Company Overview                                             45
Business Strategy                                            46
Key Transactions                                             47

Key Performance Indicators, Trends and Uncertainties 48 Corporate Governance

                                         49

                  LIQUIDITY AND CAPITAL RESOURCES

Sources and Uses of Cash                                     49
Off-Balance Sheet Arrangements                               50
Contractual Obligations                                      51
Capital Structure                                            51

                       RESULTS OF OPERATIONS

Summary                                                      52
Seniors Housing Operating                                    53
Triple-net                                                   55
Outpatient Medical                                           57
Non-Segment/Corporate                                        59

                               OTHER

Non-GAAP Financial Measures                                  60
Critical Accounting Policies                                 65



                                       44

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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
The following discussion and analysis is based primarily on the consolidated
financial statements of Welltower Inc. presented in conformity with U.S.
generally accepted accounting principles ("U.S. GAAP") for the periods presented
and should be read together with the notes thereto contained in this Annual
Report on Form 10-K. Other important factors are identified in "Item 1 -
Business" and "Item 1A - Risk Factors" above.
Executive Summary
Company Overview
Welltower Inc. (NYSE:WELL), an S&P 500 company headquartered in Toledo, Ohio, is
driving the transformation of health care infrastructure. The company invests
with leading seniors housing operators, post-acute providers and health systems
to fund the real estate and infrastructure needed to scale innovative care
delivery models and improve people's wellness and overall health care
experience. Welltower™, a real estate investment trust ("REIT"), owns interests
in properties concentrated in major, high-growth markets in the United States
("U.S."), Canada and the United Kingdom ("U.K."), consisting of seniors housing
and post-acute communities and outpatient medical properties.
The following table summarizes our consolidated portfolio for the year ended
December 31, 2020 (dollars in thousands):
                                                 Percentage of      Number 

of


     Type of Property             NOI(1)              NOI           

Properties


Seniors Housing Operating      $   755,552              37.6  %             556
Triple-net                         748,121              37.2  %             641
Outpatient Medical                 505,071              25.2  %             296
Totals                         $ 2,008,744             100.0  %      1,493


(1) Represents consolidated net operating income ("NOI") and excludes our share
of investments in unconsolidated entities. Entities in which we have a joint
venture with a minority partner are shown at 100% of the joint venture amount.
See Non-GAAP Financial Measures for additional information and reconciliation.
The COVID-19 pandemic has had and may continue to have material and adverse
effects on our financial condition, results of operations and cash flows in the
future. The extent to which the COVID-19 pandemic impacts our operations and
those of our operators and tenants will depend on future developments, which are
highly uncertain and cannot be predicted with confidence, including the scope,
severity and duration of the pandemic, the effectiveness and availability of
vaccines and the success of ongoing vaccination deployment efforts in our
facilities and the geographic areas in which we operate, the actions taken to
contain the pandemic or mitigate its impact and the direct and indirect economic
effects of the pandemic and containment measures, among others.
Our Seniors Housing Operating revenues are dependent on occupancy. While
admission bans were lifted across our portfolio during the second and third
quarter, with the ramp up of COVID-19 cases in the general community in the
fourth quarter, admissions bans, both government-imposed and voluntary bans
adopted by operators, have been reinstated in many locations which have
significantly affected occupancy rates. Occupancy has consistently declined
since the beginning of the pandemic to 76.2% as of December 31, 2020. Through
February 5, 2021, total occupancy declined an additional 180 basis points to
74.4%. Occupancy metrics represents approximate spot occupancy as reported by
our operators for properties in operation as of February 29, 2020, including
unconsolidated properties but excluding acquisitions, executed dispositions and
development conversions since such date.
We have incurred increased operational costs as a result of the introduction of
public health measures and other regulations affecting our properties, as well
as additional health and safety measures adopted by us and our operators related
to the COVID-19 pandemic, including increases in labor, personal protective
equipment and sanitation. We expect total Seniors Housing Operating expenses to
remain elevated during the pandemic and potentially beyond as these additional
health and safety measures become standard practice.
Our Triple-net operators are experiencing similar occupancy declines and
operating costs as described above with respect to our Seniors Housing Operating
properties. However, long-term/post-acute care facilities are generally
experiencing a higher degree of occupancy declines. These factors may continue
to impact the ability of our Triple-net operators to make contractual rent
payments to us in the future. Many of our Triple-net operators received funds
under the Coronavirus Aid Relief, and Economic Security Act ("CARES Act")
Paycheck Protection Program. In addition, operators of long-term/post-acute care
facilities have generally received funds from Phase 1 of the Provider Relief
Fund and operators of assisted living facilities have or are expected to receive
funds from Phase 2 of the Provider Relief Fund. Accordingly, collection of
Triple-net rent due during the COVID-19 pandemic to date (from March to
December) has generally been consistent with historical collection rates and no
significant rent concessions or deferrals have been made.

                                       45
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Our Outpatient Medical tenants have experienced temporary medical practice
closures or decreases in revenue due to government-imposed restrictions on
elective medical procedures, stay at home orders or decisions by patients to
delay treatments which may continue to adversely affect their ability to make
contractual rent payments. These factors have and may continue to cause
operators or tenants to seek modifications of such obligations, resulting in
reductions in revenue and increases in uncollectible receivables. We will
continue to evaluate each request on a case-by-case basis and determine if a
form of rent relief is warranted following an examination of the tenant's
financial health, rent coverage, current operating situation and other factors.
Outpatient Medical rent collections through March were generally consistent with
pre COVID-19 levels. During the second quarter we executed short term rent
deferrals with certain Outpatient Medical tenants which in most cases were
required to be repaid by year end. Since then we have collected approximately
99% of Outpatient Medical rent due in the second half of the year, with
uncollected amounts primarily attributable to local jurisdictions with COVID-19
related ordinances providing temporary rent relief to tenants. Furthermore,
collections of deferred rent due under executed deferrals was over 99%. To the
extent that deferred rent is not repaid as expected, or the prolonged impact of
the COVID-19 pandemic causes operators or tenants to seek further modifications
of their lease agreements, we may recognize reductions in revenue and increases
in uncollectible receivables.
As a result of uncertainty regarding the length and severity of the COVID-19
pandemic and the impact of the pandemic on our business and related industries,
our investments in and acquisitions of seniors housing and health care
properties, as well as our ability to transition or sell properties with
profitable results in the future, may be limited. In response to the COVID-19
pandemic, acquisitions during the year ended December 31, 2020 declined compared
to recent years. Additionally, we undertook certain opportunistic disposals to
enhance near-term liquidity. We have a significant development portfolio as of
December 31, 2020. To date we have only experienced minor construction and
licensing delays with respect to our development portfolio, but may experience
more significant delays in the future. Such disruptions to acquisition,
disposition and development activity may negatively impact our long-term
competitive position.
Business Strategy
Our primary objectives are to protect stockholder capital and enhance
stockholder value. We seek to pay consistent cash dividends to stockholders and
create opportunities to increase dividend payments to stockholders as a result
of annual increases in NOI and portfolio growth. To meet these objectives, we
invest across the full spectrum of seniors housing and health care real estate
and diversify our investment portfolio by property type, relationship and
geographic location.
Substantially all of our revenues are derived from operating lease rentals,
resident fees and services and interest earned on outstanding loans receivable.
These items represent our primary sources of liquidity to fund distributions and
depend upon the continued ability of our obligors to make contractual rent and
interest payments to us and the profitability of our operating properties. To
the extent that our obligors/partners experience operating difficulties and
become unable to generate sufficient cash to make payments or operating
distributions to us, there could be a material adverse impact on our
consolidated results of operations, liquidity and/or financial condition. To
mitigate this risk, we monitor our investments through a variety of methods
determined by the type of property. Our asset management process for seniors
housing properties generally includes review of monthly financial statements and
other operating data for each property, review of obligor/partner
creditworthiness, property inspections and review of covenant compliance
relating to licensure, real estate taxes, letters of credit and other
collateral. Our internal property management division manages and monitors the
outpatient medical portfolio with a comprehensive process including review of
tenant relations, lease expirations, the mix of health service providers,
hospital/health system relationships, property performance, capital improvement
needs and market conditions among other things. We evaluate the operating
environment in each property's market to determine the likely trend in operating
performance of the facility. When we identify unacceptable trends, we seek to
mitigate, eliminate or transfer the risk. Through these efforts, we generally
aim to intervene at an early stage to address any negative trends, and in so
doing, support both the collectability of revenue and the value of our
investment.
In addition to our asset management and research efforts, we also aim to
structure our relevant investments to mitigate payment risk. Operating leases
and loans are normally credit enhanced by guarantees and/or letters of credit.
In addition, operating leases are typically structured as master leases and
loans are generally cross-defaulted and cross-collateralized with other real
estate loans, operating leases or agreements between us and the obligor and its
affiliates.
For the year ended December 31, 2020, resident fees and services and rental
income represented 67% and 31%, respectively, of total revenues. Substantially
all of our operating leases are designed with escalating rent structures. Leases
with fixed annual rental escalators are generally recognized on a straight-line
basis over the initial lease period, subject to a collectability assessment.
Rental income related to leases with contingent rental escalators is generally
recorded based on the contractual cash rental payments due for the period. Our
yield on loans receivable depends upon a number of factors, including the stated
interest rate, the average principal amount outstanding during the term of the
loan and any interest rate adjustments.
Our primary sources of cash include resident fees and services, rent and
interest receipts, borrowings under our unsecured revolving credit facility and
commercial paper program, public issuances of debt and equity securities,
proceeds from investment dispositions and principal payments on loans
receivable. Our primary uses of cash include dividend distributions,
                                       46
--------------------------------------------------------------------------------
Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
debt service payments (including principal and interest), real property
investments (including acquisitions, capital expenditures, construction advances
and transaction costs), loan advances, property operating expenses, general and
administrative expenses and other expenses. Depending upon the availability and
cost of external capital, we believe our liquidity is sufficient to fund these
uses of cash.
We also continuously evaluate opportunities to finance future investments. New
investments are generally funded from temporary borrowings under our unsecured
revolving credit facility and commercial paper program, internally generated
cash and the proceeds from investment dispositions. Our investments generate
cash from NOI and principal payments on loans receivable. Permanent financing
for future investments, which replaces funds drawn under our unsecured revolving
credit facility and commercial paper program, has historically been provided
through a combination of the issuance of public debt and equity securities and
the incurrence or assumption of secured debt.
Depending upon market conditions, we believe that new investments will be
available in the future with spreads over our cost of capital that will generate
appropriate returns to our stockholders. It is also likely that investment
dispositions may occur in the future. To the extent that investment dispositions
exceed new investments, our revenues and cash flows from operations could be
adversely affected. We expect to reinvest the proceeds from any investment
dispositions in new investments. To the extent that new investment requirements
exceed our available cash on-hand, we expect to borrow under our unsecured
revolving credit facility and commercial paper program. During 2020, in response
to the COVID-19 pandemic, we were strategic and opportunistic in disposing of
certain real estate which provided significant near term liquidity. At December
31, 2020, we had $1,545,046,000 of cash and cash equivalents, $475,997,000 of
restricted cash and $3,000,000,000 of available borrowing capacity under our
unsecured revolving credit facility.
Key Transactions
Capital  The following summarizes key capital transactions that occurred during
the year ended December 31, 2020:
•In April 2020, we closed on a $1.0 billion two-year unsecured term loan. The
term loan bears interest at a rate of 1-month LIBOR + 1.20%, based on our credit
rating.
•In June 2020, we completed the issuance of $600,000,000 senior unsecured notes
bearing interest at 2.75% with a maturity date of January 2031. Net proceeds
were used to fund tender offers for $426,248,000 of our 3.75% senior unsecured
notes due 2023 and our 3.95% senior unsecured notes due 2023 which settled on
July 1, 2020. The remaining proceeds were used to reduce borrowings under our
term loan by $140,000,000.
•We sold 2,128,000 shares of common stock under our ATM and DRIP programs,
primarily in the first quarter, via both cash settle and forward sale
agreements, generating gross proceeds of approximately $175,484,000. The sale of
these shares and settlement of previously outstanding forward sales resulted in
gross proceeds of approximately $607,177,000 which were used to reduce
borrowings under our unsecured revolving credit facility.
•We extinguished $632,288,000 of secured debt at a blended average interest rate
of 2.21% throughout 2020.
Investments The following summarizes property acquisitions and joint venture
investments completed during the year ended December 31, 2020 (dollars in
thousands):
                                                                     Investment
                                            Properties                Amount(1)              Capitalization Rates(2)            Book Amount(3)

