Unless stated otherwise or the context otherwise requires, the terms "Omega",
the "Company," "we," "our" and "us" refer to Omega Healthcare Investors, Inc.
and its consolidated subsidiaries, including Omega OP, references to "Parent"
refer to Omega Healthcare Properties, Inc. without regard to its consolidated
subsidiaries, and references to "Omega OP" mean OHI Healthcare Properties
Limited Partnership and its consolidated subsidiaries.

Forward-Looking Statements and Factors Affecting Future Results



The following discussion should be read in conjunction with the financial
statements and notes thereto appearing elsewhere in this document. This document
contains "forward-looking statements" within the meaning of the federal
securities laws. These statements relate to our expectations, beliefs,
intentions, plans, objectives, goals, strategies, future events, performance and
underlying assumptions and other statements other than statements of historical
facts. In some cases, you can identify forward-looking statements by the use of
forward-looking terminology including, but not limited to, terms such as "may,"
"will," "anticipates," "expects," "believes," "intends," "should" or comparable
terms or the negative thereof. These statements are based on information
available on the date of this filing and only speak as to the date hereof and no
obligation to update such forward-looking statements should be assumed. Our
actual results may differ materially from those reflected in the forward-looking
statements contained herein as a result of a variety of factors, including,
among other things:

(i) those items discussed under "Risk Factors" in Part I, Item 1A to our annual


     report on   Form 10-K  ;


      uncertainties relating to the business operations of the operators of our

(ii) assets, including those relating to reimbursement by third-party payors,


      regulatory matters and occupancy levels;


       the impact of the novel coronavirus ("COVID-19") on our business and the
       business of our operators, including without limitation, the extent and

duration of the COVID-19 pandemic, increased costs, staffing shortages and

decreased occupancy levels experienced by operators of skilled nursing

(iii) facilities ("SNFs") and assisted living facilities ("ALFs") in connection

therewith, the ability of operators to comply with new infection control

and vaccine protocols, the long-term impact of vaccination on facility

infection rates, and the extent to which continued government support may

be available to operators to offset such costs and the conditions related

thereto;

the ability of any of Omega's operators in bankruptcy to reject unexpired

lease obligations, modify the terms of Omega's mortgages and impede the

(iv) ability of Omega to collect unpaid rent or interest during the pendency of a

bankruptcy proceeding and retain security deposits for the debtor's

obligations, and other costs and uncertainties associated with operator

bankruptcies;

our ability to re-lease, otherwise transition, or sell underperforming assets

(v) or assets held for sale on a timely basis and on terms that allow us to

realize the carrying value of these assets;

(vi) the availability and cost of capital to us;

(vii) changes in our credit ratings and the ratings of our debt securities;

(viii) competition in the financing of healthcare facilities;

(ix) competition in long-term healthcare industry and shifts in the perception of

various types of long-term care facilities, including SNFs and ALFs;

(x) additional regulatory and other changes in the healthcare sector;

(xi) changes in the financial position of our operators;

(xii) the effect of economic and market conditions generally and, particularly,

in the healthcare industry;

(xiii) changes in interest rates;

(xiv) the timing, amount and yield of any additional investments;

(xv) changes in tax laws and regulations affecting real estate investment trusts


      ("REITs");


       the potential impact of changes in the SNF and ALF markets or local real

(xvi) estate conditions on our ability to dispose of assets held for sale for the

anticipated proceeds or on a timely basis, or to redeploy the proceeds

therefrom on favorable terms;

(xvii) our ability to maintain our status as a REIT; and

the effect of other factors affecting our business or the businesses of

(xviii) our operators that are beyond our or their control, including natural

disasters, other health crises or pandemics and governmental action;


         particularly in the healthcare industry.


                                       31

  Table of Contents

Overview

Omega was incorporated in the State of Maryland on March 31, 1992 and has
elected to be taxed as a REIT for federal income tax purposes. Omega is
structured as an umbrella partnership REIT ("UPREIT") under which all of Omega's
assets are owned directly or indirectly by, and all of Omega's operations are
conducted directly or indirectly through, its operating partnership subsidiary,
Omega OP. As of June 30, 2021, Omega owned approximately 97% of the issued and
outstanding units of partnership interest in Omega OP ("Omega OP Units"), and
investors owned approximately 3% of the Omega OP Units.

Omega has one reportable segment consisting of investments in healthcare-related
real estate properties located in the United States ("U.S.") and the United
Kingdom ("U.K."). Our core business is to provide financing and capital to the
long-term healthcare industry with a particular focus on SNFs and ALFs, and to a
lesser extent, independent living facilities ("ILFs"), rehabilitation and acute
care facilities ("specialty facilities") and medical office buildings. Our core
portfolio consists of long-term leases and mortgage agreements. All of our
leases are "triple-net" leases, which require the operators (we use the term
"operator" to refer to our tenants and mortgagors and their affiliates who
manage and/or operate our properties) to pay all property-related expenses. Our
mortgage revenue derives from fixed rate mortgage loans, which are secured by
first mortgage liens on the underlying real estate and personal property of the
mortgagor. Our other investment income derives from fixed and variable rate
loans to our operators and/or their principals to fund working capital and
capital expenditures. These loans, which may be either unsecured or secured by
the collateral of the borrower, are classified as other investments.

COVID-19 Pandemic Update


For the year ended December 31, 2020 and for the first quarter of 2021, we
collected substantially all of the contractual rents and mortgage interest
payments owed to us from our operators (other than operators under a forbearance
agreement prior to the pandemic). However, in June 2021, we were informed by an
operator, which represents approximately 3% of our revenue for the six months
ended June 30, 2021 and 2020 (excluding the impact of the straight-line
write-offs in 2021), that it would be unable to pay rent to us in the
foreseeable future. As of June 30, 2021, we have been unable to collect
approximately $2.5 million of contractual rents due from this operator, which
represents one month of contractual rent under the lease agreement, and have
applied $2.5 million of the operator's security deposit funds against their
uncollected receivables. As such, we placed the operator on a cash basis for
revenue recognition based on our evaluation of the collectibility of future rent
payments due under its lease agreement, and in connection with this, we wrote
off approximately $17.4 million of straight-line receivables to rental income
during the quarter. We believe this operator was impacted by, among other
things, reduced revenue as a result of lower occupancy and increased expenses,
both as a result of the COVID-19 pandemic. As discussed in Note 2 - Contractual
Receivables and Other Receivables, we also placed a smaller operator on a cash
basis in the first quarter due to collectability concerns as a result of the
impacts of the COVID-19 pandemic. With respect to our other operators, we
collected substantially all contractual rents and mortgage interest payments due
to us from our operators during the second quarter of 2021; however, we remain
cautious as the COVID-19 pandemic continues to have a significant impact on our
operators and their financial conditions, particularly given continued
uncertainty regarding the availability of sufficient government support, the
persistence of staffing shortages that continue to impact our operators'
occupancy levels and profitability, and the commencement in April 2021 for many
of our operators of the repayment of accelerated payments of Medicare funds that
were previously received as Advanced Medicare payments in 2020.

