Quarterlytics / Healthcare / Medical - Care Facilities / Brookdale Senior Living

Brookdale Senior Living

bkd · NYSE Healthcare
Claim this profile
Ticker bkd
Exchange NYSE
Sector Healthcare
Industry Medical - Care Facilities
Employees 10,000+
← All annual reports
FY2019 Annual Report · Brookdale Senior Living
Sign in to download
Loading PDF…
2019

ANNUAL REPORT

Brookdale resident

Bringing New Life to Senior Living®

Brookdale at a Glance

OUR PLACES

MORE THAN

700

COMMUNITIES

IN

45STATES

65%

OF SENIORS LIVE WITHIN 
20 MINUTES OF A BROOKDALE 
COMMUNITY (1)

OUR PEOPLE

~ 65,000 
    RESIDENTS*

~ 20,000  
   PATIENTS

~ 50,000
   ASSOCIATES

*ABILITY TO SERVE

#143 LARGEST EMPLOYEE BASE (2)

EXPERIENCED LEADER

#1

SENIOR HOUSING  
PROVIDER (3)

12

SPECIALIZED 
CLINICAL
PROGRAMS (4)

16OPTIMUM 

LIFE 
SIGNATURES

(1) ESRI, Brookdale; senior population is defined as age 75-plus with an annual income of $50,000 or greater and within the United States.
(2) Ranked by employee count of Fortune 500 companies as of December 31, 2018
(3) As reported by units
(4) Services vary by community

 2

LETTER TO SHAREHOLDERS

Dear Fellow Shareholders, 

As  I  reflected  on  our  2019  accomplishments 
and  the  positive  momentum  that  continued 
in  the  beginning  of  2020,  I  looked  forward  to 
our  company  delivering  on  our  strategy  with 
positive  financial  growth,  built  on  a  strong 
foundation by an amazing team. Several months 
later, as I write this letter, I am extremely grateful 
for our strong organization and foundation, but 
for a very different reason. 

The  Coronavirus  (COVID-19)  pandemic  has 
forever changed our lives. For many of us, this is 
the first worldwide tragedy in our lifetimes. Yet, 
the seniors in our communities have shared their 
stories  of  living  through  the  Great  Depression, 
serving  in  World  War  II,  along  with  countless 
other  tragedies  and  challenges.  These  seniors  share  stories  to  remind  all  of  us  to  take  time 
to  acknowledge  the  current  sadness,  but  not  to  dwell  on  it.  They  remind  us  that  we  should 
celebrate the past successes that made us the strong individuals we are today and then to make 
time to intentionally remember to connect with friends, family and loved ones to celebrate life 
every day, even in the midst of our struggles. For it is through these precious moments that we 
find the strength to move forward, to become even stronger, and eventually share with future 
generations the stories of how we thrived in spite of adversity. With our residents’ wisdom and 
advice in mind, I write this letter about our past year, the present and our vision for the future.

2019
We made great progress on our “win locally” strategy introduced when I became CEO in 2018. 
We talked about our role as a provider of choice for high-quality care and personalized service 
delivered by compassionate associates to enrich the lives of the seniors we serve. In 2019, we 
successfully navigated transformational changes to reshape our business, focused on winning in 
local markets, and created shareholder value, while setting the stage for the future. I will share 
some of the key successes that have made Brookdale stronger.

Reshaping our business – through our portfolio strategy
Let me start with how we reshaped Brookdale by significantly simplifying our business. Within 
two years, we achieved our goal of generating net proceeds of $250 million by selling assets 
and  simplifying  our  partnerships  and  business  relationships.  Since  the  beginning  of  2018,  we 
also reduced our G&A costs by nearly $50 million, to adjust for this smaller portfolio.

In  January  2020,  we  unlocked  additional  value  by  selling  our  interest  in  our  unconsolidated 
CCRC venture. As a result of these transactions, our business is simpler, with a portfolio that is 
now a third smaller than when we completed the Emeritus merger in 2014. Our owned portfolio, 
which is more profitable, has increased to 60% of consolidated units. I am pleased that the vast 
majority of our portfolio restructuring is complete, and more of our attention can be focused 
on driving future growth.  

BROOKDALE ANNUAL REPORT - 2019

3 

Winning in the local markets - through our associate strategy
Brookdale is a service business focused on housing, hospitality and healthcare. Our company 
and associates help America’s seniors with their overall well-being and quality of life. Despite 
the tightest labor market in 50 years, the retention rate of our Executive Directors and Health 
and Wellness Directors, the top two leader positions in many of our communities, has remained 
around  70%.  In  2019,  we  completed  the  third  and  final  year  of  our  planned  above-industry 
investments in our community associates. While industry labor rate increases remain high, we 
achieved the market-based goals that were initially set.

Over the past two years, our culture has shifted to a stronger 
feeling of winning, as evidenced by the more than 3,000 former 
associates who returned to Brookdale in 2019. As our associates 
feel the positive change, this also reverberates throughout our 
communities. Our resident satisfaction improved, demonstrated 
by our NPS® increasing 20% since the prior survey, with more 
than 50,000 responses. Higher resident satisfaction helps drive 
higher occupancy and revenue.

Creating shareholder value – through financial performance
We saw positive momentum of senior living revenue growth starting in the second half of 2019, 
on  a  same  community  basis.  We  delivered  on  our  financial  metrics  within  or  better  than  our 
initial  annual  guidance. We  outperformed  the  industry’s  sequential  occupancy  growth  for  the 
third and fourth quarters of 2019 and had the best in-year occupancy growth since the merger 
in 2014. This positive momentum created value for our shareholders in 2019 and supports our 
investment thesis. There continues to be great long-term opportunities for Brookdale to deliver 
senior care services with our skill and scale, and we are well positioned to benefit from the Silver 
Wave demographic tailwind. 

Setting the stage for the future
As our win locally strategy became embedded in our organizational DNA and business momentum 
started to improve, the Board, my executive team and I set out to refine our strategic plan. To 
become  the  provider  of  choice,  we  needed  to  continue  to  differentiate  Brookdale  from  other 
operators. To help us get there, I strategically enhanced my executive team to add leaders with 
specific skills to complement our long-tenured operational expertise and help drive long-term 
growth opportunities.

2020
Our financial momentum continued into 2020, and our senior living business was on plan, until 
COVID-19 arrived in our country.

Our preparations for COVID-19 began early. As a starting point, we already had strong, established 
infectious  disease  prevention  and  control  protocols  and  practices.  We  recognized  the  vitally 
important role that Brookdale plays within the healthcare system. We also recognized that since 
more than 90% of our peers operate five or fewer communities, we must lead from our position of 
strength. As the largest senior living operator in the United States, we shared our knowledge and 
practices. We also leveraged our extensive relationships and created new ones to fight this virus.

NPS® and Net Promoter Score® are registered trademarks of Bain & Company, Inc., Fred Reichheld and Satmetrix Systems, Inc. 

 4

Passion, Courage, Partnership and Trust are Brookdale’s cornerstones. During this global health 
crisis,  our  associates  demonstrate  these  values  through  their  servant  leadership.  While  most 
of the nation sheltered in place, our team members left the safety of their homes to serve and 
care for our residents and patients, with a unified sense of purpose to “help keep our beloved 
seniors  safe.”  Our  associates  are  on  the  frontlines  in  this  crisis  and  are  everyday  heroes.  Our 
corporate, support center and field teams have worked around the clock to help ensure that 
our community and agency associates have the tools, training and resources that they need. 
Brookdale has united to take action and lead. Our strong response to COVID-19 is a sign of the 
strength of our organization.

Our teams are navigating through challenging circumstances with enormous dedication, courage 
and grace. They found creative solutions to engage our residents, helped care for our patients 
and found innovative ways to connect our residents with their friends and families. We also thank 
the  many  families,  partners  and  others  who  have  reached  out  to  encourage  and  support  our 
seniors  and  our  associates.  On  the  following  pages,  I  hope  you  enjoy  a  small  selection  of  the 
stories that uplift us every day. 

The future
By  focusing  on  what  matters  most,  we  are  building  deeper  relationships  with  local  health 
authorities,  healthcare  providers  and  referral  partners  and  planting  seeds  for  the  future.  We 
believe our efforts and outcomes will allow us to attract new residents more quickly in the future.

Let us not forget that Brookdale is primarily a “needs-based” business. We continue to see new 
residents move into our communities. Nearly 10% of our residents are Baby Boomers, and this is 
only the beginning of that generation entering the market for senior living services. Brookdale 
remains strong and well positioned to win in this dynamic market.