Seniors Housing Operating                          26             $      574,793                      3.5%                    $       610,857
Triple-net                                         11                     88,908                      6.5%                             90,731
Outpatient Medical                                 17                    246,516                      6.1%                            249,312
Totals                                             54             $      910,217                      4.5%                    $       950,900


(1) Represents stated pro rata purchase price including cash and any assumed
debt but excludes fair value adjustments pursuant to U.S. GAAP.
(2) Represents annualized contractual or projected NOI to be received in cash
divided by investment amounts.
(3) Represents amounts recorded in real property including fair value
adjustments pursuant to U.S. GAAP. See Note 3 to our consolidated financial
statements for additional information.
Dispositions The following summarizes property dispositions completed during the
year ended December 31, 2020 (dollars in thousands):
                                            Properties              Proceeds(1)            Capitalization Rates(2)            Book Amount(3)
Seniors Housing Operating                          31             $  1,282,439                      4.8%                    $     1,289,769
Triple-net                                          8                  109,439                      7.9%                             51,666
Outpatient Medical                                108                2,324,062                      5.6%                          1,755,864
Totals                                            147             $  3,715,940                      5.4%                    $     3,097,299


(1) Represents pro rata proceeds received upon disposition including any seller
financing.
(2) Represents annualized contractual income that was being received in cash at
date of disposition divided by disposition proceeds.
(3) Represents carrying value of net real estate assets at time of
disposition. See Note 5 to our consolidated financial statements for additional
information.
                                       47
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Dividends On February 9, 2021, the Board of Directors declared a cash dividend
for the quarter ended December 31, 2020 of $0.61 per share, consistent with the
cash dividends for the quarters ended September 30, June 30 and March 31, 2020,
representing a 30% decrease from the $0.87 per share dividend for the quarter
ended December 31, 2019. The dividend declaration represents the 199th
consecutive quarterly dividend payment.
Key Performance Indicators, Trends and Uncertainties
We utilize several key performance indicators to evaluate the various aspects of
our business. These indicators are discussed below and relate to operating
performance, credit strength and concentration risk. Management uses these key
performance indicators to facilitate internal and external comparisons to our
historical operating results, in making operating decisions, and for budget
planning purposes.
Operating Performance We believe that net income and net income attributable to
common stockholders ("NICS") per the Statement of Comprehensive Income are the
most appropriate earnings measures. Other useful supplemental measures of our
operating performance include funds from operations attributable to common
stockholders ("FFO") and consolidated net operating income ("NOI"); however,
these supplemental measures are not defined by U.S. GAAP. Please refer to the
section entitled "Non-GAAP Financial Measures" for further discussion and
reconciliations. These earnings measures are widely used by investors and
analysts in the valuation, comparison and investment recommendations of
companies. The following table reflects the recent historical trends of our
operating performance measures for the periods presented (in thousands):
                                                                          Year Ended December 31,
                                                              2020                 2019                 2018
Net income                                               $ 1,038,852          $ 1,330,410          $    829,750
Net income attributable to common stockholders               978,844            1,232,432               758,250
Funds from operations attributable to common
stockholders                                               1,102,562            1,577,080             1,392,183
Consolidated net operating income                          2,008,144            2,431,264             2,267,482


Credit Strength We measure our credit strength both in terms of leverage ratios
and coverage ratios. The leverage ratios indicate how much of our balance sheet
capitalization is related to long-term debt, net of cash and Internal Revenue
Code ("IRC") Section 1031 deposits. The coverage ratios indicate our ability to
service interest and fixed charges (interest, secured debt principal
amortization and preferred dividends). We expect to maintain capitalization
ratios and coverage ratios sufficient to maintain a capital structure consistent
with our current profile. The coverage ratios are based on adjusted earnings
before interest, taxes, depreciation and amortization ("Adjusted EBITDA").
Please refer to the section entitled "Non-GAAP Financial Measures" for further
discussion and reconciliation of these measures. Leverage ratios and coverage
ratios are widely used by investors, analysts and rating agencies in the
valuation, comparison, investment recommendations and rating of companies. The
following table reflects the recent historical trends for our credit strength
measures for the periods presented:
                                                                            

Year Ended December 31,


                                                                2020                       2019                       2018
Net debt to book capitalization ratio                          40.9%                      46.5%                       45.0%
Net debt to undepreciated book capitalization ratio            33.8%                      39.4%                       37.8%
Net debt to market capitalization ratio                        29.7%                      29.6%                       31.3%

Adjusted interest coverage ratio                               3.97x                      4.14x                       4.11x
Adjusted fixed charge coverage ratio                           3.54x                      3.78x                       3.44x


Concentration Risk We evaluate our concentration risk in terms of NOI by
property mix, relationship mix and geographic mix. Concentration risk is a
valuable measure in understanding what portion of our NOI could be at risk if
certain sectors were to experience downturns. Property mix measures the portion
of our NOI that relates to our various property types. Relationship mix measures
the portion of our NOI that relates to our current top five
relationships. Geographic mix measures the portion of our NOI that relates to
our current top five states (or international equivalents). The following table
reflects our recent historical trends of concentration risk by NOI for the years
indicated below:
                                       48

--------------------------------------------------------------------------------


Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
                                                         December 31,(1)
                                                  2020         2019         2018
Property mix:
                Seniors Housing Operating         38%          43%          43%
                Triple-net                        37%          38%          40%
                Outpatient Medical                25%          19%          17%

Relationship mix:


                Sunrise Senior Living(2)          13%          14%          15%
                ProMedica                         11%           9%           4%
                Revera(2)                          5%           6%           7%
                Avery Healthcare                   4%           3%           3%
                Sagora Senior Living               3%           3%           3%
                Remaining                         64%          65%          68%

Geographic mix:
                California                        14%          13%          14%
                United Kingdom                    10%           8%           9%
                Texas                              9%           8%           8%
                Canada                             6%           7%           7%
                Pennsylvania                       6%           6%           5%
                Remaining                         55%          58%          57%


(1) Excludes our share of investments in unconsolidated entities and
non-segment/corporate NOI. Entities in which we have a joint venture with a
minority partner are shown at 100% of the joint venture amount.
(2) Revera owns a controlling interest in Sunrise Senior Living.
We evaluate our key performance indicators in conjunction with current
expectations to determine if historical trends are indicative of future results.
Our expected results may not be achieved and actual results may differ
materially from our expectations. Factors that may cause actual results to
differ from expected results are described in more detail in "Item 1 - Business
- Cautionary Statement Regarding Forward-Looking Statements" and "Item 1A - Risk
Factors" and other sections of this Annual Report on Form 10-K. Management
regularly monitors economic and other factors to develop strategic and tactical
plans designed to improve performance and maximize our competitive position. Our
ability to achieve our financial objectives is dependent upon our ability to
effectively execute these plans and to appropriately respond to emerging
economic and company-specific trends. Please refer to "Item 1 - Business," "Item
1A - Risk Factors" in this Annual Report on Form 10-K for further discussion of
these risk factors.
Corporate Governance
Maintaining investor confidence and trust is important in today's business
environment. Our Board of Directors and management are strongly committed to
policies and procedures that reflect the highest level of ethical business
practices. Our corporate governance guidelines provide the framework for our
business operations and emphasize our commitment to increase stockholder value
while meeting all applicable legal requirements. These guidelines meet the
listing standards adopted by the New York Stock Exchange and are available on
the Internet at www.welltower.com/investors/governance. The information on our
website is not incorporated by reference in this Annual Report on Form 10-K, and
our web address is included as an inactive textual reference only.
Liquidity and Capital Resources
Sources and Uses of Cash
Our primary sources of cash include resident fees and services, rent and
interest receipts, borrowings under our unsecured revolving credit facility and
commercial paper program, public issuances of debt and equity securities,
proceeds from investment dispositions and principal payments on loans
receivable. Our primary uses of cash include dividend distributions, debt
service payments (including principal and interest), real property investments
(including acquisitions, capital expenditures, construction advances and
transaction costs), loan advances, property operating expenses, general and
administrative expenses and other expenses. These sources and uses of cash are
reflected in our Consolidated Statements of Cash Flows and are discussed in
further detail below. The following is a summary of our sources and uses of cash
flows for the periods presented (dollars in thousands):
                                       49

--------------------------------------------------------------------------------

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


                                                  Year Ended                               One Year Change                   Year Ended                  One Year Change                         Two Year Change
                                     December 31,           December 31,                                                    December 31,
                                         2020                   2019                      $                   %                 2018                     $                  %                   $                   %
Cash, cash equivalents and
restricted cash at beginning
of period                           $    385,766          $      316,129          $        69,637             22  %       $     309,303          $        6,826              2  %       $        76,463             25  %
Net cash provided from (used
in):
Operating activities                   1,364,756               1,535,968                 (171,212)           -11  %           1,583,944                 (47,976)            -3  %              (219,188)           -14  %
Investing activities                   2,347,928              (2,048,791)               4,396,719               n/a          (2,386,471)                337,680            -14  %             4,734,399               n/a
Financing activities                  (2,080,858)                577,150               (2,658,008)              n/a             818,368                (241,218)           -29  %            (2,899,226)              n/a
Effect of foreign currency
translation                                3,451                   5,310                   (1,859)           -35  %              (9,015)                 14,325               n/a                12,466               n/a
Cash, cash equivalents and
restricted cash at end of
period                              $  2,021,043          $      385,766          $     1,635,277            424  %       $     316,129          $       69,637             22  %       $     1,704,914            539  %


Operating Activities The changes in net cash provided from operating activities
are primarily attributable to declines in revenue and increases in property
operating expenses, as well as the impact of short-term deferrals granted as a
result of the COVID-19 pandemic in 2020. Please see "Results of Operations" for
discussion of net income fluctuations. For the years ended December 31, 2020,
2019 and 2018, cash flows from operations exceeded cash distributions to
stockholders.
Investing Activities  The changes in net cash used in investing activities are
primarily attributable to net changes in real property investments and
dispositions, loans receivable and investments in unconsolidated entities which
are summarized above in "Key Transactions." Please refer to Notes 3 and 5 of our
consolidated financial statements for additional information. The following is a
summary of cash used in non-acquisition capital improvement activities for the
periods presented (dollars in thousands):
                                                   Year Ended                              One Year Change                   Year Ended                  One Year Change                       Two Year Change
                                       December 31,           December 31,                                                  December 31,
                                           2020                   2019                     $                   %                2018                     $                  %                  $                  %
New development                      $     201,336          $     323,488          $      (122,152)          -38  %       $     160,706          $      162,782           101  %       $       40,630            25  %
Recurring capital
expenditures, tenant
improvements and lease
commissions                                 83,146                136,535                  (53,389)          -39  %              90,190                  46,345            51  %               (7,044)           -8  %
Renovations, redevelopments
and other capital improvements             161,843                192,289                  (30,446)          -16  %             175,993                  16,296             9  %              (14,150)           -8  %
Total                                $     446,325          $     652,312          $      (205,987)          -32  %       $     426,889          $      225,423            53  %       $       19,436             5  %


The change in new development is primarily due to the number and size of
construction projects on-going during the relevant periods. Renovations,
redevelopments and other capital improvements include expenditures to maximize
property value, increase net operating income, maintain a market-competitive
position and/or achieve property stabilization.
Financing Activities The changes in net cash provided from/used in financing
activities are primarily attributable to changes related to our long-term debt
arrangements, the issuances of common stock and dividend payments which are
summarized above in "Key Transactions." Please refer to Notes 10, 11 and 14 of
our consolidated financial statements for additional information.
On April 1, 2020, in response to uncertain financial market conditions arising
from the COVID-19 pandemic, we undertook steps to strengthen our balance sheet
and to enhance our liquidity by entering into a $1.0 billion two-year unsecured
term loan. Additionally, on June 30, 2020, we completed the issuance of
$600,000,000 senior unsecured notes with a maturity date of January 2031. Net
proceeds were used to fund tender offers for $426,248,000 of our 3.75% senior
unsecured notes due 2023 and our 3.95% senior unsecured notes due 2023, which
settled on July 1, 2020. The remaining proceeds were used to reduce borrowings
under the term loan by $140,000,000. As of December 31, 2020, we have total
near-term available liquidity of approximately $4.5 billion. However, we are
unable to accurately predict the full impact that the pandemic will have on our
results from operations, financial condition, liquidity and cash flows due to
numerous factors discussed in Part I Item 1A. Risk Factors.
Off-Balance Sheet Arrangements
At December 31, 2020, we had investments in unconsolidated entities with our
ownership generally ranging from 10% to 65%. We use financial derivative
instruments to hedge interest rate and foreign currency exchange rate exposure.
At December 31, 2020, we had nine outstanding letter of credit obligations.
Please see Notes 8, 12 and 13 to our consolidated financial statements for
additional information.


