Welltower
WELL
#161
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$128.46 B
Marketcap
$187.18
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Welltower Inc. is a real estate investment company that invests primarily in senior housing, assisted living, acute care facilities, medical office buildings, hospitals and other healthcare properties

Welltower - 10-Q quarterly report FY


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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
(Mark One)
   
þ  QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2009
or
   
o  TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ______________________to ______________________
Commission File number 1-8923
HEALTH CARE REIT, INC.
 
(Exact name of registrant as specified in its charter)
   
Delaware 34-1096634
   
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)
   
One SeaGate, Suite 1500, Toledo, Ohio 43604
   
(Address of principal executive office) (Zip Code)
(419) 247-2800
 
(Registrant’s telephone number, including area code)
 
(Former name, former address and former fiscal year, if changed since last report)
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to the filing requirements for at least the past 90 days. Yes þ No o
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted 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 and post such files). Yeso No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer þAccelerated filer o 
Non-accelerated filer o
(Do not check if a smaller reporting company)
Smaller reporting company o
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes o No þ
     As of October 31, 2009, the registrant had 123,011,917 shares of common stock outstanding.
 
 

 


 


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PART I. FINANCIAL INFORMATION
Item 1. Financial Statements
CONSOLIDATED BALANCE SHEETS
HEALTH CARE REIT, INC. AND SUBSIDIARIES
         
  September 30,  December 31, 
  2009  2008 
  (Unaudited)  (Note) 
  (In thousands) 
Assets
        
Real estate investments:
        
Real property owned:
        
Land and land improvements
 $523,107  $504,907 
Buildings and improvements
  4,933,561   4,653,871 
Acquired lease intangibles
  121,059   133,324 
Real property held for sale, net of accumulated depreciation
  37,118   48,054 
Construction in progress
  638,507   639,419 
 
      
Gross real property owned
  6,253,352   5,979,575 
Less accumulated depreciation and amortization
  (664,415)  (600,781)
 
      
Net real property owned
  5,588,937   5,378,794 
Real estate loans receivable:
        
Real estate loans receivable
  494,877   482,885 
Less allowance for losses on loans receivable
  (7,640)  (7,500)
 
      
Net real estate loans receivable
  487,237   475,385 
 
      
Net real estate investments
  6,076,174   5,854,179 
Other assets:
        
Equity investments
  3,020   1,030 
Deferred loan expenses
  24,755   23,579 
Cash and cash equivalents
  102,353   23,370 
Restricted cash
  17,493   154,070 
Receivables and other assets
  157,611   136,890 
 
      
Total other assets
  305,232   338,939 
 
      
Total assets
 $6,381,406  $6,193,118 
 
      
 
        
Liabilities and equity
        
Liabilities:
        
Borrowings under unsecured lines of credit arrangements
 $143,000  $570,000 
Senior unsecured notes
  1,651,916   1,831,151 
Secured debt
  625,571   446,525 
Accrued expenses and other liabilities
  124,769   107,157 
 
      
Total liabilities
  2,545,256   2,954,833 
Equity:
        
Preferred stock, $1.00 par value:
  288,683   289,929 
Authorized — 50,000,000 shares
        
Issued and outstanding — 11,474,093 shares at September 30, 2009 and 11,516,302 shares at December 31, 2008
        
Common stock, $1.00 par value:
  122,870   104,635 
Authorized — 225,000,000 shares
        
Issued — 123,090,353 shares at September 30, 2009 and 104,835,626 shares at December 31, 2008
        
Outstanding — 122,892,428 shares at September 30, 2009 and 104,703,702 shares at December 31, 2008
        
Capital in excess of par value
  3,878,872   3,204,690 
Treasury stock
  (7,619)  (5,145)
Cumulative net income
  1,510,449   1,354,400 
Cumulative dividends
  (1,968,336)  (1,723,819)
Accumulated other comprehensive income
  (4,942)  (1,113)
Other equity
  5,551   4,105 
 
      
Total Health Care REIT, Inc. stockholders’ equity
  3,825,528   3,227,682 
Noncontrolling interests
  10,622   10,603 
 
       
Total equity
  3,836,150   3,238,285 
 
      
Total liabilities and equity
 $6,381,406  $6,193,118 
 
      
 
NOTE:   The consolidated balance sheet at December 31, 2008 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by U.S. generally accepted accounting principles for complete financial statements.
See notes to unaudited consolidated financial statements

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CONSOLIDATED STATEMENTS OF INCOME (UNAUDITED)
HEALTH CARE REIT, INC. AND SUBSIDIARIES
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2009  2008  2009  2008 
  (In thousands, except per share data) 
Revenues:
                
Rental income
 $133,481  $126,384  $393,901  $357,588 
Interest income
  10,528   10,910   30,639   29,177 
Other income
  1,089   2,055   3,810   5,655 
 
            
Total revenues
  145,098   139,349   428,350   392,420 
 
                
Expenses:
                
Interest expense
  28,571   33,725   82,512   101,569 
Property operating expenses
  12,433   11,192   35,377   32,600 
Depreciation and amortization
  41,085   39,011   120,129   109,649 
General and administrative
  10,363   10,789   38,784   33,693 
Realized loss of derivatives
  0   1,513   0   1,513 
Loss (gain) on extinguishment of debt
  26,374   (768)  24,697   (2,094)
Provision for loan losses
  0   0   140   0 
 
            
Total expenses
  118,826   95,462   301,639   276,930 
 
            
 
                
Income from continuing operations before income taxes
  26,272   43,887   126,711   115,490 
Income tax (expense) benefit
  55   153   (17)  (1,170)
 
            
 
                
Income from continuing operations
  26,327   44,040   126,694   114,320 
 
                
Discontinued operations:
                
Gain (loss) on sales of properties
  (806)  12,619   26,907   130,813 
Impairment of assets
  (1,873)  0   (1,873)  0 
Income from discontinued operations, net
  1,037   2,661   4,361   10,903 
 
            
Discontinued operations, net
  (1,642)  15,280   29,395   141,716 
 
            
 
                
Net income
  24,685   59,320   156,089   256,036 
Less: Preferred stock dividends
  5,520   5,730   16,560   17,660 
Net income attributable to noncontrolling interests
  35   1   40   128 
 
                
 
            
Net income attributable to common stockholders
 $19,130  $53,589  $139,489  $238,248 
 
            
 
                
Average number of common shares outstanding:
                
Basic
  114,874   96,040   111,345   90,500 
Diluted
  115,289   96,849   111,749   91,121 
 
                
Earnings per share:
                
Basic:
                
Income from continuing operations attributable to common stockholders
 $0.18  $0.40  $0.99  $1.07 
Discontinued operations, net
  (0.01)  0.16   0.26   1.57 
 
            
Net income attributable to common stockholders*
 $0.17  $0.56  $1.25  $2.63 
 
            
 
                
Diluted:
                
Income from continuing operations attributable to common stockholders
 $0.18  $0.40  $0.99  $1.06 
Discontinued operations, net
  (0.01)  0.16   0.26   1.56 
 
            
Net income attributable to common stockholders*
 $0.17  $0.55  $1.25  $2.61 
 
            
 
                
Dividends declared and paid per common share
 $0.68  $0.68  $2.04  $2.02 
 
* Amounts may not sum due to rounding
See notes to unaudited consolidated financial statements

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CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (UNAUDITED)
HEALTH CARE REIT, INC. AND SUBSIDIARIES
                                         
  Nine Months Ended September 30, 2009
                          Accumulated      
          Capital in             Other      
  Preferred Common Excess of Treasury Cumulative Cumulative Comprehensive Other Noncontrolling  
(in thousands) Stock Stock Par Value Stock Net Income Dividends Income Equity Interests Total
   
Balances at beginning of period
 $289,929  $104,635  $3,204,690  $(5,145) $1,354,400  $(1,723,819) $(1,113) $4,105  $10,603  $3,238,285 
Comprehensive income:
                                        
Net income
                  156,049               40   156,089 
Other comprehensive income:
                                        
Unrealized gain (loss) on equity investments
                          667           667 
Cash flow hedge activity
                          (4,496)          (4,496)
 
                                        
Total comprehensive income
                                      152,260 
 
                                        
Contributions by noncontrolling interests
                                  1,946   1,946 
Distributions to noncontrolling interests
                                  (1,967)  (1,967)
Amounts related to issuance of common stock from dividend reinvestment and stock incentive plans, net of forfeitures
      1,236   44,672   (2,474)                      43,434 
Net proceeds from sale of common stock
      16,969   628,294                           645,263 
Conversion of preferred stock
  (1,246)  30   1,216                           0 
Option compensation expense
                              1,446       1,446 
Cash dividends paid:
                                        
Common stock-$2.04 per share
                      (227,959)              (227,959)
Preferred stock, Series D-$1.4766 per share
                      (5,906)              (5,906)
Preferred stock, Series E-$1.125 per share
                      (84)              (84)
Preferred stock, Series F-$1.4297 per share
                      (10,008)              (10,008)
Preferred stock, Series G-$1.4064 per share
                      (560)              (560)
   
Balances at end of period
 $288,683  $122,870  $3,878,872  $(7,619) $1,510,449  $(1,968,336) $(4,942) $5,551  $10,622  $3,836,150 
   
 
                                        
  Nine Months Ended September 30, 2008
                          Accumulated      
          Capital in             Other      
  Preferred Common Excess of Treasury Cumulative Cumulative Comprehensive Other Noncontrolling  
  Stock Stock Par Value Stock Net Income Dividends Income Equity Interests Total
   
Balances at beginning of period
 $330,243  $85,412  $2,394,099  $(3,952) $1,071,101  $(1,446,959) $(7,381) $2,701  $9,687  $2,434,951 
Comprehensive income:
                                        
Net income
                  255,908               128   256,036 
Other comprehensive income:
                                        
Unrealized gain (loss) on equity investments
                          (14)          (14)
Cash flow hedge activity
                          (4,510)          (4,510)
 
                                        
Total comprehensive income
                                      251,512 
 
                                        
Contributions by noncontrolling interests
                                  1,609   1,609 
Distributions to noncontrolling interests
                                  (2,466)  (2,466)
Amounts related to issuance of common stock from dividend reinvestment and stock incentive plans, net of forfeitures
      1,362   60,291   (1,193)              (99)      60,361 
Proceeds from issuance of common shares
      15,650   665,761                           681,411 
Conversion of preferred stock
  (28,342)  686   27,656                           0 
Option compensation expense
                              1,175       1,175 
Cash dividends paid:
                                        
Common stock-$2.02 per share
                      (183,080)              (183,080)
Preferred stock, Series D-$1.4766 per share
                      (5,906)              (5,906)
Preferred stock, Series E-$1.125 per share
                      (84)              (84)
Preferred stock, Series F-$1.4297 per share
                      (10,008)              (10,008)
Preferred stock, Series G-$1.4064 per share
                      (1,662)              (1,662)
   
Balances at end of period
 $301,901  $103,110  $3,147,807  $(5,145) $1,327,009  $(1,647,699) $(11,905) $3,777  $8,958  $3,227,813 
   
See notes to unaudited consolidated financial statements

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CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)
HEALTH CARE REIT, INC. AND SUBSIDIARIES
         
  Nine Months Ended 
  September 30, 
  2009  2008 
  (In thousands) 
Operating activities
        
Net income
 $156,089  $256,036 
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
        
Depreciation and amortization
  123,143   120,894 
Other amortization expenses
  10,999   11,217 
Provision for loan losses
  140   0 
Impairment of assets
  1,873   0 
Stock-based compensation expense
  8,734   6,726 
Loss (gain) on extinguishment of debt, net
  24,697   (2,094)
Rental income less than (in excess of) cash received
  8,964   (128)
Amortization related to above (below) market leases, net
  (1,344)  (676)
(Gain) loss on sales of properties
  (26,907)  (130,813)
Deferred gain on sales of properties
  0   3,708 
Increase (decrease) in accrued expenses and other liabilities
  (5,038)  24,128 
Decrease (increase) in receivables and other assets
  (10,901)  (4,594)
 
      
Net cash provided from (used in) operating activities
  290,449   284,404 
 
        
Investing activities
        
Investment in real property
  (417,378)  (872,011)
Capitalized interest
  (30,866)  (16,594)
Investment in real estate loans receivable
  (46,882)  (74,353)
Other investments, net of payments
  (5,455)  (2,657)
Principal collected on real estate loans receivable
  34,892   13,524 
Decrease (increase) in restricted cash
  136,577   (65,614)
Proceeds from sales of real property
  153,507   208,294 
Other
  (13,514)  (7,311)
 
      
Net cash provided from (used in) investing activities
  (189,119)  (816,722)
 
        
Financing activities
        
Net increase (decrease) under unsecured lines of credit arrangements
  (427,000)  80,000 
Payments to extinguish senior unsecured notes
  (201,048)  (42,330)
Net proceeds from the issuance of secured debt
  276,277   0 
Principal payments on secured debt
  (102,635)  (53,050)
Net proceeds from the issuance of common stock
  683,883   737,325 
Decrease (increase) in deferred loan expenses
  (7,286)  (26)
Contributions by noncontrolling interests
  1,946   1,609 
Distributions to noncontrolling interests
  (1,967)  (2,466)
Cash distributions to stockholders
  (244,517)  (200,740)
 
      
Net cash provided from (used in) financing activities
  (22,347)  520,322 
 
      
Increase (decrease) in cash and cash equivalents
  78,983   (11,996)
Cash and cash equivalents at beginning of period
  23,370   30,269 
 
      
Cash and cash equivalents at end of period
 $102,353  $18,273 
 
      
 
        
Supplemental cash flow information:
        
Interest paid
 $100,365  $112,890 
Income taxes paid
  534   1,576 
See notes to unaudited consolidated financial statements

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
1. Business
          Health Care REIT, Inc., an S&P 500 company with headquarters in Toledo, Ohio, is an equity real estate investment trust (“REIT”) that invests in senior housing and health care real estate. Our full service platform also offers property management and development services to our customers. As of September 30, 2009, our broadly diversified portfolio consisted of 608 properties in 39 states. Founded in 1970, we were the first real estate investment trust to invest exclusively in health care facilities. More information is available on our website at www.hcreit.com.
2. Accounting Policies and Related Matters
Basis of Presentation
          The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and with instructions to Quarterly Report on Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the nine months ended September 30, 2009 are not necessarily an indication of the results that may be expected for the year ending December 31, 2009. For further information, refer to the financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009.
3. Real Property Acquisitions and Development
          The following is a summary of our real property investment activity for the periods presented (in thousands):
                         
  Nine Months Ended 
  September 30, 2009  September 30, 2008 
  Investment  Medical Office      Investment  Medical Office    
  Properties  Buildings  Totals  Properties  Buildings  Totals 
Real property acquisitions:
                        
Independent living/CCRCs
 $0      $0  $68,300      $68,300 
Assisted living facilities
          0   45,490       45,490 
Skilled nursing facilities
          0   11,360       11,360 
Specialty care facilities
          0   182,303       182,303 
Medical office buildings
     $0   0      $121,809   121,809 
Land parcels
          0   10,000       10,000 
 
                  
Total acquisitions
  0   0   0   317,453   121,809   439,262 
Less: Assumed debt
          0       0   0 
Assumed other assets (liabilities), net
          0       (1,599)  (1,599)
 
                  
Cash disbursed for acquisitions
  0   0   0   317,453   120,210   437,663 
Construction in progress additions:
                        
Independent living/CCRCs
  131,077       131,077   198,080       198,080 
Assisted living facilities
  118,989       118,989   91,208       91,208 
Skilled nursing facilities
  19,534       19,534   19,199       19,199 
Specialty care facilities
  82,671       82,671   60,560       60,560 
Medical office buildings
      96,642   96,642       62,129   62,129 
 
                  
Total construction in progress additions
  352,271   96,642   448,913   369,047   62,129   431,176 
Less: Capitalized interest
  (26,147)  (4,719)  (30,866)  (15,624)  (970)  (16,594)
Capitalized other
          0   (119)      (119)
Accruals (1)
      (21,466)  (21,466)          0 
 
                  
Cash disbursed for construction in progress
  326,124   70,457   396,581   353,304   61,159   414,463 
Capital improvements to existing properties
  11,938   8,859   20,797   14,540   5,345   19,885 
 
                  
Total cash invested in real property
 $338,062  $79,316  $417,378  $685,297  $186,714  $872,011 
 
                  
 
(1) Represents non-cash accruals for amounts to be paid in future periods relating to properties that converted in the period noted above.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
          The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented:
                         
  Nine Months Ended 
  September 30, 2009  September 30, 2008 
  Investment  Medical Office      Investment  Medical Office    
  Properties  Buildings  Totals  Properties  Buildings  Totals 
Development projects:
                        
Independent living/CCRCs
 $102,621      $102,621  $120,452      $120,452 
Assisted living facilities
  154,835       154,835   39,446       39,446 
Skilled nursing facilities
  14,561       14,561           0 
Specialty care facilities
          0   35,151       35,151 
Medical office buildings
     $173,744   173,744      $11,823   11,823 
 
                  
Total development projects
  272,017   173,744   445,761   195,049   11,823   206,872 
Expansion projects
  4,064       4,064   40,341       40,341 
 
                  
Total construction in progress conversions
 $276,081  $173,744  $449,825  $235,390  $11,823  $247,213 
 
                  
4. Real Estate Intangibles
          The following is a summary of our real estate intangibles as of the dates indicated (dollars in thousands):
         
  September 30,  December 31, 
  2009  2008 
Assets:
        
In place lease intangibles
 $71,679  $81,500 
Above market tenant leases
  6,929   9,658 
Below market ground leases
  39,806   39,806 
Lease commissions
  2,645   2,360 
 
      
Gross historical cost
  121,059   133,324 
Accumulated amortization
  (28,087)  (31,452)
 
      
Net book value
 $92,972  $101,872 
 
      
Weighted-average amortization period in years
  30.2   28.9 
 
        
Liabilities:
        
Below market tenant leases
 $22,989  $25,265 
Above market ground leases
  3,419   3,419 
 
      
Gross historical cost
  26,408   28,684 
Accumulated amortization
  (9,588)  (8,671)
 
