of any Hedge Obligations; (c) current liabilities of Borrowers or their respective Subsidiaries incurred in the ordinary course of business but not incurred through (i) the borrowing of money, or (ii) the obtaining of credit except for credit on an open account basis customarily extended and in fact extended in connection with normal purchases of goods and services; (d) Indebtedness in respect of taxes, assessments, governmental charges or levies and claims for labor, materials and supplies to the extent that payment therefor shall not at the time be required to be made in accordance with the provisions of Section 7.8; (e) Indebtedness in respect of judgments only to the extent, for the period and for an amount not resulting in an Event of Default under Section 12.1(l); (f) endorsements for collection, deposit or negotiation and warranties of products or services, in each case incurred in the ordinary course of business; and 142 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (g) subject to the provisions of Section 9, Indebtedness of Borrowers in respect of Derivatives Contracts that are entered into in the ordinary course of business and not for speculative purposes; (h) [Intentionally Omitted]; (i) [Intentionally Omitted]; (j) Indebtedness incurred to acquire furniture, fixtures or equipment to which a Borrower or a Subsidiary thereof is a party in the ordinary course of business in an aggregate outstanding amount not to exceed $12,000,000.00 at any time (an "FF&E Lease"), provided, however, that (i) the term of any such Indebtedness cannot exceed five (5) years, (ii) such Indebtedness shall amortize in a manner consistent with Borrowers' current financings of this type, (iii) such Indebtedness cannot be reborrowed or refinanced and (iv) such Indebtedness is subject to an Intercreditor Agreement, a subordination, non-disturbance and attornment agreement and such other documents or agreements reasonably requested by Administrative Agent; (k) Indebtedness (including obligations in respect of letters of credit or bank guarantees or similar instruments for the benefit of) owed to any Person providing workers' compensation, health, disability or other employee benefits or property, casualty or liability insurance to Borrowers or any Subsidiary thereof, pursuant to reimbursement or indemnification obligations to such Person, in each case in the ordinary course of business or consistent with past practice or industry practices; (l) Indebtedness in respect of performance bonds, bid bonds, appeal bonds, surety bonds and completion guarantees and similar obligations, in each case provided in the ordinary course of business or consistent with past practice or industry practices, including those incurred to secure health, safety and environmental obligations in the ordinary course of business or consistent with past practice or industry practices; (m) Indebtedness arising from the honoring by a bank or other financial institution of a check, draft or similar instrument drawn against insufficient funds in the ordinary course of business or other cash management services or netting services, in each case incurred in the ordinary course of business; (n) Indebtedness representing deferred compensation to employees, consultants or independent contractors of Borrowers (or, to the extent such work is done for Borrowers or their respective Subsidiaries, any direct or indirect parent thereof) or any Subsidiary thereof incurred in the ordinary course of business; (o) Indebtedness consisting of the financing of insurance premiums in the ordinary course of business; and (p) obligations in respect of cash management agreements. Notwithstanding anything in this Agreement to the contrary, (i) none of the Indebtedness described in Sections 8.1(i) or 8.1(j) shall have any of the Collateral Properties, Villa Units, any other Collateral or any interest therein or any direct or indirect ownership interest in any Borrower or any Subsidiary thereof as collateral, a borrowing base, asset pool or any similar form of credit support for such Indebtedness, (ii) only the Borrower owning such Real Estate or other applicable asset, if such Indebtedness is secured as expressly permitted by Section 8.2, shall create, incur, assume, guarantee or be 143 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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or remain liable, contingently or otherwise, with respect to, any Indebtedness (including pursuant to any conditional or limited guaranty or indemnity agreement creating liability with respect to usual and customary exclusions from the non-recourse limitations governing the Non-Recourse Indebtedness of any Person, or otherwise) other than Indebtedness described in Sections 8.1(a), 8.1(c), 8.1(d), 8.1(e), 8.1(f) and 8.1(k) through 8.1(p), and (iii) in no event shall any Borrower guarantee, or otherwise be contingently liable for, any Indebtedness or other obligation of any Person that is not a Borrower. Section 8.2 Restrictions on Liens, Etc. Borrowers will not, and will not permit any of their respective Subsidiaries to (a) create or incur or suffer to be created or incurred or to exist any lien, security title, encumbrance, mortgage, deed of trust, security deed, pledge, negative pledge, charge, restriction or other security interest of any kind upon any of their respective property or assets of any character whether now owned or hereafter acquired, or upon the income or profits therefrom; (b) transfer any of their property or assets or the income or profits therefrom for the purpose of subjecting the same to the payment of Indebtedness or performance of any other obligation in priority to payment of its general creditors; (c) acquire, or agree or have an option to acquire, any property or assets upon conditional sale or other title retention or purchase money security agreement, device or arrangement (or any financing lease having substantially the same economic effect as any of the foregoing; (d) suffer to exist for a period of more than thirty (30) days after the same shall have been incurred any Indebtedness or claim or demand against any of them that if unpaid could by law or upon bankruptcy or insolvency, or otherwise, be given any priority whatsoever over any of their general creditors; (e) sell, assign, pledge or otherwise transfer any accounts, contract rights, general intangibles, chattel paper, instruments or investment property, with or without recourse; (f) in the case of securities, create or incur or suffer to be created or incurred any purchase option, call or similar right with respect to such securities; or (g) incur or maintain any obligation to any holder of Indebtedness of any of such Persons which prohibits the creation or maintenance of any lien securing the Obligations (clauses (a) through (g) above, collectively, "Liens"); provided that notwithstanding anything to the contrary contained herein, any Borrower or any such Subsidiary may create or incur or suffer to be created or incurred or to exist (collectively, "Permitted Liens"): (i) Liens on properties to secure taxes, assessments and other governmental charges (excluding any Lien imposed pursuant to any of the provisions of ERISA or pursuant to any Environmental Laws) or claims for labor, material or supplies incurred in the ordinary course of business in respect of obligations not then delinquent for more than thirty (30) days or which are being contested as expressly permitted under this Agreement; (ii) Deposits or pledges made in connection with, or to secure payment of, workers' compensation, unemployment insurance, old age pensions or other social security obligations and deposits securing liability to insurance carriers under insurance or self-insurance arrangements in respect of such obligations; (iii) Pledges and deposits and other Liens securing liability for reimbursement or indemnification obligations of (including obligations in respect of letters of credit or bank guarantees for the benefit of) insurance carriers providing property, casualty or liability insurance to any Borrower or any Subsidiary thereof; (iv) Pledges and deposits to secure the performance of bids, trade contracts, leases, statutory obligations, surety and appeal bonds, performance bonds and other obligations of a like nature, in each case in the ordinary course of business, so long as no foreclosure, sale or similar proceedings have been commenced with respect to any portion of the Collateral on account thereof; 144 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (v) Liens expressly permitted by the Mortgages and the other Security Documents; (vi) To the extent not otherwise covered herein, encumbrances consisting of cable and utility easements serving the Collateral Properties which in the reasonable discretion of Administrative Agent do not interfere materially and adversely with the ordinary conduct on the business of any Borrower or the applicable Senior Care Property, and which matters do not have nor would have a Material Adverse Effect; (vii) To the extent not otherwise covered herein, the rights of OpCo Affiliates as tenant under the Leases entered into in compliance with the terms hereof; (viii) Liens and encumbrances on Real Estate not encumbered by a Mortgage consisting of easements, rights of way, zoning restrictions, leases and other occupancy agreements, restrictions on the use of real property and defects and irregularities in the title thereto, landlord's or lessor's liens under leases to which a Borrower or a Subsidiary of such Person is a party, and other minor non-monetary liens or encumbrances none of which interferes materially with the use of such other property affected in the ordinary conduct of the business of Borrowers or their respective Subsidiaries, which defects do not individually or in the aggregate have a materially adverse effect on the business of any Borrower or any Subsidiary of Borrower individually or on such other property; (ix) Liens on assets of OpCo Affiliates granted to the landlords under the applicable leases approved by Administrative Agent and which are subject to an Intercreditor Agreement; (x) [Intentionally Omitted]; (xi) Liens on furniture, equipment or fixtures of any Borrower or any Subsidiary thereof, and the proceeds thereof, purchased with the proceeds of Recourse Indebtedness of such Borrower or such Subsidiary expressly permitted by Section 8.1(j) to secure such Recourse Indebtedness; (xii) Rights of setoff or bankers' liens upon deposits of cash in favor of banks or other depository institutions, solely to the extent incurred in connection with the maintenance of such deposit accounts in the ordinary course of business, including (A) relating to the establishment of depository relations with banks and other financial institutions not given in connection with the issuance of Indebtedness or (B) relating to pooled deposits, sweep accounts, reserve accounts or similar accounts of any Borrower or any Subsidiary thereof to permit satisfaction of overdraft or similar obligations, including with respect to credit card charge-backs and similar obligations; (xiii) Liens arising from filings of UCC financing statements or similar documents regarding leases (other than Leases) or otherwise for precautionary purposes relating to arrangements not constituting Indebtedness; (xiv) Liens solely on any cash earnest money deposits made by Borrowers or any of their respective Subsidiaries in connection with any letter of intent or purchase agreement in respect of any Investment permitted hereunder; (xv) Deposits and other Liens to secure the performance of bids, trade contracts (other than for Indebtedness), leases, statutory obligations, surety and appeal bonds, performance and return of money bonds, bids, leases, government contracts, trade contracts, agreements 145 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 with networks, agreements with utilities, and other obligations of a like nature (including letters of credit in lieu of any such bonds or to support the issuance thereof) incurred in the ordinary course of business, including those incurred to secure health, safety and environmental obligations in the ordinary course of business; (xvi) Liens securing insurance premium financing arrangements; provided that such Liens are limited to the applicable unearned insurance premiums; (xvii) Any zoning or similar law or right reserved to or vested in any governmental office or agency to control or regulate the use of any real property; and (xviii) Liens on assets other than Collateral Properties or other Collateral securing judgments that do not constitute an Event of Default under Section 12.1(l); and (xix) Liens in favor of Administrative Agent and the Lenders under the Loan Documents to secure the Obligations. Section 8.3 Restrictions on Investments. Neither any Borrower will, nor will it permit any of its Subsidiaries to, make or permit to exist or to remain outstanding any Investment except Investments in: (a) marketable direct or guaranteed obligations of the United States that mature within one (1) year from the date of purchase by any Borrower or its Subsidiary; (b) marketable direct obligations of any of the following: Federal Home Loan Mortgage Corporation, Student Loan Marketing Association, Federal Home Loan Banks, Federal National Mortgage Association, Government National Mortgage Association, Bank for Cooperatives, Federal Intermediate Credit Banks, Federal Financing Banks, Export-Import Bank of the United States, Federal Land Banks, or any other agency or instrumentality of the United States; (c) demand deposits, certificates of deposit, bankers acceptances and time deposits of United States banks having total assets in excess of $100,000,000.00; provided, however, that the aggregate amount at any time so invested with any single bank having total assets of less than $1,000,000,000.00 will not exceed $200,000.00; (d) commercial paper assigned the highest rating by two (2) or more national credit rating agencies and maturing not more than ninety (90) days from the date of creation thereof; (e) bonds or other obligations having a short term unsecured debt rating of not less than A-1+ by S&P and P-1+ by Moody's and having a long term debt rating of not less than A by S&P and A1 by Moody's issued by or by authority of any state of the United States, any territory or possession of the United States, including the Commonwealth of Puerto Rico and agencies thereof, or any political subdivision of any of the foregoing; (f) repurchase agreements having a term not greater than ninety (90) days and fully secured by securities described in Section 8.3(a), 8.3(b) or 8.3(c) with banks described in Section 8.3(c) or with financial institutions or other corporations having total assets in excess of $500,000,000.00; and 146 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (g) shares of so-called "money market funds" registered with the SEC under the Investment Company Act of 1940 which maintain a level per-share value, invest principally in investments described in Sections 8.3(a) through 8.3(f) and have total assets in excess of $50,000,000.00. (h) the acquisition or ownership of fee or leasehold interests by any Borrower or its Subsidiaries in Real Estate which is utilized for Senior Care Properties located in the continental United States or the District of Columbia and businesses and investments incidental thereto that are Collateral Properties; provided, however, that (i) the development of Villa Units on any Collateral Property is subject to compliance with clause (b) of the definition of Real Estate Borrowing Base Availability and the other applicable provisions of this Agreement and (ii) Borrowers may fund new development of Villa Units only at Collateral Properties listed on Schedule 1.1(c), and at other Collateral Properties as approved by Administrative Agent and the Majority Real Estate Revolving Loan Lenders; (i) (A) Borrowers and their Subsidiaries may hold the Equity Interests of their respective Subsidiaries in existence as of the Closing Date which are Borrowers, and (B) a Borrower may form Wholly-Owned Domestic Subsidiaries after the Closing Date, in each case, so long as such Subsidiary will own Real Estate that will become a Collateral Property or Accounts that will become Collateral and such Borrower and such Subsidiary comply with Section 7.20, as applicable; (j) Borrowers may make additional Investments in their Wholly-Owned Domestic Subsidiaries that are Borrowers; (k) Investments in the development of Villa Units included in the Real Estate Borrowing Base Availability and expansions of Collateral Properties as permitted by the Loan Documents; (l) amounts owed under the Leases of Collateral Properties with OpCo Affiliates; (m) Investments resulting from pledges and deposits permitted under Sections 8.2(ii), (iii), (xiii) and (xv); (n) Permitted IGT Loans; and (o) advances by Borrowers or their respective Subsidiaries in the form of a prepayment of expenses, so long as such expenses are being paid in accordance with customary trade terms of Borrowers or their respective Subsidiaries. Section 8.4 Merger, Consolidation. Other than with respect to any disposition expressly permitted under Section 8.8, Borrowers will not, nor will it permit any of their respective Subsidiaries or any Guarantors to, become a party to any dissolution, liquidation, disposition of all or substantially all of its assets or business, merger, reorganization, consolidation or other business combination, individually or in a series of transactions which may have a similar effect as any of the foregoing. Notwithstanding the foregoing, so long as no Default or Event of Default has occurred and is continuing immediately before and after giving effect thereto and no Change of Control would occur, the following shall be permitted without the consent of Administrative Agent or any Lender: (i) the merger or consolidation of one or more Borrowers with and into a Borrower (it being understood and agreed that, in any such event, if Parent is a party to such transaction, Parent will be the surviving Person), (ii) the merger or consolidation of two or more Subsidiaries of Borrowers; provided that no such merger or consolidation shall involve any Subsidiary that is a Borrower unless a Borrower will be the surviving Person, (iii) the merger, liquidation or dissolution of any Subsidiary of a Borrower that does not own any assets so long as any assets previously owned by such Subsidiary were disposed of in accordance with this Agreement, 147 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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sublease, (d) other than as permitted by Section 8.16(e), terminate, cancel or surrender any existing or future Lease at any Collateral Property, Leasehold Property or Villa Unit complex, (e) terminate or cancel any existing or future IGT Document or any other material sublease unless (i) required by law or (ii) such IGT Document or sublease is being terminated or cancelled in connection with the termination or cancellation of the applicable IGT Transaction and the Borrower party to such IGT Transaction, after giving effect to such termination or cancellation, (A) has in full force and effect (1) all Primary Licenses required to operate each Senior Care Property formerly subject to such IGT Transaction in compliance with applicable law, (2) all provider or similar agreements required to participate in any Third Party Payor Program in which each such Borrower participates with Medicare, Medicaid, TRICARE or any other Governmental Authority, and (3) all provider or similar agreements required to participate in any material Third Party Payor Program in which each such Borrower participates with any other Third Party Payor, and, in each case, no such Primary License, Permit or provider or similar agreement has been restricted, limited, placed in provisionary or probationary status, suspended, revoked or terminated, and (B) is, after giving effect to such termination or cancellation, able to operate such Senior Care Property, and otherwise conduct its business, in all material respects as if such IGT Transaction had not occurred, (f) accept the surrender of, or consent to or enter into the assignment or subletting of any existing or future Lease at any Collateral Property or Villa Unit complex or (g) fail to comply with its obligations and liabilities under any Lease or any IGT Document. There has been no anticipation or prepayment under any Lease or IGT Document of any of the rents, income, issues, profits or revenues from the Collateral Properties for more than one (1) month prior to the due dates of such revenues, and Borrowers will not collect or accept payment of any such revenues more than one (1) month prior to the due dates of such revenues. Section 8.17 Management. Borrowers shall not and shall not permit any Operator to enter into any Management Agreement with any Person other than EIK Manager for any Collateral Property without the prior written consent of Administrative Agent, provided that any IGT Hospital may engage an OpCo Affiliate to manage any Collateral Property so long as such OpCo Affiliate engages EIK Manager to sub-manage such Collateral Property and such consent shall not be unreasonably withheld, delayed or conditioned. Administrative Agent may condition any approval of a new manager engaged by a Borrower, any Subsidiary thereof or any Operator with respect to a Collateral Property or Villa Unit complex upon the execution and delivery to Administrative Agent of a Subordination of Management Agreement. No Management Agreement shall be (a) modified, or any provision thereof waived, in any material respect without Administrative Agent's prior written approval (which shall not be unreasonably withheld, delayed or conditioned) or (b) terminated without Administrative Agent's prior written approval, which approval in connection with such termination shall not be unreasonably withheld, delayed or conditioned if the applicable EIK Manager is in continuous material breach of such Management Agreement, and no Operator of a Collateral Property may enter into a Management Agreement with respect to a Collateral Property other than in the form approved by Administrative Agent (which shall not be unreasonably withheld, delayed or conditioned); provided, however, that a Management Agreement may be modified to reflect the removal of a Collateral Property therefrom upon the transfer of such Collateral Property in accordance with the provisions hereof or other event that results in such property no longer being collateral for the Loans in accordance with the Loan Documents. Borrowers shall not and shall not permit any Operator to increase any management fee payable under a Management Agreement by an Operator of the applicable Real Estate after the date the applicable Real Estate becomes a Collateral Property or a Villa Unit complex becomes subject to a Mortgage without the prior written consent of Administrative Agent, except as provided by such Management Agreement as in effect on the Closing Date. It shall be a condition to EIK Manager or any replacement manager being an EIK Manager under this Agreement that such EIK Manager not create, incur, assume, guaranty or otherwise be liable with respect to any Indebtedness in a principal amount in excess of $5,000,000.00 152 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 other than Indebtedness of the type described in Section 8.1(c), 8.1(d), 8.1(f), 8.1(k), 8.1(l), 8.1(m), 8.1(n) and 8.1(o). Section 8.18 OpCo Affiliate Indebtedness. Borrowers shall not permit OpCo Affiliate to incur any Indebtedness other than the types described in Sections 8.1(c), 8.1(d), 8.1(e), 8.1(f), 8.1(j) (subject to the proviso thereof but without giving effect to the maximum amount set forth therein; provided that the term of any such Indebtedness is permitted to be up to five (5) years) and 8.1(k) through 8.1(p). Section 8.19 Subordination. Borrowers shall not agree with any Person to release, terminate or subordinate its rights and remedies under any Lease other than the subordination of any Lien of Borrowers under the Leases on the assets of OpCo or an OpCo Affiliate with respect to any Indebtedness of such Persons permitted hereunder and, without limiting the foregoing, which complies with Section 8.18. Section 8.20 IGT Transactions. (a) No Borrower will permit any IGT Hospital to create, incur, assume or suffer to exist, directly or indirectly, any Lien upon the IGT Accounts. (b) No Borrower will permit any IGT Hospital to convey, sell, lease, license, assign, transfer or otherwise dispose of any IGT Accounts or any other assets used in connection with an IGT Transaction. (c) No Borrower will, without the prior written consent of Administrative Agent, (i) amend, supplement or otherwise modify any now existing or future IGT Document, (ii) grant any concessions to or waive the performance of any obligations of any IGT Hospital under any IGT Document, (iii) terminate or cancel any existing or future IGT Document, or (iv) fail to comply with its obligations and liabilities under any IGT Document. (d) Neither Borrowers nor any IGT Hospital shall fail to comply with any of the provisions set forth in Section 7.19. SECTION 9. FINANCIAL COVENANTS. Each Borrower covenants and agrees that, so long as any Obligation is outstanding or any Lender has any obligation to make any Loans or issue Letters of Credit: Section 9.1 Borrowing Base Availability. Borrowers shall not at any time permit (a) the Aggregate A/R Revolving Credit Obligations to be greater than the lesser of (i) the Total A/R Revolving Loan Commitment and (ii) the A/R Borrowing Base Availability or (b) the Aggregate Real Estate Revolving Credit Obligations to be greater than the lesser of (i) the Total Real Estate Revolving Loan Commitment and (ii) the Real Estate Borrowing Base Availability, subject to compliance with Section 3.2. Section 9.2 Total Adjusted EBITDAR to Consolidated Fixed Charges. Borrowers shall not permit at any time the ratio of Total Adjusted EBITDAR to Consolidated Fixed Charges to be less than 1.50 to 1.00; provided, however, that notwithstanding the foregoing, during the Covenant Relief Period, Borrowers shall not permit at any time the ratio of Total Adjusted EBITDAR to Consolidated Fixed 153 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 154 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 December 31, 2021 1.40 to 1.00 March 31, 2022 September 30, 2021 1.45 to 1.00 Fiscal Quarter Ending 1.40 to 1.00 June 30, 2022 Charges to be less than the applicable ratio set forth below with respect to each applicable fiscal quarter set forth below: 1.45 to 1.00 Section 9.3 Minimum Consolidated Net Worth. Borrowers shall not permit at any time Consolidated Net Worth to be less than the sum of (a) $606,602,000.00 plus (b) seventy-five percent (75%) of the sum of any additional Net Offering Proceeds after the date of this Agreement. Section 9.4 Recourse Indebtedness. Borrowers shall not permit at any time (a) the sum of (i) the Recourse Indebtedness (excluding the Loans and Letter of Credit Liabilities) of Trilogy Investors plus (ii) the product of (X) the aggregate total rent obligations due for the period of twelve (12) months following the date of determination under leases, occupancy agreements or similar agreements that are recourse to Trilogy Investors, multiplied by (Y) six (6), to exceed (b) an amount equal to twenty-five percent (25%) of Consolidated Total Asset Value; provided, however, that for no more than one (1) period of up to four (4) consecutive calendar quarters immediately following a Material Acquisition of which Borrower has given Administrative Agent written notice (with such four (4) consecutive fiscal quarter period to include the quarter in which such Material Acquisition is consummated), the amount in clause (a) of this Section 9.4 may exceed twenty-five percent (25%) of Consolidated Total Asset Value but shall not exceed thirty percent (30%) of Consolidated Total Asset Value during such period. For purposes of calculating compliance with this Section 9.4, in the event that such Recourse Indebtedness is solely pursuant to a guaranty that limits recovery with respect to the underlying obligations that are guaranteed, the amount of Recourse Indebtedness shall be calculated giving effect to such limitation. Notwithstanding anything to the contrary contained herein, during the Covenant Relief Period, Borrowers shall not permit Trilogy Investors to create, incur, assume, guarantee or become liable under any additional Recourse Indebtedness not existing immediately prior to the commencement of the Covenant Relief Period, other than the Covenant Relief Period Permitted Recourse Indebtedness subject to compliance with the terms and conditions of this Agreement, including, without limitation, this Section 9.4. Section 9.5 Distributions. (a) Borrowers shall not permit Trilogy Investors to pay for the period of the four (4) consecutive fiscal quarters most recently ended any Distribution to its partners, shareholders, members or other owners, to the extent that the aggregate amount of such Distribution paid, when added to the aggregate amount of all other Distributions paid in such period, exceeds ninety-five percent (95%) of Funds from Operations for such period; provided that no such Distributions shall be paid if Trilogy Investors would not be in pro forma compliance with the financial covenants set forth in Sections 9.2, 9.3, 9.4 and 9.5 following any such Distribution, as determined on a pro forma basis taking into account Total Adjusted EBITDAR to Consolidated Fixed Charges the proposed Distributions; provided further that the limitations contained in this Section 9.5 shall not preclude Distributions in an amount equal to the Minimum REIT Distributions. For the purposes hereof, "Minimum REIT Distributions" shall mean Distributions in the minimum amount required under the Code to maintain the REIT Status of each applicable direct or indirect owner of Trilogy Investors that is a "real estate investment trust" as a "real estate investment trust", provided that such Minimum REIT Distributions to be made by Trilogy Investors shall be limited to a pro rata amount reasonably approved by Administrative Agent based on the relative total assets of Trilogy Investors to the other assets of the direct or indirect owners of Trilogy Investors that are real estate investment trusts, as evidenced by a certification of the principal financial officer of Trilogy Investors with accompanying reasonably detailed calculations in form and substance satisfactory to Administrative Agent. (b) If an Event of Default shall have occurred and be continuing, Borrowers shall not permit Trilogy Investors to make any Distributions to its partners, shareholders, members or other owners, provided that Trilogy Investors may, nonetheless, make Distributions in an amount equal to the Minimum REIT Distributions, as evidenced by a certification of the principal financial officer of Trilogy Investors containing reasonably detailed calculations satisfactory in form and substance to Administrative Agent. (c) Notwithstanding the proviso in Section 9.5(a), at any time when an Event of Default under Sections 12.1(a) or 12.1(b) shall have occurred, an Event of Default under Sections 12.1(h), 12.1(i) or 12.1(j) shall have occurred, or the maturity of the Obligations has been accelerated, Trilogy Investors shall not make any Distributions whatsoever, directly or indirectly. (d) Notwithstanding anything to the contrary contained herein, during the Covenant Relief Period, Borrowers shall not (x) make any Distributions to their respective partners, shareholders, members or other owners except in the minimum amount necessary to permit Trilogy Investors to make Distributions in an amount equal to the Minimum REIT Distributions, and (y) permit Trilogy Investors to make any Distributions to its partners, shareholders, members or other owners, other than Distributions in an amount equal to the Minimum REIT Distributions, in each case of the foregoing clauses (x) and (y), as evidenced by a certification of the principal financial officer of Trilogy Investors containing reasonably detailed proforma calculations satisfactory in form and substance to Administrative Agent. Section 9.6 Minimum Collateral Properties Requirement. At all times, (i) the Appraised Value of the Eligible Owned Real Estate included in the calculation of Real Estate Borrowing Base Availability shall be $150,000,000.00 or greater and (ii) at least ten (10) Collateral Properties shall be Eligible Owned Real Estate included in the calculation of Real Estate Borrowing Base Availability. SECTION 10. CLOSING CONDITIONS. Section 10.1 Closing Date. The effectiveness of this Agreement and the obligations of the Lenders to make any Loan or issue and Letter of Credit shall be subject to the satisfaction of the following conditions precedent: (a) Loan Documents. Each of the Loan Documents shall have been duly executed and delivered by the respective parties thereto and shall be in full force and effect. Administrative Agent shall have received a fully executed counterpart of each such document, except that each Lender shall have receive the fully-executed original of its Note. (b) Organizational Documents and Good Standing Certificates. Administrative Agent shall have received from each Borrower, each Guarantor and such other Persons as Administrative Agent may reasonably request (A) its operating agreement or other organizational agreement of such 155 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Person, certified by a duly authorized officer of such Person, as applicable, to be true and complete, (B) its certificate or articles of formation, certified as of a recent date by the Secretary of State of such Person's state of formation and (C) certificates dated as of a recent date evidencing the good standing (or equivalent status) of such Person in its jurisdiction of organization and each applicable jurisdiction where the conduct of such Person's business activities or the ownership of its properties necessitates qualification, issued by the Secretary of State or other appropriate official of each such jurisdiction. (c) Resolutions. All action on the part of each Borrower, each Guarantor and each Person authorizing any of such Persons necessary for the valid execution, delivery and performance by each Borrower and each Guarantor of this Agreement and the other Loan Documents to which such Person is or is to become a party shall have been duly and effectively taken, and evidence thereof reasonably satisfactory to Administrative Agent shall have been provided to Administrative Agent. (d) Incumbency Certificate; Authorized Signers. Administrative Agent shall have received from each Borrower, each Guarantor and each Person authorizing any of such Persons an incumbency certificate, dated as of the Closing Date, signed by a duly authorized officer of such Person and giving the name and bearing a specimen signature of each individual who shall be authorized to sign, in the name and on behalf of such Borrower or Guarantor, each of the Loan Documents to which such Borrower or Guarantor is or is to become a party. Administrative Agent shall have also received from Parent a certificate, dated as of the Closing Date, signed by a duly authorized representative of Parent and giving the name and specimen signature of each Authorized Officer who shall be authorized to make Loan Requests and Conversion/Continuation Requests and to give notices and to take other action on behalf of Borrowers under the Loan Documents. (e) Opinions of Counsel. Administrative Agent shall have received opinions addressed to the Lenders, Swing Loan Lender, Administrative Agent and Revolving Agent and dated as of the Closing Date from counsel to each Borrower in form and substance reasonably satisfactory to Administrative Agent. (f) Performance; No Default. Each Borrower and Guarantor shall have performed and complied with all terms and conditions herein required to be performed or complied with by it on or prior to the Closing Date, and on the Closing Date there shall exist, no Default or Event of Default. (g) Representations and Warranties. The representations and warranties made by each Borrower and Guarantor in the Loan Documents or otherwise made by or on behalf of Borrowers and Guarantors in connection therewith or after the date thereof shall have been true and correct in all material respects when made and shall also be true and correct in all material respects on the Closing Date. (h) Proceedings and Documents. All proceedings in connection with the transactions contemplated by this Agreement and the other Loan Documents shall be reasonably satisfactory to Administrative Agent and Administrative Agent's counsel in form and substance, and Administrative Agent shall have received all information and such counterpart originals or certified copies of such documents and such other certificates, opinions, assurances, consents, approvals or documents as Administrative Agent and Administrative Agent's counsel may reasonably require. (i) Security Agreement and Pledge Agreement. Administrative Agent shall have received the Security Agreement and Pledge Agreement duly executed by each Borrower and Guarantor a party thereto, together with Uniform Commercial Code financing statements related thereto, certificates representing all of the certificated Equity Interests of the pledged Subsidiaries, and all other original 156 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Collateral to be delivered to Administrative Agent pursuant to the Security Agreement or Pledge Agreement, and transfer powers with respect thereto duly endorsed in blank. (j) Lien Searches. Administrative Agent shall have received Lien search results with respect to each Borrower and such other Persons as Administrative Agent may reasonably request from all appropriate jurisdictions and filing offices. (k) First Priority Liens. Administrative Agent shall have received evidence that the Liens granted pursuant to the Security Documents will be first priority perfected Liens on the Collateral (subject only to Permitted Liens that are prior to the Liens of Administrative Agent by operation of law). (l) Consents; Laws. Administrative Agent shall have received evidence reasonably satisfactory to Administrative Agent that (i) all necessary stockholder, partner, member or other consents required in connection with the consummation of the transactions contemplated by this Agreement and the other Loan Documents, have been obtained, and (ii) Borrowers are in compliance with all applicable laws and legal requirements in all material respects. (m) KYC. Each Borrower, each Guarantor and any other Person reasonably requested by any Lender shall have complied with all know-your-customer and anti-money laundering requirements of the Lenders, including the Patriot Act and the provision of a Beneficial Ownership Certification. (n) Organizational Structure. Administrative Agent shall have approved of the corporate structure of Borrowers and Guarantors. (o) Due Diligence. Completion of due diligence as reasonably requested by Administrative Agent, Administrative Agent's Special Counsel or Revolving Agent. (p) Payment of Fees. Borrowers shall have paid to each Agent the fees payable pursuant to Section 4.2 and all mortgage, recording, intangible, documentary stamp or other similar taxes and charges payable in connection with such borrowing and recording and filing of Security Documents, as determined by Administrative Agent. (q) Real Estate Documents. For each Collateral Property, the items listed on Schedules 10.10 and, if applicable, 10.11, respectively, shall have been delivered to Administrative Agent at Borrowers' expense and shall be in form and substance reasonably satisfactory to Administrative Agent. (r) Payoff Letters. Administrative Agent shall have received a pay-off letter, termination statements, canceled pledges and the like required by Administrative Agent in connection with the credit facility provided by Wells Fargo Bank, National Association and other lenders to certain of Borrowers, and the obligations thereunder shall be terminated and paid in full on the Closing Date. (s) Compliance Certificate. Administrative Agent shall have received a Compliance Certificate dated as of the Closing Date demonstrating compliance with each of the covenants calculated therein. (t) Borrowing Base Certificate. Administrative Agent shall have received a Real Estate Borrowing Base Certificate and an A/R Borrowing Base Certificate, each dated as of the Closing Date, demonstrating compliance with Section 9.1 after giving effect to the initial advances of the Loans. 157 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (u) Solvency Certificate. Administrative Agent shall have received a Solvency Certificate, dated as of the Closing Date, as to Borrowers. (v) Collections Account. Parent and each Borrower that is not the owner or lessee under a Ground Lease of a Collateral Property shall have opened a Collections Account with KeyBank. (w) Subordination of Management Agreement. Administrative Agent shall have received an executed counterpart of a Subordination of Management Agreement with respect to each Management Agreement. (x) Intercreditor Agreements. Administrative Agent shall have received an executed counterpart of each Intercreditor Agreement. (y) Control Agreements. Administrative Agent shall have received any control agreements and depositary agreements required by Administrative Agent with respect to the accounts maintained by Borrowers, duly executed by the parties thereto. (z) Other. Administrative Agent and Revolving Agent shall have reviewed and approved such other documents, instruments, certificates, opinions, assurances, consents, and approvals as Administrative Agent, Administrative Agent's Special Counsel or Revolving Agent may reasonably have requested. SECTION 11. CONDITIONS TO ALL BORROWINGS. The obligations of the Lenders to make any Loan or issue any Letter of Credit, whether on or after the Closing Date, shall also be subject to the satisfaction of the following conditions precedent: Section 11.1 Representations True; No Default. Each of the representations and warranties made by or on behalf of any Loan Party contained in this Agreement, the other Loan Documents or in any document or instrument delivered by or on behalf of any Loan Party to Administrative Agent, Revolving Agent or the Lenders pursuant to or in connection with this Agreement shall be true and correct in all material respects both as of the date as of which they were made and shall also be true and correct in all material respects as of the time of the making of such Loan or the issuance of such Letter of Credit, with the same effect as if made at and as of that time, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by this Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing. Section 11.2 Borrowing Documents. Administrative Agent shall have received a fully completed Loan Request for such Loan and the other documents and information as required by Section 2.6, or a fully completed Letter of Credit Request and the other documents and information as required by Section 2.9. Section 11.3 Endorsement to Title Policy. To the extent Administrative Agent is a beneficiary of any Mortgage, at such times as Administrative Agent shall determine in its discretion prior to each funding, to the extent available under applicable law, a "date down" endorsement to each Title Policy indicating no change in the state of title and containing no survey exceptions not approved by Administrative Agent, which endorsement shall, expressly or by virtue of a proper "revolving credit" clause or endorsement in each Title Policy, increase the coverage of each Title Policy to the aggregate amount of all Loans advanced and outstanding and Letters of Credit issued and outstanding (provided 158 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 that the amount of coverage under an individual Title Policy for an individual Collateral Property need not equal the aggregate amount of all Loans), or if such endorsement is not available, such other evidence and assurances as Administrative Agent may reasonably require (which evidence may include an affidavit from Parent stating that there have been no changes in title from the date of the last effective date of the Title Policy). Section 11.4 Future Advances Tax Payment. To the extent Administrative Agent is a beneficiary of any Mortgage, as a condition precedent to any Lender's obligations to make any Loans available to Borrowers hereunder, Borrowers will pay to Administrative Agent any actual, out-of-pocket mortgage, recording, intangible, documentary stamp or other similar taxes and charges which Administrative Agent reasonably determines to be payable as a result of such Loan to any state or any county or municipality thereof in which any of the Collateral Properties are located, and deliver to Administrative Agent such affidavits or other information which Administrative Agent reasonably determines to be necessary in connection with such payment in order to insure that the Mortgages on the Collateral Properties located in such state secure Borrowers' obligation with respect to the Loans then being requested by Borrowers. The provisions of this Section 11.4 shall not limit Borrowers' obligations under other provisions of the Loan Documents, including Section 15. SECTION 12. EVENTS OF DEFAULT; ACCELERATION; ETC. Section 12.1 Events of Default and Acceleration. If any of the following events ("Events of Default") shall occur while any Obligations remain outstanding or any Lender has any obligation to make any Loans or issue any Letter of Credit, subject to the cure periods set forth in Section 12.2: (a) Borrowers shall fail to pay any principal of the Loans or any reimbursement obligations with respect to the Letters of Credit when the same shall become due and payable, whether at the stated date of maturity or any accelerated date of maturity or at any other date fixed for payment; (b) Borrowers shall fail to pay any interest on the Loans or any fees or other sums due hereunder or under any of the other Loan Documents when the same shall become due and payable, whether at the stated date of maturity or any accelerated date of maturity or at any other date fixed for payment; (c) any Loan Party shall fail to perform any term, covenant or agreement contained in Section 9; (d) any Borrower or any of their respective Subsidiaries or any Guarantor shall fail to perform any other term, covenant or agreement contained herein or in any of the other Loan Documents or the Contribution Agreement which they are required to perform (other than those specified in the other sections or clauses of this Section 12 or in the other Loan Documents); (e) any representation or warranty made by or on behalf of any Borrower or any Guarantor in this Agreement or any other Loan Document, or any report, certificate, financial statement, request for a Loan, Letter of Credit Request or in any other document or instrument delivered pursuant to or in connection with this Agreement, any advance of a Loan, the issuance of a Letter of Credit or any of the other Loan Documents shall prove to have been false in any material respect upon the date when made or deemed to have been made or repeated; (f) any Loan Party or any of their respective Subsidiaries (other than the RHS Entities as specifically set forth below in clause (ii)) shall fail to pay when due (including at maturity), or within any applicable period of grace, any obligation for borrowed money or credit received or other 159 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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Indebtedness (including under any Derivatives Contract), or the FF&E Leases or shall fail to observe or perform any term, covenant or agreement contained in any agreement by which it is bound, evidencing or securing any obligation for borrowed money or credit received or other Indebtedness (including under any Derivatives Contract) or the FF&E Leases for such period of time as would permit (assuming the giving of appropriate notice if required) the holder or holders thereof or of any obligations issued thereunder to accelerate the maturity thereof or require the prepayment, redemption, purchase, termination or other settlement thereof; provided, however, that the events described in this Section 12.1(f) shall not constitute an Event of Default (i) solely with respect to Guarantors or any of their Subsidiaries (but specifically excluding Borrowers and any of their Subsidiaries) unless such failure to perform, together with other failures to perform as described in this Section 12.1(f), involves singly or in the aggregate obligations for Recourse Indebtedness in excess of $15,000,000.00 and which events described in this Section 12.1(f)(i) with respect to such Recourse Indebtedness of Guarantors or any of their Subsidiaries (but specifically excluding Borrowers and any of their Subsidiaries) is not cured to the reasonable satisfaction of Administrative Agent within fifteen (15) days or such occurrence or (ii) solely with respect to Guarantors or any of their Subsidiaries (other than the RHS Entities) (but specifically excluding Borrowers and any of their Subsidiaries) unless such failure to perform, together with other failures to perform as described in this Section 12.1(f), involves singly or in the aggregate obligations for Non-Recourse Indebtedness in excess of $25,000,000.00; (g) EIK Manager shall fail to pay when due (including at maturity), or within any applicable period of grace, any obligation for borrowed money or credit received or other Indebtedness (including under any Derivatives Contract), or shall fail to observe or perform any term, covenant or agreement contained in any agreement by which it is bound, evidencing or securing any obligation for borrowed money or credit received or other Indebtedness (including under any Derivatives Contract) for such period of time as would permit (assuming the giving of appropriate notice if required) the holder or holders thereof or of any obligations issued thereunder to accelerate the maturity thereof or require the prepayment, redemption, purchase, termination or other settlement thereof; provided, however, that the events described in this Section 12.1(g) shall not constitute an Event of Default unless such failure to perform, together with other failures to perform as described in this Section 12.1(g), involves singly or in the aggregate obligations for Indebtedness in excess of $5,000,000.00; (h) any Borrower, any Guarantor, any of their respective Subsidiaries, EIK Manager or any other Operator (i) shall make an assignment for the benefit of creditors, or admit in writing its general inability to pay or generally fail to pay its debts as they mature or become due, or shall petition or apply for the appointment of a trustee or other custodian, liquidator or receiver for it or any substantial part of its assets, (ii) shall commence any case or other proceeding relating to it under any bankruptcy, reorganization, arrangement, insolvency, readjustment of debt, dissolution or liquidation or similar law of any jurisdiction, now or hereafter in effect, or (iii) shall take any action to authorize or in furtherance of any of the foregoing; provided that the events described in this Section 12.1(h) as to any Subsidiary of the Guarantor that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator shall not constitute an Event of Default unless the value of the assets of any such Subsidiary or Subsidiaries that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator (calculated based on "total assets plus accumulated appreciation" as defined under GAAP) subject to an event or events described in Sections 12.1(h), 12.1(i) or 12.1(j) in the aggregate equals or exceeds $25,000,000.00; (i) a petition or application shall be filed for the appointment of a trustee or other custodian, liquidator or receiver of any Borrower, any Guarantor, any of their respective Subsidiaries, OpCo, EIK Manager or any other Operator or any substantial part of the assets of any thereof, or a case or other proceeding shall be commenced against any such Person under any bankruptcy, reorganization, arrangement, insolvency, readjustment of debt, dissolution or liquidation or similar law of any jurisdiction, now or hereafter in effect, and any such Person shall indicate its approval thereof, consent 160 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 thereto or acquiescence therein or such petition, application, case or proceeding shall not have been dismissed, rescinded, discharged or otherwise cured within sixty (60) days following the filing or commencement thereof; provided that the events described in this Section 12.1(i) as to any Subsidiary of the Guarantor that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator shall not constitute an Event of Default unless the value of the assets of any such Subsidiary or Subsidiaries that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator (calculated based on "total assets plus accumulated appreciation" as defined under GAAP) subject to an event or events described in Sections 12.1(h), 12.1(i) or 12.1(j) in the aggregate equals or exceeds $25,000,000.00; (j) a decree or order is entered appointing a trustee, custodian, liquidator or receiver for any Borrower, any Guarantor, any of their respective Subsidiaries, OpCo, EIK Manager or any other Operator or adjudicating any such Person, bankrupt or insolvent, or approving a petition in any such case or other proceeding, or a decree or order for relief is entered in respect of any such Person in an involuntary case under federal bankruptcy laws as now or hereafter constituted; provided that the events described in this Section 12.1(j) as to any Subsidiary of the Guarantor that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator shall not constitute an Event of Default unless the value of the assets of any such Subsidiary or Subsidiaries that is not a Borrower, a Subsidiary of a Borrower, a Guarantor or an Operator (calculated based on "total assets plus accumulated appreciation" as defined under GAAP) subject to an event or events described in Sections 12.1(h), 12.1(i) or 12.1(j) in the aggregate equals or exceeds $25,000,000.00; (k) any event of default (after expiration of any applicable notice and cure period) shall have occurred under any Management Agreement with EIK Manager or, with respect to any OpCo Affiliate, any Lease with such OpCo Affiliate at a Collateral Property; (l) there shall remain in force, undischarged, unsatisfied and unstayed, for more than thirty (30) days, whether or not consecutive, one (1) or more uninsured or unbonded final judgments against any Borrower, any Guarantor, any of their respective Subsidiaries, EIK Manager or any other Operator that, either individually or in the aggregate, exceed $5,000,000.00 per occurrence or during any twelve (12) month period; (m) any of the Loan Documents or the Contribution Agreement shall be canceled, terminated, revoked or rescinded otherwise than in accordance with the terms thereof or the express prior written agreement, consent or approval of the Lenders, or any action at law, suit in equity or other legal proceeding to cancel, revoke or rescind any of the Loan Documents or the Contribution Agreement shall be commenced by or on behalf of any Loan Party, or any court or any other governmental or regulatory authority or agency of competent jurisdiction shall make a determination, or issue a judgment, order, decree or ruling, to the effect that any one or more of the Loan Documents or the Contribution Agreement is illegal, invalid or unenforceable in accordance with the terms thereof; (n) any dissolution, termination, partial or complete liquidation, merger or consolidation of any Loan Party, EIK Manager or any other Operator shall occur or any sale, transfer or other disposition of the assets of any Loan Party, EIK Manager or any IGT Hospital or any other Operator shall occur, in each case, other than as expressly permitted under the terms of this Agreement or the other Loan Documents; except with respect to a merger of EIK Manager, where EIK Manager is the surviving entity or a sale, transfer or other disposition of assets by EIK Manager that does not involve a sale of all or substantially all of its assets; and except with respect to a merger of any IGT Hospital where the applicable IGT Hospital is the surviving entity or a sale, transfer or other disposition of assets by an IGT Hospital which does not cause a breach (whether with the giving of notice, passage of time, or both) under any IGT Documents; 161 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (o) with respect to any Guaranteed Pension Plan, an ERISA Reportable Event shall have occurred and the Majority Lenders shall have determined in their reasonable discretion that such event reasonably could be expected to result in liability of any Loan Party to the PBGC or such Guaranteed Pension Plan in an aggregate amount exceeding $5,000,000.00 and (x) such event in the circumstances occurring reasonably could constitute grounds for the termination of such Guaranteed Pension Plan by the PBGC or for the appointment by the appropriate United States District Court of a trustee to administer such Guaranteed Pension Plan; or (y) a trustee shall have been appointed by the United States District Court to administer such Plan; or (z) the PBGC shall have instituted proceedings to terminate such Guaranteed Pension Plan; (p) any Loan Party, EIK Manager or any other Operator or any direct shareholder, officer, director, partner or member of any of them shall be indicted for a federal crime, a punishment for which could include the forfeiture of (i) any assets of any Loan Party which in the good faith judgment of the Majority Lenders could reasonably be expected to have a Material Adverse Effect, or (ii) the Collateral, and such Person (other than any Loan Party, EIK Manager or any other Operator) is not immediately dismissed and such forfeiture irrevocably averted; (q) any Guarantor denies in writing that it has any liability or obligation under the Guaranty or any other Loan Document to which such Guarantor is a party, or shall notify Administrative Agent or any of the Lenders of such Guarantor's intention to attempt to cancel or terminate the Guaranty or any other Loan Document to which such Guarantor is a party, or shall fail to observe or comply with any term, covenant, condition or agreement under any Guaranty or any other Loan Document to which such Guarantor is a party (beyond any applicable notice and cure period); (r) any Borrower abandons, closes or otherwise fails to use all or a portion (other than de minimis portion) of any Senior Care Property (casualty and condemnation excepted); (s) any Senior Care Property shall be taken on execution or other process of law (other than by eminent domain) in any action against any Loan Party by a party other than by or on behalf of the Secured Parties; (t) any Change of Control shall occur; (u) EIK Manager shall fail to manage any Real Estate of a Borrower; or (v) Borrowers or any OpCo Affiliates shall sell, assign or otherwise transfer any of their respective assets to EIK Manager; (w) If any Borrower (or with respect to an IGT Transaction, the applicable IGT Hospital) is found to have been overpaid by an Account Debtor under a Government Receivable by more than $500,000 during any period covered by an audit conducted by such Account Debtor, and such overpayment is not repaid within thirty (30) days of its due date or reserved for in a manner reasonably acceptable to Revolving Agent; (x) If (i) any instruction or agreement regarding any Deposit Account or deposit account instructions and service agreement required pursuant to this Agreement is amended or terminated without the written consent of Administrative Agent, or any Borrower or IGT Hospital gives a notice with respect to any deposit account instructions and service agreement to change the instructions for the disposition of funds thereunder, (ii) Borrower fails to forward any collections on Accounts, or any IGT Hospital fails to forward collections on IGT Accounts, in each case to the applicable Deposit Account as required pursuant to Section 7.19, or (iii) any Loan Party directs any Account Debtor to make a payment 162 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 in respect of any Account, or any IGT Hospital directs any Account Debtor with respect to IGT Accounts to make a payment in respect of any IGT Account, in each case to any place, lockbox or Deposit Account other than as required pursuant to Section 7.19; (y) If any of the following shall occur: (i) any Borrower shall enter into a settlement or other agreement with CMS or any other Governmental Authority for an amount in excess of $500,000, or (ii) any Borrower or IGT Hospital, or any