Welltower
WELL
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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 FY2010 Q3


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Table of Contents

 
 
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, 2010
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.)
   
4500 Dorr Street, Toledo, Ohio 43615
   
(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). Yes þ 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, 2010, the registrant had 135,129,154 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, 
  2010  2009 
  (Unaudited)  (Note) 
  (In thousands) 
Assets
        
Real estate investments:
        
Real property owned:
        
Land and land improvements
 $668,135  $521,055 
Buildings and improvements
  6,350,167   5,185,328 
Acquired lease intangibles
  223,349   127,390 
Real property held for sale, net of accumulated depreciation
  16,928   45,686 
Construction in progress
  286,366   456,832 
 
      
Gross real property owned
  7,544,945   6,336,291 
Less accumulated depreciation and amortization
  (804,651)  (677,851)
 
      
Net real property owned
  6,740,294   5,658,440 
Real estate loans receivable:
        
Real estate loans receivable
  416,570   427,363 
Less allowance for losses on loans receivable
  (1,190)  (5,183)
 
      
Net real estate loans receivable
  415,380   422,180 
 
      
Net real estate investments
  7,155,674   6,080,620 
Other assets:
        
Equity investments
  213,163   5,816 
Deferred loan expenses
  29,529   22,698 
Cash and cash equivalents
  181,147   35,476 
Restricted cash
  61,224   23,237 
Receivables and other assets
  252,330   199,339 
 
      
Total other assets
  737,393   286,566 
 
      
Total assets
 $7,893,067  $6,367,186 
 
      
 
        
Liabilities and equity
        
Liabilities:
        
Borrowings under unsecured line of credit arrangement
 $  $140,000 
Senior unsecured notes
  2,585,961   1,653,027 
Secured debt
  885,494   620,995 
Accrued expenses and other liabilities
  201,529   145,713 
 
      
Total liabilities
  3,672,984   2,559,735 
Equity:
        
Preferred stock
  275,000   288,683 
Common stock
  135,046   123,385 
Capital in excess of par value
  4,429,425   3,900,666 
Treasury stock
  (11,352)  (7,619)
Cumulative net income
  1,636,589   1,547,669 
Cumulative dividends
  (2,329,215)  (2,057,658)
Accumulated other comprehensive income
  (11,459)  (2,891)
Other equity
  5,972   4,804 
 
      
Total Health Care REIT, Inc. stockholders’ equity
  4,130,006   3,797,039 
Noncontrolling interests
  90,077   10,412 
 
      
Total equity
  4,220,083   3,807,451 
 
      
Total liabilities and equity
 $7,893,067  $6,367,186 
 
      
NOTE: The consolidated balance sheet at December 31, 2009 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, 
  2010  2009  2010  2009 
  (In thousands, except per share data) 
Revenues:
                
Rental income
 $152,127  $128,527  $441,337  $379,326 
Resident fees and services
  12,809      12,809    
Interest income
  10,054   10,528   28,437   30,639 
Other income
  1,156   1,089   4,802   3,810 
 
            
Total revenues
  176,146   140,144   487,385   413,775 
Expenses:
                
Interest expense
  44,408   27,595   110,703   79,428 
Property operating expenses
  20,849   12,153   45,859   34,441 
Depreciation and amortization
  48,565   39,187   138,321   114,446 
Transaction costs
  18,835      27,301    
General and administrative
  11,628   10,363   40,331   38,784 
Loss (gain) on extinguishment of debt
  9,099   26,374   34,171   24,697 
Provision for loan losses
  28,918      28,918   140 
 
            
Total expenses
  182,302   115,672   425,604   291,936 
 
            
Income from continuing operations before income taxes and income from unconsolidated joint ventures
  (6,156)  24,472   61,781   121,839 
Income tax (expense) benefit
  (52)  55   (325)  (17)
Income from unconsolidated joint ventures
  1,899      4,496    
 
            
Income from continuing operations
  (4,309)  24,527   65,952   121,822 
Discontinued operations:
                
Gain (loss) on sales of properties
  10,526   (806)  20,559   26,907 
Impairment of assets
  (947)  (1,873)  (947)  (1,873)
Income (loss) from discontinued operations, net
  511   2,837   2,973   9,233 
 
            
Discontinued operations, net
  10,090   158   22,585   34,267 
 
            
Net income
  5,781   24,685   88,537   156,089 
Less: Preferred stock dividends
  5,347   5,520   16,340   16,560 
Less: Net income (loss) attributable to noncontrolling interests
  (690)  35   (383)  40 
 
            
Net income attributable to common stockholders
 $1,124  $19,130  $72,580  $139,489 
 
            
 
                
Average number of common shares outstanding:
                
Basic
  125,298   114,874   124,132   111,345 
Diluted
  125,842   115,289   124,660   111,749 
 
                
Earnings per share:
                
Basic:
                
Income from continuing operations attributable to common stockholders
 $(0.08) $0.17  $0.40  $0.95 
Discontinued operations, net
  0.08      0.18   0.31 
 
            
Net income attributable to common stockholders*
 $0.01  $0.17  $0.58  $1.25 
 
            
 
                
Diluted:
                
Income from continuing operations attributable to common stockholders
 $(0.08) $0.16  $0.40  $0.94 
Discontinued operations, net
  0.08      0.18   0.31 
 
            
Net income attributable to common stockholders*
 $0.01  $0.17  $0.58  $1.25 
 
            
Dividends declared and paid per common share
 $0.69  $0.68  $2.05  $2.04 
 
* Amounts may not sum due to rounding
See notes to unaudited consolidated financial statements

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CONSOLIDATED STATEMENTS OF EQUITY (UNAUDITED)
HEALTH CARE REIT, INC. AND SUBSIDIARIES

(in thousands)
                                         
  Nine Months Ended September 30, 2010 
                          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
 $288,683  $123,385  $3,900,666  $(7,619) $1,547,669  $(2,057,658) $(2,891) $4,804  $10,412  $3,807,451 
Comprehensive income:
                                        
Net income
                  88,920               (383)  88,537 
Other comprehensive income:
                                        
Unrealized gain (loss) on equity investments
                          (95)          (95)
Cash flow hedge activity
                          (8,473)          (8,473)
 
                                       
Total comprehensive income
                                      79,969 
 
                                       
Contributions by noncontrolling interests
          41,423                       82,697   124,120 
Distributions to noncontrolling interests
                                  (2,649)  (2,649)
Amounts related to issuance of common stock from dividend reinvestment and stock incentive plans, net of forfeitures
      1,691   70,540   (3,733)              (246)      68,252 
Net proceeds from sale of common stock
      9,631   413,306                           422,937 
Equity component of convertible debt
          (9,689)                          (9,689)
Redemption of preferred stock
  (165)                                  (165)
Conversion of preferred stock
  (13,518)  339   13,179                            
Option compensation expense
                              1,414       1,414 
Cash dividends paid:
                                        
Common stock cash dividends
                      (255,217)              (255,217)
Preferred stock cash dividends
                      (16,340)              (16,340)
   
Balances at end of period
 $275,000  $135,046  $4,429,425  $(11,352) $1,636,589  $(2,329,215) $(11,459) $5,972  $90,077  $4,220,083 
   
                                         
  Nine Months Ended September 30, 2009 
                          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
 $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 
Proceeds from issuance of common shares
      16,969   628,294                           645,263 
Conversion of preferred stock
  (1,246)  30   1,216                            
Option compensation expense
                              1,446       1,446 
Cash dividends paid:
                                        
Common stock cash dividends
                      (227,959)              (227,959)
Preferred stock cash dividends
                      (16,558)              (16,558)
   
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 
   
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, 
  2010  2009 
  (In thousands) 
Operating activities
        
Net income
 $88,537  $156,089 
Adjustments to reconcile net income to net cash provided from (used in) operating activities:
        
Depreciation and amortization
  140,137   123,143 
Other amortization expenses
  13,178   10,999 
Provision for loan losses
  28,918   140 
Impairment of assets
  947   1,873 
Stock-based compensation expense
  9,757   8,734 
Loss (gain) on extinguishment of debt
  34,171   24,697 
Income from unconsolidated joint ventures
  (4,496)   
Rental income less than (in excess of) cash received
  (6,200)  8,964 
Amortization related to above (below) market leases, net
  (2,112)  (1,344)
Loss (gain) on sales of properties
  (20,559)  (26,907)
Increase (decrease) in accrued expenses and other liabilities
  10,139   (5,038)
Decrease (increase) in receivables and other assets
  (1,413)  (10,901)
 
      
Net cash provided from (used in) operating activities
  291,004   290,449 
 
        
Investing activities
        
Investment in real property
  (803,364)  (417,378)
Capitalized interest
  (16,008)  (30,866)
Investment in real estate loans receivable
  (52,499)  (46,882)
Other investments, net of payments
  (75,349)  (18,969)
Principal collected on real estate loans receivable
  18,819   34,892 
Contributions to unconsolidated joint ventures
  (174,692)   
Decrease (increase) in restricted cash
  (34,279)  136,577 
Proceeds from sales of real property
  134,722   153,507 
 
      
Net cash provided from (used in) investing activities
  (1,002,650)  (189,119)
 
        
Financing activities
        
Net increase (decrease) under unsecured lines of credit arrangements
  (140,000)  (427,000)
Proceeds from issuance of senior unsecured notes
  1,378,180    
Payments to extinguish senior unsecured notes
  (495,542)  (201,048)
Net proceeds from the issuance of secured debt
  79,127   276,277 
Payments on secured debt
  (177,305)  (102,635)
Net proceeds from the issuance of common stock
  486,565   683,883 
Decrease (increase) in deferred loan expenses
  (1,993)  (7,286)
Contributions by noncontrolling interests
  2,491   1,946 
Distributions to noncontrolling interests
  (2,649)  (1,967)
Cash distributions to stockholders
  (271,557)  (244,517)
 
      
Net cash provided from (used in) financing activities
  857,317   (22,347)
 
      
Increase (decrease) in cash and cash equivalents
  145,671   78,983 
Cash and cash equivalents at beginning of period
  35,476   23,370 
 
      
Cash and cash equivalents at end of period
 $181,147  $102,353 
 
      
 
        
Supplemental cash flow information:
        
Interest paid
 $92,106  $100,365 
Income taxes paid
  220   534 
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, 2010, our broadly diversified portfolio consisted of 641 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, 2010 are not necessarily an indication of the results that may be expected for the year ending December 31, 2010. 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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010.
New Accounting Standards
     In June 2009, the Financial Accounting Standards Board (“FASB”) amended the consolidation guidance for variable interest entities. The new guidance, to be applied on a continuous basis, requires enterprises to perform a qualitative approach to determining whether or not a variable interest entity will need to be consolidated. This evaluation is based on an enterprise’s ability to direct and influence the activities of a variable interest entity that most significantly impact its economic performance. This amendment was effective as of January 1, 2010. The adoption of this guidance did not have a material impact on our consolidated financial position or results of operations.
     In July 2010, the FASB issued Accounting Standards Update No. 2010-20, Receivables (Topic 310): Disclosures about the Credit Quality of Financing Receivables and the Allowance for Credit Losses (“ASU 2010-20”). This update expands disclosures about the credit quality of our financing receivables, how that risk is analyzed and assessed in arriving at the allowance for credit losses, and changes and reasons for those changes in the allowance for credit losses. Both new and existing disclosures must be disaggregated by portfolio segment and class. The disaggregation of information is based on the level at which an entity develops and documents a systematic method for determining its allowance for credit losses. This update is effective for interim periods and fiscal years ending after December 15, 2010. We are currently evaluating the impact of ASU 2010-20 on our consolidated financial statements.
3. Real Property Acquisitions and Development
Merrill Gardens Partnership
     During the three months ended September 30, 2010, we completed the formation of our partnership with Merrill Gardens LLC to own and operate a portfolio of 38 combination senior housing and care communities located primarily in West Coast markets. We own an 80% partnership interest and Merrill Gardens owns the remaining 20% interest and continues to manage the communities. The partnership owns and operates 13 communities previously owned by us and 25 additional communities previously owned by Merrill Gardens. The transaction took advantage of the structure authorized by the REIT Investment Diversification and Empowerment Act of 2007 (“RIDEA”). The results of operations for this partnership have been included in our consolidated results of operations beginning as of September 1, 2010 and are a component of our senior housing and care segment. Consolidation is based on a combination of ownership interest and operational decision-making control authority.
     In conjunction with the formation of the partnership we contributed $254,885,000 of cash and the 13 properties previously owned by us and the partnership assumed the secured debt relating to these properties. Merrill Gardens contributed the remaining 25 properties to the partnership and the secured debt relating to these properties in exchange for their 20% interest in the partnership. The 13 properties are recorded at their historical carrying values and the noncontrolling interest was established based on such values. The difference between the fair value of the consideration received relating to these properties and the historical allocation of the 20% noncontrolling interest was recorded in capital in excess of par value. The total purchase price for the 25 communities acquired have been allocated to the tangible and identifiable intangible assets and liabilities based upon their respective fair values in accordance

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
with the Company’s accounting policies. Such allocations have not been finalized as we await final asset valuations and, as such, the allocation of the purchase consideration included in the accompanying Consolidated Balance Sheet at September 30, 2010 is preliminary and subject to adjustment. The 20% noncontrolling interest relating to the acquired 25 properties is also reflected at estimated fair value. The following table presents the preliminary allocation of the purchase price to assets and liabilities assumed, based on their estimated fair values (in thousands):
     
Land and land improvements
 $86,664 
Buildings and improvements
  423,919 
Acquired lease intangibles
  75,320 
Cash and cash equivalents
  4,777 
Restricted cash
  3,707 
Receivables and other assets
  16,459 
 
   
Total assets acquired
  610,846 
Secured debt
  235,273 
Accrued expenses and other liabilities
  3,316 
 
   
Total liabilities assumed
  238,589 
Capital in excess of par
  41,423 
Noncontrolling interests
  80,207 
 
   
Net assets acquired
 $250,627 
 
   
     The weighted average useful life of the acquired intangibles was 1.9 years as of September 30, 2010.
Real Property Investment Activity
     The following is a summary of our real property investment activity for the periods presented (in thousands):
                         