                                       32

Table of Contents



As of July 27, 2021, our operators reported cases of COVID-19 within 153, or
16%, of our 949 operating facilities as of December 31, 2020, which includes
cases involving employees and residents. This represents a meaningful decline in
cases from the 614 facilities with cases, or 64% of our 959 operating
facilities, that our operators reported as of December 22, 2020, and from the
212 facilities with cases, or 22%, of our 949 operating facilities, that our
operators reported as of April 27, 2021. We caution that we have not
independently validated any such facility virus incidence information, it may be
reported on an inconsistent basis by our operators, and we can provide no
assurance regarding its accuracy or that there have not been any changes since
the time the information was obtained from our operators; we also undertake no
duty to update this information. While we believe the declines in reported cases
noted above is due in large part to vaccination programs for COVID-19 which have
been implemented in most of our facilities, it remains uncertain when and to
what extent these vaccination programs will continue to mitigate the effects of
COVID-19 in our facilities, or how effective existing vaccines will be against
variants of the COVID-19 virus. The impact of these programs will depend in part
on the continued speed, distribution, efficacy and delivery of the vaccine in
our facilities, as well as participation levels in vaccination programs among
the residents and employees of our operators. Our operators have continued to
report considerable variation in participation levels among both employees and
residents, which we believe may change over time with additional vaccination
education efforts.

In addition to experiencing outbreaks of positive cases and deaths of residents
and employees during the pandemic, our operators have been required to, and
continue to, adapt their operations rapidly throughout the pandemic to manage
the spread of the COVID-19 virus as well as the implementation of new treatments
and vaccines, and to implement new requirements relating to infection control,
staffing levels, personal protective equipment ("PPE"), quality of care,
visitation protocols, and reporting, among other regulations, throughout the
pandemic while facing staffing shortages that have accelerated during the
pandemic and that may impede the delivery of care. Many of our operators have
reported incurring significant cost increases as a result of the COVID-19
pandemic, with dramatic increases for facilities with positive cases. We believe
these increases primarily stem from elevated labor costs, including increased
use of overtime and bonus pay and reliance on agency staffing due to staffing
shortages, as well as a significant increase in both the cost and usage of PPE,
testing equipment and processes and supplies, as well as implementation of new
infection control protocols and vaccination programs. In addition, many of our
operators have reported experiencing declines, in some cases that are material,
in occupancy levels as a result of the pandemic. While these declines on average
appear to be stabilizing and even marginally improving in recent months, it
remains unclear when and the extent to which demand and occupancy levels will
return to pre-COVID-19 levels. We believe these occupancy declines may be in
part due to staffing shortages, which in some cases have required operators to
limit admissions, as well as COVID-19 related fatalities at the facilities, the
delay of SNF placement and/or utilization of alternative care settings for those
with lower level of care needs, the suspension and/or postponement of elective
hospital procedures, fewer discharges from hospitals to SNFs and higher hospital
readmittances from SNFs.

While substantial government support, primarily through the federal CARES Act in
the U.S. and distribution of PPE, vaccines and testing equipment by federal and
state governments, has been allocated to SNFs and to a lesser extent to ALFs,
further government support will likely be needed to continue to offset these
impacts. It is unclear whether and to what extent such government support will
continue to be sufficient and timely to offset these impacts. In particular, it
remains unclear as to whether unallocated funds under the Public Health and
Social Services Emergency Fund ("Provider Relief Fund") will be distributed to
our operators in any meaningful way, whether additional funds will be added to
the Provider Relief Fund or otherwise allocated to health care operators or our
operators, or whether additional Medicaid funds under the recently enacted
American Rescue Plan Act of 2021 (the "American Rescue Plan Act") in the U.S.
will ultimately support reimbursement to our operators. Further, to the extent
the cost and occupancy impacts on our operators continue or accelerate and are
not offset by continued government relief that is sufficient and timely, we
anticipate that the operating results of certain of our operators would be
materially and adversely affected, some may be unwilling or unable to pay their
contractual obligations to us in full or on a timely basis and we may be unable
to restructure such obligations on terms as favorable to us as those currently
in place. Citing in part the impact of the COVID-19 pandemic and uncertainties
regarding the continuing availability of sufficient government support, during
the third and fourth quarters of 2020, four of our operators indicated in their
financial statements substantial doubt regarding their ability to continue

as
going concerns.

                                       33

  Table of Contents

There are a number of uncertainties we face as we consider the potential impact
of COVID-19 on our business, including how long census disruption and elevated
COVID-19 costs will last, the impact of vaccination programs and participation
levels in those programs in reducing the spread of COVID-19 in our facilities,
and the extent to which funding support from the federal government and the
states will continue to offset these incremental costs as well as lost revenues.
Notwithstanding vaccination programs, we expect that heightened clinical
protocols for infection control within facilities will continue for some period;
however, we do not know if future reimbursement rates or equipment provided by
governmental agencies will be sufficient to cover the increased costs of
enhanced infection control and monitoring.

While we continue to believe that longer term demographics will drive increasing
demand for needs-based skilled nursing care, we expect the uncertainties to our
business described above to persist at least for the near term until we can gain
more information as to the level of costs our operators will continue to
experience and for how long, and the level of additional governmental support
that will be available to them, the potential support our operators may request
from us and the future demand for needs-based skilled nursing care and senior
living facilities. We continue to monitor the impact of occupancy declines at
many of our operators, and it remains uncertain whether and when demand,
staffing availability and occupancy levels will return to pre-COVID-19 levels.

We continue to monitor the impacts of other regulatory changes, as discussed
below, including any significant limits on the scope of services reimbursed and
on reimbursement rates and fees, which could have a material adverse effect on
an operator's results of operations and financial condition, which could
adversely affect the operator's ability to meet its obligations to us.

Government Regulation and Reimbursement

The following information supplements and updates, and should be read in conjunction with, the information contained under the caption Item 1. Business - Government Regulation and Reimbursement in our Annual Report on Form 10-K for the year ended December 31, 2020.



The healthcare industry is heavily regulated. Our operators, which are primarily
based in the U.S., are subject to extensive and complex federal, state and local
healthcare laws and regulations; we also have several U.K.-based operators that
are impacted by a variety of laws and regulations in their jurisdiction. These
laws and regulations are subject to frequent and substantial changes resulting
from the adoption of new legislation, rules and regulations, and administrative
and judicial interpretations of existing law. The ultimate timing or effect of
these changes, which may be applied retroactively, cannot be predicted. Changes
in laws and regulations impacting our operators, in addition to regulatory
non-compliance by our operators, can have a significant effect on the operations
and financial condition of our operators, which in turn may adversely impact us.
There is the potential that we may be subject directly to healthcare laws and
regulations because of the broad nature of some of these regulations, such as
the Anti-kickback Statute and False Claims Act, among others.

