Overview



We are a real estate investment trust ("REIT") that commenced operations in
1986. We invest in healthcare and human service related facilities currently
including acute care hospitals, behavioral health care hospitals, specialty
hospitals, free-standing emergency departments, childcare centers and
medical/office buildings. As of July 31, 2020, we have seventy-one real estate
investments or commitments located in twenty states consisting of:

• seven hospital facilities consisting of three acute care, one behavioral

health care (currently under construction), one rehabilitation (currently


        vacant) and two sub-acute (one of which is currently vacant);


  • four free-standing emergency departments ("FEDs");

• fifty-six medical/office buildings, including five owned by unconsolidated


        limited liability companies ("LLCs")/limited liability partnerships
        ("LPs"), one of which is currently under construction, and;


  • four preschool and childcare centers.

Forward Looking Statements and Certain Risk Factors



You should carefully review all of the information contained in this Quarterly
Report, and should particularly consider any risk factors that we set forth in
this Quarterly Report and in other reports or documents that we file from time
to time with the Securities and Exchange Commission (the "SEC"). In this
Quarterly Report, we state our beliefs of future events and of our future
financial performance. In some cases, you can identify those so-called
"forward-looking statements" by words such as "may," "will," "should," "could,"
"would," "predicts," "potential," "continue," "expects," "anticipates,"
"future," "intends," "plans," "believes," "estimates," "appears," "projects" and
similar expressions, as well as statements in future tense. You should be aware
that those statements are only our predictions. Actual events or results may
differ materially. In evaluating those statements, you should specifically
consider various factors, including the risks incorporated by reference in
Item 1A Risk Factors and described elsewhere herein and in our Annual Report on
Form 10-K for the year ended December 31, 2019 in Item 1A Risk Factors and in
Item 7 Management's Discussion and Analysis of Financial Condition and Results
of Operations-Forward Looking Statements. Those factors may cause our actual
results to differ materially from any of our forward-looking statements.

Forward-looking statements should not be read as a guarantee of future
performance or results, and will not necessarily be accurate indications of the
times at, or by which, such performance or results will be achieved.
Forward-looking information is based on information available at the time and/or
our good faith belief with respect to future events, and is subject to risks and
uncertainties that could cause actual performance or results to differ
materially from those expressed in the statements. Such factors include, among
other things, the following:

• Future operations and financial results of our tenants, and in turn ours,

will likely be materially impacted by numerous factors and future

developments related to COVID-19. Such factors and developments include,

but are not limited to, the length of time and severity of the spread of

the pandemic; the volume of cancelled or rescheduled elective procedures

and the volume of COVID-19 patients treated by the operators of our

hospitals and other healthcare facilities; measures our tenants are taking


        to respond to the COVID-19 pandemic; the impact of government and
        administrative regulation, including travel bans and restrictions,
        shelter-in-place or stay-at-home orders, quarantines, the promotion of
        social distancing, business shutdowns and limitations on business

activity; changes in patient volumes at our tenants' hospitals and other

healthcare facilities due to patients' general concerns related to the

risk of contracting COVID-19 from interacting with the healthcare system;

the impact of stimulus on the health care industry and our tenants;

changes in patient volumes and payer mix caused by deteriorating

macroeconomic conditions (including increases in uninsured and

underinsured patients as the result of business closings and layoffs);

potential disruptions to clinical staffing and shortages and disruptions

related to supplies required for our tenants' employees and patients,

including equipment, pharmaceuticals and medical supplies, particularly

personal protective equipment, or PPE; potential increases to expenses

incurred by our tenants related to staffing, supply chain or other

expenditures; the impact of our indebtedness and the ability to refinance


        such indebtedness on acceptable terms; disruptions in the financial
        markets and the business of financial institutions as the result of the
        COVID-19 pandemic which could impact our ability to access capital or

increase associated borrowing costs; and changes in general economic

conditions nationally and regionally in the markets our properties are

located resulting from the COVID-19 pandemic, including higher sustained

rates of unemployment and underemployment levels and reduced consumer

spending and confidence. There may be significant declines in future bonus

rental revenue earned on our hospital properties leased to subsidiaries of

UHS to the extent that each hospital continues to experience significant


        decline in patient volumes and revenues. These factors may result in the
        inability or unwillingness on the part of some of our tenants to make
        timely payment of their rent to us at current levels or to seek to amend
        or terminate their leases which,


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in turn, would have an adverse effect on our occupancy levels and our

revenue and cash flow and the value of our properties, and potentially,


        our ability to maintain our dividend at current levels.




    •   Due to COVID-19 restrictions and its impact on the economy, we may

experience a decrease in prospective tenants which could unfavorably

impact the volume of new leases, as well as the renewal rate of existing


        leases. The COVID-19 pandemic may delay our construction projects which
        could result in increased costs and delay the timing of opening and rental

payments from those projects, although no such delays have yet occurred.

The COVID-19 pandemic could also impact our indebtedness and the ability

to refinance such indebtedness on acceptable terms, as well as risks

associated with disruptions in the financial markets and the business of

financial institutions as the result of the COVID-19 pandemic which could

impact us from a financing perspective; and changes in general economic


        conditions nationally and regionally in the markets our properties are
        located resulting from the COVID-19 pandemic. We are not able to fully

quantify the impact that these factors will have on our financial results

during 2020, but developments related to the COVID-19 pandemic are likely


        to have a material adverse impact on our future financial results.




    •   Recent legislation, including the Coronavirus Aid, Relief, and Economic

        Security Act (the "CARES Act") and the Paycheck Protection Program and
        Health Care Enhancement Act ("PPPHCE Act"), has provided funding to
        hospitals and other healthcare providers to assist them during the

COVID-19 pandemic. There is a high degree of uncertainty surrounding the

implementation of the CARES Act and the PPPHCE Act, and the federal

government may consider additional stimulus and relief efforts, but we are

unable to predict whether additional stimulus measures will be enacted or

their impact. There can be no assurance as to the total amount of

financial and other types of assistance our tenants will receive under the

CARES Act and the PPPHCE Act, and it is difficult to predict the impact of

such legislation on our tenants' operations or how they will affect

operations of our tenants' competitors. Moreover, we are unable to assess

the extent to which anticipated negative impacts on our tenants (and, in

turn, us) arising from the COVID-19 pandemic will be offset by amounts or

benefits received or to be received under the CARES Act and the PPPHCE

Act.

• A substantial portion of our revenues are dependent upon one operator,

UHS, which comprised approximately 32% and 30% of our consolidated

revenues for the three-month periods ended June 30, 2020 and 2019,

respectively, and approximately 32% and 31% if our consolidated revenues

for the six-month periods ended June 30, 2020 and 2019, respectively. We

cannot assure you that subsidiaries of UHS will renew the leases on our

three acute care hospitals (two of which are scheduled to expire in

December, 2021 and one of which is scheduled to expire in December, 2026)

and two FEDs at existing lease rates or fair market value lease rates. In


        addition, if subsidiaries of UHS exercise their options to purchase the
        respective leased hospital facilities and FEDs upon expiration of the

lease terms, our future revenues and results of operations could decrease

if we were unable to earn a favorable rate of return on the sale proceeds

received, as compared to the rental revenue currently earned pursuant to

these leases.