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Senior Housing  Medical      Senior Housing  Medical    
  and Care  Facilities  Totals  and Care  Facilities  Totals 
Real property acquisitions:
                        
Senior housing — operating
 $576,000  $  $576,000  $  $  $ 
Senior housing — triple net
  219,772      219,772          
Medical office buildings
     246,582   246,582          
 
                  
Total acquisitions
  795,772   246,582   1,042,354          
Less: Assumed debt
  (244,921)  (108,244)  (353,165)         
Assumed other items, net
  (118,901)  (31,048)  (149,949)         
 
                  
Cash disbursed for acquisitions
  431,950   107,290   539,240          
Construction in progress additions:
                        
Senior housing — triple net
  62,115      62,115   250,066      250,066 
Skilled nursing facilities
           19,534      19,534 
Hospitals
     93,931   93,931      82,671   82,671 
Medical office buildings
     91,042   91,042      96,642   96,642 
 
                  
Total construction in progress additions
  62,115   184,973   247,088   269,600   179,313   448,913 
Less: Capitalized interest
  (5,700)  (9,836)  (15,536)  (21,306)  (9,560)  (30,866)
Accruals(1)
     (8,088)  (8,088)     (21,466)  (21,466)
 
                  
Cash disbursed for construction in progress
  56,415   167,049   223,464   248,294   148,287   396,581 
Capital improvements to existing properties
  18,821   21,839   40,660   11,333   9,464   20,797 
 
                  
Total cash invested in real property
 $507,186  $296,178  $803,364  $259,627  $157,751  $417,378 
 
                  
 
(1) Represents non-cash accruals for amounts to be paid in future periods relating to properties that converted in the period noted above.
     The following is a summary of the construction projects that were placed into service and began generating revenues during the periods presented:

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
                         
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Senior Housing  Medical      Senior Housing  Medical    
  and Care  Facilities  Totals  and Care  Facilities  Totals 
Development projects:
                        
Senior housing facilities
 $269,261  $  $269,261  $257,456  $  $257,456 
Skilled nursing facilities
           14,561      14,561 
Hospitals
     96,829   96,829          
Medical office buildings
     49,144   49,144      173,744   173,744 
 
                  
Total development projects
  269,261   145,973   415,234   272,017   173,744   445,761 
Expansion projects
  2,320      2,320   4,064      4,064 
 
                  
Total construction in progress conversions
 $271,581  $145,973  $417,554  $276,081  $173,744  $449,825 
 
                  
     Transaction costs for the nine months ended September 30, 2010 primarily represent costs incurred with the Merrill Gardens partnership (including due diligence costs, fees for legal and valuation services, and termination of a pre-existing relationship computed based on the fair value of the assets acquired), lease termination fees and costs incurred in connection with the new property acquisitions.
4. Real Estate Intangibles
     The following is a summary of our real estate intangibles, excluding those classified as held for sale, as of the dates indicated (dollars in thousands):
         
  September 30, 2010  December 31, 2009 
Assets:
        
In place lease intangibles
 $149,447  $74,198 
Above market tenant leases
  27,689   10,232 
Below market ground leases
  41,874   39,806 
Lease commissions
  4,339   3,154 
 
      
Gross historical cost
  223,349   127,390 
Accumulated amortization
  (37,881)  (29,698)
 
      
Net book value
 $185,468  $97,692 
 
      
Weighted-average amortization period in years
  17.5   30.0 
 
        
Liabilities:
        
Below market tenant leases
 $54,009  $22,961 
Above market ground leases
  4,084   4,084 
 
      
Gross historical cost
  58,093   27,045 
Accumulated amortization
  (14,582)  (10,478)
 
      
Net book value
 $43,511  $16,567 
 
      
Weighted-average amortization period in years
  12.3   12.1 
5. Dispositions, Assets Held for Sale and Discontinued Operations
     During the year ended December 31, 2009, an impairment charge of $25,223,000 was recorded to reduce the carrying value of eight medical facilities to their estimated fair value less costs to sell. In determining the fair value of the properties, 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. During the nine months ended September 30, 2010, we sold 16 properties, including three of the held for sale medical facilities, for net gains of $20,559,000. At September 30, 2010, we had five medical facilities and one senior housing facility that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2010, we recorded an impairment charge of $947,000 related to two of the held for sale medical facilities to adjust the carrying values to estimated fair values less costs to sell based on current sales price expectations. The following is a summary of our real

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
property disposition activity for the periods presented (in thousands):
                         
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Senior Housing  Medical      Senior Housing  Medical    
  and Care  Facilities  Totals  and Care  Facilities  Totals 
Real property dispositions:
                        
Senior housing facilities
 $3,437  $  $3,437  $44,877  $  $44,877 
Skilled nursing facilities
  104,628      104,628   18,854      18,854 
Hospitals
              40,841   40,841 
Medical office buildings
     7,568   7,568      28,128   28,128 
 
                  
Total dispositions
  108,065   7,568   115,633   63,731   68,969   132,700 
Add: Gain on sales of real property
  18,894   1,665   20,559   13,358   13,549   26,907 
Seller financing on sales of real property
     (1,470)  (1,470)     (6,100)  (6,100)
 
                  
Proceeds from real property sales
 $126,959  $7,763  $134,722  $77,089  $76,418  $153,507 
 
                  
     We have reclassified the income and expenses attributable to all properties sold and attributable to properties held for sale at September 30, 2010 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, 
  2010  2009  2010  2009 
Revenues:
                
Rental income
 $2,602  $6,794  $9,292  $25,237 
Expenses:
                
Interest expense
  577   1,238   1,817   4,748 
Property operating expenses
  973   821   2,686   2,559 
Provision for depreciation
  541   1,898   1,816   8,697 
 
            
Income (loss) from discontinued operations, net
 $511  $2,837  $2,973  $9,233 
 
            

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
6. Real Estate Loans Receivable
     The following is a summary of our real estate loan activity for the periods presented (in thousands):
                         
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Senior Housing  Medical      Senior Housing  Medical    
  and Care  Facilities  Totals  and Care  Facilities  Totals 
Advances on real estate loans receivable:
                        
Investments in new loans
 $9,742  $15,799  $25,541  $3,316  $  $3,316 
Draws on existing loans
  28,413   15   28,428   42,226   1,340   43,566 
 
                  
Sub-total
  38,155   15,814   53,969   45,542   1,340   46,882 
Less: Seller financing on property sales
     (1,470)  (1,470)         
 
                  
Net cash advances on real estate loans
  38,155   14,344   52,499   45,542   1,340   46,882 
Receipts on real estate loans receivable:
                        
Loan payoffs
  3,809      3,809   20,440      20,440 
Principal payments on loans
  11,682   3,328   15,010   12,838   1,614   14,452 
 
                  
Total receipts on real estate loans
  15,491   3,328   18,819   33,278   1,614   34,892 
 
                  
Net advances (receipts) on real estate loans
 $22,664  $11,016  $33,680  $12,264  $(274) $11,990 
 
                  
     We recorded $28,918,000 of provision for loan losses during the nine months ended September 30, 2010. This amount includes the write-off of loans totaling $32,753,000 primarily related to certain early stage senior housing and CCRC development projects no longer being actively pursued. This was offset by a net reduction of the allowance balance by $3,835,000, resulting in an allowance for losses on loans receivable balance of $1,190,000 as of September 30, 2010.
     During the quarter ended September 30, 2010, we received title to a parcel of land and an equity interest in full satisfaction of certain loans outstanding with a combined balance of $38,848,000. For balance sheet purposes, the land parcel is recorded as land and the equity interest is accounted for as an equity method investment.
7. Investments in Unconsolidated Joint Ventures
     During the six months ended June 30, 2010, we entered into a joint venture investment with Forest City Enterprises (NYSE:FCE.A and FCE.B). We acquired a 49% interest in a seven-building life science campus with approximately 1.2 million square feet located in University Park in Cambridge, MA, which is immediately adjacent to the campus of the Massachusetts Institute of Technology. Six buildings closed on February 22, 2010 and the seventh closed on June 30, 2010. The portfolio is 100% leased and includes affiliates of investment grade pharmaceutical and research tenants such as Novartis, Genzyme, Millennium (a subsidiary of Takeda Pharmaceuticals), and Brigham and Women’s Hospital. Forest City Enterprises self-developed the portfolio and will continue to manage it on behalf of the joint venture. The life science campus is part of a mixed-use project that includes a 210-room hotel, 674 residential units, a grocery store, restaurants and retail.
     In connection with these transactions, we invested $174,692,000 of cash which is recorded as an equity investment on the balance sheet. Our share of the non-recourse secured debt assumed by the joint venture was approximately $156,729,000 with weighted-average interest rates of 7.1%. The results of operations for these properties have been included in our consolidated results of operations from the date of acquisition by the joint venture and are reflected in our income statement as income from unconsolidated joint ventures. The aggregate remaining unamortized basis difference of our investment in this joint venture of $18,411,000 at September 30, 2010 is primarily attributable to real estate and related intangible assets and will be amortized over the life of the related properties and included in the reported amount of income from unconsolidated joint ventures.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
8. Customer Concentration
     The following table summarizes certain information about our customer concentration as of September 30, 2010 (dollars in thousands):
             
  Number of Total Percent of
  Properties Investment(2) Investment(3)
Concentration by investment:(1)
            
Merrill Gardens LLC
  38  $745,473   10%
Senior Living Communities, LLC
  12   593,483   9%
Aurora Health Care, Inc.
  18   305,517   4%
Brookdale Senior Living, Inc.
  86   303,463   4%
Signature Healthcare LLC
  32   260,620   4%
Remaining portfolio
  455   4,948,308   69%
     
Totals
  641  $7,156,864   100%
     
 
(1) All of our top five customers, except for Aurora Health Care, Inc., are in our senior housing and care segment.
 
(2) Excludes our share of unconsolidated joint venture investment of $349,832,000. Please see Note 7 for additional information.
 
(3) Investments with our top five customers comprised 24% of total investments at December 31, 2009.
9. Borrowings Under Line of Credit Arrangement and Related Items
     At September 30, 2010, 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 (0.86% at September 30, 2010). The applicable margin is based on certain of our debt ratings and was 0.6% at September 30, 2010. In addition, we pay a facility fee annually to each bank based on the bank’s commitment amount. The facility fee depends on certain of our debt ratings and was 0.15% at September 30, 2010. 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 September 30, Nine Months Ended September 30,
  2010 2009 2010 2009
Balance outstanding at quarter end
 $  $143,000  $  $143,000 
Maximum amount outstanding at any month end
 $560,000  $292,000  $560,000  $559,000 
Average amount outstanding (total of daily principal balances divided by days in period)
 $220,467  $217,174  $265,465  $301,740 
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)
  2.22%  1.99%  1.74%  1.76%
10. Senior Unsecured Notes and Secured Debt
     We have $2,585,961,000 of senior unsecured notes with annual stated interest rates ranging from 3.00% to 8.00%. The carrying amounts of the senior unsecured notes represent the par value of $2,614,930,000 adjusted for any unamortized premiums or discounts and other basis adjustments related to hedging the debt with derivative instruments. See Note 11 for further discussion regarding derivative instruments.
     During the three months ended December 31, 2006, we issued $345,000,000 of 4.75% senior unsecured convertible notes due December 2026, generating net proceeds of $337,517,000. The notes are convertible, in certain circumstances, into cash and, if applicable, shares of common stock at an initial conversion rate of 20.8833 shares per $1,000 principal amount of notes, which represents an initial conversion price of approximately $47.89 per share. In general, upon conversion, the holder of each note would receive, in respect of the conversion value of such note, cash up to the principal amount of such note and common stock for the note’s conversion value in excess of such principal amount. In addition, on each of December 1, 2011, December 1, 2016 and December 1, 2021, holders may require us to purchase all or a portion of their notes at a purchase price in cash equal to 100% of the principal amount of the notes to be purchased, plus any accrued and unpaid interest. During the three months ended March 31, 2009, we

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
extinguished $5,000,000 of these notes and recognized a gain of $446,000. During the six months ended June 30, 2010, we extinguished $214,412,000 of these notes, recognized a loss of $8,837,000 and paid $18,552,000 to reacquire the equity component of convertible debt. As of September 30, 2010, we had $125,588,000 of these notes outstanding.
     In July 2007, we issued $400,000,000 of 4.75% senior unsecured convertible notes due July 2027, generating net proceeds of $388,943,000. The notes are convertible, in certain circumstances, into cash and, if applicable, shares of our common stock at an initial conversion rate of 20.0000 shares per $1,000 principal amount of notes, which represents an initial conversion price of approximately $50.00 per share. In general, upon conversion, the holder of each note would receive, in respect of the conversion value of such note, cash up to the principal amount of such note and common stock for the note’s conversion value in excess of such principal amount. In addition, on each of July 15, 2012, July 15, 2017 and July 15, 2022, holders may require us to purchase all or a portion of their notes at a purchase price in cash equal to 100% of the principal amount of the notes to be purchased, plus any accrued and unpaid interest. During the three months ended March 31, 2009, we extinguished $5,000,000 of these notes and recognized a gain of $594,000. During the six months ended June 30, 2010, we extinguished $226,914,000 of these notes, recognized a loss of $16,235,000 and paid $21,062,000 to reacquire the equity component of convertible debt. As of September 30, 2010, we had $168,086,000 of these notes outstanding.
     During the nine months ended September 30, 2010, we issued $494,403,000 of 3.00% senior unsecured convertible notes due December 2029, generating net proceeds of $486,084,000. The notes are convertible, in certain circumstances, into cash and, if applicable, shares of common stock at an initial conversion rate of 19.5064 shares per $1,000 principal amount of notes, which represents an initial conversion price of approximately $51.27 per share. In general, upon conversion, the holder of each note would receive, in respect of the conversion value of such note, cash up to the principal amount of such note and common stock for the note’s conversion value in excess of such principal amount. In addition, on each of December 1, 2014, December 1, 2019 and December 1, 2024, holders may require us to purchase all or a portion of their notes at a purchase price in cash equal to 100% of the principal amount of the notes to be purchased, plus any accrued and unpaid interest. In connection with this issuance, we recognized $29,925,000 of equity component of convertible debt.
     During the three months ended June 30, 2010, we issued $450,000,000 of 6.125% senior unsecured notes due 2020 with net proceeds of $446,328,000. During the three months ended September 30, 2010, we issued $450,000,000 of 4.70% senior unsecured notes due 2017 with net proceeds of $445,768,000. We have secured debt totaling $885,494,000, collateralized by owned properties, with annual interest rates ranging from 3.86% to 8.74%. The carrying amounts of the secured debt represent the par value of $897,265,000 adjusted for any unamortized fair value adjustments. The carrying values of the properties securing the debt totaled $1,399,126,000 at September 30, 2010. During the nine months ended September 30, 2010, we assumed $363,515,000 of first mortgage loans principal with an average rate of 6.44% secured by 41 properties. During the nine months ended September 30, 2010, we extinguished $159,475,000 of first mortgage loans principal with an average rate of 5.93% and recognized a loss of $9,099,000.
     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, 2010, we were in compliance with all of the covenants under our debt agreements.
     At September 30, 2010, the annual principal payments due on these debt obligations are as follows (in thousands):
             