      
Net book value
 $16,820  $20,013 
 
      
Weighted-average amortization period in years
  12.0   8.9 
5. Dispositions, Assets Held for Sale and Discontinued Operations
          At September 30, 2009, we had six skilled nursing facilities that satisfied the requirements for held for sale treatment. We did not recognize any impairment loss on these properties in 2009 as the fair value less estimated costs to sell exceeded our carrying values. Also, at September 30, 2009, we had four medical office buildings that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2009, an impairment charge of $1,873,000 was recorded to further reduce the carrying value of the four medical office buildings to their estimated fair value less costs to sell. In determining the fair value of the medical office buildings, we used a combination of third party appraisals based on market comparable transactions, other market listings and asset quality as well as third party offers to purchase. During the year ended December 31, 2008, an impairment charge of $32,648,000 was recorded to reduce the carrying value of 14 medical office buildings to their estimated fair value less costs to sell. In determining the fair value of the medical office buildings, we used a combination of third party appraisals based on market comparable transactions, other market listings and asset quality as well as management calculations based on projected operating income and published capitalization rates. The following is a summary of our real property disposition activity for the periods presented (in thousands):

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
                         
  Nine Months Ended 
  September 30, 2009  September 30, 2008 
  Investment  Medical Office      Investment  Medical Office    
  Properties  Buildings  Totals  Properties  Buildings  Totals 
Real property dispositions:
                        
Independent living/CCRCs
 $24,340      $24,340  $15,547      $15,547 
Assisted living facilities
  20,537       20,537   106,740       106,740 
Skilled nursing facilities
  18,854       18,854   4,489       4,489 
Specialty care facilities
  40,841       40,841   8,735       8,735 
Medical office buildings
     $28,128   28,128   0  $6,781   6,781 
Land parcels
          0   73       73 
 
                  
Total dispositions
  104,572   28,128   132,700   135,584   6,781   142,365 
Less: Gain/(loss) on sales of real property
  27,713   (806)  26,907   131,874   (1,061)  130,813 
Extinguishment of other assets/(liabilities)
          0       (113)  (113)
Seller financing on sales of real property
      (6,100)  (6,100)  (59,649)  (5,122)  (64,771)
 
                  
Proceeds from real property sales
 $132,285  $21,222  $153,507  $207,809  $485  $208,294 
 
                  
          We have reclassified the income and expenses attributable to all properties sold and attributable to properties held for sale at September 30, 2009 to discontinued operations. Expenses include an allocation of interest expense based on property carrying values and our weighted average cost of debt. The following illustrates the reclassification impact as a result of classifying properties as discontinued operations for the periods presented (in thousands):
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2009  2008  2009  2008 
Rental income
 $1,840  $7,645  $10,662  $31,418 
Expenses:
                
Interest expense
  262   1,629   1,664   7,261 
Property operating expenses
  541   676   1,623   2,009 
Provision for depreciation
  0   2,679   3,014   11,245 
 
            
Income from discontinued operations, net
 $1,037  $2,661  $4,361  $10,903 
 
            
6. Real Estate Loans Receivable
          All real estate loans receivable are in our investment property segment. The following is a summary of our real estate loan activity for the periods presented (in thousands):
         
  Nine Months Ended 
  September 30,  September 30, 
  2009  2008 
Advances on real estate loans receivable:
        
Investments in new loans
 $3,316  $120,961 
Draws on existing loans
  43,566   13,041 
 
      
Total gross investments in real estate loans
  46,882   134,002 
Less: Seller financing on sales of real property
  0   (59,649)
 
      
Net cash advances on real estate loans receivable
  46,882   74,353 
Receipts on real estate loans receivable:
        
Loan payoffs
  20,440   8,815 
Principal payments on loans
  14,452   4,709 
 
      
Total principal receipts on real estate loans
  34,892   13,524 
 
      
Net cash advances (receipts) on real estate loans receivable
 $11,990  $60,829 
 
      

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
7. Customer Concentration
          At September 30, 2009, we had 64 investment property operators and over 800 medical office building tenants. The following table summarizes certain information about our customer concentration as of September 30, 2009 (dollars in thousands):
             
  Number of  Total  Percent of 
  Properties  Investment  Investment (2) 
Concentration by investment (1):
            
Senior Living Communities, LLC
  10  $396,649   7%
Brookdale Senior Living, Inc.
  86   307,920   5%
Signature Healthcare LLC
  34   307,574   5%
Emeritus Corporation
  21   241,276   4%
Life Care Centers of America, Inc
  18   206,099   3%
Remaining portfolio
  439   4,624,296   76%
 
         
Totals
  608  $6,083,814   100%
 
         
 
(1) All of our top five customers are in our investment properties segment.
 
(2) Investments with our top five customers comprised 25% of total investments at December 31, 2008.
8. Borrowings Under Line of Credit Arrangement and Related Items
          At September 30, 2009, we had an unsecured line of credit arrangement with a consortium of sixteen banks in the amount of $1,150,000,000, which is scheduled to expire on August 5, 2011 (with the ability to extend for one year at our discretion if we are in compliance with all covenants). Borrowings under the agreement are subject to interest payable in periods no longer than three months at either the agent bank’s prime rate of interest or the applicable margin over LIBOR interest rate, at our option (0.85% at September 30, 2009). The applicable margin is based on our ratings with Moody’s Investors Service and Standard & Poor’s Ratings Services and was 0.6% at September 30, 2009. In addition, we pay a facility fee annually to each bank based on the bank’s commitment amount. The facility fee depends on our ratings with Moody’s Investors Service and Standard & Poor’s Ratings Services and was 0.15% at September 30, 2009. We also pay an annual agent’s fee of $50,000. Principal is due upon expiration of the agreement.
          The following information relates to aggregate borrowings under the unsecured line of credit arrangement for the periods presented (dollars in thousands):
                 
  Three Months Ended Nine Months Ended
  September 30, September 30,
  2009 2008 2009 2008
Balance outstanding at quarter end
 $143,000  $387,000  $143,000  $387,000 
Maximum amount outstanding at any month end
 $292,000  $701,000  $559,000  $744,000 
Average amount outstanding (total of daily principal balances divided by days in period)
 $217,174  $577,717  $301,740  $509,307 
Weighted average interest rate (actual all-in interest/fees expense divided by average borrowings outstanding)
  1.99%  3.53%  1.76%  3.85%

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
9. Senior Unsecured Notes and Secured Debt
          We have $1,651,916,000 of senior unsecured notes with annual interest rates ranging from 4.75% to 8.00%. The carrying amounts of the senior unsecured notes represent the par value of $1,661,853,000 adjusted for any unamortized premiums or discounts and other basis adjustments related to hedging the debt with derivative instruments. See Note 10 for further discussion regarding derivative instruments. During the nine months ended September 30, 2009, we extinguished $183,147,000 of senior unsecured notes principal for $201,048,000 and recognized debt extinguishment losses of $19,269,000.
          We have secured debt totaling $625,571,000, collateralized by owned properties, with annual interest rates ranging from 4.89% to 6.99%. The carrying amounts of the secured debt represent the par value of $627,790,000 adjusted for any unamortized fair value adjustments. The carrying values of the properties securing the debt totaled $908,536,000 at September 30, 2009. During the nine months ended September 30, 2009, we completed $276,277,000 of first mortgage loans secured by 31 senior housing properties with multiple levels of service and one commercial office campus. During the nine months ended September 30, 2009, we extinguished $79,743,000 of secured debt prior to maturity and recognized debt extinguishment losses of $5,428,000.
          Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of September 30, 2009, we were in compliance with all of the covenants under our debt agreements.
          At September 30, 2009, the annual principal payments due on these debt obligations were as follows (in thousands):
             
  Senior  Secured    
  Unsecured Notes (1)  Debt (1)  Totals 
2009
 $0  $2,786  $2,786 
2010
  0   12,250   12,250 
2011
  0   12,920   12,920 
2012
  76,853   19,060   95,913 
2013
  300,000   67,828   367,828 
Thereafter
  1,285,000   512,946   1,797,946 
 
         
Totals
 $1,661,853  $627,790  $2,289,643 
 
         
 
(1) Amounts represent principal amounts due and do not include unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet.
10. Derivative Instruments
          We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates. We may elect to use financial derivative instruments to hedge interest rate exposure. These decisions are principally based on our policy to manage the general trend in interest rates at the applicable dates and our perception of the future volatility of interest rates. Derivatives are recorded at fair market value on the balance sheet as assets or liabilities. The valuation of derivative instruments requires us to make estimates and judgments that affect the fair value of the instruments. Fair values for our derivatives are estimated by pricing models that consider forward yield curves and discount rates. Such amounts and the recognition of such amounts are subject to significant estimates that may change in the future.
          The following is a summary of the fair value of our derivative instruments (dollars in thousands):
             
  Balance Sheet Fair Value
  Location Sep. 30, 2009 Dec. 31, 2008
Cash flow hedge interest rate swaps
 Other liabilities $4,375  $0 

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
Cash Flow Hedges
     For instruments that are designated and qualify as a cash flow hedge, the effective portion of the gain or loss on the derivative is reported as a component of OCI, and reclassified into earnings in the same period, or periods, during which the hedged transaction affects earnings. Gains and losses on the derivative representing either hedge ineffectiveness or hedge components excluded from the assessment of effectiveness are recognized in earnings. Approximately $2,936,000 of losses, which are included in other comprehensive income, are expected to be reclassified into earnings in the next 12 months.
     The following presents the impact of derivative instruments on the statement of operations and OCI for the three and nine months ended September 30, 2009 (dollars in thousands):
                                     
    Gain (Loss) Recognized in Income
  Gain (Loss)Gain (Loss) Reclass from AOCI(Ineffective Portion and Amount
  Recognized in OCIinto Income (Effective Portion)Excluded from Effectiveness Testing)
  (Effective Portion)  Amount  Amount
  Three Nine  Three Nine  Three Nine
  Months Months  Months Months  Months Months
  Ended EndedLocation Ended EndedLocation Ended Ended
         
Interest rate swap
 $(4,644) $(4,644)
Interest expense
 $229  $148 Realized loss $0  $0 
     On August 7, 2009, we entered into an interest rate swap (the “August 2009 Swap”) for a total notional amount of $52,198,000 to hedge seven years of interest payments associated with long-term LIBOR based borrowings. The August 2009 Swap has an effective date of August 12, 2009 and a maturity date of September 1, 2016. The August 2009 Swap has the economic effect of fixing $52,198,000 at 3.93% plus a credit spread for seven years. The August 2009 Swap has been designated as a cash flow hedge and we expect it to be highly effective at offsetting changes in cash flows of interest payments on $52,198,000 of long-term debt due to changes in the LIBOR swap rate.
     On September 28, 2009, we entered into an interest rate swap (the “September 2009 Swap”) for a total notional amount of $48,155,000 to hedge seven years of interest payments associated with long-term LIBOR based borrowings. The September 2009 Swap has an effective date of September 30, 2009 and a maturity date of October 1, 2016. The September 2009 Swap has the economic effect of fixing $48,155,000 at 3.2675% plus a credit spread for seven years. The September 2009 Swap has been designated as a cash flow hedge and we expect it to be highly effective at offsetting changes in cash flows of interest payments on $48,155,000 of long-term debt due to changes in the LIBOR swap rate.
     During the three months ended September 30, 2008, we recognized a realized loss on derivatives of $1,513,000 related to forward rate-interest rate swaps that were in place to hedge future debt issuances when the timing of those issuances were revised.
Fair Value Hedges
     For derivative instruments that are designated as a fair value hedge, the gain or loss on the derivative as well as the offsetting loss or gain on the hedged risk are recognized in current earnings. There were no outstanding fair value hedges at September 30, 2009.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
11. Commitments and Contingencies
     We have an outstanding letter of credit issued for the benefit of certain insurance companies that provide workers’ compensation insurance to one of our tenants. Our obligation to provide the letter of credit terminates in 2009. At September 30, 2009, our obligation under the letter of credit was $2,450,000.
     We have an outstanding letter of credit issued for the benefit of certain insurance companies that provide liability insurance to one of our tenants. Our obligation to the tenant to provide the letter of credit terminates in 2013. At September 30, 2009, our obligation under the letter of credit was $1,000,000.
     We have an outstanding letter of credit issued for the benefit of a village in Illinois that secures the completion and installation of certain public improvements by one of our tenants in connection with the development of a property. Our obligation to provide the letter of credit terminates in 2010. At September 30, 2009, our obligation under the letter of credit was $129,057.
     We have an outstanding letter of credit issued for the benefit of a municipality in Pennsylvania in connection with the completion and installation of certain property improvements by one of our subsidiaries. The improvements are expected to be approved by the municipality in 2009. At September 30, 2009, our obligation under the letter of credit was $485,810.
     We have an outstanding letter of credit issued for the benefit of a lender as additional credit support for a secured loan of a medical office building. Our obligation to provide the letter of credit terminates when the building’s occupancy thresholds are met with qualified leases. At September 30, 2009, our obligation under the letter of credit was $475,000.
     At September 30, 2009, we had outstanding construction financings of $638,507,000 for leased properties and were committed to providing additional financing of approximately $328,553,000 to complete construction. At September 30, 2009, we had contingent purchase obligations totaling $9,446,000. These contingent purchase obligations primarily relate to deferred acquisition fundings and capital improvements. Deferred acquisition fundings are contingent upon an operator satisfying certain conditions such as payment coverage and value tests. Rents due from the tenant are increased to reflect the additional investment in the property.
     At September 30, 2009, we had operating lease obligations of $176,093,000 relating to certain ground leases and company office space. We incurred rental expense relating to our company office space of $302,000 and $899,000 for the three and nine months ended September 30, 2009, respectively, as compared to $339,000 and $883,000 for the same periods in 2008. Regarding the ground leases, we have sublease agreements with certain of our operators that require the operators to reimburse us for our monthly operating lease obligations. At September 30, 2009, aggregate future minimum rentals to be received under these noncancelable subleases totaled $30,113,000.
     At September 30, 2009, future minimum lease payments due under operating leases were as follows (in thousands):
     
2009
 $1,123 
2010
  4,422 
2011
  4,487 
2012
  4,167 
2013
  4,179 
Thereafter
  157,715 
 
   
Totals
 $176,093 
 
   
12. Stockholders’ Equity
     Preferred Stock. During the nine months ended September 30, 2009, certain holders of our Series E Cumulative Convertible and Redeemable Preferred Stock converted 609 shares into 466 shares of our common stock, leaving 74,380 of such shares outstanding at September 30, 2009. During the nine months ended September 30, 2009, certain holders of our Series G Cumulative Convertible Preferred Stock converted 41,600 shares into 29,771 shares of our common stock, leaving 399,713 of such shares outstanding at September 30, 2009.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
     Common Stock. The following is a summary of our common stock issuances during the nine months ended September 30, 2009 and 2008 (dollars in thousands, except per share amounts):
                 
  Shares Issued  Average Price  Gross Proceeds  Net Proceeds 
 
March 2008 public issuance
  3,000,000  $41.44  $124,320  $118,555 
July 2008 public issuance
  4,600,000   44.50   204,700   193,157 
September 2008 public issuance
  8,050,000   48.00   386,400   369,699 
2008 Dividend reinvestment plan issuances
  1,165,441   45.19   52,668   52,668 
2008 Option exercises
  111,395   29.14   3,246   3,246 
 
             
2008 Totals
  16,926,836      $771,334  $737,325 
 
             
 
                
February 2009 public issuance
  5,816,870  $36.85  $214,352  $210,880 
September 2009 public issuance
  9,200,000   40.40   371,680   356,691 
2009 Equity shelf plan issuances
  1,952,600   40.69   79,447   77,692 
2009 Dividend reinvestment plan issuances
  1,099,340   35.05   38,528   38,528 
2009 Option exercises
  3,434   26.67   92   92 
 
             
2009 Totals
  18,072,244      $704,099  $683,883 
 
             
     On February 20, 2009, we paid a dividend of $0.68 per share to stockholders of record on January 31, 2009. These dividends related to the period from October 1, 2008 through December 31, 2008. On May 20, 2009, we paid a dividend of $0.68 per share to stockholders of record on May 11, 2009. These dividends related to the period from January 1, 2009 to March 31, 2009. On August 20, 2009, we paid a dividend of $0.68 per share to stockholders of record on August 10, 2009. These dividends related to the period from April 1, 2009 to June 30, 2009.
Comprehensive Income
     The following is a summary of accumulated other comprehensive income as of the dates indicated (in thousands):
         
  September 30, 2009  December 31, 2008 
Unrecognized gains (losses) on cash flow hedges
 $(3,861) $635 
Unrecognized gains (losses) on equity investments
  (371)  (1,038)
Unrecognized actuarial gains (losses)
  (710)  (710)
 
      
Totals
 $(4,942) $(1,113)
 
      
     The following is a summary of comprehensive income for the periods indicated (in thousands):
                 
  Three Months Ended  Nine Months Ended 
  September 30  September 30, 
  2009  2008  2009  2008 
Unrecognized gains (losses) on cash flow hedges
 $(4,415) $(3,934) $(4,496) $(4,510)
Unrecognized losses (gains) on equity investments
  489   575   667   (14)
 
            
Total other comprehensive income
  (3,926)  (3,359)  (3,829)  (4,524)
Net income attributable to controlling interests
  24,650   59,319   156,049   255,908 
 
            
Comprehensive income attributable to controlling interests
  20,724   55,960   152,220   251,384 
Net and comprehensive income attributable to noncontrolling interests
  35   1   40   128 
 