While the depth and duration of the impact of COVID-19 is yet to be determined, our “why” has 
never  been  more  clear.  Our  purpose  —  helping  make  our  residents’  and  patients’  lives  better, 
helping  support  our  associates  and  helping  our  industry  —  is  propelling  our  success.  As  we 
have stepped up to do things that we didn’t think were possible before the pandemic, we are 
proud of the heroic efforts of our team. Fighting the battle against COVID-19 has enabled us to 
demonstrate how we help protect the highest risk segment of the population, help reduce the 
spread of COVID-19 and help reduce the burden on hospital systems.

Through the stories our residents share with us about life experiences, we gain wise perspective 
that helps us approach the challenges of this moment. Our seniors help us take each day at face 
value,  without  fear  and  without  hesitation.  Most  importantly,  they  also  give  us  the  inspiration 
to move forward with vigor, purpose and determination. I will close by saying thank you to our 
shareholders, associates, patients, residents and families, as well as our business partners. We are 
grateful for your support and wish you good health and happiness.

Sincerely, 

Lucinda M. Baier 
President and Chief Executive Officer

For our latest ESG update, please visit our Investor “Toolkit” on our website: brookdale.com/investor

BROOKDALE ANNUAL REPORT - 2019

5 

Our Residents and Families

Apart but not alone

During the COVID-19 pandemic, residents and families found unique opportunities to connect 
through sidewalk art, colorful lawn art and window visits. Here are some of the encouraging 
ways social distancing has brought residents and families together. 

1

3

4

2

6

7

5

1. A resident enjoys happy hour with a glass of wine delivered to her door from our associates. 2. A resident 
and her family enjoy a window visit. 3. Families and neighbors brighten the sidewalks of a community with 
words of encouragement. 4. Thank yous and encouraging messages line the sidewalk outside one community. 
5. One resident’s family creates a special heart-filled tree to thank associates for all of their hard work. 6. A 
resident’s grandson makes a sign to wish her a happy birthday and shares it outside her window. 7. A resident 
enjoys an ice cream social with room service as associates deliver treats to residents' apartments.

 6

Our Associates

They stepped up to do the extraordinary

Day in and day out our associates have worked to help keep our residents safe and healthy 
during the COVID-19 pandemic, on the frontlines and within the walls of our communities. 
Here are just a few examples of how their work has been recognized on social media.

1

2

3

4

1. Associates at one of our communities receive a wonderful surprise with a lawn sign, ‘Heroes Work Here’. 
2. Associates at one community post images of their superhero strength during the pandemic. 3. Another 
superhero associate poses in front of a chalk art illustration to ‘crush COVID-19’. 4. Associates answered the 
call to the #whyiamessential challenge with meaningful messages about their work and service.

BROOKDALE ANNUAL REPORT - 2019
BROOKDALE ANNUAL REPORT - 2019

7 

Brookdale Senior Living is the leading operator of senior living communities throughout the 
United States — a responsibility we take pride in. For more than 40 years we’ve put our residents 
first, providing them with the service, care and living accommodations that meet their specific 
needs.  We  offer  our  residents  access  to  a  wide  range  of  services  across  the  most  attractive 
sectors of the senior living industry. We operate and manage Independent Living, Assisted Living, 
Alzheimer’s and Dementia Care and Continuing Care Retirement Communities (CCRCs). We also 
offer a range of home health, hospice, outpatient therapy and private duty home care services to 
residents of many of our communities and to seniors living outside of our communities.

Forward-Looking Statements
Certain statements in the Letter to Shareholders included in this 2019 Annual Report may constitute 
forward-looking  statements  within  the  meaning  of  the  Private  Securities  Litigation  Reform 
Act  of  1995.  These  forward-looking  statements  are  subject  to  various  risks  and  uncertainties 
and  include  all  statements  that  are  not  historical  statements  of  fact  and  those  regarding  our 
intent, belief or expectations, including, but not limited to, statements relating to the creation 
of shareholder value; our strategy, initiatives and growth; our expectations regarding the senior 
living industry, occupancy and pricing, the demand for senior housing and demographic trends; 
and our expectations regarding the COVID-19 pandemic and its effect on our business. Factors 
which  could  have  a  material  adverse  effect  on  our  operations  and  future  prospects  or  which 
could  cause  events  or  circumstances  to  differ  from  the  forward-looking  statements  include, 
but are not limited to the impacts of the COVID-19 pandemic, including the response efforts of 
federal, state and local government authorities, businesses, individuals and us, on our business, 
results  of  operations,  cash  flow,  liquidity  and  strategic  initiatives,  which  will  depend  on  many 
factors,  some  of  which  cannot  be  foreseen,  including  the  duration,  severity  and  geographic 
concentrations of the pandemic and any resurgence of the disease, the impact of COVID-19 on 
the nation’s economy and debt and equity markets and the local economies in our markets, the 
development and availability of COVID-19 infection and antibody testing, therapeutic agents and 
vaccines and the prioritization of such resources among businesses and demographic groups, 
government  financial  and  regulatory  relief  efforts  that  may  become  available  to  business  and 
individuals, perceptions regarding the safety of senior living communities during and after the 
pandemic, changes in demand for senior living communities and our ability to adapt our sales 
and marketing efforts to meet that demand, the impact of COVID-19 on our residents’ and their 
families’  ability  to  afford  our  resident  fees,  including  due  to  changes  in  unemployment  rates, 
consumer confidence and equity markets caused by COVID-19, changes in the acuity levels of our 
new residents, the disproportionate impact of COVID-19 on seniors generally and those residing 
in  our  communities,  the  duration  and  costs  of  our  preparation  and  response  efforts,  including 
increased equipment, supplies, labor, litigation and other expenses, the impact of COVID-19 on 
our ability to complete financings, refinancings or other transactions (including dispositions) or to 
generate sufficient cash flow to cover required interest and lease payments and to satisfy financial 
and other covenants in our debt and lease documents, increased regulatory requirements and 
enforcement actions resulting from COVID-19, including those that may limit our collection efforts 
for delinquent accounts, and the frequency and magnitude of legal actions and liability claims 
that may arise due to COVID-19 or our response efforts; the risks detailed under “Safe Harbor 
Statement Under the Private Securities Litigation Reform Act of 1995” beginning on page 4 and 
“Risk Factors” beginning on page 21 of the Annual Report on Form 10-K included in this 2019 
Annual Report; as well as other risks detailed from time to time in our filings with the Securities 
and Exchange Commission, including those contained in our Quarterly Reports on Form 10-Q. 
Readers are cautioned not to place undue reliance on any of such forward-looking statements, 
which  reflect  our  management's  views  as  of  the  date  of  this  2019  Annual  Report.  We  cannot 
guarantee future results, levels of activity, performance or achievements and, except as required 
by law, we expressly disclaim any obligation to release publicly any updates or revisions to any 
such forward-looking statements to reflect any change in our expectations with regard thereto 
or change in events, conditions or circumstances on which any statement is based.

 8

FINANCIAL HIGHLIGHTS

As of and for the years ended
December 31,

(in thousands, except per share data and community data)

2019

2018

Selected Operating Data

Total revenue(1)

Income (loss) from operations(1)(2)

Net income (loss)(1)(2)

$ 

$ 

$ 

4,057,088 $ 

4,531,426

(44,498) $ 

(594,249)

(268,492) $ 

(528,352)

Net income (loss) attributable to Brookdale common stockholders(1)(2) $ 

(267,931) $ 

(528,258)

Basic and diluted net income (loss) per share attributable to 
Brookdale common stockholders(1)(2)

$ 

(1.44) $ 

(2.82)

Weighted average shares used in computing basic and diluted  
net loss per share

Adjusted EBITDA(1)(2)(3)

Net cash provided by (used in) operating activities

Adjusted Free Cash Flow(3)

Selected Balance Sheet Data

Property, plant and equipment and leasehold intangibles, net(1)(2)

Operating lease right-of-use assets(1)

Cash and cash equivalents

Marketable securities

Total assets(1)

Debt and financing and operating lease obligations(1)

Total Brookdale stockholders’ equity

Stock Data

Closing share price on December 31

Community Data

185,907  

187,468

401,169 $ 

537,681 

216,412 $ 

203,961

(76,404) $ 

4,118

5,109,834 $ 

5,275,427

1,159,738 $ 

–

 240,227 $ 

398,267

68,567 $ 

14,855

7,194,433 $ 

6,467,260

5,860,468 $ 

4,514,656

696,356 $ 

1,018,903

7.27 $ 

6.70

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

$ 

Total number of communities operated and managed (period end)

Total number of units operated and managed (period end)

763

72,267

892

84,279

(1) The Company adopted ASC 842, Leases (“ASC 842”) effective January 1, 2019, which resulted in a negative, non-recurring net impact 
of $23.1 million to net income (loss) and Adjusted EBITDA for the year ended December 31, 2019, with no impact to net cash provided by 
(used in) operating activities or Adjusted Free Cash Flow. See Note 2 to the consolidated financial statements beginning on page 83 of 
the Annual Report on Form 10-K included in this 2019 Annual Report for more information.  