  Senior  Secured    
  Unsecured Notes(1)  Debt (1)  Totals 
2010
 $  $4,927  $4,927 
2011
     53,611   53,611 
2012
  76,853   73,540   150,393 
2013
  300,000   52,987   352,987 
2014
     166,407   166,407 
Thereafter
  2,238,077   545,793   2,783,870 
 
         
Totals
 $2,614,930  $897,265  $3,512,195 
 
         
 
(1) Amounts represent principal amounts due and do not include unamortized premiums/discounts or other fair value adjustments as reflected on the balance sheet.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
11. 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. Derivates are recorded at fair value on the balance sheet as assets or liabilities. The valuation of derivative instruments requires us to make estimates and judgments that affect the fair value of the instruments. Fair values of our derivatives are estimated by pricing models that consider the forward yield curves and discount rates. 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 September 30, 2010 December 31, 2009
Cash flow hedge interest rate swaps
 Other liabilities $  $2,381 
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 other comprehensive income (“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 $1,643,000 of losses, which are included in accumulated other comprehensive income (“AOCI”), 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 periods presented (dollars in thousands):
                     
      Three Months Ended Nine Months Ended
  Location September 30, 2010 September 30, 2009 September 30, 2010 September 30, 2009
Gain (loss) on interest rate swap recognized in OCI (effective portion)
 n/a   $(3,211) $(4,644) $(10,307) $(4,644)
Gain (loss) reclassified from AOCI into income (effective portion)
 Interest expense  (236)  (229)  (1,834)  (148)
Gain (loss) recognized in income (ineffective portion and amount excluded from effectiveness testing)
 Realized loss            
     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. This swap was terminated on September 30, 2010 for a cash payment of $6,645,000. The effective portion is being amortized over the remaining term of the original swap as an adjustment to the yield on our LIBOR-based debt. The August 2009 Swap had an effective date of August 12, 2009 and a maturity date of September 1, 2016. The August 2009 Swap had the economic effect of fixing $52,198,000 at 3.93% plus a credit spread for seven years. The August 2009 Swap had been designated as a cash flow hedge and we expected 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. This swap was terminated on September 30, 2010 for a cash payment of $4,365,000. The effective portion is being amortized over the remaining term of the original swap as an adjustment to the yield on our LIBOR-based debt. The September 2009 Swap had an effective date of September 30, 2009 and a maturity date of October 1, 2016. The September 2009 Swap had the economic effect of fixing $48,155,000 at 3.2675% plus a credit spread for seven years. The September 2009 Swap had been designated as a cash flow hedge and we expected 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.
Fair Value Hedges

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
     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, 2010 or December 31, 2009.
12. Commitments and Contingencies
     We have two outstanding letters 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 letters of credit terminates in 2013. At September 30, 2010, our obligation under the letters of credit was $4,200,000.
     We have an outstanding letter of credit issued for the benefit of certain insurance companies that provide liability and property insurance to one of our tenants. Our obligation to provide the letter of credit terminates in 2013. At September 30, 2010, 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 November 2010. At September 30, 2010, our obligation under the letter of credit was $129,057.
     At September 30, 2010, we had outstanding construction in process of $286,366,000 for leased properties and were committed to providing additional funds of approximately $314,132,000 to complete construction. At September 30, 2010, we had contingent purchase obligations totaling $7,065,000. These contingent purchase obligations relate to unfunded capital improvement obligations. Rents due from the tenant are increased to reflect the additional investment in the property.
     At September 30, 2010, we had operating lease obligations of $209,719,000 relating to certain ground leases and company office space. We incurred rental expense relating to company office space of $303,000 and $938,000 for the three and nine months ended September 30, 2010, respectively, as compared to $302,000 and $899,000 for the same periods in 2009. 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, 2010, aggregate future minimum rentals to be received under these noncancelable subleases totaled $31,088,000.
     At September 30, 2010, future minimum lease payments due under operating leases are as follows (in thousands):
     
2010
 $1,250 
2011
  4,980 
2012
  5,054 
2013
  4,758 
2014
  4,781 
Thereafter
  188,896 
 
   
Totals
 $209,719 
 
   
13. Stockholders’ Equity
     The following is a summary of our stockholder’s equity capital accounts as of the dates indicated:
         
  September 30, 2010  December 31, 2009 
Preferred Stock, $1.00 par value:
        
Authorized shares
  50,000,000   50,000,000 
Issued shares
  11,000,000   11,474,093 
Outstanding shares
  11,000,000   11,474,093 
 
        
Common Stock, $1.00 par value:
        
Authorized shares
  225,000,000   225,000,000 
Issued shares
  135,293,332   123,583,242 
Outstanding shares
  135,009,522   123,385,317 

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
     Preferred Stock. 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. During the nine months ended September 30, 2010, certain holders of our Series G Cumulative Convertible Preferred Stock converted 394,200 shares into 282,078 shares of our common stock, leaving 5,513 of such shares outstanding which were redeemed by us on September 30, 2010. During the three months ended September 30, 2010, the holder of our Series E Cumulative Convertible and Redeemable Preferred Stock converted 74,380 shares into 56,935 shares of our common stock, leaving no such shares outstanding at September 30, 2010.
     Common Stock. The following is a summary of our common stock issuances during the nine months ended September 30, 2010 and 2009 (dollars in thousands, except per share amounts):
                 
  Shares Issued  Average Price  Gross Proceeds  Net Proceeds 
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 
 
             
 
                
September 2010 public issuance
  9,200,000  $45.75  $420,900  $403,921 
2010 Equity shelf plan issuances
  431,082   44.94   19,371   19,014 
2010 Dividend reinvestment plan issuances
  1,441,612   42.83   61,737   61,737 
2010 Option exercises
  56,947   33.24   1,893   1,893 
 
             
2010 Totals
  11,129,641      $503,901  $486,565 
 
             
     Dividends. The following is a summary of our dividend payments (dollars in thousands, except per share amounts):
                 
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Per Share  Amount  Per Share  Amount 
Common Stock
 $2.0500  $255,217  $2.0400  $227,959 
Series D Preferred Stock
  1.4766   5,906   1.4766   5,906 
Series E Preferred Stock
  1.1250   94   1.1250   84 
Series F Preferred Stock
  1.4297   10,008   1.4297   10,008 
Series G Preferred Stock
  1.4064   332   1.4064   560 
 
              
Totals
     $271,557      $244,517 
 
              
Comprehensive Income
     The following is a summary of accumulated other comprehensive income/(loss) as of the dates indicated (in thousands):
         
  September 30, 2010  December 31, 2009 
Unrecognized losses on cash flow hedges
 $(10,380) $(1,907)
Unrecognized losses on equity investments
  (645)  (550)
Unrecognized actuarial losses
  (434)  (434)
 
      
Totals
 $(11,459) $(2,891)
 
      

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
     The following is a summary of comprehensive income/(loss) for the periods indicated (in thousands):
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2010  2009  2010  2009 
Unrecognized losses on cash flow hedges
 $(2,975) $(4,415) $(8,473) $(4,496)
Unrecognized gains (losses) on equity investments
  42   489   (95)  667 
 
            
Total other comprehensive income (loss)
  (2,933)  (3,926)  (8,568)  (3,829)
Net income attributable to controlling interests
  6,471   24,650   88,920   156,049 
 
            
Comprehensive income attributable to controlling interests
  3,538   20,724   80,352   152,220 
Net and comprehensive income (loss) attributable to noncontrolling interests
  (690)  35   (383)  40 
 
            
Total comprehensive income
 $2,848  $20,759  $79,969  $152,260 
 
            
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. Expense, which is recognized as the options vest based on the market value at the date of the award, totaled $221,000 and $1,414,000 for the three and nine months ended September 30, 2010, respectively, as compared to $182,000 and $1,446,000 for the same periods in 2009.
14. Stock Incentive Plans
     Our Amended and Restated 2005 Long-Term Incentive Plan 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
  September 30, 2010 September 30, 2009
Dividend yield
  6.28%  7.35%
Expected volatility
  34.08%  29.36%
Risk-free interest rate
  3.23%  2.33%
Expected life (in years)
  7.0   7.0 
Weighted-average fair value
 $7.82  $4.38 
     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.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
Option Award Activity
     The following table summarizes information about stock option activity for the nine months ended September 30, 2010:
                 
  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
  1,062  $37.71   8.1     
Options granted
  280   43.29         
Options exercised
  (57)  33.24         
Options terminated
  (6)  37.82         
 
            
Options at end of period
  1,279  $$39.13   7.8  $10,502 
 
            
Options exercisable at end of period
  512  $37.21   6.1  $5,185 
Weighted average fair value of options granted during the period
     $$7.82         
                
     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, 2010. During the nine months ended September 30, 2010 and 2009, the aggregate intrinsic value of options exercised under our stock incentive plans was $668,000 and $54,000, respectively (determined as of the date of option exercise). Cash received from option exercises under our stock incentive plans was $1,893,000 for the nine months ended September 30, 2010.
     As of September 30, 2010, there was approximately $3,045,000 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, 2010, there was approximately $8,810,000 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, 2010 and changes for the nine months ended September 30, 2010:
                 
  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, 2009
  675  $5.44   405  $40.26 
Vested
  (181)  5.91   (232)  42.02 
Granted
  280   7.82   244   43.32 
Terminated
  (6)  7.06   (1)  38.55 
 
            
Non-vested at September 30, 2010
  768  $6.19   416  $41.09 
 
            

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
15. 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, 
  2010  2009  2010  2009 
Numerator for basic and diluted earnings per share — net income attributable to common stockholders
 $1,124  $19,130  $72,580  $139,489 
 
            
Denominator for basic earnings per share — weighted average shares
  125,298   114,874   124,132   111,345 
Effect of dilutive securities:
                
Employee stock options
  128   11   112    
Non-vested restricted shares
  416   404   416   404 
 
            
Dilutive potential common shares
  544   415   528   404 
 
            
Denominator for diluted earnings per share — adjusted weighted average shares
  125,842   115,289   124,660   111,749 
 
            
Basic earnings per share
 $0.01  $0.17  $0.58  $1.25 
 
            
Diluted earnings per share
 $0.01  $0.17  $0.58  $1.25 
 
            
     The diluted earnings per share calculations exclude the dilutive effect of 381,000 stock options for the three and nine months ended September 30, 2010, as compared to 418,000 and 885,000 for the same periods in 2009, because the exercise prices were less than the average market price. The outstanding convertible senior unsecured notes were not included in these calculations as the effect of the conversions into common stock was anti-dilutive for the relevant periods presented.
16. 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.
Available-for-sale Equity Investments — Available-for-sale equity investments are recorded at their fair 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 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 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):

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
                 
  September 30, 2010  December 31, 2009 
  Carrying  Fair  Carrying  Fair 
  Amount  Value  Amount  Value 
Financial Assets:
                
Mortgage loans receivable
 $78,864  $78,972  $74,517  $74,765 
Other real estate loans receivable
  337,706   347,777   352,846   354,429 
Available-for-sale equity investments
  955   955   1,050   1,050 
Cash and cash equivalents
  181,147   181,147   35,476   35,476 
 
                
Financial Liabilities:
                
Borrowings under unsecured lines of credit arrangements
 $  $  $140,000  $140,000 
Senior unsecured notes
  2,585,961   2,885,225   1,653,027   1,762,129 
Secured debt
  885,494   953,451   620,995   623,266 
Interest rate swap agreements
        2,381   2,381 
     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.
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 reported at fair value on a recurring basis. The market approach uses prices and other relevant information generated by market transactions involving identical or comparable assets or liabilities.
                 
  Fair Value Measurements as of September 30, 2010 
  Total  Level 1  Level 2  Level 3 
Available-for-sale equity investments(1)
 $955  $955  $  $ 
Assets held for sale(2)
  3,453      3,453    
 
            
Totals
 $4,408  $955  $3,453  $ 
 
            
 
(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.