            
Total comprehensive income
 $20,759  $55,961  $152,260  $251,512 
 
            
Other Equity
     Other equity consists of accumulated option compensation expense, which represents the amount of amortized compensation costs related to stock options awarded to employees and directors subsequent to January 1, 2003. Expense, which is recognized as the options vest based on the market value at the date of the award, totaled $182,000 and $1,446,000 for the three and nine months ended September 30, 2009, respectively, as compared to $241,000 and $1,175,000 for the same periods in 2008.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
13. Stock Incentive Plans
     Our 2005 Long-Term Incentive Plan, as amended and restated effective May 7, 2009, authorizes up to 6,200,000 shares of common stock to be issued at the discretion of the Compensation Committee of the Board of Directors. The 2005 Plan replaced the 1995 Stock Incentive Plan and the Stock Plan for Non-Employee Directors. The options granted to officers and key employees under the 1995 Plan continue to vest through 2010 and expire ten years from the date of grant. Our non-employee directors, officers and key employees are eligible to participate in the 2005 Plan. The 2005 Plan allows for the issuance of, among other things, stock options, restricted stock, deferred stock units and dividend equivalent rights. Vesting periods for options, deferred stock units and restricted shares generally range from three years for non-employee directors to five years for officers and key employees. Options expire ten years from the date of grant.
Valuation Assumptions
     The fair value of each option grant is estimated on the date of grant using the Black-Scholes-Merton option pricing model with the following weighted-average assumptions:
         
  Nine Months Ended Nine Months Ended
  September 30, 2009 September 30, 2008
Dividend yield (1)
  7.35%  6.47%
Expected volatility
  29.36%  20.52%
Risk-free interest rate
  2.33%  3.42%
Expected life (in years)
  7.0   6.5 
Weighted-average fair value (1)
 $4.38  $6.25 
 
(1) Certain options granted to employees in 2008 include dividend equivalent rights (“DERs”). The fair value of options with DERs also includes the net present value of projected future dividend payments over the expected life of the option discounted at the dividend yield rate.
     The dividend yield represented the dividend yield of our common stock on the dates of grant. Our computation of expected volatility was based on historical volatility. The risk-free interest rates used were the 7-year U.S. Treasury Notes yield on the date of grant. The expected life was based on historical experience of similar awards, giving consideration to the contractual terms, vesting schedules and expectations regarding future employee behavior.
Option Award Activity
     The following table summarizes information about stock option activity for the nine months ended September 30, 2009:
                 
  Number          
  of  Weighted  Weighted Average  Aggregate 
  Shares  Average  Remaining  Intrinsic 
Stock Options (000’s)  Exercise Price  Contract Life (years)  Value ($000’s) 
Options at beginning of year
  817  $38.29   8.2     
Options granted
  366   37.00         
Options exercised
  (3)  26.67         
Options terminated
  (5)  40.57         
 
            
Options at end of period
  1,175  $37.92   8.1  $4,843 
 
            
Options exercisable at end of period
  500  $36.75   6.5  $2,680 
Weighted average fair value of options granted during the period
     $4.38         
     The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying options and the quoted price of our common stock for the options that were in-the-money at September 30, 2009. During the nine months ended September 30, 2009, the aggregate intrinsic value of options exercised under our stock incentive plans was $54,000 (determined as of the date of option exercise). During the nine months ended September 30, 2008, the aggregate intrinsic value of options exercised under our stock incentive plans was $1,890,000 (determined as of the date of option exercise). Cash received from option exercises under our stock incentive plans was $92,000 and $3,246,000 for the nine months ended September 30, 2009 and 2008, respectively.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
     As of September 30, 2009, there was approximately $2,061,000 of total unrecognized compensation cost related to unvested stock options granted under our stock incentive plans. That cost is expected to be recognized over a weighted average period of four years. As of September 30, 2009, there was approximately $7,382,000 of total unrecognized compensation cost related to unvested restricted stock granted under our stock incentive plans. That cost is expected to be recognized over a weighted average period of three years.
     The following table summarizes information about non-vested stock incentive awards as of September 30, 2009 and changes for the nine months ended September 30, 2009:
                 
  Stock Options  Restricted Stock 
  Number of  Weighted Average  Number of  Weighted Average 
  Shares  Grant Date  Shares  Grant Date 
  (000’s)  Fair Value  (000’s)  Fair Value 
Non-vested at December 31, 2008
  534  $6.98   443  $41.95 
Vested
  (220)  7.41   (196)  41.48 
Granted
  366   4.38   160   37.07 
Terminated
  (5)  6.14   (2)  40.65 
 
            
Non-vested at September 30, 2009
  675  $5.44   405  $40.26 
 
            
14. Earnings Per Share
     The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data):
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2009  2008  2009  2008 
 
                
Numerator for basic and diluted earnings per share — net income attributable to common stockholders
 $19,130  $53,589  $139,489  $238,248 
 
            
 
                
Denominator for basic earnings per share — weighted average shares
  114,874   96,040   111,345   90,500 
Effect of dilutive securities:
                
Employee stock options
  11   146   0   98 
Non-vested restricted shares
  404   455   404   454 
Convertible senior unsecured notes
  0   208   0   69 
 
            
Dilutive potential common shares
  415   809   404   621 
 
            
Denominator for diluted earnings per share — adjusted weighted average shares
  115,289   96,849   111,749   91,121 
 
            
 
                
Basic earnings per share
 $0.17  $0.56  $1.25  $2.63 
 
            
Diluted earnings per share
 $0.17  $0.55  $1.25  $2.61 
 
            
     The diluted earnings per share calculations exclude the dilutive effect of 418,000 and 885,000 stock options for the three and nine months ended September 30, 2009, respectively, because the exercise prices were greater than the average market price. The diluted earnings per share calculations do not exclude the dilutive effect of any stock options for the three or nine months ended September 30, 2008, because the exercise prices were less than the average market price. The Series E Cumulative Convertible and Redeemable Preferred Stock, the Series G Cumulative Convertible Preferred Stock, the $340,000,000 senior unsecured convertible notes due December 2026 and the $395,000,000 senior unsecured convertible notes due July 2027 were not included in these calculations as the effect of the conversions into common stock was anti-dilutive for the relevant periods presented.
     We adopted FASB authoritative guidance on determining whether instruments granted in share-based payment transactions are participating securities, effective January 1, 2009, which required retrospective application. The guidance clarifies that instruments granted in share-based payment transactions that are considered to be participating securities prior to vesting should be included in the earnings allocation under the two-class method of calculating earnings per share. We determined that our restricted shares granted under our long-term incentive plans are participating securities because the restricted shares participate in non-forfeitable dividends prior to vesting. Applying the guidance did not have an impact on previously reported amounts for any period presented.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
15. Disclosure about Fair Value of Financial Instruments
     The following methods and assumptions were used to estimate the fair value of each class of financial instruments for which it is practicable to estimate that value.
Mortgage Loans and Other Real Estate Loans Receivable — The fair value of mortgage loans and other real estate loans receivable is generally estimated by discounting the estimated future cash flows using the current rates at which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities.
Cash and Cash Equivalents — The carrying amount approximates fair value.
Equity Investments — Equity investments are recorded at their fair market value.
Borrowings Under Unsecured Lines of Credit Arrangements — The carrying amount of the unsecured line of credit arrangement approximates fair value because the borrowings are interest rate adjustable.
Senior Unsecured Notes — The fair value of the senior unsecured notes payable was estimated based on publicly available trading prices.
Secured Debt — The fair value of fixed rate secured debt is estimated by discounting the estimated future cash flows using the current rates at which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. The carrying amount of variable rate secured debt approximates fair value because the borrowings are interest rate adjustable.
Interest Rate Swap Agreements — Interest rate swap agreements, if any, are recorded as assets or liabilities on the balance sheet at fair market value. Fair market value is estimated by utilizing pricing models that consider forward yield curves and discount rates.
     The carrying amounts and estimated fair values of our financial instruments are as follows (in thousands):
                 
  September 30, 2009  December 31, 2008 
  Carrying  Fair  Carrying  Fair 
  Amount  Value  Amount  Value 
Financial Assets:
                
Mortgage loans receivable
 $125,456  $127,272  $137,292  $143,285 
Other real estate loans receivable
  369,421   373,153   345,593   302,584 
Equity investments
  3,020   3,020   1,030   1,030 
Cash and cash equivalents
  102,353   102,353   23,370   23,370 
 
                
Financial Liabilities:
                
Borrowings under unsecured lines of credit arrangements
 $143,000  $143,000  $570,000  $570,000 
Senior unsecured notes
  1,651,916   1,748,454   1,831,151   1,605,770 
Secured debt
  625,571   635,943   446,525   452,262 
Interest rate swap agreements
  4,375   4,375   n/a   n/a 
     U.S. GAAP provides authoritative guidance for measuring and disclosing fair value measurements of assets and liabilities. The guidance for financial assets and liabilities was previously adopted as the standard for those assets and liabilities as of January 1, 2008. Additional guidance for non-financial assets and liabilities is effective for fiscal years beginning after November 15, 2008, and was adopted as the standard for those assets and liabilities as of January 1, 2009. The impact of adoption was not significant. The guidance defines fair value as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. The guidance also establishes a fair value hierarchy which requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The guidance describes three levels of inputs that may be used to measure fair value:
Level 1 — Quoted prices in active markets for identical assets or liabilities.
Level 2 — Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Interest rate swap agreements are valued using models that assume a hypothetical transaction to sell the asset or transfer the liability in the principal market for the asset or liability based on market data derived from interest rates and yield curves observable at commonly quoted intervals, volatilities, prepayment timing, loss severities, credit risks and default rates.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
Level 3 — Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.
     The market approach is utilized to measure fair value for our financial assets and liabilities. The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities.
                 
  Fair Value Measurements as of September 30, 2009 
(in thousands) Total  Level 1  Level 2  Level 3 
Equity investments (1)
 $1,229  $1,229  $0  $0 
Assets-held-for sale (2)
  10,137   0   10,137   0 
Interest rate swap agreements (3)
  (4,375)  0   (4,375)  0 
 
            
Totals
 $6,991  $1,229  $5,762  $0 
 
            
 
(1) Unrealized gains or losses on equity investments are recorded in accumulated other comprehensive income (loss) at each measurement date.
 
(2) Please see Note 5 for additional information.
 
(3) Please see Note 10 for additional information.
16. Segment Reporting
     We invest in senior housing and health care real estate. We evaluate our business and make resource allocations on our two business segments — investment properties and medical office buildings. Under the investment property segment, we invest in senior housing and health care real estate through acquisition and financing of primarily single tenant properties. Properties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our primary investment property types include skilled nursing facilities, assisted living facilities, independent living/continuing care retirement communities and specialty care facilities. Under the medical office building segment, our properties are typically leased to multiple tenants and generally require a certain level of property management. The accounting policies of the segments are the same as those described in the summary of significant accounting policies (see Note 1 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009). There are no intersegment sales or transfers. We evaluate performance based upon net operating income of the combined properties in each segment. Non-segment revenue consists mainly of interest income on non-real estate investments and other income. Non-segment assets consist of corporate assets including cash, deferred loan expenses and corporate office equipment. Non-property specific revenues and expenses are not allocated to individual segments in determining net operating income. Summary information for the reportable segments during the three months ended September 30, 2009 and 2008 is as follows (in thousands):
                                     
                  Property  Net  Real Estate       
  Rental  Interest  Other  Total  Operating  Operating  Depreciation/  Interest  Total 
  Income (1)  Income  Income  Revenues (1)  Expenses (1)  Income (2)  Amortization (1)  Expense (1)  Assets 
Three months ended September 30, 2009:
                                    
Investment Properties
 $100,313  $10,528  $641  $111,482      $111,482  $28,313  $3,625  $4,771,518 
Medical Office Buildings
  35,008       248   35,256  $12,974   22,282   12,772   5,151   1,448,989 
Non-segment/Corporate
          200   200       200       20,057   160,899 
 
                           
 
 $135,321  $10,528  $1,089  $146,938  $12,974  $133,964  $41,085  $28,833  $6,381,406 
 
                           
 
                                    
Three months ended September 30, 2008:
                                    
Investment Properties
 $100,071  $10,910  $1,219  $112,200      $112,200  $29,324  $1,851  $4,534,432 
Medical Office Buildings
  33,958       261   34,219  $11,868   22,351   12,366   5,415   1,422,589 
Non-segment/Corporate
          575   575       575       28,088   64,934 
 
                           
 
 $134,029  $10,910  $2,055  $146,994  $11,868  $135,126  $41,690  $35,354  $6,021,955 
 
                           

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
     Summary information for the reportable segments during the nine months ended September 30, 2009 and 2008 is as follows (in thousands):
                                     
                  Property  Net  Real Estate       
  Rental  Interest  Other  Total  Operating  Operating  Depreciation/  Interest  Total 
  Income (1)  Income  Income  Revenues (1)  Expenses (1)  Income (2)  Amortization (1)  Expense (1)  Assets 
Nine months ended September 30, 2009:
                                    
Investment Properties
 $303,709  $30,639  $2,177  $336,525      $336,525  $86,416  $8,183  $4,771,518 
Medical Office Buildings
  100,854       695   101,549  $37,000   64,549   36,727   15,603   1,448,989 
Non-segment/Corporate
          938   938       938       60,390   160,899 
 
                           
 
 $404,563  $30,639  $3,810  $439,012  $37,000  $402,012  $123,143  $84,176  $6,381,406 
 
                           
 
                                    
Nine months ended September 30, 2008:
                                    
Investment Properties
 $288,812  $29,177  $4,048  $322,037      $322,037  $82,802  $5,500  $4,534,432 
Medical Office Buildings
  100,194       708   100,902  $34,609   66,293   38,092   16,470   1,422,589 
Non-segment/Corporate
          899   899       899       86,860   64,934 
 
                           
 
 $389,006  $29,177  $5,655  $423,838  $34,609  $389,229  $120,894  $108,830  $6,021,955 
 
                           
 
(1) Includes amounts from discontinued operations.
 
(2) Net operating income (“NOI”) is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property level operating expenses, which exclude depreciation and amortization, general and administrative expenses, impairments and interest expense. We believe NOI provides investors relevant and useful information because it measures the operating performance of our properties at the property level on an unleveraged basis. We use NOI to make decisions about resource allocations and to assess the property level performance of our properties.
17. Subsequent Events
     We have evaluated subsequent events for recognition or disclosure through the time we filed this Quarterly Report on Form 10-Q with the SEC on November 5, 2009 and noted no events requiring disclosure.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
18. Retrospective Application of New Accounting Standards
     We adopted FASB Accounting Standards Codification (“ASC”) topic for Noncontrolling Interests in Consolidated Financial Statements (“Noncontrolling Interest Guidance”) and ASC topic for Accounting for Convertible Debt Instruments That May Be Settled in Cash upon Conversion (Including Partial Cash Settlement) (“Convertible Debt Guidance”), effective January 1, 2009, each of which required retrospective application. Noncontrolling Interest Guidance changed the accounting and reporting for minority interests, which have been re-characterized as non-controlling interests and classified as a component of equity. Convertible Debt Guidance provides guidance on accounting for convertible debt that may be settled in cash upon conversion. It requires bifurcation of the convertible debt instrument into a debt component and an equity component. The value of the debt component is based upon the estimated fair value of a similar debt instrument without the conversion feature. The difference between the contractual principal on the debt and the value allocated to the debt is recorded as an equity component and represents the conversion feature of the instrument. The excess of the contractual principal amount of the debt over its estimated fair value is amortized to interest expense using the effective interest method over the period used to estimate the fair value. The following tables illustrate the retrospective restatement of our previously reported consolidated balance sheet amounts to reflect the application of the new guidance for the periods indicated (in thousands):
                 
  As of December 31, 2008 
      Convertible  Noncontrolling    
  As Previously  Debt  Interests  As 
  Reported  Adjustment  Adjustment  Adjusted 
Liabilities:
                
Borrowings under unsecured lines of credit arrangements
 $570,000          $570,000 
Senior unsecured notes
  1,847,247  $(16,096)      1,831,151 
Secured debt
  446,525           446,525 
Accrued expenses and other liabilities
  107,157           107,157 
 
            
Total liabilities
  2,970,929   (16,096) $0   2,954,833 
Minority interests
  10,603       (10,603)  0 
Equity:
                
Preferred stock, $1.00 par value
  289,929           289,929 
Common stock, $1.00 par value
  104,635           104,635 
Capital in excess of par value
  3,180,628   24,062       3,204,690 
Treasury stock
  (5,145)          (5,145)
Cumulative net income
  1,362,366   (7,966)      1,354,400 
Cumulative dividends
  (1,723,819)          (1,723,819)
Accumulated other comprehensive income
  (1,113)          (1,113)
Other equity
  4,105           4,105 
 
            
Total Health Care REIT, Inc. stockholders’ equity
  3,211,586   16,096   0   3,227,682 
Noncontrolling interests
  0       10,603   10,603 
 
            
Total equity
  3,211,586   16,096   10,603   3,238,285 
 
            
Total liabilities and equity
 $6,193,118  $0  $0  $6,193,118 
 
            

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
          The following tables illustrate the retrospective restatement of our previously reported consolidated statements of income amounts to reflect the application of the aforementioned new guidance as well as discontinued operations reclassifications for the periods indicated (amounts in thousands, except per share amounts):
                     
  Three Months Ended September 30, 2008 
      Convertible  Noncontrolling  Discontinued    
  As Previously  Debt  Interests  Operations  As 
  Reported  Adjustment  Adjustment  Adjustment  Adjusted 
Revenues:
                    
Rental income
 $132,131  $0  $0  $(5,747) $126,384 
Interest income
  10,910               10,910 
Other income
  2,055               2,055 
 
               
 
  145,096   0   0   (5,747)  139,349 
 
                    
Expenses:
                    
Interest and loan expenses
  33,769   1,203       (1,247)  33,725 
Property operating expenses
  11,761           (569)  11,192 
Depreciation and amortization
  41,375           (2,364)  39,011 
General and administrative
  10,789               10,789 
Realized loss on derivatives
  1,513               1,513 
Loss (gain) on extinguishment of debt
  (768)              (768)
 
               
 
  98,439   1,203   0   (4,180)  95,462 
 
               
Income from continuing operations before income taxes and minority interests
  46,657   (1,203)  0   (1,567)  43,887 
Income tax (expense) benefit
  153               153 
 
               
Income before minority interests
  46,810   (1,203)  0   (1,567)  44,040 
Minority interests
  (1)      1       0 
 
               
Income from continuing operations
  46,809   (1,203)  1   (1,567)  44,040 
Discontinued operations:
                    
Gain (loss) on sales of properties
  12,619               12,619 
Income from discontinued operations, net
  1,094           1,567   2,661 
 