The U.S. Department of Health and Human Services ("HHS") declared a public
health emergency on January 31, 2020 following the World Health Organization's
decision to declare COVID-19 a public health emergency of international concern.
This declaration, which has been extended through October 17, 2021, allows HHS
to provide temporary regulatory waivers and new reimbursement rules designed to
equip providers with flexibility to respond to the COVID-19 pandemic by
suspending various Medicare patient coverage criteria and documentation and care
requirements, including, for example, suspension of the three-day prior hospital
stay coverage requirement and expanding the list of approved services which may
be provided via telehealth. These regulatory actions could contribute to a
change in census volumes and skilled nursing mix that may not otherwise have
occurred. It remains uncertain when federal and state regulators will resume
enforcement of those regulations which are waived or otherwise not being
enforced during the public health emergency due to the exercise of enforcement
discretion.

                                       34

  Table of Contents

These temporary changes to regulations and reimbursement, as well as emergency
legislation, including the CARES Act enacted on March 27, 2020 and discussed
below, continue to have a significant impact on the operations and financial
condition of our operators. The extent of the COVID-19 pandemic's effect on the
Company's and our operators' operational and financial performance will depend
on future developments, including the sufficiency and timeliness of additional
governmental relief, the duration, spread and intensity of the outbreak, the
impact of new vaccine distributions on our operators and their populations, as
well as the difference in how the pandemic may impact SNFs in contrast to ALFs,
all of which developments and impacts are uncertain and difficult to predict.
Due to these uncertainties, we are not able at this time to estimate the effect
of these factors on our business; however, the adverse impact on our business,
results of operations, financial condition and cash flows could be material.

A significant portion of our operators' revenue is derived from
government-funded reimbursement programs, consisting primarily of Medicare and
Medicaid. As federal and state governments continue to focus on healthcare
reform initiatives, efforts to reduce costs by government payors will likely
continue. Significant limits on the scope of services reimbursed and/or
reductions of reimbursement rates could therefore have a material adverse effect
on our operators' results of operations and financial condition. Additionally,
new and evolving payor and provider programs that are tied to quality and
efficiency could adversely impact our tenants' and operators' liquidity,
financial condition or results of operations, and there can be no assurance that
payments under any of these government health care programs are currently, or
will be in the future, sufficient to fully reimburse the property operators for
their operating and capital expenses.

Reimbursement Changes Related to COVID-19:

U.S. Federal Stimulus Funds, through the CARES Act and Provider Relief Fund,
Appropriating $178 billion to Health Care Providers. In response to the
pandemic, Congress enacted a series of economic stimulus and relief measures
throughout 2020. On March 18, 2020, the Families First Coronavirus Response Act
was enacted in the U.S., providing a temporary 6.2% increase to each qualifying
state and territory's Medicaid Federal Medical Assistance Percentage ("FMAP")
effective January 1, 2020. The temporary FMAP increase will extend through the
last day of the calendar quarter in which the public health emergency
terminates. States will make individual determinations about how this additional
Medicaid reimbursement will be applied to SNFs, if at all.

In a further response to the pandemic, the CARES Act authorized approximately
$178 billion to be distributed through the Provider Relief Fund to reimburse
eligible healthcare providers for health care related expenses or lost revenues
that are attributable to coronavirus. The Provider Relief Fund is administered
under the broad authority and discretion of HHS and recipients are not required
to repay distributions received to the extent they are used in compliance with
applicable requirements.

HHS began distributing Provider Relief Fund grants in April 2020 and has made
grants available to various provider groups in three general phases. In May
2020, HHS announced that approximately $9.5 billion in targeted distributions
would be made available to eligible skilled nursing facilities, approximately
$2.5 billion of which were composed of performance-based incentive payments tied
to a facility's infection rate. Approximately $8.5 billion in additional funds
were added to the Provider Relief Fund through the American Rescue Plan Act
enacted on March 11, 2021; however, these funds are limited to rural providers
and suppliers.

As of March 15, 2021, based on data published by HHS, it appears that less than
$29 billion of the Provider Relief Fund remains unallocated. HHS continues to
evaluate and provide allocations of, and issue regulations and guidance
regarding, grants made under the CARES Act and related legislation. There are
substantial uncertainties regarding the extent to which our operators will
receive funds which have not been allocated, whether additional funds will be
allocated to the Provider Relief Fund, health care providers or senior care
providers and whether additional payments will be distributed to providers, the
financial impact of receiving any of these funds on their operations or
financial condition, and whether operators will be able to meet the compliance
requirements associated with the funds. HHS continues to evaluate and provide
allocations of, and issue regulation and guidance regarding, grants made under
the CARES Act.

                                       35

  Table of Contents

The CARES Act and related legislation also made other forms of financial
assistance available to healthcare providers, which have the potential to impact
our operators to varying degrees. This assistance includes Medicare and Medicaid
payment adjustments and an expansion of the Medicare Accelerated and Advance
Payment Program, which made available accelerated payments of Medicare funds in
order to increase cash flow to providers. These payments are loans that
providers are scheduled to repay beginning one year from the issuance date of
each provider's or supplier's accelerated or advance payment, with repayment
made through automatic recoupment of 25% of Medicare payments otherwise owed to
the provider or supplier for eleven months, followed by an increase to 50% for
another six months, after which any outstanding balance would be repaid subject
to an interest rate of 4%. We believe these repayments commenced for many of our
operators in April 2021 and have adversely impacted, and will continue to
adversely impact, operating cash flows of these operators.

Additionally, the Centers for Medicare and Medicaid Services ("CMS") suspended
Medicare sequestration payment adjustments, which would have otherwise reduced
payments to Medicare providers by 2%, from May 1, 2020 through December 31,
2021, but also extended sequestration through 2030.  While not limited to
healthcare providers, the CARES Act additionally provided payroll tax relief for
employers, allowing them to defer payment of employer Social Security taxes that
are otherwise owed for wage payments made after March 27, 2020 through December
31, 2020 to December 31, 2021 with respect to 50% of the payroll taxes owed,
with the remaining 50% deferred until December 31, 2022.

Quality of Care Initiatives and Additional Requirements Related to COVID-19:





In addition to COVID-19 reimbursement changes, several regulatory initiatives
announced in 2020 and the first quarter of 2021 focused on addressing quality of
care in long-term care facilities, including those related to COVID-19 testing
and infection control protocols, vaccine protocols, staffing levels, reporting
requirements, and visitation policies, as well as increased inspection of
nursing homes. For example, recent updates to the Nursing Home Care website and
the Five Star Quality Rating System include revisions to the inspection process,
adjustment of staffing rating thresholds and the implementation of new quality
measures. Although the American Rescue Plan Act did not allocate specific funds
to SNF or assisted living facility providers, approximately $200 million was
allocated to quality improvement organizations to provide infection control and
vaccination uptake support to SNFs.

On June 16, 2020, the U.S. House of Representatives Select Subcommittee on the
Coronavirus Crisis announced the launch of an investigation into the COVID-19
response of nursing homes and the use of federal funds by nursing homes during
the pandemic. The Select Subcommittee continued to be active throughout the
remainder of 2020 and the first quarter of 2021. In March 2021, the Oversight
Subcommittee of the House Ways and Means Committee held a hearing on examining
the impact of private equity in the U.S. health care system, including the
impact on quality of care provided within the skilled nursing industry. These
hearings, as well as additional calls for government review of the role of
private equity in the U.S. healthcare industry, could result in legislation
imposing additional requirements on our operators.