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HEALTH CARE REIT, INC.
NOTES TO UNAUDITED CONSOLIDATED FINANCIAL STATEMENTS
17. 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 — senior housing and care and medical facilities. Our primary senior housing and care properties include skilled nursing facilities, assisted living facilities, independent living/continuing care retirement communities and combinations thereof. Under the senior housing and care segment, we invest in senior housing and health care real estate through acquisition and financing of primarily single tenant properties. Excluding our Merrill Gardens partnership (please see Note 3 for additional information), properties acquired are primarily leased under triple-net leases and we are not involved in the management of the property. Our primary medical facility properties include medical office buildings, hospitals and life science buildings. Our medical office buildings are typically leased to multiple tenants and generally require a certain level of property management. Our hospital investments are structured similar to our senior housing and care investments. Our life science investments represent investments in an unconsolidated joint venture (see Note 7 for additional information). 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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010). 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 offices and equipment among others. Non-property specific revenues and expenses are not allocated to individual segments in determining net operating income.
     During the nine months ended September 30, 2010, we changed the names of our segments and reclassified certain assets and related revenues. All hospitals that were formerly classified as investment properties have been reclassified to medical facilities. Accordingly, we have reclassified the following prior period amounts to be consistent with the current year classification for the three and nine months ended September 30, 2009, respectively: (i) rental income of $10,884,000 and $34,188,000; (ii) interest income of $1,262,000 and $3,740,000; (iii) other income of $84,000 and $256,000; and (iv) real estate depreciation/amortization of $3,460,000 and $10,284,000. Additionally, we have restated $111,000 and $298,000 of interest income from non-segment/corporate revenues to medical facilities to be consistent with the current year classification.
     Summary information for the reportable segments during the three and nine months ended September 30, 2010 and 2009 is as follows (in thousands and includes amounts from discontinued operations):
                                         
                      Property  Net  Real Estate       
  Rental  Resident Fees  Interest  Other  Total  Operating  Operating  Depreciation/  Interest  Total 
  Income  and Services  Income  Income  Revenues  Expenses  Income(1)  Amortization  Expense  Assets 
Three Months Ended September 30, 2010
                                        
Senior housing and care
 $97,658  $12,809  $9,179  $698  $120,344  $7,993  $112,351  $29,087  $7,507  $4,838,163 
Medical facilities(2)
  57,071       875   227   58,173   13,829   44,344   20,019   6,506   2,792,882 
Non-segment/Corporate
            231   231      231      30,972   262,022 
 
                              
 
 $154,729  $12,809  $10,054  $1,156  $178,748  $21,822  $156,926  $49,106  $44,985  $7,893,067 
 
                              
 
                                        
Three Months Ended September 30, 2009
                                        
Senior housing and care
 $89,429  $  $9,266  $557  $99,252  $  $99,252  $24,853  $3,625     
Medical facilities
  45,892       1,262   332   47,486   12,974   34,512   16,232   5,151     
Non-segment/Corporate
            200   200      200      20,057     
 
                              
 
 $135,321  $  $10,528  $1,089  $146,938  $12,974  $133,964  $41,085  $28,833     
 
                              
                                 
                      Property Net Real Estate  
  Rental Resident Fees Interest Other Total Operating Operating Depreciation/ Interest
  Income and Services Income Income Revenues Expenses Income(1) Amortization Expense
Nine Months Ended September 30, 2010
                                    
Senior housing and care
 $288,148  $12,809  $26,583  $2,726  $330,266  $7,993  $322,273  $84,040  $17,200 
Medical facilities(2)
  162,481       1,853   800   165,134   40,552   124,582   56,097   18,560 
Non-segment/Corporate
            1,276   1,276      1,276      76,760 
 
                           
 
 $450,629  $12,809  $28,436  $4,802  $496,676  $48,545  $448,131  $140,137  $112,520 
 
                           
 
                                    
Nine Months Ended September 30, 2009
                                    
Senior housing and care
 $269,521  $  $26,899  $1,921  $298,341  $  $298,341  $76,132  $8,183 
Medical facilities
  135,042       3,740   951   139,733   37,000   102,733   47,011   15,603 
Non-segment/Corporate
            938   938      938      60,390 
 
                           
 
 $404,563  $  $30,639  $3,810  $439,012  $37,000  $402,012  $123,143  $84,176 
 
                           
 
(1) 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.
 
(2) Excludes income and expense amounts related to our life science buildings held in an unconsolidated joint venture. Please see Note 7 for additional information.

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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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010, 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, 2010:
                         
  Investments  Percentage of  Number of  # Beds/Units  Investment per    
Type of Property (in thousands)  Investments  Properties  or Sq. Ft.  metric(1)  States 
Senior housing facilities
 $3,326,935   44.2%  264  23,098  units $   148,363  per unit   34 
Skilled nursing facilities
  1,350,142   18.0%  197  26,413  beds  51,117  per bed   26 
Hospitals
  741,008   9.9%  31  1,857  beds 438,893  per bed  13 
Medical office buildings
  1,738,779   23.2%  142  7,585,071  sq. ft.  248  per sq. ft.   25 
Life science buildings(2)
  349,832   4.7%  7       n/a   1 
 
                    
Totals
 $7,506,696   100.0%  641           39 
 
                    
 
(1) Investment per metric was computed by using the total investment amount of $7,470,996,000, which includes net real estate investments and unfunded construction commitments for which initial funding has commenced which amounted to $7,156,864,000 and $314,132,000, respectively.
 
(2) Includes our share of unconsolidated joint venture investments. Please see Note 7 to our unaudited financial statements for additional information.
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 (“CMS”) projects that national health expenditures will rise to $3.5 trillion in 2015 or 18.2% of gross domestic product (“GDP”). The average annual growth in national health expenditures for 2009 through 2019 is expected to be 6.3%, which is 0.2% faster than pre-health care reform estimates.
     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 may be 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 20.4% 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 79.2% 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.
     The following chart illustrates the projected increase in the elderly population aged 65 and over:

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
(PERFORMANCE 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;
 
  The projected population growth combined with stable or increasing health care utilization rates, which ensures demand; and
 
  The on-going merger and acquisition activity.
Health Reform Laws
     On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act (“PPACA”) and the Health Care and Education Reconciliation Act of 2010, which amends the PPACA (collectively, the “Health Reform Laws”). The Health Reform Laws contain various provisions that may directly impact us or the operators and tenants of our properties. Some provisions of the Health Reform Laws may have a positive impact on our operators’ or tenants’ revenues, by, for example, increasing coverage of uninsured individuals, while others may have a negative impact on the reimbursement of our operators or tenants by, for example, altering the market basket adjustments for certain types of health care facilities. The Health Reform Laws also enhance certain fraud and abuse penalty provisions that could apply to our operators and tenants, in the event of one or more violations of the federal health care regulatory laws. In addition, there are provisions that impact the health coverage that we and our operators and tenants provide to our respective employees. We cannot predict whether the existing Health Reform Laws, or future health care reform legislation or regulatory changes, will have a material impact on our operators’ or tenants’ property or business. If the operations, cash flows or financial condition of our operators and tenants are materially adversely impacted by the Health Reform Laws or future legislation, our revenue and operations may be adversely affected as well.
     Impact to Reimbursement of the Operators and Tenants of Our Properties. The Health Reform Laws provide for various changes to the reimbursement that our operators and tenants may receive. One such change is a reduction to the market basket adjustments for inpatient acute hospitals, long-term care hospitals, inpatient rehabilitation facilities, home health agencies, psychiatric hospitals, hospice care and outpatient hospitals. Beginning in 2010, the otherwise applicable percentage increase to the market basket for inpatient acute hospitals will decrease. Beginning in 2012, inpatient acute hospitals will also face a downward adjustment of the annual percentage increase to the market basket rate by a “productivity adjustment.” The productivity adjustment may cause the annual percentage increase to be less than zero, which would mean that inpatient acute hospitals could face payment rates for a fiscal year that are less than the payment rates for the preceding year.
     A similar productivity adjustment also applies to skilled nursing facilities beginning in 2012, which means that the payment rates for skilled nursing facilities may decrease from one year to the next. Long-term care hospitals will face a specified percentage decrease in their annual update for discharges beginning in 2010. Additionally, beginning in 2012, long-term care hospitals will be subject to the productivity adjustments, which may decrease the federal payment rates for long-term care hospitals. Similar productivity adjustments and other adjustments to payment rates will apply to inpatient rehabilitation facilities, psychiatric hospitals and outpatient hospitals beginning in 2010.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The Health Reform Laws revise other reimbursement provisions that may affect our business. For example, the Health Reform Laws mandate a one-year extension of the exceptions for medical therapy caps, which will be applicable though December 31, 2010. The Health Reform Laws also reduce states’ Medicaid disproportionate share hospital (“DSH”) allotments, starting in 2014 through 2020. These allotments would have provided additional funding for DSH hospitals that are operators or tenants of our properties, and thus, any reduction might negatively impact these operators or tenants.
     Additionally, beginning in fiscal year 2015, Medicare payments will decrease to hospitals for treatment associated with hospital acquired conditions. This decreased payment rate may negatively impact our operators or tenants. The Health Reform Laws also call for reductions in payments for discharges beginning October 1, 2012, in order to account for excess readmissions. While the exact amount of the reduction is not yet known, a reduction in payments to our operators or tenants may affect their ability to make payments to us.
     PPACA additionally calls for the creation of the Independent Payment Advisory Board (the “Board”), which will be responsible for establishing payment polices, including recommendations in the event that Medicare costs exceed a certain threshold. Proposals for recommendations submitted by the Board prior to December 31, 2018 may not include recommendations that would reduce payments for hospitals, skilled nursing facilities, and physicians, among other providers, prior to December 31, 2019. The Health Reform Laws also create other mechanisms that could permit significant changes to payment. For example, PPACA establishes the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models to reduce program expenditures through the use of demonstration programs that can waive existing reimbursement methodologies. The Health Reform Laws also provide additional Medicaid funding to allow states to carry out mandated expansion of Medicaid coverage to certain financially-eligible individuals beginning in 2014, and also permits states to expand their Medicaid coverage to these individuals as early as April 1, 2010, if certain conditions are met.
     Additionally, the Health Reform Laws delay until at least October 1, 2011, the implementation of the Resource Utilization Group, Version Four (“RUG-IV”) that would revise the payment classification system for skilled nursing facilities. The Health Reform Laws also extend certain payment rules related to long-term acute care hospitals found in the Medicare, Medicaid, and SCHIP Extension Act of 2007.
     Finally, many other changes resulting from the Health Reform Laws, or implementing regulations or guidance may negatively impact our operators and tenants. We will continue to monitor and evaluate the Health Reform Laws and implementing regulations and guidance to determine other potential effects of the reform.
     Impact of Fraud and Abuse Provisions. The Health Reform Laws revise health care fraud and abuse provisions that will affect our operators and tenants. Specifically, PPACA allows for up to treble damages under the Federal False Claims Act for violations related to state-based health insurance exchanges authorized by the Health Reform Laws, which will be implemented beginning in 2014. The Health Reform Laws also impose new civil monetary penalties for false statements or actions that lead to delayed inspections, with penalties of up to $15,000 per day for failure to grant timely access and up to $50,000 for a knowing violation. The Health Reform laws also provide for additional funding to investigate and prosecute health care fraud and abuse. Accordingly, the increased penalties under PPACA for fraud and abuse violations may have a negative impact on our operators and tenants in the event that the government brings an enforcement action or subjects them to penalties.
     Further, as recently as September 23, 2010, CMS published a proposed rulemaking to implement the enhanced provider and supplier screening provisions called for in the Health Reform Laws. Under the proposed rule, all enrolling and participating providers and suppliers would be assessed an annual administrative fee and be placed in one of three risk levels (limited, moderate, and high) based on an assessment of the entity’s overall risk of fraud, waste and abuse. The Health Reform Laws granted the Secretary of the Department of Health and Human Services significant discretionary authority to suspend, exclude, or impose fines on providers and suppliers based on the agency’s determination that such a provider or supplier is “high-risk,” and, as a result, this proposed rulemaking has the potential to materially adversely affect our operators and tenants who, if implemented, may be evaluated under the enhanced screening process.
     Additionally, provisions of Title VI of PPACA are designed to increase transparency and program integrity by skilled nursing facilities, other nursing facilities and similar providers. Specifically, skilled nursing facilities and other providers and suppliers will be required to institute compliance and ethics programs. Additionally, PPACA makes it easier for consumers to file complaints against nursing homes by mandating that states establish complaint websites. The provisions calling for enhanced transparency will increase the administrative burden and costs on these providers.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     Impact to the Health Care Plans Offered to Our Employees. The Health Reform Laws will affect employers that provide health plans to their employees. The new laws will change the tax treatment of the Medicare Part D retiree drug subsidy and extend dependent coverage for dependents up to age 26, among other changes. We are evaluating our health care plans in light of these changes. These changes may affect our operators and tenants as well.
Medicare Program Reimbursement Changes
     CMS recently released a number of rulemakings that may potentially increase or decrease the government reimbursement of our operators and tenants. To the extent that any of these rulemakings decrease government reimbursement to our operators and tenants, our revenue and operations may be indirectly, adversely affected.
     On August 16, 2010, CMS issued a final rule updating the long-term acute care hospital prospective payment system for FY 2011. Among other things, the final rule updates payment rates for acute care and long-term care hospitals and implements certain provisions of the Health Reform Laws. In the rule, CMS finalized an update of 2.5% for inflation with a cut of 0.5% as required by the Health Reform Laws and a negative 2.5% documentation and coding adjustment for long-term care hospitals. CMS also released a notice and comment rulemaking for the prospective payment system and consolidated billing for skilled nursing facilities for FY 2011 on July 22, 2010. CMS adjusts the nursing home payment rates for FY 2011 by including a market basket increase factor of 2.3% and a negative 0.6 percentage point forecast error adjustment, which would result in a net increase update of 1.7% for nursing home rates.
     CMS annually adjusts the Medicare Physician Fee Schedule payment rates based on an update formula that includes application of the Sustainable Growth Rate (“SGR”). On November 2, 2010, CMS placed the CY 2011 Physician Fee Schedule final rule on public display for an expected publication date of November 29, 2010. Among other things, CMS preliminary estimates in the final rule that the CY 2011 SGR formula will be negative 13.4%. This measure is a significant change from the figure provided in the proposed rule, and will replace the 21.3% reduction in physician Medicare reimbursement in 2010 required by the SGR formula. Additionally, in the final rule, CMS has eliminated certain CPT consultation codes, which could negatively impact the reimbursement levels received by our operators and tenants.
     Finally, on November 2, 2010, CMS placed on public display the CY 2011 Hospital Outpatient Prospective Payment System (“HOPPS”) final rule with comment period for an expected publication date of November 24, 2010. CMS estimates that the cumulative effect of all changes to payment rates for CY 2011 will have a positive effect, resulting in a 2.5% estimated increase in Medicare payments to providers paid under the HOPPS.
Economic Outlook
     The serious economic recession affecting the national and global economy has continued to impact all sectors, including to a somewhat lesser degree health care. Continuing mixed economic signals have made it difficult to predict when there might be a return to more normal and stable growth rates, employment levels and overall economic performance.
     Banks have remained cautious in their lending, but significant liquidity has been injected into the senior housing and care markets by various Government-Sponsored Enterprises. In addition, there is significant equity investment capital available for certain health care sectors, particularly medical office buildings. This has had the effect of keeping capitalization rates in these segments generally in line with or even below historic rates. Debt costs for REITs have generally come down over the past 12 months, and equity markets for health care REITs have remained open for the most part.
     As a consequence, while liquidity remains an important consideration in 2010, we have been more aggressive in pursuing attractive investment opportunities that meet our strategic and underwriting criteria. We have also been more active in accessing capital markets during this time. We believe the markets in which we invest will continue to offer stable returns during the economic downturn and significant growth potential as and when the economy begins to rebound.
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 the full spectrum of senior housing and health care real estate and diversify our investment portfolio by property type, customer and geographic location.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     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 for each property, 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 collectability of revenue and the value of our investment.
     In addition to our asset management and research efforts, 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, 2010, rental income and interest income represented 91% and 6% 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 believe our liquidity is sufficient to fund operations, meet debt service obligations (both principal and interest), make dividend distributions and complete construction projects in process. We also anticipate evaluating opportunities to finance future investments. 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, has historically been provided through a combination of public and private offerings of debt and equity securities and the incurrence or assumption of secured debt.
     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. We expect to complete gross new investments of $2.3 billion to $2.7 billion in 2010, comprised of acquisitions/joint ventures totaling $2.0 billion to $2.3 billion and funded new development of $300 million to $400 million. We anticipate the sale of real property and the repayment of loans receivable totaling approximately $200 million during 2010. 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 unsecured line of credit arrangement. At September 30, 2010, we had $181,147,000 of cash and cash equivalents, $61,224,000 of restricted cash and $1,150,000,000 of available borrowing capacity under our unsecured line of credit arrangement.
Key Transactions in 2010
     We have completed the following key transactions to date in 2010:
  our Board of Directors increased the quarterly cash dividend to $0.69 per common share, as compared to $0.68 per common share for 2009, beginning in August 2010. The dividend declared for the quarter ended September 30, 2010 represents the 158thconsecutive quarterly dividend payment;
 