(2) Includes the impact of $49.3 million and $489.9 million of non-cash impairment charges during the year ended December 31, 2019 and 
2018, respectively. See Note 5 to the consolidated financial statements beginning on page 98 of the Annual Report on Form 10-K included 
in this 2019 Annual Report for more information.  

(3) Adjusted EBITDA and Adjusted Free Cash Flow are financial measures that are not calculated in accordance with Generally Accepted 
Accounting Principles (GAAP). See "Non-GAAP Financial Measures" beginning on page 69 of the Annual Report on Form 10-K included in 
this 2019 Annual Report for the Company's definitions of its non-GAAP financial measures, reconciliations of such measures to their most 
comparable GAAP financial measures and other important information regarding the use of the Company's non-GAAP financial measures. 
During  the  first  quarter  of  2019,  the  Company  modified  its  definition  of  Adjusted  EBITDA  to  exclude  transaction  and  organizational 
restructuring costs, and its definition of Adjusted Free Cash Flow to no longer adjust net cash provided by (used in) operating activities 
for changes in working capital items other than prepaid insurance premiums financed with notes payable and lease liability for lease 
termination and modification. Amounts for all periods herein reflect application of the modified definitions.

BROOKDALE ANNUAL REPORT - 2019

9 

 
[This Page Intentionally Left Blank]

 10

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-K 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF
1934

For the fiscal year ended December 31, 2019 

or

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT
OF 1934

Commission File Number 001-32641 

BROOKDALE SENIOR LIVING INC. 
(Exact name of registrant as specified in its charter)

Delaware
(State or Other Jurisdiction of
Incorporation or Organization)

20-3068069
(I.R.S. Employer Identification No.)

111 Westwood Place, Suite 400,

Brentwood, Tennessee

(Address of principal executive offices)

Registrant's telephone number including area code

37027
(Zip Code)

(615) 221-2250

SECURITIES REGISTERED PURSUANT TO SECTION 12(b) OF THE ACT:

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, $0.01 Par Value Per Share

BKD

New York Stock Exchange

SECURITIES REGISTERED PURSUANT TO SECTION 12(g) OF THE ACT:
None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes 

 No 

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes 
No 

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities 
Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such 
reports), and (2) has been subject to such filing requirements for the past 90 days. Yes 

 No 

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted 
pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period 
that the registrant was required to submit such files). Yes 

 No 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller 
reporting company, or an emerging growth company. See the definitions of "large accelerated filer," "accelerated filer," "smaller 
reporting company," and "emerging growth company" in Rule 12b-2 of the Exchange Act.

Large accelerated filer

Non-accelerated filer

Accelerated filer

Smaller reporting company

Emerging growth company

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for 
complying with any new or revised accounting standards provided pursuant to Section 13(a) of the Exchange Act. 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes 

 No 

The aggregate market value of common stock held by non-affiliates of the registrant on June 28, 2019, the last business day of 
the registrant's most recently completed second fiscal quarter was approximately $1.4 billion. The market value calculation was 
determined using a per share price of $7.21, the price at which the registrant's common stock was last sold on the New York Stock 
Exchange on such date. For purposes of this calculation only, shares held by non-affiliates excludes only those shares beneficially 
owned by the registrant's executive officers, directors and stockholders owning 10% or more of the Company's outstanding common 
stock.

As of February 14, 2020, 184,260,609 shares of the registrant's common stock, $0.01 par value, were outstanding (excluding 
unvested restricted shares).

DOCUMENTS INCORPORATED BY REFERENCE

Certain sections of the registrant's Definitive Proxy Statement relating to its 2020 Annual Meeting of Stockholders, or an amendment 
to this Form 10-K, to be filed with the SEC within 120 days of December 31, 2019, are incorporated by reference into Part III of 
this Annual Report on Form 10-K.

TABLE OF CONTENTS
BROOKDALE SENIOR LIVING INC.

FORM 10-K

FOR THE YEAR ENDED DECEMBER 31, 2019 

PART I

Item 1

Item 1A

Item 1B

Item 2

Item 3

Item 4

PART II

Item 5

Item 6

Item 7

Business

Risk Factors

Unresolved Staff Comments

Properties

Legal Proceedings

Mine Safety Disclosures

Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of 
Equity Securities

Selected Financial Data

Management's Discussion and Analysis of Financial Condition and Results of Operations

Item 7A

Quantitative and Qualitative Disclosures About Market Risk

Item 8

Item 9

Item 9A

Item 9B

PART III

Item 10

Item 11

Item 12

Item 13

Item 14

PART IV

Item 15

Item 16

Financial Statements and Supplementary Data

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

Controls and Procedures

Other Information

Directors, Executive Officers and Corporate Governance

Executive Compensation

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder 
Matters

Certain Relationships and Related Transactions, and Director Independence

Principal Accounting Fees and Services

Exhibits, Financial Statement Schedules

Form 10-K Summary

3

PAGE

5

21

35

36

37

37

38

40

42

71

73

121

121

121

122

122

122

123

123

124
127

SAFE HARBOR STATEMENT UNDER THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995

Certain statements in this Annual Report on Form 10-K may constitute forward-looking statements within the meaning of the 
Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to various risks and uncertainties 
and include all statements that are not historical statements of fact and those regarding our intent, belief or expectations. Forward-
looking statements are generally identifiable by use of forward-looking terminology such as "may," "will," "should," "could," 
"would," "potential," "intend," "expect," "endeavor," "seek," "anticipate," "estimate," "believe," "project," "predict," "continue," 
"plan," "target," or other similar words or expressions. These forward-looking statements are based on certain assumptions and 
expectations, and our ability to predict results or the actual effect of future plans or strategies is inherently uncertain. Although we 
believe that expectations reflected in any forward-looking statements are based on reasonable assumptions, we can give no assurance 
that our assumptions or expectations will be attained and actual results and performance could differ materially from those projected. 
Factors  which  could  have  a  material  adverse  effect  on  our  operations  and  future  prospects  or  which  could  cause  events  or 
circumstances to differ from the forward-looking statements include, but are not limited to, events which adversely affect the 
ability of seniors to afford resident fees, including downturns in the economy, housing market, consumer confidence or the equity 
markets and unemployment among family members; changes in reimbursement rates, methods, or timing under governmental 
reimbursement programs including the Medicare and Medicaid programs; the impact of ongoing healthcare reform efforts; the 
effects of senior housing construction and development, oversupply, and increased competition; disruptions in the financial markets 
that affect our ability to obtain financing or extend or refinance debt as it matures and our financing costs; the risks associated 
with current global economic conditions and general economic factors such as inflation, the consumer price index, commodity 
costs, fuel and other energy costs, costs of salaries, wages, benefits, and insurance, interest rates, and tax rates; the impact of 
seasonal contagious illness or an outbreak of other contagious disease in the markets in which we operate; our ability to generate 
sufficient cash flow to cover required interest and long-term lease payments and to fund our planned capital projects; the effect of 
our indebtedness and long-term leases on our liquidity; the effect of our non-compliance with any of our debt or lease agreements 
(including the financial covenants contained therein), including the risk of lenders or lessors declaring a cross default in the event 
of our non-compliance with any such agreements and the risk of loss of our property securing leases and indebtedness due to any 
resulting lease terminations and foreclosure actions; the effect of our borrowing base calculations and our consolidated fixed charge 
coverage ratio on availability under our revolving credit facility; the potential phasing out of LIBOR which may increase the costs 
of our debt obligations; increased competition for or a shortage of personnel, wage pressures resulting from increased competition, 
low unemployment levels, minimum wage increases and changes in overtime laws, and union activity; failure to maintain the 
security and functionality of our information systems, to prevent a cybersecurity attack or breach, or to comply with applicable 
privacy and consumer protection laws, including HIPAA; our inability to achieve or maintain profitability; our ability to complete 
pending or expected  disposition, acquisition, or  other transactions  on  agreed  upon  terms  or at all,  including  in respect  of  the 
satisfaction of closing conditions, the risk that regulatory approvals are not obtained or are subject to unanticipated conditions, 
and uncertainties as to the timing of closing, and our ability to identify and pursue any such opportunities in the future; our ability 
to obtain additional capital on terms acceptable to us; our ability to complete our capital expenditures in accordance with our plans; 
our ability to identify and pursue development, investment and acquisition opportunities and our ability to successfully integrate 
acquisitions; competition for the acquisition of assets; delays in obtaining regulatory approvals; terminations, early or otherwise, 
or non-renewal of management agreements; conditions of housing markets, regulatory changes, acts of nature, and the effects of 
climate change in geographic areas where we are concentrated; terminations of our resident agreements and vacancies in the living 
spaces  we  lease;  departures  of  key  officers  and  potential  disruption  caused  by  changes  in  management;  risks  related  to  the 
implementation of our strategy, including initiatives undertaken to execute on our strategic priorities and their effect on our results; 
actions of activist stockholders, including a proxy contest; market conditions and capital allocation decisions that may influence 
our determination from time to time whether to purchase any shares under our existing share repurchase program and our ability 
to fund any repurchases; our ability to maintain consistent quality control; a decrease in the overall demand for senior housing; 
environmental  contamination  at  any  of  our  communities;  failure  to  comply  with  existing  environmental  laws;  an  adverse 
determination or  resolution of  complaints  filed  against us;  the  cost  and  difficulty  of  complying  with  increasing  and evolving 
regulation;  costs  to  respond  to,  and  adverse  determinations  resulting  from,  government  reviews,  audits  and  investigations; 
unanticipated costs to comply with legislative or regulatory developments; as well as other risks detailed from time to time in our 
filings with the Securities and Exchange Commission, including those set forth under "Item 1A. Risk Factors" contained in this 
Annual Report on Form 10-K and elsewhere in this Annual Report on Form 10-K. When considering forward-looking statements, 
you should keep in mind the risk factors and other cautionary statements in such SEC filings. Readers are cautioned not to place 
undue reliance on any of these forward-looking statements, which reflect management's views as of the date of this Annual Report 
on Form 10-K. We cannot guarantee future results, levels of activity, performance or achievements, and, except as required by 
law, we expressly disclaim any obligation to release publicly any updates or revisions to any forward-looking statements contained 
in this Annual Report on Form 10-K to reflect any change in our expectations with regard thereto or change in events, conditions 
or circumstances on which any statement is based. 