                                       36

  Table of Contents

Reimbursement Generally:

Medicaid.  The American Rescue Plan Act contains several provisions designed to
increase coverage, expand benefits, and adjust federal financing for state
Medicaid programs. For example, the American Rescue Plan Act increases the FMAP
by 10 percentage points for state home and community-based services expenditures
beginning April 1, 2021 through March 30, 2022 in an effort to assist seniors
and people with disabilities to receive services safely in the community rather
than in nursing homes and other congregate care settings. As a condition for
receiving the FMAP increase, states must enhance, expand, or strengthen their
Medicaid home and community-based services program during this period. These
potential enhancements to Medicaid reimbursement funding may be offset in
certain states by state budgetary concerns, the ability of the state to allocate
matching funds and to comply with the new requirements, the potential for
increased enrollment in Medicaid due to unemployment and declines in family
incomes resulting from the COVID-19 pandemic, and the potential allocation of
state Medicaid funds available for reimbursement away from SNFs in favor of home
and community-based programs. These challenges may particularly impact us in
states where we have a larger presence, including Florida and Texas. In Texas in
particular, several of our operators have historically experienced lower
operating margins on their SNFs, as compared to other states, as a result of
lower Medicaid reimbursement rates and higher labor costs. Our operators in
Texas may also be adversely impacted by the expected expiration, upon expiration
of the federally declared public health emergency, of an add-on by the state to
the daily reimbursement rate for Medicaid patients during the pandemic. In
Florida, added support to our operators during the pandemic has generally been
limited, and our operators in the state may be additionally adversely impacted
by the scheduled expiration in December 2021 of a three-year temporary Medicaid
reimbursement rate increase by the state. Since our operators' profit margins on
Medicaid patients are generally relatively low, more than modest reductions in
Medicaid reimbursement or an increase in the percentage of Medicaid patients has
in the past and may in the future adversely affect our operators' results of
operations and financial condition, which in turn could adversely impact us.

Medicare.  On July 29, 2021, CMS issued a final rule regarding the government
fiscal year 2022 Medicare payment rates and quality payment programs for SNFs,
with aggregate Medicare Part A payments projected to increase by $410 million,
or 1.2%, for fiscal year 2022 compared to fiscal year 2021. This estimated
reimbursement increase is attributable to a 2.7% market basket increase factor
less a 0.8 percentage point forecast error adjustment and a 0.7 percentage point
productivity adjustment, and a $1.2 million decrease due to the proposed
reduction to the SNF prospective payment system rates to account for the recent
blood-clotting factors exclusion.  The annual update is reduced by two
percentage points for SNFs that fail to submit required quality data to CMS
under the SNF Quality Reporting Program. CMS has indicated that these impact
figures did not incorporate the SNF Value-Based Program reductions that are
estimated to be $184.25 million in fiscal year 2022.

Payments to providers continue to be increasingly tied to quality and
efficiency.  The Patient Driven Payment Model ("PDPM"), which was designed by
CMS to improve the incentives to treat the needs of the whole patient, became
effective October 1, 2019. Prior to COVID-19, we believed that certain of our
operators could realize efficiencies and cost savings from increased concurrent
and group therapy under PDPM and some had reported early positive results. Given
the ongoing impacts of COVID-19, many operators are and may continue to be
restricted from pursuing concurrent and group therapy and unable to realize
these benefits. Additionally, our operators continue to adapt to the
reimbursement changes and other payment reforms resulting from the value based
purchasing programs applicable to SNFs under the 2014 Protecting Access to
Medicare Act, which became effective on October 1, 2018. These reimbursement
changes have had and may, together with any further reimbursement changes to
PDPM or value-based purchasing models, in the future have an adverse effect on
the operations and financial condition of some operators and could adversely
impact the ability of operators to meet their obligations to us.

                                       37

Table of Contents

Department of Justice and Other Enforcement Actions:



SNFs are under intense scrutiny for ensuring the quality of care being rendered
to residents and appropriate billing practices conducted by the facility. The
Department of Justice ("DOJ") has historically used the False Claims Act to
civilly pursue nursing homes that bill the federal government for services not
rendered or care that is grossly substandard. For example, California
prosecutors announced in March 2021 an investigation into a skilled nursing
provider that is affiliated with one of our operators, alleging the chain
manipulated the submission of staffing level data in order to improve its Five
Star rating. In 2020, the DOJ launched a National Nursing Home Initiative to
coordinate and enhance civil and criminal enforcement actions against nursing
homes with grossly substandard deficiencies. Such enforcement activities are
unpredictable and may develop over lengthy periods of time. An adverse
resolution of any of these enforcement activities or investigations incurred by
our operators may involve injunctive relief and/or substantial monetary
penalties, either or both of which could have a material adverse effect on their
reputation, business, results of operations and cash flows.

Critical Accounting Policies and Estimates


Our financial statements are prepared in accordance with generally accepted
accounting principles ("GAAP") in the U.S. Our preparation of the financial
statements requires us to make estimates and assumptions about future events
that affect the amounts reported in our financial statements and accompanying
footnotes. Future events and their effects cannot be determined with absolute
certainty. Therefore, the determination of estimates requires the exercise of
judgment. Actual results inevitably will differ from those estimates, and such
differences may be material to the consolidated financial statements. We have
described our accounting policies in Note 2 - Summary of Significant Accounting
Policies to our Annual Report on   Form 10-K   for the year ended December 31,
2020. There have been no material changes to our critical accounting policies or
estimates since December 31, 2020.

Results of Operations

The following is our discussion of the consolidated results of operations, financial position and liquidity and capital resources, which should be read in conjunction with our unaudited consolidated financial statements and accompanying notes.

Three Months Ended June 30, 2021 and 2020

Revenues



Our revenues for the three months ended June 30, 2021 totaled $257.4 million, an
increase of approximately $1.0 million over the same period in 2020. The $1.0
million increase was primarily the result of (i) a $30.4 million increase in
rental income resulting from facility acquisitions, facilities placed in
service, and facility transitions and (ii) a $3.2 million increase in mortgage
interest income and other investment income primarily related to new and
refinanced mortgages or notes and additional funding to existing operators
offset by principal payments. These increases were partially offset by (i) a
$21.5 million decrease in rental income primarily resulting from placing certain
operators on a cash basis for revenue recognition, (ii) a $2.4 million decrease
in rental income resulting from the acceleration of certain in-place lease
liabilities, (iii) a $6.8 million decrease in rental income resulting from
facility sales and facility transitions and (iv) a $1.6 million decrease in
miscellaneous income which is primarily related to an operator's late fees

and
reduced management fees.