  we completed $1,580,059,000 of gross investments and had $119,442,000 of investment payoffs during the nine months ended September 30, 2010;
 
  we issued $494,403,000 of 3.00% convertible senior unsecured notes due 2029 and repurchased $441,326,000 of 4.75% convertible senior unsecured notes due 2026 and 2027 in March and June 2010;
 
  we issued $450,000,000 of 6.125% senior unsecured notes due 2020 with net proceeds of $446,328,000 in April and June 2010;
 
  we raised $81,977,000 of HUD mortgage loans at an average rate of 5.10%;
 
  we issued $450,000,000 of 4.70% senior unsecured notes due 2017 with net proceeds of $445,768,000 in September 2010;

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
  we completed a public offering of 9,200,000 shares of common stock with net proceeds of approximately $403,921,000 in September 2010; and
 
  we completed our RIDEA partnership with Merrill Gardens LLC in September 2010.
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,
  2009 2009 2009 2009 2010 2010 2010
Net income attributable to common stockholders
 $61,119  $59,240  $19,130  $31,700  $25,812  $45,646  $1,124 
Funds from operations
  85,322   89,207   60,933   56,290   63,087   92,214   41,108 
Net operating income(1)
  134,819   133,228   133,964   145,667   143,055   157,415   164,292 
 
                            
Per share data (fully diluted):
                            
Net income attributable to common stockholders
 $0.56  $0.53  $0.17  $0.26  $0.21  $0.37  $0.01 
Funds from operations
  0.79   0.80   0.53   0.46   0.51   0.74   0.33 
 
(1) Includes our share of net operating income from unconsolidated joint ventures.
     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 compliance with our debt covenants. 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:
                             
  Three Months Ended
  March 31, June 30, September 30, December 31, March 31, June 30, September 30,
  2009 2009 2009 2009 2010 2010 2010
Debt to book capitalization ratio
  43%  44%  39%  39%  43%  46%  45%
Debt to undepreciated book capitalization ratio
  39%  40%  35%  35%  39%  41%  41%
Debt to market capitalization ratio
  41%  40%  31%  30%  32%  36%  34%
 
                            
Interest coverage ratio
  3.88x  3.74x  2.63x  3.21x  3.08x  3.48x  2.25x
Fixed charge coverage ratio
  3.18x  3.07x  2.16x  2.57x  2.44x  2.78x  1.86x

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     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,
  2009 2009 2009 2009 2010 2010 2010
Asset mix:
                            
Real property
  92%  92%  92%  93%  93%  93%  94%
Real estate loans receivable
  8%  8%  8%  7%  7%  7%  6%
 
                            
Investment mix:(1)
                            
Senior housing facilities
  40%  40%  40%  42%  38%  39%  44%
Skilled nursing facilities
  27%  26%  26%  25%  22%  21%  18%
Hospitals
  10%  10%  11%  10%  10%  10%  10%
Medical office buildings
  23%  24%  23%  23%  25%  25%  23%
Life science buildings
  0%  0%  0%  0%  5%  5%  5%
 
                            
Customer mix:(1)
                            
Merrill Gardens LLC
                          10%
Senior Living Communities, LLC
  6%  6%  7%  7%  8%  8%  8%
Aurora Health Care, Inc.
                  5%  5%  4%
Brookdale Senior Living Inc
  5%  5%  5%  5%  5%  4%  4%
Signature Healthcare LLC
  5%  5%  5%  5%  4%  4%  4%
Emeritus Corporation
  4%  4%  4%  4%  4%  3%    
Life Care Centers of America, Inc.
  5%  4%  3%  3%            
Remaining customers
  75%  76%  76%  76%  74%  76%  70%
 
                            
Geographic mix:(1)
                            
California
  8%  8%  8%  9%  9%  9%  11%
Florida
  14%  13%  13%  12%  12%  11%  10%
Texas
  11%  11%  11%  11%  10%  10%  9%
Massachusetts
  7%  7%  7%  7%  11%  11%  9%
Washington
                          7%
Wisconsin
                  7%  7%    
Ohio
          5%  6%            
Tennessee
  5%  5%                    
Remaining states
  55%  56%  56%  55%  51%  52%  54%
 
(1) Includes our share of unconsolidated joint venture investments.
     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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010, 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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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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,
  2009 2009 2009 2009 2010 2010 2010
Net operating income:
                            
Senior housing and care
 $98,950  $100,137  $99,252  $101,024  $102,307  $107,620  $112,351 
Medical facilities(1)
  35,493   32,728   34,512   44,411   40,517   48,983   51,710 
Non-segment/corporate
  376   363   200   232   231   812   231 
   
Net operating income
 $134,819  $133,228  $133,964  $145,667  $143,055  $157,415  $164,292 
   
 
(1) Includes our share of net operating income from unconsolidated joint ventures.
     Payment coverage. Payment coverage of our operators continues to remain strong. Our overall payment coverage is at 2.11 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, 2008 June 30, 2009 June 30, 2010
  CBMF CAMF CBMF CAMF CBMF CAMF
Senior housing facilities
  1.51x   1.29x   1.51x   1.30x   1.54x   1.31x 
Skilled nursing facilities
  2.29x   1.68x   2.24x   1.64x   2.37x   1.75x 
Hospitals
  2.39x   1.86x   2.37x   2.05x   2.65x   2.32x 
 
                        
Weighted averages
  1.99x   1.54x   1.98x   1.55x   2.11x   1.66x 
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., 4500 Dorr Street, Toledo, Ohio 43615-4040.
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 offerings 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.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The following is a summary of our sources and uses of cash flows (dollars in thousands):
                 
  Nine Months Ended Change
  September 30, 2010 September 30, 2009 $  % 
Cash and cash equivalents at beginning of period
 $35,476  $23,370  $12,106   52%
Cash provided from operating activities
  291,004   290,449   555   0%
Cash used in investing activities
  (1,002,650)  (189,119)  (813,531)  430%
Cash provided from (used in) financing activities
  857,317   (22,347)  879,664   n/a 
     
Cash and cash equivalents at end of period
 $181,147  $102,353  $78,794   77%
     
     Operating Activities. The change in net cash provided from operating activities is primarily attributable to an increase in net income, excluding gains/losses on sales of properties, depreciation and amortization and debt extinguishment charges. These items are 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):
                 
  Nine Months Ended  Change 
  September 30, 2010  September 30, 2009  $  % 
Gross straight-line rental income
 $12,414  $14,499  $(2,085)  -14%
Cash receipts due to real property sales
  (752)  (3,452)  2,700   -78%
Prepaid rent receipts
  (5,462)  (20,011)  14,549   -73%
Amortization related to below (above) market leases, net
  2,112   1,344   768   57%
 
            
 
 $8,312  $(7,620) $15,932   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 current year. The fluctuation in prepaid rent receipts is primarily due to changes 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 
  September 30, 2010  September 30, 2009 
  Senior Housing  Medical      Senior Housing  Medical    
  and Care  Facilities  Totals  and Care  Facilities  Totals 
Advances on real estate loans receivable:
                        
Investments in new loans
 $9,742  $15,799  $25,541  $3,316  $  $3,316 
Draws on existing loans
  28,413   15   28,428   42,226   1,340   43,566 
 
                  
Sub-total
  38,155   15,814   53,969   45,542   1,340   46,882 
Less: Seller financing on property sales
     (1,470)  (1,470)         
 
                  
Net cash advances on real estate loans
  38,155   14,344   52,499   45,542   1,340   46,882 
Receipts on real estate loans receivable:
                        
Loan payoffs
  3,809      3,809   20,440      20,440 
Principal payments on loans
  11,682   3,328   15,010   12,838   1,614   14,452 
 
                  
Total receipts on real estate loans
  15,491   3,328   18,819   33,278   1,614   34,892 
 
                  
Net advances (receipts) on real estate loans
 $22,664  $11,016  $33,680  $12,264  $(274) $11,990 
 
                  

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
                 
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Properties  Amount  Properties  Amount 
Real property acquisitions:
                
Senior housing — operating
  25  $576,000     $ 
Senior housing — triple net
  15   219,772       
Medical office buildings
  19   246,582       
 
            
Total acquisitions
  59   1,042,354       
Less: Assumed debt
      (353,165)       
Assumed other items, net
      (149,949)       
 
              
Cash disbursed for acquisitions
      539,240        
Construction in progress additions
      223,464       396,581 
Capital improvements to existing properties
      40,660       20,797 
 
              
Total cash invested in real property
      803,364       417,378 
 
                
Real property dispositions:
                
Senior housing — triple net
  1   3,437   10   44,877 
Skilled nursing facilities
  12   104,628   3   18,854 
Hospitals
        2   40,841 
Medical office buildings
  3   7,568   10   28,128 
 
            
Total dispositions
  16   115,633   25   132,700 
Less: Gains (losses) on sales of real property
      20,559       26,907 
Seller financing on sales of real property
      (1,470)      (6,100)
 
              
Proceeds from real property sales
      134,722       153,507 
 
                
 
            
Net cash investments in real property
  43  $668,642   (25) $263,871 
 
            
     The contributions to unconsolidated joint ventures represent $174,692,000 of cash invested by us in the joint venture with Forest City Enterprises. Please see Note 7 to our unaudited financial statements for additional information.
     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, 2010, we had a net decrease of $140,000,000 on our unsecured line of credit arrangement as compared to a net decrease of $427,000,000 for the same period in 2009. The changes in our senior unsecured notes are due to (i) the issuance of $494,403,000 of convertible senior unsecured notes in March and June 2010; (ii) the repurchase of $441,326,000 of convertible senior unsecured notes in March and June 2010; (iii) the issuance of $450,000,000 of senior unsecured notes in April and June 2010; (iv) the issuance of $450,000,000 of senior unsecured notes in September 2010; and (v) the extinguishment of $183,147,000 of various senior unsecured notes in March and September 2009. The changes in our secured debt are due to (i) the extinguishment of $159,475,000 of secured debt in September 2010; and (ii) the extinguishment of $79,743,000 of secured debt in September 2009.
     We may repurchase, redeem or refinance convertible and non-convertible senior unsecured notes from time to time, taking advantage of favorable market conditions when available. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, a tender offer or, in some cases, through the early redemption of such securities pursuant to their terms. The non-convertible senior unsecured notes are redeemable at our option, at any time in whole or from time to time in part, at a redemption price equal to the sum of (1) the principal amount of the notes (or portion of such notes) being redeemed plus accrued and unpaid interest thereon up to the redemption date and (2) any “make-whole” amount due under the terms of the notes in connection with early redemptions. We cannot redeem the March and June 2010 convertible senior unsecured notes prior to December 1, 2014 unless such redemption is necessary to preserve our status as a REIT. However, on or after December 1, 2014, we may from time to time at our option redeem those notes, in whole or in part, for cash, at a redemption price equal to 100% of the principal amount of the notes we redeem, plus any accrued and unpaid interest to, but excluding, the redemption date. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The following is a summary of our common stock issuances for the nine months ended September 30, 2010 and 2009 (dollars in thousands, except per share amounts):
                 
  Shares Issued  Average Price  Gross Proceeds  Net Proceeds 
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 
 
             
September 2010 public issuance
  9,200,000  $45.75  $420,900  $403,921 
2010 Equity shelf plan issuances
  431,082   44.94   19,371   19,014 
2010 Dividend reinvestment plan issuances
  1,441,612   42.83   61,737   61,737 
2010 Option exercises
  56,947   33.24   1,893   1,893 
 
             
2010 Totals
  11,129,641      $503,901  $486,565 
 
             
     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 shares outstanding. The following is a summary of our dividend payments (in thousands, except per share amounts):
                 
  Nine Months Ended 
  September 30, 2010  September 30, 2009 
  Per Share  Amount  Per Share  Amount 
Common Stock
 $2.0500  $255,217  $2.0400  $227,959 
Series D Preferred Stock
  1.4766   5,906   1.4766   5,906 
Series E Preferred Stock
  1.1250   94   1.1250   84 
Series F Preferred Stock
  1.4297   10,008   1.4297   10,008 
Series G Preferred Stock
  1.4064   332   1.4064   560 
 