officer, director, shareholder or managing employee of a Borrower or an IGT Hospital (i) shall have been found guilty of an act of fraud (ii) shall have been indicted for or convicted of a felony crime that relates to any Medical Services or Third Party Payor Program; (z) (i) Any Trilogy Pharmacy Company enters into a settlement agreement with the FDA for an amount in excess of $500,000; or (ii) the FDA revokes any authorization or permission granted under any material Registration; (aa) If at any time during the term of this Agreement, five (5) or more Senior Care Properties have outstanding Medicare or Medicaid survey deficiencies at Level G, H, I, J, K, L or worse that have been outstanding for a period greater than ninety (90) days or have resulted in the imposition by CMS or the applicable state survey agency of sanctions in the form of a program termination, temporary management, denial of payment for new admissions as a result of Medicare or Medicaid survey deficiencies or state monitoring; (bb) Any Senior Care Property has been closed or ordered to be closed by any Governmental Authority, or any Governmental Authority ceases to permit new patients, residents or tenants to be admitted to any Senior Care Property; or (cc) If any of the following shall occur: (i) any of the IGT Documents shall be canceled, terminated, revoked or rescinded other than in accordance with the terms thereof or with the express prior written agreement, consent or approval of Administrative Agent, or any action at law, suit in equity or other legal proceeding to cancel, revoke or rescind any of the IGT Documents shall be commenced by or on behalf of any Borrower or any IGT Hospital, or any court or any other governmental or regulatory authority or agency of competent jurisdiction shall make a determination, or issue a judgment, order, decree or ruling, to the effect that any one or more of the IGT Documents is illegal, invalid or unenforceable in accordance with the terms thereof; or (ii) any IGT Hospital denies that it has any liability or obligation under any of the IGT Documents, or shall notify any Borrower, Administrative Agent or any of the Lenders of such IGT Hospital's intention to attempt to cancel or terminate any of the IGT Documents, or shall fail to observe or comply with any term, covenant, condition or agreement under any of the IGT Documents; then, upon and during the continuance of such Event of Default, Administrative Agent may, and, upon the request of the Majority Lenders, shall by notice in writing to Borrowers declare all amounts owing with respect to this Agreement, the Notes, the Letters of Credit and the other Loan Documents to be, and they shall thereupon forthwith become, immediately due and payable without presentment, demand, protest or other notice of any kind, all of which are hereby expressly waived by Borrowers; provided that in the event of any Event of Default specified in Section 12.1(h), 12.1(i) or 12.1(j), all such amounts shall 163 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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become immediately due and payable automatically and without any requirement of presentment, demand, protest or other notice of any kind from any of the Lenders or Administrative Agent, Borrowers hereby expressly waiving any right to notice of intent to accelerate and notice of acceleration. Upon demand by Administrative Agent or the Majority Real Estate Revolving Loan Lenders in their absolute and sole discretion after the occurrence and during the continuance of an Event of Default, and regardless of whether the conditions precedent in this Agreement for a Real Estate Revolving Loan have been satisfied, the Real Estate Revolving Loan Lenders will cause a Real Estate Revolving Loan to be made in the undrawn amount of all Letters of Credit. The proceeds of any such Real Estate Revolving Loan will be pledged to and held by Administrative Agent as security for any amounts that become payable under the Letters of Credit. In the alternative, if demanded by Administrative Agent in its absolute and sole discretion after the occurrence and during the continuance of an Event of Default, Borrowers will deposit into the Collateral Account and pledge to Administrative Agent cash in an amount equal to 105% of the amount of all undrawn Letters of Credit. Such amounts will be pledged to and held by Administrative Agent for the benefit of the Lenders as security for any amounts that become payable under the Letters of Credit. Upon any draws under Letters of Credit, at Administrative Agent's sole discretion, Administrative Agent may apply any such amounts to the repayment of amounts drawn thereunder and upon the expiration of the Letters of Credit any remaining amounts will be applied to the payment of all other Obligations or if there are no outstanding Obligations and the Lenders have no further obligation to make Real Estate Revolving Loans, A/R Revolving Loans or issue Letters of Credit or if such excess no longer exists, such proceeds deposited by Borrowers will be released to Borrowers. Section 12.2 Certain Cure Periods; Limitation of Cure Periods. (a) Notwithstanding anything contained in Section 12.1 to the contrary, (i) no Event of Default shall exist hereunder upon the occurrence of any failure described in Section 12.1(b) in the event that Borrowers cure such Default within five (5) Business Days after the date such payment is due (or, with respect to any payments other than interest on the Loans or any fees due under the Loan Documents, within five (5) Business Days after written notice thereof shall have been given to Parent by Administrative Agent), provided, however, that Borrowers shall not be entitled to receive more than two (2) grace or cure periods in the aggregate pursuant to this clause (i) in any period of three hundred sixty-five (365) days ending on the date of any such occurrence of Default, and provided further, that no such cure period shall apply to any payments due upon the maturity of the Notes, (ii) no Event of Default shall exist hereunder upon the occurrence of any failure described in Section 12.1(d) in the event that Borrowers cure (or causes to be cured) such Default within thirty (30) days following receipt of written notice of such default, provided that the provisions of this clause (ii) shall not pertain to defaults consisting of a failure to provide insurance as required by Section 7.7, to any default (whether of any Borrower or any Guarantor) consisting of a failure to comply with Section 7.4(a)(iii)(A), 7.4(a)(x), 7.12, 7.13 (other than clause (b) of the first sentence thereof), 7.16, 7.17, 7.18, 7.19, 7.20, 7.21, 7.22, 7.25, 7.26, 8.1, 8.2, 8.3, 8.4, 8.7, 8.8, 8.9, 8.12, 8.16, 8.17, 8.18 or 8.19, or to any Default excluded from any provision of cure of defaults contained in any other of the Loan Documents and (iii) no Event of Default shall exist hereunder upon the occurrence of any event of default under Section 12.1(k) with respect to any Management Agreement in the event Borrowers, within thirty (30) days of such occurrence, replace the existing EIK Manager and related Management Agreements with a successor EIK Manager and Management Agreements with such successor EIK Manager that, in each case, (A) comply with the requirements of this Agreement and (B) are approved by the Majority Lenders, which approval shall not be unreasonably withheld, delayed or conditioned; provided that during that period there shall be no material adverse effect on any Loan Party's, any Subsidiary of a Borrower's or any Operator's ability to accept or retain patients or residents, provide Ancillary Services at any Senior Care Property, receive payment or reimbursement for care or services provided at, or operate, any Senior Care Property for its current use with not less than the current number of licensed beds, shall not result in any material civil or 164 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 criminal penalty or remedy against any Loan Party, IGT Hospital or Operator, and shall not result in the appointment of a receiver or manager. (b) In the event that there shall occur any Default or Event of Default that affects only certain Collateral Properties or Senior Care Properties, or the owner(s) and/or Operator(s) thereof, then Borrowers may elect to cure such Default or Event of Default (so long as no other Default or Event of Default would arise as a result) by electing to have (i) if such Default or Event of Default affects one or more Collateral Properties, Administrative Agent remove such Collateral Properties from the calculation of the Collateral Pool Value and the Real Estate Borrowing Base Availability and reducing (to the extent necessary) the outstanding Real Estate Revolving Loans and Letter of Credit Liabilities so that no Default or Event of Default exists under this Agreement or (ii) if such Default or Event of Default affects one or more other Senior Care Properties that are not Collateral Properties, Revolving Agent remove the applicable Borrowers from the calculation of A/R Borrowing Base Availability and reducing (to the extent necessary) the outstanding A/R Revolving Loans so that no Default or Event of Default exists under this Agreement, in which event such removal and reduction shall be completed within ten (10) Business Days after receipt of notice of such Default or Event of Default from Administrative Agent, the Majority Real Estate Revolving Loan Lenders or the Majority A/R Revolving Loan Lenders and, following such time when such Collateral Property is removed from the calculation of the Collateral Pool Value and Real Estate Borrowing Base Availability or such Borrower is removed from the calculation of A/R Borrowing Base Availability, as the case may be, there shall be no Default or Event of Default solely with respect to such Collateral Property to the extent there are representations or warranties, covenants, Defaults or Events of Default that relate solely to such Collateral Property. Section 12.3 Termination of Total Commitment. If any one or more Events of Default specified in Section 12.1(h), 12.1(i), 12.1(j) or 12.1(l) shall occur, then immediately and without any action on the part of Administrative Agent or any Lender any unused portion of the Total Commitment hereunder shall terminate and the Lenders shall be relieved of any obligations to make Loans or issue Letters of Credit hereunder. If any other Event of Default shall have occurred, Administrative Agent may, and upon the election of the Majority A/R Revolving Loan Lenders or the Majority Real Estate Revolving Loan Lenders, as applicable shall, by notice to Borrowers terminate the obligation to make A/R Revolving Loans, Real Estate Revolving Loans or issue Letters of Credit hereunder. No termination under this Section 12.3 shall relieve Borrowers or the Guarantors of their obligations to the Lenders arising under this Agreement or the other Loan Documents. Section 12.4 Remedies. In case any one or more Events of Default shall have occurred and be continuing, and whether or not the Lenders shall have accelerated the maturity of the Loans pursuant to Section 12.1, Administrative Agent, on behalf of the Lenders may, and upon the direction of the Majority Lenders, shall proceed to protect and enforce their rights and remedies under this Agreement, the Notes or any of the other Loan Documents by suit in equity, action at law or other appropriate proceeding, including to the full extent permitted by applicable law the specific performance of any covenant or agreement contained in this Agreement and the other Loan Documents, the obtaining of the ex parte appointment of a receiver, and, if any amount shall have become due, by declaration or otherwise, the enforcement of the payment thereof. No remedy herein conferred upon Administrative Agent or the holder of any Note is intended to be exclusive of any other remedy and each and every remedy shall be cumulative and shall be in addition to every other remedy given hereunder or now or hereafter existing at law or in equity or by statute or any other provision of law. Notwithstanding the provisions of this Agreement providing that the Loans may be evidenced by multiple Notes in favor of the Lenders, the Lenders acknowledge and agree that only Administrative Agent may exercise any remedies arising by reason of a Default or Event of Default. If any Loan Party fails to perform any agreement or covenant contained in this Agreement or any of the other Loan Documents beyond any applicable period for notice and cure, Administrative Agent may itself perform, or cause to be performed, any agreement or covenant 165 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 of such Person contained in this Agreement or any of the other Loan Documents which such Person shall fail to perform, and the reasonable and documented out-of-pocket costs of such performance, together with any reasonable expenses, including reasonable attorneys' fees actually incurred (including attorneys' fees incurred in any appeal) by Administrative Agent in connection therewith, shall be payable by Borrowers upon demand and shall constitute a part of the Obligations and shall if not paid within five (5) days after demand bear interest at the Default Rate. In the event that all or any portion of the Obligations is collected by or through an attorney-at-law, Borrowers shall pay all actual, out-of-pocket costs of collection including reasonable attorney's fees. Section 12.5 Collateral Account. (a) As collateral security for the prompt payment in full when due of all Letter of Credit Liabilities, Swing Loans and the other Obligations, Borrowers hereby pledge and grant to Administrative Agent, for the ratable benefit of Administrative Agent and the Lenders as provided herein, a security interest in all of its right, title and interest in and to the Collateral Account and the balances from time to time in the Collateral Account (including the investments and reinvestments therein provided for below). The balances from time to time in the Collateral Account shall not constitute payment of any Letter of Credit Liabilities or Swing Loans until applied by Administrative Agent as provided herein. Anything in this Agreement to the contrary notwithstanding, funds held in the Collateral Account shall be subject to withdrawal only as provided in this Section 12.5. (b) Amounts on deposit in the Collateral Account shall be invested and reinvested by Administrative Agent in such Cash Equivalents as Administrative Agent shall determine in its sole discretion. All such investments and reinvestments shall be held in the name of and be under the sole dominion and control of Administrative Agent for the ratable benefit of the Lenders. Administrative Agent shall exercise reasonable care in the custody and preservation of any funds held in the Collateral Account and shall be deemed to have exercised such care if such funds are accorded treatment substantially equivalent to that which Administrative Agent accords other funds deposited with Administrative Agent, it being understood that Administrative Agent shall not have any responsibility for taking any necessary steps to preserve rights against any parties with respect to any funds held in the Collateral Account. (c) If a drawing pursuant to any Letter of Credit occurs on or prior to the expiration date of such Letter of Credit, Borrowers and the Lenders authorize Administrative Agent to use the monies deposited in the Collateral Account to make payment to the beneficiary with respect to such drawing or the payee with respect to such presentment. If a Swing Loan is not refinanced as a Base Rate Loan as provided in Section 2.4, then Administrative Agent is authorized to use monies deposited in the Collateral Account to make payment to the Swing Loan Lender with respect to any participation not funded by a Defaulting Lender. (d) If an Event of Default exists, the Majority Real Estate Revolving Loan Lenders may, in their discretion, at any time and from time to time, instruct Administrative Agent to liquidate any such investments and reinvestments and apply proceeds thereof to the Obligations in accordance with Section 3.6. (e) So long as no Default or Event of Default exists, and to the extent amounts on deposit in the Collateral Account exceed 105% of the aggregate amount of the Letter of Credit Liabilities then due and owing and the pro rata share of any Letter of Credit Liabilities and Swing Loans of any Defaulting Lender after giving effect to Section 2.12(c), Administrative Agent shall, from time to time, at the request of Parent, deliver to Parent on behalf of Borrowers within ten (10) Business Days after Administrative Agent's receipt of such request from Parent, against receipt but without any recourse, 166 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 warranty or representation whatsoever, such of the balances in the Collateral Account as exceed the aggregate amount of the Letter of Credit Liabilities and Swing Loans at such time. (f) Borrowers shall pay to Administrative Agent from time to time such fees as Administrative Agent normally charges for similar services in connection with Administrative Agent's administration of the Collateral Account and investments and reinvestments of funds therein. Each Borrower authorizes Administrative Agent to file such financing statements as Administrative Agent may reasonably require in order to perfect Administrative Agent's security interest in the Collateral Account, and each Borrower shall promptly upon demand execute and deliver to Administrative Agent such other documents as Administrative Agent may reasonably request to evidence its security interest in the Collateral Account. SECTION 13. SETOFF. Regardless of the adequacy of any Collateral, during the continuance of any Event of Default under Section 12.1(a) or Section 12.1(b), including in connection with any acceleration of the Obligations, any deposits (general or specific, time or demand, provisional or final, regardless of currency, maturity, or the branch where such deposits are held) or other sums credited by or due from any Lender to Borrowers or the Guarantors and any securities or other property of Borrowers or the Guarantors in the possession of such Lender may, without notice to any Borrower or any Guarantor (any such notice being expressly waived by each Borrower and each Guarantor) but with the prior written approval of Administrative Agent, be applied to or set off against the payment of Obligations and any and all other liabilities, direct, or indirect, absolute or contingent, due or to become due, now existing or hereafter arising, of Borrowers or the Guarantors to such Lender. Each of the Lenders agree with each other Lender that if such Lender shall receive from Borrowers or the Guarantors, whether by voluntary payment, exercise of the right of setoff, or otherwise, and shall retain and apply to the payment of the Note or Notes held by such Lender (but excluding the Swing Loan Note) any amount in excess of its ratable portion of the payments received by all of the Lenders with respect to the Notes held by all of the Lenders, such Lender will make such disposition and arrangements with the other Lenders with respect to such excess, either by way of distribution, pro tanto assignment of claims, subrogation or otherwise as shall result in each Lender receiving in respect of the Notes held by it its proportionate payment as contemplated by this Agreement; provided that if all or any part of such excess payment is thereafter recovered from such Lender, such disposition and arrangements shall be rescinded and the amount restored to the extent of such recovery, but without interest. In the event that any Defaulting Lender shall exercise any such right of setoff, (a) all amounts so set off shall be paid over immediately to Administrative Agent for further application in accordance with the provisions of this Agreement and, pending such payment, shall be segregated by such Defaulting Lender from its other funds and deemed held in trust for the benefit of Administrative Agent and the Lenders, and (b) such Defaulting Lender shall provide promptly to Administrative Agent a statement describing in reasonable detail the Obligations owing to such Defaulting Lender as to which it exercised such right of setoff. SECTION 14. AGENTS. Section 14.1 Authorization. Each Agent is authorized to take such action on behalf of each of the Lenders and to exercise all such powers as are hereunder and under any of the other Loan Documents and any related documents delegated to such Agent, together with such powers as are reasonably incident thereto, provided that no duties or responsibilities not expressly assumed herein or therein shall be implied to have been assumed by such Agent. The obligations of each Agent hereunder are primarily administrative in nature, and nothing contained in this Agreement or any of the other Loan Documents shall be construed to constitute such Agent as a trustee for any Lender or to create an agency or fiduciary relationship. Administrative Agent shall act as the contractual representative of the Lenders hereunder, 167 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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and notwithstanding the use of the term "Administrative Agent", it is understood and agreed that Administrative Agent shall not have any fiduciary duties or responsibilities to any Lender by reason of this Agreement or any other Loan Document and is acting as an independent contractor, the duties and responsibilities of which are limited to those expressly set forth in this Agreement and the other Loan Documents. Revolving Agent shall act as the contractual representative of the A/R Revolving Loan Lenders hereunder, and notwithstanding the use of the term "Revolving Agent", it is understood and agreed that Revolving Agent shall not have any fiduciary duties or responsibilities to any Lender by reason of this Agreement or any other Loan Document and is acting as an independent contractor, the duties and responsibilities of which are limited to those expressly set forth in this Agreement and the other Loan Documents. Borrowers, Guarantors and any other Person shall be entitled to conclusively rely on a statement from an Agent that it has the authority to act for and bind the Lenders pursuant to this Agreement and the other Loan Documents. Section 14.2 Employees and Agents. Each Agent may exercise its powers and execute its duties by or through employees or agents and shall be entitled to take, and to rely on, advice of counsel concerning all matters pertaining to its rights and duties under this Agreement and the other Loan Documents. Each Agent may utilize the services of such Persons as such Agent may reasonably determine, and all reasonable fees and expenses of any such Persons shall be paid by Borrowers. Section 14.3 No Liability. Neither any Agent nor any of its shareholders, directors, officers or employees nor any other Person assisting them in their duties nor any agent, or employee thereof, shall be liable to any Lender for (a) any waiver, consent or approval given or any action taken, or omitted to be taken, in good faith by it or them hereunder or under any of the other Loan Documents, or in connection herewith or therewith, or be responsible for the consequences of any oversight or error of judgment whatsoever, except that such Agent or such other Person, as the case may be, shall be liable for losses due to its willful misconduct or gross negligence as finally determined by a court of competent jurisdiction after the expiration of all applicable appeal periods or (b) any action taken or not taken by such Agent with the consent or at the request of the Majority Lenders or, as applicable, the Majority A/R Revolving Loan Lenders, the Majority Real Estate Revolving Loan Lenders or all Lenders, as the case may be. No Agent shall be deemed to have knowledge or notice of the occurrence of any Default or Event of Default, unless such Agent has received notice from a Lender or any Borrower referring to the Loan Documents and describing with reasonable specificity such Default or Event of Default and stating that such notice is a "notice of default". Section 14.4 No Representations. No Agent shall be responsible for the execution or validity or enforceability of this Agreement, the Notes, any of the other Loan Documents or any instrument at any time constituting, or intended to constitute, collateral security for the Notes, or for the value of any such collateral security or for the validity, enforceability or collectability of any such amounts owing with respect to the Notes, or for any recitals or statements, warranties or representations made herein, or any agreement, instrument or certificate delivered in connection therewith or in any of the other Loan Documents or in any certificate or instrument hereafter furnished to it by or on behalf of Borrowers, the Guarantors or any of their respective Subsidiaries, or be bound to ascertain or inquire as to the performance or observance of any of the terms, conditions, covenants or agreements herein or in any of the other Loan Documents. No Agent shall be bound to ascertain whether any notice, consent, waiver or request delivered to it by Borrowers, the Guarantors or any holder of any of the Notes shall have been duly authorized or is true, accurate and complete. Neither Agent has made nor does it now make any representations or warranties, express or implied, nor does it assume any liability to the Secured Parties, with respect to the creditworthiness or financial condition of Borrowers, the Guarantors or any of their respective Subsidiaries, or the value of the Collateral or any other assets of any Borrower, any Guarantor or any of their respective Subsidiaries. Each Lender acknowledges that it has, independently and without reliance upon any Agent or any other Lender, and based upon such information and documents as it has 168 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 deemed appropriate, made its own credit analysis and decision to enter into this Agreement. Each Lender also acknowledges that it will, independently and without reliance upon any Agent or any other Lender, based upon such information and documents as it deems appropriate at the time, continue to make its own credit analysis and decisions in taking or not taking action under this Agreement and the other Loan Documents. Administrative Agent's Special Counsel has only represented Administrative Agent and KeyBank in connection with the Loan Documents and the only attorney client relationship or duty of care is between Administrative Agent's Special Counsel and Administrative Agent or KeyBank. Revolving Agent and each Lender has been independently represented by separate counsel on all matters regarding the Loan Documents and the granting and perfecting of liens in the Collateral. Section 14.5 Payments. (a) A payment by any Borrower or any Guarantor to Administrative Agent hereunder or under any of the other Loan Documents for the account of any Lender shall constitute a payment to such Lender. Administrative Agent agrees to distribute to each Lender not later than one (1) Business Day after Administrative Agent's receipt of good funds, determined in accordance with Administrative Agent's customary practices, such Lender's pro rata share of payments received by Administrative Agent for the account of the Lenders except as otherwise expressly provided herein or in any of the other Loan Documents. Notwithstanding anything to the contrary contained in this Agreement, if any Lender becomes a Defaulting Lender, then, until such time as such Lender is no longer a Defaulting Lender, each payment by Borrowers hereunder shall be applied in accordance with Section 2.12(d). (b) If in the opinion of Administrative Agent the distribution of any amount received by it in such capacity hereunder, under the Notes or under any of the other Loan Documents might involve it in liability, it may refrain from making such distribution until its right to make such distribution shall have been adjudicated by a court of competent jurisdiction. If a court of competent jurisdiction shall adjudge that any amount received and distributed by Administrative Agent is to be repaid, each Person to whom any such distribution shall have been made shall either repay to Administrative Agent its proportionate share of the amount so adjudged to be repaid or shall pay over the same in such manner and to such Persons as shall be determined by such court. In the event that Administrative Agent shall refrain from making any distribution of any amount received by it as provided in this Section 14.5(b), Administrative Agent shall endeavor to hold such amounts in an interest bearing account and at such time as such amounts may be distributed to the Lenders, Administrative Agent shall distribute to each Lender, based on their respective Commitment Percentages, its pro rata share of the interest or other earnings from such deposited amount. Section 14.6 Holders of Notes. Subject to the terms of Section 18, each Agent may deem and treat the payee of any Note as the absolute owner or purchaser thereof for all purposes hereof until it shall have been furnished in writing with a different name by such payee or by a subsequent holder, assignee or transferee. Section 14.7 Indemnity. The Lenders ratably agree hereby to indemnify and hold harmless each Agent from and against any and all claims, actions and suits (whether groundless or otherwise), losses, damages, costs, expenses (including any expenses for which such Agent has not been reimbursed by Borrowers as required by Section 15), and liabilities of every nature and character arising out of or related to this Agreement, the Notes, or any of the other Loan Documents or the transactions contemplated or evidenced hereby or thereby, or such Agent's actions taken hereunder or thereunder, except to the extent that any of the same shall be directly caused by such Agent's willful misconduct or gross negligence as finally determined by a court of competent jurisdiction after the expiration of all 169 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 applicable appeal periods. The agreements in this Section 14.7 shall survive the payment of all amounts payable under the Loan Documents. Section 14.8 Agents as Lenders. In its individual capacity, each of KeyBank and CIT Bank, N.A. shall have the same obligations and the same rights, powers and privileges in respect to its Commitments and the Loans made by it, and as the holder of any of the Notes as it would have were it not also an Agent. Section 14.9 Resignation. Any Agent may resign at any time by giving at least thirty (30) calendar days prior written notice thereof to the Lenders, Parent and the other Agent. Revolving Agent shall resign in the event neither it nor any of its Affiliates or Related Funds are Lenders. Any such resignation of Administrative Agent may at such Agent's option also constitute, as applicable, Administrative Agent's resignation as the Issuing Lender and the Swing Loan Lender. Upon any such resignation, the Majority Lenders, subject to the terms of Section 18.1, shall have the right to appoint as a successor Agent and, if applicable, Issuing Lender and Swing Loan Lender, any Lender or any bank whose senior debt obligations are rated not less than "A" or its equivalent by Moody's or not less than "A" or its equivalent by S&P and which has a net worth of not less than $500,000,000.00; provided, however, that Revolving Agent shall be a Lender or a Lender shall be an Affiliate or Related Fund of Revolving Agent at all times. Unless a Default or Event of Default shall have occurred and be continuing, such successor Agent and, if applicable, Issuing Lender and Swing Loan Lender, shall be reasonably acceptable to Parent. If no successor Agent shall have been appointed and shall have accepted such appointment within ten (10) days after the retiring Agent's giving of notice of resignation (or the date of Revolving Agent's mandatory resignation, as applicable), then the retiring Agent may, on behalf of the Lenders, appoint a successor Agent, which shall be any Lender or any bank whose senior debt obligations are rated not less than "A2" or its equivalent by Moody's or not less than "A" or its equivalent by S&P and which has a net worth of not less than $500,000,000.00; provided, however, that Revolving Agent shall be a Lender or a Lender shall be an Affiliate or Related Fund of Revolving Agent at all times. Upon the acceptance of any appointment as Agent and, if applicable, the Issuing Lender and the Swing Loan Lender, hereunder by a successor Agent and, if applicable, Issuing Lender and Swing Loan Lender, such successor Agent and, if applicable, Issuing Lender and Swing Loan Lender, shall thereupon succeed to and become vested with all the rights, powers, privileges and duties of the retiring Agent and, if applicable, Issuing Lender and Swing Loan Lender, and the retiring Agent and, if applicable, Issuing Lender and Swing Loan Lender, shall be discharged from its duties and obligations hereunder as such Agent and, if applicable, the Issuing Lender and the Swing Loan Lender. After any retiring Agent's resignation, the provisions of this Agreement and the other Loan Documents shall continue in effect for its benefit in respect of any actions taken or omitted to be taken by it while it was acting as an Agent, the Issuing Lender and the Swing Loan Lender. If the resigning Agent shall also resign as the Issuing Lender, such successor Agent shall issue letters of credit in substitution for the Letters of Credit, if any, outstanding at the time of such succession or shall make other arrangements satisfactory to the current Issuing Lender, in either case, to assume effectively the obligations of the current Agent with respect to such Letters of Credit. Upon any change in any Agent under this Agreement, the resigning Agent shall execute such assignments of and amendments to the Loan Documents as may be necessary to substitute the successor Agent for the resigning Agent. Section 14.10 Duties in the Case of Enforcement. In case one or more Defaults or Events of Default have occurred and shall be continuing, and whether or not acceleration of the Obligations shall have occurred, Administrative Agent may and, if (a) so requested by the Majority Lenders and (b) the Lenders have provided to Administrative Agent such additional indemnities and assurances in accordance with their respective Commitment Percentages against expenses and liabilities as Administrative Agent may reasonably request, shall proceed to exercise all or any legal and equitable and other rights or remedies as it may have; provided, however, that unless and until Administrative Agent 170 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 shall have received such directions, Administrative Agent may (but shall not be obligated to) take such action, to the extent permitted by the Loan Documents, or refrain from taking such action, with respect to such Default or Event of Default as it shall deem to be in the best interests of the Lenders. Without limiting the generality of the foregoing, if Administrative Agent reasonably determines payment is in the best interest of all the Lenders, Administrative Agent may without the approval of the Lenders pay taxes and insurance premiums and spend money for maintenance, repairs or other expenses which may be necessary to be incurred, and Administrative Agent shall promptly thereafter notify the Lenders of such action. Each Lender shall, within thirty (30) days of request therefor, pay to Administrative Agent its Commitment Percentages of the reasonable costs incurred by Administrative Agent in taking any such actions hereunder to the extent that such costs shall not be promptly reimbursed to Administrative Agent by Borrowers or the Guarantors or out of the Collateral within such period. The Majority Lenders may direct Administrative Agent in writing as to the method and the extent of any such exercise, the Lenders hereby agreeing to indemnify and hold Administrative Agent harmless in accordance with their respective Commitment Percentages from all liabilities incurred in respect of all actions taken or omitted in accordance with such directions, provided that Administrative Agent need not comply with any such direction to the extent that Administrative Agent reasonably believes Administrative Agent's compliance with such direction to be unlawful in any applicable jurisdiction or commercially unreasonable under the UCC as enacted in any applicable jurisdiction. Section 14.11 Request for Agent Action. Administrative Agent and the Lenders acknowledge that in the event that Administrative Agent is the beneficiary of a Mortgage, (a) in the ordinary course of business of Borrowers, Borrowers will enter into leases or rental agreements covering Collateral Properties that may require the execution of a subordination, attornment and non-disturbance agreement in favor of the tenant thereunder, (b) in the ordinary course of business of Borrowers, Real Estate may be subject to a Taking, or (c) in the ordinary course of business of Borrowers, any Borrower may desire to enter into easements or other agreements affecting the Collateral Properties, or take other actions or enter into other agreements in the ordinary course of business (including Leases) which similarly require the consent, approval or agreement of Administrative Agent. In connection with the foregoing, the Lenders hereby expressly authorize Administrative Agent to (w) execute and deliver to Borrowers subordination, attornment and non-disturbance agreements with any tenant under a Lease upon such terms as Administrative Agent in its good faith judgment determines are appropriate (Administrative Agent in the exercise of its good faith judgment may agree to allow some or all of the casualty, condemnation, restoration or other provisions of the applicable Lease to control over the applicable provisions of the Loan Documents), (x) execute releases of liens in connection with any Taking or the land swap described in clause (c) above, (y) execute consents or subordinations in form and substance satisfactory to Administrative Agent in connection with any easements or agreements affecting the Real Estate, or (z) execute consents, approvals, or other agreements in form and substance satisfactory to Administrative Agent in connection with such other actions or agreements as may be necessary in the ordinary course of Borrowers' business. Section 14.12 Bankruptcy. In the event a bankruptcy or other insolvency proceeding is commenced by or against any Borrower or any Guarantor with respect to the Obligations, Administrative Agent shall have the sole and exclusive right to file and pursue a joint proof claim on behalf of all Lenders. Any votes with respect to such claims or otherwise with respect to such proceedings shall be subject to the vote of the Majority Lenders or all of the Lenders as required by this Agreement. Each Lender irrevocably waives its right to file or pursue a separate proof of claim in any such proceedings unless Administrative Agent fails to file such claim within thirty (30) days after receipt of written notice from the Lenders requesting that Administrative Agent file such proof of claim. Section 14.13 Reliance by Agents. Each Agent shall be entitled to rely upon, and shall not incur any liability for relying upon, any notice, request, certificate, consent, statement, instrument, 171 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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document or other writing (including any electronic message, Internet or intranet website posting or other distribution) believed by it to be genuine and to have been signed, sent or otherwise authenticated by an Authorized Officer. Each Agent also may rely upon any statement made to it orally or by telephone and believed by it to have been made by the proper Person, and shall not incur any liability for relying thereon. In determining compliance with any condition hereunder to the making of a Loan, that by its terms must be fulfilled to the satisfaction of a Lender, each Agent may presume that such condition is satisfactory to such Lender unless such Agent shall have received notice to the contrary from such Lender prior to the making of such Loan. Each Agent may consult with legal counsel (who may be counsel for Borrowers), independent accountants and other experts selected by it, and shall not be liable for any action taken or not taken by it in accordance with the advice of any such counsel, accountants or experts. Section 14.14 Approvals. If consent is required for some action under this Agreement (including any amendment or waiver of the Loan Documents), or except as otherwise provided herein an approval of the Lenders, the Majority Lenders, the Majority A/R Revolving Loan Lenders or the Majority Real Estate Revolving Loan Lenders is required or permitted under this Agreement, each Lender agrees to give the applicable Agent, with a copy to Administrative Agent if the applicable Agent is Revolving Agent, within ten (10) Business Days of receipt of the request for action from such Agent together with all reasonably requested information related thereto (or such lesser period of time required by the terms of the Loan Documents), notice in writing of approval or disapproval (collectively, "Directions") in respect of any action requested or proposed in writing pursuant to the terms hereof. Each Agent agrees to provide notice of the initial request for action pursuant to this Section 14.14 to the Lenders through the use of Intralinks, Debtdomain, SyndTrak or any other electronic information dissemination system. If such Agent submits a written request for consent with respect to this Agreement to the Lenders and any Lender fails to provide Directions within ten (10) Business Days after such Lender receives from such Agent such initial request for Directions together with all reasonably requested information relating thereto, then such Agent shall make a second request for approval, which approval shall include the following in capital, bolded, block letters on the first page thereof: "THE FOLLOWING REQUEST REQUIRES A RESPONSE WITHIN FIVE (5) BUSINESS DAYS OF RECEIPT. FAILURE TO DO SO WILL BE DEEMED APPROVAL OF THE REQUEST." If such Agent submits to such Lender a second written request to approve or disapprove such action, and such Lender fails to provide Directions within five (5) Business Days after such Lender receives from such Agent such second request, then such Lender's failure to respond to such request for Directions within the required time period shall be deemed to constitute a Direction to take such requested action; provided, however, that such deemed approval shall only apply to a request that requires approval of the Majority Lenders and not to any request that requires approval of all Lenders. Section 14.15 Collateral. Administrative Agent is hereby authorized to hold all Collateral pledged pursuant to this Agreement or any Security Document and to act on behalf of itself and the Secured Parties, in its own capacity and through other agents appointed by it, thereunder; provided, that Administrative Agent shall not agree to the release of any Collateral except in accordance with the terms of this Agreement. Each Lender acknowledges that the Loans and all interest, fees and expenses hereunder constitute one Indebtedness, secured by all of the Collateral. Administrative Agent hereby appoints each Lender as its agent (and each Lender hereby accepts such appointment) for the purpose of perfecting Administrative Agent's Liens in assets which, in accordance with the Uniform Commercial Code, can be perfected by possession. Should any Lender obtain possession of any such Collateral, subject to the limitations set forth in the deposit account control agreements that are Loan Documents, 172 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 such Lender shall promptly, upon Administrative Agent's request therefor, deliver such Collateral to Administrative Agent or in accordance with Administrative Agent's instructions. Section 14.16 Borrowers Not Beneficiaries. Except for the provisions of Section 14.9 relating to the appointment of a successor Agent, the provisions of this Section 14 are solely for the benefit of Agents and the Lenders, may not be enforced by any Borrower or any Guarantor, and except for the provisions of Section 14.9, may be modified or waived without the approval or consent of Borrowers. Section 14.17 Intercreditor Agreements. The Lenders hereby (a) authorize Administrative Agent to execute and deliver each Intercreditor Agreement on behalf of the Secured Parties and to perform its obligations thereunder and (b) agree to be bound by the provisions of each Intercreditor Agreement. Section 14.18 Release of Collateral. (a) Each Lender hereby directs, in accordance with the terms of this Agreement, Administrative Agent to release any Lien held by Administrative Agent for the benefit of Secured Parties: (i) against all of the Collateral, upon the payment in full of the Obligations (excluding any contingent indemnification and reimbursement claims not then due) and termination of the Commitments, provided that Administrative Agent has not received a written notice from a Bank Product Provider or a Lender Hedge Provider that any Bank Product Obligations or any Hedge Obligation is then due and payable to such Person; or (ii) against any part of the Collateral sold or disposed of by the Loan Parties if such sale or disposition is expressly permitted by Section 5.3 or 8.8 or is otherwise consented to by Administrative Agent, to the extent permitted by this Agreement, or the requisite Lenders for such release as set forth in Section 27, as certified to Administrative Agent by Parent in a certificate of an Authorized Officer. (b) Each Lender hereby directs Administrative Agent to execute and deliver or file or authorize the filing of such termination and partial release statements and do such other things as are necessary to release Liens to be released pursuant to this Section 14.18 promptly upon the effectiveness of any such release. Upon request by Administrative Agent at any time, the Lenders will confirm in writing Administrative Agent's authority to release particular types or items of Collateral pursuant to this Section 14.18. Section 14.19 Erroneous Payments. (a) If the Administrative Agent notifies a Lender, Issuing Lender or Secured Party, or any Person who has received funds on behalf of a Lender, Issuing Lender or Secured Party such Lender or Issuing Lender (any such Lender, Issuing Lender, Secured Party or other recipient, a "Payment Recipient") that the Administrative Agent has determined in its sole discretion (whether or not after receipt of any notice under immediately succeeding clause (b)) that any funds received by such Payment Recipient from the Administrative Agent or any of its Affiliates were erroneously transmitted to, or otherwise erroneously or mistakenly received by, such Payment Recipient (whether or not known to such Lender, Issuing Lender, Secured Party or other Payment Recipient on its behalf) (any such funds, whether received as a payment, prepayment or repayment of 173 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 principal, interest, fees, distribution or otherwise, individually and collectively, an "Erroneous Payment") and demands the return of such Erroneous Payment (or a portion thereof), such Erroneous Payment shall at all times remain the property of the Administrative Agent and shall be segregated by the Payment Recipient and held in trust for the benefit of the Administrative Agent, and such Lender, Issuing Lender or Secured Party shall (or, with respect to any Payment Recipient who received such funds on its behalf, shall cause such Payment Recipient to) promptly, but in no event later than two (2) Business Days thereafter, return to the Administrative Agent the amount of any such Erroneous Payment (or portion thereof) as to which such a demand was made, in same day funds (in the currency so received), together with interest thereon in respect of each day from and including the date such Erroneous Payment (or portion thereof) was received by such Payment Recipient to the date such amount is repaid to the Administrative Agent in same day funds at the greater of the Federal Funds Effective Rate and a rate determined by the Administrative Agent in accordance with banking industry rules on interbank compensation from time to time in effect. A notice of the Administrative Agent to any Payment Recipient under this clause (a) shall be conclusive, absent manifest error. (b) Without limiting immediately preceding clause (a), each Lender, Issuing Lender or Secured Party, or any Person who has received funds on behalf of a Lender, Issuing Lender or Secured Party such Lender or Issuing Lender, hereby further agrees that if it receives a payment, prepayment or repayment (whether received as a payment, prepayment or repayment of principal, interest, fees, distribution or otherwise) from the Administrative Agent (or any of its Affiliates) (x) that is in a different amount than, or on a different date from, that specified in a notice of payment, prepayment or repayment sent by the Administrative Agent (or any of its Affiliates) with respect to such payment, prepayment or repayment, (y) that was not preceded or accompanied by a notice of payment, prepayment or repayment sent by the Administrative Agent (or any of its Affiliates), or (z) that such Lender, Issuing Lender or Secured Party, or other such recipient, otherwise becomes aware was transmitted, or received, in error or by mistake (in whole or in part) in each case: (i) (A) in the case of immediately preceding clauses (x) or (y), an error shall be presumed to have been made (absent written confirmation from the Administrative Agent to the contrary) or (B) an error has been made (in the case of immediately preceding clause (z)), in each case, with respect to such payment, prepayment or repayment; and (ii) such Lender, Issuing Lender or Secured Party shall (and shall cause any other recipient that receives funds on its respective behalf to) promptly (and, in all events, within one Business Day of its knowledge of such error) notify the Administrative Agent of its receipt of such payment, prepayment or repayment, the details thereof (in reasonable detail) and that it is so notifying the Administrative Agent pursuant to this Section 14.19(b). (c) Each Lender, Issuing Lender or Secured Party hereby authorizes the Administrative Agent to set off, net and apply any and all amounts at any time owing to such Lender, Issuing Lender or Secured Party under any Loan 174 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Document, or otherwise payable or distributable by the Administrative Agent to such Lender, Issuing Lender or Secured Party from any source, against any amount due to the Administrative Agent under immediately preceding clause (a) or under the indemnification provisions of this Agreement. (d) In the event that an Erroneous Payment (or portion thereof) is not recovered by the Administrative Agent for any reason, after demand therefor by the Administrative Agent in accordance with immediately preceding clause (a), from any Lender or Issuing Lender that has received such Erroneous Payment (or portion thereof) (and/or from any Payment Recipient who received such Erroneous Payment (or portion thereof) on its respective behalf) (such unrecovered amount, an "Erroneous Payment Return Deficiency"), upon the Administrative Agent's notice to such Lender or Issuing Lender at any time, (i) such Lender or Issuing Lender shall be deemed to have assigned its Loans (but not its Commitments) of the relevant class of Loans with respect to which such Erroneous Payment was made (the "Erroneous Payment Impacted Class") in an amount equal to the Erroneous Payment Return Deficiency (or such lesser amount as the Administrative Agent may specify) (such assignment of the Loans (but not Commitments) of the Erroneous Payment Impacted Class, the "Erroneous Payment Deficiency Assignment") at par plus any accrued and unpaid interest (with the assignment fee to be waived by the Administrative Agent in such instance), and is hereby (together with the Borrower) deemed to execute and deliver an Assignment and Acceptance Agreement (or, to the extent applicable, an agreement incorporating an Assignment and Acceptance Agreement by reference pursuant to an approved electronic platform as to which the Administrative Agent and such parties are participants) with respect to such Erroneous Payment Deficiency Assignment, and such Lender or Issuing Lender shall deliver any Notes evidencing such Loans to the Borrower or the Administrative Agent, (ii) the Administrative Agent as the assignee Lender shall be deemed to acquire the Erroneous Payment Deficiency Assignment, (iii) upon such deemed acquisition, the Administrative Agent as the assignee Lender shall become a Lender or Issuing Lender, as applicable, hereunder with respect to such Erroneous Payment Deficiency Assignment and the assigning Lender or assigning Issuing Lender shall cease to be a Lender or Issuing Lender, as applicable, hereunder with respect to such Erroneous Payment Deficiency Assignment, excluding, for the avoidance of doubt, its obligations under the indemnification provisions of this Agreement and its applicable Commitments which shall survive as to such assigning Lender or assigning Issuing Lender and (iv) the Administrative Agent may reflect in the Register its ownership interest in the Loans subject to the Erroneous Payment Deficiency Assignment. The Administrative Agent may, in its discretion, sell any Loans acquired pursuant to an Erroneous Payment Deficiency Assignment and upon receipt of the proceeds of such sale, the Erroneous Payment Return Deficiency owing by the applicable Lender or Issuing Lender shall be reduced by the net proceeds of the sale of such Loan (or portion thereof), and the Administrative Agent shall retain all other rights, remedies and claims against such Lender or Issuing Lender (and/or against any recipient that receives funds on its respective behalf). For the avoidance of doubt, no Erroneous Payment Deficiency Assignment will reduce the Commitments of any Lender or Issuing Lender and such Commitments shall remain available in accordance with the terms of this Agreement. In addition, each party hereto agrees that, except to the extent that the Administrative Agent 175 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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has sold a Loan (or portion thereof) acquired pursuant to an Erroneous Payment Deficiency Assignment, and irrespective of whether the Administrative Agent may be equitably subrogated, the Administrative Agent shall be contractually subrogated to all the rights and interests of the applicable Lender, Issuing Lender or Secured Party under the Loan Documents with respect to each Erroneous Payment Return Deficiency (the "Erroneous Payment Subrogation Rights"). (e) The parties hereto agree that an Erroneous Payment shall not pay, prepay, repay, discharge or otherwise satisfy any Obligations owed by the Borrower or any other Loan Party, except, in each case, to the extent such Erroneous Payment is, and solely with respect to the amount of such Erroneous Payment that is, comprised of funds received by the Administrative Agent from the Borrower or any other Loan Party for the purpose of making such Erroneous Payment. (f) To the extent permitted by applicable law, no Payment Recipient shall assert any right or claim to an Erroneous Payment, and hereby waives, and is deemed to waive, any claim, counterclaim, defense or right of set-off or recoupment with respect to any demand, claim or counterclaim by the Administrative Agent for the return of any Erroneous Payment received, including without limitation waiver of any defense based on "discharge for value" or any similar doctrine. (g) Each party's obligations, agreements and waivers under this Section 14.19 shall survive the resignation or replacement of the Administrative Agent, any transfer of rights or obligations by, or the replacement of, a Lender or Issuing Lender, the termination of the Commitments and/or the repayment, satisfaction or discharge of all Obligations (or any portion thereof) under any Loan Document. SECTION 15. EXPENSES. Borrowers agree to pay (a) the reasonable costs of producing and reproducing this Agreement, the other Loan Documents and the other agreements and instruments mentioned herein for the purpose of providing copies thereof to Borrowers, Guarantors, Lenders and their respective counsel, (b) any Indemnified Taxes (including any interest and penalties in respect thereto) payable by any Agent or any of the Lenders, including any recording, mortgage, documentary or intangibles taxes in connection with the Loan Documents, or other taxes payable on or with respect to the transactions contemplated by this Agreement, including any such taxes payable by any Agent or any of the Lenders after the Closing Date (Borrowers hereby agreeing to indemnify each Agent and each Lender with respect thereto), (c) all out-of-pocket title insurance premiums, engineer's fees, environmental reviews and reasonable out-of-pocket fees, expenses and disbursements of the counsel to Administrative Agent and Co-Lead Arrangers and any local counsel to Administrative Agent incurred in connection with the preparation, administration, or interpretation of the Loan Documents and other instruments mentioned herein, and amendments, modifications, approvals, consents or waivers hereto or hereunder, (d) the reasonable and documented out-of-pocket fees, costs, expenses and disbursements of Administrative Agent and Co-Lead Arrangers incurred in connection with the syndication or participation (by KeyBank) of the Loans, (e) all other reasonable and documented out-of-pocket fees, expenses and disbursements of Administrative Agent incurred by Administrative Agent in connection with the preparation, administration or interpretation of the Loan Documents and other instruments mentioned herein, the addition or substitution of additional Collateral, the review of Leases and related documents, the making of each 176 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 advance hereunder, the issuance of Letters of Credit and the syndication of the Total Commitment pursuant to Section 18 (without duplication of those items addressed in clause (d) above) and the release of Collateral, (f) all reasonable and documented out-of-pocket expenses (including attorneys' fees and costs, and fees and costs of appraisers, engineers, investment bankers or other experts retained by Administrative Agent or any Lender) incurred by any Lender or Administrative Agent in connection with (i) the enforcement of or preservation of rights under any of the Loan Documents against Borrowers or the Guarantors or the administration thereof after the occurrence of a Default or Event of Default and (ii) any litigation, proceeding or dispute whether arising hereunder or otherwise, in any way related to Administrative Agent's, or any of the Lenders' relationship with Borrowers or the Guarantors, (g) all reasonable fees, expenses and disbursements of Administrative Agent incurred in connection with UCC searches, UCC filings, title rundowns, title searches or mortgage recordings, (h) all reasonable and documented out-of-pocket fees, expenses and disbursements (including reasonable attorneys' fees and costs) which may be incurred by KeyBank in connection with the execution and delivery of this Agreement and the other Loan Documents (without duplication of any of the items listed above), (i) all out-of-pocket expenses relating to the use of Intralinks, SyndTrak or any other similar system for the dissemination and sharing of documents and information in connection with the Loans, and (j) all out-of-pocket fees, expenses, and disbursements incurred by Revolving Agent in connection with the performance of its duties under this Agreement, and including reasonable out-of-pocket fees, expenses and disbursements of counsel to Revolving Agent in connection therewith and in connection with Revolving Agent's entry into the Loan Documents. The covenants of this Section 15 shall survive the repayment of the Loans and the termination of the obligations of the Lenders hereunder. SECTION 16. INDEMNIFICATION. Each Borrower agrees to indemnify and hold harmless Administrative Agent, Revolving Agent, each Lender, each Co-Lead Arranger and each director, officer, employee, agent, attorney and Affiliate thereof and Person who controls Administrative Agent, Revolving Agent, any Lender or any Co-Lead Arranger against any and all claims, actions and suits, whether groundless or otherwise, and from and against any and all liabilities, losses, damages and expenses of every nature and character arising out of or