                                       50
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Contractual Obligations
The following table summarizes our payment requirements under contractual
obligations as of December 31, 2020 (in thousands):
                                                                                         Payments Due by Period
Contractual Obligations                                Total                 2021              2022-2023            2024-2025            Thereafter

Senior unsecured notes and term credit
facilities:(1)
U.S. Dollar senior unsecured notes                $  8,273,752          $   

- $ 673,752 $ 2,600,000 $ 5,000,000


   Canadian Dollar senior unsecured
notes(2)                                               235,239                    -                    -                    -               235,239
   Pounds Sterling senior unsecured
notes(2)                                             1,434,510                    -                    -                    -             1,434,510
U.S. Dollar term credit facility                     1,370,000                    -            1,370,000                    -                     -
   Canadian Dollar term credit facility(2)             196,032                    -              196,032                    -                     -
Secured debt:(1,2)
Consolidated                                         2,378,073              451,038              833,433              397,785               695,817
   Unconsolidated                                    1,064,949               54,073              206,924              557,508               246,444

Contractual interest obligations:(3)



   Senior unsecured notes and term loans(2)          3,872,398              423,475              816,492              651,101             1,981,330
   Consolidated secured debt(2)                        309,885               72,990              101,412               58,755                76,728
   Unconsolidated secured debt(2)                      200,426               35,099               65,011               42,031                58,285
Financing lease liabilities(4)                         197,427                8,777               78,026                2,950               107,674
Operating lease obligations(4)                       1,002,538               20,316               38,133               33,955               910,134
Purchase obligations(5)                                784,797              399,771              309,660               65,920                 9,446

Total contractual obligations                     $ 21,320,026          $ 

1,465,539 $ 4,688,875 $ 4,410,005 $ 10,755,607




(1) Amounts represent principal amounts due and do not reflect unamortized
premiums/discounts or other fair value adjustments as reflected on the
Consolidated Balance Sheets.
(2) Based on foreign currency exchange rates in effect as of balance sheet date.
(3) Based on variable interest rates in effect as of December 31, 2020.
(4) See Note 6 to our consolidated financial statements for additional
information.
(5) See Note 13 to our consolidated financial statements for additional
information.
Capital Structure
Please refer to "Credit Strength" above for a discussion of our leverage and
coverage ratio trends. Our debt agreements contain various covenants,
restrictions and events of default. Certain agreements require us to maintain
financial ratios and minimum net worth and impose certain limits on our ability
to incur indebtedness, create liens and make investments or acquisitions. As of
December 31, 2020, we were in compliance with all of the covenants under our
debt agreements. None of our debt agreements contain provisions for acceleration
which could be triggered by our debt ratings. However, under our primary
unsecured credit facility, the ratings on our senior unsecured notes are used to
determine the fees and interest charged. We plan to manage the company to
maintain compliance with our debt covenants and with a capital structure
consistent with our current profile. Any downgrades in terms of ratings or
outlook by any or all of the rating agencies could have a material adverse
impact on our cost and availability of capital, which could have a material
adverse impact on our consolidated results of operations, liquidity and/or
financial condition.
On May 17, 2018, we filed with the Securities and Exchange Commission (1) an
open-ended automatic or "universal" shelf registration statement covering an
indeterminate amount of future offerings of debt securities, common stock,
preferred stock, depositary shares, warrants and units and (2) a registration
statement in connection with our enhanced dividend reinvestment plan ("DRIP")
under which we may issue up to 15,000,000 shares of common stock. As of January
29, 2021, 2,541,750 shares of common stock remained available for issuance under
the DRIP registration statement. On February 25, 2019, we entered into separate
amended and restated equity distribution agreements with each of Barclays
Capital Inc., Citigroup Global Markets Inc., Credit Agricole Securities (USA)
Inc., Deutsche Bank Securities Inc., Goldman Sachs & Co. LLC, J.P. Morgan
Securities LLC, KeyBanc Capital Markets Inc., Merrill Lynch, Pierce, Fenner &
Smith Incorporated, Morgan Stanley & Co. LLC, MUFG Securities Americas Inc., RBC
Capital Markets, LLC, UBS Securities LLC and Wells Fargo Securities, LLC
relating to the offer and sale from time to time of up to $1,500,000,000
aggregate amount of our common stock ("Equity Shelf Program"). The Equity Shelf
Program also allows us to enter into forward sale agreements. As of January 29,
2021, we had $499,341,000 of remaining capacity under the Equity Shelf Program
and there were no outstanding forward sales agreements. Depending upon market
conditions, we anticipate issuing securities under our registration statements
to invest in additional properties and to repay borrowings under our unsecured
revolving credit facility and commercial paper program.
On May 1, 2020, our Board of Directors authorized a share repurchase program
whereby we may repurchase up to $1 billion of common stock through December 31,
2021 (the "Repurchase Program"). Under this authorization, we are not required
to purchase shares but may choose to do so in the open market or through private
transactions at times and amounts based on our
                                       51
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
evaluation of market conditions and other factors. We expect to finance any
share repurchases under the Repurchase Program using available cash and may use
proceeds from borrowings or debt offerings.
Results of Operations
Summary
Our primary sources of revenue include resident fees and services, rent and
interest income. Our primary expenses include property operating expenses,
depreciation and amortization, interest expense, general and administrative
expenses, and other expenses. We evaluate our business and make resource
allocations on our three business segments: Seniors Housing Operating,
Triple-net and Outpatient Medical. The primary performance measures for our
properties are NOI and same store NOI ("SSNOI") and other supplemental measures
include FFO and Adjusted EBITDA, which are further discussed below. Please see
"Non-GAAP Financial Measures" for additional information and reconciliations
related to these supplemental measures.
This section of this Form 10-K generally discusses 2020 and 2019 items and
year-to-year comparisons between 2020 and 2019. Discussions of 2018 items and
year-to-year comparisons between 2019 and 2018 that are not included in this
Form 10-K can be found in "Management's Discussion and Analysis of Financial
Condition and Results of Operations" in Part II, Item 7 of the Company's Annual
Report on Form 10-K for the fiscal year ended December 31, 2019.
The following is a summary of our results of operations for the periods
presented (dollars in thousands, except per share amounts):
                                                  Year Ended                              One Year Change                   Year Ended                  One Year Change                       Two Year Change
                                      December 31,          December 31,                                                   December 31,
                                          2020                  2019                   Amount                %                 2018                  Amount                %               Amount                %
Net income                           $  1,038,852          $  1,330,410          $      (291,558)           -22  %       $     829,750          $      500,660            60  %       $      209,102             25  %
NICS                                      978,844             1,232,432                 (253,588)           -21  %             758,250                 474,182            63  %              220,594             29  %
FFO                                     1,102,562             1,577,080                 (474,518)           -30  %           1,392,183                 184,897            13  %             (289,621)           -21  %
Adjusted EBITDA                         2,048,412             2,328,202                 (279,790)           -12  %           2,153,005                 175,197             8  %             (104,593)            -5  %
Consolidated NOI                        2,008,144             2,431,264                 (423,120)           -17  %           2,267,482                 163,782             7  %             (259,338)           -11  %

Per share data (fully
diluted):
Net income attributable to
common
stockholders (1)                     $       2.33          $       3.05          $         (0.72)           -24  %       $        2.02          $         1.03            51  %       $         0.31             15  %
Funds from operations
attributable to
common stockholders                  $       2.64          $       3.91          $         (1.27)           -32  %       $        3.71          $         0.20             5  %       $        (1.07)           -29  %

Adjusted interest coverage
ratio                                          3.97x                 4.14x                   -0.17x          -4  %                  4.11x                   0.03x          1  %                  -0.14x          -3  %
Adjusted fixed charge coverage
ratio                                          3.54x                 3.78x                   -0.24x          -6  %                  3.44x                   0.34x         10  %                   0.10x           3  %

(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.

The following table represents the changes in outstanding common stock for the period from January 1, 2018 to December 31, 2020 (in thousands):


                                                                                Year Ended
                                             December 31, 2020              December 31, 2019              December 31, 2018                  Totals
Beginning balance                                  410,257                        383,675                        371,732                          371,732

Dividend reinvestment plan
issuances                                              264                          5,799                          6,529                           12,592

Preferred stock conversions                              -                         12,712                              -                           12,712

Option exercises                                         -                             11                             57                               68
Equity Shelf Program issuances                       6,800                          7,856                          5,241                           19,897
Repurchase of common stock                            (202)                             -                              -                             (202)
Other, net                                             282                            204                            116                              602
Ending balance                                     417,401                        410,257                        383,675                          417,401

Average number of shares outstanding:
Basic                                              415,451                        401,845                        373,620
Diluted                                            417,387                        403,808                        375,250


During the past three years, inflation has not significantly affected our
earnings because of the moderate inflation rate. Additionally, a portion of our
earnings are derived primarily from long-term investments with predictable rates
of return. These investments are mainly financed with a combination of equity,
senior unsecured notes, secured debt and borrowings under our primary unsecured
credit facility. During inflationary periods, which generally are accompanied by
rising interest rates, our ability to grow may be adversely affected because the
yield on new investments may increase at a slower rate than new borrowing costs.
Presuming the current inflation rate remains moderate and long-term interest
rates do not increase significantly, we believe that inflation will not impact
the availability of equity and debt financing for us.