               
 
  13,713   0   0   1,567   15,280 
 
               
Net income
  60,522   (1,203)  1   0   59,320 
Less: Preferred stock dividends
  5,730               5,730 
Net income attributable to noncontrolling interests
  0       1       1 
 
               
Net income attributable to common stockholders
 $54,792  $(1,203) $0  $0  $53,589 
 
               
 
                    
Average number of common shares outstanding:
                    
Basic
  96,040   96,040   96,040   96,040   96,040 
Diluted
  96,849   96,849   96,849   96,849   96,849 
 
                    
Earnings per share:
                    
Basic:
                    
Income from continuing operations attributable to common stockholders
 $0.43  $(0.01) $0.00  $(0.02) $0.40 
Discontinued operations, net
  0.14   0.00   0.00   0.02   0.16 
 
               
Net income attributable to common stockholders
 $0.57  $(0.01) $0.00  $0.00  $0.56 
 
               
 
                    
Diluted:
                    
 
                    
Income from continuing operations attributable to common stockholders
 $0.42  $(0.01) $0.00  $(0.02) $0.40 
Discontinued operations, net
  0.14   0.00   0.00   0.02   0.16 
 
               
Net income attributable to common stockholders
 $0.57  $(0.01) $0.00  $0.00  $0.55 
 
               

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS — Continued
                     
  Nine Months Ended September 30, 2008 
      Convertible  Noncontrolling  Discontinued    
  As Previously  Debt  Interests  Operations  As 
  Reported  Adjustment  Adjustment  Adjustment  Adjusted 
Revenues:
                    
Rental income
 $375,690  $0  $0  $(18,102) $357,588 
Interest income
  29,177               29,177 
Other income
  5,655               5,655 
 
               
 
  410,522   0   0   (18,102)  392,420 
Expenses:
                    
Interest expense
  102,074   3,609       (4,114)  101,569 
Property operating expenses
  34,330           (1,730)  32,600 
Depreciation and amortization
  117,293           (7,644)  109,649 
General and administrative
  33,693               33,693 
Realized loss on derivatives
  1,513               1,513 
Loss (gain) on extinguishment of debt
  (2,094)              (2,094)
 
               
 
  286,809   3,609   0   (13,488)  276,930 
 
               
Income from continuing operations before income taxes and minority interests
  123,713   (3,609)  0   (4,614)  115,490 
Income tax (expense) benefit
  (1,170)              (1,170)
 
               
Income before minority interests
  122,543   (3,609)  0   (4,614)  114,320 
Minority interests
  (128)      128       0 
 
               
Income from continuing operations
  122,415   (3,609)  128   (4,614)  114,320 
Discontinued operations:
                    
Gain (loss) on sales of properties
  130,813               130,813 
Income from discontinued operations, net
  6,289           4,614   10,903 
 
               
 
  137,102   0   0   4,614   141,716 
 
               
Net income
  259,517   (3,609)  128   0   256,036 
Less: Preferred stock dividends
  17,660               17,660 
Net income attributable to noncontrolling interests
  0       128       128 
 
               
Net income attributable to common stockholders
 $241,857  $(3,609) $0  $0  $238,248 
 
               
 
                    
Average number of common shares outstanding:
                    
Basic
  90,500   90,500   90,500   90,500   90,500 
Diluted
  91,121   91,121   91,121   91,121   91,121 
 
                    
Earnings per share:
                    
Basic:
                    
Income from continuing operations attributable to common stockholders
 $1.16  $(0.04) $0.00  $(0.05) $1.07 
Discontinued operations, net
  1.51   0.00   0.00   0.05   1.57 
 
               
Net income attributable to common stockholders
 $2.67  $(0.04) $0.00  $0.00  $2.63 
 
               
 
                    
Diluted:
                    
Income from continuing operations attributable to common stockholders
 $1.15  $(0.04) $0.00  $(0.05) $1.06 
Discontinued operations, net
  1.50   0.00   0.00   0.05   1.56 
 
               
Net income attributable to common stockholders
 $2.65  $(0.04) $0.00  $0.00  $2.61 
 
               

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
          The following discussion and analysis is based primarily on the consolidated financial statements of Health Care REIT, Inc. for the periods presented and should be read together with the notes thereto contained in this Quarterly Report on Form 10-Q. Other important factors are identified in our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009, including factors identified under the headings “Business,” “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
Executive Summary
Company Overview
          Health Care REIT, Inc. is an equity real estate investment trust (“REIT”) that invests in senior housing and health care real estate. Founded in 1970, we were the first REIT to invest exclusively in health care facilities. The following table summarizes our portfolio as of September 30, 2009:
                         
  Investments  Percentage of  Number of  # Beds/Units  Investment per    
Type of Property (in thousands)  Investments  Properties  or Sq. Ft.  metric (1)  States 
Independent living/CCRCs
 $1,179,708   19.3%  57  7,047 units $175,531 per unit  20 
Assisted living facilities
  1,289,485   21.2%  180  11,140 units 119,383 per unit  30 
Skilled nursing facilities
  1,561,406   25.7%  223  30,211 beds 51,843 per bed  26 
Specialty care facilities
  636,853   10.5%  28  1,629 beds 502,995p er bed  13 
Medical office buildings
  1,416,362   23.3%  120  5,615,653 sq. ft. 260 per sq. ft.  23 
 
                     
Totals
 $6,083,814   100.0%  608             
 
                     
 
(1) Investment per metric was computed by using the total committed investment amount of $6,412,367,000, which includes net real estate investments and unfunded construction commitments for which initial funding has commenced which amounted to $6,083,814,000 and $328,553,000, respectively.
Health Care Industry
          The demand for health care services, and consequently health care properties, is projected to reach unprecedented levels in the near future. The Centers for Medicare and Medicaid Services projects that national health expenditures will rise to $3.8 trillion in 2015 or 18.8% of gross domestic product (“GDP”). This is up from $2 trillion or 15.9% of GDP in 2005. Health expenditures per capita are projected to rise 5.8% per year from 2005 to 2015. While demographics are the primary driver of demand, economic conditions and availability of services contribute to health care service utilization rates. We believe the health care property market is less susceptible to fluctuations and economic downturns relative to other property sectors. Investor interest in the market remains strong, especially in specific sectors such as medical office buildings, regardless of the current stringent lending environment. As a REIT, we believe we are situated to benefit from any turbulence in the capital markets due to our access to capital.
          The total U.S. population is projected to increase by 19% through 2030. The elderly are an important component of health care utilization, especially independent living services, assisted living services, skilled nursing services, inpatient and outpatient hospital services and physician ambulatory care. The elderly population aged 65 and over is projected to increase by 81% through 2030. Most health care services are provided within a health care facility such as a hospital, a physician’s office or a senior housing facility. Therefore, we believe there will be continued demand for companies such as ours with expertise in health care real estate.

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          The following chart illustrates the projected increase in the elderly population aged 65 and over:
(PREFORMANCE GRAPH)
          Source: U.S. Census Bureau
          Health care real estate investment opportunities tend to increase as demand for health care services increases. We recognize the need for health care real estate as it correlates to health care service demand. Health care providers require real estate to house their businesses and expand their services. We believe that investment opportunities in health care real estate will continue to be present due to the:
  Specialized nature of the industry which enhances the credibility and experience of our company;
 
  Projected population growth combined with stable or increasing health care utilization rates which ensures demand; and
 
  On-going merger and acquisition activity.
          Recent Developments. Both the Senate and House of Representatives are considering legislation to reform the U.S. healthcare system. Proposed reform involves the expansion of coverage through existing government programs, public cooperatives, and national and state exchanges to reform the commercial/private insurance market, and may include individual and employer mandates and a public option. Future reform, increased coverage, changes in Medicare and Medicaid, changes in provider reimbursement, and changes in healthcare sector funding could have a significant impact on our operators’ financial situation and strategy. We continue to monitor these proposals as they move through the legislative process and work with our political advisors to follow the issues.
     Economic Outlook
          Beginning in late 2007 and throughout 2008, the U.S. and global economy entered a serious recession. The current economic environment is characterized by a severe residential housing slump, depressed commercial real estate valuations, weakened consumer confidence, rising unemployment and concerns regarding inflation, deflation and stagflation. Numerous financial systems around the globe have become illiquid and banks have become less willing to lend to other banks and borrowers. Further, capital markets have become and remain volatile as risk is repriced and investments are revalued. Uncertainty remains in terms of the depth and duration of these adverse economic conditions.
          The conditions described above have created an environment of limited capital availability and increasing capital costs. This was most evident in the credit markets, where lending institutions cut back on loans, tightened credit standards and significantly increased interest rate spreads. The equity markets were characterized by sporadic accessibility until late 2008, when share prices in most sectors declined significantly. Continued volatility in the capital markets could limit our ability to access debt or equity funds which, in turn, could impact our ability to finance future investments and react to changing economic and business conditions. This difficult operating environment also may make it more difficult for some of our operators/tenants to meet their obligations to us.
          During 2008, our focus gradually shifted from investment to capital preservation. To that end, our efforts in 2009 have been directed towards: liquidity, portfolio management and investment rationalization.
  Liquidity. Liquidity has become increasingly important and we have concentrated our efforts on further strengthening our balance sheet. We raised over $1 billion in funds during 2008 from a combination of three common stock offerings, our dividend reinvestment plan, our new equity shelf program, property sales and loan payoffs. We generated an additional $862.1 million from these sources during the nine months ended September 30, 2009. As always, we will continue to closely monitor the credit and capital markets for opportunities to raise reasonably priced capital.

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  Portfolio Management. Our investment approach has produced a portfolio that is very diverse with strong property level payment coverages. Yet, today’s adverse economic conditions can negatively impact even the strongest portfolio. Our portfolio management program is designed to maintain our portfolio’s strength through a combination of extensive industry research, stringent origination and underwriting protocols and a rigorous asset management process.
 
  Investment Strategy. For the short-term, we expect to fund our ongoing development projects and will evaluate new investments selectively and only when funding sources are clearly identified. However, we will continue to strengthen our existing customer relationships and begin to cultivate new relationships. We remain focused on preserving liquidity, but we intend to take advantage of what we believe will be increasingly attractive investment opportunities over time.
Business Strategy
          Our primary objectives are to protect stockholder capital and enhance stockholder value. We seek to pay consistent cash dividends to stockholders and create opportunities to increase dividend payments to stockholders as a result of annual increases in rental and interest income and portfolio growth. To meet these objectives, we invest across a broad spectrum of senior housing and health care real estate and diversify our investment portfolio by property type, operator/tenant and geographic location.
          Substantially all of our revenues and sources of cash flows from operations are derived from operating lease rentals and interest earned on outstanding loans receivable. These items represent our primary source of liquidity to fund distributions and are dependent upon our obligors’ continued ability to make contractual rent and interest payments to us. To the extent that our obligors experience operating difficulties and are unable to generate sufficient cash to make payments to us, there could be a material adverse impact on our consolidated results of operations, liquidity and/or financial condition. To mitigate this risk, we monitor our investments through a variety of methods determined by the type of property and operator/tenant. Our asset management process includes review of monthly financial statements, periodic review of obligor credit, periodic property inspections and review of covenant compliance relating to licensure, real estate taxes, letters of credit and other collateral. In monitoring our portfolio, our personnel use a proprietary database to collect and analyze property-specific data. Additionally, we conduct extensive research to ascertain industry trends and risks. Through these asset management and research efforts, we are typically able to intervene at an early stage to address payment risk, and in so doing, support both the collectibility of revenue and the value of our investment.
          With respect to our investment properties, we also structure our investments to help mitigate payment risk. Operating leases and loans are normally credit enhanced by guaranties and/or letters of credit. In addition, operating leases are typically structured as master leases and loans are generally cross-defaulted and cross-collateralized with other loans, operating leases or agreements between us and the obligor and its affiliates.
          For the nine months ended September 30, 2009, rental income and interest income represented 92% and 7%, respectively, of total gross revenues (including revenues from discontinued operations). Substantially all of our operating leases are designed with either fixed or contingent escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period. Our yield on loans receivable depends upon a number of factors, including the stated interest rate, the average principal amount outstanding during the term of the loan and any interest rate adjustments.
          Depending upon the availability and cost of external capital, we anticipate investing in additional properties. New investments are generally funded from temporary borrowings under our unsecured line of credit arrangement, internally generated cash and the proceeds from sales of real property. Our investments generate internal cash from rent and interest receipts and principal payments on loans receivable. Permanent financing for future investments, which replaces funds drawn under the unsecured line of credit arrangement, is expected to be provided through a combination of public and private offerings of debt and equity securities and the incurrence or assumption of secured debt. We believe our liquidity and various sources of available capital are sufficient to fund operations, meet debt service obligations (both principal and interest), make dividend distributions and finance future investments.
          Depending upon market conditions, we believe that new investments will be available in the future with spreads over our cost of capital that will generate appropriate returns to our stockholders. During the nine months ended September 30, 2009, we completed $507,733,000 of gross investments and $153,140,000 of investment payoffs, resulting in $354,593,000 of net new investments. We expect to complete gross new investments of approximately $550,000,000 during 2009, comprised of funded new development. We anticipate the sale of real property and the repayment of loans receivable totaling approximately $250,000,000 resulting in net new investments of approximately $300,000,000 during 2009. It is possible that additional loan repayments or sales of real property may occur in the future. To the extent that loan repayments and real property sales exceed new investments, our revenues and cash flows from operations could be adversely affected. We expect to reinvest the proceeds from any loan repayments and real property sales in new investments. To the extent that new investment requirements exceed our available cash on hand, we expect to borrow under our

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unsecured line of credit arrangement. At September 30, 2009, we had $102,353,000 of cash and cash equivalents, $17,493,000 of restricted cash and $1,007,000,000 of available borrowing capacity under our unsecured line of credit arrangement.
Key Transactions in 2009
          We have completed the following key transactions during the nine months ended September 30, 2009:
  our Board of Directors approved a quarterly cash dividend of $0.68 per share, which is consistent with the quarterly dividend paid for 2008. The dividend declared for the quarter ended September 30, 2009 represents the 154th consecutive quarterly dividend payment;
 
  we completed $507,733,000 of gross investments and had $153,140,000 of investment payoffs;
 
  we were added to the S&P 500 Index in January 2009;
 
  we completed a public offering of 5,816,870 shares of common stock with net proceeds of approximately $210,880,000 in February 2009;
 
  we completed $265,527,000 of first mortgage loans secured by 31 senior housing properties with multiple levels of service. The debt has terms ranging from seven to ten years. The debt had weighted average initial interest rates of 5.98% after giving effect to certain interest rate swap agreements. KeyBank Capital Markets, Inc. originated the loans and sold them to Freddie Mac;
 
  we extinguished $79,743,000 of secured debt with weighted average interest rates of 7.26% prior to maturity;
 
  we extinguished $183,147,000 of unsecured senior notes with weighted average interest rates of 7.82%; and
 
  we completed a public offering of 9,200,000 shares of common stock with net proceeds of approximately $356,691,000 in September 2009.
Key Performance Indicators, Trends and Uncertainties
          We utilize several key performance indicators to evaluate the various aspects of our business. These indicators are discussed below and relate to operating performance, concentration risk and credit strength. Management uses these key performance indicators to facilitate internal and external comparisons to our historical operating results, in making operating decisions and for budget planning purposes.
          Operating Performance. We believe that net income attributable to common stockholders (“NICS”) is the most appropriate earnings measure. Other useful supplemental measures of our operating performance include funds from operations (“FFO”) and net operating income (“NOI”); however, these supplemental measures are not defined by U.S. generally accepted accounting principles (“U.S. GAAP”). Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion and reconciliations of FFO and NOI. These earnings measures and their relative per share amounts are widely used by investors and analysts in the valuation, comparison and investment recommendations of companies. The following table reflects the recent historical trends of our operating performance measures for the periods presented (in thousands, except per share data):
                             
  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
  2008 2008 2008 2008 2009 2009 2009
Net income attributable to common stockholders
 $29,249  $155,410  $53,589  $21,850  $61,119  $59,240  $19,130 
Funds from operations
  68,710   76,785   82,573   30,799   85,322   89,207   60,933 
Net operating income
  124,607   129,495   135,126   136,907   134,819   133,228   133,964 
 
                            
Per share data (fully diluted):
                            
Net income attributable to common stockholders
 $0.34  $1.73  $0.55  $0.21  $0.56  $0.53  $0.17 
Funds from operations
  0.79   0.85   0.85   0.30   0.79   0.80   0.53 
          Credit Strength. We measure our credit strength both in terms of leverage ratios and coverage ratios. Our leverage ratios include debt to book capitalization and debt to market capitalization. The leverage ratios indicate how much of our balance sheet capitalization is related to long-term debt. The coverage ratios indicate our ability to service interest and fixed charges (interest, secured debt principal amortization and preferred dividends). We expect to maintain capitalization ratios and coverage ratios sufficient to maintain investment grade ratings with Moody’s Investors Service, Standard & Poor’s Ratings Services and Fitch Ratings. The coverage ratios are based on earnings before interest, taxes, depreciation and amortization (“EBITDA”) which is discussed in further detail, and reconciled to net income, below in “Non-GAAP Financial Measures.” Leverage ratios and coverage ratios are widely used by investors, analysts and rating agencies in the valuation, comparison, investment recommendations and rating of companies. The following table reflects the recent historical trends for our credit strength measures for the periods presented:

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  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
  2008 2008 2008 2008 2009 2009 2009
   
Debt to book capitalization ratio
  52%  53%  45%  47%  43%  44%  39%
Debt to undepreciated book capitalization ratio
  47%  49%  41%  43%  39%  40%  35%
Debt to market capitalization ratio
  39%  41%  31%  38%  41%  40%  31%
 