4

Item 1. 

Business

PART I

Unless otherwise specified, references to "Brookdale," "we," "us," "our," or "the Company" in this Annual Report on Form 10-K 
mean Brookdale Senior Living Inc. together with its consolidated subsidiaries. 

Our Business

As of February 1, 2020, we are the largest operator of senior living communities in the United States based on total capacity, with 
743 communities in 45 states and the ability to serve approximately 65,000 residents. We offer our residents access to a broad 
continuum of services across the most attractive sectors of the senior living industry. We operate and manage independent living, 
assisted living, memory care, and continuing care retirement communities ("CCRCs"). We also offer a range of home health, 
hospice, and outpatient therapy services to more than 20,000 patients as of that date. 

Our community and service offerings combine housing with hospitality and healthcare services. Our senior living communities 
offer residents a supportive home-like setting, assistance with activities of daily living ("ADLs") such as eating, bathing, dressing, 
toileting, transferring/walking, and, in certain communities, licensed skilled nursing services. We also provide home health, hospice, 
and outpatient therapy services to residents of many of our communities and to seniors living outside of our communities. By 
providing residents with a range of service options as their needs change, we provide greater continuity of care, enabling seniors 
to age-in-place, which we believe enables them to maintain residency with us for a longer period of time. The ability of residents 
to age-in-place is also beneficial to our residents and their families who are concerned with care decisions for their elderly relatives. 

Strategy

Our goal is to be the first choice in senior living by being the nation's most trusted and effective senior living provider and employer. 
We believe there are significant opportunities to deliver stockholder value as we execute on our strategy to achieve this goal. We 
continue to execute our core operational strategy that we initiated in early 2018, and we believe successful execution on that 
strategy provides the best opportunity for us to create stockholder value. We have supplemented our operational strategy with 
initiatives intended to complement and enhance our core operational efforts and to position us for future growth and success as 
we encounter changes and trends in demographics, technology, and healthcare delivery methods. Our refined strategy is focused 
on these priorities: 

•  Continued Operational Improvement and Simplification. We are focused on our core senior living communities and intend 
to continue to drive improvements in our senior living portfolio by winning locally. Through our "win locally" initiative, we 
intend to provide choices for high quality care and personalized service by caring associates while leveraging our industry-
leading scale and experience. Such efforts include improvements to our sales and marketing process, prioritizing communities 
with the most opportunities for improvement, and ensuring that our communities are ready for new competition. We also 
continue to focus on attracting, engaging, developing, and retaining the best associates by maintaining a compelling value 
proposition in the areas of compensation, leadership, career development, and meaningful work. We believe engaged associates 
lead to an enhanced resident experience, lower turnover, and, ultimately, improved operations. To sharpen our focus on our 
core senior living operations, we are (and have been) executing on initiatives to reduce the complexity of our business and 
to ensure appropriate risk-reward tradeoffs in our highly regulated product lines. Such initiatives include exiting our entry 
fee CCRC business and continuing to optimize our management services business. 

• 

Senior Living Portfolio. Since initiating our operational turnaround strategy in early 2018, we have continued our portfolio 
optimization initiative through which we have disposed  of owned  and leased communities  and  restructured leases. Such 
transactions have  included restructuring our leases with our three largest landlords, sales  of 36 owned communities, and 
dispositions of substantially all of our interests in unconsolidated ventures  (including our equity interests in 14  entry fee 
CCRCs). As we emerge from our disposition phase, we intend to (i) increase our ownership percentage in our senior housing 
portfolio through acquiring leased or managed communities and exiting underperforming leases when possible, (ii) expand 
our footprint and services in core markets where we have, or can achieve, a clear leadership position, (iii) formalize and 
execute an ongoing capital recycling program, including opportunistically selling certain communities to invest in expansion 
of our existing communities and the acquisition or development of newer communities with lower capital expenditure needs, 
and (iv) pivot back to portfolio growth through targeted development, investment, and acquisition opportunities such as de 
novo development and selective acquisitions of senior living communities and operating companies. We will continue to 
invest in our development capital expenditures program through which we expand, renovate, reposition, and redevelop selected 
existing  senior  living  communities  where  economically  advantageous.  For  2020,  we  expect  to  continue  to  pursue  non-
development capital expenditures at higher-than-typical amounts, but at significantly less than 2019 amounts. Beginning in 

5

2021, we expect our annual community-level capital expenditures to be between $2,000 and $2,500 per weighted average 
unit. 

•  Expansion of Healthcare and Service Platform. Our vision is to enable those we serve to live well by offering the most 
integrated and highest-quality healthcare and wellness platform in the senior living industry. We intend to pilot a more integrated 
healthcare service model in certain markets in 2020. We also intend to pursue initiatives designed to accelerate growth in our 
healthcare services business, primarily by growing our hospice and home health business lines, and to grow our private duty 
business.  Such  initiatives  may  include  further  acquisitions  of  hospice  agencies  or  certificates  of  need  in  our  geographic 
footprint, further expansion of our services to seniors living outside our communities, implementation of improvements to 
our  sales  and  marketing  efforts  associated  with  our  healthcare  services  business,  and  pursuit  of  additional  or  expanded 
relationships with managed care providers. We believe the successful execution of these initiatives will increase our revenues 
and improve the results of operations of our Health Care Services segment and that the overall implementation of our integrated 
healthcare  strategy  will  benefit  our  core  senior  housing  business  by  increasing  move-ins,  improving  resident  health  and 
wellbeing, and increasing our average length of stay and occupancy. 

•  Driving Innovation and Leveraging Technology. We are engaged in a variety of innovation initiatives and over time plan 
to pilot and test new ideas, technologies, and operating models in order to enhance our residents' experience, improve outcomes, 
and increase average length of stay and occupancy. With our technology platform, we also expect to identify solutions to 
reduce complexity, increase productivity, lower costs, and increase our ability to partner with third parties. 

Recent Developments 

Community Portfolio 

Since launching our core operational strategy in February 2018, we have executed on the initiative to optimize our community 
portfolio through dispositions of owned and leased communities and restructuring leases. We undertook this initiative to simplify 
and streamline our business, increase the quality and durability of our cash flow, improve our liquidity, reduce our debt and lease 
leverage, and increase our ownership in our consolidated community portfolio. Such activities included our transactions with 
Ventas, Inc. ("Ventas") and Welltower Inc. ("Welltower") announced during 2018 and our transactions with Healthpeak Properties, 
Inc. ("Healthpeak") (f/k/a HCP, Inc.) announced on October 1, 2019. 

As a  result of these initiatives and other  lease restructuring, expiration  and termination activity, and  other  transactions, since 
January 1, 2018 through February 1, 2020 we have: 

• 
• 
• 
• 

• 
• 

restructured our triple-net lease portfolios with our three largest lessors;
terminated our triple-net lease obligations on an aggregate of 99 communities;
acquired 32 formerly-leased or managed communities;
disposed of an aggregate of 36 owned communities generating $288.3 million of proceeds, net of related debt and transaction 
costs; 
sold substantially all of our ownership interests in unconsolidated ventures, including our entry fee CCRC venture; and
reduced our management of communities on behalf of former unconsolidated ventures and third parties. 