• In certain of our markets, the general real estate market has been

unfavorably impacted by increased competition/capacity and decreases in


        occupancy and rental rates which may adversely impact our operating
        results and the underlying value of our properties.

• A number of legislative initiatives have recently been passed into law

that may result in major changes in the health care delivery system on a

national or state level to the operators of our facilities, including UHS.

No assurances can be given that the implementation of these new laws will

not have a material adverse effect on the business, financial condition or

results of operations of our operators.

• The potential indirect impact of the Tax Cuts and Jobs Act of 2017, signed


        into law on December 22, 2017, which makes significant changes to
        corporate and individual tax rates and calculation of taxes, which could
        potentially impact our tenants and jurisdictions, both positively and

negatively, in which we do business, as well as the overall investment

thesis for REITs.

• A subsidiary of UHS is our Advisor and our officers are all employees of a


        wholly-owned subsidiary of UHS, which may create the potential for
        conflicts of interest.

• Lost revenues resulting from the exercise of purchase options, lease

expirations and renewals and other restructuring (see Item 2. Management's

Discussion and Analysis of Financial Condition and Results of

Operations-Hospital Leases, for additional disclosure related to lease

expirations and subsequent vacancies that occurred during the second and

third quarters of 2019 on two hospital facilities that, on a combined

basis, comprised approximately 2% of our consolidated revenues during each

of the years ended December 31, 2018 and 2017).

• Our ability to continue to obtain capital on acceptable terms, including


        borrowed funds, to fund future growth of our business.


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• The outcome and effects of known and unknown litigation, government

investigations, and liabilities and other claims asserted against us, UHS

or the other operators of our facilities. UHS and its subsidiaries are

subject to legal actions, purported shareholder class actions and

shareholder derivative cases, governmental investigations and regulatory

actions and the effects of adverse publicity relating to such matters.

Since UHS comprised approximately 32% and 30% of our consolidated revenues

during the three-month periods ended June 30, 2020 and 2019, respectively,

and 32% and 31% of our consolidated revenues during the six-month periods

ended June 30, 2020 and 2019, respectively, and since a subsidiary of UHS

is our Advisor, you are encouraged to obtain and review the disclosures

contained in the Legal Proceedings section of Universal Health Services,

Inc.'s Forms 10-Q and 10-K, as publicly filed with the Securities and

Exchange Commission. Those filings are the sole responsibility of UHS and

are not incorporated by reference herein.

• Failure of UHS or the other operators of our hospital facilities to comply

with governmental regulations related to the Medicare and Medicaid

licensing and certification requirements could have a material adverse

impact on our future revenues and the underlying value of the property.

• The potential unfavorable impact on our business of the deterioration in

national, regional and local economic and business conditions, including a

further worsening of credit and/or capital market conditions, which may

adversely affect our ability to obtain capital which may be required to


        fund the future growth of our business and refinance existing debt with
        near term maturities.

• A continuation in the deterioration in general economic conditions which

has resulted in increases in the number of people unemployed and/or

insured and likely increase the number of individuals without health

insurance; as a result, the operators of our facilities may experience

declines in patient volumes which could result in decreased occupancy

rates at our medical office buildings.

• A continuation of the worsening of the economic and employment conditions


        in the United States will likely materially affect the business of our
        operators, including UHS, which will likely unfavorably impact our future
        bonus rentals (on the UHS hospital facilities) and may potentially have a

negative impact on the future lease renewal terms and the underlying value

of the hospital properties.

• Real estate market factors, including without limitation, the supply and

demand of office space and market rental rates, changes in interest rates

as well as an increase in the development of medical office condominiums

in certain markets.

• The impact of property values and results of operations of severe weather

conditions, including the effects of hurricanes.

• Government regulations, including changes in the reimbursement levels

under the Medicare and Medicaid programs.

• The issues facing the health care industry that affect the operators of

our facilities, including UHS, such as: changes in, or the ability to

comply with, existing laws and government regulations; unfavorable changes


        in the levels and terms of reimbursement by third party payors or
        government programs, including Medicare (including, but not limited to,
        the potential unfavorable impact of future reductions to Medicare

reimbursements resulting from the Budget Control Act of 2011, as discussed

in the next bullet point below) and Medicaid (most states have reported

significant budget deficits that have, in the past, resulted in the

reduction of Medicaid funding to the operators of our facilities,

including UHS); demographic changes; the ability to enter into managed

care provider agreements on acceptable terms; an increase in uninsured and

self-pay patients which unfavorably impacts the collectability of patient

accounts; decreasing in-patient admission trends; technological and

pharmaceutical improvements that may increase the cost of providing, or

reduce the demand for, health care, and; the ability to attract and retain

qualified medical personnel, including physicians.

• Pending limits for most federal agencies and programs aimed at reducing

budget deficits by $917 billion between 2012 and 2021, according to a

report released by the Congressional Budget Office. Among its other

provisions, the law established a bipartisan Congressional committee,

known as the Joint Select Committee on Deficit Reduction (the "Joint

Committee"), which was tasked with making recommendations aimed at

reducing future federal budget deficits by an additional $1.5 trillion


        over 10 years. The Joint Committee was unable to reach an agreement by the
        November 23, 2011 deadline and, as a result, across-the-board cuts to

discretionary, national defense and Medicare spending were implemented on

March 1, 2013 resulting in Medicare payment reductions of up to 2% per
        fiscal year with a uniform percentage reduction across all Medicare
        programs. The Bipartisan Budget Act of 2015, enacted on November 2, 2015,
        continued the 2% reductions to Medicare reimbursement imposed under the

Budget Control Act of 2011. The CARES Act suspended payment reductions

between May 1 and December 31, 2020, in exchange for extended cuts through

2030. We cannot predict whether Congress will restructure the implemented

Medicare payment reductions or what other federal budget deficit reduction

initiatives may be proposed by Congress going forward. We also cannot


        predict the effect these enactments will have on the operators of our
        properties (including UHS), and thus, our business.