                            
Interest coverage ratio
  2.86x   6.17x   3.50x   2.70x   3.88x   3.74x   2.63x 
Fixed charge coverage ratio
  2.37x   5.15x   2.91x   2.24x   3.18x   3.07x   2.16x 
          Concentration Risk. We evaluate our concentration risk in terms of asset mix, investment mix, customer mix and geographic mix. Concentration risk is a valuable measure in understanding what portion of our investments could be at risk if certain sectors were to experience downturns. Asset mix measures the portion of our investments that are real property. In order to qualify as an equity REIT, at least 75% of our real estate investments must be real property whereby each property, which includes the land, buildings, improvements, intangibles and related rights, is owned by us and leased to a tenant pursuant to a long-term operating lease. Investment mix measures the portion of our investments that relate to our various property types. Customer mix measures the portion of our investments that relate to our top five customers. Geographic mix measures the portion of our investments that relate to our top five states. The following table reflects our recent historical trends of concentration risk for the periods presented:
                             
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
  2008 2008 2008 2008 2009 2009 2009
   
Asset mix:
                            
Real property
  92%  91%  91%  92%  92%  92%  92%
Real estate loans receivable
  8%  9%  9%  8%  8%  8%  8%
 
                            
Investment mix:
                            
Independent living/CCRCs
  16%  17%  18%  19%  19%  19%  19%
Assisted living facilities
  21%  21%  20%  20%  21%  21%  21%
Skilled nursing facilities
  31%  29%  28%  27%  27%  26%  26%
Specialty care facilities
  7%  10%  10%  11%  10%  10%  11%
Medical office buildings
  25%  23%  24%  23%  23%  24%  23%
 
                            
Customer mix:
                            
Senior Living Communities, LLC
  4%  5%  6%  6%  6%  6%  7%
Signature Healthcare LLC
  6%  6%  6%  5%  5%  5%  5%
Brookdale Senior Living Inc
  5%  5%  5%  5%  5%  5%  5%
Emeritus Corporation
  7%  5%  5%  4%  4%  4%  4%
Life Care Centers of America, Inc
  5%  5%  5%  5%  5%  4%  3%
Remaining customers
  73%  74%  73%  75%  75%  76%  76%
 
                            
Geographic mix:
                            
Florida
  15%  14%  14%  14%  14%  13%  13%
Texas
  13%  12%  12%  11%  11%  11%  11%
California
  7%  8%  8%  8%  8%  8%  8%
Massachusetts
  7%  7%  7%  7%  7%  7%  7%
Ohio
                          5%
Tennessee
  6%  6%  6%  6%  5%  5%    
Remaining states
  52%  53%  53%  54%  55%  56%  56%
          We evaluate our key performance indicators in conjunction with current expectations to determine if historical trends are indicative of future results. Our expected results may not be achieved and actual results may differ materially from our expectations. Factors that may cause actual results to differ from expected results are described in more detail in “Forward-Looking Statements and Risk Factors” and other sections of this Quarterly Report on Form 10-Q. Management regularly monitors economic and other factors to develop strategic and tactical plans designed to improve performance and maximize our competitive position. Our ability to achieve our financial objectives is dependent upon our ability to effectively execute these plans and to appropriately respond to emerging economic and company-specific trends. Please refer to our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009, under the headings “Business,” “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” for further discussion of these risk factors.

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Portfolio Update
          Net operating income. The primary performance measure for our properties is net operating income (“NOI”) as discussed below in “Non-GAAP Financial Measures.” The following table summarizes our net operating income for the periods indicated (in thousands):
                             
  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
  2008 2008 2008 2008 2009 2009 2009
   
Net operating income:
                            
Investment properties
 $102,321  $107,515  $112,200  $114,773  $112,960  $112,082  $111,482 
Medical office buildings
  22,076   21,865   22,351   21,341   21,483   20,783   22,282 
Non-segment/corporate
  210   115   575   793   376   363   200 
   
Net operating income
 $124,607  $129,495  $135,126  $136,907  $134,819  $133,228  $133,964 
   
          Payment coverage. Payment coverage of the operators in our investment property portfolio continues to remain strong. Our overall payment coverage is at 1.98 times. The table below reflects our recent historical trends of portfolio coverage. Coverage data reflects the 12 months ended for the periods presented. CBMF represents the ratio of our customers’ earnings before interest, taxes, depreciation, amortization, rent and management fees to contractual rent or interest due us. CAMF represents the ratio of our customers’ earnings before interest, taxes, depreciation, amortization and rent (but after imputed management fees) to contractual rent or interest due us.
                         
  June 30, 2007 June 30, 2008 June 30, 2009
  CBMF CAMF CBMF CAMF CBMF CAMF
Independent living/CCRCs
  1.46x   1.26x   1.36x   1.15x   1.29x   1.09x 
Assisted living facilities
  1.59x   1.37x   1.56x   1.33x   1.58x   1.36x 
Skilled nursing facilities
  2.21x   1.60x   2.29x   1.68x   2.24x   1.64x 
Specialty care facilities
  2.57x   2.01x   2.39x   1.86x   2.37x   2.05x 
 
                        
Weighted averages
  1.96x   1.52x   1.99x   1.54x   1.98x   1.55x 
Corporate Governance
          Maintaining investor confidence and trust has become increasingly important in today’s business environment. Our Board of Directors and management are strongly committed to policies and procedures that reflect the highest level of ethical business practices. Our corporate governance guidelines provide the framework for our business operations and emphasize our commitment to increase stockholder value while meeting all applicable legal requirements. These guidelines meet the listing standards adopted by the New York Stock Exchange and are available on our website at www.hcreit.com and from us upon written request sent to the Senior Vice President — Administration and Corporate Secretary, Health Care REIT, Inc., One SeaGate, Suite 1500, P.O. Box 1475, Toledo, Ohio 43603-1475.
Liquidity and Capital Resources
Sources and Uses of Cash
          Our primary sources of cash include rent and interest receipts, borrowings under the unsecured line of credit arrangement, public and private issuances of debt and equity securities, proceeds from the sales of real property and principal payments on loans receivable. Our primary uses of cash include dividend distributions, debt service payments (including principal and interest), real property investments (including construction advances), loan advances and general and administrative expenses. These sources and uses of cash are reflected in our Consolidated Statements of Cash Flows and are discussed in further detail below. The following is a summary of our sources and uses of cash flows (dollars in thousands):
                 
  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  % 
 
                
Cash and cash equivalents at beginning of period
 $23,370  $30,269  $(6,899)  -23%
Cash provided from (used in) operating activities
  290,449   284,404   6,045   2%
Cash provided from (used in) investing activities
  (189,119)  (816,722)  627,603   -77%
Cash provided from (used in) financing activities
  (22,347)  520,322   (542,669)  n/a 
 
            
Cash and cash equivalents at end of period
 $102,353  $18,273  $84,080   460%
 
            
          Operating Activities. The change in net cash provided from operating activities is primarily attributable to an increase in net income, excluding gains on sales of properties and depreciation and amortization. The increase in net income is discussed below in “Results of Operations.” The following is a summary of our straight-line rent and above/below market lease amortization (dollars in thousands):

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  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  % 
 
                
Gross straight-line rental income
 $14,499  $15,807  $(1,308)  -8%
Cash receipts due to real property sales
  (3,452)  (1,896)  (1,556)  82%
Prepaid rent receipts
  (20,011)  (13,783)  (6,228)  45%
Amortization related to above (below) market leases, net
  1,344   676   668   99%
 
            
 
 $(7,620) $804  $(8,424)  n/a 
 
            
          Gross straight-line rental income represents the non-cash difference between contractual cash rent due and the average rent recognized pursuant to U.S. GAAP for leases with fixed rental escalators, net of collectability reserves. This amount is positive in the first half of a lease term (but declining every year due to annual increases in cash rent due) and is negative in the second half of a lease term. The fluctuation in cash receipts due to real property sales is attributable to the lack of straight-line rent receivable balances on properties sold during the nine months ended September 30, 2008. The fluctuation in prepaid rent receipts is primarily due to an increase in prepaid rent received at certain construction projects.
          Investing Activities. The changes in net cash used in investing activities are primarily attributable to net changes in real property and real estate loans receivable. The following is a summary of our investment and disposition activities (dollars in thousands):
                 
  Nine Months Ended 
  Sep. 30, 2009  Sep. 30, 2008 
  Properties  Amount  Properties  Amount 
 
                
Real property acquisitions:
                
Independent living/CCRCs
     $0   2  $68,300 
Assisted living facilities
      0   3   45,490 
Skilled nursing facilities
      0   1   11,360 
Specialty care facilities
      0   6   182,303 
Medical office buildings
      0   7   121,809 
Land parcels
      0   1   10,000 
 
            
Total acquisitions
  0   0   20   439,262 
Less: Assumed debt
      0       0 
Assumed other assets (liabilities), net
      0       (1,599)
 
              
Cash disbursed for acquisitions
      0       437,663 
Construction in progress additions
      396,581       414,463 
Capital improvements to existing properties
      20,797       19,885 
 
              
Total cash invested in real property
      417,378       872,011 
 
                
Real property dispositions:
                
Independent living/CCRCs
  1   24,340   2   15,547 
Assisted living facilities
  9   20,537   20   106,740 
Skilled nursing facilities
  3   18,854   3   4,489 
Specialty care facilities
  2   40,841   1   6,781 
Medical office buildings
  10   28,128   1   8,735 
Land parcels
      0       73 
 
            
Total dispositions
  25   132,700   27   142,365 
Less: Gain/(loss) on sales of real property
      26,907       130,813 
Extinguishment of other assets/(liabilities)
      0       (113)
Seller financing on sales of real property
      (6,100)      (64,771)
 
              
Proceeds from real property sales
      153,507       208,294 
 
            
 
Net cash investments in real property
  (25) $263,871   (7) $663,717 
 
            
 
                
Advances on real estate loans receivable:
                
Investments in new loans
     $3,316      $120,961 
Draws on existing loans
      43,566       13,041 
 
              
Total gross investments in real estate loans
      46,882       134,002 
Less: Seller financing on sales of real property
      0       (59,649)
 
              
Net cash advances on real estate loans receivable
      46,882       74,353 
Receipts on real estate loans receivable:
                
Loan payoffs
      20,440       8,815 
Principal payments on loans
      14,452       4,709 
 
              
Total principal receipts on real estate loans
      34,892       13,524 
 
              
Net cash advances (receipts) on real estate loans receivable
     $11,990      $60,829 
 
              

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          Financing Activities. The changes in net cash provided from or used in financing activities are primarily attributable to changes related to our long-term debt arrangements, proceeds from the issuance of common stock and dividend payments.
          For the nine months ended September 30, 2009, we had a net decrease of $427,000,000 on our unsecured line of credit arrangement as compared to a net increase of $80,000,000 for the same period in 2008. The changes in our senior unsecured notes are due to the extinguishment of $183,147,000 of various senior unsecured notes in March and September 2009 and the extinguishment of $42,330,000 of our 7.625% senior unsecured notes in March 2008. During the nine months ended September 30, 2009, we extinguished secured debt loans totaling $79,743,000 with a weighted-average interest rate of 7.26%. During the nine months ended September 30, 2008, we extinguished secured debt loans totaling $47,061,000 with a weighted-average interest rate of 6.76%.
          The following is a summary of our common stock issuances for the nine months ended September 30, 2009 and 2008 (dollars in thousands, except per share amounts):
                 
  Shares Issued  Average Price  Gross Proceeds  Net Proceeds 
 
                
March 2008 public issuance
  3,000,000  $41.44  $124,320  $118,555 
July 2008 public issuance
  4,600,000   44.50   204,700   193,157 
September 2008 public issuance
  8,050,000   48.00   386,400   369,699 
2008 Dividend reinvestment plan issuances
  1,165,441   45.19   52,668   52,668 
2008 Option exercises
  111,395   29.14   3,246   3,246 
 
             
2008 Totals
  16,926,836      $771,334  $737,325 
 
             
 
                
February 2009 public issuance
  5,816,870  $36.85  $214,352  $210,880 
September 2009 public issuance
  9,200,000   40.40   371,680   356,691 
2009 Equity shelf plan issuances
  1,952,600   40.69   79,447   77,692 
2009 Dividend reinvestment plan issuances
  1,099,340   35.05   38,528   38,528 
2009 Option exercises
  3,434   26.67   92   92 
 
             
2009 Totals
  18,072,244      $704,099  $683,883 
 
             
          In order to qualify as a REIT for federal income tax purposes, we must distribute at least 90% of our taxable income (including 100% of capital gains) to our stockholders. The increase in dividends is primarily attributable to an increase in our common stock.
          The following is a summary of our dividend payments (in thousands, except per share amounts):
                 
  Nine Months Ended 
  Sep. 30, 2009  Sep. 30, 2008 
  Per Share  Amount  Per Share  Amount 
 
                
Common Stock
 $2.0400  $227,959  $2.0200  $183,080 
Series D Preferred Stock
  1.4766   5,906   1.4766   5,906 
Series E Preferred Stock
  1.1250   84   1.1250   84 
Series F Preferred Stock
  1.4297   10,008   1.4297   10,008 
Series G Preferred Stock
  1.4064   560   1.4064   1,662 
 
              
Totals
     $244,517      $200,740 
 
              
Off-Balance Sheet Arrangements
          At September 30, 2009, we had five outstanding letter of credit obligations totaling $4,540,000 and expiring between 2009 and 2013. Please see Note 11 to our unaudited consolidated financial statements for additional information.
          We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates. We may or may not elect to use financial derivative instruments to hedge interest rate exposure. These decisions are principally based on the general trend in interest rates at the applicable dates, our perception of the future volatility of interest rates and our relative levels of variable rate debt and variable rate investments. Please see Note 10 to our unaudited consolidated financial statements for additional information.

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Contractual Obligations
          The following table summarizes our payment requirements under contractual obligations as of September 30, 2009 (in thousands):
                     
  Payments Due by Period 
Contractual Obligations Total  2009  2010-2011  2012-2013  Thereafter 
 
                    
Unsecured line of credit arrangement
 $143,000  $0  $143,000  $0  $0 
Senior unsecured notes (1)
  1,661,853   0   0   376,853   1,285,000 
Secured debt (1)
  627,790   2,786   25,170   86,888   512,946 
Contractual interest obligations
  1,178,442   43,378   262,762   245,394   626,908 
Capital lease obligations
  0   0   0   0   0 
Operating lease obligations
  176,093   1,123   8,909   8,346   157,715 
Purchase obligations
  337,999   32,223   302,339   3,437   0 
Other long-term liabilities
  4,603   112   488   4,003   0 
 
               
Total contractual obligations
 $4,129,780  $79,622  $742,668  $724,921  $2,582,569 
 
               
 
(1) Amounts represent principal amounts due and do not reflect unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet.
          At September 30, 2009, we had an unsecured line of credit arrangement with a consortium of sixteen banks in the amount of $1.15 billion, which is scheduled to expire on August 5, 2011. Borrowings under the agreement are subject to interest payable in periods no longer than three months at either the agent bank’s prime rate of interest or the applicable margin over LIBOR interest rate, at our option (0.85% at September 30, 2009). The applicable margin is based on our ratings with Moody’s Investors Service and Standard & Poor’s Ratings Services and was 0.6% at September 30, 2009. In addition, we pay a facility fee annually to each bank based on the bank’s commitment amount. The facility fee depends on our ratings with Moody’s Investors Service and Standard & Poor’s Ratings Services and was 0.15% at September 30, 2009. We also pay an annual agent’s fee of $50,000. Principal is due upon expiration of the agreement. At September 30, 2009, we had $143,000,000 outstanding under the unsecured line of credit arrangement and estimated total contractual interest obligations of $7,893,000. Contractual interest obligations are estimated based on the assumption that the balance of $143,000,000 at September 30, 2009 is constant until maturity at interest rates in effect at September 30, 2009.
          We have $1,661,853,000 of senior unsecured notes principal outstanding with fixed annual interest rates ranging from 4.75% to 8%, payable semi-annually. Total contractual interest obligations on senior unsecured notes totaled $938,125,000 at September 30, 2009. Additionally, we have secured debt with total outstanding principal of $627,790,000, collateralized by owned properties, with annual interest rates ranging from 4.89% to 6.99%, payable monthly. The carrying values of the properties securing the debt totaled $908,536,000 at September 30, 2009. Total contractual interest obligations on secured debt totaled $232,424,000 at September 30, 2009.
          At September 30, 2009, we had operating lease obligations of $176,093,000 relating primarily to ground leases at certain of our properties and office space leases.
          Purchase obligations are comprised of unfunded construction commitments and contingent purchase obligations. At September 30, 2009, we had outstanding construction financings of $638,507,000 for leased properties and were committed to providing additional financing of approximately $328,553,000 to complete construction. At September 30, 2009, we had contingent purchase obligations totaling $9,446,000. These contingent purchase obligations primarily relate to deferred acquisition fundings and capital improvements. Deferred acquisition fundings are contingent upon a tenant satisfying certain conditions in the lease. Upon funding, amounts due from the tenant are increased to reflect the additional investment in the property.
          Other long-term liabilities relate to our Supplemental Executive Retirement Plan (“SERP”) and certain non-compete agreements. We have a SERP, a non-qualified defined benefit pension plan, which provides certain executive officers with supplemental deferred retirement benefits. The SERP provides an opportunity for participants to receive retirement benefits that cannot be paid under our tax-qualified plans because of the restrictions imposed by ERISA and the Internal Revenue Code of 1986, as amended. Benefits are based on compensation and length of service and the SERP is unfunded. No contributions by the company are anticipated for the 2009 fiscal year. Benefit payments are expected to total $4,003,000 during the next five fiscal years and no benefit payments are expected to occur during the succeeding five fiscal years. We use a December 31 measurement date for the SERP. The accrued liability on our balance sheet for the SERP was $3,649,000 and $3,109,000 at September 30, 2009 and December 31, 2008, respectively.
          In connection with the Windrose merger, we entered into consulting agreements with Fred S. Klipsch and Frederick L. Farrar, which expired in December 2008. We entered into a new consulting agreement with Mr. Farrar in December 2008, which expires in December 2009 and may be terminated at any time by Mr. Farrar. Each consultant has agreed not to compete with us for a period of two years following termination or expiration of the agreement. In exchange for complying with the covenant not to compete, Messers. Klipsch and Farrar will receive eight quarterly payments of $75,000 and $37,500, respectively, with the first payment to be made on the date of termination or expiration of the agreement. The first payment to Mr. Klipsch was made in December 2008.