                                       52
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Seniors Housing Operating
The following is a summary of our SSNOI at Welltower's Share for the Seniors
Housing Operating segment (dollars in thousands):
                                                              QTD Pool                                                                   YTD Pool
                                       Three Months Ended                          Change                             Year Ended                              Change
                                December 31,        December 31,                                           December 31,        December 31,
                                    2020                2019                 $                 %               2020                2019                  $                 %
SSNOI(1)                        $  154,373          $  216,166          $ (61,793)          -28.6  %       $  591,133          $  764,328          $ (173,195)          -22.7  %


(1) Relates to 514 properties for the QTD Pool and 399 properties for the YTD
Pool. Please see "Non-GAAP Financial Measures for additional information and
reconciliations.
The following is a summary of our results of operations for the Seniors Housing
Operating segment for the years presented (dollars in thousands):
                                                                                      Year Ended                               One Year Change                   Year Ended                  One Year Change                        Two Year Change
                                                                          December 31,          December 31,                                                    December 31,
                                                                              2020                  2019                     $                    %                 2018                     $                  %                  $                    %
Revenues:
                            Resident fees and services                   $  3,074,022          $  3,448,175          $      (374,153)             -11  %       $  3,234,852          $      213,323             7  %       $      (160,830)             -5  %
                            Interest income                                       618                    36                      582                 n/a                578                    (542)          -94  %                    40               7  %
                            Other income                                        7,223                 8,658                   (1,435)             -17  %              5,024                   3,634            72  %                 2,199              44  %
                            Total revenues                                  3,081,863             3,456,869                 (375,006)             -11  %          3,240,454                 216,415             7  %              (158,591)             -5  %
Property operating expenses                                                 2,326,311             2,417,349                  (91,038)              -4  %          2,255,432                 161,917             7  %                70,879               3  %
                            NOI(1)                                            755,552             1,039,520                 (283,968)             -27  %            985,022                  54,498             6  %              (229,470)            -23  %

Other expenses:


                            Depreciation and amortization                     544,462               553,189                   (8,727)              -2  %            529,449                  23,740             4  %                15,013               3  %
                            Interest expense                                   54,901                67,983                  (13,082)             -19  %             69,060                  (1,077)           -2  %               (14,159)            -21  %
                            Loss (gain) on extinguishment of debt,
                            net                                                12,659                 1,614                   11,045              684  %                110                   1,504              n/a                12,549                n/a
                            Provision for loan losses                             671                     -                      671                 n/a                  -                       -              n/a                   671                n/a
                            Impairment of assets                              100,741                 2,145                   98,596                 n/a              7,599                  (5,454)          -72  %                93,142           1,226  %
                            Other expenses                                     14,265                26,348                  (12,083)             -46  %              6,624                  19,724           298  %                 7,641             115  %
                                                                              727,699               651,279                   76,420               12  %            612,842                  38,437             6  %               114,857              19  %

Income (loss) from continuing operations before income taxes and other items

                                                                    27,853               388,241                 (360,388)             -93  %            372,180                  16,061             4  %              (344,327)            -93  %
Income (loss) from unconsolidated entities                                    (33,857)               12,388                  (46,245)            -373  %            (28,142)                 40,530           144  %                (5,715)            -20  %
Gain (loss) on real estate dispositions, net                                  328,249               528,747                 (200,498)             -38  %             (2,245)                530,992              n/a               330,494                n/a
Income from continuing operations                                             322,245               929,376                 (607,131)             -65  %            341,793                 587,583           172  %               (19,548)             -6  %
Net income (loss)                                                             322,245               929,376                 (607,131)             -65  %            341,793                 587,583           172  %               (19,548)             -6  %
Less: Net income (loss) attributable to noncontrolling interests               20,301                56,513                  (36,212)             -64  %               (660)                 57,173              n/a                20,961                n/a
Net income (loss) attributable to common stockholders                    $    301,944          $    872,863          $      (570,919)             -65  %       $    342,453          $      530,410           155  %       $       (40,509)            -12  %


 (1) See Non-GAAP Financial Measures below.
Decreases in resident fees and services and property operating expenses are
primarily a result of property dispositions and decreases in occupancy across
the portfolio due to the COVID-19 pandemic. Occupancy within our Seniors Housing
Operating portfolio has declined as follows:
                                 Feb.              Mar.              Apr.               May              Jun.              Jul.              Aug.              Sep.              Oct.              Nov.              Dec.
Spot occupancy (1)                85.6  %           84.9  %           82.6  %           80.9  %           79.9  %           79.3  %           78.7  %           78.4  %           78.0  %           77.3  %           76.2  %
Sequential occupancy
change                                              (0.7) %           (2.3) %           (1.7) %           (1.0) %           (0.6) %           (0.6) %           (0.3) %           (0.4) %           (0.7) %           (1.1) %


(1) Spot occupancy represents approximate month end occupancy for properties in
operation as of February 29, 2020, including unconsolidated properties but
excluding acquisitions, dispositions and development conversions since this
date.
In addition, we have experienced increased operational costs, net of
reimbursements, of $78,792,000 during the year ended December 31, 2020, included
in property operating expenses relating to our consolidated properties. These
expenses were incurred as a result of the introduction of public health measures
and other regulations affecting our properties, as well as additional health and
safety measures adopted by us and our operators related to the COVID-19
pandemic, including increases in labor and property cleaning expenses and
expenditures related to our efforts to procure PPE and supplies, net of
reimbursements. We expect total portfolio expenses to be elevated during the
pandemic and potentially beyond as these additional health and safety measures
become standard practice.
                                       53
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
In 2020 applications were made for amounts under Phase 2 and Phase 3 of the
Provider Relief Fund following the announcement from the Department of Health
and Human Services that it expanded the eligibility of the CARES Act Provider
Relief Fund to include assisted living facilities. During the fourth quarter, we
received Provider Relief Funds of approximately $9 million which was recognized
as a reduction to property operating expenses. To date in 2021, we have received
approximately $34 million of Provider Relief Funds.
During the year ended December 31, 2020, we recorded impairment charges of
$100,741,000 related to 15 held for sale or sold properties and six held for use
properties. During the year ended December 31, 2019, we recorded impairment
charges of $2,145,000 related to four held for use properties. Transaction costs
related to asset acquisitions are capitalized as a component of the purchase
price. Changes in the gain on sale of properties are due to the volume of
property sales and sales prices. During the year ended December 31, 2020, we
recognized a gain on real estate disposition of $313 million related to an 11
property U.S. portfolio. During the year ended December 31, 2019, we recognized
a gain on real estate disposition of $520 million related to the Benchmark
Senior Living portfolio. The fluctuation in other expenses is primarily due to
the timing of noncapitalizable transaction costs associated with acquisitions
and operator transitions.
Depreciation and amortization fluctuates as a result of acquisitions,
disposition and transitions. To the extent we acquire or dispose of additional
properties in the future, our provision for depreciation and amortization will
change accordingly.
During the year ended December 31, 2020, we completed three Seniors Housing
Operating construction projects representing $93,188,000 or $300,606 per
unit. The following is a summary of our consolidated Seniors Housing Operating
construction projects, excluding expansions, pending as of December 31, 2020
(dollars in thousands):
Location                Units/Beds         Commitment       Balance       Est. Completion
Potomac, MD                 120           $   56,720      $  48,783            2Q21
Beckenham, UK               100               64,348         45,722            3Q21
Barnet, UK                  100               70,769         41,215            4Q21
Hendon, UK                  102               75,824         50,817            1Q22
Princeton, NJ                80               29,780         19,209            3Q22
Berea, OH                   120               14,934          1,538            4Q22
Painesville, OH             119               14,462          1,508            4Q22
Beaver, PA                  116               14,184          1,152            4Q22
                            857           $  341,021        209,944
Toronto, ON          Project in planning stage               46,856
Brookline, MA        Project in planning stage               23,679
Washington, DC       Project in planning stage               22,951
Columbus, OH         Project in planning stage               11,492
Raleigh, NC          Project in planning stage                3,107
                                                          $ 318,029


Interest expense represents secured debt interest expense which fluctuates based
on the net effect and timing of assumptions, segment transitions, fluctuations
in foreign currency rates, extinguishments and principal amortizations. The
fluctuations in loss (gain) on extinguishment of debt is primarily attributable
to the volume of extinguishments and terms of the related secured debt. The
following is a summary of our Seniors Housing Operating segment property secured
debt principal activity (dollars in thousands):
                                                  Year Ended                                      Year Ended                                      Year Ended
                                               December 31, 2020                               December 31, 2019                               December 31, 2018
                                                            Weighted Avg.                                   Weighted Avg.                                   Weighted Avg.
                                       Amount               Interest Rate              Amount               Interest Rate              Amount               Interest Rate
Beginning balance                  $  2,115,037                 3.54%              $  1,810,587                 3.87%              $  1,988,700                 3.66%
Debt transferred in                           -                  -%                           -                  -%                      35,830                 3.84%
Debt issued                              62,055                 2.55%                   343,696                 3.11%                    45,447                 3.40%
Debt assumed                                  -                  -%                     183,061                 4.58%                   121,612                 5.55%
Debt extinguished                      (441,208)                2.18%                  (219,864)                4.28%                  (240,095)                4.83%
Debt transferred out                          -                  -%                     (12,072)                3.89%                         -                  -%

Principal payments                      (48,498)                3.30%                   (43,997)                3.45%                   (47,886)                3.59%
Foreign currency                         18,803                 2.93%                    53,626                 3.33%                   (93,021)                3.31%
Ending balance                     $  1,706,189                 3.05%              $  2,115,037                 3.54%              $  1,810,587                 3.87%

Monthly averages                   $  1,875,910                 3.19%              $  1,966,892                 3.70%              $  1,915,663                 3.74%


                                       54

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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
The majority of our Seniors Housing Operating properties are formed through
partnership interests. Losses from unconsolidated entities during the year ended
December 31, 2020 are largely attributable to depreciation and amortization of
short-lived intangible assets related to certain investments in unconsolidated
joint ventures. The gains from unconsolidated entities during the year ended
December 31, 2019 are largely due to a gain on the disposition of an
unconsolidated entity. Net income attributable to noncontrolling interests
represents our partners' share of net income (loss) related to joint ventures.
The increase during the years ended December 31, 2020 and 2019 relates primarily
to our partner's share of the gains recognized on the sale of the 11 property
U.S. portfolio and the Benchmark Senior Living portfolio, respectively.
Triple-net
The following is a summary of our SSNOI at Welltower's Share for the Triple-net
segment (dollars in thousands):
                                                             QTD Pool                                                                 YTD Pool
                                       Three Months Ended                         Change                             Year Ended                            Change
                                December 31,        December 31,                                          December 31,        December 31,
                                    2020                2019                 $                %               2020                2019                $               %
SSNOI(1)                        $  168,697          $  170,052          $ (1,355)           -0.8  %       $  628,972          $  624,877          $ 4,095            0.7  %


(1) Relates to 632 properties for the QTD Pool and 608 properties for the YTD
Pool. Please see Non-GAAP Financial Measures for additional information and
reconciliations.
The following is a summary of our results of operations for the Triple-net
segment for the years presented (dollars in thousands):
                                                                          Year Ended                               One Year Change                   Year Ended                    One Year Change                          Two Year Change
                                                              December 31,           December 31,                                                   December 31,
                                                                  2020                   2019                     $                   %                 2018                     $                    %                    $                    %
Revenues:
                Rental income                               $     733,776          $     903,798          $      (170,022)           -19  %       $     828,865          $       74,933                 9  %       $       (95,089)            -11  %
                Interest income                                    62,625                 62,599                       26              -  %              54,926                   7,673                14  %                 7,699              14  %
                Other income                                        4,903                  6,246                   (1,343)           -22  %              17,173                 (10,927)              -64  %               (12,270)            -71  %
                Total revenues                                    801,304                972,643                 (171,339)           -18  %             900,964                  71,679                 8  %               (99,660)            -11  %
                Property operating expenses                        53,183                 53,900                     (717)            -1  %                 915                  52,985             5,791                   52,268           5,712
                NOI(1)                                            748,121                918,743                 (170,622)           -19  %             900,049                  18,694                 2  %              (151,928)            -17  %

Other expenses:


                Depreciation and amortization                     232,604                232,626                      (22)             -  %             235,480                  (2,854)               -1  %                (2,876)             -1  %
                Interest expense                                    9,477                 12,892                   (3,415)           -26  %              14,225                  (1,333)               -9  %                (4,748)            -33  %
                Loss (gain) on derivatives and
                financial instruments, net                         11,049                 (4,399)                  15,448            351  %              (4,016)                   (383)              -10  %                15,065             375  %
                Loss (gain) on extinguishment of
                debt, net                                               -                      -                        -               n/a                 (32)                     32               100  %                    32             100  %
                Provision for loan losses                          90,563                 18,690                   71,873            385                      -                  18,690                  n/a                90,563                n/a
                Impairment of assets                               34,867                 11,926                   22,941            192  %             107,980                 (96,054)              -89  %               (73,113)            -68  %
                Other expenses                                     22,923                 13,771                    9,152             66  %              90,975                 (77,204)              -85  %               (68,052)            -75  %
                                                                  401,483                285,506                  115,977             41  %             444,612                (159,106)              -36  %               (43,129)            -10  %

Income from continuing operations before income taxes and other items

                                                   346,638                633,237                 (286,599)           -45  %             455,437                 177,800                39  %              (108,799)            -24  %
Income (loss) from unconsolidated entities                         18,462                 22,985                   (4,523)           -20  %              21,938                   1,047                 5  %                (3,476)            -16  %
Gain (loss) on real estate dispositions, net                       64,288                218,322                 (154,034)           -71  %             196,589                  21,733                11  %              (132,301)            -67  %
Income from continuing operations                                 429,388                874,544                 (445,156)           -51  %             673,964                 200,580                30  %              (244,576)            -36  %
Net income                                                        429,388                874,544                 (445,156)           -51  %             673,964                 200,580                30  %              (244,576)            -36  %
Less: Net income attributable to noncontrolling
interests                                                          39,985                 36,271                    3,714             10  %              19,306                  16,965                88  %                20,679             107  %
Net income attributable to common stockholders              $     389,403          $     838,273          $      (448,870)           -54  %       $     654,658          $      183,615                28  %       $      (265,255)            -41  %

(1) See Non-GAAP Financial Measures below.