              
Totals
     $271,557      $244,517 
 
              
Off-Balance Sheet Arrangements
     During the three months ended March 31, 2010, we entered into a joint venture investment with Forest City Enterprises (NYSE:FCE.A and FCE.B). In connection with this transaction, we invested $174,692,000 of cash which is recorded as an equity investment on the balance sheet. Our share of the non-recourse secured debt assumed by the joint venture was approximately $156,729,000 with weighted-average interest rates of 7.1%. Please see Note 7 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 11 to our unaudited consolidated financial statements for additional information.
     At September 30, 2010, we had four outstanding letter of credit obligations totaling $5,329,057 and expiring between 2010 and 2013. Please see Note 12 to our unaudited consolidated financial statements for additional information.
Contractual Obligations
     The following table summarizes our payment requirements under contractual obligations as of September 30, 2010 (in thousands):

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
                     
  Payments Due by Period 
Contractual Obligations Total  2010  2011-2012  2013-2014  Thereafter 
Unsecured line of credit arrangement
 $  $  $  $  $ 
Senior unsecured notes(1)
  2,614,930      76,853   300,000   2,238,077 
Secured debt(1)
  897,265   4,927   127,151   219,394   545,793 
Contractual interest obligations
  1,548,381   63,064   362,304   315,574   807,439 
Capital lease obligations
               
Operating lease obligations
  209,719   1,250   10,034   9,539   188,896 
Purchase obligations
  321,197   4,364   316,833       
Other long-term liabilities
  4,946   75   1,065   1,903   1,903 
 
               
Total contractual obligations
 $5,596,438  $73,680  $894,240  $846,410  $3,782,108 
 
               
 
(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, 2010, 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 (0.86% at September 30, 2010). The applicable margin is based on certain of our debt ratings and was 0.6% at September 30, 2010. In addition, we pay a facility fee annually to each bank based on the bank’s commitment amount. The facility fee depends on certain of our debt ratings and was 0.15% at September 30, 2010. We also pay an annual agent’s fee of $50,000. Principal is due upon expiration of the agreement.
     We have $2,614,930,000 of senior unsecured notes principal outstanding with fixed annual interest rates ranging from 3.00% to 8.00%, payable semi-annually. Total contractual interest obligations on senior unsecured notes totaled $1,207,621,000 at September 30, 2010. A total of $788,077,000 of our senior unsecured notes are convertible notes that also contain put features. Please see Note 10 to our unaudited consolidated financial statements for additional information.
     Additionally, we have secured debt with total outstanding principal of $897,265,000, collateralized by owned properties, with fixed annual interest rates ranging from 3.86% to 8.74%, payable monthly. The carrying values of the properties securing the debt totaled $1,399,126,000 at September 30, 2010. Total contractual interest obligations on secured debt totaled $340,760,000 at September 30, 2010.
     At September 30, 2010, we had operating lease obligations of $209,719,000 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, 2010, we had outstanding construction financings of $286,366,000 for leased properties and were committed to providing additional financing of approximately $314,132,000 to complete construction. At September 30, 2010, we had contingent purchase obligations totaling $7,065,000. These contingent purchase obligations relate to unfunded capital improvement obligations. 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 2010 fiscal year. Benefit payments are expected to total $4,758,000 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 $3,722,000 and $3,287,000 at September 30, 2010 and December 31, 2009, 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 expired in December 2009. Each consultant has agreed not to compete with us for a period of two years following the expiration of the agreement. In exchange for complying with the covenant not to compete, Messers. Klipsch and Farrar receive eight quarterly payments of $75,000 and $37,500, respectively, with the first payment to be made on the date of expiration of the agreement. The first payment to Mr. Klipsch was made in December 2008 and the final payment in September 2010. The first payment to Mr. Farrar was made in January 2010.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Capital Structure
     As of September 30, 2010, we had total equity of $4,220,083,000 and a total outstanding debt balance of $3,471,455,000, which represents a debt to total book capitalization ratio of 45%. Our ratio of debt to market capitalization was 34% at September 30, 2010. For the three months ended September 30, 2010, our interest coverage ratio was 2.25x and our fixed charge coverage ratio was 1.86x. Also, at September 30, 2010, we had $181,147,000 of cash and cash equivalents, $61,224,000 of restricted cash and $1,150,000,000 of available borrowing capacity under our unsecured line of credit arrangement.
     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, 2010, 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. However, under our unsecured line of credit arrangement, the ratings on our senior unsecured notes are used to determine the fees and interest charged.
     We plan to manage the company to maintain compliance with our debt covenants and with a capital structure consistent with our current profile. Any downgrades in terms of ratings or outlook by any or all of the rating agencies could have a material adverse impact on our cost and availability of capital, which could 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, 2010, we had an effective registration statement on file in connection with our enhanced dividend reinvestment plan under which we may issue up to 10,000,000 shares of common stock. As of October 31, 2010, 8,915,091 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”). As of October 31, 2010, we had $119,985,000 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
  September 30, September 30,         September 30, September 30,    
  2010 2009 Amount % 2010 2009 Amount %
Net income attributable to common stockholders
 $1,124  $19,130  $(18,006)  -94% $72,580  $139,489  $(66,909)  -48%
Funds from operations
  41,108   60,933   (19,825)  -33%  196,405   235,463   (39,058)  -17%
EBITDA
  99,924   94,548   5,376   6%  341,519   363,425   (21,906)  -6%
Net operating income
  164,292   133,964   30,328   23%  464,760   402,012   62,748   16%
 
                                
Per share data (fully diluted):
                                
Net income attributable to common stockholders
 $0.01  $0.17  $(0.16)  -94% $0.58  $1.25  $(0.67)  -54%
Funds from operations
  0.33   0.53   (0.20)  -38%  1.58   2.11   (0.53)  -25%
 
                                
Interest coverage ratio
  2.25x   2.63x   -0.38x   -14%  2.90x   3.41x   -0.51x   -15%
Fixed charge coverage ratio
  1.86x   2.16x   -0.30x   -14%  2.34x   2.80x   -0.46x   -16%

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     We evaluate our business and make resource allocations on our two business segments — senior housing and care properties and medical facilities. Please see Note 17 to our unaudited consolidated financial statements for additional information.
     Senior Housing and Care Properties
     The following is a summary of our results of operations for the senior housing and care properties segment (dollars in thousands):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  September 30,  September 30,          September 30,  September 30,       
  2010  2009  $  %  2010  2009  $  % 
Revenues:
                                
Rental income
 $95,357  $84,391  $10,966   13% $280,345  $251,016  $29,329   12%
Resident fees and services
  12,809      12,809   n/a   12,809      12,809   n/a 
Interest income
  9,179   9,266   (87)  -1%  26,583   26,899   (316)  -1%
Other income
  698   557   141   25%  2,726   1,921   805   42%
 
                        
 
  118,043   94,214   23,829   25%  322,463   279,836   42,627   15%
Expenses:
                                
Interest expense
  6,979   2,755   4,224   153%  15,535   4,687   10,848   231%
Property operating expenses
  7,993      7,993   n/a   7,993      7,993   n/a 
Depreciation and amortization
  28,546   23,593   4,953   21%  82,224   69,730   12,494   18%
Transaction costs
  18,820      18,820   n/a   24,483      24,483   n/a 
Loss on extinguishment of debt
  7,791   2,057   5,734   279%  7,791   2,057   5,734   279%
Provision for loan losses
  28,918      28,918   n/a   28,918   140   28,778   20556%
 
                        
 
  99,047   28,405   70,642   249%  166,944   76,614   90,330   118%
 
                        
Income from continuing operations before income taxes
  18,996   65,809   (46,813)  -71%  155,519   203,222   (47,703)  -23%
 
                        
Income from continuing operations
  18,996   65,809   (46,813)  -71%  155,519   203,222   (47,703)  -23%
Discontinued operations:
                                
Gain on sales of properties
  10,526      10,526   n/a   18,894   13,358   5,536   41%
Income from discontinued operations, net
  1,232   2,908   (1,676)  -58%  4,322   8,607   (4,285)  -50%
 
                        
Discontinued operations, net
  11,758   2,908   8,850   304%  23,216   21,965   1,251   6%
 
                        
Net income
  30,754   68,717   (37,963)  -55%  178,735   225,187   (46,452)  -21%
Less: Net income attributable to noncontrolling interests
  567      567   n/a   567      567   n/a 
 
                        
Net income attributable to common stockholders
 $30,187  $68,717  $(38,530)  -56% $178,168  $225,187  $(47,019)  -21%
 
                        
     The increase in rental income is primarily attributable to the conversion of newly constructed senior housing and care properties subsequent to September 30, 2009 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.
     As discussed in Note 3 to our unaudited consolidated financial statements, we completed our partnership with Merrill Gardens LLC in September 2010. The results of operations for this partnership have been included in our consolidated results of operations from the date of acquisition and represent the sole component of resident fees and services, property operating expenses and net income attributable to noncontrolling interests for this segment.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     Interest expense for the three and nine months ended September 30, 2010 represents $7,507,000 and $17,200,000, respectively, of secured debt interest expense offset by interest allocated to discontinued operations. Interest expense for the three and nine months ended September 30, 2009 represents $3,625,000 and $8,183,000, respectively, 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. The following is a summary of our senior housing and care property secured debt principal activity (dollars in thousands):
                                 
  Three Months Ended  Three Months Ended  Nine Months Ended  Nine Months Ended 
  September 30, 2010  September 30, 2009  September 30, 2010  September 30, 2009 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
Beginning balance
 $388,092   5.705% $194,512   6.283% $298,492   5.998% $94,234   6.996%
Debt issued
         132,456   5.863%  81,977   4.600%  265,527   5.982%
Debt assumed
  247,087   6.053%     0.000%  257,375   6.057%     0.000%
Debt extinguished
  (150,981)  5.924%  (26,575)  7.402%  (150,981)  5.924%  (47,502)  7.414%
Principal payments
  (1,581)  5.918%  (743)  6.360%  (4,246)  5.978%  (12,609)  7.780%
 
                        
Ending balance
 $482,617   5.815% $299,650   5.998% $482,617   5.815% $299,650   5.998%
 
                        
Monthly averages
 $411,312   5.738% $326,590   6.113% $345,020   5.875% $358,738   6.246%
     Depreciation and amortization increased primarily as a result of the conversions of newly constructed investment properties subsequent to September 30, 2009. To the extent that we acquire or dispose of additional properties in the future, our provision for depreciation and amortization will change accordingly.
     Transaction costs for the nine months ended September 30, 2010 primarily represent costs incurred with the Merrill Gardens partnership, lease termination fees and costs incurred in connection with other new property acquisitions.
     During the nine months ended September 30, 2010, we sold 12 senior housing and care properties. The following illustrates the reclassification impact as a result of classifying the properties sold subsequent to January 1, 2009 or held for sale at September 30, 2010 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, 
  2010  2009  2010  2009 
Rental income
 $2,301  $5,038  $7,803  $18,505 
Expenses:
                
Interest expense
  528   870   1,665   3,496 
Provision for depreciation
  541   1,260   1,816   6,402 
 
            
Income from discontinued operations, net
 $1,232  $2,908  $4,322  $8,607 
 
            
     As a result of our quarterly evaluations, we recorded $28,918,000 of provision for loan losses during the nine months ended September 30, 2010. This amount includes the write-off of loans totaling $32,753,000 primarily related to certain early stage senior housing and CCRC development projects. This was offset by a net reduction of the allowance balance by $3,835,000. 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.”

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     Medical Facilities
     The following is a summary of our results of operations for the medical facilities segment (dollars in thousands):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  September 30,  September 30,          September 30,  September 30,       
  2010  2009  $  %  2010  2009  $  % 
Revenues:
                                
Rental income
 $56,770  $44,136  $12,634   29% $160,992  $128,310  $32,682   25%
Interest income
  875   1,262   (387)  -31%  1,853   3,740   (1,887)  -50%
Other income
  227   332   (105)  -32%  800   951   (151)  -16%
 
                        
 
  57,872   45,730   12,142   27%  163,645   133,001   30,644   23%
Expenses:
                                
Interest expense
  6,457   4,783   1,674   35%  18,408   14,351   4,057   28%
Property operating expenses
  12,856   12,153   703   6%  37,866   34,441   3,425   10%
Depreciation and amortization
  20,019   15,594   4,425   28%  56,097   44,716   11,381   25%
Transaction costs
  15      15   n/a   2,818      2,818   n/a 
Loss (gain) on extinguishment of debt
  1,308   3,371   (2,063)  -61%  1,308   3,371   (2,063)  -61%
 
                        
 
  40,655   35,901   4,754   13%  116,497   96,879   19,618   20%
 
                        
Income from continuing operations before income taxes and income from unconsolidated joint ventures
  17,217   9,829   7,388   75%  47,148   36,122   11,026   31%
Income tax (expense) benefit
  73   25   48   192%  (174)  (232)  58   -25%
Income from unconsolidated joint ventures
  1,899      1,899   n/a   4,496      4,496   n/a 
 
                        
Income from continuing operations
  19,189   9,854   9,335   95%  51,470   35,890   15,580   43%
Discontinued operations:
                                
Gain (loss) on sales of properties
     (806)  806   -100%  1,665   13,549   (11,884)  -88%
Impairment of assets
  (947)  (1,873)  926   -49%  (947)  (1,873)  926   -49%
Income (loss) from discontinued operations, net
  (721)  (71)  (650)  915%  (1,349)  626   (1,975)  n/a 
 
                        
Discontinued operations, net
  (1,668)  (2,750)  1,082   -39%  (631)  12,302   (12,933)  n/a 
 
                        
Net income (loss)
  17,521   7,104   10,417   147%  50,839   48,192   2,647   5%
Less: Net income (loss) attributable to noncontrolling interests
  (123)  35   (158)  n/a   184   40   144   360%
 