relating to this Agreement or any of the other Loan Documents or the transactions contemplated hereby and thereby including (a) any and all claims for brokerage, leasing, finders or similar fees which may be made relating to the Collateral Properties, other Real Estate or the Loans, (b) any condition of the Collateral Properties or other Real Estate, (c) any actual or proposed use by any Borrower of the proceeds of any of the Loans or Letters of Credit, (d) any actual or alleged infringement of any patent, copyright, trademark, service mark or similar right of any Loan Party, (e) Borrowers and the Guarantors entering into or performing this Agreement or any of the other Loan Documents, (f) any actual or alleged violation of any law, ordinance, code, order, rule, regulation, approval, consent, permit or license relating to the Collateral Properties or any other Real Estate, (g) with respect to Borrowers and the Guarantors and their respective properties and assets, the violation of any Environmental Law, the Release or threatened Release of any Hazardous Substances or any action, suit, proceeding or investigation brought or threatened with respect to any Hazardous Substances (including claims with respect to wrongful death, personal injury, nuisance or damage to property), and (h) any use of Intralinks, SyndTrak or any other system for the dissemination and sharing of documents and information, in each case including the reasonable out-of-pocket fees and disbursements of counsel incurred in connection with any such investigation, litigation or other proceeding; provided, however, that Borrowers shall not be obligated under this Section 16 to indemnify any Person for liabilities arising from such Person's own gross negligence, willful misconduct or breach by such Person of its obligations under this Agreement or any other Loan Document, in each case, as determined by a court of competent jurisdiction after the exhaustion of all applicable appeal periods. In litigation, or the preparation therefor, the Lenders, Revolving Agent and Administrative Agent shall be entitled to select a single law firm as their own counsel and, in addition to the foregoing indemnity, each Borrower agrees to pay promptly the reasonable 177 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 out-of-pocket fees and expenses of such counsel. If, and to the extent that the obligations of any Borrower under this Section 16 are unenforceable for any reason, such Borrower hereby agrees to make the maximum contribution to the payment in satisfaction of such obligations which is permissible under applicable law. The provisions of this Section 16 shall survive the repayment of the Loans and the termination of the obligations of the Lenders hereunder. SECTION 17. SURVIVAL OF COVENANTS, ETC. All covenants, agreements, representations and warranties made herein, in the Notes, in any of the other Loan Documents or in any documents or other papers delivered by or on behalf of any Loan Party pursuant hereto or thereto shall be deemed to have been relied upon by the Lenders and each Agent, notwithstanding any investigation heretofore or hereafter made by any of them, and shall survive the making by the Lenders of any of the Loans, as herein contemplated, and shall continue in full force and effect so long as any amount due under this Agreement or the Notes or any of the other Loan Documents remains outstanding or any Letters of Credit remain outstanding or any Lender has any obligation to make any Loans or issue Letters of Credit. The indemnification obligations of Borrowers provided herein and in the other Loan Documents shall survive the full repayment of amounts due and the termination of the obligations of the Lenders hereunder and thereunder to the extent provided herein and therein. All statements contained in any certificate delivered to any Lender or any Agent at any time by or on behalf of any Loan Party pursuant hereto or in connection with the transactions contemplated hereby shall constitute representations and warranties by such Person hereunder. SECTION 18. ASSIGNMENT AND PARTICIPATION. Section 18.1 Conditions to Assignment by Lenders. Except as provided herein, each Lender may assign to one or more banks or other entities all or a portion of its interests, rights and obligations under this Agreement (including all or a portion of its Commitment Percentages and Commitments and the same portion of the Loans at the time owing to it and the Notes held by it); provided that (a) Administrative Agent, the Issuing Lender and, so long as no Default or Event of Default exists hereunder, Parent shall have each given its prior written consent to such assignment, which consent shall not be unreasonably withheld or delayed, and if Parent does not respond to any such request for consent within five (5) Business Days, Parent shall be deemed to have consented (provided that such consent shall not be required for any assignment to another Lender, to a Related Fund, to a lender or an Affiliate of a Lender which controls, is controlled by or is under common control with the assigning Lender or to a wholly-owned Subsidiary of such Lender), (b) each such assignment shall be of a constant, and not a varying, percentage of all of the assigning Lender's rights and obligations under this Agreement with respect to its Commitments, (c) each Commitment of such Lender shall be assigned pursuant to such assignment, and such assignment shall assign the same percentage of each of such Lender's Commitments, (d) the parties to such assignment shall execute and deliver to Administrative Agent, for recording in the Register (as hereinafter defined) an assignment and acceptance agreement in the form of Exhibit M (an "Assignment and Acceptance Agreement"), together with any Notes subject to such assignment, (e) in no event shall any assignment be to any Person controlling, controlled by or under common control with, or which is not otherwise free from influence or control by any Borrower or any Guarantor or be to a Defaulting Lender or an Affiliate of a Defaulting Lender, (f) such assignee shall have a net worth or unfunded commitment as of the date of such assignment of not less than $500,000,000.00 (unless otherwise approved by Administrative Agent and, so long as no Default or Event of Default exists hereunder, Parent), (g) such assignee shall acquire an interest in the Loans of not less than $5,000,000.00 and integral multiples of $1,000,000.00 in excess thereof (or if less, the remaining Loans of the assignor), unless waived by Administrative Agent, and so long as no Default or Event of Default exists hereunder, Parent and (h) if such assignment is less than the assigning Lender's entire Commitments, the assigning Lender shall retain an interest in the Loans of not less than 178 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 $5,000,000.00. Upon execution, delivery, acceptance and recording of such Assignment and Acceptance Agreement, (i) the assignee thereunder shall be a party hereto and all other Loan Documents executed by the Lenders and, to the extent provided in such Assignment and Acceptance Agreement, have the rights and obligations of a Lender hereunder, (ii) the assigning Lender shall, upon payment to Administrative Agent of the registration fee referred to in Section 18.2, be released from its obligations under this Agreement arising after the effective date of such assignment with respect to the assigned portion of its interests, rights and obligations under this Agreement, and (iii) Administrative Agent may unilaterally amend Schedule 1.1(a) to reflect such assignment. In connection with each assignment, the assignee shall represent and warrant to Administrative Agent, the assignor and each other Lender as to whether such assignee is controlling, controlled by, under common control with or is not otherwise free from influence or control by, any Borrower or any Guarantor and whether such assignee is a Defaulting Lender or an Affiliate of a Defaulting Lender. In connection with any assignment of rights and obligations of any Defaulting Lender, no such assignment shall be effective unless and until, in addition to the other conditions thereto set forth herein, the parties to the assignment shall make such additional payments to Administrative Agent in an aggregate amount sufficient, upon distribution thereof as appropriate (which may be outright payment, purchases by the assignee of participations or actions, including funding, with the consent of Parent and Administrative Agent, the applicable pro rata share of Loans previously requested but not funded by the Defaulting Lender to each of which the applicable assignee and assignor hereby irrevocably consent), to (x) pay and satisfy in full all payment liabilities then owed by such Defaulting Lender to Administrative Agent or any Lender hereunder (and interest accrued thereon) and (y) acquire (and fund as appropriate) its full pro rata share of all Loans and participations in Letters of Credit and Swing Loans in accordance with its Commitment Percentages. Notwithstanding the foregoing, in the event that any assignment of rights and obligations of any Defaulting Lender hereunder shall become effective under applicable law without compliance with the provisions of this paragraph, then the assignee of such interest shall be deemed to be a Defaulting Lender for all purposes of this Agreement until such compliance occurs. Section 18.2 Register. Administrative Agent shall maintain on behalf of Borrowers a copy of each assignment delivered to it and a register or similar list (the "Register") for the recordation of the names and addresses of the Lenders and the Commitment Percentages of and principal amount of the Loans owing to the Lenders from time to time. The entries in the Register shall be conclusive, in the absence of manifest error, and Borrowers, the Guarantors, Administrative Agent and the Lenders may treat each Person whose name is recorded in the Register as a Lender hereunder for all purposes of this Agreement. The Register shall be available for inspection by Parent and the Lenders at any reasonable time and from time to time upon reasonable prior notice. Upon each such recordation, the assigning Lender agrees to pay to Administrative Agent a registration fee in the sum of $3,500.00. Section 18.3 New Notes. Upon its receipt of an Assignment and Acceptance Agreement executed by the parties to such assignment, together with each Note subject to such assignment, Administrative Agent shall record the information contained therein in the Register. Within five (5) Business Days after the later of (a) receipt of notice of such assignment from Administrative Agent and (b) a request from the assignee to execute and deliver a new Note to the order of such assignee, Borrowers, at Borrowers' expense, shall execute and deliver to Administrative Agent, in exchange for each surrendered original Note (or an indemnity agreement, as provided in Section 31), a new Note to the order of such assignee in an amount equal to the amount assigned to such assignee pursuant to such Assignment and Acceptance Agreement and, if the assigning Lender has retained some portion of its obligations hereunder, a new Note to the order of the assigning Lender in an amount equal to the amount retained by it hereunder. Such new Notes shall provide that they are replacements for the surrendered Notes, shall be in an aggregate principal amount equal to the aggregate principal amount of the surrendered Notes, shall be dated the effective date of such Assignment and Acceptance Agreement and shall otherwise be in substantially the form of the assigned Notes. The surrendered original Notes shall 179 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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be canceled and returned to Parent (or Borrowers shall receive an indemnity agreement, as provided in Section 31). Section 18.4 Participations. Each Lender may sell participations to one or more Lenders or other entities in all or a portion of such Lender's rights and obligations under this Agreement and the other Loan Documents; provided that (a) any such sale or participation shall not affect the rights and duties of the selling Lender hereunder; provided, further, with respect to Section 4.8, that the participant's rights shall be subject to the requirements and limitations therein, including the requirements under Section 4.3(f) (it being understood that the documentation required under Section 4.3(f) shall be delivered to the participating Lender)) to the same extent as if it were a Lender and had acquired its interest by assignment pursuant to Section 18.1; and that such participant (A) agrees to be subject to the provisions of Section 4.8 as if it were an assignee under Section 18.1; and (B) shall not be entitled to receive any greater payment under Section 4.8, with respect to any participation, than its participating Lender would have been entitled to receive, except to the extent such entitlement to receive a greater payment results from a change in Applicable Law that occurs after the participant acquired the applicable participation, (b) such participation shall not entitle such participant to any rights or privileges under this Agreement or any Loan Documents, including rights granted to the Lenders under Sections 4.8, 4.9, 4.10 and 13, (c) such participation shall not entitle the participant to the right to approve waivers, amendments or modifications, (d) such participant shall have no direct rights against the Loan Parties, (e) such sale is effected in accordance with all applicable laws, and (f) such participant shall not be a Person controlling, controlled by or under common control with, or which is not otherwise free from influence or control by any Borrower or any Guarantor and shall not be a Defaulting Lender or an Affiliate of a Defaulting Lender; provided, however, such Lender may agree with the participant that it will not, without the consent of the participant, agree to (i) increase, or extend the term or extend the time or waive any requirement for the reduction or termination of, such Lender's Commitments, (ii) extend the date fixed for the payment of principal of or interest on the Loans or portions thereof owing to such Lender (other than pursuant to an extension of the Maturity Date pursuant to Section 2.11), (iii) reduce the amount of any such payment of principal, (iv) reduce the rate at which interest is payable thereon or (v) release any Guarantor or any material Collateral (except as otherwise permitted under this Agreement). Any Lender which sells a participation shall promptly notify Administrative Agent of such sale. Each Lender that sells a participation shall, acting solely for this purpose as a non-fiduciary agent of Borrowers, maintain a register on which it enters the name and address of each Participant and the principal amounts (and stated interest) of each participant's interest in the Loans or other obligations under the Loan Documents (the "Participant Register"); provided that no Lender shall have any obligation to disclose all or any portion of the Participant Register (including the identity of any participant or any information relating to a participant's interest in such Lender's Commitments, Loans, or its other obligations under any Loan Document) to any Person except to the extent that such disclosure is necessary to establish that such Commitment, Loan, or other obligation is in registered form under Section 5f.103-1(c) of the United States Treasury Regulations. The entries in the Participant Register shall be conclusive absent manifest error, and such Lender shall treat each Person whose name is recorded in the Participant Register as the owner of such participation for all purposes of this Agreement notwithstanding any notice to the contrary. For the avoidance of doubt, Administrative Agent (in its capacity as Administrative Agent) shall have no responsibility for maintaining a Participant Register. Section 18.5 Pledge by Lender. Any Lender may at any time pledge all or any portion of its interest and rights under this Agreement (including all or any portion of its Note) to any of the twelve (12) Federal Reserve Banks organized under Section 4 of the Federal Reserve Act, 12 U.S.C. Section 341 or to such other Person as Administrative Agent may approve to secure obligations of such Lender. No such pledge or the enforcement thereof shall release the pledgor Lender from its obligations hereunder or under any of the other Loan Documents. 180 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Section 18.6 No Assignment by Borrowers. No Borrower shall assign or transfer any of its rights or obligations under this Agreement without the prior written consent of each of the Lenders. Section 18.7 Disclosure. Each Borrower agrees to promptly cooperate with any Lender in connection with any proposed assignment or participation of all or any portion of its Commitments. Each Borrower agrees that in addition to disclosures made in accordance with standard banking practices any Lender may disclose information obtained by such Lender pursuant to this Agreement to assignees or participants and potential assignees or participants hereunder. Each Lender agrees for itself that it shall use reasonable efforts in accordance with its customary procedures to hold confidential all non-public information obtained from any Borrower or any Guarantor that has been identified in writing as confidential by any of them, and shall use reasonable efforts in accordance with its customary procedures to not disclose such information to any other Person, it being understood and agreed that, notwithstanding the foregoing, a Lender may make (a) disclosures to its participants (provided such Persons are advised of the provisions of this Section 18.7), (b) disclosures to its directors, officers, employees, Affiliates, accountants, appraisers, legal counsel and other professional advisors of such Lender (provided that such Persons who are not employees of such Lender are advised of the provision of this Section 18.7), (c) disclosures customarily provided or reasonably required by any potential or actual bona fide assignee, transferee or participant or their respective directors, officers, employees, Affiliates, accountants, appraisers, legal counsel and other professional advisors in connection with a potential or actual assignment or transfer by such Lender of any Loans or any participations therein (provided such Persons are advised of the provisions of this Section 18.7), (d) disclosures to bank regulatory authorities or self-regulatory bodies with jurisdiction over such Lender, or (e) disclosures required or requested by any other Governmental Authority or representative thereof or pursuant to legal process; provided that, unless specifically prohibited by applicable law or court order, each Lender shall notify Parent of any request by any Governmental Authority or representative thereof prior to disclosure (other than any such request in connection with any examination of such Lender by such Governmental Authority) for disclosure of any such non-public information prior to disclosure of such information. In addition, each Lender may make disclosure of such information to any contractual counterparty in swap agreements or such contractual counterparty's professional advisors (so long as such contractual counterparty or professional advisors agree to be bound by the provisions of this Section 18.7). Non-public information shall not include any information which is or subsequently becomes publicly available other than as a result of a disclosure of such information by a Lender, or prior to the delivery to such Lender is within the possession of such Lender if such information is not known by such Lender to be subject to another confidentiality agreement with or other obligations of secrecy to Borrowers or the Guarantors, or is disclosed with the prior approval of Borrowers. Nothing herein shall prohibit the disclosure of non-public information to the extent necessary to enforce the Loan Documents. Section 18.8 Mandatory Assignment. In the event Borrowers request that certain amendments, modifications or waivers be made to this Agreement or any of the other Loan Documents which request requires approval of all of the Lenders or all of the Lenders directly affected thereby and is approved by the Majority Lenders, but is not approved by one or more of the Lenders (any such non-consenting Lender shall hereafter be referred to as the "Non-Consenting Lender"), then, within thirty (30) Business Days after Parent's receipt of notice of such disapproval by such Non-Consenting Lender, Borrowers shall have the right as to such Non-Consenting Lender, to be exercised by delivery of written notice delivered to Administrative Agent and the Non-Consenting Lender within thirty (30) Business Days of receipt of such notice, to elect to cause the Non-Consenting Lender to transfer its Commitments to an assignee reasonably acceptable to Administrative Agent. Upon any such purchase of the Commitments of the Non-Consenting Lender, the Non-Consenting Lender's interests in the Obligations and its rights hereunder and under the Loan Documents shall terminate at the date of purchase, and the Non-Consenting Lender shall promptly execute and deliver any and all documents reasonably requested by Administrative Agent to surrender and transfer such interest, including an Assignment and 181 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Acceptance Agreement and such Non-Consenting Lender's original Note. The purchase price for the Non-Consenting Lender's Commitments shall equal any and all amounts outstanding and owed by Borrowers to the Non-Consenting Lender, including principal and all accrued and unpaid interest or fees, plus any applicable amounts payable pursuant to Section 4.7 which would be owed to such Non-Consenting Lender if the Loans were to be repaid in full on the date of such purchase of the Non-Consenting Lender's Commitments (provided that Borrowers may pay to such Non-Consenting Lender any interest, fees or other amounts (other than principal) owing to such Non-Consenting Lender). Section 18.9 Amendments to Loan Documents. Upon any such assignment, Borrowers and the Guarantors shall, upon the request of Administrative Agent, enter into such documents as may be reasonably required by Administrative Agent to modify the Loan Documents to reflect such assignment; provided such documents shall not create any new obligations or reduce any rights of Borrowers or Guarantors. Section 18.10 Titled Agents. The Titled Agents shall not have any additional rights or obligations under the Loan Documents, except for those rights, if any, as a Lender. SECTION 19. NOTICES. (a) Each notice, demand, election or request provided for or permitted to be given pursuant to this Agreement (hereinafter in this Section 19 referred to as "Notice"), but specifically excluding to the maximum extent permitted by law any notices of the institution or commencement of foreclosure proceedings, must be in writing and shall be deemed to have been properly given or served by personal delivery or by sending same by overnight courier or by depositing same in the United States Mail, postpaid and registered or certified, return receipt requested, by telecopy or, as expressly permitted herein, electronic mail (but specifically excluding notices of Default, Event of Default or acceleration of the Loans) and addressed as follows: If to Administrative Agent or KeyBank: KeyBank National Association Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields E-mail: Yolanda_Fields@keybank.com With a copy to: KeyBank Real Estate Capital 127 Public Square Cleveland, Ohio 44114 Attn: Laura Conway Telecopy No.: (216) 689-5970689-3630 E-mail: Laura_Conway@keybank.com and KeyBank Real Estate Capital 1200 Abernathy Road NE, Suite 1550 Atlanta, Georgia 30328 182 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Attn: Mark Amantea Telecopy No.: (770) 510-2195 E-mail: Mark_J_Amantea@KeyBank.com and Dentons US LLP 303 Peachtree Street, N.E., Suite 5300 Atlanta, Georgia 30308 Attn: William F. TimmonsSuneet Sidhu, Esq. Telecopy No.: (404) 527-4198 E-mail: bill.timmonssuneet.sidhu@dentons.com If to the Revolving Agent: CIT Bank, N.A. 11 West 42nd Street, 12th Floor New York, New York 10036 Attn: Healthcare Portfolio Manager Telecopy No.: (866) 344-1368 Email: Richard.Reynoso@cit.com If to a Borrower: c/o Trilogy Management Services, LLC Forum Office Park II 303 N. Hurstbourne Parkway, Suite 200 Louisville, Kentucky 40222 Attention: Bradley WilliamsonGregory A. Conner Telecopy No.: (502) 213-1800716-6510 E-mail: Bradley.WilliamsonGreg.Conner@trilogyhs.com With a copy to: Baker, Donelson, Bearman, Caldwell & Berkowitz, PC 211 Commerce Bradley Arant Boult Cummings LLP Roundabout Plaza 1600 Division Street, Suite 800700 Baker Donelson Center Nashville, Tennessee 37201TN 37203 Attention: Elizabeth C. Sauer Phone No.: (615) 726-5745252-4423 Telecopy No.: (615) 744-5745 E-mail: esauer@bakerdonelsonecsauer@bradley.com to any other Lender which is a party hereto, at the address for such Lender set forth on Schedule 1.1(a), and to any Lender which may hereafter become a party to this Agreement, at such address as may be designated by such Lender. Each Notice shall be effective upon being personally delivered or upon being sent by overnight courier or upon being deposited in the United States Mail as aforesaid, or if transmitted by electronic mail, as provided in Section 19(c) with respect to electronic mail. The time period in which a response to such Notice must be given or any action taken with respect thereto (if any), 183 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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however, shall commence to run from the date of receipt if personally delivered or sent by overnight courier, or if so deposited in the United States Mail, the earlier of three (3) Business Days following such deposit or the date of receipt as disclosed on the return receipt or as provided in Section 19(c) with respect to electronic mail. Rejection or other refusal to accept or the inability to deliver because of changed address for which no notice was given or for any other reason shall be deemed to be receipt of the Notice sent. By giving at least fifteen (15) days prior Notice thereof, a Borrower, a Lender or Agent shall have the right from time to time and at any time during the term of this Agreement to change their respective addresses and each shall have the right to specify as its address any other address within the United States. (b) Loan Documents and notices under the Loan Documents may, with Administrative Agent's or Revolving Agent's, as applicable, approval, be transmitted or signed by signatures delivered in "PDF" format by electronic mail. The effectiveness of any such documents and signatures shall, subject to applicable law, have the same force and effect as an original copy with manual signatures and shall be binding on Borrowers, the Guarantors, Administrative Agent, Revolving Agent and the Lenders. Each Agent may also require that any such documents and signature delivered by facsimile or "PDF" format by electronic mail be confirmed by a manually-signed original thereof; provided, however, that the failure to request or deliver any such manually-signed original shall not affect the effectiveness of any facsimile or "PDF" document or signature. (c) Notices and other communications to Administrative Agent, the Revolving Agent, the Lenders, the Issuing Lender and the Swing Loan Lender hereunder may be delivered or furnished by electronic communication (including e-mail and Internet or intranet websites) pursuant to procedures approved by Administrative Agent (and, if to Revolving Agent, Revolving Agent, provided that the foregoing shall not apply to notices to any Lender (including Issuing Lender) pursuant to Section 2 if such Lender (including Issuing Lender) has notified Administrative Agent that it is incapable of receiving notices under such Section by electronic communications. Administrative Agent, Revolving Agent, Borrowers or Guarantors may, in their discretion, agree to accept notices and other communications to it hereunder by electronic communications pursuant to procedures approved by it; provided that approval of such procedures may be limited to particular notices or communications. Unless Administrative Agent otherwise prescribes, (i) notices and other communications sent to an e-mail address of any Borrower, any Guarantor or any Affiliate shall be deemed received upon the sender's receipt of an acknowledgement from the intended recipient (such as by the "return receipt requested" function, as available, return e-mail or other written acknowledgement), and (ii) notices or communications to any Agent or any Lender posted to an Internet or intranet website shall be deemed received upon the deemed receipt by the intended recipient, at its e-mail address as described in the foregoing clause (i), of notification that such notice or communication is available and identifying the website address therefor; provided that, for both clauses (i) and (ii) above, if such notice, e-mail or other communication is not sent during the normal business hours of the recipient, such notice or communication shall be deemed to have been sent at the opening of business on the next Business Day. SECTION 20. RELATIONSHIP. Neither any Agent nor any Lender has any fiduciary relationship with or fiduciary duty to any Borrower, any Guarantor or their respective Subsidiaries arising out of or in connection with this Agreement or the other Loan Documents or the transactions contemplated hereunder and thereunder, and the relationship between each Lender and Agents, on the one hand, and the Loan Parties, on the other hand, is solely that of a lender and debtor, and nothing contained herein or in any of the other Loan Documents shall in any manner be construed as making the parties hereto partners, joint venturers or any other relationship other than lender and debtor. 184 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SECTION 21. GOVERNING LAW; CONSENT TO JURISDICTION AND SERVICE. THIS AGREEMENT AND EACH OF THE OTHER LOAN DOCUMENTS, EXCEPT AS OTHERWISE SPECIFICALLY PROVIDED HEREIN OR THEREIN, SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5- 1401, BE GOVERNED BY THE LAWS OF THE STATE OF NEW YORK. EACH BORROWER AGREES THAT ANY SUIT FOR THE ENFORCEMENT OF THIS AGREEMENT OR ANY OF THE OTHER LOAN DOCUMENTS MAY BE BROUGHT IN ANY COURT OF COMPETENT JURISDICTION IN THE STATE OF NEW YORK (INCLUDING ANY FEDERAL COURT SITTING THEREIN). EACH BORROWER FURTHER ACCEPTS, GENERALLY AND UNCONDITIONALLY, THE NON-EXCLUSIVE JURISDICTION OF SUCH COURTS AND ANY RELATED APPELLATE COURT AND IRREVOCABLY (a) AGREES TO BE BOUND BY ANY JUDGMENT RENDERED THEREBY WITH RESPECT TO THIS AGREEMENT AND ANY OF THE OTHER LOAN DOCUMENTS AND (b) WAIVES ANY OBJECTION IT MAY NOW OR HEREAFTER HAVE AS TO THE VENUE OF ANY SUCH PROCEEDING BROUGHT IN SUCH A COURT OR THAT SUCH A COURT IS AN INCONVENIENT FORUM. EACH BORROWER FURTHER AGREES THAT SERVICE OF PROCESS IN ANY SUCH SUIT MAY BE MADE UPON SUCH BORROWER IN THE MANNER PROVIDED FOR NOTICES IN SECTION 19. NOTHING IN THIS AGREEMENT OR IN ANY OTHER LOAN DOCUMENT SHALL AFFECT ANY RIGHT THAT ADMINISTRATIVE AGENT, REVOLVING AGENT OR ANY LENDER MAY OTHERWISE HAVE TO BRING ANY ACTION OR PROCEEDING RELATING TO THIS AGREEMENT OR ANY OTHER LOAN DOCUMENT AGAINST ANY BORROWER, ANY GUARANTOR OR ANY OF THEIR PROPERTIES IN THE COURTS OF ANY JURISDICTION. EACH BORROWER CONSENTS TO THE NONEXCLUSIVE JURISDICTION OF SUCH COURTS AND THE SERVICE OF PROCESS IN ANY SUCH SUIT BEING MADE UPON SUCH BORROWER IN THE MANNER PROVIDED FOR NOTICES IN SECTION 19. SECTION 22. HEADINGS. The captions in this Agreement are for convenience of reference only and shall not define or limit the provisions hereof. SECTION 23. COUNTERPARTS. This Agreement and any amendment hereof may be executed in several counterparts and by each party on a separate counterpart, each of which when so executed and delivered shall be an original, and all of which together shall constitute one instrument. In proving this Agreement it shall not be necessary to produce or account for more than one such counterpart signed by the party against whom enforcement is sought. SECTION 24. ENTIRE AGREEMENT, ETC. This Agreement and the Loan Documents is intended by the parties as the final, complete and exclusive statement of the transactions evidenced by this Agreement and the Loan Documents, except, as among KeyBank, KeyBanc Capital Markets, Inc., and Trilogy Investors as set forth in Administrative Agent Fee Letter and as among Revolving Agent and Borrowers as set forth in the Revolving Agent Fee Letter, to the extent otherwise agreed by such parties. All prior or contemporaneous promises, agreements and understandings, whether oral or written, are deemed to be superseded by this Agreement and the Loan Documents, and no party is relying on any promise, agreement or understanding not set forth in this Agreement and the Loan Documents. Neither this Agreement nor any term hereof may be 185 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 changed, waived, discharged or terminated, except as provided in Section 27. The parties hereto have participated jointly in the negotiation and drafting of this Agreement and each of the other Loan Documents. In the event an ambiguity or question of intent or interpretation arises, this Agreement and each other Loan Document shall be construed as if drafted jointly by the parties hereto and no presumption or burden of proof shall arise favoring or disfavoring any party by virtue of the authorship of any provisions of this Agreement or any other Loan Document. SECTION 25. WAIVER OF JURY TRIAL AND CERTAIN DAMAGE CLAIMS. EACH OF BORROWERS, ADMINISTRATIVE AGENT, REVOLVING AGENT AND THE LENDERS HEREBY WAIVES ITS RIGHT TO A JURY TRIAL WITH RESPECT TO ANY ACTION OR CLAIM ARISING OUT OF ANY DISPUTE IN CONNECTION WITH THIS AGREEMENT, ANY NOTE OR ANY OF THE OTHER LOAN DOCUMENTS, ANY RIGHTS OR OBLIGATIONS HEREUNDER OR THEREUNDER OR THE PERFORMANCE OF SUCH RIGHTS AND OBLIGATIONS. EACH OF BORROWERS, ADMINISTRATIVE AGENT, REVOLVING AGENT AND THE LENDERS HEREBY WAIVES ANY RIGHT IT MAY HAVE TO CLAIM OR RECOVER IN ANY SUCH LITIGATION ANY SPECIAL, INDIRECT OR CONSEQUENTIAL DAMAGES AND TO THE EXTENT PERMITTED BY APPLICABLE LAW, PUNITIVE OR ANY DAMAGES OTHER THAN, OR IN ADDITION TO, ACTUAL DAMAGES. EACH BORROWER (A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY LENDER, ADMINISTRATIVE AGENT OR REVOLVING AGENT HAS REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH LENDER, ADMINISTRATIVE AGENT OR REVOLVING AGENT WOULD NOT, IN THE EVENT OF LITIGATION, SEEK TO ENFORCE THE FOREGOING WAIVERS AND (B) ACKNOWLEDGES THAT ADMINISTRATIVE AGENT, REVOLVING AGENT AND THE LENDERS HAVE BEEN INDUCED TO ENTER INTO THIS AGREEMENT AND THE OTHER LOAN DOCUMENTS TO WHICH THEY ARE PARTIES BY, AMONG OTHER THINGS, THE WAIVERS AND CERTIFICATIONS CONTAINED IN THIS SECTION 25. EACH BORROWER ACKNOWLEDGES THAT IT HAS HAD AN OPPORTUNITY TO REVIEW THIS SECTION 25 WITH LEGAL COUNSEL AND THAT SUCH BORROWER AGREES TO THE FOREGOING AS ITS FREE, KNOWING AND VOLUNTARY ACT. SECTION 26. DEALINGS WITH BORROWERS. Administrative Agent, Revolving Agent, each Lender and each Affiliate thereof may accept deposits from, extend credit to, invest in, act as trustee under indentures of, serve as financial advisor of, and generally engage in any kind of banking, trust or other business with Borrowers, Guarantors and their respective Subsidiaries or any of their Affiliates regardless of the capacity of Administrative Agent, Revolving Agent, such Lender or such Affiliate hereunder. The Lenders acknowledge that, pursuant to such activities, KeyBank or its Affiliates or CIT Bank, N.A. or its Affiliates, may receive information regarding such Persons (including information that may be subject to confidentiality obligations in favor of such Person) and acknowledge that Agents shall be under no obligation to provide such information to them. SECTION 27. CONSENTS, AMENDMENTS, WAIVERS, ETC. Except as otherwise expressly provided in this Agreement, any consent or approval required or permitted by this Agreement may be given, and any term of this Agreement or of any other instrument related hereto or mentioned herein may be amended, and the performance or observance by the Loan Parties of any terms of this Agreement or such other instrument or the continuance of any Default or Event of Default may be waived (either generally or in a particular instance and either retroactively or 186 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 prospectively) with, but only with, the written consent of the Majority Lenders; provided, however, that the Administrative Agent Fee Letter and the Revolving Agent Fee Letter may be amended or otherwise modified, or rights or privileges thereunder waived, in a writing executed by the respective parties thereto only; and the definition of Change of Control may be amended or otherwise modified, or compliance therewith waived, in a writing executed by Administrative Agent and Majority Lenders. Notwithstanding the foregoing, none of the following may occur without the written consent of each Lender directly affected thereby (it being understood and agreed that the following clauses (h), (i) and (l) directly affect each Lender): (a) a reduction in the rate of interest on the Notes (other than a reduction or waiver of default interest); (b) an increase in the amount of the Commitment of the Lenders or the Total Commitment (except as provided in Section 2.10 and Section 18.1); (c) a forgiveness, reduction or waiver of the principal of any unpaid Loan or any interest thereon (other than a reduction or waiver of default interest) or fee payable under the Loan Documents; (d) a change in the amount of any fee payable to a Lender hereunder; (e) the postponement of any date fixed for any payment of principal of or interest on any Loan; (f) an extension of the Maturity Date (except as provided in Section 2.11); (g) a change in Section 3.2 or Section 3.6, or a change in the manner of distribution of any payments to the Lenders or any Agent; (h) the release of any Borrower, any Guarantor or any Collateral except as otherwise provided in this Agreement; (i) an amendment of the definition of Majority Lenders or of any requirement for consent by all of the Lenders; (j) any modification to require a Lender to fund a pro rata share of a request for an advance of any Loan made by Borrowers other than based on its Commitment Percentage; (k) an amendment to this Section 27; or (l) an amendment of any provision of this Agreement or the Loan Documents which requires the approval of all of the Lenders or the Majority Lenders, the Majority A/R Revolving Loan Lenders or the Majority Real Estate Revolving Loan Lenders to require a lesser number of Lenders to approve such action; provided, however, that this Agreement and the other Loan Documents may be amended (or amended and restated), modified or supplemented with the written consent of Administrative Agent and the applicable Loan Party or Loan Parties party thereto to (x) cure any ambiguity, omission, defect or inconsistency, so long as such amendment, modification or supplement does not adversely affect the rights of any Lender and (y) reflect one or more Commitment Increases and to permit the extensions of credit from time to time outstanding thereunder and the accrued interest and fees in respect thereof to share ratably in the benefits of this Agreement and the other Loan Documents with the Real Estate Revolving Loans or A/R Revolving Loans, as applicable, and the accrued interest and fees in respect thereof; provided, that the conditions set forth in Section 2.10 are satisfied. The provisions of Section 14 may not be amended without the written consent of Administrative Agent, or with respect to the provisions of Section 14 relating to the Revolving Agent, the Revolving Agent. There shall be no amendment, modification or waiver of any provision in the Loan Documents with respect to Administrative Agent or the Revolving Agent nor any change in the rights, duties or obligations of Administrative Agent or the Revolving Agent under this Agreement or any other Loan Document without the written consent of Administrative Agent or the Revolving Agent, as applicable. There shall be no amendment, modification or waiver of any provision in the Loan Documents which result in a modification of the conditions to funding with respect to the Real Estate Revolving Loan Commitment or the A/R Revolving Loan Commitment without the written consent of the Majority Real Estate Revolving Lenders or the Majority A/R Revolving Lenders, respectively, nor any amendment, modification or waiver that disproportionately affects the Real Estate Revolving Loan Lenders or the A/R Revolving Loan Lenders without the approval of the Majority Real Estate Revolving Loan Lenders or Majority A/R Revolving Loan Lenders, respectively. Any amendment of any provision of any Loan Document that requires the approval of the Majority Real Estate Revolving Loan Lenders to require a lesser number of Lenders to approve such action, shall require the approval of each Revolving Loan Lender and, in the case of an amendment to any provision of the Loan Documents that requires the approval of the Majority A/R Revolving Loan Lenders to require a lesser number of Lenders to approve such action shall require the approval of each A/R Revolving Loan Lender. There shall be no amendment, modification or waiver of any provision in the Loan Documents with respect to Swing Loans without the consent of the Swing Loan Lender, nor any amendment, modification or waiver of any 187 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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provision in the Loan Documents with respect to Letters of Credit or Issuing Lender without the consent of Issuing Lender. Notwithstanding anything to the contrary herein, no Defaulting Lender shall have any right to approve or disapprove any amendment, waiver or consent hereunder (and any amendment, waiver or consent which by its terms requires the consent of all Lenders or each affected Lender may be effected with the consent of the applicable Lenders other than Defaulting Lenders), except that no Commitment of any Defaulting Lender may be increased without the consent of such Lender. Each Borrower agrees to enter into such commercially reasonable modifications or amendments of this Agreement or the other Loan Documents as reasonably may be requested by KeyBank and Co-Lead Arrangers in connection with the syndication of the Loans and the Total Commitment, provided that no such amendment or modification materially affects or increases any of the obligations, or reduces the rights, of Borrowers and Guarantors hereunder. No waiver shall extend to or affect any obligation not expressly waived or impair any right consequent thereon. No course of dealing or delay or omission on the part of any Agent or any Lender in exercising any right shall operate as a waiver thereof or otherwise be prejudicial thereto. No notice to or demand upon Borrowers shall entitle Borrowers to other or further notice or demand in similar or other circumstances. SECTION 28. SEVERABILITY. The provisions of this Agreement are severable, and if any one clause or provision hereof shall be held invalid or unenforceable in whole or in part in any jurisdiction, then such invalidity or unenforceability shall affect only such clause or provision, or part thereof, in such jurisdiction, and shall not in any manner affect such clause or provision in any other jurisdiction, or any other clause or provision of this Agreement in any jurisdiction. SECTION 29. TIME OF THE ESSENCE. Time is of the essence with respect to each and every covenant, agreement and obligation of the Loan Parties under this Agreement and the other Loan Documents. SECTION 30. NO UNWRITTEN AGREEMENTS. THE LOAN DOCUMENTS REPRESENT THE FINAL AGREEMENT BETWEEN THE PARTIES AND MAY NOT BE CONTRADICTED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OF THE PARTIES. THERE ARE NO UNWRITTEN ORAL AGREEMENTS BETWEEN THE PARTIES. ANY ADDITIONAL TERMS OF THE AGREEMENT BETWEEN THE PARTIES ARE SET FORTH BELOW. SECTION 31. REPLACEMENT NOTES. Upon receipt of evidence reasonably satisfactory to Borrowers of the loss, theft, destruction or mutilation of any Note, and in the case of any such loss, theft or destruction, upon delivery of an indemnity agreement reasonably satisfactory to Borrowers and Borrowers' counsel or, in the case of any such mutilation, upon surrender and cancellation of the applicable Note, Borrowers will execute and deliver, in lieu thereof, a replacement Note, identical in form and substance to the applicable Note and dated as of the date of the applicable Note and upon such execution and delivery all references in the Loan Documents to such Note shall be deemed to refer to such replacement Note. All reasonable costs and expenses incurred by Borrowers in connection with the foregoing, including reasonable attorneys' fees, shall be paid by the Lender that requested the replacement Note. 188 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SECTION 32. NO THIRD PARTIES BENEFITED. This Agreement and the other Loan Documents are made and entered into for the sole protection and legal benefit of Borrowers, the Lenders, Administrative Agent, Revolving Agent, Co-Lead Arrangers and their permitted successors and assigns, and no other Person shall be a direct or indirect legal beneficiary of, or have any direct or indirect cause of action or claim in connection with, this Agreement or any of the other Loan Documents. All conditions to the performance of the obligations of Administrative Agent, Revolving Agent and the Lenders under this Agreement, including the obligation to make Loans and issue Letters of Credit, are imposed solely and exclusively for the benefit of Administrative Agent, Revolving Agent and the Lenders and no other Person shall have standing to require satisfaction of such conditions in accordance with their terms or be entitled to assume that Administrative Agent and the Lenders will refuse to make Loans or issue Letters of Credit in the absence of strict compliance with any or all thereof and no other Person shall, under any circumstances, be deemed to be a beneficiary of such conditions, any and all of which may be freely waived in whole or in part by Administrative Agent and the Lenders at any time if in their sole discretion they deem it desirable to do so. In particular, Agents and the Lenders make no representations and assume no obligations as to third parties concerning the quality of any construction by Borrowers or any of its Subsidiaries of any development or the absence therefrom of defects. SECTION 33. PATRIOT ACT. Each Lender and each Agent (for itself and not on behalf of any Lender) hereby notifies Borrowers that, pursuant to the requirements of the Patriot Act, it is required to obtain, verify and record information that identifies Borrowers, which information includes names and addresses and other information that will allow such Lender or such Agent, as applicable, to identify Borrowers in accordance with the Patriot Act. SECTION 34. BANK PRODUCT PROVIDERS AND LENDER HEDGE PROVIDERS. Each Bank Product Provider and Lender Hedge Provider shall be deemed a third party beneficiary hereof and of the provisions of the other Loan Documents for purposes of any reference in a Loan Document to such parties, it being understood and agreed, however, that the rights and benefits of such Bank Product Provider and such Lender Hedge Provider under the Loan Documents consist exclusively of such Bank Product Provider's and such Lender Hedge Provider's right to share in payments and collections of the Collateral as more fully set forth herein. In addition, each Bank Product Provider, by virtue of entering into a Bank Product Agreement, shall be automatically deemed to have agreed that Revolving Agent shall have the right, but shall have no obligation, to establish, maintain, relax, or release reserves in respect of the Bank Product Obligations and that if reserves are established there is no obligation on the part of Revolving Agent to determine or insure whether the amount of any such reserve is appropriate or not. In connection with any such distribution of payments and collections, or any release of Collateral, Administrative Agent shall be entitled to assume no amounts are due to any Bank Product Provider or any Lender Hedge Provider unless such Bank Product Provider or such Lender Hedge Provider has notified each Agent in writing of the amount of any such liability owed to it prior to such distribution or release. In connection with calculation of the A/R Borrowing Base Availability, Revolving Agent shall be entitled to assume no amounts are due to any Bank Product Provider unless such Bank Product Provider has notified Revolving Agent in writing of the amount of any such liability owed to it prior to such calculation. No Agent shall have any obligation to calculate the amount due and payable with respect to any Bank Products or Hedge Obligations, but may rely upon the written certification of the amount due and payable from the applicable Bank Product Provider or Lender Hedge Provider. In the absence of an updated certification, each Agent shall be entitled to assume that the amount due and payable to the applicable Bank Product Provider or Lender Hedge Provider is the 189 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 amount last certified to Agents by such Bank Product Provider or Lender Hedge Provider as being due and payable (less any distributions made to such Bank Product Provider or Lender Hedge Provider on account thereof). In no event shall the approval of any Person in its capacity as Bank Product Provider or Lender Hedge Provider be required in connection with the release or termination of any security interest or Lien of Administrative Agent. SECTION 35. ACKNOWLEDGEMENT AND CONSENT TO BAIL-IN OF EEAAFFECTED FINANCIAL INSTITUTIONS. Notwithstanding anything to the contrary in any Loan Document or in any other agreement, arrangement or understanding among any such parties, each party hereto acknowledges that any liability of any EEAAffected Financial Institution arising under any Loan Document, to the extent such liability is unsecured, may be subject to the write-down and conversion powers of an EEAthe applicable Resolution Authority and agrees and consents to, and acknowledges and agrees to be bound by: (a) the application of any Write-Down and Conversion Powers by an EEAthe applicable Resolution Authority to any such liabilities arising hereunder which may be payable to it by any party hereto that is an EEAAffected Financial Institution; and (b) the effects of any Bail-In Action on any such liability, including, if applicable: (i) a reduction in full or in part or cancellation of any such liability; (ii) a conversion of all, or a portion of, such liability into shares or other instruments of ownership in such EEAAffected Financial Institution, its parent undertaking, or a bridge institution that may be issued to it or otherwise conferred on it, and that such shares or other instruments of ownership will be accepted by it in lieu of any rights with respect to any such liability under this Agreement or any other Loan Document; or (iii) the variation of the terms of such liability in connection with the exercise of the write-down and conversion powers of any EEAthe applicable Resolution Authority. SECTION 36. CONSENT TO AMENDMENT AND RESTATEMENT; EFFECT OF AMENDMENT AND RESTATEMENT. Pursuant to Section 27 of the Original Credit Agreement, KeyBank as Administrative Agent under, and as defined in, the Original Credit Agreement and each Lender under, and as defined in, the Original Credit Agreement (including, for the avoidance of doubt, the Exiting Lenders) hereby consents to the amendment and restatement of the Original Credit Agreement pursuant to the terms of this Agreement, and the execution of the other Loan Documents. The Lenders authorize Administrative Agent to enter into the other Loan Documents. The parties hereto acknowledge and agree that entering into this Agreement, and the other Loan Documents, does not constitute a novation of the Original Credit Agreement or the other Loan Documents (as defined in the Original Credit Agreement) or a novation, termination, extinguishment or discharge of the "Obligations" under the Original Credit Agreement or such other Loan Documents, which remain outstanding as of the Closing Date, and Borrowers hereby ratifies, renews and extends the Security Documents to which they are a party and the liens and security interests created thereby in their entirety, which liens and security interests continue in full force and effect from the original date thereof without interruption, novation or discharge. All interest and fees accrued and unpaid (determined after giving effect to any payments made to Exiting Lenders on the Closing Date) under the Original Credit Agreement as of the date of this Agreement shall be due and payable in the amount determined pursuant to the Original Credit 190 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Agreement for periods prior to the Closing Date on the next payment date for such interest or fee set forth in this Agreement. SECTION 37. WAIVER OF CLAIMS. Borrowers, for themselves and on behalf of Guarantors, acknowledge, represent and agree that Borrowers and Guarantors as of the date hereof have no defenses, setoffs, claims, counterclaims or causes of action of any kind or nature whatsoever with respect to the "Loan Documents" (as defined in the Original Credit Agreement), the administration or funding of the "Loans" (as defined in the Original Credit Agreement) or with respect to any acts or omissions of Agent or any Lender, or any past or present officers, agents or employees of Administrative Agent or any Lender, under the Original Credit Agreement, and each of Borrowers and Guarantors does hereby expressly waive, release and relinquish any and all such defenses, setoffs, claims, counterclaims and causes of action, if any. SECTION 38. ACKNOWLEDGEMENT REGARDING ANY SUPPORTED QFCs. To the extent that the Loan Documents provide support, through a guarantee or otherwise, for a Derivatives Contract or any other agreement or instrument that is a QFC (such support, "QFC Credit Support" and each such QFC a "Supported QFC"), the parties acknowledge and agree as follows with respect to the resolution power of the Federal Deposit Insurance Corporation under the Federal Deposit Insurance Act and Title II of the Dodd-Frank Wall Street Reform and Consumer Protection Act (together with the regulations promulgated thereunder, the "U.S. Special Resolution Regimes") in respect of such Supported QFC and QFC Credit Support (with the provisions below applicable notwithstanding that the Loan Documents and any Supported QFC may in fact be stated to be governed by the laws of the State of New York and/or of the United States or any other state of the United States): In the event a Covered Entity that is party to a Supported QFC (each, a "Covered Party") becomes subject to a proceeding under a U.S. Special Resolution Regime, the transfer of such Supported QFC and the benefit of such QFC Credit Support (and any interest and obligation in or under such Supported QFC and such QFC Credit Support, and any rights in property securing such Supported QFC or such QFC Credit Support) from such Covered Party will be effective to the same extent as the transfer would be effective under the U.S. Special Resolution Regime if the Supported QFC and such QFC Credit Support (and any such interest, obligation and rights in property) were governed by the laws of the United States or a state of the United States. In the event a Covered Party or a BHC Act Affiliate of a Covered Party becomes subject to a proceeding under a U.S. Special Resolution Regime, Default Rights under the Loan Documents that might otherwise apply to such Supported QFC or any QFC Credit Support that may be exercised against such Covered Party are permitted to be exercised to no greater extent than such Default Rights could be exercised under the U.S. Special Resolution Regime if the Supported QFC and the Loan Documents were governed by the laws of the United States or a state of the United States. Without limitation of the foregoing, it is understood and agreed that rights and remedies of the parties with respect to a Defaulting Lender shall in no event affect the rights of any Covered Party with respect to a Supported QFC or any QFC Credit Support. [Remainder of page intentionally left blank.] 191 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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IN WITNESS WHEREOF, each of the undersigned have caused this Agreement to be executed by its duly authorized representatives as of the date first set forth above. BORROWERS: PARAGON OUTPATIENT REHABILITATION SERVICES, LLC, an Indiana limited liability company PCA-CORRECTIONS, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF ALLEN II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CLERMONT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COLUMBUS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COMMERCE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CORYDON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CYNTHIANA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF DAVIESS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF FAYETTE III, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF GENESEE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF GLEN RIDGE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HAMILTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HENRY, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HENRY II, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HURON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF JEFFERSON II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF KENT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LAPEER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 TRILOGY HEALTHCARE OF LIVINGSTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE EAST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE NORTHEAST, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF LOUISVILLE SOUTHWEST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOWELL, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MERCER, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MILFORD, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTGOMERY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTICELLO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MORGAN, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OPERATIONS OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF MUSKINGUM, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NEW ALBANY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NORTH BALTIMORE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM III, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SEYMOUR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SYLVANIA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VANDERBURGH, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VIGO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF WOOD COUNTY SUCCESSOR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OPERATIONS OF SPRINGFIELD II, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 TRILOGY MISSION RX, LLC, a Delaware limited liability company TRILOGY NUSCRIPTRX, LLC, a Delaware limited liability company TRILOGY PCA HOLDINGS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE COLUMBUS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE CYNTHIANA, LLC, a Delaware limited liability company TRILOGY REAL ESTATE FAYETTE III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HARRISON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HOWELL, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HURON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY V, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE MORGAN, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NEW ALBANY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NORTHPOINTE, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OAKLAND, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF GRAND BLANC, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF LAPEER, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OHIO, LLC, a Delaware limited liability company TRILOGY REAL ESTATE PUTNAM II, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF SEYMOUR, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 TRILOGY REAL ESTATE VIGO, LLC, a Delaware limited liability company TRILOGY REHAB SERVICES, LLC, a Delaware limited liability company TRILOGY RER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4