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Capital Structure
          As of September 30, 2009, we had stockholders’ equity of $3,836,150,000 and a total outstanding debt balance of $2,420,487,000, which represents a debt to total book capitalization ratio of 39%. Our ratio of debt to market capitalization was 31% at September 30, 2009. For the nine months ended September 30, 2009, our interest coverage ratio was 3.41 to 1.00. For the nine months ended September 30, 2009, our fixed charge coverage ratio was 2.80 to 1.00. Also, at September 30, 2009, we had $102,353,000 of cash and cash equivalents, $17,493,000 of restricted cash and $1,007,000,000 of available borrowing capacity under our unsecured line of credit arrangement. During the nine months ended September 30, 2009, we completed two public offerings of common stock, totaling 15,016,870 shares with aggregate net proceeds of approximately $567,571,000.
          Our debt agreements contain various covenants, restrictions and events of default. Certain agreements require us to maintain certain financial ratios and minimum net worth and impose certain limits on our ability to incur indebtedness, create liens and make investments or acquisitions. As of September 30, 2009, we were in compliance with all of the covenants under our debt agreements. Please refer to the section entitled “Non-GAAP Financial Measures” for further discussion. None of our debt agreements contain provisions for acceleration which could be triggered by our debt ratings with Moody’s Investors Service and Standard & Poor’s Ratings Services. However, under our unsecured line of credit arrangement, these ratings on our senior unsecured notes are used to determine the fees and interest charged.
          As of October 31, 2009, our senior unsecured notes were rated Baa2 (stable), BBB- (stable) and BBB (stable) by Moody’s Investors Service, Standard & Poor’s Ratings Services and Fitch Ratings, respectively. We plan to manage the company to maintain investment grade status with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the noted rating agencies could have a material adverse impact on our cost and availability of capital, which could in turn have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition.
          On May 7, 2009, we filed an open-ended automatic or “universal” shelf registration statement with the Securities and Exchange Commission covering an indeterminate amount of future offerings of debt securities, common stock, preferred stock, depositary shares, warrants and units. As of October 31, 2009, we had an effective registration statement on file in connection with our enhanced dividend reinvestment plan under which we may issue up to 10,760,247 shares of common stock. As of October 31, 2009, 6,807,465 shares of common stock remained available for issuance under this registration statement. In November 2008, we entered into an Equity Distribution Agreement with UBS Securities LLC relating to the offer and sale from time to time of up to $250,000,000 aggregate amount of our common stock (“Equity Shelf Program”). We issued 1,952,600 shares of common stock under the Equity Shelf Program during the nine months ended September 30, 2009. As of October 31, 2009, we had $139,356,000 of remaining capacity under the Equity Shelf Program. Depending upon market conditions, we anticipate issuing securities under our registration statements to invest in additional properties and to repay borrowings under our unsecured line of credit arrangement.
Results of Operations
          Our primary sources of revenue include rent and interest. Our primary expenses include interest expense, depreciation and amortization, property operating expenses and general and administrative expenses. These revenues and expenses are reflected in our Consolidated Statements of Income and are discussed in further detail below. The following is a summary of our results of operations (dollars in thousands, except per share amounts):
                                 
  Three Months Ended Change Nine Months Ended Change
  Sep. 30, 2009 Sep. 30, 2008 Amount % Sep. 30, 2009 Sep. 30, 2008 Amount %
 
Net income available to common stockholders
 $19,130  $53,589  $(34,459)  -64% $139,489  $238,248  $(98,759)  -41%
Funds from operations
  60,933   82,573   (21,640)  -26%  235,463   228,068   7,395   3%
EBITDA
  94,548   136,211   (41,663)  -31%  363,425   486,930   (123,505)  -25%
Net operating income
  133,964   135,126   (1,162)  -1%  402,012   389,229   12,783   3%
Per share data (fully diluted):
                                
Net income available to common stockholders
 $0.17  $0.55  $(0.38)  -69% $1.25  $2.61  $(1.36)  -52%
Funds from operations
  0.53   0.85   (0.32)  -38%  2.11   2.50   (0.39)  -16%
 
                                
Interest coverage ratio
  2.63x  3.50x  -0.87x  -25%  3.41x  4.16x  -0.75x  -18%
Fixed charge coverage ratio
  2.16x  2.91x  -0.75x  -26%  2.80x  3.46x  -0.66x  -19%
          We evaluate our business and make resource allocations on our two business segments — investment properties and medical office buildings. Under the investment property segment, properties are primarily leased under triple-net leases and we are not involved

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in the management of the property. Under the medical office building segment, our properties are typically leased under gross leases, modified gross leases or triple-net leases, to multiple tenants, and generally require a certain level of property management. There are no intersegment sales or transfers. Non-segment revenue consists mainly of interest income on non-real estate investments and other income. Non-property specific revenues and expenses are not allocated to individual segments in determining net operating income. Please see Note 16 to our unaudited consolidated financial statements for additional information.
          Investment Properties
          The following is a summary of our results of operations for the investment properties segment (dollars in thousands):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  %  Sep. 30, 2009  Sep. 30, 2008  $  % 
Revenues:
                                
Rental income
 $98,998  $93,418  $5,580   6% $294,850  $261,181  $33,669   13%
Interest income
  10,528   10,910   (382)  -4%  30,639   29,177   1,462   5%
Other income
  641   1,219   (578)  -47%  2,177   4,048   (1,871)  -46%
 
                        
 
  110,167   105,547   4,620   4%  327,666   294,406   33,260   11%
Expenses:
                                
Interest expense
  3,490   594   2,896   488%  6,917   (542)  7,459   n/a 
Depreciation and amortization
  28,313   27,223   1,090   4%  83,402   73,847   9,555   13%
Loss (gain) on extinguishment of debt
  2,057   (768)  2,825   n/a   2,057   (808)  2,865   n/a 
Provision for loan losses
  0   0   0   n/a   140   0   140   n/a 
 
                        
 
  33,860   27,049   6,811   25%  92,516   72,497   20,019   28%
 
                        
 
                                
Income from continuing operations before income taxes
  76,307   78,498   (2,191)  -3%  235,150   221,909   13,241   6%
Income tax expense
  0   0   0   n/a   0   (1,351)  1,351   -100%
 
                        
Income from continuing operations
  76,307   78,498   (2,191)  -3%  235,150   220,558   14,592   7%
Discontinued operations:
                                
Gain (loss) on sales of properties
  0   13,680   (13,680)  -100%  27,713   131,874   (104,161)  -79%
Income (loss) from discontinued operations, net
  1,180   3,295   (2,115)  -64%  4,579   12,634   (8,055)  -64%
 
                        
Discontinued operations, net
  1,180   16,975   (15,795)  -93%  32,292   144,508   (112,216)  -78%
 
                        
Net income
 $77,487  $95,473  $(17,986)  -19% $267,442  $365,066  $(97,624)  -27%
 
                        
          The increase in rental income is primarily attributable to the acquisitions of new investment properties subsequent to September 30, 2008 from which we receive rent. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index and/or changes in the gross operating revenues of the tenant’s properties. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If gross operating revenues at our facilities and/or the Consumer Price Index do not increase, a portion of our revenues may not continue to increase. Sales of real property would offset revenue increases and, to the extent that they exceed new acquisitions, could result in decreased revenues. Our leases could renew above or below current rent rates, resulting in an increase or decrease in rental income. Interest income increased from 2008 primarily due to an increase in the balance of outstanding loans.
          Interest expense for the nine months ended September 30, 2009 represents $8,183,000 of secured debt interest expense including $270,000 of swap losses offset by interest allocated to discontinued operations. Interest expense for the nine months ended September 30, 2008 represents $5,500,000 of secured debt interest expense offset by interest allocated to discontinued operations. The change in secured debt interest expense is due to the net effect and timing of assumptions, extinguishments and principal amortizations. During the nine months ended September 30, 2009, we extinguished certain investment property secured debt loans and recognized extinguishment losses of $2,057,000. During the nine months ended September 30, 2008, we extinguished certain investment property secured debt loans and recognized extinguishment gains of $808,000. The following is a summary of our investment property secured debt principal activity (dollars in thousands):

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  Three Months Ended  Three Months Ended  Nine Months Ended  Nine Months Ended 
  September 30, 2009  September 30, 2008  September 30, 2009  September 30, 2008 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
Beginning balance
 $194,512   6.283% $105,910   6.994% $94,234   6.996% $114,543   7.000%
Debt issued
  132,456   5.863%  0   0.000%  265,527   5.982%  0   0.000%
Debt extinguished
  (26,575)  7.402%  (10,358)  6.980%  (47,502)  7.414%  (17,821)  7.022%
Principal payments
  (743)  6.360%  (660)  6.972%  (12,609)  7.780%  (1,830)  6.973%
 
                        
Ending balance
 $299,650   5.998% $94,892   6.996% $299,650   5.998% $94,892   6.996%
 
                        
 
                                
Monthly averages
 $326,590   6.113% $100,395   6.995% $358,738   6.246% $106,814   6.996%
          Depreciation and amortization increased primarily as a result of the acquisitions of new investment properties subsequent to September 30, 2008. To the extent that we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.
          At September 30, 2009, we had six skilled nursing facilities that satisfied the requirements for held for sale treatment. We did not recognize any impairment losses on these assets as the fair value less estimated costs to sell exceeded our carrying values. During the nine months ended September 30, 2009, we sold 16 investment properties with carrying values of $104,572,000 for net gains of $27,713,000. During the nine months ended September 30, 2008, we sold 26 investment properties and one parcel of land with a carrying value of $135,584,000 for a gain of $131,874,000 and a deferred gain of $3,708,000. The following illustrates the reclassification impact as a result of classifying investment properties sold subsequent to January 1, 2008 or held for sale at September 30, 2009 as discontinued operations for the periods presented. Please refer to Note 5 to our unaudited consolidated financial statements for further discussion.
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2009  2008  2009  2008 
Rental income
 $1,315  $6,653  $8,859  $27,631 
 
                
Expenses:
                
Interest expense
  135   1,257   1,266   6,042 
Provision for depreciation
  0   2,101   3,014   8,955 
 
            
Income (loss) from discontinued operations, net
 $1,180  $3,295  $4,579  $12,634 
 
            
          As a result of our quarterly evaluations, we recorded a $140,000 addition to the allowance for loan losses during the nine months ended September 30, 2009. The provision for loan losses is related to our critical accounting estimate for the allowance for loan losses and is discussed in “Critical Accounting Policies.”
          During the nine months ended September 30, 2008, we recorded $1,325,000 of income taxes in connection with an investment gain.
          Medical Office Buildings
          The following is a summary of our results of operations for the medical office buildings segment (dollars in thousands):

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  Three Months Ended  Change  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  %  Sep. 30, 2009  Sep. 30, 2008  $  % 
Revenues:
                                
Rental income
 $34,483  $32,966  $1,517   5% $99,051  $96,407  $2,644   3%
Other income
  248   261   (13)  -5%  695   708   (13)  -2%
 
                        
 
  34,731   33,227   1,504   5%  99,746   97,115   2,631   3%
 
                                
Expenses:
                                
Interest expense
  5,024   5,043   (19)  0%  15,205   15,251   (46)  0%
Property operating expenses
  12,433   11,192   1,241   11%  35,377   32,600   2,777   9%
Depreciation and amortization
  12,772   11,788   984   8%  36,727   35,802   925   3%
Loss (gain) on extinguishment of debt
  3,371   0   3,371   n/a   3,371   (1,286)  4,657   n/a 
 
                        
 
  33,600   28,023   5,577   20%  90,680   82,367   8,313   10%
 
                        
Income from continuing operations before income taxes
  1,131   5,204   (4,073)  -78%  9,066   14,748   (5,682)  -39%
Income tax (expense) benefit
  25   (4)  29   n/a   (232)  (49)  (183)  373%
 
                        
Income from continuing operations
  1,156   5,200   (4,044)  -78%  8,834   14,699   (5,865)  -40%
Discontinued operations:
                                
Gain (loss) on sales of properties
  (806)  (1,061)  255   -24%  (806)  (1,061)  255   -24%
Impairment of assets
  (1,873)  0   (1,873)  n/a   (1,873)  0   (1,873)  n/a 
Income (loss) from
                                
discontinued operations, net
  (143)  (634)  491   -77%  (218)  (1,731)  1,513   -87%
 
                        
Discontinued operations, net
  (2,822)  (1,695)  (1,127)  66%  (2,897)  (2,792)  (105)  4%
 
                        
Net income (loss)
  (1,666)  3,505   (5,171)  n/a   5,937   11,907   (5,970)  -50%
Less: Net income attributable to noncontrolling interests
  35   1   34   3400%  40   128   (88)  -69%
 
                        
Net income attributable to common stockholders
 $(1,701) $3,504  $(5,205)  n/a  $5,897  $11,779  $(5,882)  -50%
 
                        
          The increase in rental income is primarily attributable to the acquisitions of medical office buildings subsequent to September 30, 2008 from which we receive rent. Certain of our leases contain annual rental escalators that are contingent upon changes in the Consumer Price Index. These escalators are not fixed, so no straight-line rent is recorded; however, rental income is recorded based on the contractual cash rental payments due for the period. If the Consumer Price Index does not increase, a portion of our revenues may not continue to increase. Sales of real property would offset revenue increases and, to the extent that they exceed new acquisitions, could result in decreased revenues. Our leases could renew above or below current rent rates, resulting in an increase or decrease in rental income. Other income is attributable to third party management fee income.
          Interest expense for the nine months ended September 30, 2009 represents $15,603,000 of secured debt interest expense offset by interest allocated to discontinued operations. Interest expense for the nine months ended September 30, 2008 represents $16,470,000 of secured debt interest expense offset by interest allocated to discontinued operations. The change in secured debt interest expense is primarily due to the net effect and timing of assumptions, extinguishments and principal amortizations. During the nine months ended September 30, 2009, we extinguished certain medical office building secured debt loans and recognized extinguishment losses of $3,371,000. During the nine months ended September 30, 2008, we extinguished certain medical office building secured debt loans and recognized extinguishment gains of $1,286,000. The following is a summary of our medical office building secured debt principal activity (dollars in thousands):
                                 
  Three Months Ended  Three Months Ended  Nine Months Ended  Nine Months Ended 
  September 30, 2009  September 30, 2008  September 30, 2009  September 30, 2008 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
Beginning balance
 $351,146   5.799% $360,451   5.795% $354,145   5.799% $392,430   5.854%
Debt extinguished
  (32,241)  7.033%  0   0.000%  (32,241)  7.033%  (29,239)  6.600%
Principal payments
  (1,451)  5.722%  (1,420)  5.749%  (4,450)  5.746%  (4,160)  5.736%
 
                        
Ending balance
 $317,454   5.675% $359,031   5.795% $317,454   5.675% $359,031   5.795%
 
                        
 
                                
Monthly averages
 $350,412   5.800% $359,732   5.795% $351,919   5.799% $368,627   5.804%
          The increase in property operating expenses is primarily attributable to the acquisition of new medical office buildings for which we incur certain property operating expenses offset by property operating expenses associated with discontinued operations.
          Income tax expense is related to third party management fee income.

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          Net income attributable to noncontrolling interests primarily relates to certain joint venture properties that are consolidated in our operating results. The decrease is due to our acquisition of a noncontrolling interest subsequent to September 30, 2008.
          At September 30, 2009, we had four medical office buildings that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2009, an impairment charge of $1,873,000 was recorded to further reduce the carrying value of the four medical office buildings to their estimated fair value less costs to sell. In determining the fair value of the medical office buildings, we used a combination of third party appraisals based on market comparable transactions, other market listings and asset quality as well as third party offers to purchase. During the year ended December 31, 2008, an impairment charge of $32,648,000 was recorded to reduce the carrying value of 14 medical office buildings to their estimated fair value less costs to sell. In determining the fair value of the medical office buildings, we used a combination of third party appraisals based on market comparable transactions, other market listings and asset quality as well as management calculations based on projected operating income and published capitalization rates. Please see Note 4 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009, for additional information. The following illustrates the reclassification impact as a result of classifying medical office buildings sold subsequent to January 1, 2008 or held for sale at September 30, 2009 as discontinued operations for the periods presented. Please refer to Note 5 to our unaudited consolidated financial statements for further discussion.
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2009  2008  2009  2008 
Rental income
 $525  $992  $1,803  $3,787 
Expenses:
                
Interest expense
  127   372   398   1,219 
Property operating expenses
  541   676   1,623   2,009 
Provision for depreciation
  0   578   0   2,290 
 
            
Income (loss) from discontinued operations, net
 $(143) $(634) $(218) $(1,731)
 
            
          Non-Segment/Corporate
          The following is a summary of our results of operations for the non-segment/corporate activities (dollars in thousands):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  %  Sep. 30, 2009  Sep. 30, 2008  $  % 
  (In thousands, except per share data)         
Revenues:
                                
Other income
 $200  $575  $(375)  -65% $938  $899  $39   4%
Expenses:
                                
Interest expense
  20,057   28,088   (8,031)  -29%  60,390   86,860   (26,470)  -30%
Realized loss on derivatives
  0   1,513   (1,513)  -100%  0   1,513   (1,513)  -100%
General and administrative
  10,363   10,789   (426)  -4%  38,784   33,693   5,091   15%
Loss on extinguishments of debt
  20,946   0   20,946   n/a   19,269   0   19,269   n/a 
 
                        
 
  51,366   40,390   10,976   27%  118,443   122,066   (3,623)  -3%
 
                        
Net loss from continuing operations before income taxes
  (51,166)  (39,815)  (11,351)  29%  (117,505)  (121,167)  3,662   -3%
Income tax (expense) benefit
  30   157   (127)  -81%  215   230   (15)  -7%
 
                        
Net loss
  (51,136)  (39,658)  (11,478)  29%  (117,290)  (120,937)  3,647   -3%
Preferred stock dividends
  5,520   5,730   (210)  -4%  16,560   17,660   (1,100)  -6%
 
                        
Net loss attributable to common stockholders
 $(56,656) $(45,388) $(11,268)  25% $(133,850) $(138,597) $4,747   -3%
 
                        
          Other income primarily represents income from non-real estate activities such as interest earned on temporary investments of cash reserves.
          The following is a summary of our non-segment/corporate interest expense (dollars in thousands):