6

As of February 1, 2020, we owned 356 communities, representing a majority of our consolidated community portfolio, and leased 
307 communities. We also managed 77 communities on behalf of third parties and three communities for which we have an equity 
interest. The charts below show the foregoing changes in our portfolio from January 1, 2018 to February 1, 2020.

During the remainder of the year ending December 31, 2020, we expect to close on the dispositions of three owned communities 
(495 units) classified as held for sale as of December 31, 2019 and the termination of our lease obligation on three communities 
(205 units) for which we have provided notice of non-renewal. We also anticipate terminations of certain of our management 
arrangements with third parties as we transition to new operators our management on certain former unconsolidated ventures in 
which we sold our interest and our interim management on formerly leased communities. The closings of the various pending and 
expected transactions are, or will be, subject to the satisfaction of various closing conditions, including (where applicable) the 
receipt of regulatory approvals. However, there can be no assurance that the transactions will close or, if they do, when the actual 
closings will occur. 

See "Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations" for more information 
about the foregoing transactions and their impact on our results of operations. 

Capital Expenditures

During 2018, we completed an intensive review of our community-level capital expenditure needs with a focus on ensuring that 
our communities are in appropriate physical condition to support our strategy and determining what additional investments are 
needed to protect the value of our community portfolio. Our total community-level capital expenditures were $238.7 million for 
2019, which was an increase of $97.7 million from  2018,  and  $34.8 million  of which was reimbursed by  our  lessors. In  the 
aggregate, we expect our full-year 2020 non-development capital expenditures, net of anticipated lessor reimbursements, to be 
approximately $190 million, which includes a decrease of approximately $50 million in our community-level capital expenditures 
relative to 2019, as we have completed a significant portion of the major building infrastructure projects identified in our 2018 
review.  In  addition,  we  expect  our  full-year  2020  development  capital  expenditures  to  be  approximately  $30  million,  net  of 
anticipated lessor reimbursements, and such projects include those for expansion, repositioning, redeveloping, and major renovation 
of selected existing senior living communities. We anticipate that our 2020 capital expenditures will be funded from cash on hand, 
cash flows from operations, reimbursements from lessors, and, if necessary, amounts drawn on our secured credit facility. 

The Senior Living Industry

The  senior  living  industry  has  undergone  dramatic  growth  in  the  last  25  years,  marked  by  the  emergence  of  assisted  living 
communities in the mid-1990s, and it remains highly fragmented with numerous local and regional operators. According to data 
from the National Investment Center for the Seniors Housing & Care Industry ("NIC"), there were more than 2,400 local and 
regional senior housing operators as of December 31, 2019, of which more than 90% operated five or fewer communities. We are 
one of a limited number of large operators that provide a broad range of community locations and service level offerings at varying 
price levels.

Beginning in 2007, the senior housing industry was affected negatively by the downturn in the general economy, which resulted 
in a  near  halt  in construction  of  new communities. The  industry  experienced  a slow  recovery  in  occupancy  and  rate  growth 
beginning in 2010 according to NIC. In more recent years, as the economy has improved and demographic trends favorable to the 

7

industry have drawn nearer, the industry has attracted increased investment resulting in increased construction and development 
of new senior housing supply. New openings of senior housing communities and oversupply have subjected the senior housing 
industry to increased competitive pressures.

Data from NIC shows that industry occupancy began to decrease starting in 2016 as a result of new openings and oversupply. 
During and since 2016, we have experienced an elevated rate of competitive new openings, with significant new competition 
opening in many markets, which has adversely affected our occupancy, revenues, results of operations, and cash flow. Elevated 
rates of competitive new openings and pressures on our occupancy and rate growth continued through 2019. On an industry basis, 
data from NIC shows that net absorption of units, a marker of demand, for the third quarter of 2019 was the highest single quarter 
since 2006. Projections from NIC, as applied to our product mix, suggest that annual absorption will be around equilibrium with 
new supply during 2020. We believe that a number of trends will contribute to the continued growth of the senior living industry 
in coming years. 

As a result of scientific and medical breakthroughs over the past 30 years, seniors are living longer. Due to demographic trends, 
and continuing advances in science, nutrition, and healthcare, the senior population will continue to grow, and we expect the 
demand for senior housing and healthcare services to continue to increase in future years. The primary market of the senior living 
industry is individuals age 80 and older. According to United States Census data, that group's population is projected to increase 
by nearly 50% to a population of 20 million by 2030. Senior housing penetration, the total number of senior housing units divided 
by households headed by someone 75 years old or older, continues to be approximately 11%. 

We believe the senior living industry has been and will continue to be impacted by several other trends. As seniors are living longer 
and this segment of the population rapidly grows, so will the number living with Alzheimer's disease and other dementias and the 
burden of chronic diseases and conditions. As a result of increased mobility in society, a reduction of average family size, and 
increased number of two-wage earner couples, families struggle to provide care for seniors and therefore look for alternatives 
outside of their family for care. There is a growing consumer awareness among seniors and their families concerning the types of 
services provided by senior living operators, which has further contributed to the demand for senior living services. 

In recent years, the high level of new openings, as well as lower levels of unemployment generally, have contributed to wage 
pressures and increased competition for community leadership and personnel. We continue to address new competition by focusing 
on operations with the objective to ensure high customer satisfaction, retain key leadership, and actively engage district and regional 
management in community operations; enhancing our local and national marketing and public relations efforts; and evaluating 
current community position relative to competition and repositioning if necessary (e.g., services, amenities, programming, and 
price). Like other companies, our financial results may be negatively impacted by increasing salaries, wages, and benefits costs 
for our associates. Typically the industry has reduced the impact of wage increases by implementing price increases, although 
there can be no assurance that such costs can be covered each year. Higher costs of food, utilities, insurance, and real estate taxes 
may also have a negative impact on our financial results. 

Challenges in our industry include increased state and local regulation of the assisted living, memory care, and skilled nursing 
sectors, which has led to an increase in the cost of doing business. The regulatory environment continues to intensify in the number 
and types of laws and regulations affecting us, accompanied by increased enforcement activity by state and local officials. In 
addition, there continue to be various federal and state legislative and regulatory proposals to implement cost containment measures 
that would limit payments to healthcare providers in the future. We cannot predict what action, if any, Congress will take on 
reimbursement policies of the Medicare or Medicaid programs or what future rule changes the Centers for Medicare & Medicaid 
Services ("CMS") will implement. Changes  in the  reimbursement rates,  such  as the  recent implementation of  Patient Driven 
Payment Model ("PDPM") and Patient-Driven Groupings Model ("PDGM"), or methods or timing of government reimbursement 
programs could adversely affect our revenues, results of operations, and cash flow. 

Competition

The senior living industry is highly competitive. We compete with numerous organizations, including not-for-profit entities, that 
offer  similar communities and services, such as home  health care  and  hospice agencies,  community-based service  programs, 
retirement  communities,  convalescent  centers,  and  other  senior  living  providers.  In  general,  regulatory  and  other  barriers  to 
competitive entry in the independent living, assisted living, and memory care sectors of the senior living industry are not substantial. 
Consequently, we may encounter competition that could limit our ability to attract and retain residents and associates, raise or 
maintain resident fees, and expand our business, which could have a material adverse effect on our occupancy, revenues, results 
of operations, and cash flows. Our major publicly-traded senior housing competitors are Capital Senior Living Corporation and 
Five Star Senior Living, Inc. Our major private senior housing competitors include Holiday Retirement, Life Care Services, LLC, 
Atria Senior Living Inc., Senior Lifestyle Corp., and Sunrise Senior Living, LLC, as well as a large number of not-for-profit 
entities. 

8

Over  the  long  term  we  plan  to  evaluate  and,  where  opportunities  arise,  pursue  development,  investment,  and  acquisition 
opportunities such as selective acquisitions of senior living communities and operating companies. The market for acquiring and/
or operating senior living communities is highly competitive, and some of our present and potential senior living competitors 
have, or may obtain, greater financial resources than us and may have a lower cost of capital. In addition, several publicly-traded 
and non-traded real estate investment trusts ("REITs") and private equity firms have similar objectives as we do, along with greater 
financial resources and/or lower costs of capital than we are able to obtain. Partially as a result of tax law changes enacted through 
REIT Investment Diversification and Empowerment Act ("RIDEA"), we now compete more directly with the various publicly-
traded healthcare REITs for the acquisition of senior housing properties, the largest of which are Healthpeak, Ventas, and Welltower. 