                                       38

  Table of Contents

Expenses

Expenses for the three months ended June 30, 2021 totaled $175.1 million, an
increase of approximately $7.1 million over the same period in 2020. The $7.1
million increase was primarily due to: (i) a $3.5 million increase in provision
for credit losses primarily resulting from a $4.5 million reserve related to a
term loan, (ii) a $3.6 million increase in interest expense primarily resulting
from the issuance during the fourth quarter of 2020 of the $700 million of
Senior Notes due 2031 and the issuance during the first quarter of 2021 of the
$700 million of Senior Notes due 2033, partially offset by the retirement of
term loans in the fourth quarter of 2020 and (iii) a $2.2 million increase in
depreciation expense primarily resulting from facility acquisitions and capital
additions, offset by facility sales and facilities reclassified to assets held
for sale. These increases were partially offset by a $3.2 million decrease in
impairment on real estate properties related to three facilities in the second
quarter of 2021 compared to 10 facilities during the same period in 2020.

Other Income (Expense)



For the three months ended June 30, 2021, total other income was $4.3 million, a
decrease of approximately $8.7 million over the same period in 2020. The
decrease was mainly due to an $8.7 million decrease in gain on assets sold
related to the sale of six facilities in the second quarter of 2021 compared to
the sale of 15 facilities during the same period in 2020.

Six Months Ended June 30, 2021 and 2020

Revenues


Our revenues for the six months ended June 30, 2021 totaled $531.2 million, an
increase of approximately $21.8 million over the same period in 2020. The $21.8
million increase was primarily the result of (i) a $54.7 million increase in
rental income resulting from facility acquisitions, facilities placed in
service, and facility transitions and (ii) an $8.2 million increase in mortgage
interest income and other investment income primarily related to new and
refinanced mortgages or notes and additional funding to existing operators.
These increases were partially offset by (i) a $29.4 million decrease in rental
income resulting from operators placed on a cash basis for revenue recognition,
(ii) a $5.3 million decrease in rental income resulting from facility sales and
facility transitions, and (iii) a $2.1 million decrease in miscellaneous income
which is primarily related to an operator's late fees and reduced management
fees.

Expenses

Expenses for the six months ended June 30, 2021 totaled $366.3 million, an
increase of approximately $36.0 million over the same period in 2020. The $36.0
million increase was primarily due to: (i) a $21.9 million increase in
impairment on real estate properties related to seven facilities compared to 13
facilities during the same period in 2020, (ii) a $6.9 million increase in
interest expense primarily resulting from the issuance during the fourth quarter
of 2020 of the $700 million of Senior Notes due 2031 and the issuance during the
first quarter of 2021 of the $700 million of Senior Notes due 2033, partially
offset by the retirement of term loans in the fourth quarter of 2020, (iii) a
$4.4 million increase in depreciation expense primarily resulting from facility
acquisitions and capital additions, offset by facility sales and facilities
reclassified to assets held for sale (discussed in further detail below), (iv) a
$1.8 million increase in acquisition, merger and transition related costs
primarily resulting from the Daybreak transition, and (v) a $1.0 million
increase in provision for credit losses primarily resulting from a $4.5 million
reserve related to a term loan, increases in loan balances and increases in
average time to maturity offset by decreases in loss rates compared to the

same
period in 2020.

Other Income (Expense)

For the six months ended June 30, 2021, total other income was $75.2 million, an
increase of approximately $61.2 million over the same period in 2020. The
increase was mainly due to a $89.8 million increase in gain on assets sold
related to the sale of 30 facilities compared to the sale of 21 facilities
during the same period in 2020 offset by a $30.1 million increase in loss on
debt extinguishment primarily related to fees, premiums, and expenses related to
the purchase of $350 million of the 4.375% Senior Notes due 2023 during the

first quarter of 2021.

                                       39

  Table of Contents

National Association of Real Estate Investment Trusts Funds From Operations



Our funds from operations ("Nareit FFO") for the three months ended June 30,
2021 was $180.8 million compared to $186.5 million for the same period in 2020.
Our Nareit FFO for the six months ended June 30, 2021 was $351.1 million
compared to $367.5 million for the same period in 2020.

We calculate and report Nareit FFO in accordance with the definition of Funds
from Operations and interpretive guidelines issued by the National Association
of Real Estate Investment Trusts ("Nareit"), and, consequently, Nareit FFO is
defined as net income (computed in accordance with GAAP), adjusted for the
effects of asset dispositions and certain non-cash items, primarily depreciation
and amortization and impairment on real estate assets, and after adjustments for
unconsolidated partnerships and joint ventures and changes in the fair value of
warrants. Adjustments for unconsolidated partnerships and joint ventures are
calculated to reflect funds from operations on the same basis. We believe that
Nareit FFO is an important supplemental measure of our operating performance.
Because the historical cost accounting convention used for real estate assets
requires depreciation (except on land), such accounting presentation implies
that the value of real estate assets diminishes predictably over time, while
real estate values instead have historically risen or fallen with market
conditions. Nareit FFO was designed by the real estate industry to address this
issue. Nareit FFO herein is not necessarily comparable to Nareit FFO of other
REITs that do not use the same definition or implementation guidelines or
interpret the standards differently from us.

Nareit FFO is a non-GAAP financial measure. We use Nareit FFO as one of several
criteria to measure the operating performance of our business. We further
believe that by excluding the effect of depreciation, amortization, impairment
on real estate assets and gains or losses from sales of real estate, all of
which are based on historical costs and which may be of limited relevance in
evaluating current performance, Nareit FFO can facilitate comparisons of
operating performance between periods and between other REITs. We offer this
measure to assist the users of our financial statements in evaluating our
financial performance under GAAP, and Nareit FFO should not be considered a
measure of liquidity, an alternative to net income or an indicator of any other
performance measure determined in accordance with GAAP. Investors and potential
investors in our securities should not rely on this measure as a substitute for
any GAAP measure, including net income. The following table presents our Nareit
FFO results for the three and six months ended June 30, 2021 and 2020:


                                               Three Months Ended          Six Months Ended
                                                    June 30,                   June 30,
                                               2021          2020         2021           2020

                                                 (in thousands)
Net income                                   $  86,863    $  101,960   $   251,229    $  194,239
Deduct gain from real estate dispositions      (4,123)      (12,843)     (104,465)      (14,681)
Add back loss (deduct gain) from real
estate dispositions - unconsolidated
joint ventures                                     177       (1,838)      

(14,747) (1,955)


                                                82,917        87,279       132,017       177,603
Elimination of non-cash items included in
net income:
Depreciation and amortization                   85,799        83,586       170,648       166,229
Depreciation - unconsolidated joint
ventures                                         3,067         3,550         6,428         7,182
Add back impairments on real estate
properties                                       8,822        11,988        37,511        15,627
Add back impairments on real estate
properties - unconsolidated joint
ventures                                           252             -         4,430             -
(Deduct) add back unrealized (gain) loss
on warrants                                       (29)            65            43           840
Nareit FFO                                   $ 180,828    $  186,468   $   351,077    $  367,481


                                       40

  Table of Contents

Portfolio and Recent Developments

The following table summarizes the significant asset acquisitions that occurred during the first six months of 2021:




              Number of                                                           Total              Initial
              Facilities                        Country/                       Investment             Annual

Period    SNF ALF Specialty                      State                     

  (in millions)       Cash Yield(1)
  Q1        -  17         7    AZ, CA, FL, IL, NJ, OR, PA, TN, TX, VA, WA    $         511.3 (2)            8.43 %
  Q1        6   -         -                        FL                                   83.1                9.25 %
Total       6  17         7                                                  $         594.4

(1) The initial annual cash yield reflects the initial cash rent divided by the

purchase price.