The decrease in rental income is primarily attributable to the write-off of
straight-line rent receivable balances of $146,508,000 during the year ended
December 31, 2020, relating to leases for which collection of substantially all
contractual lease payments was no longer deemed probable. Included in such
amounts was $91,025,000 relating to Genesis Healthcare whom noted substantial
doubt as to their ability to continue as a going concern in August. Certain of
our leases contain annual rental escalators that are contingent upon changes in
the Consumer Price Index and/or changes in the gross operating revenues of the
tenant's properties. These escalators are not fixed, so no straight-line rent is
recorded; however, rental income is recorded based on the contractual cash
rental payments due for the period. If gross operating revenues at our
facilities and/or the Consumer Price Index do not increase, a portion of our
revenues may not continue to increase. For the three months ended
                                       55
--------------------------------------------------------------------------------
Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
December 31, 2020, we had 18 leases with rental rate increasers ranging from
0.07% to 0.34% in our Triple-net portfolio. Our Triple-net operators are
experiencing similar impacts on occupancy and operating costs due to the
COVID-19 pandemic as described above with respect to our Seniors Housing
Operating properties. However, long-term/post-acute facilities are generally
experiencing a higher degree of occupancy declines which may impact the ability
of our Triple-net operators to make contractual rent payments to us in the
future. Many of our Triple-net operators received funds under the CARES Act
Paycheck Protection Program. In addition, operators of long-term/post-acute
facilities have generally received funds from Phase 1 of the Provider Relief
Fund and operators of assisted living facilities have or are expected to receive
funds from Phase 2 of the Provider Relief Fund. Accordingly, collection of rent
due during the COVID-19 pandemic to date (March through December) has generally
been consistent with historical collection rates and no significant rent
concessions or deferrals have been made.
Depreciation and amortization fluctuates as a result of acquisitions,
disposition and transitions of triple-net properties. To the extent we acquire
or dispose of additional properties in the future, our provision for
depreciation and amortization will change accordingly.
During the year ended December 31, 2020, we recognized a provision for loan
losses of $90,563,000, of which $80,873,000 represents additional reserves as a
result of the current collateral estimate related to the Genesis Healthcare
outstanding loans. During the year ended December 31, 2019, we recognized a
provision for loan losses of $18,690,000 to fully reserve for certain real
estate loans receivable that were no longer deemed collectible. During the year
ended December 31, 2020, we recorded impairment charges of $34,867,000 related
to one held for sale and four held for use properties. During the year ended
December 31, 2019, we recorded impairment charges of $11,374,000 related to two
properties. Changes in the gain on sales of properties are related to the volume
and timing of property sales and the sales prices. The fluctuation in other
expense is primarily due to noncapitalizable transaction costs from acquisitions
and segment transitions.
During the year ended December 31, 2020, we completed three Triple-net
construction projects representing $75,149,000 or $224,997 per unit. The
following is a summary of our consolidated Triple-net construction projects,
excluding expansions, pending as of December 31, 2020 (dollars in thousands):
Location                  Units/Beds       Commitment      Balance       Est. Completion
Thousand Oaks, CA             82          $   25,391      $ 21,408            1Q21
Redhill, UK                   76              21,723        11,869            2Q21
Leicester, UK                 60              15,301         5,566            1Q22
Wombourne, UK                 66              16,394         5,537            2Q22
Raleigh, NC                  191             154,256        14,339            2Q23
Total                        475          $  233,065      $ 58,719


Loss (gain) on derivatives and financial instruments, net is primarily
attributable to the mark-to-market adjustments recorded on our Genesis
Healthcare available-for-sale investment. Interest expense represents secured
debt interest expense and related fees. The change in secured debt interest
expense is due to the net effect and timing of assumptions, segment transitions,
fluctuations in foreign currency rates, extinguishments and principal
amortizations. The following is a summary of our Triple-net secured debt
principal activity for the periods presented (dollars in thousands):
                                                  Year Ended                                      Year Ended                                      Year Ended
                                               December 31, 2020                               December 31, 2019                               December 31, 2018
                                                            Weighted Avg.                                   Weighted Avg.                                   Weighted Avg.
                                       Amount               Interest Rate              Amount               Interest Rate              Amount               Interest Rate
Beginning balance                  $    306,038                 3.60%              $    288,386                 3.63%              $    347,474                 3.55%
Debt transferred in                           -                  -%                      12,072                 3.89%                         -                  -%

Debt extinguished                      (176,875)                2.03%                         -                  -%                      (4,107)                4.94%
Debt transferred out                          -                  -%                           -                  -%                     (35,830)                3.84%

Principal payments                       (4,376)                5.16%                    (4,017)                5.21%                    (3,982)                5.38%
Foreign currency                         (1,135)                2.97%                     9,597                 2.99%                   (15,169)                3.44%
Ending balance                     $    123,652                 4.91%              $    306,038                 3.60%              $    288,386                 3.63%

Monthly averages                   $    215,796                 3.85%              $    294,080                 3.63%              $    321,730                 3.51%


A portion of our Triple-net properties were formed through partnerships. Income
or loss from unconsolidated entities represents our share of net income or
losses from partnerships where we are the noncontrolling partner. The decrease
in income from unconsolidated entities during the year ended December 31, 2020
is primarily related to the write-off of Genesis Healthcare straight-line rent
receivable balances at unconsolidated entities. Net income attributable to
noncontrolling interests represents our partners' share of net income relating
to those partnerships where we are the controlling partner.

                                       56
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Outpatient Medical
The following is a summary of our SSNOI at Welltower Share for the Outpatient
Medical segment (dollars in thousands):
                                                            QTD Pool                                                               YTD Pool
                                        Three Months Ended                       Change                           Year Ended                            Change
                                 December 31,        December 31,                                      December 31,        December 31,
                                     2020                2019               $              %               2020                2019                $               %
SSNOI(1)                        $    84,985          $   84,144          $ 841            1.0  %       $  252,512          $  246,789          $ 5,723            2.3  %



(1) Relates to 303 properties for the QTD Pool and 231 properties for the YTD
Pool. Please see Non-GAAP Financial Measures for additional information and
reconciliations.
The following is a summary of our results of operations for the Outpatient
Medical segment for the periods presented (dollars in thousands):
                                                                             Year Ended                               One Year Change                   Year Ended                   One Year Change                          Two Year Change
                                                                 December 31,           December 31,                                                   December 31,
                                                                     2020                   2019                     $                   %                 2018                     $                    %                   $                   %
Revenues:
                    Rental income                              $     709,584          $     684,602          $       24,982               4  %       $     551,557          $       133,045              24  %       $      158,027              29  %
                    Interest income                                    5,913                  1,195                   4,718             395  %                 310                      885             285  %                5,603                n/a
                    Other income                                       4,522                  2,031                   2,491             123  %               4,939                   (2,908)            -59  %                 (417)             -8  %
                    Total revenues                                   720,019                687,828                  32,191               5  %             556,806                  131,022              24  %              163,213              29  %
Property operating expenses                                          214,948                218,793                  (3,845)             -2  %             176,670                   42,123              24  %               38,278              22  %
                    NOI(1)                                           505,071                469,035                  36,036               8  %             380,136                   88,899              23  %              124,935              33  %

Other expenses:


                    Depreciation and amortization                    261,371                241,258                  20,113               8  %             185,530                   55,728              30  %               75,841              41  %
                    Interest expense                                  17,579                 13,411                   4,168              31  %               7,051                    6,360              90  %               10,528             149  %
                    Loss (gain) on extinguishment of
                    debt, net                                          1,046                      -                   1,046                n/a              11,928                  (11,928)           -100  %              (10,882)            -91  %
                    Provision for loan losses.                         3,202                      -                   3,202                n/a                   -                        -                n/a                3,202                n/a
                    Impairment of assets                                   -                 14,062                 (14,062)           -100  %                   -                   14,062                n/a                    -                n/a
                    Other expenses                                     8,218                  1,788                   6,430             360  %               7,570                   (5,782)            -76  %                  648               9  %
                                                                     291,416                270,519                  20,897               8  %             212,079                   58,440              28  %               79,337              37  %

Income from continuing operations before income taxes and other item

                                                       213,655                198,516                  15,139               8  %             168,057                   30,459              18  %               45,598              27  %
Income (loss) from unconsolidated entities                             7,312                  7,061                     251               4  %               5,563                    1,498              27  %                1,749              31  %
Gain (loss) on real estate dispositions, net                         695,918                    972                 694,946                n/a             221,231                 (220,259)           -100  %              474,687             215  %
Income from continuing operations                                    916,885                206,549                 710,336             344  %             394,851                 (188,302)            -48  %              522,034             132  %
Net income (loss)                                                    916,885                206,549                 710,336             344  %             394,851                 (188,302)            -48  %              522,034             132  %

Less: Net income (loss) attributable to noncontrolling interests

                                                               (278)                 5,194                  (5,472)           -105  %               6,150                     (956)            -16  %               (6,428)           -105  %
Net income (loss) attributable to common stockholders          $     917,163          $     201,355          $      715,808             355  %       $     388,701          $      (187,346)            -48  %       $      528,462             136  %


(1) See Non-GAAP Financial Measures below.
Increases in rental income are primarily attributable to the acquisitions of new
properties and the conversion of newly constructed outpatient medical
properties, particularly the $1.25 billion CNL Healthcare Properties portfolio
acquisition that closed in May 2019, partially offset by 2020 dispositions.
Certain of our leases contain annual rental escalators that are contingent upon
changes in the Consumer Price Index. These escalators are not fixed, so no
straight-line rent is recorded; however, rental income is recorded based on the
contractual cash rental payments due for the period. If the Consumer Price Index
does not increase, a portion of our revenues may not continue to increase. Our
leases could renew above or below current rental rates, resulting in an increase
or decrease in rental income. For the three months ended December 31, 2020, our
consolidated outpatient medical portfolio signed 133,859 square feet of new
leases and 282,719 square feet of renewals. The weighted-average term of these
leases was six years, with a rate of $26.55 per square foot and tenant
improvement and lease commission costs of $15.23 per square foot. Substantially
all of these leases contain an annual fixed or contingent escalation rent
structure ranging from 2.0% to 3.5%.
In addition, our Outpatient Medical tenants are experiencing temporary medical
practice closures or decreases in revenue due to government imposed restrictions
on elective medical procedures or decisions by patients to delay treatments
which may adversely affect their ability to make contractual rent payments.
Outpatient Medical rent collections through March were generally consistent with
pre COVID-19 levels. During the second quarter we executed short term rent
deferrals with certain Outpatient Medical tenants which in most cases were
required to be repaid by year end. Since then we have collected approximately
99% of Outpatient Medical rent due in the second half of the year, with
uncollected amounts primarily attributable to local jurisdictions with COVID-19
related ordinances providing temporary rent relief to tenants. Furthermore,
                                       57
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
collections of deferred rent due under executed deferrals was over 99%. To the
extent that deferred rent is not repaid as expected, or the prolonged impact of
the COVID-19 pandemic causes operators or tenants to seek further modifications
of their lease agreements, we may recognize reductions in revenue and increases
in uncollectible receivables.
The fluctuation in property operating expenses and depreciation and amortization
are primarily attributable to acquisitions and construction conversions of
outpatient medical facilities, offset by dispositions. To the extent that we
acquire or dispose of additional properties in the future, these amounts will
change accordingly. During the year ended December 31, 2019, we recognized
impairment charges of $14,062,000 related to three held for sale properties as
the carrying values exceeded the estimated fair values less costs to sell.
Changes in gains/losses on sales of properties are related to volume of property
sales and the sales prices. The increase in other expense during the year ended
December 31, 2020 is primarily due to noncapitalizable transaction costs from
acquisitions no longer expected to be consummated.
During the year ended December 31, 2020, we completed three Outpatient Medical
construction projects representing $43,493,000 or $306 per square foot. The
following is a summary of our consolidated Outpatient Medical construction
projects pending as of December 31, 2020 (dollars in thousands):
Location            Square Feet       Commitment       Balance       Est. Completion
Brooklyn, NY        140,955          $  105,306      $ 104,148            2Q21
Kalamazoo, MI        40,607              14,267          2,654            3Q21
Total               181,562          $  119,573      $ 106,802