Our History

Brookdale Senior Living Inc. was formed as a Delaware corporation in June 2005 for the purpose of combining two leading senior 
living operating companies, Brookdale Living Communities, Inc. and Alterra Healthcare Corporation, which had been operating 
independently since 1986 and 1981, respectively. On November 22, 2005, we completed our initial public offering of common 
stock, and on July 25, 2006, we acquired American Retirement Corporation, another leading senior living provider that had been 
operating independently since 1978. On September 1, 2011, we completed the acquisition of Horizon Bay, which was the then-
ninth largest operator of senior living communities in the United States. On July 31, 2014, we completed our acquisition by merger 
of Emeritus Corporation, which was the then-second largest operator of senior living communities in the United States. 

Segments

As of December 31, 2019, we had five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; 
Health Care Services; and Management Services. These segments were determined based on the way that our chief operating 
decision maker organizes our business activities for making operating decisions, assessing performance, developing strategy, and 
allocating capital resources. 

Communities that we own or lease are included in the Independent Living, Assisted Living and Memory Care, or CCRCs segment, 
as applicable. The home health, hospice, and outpatient therapy services provided to our residents and seniors living outside of 
our communities are generally included in the Health Care Services segment, while skilled nursing and inpatient healthcare services 
provided in our skilled nursing units are included in the CCRCs segment. Communities that we manage on behalf of third parties 
or unconsolidated ventures in which we have an ownership interest are included in the Management Services segment. The table 
below shows the number of communities and units within each of our senior housing and Management Services segments as of 
December 31, 2019. 

Segments

Independent Living

Assisted Living and Memory Care

CCRCs

Management Services

Total

Communities

Units

% of Total
Units

Average
Number of
Units per
Community

68

573

22

100

763

12,514

35,956

5,711

18,086

72,267

17.3%

49.8%

7.9%

25.0%

100.0%

184

63

260

181

95

9

For the year ended December 31, 2019, we generated 80.1% of our resident fee revenue from private pay customers, 15.9% from 
government reimbursement programs (primarily Medicare) and 4.0% from other payor sources. Approximately 86.1% of resident 
fee revenue was derived from our senior housing segments, of which 47.0% of our resident fee revenue was generated from owned 
communities and 39.1% was generated from leased communities. Our Health Care Services segment generated 13.9% of resident 
fee revenue. The table below shows the percentage of our resident fee and management fee revenue attributable to each of our 
segments for the year ended December 31, 2019. 

Segments (in thousands)

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Management Services

Total resident fee and management fee revenue

Resident Fee and
Management Fee Revenue

% of Total

$

$

544,558

1,815,938

402,175

447,260

57,108

16.7%

55.6%

12.3%

13.7%

1.7%

3,267,039

100.0%

Further operating results and financial metrics from our five segments are discussed further in "Item 7. Management's Discussion 
and Analysis of Financial Condition and Results of Operations" and Note 20 to our consolidated financial statements contained 
in "Item 8. Financial Statements and Supplementary Data."

Our Community Offerings

We offer a variety of senior living communities in locations across the United States. We operate and manage independent living, 
assisted living, and memory care communities, and CCRCs. The majority of our units are organized in campus-like settings or 
stand-alone communities offering multiple service levels. 

Independent Living Communities

Our independent living communities are primarily designed for middle to upper income seniors who desire a change in lifestyle 
within a residential environment to live life to the fullest. A number of our independent living residents relocate to one of our 
communities in order to be in a metropolitan area that is closer to their adult children. The majority of our independent living 
communities consist of both independent and assisted living units in a single community, which allows residents to age-in-place 
by providing them with a broad continuum of senior independent and assisted living services. While the number varies depending 
upon  the  particular  community,  as  of  December 31,  2019  approximately  80%  of  all  of  the  units  at  our  independent  living 
communities were independent living units, with the balance of the units licensed for assisted living and memory care. 

Our independent living communities generally are large multi-story buildings averaging 184 units with extensive common areas 
and amenities. Residents may choose from studio, one-bedroom, and two-bedroom units, depending upon the specific community. 
Each independent living community provides residents with basic services such as dining service options, 24-hour emergency 
response, housekeeping, and recreational activities. Most of these communities also offer custom tailored concierge and personal 
assistance/private  duty  services  at  an  additional  charge,  which  may  include  medication  reminders,  check-in,  transportation, 
shopping, escort, and companion services. 

In addition  to the basic services,  our independent living communities  that  include assisted  living also  provide  residents with 
personal care and convenience service options to provide assistance with ADLs. The levels of care provided to residents vary from 
community to community depending, among other things, upon the licensing requirements and healthcare regulations of the state 
in which the community is located.

Residents in our independent living communities are able to maintain their residency for an extended period of time due to the 
range of service options available (not including skilled nursing). Residents with cognitive or physical frailties and higher level 
service needs are accommodated with supplemental services in their own units or, in certain communities, are cared for in a more 
structured and supervised environment on a separate wing or floor. These communities also generally have a dedicated assisted 
living staff and separate assisted living dining rooms and activity areas. 

10

Assisted Living and Memory Care Communities

Our assisted living and memory care communities offer housing and 24-hour assistance with ADLs to mid-acuity and frail elderly 
residents. Residents typically enter an assisted living or memory care community due to a relatively immediate need for services 
that may have been triggered by a medical event. Our assisted living and memory care communities include both freestanding, 
multi-story communities with more than 50 beds, and smaller, freestanding, single story communities. Depending upon the specific 
location, the community may include (i) private studio, one-bedroom, and one-bedroom deluxe apartments, or (ii) individual rooms 
for one or two residents in wings or "neighborhoods" scaled to a single-family home, which includes a living room, dining room, 
patio or enclosed porch, laundry room, and personal care area, as well as a caregiver work station.

We also provide memory care services at freestanding memory care communities that are specially designed for residents with 
dementia, including Alzheimer's disease and other forms of cognitive impairment. Our freestanding memory care communities 
have  approximately  20  to  70  beds  and  some  are  part  of  a  campus-like  setting  which  includes  a  freestanding  assisted  living 
community. As of December 31, 2019, we provide memory care services at 392 of our communities, aggregating 10,350 memory 
care units across our segments. These communities include 112 freestanding memory care communities with 4,347 units included 
in our Assisted Living and Memory Care segment. 

All residents at our assisted living and memory care communities are eligible to receive the basic care  level, which includes 
ongoing health assessments, three meals per day and snacks, 24-hour staff assistance, coordination of special diets planned by a 
registered dietitian, assistance with coordination of physician care, social and recreational activities, housekeeping, and personal 
laundry services. In some locations we offer our residents exercise programs and programs designed to address issues associated 
with early stages of Alzheimer's disease and other dementias. For an additional cost at these communities, we offer higher levels 
of personal care services to residents who are more physically frail or require more frequent or intensive physical assistance or 
increased personal care and supervision due to cognitive impairments.

As a result of their progressive decline in cognitive abilities, residents at our memory care units typically require higher levels of 
personal care and services than in assisted living and therefore pay  higher monthly service fees. Specialized services include 
assistance with ADLs, behavior management, and an activities program, the goal of which is to provide a normalized environment 
that supports residents' remaining functional abilities. 

CCRCs

Our CCRCs are large communities that offer a variety of living arrangements and services to accommodate all levels of physical 
ability and health. Most of our CCRCs have independent living, assisted living, and skilled nursing available on one campus or 
within the immediate area, and some also include memory care services. Our CCRCs residents are generally senior citizens who 
are seeking a community that offers a broad continuum of care so that they can age-in-place. These residents generally first enter 
the community as a resident of an independent living unit and may later move into an assisted living or skilled nursing area as 
their needs change. 

Our Healthcare Services Offerings 

Through our Health Care Services segment we currently provide home health, hospice, and outpatient therapy services, as well 
as education and wellness programs, to residents of many of our communities and to seniors living outside of our communities. 
As of December 31, 2019, our Health Care Services segment platform included networks in 28 states with the ability to provide 
home health services to approximately 65% of our units, hospice services to approximately 25% of our units, and outpatient therapy 
to approximately 20% of our units. Skilled nursing and inpatient healthcare services provided in our skilled nursing units are 
included in the CCRCs segment. During the year ended 2019, we generated approximately 50% of our Health Care Services 
segment revenue from residents at our communities and approximately 50% from our patients outside our communities. 