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AGENT AND LENDERS: KEYBANK NATIONAL ASSOCIATION, individually as a Lender and as Administrative Agent By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 CIT BANK, N.A., individually as a Lender and as Revolving Agent By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 REGIONS BANK, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 BANK OF AMERICA, N.A., as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4

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THE HUNTINGTON NATIONAL BANK, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 SYNOVUS FINANCIAL CORPORATION, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 PACIFIC WESTERN BANK, a California state chartered bank, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4 CIBC BANK USA, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3ACTIVE\122519032\V-4

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BOKF, NA dba BANK OF OKLAHOMA, as a Lender By: Name: Title: FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 FIRST AMENDED AND RESTATED SENIOR SECURED CREDIT AGREEMENT US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXITING LENDERS Each of the lenders executing below (each, an "Exiting Lender") is a "Lender" under the Original Credit Agreement that is not continuing as a lender under the First Amended and Restated Master Credit Agreement to which this signature page is attached (the "Amended Credit Agreement"). Simultaneously with the effective date and time of the Amended Credit Agreement (the "Effective Date"), and the payment all outstanding amounts due or accrued and unpaid to each Exiting Lender under the Original Credit Agreement and the other "Loan Documents" (as defined in the Original Credit Agreement), including all principal, accrued and unpaid interest and fees, and any amounts under Section 4.7 of the Original Credit Agreement, each of the Exiting Lenders shall cease to be a "Lender" under the Original Credit Agreement, and shall have no further liabilities or obligations thereunder; provided that, notwithstanding anything else provided herein or otherwise, any rights of an Exiting Lender under the Loan Documents (as defined in the Original Credit Agreement) that are intended by their express terms to survive termination of the Commitments (as defined in the Original Credit Agreement) or the repayment, satisfaction or discharge of obligations under any such Loan Document shall survive for such Exiting Lender. Furthermore, no Exiting Lender shall be a "Lender" under the Amended Credit Agreement and shall not have any liabilities or obligations under the Amended Credit Agreement. To the extent required under the Original Credit Agreement, each Exiting Lender consents to the amendment of the Original Credit Agreement and the "Loan Documents" (as defined in the Original Credit Agreement). The undersigned Exiting Lenders have duly executed this Agreement for the limited purpose of acknowledging and agreeing to the terms set forth above under "Exiting Lenders": EXITING LENDERS: OPUS BANK, as an Exiting Lender By: Name: _________________________________ Title:__________________________________ CADENCE BANK, N.A., as an Exiting Lender By: Name: _________________________________ Title: __________________________________ EXHIBIT A FORM OF A/R REVOLVING LOAN NOTE $______________ _____________, 20__ FOR VALUE RECEIVED, each of the undersigned (collectively, "Makers"), hereby promises, jointly and severally, to pay to ________________ ("Payee"), or order, in accordance with the terms of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, among the undersigned Makers, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto (as the same may be varied, extended, supplemented, consolidated, amended, replaced, increased, renewed or modified or restated from time to time in accordance with its terms, the "Credit Agreement"), to the extent not sooner paid, on or before the Maturity Date, the principal sum of _______ Million and No/100 Dollars ($__,000,000.00), or such amount as may be advanced by Payee under the Credit Agreement as an A/R Revolving Loan with daily interest from the date thereof, computed as provided in the Credit Agreement, on the principal amount hereof from time to time unpaid, at a rate per annum on each portion of the principal amount which shall at all times be equal to the rate of interest applicable to such portion in accordance with the Credit Agreement, and with interest on overdue principal and, to the extent permitted by applicable law, on overdue installments of interest and late charges at the rates provided in the Credit Agreement. Interest shall be payable on the dates specified in the Credit Agreement, except that all accrued interest shall be paid at the stated or accelerated maturity hereof or upon the prepayment in full hereof. Capitalized terms used herein and not otherwise defined herein shall have the meanings set forth in the Credit Agreement. Payments hereunder shall be made to Administrative Agent for Payee at 127 Public Square, Cleveland, Ohio 44114-1306, or at such other address as Administrative Agent may designate from time to time by notice to Parent and the Lenders. This Note is one of one or more A/R Revolving Loan Notes evidencing borrowings under and is entitled to the benefits and subject to the provisions of the Credit Agreement. The principal of this Note may be due and payable in whole or in part prior to the Maturity Date and is subject to mandatory prepayment in the amounts and under the circumstances set forth in the Credit Agreement, and may be prepaid in whole or from time to time in part, all as set forth in the Credit Agreement and the other Loan Documents. Notwithstanding anything in this Note to the contrary, all agreements between the undersigned Makers and the Lenders, Administrative Agent and Revolving Agent, whether now existing or hereafter arising and whether written or oral, are hereby limited so that in no contingency, whether by reason of acceleration of the maturity of any of the Obligations or otherwise, shall the interest contracted for, charged or received by the Lenders exceed the maximum amount permissible under applicable law. If, from any circumstance whatsoever, interest would otherwise be payable to the Lenders in excess of the maximum lawful amount, the interest payable to the Lenders shall be reduced to the maximum amount permitted under applicable law; and if from any circumstance the Lenders shall ever receive anything of value deemed interest by applicable law in excess of the maximum lawful amount, an amount equal to any excessive interest shall be applied to the reduction of the principal balance of the Obligations of the undersigned Makers and to the payment of interest or, if such excessive interest exceeds the unpaid balance of principal of the Obligations of the undersigned Makers, such excess shall be refunded to the undersigned Makers. All interest paid or agreed to be paid to the Lenders shall, to the extent permitted by applicable law, be amortized, prorated, allocated and spread throughout the full period until payment in full of the principal of the Obligations of the undersigned Makers (including the period of any renewal A-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 or extension thereof) so that the interest thereon for such full period shall not exceed the maximum amount permitted by applicable law. This paragraph shall control all agreements between the undersigned Makers and the Lenders and Administrative Agent. In case an Event of Default shall occur and be continuing, the entire principal amount of this Note may become or be declared due and payable in the manner and with the effect provided in said Credit Agreement. This Note shall, pursuant to New York General Obligations Law Section 5-1401, be governed by the laws of the State of New York. The undersigned Makers and all guarantors and endorsers hereby waive presentment, demand, notice, protest, notice of intention to accelerate the indebtedness evidenced hereby, notice of acceleration of the indebtedness evidenced hereby and all other demands and notices in connection with the delivery, acceptance, performance and enforcement of this Note, except as specifically otherwise provided in the Credit Agreement, and assent to extensions of time of payment or forbearance or other indulgence without notice. [Remainder of page intentionally left blank.] A-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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IN WITNESS WHEREOF, each of the undersigned has by its duly authorized officer executed this Note on the day and year first above written. PARAGON OUTPATIENT REHABILITATION SERVICES, LLC, an Indiana limited liability company PCA-CORRECTIONS, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF ALLEN II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CLERMONT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COLUMBUS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COMMERCE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CORYDON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CYNTHIANA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF DAVIESS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF FAYETTE III, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF GENESEE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF GLEN RIDGE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HAMILTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HENRY, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HENRY II, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HURON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF JEFFERSON II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF KENT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LAPEER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary A-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY HEALTHCARE OF LIVINGSTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE EAST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE NORTHEAST, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF LOUISVILLE SOUTHWEST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOWELL, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MERCER, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MILFORD, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTGOMERY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTICELLO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MORGAN, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OPERATIONS OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF MUSKINGUM, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NEW ALBANY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NORTH BALTIMORE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM III, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SEYMOUR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SYLVANIA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VANDERBURGH, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VIGO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF WOOD COUNTY SUCCESSOR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OPERATIONS OF SPRINGFIELD II, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary A-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY MISSION RX, LLC, a Delaware limited liability company TRILOGY NUSCRIPTRX, LLC, a Delaware limited liability company TRILOGY PCA HOLDINGS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE COLUMBUS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE CYNTHIANA, LLC, a Delaware limited liability company TRILOGY REAL ESTATE FAYETTE III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HARRISON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HOWELL, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HURON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY V, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE MORGAN, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NEW ALBANY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NORTHPOINTE, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OAKLAND, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF GRAND BLANC, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF LAPEER, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OHIO, LLC, a Delaware limited liability company TRILOGY REAL ESTATE PUTNAM II, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF SEYMOUR, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary A-5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY REAL ESTATE VIGO, LLC, a Delaware limited liability company TRILOGY REHAB SERVICES, LLC, a Delaware limited liability company TRILOGY RER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary A-6 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT B FORM OF REAL ESTATE REVOLVING LOAN NOTE $______________ _______________, 20__ FOR VALUE RECEIVED, each of the undersigned (collectively, "Makers"), hereby promises, jointly and severally, to pay to ________________ ("Payee"), or order, in accordance with the terms of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, among the undersigned Makers, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto (as the same may be varied, extended, supplemented, consolidated, amended, replaced, increased, renewed or modified or restated from time to time in accordance with its terms, the "Credit Agreement"), to the extent not sooner paid, on or before the Maturity Date, the principal sum of _______ Million and No/100 Dollars ($__,000,000.00), or such amount as may be advanced by Payee under the Credit Agreement as a Real Estate Revolving Loan with daily interest from the date thereof, computed as provided in the Credit Agreement, on the principal amount hereof from time to time unpaid, at a rate per annum on each portion of the principal amount which shall at all times be equal to the rate of interest applicable to such portion in accordance with the Credit Agreement, and with interest on overdue principal and, to the extent permitted by applicable law, on overdue installments of interest and late charges at the rates provided in the Credit Agreement. Interest shall be payable on the dates specified in the Credit Agreement, except that all accrued interest shall be paid at the stated or accelerated maturity hereof or upon the prepayment in full hereof. Capitalized terms used herein and not otherwise defined herein shall have the meanings set forth in the Credit Agreement. Payments hereunder shall be made to Administrative Agent for Payee at 127 Public Square, Cleveland, Ohio 44114-1306, or at such other address as Administrative Agent may designate from time to time by notice to Parent and the Lenders. This Note is one of one or more Real Estate Revolving Loan Notes evidencing borrowings under and is entitled to the benefits and subject to the provisions of the Credit Agreement. The principal of this Note may be due and payable in whole or in part prior to the Maturity Date and is subject to mandatory prepayment in the amounts and under the circumstances set forth in the Credit Agreement, and may be prepaid in whole or from time to time in part, all as set forth in the Credit Agreement and the other Loan Documents. Notwithstanding anything in this Note to the contrary, all agreements between the undersigned Makers and the Lenders, Administrative Agent and Revolving Agent, whether now existing or hereafter arising and whether written or oral, are hereby limited so that in no contingency, whether by reason of acceleration of the maturity of any of the Obligations or otherwise, shall the interest contracted for, charged or received by the Lenders exceed the maximum amount permissible under applicable law. If, from any circumstance whatsoever, interest would otherwise be payable to the Lenders in excess of the maximum lawful amount, the interest payable to the Lenders shall be reduced to the maximum amount permitted under applicable law; and if from any circumstance the Lenders shall ever receive anything of value deemed interest by applicable law in excess of the maximum lawful amount, an amount equal to any excessive interest shall be applied to the reduction of the principal balance of the Obligations of the undersigned Makers and to the payment of interest or, if such excessive interest exceeds the unpaid balance of principal of the Obligations of the undersigned Makers, such excess shall be refunded to the undersigned Makers. All interest paid or agreed to be paid to the Lenders shall, to the extent permitted by applicable law, be amortized, prorated, allocated and spread throughout the full period until payment B-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 in full of the principal of the Obligations of the undersigned Makers (including the period of any renewal or extension thereof) so that the interest thereon for such full period shall not exceed the maximum amount permitted by applicable law. This paragraph shall control all agreements between the undersigned Makers and the Lenders and Administrative Agent. In case an Event of Default shall occur and be continuing, the entire principal amount of this Note may become or be declared due and payable in the manner and with the effect provided in said Credit Agreement. This Note shall, pursuant to New York General Obligations Law Section 5-1401, be governed by the laws of the State of New York. The undersigned Makers and all guarantors and endorsers hereby waive presentment, demand, notice, protest, notice of intention to accelerate the indebtedness evidenced hereby, notice of acceleration of the indebtedness evidenced hereby and all other demands and notices in connection with the delivery, acceptance, performance and enforcement of this Note, except as specifically otherwise provided in the Credit Agreement, and assent to extensions of time of payment or forbearance or other indulgence without notice. This Note, together with the other Real Estate Revolving Loan Notes executed pursuant to the Credit Agreement contemporaneously with the execution hereof, are executed in amendment and restatement of, and not as a novation or an accord and satisfaction of, the "Revolving Loan Notes" under the Original Credit Agreement. [Remainder of page intentionally left blank.] B-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 IN WITNESS WHEREOF, each of the undersigned has by its duly authorized officer executed this Note on the day and year first above written. PARAGON OUTPATIENT REHABILITATION SERVICES, LLC, an Indiana limited liability company PCA-CORRECTIONS, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF ALLEN II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CLERMONT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COLUMBUS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COMMERCE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CORYDON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CYNTHIANA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF DAVIESS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF FAYETTE III, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF GENESEE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF GLEN RIDGE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HAMILTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HENRY, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HENRY II, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HURON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF JEFFERSON II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF KENT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LAPEER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary B-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY HEALTHCARE OF LIVINGSTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE EAST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE NORTHEAST, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF LOUISVILLE SOUTHWEST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOWELL, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MERCER, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MILFORD, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTGOMERY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTICELLO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MORGAN, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OPERATIONS OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF MUSKINGUM, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NEW ALBANY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NORTH BALTIMORE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM III, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SEYMOUR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SYLVANIA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VANDERBURGH, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VIGO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF WOOD COUNTY SUCCESSOR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OPERATIONS OF SPRINGFIELD II, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary B-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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TRILOGY MISSION RX, LLC, a Delaware limited liability company TRILOGY NUSCRIPTRX, LLC, a Delaware limited liability company TRILOGY PCA HOLDINGS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE COLUMBUS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE CYNTHIANA, LLC, a Delaware limited liability company TRILOGY REAL ESTATE FAYETTE III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HARRISON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HOWELL, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HURON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY V, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE MORGAN, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NEW ALBANY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NORTHPOINTE, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OAKLAND, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF GRAND BLANC, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF LAPEER, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OHIO, LLC, a Delaware limited liability company TRILOGY REAL ESTATE PUTNAM II, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF SEYMOUR, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary B-5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY REAL ESTATE VIGO, LLC, a Delaware limited liability company TRILOGY REHAB SERVICES, LLC, a Delaware limited liability company TRILOGY RER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary B-6 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT C FORM OF SWING LOAN NOTE $35,000,000.00 _______________, 20__ FOR VALUE RECEIVED, each of the undersigned (collectively, "Makers"), hereby promises, jointly and severally, to pay to ________________ ("Payee"), or order, in accordance with the terms of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019, among the undersigned Makers, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto (as the same may be varied, extended, supplemented, consolidated, amended, replaced, increased, renewed or modified or restated from time to time in accordance with its terms, the "Credit Agreement"), to the extent not sooner paid, on or before the Maturity Date, the principal sum of Thirty-Five Million and No/100 Dollars ($35,000,000.00), or such amount as may be advanced by Payee under the Credit Agreement as a Swing Loan with daily interest from the date thereof, computed as provided in the Credit Agreement, on the principal amount hereof from time to time unpaid, at a rate per annum on each portion of the principal amount which shall at all times be equal to the rate of interest applicable to such portion in accordance with the Credit Agreement, and with interest on overdue principal and, to the extent permitted by applicable law, on overdue installments of interest and late charges at the rates provided in the Credit Agreement. Interest shall be payable on the dates specified in the Credit Agreement, except that all accrued interest shall be paid at the stated or accelerated maturity hereof or upon the prepayment in full hereof. Capitalized terms used herein and not otherwise defined herein shall have the meanings set forth in the Credit Agreement. Payments hereunder shall be made to Administrative Agent for Payee at 127 Public Square, Cleveland, Ohio 44114-1306, or at such other address as Administrative Agent may designate from time to time by notice to Parent and the Lenders. This Note is one of one or more Swing Loan Notes evidencing borrowings under and is entitled to the benefits and subject to the provisions of the Credit Agreement. The principal of this Note may be due and payable in whole or in part prior to the Maturity Date and is subject to mandatory prepayment in the amounts and under the circumstances set forth in the Credit Agreement, and may be prepaid in whole or from time to time in part, all as set forth in the Credit Agreement and the other Loan Documents. Notwithstanding anything in this Note to the contrary, all agreements between the undersigned Makers and the Lenders and Administrative Agent, whether now existing or hereafter arising and whether written or oral, are hereby limited so that in no contingency, whether by reason of acceleration of the maturity of any of the Obligations or otherwise, shall the interest contracted for, charged or received by the Lenders exceed the maximum amount permissible under applicable law. If, from any circumstance whatsoever, interest would otherwise be payable to the Lenders in excess of the maximum lawful amount, the interest payable to the Lenders shall be reduced to the maximum amount permitted under applicable law; and if from any circumstance the Lenders shall ever receive anything of value deemed interest by applicable law in excess of the maximum lawful amount, an amount equal to any excessive interest shall be applied to the reduction of the principal balance of the Obligations of the undersigned Makers and to the payment of interest or, if such excessive interest exceeds the unpaid balance of principal of the Obligations of the undersigned Makers, such excess shall be refunded to the undersigned Makers. All interest paid or agreed to be paid to the Lenders shall, to the extent permitted by applicable law, be amortized, prorated, allocated and spread throughout the full period until payment in full of the principal of the Obligations of the undersigned Makers (including the period of any renewal or extension thereof) so that the interest thereon for such full period shall not exceed the maximum C-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 amount permitted by applicable law. This paragraph shall control all agreements between the undersigned Makers and the Lenders and Administrative Agent. In case an Event of Default shall occur and be continuing, the entire principal amount of this Note may become or be declared due and payable in the manner and with the effect provided in said Credit Agreement. This Note shall, pursuant to New York General Obligations Law Section 5-1401, be governed by the laws of the State of New York. The undersigned Makers and all guarantors and endorsers hereby waive presentment, demand, notice, protest, notice of intention to accelerate the indebtedness evidenced hereby, notice of acceleration of the indebtedness evidenced hereby and all other demands and notices in connection with the delivery, acceptance, performance and enforcement of this Note, except as specifically otherwise provided in the Credit Agreement, and assent to extensions of time of payment or forbearance or other indulgence without notice. This Note is executed in amendment and restatement of, and not as a novation or an accord and satisfaction of, the "Swing Loan Note" under the Original Credit Agreement. [Remainder of page intentionally left blank.] C-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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IN WITNESS WHEREOF, each of the undersigned has by its duly authorized officer executed this Note on the day and year first above written. PARAGON OUTPATIENT REHABILITATION SERVICES, LLC, an Indiana limited liability company PCA-CORRECTIONS, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF ALLEN II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CLERMONT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COLUMBUS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF COMMERCE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CORYDON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF CYNTHIANA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF DAVIESS, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF FAYETTE III, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF GENESEE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF GLEN RIDGE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HAMILTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF HENRY, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HENRY II, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF HURON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF JEFFERSON II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF KENT, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LAPEER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary C-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY HEALTHCARE OF LIVINGSTON, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE EAST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOUISVILLE NORTHEAST, LLC, a Kentucky limited liability company TRILOGY HEALTHCARE OF LOUISVILLE SOUTHWEST, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF LOWELL, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MERCER, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MILFORD, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTGOMERY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MONTICELLO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MORGAN, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OPERATIONS OF MUNCIE, LLC, an Indiana limited liability company TRILOGY HEALTHCARE OF MUSKINGUM, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NEW ALBANY, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF NORTH BALTIMORE, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM II, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF PUTNAM III, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SEYMOUR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF SYLVANIA, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VANDERBURGH, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF VIGO, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OF WOOD COUNTY SUCCESSOR, LLC, a Delaware limited liability company TRILOGY HEALTHCARE OPERATIONS OF SPRINGFIELD II, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary C-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY MISSION RX, LLC, a Delaware limited liability company TRILOGY NUSCRIPTRX, LLC, a Delaware limited liability company TRILOGY PCA HOLDINGS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE COLUMBUS, LLC, a Delaware limited liability company TRILOGY REAL ESTATE CYNTHIANA, LLC, a Delaware limited liability company TRILOGY REAL ESTATE FAYETTE III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HARRISON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HOWELL, LLC, a Delaware limited liability company TRILOGY REAL ESTATE HURON, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY III, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY V, LLC, a Delaware limited liability company TRILOGY REAL ESTATE KENTUCKY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE MORGAN, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NEW ALBANY, LLC, a Delaware limited liability company TRILOGY REAL ESTATE NORTHPOINTE, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OAKLAND, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF BATTLE CREEK, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF GRAND BLANC, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF LAPEER, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OHIO, LLC, a Delaware limited liability company TRILOGY REAL ESTATE PUTNAM II, LLC, a Delaware limited liability company TRILOGY REAL ESTATE OF SEYMOUR, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary C-5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY REAL ESTATE VIGO, LLC, a Delaware limited liability company TRILOGY REHAB SERVICES, LLC, a Delaware limited liability company TRILOGY RER, LLC, a Delaware limited liability company By: Name: Brad Williamson Title: Senior Vice-President, Treasurer and Assistant Secretary C-6 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT D FORM OF JOINDER AGREEMENT THIS JOINDER AGREEMENT NO. [___] (this "Agreement") is executed as of [_______________], 20[__], by the parties executing this Agreement as a joining party (each, a "Joining Party" and collectively, "Joining Parties"), and delivered to KeyBank National Association, as Administrative Agent, pursuant to Section 7.20 of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the "Credit Agreement"; capitalized terms used but not defined in this Agreement shall have the meanings defined for those terms in the Credit Agreement) among Trilogy RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other parties now or thereafter party thereto, as Borrowers, the Lenders party thereto from time to time, Administrative Agent, and CIT Bank, N.A., as Revolving Agent. W I T N E S S E T H: WHEREAS, pursuant to the Credit Agreement, Administrative Agent and the Lenders have made and continue to make certain financial accommodations to Borrowers from time to time; WHEREAS, pursuant to Section 7.20 of the Credit Agreement, each of Joining Parties has been required to become a Borrower; and WHEREAS, Joining Parties expect to realize direct and indirect benefits as a result of becoming Borrowers under the Credit Agreement and having access to the credit facilities made available thereunder; NOW, THEREFORE, for and in consideration of the foregoing and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as set forth below. 1. Joinder. (a) By this Agreement, each Joining Party hereby becomes a "Borrower" under the Credit Agreement, the Notes, the Indemnity Agreement and the other Loan Documents with respect to all of the Obligations under the Credit Agreement, the Notes, the Indemnity Agreement and the other Loan Documents, whether now existing or hereafter incurred, and a "Contributing Party" under the Contribution Agreement. Each Joining Party agrees that it is and shall be bound by, and hereby assumes, all representations, warranties, covenants, terms, conditions, duties and waivers applicable to a "Borrower" and a "Contributing Party" under the Credit Agreement, the Notes, the Indemnity Agreement, the other Loan Documents and the Contribution Agreement. (b) Each Joining Party represents and warrants to Administrative Agent that, as of the date hereof, the representations and warranties contained in the Credit Agreement and the other Loan Documents applicable to a "Borrower" are true and correct in all material respects as applied to such Joining Party as a Borrower. As of the date hereof, all covenants and agreements in the Loan Documents and the Contribution Agreement of Borrowers apply to Joining Parties and no Default or Event of Default exists with respect to Joining Parties. (c) Each Joining Party hereby agrees that, as of the date hereof, the Credit Agreement, the other Loan Documents and the Contribution Agreement heretofore delivered to Administrative Agent and the Lenders shall be a joint and several obligation of such Joining Party to the same extent as if D-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 executed and delivered by such Joining Party, and, upon request by Administrative Agent, such Joining Party will promptly execute and deliver such other agreements, instruments and other documents requested by Administrative Agent to confirm such obligations or to further evidence the fact that such Joining Party has become a party to the Credit Agreement, the other Loan Documents and the Contribution Agreement. 2. Acknowledgment of Joining Parties. Each Joining Party hereby acknowledges, represents and agrees as follows: (a) the Loan Documents are in full force and effect and constitute the valid and legally binding obligations of each Joining Party, enforceable against each Joining Party in accordance with their respective terms, and the execution and delivery of this Agreement does not constitute, and shall not be deemed to constitute, a release, waiver or satisfaction of any Borrower's or any Joining Party's obligations under the Loan Documents, except as expressly provided herein; (b) this Agreement shall not constitute a modification of the Credit Agreement or any of the other Loan Documents or a course of dealing with Administrative Agent and the Lenders at variance with the Credit Agreement or the other Loan Documents such as to require further notice by Administrative Agent or any Lender to require strict compliance with the terms of the Credit Agreement and the other Loan Documents in the future; (c) Administrative Agent and the Lenders reserve the right to, and do in fact, require strict compliance with all terms and provisions of the Credit Agreement and the other Loan Documents; and (d) Joining Parties do not have any knowledge of any challenge to the claims of Administrative Agent or any Lender arising under the Loan Documents, or to the effectiveness of the Loan Documents. 3. Representations and Warranties. Each Joining Party represents and warrants to Administrative Agent and the Lenders as set forth below. 3.1 Authorization. The execution, delivery and performance of this Agreement and the transactions contemplated hereby (a) are within the authority of each Joining Party, (b) have been duly authorized by all necessary proceedings on the part of each Joining Party, (c) do not and will not conflict with or result in any breach or contravention of any provision of law, statute, rule or regulation to which any Joining Party is subject or any judgment, order, writ, injunction, license or permit applicable to any Joining Party, (d) do not and will not conflict with or constitute a default (whether with the passage of time or the giving of notice, or both) under any provision of any partnership agreement or certificate, certificate of formation, operating agreement, articles of incorporation or other charter documents or bylaws of, or any mortgage, indenture, agreement, contract or other instrument binding upon, any Joining Party or any of their respective properties or to which any Joining Party is subject, and (e) do not and will not result in or require the imposition of any Lien on any of the properties, assets or rights of any Joining Party. 3.2 Enforceability. The execution and delivery of this Agreement is valid and a legally binding obligation of each Joining Party, enforceable in accordance with the respective terms and provisions hereof except as enforceability is limited by bankruptcy, insolvency, reorganization, moratorium or other laws relating to or affecting generally the enforcement of creditors' rights and the effect of general principles of equity. D-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 3.3 Approvals. The execution, delivery and performance of this Agreement and the transactions contemplated hereby do not require the approval or consent of any Person or the authorization, consent, approval of or any license or permit issued by, or any filing or registration with, or the giving of any notice to, any court, department, board, commission or other governmental agency or authority other than those already obtained. 4. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed to be an original, but all such separate counterparts shall together constitute but one and the same instrument. Delivery of a counterpart hereof by facsimile transmission or by other electronic transmission shall be as effective as delivery of a manually executed counterpart hereof. 5. Continuing Validity. Each of the Loan Documents is, and shall remain, in full force and effect. 6. Governing Law. This Agreement shall pursuant to New York General Obligations Law Section 5-1401 be construed in accordance with and governed by the laws of the State of New York. [Remainder of this page intentionally left blank.] D-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the day and year first set forth above. JOINING PARTY: [NAME OF NEW JOINING PARTY] By: Name: Title: [NAME OF NEW JOINING PARTY] By: Name: Title: ADMINISTRATIVE AGENT: KEYBANK NATIONAL ASSOCIATION, as Administrative Agent By: Name: Title: D-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT E [RESERVED] E-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT f FORM OF REQUEST FOR LOAN/CONVERSION KeyBank National Association, as Administrative Agent Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields Ladies and Gentlemen: This request is delivered pursuant to the provisions of Section [2.6/4.1] of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among TRILOGY RER, LLC, a Delaware limited liability company, as a Borrower ("Parent") and the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto. Terms defined in the Credit Agreement and not otherwise defined herein are used herein as defined in the Credit Agreement, Parent hereby requests, on behalf of itself and the other Borrowers, and certifies as follows: 1. Loan. Borrowers hereby request a [Real Estate Revolving Loan under Section 2.1] [A/R Revolving Loan under Section 2.2] [A/R Swing Loan under Section 2.4] [Real Estate Swing Loan under Section 2.4] [conversion of a Loan under Section 4.1] of the Credit Agreement: Principal Amount: $__________ Type (LIBOR Rate, Base Rate): Drawdown/Conversion Date: Interest Period for LIBOR Rate Loans: [If a request of a Loan under Section 2.1 or Section 2.2 or a Swing Loan under Section 2.4, add the following: by credit to the general account of [designate Borrower] with Administrative Agent at Administrative Agent's Head Office.] [If the requested Loan is a Swing Loan and Borrowers desire for such Loan to be a LIBOR Rate Loan following its conversion as provided in Section 2.4(d), specify the Interest Period following conversion:_________________] 2. Use of Proceeds. Such Loan shall be used in accordance with the terms of Section 2.8 of the Credit Agreement. 3. No Default. The undersigned Authorized Officer of Parent certifies, on behalf of Borrowers, that Loan Parties are and will be in compliance with all covenants under the Loan Documents after giving effect to the making or conversion, as the case may be, of the Loan requested hereby and no Default or Event of Default has occurred and is continuing. F-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 4. Borrowing Base Certificate. [If a request of an A/R Revolving Loan or Real Estate Revolving Loan under Section 2.1 or Section 2.2 or Swing Loan under Section 2.4, add the following: Attached hereto is [an A/R] [a Real Estate] Borrowing Base Certificate setting forth a calculation of the [A/R/Real Estate] Borrowing Base Availability after giving effect to the [A/R/Real Estate] Revolving Loan requested hereby. After giving effect to the making of such Loan, (a) the Aggregate A/R Revolving Credit Obligations shall not be greater than the lesser of (i) the Total A/R Revolving Loan Commitment and (ii) the A/R Borrowing Base Availability, and (b) the Aggregate Real Estate Revolving Credit Obligations shall not be greater than the lesser of (i) the Total Real Estate Revolving Loan Commitment and (ii) the Real Estate Borrowing Base Availability.] [INCLUDE IF NOTICE IS DELIVERED IN CONNECTION WITH A DRAW: 5. Representations True. The undersigned certifies, represents and agrees, on behalf of Borrowers, that each of the representations and warranties made by any Loan Party contained in the Credit Agreement, the other Loan Documents or in any document or instrument delivered by or on behalf of any Loan Party to Administrative Agent, Revolving Agent or the Lenders pursuant to or in connection with the Credit Agreement shall be true and correct in all material respects both as of the date as of which they were made and shall also be true and correct in all material respects as of the time of the making of such Loan, with the same effect as if made at and as of that time, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing.] [5/6]. Other Conditions. The undersigned certifies, represents and agrees, on behalf of Borrowers, that all conditions to the making or conversion, as the case may be, of the Loan requested hereby set forth in the Credit Agreement have been satisfied or waived in writing. [6/7]. Definitions. Terms defined in the Credit Agreement are used herein with the meanings so defined. IN WITNESS WHEREOF, the undersigned has duly executed this request this _____ day of _____________, 20__. TRILOGY RER, LLC, a Delaware limited liability company, on behalf of Borrowers By: Name: Title: F-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT G FORM OF LETTER OF CREDIT REQUEST [Date] KeyBank National Association, as Administrative Agent Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields Re: Letter of Credit Request under Credit Agreement Ladies and Gentlemen: Pursuant to Section 2.9 of that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among Trilogy RER, LLC ("Parent"), as a Borrower, the other Persons now or hereafter a party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto, we hereby request that you issue a Letter of Credit as follows: (i) Name and address of beneficiary: (ii) Face amount: $(iii) Proposed Issuance Date: (iv) Proposed Expiration Date: (v) Other terms and conditions as set forth in the proposed form of Letter of Credit attached hereto. (vi) Purpose of Letter of Credit: This Letter of Credit Request is submitted pursuant to, and shall be governed by, and subject to satisfaction of, the terms, conditions and provisions set forth in Section 2.9 of the Credit Agreement. The undersigned Authorized Officer certifies, on behalf of Borrowers, that the Loan Parties are and will be in compliance with all covenants under the Loan Documents after giving effect to the issuance of the Letter of Credit requested hereby and no Default or Event of Default has occurred and is continuing. Attached hereto is a Real Estate Borrowing Base Certificate setting forth a calculation of the Real Estate Borrowing Base Availability after giving effect to the Letter of Credit requested hereby. We also understand that if you grant this request this request obligates us to accept the requested Letter of Credit and pay the issuance fee and Letter of Credit fee as required by Section 2.9(e). All capitalized terms defined in the Credit Agreement and used herein without definition shall have the meanings set forth in Section 1.1 of the Credit Agreement. G-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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The undersigned certifies, represents and agrees, on behalf of Borrowers, that each of the representations and warranties made by any Loan Party contained in the Credit Agreement, the other Loan Documents or in any document or instrument delivered by or on behalf of any Loan Party to Administrative Agent or the Lenders pursuant to or in connection with the Credit Agreement shall be true and correct in all material respects both as of the date as of which they were made and shall also be true and correct in all material respects as of the time of the proposed issuance of such Letter of Credit, with the same effect as if made at and as of that time, except to the extent of changes in the facts and circumstances after the date such representation and warranty was made that resulted from actions or inactions not prohibited by the Credit Agreement (it being understood and agreed that any representation or warranty which by its terms is made as of a specified date shall be required to be true and correct only as of such specified date), and no Default or Event of Default shall have occurred and be continuing.] The undersigned certifies, represents and agrees, on behalf of Borrowers, that all conditions to the issuance of the Letter of Credit requested hereby set forth in the Credit Agreement have been satisfied or waived in writing. Very truly yours, TRILOGY RER, LLC, a Delaware limited liability company, on behalf of Borrowers By: Name: Title: G-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT H FORM OF LETTER OF CREDIT APPLICATION H-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 H-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 H-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT I-1 FORM OF U.S. TAX COMPLIANCE CERTIFICATE (For Foreign Lenders That Are Not Partnerships For U.S. Federal Income Tax Purposes) Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the "Credit Agreement"), among Trilogy RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto (together with Parent, collectively, "Borrowers" and each, a "Borrower"), as Borrowers, KeyBank National Association ("KeyBank"), as a Lender, the other lending institutions which are parties to the Credit Agreement from time to time as Lenders, KeyBank, as Administrative Agent, and CIT Bank, N.A., as Revolving Agent. Pursuant to the provisions of Section 4.3 of the Credit Agreement, the undersigned hereby certifies that (a) it is the sole record and beneficial owner of the Loan(s) (as well as any Note(s) evidencing such Loan(s)) in respect of which it is providing this certificate, (b) it is not a bank within the meaning of Section 881(c)(3)(A) of the Code, (c) it is not a "10 percent shareholder" of a Borrower within the meaning of Section 871(h)(3)(B) of the Code and (d) it is not a "controlled foreign corporation" as described in Section 881(c)(3)(C) of the Code. The undersigned has furnished Administrative Agent and Parent with a certificate of its non-U.S. Person status on an appropriate IRS Form W-8BEN. By executing this certificate, the undersigned agrees that (a) if the information provided on this certificate changes, the undersigned shall promptly so inform Administrative Agent and Parent, and (b) the undersigned shall have at all times furnished Administrative Agent and Parent with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two (2) calendar years preceding such payments. Unless otherwise defined herein, terms defined in the Credit Agreement and used herein shall have the meanings given to them in the Credit Agreement. [NAME OF LENDER] By: Name: Title: Date: _______________, 20__ I-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT I-2 FORM OF U.S. TAX COMPLIANCE CERTIFICATE (For Foreign Participants That Are Not Partnerships For U.S. Federal Income Tax Purposes) Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the "Credit Agreement"), among Trilogy RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto (together with Parent, collectively, "Borrowers" and each, a "Borrower"), as Borrowers, KeyBank National Association ("KeyBank"), as a Lender, the other lending institutions which are parties to the Credit Agreement from time to time as Lenders, KeyBank, as Administrative Agent, and CIT Bank, N.A., as Revolving Agent. Pursuant to the provisions of Section 4.3 of the Credit Agreement, the undersigned hereby certifies that (a) it is the sole record and beneficial owner of the participation in respect of which it is providing this certificate, (b) it is not a bank within the meaning of Section 881(c)(3)(A) of the Code, (c) it is not a "10 percent shareholder" of a Borrower within the meaning of Section 871(h)(3)(B) of the Code and (d) it is not a "controlled foreign corporation" as described in Section 881(c)(3)(C) of the Code. The undersigned has furnished its participating Lender with a certificate of its non-U.S. Person status on an appropriate IRS Form W-8BEN. By executing this certificate, the undersigned agrees that (a) if the information provided on this certificate changes, the undersigned shall promptly so inform such Lender in writing, and (b) the undersigned shall have at all times furnished such Lender with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two (2) calendar years preceding such payments. Unless otherwise defined herein, terms defined in the Credit Agreement and used herein shall have the meanings given to them in the Credit Agreement. [NAME OF PARTICIPANT] By: Name: Title: Date: _______________, 20__ I-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT I-3 FORM OF U.S. TAX COMPLIANCE CERTIFICATE (For Foreign Participants That Are Partnerships For U.S. Federal Income Tax Purposes) Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the "Credit Agreement"), among Trilogy RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto (together with Parent, collectively, "Borrowers" and each, a "Borrower"), as Borrowers, KeyBank National Association ("KeyBank"), as a Lender, the other lending institutions which are parties to the Credit Agreement from time to time as Lenders, KeyBank, as Administrative Agent, and CIT Bank, N.A., as Revolving Agent. Pursuant to the provisions of Section 4.3 of the Credit Agreement, the undersigned hereby certifies that (a) it is the sole record owner of the participation in respect of which it is providing this certificate, (b) its direct or indirect partners/members are the sole beneficial owners of such participation, (c) with respect such participation, neither the undersigned nor any of its direct or indirect partners/members is a bank extending credit pursuant to a loan agreement entered into in the ordinary course of its trade or business within the meaning of Section 881(c)(3)(A) of the Code, (d) none of its direct or indirect partners/members is a "10 percent shareholder" of a Borrower within the meaning of Section 871(h)(3)(B) of the Code and (e) none of its direct or indirect partners/members is a "controlled foreign corporation" as described in Section 881(c)(3)(C) of the Code. The undersigned has furnished its participating Lender with IRS Form W-8IMY accompanied by one (1) of the following forms from each of its partners/members that is claiming the portfolio interest exemption: (a) an appropriate IRS Form W-8BEN or (b) an IRS Form W-8IMY accompanied by an appropriate IRS Form W-8BEN from each of such partner's/member's beneficial owners that is claiming the portfolio interest exemption. By executing this certificate, the undersigned agrees that (y) if the information provided on this certificate changes, the undersigned shall promptly so inform such Lender and (z) the undersigned shall have at all times furnished such Lender with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two (2) calendar years preceding such payments. Unless otherwise defined herein, terms defined in the Credit Agreement and used herein shall have the meanings given to them in the Credit Agreement. [NAME OF PARTICIPANT] By: Name: Title: Date: _______________, 20__ I-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT I-4 FORM OF U.S. TAX COMPLIANCE CERTIFICATE (For Foreign Lenders That Are Partnerships For U.S. Federal Income Tax Purposes) Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as amended, restated, supplemented or otherwise modified from time to time, the "Credit Agreement"), among Trilogy RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto (together with Parent, collectively, "Borrowers" and each, a "Borrower"), as Borrowers, KeyBank National Association ("KeyBank"), as a Lender, the other lending institutions which are parties to the Credit Agreement from time to time as Lenders, KeyBank, as Administrative Agent, and CIT Bank, N.A., as Revolving Agent. Pursuant to the provisions of Section 4.3 of the Credit Agreement, the undersigned hereby certifies that (a) it is the sole record owner of the Loan(s) (as well as any Note(s) evidencing such Loan(s)) in respect of which it is providing this certificate, (b) its direct or indirect partners/members are the sole beneficial owners of such Loan(s) (as well as any Note(s) evidencing such Loan(s)), (c) with respect to the extension of credit pursuant to this Credit Agreement or any other Loan Document, neither the undersigned nor any of its direct or indirect partners/members is a bank extending credit pursuant to a loan agreement entered into in the ordinary course of its trade or business within the meaning of Section 881(c)(3)(A) of the Code, (d) none of its direct or indirect partners/members is a "10 percent shareholder" of a Borrower within the meaning of Section 871(h)(3)(B) of the Code and (e) none of its direct or indirect partners/members is a "controlled foreign corporation" as described in Section 881(c)(3)(C) of the Code. The undersigned has furnished Administrative Agent and Parent with IRS Form W-8IMY accompanied by one (1) of the following forms from each of its partners/members that is claiming the portfolio interest exemption: (a) an appropriate IRS Form W-8BEN or (b) an appropriate IRS Form W-8IMY accompanied by an IRS Form W-8BEN from each of such partner's/member's beneficial owners that is claiming the portfolio interest exemption. By executing this certificate, the undersigned agrees that (y) if the information provided on this certificate changes, the undersigned shall promptly so inform Administrative Agent and Parent, and (z) the undersigned shall have at all times furnished Administrative Agent and Parent with a properly completed and currently effective certificate in either the calendar year in which each payment is to be made to the undersigned, or in either of the two (2) calendar years preceding such payments. Unless otherwise defined herein, terms defined in the Credit Agreement and used herein shall have the meanings given to them in the Credit Agreement. [NAME OF LENDER] By: Name: Title: Date: _______________, 20__ I-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT J FORM OF REAL ESTATE BORROWING BASE CERTIFICATE KeyBank National Association, as Administrative Agent 1200 Abernathy Road, Suite 1550 Atlanta, Georgia 30328 Attn: Mark J. Amantea Ladies and Gentlemen: Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among TRILOGY RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto. Terms defined in the Credit Agreement and not otherwise defined herein are used herein as defined in the Credit Agreement. Pursuant to the Credit Agreement, Parent, on behalf of Borrowers, is furnishing to you herewith this Real Estate Borrowing Base Certificate and supporting calculations and information. The information presented herein has been prepared in accordance with the requirements of the Credit Agreement. The undersigned is providing the attached information to demonstrate the components of the Real Estate Borrowing Base Availability and the calculation of the Real Estate Borrowing Base Availability. All Collateral Properties included in the calculation of the Real Estate Borrowing Base Availability satisfy the requirements of the Credit Agreement to be included therein. Parent hereby certifies that, as of the date hereof, no Default or Event of Default exists. IN WITNESS WHEREOF, the undersigned has duly executed this Real Estate Borrowing Base Certificate on behalf of Parent and the other Borrowers (and not, in either case, in his or her individual capacity) this _____ day of ___________, 20__. TRILOGY RER, LLC, a Delaware limited liability company, on behalf of Borrowers By: Name: Title: (SEAL) J-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 J-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 REAL ESTATE BORROWING BASE WORKSHEET J-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 J-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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J-5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBIT K FORM OF A/R BORROWING BASE CERTIFICATE CIT Bank, N.A., as Revolving Agent 11 West 42nd Street, 12th Floor New York, New York 10036 Attn: Healthcare Portfolio Manager KeyBank National Association, as Administrative Agent 1200 Abernathy Road, Suite 1550 Atlanta, Georgia 30328 Attn: Mark J. Amantea Ladies and Gentlemen: Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among TRILOGY RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto. Terms defined in the Credit Agreement and not otherwise defined herein are used herein as defined in the Credit Agreement. Pursuant to the Credit Agreement, Parent, on behalf of Borrowers, is furnishing to you herewith this A/R Borrowing Base Certificate and supporting calculations and information. The information presented herein has been prepared in accordance with the requirements of the Credit Agreement. The undersigned is providing the attached information to demonstrate the components of the A/R Borrowing Base Availability and the calculation of the A/R Borrowing Base Availability. All Eligible Accounts included in the calculation of the A/R Borrowing Base Availability satisfy the requirements of the Credit Agreement to be included therein. Parent hereby certifies that, as of the date hereof, no Default or Event of Default exists. IN WITNESS WHEREOF, the undersigned has duly executed this A/R Borrowing Base Certificate on behalf of Parent and the other Borrowers (and not, in either case, in his or her individual capacity) this _____ day of ___________, 20__. TRILOGY RER, LLC, a Delaware limited liability company, on behalf of Borrowers By: Name: Title: K-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 (SEAL) US_Active\120558968\V-3US_ACTIVE\122519032\V-4 K-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT L FORM OF COMPLIANCE CERTIFICATE KeyBank National Association, as Administrative Agent 1200 Abernathy Road, Suite 1550 Atlanta, Georgia 30328 Attention: Mark Amantea Ladies and Gentlemen: Reference is made to that certain First Amended and Restated Senior Secured Credit Agreement dated as of September 5, 2019 (as the same may hereafter be amended, the "Credit Agreement"), among TRILOGY RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto as Borrowers, KeyBank National Association, as Administrative Agent, CIT Bank, N.A., as Revolving Agent, and the Lenders from time to time party thereto. Terms defined in the Credit Agreement and not otherwise defined herein are used herein as defined in the Credit Agreement. Pursuant to the Credit Agreement, the undersigned [chief financial officer] or [chief accounting officer]] of Parent, on Borrowers' behalf, [and Trilogy Investors, on Borrowers' and Guarantors' behalf] [is/are] furnishing to you herewith (or has most recently furnished to you) the consolidated financial statements of Trilogy Investors and its Subsidiaries for the fiscal period ended _______________ (the "Balance Sheet Date"). Such financial statements have been prepared in accordance with GAAP and present fairly the consolidated financial position of Trilogy Investors and its Subsidiaries at the date thereof and the results of its operations for the periods covered thereby. Pursuant to the Credit Agreement, Parent, on Borrowers' behalf, [and Trilogy Investors], [is/are] furnishing to you herewith the financial statements and other information required to be delivered pursuant to Sections 7.4(a)(iii)(A), 7.4(a)(iii)(B), 7.4(a)(iii)(C), 7.4(a)(iii)(D), 7.4(a)(iii)(E), [7.4(a)(x) and 7.4(a)(xi)] of the Credit Agreement. Such financial statements and other information have been prepared in accordance with GAAP, as applicable to such information, and present fairly the financial position of Trilogy Investors and its Subsidiaries at the date thereof and the results of its operations for the periods covered thereby. Neither any Borrower or Guarantor is in default of any Indebtedness of such Person. [If there is a default under such Indebtedness, please specify.] This certificate is submitted in compliance with requirements of Section 2.10(d), 5.3(b), 7.4(a)(iii)(A), 7.12(c) or 10.1(s) of the Credit Agreement, as applicable. If this certificate is provided under a provision other than Section 7.4(a)(iii)(A) of the Credit Agreement, the calculations provided below for the applicable period are made using the consolidated financial statements of Trilogy Investors and its Subsidiaries as of the Balance Sheet Date adjusted in the best good faith estimate of Trilogy Investors to give effect to the making of a Loan, issuance of a Letter of Credit, acquisition or disposition of property or other event that occasions the preparation of this certificate; and the nature of such event and the estimate of Trilogy Investors of its effects are set forth in reasonable detail in an attachment hereto. The undersigned officer is the chief executive officer or chief financial officer of Trilogy Investors. L-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 The undersigned representative has caused the provisions of the Loan Documents to be reviewed and has no knowledge of any Default or Event of Default. (Note: If the signer does have knowledge of any Default or Event of Default, the form of certificate should be revised to specify the Default or Event of Default, the nature thereof and the actions taken, being taken or proposed to be taken by any Borrower or any Guarantor with respect thereto.) Borrowers continue to comply with the terms of Section 6.37 of the Credit Agreement as of the date of this certificate, and the representations and warranties of Borrowers set forth in Section 6.37 of the Credit Agreement are true and correct in all material respects as of the date of this certificate. The undersigned is providing the attached information to demonstrate compliance as of the date hereof with the covenants described in the attachment hereto. IN WITNESS WHEREOF, the undersigned has duly executed this Compliance Certificate this _____ day of ___________, 20__. TRILOGY RER, LLC, a Delaware limited liability company, on behalf of itself and Borrowers By: Name: Title: TRILOGY INVESTORS, LLC, a Delaware limited liability company By: Name: Title: L-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 APPENDIX TO COMPLIANCE CERTIFICATE COMPLIANCE CALCULATIONS For the period ending [DATE] L-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 L-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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EXHIBIT M FORM OF ASSIGNMENT AND ACCEPTANCE AGREEMENT THIS ASSIGNMENT AND ACCEPTANCE AGREEMENT (this "Agreement") dated ____________________, by and between ____________________________ ("Assignor"), and ____________________________ ("Assignee"). W I T N E S S E T H: WHEREAS, Assignor is a party to that certain First Amended and Restated Senior Secured Credit Agreement, dated as of September 5, 2019, among TRILOGY RER, LLC, a Delaware limited liability company ("Parent"), as a Borrower, the other Persons now or thereafter party thereto, as Borrowers, the Lenders that are or may become a party thereto, KEYBANK NATIONAL ASSOCIATION, as Administrative Agent, and CIT BANK, N.A., as Revolving Agent (as amended from time to time, the "Credit Agreement"); and WHEREAS, Assignor desires to transfer to Assignee its [A/R Revolving Loan] [Real Estate Revolving Loan] Commitment under the Credit Agreement, its rights with respect to the Commitment assigned and its outstanding Loans with respect thereto; NOW, THEREFORE, for and in consideration of the sum of Ten and No/100 Dollars ($10.00) and other good and valuable considerations, the receipt and sufficiency of which are hereby acknowledged, Assignor and Assignee hereby agree as follows: 1. Definitions. Terms defined in the Credit Agreement and used herein without definition shall have the respective meanings assigned to such terms in the Credit Agreement. 2. Assignment. (a) Subject to the terms and conditions of this Agreement and in consideration of the payment to be made by Assignee to Assignor pursuant to Paragraph 5 of this Agreement, effective as of the "Assignment Date" (as defined in Paragraph 7 below), Assignor hereby irrevocably sells, transfers and assigns to Assignee, without recourse, a $_______________ [A/R Revolving Loan] [Real Estate Revolving Loan] Commitment, and a ____________________ percent (_____%) [A/R Revolving Loan] [Real Estate Revolving Loan] Commitment Percentage, and a corresponding interest in and to all of the other rights and obligations under the Credit Agreement and the other Loan Documents (the assigned interests being hereinafter referred to as the "Assigned Interests"), including Assignor's share of all outstanding [A/R] [Real Estate] Revolving Loans with respect to the Assigned Interests and the right to receive interest and principal on and all other fees and amounts in accordance with the Credit Agreement with respect to the Assigned Interests, all from and after the Assignment Date, all as if Assignee were an original Lender under and signatory to the Credit Agreement having [an A/R Revolving Loan] [a Real Estate Revolving Loan] Commitment Percentage equal to the amount of the respective Assigned Interests. (b) Assignee, subject to the terms and conditions hereof, hereby assumes all obligations of Assignor with respect to the Assigned Interests from and after the Assignment Date as if Assignee were an original Lender under and signatory to the Credit Agreement, which obligations shall include, but shall not be limited to, the obligation to make [A/R] [Real Estate] Revolving Loans to Borrowers with respect to the Assigned Interests and to indemnify Administrative Agent as provided therein (such obligations, together with all other obligations set forth in the Credit Agreement and the M-1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 other Loan Documents are hereinafter collectively referred to as the "Assigned Obligations"). Assignor shall have no further duties or obligations with respect to, and shall have no further interest in, the Assigned Obligations or the Assigned Interests. 3. Representations and Requests of Assignor. (a) Assignor represents and warrants to Assignee (i) that it is legally authorized to, and has full power and authority to, enter into this Agreement and perform its obligations under this Agreement; (ii) that as of the date hereof, before giving effect to the assignment contemplated hereby the amount of Assignor's [A/R Revolving Loan] [Real Estate Revolving Loan] Commitment is $____________ and the aggregate outstanding principal balance of the [A/R] [Real Estate] Revolving Loans made by it equals $____________, and (iii) that it has forwarded to Administrative Agent the [A/R] [Real Estate] Revolving Loan Note held by Assignor, if any. Assignor makes no representation or warranty, express or implied, and assumes no responsibility with respect to any statements, warranties or representations made in or in connection with the Loan Documents or the execution, legality, validity, enforceability, genuineness or sufficiency of any Loan Document or any other instrument or document furnished pursuant thereto or in connection with the Loan, the collectability of the Loans, the continued solvency of the Loan Parties or the continued existence, sufficiency or value of any assets of the Loan Parties which may be realized upon for the repayment of the Loans, or the performance or observance by the Loan Parties of any of their respective obligations under the Loan Documents to which it is a party or any other instrument or document delivered or executed pursuant thereto or in connection with the Loan; other than that it is the legal and beneficial owner of, or has the right to assign, the interests being assigned by it hereunder and that such interests are free and clear of any adverse claim. (b) If the applicable box is checked below, Assignor requests that Administrative Agent obtain replacement notes for each of Assignor and Assignee as provided in the Credit Agreement. � Replacement Note Requested for Assignor � Replacement Note Requested for Assignee. 4. Representations of Assignee. Assignee makes and confirms to Administrative Agent, Assignor and the other Lenders all of the representations, warranties and covenants of a Lender under Sections 14 and 18 of the Credit Agreement. Without limiting the foregoing, Assignee (a) represents and warrants that it is legally authorized to, and has full power and authority to, enter into this Agreement and perform its obligations under this Agreement; (b) confirms that it has received copies of such documents and information as it has deemed appropriate to make its own credit analysis and decision to enter into this Agreement; (c) agrees that it has and will, independently and without reliance upon Assignor, any other Lender, Administrative Agent, Revolving Agent or any Titled Agent and based upon such documents and information as it shall deem appropriate at the time, continue to make its own credit decisions in evaluating the Loans, the Loan Documents, the creditworthiness of the Loan Parties and the value of the assets of the Loan Parties, and taking or not taking action under the Loan Documents; (d) appoints and authorizes Administrative Agent to take such action as agent on its behalf and to exercise such powers as are reasonably incidental thereto pursuant to the terms of the Loan Documents; (e) agrees that, by this Assignment, Assignee has become a party to and will perform in accordance with their terms all the obligations which by the terms of the Loan Documents are required to be performed by it as a Lender; (f) represents and warrants that Assignee does not control, is not controlled by, is not under common control with and is otherwise free from influence or control by, any Loan Party and is not a Defaulting Lender or Affiliate of a Defaulting Lender, (g) represents and warrants that if Assignee is not incorporated under the laws of the United States or any State, it has on or prior to the date hereof delivered to Parent and Administrative Agent certification as to its exemption (or lack thereof) from M-2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 deduction or withholding of any United States federal income taxes and (h) Assignee has a net worth or unfunded commitments as of the date hereof of not less than $500,000,000.00 unless waived in writing by Parent and Administrative Agent as required by the Credit Agreement. Assignee agrees that Borrowers may rely on the representation contained in Section 4(h). 5. Payments to Assignor. In consideration of the assignment made pursuant to Paragraph 1 of this Agreement, Assignee agrees to pay to Assignor on the Assignment Date, an amount equal to $____________ representing the aggregate principal amount outstanding of the Loans owing to Assignor under the Credit Agreement and the other Loan Documents with respect to the Assigned Interests. 6. Payments by Assignor. Assignor agrees to pay Administrative Agent on the Assignment Date the registration fee required by Section 18.2 of the Credit Agreement. 7. Effectiveness. (a) The effective date for this Agreement shall be _______________ (the "Assignment Date"). Following the execution of this Agreement, each party hereto shall deliver its duly executed counterpart hereof to Administrative Agent for acceptance and recording in the Register by Administrative Agent. (b) Upon such acceptance and recording and from and after the Assignment Date, (i) Assignee shall be a party to the Credit Agreement and, to the extent of the Assigned Interests, have the rights and obligations of a Lender thereunder, and (ii) Assignor shall, with respect to the Assigned Interests, relinquish its rights and be released from its obligations under the Credit Agreement. (c) Upon such acceptance and recording and from and after the Assignment Date, Administrative Agent shall make all payments in respect of the rights and interests assigned hereby accruing after the Assignment Date (including payments of principal, interest, fees and other amounts) to Assignee. (d) All outstanding LIBOR Rate Loans shall continue in effect for the remainder of their applicable Interest Periods and Assignee shall accept the currently effective interest rates on its Assigned Interest of each LIBOR Rate Loan. 7. Notices. Assignee specifies as its address for notices and its Lending Office for all assigned Loans, the offices set forth below: Notice Address: Attn: Facsimile: Domestic Lending Office: Same as above Eurodollar Lending Office: Same as above M-3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 8. Payment Instructions. All payments to Assignee under the Credit Agreement shall be made as provided in the Credit Agreement in accordance with the separate instructions delivered to Administrative Agent. 9. GOVERNING LAW. THIS AGREEMENT SHALL BE DEEMED TO BE A CONTRACTUAL OBLIGATION UNDER, AND SHALL, PURSUANT TO NEW YORK GENERAL OBLIGATIONS LAW SECTION 5-1401, BE GOVERNED BY AND CONSTRUED AND ENFORCED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK. 10. Counterparts. This Agreement may be executed in any number of counterparts which shall together constitute but one and the same agreement. 11. Amendments. This Agreement may not be amended, modified or terminated except by an agreement in writing signed by Assignor and Assignee, and consented to by Administrative Agent. 12. Successors. This Agreement shall inure to the benefit of the parties hereto and their respective successors and assigns as permitted by the terms of Credit Agreement. [signatures on following page] M-4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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M-5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 CONSENTED TO BY:1 TRILOGY RER, LLC, as Parent By: Name: Title: IN WITNESS WHEREOF, intending to be legally bound, each of the undersigned has caused this Agreement to be executed on its behalf by its officers thereunto duly authorized, as of the date first above written. ASSIGNEE: By: Title: ASSIGNOR: By: Title: RECEIPT ACKNOWLEDGED AND ASSIGNMENT CONSENTED TO BY: KEYBANK NATIONAL ASSOCIATION, as Administrative Agent By: Title: 1 Insert to extent required by Credit Agreement. SCHEDULE 1.1(a) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 18.054285714286 % Real Estate Revolving Loan Commitment $58,681,000.00 18.055692307692 % Real Estate Revolving Loan Commitment Percentage $65,000,000.00 Name and Address Commitment Regions Bank Domestic Lending Office: Regions Bank One Indiana Square Indianapolis, Indiana 46204 Attn: Jack Boudler LIBOR Lending Office: Same as above Notices: See Section 19 $6,319,000.00 A/R Revolving Loan Commitment 18.054285714286 % $58,681,000.00 SCHEDULE 1.1(a) LENDERS, COMMITMENTS AND COMMITMENT PERCENTAGES 18.055692307692 % KeyBank National Association Domestic Lending Office: KeyBank National Association Mailcode: NY-00-72-0100 726 Exchange Street, Suite 900 Buffalo, New York 14210 Attn: Yolanda M. Fields LIBOR Lending Office: Same as above Notices: See Section 19 $65,000,000.00 A/R Revolving Loan Commitment Percentage $6,319,000.00 SCHEDULE 1.1(a) - PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 $36,111,000.00 A/R Revolving Loan Commitment 11.111076923077 % Total Commitment $40,000,000.00 11.111111111111 % Total Commitment Percentage A/R Revolving Loan Commitment Percentage The Huntington National Bank Domestic Lending Office: The Huntington National Bank 10200 Forest Green Boulevard, Suite 112 Louisville, Kentucky 40223 Attn: Michael Kinnick LIBOR Lending Office: Same as above Notices: See Section 19 $3,889,000.00 Name and Address 11.111428571429 % Bank of America, N.A. Domestic Lending Office: Bank of America, N.A. 222 2nd Ave. S., Suite 2440 Nashville, Tennessee 37201 Attn: Hope Walker LIBOR Lending Office: Same as above Notices: See Section 19 $36,111,000.00 Real Estate Revolving Loan Commitment 11.111076923077 % $3,889,000.00 $40,000,000.00 11.111111111111 % 11.111428571429 % Real Estate Revolving Loan Commitment Percentage SCHEDULE 1.1(a) - PAGE 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 $31,597,000.00 A/R Revolving Loan Commitment 9.722153846154% Total Commitment $35,000,000.00 9.722222222222% Total Commitment Percentage A/R Revolving Loan Commitment Percentage Synovus Financial Corporation Domestic Lending Office: Synovus Financial Corporation 800 Shades Creek Parkway, Suite 325 Birmingham, Alabama 35209 Attn: Kathyrn H. Buchanan LIBOR Lending Office: Same as above Notices: See Section 19 $3,403,000.00 Name and Address 9.722857142857% CIT Bank, N.A. Domestic Lending Office: CIT Bank, N.A. 11 w. 42ND Street, 12th Floor New York, New York 10036 Attn: Thomas Gatsios LIBOR Lending Office: Same as above Notices: See Section 19 $31,597,000.00 Real Estate Revolving Loan Commitment 9.722153846154% $3,403,000.00 $35,000,000.00 9.722222222222% 9.722857142857% Real Estate Revolving Loan Commitment Percentage