• An increasing number of legislative initiatives have been passed into law


        that may result in major changes in the health care delivery system on a
        national or state level. Legislation has already been enacted that has
        eliminated the penalty for


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failing to maintain health coverage that was part of the original Patient

Protection and Affordable Care Act (the "ACA") and Healthcare and

Education Reconciliation Act of 2010 (collectively referred to as the

"Legislation"). President Trump has already taken executive actions: (i)

requiring all federal agencies with authorities and responsibilities under


        the Legislation to "exercise all authority and discretion available to
        them to waiver, defer, grant exemptions from, or delay" parts of the

Legislation that place "unwarranted economic and regulatory burdens" on

states, individuals or health care providers; (ii) the issuance of a final

rule in June, 2018 by the Department of Labor to enable the formation of

association health plans that would be exempt from certain Legislation

requirements such as the provision of essential health benefits; (iii) the


        issuance of a final rule in August, 2018 by the Department of Labor,
        Treasury, and Health and Human Services to expand the availability of
        short-term, limited duration health insurance, (iv) eliminating
        cost-sharing reduction payments to insurers that would otherwise offset

deductibles and other out-of-pocket expenses for health plan enrollees at

or below 250 percent of the federal poverty level; (v) relaxing

requirements for state innovation waivers that could reduce enrollment in

the individual and small group markets and lead to additional enrollment


        in short-term, limited duration insurance and association health plans;
        (vi) the issuance of a final rule in June, 2019 by the Departments of

Labor, Treasury, and Health and Human Services that would incentivize the

use of health reimbursement arrangements by employers to permit employees


        to purchase health insurance in the individual market, and; (vii)
        directing the issuance of federal rulemaking by executive agencies to
        increase transparency of healthcare price and quality information. The
        uncertainty resulting from these Executive Branch policies has led to

reduced Exchange enrollment in 2018 and 2019 and is expected to further

worsen the individual and small group market risk pools in future

years. It is also anticipated that these and future policies may create

additional cost and reimbursement pressures on hospitals, including ours.

In addition, while attempts to repeal the entirety of the ACA have not

been successful to date, a key provision of the ACA was repealed as part

of the Tax Cuts and Jobs Act and on December 14, 2018, a federal U.S.

District Court Judge in Texas ruled the entire ACA is unconstitutional.

That ruling was stayed and has been appealed. On December 18, 2019, the

5th Circuit Court of Appeals voted 2-1 to strike down the ACA individual

mandate as unconstitutional and sent the case back to the U.S. District


        Court in Texas to determine which ACA provisions should be stricken with
        the mandate. On March 2, 2020, the U.S. Supreme Court agreed to hear,

during the 2020-2021 term, two consolidated cases, filed by the State of

California and the United States House of Representatives, asking the

Supreme Court to review the ruling by the Fifth Circuit Court of Appeals.

Oral argument is expected in late 2020, and a ruling is not expected until

after the November 2020 election. We are unable to predict the final

outcome of this matter which has caused greater uncertainty regarding the

future status of the ACA. If all or any parts of the ACA are ultimately

found to be unconstitutional, it could have a material adverse effect on


        the business, financial condition and results of operations of the
        operators of our properties, and, thus, our business.

• There can be no assurance that if any of the announced or proposed changes

described above are implemented there will not be negative financial


        impact on the operators of our hospitals, which material effects may
        include a potential decrease in the market for health care services or a

decrease in the ability of the operators of our hospitals to receive

reimbursement for health care services provided which could result in a

material adverse effect on the financial condition or results of

operations of the operators of our properties, and, thus, our business.

• Competition for properties include, but are not limited to, other REITs,

private investors and firms, banks and other companies, including UHS. In

addition, we may face competition from other REITs for our tenants.

• The operators of our facilities face competition from other health care

providers, including physician owned facilities and other competing

facilities, including certain facilities operated by UHS but the real

property of which is not owned by us. Such competition is experienced in

markets including, but not limited to, McAllen, Texas, the site of our

McAllen Medical Center, a 370-bed acute care hospital, and Riverside

County, California, the site of our Southwest Healthcare System-Inland

Valley Campus, a 130-bed acute care hospital.

• Changes in, or inadvertent violations of, tax laws and regulations and


        other factors than can affect REITs and our status as a REIT.



• The individual and collective impact of the changes made by the CARES Act

on REITs and their security holders are uncertain and may not become

evident for some period of time; it is also possible additional

legislation could be enacted in the future as a result of the COVID-19


        pandemic which may affect the holders of our securities.


    •   Should we be unable to comply with the strict income distribution
        requirements applicable to REITs, utilizing only cash generated by
        operating activities, we would be required to generate cash from other
        sources which could adversely affect our financial condition.

• Our ownership interest in five LLCs/LPs in which we hold non-controlling


        equity interests. In addition, pursuant to the operating and/or
        partnership agreements of the four LLCs/LPs in which we continue to hold
        non-controlling ownership interests, the third-party member and the Trust,

at any time, potentially subject to certain conditions, have the right to

make an offer ("Offering Member") to the other member(s) ("Non-Offering


        Member") in which it either agrees to: (i) sell


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the entire ownership interest of the Offering Member to the Non-Offering


        Member ("Offer to Sell") at a price as determined by the Offering Member
        ("Transfer Price"), or; (ii) purchase the entire ownership interest of the

Non-Offering Member ("Offer to Purchase") at the equivalent proportionate

Transfer Price. The Non-Offering Member has 60 to 90 days to either:

(i) purchase the entire ownership interest of the Offering Member at the

Transfer Price, or; (ii) sell its entire ownership interest to the

Offering Member at the equivalent proportionate Transfer Price. The

closing of the transfer must occur within 60 to 90 days of the acceptance


        by the Non-Offering Member.


  • Fluctuations in the value of our common stock.


    •   Other factors referenced herein or in our other filings with the
        Securities and Exchange Commission.


Given these uncertainties, risks and assumptions, you are cautioned not to place
undue reliance on such forward-looking statements. Our actual results and
financial condition, including the operating results of our lessees and the
facilities leased to subsidiaries of UHS, could differ materially from those
expressed in, or implied by, the forward-looking statements.

Forward-looking statements speak only as of the date the statements are made. We
assume no obligation to publicly update any forward-looking statements to
reflect actual results, changes in assumptions or changes in other factors
affecting forward-looking information, except as may be required by law. All
forward-looking statements attributable to us or persons acting on our behalf
are expressly qualified in their entirety by this cautionary statement.

Critical Accounting Policies and Estimates



The preparation of financial statements in conformity with accounting principles
generally accepted in the United States of America requires us to make estimates
and assumptions that affect the amounts reported in our consolidated financial
statements and accompanying notes.

We consider our critical accounting policies to be those that require us to make
significant judgments and estimates when we prepare our financial statements,
including the following:

Purchase Accounting for Acquisition of Investments in Real Estate: Purchase
accounting is applied to the assets and liabilities related to all real estate
investments acquired from third parties. In accordance with current accounting
guidance, we account for our property acquisitions as acquisitions of assets,
which requires the capitalization of acquisition costs to the underlying assets
and prohibits the recognition of goodwill or bargain purchase gains. The fair
value of the real estate acquired is allocated to the acquired tangible assets,
consisting primarily of land, building and tenant improvements, and identified
intangible assets and liabilities, consisting of the value of above-market and
below-market leases, and acquired ground leases, based in each case on their
fair values. Loan premiums, in the case of above market rate assumed loans, or
loan discounts, in the case of below market assumed loans, are recorded based on
the fair value of any loans assumed in connection with acquiring the real
estate.