On January 20, 2021, we acquired 24 facilities from Healthpeak Properties,

(2) Inc. The acquisition involved the assumption of an in-place master lease with

Brookdale Senior Living Inc.

During the second quarter of 2021, we acquired one parcel of land (not reflected in the table above) for approximately $10.4 million.

Other Recent Developments



On July 1, 2021, the Company financed six SNFs in Ohio and amended an existing
$6.4 million mortgage to include the six facilities in a consolidated $72.4
million mortgage for eight Ohio facilities bearing interest at an initial rate
of 10.5% per annum. In conjunction with this transaction, the Company also
acquired three Maryland facilities that were previously subject to a mortgage
issued by the Company bearing interest at 13.75% per annum with a principal
balance of $36.0 million. The purchase price for these three facilities was
equal to the remaining mortgage principal amount, and the three acquired
Maryland facilities were subsequently leased back to the seller for a term
expiring on December 31, 2032, assuming Omega exercises the options under the
agreement. The base rent in the initial year is approximately $5.0 million and
includes annual escalators of 2.5%. On July 1, 2021, the Company also entered
into a $12.0 million revolving credit facility agreement with this operator for
working capital expenses for the eight Ohio facilities discussed above with a
maturity date of June 30, 2022. The credit facility bears interest at 10% per
annum.

On July 14, 2021, the Company acquired two U.K. facilities for $9.5 million and
entered into a lease with an existing operator with an initial term expiring on
April 23, 2027. The base rent in the initial year is approximately $0.8 million
and includes annual escalators of 2.5%.





Asset Sales, Impairments, Contractual Receivables and Other Receivables and Lease Inducements

Asset Sales



During the first quarter of 2021, we sold 24 facilities subject to operating
leases for approximately $188.3 million in net cash proceeds, recognizing a net
gain of approximately $100.3 million.

During the second quarter of 2021, we sold six facilities subject to operating
leases for approximately $12.9 million in net cash proceeds, recognizing a net
gain of approximately $4.1 million. As of June 30, 2021, we have nine facilities
and one parcel of land, totaling $35.3 million, classified as assets held for
sale. We expect to sell these facilities over the next twelve months.

                                       41

  Table of Contents

Impairments

During the first quarter of 2021, we recorded impairments on real estate
properties of approximately $28.7 million on four facilities (three were
subsequently reclassified to assets held for sale in the first quarter of 2021).
During the second quarter of 2021, we recorded impairments on real estate
properties of approximately $8.8 million on three facilities (all three were
subsequently reclassified to assets held for sale in the second quarter of
2021). Our recorded impairments were primarily the result of decisions to exit
certain non-strategic facilities and/or operators. We reduced the net book value
of the impaired facilities to their estimated fair values or, with respect to
the facilities reclassified to held for sale, to their estimated fair values
less costs to sell. To estimate the fair value of the facilities, we utilized a
market approach which considered binding sale agreements (a Level 1 input)
and/or non-binding offers from unrelated third parties and/or broker quotes (a
Level 3 input).

Contractual Receivables, Other Receivables and Lease Inducements

A summary of our net receivables by type is as follows:




                                           June 30,       December 31,
                                              2021            2020

                                                  (in thousands)

Contractual receivables - net              $   10,948    $        10,408

Effective yield interest receivables $ 11,554 $ 12,195 Straight-line rent receivables

                138,449            139,046
Lease inducements                              79,506             83,425

Other receivables and lease inducements $ 229,509 $ 234,666




During the first and second quarters of 2021, we wrote-off approximately $2.7
million and $17.4 million, respectively, of straight-line rent receivables to
rental income as a result of transitioning one facility and placing two
operators on a cash basis due to changes in our evaluation of the collectibility
of future rent payments due under the lease agreements.

Based on our evaluation of the collectibility of future rent payments due under
the lease agreements for the two operators discussed above, we do not believe it
is probable that we will be able to collect substantially all rents due. These
two operators generated approximately 3% of our total revenues (excluding the
impact of straight-line rent  receivable write-offs in 2021) for the six months
ended June 30, 2021 and 2020. For the six months ended June 30, 2021, we have
been unable to collect approximately $3.5 million of contractual rents due from
these operators. We have applied $2.5 million of one of the operator's security
deposit funds against their uncollected receivables, which represents one month
of contractual rent under the lease agreement. We have subordinated debt to a
third party with an outstanding principal balance of $20 million that matures in
December 2021 (see Note 13 - Borrowing Arrangements in our Annual Report on

Form 10-K for the year ended December 31, 2020). However, that indebtedness (interest and, under some circumstances, principal) is subject to offset if contractual rent is not paid when due by one of the subject operators.

Other Investments

Genesis



On March 6, 2018, we amended certain terms of our $48.0 million secured term
loan with Genesis Healthcare, Inc. ("Genesis"). The $48.0 million term loan
bears interest at a fixed rate of 14% per annum, of which 9% per annum is
paid-in-kind and was initially scheduled to mature on July 29, 2020. The
maturity date of this loan was extended during the first quarter of 2021 to
January 1, 2024. This term loan (and the $16.0 million term loan discussed
below) is secured by a first priority lien on and security interest in certain
collateral of Genesis. As of June 30, 2021, approximately $68.2 million is
outstanding on this term loan.

                                       42

Table of Contents



Also on March 6, 2018, we provided Genesis an additional $16.0 million secured
term loan bearing interest at a fixed rate of 10% per annum, of which 5% per
annum is paid-in-kind, and was initially scheduled to mature on July 29, 2020.
The maturity date of this loan was extended during the first quarter of 2021 to
January 1, 2024. As of June 30, 2021, approximately $18.9 million is outstanding
on this term loan.

Daybreak

During the first quarter of 2021, we transitioned 14 Daybreak Ventures, LLC
("Daybreak") facilities to existing operators and sold two Daybreak facilities.
During the second quarter of 2021, we sold the two remaining Daybreak
facilities. The total annual rent or rent equivalents achieved through
transitioning the Daybreak portfolio equal $16.6 million. On April 6, 2021, we
terminated the Daybreak master lease and exited that relationship.

We continue to closely monitor the performance of all of our operators, as well as industry trends and developments generally.

Liquidity and Capital Resources

At June 30, 2021, we had total assets of $9.8 billion, total equity of $4.2 billion and debt of $5.3 billion, representing approximately 55.9% of total capitalization.

Financing Activities and Borrowing Arrangements

Revolving Credit Facility



On April 30, 2021, Omega entered into a credit agreement (the "2021 Omega Credit
Agreement") providing us with a new $1.45 billion senior unsecured multicurrency
revolving credit facility (the "Revolving Credit Facility"), replacing our
previous $1.25 billion senior unsecured 2017 multicurrency revolving credit
facility (the "2017 Revolving Credit Facility"). The 2021 Omega Credit Agreement
contains an accordion feature permitting us, subject to compliance with
customary conditions, to increase the maximum aggregate commitments thereunder
to $2.5 billion, by requesting an increase in the aggregate commitments under
the Revolving Credit Facility or by adding term loan tranches.