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SCHEDULE 1.1(a) - PAGE 4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 $27,083,000.00 A/R Revolving Loan Commitment 8.333230769231% Total Commitment $30,000,000.00 8.333333333333% Total Commitment Percentage A/R Revolving Loan Commitment Percentage Pacific Western Bank Domestic Lending Office: Pacific Western Bank 5404 Wisconsin Ave., 2nd Floor Chevy Chase, Maryland 20815 Attn: Jason Schwartz LIBOR Lending Office: Same as above Notices: See Section 19 $2,917,000.00 Name and Address 8.334285714286% CIBC Bank USA Domestic Lending Office: CIBC Bank USA 120 S. LaSalle Street Chicago, Illinois 60603 Attn: Michael Velazquez LIBOR Lending Office: Same as above Notices: See Section 19 $27,083,000.00 Real Estate Revolving Loan Commitment 8.333230769231% $2,917,000.00 $30,000,000.00 8.333333333333% 8.334285714286% Real Estate Revolving Loan Commitment Percentage SCHEDULE 1.1(a) - PAGE 5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 $18,056,000.00 A/R Revolving Loan Commitment 5.555692307692% Total Commitment $20,000,000.00 5.555555555556% Total Commitment Percentage A/R Revolving Loan Commitment Percentage TOTAL $35,000,000.0 0 Name and Address 100% BOKF, NA dba Bank of Oklahoma Domestic Lending Office: BOKF One Williams Center, 8th Floor Tulsa, Oklahoma 74172 Attn: Chris Rollman LIBOR Lending Office: Same as above Notices: See Section 19 325,000,000.00 Real Estate Revolving Loan Commitment 100% $1,944,000.00 $360,000,000.0 0 100% 5.554285714286% Percentages may not equal 100% due to rounding. Real Estate Revolving Loan Commitment Percentage SCHEDULE 1.1(b) PRE-APPROVED COLLATERAL PROPERTIES River Terrace Health Campus, 120 Presbyterian Way, Madison, Indiana 47250 RidgeCrest Health Campus, 703 Robinson Road, Jackson, MI 49203 SCHEDULE 1.1(c) PRE-APPROVED VILLA UNITS The Willows at Willard Villas, 1050 Neal Zick Road, Willard, Ohio 44890 Cypress Point Health Campus Villas, 600 West National Road, Englewood, Ohio 45322