The fair values of the tangible assets of an acquired property are determined
based on comparable land sales for land and replacement costs adjusted for
physical and market obsolescence for the improvements. The fair values of the
tangible assets of an acquired property are also determined by valuing the
property as if it were vacant, and the "as-if-vacant" value is then allocated to
land, building and tenant improvements based on management's determination of
the relative fair values of these assets. Management determines the as-if-vacant
fair value of a property based on assumptions that a market participant would
use, which is similar to methods used by independent appraisers. In addition,
there is intangible value related to having tenants leasing space in the
purchased property, which is referred to as in-place lease value. Such value
results primarily from the buyer of a leased property avoiding the costs
associated with leasing the property and also avoiding rent losses and
unreimbursed operating expenses during the hypothetical lease-up period. Factors
considered by management in performing these analyses include an estimate of
carrying costs during the expected lease-up periods considering current market
conditions and costs to execute similar leases. In estimating carrying costs,
management includes real estate taxes, insurance and other operating expenses
and estimates of lost rental revenue during the expected lease-up periods based
on current market demand. Management also estimates costs to execute similar
leases including leasing commissions, tenant improvements, legal and other
related costs. The value of in-place leases are amortized to expense over the
remaining initial terms of the respective leases.



In allocating the fair value of the identified intangible assets and liabilities
of an acquired property, above-market and below-market in-place lease values are
recorded based on the present value (using an interest rate which reflects the
risks associated with the leases acquired) of the difference between (i) the
contractual amounts to be paid pursuant to the in-place leases and
(ii) estimated fair market lease rates from the perspective of a market
participant for the corresponding in-place leases, measured, for above-market
leases, over a period equal to the remaining non-cancelable term of the lease
and, for below-market leases, over a period equal to the initial term plus any
below market fixed rate renewal periods. The capitalized above-market lease
values are amortized as a reduction of rental

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income over the remaining non-cancelable terms of the respective leases. The capitalized below-market lease values, also referred to as acquired lease obligations, are amortized as an increase to rental income over the initial terms of the respective leases.



Asset Impairment:  We review each of our properties for indicators that its
carrying amount may not be recoverable. Examples of such indicators may include
a significant decrease in the market price of the property, a change in the
expected holding period for the property, a significant adverse change in how
the property is being used or expected to be used based on the underwriting at
the time of acquisition, an accumulation of costs significantly in excess of the
amount originally expected for the acquisition or development of the property,
or a history of operating or cash flow losses of the property. When such
impairment indicators exist, we review an estimate of the future undiscounted
net cash flows (excluding interest charges) expected to result from the real
estate investment's use and eventual disposition and compare that estimate to
the carrying value of the property. We consider factors such as future operating
income, trends and prospects, as well as the effects of leasing demand,
competition and other factors. If our future undiscounted net cash flow
evaluation indicates that we are unable to recover the carrying value of a real
estate investment, an impairment loss is recorded to the extent that the
carrying value exceeds the estimated fair value of the property. The evaluation
of anticipated cash flows is highly subjective and is based in part on
assumptions regarding future occupancy, rental rates and capital requirements
that could differ materially from actual results in future periods. Since cash
flows on properties considered to be long-lived assets to be held and used are
considered on an undiscounted basis to determine whether the carrying value of a
property is recoverable, our strategy of holding properties over the long-term
directly decreases the likelihood of their carrying values not being recoverable
and therefore requiring the recording of an impairment loss. If our strategy
changes or market conditions otherwise dictate an earlier sale date, an
impairment loss may be recognized and such loss could be material. If we
determine that the asset fails the recoverability test, the affected assets must
be reduced to their fair value.



We generally estimate the fair value of rental properties utilizing a discounted
cash flow analysis that includes projections of future revenues, expenses and
capital improvement costs that a market participant would use based on the
highest and best use of the asset, which is similar to the income approach that
is commonly utilized by appraisers. In certain cases, we may supplement this
analysis by obtaining outside broker opinions of value or third party
appraisals.



In considering whether to classify a property as held for sale, we consider
factors such as whether management has committed to a plan to sell the property,
the property is available for immediate sale in its present condition for a
price that is reasonable in relation to its current value, the sale of the
property is probable, and actions required for management to complete the plan
indicate that it is unlikely that any significant changes will made to the
plan. If all the criteria are met, we classify the property as held for sale.
Upon being classified as held for sale, depreciation and amortization related to
the property ceases and it is recorded at the lower of its carrying amount or
fair value less cost to sell. The assets and related liabilities of the property
are classified separately on the consolidated balance sheets for the most recent
reporting period. Only those assets held for sale that constitute a strategic
shift or that will have a major effect on our operations are classified as
discontinued operations.

An other than temporary impairment of an investment in an unconsolidated LLC is
recognized when the carrying value of the investment is not considered
recoverable based on evaluation of the severity and duration of the decline in
value, including projected declines in cash flow. To the extent impairment has
occurred, the excess carrying value of the asset over its estimated fair value
is charged to income.



Federal Income Taxes:  No provision has been made for federal income tax
purposes since we qualify as a REIT under Sections 856 to 860 of the Internal
Revenue Code of 1986, and intend to continue to remain so qualified.  To qualify
as a REIT, we must meet certain organizational and operational requirements,
including a requirement to distribute at least 90% of our annual REIT taxable
income to shareholders. As a REIT, we generally will not be subject to federal,
state or local income tax on income that we distribute as dividends to our
shareholders.

We are subject to a federal excise tax computed on a calendar year basis. The
excise tax equals 4% of the amount by which 85% of our ordinary income plus 95%
of any capital gain income for the calendar year exceeds cash distributions
during the calendar year, as defined. No provision for excise tax has been
reflected in the financial statements as no tax was due.

Earnings and profits, which determine the taxability of dividends to
shareholders, will differ from net income reported for financial reporting
purposes due to the differences for federal tax purposes in the cost basis of
assets and in the estimated useful lives used to compute depreciation and the
recording of provision for investment losses.

Results of Operations

During the three-month period ended June 30, 2020, net income was $4.7 million, as compared to $4.3 million during the second quarter of 2019. The $439,000 increase was attributable to:


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$694,000 decrease resulting from lease expirations on two hospital

facilities located in Corpus Christi, Texas, and Evansville, Indiana,

that occurred on June 1, 2019 and September 30, 2019, respectively (each


          facility has remained vacant since the respective date of lease
          expiration);

$765,000 increase resulting from a decrease in interest expense,

primarily due to a decrease in our average cost of borrowings under our


          revolving credit agreement, partially offset by an increase in our
          average outstanding borrowings, and;


  • $368,000 of other combined net increases.


During the six-month period ended June 30, 2020, net income was $9.3 million, as compared to $8.5 million during the six-month period of 2019. The $781,000 increase was attributable to:

$1.25 million decrease resulting from lease expirations on two hospital

facilities located in Corpus Christi, Texas, and Evansville, Indiana,

that occurred on June 1, 2019 and September 30, 2019, respectively (each


          facility has remained vacant since the respective date of lease
          expiration);

$250,000 decrease resulting from a gain on the sale of land recorded


          during the first six months of 2019;


        • $373,000 increase resulting from a decrease in depreciation and
          amortization expense;

$1.1 million increase resulting from a decrease in interest expense,

primarily due to a decrease in our average cost of borrowings under our


          revolving credit agreement, partially offset by an increase in our
          average outstanding borrowings, and;


  • $763,000 of other combined net increases.