Total interest expense represents secured debt interest expense. The change in
secured debt interest expense is primarily due to the net effect and timing of
assumptions, extinguishments and principal amortizations. The following is a
summary of our Outpatient Medical secured debt principal activity for the
periods presented (dollars in thousands):
                                                  Year Ended                                      Year Ended                                      Year Ended
                                               December 31, 2020                               December 31, 2019                               December 31, 2018
                                                            Weighted Avg.                                   Weighted Avg.                                   Weighted Avg.
                                       Amount               Interest Rate              Amount               Interest Rate              Amount               Interest Rate
Beginning balance                  $    572,267                 3.97%              $    386,738                 4.20%              $    279,951                 4.72%
Debt assumed                                  -                  -%                     202,084                 4.12%                   171,275                 3.99%
Debt extinguished                       (14,205)                5.34%                   (10,244)                5.75%                   (61,291)                7.43%
Principal payments                       (9,833)                4.60%                    (6,311)                4.97%                    (3,197)                5.91%
Ending balance                     $    548,229                 3.55%              $    572,267                 3.97%              $    386,738                 4.20%

Monthly averages                   $    562,017                 3.72%              $    397,756                 4.15%              $    238,214                 4.25%


A portion of our Outpatient Medical properties were formed through
partnerships. Income or loss from unconsolidated entities represents our share
of net income or losses from partnerships where we are the noncontrolling
partner. Net income attributable to noncontrolling interests represents our
partners' share of net income or loss relating to those partnerships where we
are the controlling partner.














                                       58

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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Non-Segment/Corporate
The following is a summary of our results of operations for the
Non-Segment/Corporate activities (dollars in thousands) for the periods
presented:
                                                                                Year Ended                               One Year Change                   Year Ended                   One Year Change                         Two Year Change
                                                                    December 31,           December 31,                                        
December 31,
                                                                        2020                   2019                     $                   %                 2018                     $                   %                   $                   %
Revenues:
                      Other income                                $       2,781          $       3,966          $       (1,185)            -30  %       $       2,275          $        1,691              74  %       $          506              22  %
                      Total revenues                                      2,781                  3,966                  (1,185)            -30  %               2,275                   1,691              74  %                  506              22  %
Property operating expenses                                               3,381                      -                   3,381                n/a                   -                       -                n/a                3,381                n/a
                      NOI(1)                                               (600)                 3,966                  (4,566)           -115  %               2,275                   1,691              74  %               (2,875)           -126  %
Other expenses:

                      Interest expense                                  432,431                461,273                 (28,842)             -6  %             436,256                  25,017               6  %               (3,825)             -1  %
                      General and administrative expenses               128,394                126,549                   1,845               1  %             126,383                     166               0  %                2,011               2  %

                      Loss (gain) on extinguishments of
                      debt, net                                          33,344                 82,541                 (49,197)            -60  %               4,091                  78,450           1,918  %               29,253             715  %
                      Other expenses                                     24,929                 10,705                  14,224             133  %               7,729                   2,976              39  %               17,200             223  %
                      Total expenses                                    619,098                681,068                 (61,970)             -9  %             574,459                 106,609              19  %               44,639               8  %

Loss from continuing operations before income taxes and other items

                                                            (619,698)              (677,102)                 57,404               8  %            (572,184)               (104,918)            -18  %              (47,514)             -8  %
Gain (loss) on real estate dispositions, net                                  -                      -                       -                n/a                   -                       -                n/a                    -                n/a
Income tax benefit (expense)                                             (9,968)                (2,957)                 (7,011)           -237  %              (8,674)                  5,717              66  %               (1,294)            -15  %
Loss from continuing operations                                        (629,666)              (680,059)                 50,393               7  %            (580,858)                (99,201)            -17  %              (48,808)             -8  %
Preferred stock dividends                                                     -                      -                       -                n/a              46,704                 (46,704)           -100  %              (46,704)           -100  %
Net loss attributable to common stockholders                      $    (629,666)         $    (680,059)         $       50,393               7  %       $    (627,562)         $      (52,497)             -8  %       $       (2,104)              0  %

(1) See Non-GAAP Financial Measures below.



Property operating expenses represent insurance costs related to our captive
insurance company formed as of July 1, 2020, which acts as a direct insurer of
property level insurance coverage for our portfolio.

The following is a summary of our Non-Segment/Corporate interest expense for the periods presented (dollars in thousands):


                                                Year Ended                              One Year Change                  Year Ended                   One Year Change                         Two Year Change
                                    December 31,           December 31,                                                 December 31,
                                        2020                   2019                     $                  %                2018                     $                   %                   $                   %
Senior unsecured notes            $     400,014          $     402,133          $       (2,119)           -1  %       $     387,955          $       14,178               4  %       $       12,059               3  %
Secured debt                                  -                      -                       -              n/a                 115                    (115)           -100  %                 (115)           -100  %
Unsecured credit facility
and commercial paper
program                                  15,313                 43,861                 (28,548)          -65  %              34,626                   9,235              27  %              (19,313)            -56  %
Loan expense                             17,104                 15,279                   1,825            12  %              13,560                   1,719              13  %                3,544              26  %
Totals                            $     432,431          $     461,273          $      (28,842)           -6  %       $     436,256          $       25,017               6  %       $       (3,825)             -1  %


The change in interest expense on senior unsecured notes is due to the net
effect of issuances and extinguishments, as well as the movement in foreign
exchange rates and related hedge activity. Please refer to Note 11 to
consolidated financial statements for additional information. The change in
interest expense on our unsecured credit facility and commercial paper program
is due primarily to the net effect and timing of draws, paydowns and variable
interest rate changes. Please refer to Note 10 of our consolidated financial
statements for additional information regarding our unsecured revolving credit
facility and commercial paper program. Loan expenses represent the amortization
of costs incurred in connection with senior unsecured notes issuances. The loss
on extinguishment recognized during the year ended December 31, 2020 is due
primarily to the early extinguishment of $160,872,000 of our 3.75% senior
unsecured notes due March 2023 and $265,376,000 of our 3.95% senior unsecured
notes due September 2023. The loss on extinguishment recognized in 2019 is due
primarily to the early extinguishment of the $600,000,000 of 4.125% senior
unsecured notes due 2019 and the $450,000,000 of 6.125% senior unsecured notes
due 2020 in March 2019, the early extinguishment of the $450,000,000 of 4.95%
senior unsecured notes due 2021 and the $600,000,000 of 5.25% senior unsecured
notes due 2022 in September 2019 and the early redemption of the $300 million
Canadian-denominated 3.35% senior unsecured notes due 2020 in December 2019.
General and administrative expenses as a percentage of consolidated revenues for
the years ended December 31, 2020, 2019 and 2018 were 2.79%, 2.47% and 2.69%,
respectively. Other expenses for all years include severance-related costs
associated with the departure of certain executive officers and key employees.
Income tax expense primarily relates to state taxes, foreign taxes and taxes
based on income generated by entities that are structured as TRSs.
                                       59
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Other
Non-GAAP Financial Measures
We believe that net income and net income attributable to common stockholders
("NICS"), as defined by U.S. GAAP, are the most appropriate earnings
measurements. However, we consider FFO, NOI, SSNOI, EBITDA and Adjusted EBITDA
to be useful supplemental measures of our operating performance. Historical cost
accounting for real estate assets in accordance with U.S. GAAP implicitly
assumes that the value of real estate assets diminishes predictably over time as
evidenced by the provision for depreciation. However, since real estate values
have historically risen or fallen with market conditions, many industry
investors and analysts have considered presentations of operating results for
real estate companies that use historical cost accounting to be insufficient. In
response, the National Association of Real Estate Investment Trusts ("NAREIT")
created funds from operations attributable to common stockholders ("FFO") as a
supplemental measure of operating performance for REITs that excludes historical
cost depreciation from net income. FFO, as defined by NAREIT, means NICS,
computed in accordance with U.S. GAAP, excluding gains (or losses) from sales of
real estate and impairment of depreciable assets, plus depreciation and
amortization, and after adjustments for unconsolidated entities and
noncontrolling interests.
Consolidated net operating income ("NOI") is used to evaluate the operating
performance of our properties. We define NOI as total revenues, including tenant
reimbursements, less property operating expenses. Property operating expenses
represent costs associated with managing, maintaining and servicing tenants for
our properties. These expenses include, but are not limited to, property-related
payroll and benefits, property management fees paid to operators, marketing,
housekeeping, food service, maintenance, utilities, property taxes and
insurance. General and administrative expenses represent costs unrelated to
property operations. These expenses include, but are not limited to, payroll and
benefits, professional services, office expenses and depreciation of corporate
fixed assets. Same store NOI ("SSNOI") is used to evaluate the operating
performance of our properties using a consistent population which controls for
changes in the composition of our portfolio. We believe the drivers of property
level NOI for both consolidated properties and unconsolidated properties are
generally the same and therefore, we evaluate SSNOI based on our ownership
interest in each property ("Welltower Share"). To arrive at Welltower's Share,
NOI is adjusted by adding our minority ownership share related to unconsolidated
properties and by subtracting the minority partners' noncontrolling ownership
interests for consolidated properties. We do not control investments in
unconsolidated properties and while we consider disclosures at Welltower Share
to be useful, they may not accurately depict the legal and economic implications
of our joint venture arrangements and should be used with caution. As used
herein, same store is generally defined as those revenue-generating properties
in the portfolio for the relevant year-over-year reporting periods. Acquisitions
and development conversions are included in SSNOI five full quarters or eight
full quarters after acquisition or being placed into service for the QTD Pool
and the YTD Pool, respectively. Land parcels, loans and sub-leases, as well as
any properties sold or classified as held for sale during the respective periods
are excluded from SSNOI. Redeveloped properties (including major refurbishments
of a Seniors Housing Operating property where 20% or more of units are
simultaneously taken out of commission for 30 days or more or Outpatient Medical
properties undergoing a change in intended use) are excluded from SSNOI until
five full quarters or eight full quarters post completion of the redevelopment
for the QTD Pool and YTD Pool, respectively. Properties undergoing operator
transitions and/or segment transitions are also excluded from SSNOI until five
full quarters or eight full quarters post completion of the transition for the
QTD Pool and YTD Pool, respectively. In addition, properties significantly
impacted by force majeure, acts of God, or other extraordinary adverse events
are excluded from SSNOI until five full quarters or eight full quarters after
the properties are placed back into service for the QTD Pool and YTD Pool,
respectively. SSNOI excludes non-cash NOI and includes adjustments to present
consistent ownership percentages and to translate Canadian properties and U.K.
properties using a consistent exchange rate. We believe NOI and SSNOI provide
investors relevant and useful information because they measure the operating
performance of our properties at the property level on an unleveraged basis. We
use NOI and SSNOI to make decisions about resource allocations and to assess the
property level performance of our properties.
EBITDA is defined as earnings (net income) before interest, taxes, depreciation
and amortization. Adjusted EBITDA is defined as EBITDA excluding unconsolidated
entities and including adjustments for stock-based compensation expense,
provision for loan losses, gains/losses on extinguishment of debt,
gains/loss/impairments on properties, gains/losses on derivatives and financial
instruments, other expense, additional other income and other impairment
charges. We believe that EBITDA and Adjusted EBITDA, along with net income, are
important supplemental measures because they provide additional information to
assess and evaluate the performance of our operations. We primarily use these
measures to determine our interest coverage ratio, which represents EBITDA and
Adjusted EBITDA divided by total interest, and our fixed charge coverage ratio,
which represents EBITDA and Adjusted EBITDA divided by fixed charges. Fixed
charges include total interest, secured debt principal amortization, and
preferred dividends. Covenants in our unsecured senior notes and primary credit
facility contain financial ratios based on a definition of EBITDA and Adjusted
EBITDA that is specific to those agreements. Our leverage ratios are defined as
the proportion of net debt to total capitalization and include book
capitalization, undepreciated book capitalization and market capitalization.
Book capitalization represents the sum of net debt (defined as total long-term
debt, excluding operating lease liabilities, less cash and cash equivalents and
any IRC Section 1031 deposits), total equity and redeemable noncontrolling
interests. Undepreciated book capitalization represents book capitalization
adjusted for accumulated
                                       60
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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
depreciation and amortization. Market capitalization represents book
capitalization adjusted for the fair market value of our common stock.
Our supplemental reporting measures and similarly entitled financial measures
are widely used by investors, equity and debt analysts and rating agencies in
the valuation, comparison, rating and investment recommendations of companies.
Management uses these financial measures to facilitate internal and external
comparisons to our historical operating results and in making operating
decisions. Additionally, these measures are utilized by the Board of Directors
to evaluate management. None of our supplemental measures represent net income
or cash flow provided from operating activities as determined in accordance with
U.S. GAAP and should not be considered as alternative measures of profitability
or liquidity. Finally, the supplemental measures, as defined by us, may not be
comparable to similarly entitled items reported by other real estate investment
trusts or other companies.
The table below reflects the reconciliation of FFO to NICS, the most directly
comparable U.S. GAAP measure, for the periods presented. Noncontrolling interest
and unconsolidated entity amounts represent adjustments to reflect our share of
depreciation and amortization, gains/losses on real estate dispositions and
impairments of assets. Amounts are in thousands except for per share data.
                                                                            Year Ended December 31,
FFO Reconciliation:                                              2020                 2019                 2018
Net income attributable to common stockholders              $   978,844          $ 1,232,432          $   758,250
Depreciation and amortization                                 1,038,437            1,027,073              950,459
Impairment of assets                                            135,608               28,133              115,579
Loss (gain) on real estate dispositions, net                 (1,088,455)            (748,041)            (415,575)
Noncontrolling interests                                        (23,968)             (20,197)             (69,193)
Unconsolidated entities                                          62,096               57,680               52,663
Funds from operations attributable to common
stockholders                                                $ 1,102,562