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SCHEDULE 1.1(d) BORROWERS PROVIDING A/R COLLATERAL Each of the entities listed below are Borrowers as of the Closing Date providing Collateral included in the calculation of A/R Borrowing Base Availability: 1. Trilogy Healthcare of Milford, LLC 2. Trilogy Healthcare of Vanderburgh, LLC 3. Trilogy Healthcare of Lowell, LLC 4. Trilogy Healthcare of Daviess, LLC 5. Trilogy Healthcare of Monticello, LLC 6. Trilogy Healthcare of Columbus, LLC 7. Trilogy Healthcare of Corydon, LLC 8. Trilogy Healthcare Operations of Muncie, LLC 9. Trilogy Healthcare of New Albany, LLC 10. Trilogy Healthcare of Seymour, LLC 11. Trilogy Healthcare of Vigo, LLC 12. Trilogy Healthcare of Henry, LLC 13. Trilogy Healthcare of Mercer, LLC 14. Trilogy Healthcare of Louisville Northeast, LLC 15. Trilogy Healthcare of Jefferson II, LLC 16. Trilogy Healthcare of Cynthiana, LLC 17. Trilogy Healthcare of Fayette III, LLC 18. Trilogy Healthcare of Glen Ridge, LLC 19. Trilogy Healthcare of Louisville Southwest, LLC 20. Trilogy Healthcare of Louisville East, LLC 21. Trilogy Healthcare of Battle Creek, LLC 22. Trilogy Healthcare of Genesee, LLC 23. Trilogy Healthcare of Livingston, LLC SCHEDULE 1.1(d) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 24. Trilogy Healthcare of Commerce, LLC 25. Trilogy Healthcare of Lapeer, LLC 26. Trilogy Healthcare Operations of Springfield II, LLC 27. Trilogy Healthcare of Sylvania, LLC 28. Trilogy Healthcare of Clermont, LLC 29. Trilogy Healthcare of Hamilton, LLC 30. Trilogy Healthcare of Montgomery, LLC 31. Trilogy Healthcare of Putnam III, LLC 32. Trilogy Healthcare of Allen II, LLC 33. Trilogy Healthcare of Morgan, LLC 34. Trilogy Healthcare of North Baltimore, LLC 35. Trilogy Healthcare of Putnam II, LLC 36. Trilogy Healthcare of Huron, LLC 37. Trilogy Healthcare of Muskingum, LLC 38. Trilogy Healthcare of Kent, LLC 39. PCA-Corrections, LLC 40. Trilogy Mission RX, LLC 41. Trilogy NuScriptRX, LLC 42. Trilogy PCA Holdings, LLC 43. Trilogy Rehab Services, LLC 44. Paragon Outpatient Rehabilitation Services, LLC SCHEDULE 1.1(d) - PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 1.1(e) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Trilogy Real Estate Kentucky III, LLC Cedar Ridge Health Campus, 1217 US Highway 62E, Cynthiana, KY Trilogy Healthcare of Glen Ridge, LLC Trilogy Real Estate Cynthiana, LLC Harrison Springs Health Campus, 871 Pacer Drive NW, Corydon, IN Autumn Woods Health Campus, 2911 Green Valley Rd, New Albany, IN Trilogy Real Estate Harrison, LLC Trilogy Healthcare of Cynthiana, LLC Trilogy Healthcare of Corydon, LLC Highland Oaks Health Center 4114 N State Route 376 NW McConnelsville, OH 43756 Trilogy Real Estate New Albany, LLC Trilogy Real Estate Morgan, LLC Cobblestone Crossings Health Campus, 1850 E. Howard Wayne Dr., Terre Haute, IN Trilogy Healthcare of Morgan, LLC Collateral Property Trilogy Real Estate Vigo, LLC Morrison Woods Health Campus, 4100 N Morrison Road, Muncie, IN Trilogy Healthcare of New Albany, LLC Trilogy Healthcare of Muncie, LLC Trilogy Healthcare of Vigo, LLC Trilogy Healthcare Operations of Muncie, LLC Park Terrace Health Campus, 9700 Stonestreet Rd, Louisville, KY Trilogy Real Estate Kentucky, LLC Covered Bridge Health Campus, 1675 W. Tipton Street, Seymour, IN2 Trilogy Healthcare of Louisville Southwest, LLC Owner Trilogy Real Estate of Seymour, LLC Park Terrace MOB [Medical Plaza I and II] 9702 Stonestreet Rd, Louisville, KY Briar Hill Health Campus, 600 Sterling Drive, North Baltimore, OH Trilogy Real Estate Kentucky, LLC Trilogy Healthcare of Seymour, LLC SCHEDULE 1.1(e) BORROWERS OWNING OR OPERATING COLLATERAL PROPERTIES Senior Living at Forest Ridge, 2800 Forest Ridge Parkway, New Castle, IN Trilogy Healthcare of Wood County Successor, LLC Trilogy Healthcare of Henry II, LLC Cypress Pointe Health Campus, 600 West National Rd, Englewood, OH Trilogy Healthcare of Henry, LLC Tenant Trilogy Real Estate Ohio, LLC Silver Oaks Health Campus, 2011 Chapa Dr, Columbus, IN3 Trilogy Healthcare of North Baltimore, LLC Trilogy Real Estate Columbus, LLC Trilogy Healthcare of Montgomery, LLC Trilogy Healthcare of Columbus, LLC Glen Ridge Health Campus, 6415 Calm River Way, Louisville, KY 2 The land is leased pursuant to a ground lease. 3 The land is leased pursuant to a ground lease. SCHEDULE 1.1(e) - PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Owner Trilogy Healthcare of Battle Creek, LLC The Meadows of Leipsic, 901 East Main St, Leipsic, OH Trilogy Real Estate Ohio, LLC The Oaks at Woodfield, 5370 East Baldwin Rd, Grand Blanc, MI Trilogy Real Estate Ohio, LLC Trilogy Real Estate of Grand Blanc, LLC Trilogy Healthcare of Genesee, LLC Trilogy Healthcare of Putnam III, LLC Trilogy Healthcare of Allen II, LLC The Villas at Westlake, 5916-5996, 6000 Lake Villa Circle, Commerce, MI Trilogy Real Estate Oakland, LLC Tenant Trilogy Healthcare of Commerce, LLC The Meadows of Ottawa, 147 Putnam Parkway, Ottawa, OH The Willows at Citation, 1376 Silver Springs Dr, Lexington, KY Trilogy Real Estate Putnam II, LLC Trilogy Real Estate Fayette III, LLC Collateral Property Trilogy Healthcare of Fayette III, LLC Trilogy Healthcare of Putnam II, LLC Stonegate Health Campus, 2525 DeMille Blvd, Lapeer, MI The Willows at Howell, 1500 Byron Rd, Howell, MI Trilogy Real Estate Howell, LLC Trilogy Healthcare of Livingston, LLC The Oaks at Northpointe, 3291 Northpointe Dr, Zanesville, OH Trilogy Real Estate of Lapeer, LLC The Willows at Willard, 1050 Neal Zick Rd, Willard, OH4 Trilogy Real Estate Northpointe, LLC Trilogy Real Estate Huron, LLC Trilogy Healthcare of Huron, LLC Trilogy Healthcare of Muskingum, LLC Trilogy Healthcare of Lapeer, LLC Westport Place Health Campus, 4247 Westport Rd, Louisville, KY Trilogy Real Estate Kentucky V, LLC Springview Manor, 883 W. Spring St, Lima, OH Trilogy Healthcare of Louisville East, LLC The Oaks at NorthPointe Woods, 706 North Ave, Battle Creek, MI Trilogy Real Estate of Battle Creek, LLC 4 A portion of the land is leased pursuant to a ground lease.

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SCHEDULE 4.3 ACCOUNTS Bank: KeyBank National Association Account of: Trilogy RER, LLC Account #: 359681550778 Bank: KeyBank National Association Account of: Trilogy Healthcare of Battle Creek, LLC Account #: 359681408043 SCHEDULE 4.3 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.3 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Trilogy Healthcare of Louisville Northeast, LLC PCA-Corrections, LLC Capital Source First Dose Machine New Furniture & Equipment Capsa Solutions Cumberland Valley Trilogy Healthcare of Lowell, LLC First Dose Machine Capital Source New Furniture & Equipment Trilogy Healthcare of Mercer, LLC PCA-Corrections, LLC The Leasing Group PCA-Corrections, LLC New Furniture & Equipment Capsa Solutions SynMed Machine Trilogy Healthcare of Putnam II, LLC First Dose Machine Capital Source Capsa Solutions New Furniture & Equipment Third Party Trilogy Healthcare of Seymour, LLC PCA-Corrections, LLC The Leasing Group First Dose Machine Senior TV Capsa Solutions Trilogy Healthcare of Sylvania, LLC First Dose Machine The Leasing Group 12-Passenger Van SCHEDULE 6.3 TITLE TO PROPERTIES The Borrowers identified in the chart below lease assets from the third party listed across from their respective names. Trilogy Healthcare of Sylvania, LLC Trilogy Healthcare of Clermont, LLC The Leasing Group PCA-Corrections, LLC New Furniture & Equipment The Leasing Group PCA-Corrections, LLC Trilogy Healthcare Operations of Muncie, LLC New Furniture & Equipment The Leasing Group Capsa Solutions Senior TV Assets Trilogy Healthcare Operations of Springfield II, LLC Trilogy Healthcare of Columbus, LLC The Leasing Group First Dose Machine New Furniture & Equipment The Leasing Group Capsa Solutions Trilogy Mission RX, LLC Senior TV Cumberland Valley Dosis Machine Trilogy NuScriptRx, LLC Trilogy Healthcare of Corydon, LLC Americorp PCA-Corrections, LLC TCGRX Machine The Leasing Group First Dose Machine Trilogy NuScriptRx, LLC New Furniture & Equipment Americorp Cumberland Valley TCGRX Machine Trilogy NuScriptRx, LLC Trilogy Healthcare of Daviess, LLC Americorp Dosis Machine TCGRX Machine Capital Source Trilogy NuScriptRx, LLC New Furniture & Equipment Americorp TCGRX Machine Trilogy NuScriptRx, LLC Trilogy Healthcare of Jefferson II, LLC Americorp PCA-Corrections, LLC TCGRX Machine The Leasing Group PCA-Corrections, LLC Trilogy NuScriptRx, LLC New Furniture & Equipment Americorp Capsa Solutions TCGRX Machine PCA-Corrections, LLC Trilogy NuScriptRx, LLC Trilogy Healthcare of Livingston, LLC Americorp First Dose Machine TCGRX Machine Capital Source Capsa Solutions Trilogy NuScriptRx, LLC New Furniture & Equipment Graybar Shoretel Phone System Borrower SCHEDULE 6.6 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 lakesofmonclova.com SCHEDULE 6.6 TRADEMARKS, TRADENAMES, SERVICE MARKS OR LOGOS Borrowers claim only common law rights for local use in the 'names' of its senior care facilities listed on Schedule 6.22(a) attached collaterally hereto and incorporated herein by reference, and in "Trilogy Health Services," "Trilogy Healthcare Centers," and in the following mark: Trilogy Health Services, LLC (not any Borrower or Guarantor) owns the following registered website domains used in connection with its business: lakesofsylvania.com creasyspringshc.com bethanypointehc.com legacyatenglishstation.com autumnwoodshc.com legacyatlibertyridge.com cumberlandpointehc.com legacyatwoodbinesprings.com arlingtonplacehc.com meadowsofdelphos.com cypresspointehs.com blairridge.com meadowsofkalida.com meadowsofleipsic.com Fit.thetrilogyfoundation.org meadowsofottawa.com millpondhc.com forestglenhc.com briarhillhc.com morrisonwoodshc.com avalonspringshc.com MSJOSSTARS.COM forestparkhc.com novilakeshc.com nriverhc.com forestspringshc.com bridgepointehc.com oaksatbethesda.com oaksatnorthpointe.comforestviewhc.com oakwoodhs.com orchardgrovehc.com franciscanhc.com campusofdistinction.com orchardpointehc.com baptisthomeeast.com owenvalleyhc.com genoahs.com paddocksprings.com ashfordplacehc.com paragonmatch.com glenoakshc.com cedarcreekhc.com paragonrehab.com paragon-rehab.com glenridgehc.com parkterracehc.com ambermanorhc.com parrsatspringhurst.com greenleafhs.com cedarridgehs.com parrsatspringhurst.org baptisthomeeast.org parrsrest.com hamptonoakshc.com parrsrest.org pcamatch.com harrisonscrossinghc.com clearvistalakehc.com prairielakeshc.com richlandmanorhc.com harrisonspringshc.com ridgecresths.com ridgewoodhs.com hearthstonehc.com cobblestonehc.com riveroakshc.com baptisthomesinc.com riverpointehs.com heatherhillscare.com riverterracehealthcampus.co m aspenplacehc.com riverterrhc.com highlandoakshc.com cornelltrace.com Sandersridgehc.com scenichillshs.com homewoodhc.com scenichillsmonastery.com seniorlivingatforestridge.com icanliveadream.com cornelltrace.org shelbycrossinghc.com baptisthomesinc.org silveroakshc.com icanliveadream.org springhursthc.com springhursthealthandrehab.co m lakelandrhc.com coveredbridgehc.com SCHEDULE 1.1(e) - PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 stmaryhcc.com villasatbethanypointe.com villasatblairridge.com thorntonterracehc.com villasatcobblestone.com villasatcreasysprings.com thsbreezie.com stonebridgehs.com villasatforestglen.com springsofmooresville.com villasatforestsprings.com trilogybff.com villasatharrisonsprings.com villasatleipsic.com trilogybyroncenter.com stonecrofthc.com villasatsilvercrest.com villasatspringhurst.com trilogyfasttrack.com villasatstcharles.com villasattriplecreek.com trilogyfoundation.com stonegatehc.com villasatwaterfordplace.com springsofrichmond.com villasatwestlake.com trilogygahanna.com violetspringshc.com springsatlafayette.com waterfordcrossinghc.com trilogyhilliard.com susansavings.com waterfordcrossingsl.com waterfordplacehc.com trilogyhs.com wellbrookeatavon.com springhurstpines.com wellbrookeatcrawfordsville.co m trilogyjobs.com theglensl.com wellbrookeatwestfield.com springviewmanorhc.com wellbrookeavon.com trilogymatch.com wellbrookecrawfordsville.com wellbrookeofavon.com trilogymountwashington.com theheritagehc.com wellbrookeofcarmel.com wellbrookeofcrawfordsville.co m trilogynamedrop.com wellbrookeofkokomo.com springhursthealthandrehab.or g wellbrookeofsouthbend.com trilogynewalbany.com themapleshc.com wellbrookeofwabash.com standrewshc.com wellbrookeofwestfield.com trilogypickerington.com wellbrookewestfield.com springsatstonybrook.com westlakehc.com trilogytiffin.com theoaksatcascade.com westlakehealthcampus.com westpicoterrace.com trilogytravelclub.com westportplacehc.com westriverhc.comtriplecreekretirement.com theoaksatwoodfield.com whiteoakhc.com stcharleshc.com willardhc.com tristarhc.com willowsatbellevue.com willowsatcitation.com trsrehab.com theoakshc.com willowsateastlansing.com willowsatfritzfarm.com valleyviewhc.com willowsathamburg.com willowsatharrodsburg.com villagegreenhc.com thetrilogyfoundation.org willowsathowell.com stelizabethhc.com willowsatokemos.com villagesatoakridge.com willowsattiffin.com springsoflima.com willowsatwillard.com villagesatsilvercrest.com thevillasatoakridge.com woodbridgehc.com woodedglensl.com villasatashfordplace.com woodmonthc.com springhurstpines.org workwithpurposetoday.com villasatbellevue.com thevillasatoakwood.com

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None of the trademarks, trade names, service marks, or logos on this Schedule 6.6 are registered or subject to any license or provision of law limiting their assignability or use except. SCHEDULE 6.6 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.7 PENDING LITIGATION None. SCHEDULE 6.7 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.10 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 PARAGON OUTPATIENT REHABILITATION SERVICES, LLC TRILOGY HEALTHCARE OF CYNTHIANA, LLC 61-1771489 38-3941031 38-3863509 SCHEDULE 6.10 TAX STATUS; TAX PAYOR IDENTIFICATION NUMBERS No exceptions. GUARANTORS: TRILOGY HEALTHCARE OF DAVIESS, LLC 61-1717291 PCA-CORRECTIONS, LLC TRILOGY HEALTHCARE OF FAYETTE III, LLC 27-4627897 61-1267449 TRILOGY PRO SERVICES, LLC TRILOGY HEALTHCARE OF GENESEE, LLC 20-5352580 TRILOGY HEALTHCARE OF ALLEN II, LLC TRILOGY HEALTHCARE OF GLEN RIDGE, LLC 35-2542381 47-5294379 20-4787999 TRILOGY INVESTORS, LLC TRILOGY HEALTHCARE OF HAMILTON, LLC 20-3482181 TRILOGY HEALTHCARE OF BATTLE CREEK, LLC TRILOGY HEALTHCARE OF HENRY, LLC 45-3136148 20-4787402 TRILOGY OPCO, LLC TRILOGY HEALTHCARE OF HENRY II, LLC 45-3143058 20-0985191 TRILOGY HEALTHCARE OF CLERMONT, LLC TRILOGY HEALTHCARE OF HURON, LLC 37-1792471 20-2887268 81-1677558 GUARANTORS TRILOGY HEALTHCARE OF JEFFERSON II, LLC 81-3667101 BORROWERS: TRILOGY HEALTHCARE OF COLUMBUS, LLC TRILOGY HEALTHCARE OF KENT, LLC 81-4062108 32-0449364 TRILOGY HEALTHCARE OF LAPEER, LLC 26-2481002 BORROWER TRILOGY HEALTHCARE OF COMMERCE, LLC TRILOGY HEALTHCARE OF LIVINGSTON, LLC 26-2480927 82-2378020 EIN TRILOGY HEALTHCARE OF LOUISVILLE EAST, LLC 27-1007235 TRILOGY HEALTHCARE HOLDINGS, INC. TRILOGY HEALTHCARE OF CORYDON, LLC TRILOGY HEALTHCARE OF LOUISVILLE NORTHEAST, LLC 38-3870319 37-1784348 EIN SCHEDULE 1.1(e) - PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 TRILOGY HEALTHCARE OF MUSKINGUM, LLC TRILOGY HEALTHCARE OPERATIONS OF SPRINGFIELD II, LLC 30-0827529 27-3229467 26-2408288 TRILOGY MISSION RX, LLC 35-2521646 TRILOGY HEALTHCARE OF NEW ALBANY, LLC TRILOGY NUSCRIPTRX, LLC 82-1778580 30-0842276 TRILOGY HEALTHCARE OF MERCER, LLC TRILOGY PCA HOLDINGS, LLC 26-0164761 TRILOGY HEALTHCARE OF MONTICELLO, LLC TRILOGY HEALTHCARE OF NORTH BALTIMORE, LLC TRILOGY REAL ESTATE COLUMBUS, LLC 61-1812625 20-8789992 27-2607249 TRILOGY REAL ESTATE CYNTHIANA, LLC 81-2505272 36-4818714 TRILOGY HEALTHCARE OF PUTNAM II, LLC TRILOGY REAL ESTATE FAYETTE III, LLC 81-2278540 20-3843860 TRILOGY HEALTHCARE OF LOUISVILLE SOUTHWEST, LLC TRILOGY REAL ESTATE HARRISON, LLC 37-1781232 TRILOGY HEALTHCARE OF MORGAN, LLC TRILOGY HEALTHCARE OF PUTNAM III, LLC TRILOGY REAL ESTATE HOWELL, LLC 81-2378643 20-4788076 27-3229523 TRILOGY REAL ESTATE HURON, LLC 27-3294974 TRILOGY HEALTHCARE OF LOWELL, LLC TRILOGY HEALTHCARE OF SEYMOUR, LLC TRILOGY REAL ESTATE KENTUCKY III, LLC 27-0558719 32-0448464 TRILOGY HEALTHCARE OF MILFORD, LLC TRILOGY REAL ESTATE KENTUCKY V, LLC 30-0796641 TRILOGY HEALTHCARE OF MUNCIE, LLC TRILOGY HEALTHCARE OF SYLVANIA, LLC TRILOGY REAL ESTATE KENTUCKY, LLC 26-0193715 37-1792882 45-3306354 TRILOGY REAL ESTATE MORGAN, LLC 35-2507632 37-1765070 TRILOGY HEALTHCARE OF VANDERBURGH, LLC TRILOGY REAL ESTATE NEW ALBANY, LLC 81-2558138 27-3236912 38-3900428 TRILOGY REAL ESTATE NORTHPOINTE, LLC 81-2306593 TRILOGY HEALTHCARE OPERATIONS OF MUNCIE, LLC TRILOGY HEALTHCARE OF VIGO, LLC TRILOGY REAL ESTATE OAKLAND, LLC 32-0518430 26-2762879 61-1673311 TRILOGY REAL ESTATE OF BATTLE CREEK, LLC 37-1792517 20-3360543 TRILOGY HEALTHCARE OF WOOD COUNTY SUCCESSOR, LLC TRILOGY REAL ESTATE OF GRAND BLANC, LLC 30-0883702 47-5668999 TRILOGY HEALTHCARE OF MONTGOMERY, LLC

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SCHEDULE 1.1(e) - PAGE 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 61-1770908 20-2886974 30-0883595 TRILOGY REAL ESTATE VIGO, LLC 36-4793975 TRILOGY REAL ESTATE PUTNAM II, LLC TRILOGY REHAB SERVICES, LLC 20-3847825 32-0546565 TRILOGY REAL ESTATE OF LAPEER, LLC TRILOGY RER, LLC 61-1933285 TRILOGY REAL ESTATE OHIO, LLC TRILOGY REAL ESTATE OF SEYMOUR, LLC SCHEDULE 6.14 CERTAIN TRANSACTIONS None. SCHEDULE 6.14 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.17 TRADE NAME/PLACE OF BUSINESS See Schedule 6.6 attached collaterally hereto and incorporated herein by reference. SCHEDULE 6.17 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.20(a) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 DE DE LLC Class of Interest 100% LLC Trilogy Healthcare of Wood County Successor, LLC 100% DE % of Class Owned LLC 100% Trilogy Healthcare Holdings, Inc. Trilogy Real Estate Cynthiana, LLC DE DE LLC Name of Subsidiary 100% Common Stock TRILOGY INVESTORS, LLC owns the following: Trilogy Real Estate Vigo, LLC 100% DE LLC 100% TRILOGY RER, LLC owns the following: Trilogy Real Estate of Seymour, LLC State of Domicile DE LLC Trilogy RER, LLC 100% Trilogy Real Estate New Albany, LLC SCHEDULE 6.20(a) ORGANIZATIONAL STRUCTURE TRILOGY INVESTORS, LLC, a Delaware limited liability company  Trilogy Real Estate Investment Trust, Inc., a Maryland corporation, owns 96.74% of the outstanding membership interest of Trilogy Investors, LLC.  Randall J. Bufford owns 2.7944% of the outstanding membership interest of Trilogy Investors, LLC.  Leigh Ann Barney owns 0.2567% outstanding membership interest of Trilogy Investors, LLC.  Gloria Ising owns 0.0557% outstanding membership interest of Trilogy Investors, LLC.  John Eckman owns 0.0482% outstanding membership interest of Trilogy Investors, LLC.  Michael Bryant owns 0.0315% outstanding membership interest of Trilogy Investors, LLC.  Rhonda Sanders-Simmonds owns 0.0291% outstanding membership interest of Trilogy Investors, LLC.  Cheryl Johnson owns 0.0268% outstanding membership interest of Trilogy Investors, LLC.  Lance Miller owns 0.0031% outstanding membership interest of Trilogy Investors, LLC.  Joe Whitt owns 0.0020% outstanding membership interest of Trilogy Investors, LLC.  Lisa McClure owns 0.0020% outstanding membership interest of Trilogy Investors, LLC.  Madhu Krish owns 0.0015% outstanding membership interest of Trilogy Investors, LLC.  Andra Bladen owns 0.0008% outstanding membership interest of Trilogy Investors, LLC.  Brad Williamson owns 0.0008% outstanding membership interest of Trilogy Investors, LLC.  Mary Smith owns 0.0007% outstanding membership interest of Trilogy Investors, LLC.  Dawn Black owns 0.0007% outstanding membership interest of Trilogy Investors, LLC.  Marnie Davisson owns 0.0002% outstanding membership interest of Trilogy Investors, LLC.

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SCHEDULE 6.20(a) – PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 LLC LLC 100% Trilogy Real Estate Ohio, LLC 100% Trilogy Healthcare of Vanderburgh, LLC 100% DE LLC 100% 100% Trilogy Real Estate of Battle Creek, LLC Trilogy Healthcare of Lowell, LLC DE DE LLC LLC 100% Trilogy Real Estate Kentucky, LLC 100% Trilogy Healthcare of Monticello, LLC DE LLC DE 100% Trilogy Real Estate of Grand Blanc, LLC DE Trilogy Healthcare Operations of Muncie, LLC DE IN LLC LLC LLC 100% Trilogy Real Estate Harrison, LLC 100% Trilogy Healthcare of New Albany, LLC 100% DE LLC Class of Interest 100% Trilogy Real Estate Oakland, LLC Trilogy Healthcare of Seymour, LLC DE DE DE LLC LLC 100% Trilogy Healthcare of Henry II, LLC 100% Trilogy Healthcare of Vigo, LLC LLC DE LLC IN 100% Trilogy Real Estate Fayette III, LLC LLC Trilogy Healthcare of Milford, LLC DE DE LLC LLC LLC 100% Name of Subsidiary 100% Trilogy Healthcare of Henry, LLC 100% IN LLC 100% 100% Trilogy Real Estate Howell, LLC Trilogy Healthcare of Daviess, LLC DE DE 100% LLC LLC 100% Trilogy Real Estate Columbus, LLC 100% Trilogy Healthcare of Cynthiana, LLC DE LLC DE 100% Trilogy Real Estate Huron, LLC % of Class Owned Trilogy Healthcare of Mercer, LLC DE DE LLC LLC LLC 100% Trilogy Real Estate Morgan, LLC 100% Trilogy Healthcare of Fayette III, LLC 100% KY LLC 100% Trilogy Real Estate Kentucky V, LLC Trilogy Healthcare of Louisville Northeast, LLC DE KY DE LLC LLC 100% Trilogy Real Estate of Lapeer, LLC 100% Trilogy Healthcare of Glen Ridge, LLC DE LLC DE 100% TRILOGY HEALTHCARE HOLDINGS, INC. owns the following: LLC Trilogy Healthcare of Louisville Southwest, LLC DE LLC LLC Trilogy OpCo, LLC 100% Trilogy Real Estate Kentucky III, LLC DE Trilogy Healthcare of Jefferson II, LLC 100% DE LLC LLC 100% 100% 100% Trilogy Healthcare of Louisville East, LLC DE LLC Trilogy Pro Services, LLC 100% Trilogy Real Estate Putnam II, LLC DE Trilogy Healthcare of Lapeer, LLC DE LLC LLC DE 100% 100% DE Trilogy Healthcare of Battle Creek, LLC DE LLC LLC TRILOGY OPCO, LLC owns the following: 100% Trilogy Healthcare of Muncie, LLC Trilogy Healthcare of Genesee, LLC 100% DE Trilogy Healthcare of Columbus, LLC LLC State of Domicile 100% DE Trilogy Healthcare of Commerce, LLC LLC DE IN LLC 100% 100% Trilogy Real Estate Northpointe, LLC Trilogy Healthcare of Livingston, LLC LLC DE Trilogy Healthcare of Corydon, LLC LLC DE 100% DE LLC SCHEDULE 6.20(a) – PAGE 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 DE Trilogy Healthcare of Clermont, LLC LLC DE LLC LLC Trilogy Healthcare of Kent, LLC 100% 100% 100% Trilogy Healthcare of Huron, LLC DE LLC Trilogy Healthcare of Morgan, LLC 100% DE Trilogy Healthcare of Muskingum, LLC DE DE LLC LLC Trilogy Healthcare of Montgomery 100% 100% Class of Interest TRILOGY PRO SERVICES, LLC owns the following: DE Trilogy PCA Holdings, LLC Trilogy Healthcare of North Baltimore, LLC DE LLC LLC DE 100% LLC LLC Trilogy Rehab Services, LLC Name of Subsidiary DE 100% LLC 100% 100% 100% Trilogy Mission RX, LLC Trilogy Healthcare of Putnam II, LLC DE LLC DE 100% % of Class Owned LLC Trilogy NuScriptRX, LLC Trilogy Healthcare of Putnam III, LLC DE 100% LLC 100% DE PCA-Corrections, LLC Trilogy Healthcare Operations of Springfield II, LLC KY LLC DE 68.68% LLC LLC TRILOGY REHAB SERVICES, LLC owns the following: Trilogy Healthcare of Hamilton, LLC 100% Paragon Outpatient Rehabilitation Services, LLC 100% IN LLC 100% Trilogy Healthcare of Sylvania, LLC TRILOGY PCA HOLDINGS, LLC owns the following: DE DE PCA-Corrections, LLC LLC KY Trilogy Healthcare of Allen II, LLC LLC 100% 31.32% State of Domicile SCHEDULE 6.20(b) UNCONSOLIDATED AFFILIATES OF BORROWERS AND THEIR SUBSIDIARIES None. SCHEDULE 6.20(b) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.21 LEASES, ETC. ----------------------------------------------- Schedule 6.21(a) Free Rent; Defaults Under Leases; Parking Compliance None. ----------------------------------------------- Schedule 6.21(b) Subleases None, except for immaterial subleases and the subleases disclosed in Schedule 6.22(a) which is collaterally attached hereto and incorporated herein by reference. ------------------------------------------------ Schedule 6.21(c) Management Agreements 1. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Allen II, LLC and the EIK. 2. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Battle Creek, LLC and the EIK. 3. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Columbus, LLC and the EIK. 4. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Commerce LLC and the EIK. 5. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Corydon, LLC and the EIK. 6. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Cynthiana, LLC and the EIK. 7. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Fayette III, LLC and the EIK. 8. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Genesee, LLC and the EIK. 9. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Glen Ridge, LLC and the EIK. 10. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Henry, LLC and the EIK. SCHEDULE 6.21 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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11. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Huron, LLC and the EIK. 12. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Lapeer, LLC and the EIK. 13. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Livingston, LLC and the EIK. 14. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Louisville East, LLC and the EIK. 15. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Louisville Southwest, LLC and the EIK. 16. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Montgomery, LLC and the EIK. 17. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Morgan, LLC and the EIK. 18. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Muskingum, LLC and the EIK. 19. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of New Albany, LLC and the EIK. 20. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of North Baltimore, LLC and the EIK. 21. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Putnam II, LLC and the EIK. 22. The Management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Putnam III, LLC and the EIK. 23. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Seymour, LLC and the EIK. 24. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare of Vigo, LLC and the EIK. 25. The Sub-management Agreement, dated as of September 4, 2019, between Trilogy Healthcare Operations of Muncie, LLC and the EIK. SCHEDULE 6.21 – PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.22(a) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Ground Lease: Board of Aviation Commissioners Corydon, IN 47112 Facility Name: County Harrison County PropCo/Tenant: Fee Owner/PropCo Trilogy Real Estate Columbus, LLC {DE} Trilogy Real Estate Harrison, LLC {DE} City, State, Zip: OpCo/Subtenant: Silver Oaks Health Campus Trilogy Healthcare of Corydon, LLC {DE} OpCo/Subtenant: Columbus, IN 47203 Third party IGT Subtenant/Operator (if applicable): Trilogy Healthcare of Columbus, LLC {DE} Harrison County Hospital SCHEDULE 6.22(a) REAL ESTATE AS OF THE CLOSING DATE A. Owned Properties Facility Name: Morrison Woods Health Campus (excluding the Memory Care Facility and the Villas) Third party IGT Subtenant/Operator (if applicable): Street Address: Henry County Memorial Hospital 4100 N. Morrison Road County City, State, Zip: Muncie, IN 47304 Facility Name: County Bartholomew County Delaware County Harrison Springs Health Campus Street Address: Fee Owner/PropCo: Trilogy Healthcare of Muncie, LLC {IN} Street Address: OpCo/Tenant: Trilogy Healthcare Operations of Muncie, LLC {IN} 871 Pacer Drive Fee Owner: Third party IGT Subtenant/Operator (if applicable): Hancock Regional Hospital 2011 Chapa Drive City, State, Zip: SCHEDULE 6.22(a) – PAGE 2 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Daviess County Hospital Facility Name: Covered Bridge Health Campus Street Address: 1675 W. Tipton Street Facility Name: County City, State, Zip: Cedar Ridge Health Campus Seymour, IN 47150 Street Address: County Floyd County Jackson County Street Address: Facility Name: Fee Owner 1217 US Highway 62E Ground Lease: Schleters', LLC PropCo/Tenant: 2911 Green Valley Road Trilogy Real Estate of Seymour, LLC {DE} City, State, Zip: Fee Owner/PropCo: OpCo/Subtenant: Cynthiana, KY 41031 Trilogy Healthcare of Seymour, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Trilogy Real Estate New Albany, LLC {DE} Jackson County Schneck Memorial Hospital County Facility Name: Harrison County Cobblestone Crossings Health Campus Street Address: Autumn Woods Health Campus 1850 E. Howard Wayne Drive Fee Owner/PropCo: OpCo/Tenant: City, State, Zip: Trilogy Real Estate Cynthiana, LLC{DE} Terre Haute, IN 47802 City, State, Zip: County Trilogy Healthcare of New Albany, LLC {DE} Vigo County OpCo/Tenant: Fee Owner/PropCo: Trilogy Healthcare of Cynthiana, LLC {DE} Trilogy Real Estate Vigo, LLC {DE} OpCo/Tenant: New Albany, IN 47150 Trilogy Healthcare of Vigo, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): Daviess County Hospital Putnam County Hospital SCHEDULE 6.22(a) – PAGE 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A Street Address: Facility Name: Glen Ridge Health Campus County Street Address: Facility Name: 6415 Calm River Way The Willows at Citation City, State, Zip: Henry County Louisville, KY 40299 2800 Forest Ridge Parkway County Street Address: Jefferson County 1376 Silver Springs Drive Fee Owner/PropCo: Senior Living at Forest Ridge Trilogy Real Estate Kentucky III, LLC {DE} Fee Owner/PropCo: OpCo/Tenant: City, State, Zip: Trilogy Healthcare of Glen Ridge, LLC {DE} Lexington, KY 40511 Third party IGT Subtenant/Operator (if applicable): Trilogy Healthcare of Henry II, LLC {IN} N/A Facility Name: County Park Terrace Health Campus (including medical office buildings) Fayette County Street Address: City, State, Zip: 9700 Stonestreet Road OpCo/Tenant: City, State, Zip: Fee Owner/PropCo: Louisville, KY 40272 Trilogy Real Estate Fayette III, LLC {DE} County Trilogy Healthcare of Henry, LLC {IN} Jefferson County New Castle, IN 47362 Fee Owner/PropCo: OpCo/Tenant: Trilogy Real Estate Kentucky, LLC {DE} Trilogy Healthcare of Fayette III, LLC {KY} OpCo/Tenant: Facility Name: Trilogy Healthcare of Louisville Southwest, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): N/A N/A