Total revenues decreased $45,000, or 0.2% during the three-month period ended
June 30, 2020, as compared to the comparable quarter of 2019, and increased
$50,000, or 0.1% during the six-month period ended June 30, 2020, as compared to
the comparable period of 2019.

Included in our other operating expenses are expenses related to the
consolidated medical office buildings and two vacant hospital facilities (as
discussed herein), which totaled $4.7 million and $4.5 million for the
three-month periods ended June 30, 2020 and 2019, respectively, and $9.4 million
and $9.0 million for the six-month periods ended June 30, 2020 and 2019,
respectively. A large portion of the expenses associated with our consolidated
medical office buildings is passed on directly to the tenants either directly as
tenant reimbursements of common area maintenance expenses or included in base
rental amounts. Tenant reimbursements for operating expenses are accrued as
revenue in the same period the related expenses are incurred and are included as
lease revenue in our condensed consolidated statements of income. Included in
our operating expenses for the three and six months ended June 30, 2020, is
$183,000 and $381,000, respectively, of aggregate operating expenses related to
the two above-mentioned vacant hospital facilities located in Corpus Christi,
Texas, and Evansville, Indiana.

Funds from operations ("FFO") is a widely recognized measure of performance for
Real Estate Investment Trusts ("REITs"). We believe that FFO and FFO per diluted
share, which are non-GAAP financial measures, are helpful to our investors as
measures of our operating performance. We compute FFO, as reflected on the
attached Supplemental Schedules, in accordance with standards established by the
National Association of Real Estate Investment Trusts ("NAREIT"), which may not
be comparable to FFO reported by other REITs that do not compute FFO in
accordance with the NAREIT definition, or that interpret the NAREIT definition
differently than we interpret the definition. FFO adjusts for the effects of
gains, such as gains on transactions during the periods presented. To the extent
a REIT recognizes a gain or loss with respect to the sale of incidental assets,
such as the sale of land peripheral to operating properties, the REIT has the
option to exclude or include such gains and losses in the calculation of FFO. We
have opted to exclude gains and losses from sales of incidental assets in our
calculation of FFO. FFO does not represent cash generated from operating
activities in accordance with GAAP and should not be considered to be an
alternative to net income determined in accordance with GAAP. In addition, FFO
should not be used as: (i) an indication of our financial performance determined
in accordance with GAAP; (ii) an alternative to cash flow from operating
activities determined in accordance with GAAP; (iii) a measure of our liquidity,
or; (iv) an indicator of funds available for our cash needs, including our
ability to make cash distributions to shareholders.

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Below is a reconciliation of our reported net income to FFO for the three and six-month periods ended June 30, 2020 and 2019 (in thousands):



                                            Three Months Ended           Six Months Ended
                                                 June 30,                    June 30,
                                            2020          2019          2020          2019
Net income                               $    4,700     $   4,261     $   9,254     $   8,473
Depreciation and amortization expense
on consolidated
  investments                                 6,381         6,426        12,761        13,134
Depreciation and amortization expense
on unconsolidated
  affiliates                                    293           291           579           574
Gain on sale of land                              -             -             -          (250 )
Funds From Operations                    $   11,374     $  10,978     $  22,594     $  21,931
Weighted average number of shares
outstanding - Basic                          13,739        13,730        13,737        13,729
Weighted average number of shares
outstanding - Diluted                        13,761        13,749        13,759        13,748
Funds From Operations per diluted
share                                    $     0.83     $    0.80     $    1.64     $    1.60




Our FFO increased $396,000, or $.03 per diluted share, during the second quarter
of 2020, as compared to the second quarter of 2019. The net increase was
primarily due to: (i) an unfavorable impact of $694,000, or $.05 per diluted
share, related to the above-mentioned vacancies at two of our hospitals as a
result of lease expirations on June 1, 2019 and September 30, 2019 (excluding
the related interest expense impact); (ii) a favorable impact of $765,000, or
$.06 per diluted share, resulting from a decrease in interest expense, resulting
primarily from a decrease in our average cost of borrowings pursuant to our
revolving credit agreement, partially offset by an increase in our average
outstanding borrowings, and; (iii) other combined net increases of $325,000, or
$.02 per diluted share.



Our FFO increased $663,000, or $.04 per diluted share, during the first six
months of 2020, as compared to the first six months of 2019, primarily due to:
(i) an unfavorable impact of $1.25 million, or $.09 per diluted share, related
to the above-mentioned vacancies at two of our hospitals as a result of lease
expirations on June 1, 2019 and September 30, 2019 (excluding the related
interest expense impact); (ii) a favorable impact of $1.1 million, or $.08 per
diluted share, resulting from a decrease in interest expense, resulting
primarily from a decrease in our average cost of borrowings pursuant to our
revolving credit agreement, partially offset by an increase in our average
outstanding borrowings, and; (iii) other combined net increases of $768,000, or
$.05 per diluted share.



Other Operating Results

Interest Expense:

As reflected in the schedule below, interest expense was $2.0 million and $2.8 million during the three-month periods ended June 30, 2020 and 2019, respectively and $4.3 million and $5.5 million during the six-month periods ended June 30, 2020 and 2019, respectively (amounts in thousands):




                                    Three Months         Three Months        Six Months          Six Months
                                        Ended                Ended             Ended               Ended
                                      June 30,             June 30,           June 30,            June 30,
                                        2020                 2019               2020                2019

Revolving credit agreement $ 1,075 $ 1,962 $ 2,698 $ 3,905 Mortgage interest

                             654                  674             1,312               1,392
Interest rate swaps/caps
expense/(income), net                         182   (b.)             -               131   (b.)         (122 ) (a.)
Amortization of financing fees                172                  157               329                 323
Amortization of fair value of
debt                                          (13 )                (13 )             (26 )               (26 )
Capitalized interest on major
projects                                      (61 )                  -              (126 )                 -
Other interest                                  7                    1                 7                   1
Interest expense, net               $       2,016        $       2,781      $      4,325        $      5,473




   (a.) Represents interest paid to us by the counterparties pursuant to two
        interest rate caps with a combined notional amount of $60 million, which
        expired in March, 2019.

(b.) Represents net interest paid by us to the counterparties pursuant to three

interest rate SWAPs with a combined notional amount of $140 million.