The home health services we provide include skilled nursing, physical therapy, occupational therapy, speech language pathology, 
home health aide services, and social services as needed. Our hospice services include clinical and skilled care, as well as spiritual 
and  emotional  counseling.  Our  outpatient  therapy  services  include  physical  therapy,  occupational  therapy,  speech  language 
pathology services, and other specialized therapy. The majority of our home health, hospice, and outpatient therapy services are 
reimbursed by government reimbursement programs, primarily Medicare, and non-covered services are paid directly by residents 
from private pay sources. Our education and wellness programs focus on wellness and physical fitness to allow residents to maintain 
maximum independence. These services provide many continuing education opportunities for seniors and their families through 
health fairs, seminars, and other consultative interactions. We believe that our integrated healthcare services offerings are unique 
among senior housing operators and that we have a significant advantage over our senior housing competitors with respect to 
providing such services because of our established infrastructure, scale, and experience. 

11

Management Services

As of December 31, 2019, we managed 17 communities for which we have an equity interest and 83 communities on behalf of 
third parties, which represented approximately 25% of our senior housing capacity. The table below shows the type and number 
of communities and units contained in our Management Services segment as of December 31, 2019 and the percentage of our 
management fee revenue attributable to such community types for the year ended December 31, 2019. 

Community Type

Independent living

Assisted living and memory care

CCRC

Total

Communities

16

48

36

100

Units

3,084

4,095

10,907

18,086

% of Total
Units

Management
Fees

% of Total
Management
Fees

17.1%

22.6%

60.3%

100.0%

$

$

12,969

9,614

34,525

57,108

22.7%

16.8%

60.5%

100.0%

Effective January 31, 2020, we terminated our management agreements with respect to 14 entry fee CCRCs (6,383 units) pursuant 
to the agreements entered into with Healthpeak on October 1, 2019. 

Under our management arrangements, we receive management fees, which are generally determined by an agreed upon percentage 
of gross revenues (as defined in the management arrangement), as well as reimbursed expenses, which represent the reimbursement 
of certain expenses we incur on behalf of the owners. A majority of our management arrangements as of December 31, 2019 are 
interim management arrangements entered into in connection with prior lease terminations that may be terminated by either party 
on short notice and without any reason, have a remaining term of approximately one year or less, or may be terminated by the 
owner within the next year. Generally either party to our management arrangements may terminate upon the occurrence of an 
event of default caused by the other party, generally subject to cure rights. Several long-term agreements also provide for early 
termination rights of the owner which may in some cases require an early termination fee. Termination, early or otherwise, or non-
renewal of, or renewal on less-favorable terms, of our management arrangements could cause an unexpected loss in revenues and 
would negatively impact our results of operations and cash flows. 

During  the  year  ended  December 31,  2019,  approximately  54%  of  our  management  fees  revenue  was  derived  from  services 
provided to entities in which Healthpeak held an interest, including 38% of our management fees revenue derived from services 
provided to our unconsolidated entry fee CCRC venture with Healthpeak of which we sold our interest in 14 of 16 communities 
effective January 31, 2020. 

Competitive Strengths

We believe our national network of senior living communities and healthcare services networks are well positioned to benefit 
from the future growth and increasing demand in the industry. Some of our most significant competitive strengths are: 

• 

Skilled management team with extensive experience. Our senior management team and our Board of Directors have extensive 
experience in the senior living, healthcare, hospitality, and real estate industries, including the operation and management of 
a broad range of senior living assets. 

•  Geographically diverse, high-quality, purpose-built communities. As of February 1, 2020, we are the largest operator of senior 
living communities in the United States based on total capacity, with 743 communities in 45 states and the ability to serve 
approximately 65,000 residents. 

•  Ability to provide a broad spectrum of care. Given our diverse mix of independent living, assisted living and memory care 
communities, and CCRCs, as well as our healthcare services offerings, we are able to meet a wide range of our residents' and 
patients' needs. We believe that we are one of the few companies in the senior living industry with this capability and the only 
company that does so at scale on a national basis. We believe that our multiple product offerings create marketing synergies 
and cross-selling opportunities. 

• 

Significant experience in providing healthcare services. Through our Health Care Services segment, we provide a range of 
home health, hospice, outpatient therapy, education, wellness, and other services to residents of certain of our communities 
and to seniors outside our communities, which we believe is a distinct competitive difference among senior housing operators. 
We have significant experience in providing these services and expect to increase revenues as we expand our offerings of 

12

these services to additional residents and seniors living outside of our communities. As of February 1, 2020, we serve over 
20,000 patients.

• 

The size of our business allows us to realize cost and operating efficiencies while continuing a local-community focus. The 
size of our business allows us to realize cost savings, economies of scale in the procurement of goods and services, and access 
to favorable debt and financing terms.  Our scale also  allows  us to  achieve increased efficiencies  with  respect to various 
corporate functions. We negotiate contracts for food, insurance, and other goods and services with the advantages that scale 
provides. In addition, we leverage our centralized corporate functions such as finance, human resources, legal, information 
technology, and marketing. We intend to utilize our expertise and size to capitalize on economies of scale resulting from our 
national  platform  and  to  enhance  our  residents'  and  patients'  experiences.  We  believe  that  our  geographic  footprint  and 
centralized infrastructure provide us with a significant operational advantage over local and regional operators of senior living 
communities. 

Seasonality

Our senior housing business has typically experienced some seasonality, which we experience in certain regions more than others, 
due to weather patterns, geography, and higher incidence and severity of flu and other illnesses during winter months. Although 
our seasonal pattern varies from year to year, our average monthly occupancy generally begins to decline sequentially in the fourth 
quarter of the year, and we generally expect average monthly occupancy to begin to increase towards the end of the second quarter 
each year. Utility expenses trend seasonally high in the first quarter and third quarter of each year. Operating expenses, such as 
labor, food, and supplies also trend higher in the second half of the year compared with the first half due to an increased number 
of working days. 

Operations

Operations Overview

We have implemented intensive standards, policies and procedures, and systems, including detailed staff resources and training 
materials, which we believe have  contributed to  high  levels  of  customer service.  Further, we  believe our  centralized support 
infrastructure allows our community-based leaders and personnel to focus on resident care and family connections. 

Consolidated Corporate Operations Support

We have developed a centralized support infrastructure and services platform, which provides us with a significant operational 
advantage over local and regional operators of senior living communities. The size of our business also allows us to achieve 
increased efficiencies with respect to various corporate functions such as procurement, human resources, finance, accounting, 
legal, information technology, and marketing. We are also able to realize cost efficiencies in the purchasing of food, supplies, 
insurance, benefits, and other goods and services. In addition, we have established centralized operations groups to support all of 
our product lines and communities in areas such as training, regulatory affairs, asset management, dining, clinical services, sales, 
customer engagement, marketing, and procurement. We have also established company-wide policies and procedures relating to, 
among other things: resident care; community design and community operations; billing and collections; accounts payable; finance 
and accounting; risk management; development of associate training materials and programs; advertising and marketing activities; 
the hiring and training of management and other community-based personnel; compliance with applicable local and state regulatory 
requirements; and implementation of our acquisition, development, and leasing plans. 

Community Staffing and Training

Each community has an Executive Director responsible for the overall day-to-day operations of the community, including quality 
of care and service, social services, and financial performance. Each Executive Director receives specialized training from our 
learning and  development  associates.  In  addition, a  portion of  each  Executive Director's  compensation  is  directly tied to  the 
operating performance of the community and key care and service quality measures. We continue to take actions intended to 
simplify the role of our Executive Directors to allow them to focus on our residents and their families and our associates. We 
believe that the quality of our communities, coupled with our competitive compensation philosophy and our ability to provide 
industry-leading systems and training, has enabled us to attract high-quality, professional community Executive Directors. 

Depending upon the size and type of the community, each Executive Director is supported by key leaders, a Health and Wellness 
Director (or nursing director), and/or a Sales Director. The Health and Wellness Director or nursing director is directly responsible 
for day-to-day care of residents. The Sales Director oversees the community's sales, marketing, and community outreach programs. 

13

Other key positions supporting each community may include individuals responsible for food service, healthcare services, activities, 
housekeeping, and maintenance. 

We believe that quality of care and operating efficiency can be maximized by direct resident and staff contact. Associates involved 
in resident care, including administrative staff, are trained in support and care protocols, including emergency response techniques. 
We have adopted formal training and evaluation procedures to help ensure quality care for our residents. We have extensive policy 
and procedure manuals and hold regular training sessions for management and staff at each community. 

Quality Assurance

We maintain quality assurance programs at each of our communities through our corporate and regional staff. Our quality assurance 
programs are designed to achieve a high degree of resident and family member satisfaction through the care and services that we 
provide. Our quality control measures include, among other things, community inspections conducted by corporate staff on a 
regular basis. These inspections cover the appearance of the exterior and grounds; the appearance and cleanliness of the interior; 
the professionalism and friendliness of staff; quality of resident care (including assisted living services, nursing care, therapy, and 
home health programs); the quality of activities and the dining program; observance of residents in their daily living activities; 
and compliance with government regulations. Our quality control measures also include the survey of residents and family members 
on a regular basis to monitor their perception of the quality of services we provide to residents. 