$ 1,577,080 $ 1,392,183



Average diluted shares outstanding:                             417,387              403,808              375,250

Per diluted share data:
Net income attributable to common stockholders(1)           $      2.33          $      3.05          $      2.02
Funds from operations attributable to common
stockholders                                                $      2.64

$ 3.91 $ 3.71

(1) Includes adjustment to the numerator for income (loss) attributable to OP unitholders.





The following tables reflect the reconciliation of NOI to net income, the most
directly comparable U.S. GAAP measure, for the years presented. Dollar amounts
are in thousands.

                                                                                 Year Ended December 31,
NOI Reconciliation:                                                 2020                  2019                  2018
Net income                                                     $  1,038,852          $  1,330,410          $    829,750
Loss (gain) on real estate dispositions, net                     (1,088,455)             (748,041)             (415,575)
Loss (income) from unconsolidated entities                            8,083               (42,434)                  641
Income tax expense (benefit)                                          9,968                 2,957                 8,674
Other expenses                                                       70,335                52,612               112,898
Impairment of assets                                                135,608                28,133               115,579
Provision for loan losses                                            94,436                18,690                     -
Loss (gain) on extinguishment of debt, net                           47,049                84,155                16,097

Loss (gain) on derivatives and financial instruments, net

                                                                  11,049                (4,399)               (4,016)
General and administrative expenses                                 128,394               126,549               126,383
Depreciation and amortization                                     1,038,437             1,027,073               950,459
Interest expense                                                    514,388               555,559               526,592
Consolidated net operating income (NOI)                        $  2,008,144          $  2,431,264          $  2,267,482

NOI by segment:
Seniors Housing Operating                                      $    755,552          $  1,039,520          $    985,022
Triple-net                                                          748,121               918,743               900,049
Outpatient Medical                                                  505,071               469,035               380,136
Non-segment/corporate                                                  (600)                3,966                 2,275
Total NOI                                                      $  2,008,144          $  2,431,264          $  2,267,482



                                       61

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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Quarterly NOI by Segment:
(in thousands)                                                                                            Three Months Ended                                                                                   Year Ended
                                                      March 31,                              June 30,                           September 30,                          December 31,                           December 31,
                                               2020               2019               2020               2019               2020               2019               2020               2019                2020                 2019
Seniors Housing Operating:
Total revenues                             $ 851,128          $ 872,386

$ 773,650 $ 915,529 $ 742,065 $ 835,496

$ 715,020 $ 833,458 $ 3,081,863 $ 3,456,869 Property operating expenses

                  607,871            607,686            595,513            637,317            567,704            581,341            555,223            591,005            2,326,311            2,417,349
NOI                                        $ 243,257          $ 264,700          $ 178,137          $ 278,212          $ 174,361          $ 254,155          $ 159,797          $ 242,453          $   755,552          $ 1,039,520

Triple-net:
Total revenues                             $ 207,729          $ 248,241          $ 233,619          $ 240,758          $ 120,928          $ 244,607

$ 239,028 $ 239,037 $ 801,304 $ 972,643 Property operating expenses

                   13,302             14,955             13,563             12,823             12,567             13,922             13,751             12,200               53,183               53,900
NOI                                        $ 194,427          $ 233,286          $ 220,056          $ 227,935          $ 108,361          $ 230,685          $ 225,277          $ 226,837          $   748,121          $   918,743

Outpatient Medical:
Total revenues                             $ 199,329          $ 149,461          $ 180,831          $ 163,365          $ 172,704          $ 185,189

$ 167,155 $ 189,813 $ 720,019 $ 687,828 Property operating expenses

                   60,608             48,166             51,688             50,987             52,728             60,325             49,924             59,315              214,948              218,793
NOI                                        $ 138,721          $ 101,295          $ 129,143          $ 112,378          $ 119,976          $ 124,864          $ 117,231          $ 130,498          $   505,071          $   469,035

Corporate:
Total revenues                             $     416          $   2,157          $     375          $     454          $   1,177          $     841          $     813          $     514          $     2,781          $     3,966
Property operating expenses                           -               -                     -               -                 1,718               -                 1,663               -                3,381                    -
NOI                                        $     416          $   2,157          $     375          $     454          $    (541)         $     841          $    (850)         $     514          $      (600)         $     3,966



The following is a reconciliation of the properties included in our QTD Pool and
YTD Pool for SSNOI:

                                                                                      QTD Pool                                                                                       YTD Pool
                                               Seniors Housing                                                                                Seniors Housing
SSNOI Property Reconciliations:                   Operating              Triple-net            Outpatient Medical            Total               Operating              Triple-net            Outpatient Medical            

Total


Consolidated properties                                556                    641                      296                   1,493                    556                    641                      296                   1,493
Unconsolidated properties                               90                     39                       72                     201                     90                     39                       72                     201
Total properties                                       646                    680                      368                   1,694                    646                    680                      368                   1,694

Recent acquisitions/development


  conversions(1)                                       (46)                   (18)                     (51)                   (115)                   (93)                   (24)                    (123)                   (240)
Under development                                      (27)                    (4)                      (2)                    (33)                   (27)                    (4)                      (2)                    (33)
Under redevelopment(2)                                 (10)                    (1)                      (2)                    (13)                   (11)                    (1)                      (2)                    

(14)


Current held for sale                                  (10)                    (1)                      (2)                    (13)                   (10)                    (1)                      (2)                    

(13)


Loans, land parcels and subleases                      (11)                   (18)                      (8)                    (37)                   (11)                   (18)                      (8)                    (37)
Transitions(3)                                         (27)                    (6)                       -                     (33)                   (93)                   (24)                       -                    (117)
Other(4)                                                (1)                     -                        -                      (1)                    (2)                     -                        -                      (2)
Same store properties                                  514                    632                      303                   1,449                    399                    608                      231                   1,238

(1) Acquisitions and development conversions will enter the QTD Pool and YTD Pool five full quarters and eight full quarters after acquisition or certificate of occupancy, respectively.
(2) Redevelopment properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations post redevelopment completion, respectively.
(3) Transitioned properties will enter the QTD Pool and YTD Pool after five full quarters and eight full quarters of operations with the new operator in place or under the new structure, respectively.
(4) Includes one closed property in the QTD pool and one closed property and one flooded property in the YTD pool.










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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
The following is a reconciliation of our consolidated NOI to same store NOI for
the periods presented for the respective pools. Dollar amounts are in thousands.
                                                           QTD Pool                                   YTD Pool
                                                      Three Months Ended                         Twelve Months Ended
                                               December 31,        

December 31, December 31, December 31, SSNOI Reconciliations:

                             2020                 2019                 2020                  2019
Seniors Housing Operating:
Consolidated NOI                              $   159,797          $   

242,453 $ 755,552 $ 1,039,520 NOI attributable to unconsolidated investments

                                        13,182               16,491                53,736                65,387
NOI attributable to noncontrolling
interests                                          (9,405)             (19,436)              (51,334)              (81,426)

Non-cash NOI attributable to same store
properties                                           (349)                (842)               (3,239)               (4,295)
NOI attributable to non-same store
properties                                         (8,291)             (23,254)             (166,567)             (261,002)
Currency and ownership adjustments (1)               (561)                 754                 2,985                 6,144
SSNOI at Welltower Share                          154,373              216,166               591,133               764,328

Triple-net:
Consolidated NOI                                  225,277             

226,837 $ 748,121 $ 918,743 NOI attributable to unconsolidated investments

                                         4,818                5,133                13,797                20,532
NOI attributable to noncontrolling
interests                                         (14,563)             (14,751)              (58,288)              (58,462)

Non-cash NOI attributable to same store
properties                                        (12,313)             (15,224)               80,630               (58,846)
NOI attributable to non-same store
properties                                        (34,236)             (32,080)             (155,566)             (197,487)
Currency and ownership adjustments (1)               (286)                 137                      278                   397
SSNOI at Welltower Share                          168,697              170,052               628,972               624,877

Outpatient Medical:
Consolidated NOI                                  117,231              130,498               505,071               469,035
NOI attributable to unconsolidated
investments                                         3,481                  541                 9,629                 1,930
NOI attributable to noncontrolling
interests                                          (4,264)              (6,853)              (16,565)              (27,637)

Non-cash NOI attributable to same store
properties                                         (1,542)              (2,915)               (1,094)               (2,807)
NOI attributable to non-same store
properties                                        (24,050)             (19,674)             (204,525)             (129,723)
Currency and ownership adjustments (1)             (5,871)             (17,453)              (40,004)              (64,009)
SSNOI at Welltower Share                           84,985               84,144               252,512               246,789

SSNOI at Welltower Share:
Seniors Housing Operating                         154,373              216,166               591,133               764,328
Triple-net                                        168,697              170,052               628,972               624,877
Outpatient Medical                                 84,985               84,144               252,512               246,789
Total                                         $   408,055          $   470,362          $  1,472,617          $  1,635,994