Interest expense decreased by approximately $765,000 during the three-month
period ended June 30, 2020, as compared to the comparable period of 2019, due
primarily to: (i) a $887,000 decrease in the interest expense on our revolving
credit agreement resulting from a decrease in our average cost of borrowings
pursuant to our revolving credit agreement (1.7% during the three months ended
June 30, 2020 as compared to 3.7% in the comparable quarter of 2019), partially
offset by an increase in our average outstanding borrowings ($215.5 million
during the three months ended June 30, 2020 as compared to $195.9 million in the

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comparable 2019 quarter); (ii) a $182,000 net increase in interest rate swap
expense, resulting from payments made by us to the counterparties pursuant to
the terms of the swap agreements (combined notional amount of $140 million)
during the second quarter of 2020; (iii) a $61,000 decrease in interest expense
related to capitalized interest on major projects, and; (iv) $1,000 of other
combined net increases in interest expense.

Interest expense decreased by approximately $1.1 million during the six-month
period ended June 30, 2020, as compared to the comparable period of 2019, due
primarily to: (i) a $1.2 million decrease in the interest expense on our
revolving credit agreement resulting from a decrease in our average cost of
borrowings pursuant to our revolving credit agreement (2.2% during the six
months ended June 30, 2020 as compared to 3.7% in the comparable six-month
period of 2019), partially offset by an increase in our average outstanding
borrowings ($214.4 million during the six months ended June 30, 2020 as compared
to $195.0 million in the comparable 2019 six month-period); (ii) a $253,000 net
increase in interest rate swap/caps expense during the six-months ended June 30,
2020 as compared to the comparable period in 2019; (iii) a $80,000 decrease in
mortgage interest expense, resulting primarily from the repayment of a mortgage
loan during the second quarter of 2019; (iv) a $126,000 decrease in interest
expense related to capitalized interest on major projects, and; (v) $12,000 of
other combined net increases in interest expense.



COVID-19 Impact



The COVID-19 pandemic began to significantly impact the United States in
mid-March, 2020. As a result of various policies implemented by the federal and
state governments, and varying by individual state, many non-essential
businesses in the nation were closed for varying time periods. With the
exception of the operators of our four preschool and childcare centers, which
were closed from mid-March until mid-June, we believe that most of the tenants
occupying our hospitals, medical office buildings ("MOBs") and ambulatory care
centers were permitted to continue operating if they elected to do so.

Tenants representing approximately 98% of our occupied square footage have paid
their June rent. We believe that as of June 30, 2020, substantially all of our
tenants have resumed operations of their businesses. However, many of our
properties are located in states that have experienced significant increases in
COVID-19 infections in June, July and early August. Such states include Arizona,
California, Florida, Georgia, Nevada and Texas. Although COVID-19 has not had a
material adverse impact on our results of operations through June 30, 2020, we
believe that the potentially adverse impact that the pandemic may have on our
future operations and financial results of our tenants, and in turn ours, will
depend upon many factors, most of which are beyond our, or our tenants', ability
to control or predict. Since the underlying businesses in each of our properties
are operated by the tenants, we can provide no assurance that the businesses
will continue to operate in the future, or stay current with their lease
obligations.

Since the bonus rents earned by us on the three acute care hospitals leased to
wholly-owned subsidiaries of Universal Health Services, Inc., are computed based
upon a computation that compares each hospital's current quarter revenue to the
corresponding quarter in the base year, we could experience significant declines
in future bonus rental revenue earned on these properties should those hospitals
continue to experience significant declines in patient volumes and revenues.
These hospitals believe that, to the extent that they experience revenue
declines and increased expenses resulting from the COVID-19 pandemic, as
ultimately measured over the life of the pandemic, they are eligible for
emergency fund grants as provided for by the Coronavirus Aid, Relief, and
Economic Security Act ("CARES Act"). Our financial statements for the three and
six-month periods ended June 30, 2020 include bonus rental attributable to
revenues recorded by these three hospitals in connection with CARES Act
grants.



Throughout the common areas of many properties in our portfolio, we have
implemented COVID-19 risk mitigating actions such as, enhanced cleaning
protocols including supplemental cleaning and sanitizing of high-touch points,
limiting points of entry at certain facilities, and coordinating with health
care providers to assess or screen patients prior to entering certain of our
MOBs.

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Lease Expirations/Vacancies of Two Hospital Facilities



As previously disclosed, the tenants in two of our hospital facilities had
provided notice to us that they did not intend to renew the leases upon the
scheduled expiration of the respective facilities. The leases on these two
hospital facilities, located in Evansville, Indiana, and Corpus Christi, Texas,
expired on May 31, 2019 and June 1, 2019, respectively. Prior to the vacancy of
the property on September 30, 2019, the former tenant of the hospital located in
Evansville, Indiana, entered into a short-term lease with us, which covered the
period of June 1, 2019 through September 30, 2019, at a substantially increased
lease rate as compared to the original lease rate.

The combined lease revenue generated at these facilities amounted to $537,000
and $900,000 during the three and six-month periods ended June 30, 2019,
respectively. The hospital located in Evansville, Indiana, has remained vacant
since September 30, 2019 and the hospital located in Corpus Christi, Texas, has
remained vacant since June 1, 2019.

We continue to market each property for lease to new tenants. However, should
these properties continue to remain owned and vacant for an extended period of
time, or should we experience decreased lease rates on future leases, as
compared to prior/expired lease rates, or incur substantial renovation costs to
make the properties suitable for other operators/tenants, our future results of
operations could be materially unfavorably impacted.



Liquidity and Capital Resources

Net cash provided by operating activities



Net cash provided by operating activities was $23.2 million during the six-month
period ended June 30, 2020 as compared to $21.5 million during the comparable
period of 2019. The $1.8 million net increase was attributable to:

• A favorable change of $758,000 due to an increase in net income

plus/minus the adjustments to reconcile net income to net cash provided

by operating activities (depreciation and amortization, amortization

related to above/below market leases, amortization of debt premium,

amortization of deferred financing costs, stock-based compensation and

gain on sale of land), as discussed above;

• a favorable change of $527,000 in accrued expenses and other liabilities;




  • a favorable change of $204,000 in leasing costs paid;

• a favorable change of $910,000 in tenant reserves, deposits and deferred


          and prepaid rents, and;


  • other combined net unfavorable changes of $645,000.

Net cash used in investing activities

Net cash used in investing activities was $11.3 million during the first six months of 2020 as compared to $3.0 million during the first six months of 2019.



During the six-month period ended June 30, 2020 we funded: (i) $13.3 million in
additions to real estate investments including $10.1 million of construction
costs related to a newly constructed, 108-bed behavioral health care hospital
located in Clive, Iowa, that is scheduled to be completed in late 2020 or early
2021, and tenant improvements at various MOBs, and; (ii) $3.2 million in equity
investments in unconsolidated LLCs. In addition, during the six-months ended
June 30, 2020, we received $5.2 million of cash distributions from our
unconsolidated LLCs, consisting of proceeds generated from a construction loan
obtained by Grayson Properties II during the second quarter of 2020.

During the six-month period ended June 30, 2019 we funded: (i) $598,000 in
equity investments in unconsolidated LLCs, and; (ii) $3.0 million in capital
additions to real estate investments including tenant improvements at various
MOBs. In addition, during the six-month period ended June 30, 2019 we received:
(i) $245,000 of cash proceeds from the divestiture of land, and; (ii) $348,000
of cash distributions from our unconsolidated LLCs.