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SCHEDULE 6.22(a) – PAGE 4 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: The Oaks at Woodfield Street Address: 5370 Baldwin Road Facility Name: County City, State, Zip: The Oaks at NorthPointe Woods Grand Blanc, MI 48439 Street Address: County Jefferson County Genesee County Street Address: Facility Name: Fee Owner/PropCo: 706 North Avenue Trilogy Real Estate of Grand Blanc, LLC {DE} OpCo/Tenant: 4247 Westport Road Trilogy Healthcare of Genesee, LLC {DE} City, State, Zip: Fee Owner/PropCo: Third party IGT Subtenant/Operator (if applicable): Battle Creek, MI 49017 N/A Facility Name: Trilogy Real Estate Kentucky V, LLC {DE} The Willows at Howell County Street Address: Calhoun County 1500 Byron Road City, State, Zip: Westport Place Health Campus Howell, MI 48855 Fee Owner/PropCo: OpCo/Tenant: County Trilogy Real Estate of Battle Creek, LLC {DE} Livingston County City, State, Zip: Fee Owner/PropCo: Trilogy Healthcare of Louisville East, LLC {DE} Trilogy Real Estate Howell, LLC {DE} OpCo/Tenant: OpCo/Tenant: Trilogy Healthcare of Battle Creek, LLC {DE} Trilogy Healthcare of Livingston, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Louisville, KY 40207 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 5 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: The Meadows of Leipsic Street Address: 901 East Main Street Facility Name: County City, State, Zip: Cypress Pointe Health Campus Leispic, OH 45856 Street Address: County Lapeer County Putnam Street Address: Facility Name: Fee Owner/PropCo: 600 West National Road Trilogy Real Estate Ohio, LLC OpCo/Tenant: 2525 DeMille Boulevard Trilogy Healthcare of Putnam III, LLC {DE} City, State, Zip: Fee Owner/PropCo: Third party IGT Subtenant/Operator (if applicable): Englewood, OH 45322 N/A Facility Name: Trilogy Real Estate of Lapeer, LLC {DE} Springview Manor County Street Address: Montgomery County 883 W. Spring Street City, State, Zip: Stonegate Health Campus Lima, OH 45805 Fee Owner/PropCo: OpCo/Tenant: County Trilogy Real Estate Ohio, LLC {DE} Allen County City, State, Zip: Fee Owner/PropCo: Trilogy Healthcare of Lapeer, LLC {DE} Trilogy Real Estate Ohio, LLC {DE} OpCo/Tenant: OpCo/Tenant: Trilogy Healthcare of Montgomery, LLC {DE} Trilogy Healthcare of Allen II, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Lapeer, MI 48446 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 6 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: The Meadows of Ottawa Street Address: 147 Putnam Parkway Facility Name: County City, State, Zip: Briar Hill Health Campus Ottawa, OH 45875 Street Address: County Morgan County Putnam County Street Address: Facility Name: Fee Owner/PropCo: 600 Sterling Drive Trilogy Real Estate Putnam II, LLC {DE} OpCo/Tenant: 4114 N. State Route 376 NW Trilogy Healthcare of Putnam II, LLC {DE} City, State, Zip: Fee Owner/PropCo: Third party IGT Subtenant/Operator (if applicable): North Baltimore, OH 45872 N/A Facility Name: Trilogy Real Estate Morgan, LLC {DE} The Oaks at Northpointe County Street Address: Wood County 3291 Northpointe Drive City, State, Zip: Highland Oaks Health Center Zanesville, OH 43701 Fee Owner/PropCo: OpCo/Tenant: County Trilogy Healthcare of Wood County Successor, LLC {DE} Muskingum County City, State, Zip: Fee Owner/PropCo: Trilogy Healthcare of Morgan, LLC {DE} Trilogy Real Estate Northpointe, LLC{DE} OpCo/Tenant: OpCo/Tenant: Trilogy Healthcare of North Baltimore, LLC {DE} Trilogy Healthcare of Muskingum, LLC {DE} Third party IGT Subtenant/Operator (if applicable): McConnelsville, OH 43756 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 7 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A Facility Name: Paddock Springs Health Campus Facility Name: County Street Address: The Willows at Willard 2695 Shelden Street Street Address: City, State, Zip: Oakland County Warsaw, IN 46582 Street Address: Facility Name: County 1050 Neal Zick Road Kosciusko County Fee Owner/PropCo: 6000 Lake Villa Circle Trilogy Real Estate Kosciusko, LLC {DE} City, State, Zip: Fee Owner/PropCo: OpCo/Tenant: Willard, OH 44890 Trilogy Healthcare of Milford, LLC {DE} Mortgagee: Trilogy Real Estate Oakland, LLC {DE} Canadian Imperial Bank of Commerce County Third party IGT Subtenant/Operator (if applicable): Huron County Hancock Regional Hospital B. Leased Properties Facility Name: The Villas of Westlake West River Health Campus Ground Lessor: OpCo/Tenant: Street Address: Mercy Health-Willard Hospital, LLC 714 S. Eickhoff Road City, State, Zip: City, State, Zip: Trilogy Healthcare of Commerce, LLC {DE} Evansville, IN 47712 Fee Owner/PropCo: County Trilogy Real Estate Huron, LLC {DE} Vanderburgh County Lessor: Commerce, MI 48382 G&L Partnership, L.P. OpCo/Tenant: Third party IGT Subtenant/Operator (if applicable): OpCo/Tenant: Trilogy Healthcare of Huron, LLC {DE} Trilogy Healthcare of Vanderburgh, LLC {DE} Third party IGT Subtenant/Operator (if applicable): N/A Good Samaritan Hospital Third party IGT Subtenant/Operator (if applicable):

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SCHEDULE 6.22(a) – PAGE 8 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Hancock Regional Hospital Street Address: Facility Name: Forest Springs Health Campus County Street Address: Facility Name: 4120 Wooded Acre Lane White Oak Health Campus City, State, Zip: Lake County Louisville, KY 40245 18275 Burr Street County Street Address: Jefferson County 814 S. 6th Street Lessor: Cedar Creek Health Campus Louisville Healthcare Partners, LLC Lessor: OpCo/Tenant: City, State, Zip: Trilogy Healthcare of Louisville Northeast, LLC {KY} Monticello, IN 47960 Third party IGT Subtenant/Operator (if applicable): Oakbrook Properties, LLC N/A Facility Name: County Triple Creek Retirement Community White County Street Address: City, State, Zip: 11230 Pippin Road OpCo/Tenant: City, State, Zip: Lessor: Colerain, OH 45231 G&L Partnership, L.P. County Trilogy Healthcare of Lowell, LLC {DE} Hamilton County Lowell, IN 46356 Lessors: OpCo/Tenant: C&K Partners and Oakwood Trading Trilogy Healthcare of Monticello, LLC {DE} OpCo/Tenant: Facility Name: Trilogy Healthcare of Hamilton, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): N/A Witham Memorial Hospital SCHEDULE 6.22(a) – PAGE 9 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: The Lakes of Sylvania Street Address: 5351 Mitchaw Road Facility Name: County City, State, Zip: Wooded Glen Health Campus Sylvania, OH 43560 Street Address: County Mercer County Lucas County Street Address: Facility Name: Lessor: 2900 Bechtle Avenue Sylvania Healthcare Partners, LLC OpCo/Tenant: 180 Lucky Man Way Trilogy Healthcare of Sylvania, LLC {DE} City, State, Zip: Lessor: Third party IGT Subtenant/Operator (if applicable): Springfield, OH 45504 N/A Facility Name: Harrodsburg Partners, LLC The Glen County Street Address: Clark County 4300 Gleneste-Withamsville Rd City, State, Zip: The Willows at Harrodsburg Union Township, OH 45245 Lessor: OpCo/Tenant: County Englewood Partners, LLC Clermont County City, State, Zip: Fee Owner/PropCo: Trilogy Healthcare of Mercer, LLC {DE} Macomb Partners of Kentucky, LLC OpCo/Tenant: OpCo/Tenant: Trilogy Healthcare Operations of Springfield II, LLC {DE} Trilogy Healthcare of Clermont, LLC {DE} Third party IGT Subtenant/Operator (if applicable): Harrodsburg, KY 40330 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 10 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: The Oaks at Cascade Street Address: 1157 Medical Park Drive Facility Name: County City, State, Zip: The Villages at Oak Ridge Grand Rapids, MI 49546 Street Address: County Jefferson County Kent County Street Address: Facility Name: Lessor: 1694 Troy Road PVR - Heather Hills OpCo/Tenant: 2200 Stony Brook Drive Trilogy Healthcare of Kent, LLC {DE} City, State, Zip: Lessor: Third party IGT Subtenant/Operator (if applicable): Washington, IN 47501 N/A Facility Name: Stonybrook Health Partners, LLC PCA Louisville Pharmacy County Street Address: Daviess County 2701 Chestnut Station Court City, State, Zip: The Springs at Stony Brook Louisville, KY 40299 Lessor: OpCo/Tenant: County Lynncom, LLC Jefferson County City, State, Zip: Lessor: Trilogy Healthcare of Jefferson II, LLC {DE} ACP, LLC OpCo/Tenant: OpCo/Tenant: Trilogy Healthcare of Daviess, LLC {DE} PCA-Corrections, LLC {KY} Third party IGT Subtenant/Operator (if applicable): Louisville, KY 40220 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 11 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: PCA Indianapolis Pharmacy Street Address: 5925 West 71st Street, Suite B Facility Name: County City, State, Zip: Curo Pharmacy Indianapolis, IN Street Address: County Franklin County Marion County Street Address: Facility Name: Lessor: 4665 44th Street SE, Suite A-1106 PF Realty LLC OpCo/Tenant: 4014 Venture Court PCA-Corrections, LLC {KY} City, State, Zip: Lessor: Third party IGT Subtenant/Operator (if applicable): Grand Rapids, MI 49512 N/A Facility Name: Westpointe Metro Lake SPE, LLC PCA Southern Indiana County Street Address: Kent County 1740 Williamsburg Drive, Suite A City, State, Zip: Choice Pharmacy Jeffersonville, IN 47130 Lessor: OpCo/Tenant: County Open Terrace Associates, LLC Clark County City, State, Zip: Lessor: PCA-Corrections, LLC {KY} William Sprigler Bridge Limited Partnership OpCo/Tenant: OpCo/Tenant: PCA-Corrections, LLC {KY} PCA-Corrections, LLC {KY} Third party IGT Subtenant/Operator (if applicable): Columbus, OH 43228 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable):

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SCHEDULE 6.22(a) – PAGE 12 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 N/A N/A Facility Name: Liberty Heights Street Address: 12105 Ambassador Drive Facility Name: County City, State, Zip: PCA NuScriptRX Colorado Springs, CO 80921 Street Address: County Armstrong County El Paso County Street Address: Facility Name: Lessor: 5215 Linbar Drive, Suite 210 GA HC REIT Liberty TRS SUB, LLC OpCo/Tenant: 201 N. Jefferson Street, Suite 300 Paragon Outpatient Rehabilitation Services, LLC {IN} City, State, Zip: Lessor: Third party IGT Subtenant/Operator (if applicable): Nashville, TN 37211 N/A Facility Name: Seven Six Partners, LLC Lincolnwood Place County Street Address: Davidson County 7000 North McCormick Blvd. City, State, Zip: Mission Pharmacy Licolnwood, IL 60712 Lessor: OpCo/Tenant: County Firstcal Industrial Acquisition, LLC Cook County City, State, Zip: Lessor: Trilogy Mission RX, LLC {DE} GA HC REIT II Lincolnwood TRS SUB, LLC OpCo/Tenant: OpCo/Tenant: Trilogy NuScriptRX, LLC {DE} Paragon Outpatient Rehabilitation Services, LLC {IN} Third party IGT Subtenant/Operator (if applicable): Kittanning, PA 16201 N/A Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): SCHEDULE 6.22(a) – PAGE 13 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 GA HC REIT II Evergreen TRS SUB, LLC County Hamilton County Evergreen Retirement Community Lessor: OpCo/Tenant: GA HC REIT II Seasons TRS SUB, LLC City, State, Zip: Paragon Outpatient Rehabilitation Services, LLC {IN} OpCo/Tenant: Paragon Outpatient Rehabilitation Services, LLC {IN} Cincinnati, OH 45215 Third party IGT Subtenant/Operator (if applicable): Third party IGT Subtenant/Operator (if applicable): N/A N/A Facility Name: Clarendale of Schererville Street Address: 7770 Burr Street Facility Name: County City, State, Zip: Seasons Retirement Community Schererville, IN 46375 Street Address: County Hamilton County Lake County Street Address: Facility Name: Lessor: 7100 Dearwester Drive Ryan Companies OpCo/Tenant: 230 W. Galbraith Road Paragon Outpatient Rehabilitation Services, LLC {IN} City, State, Zip: Lessor: Third party IGT Subtenant/Operator (if applicable): Cincinnati, OH 45236 N/A SCHEDULE 6.22(b) REAL ESTATE EXCEPTIONS No exceptions, other than such matters as may be disclosed on the Title Policies and/or the Surveys. SCHEDULE 6.22(b) – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 SCHEDULE 6.24 OTHER DEBT 1. Trilogy Investors is a guarantor under that certain Construction Loan Agreement dated as of March 13, 2018, by and among Trilogy Real Estate Kosciusko, LLC and Trilogy Real Estate Ferdinand II, LLC, as borrowers, and CIBC Bank USA, as the lender, providing for a construction loan in the principal amount of up to $20,827,500. 2. Trilogy Investors is a guarantor, jointly and severally with EB Partners, LLC, of the obligations of the borrowers under that certain Term Loan Agreement dated as of June 28, 2019, by and among, RHS PropCo Mooresville, LLC, Trilogy Real Estate Bloomington, LLC, Trilogy Real Estate Floyd, LLC and RHS Partners of Mooresville, LLC Trilogy Healthcare of Bloomington, LLC, Trilogy Healthcare of Floyd, LLC, KeyBank National Association, and the other lending institutions which are or may become parties thereto, providing for a term loan in the principal amount of up to $43,300,000. 3. Trilogy Investors is a guarantor of the tenant's purchase obligation in the amount of $10,100,000 under that certain Development and Lease Agreement dated and effective as of January 1, 2018, by and between DMK Pickerington, LLC, as the landlord and Trilogy Real Estate Fairfield, LLC, as the tenant. 4. Trilogy Investors is a guarantor of the tenant's purchase obligation in the amount of $7,600,000, pertaining to the villas, clubhouse and the building containing thirty five assisted living / memory care beds, under that certain Development and Lease Agreement dated and effective as of May 31, 2017, by and between TGY Muncie, LLC, as the landlord, and Trilogy Real Estate Muncie, LLC, as the tenant. SCHEDULE 6.24 – PAGE 1 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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acceptable to the Majority Real Estate Revolving Loan Lenders in their reasonable discretion and to otherwise be in form and substance reasonably satisfactory to Administrative Agent in its sole discretion. (q) Zoning and Land Use Compliance. Such evidence regarding zoning and land use compliance as Administrative Agent may require and approve in its reasonable discretion, including a zoning report in form and substance satisfactory to Administrative Agent. (r) License and Permits. A copy of any permits or any licenses needed to construct and operate the Villa Units, including, as applicable, the Primary Licenses. (s) Environmental Disclosure. Such evidence regarding compliance with Section 6.19(d) as Administrative Agent may reasonably require. (t) Flood. A flood hazard determination on a FEMA approved form and a signed notification, if applicable, to the required qualification documents if such Real Estate is in a flood zone. (u) KYC. Each Borrower and any other Person reasonably requested by any Lender shall have complied with all know-your-customer and anti-money laundering requirements of the Lenders, including the Patriot Act and the provision of a Beneficial Ownership Certification. (v) Appraisal. An Appraisal of such Villa Units, in form and substance satisfactory to Administrative Agent as provided in Section 5.2 and having a date reasonably acceptable to Administrative Agent. (w) Financial Information. A pro forma calculation of Collateral Pool Value and covenant compliance certificate showing the impact of such Real Estate. (x) Additional Documents. Such other agreements, documents, certificates, reports, assurances or due diligence deliverables as Administrative Agent may reasonably require. SCHEDULE 10.11 – PAGE 3 US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 EXHIBITS AND SCHEDULES Exhibits: Exhibit A FORM OF A/R REVOLVING LOAN NOTE Exhibit B FORM OF REAL ESTATE REVOLVING LOAN NOTE Exhibit C FORM OF SWING LOAN NOTE Exhibit D FORM OF JOINDER Exhibit E RESERVED Exhibit F FORM OF REQUEST FOR LOAN/CONVERSION Exhibit G FORM OF LETTER OF CREDIT REQUEST Exhibit H FORM OF LETTER OF CREDIT APPLICATION Exhibit I FORMS OF U.S. TAX COMPLIANCE CERTIFICATES Exhibit J FORM OF REAL ESTATE BORROWING BASE CERTIFICATE Exhibit K FORM OF A/R BORROWING BASE CERTIFICATE Exhibit L FORM OF COMPLIANCE CERTIFICATE Exhibit M FORM OF ASSIGNMENT AND ACCEPTANCE AGREEMENT Schedules: Schedule 1.1(a) LENDERS, COMMITMENTS AND COMMITMENT PERCENTAGES Schedule 1.1(b) PRE-APPROVED COLLATERAL PROPERTIES Schedule 1.1(c) PRE-APPROVED VILLA UNITS Schedule 1.1(d) BORROWERS PROVIDING A/R COLLATERAL Schedule 1.1(e) BORROWERS OWNING OR OPERATING A COLLATERAL PROPERTY Schedule 4.3 ACCOUNTS Schedule 6.3 TITLE TO PROPERTIES Schedule 6.6 TRADEMARKS, TRADE NAMES Schedule 6.7 PENDING LITIGATION Schedule 6.10 TAX STATUS; TAX IDENTIFICATION NUMBERS Schedule 6.14 CERTAIN TRANSACTIONS Schedule 6.17 TRADE NAME/PLACE OF BUSINESS Schedule 6.20(a) ORGANIZATIONAL STRUCTURE Schedule 6.20(b) UNCONSOLIDATED AFFILIATES OF BORROWERS AND THEIR SUBSIDIARIES Schedule 6.21 LEASES, ETC. Schedule 6.22(a) REAL ESTATE AS OF THE CLOSING DATE Schedule 6.22(b) REAL ESTATE EXCEPTIONS US_Active\120558968\V-3US_ACTIVE\122519032\V-4 Schedule 6.24 OTHER DEBT Schedule 6.32 HEALTHCARE EXCEPTIONS Schedule 7.19 BANK ACCOUNTS Schedule 7.30 IGT TRANSACTIONS Schedule 10.10 ELIGIBLE OWNED REAL ESTATE QUALIFICATION DOCUMENTS Schedule 10.11 ELIGIBLE VILLA UNIT QUALIFICATION DOCUMENTS US_Active\120558968\V-3US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** Page SECTION 1. DEFINITIONS AND RULES OF INTERPRETATION 1 Section 1.1 Definitions 1 Section 1.2 Rules of Interpretation 4548 Section 1.3 Rates 4751 SECTION 2. THE CREDIT FACILITY 4751 Section 2.1 Real Estate Revolving Loans 4751 Section 2.2 A/R Revolving Loans 4852 Section 2.3 Facility Unused Fees 4953 Section 2.4 Swing Loan Commitment 4953 Section 2.5 Interest on Loans 5357 Section 2.6 Requests for Loans 5357 Section 2.7 Funds for Loans 5357 Section 2.8 Use of Proceeds 5458 Section 2.9 Letters of Credit 5458 Section 2.10 Increase in Commitments 5761 Section 2.11 Extension of Maturity Date 6165 Section 2.12 Defaulting Lenders 6266 Section 2.13 Borrowing Agency Provisions; Joint and Several Liability; Waivers 6569 Section 2.14 Termination or Reduction of the Commitments 6973 Section 2.15 No Novation 7074 SECTION 3. REPAYMENT OF THE LOANS 7074 Section 3.1 Stated Maturity 7074 Section 3.2 Mandatory Prepayments 7074 Section 3.3 Optional Prepayments 7175 Section 3.4 Partial Prepayments 7175 Section 3.5 Effect of Prepayments 7175 Section 3.6 Application of Payments 7175 SECTION 4. CERTAIN GENERAL PROVISIONS 7377 Section 4.1 Conversion/Continuation Options 7377 Section 4.2 Fees 7377 Section 4.3 Funds for Payments 7478 i US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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**TABLE OF CONTENTS** (continued) Page Section 4.4 Computations 7882 Section 4.5 Suspension of LIBOR Rate Loans78Temporary Inability to Determine Rates 82 Section 4.6 Illegality 7882 Section 4.7 Additional Interest 78Breakage Compensation 83 Section 4.8 Additional Costs, Etc. 7983 Section 4.9 Capital Adequacy 8084 Section 4.10 Breakage Costs 80Intentionally Omitted 85 Section 4.11 Default Interest; Late Charge 8085 Section 4.12 Certificate 8185 Section 4.13 Limitation on Interest 8185 Section 4.14 Certain Provisions Relating to Increased Costs 8186 Section 4.15 Successor LIBOR Rate IndexPermanent Ability to Determine Rate; Benchmark Replacement. 8286 SECTION 5. COLLATERAL SECURITY 8687 Section 5.1 Collateral 8687 Section 5.2 Appraisals 8688 Section 5.3 Release of Collateral Properties 8688 Section 5.4 Addition of Collateral Properties and Villa Units 8889 Section 5.5 Additional Borrowers 8991 Section 5.6 Release of Collateral 9092 SECTION 6. REPRESENTATIONS AND WARRANTIES 9092 Section 6.1 Corporate Authority, Etc. 9092 Section 6.2 Governmental Approvals 9193 Section 6.3 Title to Properties 9193 Section 6.4 Financial Statements 9193 Section 6.5 No Material Changes 9193 Section 6.6 Franchises, Patents, Copyrights, Etc. 9193 Section 6.7 Litigation 9293 Section 6.8 No Material Adverse Contracts, Etc. 9294 Section 6.9 Compliance with Other Instruments, Laws, Etc. 9294 Section 6.10 Tax Status 9294 ii US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** (continued) Page Section 6.11 No Event of Default 9294 Section 6.12 Investment Company Act 9394 Section 6.13 Setoff, Etc. 9394 Section 6.14 Certain Transactions 9395 Section 6.15 Employee Benefit Plans 9395 Section 6.16 Disclosure 9395 Section 6.17 Trade Name; Place of Business 9496 Section 6.18 Regulations T, U and X 9496 Section 6.19 Environmental Compliance 9496 Section 6.20 Subsidiaries; Organizational Structure 9597 Section 6.21 Leases 9597 Section 6.22 Real Estate 9798 Section 6.23 Brokers 98100 Section 6.24 Other Debt 98100 Section 6.25 Solvency 98100 Section 6.26 No Bankruptcy Filing 98100 Section 6.27 No Fraudulent Intent 98100 Section 6.28 Transaction in Best Interests of Borrowers and Guarantors; Consideration 98100 Section 6.29 Contribution Agreement 99100 Section 6.30 Representations and Warranties of Borrowers 99101 Section 6.31 OFAC 99101 Section 6.32 Healthcare Representations 99101 Section 6.33 FDA Regulatory Compliance. 101103 Section 6.34 Accounts 102104 Section 6.35 Ground Lease 102104 Section 6.36 Labor Matters 102104 Section 6.37 Single Purpose Entity/Separateness 103105 Section 6.38 Holding Companies 105106 Section 6.39 Michigan Lessees 105106 SECTION 7. AFFIRMATIVE COVENANTS 105107 iii US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** (continued) Page Section 7.1 Punctual Payment 105107 Section 7.2 Maintenance of Office 105107 Section 7.3 Records and Accounts 105107 Section 7.4 Financial Statements; Borrowing Base Information; other Certificates and Information 106107 Section 7.5 Notices 111113 Section 7.6 Existence; Maintenance of Properties 113115 Section 7.7 Insurance; Condemnation 113115 Section 7.8 Taxes; Liens 118120 Section 7.9 Inspection of Properties and Books 119120 Section 7.10 Compliance with Laws, Contracts, Licenses, and Permits 119121 Section 7.11 Further Assurances 119121 Section 7.12 Collateral Properties 120121 Section 7.13 Business Operations 121122 Section 7.14 Healthcare Laws and Covenants 121123 Section 7.15 Registered Service Mark 123125 Section 7.16 Distributions of Income to Borrowers 123125 Section 7.17 Plan Assets 124125 Section 7.18 Assignments and Records of Accounts; Verification of Accounts 124125 Section 7.19 Bank Accounts 124126 Section 7.20 Formation of Subsidiaries 126127 Section 7.21 Separateness 126128 Section 7.22 EIK 126128 Section 7.23 Construction of Villa Units 127128 Section 7.24 Inspection by Administrative Agent or any Lender of Construction at the Villa Units Complexes 127128 Section 7.25 Mechanics' Liens and Contest Thereof 127129 Section 7.26 Settlement of Mechanics' Lien Claims 127129 Section 7.27 Villa Unit Advances 127129 Section 7.28 Sanctions 128129 Section 7.29 KYC 128130 iv US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** (continued) Page Section 7.30 Existing and Future IGT Transactions. 128130 Section 7.31 Post-Closing Obligations 130132 SECTION 8. NEGATIVE COVENANTS 131132 Section 8.1 Restrictions on Indebtedness 131132 Section 8.2 Restrictions on Liens, Etc. 132134 Section 8.3 Restrictions on Investments 134136 Section 8.4 Merger, Consolidation 136137 Section 8.5 Sale and Leaseback 136138 Section 8.6 Compliance with Environmental Laws 136138 Section 8.7 Distributions by Borrowers 138139 Section 8.8 Asset Sales 138139 Section 8.9 Restriction on Prepayment of Indebtedness 138140 Section 8.10 Zoning and Contract Changes and Compliance 138140 Section 8.11 Derivatives Contracts 139140 Section 8.12 Transactions with Affiliates 139140 Section 8.13 Equity Pledges 139140 Section 8.14 Management Fees 139141 Section 8.15 Inconsistent Agreements 139141 Section 8.16 Leases of Property 139141 Section 8.17 Management 140142 Section 8.18 OpCo Affiliate Indebtedness 141142 Section 8.19 Subordination 141142 SECTION 9. FINANCIAL COVENANTS 141143 Section 9.1 Borrowing Base Availability 141143 Section 9.2 Total Adjusted EBITDAR to Consolidated Fixed Charges 142143 Section 9.3 Minimum Consolidated Net Worth 142144 Section 9.4 Recourse Indebtedness 142144 Section 9.5 Distributions 142144 Section 9.6 Minimum Collateral Properties Requirement 143145 SECTION 10. CLOSING CONDITIONS 143145 Section 10.1 Closing Date 143145 v US_Active\120558968\V-3 US_ACTIVE\122519032\V-4

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**TABLE OF CONTENTS** (continued) Page SECTION 11. CONDITIONS TO ALL BORROWINGS 146148 Section 11.1 Representations True; No Default 146148 Section 11.2 Borrowing Documents 146148 Section 11.3 Endorsement to Title Policy 146148 Section 11.4 Future Advances Tax Payment 147148 SECTION 12. EVENTS OF DEFAULT; ACCELERATION; ETC. 147148 Section 12.1 Events of Default and Acceleration 147148 Section 12.2 Certain Cure Periods; Limitation of Cure Periods 152153 Section 12.3 Termination of Total Commitment 153154 Section 12.4 Remedies 153155 Section 12.5 Collateral Account 154155 SECTION 13. SETOFF 155156 SECTION 14. AGENTS 155157 Section 14.1 Authorization 155157 Section 14.2 Employees and Agents 156157 Section 14.3 No Liability 156157 Section 14.4 No Representations 156158 Section 14.5 Payments 157158 Section 14.6 Holders of Notes 157159 Section 14.7 Indemnity 157159 Section 14.8 Agents as Lenders 158159 Section 14.9 Resignation 158159 Section 14.10 Duties in the Case of Enforcement 158160 Section 14.11 Request for Agent Action 159160 Section 14.12 Bankruptcy 159161 Section 14.13 Reliance by Agents 159161 Section 14.14 Approvals 160161 Section 14.15 Collateral 160162 Section 14.16 Borrowers Not Beneficiaries 160162 Section 14.17 Intercreditor Agreements 161162 Section 14.18 Release of Collateral 161162 vi US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** (continued) Page Section 14.19 Erroneous Payments 161163 SECTION 15. EXPENSES 165 SECTION 16. INDEMNIFICATION 166 SECTION 17. SURVIVAL OF COVENANTS, ETC. 167 SECTION 18. ASSIGNMENT AND PARTICIPATION 167 Section 18.1 Conditions to Assignment by Lenders 167 Section 18.2 Register 168 Section 18.3 New Notes 168 Section 18.4 Participations 169 Section 18.5 Pledge by Lender 169 Section 18.6 No Assignment by Borrowers 170 Section 18.7 Disclosure 170 Section 18.8 Mandatory Assignment 170 Section 18.9 Amendments to Loan Documents 171 Section 18.10 Titled Agents 171 SECTION 19. NOTICES 171 SECTION 20. RELATIONSHIP 173 SECTION 21. GOVERNING LAW; CONSENT TO JURISDICTION AND SERVICE 173 SECTION 22. HEADINGS 174 SECTION 23. COUNTERPARTS 174 SECTION 24. ENTIRE AGREEMENT, ETC. 174 SECTION 25. WAIVER OF JURY TRIAL AND CERTAIN DAMAGE CLAIMS 174 SECTION 26. DEALINGS WITH BORROWERS 175 SECTION 27. CONSENTS, AMENDMENTS, WAIVERS, ETC. 175 SECTION 28. SEVERABILITY 177 SECTION 29. TIME OF THE ESSENCE 177 SECTION 30. NO UNWRITTEN AGREEMENTS 177 SECTION 31. REPLACEMENT NOTES 177 SECTION 32. NO THIRD PARTIES BENEFITED 177 SECTION 33. PATRIOT ACT 178 SECTION 34. BANK PRODUCT PROVIDERS AND LENDER HEDGE PROVIDERS 178 vii US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 **TABLE OF CONTENTS** (continued) Page SECTION 35. ACKNOWLEDGEMENT AND CONSENT TO BAIL-IN OF AFFECTED FINANCIAL INSTITUTIONS 178 SECTION 36. CONSENT TO AMENDMENT AND RESTATEMENT; EFFECT OF AMENDMENT AND RESTATEMENT 179 SECTION 37. WAIVER OF CLAIMS 179 SECTION 38. ACKNOWLEDGEMENT REGARDING ANY SUPPORTED QFCs 179 viii US_Active\120558968\V-3 US_ACTIVE\122519032\V-4 Moved deletion Input: Rendering set Inserted cell Description Underline Strikethrough Deleted cell #122519032v1 - Trilogy - COMPOSITE First Amended and Restated Credit Agreement (with SOFR Amendments) Moved cell Legend: Split/Merged cell Insertion Document comparison by Workshare 10.0 on Monday, December 19, 2022 4:03:58 PM Padding cell Document 2 ID Deletion Statistics: Document 1 ID iManage://WORKSITE.US.DENTONS.COM/US_ACTIVE/ 122519032/4 Count Moved from Insertions 611 Moved to Deletions iManage://WORKSITE.US.DENTONS.COM/US_ACTIVE/ 122519032/1 565 Description Moved from Style change 43 Moved to #122519032v4 - KeyBank/Trilogy - Third Amendment to First AR Credit Agreement - Annex 1 43 Format change

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Format changes Style changes 0 0 Total changes 1262

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## Exhibit 21.1

**Exhibit 21.1**

**American Healthcare REIT, Inc.**

**List of Subsidiaries**

**As of March 17, 2023** 

AHI Management Services, Inc. (Delaware)

AHR Batesville TRS Sub, LLC (Delaware)

AHR Cedar Park TRS Sub, LLC (Delaware)

AHR Cedar Park TX ALF, LLC (Delaware)

AHR Cleveland TRS Sub, LLC (Delaware)

AHR Corpus Christi TRS Sub, LLC (Delaware)

AHR Corpus Christi TX ALF, LLC (Delaware)

AHR League City TRS Sub, LLC (Delaware)

AHR League City TX ALF, LLC-(Delaware)

AHR Round Rock TRS Sub, LLC (Delaware)

AHR Round Rock TX ALF, LLC (Delaware)

AHR Springdale TRS Sub, LLC (Delaware)

AHR Springing Member I, LLC (Delaware)

AHR Springing Member II, LLC (Delaware)

AHR Sugarland TRS Sub, LLC (Delaware)

AHR Sugarland TX ALF, LLC (Delaware)

AHR Sun Prairie TRS Sub, LLC (Delaware)

AHR Temple TRS Sub, LLC (Delaware)

AHR Temple TX ALF, LLC (Delaware)

AHR Texas ALF Portfolio, LLC (Delaware)

AHR TRS Delta Valley Holdings, LLC (Delaware)

AHR TRS Texas Holdings LLC (Delaware)

AHR TRS Wisconsin Holdings, LLC (Delaware)

AHR Tyler TRS Sub, LLC (Delaware)

AHR Tyler TX ALF, LLC (Delaware)

AHR Waunakee TRS Sub, LLC (Delaware)

American Healthcare Investors, LLC (Delaware)

American Healthcare Opps Holdings, LLC (Delaware)

American Healthcare REIT Holdings, LP (Delaware)

American Healthcare TRS, LLC (Delaware)

Continental Merger Sub, LLC (Maryland)

GAHC3 95th Naperville IL MOB, LLC (Delaware)

GAHC3 Acworth GA MOB, LLC (Delaware)

GAHC3 Austell GA MOB, LLC (Delaware)

GAHC3 Batesville MS ALF, LLC (Delaware)

GAHC3 Bennington NE ALF TRS Sub, LLC (Delaware)

GAHC3 Bennington NE ALF, LLC (Delaware)

GAHC3 Bethlehem PA ILF TRS Sub, LLC (Delaware)

GAHC3 Bethlehem PA ILF, LLC (Delaware)

GAHC3 Boyertown PA ALF TRS Sub, LLC (Delaware)

GAHC3 Boyertown PA ALF, LLC (Delaware)

GAHC3 Braintree MA SNF, LLC (Delaware)

GAHC3 Brighton MA SNF, LLC (Delaware)

GAHC3 Bronx NY MOB, LLC (Delaware)

GAHC3 Carolina Commons SC MOB, LLC (Delaware)

GAHC3 Chesterfield Corporate Plaza, LLC (Delaware)

GAHC3 Chorus Senior Housing Portfolio, LLC (Delaware)

GAHC3 Clemmons NC TRS Sub, LLC (Delaware)

GAHC3 Clemmons NC ALF, LP (Delaware)

GAHC3 Cleveland MS ALF, LLC (Delaware)

GAHC3 Delta Valley ALF Portfolio, LLC (Delaware)

GAHC3 Durango CO Medical Center, LLC (Delaware)

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**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC3 Duxbury MA SNF, LLC (Delaware)

GAHC3 East Texas MOB Portfolio, LLC (Delaware)

GAHC3 Elkhart IN ALF TRS Sub, LLC (Delaware)

GAHC3 Elkhart IN ALF, LLC (Delaware)

GAHC3 Elkhart IN ILF TRS Sub, LLC (Delaware)

GAHC3 Elkhart IN ILF, LLC (Delaware)

GAHC3 FM Class B, LLC (Delaware)

GAHC3 Fox Grape SNF Portfolio, LLC (Delaware)

GAHC3 Friendswood TX MOB, LLC (Delaware)

GAHC3 Garner NC TRS Sub, LLC (Delaware)

GAHC3 Garner NC ALF, LP (Delaware)

GAHC3 Glen Burnie MD MOB, LLC (Delaware)

GAHC3 Hingham MA SNF, LLC (Delaware)

GAHC3 Hobart IN ALF TRS Sub, LLC (Delaware)

GAHC3 Hobart IN ALF, LLC (Delaware)

GAHC3 Homewood AL MOB, LLC (Delaware)

GAHC3 Huntersville NC TRS Sub, LLC (Delaware)

GAHC3 Huntersville NC ALF, LP (Delaware)

GAHC3 Independence MOB Portfolio, LLC (Delaware)

GAHC3 IOM Senior Housing Limited (United Kingdom)

GAHC3 Joplin MO MOB, LLC (Delaware)

GAHC3 Keller TX MOB, LLC (Delaware)

GAHC3 King of Prussia PA MOB, LLC (Delaware)

GAHC3 Kingwood MOB Portfolio, LLC (Delaware)

GAHC3 Kingwood TX MOB I, LLC (Delaware)

GAHC3 Kingwood TX MOB II, LLC (Delaware)

GAHC3 Lakeview IN Medical Plaza, LLC (Delaware)

GAHC3 Lakeview IN MOB JV, LLC (Delaware)

GAHC3 LaPorte IN ALF TRS Sub, LLC (Delaware)

GAHC3 LaPorte IN ALF, LLC (Delaware)

GAHC3 Lee's Summit MO MOB, LLC (Delaware)

GAHC3 Lithonia GA MOB, LLC (Delaware)

GAHC3 Longview TX CSC MOB, LLC (Delaware)

GAHC3 Longview TX Institute MOB, LLC (Delaware)

GAHC3 Longview TX Medical Plaza, LLC (Delaware)

GAHC3 Longview TX Occupational MOB, LLC (Delaware)

GAHC3 Longview TX Outpatient MOB I, LLC (Delaware)

GAHC3 Longview TX Outpatient MOB II, LLC (Delaware)

GAHC3 Marietta GA MOB II, LLC (Delaware)

GAHC3 Marietta GA MOB, LLC (Delaware)