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  Three Months Ended  Change  Nine Months Ended  Change 
  Sep. 30, 2009  Sep. 30, 2008  $  %  Sep. 30, 2009  Sep. 30, 2008  $  % 
 
                                
Senior unsecured notes
 $27,146  $27,718  $(572)  -2% $82,149  $83,827  $(1,678)  -2%
Secured debt
  90   0   90   n/a   90   0   90   n/a 
Unsecured lines of credit
  1,081   5,099   (4,018)  -79%  3,979   14,723   (10,744)  -73%
Capitalized interest
  (9,975)  (6,364)  (3,611)  57%  (30,866)  (16,594)  (14,272)  86%
SWAP losses (savings)
  (40)  (40)  0   0%  (121)  (121)  0   0%
Loan expense
  1,755   1,675   80   5%  5,159   5,025   134   3%
 
                        
Totals
 $20,057  $28,088  $(8,031)  -29% $60,390  $86,860  $(26,470)  -30%
 
                        
          The change in interest expense on senior unsecured notes is due to the effect of extinguishments. During the nine months ended September 30, 2009, we extinguished $183,147,000 of unsecured senior notes with weighted average interest rates of 7.82% and recognized extinguishment losses of $19,269,000. The following is a summary of our senior unsecured note principal activity (dollars in thousands):
                                 
  Three Months Ended  Three Months Ended  Nine Months Ended  Nine Months Ended 
  September 30, 2009  September 30, 2008  September 30, 2009  September 30, 2008 
  Face  Weighted Avg.  Face  Weighted Avg.  Face  Weighted Avg.  Face  Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
 
                                
Beginning balance
 $1,823,277   5.773% $1,845,000   5.782% $1,845,000   5.782% $1,887,330   5.823%
Principal payments
  (161,424)  8.000%  0   0.000%  (183,147)  7.823%  (42,330)  7.625%
 
                        
Ending balance
 $1,661,853   5.557% $1,845,000   5.782% $1,661,853   5.557% $1,845,000   5.782%
 
                        
 
                                
Monthly averages
 $1,782,921   5.723% $1,845,000   5.782% $1,813,652   5.756% $1,863,141   5.800%
          During the nine months ended September 30, 2009, we completed a $10,750,000 first mortgage loan secured by a commercial real estate campus. The 10-year debt has a fixed interest rate of 6.37%.
          The change in interest expense on the unsecured line of credit arrangement is due primarily to the net effect and timing of draws, paydowns and variable interest rate changes. The following is a summary of our unsecured line of credit arrangement (dollars in thousands):
                 
  Three Months Ended September 30,  Nine Months Ended September 30, 
  2009  2008  2009  2008 
Balance outstanding at quarter end
 $143,000  $387,000  $143,000  $387,000 
Maximum amount outstanding at any month end
 $292,000  $701,000  $559,000  $744,000 
Average amount outstanding (total of daily principal balances divided by days in period)
 $217,174  $577,717  $301,740  $509,307 
Weighted average interest rate (actual all-in interest/fees expense divided by average borrowings outstanding)
  1.99%  3.53%  1.76%  3.85%
          We capitalize certain interest costs associated with funds used to finance the construction of properties owned directly by us. The amount capitalized is based upon the balances outstanding during the construction period using the rate of interest that approximates our cost of financing. Our interest expense is reduced by the amount capitalized.
          Please see Note 10 to our unaudited consolidated financial statements for a discussion of our interest rate swap agreements and their impact on interest expense.
          Loan expense represents the amortization of deferred loan costs incurred in connection with the issuance and amendments of debt. Loan expense for the nine months ended September 30, 2009 is consistent with the prior year.
          General and administrative expenses as a percentage of consolidated revenues (including revenues from discontinued operations) for the three and nine months ended September 30, 2009 were 7.05% and 8.83%, respectively, as compared with 7.34% and 7.95% for the same periods in 2008. The year-to-date increase from 2008 is primarily related to $3,909,000 of non-recurring expenses recognized during the nine months ended September 30, 2009 in connection with the departure of Raymond W. Braun who formerly served as President of the company.

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          The change in preferred dividends is primarily attributable to preferred stock conversions into common stock. The following is a summary of our preferred stock activity (dollars in thousands):
                                 
  Three Months Ended Three Months Ended Nine Months Ended Nine Months Ended
  September 30, 2009 September 30, 2008 September 30, 2009 September 30, 2008
      Weighted Avg.     Weighted Avg.     Weighted Avg.     Weighted Avg.
  Shares Dividend Rate Shares Dividend Rate Shares Dividend Rate Shares Dividend Rate
Beginning balance
  11,475,093   7.697%  12,048,839   7.688%  11,516,302   7.696%  12,879,189   7.676%
Shares converted
  (1,000)  7.500%  (127,780)  7.500%  (42,209)  7.478%  (958,130)  7.500%
 
                                
Ending balance
  11,474,093   7.697%  11,921,059   7.690%  11,474,093   7.697%  11,921,059   7.690%
 
                                
 
                                
Monthly averages
  11,474,593   7.697%  11,953,449   7.689%  11,485,097   7.697%  12,323,623   7.684%
Non-GAAP Financial Measures
          We believe that net income, as defined by U.S. GAAP, is the most appropriate earnings measurement. However, we consider FFO to be a useful supplemental measure of our operating performance. Historical cost accounting for real estate assets in accordance with U.S. GAAP implicitly assumes that the value of real estate assets diminishes predictably over time as evidenced by the provision for depreciation. However, since real estate values have historically risen or fallen with market conditions, many industry investors and analysts have considered presentations of operating results for real estate companies that use historical cost accounting to be insufficient. In response, the National Association of Real Estate Investment Trusts (“NAREIT”) created FFO as a supplemental measure of operating performance for REITs that excludes historical cost depreciation from net income. FFO, as defined by NAREIT, means net income, computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of real estate, plus depreciation and amortization, and after adjustments for unconsolidated partnerships and joint ventures.
          Net operating income (“NOI”) is used to evaluate the operating performance of our properties. We define NOI as total revenues, including tenant reimbursements, less property level operating expenses, which exclude depreciation and amortization, general and administrative expenses, impairments and interest expense. We believe NOI provides investors relevant and useful information because it measures the operating performance of our properties at the property level on an unleveraged basis. We use NOI to make decisions about resource allocations and to assess the property level performance of our properties.
          EBITDA stands for earnings before interest, taxes, depreciation and amortization. We believe that EBITDA, along with net income and cash flow provided from operating activities, is an important supplemental measure because it provides additional information to assess and evaluate the performance of our operations. We primarily utilize EBITDA to measure our interest coverage ratio, which represents EBITDA divided by total interest, and our fixed charge coverage ratio, which represents EBITDA divided by fixed charges. Fixed charges include total interest, secured debt principal amortization and preferred dividends.
          A covenant in our line of credit arrangement contains a financial ratio based on a definition of EBITDA that is specific to that agreement. Failure to satisfy this covenant could result in an event of default that could have a material adverse impact on our cost and availability of capital, which could in turn have a material adverse impact on our consolidated results of operations, liquidity and/or financial condition. Due to the materiality of this debt agreement and the financial covenant, we have disclosed Adjusted EBITDA, which represents EBITDA as defined above and adjusted for stock-based compensation expense, provision for loan losses and gain/loss on extinguishment of debt. We use Adjusted EBITDA to measure our adjusted fixed charge coverage ratio, which represents Adjusted EBITDA divided by fixed charges on a trailing twelve months basis. Fixed charges include total interest (excluding capitalized interest and non-cash interest expenses), secured debt principal amortization and preferred dividends. Our covenant requires an adjusted fixed charge ratio of at least 1.75 times.
          Other than Adjusted EBITDA, our supplemental reporting measures and similarly entitled financial measures are widely used by investors, equity and debt analysts and rating agencies in the valuation, comparison, rating and investment recommendations of companies. Management uses these financial measures to facilitate internal and external comparisons to our historical operating results and in making operating decisions. Additionally, these measures are utilized by the Board of Directors to evaluate management. Adjusted EBITDA is used solely to determine our compliance with a financial covenant of our line of credit arrangement and is not being presented for use by investors for any other purpose. None of our supplemental measures represent net income or cash flow provided from operating activities as determined in accordance with U.S. GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the supplemental measures, as defined by us, may not be comparable to similarly entitled items reported by other real estate investment trusts or other companies. Multi-period amounts may not equal the sum of the individual quarterly amounts due to rounding.

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          The table below reflects the reconciliation of FFO to net income attributable to common stockholders, the most directly comparable U.S. GAAP measure, for the periods presented. The provisions for depreciation and amortization include provisions for depreciation and amortization from discontinued operations. Amounts are in thousands except for per share data.
                             
  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
 2008 2008 2008 2008 2009 2009 2009
   
FFO Reconciliation:
                            
Net income attributable to common stockholders
 $29,249  $155,410  $53,589  $21,850  $61,119  $59,240  $19,130 
Depreciation and amortization
  39,574   39,630   41,690   42,150   41,326   40,731   41,085 
Loss (gain) on sales of properties
  (26)  (118,168)  (12,619)  (33,120)  (17,036)  (10,677)  806 
Noncontrolling interests
  (87)  (87)  (87)  (81)  (87)  (87)  (88)
   
Funds from operations
 $68,710  $76,785  $82,573  $30,799  $85,322  $89,207  $60,933 
 
                            
Average common shares outstanding:
                            
Basic
  86,100   89,294   96,040   103,329   108,214   110,864   114,874 
Diluted
  86,610   89,853   96,849   103,840   108,624   111,272   115,289 
 
                            
Per share data:
                            
Net income attributable to common stockholders
                            
Basic
 $0.34  $1.74  $0.56  $0.21  $0.56  $0.53  $0.17 
Diluted
  0.34   1.73   0.55   0.21   0.56   0.53   0.17 
 
                            
Funds from operations
                            
Basic
 $0.80  $0.86  $0.86  $0.30  $0.79  $0.80  $0.53 
Diluted
  0.79   0.85   0.85   0.30   0.79   0.80   0.53 
         
  Nine Months Ended
  September 30, September 30,
 2008 2009
   
FFO Reconciliation:
        
Net income available to common stockholders
 $238,248  $139,489 
Depreciation and amortization
  120,894   123,143 
Loss (gain) on sales of properties
  (130,813)  (26,907)
Noncontrolling interests
  (261)  (262)
   
Funds from operations
 $228,068  $235,463 
 
        
Average common shares outstanding:
        
Basic
  90,500   111,345 
Diluted
  91,121   111,749 
 
        
Per share data:
        
Net income available to common stockholders
        
Basic
 $2.63  $1.25 
Diluted
  2.61   1.25 
 
        
Funds from operations
        
Basic
 $2.52  $2.11 
Diluted
  2.50   2.11 
          The following table reflects the reconciliation of NOI for the periods presented. All amounts include amounts from discontinued operations, if applicable. Amounts are in thousands.

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  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
 2008 2008 2008 2008 2009 2009 2009
   
NOI Reconciliation:
                            
Total revenues:
                            
Investment properties:
                            
Rental income:
                            
Independent living/CCRCs
 $13,414  $14,881  $18,545  $19,562  $19,996  $20,001  $19,070 
Assisted living facilities
  30,228   31,071   28,189   27,521   27,708   28,392   28,634 
Skilled nursing facilities
  40,100   40,260   40,687   40,595   41,731   41,598   41,337 
Specialty care facilities
  8,191   10,595   12,650   12,359   12,677   11,293   11,272 
   
Investment property rental income
  91,933   96,807   100,071   100,037   102,112   101,284   100,313 
Interest income
  9,092   9,175   10,910   10,886   9,953   10,158   10,528 
Other income
  1,296   1,533   1,219   3,850   895   640   641 
   
Total investment property revenues
  102,321   107,515   112,200   114,773   112,960   112,082   111,482 
Medical office buildings:
                            
Rental income
  33,233   33,003   33,958   33,138   33,253   32,593   35,008 
Other income
  210   237   261   222   213   234   248 
   
Total medical office building revenues
  33,443   33,240   34,219   33,360   33,466   32,827   35,256 
Corporate other income
  210   115   575   793   376   363   200 
   
Total revenues
  135,974   140,870   146,994   148,926   146,802   145,272   146,938 
Property operating expenses:
                            
Investment properties
  0   0   0   0   0   0   0 
Medical office buildings
  11,367   11,375   11,868   12,019   11,983   12,044   12,974 
Non-segment/corporate
  0   0   0   0   0   0   0 
   
Total property operating expenses
  11,367   11,375   11,868   12,019   11,983   12,044   12,974 
Net operating income:
                            
Investment properties
  102,321   107,515   112,200   114,773   112,960   112,082   111,482 
Medical office buildings
  22,076   21,865   22,351   21,341   21,483   20,783   22,282 
Non-segment/corporate
  210   115   575   793   376   363   200 
   
Net operating income
 $124,607  $129,495  $135,126  $136,907  $134,819  $133,228  $133,964 
   
         
  Nine Months Ended
  September 30, September 30,
 2008 2009
   
NOI Reconciliation:
        
Total revenues:
        
Investment properties:
        
Rental income:
        
Independent living/CCRCs
 $46,841  $58,588 
Assisted living facilities
  89,488   85,212 
Skilled nursing facilities
  121,047   124,667 
Specialty care facilities
  31,436   35,242 
   
Investment property rental income
  288,812   303,709 
Interest income
  29,177   30,639 
Other income
  4,048   2,177 
   
Total investment property revenues
  322,037   336,525 
Medical office buildings:
        
Rental income
  100,194   100,854 
Other income
  708   695 
   
Total medical office building revenues
  100,902   101,549 
Corporate other income
  899   938 
   
Total revenues
  423,838   439,012 
Property operating expenses:
        
Investment properties
  0   0 
Medical office buildings
  34,609   37,000 
Non-segment/corporate
  0   0 
   
Total property operating expenses
  34,609   37,000 
Net operating income:
        
Investment properties
  322,037   336,525 
Medical office buildings
  66,293   64,549 
Non-segment/corporate
  899   938 
   
Net operating income
 $389,229  $402,012 
   

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          The table below reflects the reconciliation of EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Interest expense and the provisions for depreciation and amortization include discontinued operations. Dollars are in thousands.
                             
  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
 2008 2008 2008 2008 2009 2009 2009
   
EBITDA Reconciliation:
                            
Net income
 $35,458  $161,259  $59,320  $27,389  $66,645  $64,759  $24,685 
Interest expense
  37,320   36,155   35,354   32,230   28,011   27,332   28,833 
Income tax expense (benefit)
  1,279   44   (153)  136   50   21   (55)
Depreciation and amortization
  39,574   39,630   41,690   42,150   41,326   40,731   41,085 
   
EBITDA
 $113,631  $237,088  $136,211  $101,905  $136,032  $132,843  $94,548 
 
                            
Interest Coverage Ratio:
                            
Interest expense
 $37,320  $36,155  $35,354  $32,230  $28,011  $27,332  $28,833 
Non-cash interest expense
  (2,790)  (2,769)  (2,773)  (2,899)  (2,772)  (2,844)  (2,895)
Capitalized interest
  5,167   5,063   6,364   8,435   9,865   11,026   9,975 
   
Total interest
  39,697   38,449   38,945   37,766   35,104   35,514   35,913 
EBITDA
 $113,631  $237,088  $136,211  $101,905  $136,032  $132,843  $94,548 
   
Interest coverage ratio
  2.86  6.17  3.50  2.70  3.88  3.74  2.63
 
                            
Fixed Charge Coverage Ratio:
                            
Total interest
 $39,697  $38,449  $38,945  $37,766  $35,104  $35,514  $35,913 
Secured debt principal payments
  2,093   1,817   2,080   2,129   2,206   2,177   2,298 
Preferred dividends
  6,147   5,784   5,730   5,541   5,524   5,516   5,520 
   
Total fixed charges
  47,937   46,050   46,755   45,436   42,834   43,207   43,731 
EBITDA
 $113,631  $237,088  $136,211  $101,905  $136,032  $132,843  $94,548 
   
Fixed charge coverage ratio
  2.37  5.15  2.91  2.24  3.18  3.07  2.16
         
  Nine Months Ended
  September 30, September 30,
 2008 2009
   
EBITDA Reconciliation:
        
Net income
 $256,036  $156,089 
Interest expense
  108,830   84,176 
Tax expense (benefit)
  1,170   17 
Depreciation and amortization
  120,894   123,143 
   
EBITDA
 $486,930  $363,425 
 
        
Interest Coverage Ratio:
        
Interest expense
 $108,830  $84,176 
Non-cash interest expense
  (8,332)  (8,511)
Capitalized interest
  16,594   30,866 
   
Total interest
  117,092   106,531 
EBITDA
 $486,930  $363,425 
   
Interest coverage ratio
  4.16  3.41
 
        
Fixed Charge Coverage Ratio:
        
Total interest
 $117,092  $106,531 
Secured debt principal payments
  5,990   6,681 
Preferred dividends
  17,660   16,560 
   
Total fixed charges
  140,742   129,772 
EBITDA
 $486,930  $363,425 
   
Fixed charge coverage ratio
  3.46  2.80

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          The table below reflects the reconciliation of Adjusted EBITDA to net income, the most directly comparable U.S. GAAP measure, for the periods presented. Interest expense and the provisions for depreciation and amortization include discontinued operations. Dollars are in thousands.
                     