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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
The table below reflects the reconciliation of EBITDA and Adjusted EBITDA to net
income, the most directly comparable U.S. GAAP measure, for the periods
presented. Dollars are in thousands.
                                                                            Year Ended December 31,
Adjusted EBITDA Reconciliation:                                  2020                 2019                 2018
Net income (loss)                                           $ 1,038,852          $ 1,330,410          $   829,750
Interest expense                                                514,388              555,559              526,592
Income tax expense (benefit)                                      9,968                2,957                8,674
Depreciation and amortization                                 1,038,437            1,027,073              950,459
EBITDA                                                        2,601,645            2,915,999            2,315,475
Loss (income) from unconsolidated entities                        8,083              (42,434)                 641
Stock-based compensation expense(1)                              28,318               25,047               27,646
Loss (gain) on extinguishment of debt, net                       47,049               84,155               16,097
Loss (gain) on real estate dispositions, net                 (1,088,455)            (748,041)            (415,575)
Impairment of assets                                            135,608               28,133              115,579
Provision for loan losses                                        94,436               18,690                    -
Loss (gain) on derivatives and financial instruments,
net                                                              11,049               (4,399)              (4,016)
Other expenses(1)                                                64,171               51,052              111,990
Other impairment                                                146,508                    -                    -
Additional other income                                               -                    -              (14,832)
Adjusted EBITDA                                             $ 2,048,412          $ 2,328,202          $ 2,153,005

Adjusted Interest Coverage Ratio:
Interest expense                                            $   514,388          $   555,559          $   526,592
Capitalized interest                                             17,472               15,272                7,905
Non-cash interest expense                                       (15,751)              (8,645)             (10,860)
Total interest                                                  516,109              562,186              523,637
Adjusted EBITDA                                             $ 2,048,412          $ 2,328,202          $ 2,153,005
Adjusted interest coverage ratio                                     3.97x                4.14x                4.11x

Adjusted Fixed Charge Coverage Ratio:
Total interest                                              $   516,109          $   562,186          $   523,637
Secured debt principal payments                                  62,707               54,325               56,288
Preferred dividends                                                   -                    -               46,704
Total fixed charges                                             578,816              616,511              626,629
Adjusted EBITDA                                             $ 2,048,412          $ 2,328,202          $ 2,153,005
Adjusted fixed charge coverage ratio                                 3.54x                3.78x                3.44x


(1) Certain severance-related costs are included in stock-based compensation and excluded from other expenses.




























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Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
Our leverage ratios include book capitalization, undepreciated book
capitalization and market capitalization. Book capitalization represents the sum
of net debt (defined as total long-term debt less cash and cash equivalents and
any IRC Section 1031 deposits), total equity and redeemable noncontrolling
interests. Undepreciated book capitalization represents book capitalization
adjusted for accumulated depreciation and amortization. Market capitalization
represents book capitalization adjusted for the fair market value of our common
stock. Our leverage ratios are defined as the proportion of net debt to total
capitalization. The table below reflects the reconciliation of our leverage
ratios to our balance sheets for the periods presented. Amounts are in
thousands, except share price.

                                                                                                        Year Ended December 31,
                                                                                           2020                  2019                  2018
Book capitalization:
Unsecured credit facility and commercial paper                              

$ - $ 1,587,597 $ 1,147,000 Long-term debt obligations(1)

                                                           13,905,822            13,436,365            12,150,144
Cash and cash equivalents(2)                                                            (1,968,765)             (284,917)             (215,376)
Total net debt                                                                          11,937,057            14,739,045            13,081,768
Total equity and noncontrolling interests(3)                                            17,225,062            16,982,504            16,010,645
Book capitalization                                                                   $ 29,162,119          $ 31,721,549          $ 29,092,413
                               Net debt to book capitalization ratio                          40.9  %               46.5  %               45.0  %

Undepreciated book capitalization:
Total net debt                                                              

$ 11,937,057 $ 14,739,045 $ 13,081,768 Accumulated depreciation and amortization


             6,104,297             5,715,459             5,499,958
Total equity and noncontrolling interests(3)                                            17,225,062            16,982,504            16,010,645
Undepreciated book capitalization                                                     $ 35,266,416          $ 37,437,008          $ 34,592,371
                               Net debt to undepreciated book capitalization
                               ratio                                                          33.8  %               39.4  %               37.8  %

Market capitalization:
Common shares outstanding                                                                  417,401               410,257               383,675
Period end share price                                                     

$ 64.62 $ 81.78 $ 69.41 Common equity market capitalization

$ 26,972,453          $ 33,550,817          $ 26,630,882
Total net debt                                                                          11,937,057            14,739,045            13,081,768
Noncontrolling interests(3)                                                              1,252,343             1,442,060             1,378,311
Preferred stock                                                                                  -                     -               718,498
Market capitalization:                                                                $ 40,161,853          $ 49,731,922          $ 41,809,459
                               Net debt to market capitalization ratio                        29.7  %               29.6  %               31.3  %


(1) Amounts include senior unsecured notes, secured debt and lease liabilities
related to financing leases, as reflected on our Consolidated Balance Sheets.
Operating lease liabilities related to the ASC 842 adoption are excluded.
(2) Inclusive of IRC Section 1031 deposits, if any.
(3) Includes amounts attributable to both redeemable noncontrolling interests
and noncontrolling interests as reflected on our Consolidated Balance Sheets.

Critical Accounting Policies
Our consolidated financial statements are prepared in accordance with U.S. GAAP,
which requires us to make estimates and assumptions. Management considers an
accounting estimate or assumption critical if:
•the nature of the estimates or assumptions is material due to the levels of
subjectivity and judgment necessary to account for highly uncertain matters or
the susceptibility of such matters to change; and
•the impact of the estimates and assumptions on financial condition or operating
performance is material.
Management has discussed the development and selection of its critical
accounting policies with the Audit Committee of the Board of Directors.
Management believes the current assumptions and other considerations used to
estimate amounts reflected in our consolidated financial statements are
appropriate and are not reasonably likely to change in the future. However,
since these estimates require assumptions to be made that were uncertain at the
time the estimate was made, they bear the risk of change. If actual experience
differs from the assumptions and other considerations used in estimating amounts
reflected in our consolidated financial statements, the resulting changes could
have a material adverse effect on our consolidated results of operations,
liquidity and/or financial condition. Please refer to Note 2 to our consolidated
financial statements for further information on significant accounting policies
that impact us and for the impact of new accounting standards, including
accounting pronouncements that were issued but not yet adopted by us.
The following table presents information about our critical accounting policies,
as well as the material assumptions used to develop each estimate:
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Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations


               Nature of Critical                                   

Assumptions/Approach


              Accounting Estimate                                           Used
Impairment of Real Property                      Quarterly, we evaluate our real estate investments on a
                                                 property by property basis to determine if there are
Assessing impairment of real property involves   indicators of impairment. These indicators may include
subjectivity in determining if indicators of     expected operational performance, the tenant's ability to
impairment are present and in estimating the     make rent payments, a decision to dispose of an asset
future undiscounted cash flows or estimated fair before the end of its estimated useful life and changes in
value of an asset. In estimating the             the market that may permanently reduce the value of the
undiscounted cash flows or fair value, key       property. If indicators of impairment exist, an
assumptions that would be made are the           undiscounted cash flow analysis will be prepared and the
estimation of future rental revenues, operating  results of such analysis will be compared to the current
expenses, capitalization rates and the ability   net book value to determine if an impairment charge is
and intent to hold the respective asset, all of  necessary. This analysis requires us to use judgment in
which are affected by our expectations of future determining whether indicators of impairment exist and to
market or economic conditions. These estimates   estimate the expected future undiscounted cash flows or
can have a significant impact on the             estimated fair values of the property. Properties that
undiscounted cash flows or estimated fair value  meet the held for sale criteria are recorded at the lesser
of an asset.                                     of the fair value less costs to sell or carrying value.
Real Estate Acquisitions

We believe that substantially all of our real    The allocation of the purchase price to the related real
estate acquisitions are considered asset         estate acquired (tangible assets and intangible assets and
acquisitions for which we record the related     liabilities) involves subjectivity as such allocations are
real estate acquired (tangible assets and        based on a relative fair value analysis. In determining
identifiable intangible assets and liabilities)  the fair values that drive such analysis, we estimate the
at cost on a relative fair value basis.          fair value of each component of the real estate acquired
Liabilities assumed and any associated           which generally includes land, buildings and improvements,
noncontrolling interests are reflected at fair   the above or below market component of in-place leases and
value. Tangible assets consist primarily of      the value of in-place leases. Significant assumptions used
land, building and improvements. Identifiable    to determine such fair values include comparable land
intangible assets and liabilities primarily      sales, capitalization rates, discount rates, market rental
consist of the above or below market component   rates and property operating data, all of which can be
of in-place leases and the value of in-place     impacted by expectations about future market or economic
leases. The total amount of other intangible     conditions. Our estimates of the values of these
assets acquired is further allocated to in-place components affect the amount of depreciation and
lease values and customer relationship values    amortization we record over the estimated useful life of
based on management's evaluation of the specific the property or the term of the lease.
characteristics of each tenant's lease and our
overall relationship with respect to that
tenant.
Principles of Consolidation

The consolidated financial statements include    We make judgments about which entities are VIEs based on
our accounts, the accounts of our wholly-owned   an assessment of whether (i) the equity investors as a
subsidiaries, and the accounts of joint venture  group, if any, do not have a controlling financial
entities in which we own a majority voting       interest, or (ii) the equity investment at risk is
interest with the ability to control operations  insufficient to finance that entity's activities without
and where no substantive participating rights or additional subordinated financial support. We make
substantive kick out rights have been granted to judgments with respect to our level of influence or
the noncontrolling interests. In addition, we    control of an entity and whether we are (or are not) the
consolidate those entities deemed to be variable primary beneficiary of a VIE. Consideration of various
interest entities ("VIEs") in which we are       factors includes, but is not limited to, our ability to
determined to be the primary beneficiary. All    direct the activities that most significantly impact the
material intercompany transactions and balances  entity's economic performance, our form of ownership
have been eliminated in consolidation.           interest, our 

representation on the entity's governing


                                                 body, the size and 

seniority of our investment, our


                                                 ability and the rights of 

other investors to participate


                                                 in policy making 

decisions, replace the manager and/or


                                                 liquidate the entity, if 

applicable. Our ability to


                                                 correctly assess our 

influence or control over an entity


                                                 at inception of our 

involvement or on a continuous basis


                                                 when determining the 

primary beneficiary of a VIE affects


                                                 the presentation of these 

entities in our consolidated


                                                 financial statements. If 

we perform a primary beneficiary


                                                 analysis at a date other 

than at inception of the VIE, our


                                                 assumptions may be 

different and may result in the


                                                 identification of a 

different primary beneficiary.


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


               Nature of Critical                                   

Assumptions/Approach


              Accounting Estimate                                           

Used

Allowance for Credit Losses on Loans Receivable



The allowance for credit losses is maintained at The determination of the allowance for credit losses is
a level believed adequate to absorb potential    based on a quarterly evaluation of all outstanding loans,
losses in our loans receivable. The              including general economic conditions and estimated
determination of the credit allowance is based   collectability of loan payments. We evaluate the
on a quarterly evaluation of all outstanding     collectability of our loans receivable based on a
loans, including general economic conditions and combination of factors, including, but not limited to,
estimated collectability of loan payments.       payment status, historical loan charge-offs, financial
                                                 strength of the borrower 

and guarantors, and nature,


                                                 extent and value of the 

underlying collateral. A loan is


                                                 considered to have 

deteriorated credit quality when, based


                                                 on current information and 

events, it is probable that we


                                                 will be unable to collect 

all amounts due as scheduled


                                                 according to the 

contractual terms of the loan agreement.


                                                 For those loans we 

identified as having deteriorated


                                                 credit quality, we 

determine the amount of credit loss on


                                                 an individual basis. 

Placement on non-accrual status may


                                                 be required. Consistent 

with this definition, all loans on


                                                 non-accrual are deemed to 

have deteriorated credit


                                                 quality. To the extent 

circumstances improve and the risk


                                                 of collectability is 

diminished, we may return these loans


                                                 to income accrual status. 

While a loan is on non-accrual


                                                 status, any cash receipts 

are applied against the


                                                 outstanding principal 

balance. For the remaining loans, we


                                                 assess credit loss on a 

collective pool basis and use our


                                                 historical loss experience 

for similar loans to determine


                                                 the reserve for credit losses.



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