GAHC3 Marshall TX MOB, LLC (Delaware)

GAHC3 Middletown OH MOB, LLC (Delaware)

GAHC3 Middletown OH MOB II, LLC (Delaware)

GAHC3 Mint Hill NC TRS Sub, LLC (Delaware)

GAHC3 Mint Hill NC ALF, LP (Delaware)

GAHC3 Mishawaka IN ALF TRS Sub, LLC (Delaware)

GAHC3 Mishawaka IN ALF, LLC (Delaware)

GAHC3 Mishawaka IN Parcel, LLC (Delaware)

GAHC3 Mooresville NC TRS Sub, LLC (Delaware)

GAHC3 Mooresville NC ALF, LP (Delaware)

GAHC3 Morristown NJ MOB, LLC (Delaware)

GAHC3 Mount Dora FL MOB II, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC3 Mount Dora FL MOB, LLC (Delaware)

GAHC3 Mount Olympia MOB Portfolio, LLC (Delaware)

GAHC3 Mountain Crest Senior Housing Portfolio, LLC (Delaware)

GAHC3 Mt. Juliet TN MOB, LLC (Delaware)

GAHC3 Napa Medical Center, LLC (Delaware)

GAHC3 Naperville MOB Portfolio (Delaware)

GAHC3 Nebraska Senior Housing Portfolio, LLC (Delaware)

GAHC3 New London CT MOB, LLC (Delaware)

GAHC3 Niles MI ALF TRS Sub, LLC (Delaware)

GAHC3 Niles MI ALF, LLC (Delaware)

GAHC3 North Carolina ALF Portfolio, LLC (Delaware)

GAHC3 North Carolina ALF Portfolio GP, LLC (Delaware)

GAHC3 North Raleigh NC TRS Sub, LLC (Delaware)

GAHC3 North Raleigh NC ALF, LP (Delaware)

GAHC3 Norwich CT MOB I, LLC (Delaware)

GAHC3 Norwich CT MOB II, LLC (Delaware)

GAHC3 Norwich CT MOB Portfolio, LLC (Delaware)

GAHC3 Ogden Naperville IL MOB, LLC (Delaware)

GAHC3 Olympia Fields IL MOB, LLC (Delaware)

GAHC3 Omaha NE ALF TRS Sub, LLC (Delaware)

GAHC3 Omaha NE ALF, LLC (Delaware)

GAHC3 Orange Star Medical Portfolio, LLC (Delaware)

GAHC3 Palmyra PA ALF TRS Sub, LLC (Delaware)

GAHC3 Palmyra PA ALF, LLC (Delaware)

GAHC3 Paoli PA Medical Plaza, LLC (Delaware)

GAHC3 Pennsylvania Senior Housing Portfolio, LLC (Delaware)

GAHC3 Premier Novi MI MOB, LLC (Delaware)

GAHC3 Quincy MA SNF, LLC (Delaware)

GAHC3 Richmond VA ALF TRS Sub, LLC (Delaware)

GAHC3 Richmond VA ALF, LLC (Delaware)

GAHC3 Snellville GA MOB, LLC (Delaware)

GAHC3 Somerville MA MOB, LLC (Delaware)

GAHC3 Southern Illinois MOB Portfolio, LLC (Delaware)

GAHC3 Southgate KY MOB, LLC (Delaware)

GAHC3 Southlake TX Hospital, LLC (Delaware)

GAHC3 Springdale AR ALF, LLC (Delaware)

GAHC3 Stockbridge GA MOB II, LLC (Delaware)

GAHC3 Stockbridge GA MOB III, LLC (Delaware)

GAHC3 Stockbridge GA MOB, LLC (Delaware)

GAHC3 Trilogy JV, LLC (Delaware)

GAHC3 TRS Carolina Holdings, LLC (Delaware)

GAHC3 TRS Chorus Holdings, LLC (Delaware)

GAHC3 TRS Mountain Crest Holdings, LLC (Delaware)

GAHC3 TRS Pennsylvania Holdings, LLC (Delaware)

GAHC3 TRS Rotary Holdings, LLC (Delaware)

GAHC3 U.K. Laverstock Ltd (United Kingdom)

GAHC3 U.K. Senior Care Holding Ltd (United Kingdom)

GAHC3 Verona NJ MOB, LLC (Delaware)

GAHC3 Voorhees NJ MOB, LLC (Delaware)

GAHC3 Wake Forest NC TRS Sub, LLC (Delaware)

GAHC3 Wake Forest NC ALF, LP (Delaware)

GAHC3 Washington DC SNF, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC3 Waterloo IL Dialysis Center, LLC (Delaware)

GAHC3 Waterloo IL MOB & Imaging Center, LLC (Delaware)

GAHC3 Waterloo IL MOB Parcel, LLC (Delaware)

GAHC3 Waterloo IL Surgery Center, LLC (Delaware)

GAHC3 Westbrook CT MOB, LLC (Delaware)

GAHC3 Wharton TX MOB, LLC (Delaware)

GAHC3 Wichita KS MOB, LLC (Delaware)

GAHC3 York PA ALF TRS Sub, LLC (Delaware)

GAHC3 York PA ALF, LLC (Delaware)

GAHC4 Athens GA MOB Portfolio, LLC (Delaware)

GAHC4 Athens GA MOB I, LLC (Delaware)

GAHC4 Athens GA MOB II, LLC (Delaware)

GAHC4 Auburn CA MOB, LLC (Delaware)

GAHC4 Arvada CO MOB, LLC (Delaware)

GAHC4 Balmoral FL SH, LLC (Delaware)

GAHC4 Balmoral FL TRS Sub, LLC (Delaware)

GAHC4 Battle Creek MI MOB, LLC (Delaware)

GAHC4 Bayou JV, LLC (Delaware)

GAHC4 Bayou JV Partner, LLC (Delaware)

GAHC4 Bayside FL SH, LLC (Delaware)

GAHC4 Bayside FL TRS Sub, LLC (Delaware)

GAHC4 Beaumont TX ALF, LLC (Delaware)

GAHC4 Beaumont TX TRS Sub, LLC (Delaware)

GAHC4 Belmont CA ALF, LLC (Delaware)

GAHC4 Belmont CA TRS SUB, LLC (Delaware)

GAHC4 Blue Badger MOB Portfolio, LLC (Delaware)

GAHC4 Bloomington IL MOB, LLC (Delaware)

GAHC4 Bradenton FL SH, LLC (Delaware)

GAHC4 Bradenton FL TRS Sub, LLC (Delaware)

GAHC4 Catalina JV Partner, LLC (Delaware)

GAHC4 Catalina JV, LLC (Delaware)

GAHC4 Catalina SH Portfolio, LLC (Delaware)

GAHC4 Centennial CO MOB, LLC (Delaware)

GAHC4 Charlottesville VA MOB, LLC (Delaware)

GAHC4 Central FL Senior Housing Portfolio, LLC (Delaware)

GAHC4 Central Wisconsin SC Portfolio, LLC (Delaware)

GAHC4 Chattanooga TN MOB, LLC (Delaware)

GAHC4 Chesterton IN MOB, LLC (Delaware)

GAHC4 Colorado Foothills MOB Portfolio, LLC (Delaware)

GAHC4 Colorado Springs CO MOB, LLC (Delaware)

GAHC4 Columbia IL MC, LLC (Delaware)

GAHC4 Columbia IL SH, LLC (Delaware)

GAHC4 Crown Point IN MOB, LLC (Delaware)

GAHC4 Cullman AL MOB I, LLC (Delaware)

GAHC4 Cullman AL MOB II, LLC (Delaware)

GAHC4 Cullman AL MOB III, LLC (Delaware)

GAHC4 Edmonds WA MOB, LLC (Delaware)

GAHC4 Evendale OH MOB, LLC (Delaware)

GAHC4 Fairfield CA MC, LLC (Delaware)

GAHC4 Fairfield CA TRS Sub, LLC (Delaware)

GAHC4 Fairfield County CT MOB Portfolio, LLC (Delaware)

GAHC4 Flemington NJ MOB Portfolio, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC4 Flemington 1 Wescott NJ MOB, LLC (Delaware)

GAHC4 Flemington Sand Hill NJ MOB, LLC (Delaware)

GAHC4 Florissant MO SNF, LLC (Delaware)

GAHC4 Forest Oaks FL SH, LLC (Delaware)

GAHC4 Forest Oaks FL TRS Sub, LLC (Delaware)

GAHC4 Fresno CA MOB, LLC (Delaware)

GAHC4 Glendale WI MOB, LLC (Delaware)

GAHC4 Gonzales LA ALF, LLC (Delaware)

GAHC4 Gonzales LA TRS Sub, LLC (Delaware)

GAHC4 Grand Junction CO MOB, LLC (Delaware)

GAHC4 Grande FL SH, LLC (Delaware)

GAHC4 Grande FL TRS Sub, LLC (Delaware)

GAHC4 Great Nord MOB Portfolio, LLC (Delaware)

GAHC4 Haverhill MA MOB, LLC (Delaware)

GAHC4 Holland MI ALF, LLC (Delaware)

GAHC4 Howell MI ALF, LLC (Delaware)

GAHC4 Iron MOB Portfolio, LLC (Delaware)

GAHC4 Kansas City MO SNF, LLC (Delaware)

GAHC4 Lafayette LA ALF Portfolio, LLC (Delaware)

GAHC4 Lafayette LA ALF, LLC (Delaware)

GAHC4 Lafayette LA MC, LLC (Delaware)

GAHC4 Lafayette TRS OpCo Holdco, LLC (Delaware)

GAHC4 Lafayette ALF TRS Sub, LLC (Delaware)

GAHC4 Lafayette MC TRS Sub, LLC (Delaware)

GAHC4 Lake Morton FL SH, LLC (Delaware)

GAHC4 Lake Morton FL TRS Sub, LLC (Delaware)

GAHC4 Lansing MI ALF, LLC (Delaware)

GAHC4 Lawrenceville GA MOB, LLC (Delaware)

GAHC4 Lawrenceville GA MOB II, LLC (Delaware)

GAHC4 Lithonia GA MOB, LLC (Delaware)

GAHC4 Louisiana SH Portfolio, LLC (Delaware)

GAHC4 Marysville OH MOB, LLC (Delaware)

GAHC4 Madera CA SH, LLC (Delaware)

GAHC4 Madera CA TRS Sub, LLC (Delaware)

GAHC4 Memphis TN MOB, LLC (Delaware)

GAHC4 Menlo Park CA MC, LLC (Delaware)

GAHC4 Menlo Park CA TRS Sub, LLC (Delaware)

GAHC4 Michigan ALF Portfolio, LLC (Delaware)

GAHC4 Milan MO SNF, LLC (Delaware)

GAHC4 Mill Creek WA MOB, LLC (Delaware)

GAHC4 Mint Hill NC MOB, LP (Delaware)

GAHC4 Millstadt IL SH, LLC (Delaware)

GAHC4 Missouri SNF Portfolio, LLC (Delaware)

GAHC4 Moberly MO SNF, LLC (Delaware)

GAHC4 Modesto CA MOB, LLC (Delaware)

GAHC4 Monroe LA SH, LLC (Delaware)

GAHC4 Monroe LA TRS Sub, LLC (Delaware)

GAHC4 New Iberia LA SH, LLC (Delaware)

GAHC4 New Iberia LA TRS Sub, LLC (Delaware)

GAHC4 Northern CA Senior Housing Portfolio, LLC (Delaware)

GAHC4 Northern CA TRS OpCo Holdco, LLC (Delaware)

GAHC4 Northview Grand Rapids MI ALF, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC4 Overland Park KS MOB, LLC (Delaware)

GAHC4 Peninsula FL JV, LLC (Delaware)

GAHC4 Peninsula FL JV Partner, LLC (Delaware)

GAHC4 Pinnacle Senior Housing Portfolio, LLC (Delaware)

GAHC4 Pinnacle SH JV, LLC (Delaware)

GAHC4 Pinnacle SH JV Partner, LLC (Delaware)

GAHC4 Plymouth MN MOB, LLC (Delaware)

GAHC4 Pottsville PA MOB, LLC (Delaware)

GAHC4 Red Bud IL SH, LLC (Delaware)

GAHC4 Renaissance FL SH, LLC (Delaware)

GAHC4 Renaissance FL TRS Sub, LLC (Delaware)

GAHC4 Reno NV MOB, LLC (Delaware)

GAHC4 Reno NV MOB Sole Member, LLC (Delaware)

GAHC4 Riverside Grand Rapids MI ALF, LLC (Delaware)

GAHC4 Rochester Hills MI MOB, LLC (Delaware)

GAHC4 Roseburg OR MOB, LLC (Delaware)

GAHC4 Roseburg OR MOB Sole Member, LLC (Delaware)

GAHC4 Sacramento CA ALF, LLC (Delaware)

GAHC4 Sacramento CA TRS Sub, LLC (Delaware)

GAHC4 Salisbury MO SNF, LLC (Delaware)

GAHC4 Sauk Prairie WI MOB, LLC (Delaware)

GAHC4 Sauk Prairie WI MOB Member, LLC (Delaware)

GAHC4 Sedalia MO SNF, LLC (Delaware)

GAHC4 Shelbyville IL SNF, LLC (Delaware)

GAHC4 Shreveport LA ALF, LLC (Delaware)

GAHC4 Shreveport LA TRS Sub, LLC (Delaware)

GAHC4 Slidell LA ALF, LLC (Delaware)

GAHC4 Slidell LA TRS Sub, LLC (Delaware)

GAHC4 Southfield MI MOB, LLC (Delaware)

GAHC4 Southfield MI MOB Member, LLC (Delaware)

GAHC4 Spring Haven FL SH, LLC (Delaware)

GAHC4 Spring Haven FL TRS Sub, LLC (Delaware)

GAHC4 Spring Oaks FL SH, LLC (Delaware)

GAHC4 Spring Oaks FL TRS Sub, LLC (Delaware)

GAHC4 St. Elizabeth MO SNF, LLC (Delaware)

GAHC4 Stratford CT MOB, LLC (Delaware)

GAHC4 Sun Prairie WI SC, LLC (Delaware)

GAHC4 Surprise AZ MOB, LLC (Delaware)

GAHC4 SW Illinois Senior Housing Portfolio, LLC (Delaware)

GAHC4 Sylacauga AL MOB, LLC (Delaware)

GAHC4 Tarkio MO SNF, LLC (Delaware)

GAHC4 Tinley Park IL MOB, LLC (Delaware)

GAHC4 Trenton MO SNF, LLC (Delaware)

GAHC4 Trilogy JV, LLC (Delaware)

GAHC4 TRS Bayou Holdings, LLC (Delaware)

GAHC4 TRS Catalina Holdings, LLC (Delaware)

GAHC4 TRS Peninsula Holdings, LLC (Delaware)

GAHC4 TRS Pinnacle Holdings, LLC (Delaware)

GAHC4 Trumbull CT MOB, LLC (Delaware)

GAHC4 Warrenton MO ALF, LLC (Delaware)

GAHC4 Warrenton MO TRS Sub, LLC (Delaware)

GAHC4 Waunakee WI SC, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

GAHC4 Waterloo IL SH, LLC (Delaware)

GAHC4 West Des Moines IA ALF, LLC (Delaware)

GAHC4 West Haven UT SH, LLC (Delaware)

GAHC4 West Haven UT TRS Sub, LLC (Delaware)

GAHC4 Wyoming MI ALF, LLC (Delaware)

Orchard St Albans Housing Portfolio Ltd (United Kingdom)

Arlington Dialysis, LLC (Delaware)

Franciscan Dialysis, LLC (Delaware)

LCS Avon LLC (Iowa)

LCS Crawfordsville LLC (Iowa)

LCS Kokomo LLC (Iowa)

LCS South Bend LLC (Iowa)

LCS Wabash LLC (Iowa)

LCS Westfield LLC (Iowa)

Paragon Outpatient Rehabilitation Services, LLC (Delaware)

Park Terrace Dialysis, LLC (Delaware)

PCA-Corrections, LLC (Kentucky)

RHS Dialysis, LLC (Delaware)

RHS Partners of Arlington, LLC (Delaware)

RHS Partners of Bloomington, LLC (Delaware)

RHS Partners of Carmel, LLC (Delaware)

RHS Partners of Castleton, LLC (Delaware)

RHS Partners of Lafayette, LLC (Delaware)

RHS Partners of Mooresville, LLC (Delaware)

RHS Partners of Richmond, LLC (Delaware)

RHS Partners of Terre Haute, LLC (Delaware)

RHS PropCo Mooresville, LLC (Delaware)

Synchrony Lab Services, LLC (Delaware)

Synchrony North Carolina, LLC (Delaware)

Synchrony Pharmacy, LLC (Delaware)

Synchrony Workforce Solutions, LLC (Delaware)

Trilogy Briar Hill Medical, LLC (Delaware)

Trilogy Construction LLC (Delaware)

Trilogy Dialysis, LLC (Delaware)

Trilogy Health Services, LLC (Delaware)

Trilogy Healthcare Centers, LLC (Kentucky)

Trilogy Healthcare Holdings, Inc. (Delaware)

Trilogy Healthcare Master Tenant II, LLC (Delaware)

Trilogy Healthcare Master Tenant IV, LLC (Delaware)

Trilogy Healthcare Master Tenant V, LLC (Delaware)

Trilogy Healthcare Master Tenant VI, LLC (Delaware)

Trilogy Healthcare Master Tenant VII, LLC (Delaware)

Trilogy Healthcare Master Tenant VIII, LLC (Delaware)

Trilogy Healthcare Master Tenant, LLC (Indiana)

Trilogy Healthcare of Allen II, LLC (Delaware)

Trilogy Healthcare of Allen, LLC (Delaware)

Trilogy Healthcare of Anderson, LLC (Delaware)

Trilogy Healthcare of Ann Arbor, LLC (Delaware)

Trilogy Healthcare of Batesville, LLC (Indiana)

Trilogy Healthcare of Battle Creek, LLC (Delaware)

Trilogy Healthcare of Beavercreek, LLC (Delaware)

Trilogy Healthcare of Bedford,, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy Healthcare of Bellevue, LLC (Delaware)

Trilogy Healthcare of Belmont, LLC (Delaware)

Trilogy Healthcare of Bloomington, LLC (Delaware)

Trilogy Healthcare of Boonville, LLC (Delaware)

Trilogy Healthcare of Bowling Green, LLC (Delaware)

Trilogy Healthcare of Bullitt, LLC (Delaware)

Trilogy Healthcare of Butler, LLC (Delaware)

Trilogy Healthcare of Carroll, LLC (Delaware)

Trilogy Healthcare of Circleville, LLC (Delaware)

Trilogy Healthcare of Clermont, LLC (Delaware)

Trilogy Healthcare of Clinton, LLC (Delaware)

Trilogy Healthcare of Columbus, LLC (Delaware)

Trilogy Healthcare of Corydon, LLC (Delaware)

Trilogy Healthcare of Cynthiana, LLC (Delaware)

Trilogy Healthcare of Daviess, LLC (Delaware)

Trilogy Healthcare of Dearborn, LLC (Delaware)

Trilogy Healthcare of Delphos, LLC (Delaware)

Trilogy Healthcare of Elkhart, LLC (Delaware)

Trilogy Healthcare of Evansville RP, LLC (Delaware)

Trilogy Healthcare of Fayette I, LLC (Kentucky)

Trilogy Healthcare of Fayette II, LLC (Delaware)

Trilogy Healthcare of Fayette III, LLC (Kentucky)

Trilogy Healthcare of Ferdinand, LLC (Delaware)

Trilogy Healthcare of Floyd, LLC (Delaware)

Trilogy Healthcare of Franklin III, LLC (Delaware)

Trilogy Healthcare of Gahanna, LLC (Delaware)

Trilogy Healthcare of Genesee, LLC (Delaware)

Trilogy Healthcare of Glen Ridge, LLC (Delaware)

Trilogy Healthcare of Goshen, LLC (Delaware)

Trilogy Healthcare of Greencastle, LLC (Indiana)

Trilogy Healthcare of Greenfield, LLC (Delaware)

Trilogy Healthcare of Greensburg, LLC (Indiana)

Trilogy Healthcare of Greenville, LLC (Indiana)

Trilogy Healthcare of Hamilton II, LLC (Delaware)

Trilogy Healthcare of Hamilton III, LLC (Delaware)

Trilogy Healthcare of Hamilton, LLC (Delaware)

Trilogy Healthcare of Hancock II, LLC (Delaware)

Trilogy Healthcare of Hancock, LLC (Delaware)

Trilogy Healthcare of Hanover, LLC (Delaware)

Trilogy Healthcare of Henry II, LLC (Indiana)

Trilogy Healthcare of Henry, LLC (Indiana)

Trilogy Healthcare of Hilliard, LLC (Delaware)

Trilogy Healthcare of Holland, LLC (Delaware)

Trilogy Healthcare of Holly, LLC (Delaware)

Trilogy Healthcare of Hudsonville, LLC (Delaware)

Trilogy Healthcare of Huron, LLC (Delaware)

Trilogy Healthcare of Ingham, LLC (Delaware)

Trilogy Healthcare of Jasper, LLC (Delaware)

Trilogy Healthcare of Jefferson II, LLC (Delaware)

Trilogy Healthcare of Jefferson, LLC (Delaware)

Trilogy Healthcare of Kalamazoo, LLC (Delaware)

Trilogy Healthcare of Kendallville, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy Healthcare of Kent, LLC (Delaware)

Trilogy Healthcare of Kokomo, LLC (Delaware)

Trilogy Healthcare of Lafayette, LLC (Delaware)

Trilogy Healthcare of LaGrange, LLC (Delaware)

Trilogy Healthcare of Lake, LLC (Delaware)

Trilogy Healthcare of Lancaster, LLC (Delaware)

Trilogy Healthcare of Lapeer, LLC (Delaware)

Trilogy Healthcare of Lawrenceburg, LLC (Delaware)

Trilogy Healthcare of Lebanon, LLC (Delaware)

Trilogy Healthcare of Liberty Township (Delaware)

Trilogy Healthcare of Lima II, LLC (Delaware)

Trilogy Healthcare of Livingston II, LLC (Delaware)

Trilogy Healthcare of Livingston, LLC (Delaware)

Trilogy Healthcare of Logansport, LLC (Delaware)

Trilogy Healthcare of Louisville East, LLC (Delaware)

Trilogy Healthcare of Louisville Northeast, LLC (Kentucky)

Trilogy Healthcare of Louisville Southwest, LLC (Delaware)

Trilogy Healthcare of Lowell, LLC (Delaware)

Trilogy Healthcare of Lucas, LLC (Delaware)

Trilogy Healthcare of Macomb, LLC (Delaware)

Trilogy Healthcare of Mercer, LLC (Delaware)

Trilogy Healthcare of Miami, LLC (Delaware)

Trilogy Healthcare of Milford, LLC (Delaware)

Trilogy Healthcare of Montgomery II, LLC (Delaware)

Trilogy Healthcare of Montgomery, LLC (Delaware)

Trilogy Healthcare of Monticello II, LLC (Delaware)

Trilogy Healthcare of Monticello, LLC (Delaware)

Trilogy Healthcare of Muncie II, LLC (Delaware)

Trilogy Healthcare of Muncie, LLC (Indiana)

Trilogy Healthcare of Muskegon, LLC (Delaware)

Trilogy Healthcare of Muskingum II, LLC (Ohio)

Trilogy Healthcare of Muskingum, LLC (Delaware)

Trilogy Healthcare of New Albany, LLC (Delaware)

Trilogy Healthcare of Noblesville, LLC (Delaware)

Trilogy Healthcare of North Baltimore, LLC (Delaware)

Trilogy Healthcare of Oakland II, LLC (Delaware)

Trilogy Healthcare of Oakland, LLC (Delaware)

Trilogy Healthcare of Oakwood, LLC (Delaware)

Trilogy Healthcare of Ottawa, LLC (Delaware)

Trilogy Healthcare of Petersburg, LLC (Delaware)

Trilogy Healthcare of Pickerington, LLC (Delaware)

Trilogy Healthcare of Portage, LLC (Delaware)

Trilogy Healthcare of Porter, LLC (Delaware)

Trilogy Healthcare of Princeton, LLC (Delaware)

Trilogy Healthcare of Putnam II, LLC (Delaware)

Trilogy Healthcare of Putnam III, LLC (Delaware)

Trilogy Healthcare of Putnam, LLC (Delaware)

Trilogy Healthcare of Richmond, LLC (Indiana)

Trilogy Healthcare of River Oaks, LLC (Delaware)

Trilogy Healthcare of Romeo, LLC (Delaware)

Trilogy Healthcare of Sandusky, LLC (Minnesota)

Trilogy Healthcare of Scottsburg, LLC (Indiana)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy Healthcare of Seymour, LLC (Delaware)

Trilogy Healthcare of Shelbyville, LLC (Indiana)

Trilogy Healthcare of Springfield, LLC (Indiana)

Trilogy Healthcare of Stonebridge, LLC (Delaware)

Trilogy Healthcare of Sylvania, LLC (Delaware)

Trilogy Healthcare of Tell City, LLC (Delaware)

Trilogy Healthcare of Tiffin, LLC (Delaware)

Trilogy Healthcare of Tippecanoe II, LLC (Delaware)

Trilogy Healthcare of Tippecanoe, LLC (Delaware)

Trilogy Healthcare of Vanderburgh III, LLC (Delaware)

Trilogy Healthcare of Vanderburgh, LLC (Delaware)

Trilogy Healthcare of Vermilion, LLC (Delaware)

Trilogy Healthcare of Vigo, LLC (Delaware)

Trilogy Healthcare of Vincennes, LLC (Delaware)

Trilogy Healthcare of Wabash, LLC (Delaware)

Trilogy Healthcare of Washtenaw, LLC (Delaware)

Trilogy Healthcare of Wood County Successor, LLC (Delaware)

Trilogy Healthcare Operations of Batesville, LLC (Indiana)

Trilogy Healthcare Operations of Greencastle, LLC (Indiana)

Trilogy Healthcare Operations of Madison, LLC (Delaware)

Trilogy Healthcare Operations of Muncie, LLC (Indiana)

Trilogy Healthcare Operations of New Castle, LLC (Indiana)

Trilogy Healthcare Operations of Richmond, LLC (Indiana)

Trilogy Healthcare Operations of Scottsburg, LLC (Indiana)

Trilogy Healthcare Operations of Shelbyville, LLC (Indiana)

Trilogy Healthcare Operations of Springfield II, LLC (Delaware)

Trilogy Healthcare Operations of Springfield, LLC (Indiana)

Trilogy Healthcare Real Estate of New Castle, LLC (Indiana)

Trilogy Investors, LLC (Delaware)

Trilogy Kalida Development, LLC (Delaware)

Trilogy Manor House Operations, LLC (Delaware)

Trilogy Manor House, LLC (Delaware)

Trilogy Mission RX, LLC (Delaware)

Trilogy North Carolina Rx LLC (Delaware)

Trilogy NuScriptRx, LLC (Delaware)

Trilogy Opco, LLC (Delaware)

Trilogy Operations Monclova Villas, LLC (Delaware)

Trilogy Operations Romeo IL, LLC (Delaware)

Trilogy Operations Springhurst Villas, LLC (Delaware)

Trilogy PCA Holdings, LLC (Delaware)

Trilogy Pro Services, LLC (Delaware)

Trilogy PropCo Finance, LLC (Delaware)

Trilogy PropCo II Finance A, LLC (Delaware)

Trilogy PropCo II Finance B, LLC (Delaware)

Trilogy PropCo II Finance C, LLC (Delaware)

Trilogy PropCo II, LLC (Delaware)

Trilogy PropCo Master Tenant I, LLC (Delaware)

Trilogy PropCo Master Tenant IV, LLC (Delaware)

Trilogy PropCo Tenant of Daviess, LLC (Delaware)

Trilogy PropCo Tenant of Hamilton, LLC (Delaware)

Trilogy PropCo Tenant of Kendallville, LLC (Delaware)

Trilogy PropCo Tenant of Louisville Northeast, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy PropCo Tenant of Lowell, LLC (Delaware)

Trilogy PropCo Tenant of Macomb, LLC (Delaware)

Trilogy PropCo Tenant of Monticello, LLC (Delaware)

Trilogy PropCo Tenant of Tell City, LLC (Delaware)

Trilogy PropCo Tenant of Vanderburgh, LLC (Delaware)

Trilogy Property Holdings, LLC (Delaware)

Trilogy Real Estate Anderson, LLC (Delaware)

Trilogy Real Estate Ann Arbor, LLC (Delaware)

Trilogy Real Estate Beavercreek, LLC (Delaware)

Trilogy Real Estate Bedford, LLC (Delaware)

Trilogy Real Estate Bellevue, LLC (Delaware)

Trilogy Real Estate Bethesda, LLC (Delaware)

Trilogy Real Estate Bloomington, LLC (Delaware)

Trilogy Real Estate Boonville, LLC (Delaware)

Trilogy Real Estate Bowling Green, LLC (Delaware)

Trilogy Real Estate Bullitt, LLC (Delaware)

Trilogy Real Estate Butler II, LLC (Delaware)

Trilogy Real Estate Butler, LLC (Delaware)

Trilogy Real Estate Circleville, LLC (Delaware)

Trilogy Real Estate Clark, LLC (Delaware)

Trilogy Real Estate Clermont, LLC (Delaware)

Trilogy Real Estate Cloister, LLC (Delaware)

Trilogy Real Estate Columbus, LLC (Delaware)

Trilogy Real Estate Corydon, LLC (Delaware)

Trilogy Real Estate Creasy Springs, LLC (Delaware)

Trilogy Real Estate Cynthiana, LLC (Delaware)

Trilogy Real Estate Delphos II, LLC (Delaware)

Trilogy Real Estate Delphos, LLC (Delaware)

Trilogy Real Estate East Lansing, LLC (Delaware)

Trilogy Real Estate English Station, LLC (Delaware)

Trilogy Real Estate Evansville RP, LLC (Delaware)

Trilogy Real Estate Fairfield, LLC (Delaware)

Trilogy Real Estate Fayette II, LLC (Delaware)

Trilogy Real Estate Fayette III, LLC (Delaware)

Trilogy Real Estate Fayette, LLC (Delaware)

Trilogy Real Estate Ferdinand II, LLC (Delaware)

Trilogy Real Estate Floyd, LLC (Delaware)

Trilogy Real Estate Forest Springs, LLC (Delaware)

Trilogy Real Estate Franklin III, LLC (Delaware)

Trilogy Real Estate Fremont, LLC (Delaware)

Trilogy Real Estate Gahanna, LLC (Delaware)

Trilogy Real Estate Genoa II, LLC (Delaware)

Trilogy Real Estate Greensburg, LLC (Delaware)

Trilogy Real Estate Greenville II, LLC (Delaware)

Trilogy Real Estate Greenville, LLC (Delaware)

Trilogy Real Estate Hamilton III, LLC (Delaware)

Trilogy Real Estate Hancock II, LLC (Delaware)

Trilogy Real Estate Hancock, LLC (Delaware)

Trilogy Real Estate Hanover II, LLC (Delaware)

Trilogy Real Estate Hanover, LLC (Delaware)

Trilogy Real Estate Harrison, LLC (Delaware)

Trilogy Real Estate Harrodsburg, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy Real Estate Hilliard, LLC (Delaware)

Trilogy Real Estate Holland, LLC (Delaware)

Trilogy Real Estate Holly, LLC (Delaware)

Trilogy Real Estate Howell, LLC (Delaware)

Trilogy Real Estate Hudsonville, LLC (Delaware)

Trilogy Real Estate Huron II, LLC (Delaware)

Trilogy Real Estate Huron, LLC (Delaware)

Trilogy Real Estate Illinois, LLC (Delaware)

Trilogy Real Estate Indiana II, LLC (Delaware)

Trilogy Real Estate Indiana III, LLC (Delaware)

Trilogy Real Estate Investment Trust (Maryland)

Trilogy Real Estate Jasper II, LLC (Delaware)

Trilogy Real Estate Jasper, LLC (Delaware)

Trilogy Real Estate Jefferson-SB, LLC (Delaware)

Trilogy Real Estate Kalamazoo, LLC (Delaware)

Trilogy Real Estate Kendallville, LLC (Delaware)

Trilogy Real Estate Kent II, LLC (Delaware)

Trilogy Real Estate Kent, LLC (Delaware)

Trilogy Real Estate Kentucky II, LLC (Delaware)

Trilogy Real Estate Kentucky III, LLC (Delaware)

Trilogy Real Estate Kentucky V, LLC (Delaware)

Trilogy Real Estate Kentucky, LLC (Delaware)

Trilogy Real Estate Kokomo II, LLC (Delaware)

Trilogy Real Estate Kokomo, LLC (Delaware)

Trilogy Real Estate Kosciusko, LLC (Delaware)

Trilogy Real Estate Lafayette II, LLC (Delaware)

Trilogy Real Estate LaGrange, LLC (Delaware)

Trilogy Real Estate Lancaster, LLC (Delaware)

Trilogy Real Estate Lima II, LLC (Delaware)

Trilogy Real Estate Lima, LLC (Delaware)

Trilogy Real Estate Livingston, LLC (Delaware)

Trilogy Real Estate Lowell, LLC (Delaware)

Trilogy Real Estate Macomb II, LLC (Delaware)

Trilogy Real Estate Macomb, LLC (Delaware)

Trilogy Real Estate Madison, LLC (Delaware)

Trilogy Real Estate Mercer, LLC (Delaware)

Trilogy Real Estate Monclova Villas, LLC (Delaware)

Trilogy Real Estate Monclova, LLC (Delaware)

Trilogy Real Estate Montgomery II, LLC (Delaware)

Trilogy Real Estate Montgomery, LLC (Delaware)

Trilogy Real Estate Muncie (Delaware)

Trilogy Real Estate Muskegon, LLC (Delaware)

Trilogy Real Estate New Albany, LLC (Delaware)

Trilogy Real Estate Noblesville, LLC (Delaware)

Trilogy Real Estate North River, LLC (Delaware)

Trilogy Real Estate Northpointe, LLC (Delaware)

Trilogy Real Estate Novi, LLC (Delaware)

Trilogy Real Estate Oakland, LLC (Delaware)

Trilogy Real Estate Oakwood, LLC (Delaware)

Trilogy Real Estate of Battle Creek, LLC (Delaware)

Trilogy Real Estate of Commerce, LLC (Delaware)

Trilogy Real Estate of Darke, LLC (Delaware)

------

**American Healthcare REIT, Inc.**

**List of Subsidiaries** — **(Continued)**

**As of March 17, 2023**

Trilogy Real Estate of Elkhart, LLC (Delaware)

Trilogy Real Estate of Findlay, LLC (Delaware)

Trilogy Real Estate of Genoa, LLC (Delaware)

Trilogy Real Estate of Goshen, LLC (Delaware)

Trilogy Real Estate of Grand Blanc, LLC (Delaware)

Trilogy Real Estate of Kalida, LLC (Delaware)

Trilogy Real Estate of Lafayette, LLC (Delaware)

Trilogy Real Estate of Lake, LLC (Delaware)

Trilogy Real Estate of Lapeer, LLC (Delaware)

Trilogy Real Estate of Lebanon, LLC (Delaware)

Trilogy Real Estate of Logansport, LLC (Delaware)

Trilogy Real Estate of Perry, LLC (Delaware)

Trilogy Real Estate of Porter, LLC (Delaware)

Trilogy Real Estate of Seymour, LLC (Delaware)

Trilogy Real Estate of Vincennes, LLC (Delaware)

Trilogy Real Estate of West Lafayette, LLC (Delaware)

Trilogy Real Estate Ohio, LLC (Delaware)

Trilogy Real Estate Okemos, LLC (Delaware)

Trilogy Real Estate Ottawa, LLC (Delaware)

Trilogy Real Estate Petersburg, LLC (Delaware)

Trilogy Real Estate Portage, LLC (Delaware)

Trilogy Real Estate Porter II, LLC (Delaware)

Trilogy Real Estate Putnam II, LLC (Delaware)

Trilogy Real Estate Romeo II, LLC (Delaware)

Trilogy Real Estate Romeo, LLC (Delaware)

Trilogy Real Estate Sanders Ridge, LLC (Delaware)

Trilogy Real Estate Seneca, LLC (Delaware)

Trilogy Real Estate Springfield, LLC (Delaware)

Trilogy Real Estate Springhurst, LLC (Delaware)

Trilogy Real Estate Stony Brook, LLC (Delaware)

Trilogy Real Estate Sylvania II, LLC (Delaware)

Trilogy Real Estate Sylvania, LLC (Delaware)

Trilogy Real Estate Union Township, LLC (Delaware)

Trilogy Real Estate Vanderburgh III, LLC (Delaware)

Trilogy Real Estate Vermilion, LLC (Delaware)

Trilogy Real Estate Vigo, LLC (Delaware)

Trilogy Real Estate Washtenaw, LLC (Delaware)

Trilogy Real Estate White Oaks II, LLC (Delaware)

Trilogy Real Estate White Oaks, LLC (Delaware)

Trilogy Rehab Services, LLC (Delaware)

Trilogy REIT Holdings, LLC (Delaware)

Trilogy RER, LLC (Delaware)

Trilogy Sky, LLC (Delaware)

Trilogy Transportation, LLC (Delaware)

Triple Creek Dialysis, LLC (Delaware)

Waterford Dialysis, LLC (Delaware)

Willows of Springhurst OpCo, LLC (Delaware)

Willows of Springhurst PropCo, LLC (Delaware)

## Exhibit 23.1

**Exhibit 23.1**

**CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM**

We consent to the incorporation by reference in Registration Statement No. 333-229301 on Form S-3 of our report dated March 17, 2023, relating to the financial statements of American Healthcare REIT, Inc., appearing in this Annual Report on Form 10-K for the year ended December 31, 2022.

/s/ Deloitte & Touche LLP

Costa Mesa, California

March 17, 2023

## Exhibit 31.1

**Exhibit 31.1**

**CERTIFICATION OF CHIEF EXECUTIVE OFFICER**

**Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002**

I, Danny Prosky, certify that:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1. I have reviewed this Quarterly Report on Form 10-K of American Healthcare REIT, Inc.;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;c) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;d) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

---

| | | |
|:---|:---|:---|
| March 17, 2023 | By: | /s/ DANNY PROSKY |
| Date |  | Danny Prosky |
|  |  | Chief Executive Officer, President and Director |
|  |  | (Principal Executive Officer) |

---

## Exhibit 31.2

**Exhibit 31.2**

**CERTIFICATION OF CHIEF FINANCIAL OFFICER**

**Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002**

I, Brian S. Peay, certify that:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;1. I have reviewed this Quarterly Report on Form 10-K of American Healthcare REIT, Inc.;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;4. The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;c) Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;d) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;5. The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of the registrant's board of directors (or persons performing the equivalent functions):

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

---

| | | |
|:---|:---|:---|
| March 17, 2023 | By: | /s/ BRIAN S. PEAY |
| Date |  | Brian S. Peay |
|  |  | Chief Financial Officer |
|  |  | (Principal Financial Officer and Principal Accounting Officer) |

---

## Exhibit 32.1

**Exhibit 32.1**

**CERTIFICATION OF CHIEF EXECUTIVE OFFICER**

**Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002**

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) the accompanying Quarterly Report on Form 10-K of the Company for the period ended December 31, 2022 (the "Report") fully complies with the requirements of Section 13(a) or Section 15(d), as applicable, of the Securities Exchange Act of 1934, as amended; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

---

| | | |
|:---|:---|:---|
| March 17, 2023 | By: | /s/ DANNY PROSKY |
| Date |  | Danny Prosky |
|  |  | Chief Executive Officer, President and Director |
|  |  | (Principal Executive Officer) |

---

## Exhibit 32.2

**Exhibit 32.2**

**CERTIFICATION OF CHIEF FINANCIAL OFFICER**

**Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002**

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) the accompanying Quarterly Report on Form 10-K of the Company for the period ended December 31, 2022 (the "Report") fully complies with the requirements of Section 13(a) or Section 15(d), as applicable, of the Securities Exchange Act of 1934, as amended; and

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

---

| | | |
|:---|:---|:---|
| March 17, 2023 | By: | /s/ BRIAN S. PEAY |
| Date |  | Brian S. Peay |
|  |  | Chief Financial Officer |
|  |  | (Principal Financial Officer and Principal Accounting Officer) |

---

<br>