The Revolving Credit Facility bears interest at LIBOR (or in the case of loans
denominated in GBP, the Sterling overnight index average reference rate plus an
adjustment of 0.1193% per annum) plus an applicable percentage (with a range of
95 to 185 basis points) based on our credit ratings. The Revolving Credit
Facility matures on April 30, 2025, subject to Omega's option to extend such
maturity date for two six-month periods. The Revolving Credit Facility may be
drawn in Euros, GBP, Canadian Dollars (collectively, "Alternative Currencies")
or U.S. Dollars ("USD"), with a $1.15 billion tranche available in USD and a
$300 million tranche available in Alternative Currencies. For purposes of the
Revolving Credit Facility, references to LIBOR include the Canadian dealer
offered rates for amounts offered in Canadian Dollars and any other Alternative
Currency rate approved in accordance with the terms of the 2021 Omega Credit
Agreement for amounts offered in any other non-London interbank offered rate
quoted currency, as applicable.

We incurred $12.9 million of deferred costs in connection with the 2021 Omega Credit Agreement.



OP Term Loan

On April 30, 2021, Omega OP entered into a credit agreement (the "2021 Omega OP
Credit Agreement") providing it with a new $50 million senior unsecured term
loan facility (the "OP Term Loan"). The OP Term Loan replaces the $50 million
senior unsecured term loan obtained in 2017 (the "2017 OP Term Loan") and the
related credit agreement. The OP Term Loan bears interest at LIBOR plus an
applicable percentage (with a range of 85 to 185 basis points) based on our
credit ratings. The OP Term Loan matures on April 30, 2025, subject to Omega
OP's option to extend such maturity date for two, six-month periods.

We incurred $0.4 million of deferred costs in connection with the 2021 Omega OP Credit Agreement.



                                       43

  Table of Contents

$700 Million 3.250% Senior Notes due 2033



In March 2021, we issued $700 million aggregate principal amount of our 3.250%
Senior Notes due 2033 (the "2033 Senior Notes"). The 2033 Senior Notes mature on
April 15, 2033. The 2033 Senior Notes were sold at an issue price of 99.304% of
their face value before the underwriters' discount. We used the proceeds from
this offering to pay down outstanding borrowings on the Revolving Line of
Credit, repay the Sterling term loan, and fund the tender offer to purchase $350
million of the 4.375% Senior Notes due 2023 and the payment of accrued interest
and related fees, premiums and expenses. In connection with this transaction, we
recorded approximately $29.7 million in related fees, premiums, and expenses
which were recorded as Loss on debt extinguishment in our Consolidated Statement
of Operations.

$400 Million Forward Starting Swaps



On March 27, 2020, we entered into five forward starting swaps totaling $400
million. We designated the forward starting swaps as cash flow hedges of
interest rate risk associated with interest payments on a forecasted issuance of
fixed rate long-term debt, initially expected to occur within the next five
years. The swaps are effective on August 1, 2023 and expire on August 1, 2033
and were issued at a fixed rate of approximately 0.8675%. In March 2021, in
conjunction with the issuance of $700 million aggregate principal amount of our
3.25% Senior Notes due 2033, we discontinued hedge accounting for these five
forward starting swaps. Amounts reported in Accumulated Other Comprehensive
Income ("AOCI") related to these discontinued cash flow hedging relationships
will be reclassified to interest expense over a ten year term. Simultaneously,
we re-designated these swaps in new cash flow hedging relationships of interest
rate risk associated with interest payments on another forecasted issuance of
long-term debt. We are hedging our exposure to the variability in future cash
flows for forecasted transactions over a maximum period of 46 months (excluding
forecasted transactions related to the payment of variable interest on existing
financial instruments).

£174 Million Foreign Exchange Forward Starting Swaps


From the issuance date of our GBP borrowings through the prepayment date in
March 2021, we used a nonderivative, GBP-denominated term loan and line of
credit totaling £174 million to hedge a portion of our net investments in
foreign operations. During March 2021 and concurrent with the settlement of our
GBP-denominated term loan and repayment of our GBP-denominated borrowings under
our line of credit, we entered into four foreign currency forwards that mature
on March 8, 2024 to hedge a portion of our net investments in foreign
operations, effectively replacing the terminated net investment hedge. For these
derivatives that are designated and qualify as net investment hedges, the gain
or loss on the derivative is reported in AOCI as part of the cumulative
translation adjustment. Amounts are reclassified out of AOCI into earnings when
the hedged net investment is either sold or substantially liquidated.

Supplemental Guarantor Information


Parent has issued approximately $4.9 billion aggregate principal of senior notes
outstanding at June 30, 2021 that were registered under the Securities Act of
1933, as amended. The senior notes are guaranteed by Omega OP.

The SEC adopted amendments to Rule 3-10 of Regulation S-X and created Rule 13-01
to simplify disclosure requirements related to certain registered securities,
such as our senior notes. As a result of these amendments, registrants are
permitted to provide certain alternative financial and non-financial
disclosures, to the extent material, in lieu of separate financial statements
for subsidiary issuers and guarantors of registered debt securities.
Accordingly, separate consolidated financial statements of Omega OP have not
been presented. Parent and Omega OP, on a combined basis, have no material
assets, liabilities or operations other than financing activities (including
borrowings under the outstanding senior notes, the Revolving Credit Facility and
the OP Term Loan) and their investments in non-guarantor subsidiaries.

                                       44

Table of Contents



Omega OP is currently the sole guarantor of our senior notes. The guarantees by
Omega OP of our senior notes are full and unconditional and joint and several
with respect to the payment of the principal and premium and interest on our
senior notes. The guarantees of Omega OP are senior unsecured obligations of
Omega OP that rank equal with all existing and future senior debt of Omega OP
and are senior to all subordinated debt. However, the guarantees are effectively
subordinated to any secured debt of Omega OP. As of June 30, 2021, there were no
significant restrictions on the ability of Omega OP to make distributions to
Omega.

At-The-Market Offering Programs



During the third quarter of 2015, Omega entered into Equity Distribution
Agreements with several financial institutions to sell $500.0 million of shares
of common stock from time to time through an "at-the-market" ("ATM") offering
program (the "2015 ATM Program").

During the second quarter of 2021, the we terminated the 2015 ATM Program and
entered into a new ATM Equity Offering Sales Agreement pursuant to which shares
of common stock having an aggregate gross sales price of up to $1.0 billion (the
"2021 ATM Program") may be sold from time to time (i) by Omega through several
financial institutions acting as a sales agent or directly to the financial
institutions as principals, or (ii) by several financial institutions acting as
forward sellers on behalf of any forward purchasers pursuant to a forward sale
agreement. Under the 2021 ATM Program, compensation for sales of the shares will
not exceed 2% of the gross sales price per share for shares sold through each
financial institution. The use of forward sales under the 2021 ATM Program
generally allows Omega to lock in a price on the sale of shares of common stock
when sold by the forward sellers but defer receiving the net proceeds from such
sales until the shares of our common stock are issued at settlement on a later
date. We did not utilize the forward provisions under the 2021 ATM Program
during the three months ended June 30, 2021.