Net cash used in financing activities



Net cash used in financing activities was $11.7 million during the six months
ended June 30, 2020, as compared to $17.5 million during the six months ended
June 30, 2019.

During the six-month period ended June 30, 2020, we paid: (i) $907,000 on
mortgage notes payable that are non-recourse to us; (ii) $362,000 of financing
costs related to the revolving credit agreement, including amendment fees
incurred during the second quarter of 2020, and; (iii) $18.9 million of
dividends. Additionally, during the six months ended June 30, 2020, we received:
(i) $8.3 million of

                                       29

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net borrowings on our revolving credit agreement, and; (ii) $223,000 of net cash from the issuance of shares of beneficial interest, as discussed below.



During the six-month period ended June 30, 2019, we paid: (i) $4.9 million of
net outstanding borrowings under our revolving credit agreement; (ii) $3.4
million on mortgage notes payable that are non-recourse to us, including the
repayment of $2.5 million related to a previously outstanding mortgage note
payable on one property that was funded utilizing borrowings under our revolving
credit agreement; (iii) $35,000 of financing costs related to the revolving
credit agreement, and; (iii) $9.3 million of dividends (excluded $9.4 million of
dividends declared on June 12, 2019 that was paid on July 2, 2019).
Additionally, during the six months ended June 30, 2019, we received $61,000 of
net cash from the issuance of shares of beneficial interest.

During the second quarter of 2020, we commenced an at-the-market ("ATM") equity
issuance program, pursuant to the terms of which we may sell, from time-to-time,
common shares of our beneficial interest up to an aggregate sales price of $100
million to or through BofA Securities, Inc., Credit Agricole Securities (USA)
Inc., Fifth Third Securities, Inc., SunTrust Robinson Humphrey, Inc. and Wells
Fargo Securities, LLC (collectively, the Agents). Pursuant to this ATM Program,
during the second quarter of 2020, we issued 2,704 shares at an average price of
$101.30 per share which generated approximately $270,000 of net cash proceeds
(net of compensation to BofA Securities, Inc. of approximately
$4,000). Additionally, we paid or incurred approximately $435,000 in various
fees and expenses related to the commencement of our ATM program.

Additional cash flow and dividends paid information for the six-month periods ended June 30, 2020 and 2019:



As indicated on our condensed consolidated statement of cash flows, we generated
net cash provided by operating activities of $23.2 million and $21.5 million
during the six-month periods ended June 30, 2020 and 2019, respectively. As also
indicated on our statement of cash flows, non-cash expenses including
depreciation and amortization expense, amortization related to above/below
market leases, amortization of debt premium, amortization of deferred financing
costs, stock-based compensation expense and gain on transaction (as applicable)
are the primary differences between our net income and net cash provided by
operating activities during each period.

We declared and paid dividends of $18.9 million during the six months ended June
30, 2020 and declared dividends of $18.6 million during the six months ended
June 30, 2019 ($9.4 million of which was paid in July, 2019). During the first
six months of 2020, the $23.2 million of net cash provided by operating
activities was approximately $4.3 million greater than the $18.9 million of
dividends paid during the first six months of 2020. During the first six months
of 2019, the $21.5 million of net cash provided by operating activities was
approximately $2.9 million greater that the $18.6 million of dividends declared
during the first six months of 2019.

As indicated in the cash flows from investing activities and cash flows from
financing activities sections of the statements of cash flows, there were
various other sources and uses of cash during the six months ended June 30, 2020
and 2019. From time to time, various other sources and uses of cash may include
items such as investments and advances made to/from LLCs, additions to real
estate investments, acquisitions/divestiture of properties, net
borrowings/repayments of debt, and proceeds generated from the issuance of
equity. Therefore, in any given period, the funding source for our dividend
payments is not wholly dependent on the operating cash flow generated by our
properties. Rather, our dividends as well as our capital reinvestments into our
existing properties, acquisitions of real property and other investments are
funded based upon the aggregate net cash inflows or outflows from all sources
and uses of cash from the properties we own either in whole or through LLCs, as
outlined above.

In determining and monitoring our dividend level on a quarterly basis, our
management and Board of Trustees consider many factors in determining the amount
of dividends to be paid each period. These considerations primarily include:
(i) the minimum required amount of dividends to be paid in order to maintain our
REIT status; (ii) the current and projected operating results of our properties,
including those owned in LLCs, and; (iii) our future capital commitments and
debt repayments, including those of our LLCs. Based upon the information
discussed above, as well as consideration of projections and forecasts of our
future operating cash flows, management and the Board of Trustees have
determined that our operating cash flows have been sufficient to fund our
dividend payments. Future dividend levels will be determined based upon the
factors outlined above with consideration given to our projected future results
of operations.

We expect to finance all capital expenditures and acquisitions and pay dividends
utilizing internally generated and additional funds. Additional funds may be
obtained through: (i) borrowings under our existing $350 million revolving
credit agreement (which had $123.1 million of available borrowing capacity, net
of outstanding borrowings and letters of credit as of June 30, 2020);
(ii) borrowings under or refinancing of existing third-party debt pursuant to
mortgage loan agreements entered into by our consolidated and unconsolidated
LLCs/LPs; (iii) the issuance of equity pursuant to our ATM program, and/or;
(iv) the issuance of other long-term debt.

We believe that our operating cash flows, cash and cash equivalents, available borrowing capacity under our revolving credit agreement and access to the capital markets provide us with sufficient capital resources to fund our operating, investing and financing requirements for the next twelve months, including providing sufficient capital to allow us to make distributions necessary to enable


                                       30

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us to continue to qualify as a REIT under Sections 856 to 860 of the Internal
Revenue Code of 1986. In the event we need to access the capital markets or
other sources of financing, there can be no assurance that we will be able to
obtain financing on acceptable terms or within an acceptable time. Our inability
to obtain financing on terms acceptable to us could have a material unfavorable
impact on our results of operations, financial condition and liquidity.

Credit facilities and mortgage debt



Management routinely monitors and analyzes the Trust's capital structure in an
effort to maintain the targeted balance among capital resources including the
level of borrowings pursuant to our $350 million revolving credit facility, the
level of borrowings pursuant to non-recourse mortgage debt secured by the real
property of our properties and our level of equity including consideration of
additional equity issuances pursuant to our ATM equity issuance program. This
ongoing analysis considers factors such as the current debt market and interest
rate environment, the current/projected occupancy and financial performance of
our properties, the current loan-to-value ratio of our properties, the Trust's
current stock price, the capital resources required for anticipated acquisitions
and the expected capital to be generated by anticipated divestitures. This
analysis, together with consideration of the Trust's current balance of
revolving credit agreement borrowings, non-recourse mortgage borrowings and
equity, assists management in deciding which capital resource to utilize when
events such as refinancing of specific debt components occur or additional funds
are required to finance the Trust's growth.