                        
Net income (loss) attributable to common stockholders
 $17,644  $7,069  $10,575   150% $50,655  $48,152  $2,503   5%
 
                        
     The increase in rental income is primarily attributable to the acquisitions and construction conversions of medical facilities subsequent to September 30, 2009 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. Interest income decreased from the prior period primarily due to a decline in outstanding balances for medical facility real estate loans. Other income is attributable to third party management fee income.
     Interest expense for the three and nine months ended September 30, 2010 represents $6,506,000 and $18,560,000, respectively, of secured debt interest expense offset by interest allocated to discontinued operations. Interest expense for the three and nine months ended September 30, 2009 represents $5,151,000 and $15,603,000, respectively, 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

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
assumptions, extinguishments and principal amortizations. The following is a summary of our medical facilities secured debt principal activity (dollars in thousands):
                                 
  Three Months Ended  Three Months Ended  Nine Months Ended  Nine Months Ended 
  September 30, 2010  September 30, 2009  September 30, 2010  September 30, 2009 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
Beginning balance
 $415,570   6.098% $351,146   5.799% $314,065   5.677% $354,145   5.799%
Debt assumed
     0.000%     0.000%  106,140   7.352%     0.000%
Debt extinguished
  (8,494)  6.045%  (32,241)  7.033%  (8,494)  6.045%  (32,241)  7.033%
Principal payments
  (2,307)  6.131%  (1,451)  5.722%  (6,942)  6.200%  (4,450)  5.746%
 
                        
Ending balance
 $404,769   6.099% $317,454   5.675% $404,769   6.099% $317,454   5.675%
 
                        
 
                                
Monthly averages
 $412,278   6.099% $350,412   5.800% $394,779   6.032% $351,919   5.799%
     The increase in property operating expenses and depreciation and amortization is primarily attributable to acquisitions and construction conversions of new medical facilities for which we incur certain property operating expenses offset by property operating expenses associated with discontinued operations.
     Transaction costs for the nine months ended September 30, 2010 represent costs incurred in connection with the acquisition of new properties.
     Income tax expense is primarily related to third party management fee income.
     Income from unconsolidated joint ventures represents our share of net income related to our joint venture investment with Forest City Enterprises. The following is a summary of our net income from this investment for the periods presented (in thousands):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  September 30,  September 30,          September 30,  September 30,       
  2010  2009  $  %  2010  2009  $  % 
Revenues
 $10,401  $  $10,401   n/a  $23,481  $  $23,481   n/a 
Operating expenses
  3,035      3,035   n/a   6,852      6,852   n/a 
 
                        
Net operating income
  7,366      7,366   n/a   16,629      16,629   n/a 
Depreciation and amortization
  2,696      2,696   n/a   5,794      5,794   n/a 
Interest expense
  2,362      2,362   n/a   5,399      5,399   n/a 
Asset management fee
  409      409   n/a   940      940   n/a 
 
                        
Net income
 $1,899  $  $1,899   n/a  $4,496  $  $4,496   n/a 
 
                        
     During the year ended December 31, 2009, an impairment charge of $25,223,000 was recorded to reduce the carrying value of eight medical facilities to their estimated fair value less costs to sell. In determining the fair value of the properties, 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. During the nine months ended September 30, 2010, we sold three of the held for sale medical facilities, for net gains of $1,665,000. At September 30, 2010, we had five medical facilities that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2010, we recorded an impairment charge of $947,000 related to two of the held for sale medical facilities to adjust the carrying values to estimated fair values less costs to sell based on current sales price expectations. The following illustrates the reclassification impact as a result of classifying medical facilities sold subsequent to January 1, 2009 or held for sale at September 30, 2010 as discontinued operations for the periods presented. Please refer to Note 5 to our unaudited consolidated financial statements for further discussion.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
                 
  Three Months Ended  Nine Months Ended 
  September 30,  September 30, 
  2010  2009  2010  2009 
Rental income
 $301  $1,756  $1,489  $6,732 
Expenses:
                
Interest expense
  49   368   152   1,252 
Property operating expenses
  973   821   2,686   2,559 
Provision for depreciation
     638      2,295 
 
            
Income (loss) from discontinued operations, net
 $(721) $(71) $(1,349) $626 
 
            
     Net income attributable to non-controlling interests primarily relates to certain properties that are consolidated in our operating results but where we have less than a 100% ownership interest.
     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 
  September 30,  September 30,          September 30,  September 30,       
  2010  2009  $  %  2010  2009  $  % 
Revenues:
                                
Other income
 $231  $200  $31   16% $1,276  $938  $338   36%
Expenses:
                                
Interest expense
  30,972   20,057   10,915   54%  76,760   60,390   16,370   27%
General and administrative
  11,628   10,363   1,265   12%  40,331   38,784   1,547   4%
Loss (gain) on extinguishments of debt
     20,946   (20,946)  -100%  25,072   19,269   5,803   30%
 
                        
 
  42,600   51,366   (8,766)  -17%  142,163   118,443   23,720   20%
 
                        
Loss from continuing operations before income taxes
  (42,369)  (51,166)  8,797   -17%  (140,887)  (117,505)  (23,382)  20%
Income tax (expense) benefit
  (125)  30   (155)  n/a   (151)  215   (366)  n/a 
 
                        
Net loss
  (42,494)  (51,136)  8,642   -17%  (141,038)  (117,290)  (23,748)  20%
Preferred stock dividends
  5,347   5,520   (173)  -3%  16,340   16,560   (220)  -1%
 
                        
Net loss attributable to common stockholders
 $(47,841) $(56,656) $8,815   -16% $(157,378) $(133,850) $(23,528)  18%
 
                        
     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):
                                 
  Three Months Ended  Change  Nine Months Ended  Change 
  September 30,  September 30,          September 30,  September 30,       
  2010  2009  $  %  2010  2009  $  % 
Senior unsecured notes
 $31,522  $27,146  $4,376   16% $83,894  $82,149  $1,745   2%
Secured debt
  160   90   70   78%  463   90   373   414%
Unsecured lines of credit
  1,221   1,081   140   13%  3,459   3,979   (520)  -13%
Capitalized interest
  (3,656)  (9,975)  6,319   -63%  (16,008)  (30,866)  14,858   -48%
SWAP savings
  (40)  (40)     0%  (121)  (121)     0%
Loan expense
  1,765   1,755   10   1%  5,073   5,159   (86)  -2%
 
                        
Totals
 $30,972  $20,057  $10,915   54% $76,760  $60,390  $16,370   27%
 
                        

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The change in interest expense on senior unsecured notes is due to the net effect of issuances and extinguishments. 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, 2010  September 30, 2009  September 30, 2010  September 30, 2009 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate  Amount  Interest Rate 
Beginning balance
 $2,164,930   5.256% $1,823,277   5.773% $1,661,853   5.557% $1,845,000   5.782%
Debt issued
  450,000   4.700%     0.000%  1,394,403   4.557%     0.000%
Debt extinguished
         (161,424)  8.000%  (441,326)  4.750%  (183,147)  7.823%
 
                        
Ending balance
 $2,614,930   5.160% $1,661,853   5.557% $2,614,930   5.160% $1,661,853   5.557%
 
                        
Monthly averages
 $2,277,430   5.228% $1,782,921   5.723% $2,025,167   5.313% $1,813,652   5.756%
     During the three 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, 
  2010  2009  2010  2009 
Balance outstanding at quarter end
 $  $143,000  $  $143,000 
Maximum amount outstanding at any month end
 $560,000  $292,000  $560,000  $559,000 
Average amount outstanding (total of daily principal balances divided by days in period)
 $220,467  $217,174  $265,465  $301,740 
Weighted average interest rate (actual interest expense divided by average borrowings outstanding)
  2.22%  1.99%  1.74%  1.76%
     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 11 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, 2010 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, 2010 were 6.51% and 8.12%, respectively, as compared to 7.05% and 8.83% for the same periods in 2009. The change from prior year is primarily related to the recognition of $2,853,000 of expenses in connection with a performance-based stock grant during the nine months ended September 30, 2010 and additional salary and benefits to attract and retain appropriate personnel to support our business growth. This was partially offset by $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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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     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, 2010  September 30, 2009  September 30, 2010  September 30, 2009 
      Weighted Avg.      Weighted Avg.      Weighted Avg.      Weighted Avg. 
  Shares  Dividend Rate  Shares  Dividend Rate  Shares  Dividend Rate  Shares  Dividend Rate 
 
                                
Beginning balance
  11,397,252   7.697%  11,475,093   7.697%  11,474,093   7.697%  11,516,302   7.696%
Shares redeemed
  (5,513)  7.500%     0.000%  (5,513)  7.500%     0.000%
Shares converted
  (391,739)  7.215%  (1,000)  7.500%  (468,580)  7.265%  (42,209)  7.478%
 
                        
Ending balance
  11,000,000   7.716%  11,474,093   7.697%  11,000,000   7.716%  11,474,093   7.697%
 
                        
Monthly averages
  11,297,939   7.703%  11,474,593   7.697%  11,383,466   7.700%  11,485,097   7.697%

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The tables below reflect 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. Noncontrolling interest amounts represent the noncontrolling interests’ share of transaction costs and depreciation and amortization. Unconsolidated joint venture amounts represent our share of unconsolidated joint ventures’ depreciation and amortization. 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, 
  2009  2009  2009  2009  2010  2010  2010 
FFO Reconciliation:                            
Net income attributable to common stockholders
 $61,119  $59,240  $19,130  $31,700  $25,812  $45,646  $1,124 
Depreciation and amortization
  41,326   40,731   41,085   41,780   43,581   47,451   49,106 
Loss (gain) on sales of properties
  (17,036)  (10,677)  806   (16,487)  (6,718)  (3,314)  (10,526)
Noncontrolling interests
  (87)  (87)  (88)  (703)  (363)  108   (1,292)
Unconsolidated joint ventures
              775   2,323   2,696 
 
                     
Funds from operations
 $85,322  $89,207  $60,933  $56,290  $63,087  $92,214  $41,108 
 
                            
Average common shares outstanding:
                            
Basic
  108,214   110,864   114,874   122,700   123,270   123,808   125,298 
Diluted
  108,624   111,272   115,289   123,105   123,790   124,324   125,842 
 
                            
Per share data:
                            
Net income attributable to common stockholders
                            
Basic
 $0.56  $0.53  $0.17  $0.26  $0.21  $0.37  $0.01 
Diluted
  0.56   0.53   0.17   0.26   0.21   0.37   0.01 
 
                            
Funds from operations
                            
Basic
 $0.79  $0.80  $0.53  $0.46  $0.51  $0.74  $0.33 
Diluted
  0.79   0.80   0.53   0.46   0.51   0.74   0.33 
         
  Nine Months Ended 
  September  September 
  30,  30, 
  2009  2010 
FFO Reconciliation:        
Net income attributable to common stockholders
 $139,489  $72,580 
Depreciation and amortization
  123,143   140,137 
Loss (gain) on sales of properties
  (26,907)  (20,559)
Noncontrolling interests
  (262)  (1,547)
Unconsolidated joint ventures
     5,794 
 
      
Funds from operations
 $235,463  $196,405 
 
        
Average common shares outstanding:
        
Basic
  111,345   124,132 
Diluted
  111,749   124,660 
 
        
Per share data:
        
Net income attributable to common stockholders
        
Basic
 $1.25  $0.58 
Diluted
  1.25   0.58 
 
        
Funds from operations
        
Basic
 $2.11  $1.58 
Diluted
  2.11   1.58 

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The following tables reflect the reconciliation of NOI for the periods presented. All amounts include amounts from discontinued operations, if applicable. Our share of revenues and expenses from unconsolidated joint ventures for life science buildings are included in medical facilities. Amounts are in thousands.
                             
  Three Months Ended 
  March 31,  June 30,  September 30,  December 31,  March 31,  June 30,  September 30, 
  2009  2009  2009  2009  2010  2010  2010 
NOI Reconciliation:                            
Total revenues:
                            
Senior housing and care:
                            
Rental income:
                            
Senior housing
 $47,704  $47,678  $47,446  $47,856  $52,366  $56,197  $56,162 
Skilled nursing facilities
  41,731   42,979   41,983   40,733   40,872   41,057   41,496 
 
                     
Sub-total
  89,435   90,657   89,429   88,589   93,238   97,254   97,658 
Resident fees and services
                    12,809 
Interest income
  8,723   8,910   9,266   9,046   8,575   8,830   9,179 
Other income
  792   570   557   3,389   494   1,536   698 
 
                     
Total senior housing and care revenues
  98,950   100,137   99,252   101,024   102,307   107,620   120,344 
Medical facilities:
                            
Rental income
                            
Medical office buildings
  33,253   32,593   35,008   35,980   40,088   42,056   43,758 
Hospitals
  12,677   10,627   10,884   10,779   10,781   12,484   13,313 
Life science buildings
              3,725   9,355   10,401 
 
                     
Sub-total
  45,930   43,220   45,892   46,759   54,594   63,895   67,472 
Interest income
  1,230   1,248   1,262   1,201   473   505   875 
Other income
  316   304   332   8,415   271   302   227 
 
                     
Total medical facilities revenues
  47,476   44,772   47,486   56,375   55,338   64,702   68,574 
Corporate other income
  376   363   200   232   231   812   231 
 
                     
Total revenues
  146,802   145,272   146,938   157,631   157,876   173,134   189,149 
Property operating expenses:
                            
Senior housing and care
                    7,993 
Medical facilities:
                            
Medical office buildings
  11,983   12,044   12,974   11,964   12,992   12,853   13,307 
Hospitals
              728   150   522 
Life science buildings
              1,101   2,716   3,035 
 
                     
Sub-total
  11,983   12,044   12,974   11,964   14,821   15,719   16,864 
Non-segment/corporate
                     
 
                     
Total property operating expenses
  11,983   12,044   12,974   11,964   14,821   15,719   24,857 
Net operating income:
                            
Senior housing and care
  98,950   100,137   99,252   101,024   102,307   107,620   112,351 
Medical facilities
  35,493   32,728   34,512   44,411   40,517   48,983   51,710 
Non-segment/corporate
  376   363   200   232   231   812   231 
 