The table below presents information regarding the shares issued under the 2021 and 2015 ATM Programs for the three and six months ended June 30, 2020 and 2021:




                                 Shares issued  Average Net Price   Gross

Proceeds Commissions Net Proceeds


                   Period Ended  (in millions)    Per Share(1)                    (in millions)
Three Months Ended June 30, 2020             - $                 - $              - $           - $           -
Three Months Ended June 30, 2021           2.5               36.23             92.4           1.9          90.5
 Six Months Ended  June 30, 2020           0.1               36.18              2.0           0.2           1.8
 Six Months Ended  June 30, 2021           4.1               36.60            153.8           3.2         150.6


(1) Represents the average price per share after commissions.

Dividend Reinvestment and Common Stock Purchase Plan

The table below presents information regarding the shares issued under the Dividend Reinvestment and Common Stock Purchase Plan for the three and six months ended June 30, 2020 and 2021:




                                 Shares issued  Gross Proceeds
                   Period Ended  (in millions)  (in millions)
Three Months Ended June 30, 2020             - $              -
Three Months Ended June 30, 2021           1.6             61.8
 Six Months Ended  June 30, 2020           0.1              3.7
 Six Months Ended  June 30, 2021           2.0             77.3


                                       45

  Table of Contents

Commitments

We have committed to fund the construction of new leased and mortgaged
facilities, capital improvements and other commitments. We expect the funding of
these commitments to be completed over the next several years. Our remaining
commitments at June 30, 2021, are outlined in the table below (in thousands):



Total commitments             $   539,528
Amounts funded to date (1)      (415,281)
Remaining commitments (2)     $   124,247

(1) Includes finance costs.

(2) This amount excludes our remaining commitments to fund under our other

investments of approximately $67.6 million.

Dividends


As a REIT, we are required to distribute dividends (other than capital gain
dividends) to our stockholders in an amount at least equal to (A) the sum of (i)
90% of our "REIT taxable income" (computed without regard to the dividends paid
deduction and our net capital gain), and (ii) 90% of the net income (after tax),
if any, from foreclosure property, minus (B) the sum of certain items of
non-cash income. In addition, if we dispose of any built-in gain asset during a
recognition period, we will be required to distribute at least 90% of the
built-in gain (after tax), if any, recognized on the disposition of such asset.
Such distributions must be paid in the taxable year to which they relate, or in
the following taxable year if declared before we timely file our tax return for
such year and paid on or before the first regular dividend payment after such
declaration. In addition, such distributions are required to be made pro rata,
with no preference to any share of stock as compared with other shares of the
same class, and with no preference to one class of stock as compared with
another class except to the extent that such class is entitled to such a
preference. To the extent that we do not distribute all of our net capital gain
or do distribute at least 90%, but less than 100% of our "REIT taxable income"
as adjusted, we will be subject to tax thereon at regular ordinary and capital
gain corporate tax rates.

For the six months ended June 30, 2021, we paid dividends of approximately
$316.5 million to our common stockholders. On February 16, 2021, we paid
dividends of $0.67 per outstanding common share to the common stockholders of
record as of the close of business on February 8, 2021.  On May 17, 2021, we
paid dividends of $0.67 per outstanding common share to the common stockholders
of record as of the close of business on May 3, 2021.

Liquidity



We believe our liquidity and various sources of available capital, including
cash from operations, our existing availability under our credit facilities,
existing equity sales programs, facility sales and expected proceeds from
mortgage and other investment payoffs are adequate to finance operations, meet
recurring debt service requirements and fund future investments through the next
twelve months.

We regularly review our liquidity needs, the adequacy of cash flow from operations, and other expected liquidity sources to meet these needs. We believe our principal short-term liquidity needs are to fund:



 ? normal recurring expenses;


 ? debt service payments;

? capital improvement programs;

? common stock dividends; and

? growth through acquisitions of additional properties.




                                       46

  Table of Contents

The primary source of liquidity is our cash flows from operations. Operating
cash flows have historically been determined by: (i) the number of facilities we
lease or have mortgages on; (ii) rental and mortgage rates; (iii) our debt
service obligations; (iv) general and administrative expenses and (v) our
operators' ability to pay amounts owed. The timing, source and amount of cash
flows provided by or used in financing activities and in investing activities
are sensitive to the capital markets environment, especially to changes in
interest rates. Changes in the capital markets environment may impact the
availability of cost-effective capital and affect our plans for acquisition and
disposition activity.

Cash, cash equivalents and restricted cash totaled $104.6 million as of June 30,
2021, a decrease of $63.0 million as compared to the balance at December 31,
2020. The following is a discussion of changes in cash, cash equivalents and
restricted cash due to operating, investing and financing activities, which are
presented in our Consolidated Statements of Cash Flows.

Operating Activities - Operating activities generated $378.3 million of net cash
flow for the six months ended June 30, 2021, as compared to $329.4 million for
the same period in 2020, an increase of $48.9 million, which is primarily driven
by an increase of $45.9 million of net income, adjusted for non-cash items, due
to revenue growth as a result of facility acquisitions and transitions,
investments in mortgages and other investments. A $3.0 million change in the net
movements of the operating assets and liabilities, primarily driven by a
reduction in lease inducements provided to our operators, also contributed to
the overall increase in cash provided by operating activities.

Investing Activities - Net cash flow from investing activities was an outflow of
$387.1 million for the six months ended June 30, 2021, as compared to an outflow
of $96.7 million for the same period in 2020. The $290.4 million change in cash
flow from investing activities related primarily to (i) a $579.0 million
increase in real estate acquisitions and (ii) a $8.5 million increase in
investments in unconsolidated joint ventures, offset by (i) a $145.1 million
increase in proceeds from the sales of real estate investments, (ii) a $79.6
million increase in mortgages collections, net of placements, (iii) a $38.5
million decrease in investment in construction in progress and capital
expenditures, (iv) a $27.4 million increase in other investment proceeds, net of
new investments, (v) a $3.1 million increase in receipts from insurance proceeds
and (vi) a $2.5 million refund of an acquisition related deposit in the first
quarter of 2021.

Financing Activities - Net cash flow from financing activities was an outflow of
$54.3 million for the six months ended June 30, 2021, as compared to an outflow
of $224.1 million for the same period in 2020. The $169.8 million change in cash
provided by financing activities was primarily related to (i) a $148.9 million
increase in cash proceeds from the issuance of common stock in 2021, as compared
to the same period in 2020, (ii) a $73.5 million increase in net proceeds from
our dividend reinvestment plan in 2021, as compared to the same period in 2020
and (iii) $7.8 million increase in proceeds from other long-term borrowings, net
of repayments offset by (i) a $48.1 million increase in payment of financing
related costs and (ii) a $9.4 million increase in dividends paid.

© Edgar Online, source Glimpses