In June 2020, we entered into the first amendment (the "First Amendment") to the
revolving credit agreement ("Credit Agreement"), pursuant to which, among other
things, an additional tranche of revolving credit commitments in the amount of
$50 million, designated as the "Revolving B Facility", was established thereby
increasing the aggregate revolving credit commitment to $350 million from $300
million. The Credit Agreement, as amended, which is scheduled to mature in March
2022, provides for a revolving credit facility in an aggregate principal amount
of $350 million, including a $40 million sublimit for letters of credit and a
$30 million sublimit for swingline/short-term loans. The Credit Agreement also
provides for options to extend the maturity date for two additional six month
periods. Borrowings under the Credit Agreement are guaranteed by certain
subsidiaries of the Trust. In addition, borrowings under the Credit Agreement
are secured by first priority security interests in and liens on all equity
interests in certain of the Trust's wholly-owned subsidiaries. The remainder of
the revolving credit commitments provided under the Credit Agreement that were
in effect prior to giving effect to the First Amendment, has been designated as
the "Revolving A Facility".

Borrowings made pursuant to the Revolving A Facility will bear interest, at our
option, at one, two, three, or six-month LIBOR plus an applicable margin ranging
from 1.10% to 1.35% or at the Base Rate plus an applicable margin ranging from
0.10% to 0.35%. The Credit Agreement defines "Base Rate" as the greater of:
(a) the administrative agent's prime rate; (b) the federal funds effective rate
plus 1/2 of 1%, and; (c) one month LIBOR plus 1%. A facility fee of 0.15% to
0.35% will be charged on the total commitment of the Revolving A Facility of the
Credit Agreement. The margins over LIBOR, Base Rate and the facility fee are
based upon our total leverage ratio. At June 30, 2020, the applicable margin
over the LIBOR rate was 1.20%, the margin over the Base Rate was 0.20%, and the
facility fee was 0.20%.

Borrowings made pursuant to the Revolving B Facility will bear interest, at our
option, at one, two, three, or six months LIBOR plus an applicable margin
ranging from 1.85% to 2.10% or at the Base Rate plus an applicable margin
ranging from 0.85% to 1.10%. The Credit Agreement defines "Base Rate" as the
greatest of (a) the Administrative Agent's prime rate, (b) the federal funds
effective rate plus 1/2 of 1% and (c) one month LIBOR plus 1%. The initial
applicable margin is 1.95% for LIBOR loans and 0.95% for Base Rate loans. A
facility fee of 0.15% to 0.35% will be charged on the total commitment of the
Revolving B Facility of the Credit Agreement. The margins over LIBOR, Base Rate
and the facility fee are based upon our total leverage ratio. At June 30, 2020,
the applicable margin over the LIBOR rate was 1.95%, the margin over the Base
Rate was 0.95% and the facility fee was 0.20%.

At June 30, 2020, we had $221.3 million of outstanding borrowings and $5.6
million of letters of credit outstanding under our Credit Agreement. We had
$123.1 million of available borrowing capacity, net of the outstanding
borrowings and letters of credit outstanding as of June 30, 2020. There are no
compensating balance requirements. At December 31, 2019, we had $213.0 million
of outstanding borrowings outstanding against our revolving credit agreement and
$87.0 million of available borrowing capacity.

The Credit Agreement contains customary affirmative and negative covenants,
including limitations on certain indebtedness, liens, acquisitions and other
investments, fundamental changes, asset dispositions and dividends and other
distributions. The Credit Agreement also contains restrictive covenants
regarding the Trust's ratio of total debt to total assets, the fixed charge
coverage ratio, the ratio of total secured debt to total asset value, the ratio
of total unsecured debt to total unencumbered asset value, and minimum tangible
net worth, as well as customary events of default, the occurrence of which may
trigger an acceleration of amounts outstanding under the Credit Agreement. We
are in compliance with all of the covenants at June 30, 2020 and December 31,
2019. We also believe that we would remain in compliance if, based on the
assumption that the majority of the potential new borrowings will be used to
fund investments, the full amount of our commitment was borrowed.





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The following table includes a summary of the required compliance ratios, giving
effect to the covenants contained in the Credit Agreement (dollar amounts in
thousands):

                                      June 30,     December 31,
                         Covenant       2020           2019
Tangible net worth      > =$125,000   $ 153,292   $      167,181
Total leverage                < 60%        43.6 %           42.3 %
Secured leverage              < 30%         9.0 %            9.1 %
Unencumbered leverage         < 60%        40.2 %           38.5 %
Fixed charge coverage       > 1.50x        4.3x             4.0x




As indicated on the following table, we have various mortgages, all of which are
non-recourse to us, included on our condensed consolidated balance sheet as of
June 30, 2020 (amounts in thousands):



                                                Outstanding
                                                  Balance             Interest          Maturity
Facility Name                               (in thousands) (a.)         Rate              Date
700 Shadow Lane and Goldring MOBs fixed
rate
  mortgage loan                            $               5,547            4.54 %        June, 2022
BRB Medical Office Building fixed rate
mortgage loan                                              5,614            4.27 %    December, 2022
Desert Valley Medical Center fixed rate
mortgage loan                                              4,587            3.62 %     January, 2023
2704 North Tenaya Way fixed rate
mortgage loan                                              6,653            4.95 %    November, 2023
Summerlin Hospital Medical Office
Building III fixed
  rate mortgage loan                                      13,158            4.03 %       April, 2024
Tuscan Professional Building fixed rate
mortgage loan                                              3,216            5.56 %        June, 2025
Phoenix Children's East Valley Care
Center fixed rate
  mortgage loan                                            8,841            3.95 %     January, 2030
Rosenberg Children's Medical Plaza fixed
rate mortgage loan                                        12,621            4.42 %   September, 2033
Total, excluding net debt premium and
net financing fees                                        60,237
   Less net financing fees                                  (533 )
   Plus net debt premium                                     167
Total mortgages notes payable,
non-recourse to us, net                    $              59,871



(a.) All mortgage loans require monthly principal payments through maturity and

either fully amortize or include a balloon principal payment upon

maturity.




The mortgages are secured by the real property of the buildings as well as
property leases and rents. The mortgages outstanding as of June 30, 2020 had a
combined fair value of approximately $62.4 million. At December 31, 2019, we had
various mortgages, all of which were non-recourse to us, included in our
condensed consolidated balance sheet. The combined outstanding balance of these
various mortgages was $61.1 million and had a combined fair value of
approximately $63.1 million.

Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow.

Off Balance Sheet Arrangements



As of June 30, 2020, we are party to certain off balance sheet arrangements
consisting of standby letters of credit and equity and debt financing
commitments. Our outstanding letters of credit at June 30, 2020 totaled $5.6
million related to Grayson Properties II. As of December 31, 2019, we did not
have any off balance sheet arrangements other than equity and debt financing
commitments.

Acquisition and Divestiture Activity

Please see Note 4 to the condensed consolidated financial statements for completed transactions.


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