                     
Net operating income
 $134,819  $133,228  $133,964  $145,667  $143,055  $157,415  $164,292 
 
                     

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
         
  Nine Months Ended 
  September 30,  September 30, 
  2009  2010 
NOI Reconciliation:
        
Total revenues:
        
Senior housing and care:
        
Rental income:
        
Senior housing
 $142,828  $164,723 
Skilled nursing facilities
  126,693   123,425 
 
      
Sub-total
  269,521   288,148 
Resident fees and services
     12,809 
Interest income
  26,899   26,583 
Other income
  1,921   2,726 
 
      
Total senior housing and care revenues
  298,341   330,266 
Medical facilities:
        
Rental income
        
Medical office buildings
  100,854   125,903 
Hospitals
  34,188   36,578 
Life science buildings
     23,481 
 
      
Sub-total
  135,042   185,962 
Interest income
  3,740   1,853 
Other income
  951   800 
 
      
Total medical facilities revenues
  139,733   188,615 
Corporate other income
  938   1,276 
 
      
Total revenues
  439,012   520,157 
Property operating expenses:
        
Senior housing and care
     7,993 
Medical facilities:
        
Medical office buildings
  37,000   39,152 
Hospitals
     1,400 
Life science buildings
     6,852 
 
      
Sub-total
  37,000   47,404 
Non-segment/corporate
      
 
      
Total property operating expenses
  37,000   55,397 
Net operating income:
        
Senior housing and care
  298,341   322,273 
Medical facilities
  102,733   141,211 
Non-segment/corporate
  938   1,276 
 
      
Net operating income
 $402,012  $464,760 
 
      

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     The tables below reflect 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,
  2009 2009 2009 2009 2010 2010 2010
EBITDA Reconciliation:
                            
Net income
 $66,645  $64,759  $24,685  $36,838  $31,694  $51,064  $5,781 
Interest expense
  28,011   27,332   28,833   25,596   29,985   37,550   44,985 
Income tax expense (benefit)
  50   21   (55)  151   84   188   52 
Depreciation and amortization
  41,326   40,731   41,085   41,780   43,581   47,451   49,106 
   
EBITDA
 $136,032  $132,843  $94,548  $104,365  $105,344  $136,253  $99,924 
 
                            
Interest Coverage Ratio:
                            
Interest expense
 $28,011  $27,332  $28,833  $25,596  $29,985  $37,550  $44,985 
Non-cash interest expense
  (2,772)  (2,844)  (2,895)  (3,387)  (2,841)  (3,659)  (4,258)
Capitalized interest
  9,865   11,026   9,975   10,305   7,076   5,276   3,656 
   
Total interest
  35,104   35,514   35,913   32,514   34,220   39,167   44,383 
EBITDA
 $136,032  $132,843  $94,548  $104,365  $105,344  $136,253  $99,924 
   
Interest coverage ratio
  3.88  3.74  2.63  3.21  3.08  3.48  2.25
 
                            
Fixed Charge Coverage Ratio:
                            
Total interest
 $35,104  $35,514  $35,913  $32,514  $34,220  $39,167  $44,383 
Secured debt principal payments
  2,206   2,177   2,298   2,611   3,378   4,325   4,019 
Preferred dividends
  5,524   5,516   5,520   5,520   5,509   5,484   5,347 
   
Total fixed charges
  42,834   43,207   43,731   40,645   43,107   48,976   53,749 
EBITDA
 $136,032  $132,843  $94,548  $104,365  $105,344  $136,253  $99,924 
   
Fixed charge coverage ratio
  3.18  3.07  2.16  2.57  2.44  2.78  1.86
         
  Nine Months Ended
  September 30, September 30,
  2009 2010
EBITDA Reconciliation:
        
Net income
 $156,089  $88,537 
Interest expense
  84,176   112,520 
Income tax expense
  17   325 
Depreciation and amortization
  123,143   140,137 
 
        
EBITDA
 $363,425  $341,519 
 
        
Interest Coverage Ratio:
        
Interest expense
 $84,176  $112,520 
Non-cash interest expense
  (8,511)  (10,759)
Capitalized interest
  30,866   16,008 
   
Total interest
  106,531   117,769 
EBITDA
 $363,425  $341,519 
   
Interest coverage ratio
  3.41  2.90
 
        
Fixed Charge Coverage Ratio:
        
Total interest
 $106,531  $117,769 
Secured debt principal payments
  6,681   11,723 
Preferred dividends
  16,560   16,340 
   
Total fixed charges
  129,772   145,832 
EBITDA
 $363,425  $341,519 
   
Fixed charge coverage ratio
  2.80  2.34

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
     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 
  March 31,  June 30,  September 30,  December 31,  March 31,  June 30,  September 30, 
  2009  2009  2009  2009  2010  2010  2010 
Adjusted EBITDA Reconciliation:
                            
Net income
 $314,613  $218,112  $183,478  $192,927  $157,976  $144,282  $125,377 
Interest expense
  131,750   122,927   116,406   109,772   111,746   121,964   138,116 
Income tax expense
  77   54   152   168   201   368   475 
Depreciation and amortization
  164,797   165,898   165,292   164,923   167,177   173,897   181,918 
Stock-based compensation expense
  11,360   11,034   10,637   9,633   10,619   10,736   10,669 
Provision for loan losses
  234   234   234   23,261   23,121   23,121   52,039 
Loss (gain) on extinguishment of debt
  (2,446)  (2,446)  24,696   25,107   44,822   51,857   34,582 
   
Adjusted EBITDA
 $620,385  $515,813  $500,895  $525,791  $515,662  $526,225  $543,176 
 
                            
Adjusted Fixed Charge Coverage Ratio:
                            
Interest expense
 $131,750  $122,927  $116,406  $109,772  $111,746  $121,964  $138,116 
Capitalized interest
  29,727   35,690   39,301   41,170   38,381   32,631   26,313 
Non-cash interest expense
  (11,214)  (11,289)  (11,410)  (11,898)  (11,967)  (12,782)  (14,145)
Secured debt principal payments
  8,232   8,592   8,810   9,292   10,464   12,612   14,333 
Preferred dividends
  22,579   22,311   22,101   22,079   22,064   22,032   21,860 
   
Total fixed charges
  181,074   178,231   175,208   170,415   170,688   176,457   186,477 
Adjusted EBITDA
 $620,385  $515,813  $500,895  $525,791  $515,662  $526,225  $543,176 
   
Adjusted fixed charge coverage ratio
  3.43  2.89  2.86  3.09  3.02  2.98  2.91

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010, for further information regarding significant accounting policies that impact us. There have been no material changes to these policies in 2010.
     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
          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.

During the year ended December 31, 2009, an impairment charge of $25,223,000 was recorded to reduce the carrying value of eight medical facilities to their estimated fair value less costs to sell. In determining the fair value of the properties, 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. During the nine months ended September 30, 2010, we sold 16 properties, including three of the held for sale medical facilities, for net gains of $20,559,000. At September 30, 2010, we had five medical facilities and one senior housing facility that satisfied the requirements for held for sale treatment. During the three months ended September 30, 2010, we recorded an impairment charge of $947,000 related to two of the held for sale medical facilities to adjust the carrying values to estimated fair values less costs to sell based on current sales price expectations.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
   
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, 2010, we recorded $103,670,000, $29,539,000 and $6,928,000 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 38.1 years, 11.3 years and 9.9 years, respectively, for the nine months ended September 30, 2010.
          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 collectibility of our revenues and related receivables on an on-going basis. We evaluate collectibility 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 collectibility 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, 2010, we recognized $28,437,000 of interest income, $12,809,000 of resident fees and services, and $450,629,000 of rental income, including discontinued operations. Cash receipts on leases with deferred revenue provisions were $6,214,000 as compared to gross straight-line rental income recognized of $12,414,000 for the nine months ended September 30, 2010. At September 30, 2010, our straight-line receivable balance was $86,606,000, net of reserves totaling $273,000. Also at September 30, 2010, we had real estate loans with outstanding balances of $10,889,000 on non-accrual status.
          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, 2010, we did not participate in any interest rate swap agreements.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
   
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 $28,918,000 of provision for loan losses during the nine months ended September 30, 2010. This amount includes the write-off of loans totaling $32,753,000 primarily related to certain early stage senior housing and CCRC development projects. This was offset by a net reduction of the allowance balance by $3,835,000, resulting in an allowance for loan losses of $1,190,000 relating to real estate loans with outstanding balances of $10,889,000, all of which were on non-accrual status at September 30, 2010.
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, responding to government investigations and punitive settlements and operators’/tenants’ difficulty in cost-effectively obtaining and maintaining adequate liability and other insurance; changes in financing terms; competition within the health care, senior housing and life science 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; 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 or joint venture partner bankruptcies or insolvencies; the cooperation of joint venture partners; government regulations affecting Medicare and Medicaid reimbursement rates and operational requirements; regulatory approval and market acceptance of the products and technologies of life science tenants; 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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010, 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, 2010  December 31, 2009 
  Principal  Change in  Principal  Change in 
  balance  fair value  balance  fair value 
Senior unsecured notes
 $2,614,930  $(226,147) $1,661,853  $(129,350)
Secured debt
  826,615   (44,903)  491,094   (22,522)
 
            
Totals
 $3,441,545  $(271,050) $2,152,947  $(151,872)
 
            
          Our variable rate debt, including our unsecured line of credit arrangement, is reflected at fair value. At September 30, 2010, we had $0 outstanding related to our variable rate line of credit and $70,650,000 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 $707,000. At December 31, 2009, we had $140,000,000 outstanding related to our variable rate line of credit and $131,952,000 outstanding related to our variable rate secured debt. Assuming no changes in outstanding balances, a 1% increase in interest rates would have resulted in increased annual interest expense of $2,720,000.
          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.

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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, 2009, as updated by our Current Report on Form 8-K filed May 10, 2010.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Issuer Purchases of Equity Securities
             
          Total Number of Shares Maximum Number of
  Total Number     Purchased as Part of Shares that May Yet Be
  of Shares Average Price Paid Publicly Announced Plans Purchased Under the Plans
Period Purchased(1) Per Share or Programs(2) or Programs
July 1, 2010 through July 31, 2010
  873  $42.41     
August 1, 2010 through August 31, 2010
            
September 1, 2010 through September 30, 2010
            
 
            
Totals
  873  $42.41     
 
(1) During the three months ended September 30, 2010, 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.
Item 5.Other Information
Preferred Stock — Certificates of Elimination
     On November 4, 2010, we filed certificates of elimination with the Delaware Secretary of State to eliminate from our Second Restated Certificate of Incorporation, as amended, all matters set forth in the certificates of designation for the 6% Series E Cumulative Convertible and Redeemable Preferred Stock and the 7.5% Series G Cumulative Convertible Preferred Stock.
     During the nine months ended September 30, 2010, certain holders of our Series G Cumulative Convertible Preferred Stock converted 394,200 shares into 282,078 shares of our common stock, leaving 5,513 of such shares outstanding which were redeemed by us on September 30, 2010. During the three months ended September 30, 2010, the holder of our Series E Cumulative Convertible and Redeemable Preferred Stock converted 74,380 shares into 56,935 shares of our common stock, leaving no such shares outstanding at September 30, 2010.

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Item 6.Exhibits
   
3.1
 Certificate of Elimination of 6% Series E Cumulative Convertible and Redeemable Preferred Stock of the company.
 
  
3.2
 Certificate of Elimination of 7.5% Series G Cumulative Convertible Preferred Stock of the company.
 
  
4.1
 Indenture, dated as of March 15, 2010, between the company and The Bank of New York Mellon Trust Company, N.A., as trustee (the “Trustee”) (filed with the Securities and Exchange Commission as Exhibit 4.1 to the company’s Form 8-K filed March 15, 2010, and incorporated herein by reference thereto).
 
  
4.2
 Supplemental Indenture No. 3, dated as of September 10, 2010, between the company and the Trustee (filed with the Securities and Exchange Commission as Exhibit 4.2 to the company’s Form 8-K filed September 10, 2010, and incorporated herein by reference thereto).
 
  
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.
 
  
101.INS
 XBRL Instance Document*
 
  
101.SCH
 XBRL Taxonomy Extension Schema Document*
 
  
101.CAL
 XBRL Taxonomy Extension Calculation Linkbase Document*
 
  
101.LAB
 XBRL Taxonomy Extension Label Linkbase Document*
 
  
101.PRE
 XBRL Taxonomy Extension Presentation Linkbase Document*
 
  
101.DEF
 XBRL Taxonomy Extension Definition Linkbase Document*
 
* Attached as Exhibit 101 to this Quarterly Report on Form 10-Q are the following materials, formatted in XBRL (eXtensible Business Reporting Language): (i) the Consolidated Balance Sheets at September 30, 2010 and December 31, 2009, (ii) the Consolidated Statements of Income for the three and nine months ended September 30, 2010 and 2009, (iii) the Consolidated Statements of Equity for the nine months ended September 30, 2010 and 2009, (iv) the Consolidated Statements of Cash Flows for the nine months ended September 30, 2010 and 2009 and (v) the Notes to Unaudited Consolidated Financial Statements tagged as blocks of text.
 
  Pursuant to Rule 406T of Regulation S-T, the Interactive Data Files on Exhibit 101 hereto are deemed not filed or part of a registration statement or prospectus for purposes of Sections 11 or 12 of the Securities Act of 1933, as amended, are deemed not filed for purposes of Section 18 of the Securities and Exchange Act of 1934, as amended, and otherwise are not subject to liability under those sections.

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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 8, 2010 By:  /s/ GEORGE L. CHAPMAN   
 George L. Chapman,  
 Chairman, Chief Executive Officer and President
(Principal Executive Officer) 
 
 
   
Date: November 8, 2010 By:  /s/ SCOTT A. ESTES   
 Scott A. Estes,  
 Executive Vice President and Chief Financial Officer (Principal Financial Officer)  
   
Date: November 8, 2010 By:  /s/ PAUL D. NUNGESTER, JR.   
 Paul D. Nungester, Jr.,  
 Vice President and Controller
(Principal Accounting Officer) 
 

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