  Twelve Months Ended
  September 30, December 31, March 31, June 30, September 30,
 2008 2008 2009 2009 2009
   
Adjusted EBITDA Reconciliation:
                    
Net income
 $303,603  $283,425  $314,613  $218,112  $183,478 
Interest expense
  147,596   141,059   131,750   122,927   116,406 
Income tax expense (benefit)
  1,439   1,306   77   54   152 
Depreciation and amortization
  160,975   163,045   164,797   165,898   165,292 
Stock-based compensation expense
  8,024   8,530   11,360   11,034   10,637 
Provision for loan losses
  0   94   234   234   234 
Loss (gain) on extinguishment of debt
  (3,175)  (2,094)  (2,446)  (2,446)  24,696 
   
Adjusted EBITDA
 $618,462  $595,365  $620,385  $515,813  $500,895 
 
                    
Adjusted Fixed Charge Coverage Ratio:
                    
Interest expense
 $147,596  $141,059  $131,750  $122,927  $116,406 
Capitalized interest
  21,062   25,029   29,727   35,690   39,301 
Non-cash interest expense
  (11,325)  (11,231)  (11,214)  (11,289)  (11,410)
Secured debt principal payments
  8,137   8,119   8,232   8,592   8,810 
Preferred dividends
  23,840   23,201   22,579   22,311   22,101 
   
Total fixed charges
  189,310   186,177   181,074   178,231   175,208 
Adjusted EBITDA
 $618,462  $595,365  $620,385  $515,813  $500,895 
   
Adjusted fixed charge coverage ratio
  3.27  3.20  3.43  2.89  2.86

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Critical Accounting Policies
          Our consolidated financial statements are prepared in accordance with U.S. GAAP, which requires us to make estimates and assumptions. Management considers an accounting estimate or assumption critical if:
  the nature of the estimates or assumptions is material due to the levels of subjectivity and judgment necessary to account for highly uncertain matters or the susceptibility of such matters to change; and
 
  the impact of the estimates and assumptions on financial condition or operating performance is material.
     Management has discussed the development and selection of its critical accounting policies with the Audit Committee of the Board of Directors and the Audit Committee has reviewed the disclosure presented below relating to them. Management believes the current assumptions and other considerations used to estimate amounts reflected in our consolidated financial statements are appropriate and are not reasonably likely to change in the future. However, since these estimates require assumptions to be made that were uncertain at the time the estimate was made, they bear the risk of change. If actual experience differs from the assumptions and other considerations used in estimating amounts reflected in our consolidated financial statements, the resulting changes could have a material adverse effect on our consolidated results of operations, liquidity and/or financial condition. Please refer to Note 1 to the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009, for further information regarding significant accounting policies that impact us. There have been no material changes to these policies in 2009.
     The following table presents information about our critical accounting policies, as well as the material assumptions used to develop each estimate:
   
Nature of Critical Assumptions/Approach
Accounting Estimate Used
 
  
Allowance for Loan Losses
  
 
  
We maintain an allowance for loan losses in accordance with U.S. GAAP. The allowance for loan losses is maintained at a level believed adequate to absorb potential losses in our loans receivable. The determination of the allowance is based on a quarterly evaluation of all outstanding loans. If this evaluation indicates that there is a greater risk of loan charge-offs, additional allowances or placement on non-accrual status may be required. A loan is impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due as scheduled according to the contractual terms of the original loan agreement. Consistent with this definition, all loans on non-accrual are deemed impaired. To the extent circumstances improve and the risk of collectability is diminished, we will return these loans to full accrual status.
 The determination of the allowance is based on a quarterly evaluation of all outstanding loans, including general economic conditions and estimated collectability of loan payments and principal. We evaluate the collectability of our loans receivable based on a combination of factors, including, but not limited to, delinquency status, historical loan charge-offs, financial strength of the borrower and guarantors and value of the underlying property.

As a result of our quarterly evaluations, we recorded a $140,000 addition to the allowance for loan losses during the nine months ended September 30, 2009, resulting in an allowance for loan losses of $7,640,000 relating to loans with outstanding balances of $122,742,000. Also at September 30, 2009, we had loans with outstanding balances of $72,365,000 on non-accrual status.

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Nature of Critical Assumptions/Approach
Accounting Estimate Used
 
  
Business Combinations
  
 
  
Substantially all of the properties owned by us are leased under operating leases and are recorded at cost. The cost of our real property is allocated to land, buildings, improvements and intangibles in accordance with U.S. GAAP.
 We compute depreciation and amortization on our properties using the straight-line method based on their estimated useful lives which range from 15 to 40 years for buildings and five to 15 years for improvements. Lives for intangibles are based on the remaining term of the underlying leases.
 
  
 
 For the nine months ended September 30, 2009, we recorded $90,669,000, $24,944,000 and $7,530,000 as provisions for depreciation and amortization relating to buildings, improvements and intangibles, respectively, including amounts reclassified as discontinued operations. The average useful life of our buildings, improvements and intangibles was 36.4 years, 10.9 years and 8.3 years, respectively, for the nine months ended September 30, 2009.
 
  
Impairment of Long-Lived Assets
  
 
  
We review our long-lived assets for potential impairment in accordance with U.S. GAAP. An impairment charge must be recognized when the carrying value of a long-lived asset is not recoverable. The carrying value is not recoverable if it exceeds the sum of the undiscounted cash flows expected to result from the use and eventual disposition of the asset. If it is determined that a permanent impairment of a long-lived asset has occurred, the carrying value of the asset is reduced to its fair value and an impairment charge is recognized for the difference between the carrying value and the fair value.
 The net book value of long-lived assets is reviewed quarterly on a property by property basis to determine if there are indicators of impairment. These indicators may include anticipated operating losses at the property level, the tenant’s inability to make rent payments, a decision to dispose of an asset before the end of its estimated useful life and changes in the market that may permanently reduce the value of the property. If indicators of impairment exist, then the undiscounted future cash flows from the most likely use of the property are compared to the current net book value. This analysis requires us to determine if indicators of impairment exist and to estimate the most likely stream of cash flows to be generated from the property during the period the property is expected to be held.
 
  
 
 At September 30, 2009, we had four medical office buildings that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2009, an impairment charge of $1,873,000 was recorded to further reduce the carrying value of the four medical office buildings to their estimated fair value less costs to sell. In determining the fair value of the medical office buildings, we used a combination of third party appraisals based on market comparable transactions, other market listings and asset quality as well as third party offers to purchase.
 
  
Fair Value of Derivative Instruments
  
 
  
The valuation of derivative instruments is accounted for in accordance with U.S. GAAP, which requires companies to record derivatives at fair market value on the balance sheet as assets or liabilities.
 The valuation of derivative instruments requires us to make estimates and judgments that affect the fair value of the instruments. Fair values for our derivatives are estimated by utilizing pricing models that consider forward yield curves and discount rates. Such amounts and the recognition of such amounts are subject to significant estimates which may change in the future. At September 30, 2009, we participated in two interest rate swap agreements which are reported at their fair value of $4,375,000 and are included in other liabilities and accumulated other comprehensive income.

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Nature of Critical Assumptions/Approach
Accounting Estimate Used
 
  
Revenue Recognition
  
 
  
Revenue is recorded in accordance with U.S. GAAP, which requires that revenue be recognized after four basic criteria are met. These four criteria include persuasive evidence of an arrangement, the rendering of service, fixed and determinable income and reasonably assured collectability. If the collectability of revenue is determined incorrectly, the amount and timing of our reported revenue could be significantly affected. Interest income on loans is recognized as earned based upon the principal amount outstanding subject to an evaluation of collectability risk. Substantially all of our operating leases contain fixed and/or contingent escalating rent structures. Leases with fixed annual rental escalators are generally recognized on a straight-line basis over the initial lease period, subject to a collectability assessment. Rental income related to leases with contingent rental escalators is generally recorded based on the contractual cash rental payments due for the period.
 We evaluate the collectability of our revenues and related receivables on an on-going basis. We evaluate collectability based on assumptions and other considerations including, but not limited to, the certainty of payment, payment history, the financial strength of the investment’s underlying operations as measured by cash flows and payment coverages, the value of the underlying collateral and guaranties and current economic conditions.

If our evaluation indicates that collectability is not reasonably assured, we may place an investment on non-accrual or reserve against all or a portion of current income as an offset to revenue.

For the nine months ended September 30, 2009, we recognized $30,639,000 of interest income and $404,563,000 of rental income, including discontinued operations. Cash receipts on leases with deferred revenue provisions were $23,463,000 as compared to gross straight-line rental income recognized of $14,499,000 for the nine months ended September 30, 2009. At September 30, 2009, our straight-line receivable balance was $35,999,000, net of reserves totaling $379,000. Also at September 30, 2009, we had loans with outstanding balances of $72,365,000 on non-accrual status.
Forward-Looking Statements and Risk Factors
          This Quarterly Report on Form 10-Q may contain “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. These forward-looking statements concern and are based upon, among other things, the possible expansion of the company’s portfolio; the sale of properties; the performance of its operators and properties; its occupancy rates; its ability to acquire or develop properties; its ability to manage properties; its ability to enter into agreements with viable new tenants for vacant space or for properties that the company takes back from financially troubled tenants, if any; its ability to make distributions; its policies and plans regarding investments, financings and other matters; its tax status as a real estate investment trust; its ability to appropriately balance the use of debt and equity; its ability to access capital markets or other sources of funds; its critical accounting policies; and its ability to meet its earnings guidance. When the company uses words such as “may,” “will,” “intend,” “should,” “believe,” “expect,” “anticipate,” “project,” “estimate” or similar expressions, it is making forward-looking statements. Forward-looking statements are not guarantees of future performance and involve risks and uncertainties. The company’s expected results may not be achieved, and actual results may differ materially from expectations. This may be a result of various factors, including, but not limited to: the status of the economy; the status of capital markets, including availability and cost of capital; issues facing the health care industry, including compliance with, and changes to, regulations and payment policies; operators’/tenants’ difficulty in cost-effectively obtaining and maintaining adequate liability and other insurance; changes in financing terms; competition within the health care and senior housing industries; negative developments in the operating results or financial condition of operators/tenants, including, but not limited to, their ability to pay rent and repay loans; the company’s ability to transition or sell facilities with profitable results; the failure to make new investments as and when anticipated; the failure of closings to occur as and when anticipated; acts of God affecting the company’s properties; the company’s ability to re-lease space at similar rates as vacancies occur; the company’s ability to timely reinvest sale proceeds at similar rates to assets sold; operator/tenant bankruptcies or insolvencies; government regulations affecting Medicare and Medicaid reimbursement rates and operational requirements; liability or contract claims by or against operators/tenants; unanticipated difficulties and/or expenditures relating to future acquisitions; environmental laws affecting the company’s properties; changes in rules or practices governing the company’s financial reporting; and legal and operational matters, including real estate investment trust qualification and key management personnel recruitment and retention. Other important factors are identified in the company’s Annual Report on Form 10-K for the year ended December 31, 2008, as updated by our Current Report on Form 8-K filed August 6, 2009, including factors identified under the headings “Business,” “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Finally, the company assumes no obligation to update or revise any forward-looking statements or to update the reasons why actual results could differ from those projected in any forward-looking statements.

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Item 3. Quantitative and Qualitative Disclosures about Market Risk
          We are exposed to various market risks, including the potential loss arising from adverse changes in interest rates. We seek to mitigate the effects of fluctuations in interest rates by matching the terms of new investments with new long-term fixed rate borrowings to the extent possible. We may or may not elect to use financial derivative instruments to hedge interest rate exposure. These decisions are principally based on our policy to match our variable rate investments with comparable borrowings, but are also based on the general trend in interest rates at the applicable dates and our perception of the future volatility of interest rates. This section is presented to provide a discussion of the risks associated with potential fluctuations in interest rates.
          We historically borrow on our unsecured line of credit arrangement to acquire, construct or make loans relating to health care and senior housing properties. Then, as market conditions dictate, we will issue equity or long-term fixed rate debt to repay the borrowings under the unsecured line of credit arrangement.
          A change in interest rates will not affect the interest expense associated with our fixed rate debt. Interest rate changes, however, will affect the fair value of our fixed rate debt. Changes in the interest rate environment upon maturity of this fixed rate debt could have an effect on our future cash flows and earnings, depending on whether the debt is replaced with other fixed rate debt, variable rate debt or equity or repaid by the sale of assets. To illustrate the impact of changes in the interest rate markets, we performed a sensitivity analysis on our fixed rate debt instruments whereby we modeled the change in net present values arising from a hypothetical 1% increase in interest rates to determine the instruments’ change in fair value. The following table summarizes the analysis performed as of the dates indicated (in thousands):
                 
  September 30, 2009  December 31, 2008 
  Principal  Change in  Principal  Change in 
  balance  fair value  balance  fair value 
 
                
Senior unsecured notes
 $1,661,853  $(128,552) $1,845,000  $(112,438)
 
                
Fixed rate secured debt
  495,334   (24,105)  448,378   (17,966)
 
            
 
                
Totals
 $2,157,187  $(152,657) $2,293,378  $(130,404)
 
            
          On September 12, 2007, we entered into two forward-starting interest rate swaps (the “September 2007 Swaps”) for a total notional amount of $250,000,000 to hedge 10 years of interest payments associated with a long-term borrowing that was expected to occur in 2008. The September 2007 Swaps each had an effective date of September 12, 2008 and a maturity date of September 12, 2018. We expected to settle the 2007 Swaps when the debt was to be priced. The September 2007 Swaps were to have the economic effect of fixing $250,000,000 of our future debt at 4.469% plus a credit spread for 10 years. The September 2007 Swaps had been designated as cash flow hedges and we expected the 2007 Swaps to be highly effective at offsetting changes in cash flows of interest payments on $250,000,000 of our future debt due to changes in the LIBOR swap rate. Therefore, effective changes in the fair value of the September 2007 Swaps were recorded in AOCI and were to be reclassified to interest expense when the hedged forecasted transactions affected earnings (as interest payments are made on the expected debt issuance). The ineffective portion of the changes in fair value was to be recorded directly in earnings. During the year ended December 31, 2008, as a result of the severe dislocation in the credit markets, we terminated plans to issue debt and also terminated the September 2007 Swaps for $23,393,000. Amounts previously recorded in AOCI were reclassified to realized loss on derivatives resulting in $23,393,000 of expense as the forecasted transaction was no longer probable to occur.
          On August 7, 2009, we entered into an interest rate swap (the “August 2009 Swap”) for a total notional amount of $52,198,000 to hedge seven years of interest payments associated with long-term LIBOR based borrowings. The August 2009 Swap has an effective date of August 12, 2009 and a maturity date of September 1, 2016. The August 2009 Swap has the economic effect of fixing $52,198,000 at 3.93% plus a credit spread for seven years. The August 2009 Swap has been designated as a cash flow hedge and we expect it to be highly effective at offsetting changes in cash flows of interest payments on $52,198,000 of long-term debt due to changes in the LIBOR swap rate.
          On September 28, 2009, we entered into an interest rate swap (the “September 2009 Swap”) for a total notional amount of $48,155,000 to hedge seven years of interest payments associated with long-term LIBOR based borrowings. The September 2009 Swap has an effective date of September 30, 2009 and a maturity date of October 1, 2016. The September 2009 Swap has the economic effect of fixing $48,155,000 at 3.2675% plus a credit spread for seven years. The September 2009 Swap has been designated as a cash flow hedge and we expect it to be highly effective at offsetting changes in cash flows of interest payments on $48,155,000 of long-term debt due to changes in the LIBOR swap rate.

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          Our variable rate debt, including our unsecured line of credit arrangement, is reflected at fair value. At September 30, 2009, we had $143,000,000 outstanding related to our variable rate line of credit and $132,456,000 outstanding related to our variable rate secured debt. Assuming no changes in outstanding balances, a 1% increase in interest rates would result in increased annual interest expense of $2,755,000. At December 31, 2008, we had $570,000,000 outstanding related to our variable rate debt and assuming no changes in outstanding balances, a 1% increase in interest rates would have resulted in increased annual interest expense of $5,700,000.
          We are subject to risks associated with debt financing, including the risk that existing indebtedness may not be refinanced or that the terms of refinancing may not be as favorable as the terms of current indebtedness. The majority of our borrowings were completed under indentures or contractual agreements that limit the amount of indebtedness we may incur. Accordingly, in the event that we are unable to raise additional equity or borrow money because of these limitations, our ability to acquire additional properties may be limited.
Item 4. Controls and Procedures
          Our management, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rule 13a-15(e) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)) as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures are effective in providing reasonable assurance that information required to be disclosed by us in the reports we file with or submit to the Securities and Exchange Commission (“SEC”) under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms. No changes in our internal control over financial reporting (as defined in Rule 13a-15(f) under the Exchange Act) occurred during the fiscal quarter covered by this Quarterly Report on Form 10-Q that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
PART II. OTHER INFORMATION
Item 1A. Risk Factors
          Except as provided in “Item 2 — Management’s Discussion and Analysis of Financial Condition and Results of Operations — Forward Looking Statements and Risk Factors,” there have been no material changes from the risk factors identified under the heading “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2008.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
ISSUER PURCHASES OF EQUITY SECURITIES
                 
          Total Number    
          of Shares Purchased  Maximum Number 
          as Part of Publicly  of Shares that May 
  Total Number      Announced  Yet Be Purchased 
  of Shares  Average Price  Plans or Programs  Under the Plans or 
Period Purchased (1)  Paid Per Share  (2)  Programs 
July 1, 2009 through July 31, 2009
  932  $34.52         
August 1, 2009 through August 31, 2009
                
September 1, 2009 through September 30, 2009
                
 
              
Totals
  932  $34.52         
 
              
 
(1) During the three months ended September 30, 2009, the company acquired shares of common stock held by employees who tendered owned shares to satisfy the tax withholding on the lapse of certain restrictions on restricted stock.
 
(2) No shares were purchased as part of publicly announced plans or programs.

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Item 6. Exhibits
 31.1 Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer.
 
 31.2 Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer.
 
 32.1 Certification pursuant to 18 U.S.C. Section 1350 by Chief Executive Officer.
 
 32.2 Certification pursuant to 18 U.S.C. Section 1350 by Chief Financial Officer.
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
     
 HEALTH CARE REIT, INC.
 
 
Date: November 5, 2009 By:  /s/ George L. Chapman  
  George L. Chapman,  
  Chairman, Chief Executive Officer and President
(Principal Executive Officer) 
 
 
   
Date: November 5, 2009 By:  /s/ Scott A. Estes  
  Scott A. Estes,  
  Executive Vice President and Chief Financial Officer
(Principal Financial Officer) 
 
 
   
Date: November 5, 2009 By:  /s/ Paul D. Nungester, Jr.  
  Paul D. Nungester, Jr.,  
  Vice President and Controller
(Principal Accounting Officer) 
 
 

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