In order to foster a sense of belonging and engagement, as well as to respond to residents' needs and desires, at many of our 
communities, we have established a resident council or other resident advisory committees that meet at least monthly with the 
Executive Director of the community. Separate resident committees also exist at many of these communities for food service, 
activities, marketing, and hospitality. These committees promote resident involvement and satisfaction and enable community 
management to be more responsive to their residents' needs and desires. 

Marketing and Sales

Our marketing efforts are intended to create awareness of our brand and services to educate prospects and referral sources about 
the Brookdale difference. We meet prospects where they are in their journey, whether they are learning about senior living for the 
first time or need to schedule a visit at one of our communities. We target a variety of audiences who have a role in the decision-
making process for senior housing and our healthcare services, including potential residents, their family members and referral 
sources, including the medical community (hospital discharge planners, physicians, skilled nursing facilities, home health agencies, 
and  social  workers),  professional  organizations,  employer  groups,  clergy,  area  agencies  for  the  elderly,  and  paid  referral 
organizations. Our marketing associates develop strategies to promote our communities at the local market and national level. We 
execute an integrated marketing campaign approach, including local media and outreach programs, digital advertising, social 
media, print advertising, e-mail, direct mail, and special  events,  such as  health fairs  and  community receptions. We  generate 
hundreds of thousands of customer inquiries that go directly to our communities and Brookdale website. All online forms and 
many calls are handled by trained senior living advisors in our Brookdale Connection Center, who schedule visits directly to our 
communities. Certain resident referral programs have been established and promoted at many communities within the limitations 
of federal and state laws. 

We will continue to leverage and grow our Brookdale brand to win locally in the markets we serve. In many markets where we 
offer more choices for senior living based on budget, lifestyle, and care needs, we use a network selling methodology to educate 
prospects on all of the options available. With our selling model, sales associates are organized to support individual and multiple 
communities directly. To meet the needs of local demand and supply, we create differentiated value through the segmentation of 
our communities based on price, service offerings, amenities, and programs offered. 

Employees

As of December 31, 2019, we had approximately 38,400 full-time employees and approximately 20,000 part-time employees, of 
which approximately 500 work in our Brentwood, Tennessee headquarters office and approximately 500 work in our Milwaukee, 
Wisconsin office. We currently consider our relationship with our employees to be good. 

Industry Regulation

The regulatory environment surrounding the senior living industry continues to intensify in the number and type of laws and 
regulations affecting it. Federal, state, and local officials are increasingly focusing their efforts on enforcement of these laws and 
regulations. This is particularly true for large for-profit, multi-community providers like us. Some of the laws and regulations that 
impact  our  industry  include:  state  and  local  laws  impacting  licensure,  protecting  consumers  against  deceptive  practices,  and 
14

generally affecting the communities' management of property and equipment and how we otherwise conduct our operations, such 
as fire, health, and safety laws and regulations, and privacy laws; federal and state laws governing Medicare and Medicaid, which 
regulate allowable costs, pricing, quality of services, quality of care, food service, resident rights (including abuse and neglect) 
and fraud; federal and state residents' rights statutes and regulations; Anti-Kickback and physicians referral ("Stark") laws; and 
safety and health standards set by the Occupational Safety and Health Administration. We are unable to predict the future course 
of federal, state, and local legislation or regulation. Changes in the regulatory framework could have a material adverse effect on 
our business. 

Many senior living communities are also subject to regulation and licensing by state and local health and social service agencies 
and other regulatory authorities. Although requirements vary from state to state, these requirements may address, among others, 
the following: personnel education, training, and records; community services; staffing; physical plant specifications; furnishing 
of  resident  units;  food  and  housekeeping  services;  emergency  evacuation  plans;  emergency  power  generator  requirements; 
professional licensing and certification of staff; and resident rights and responsibilities. In several of the states there are different 
levels of care that can be provided based on the level of licensure. Several of the states in which we operate, or intend to operate, 
assisted  living  and  memory  care  communities,  home  health  and  hospice  agencies,  and/or  skilled  nursing  facilities  require  a 
certificate of need before the community or agency can be opened or the services at an existing community can be expanded. 
Senior living communities may also be subject to state and/or local building, zoning, fire, and food service codes and must be in 
compliance with these local codes before licensing or certification may be granted. These laws and regulatory requirements could 
affect our ability to expand into new markets and to expand our services and communities in existing markets. 

Unannounced surveys or inspections may occur annually or bi-annually, or following a regulator's receipt of a complaint about 
the provider. From time to time in the ordinary course of business, we receive survey reports from state regulatory bodies resulting 
from such inspections or surveys. Most inspection deficiencies are resolved through a plan of corrective action relating to the 
community's operations, but the reviewing agency may have the authority to take further action against a licensed or certified 
community or agency, which could result in the imposition of fines, imposition of a provisional or conditional license, suspension 
or  revocation  of  a  license,  suspension  or  denial  of  admissions,  loss  of  certification  as  a  provider  under  federal  and/or  state 
reimbursement programs, or imposition of other sanctions, including criminal penalties. Loss, suspension, or modification of a 
license may also cause us to default under our debt and lease documents and/or trigger cross-defaults. Sanctions may be taken 
against providers or facilities without regard to the providers' or facilities' history of compliance. We may also expend considerable 
resources to respond to federal and state investigations or other enforcement action under applicable laws or regulations. To date, 
none of the deficiency reports received by us has resulted in a suspension, fine, or other disposition that has had a material adverse 
effect on our revenues, results of operations, or cash flows. However, any future substantial failure to comply with any applicable 
legal and regulatory requirements could result in a material adverse effect to our business as a whole. In addition, states Attorneys 
General vigorously enforce consumer protection laws as those laws relate to the senior living industry. State Medicaid Fraud and 
Abuse Units may also investigate assisted living and memory care communities even if the community or any of its residents do 
not receive federal or state funds. 

Regulation of  the senior  living  industry is  evolving at  least partly  because of  the  growing  interests of  a  variety  of  advocacy 
organizations and political movements attempting to standardize regulations for certain segments of the industry, particularly 
assisted living and memory care. Our operations could suffer from future regulatory developments, such as federal assisted living 
and memory care laws and regulations, as well as mandatory increases in the scope and severity of deficiencies determined by 
survey or inspection officials or an increase the number of citations that can result in civil or criminal penalties. Certain current 
state laws and regulations allow enforcement officials to make determinations on whether the care provided by one or more of 
our communities exceeds the level of care for which the community is licensed. Furthermore, certain states may allow citations 
in one community to impact other communities in the state. Revocation or suspension of a license, or a citation, at a given community 
could therefore impact our ability to obtain new licenses or to renew existing licenses at other communities, which may also cause 
us to be in default under our loan or lease agreements and trigger cross-defaults or may also trigger defaults under certain of our 
credit agreements, or adversely affect our ability to operate and/or obtain financing in the future. If a state were to find that one 
community's citation will impact another of our communities, this will also increase costs and result in increased surveillance by 
the state survey agency. If regulatory requirements increase, whether through enactment of new laws or regulations or changes in 
the enforcement of existing rules, including increased enforcement brought about by advocacy groups, in addition to federal and 
state regulators, our operations could be adversely affected. Any adverse finding by survey and inspection officials may serve as 
the basis for false claims lawsuits by private plaintiffs and may lead to investigations under federal and state laws, which may 
result in civil and/or criminal penalties against the community or individual. 

There are various extremely complex federal and state laws governing a wide array of referrals, relationships, and arrangements 
and prohibiting fraud by healthcare providers, including those in the senior living industry, and governmental agencies are devoting 
increasing attention and resources to such anti-fraud initiatives. The Health Insurance Portability and Accountability Act of 1996, 
or HIPAA, and the Balanced Budget Act of 1997 expanded the penalties for healthcare fraud. With respect to our participation in 
15

federal healthcare reimbursement programs, the government or private individuals acting on behalf of the government may bring 
an action under the False Claims Act alleging that a healthcare provider has defrauded the government and seek treble damages 
for false claims and the payment of additional monetary civil penalties. The False Claims Act allows a private individual with 
knowledge of fraud to bring a claim on behalf of the federal government and earn a percentage of the federal government's recovery. 
Because of these incentives, so-called "whistleblower" suits have become more frequent. 

Additionally, since we operate communities and agencies that participate in federal and/or state healthcare reimbursement programs, 
we are subject to federal and state laws that prohibit anyone from presenting, or causing to be presented, claims for reimbursement 
which are false, fraudulent, or are for items or services that were not provided as claimed. Similar state laws vary from state to 
state. Violation of any of these laws can result in loss of licensure, citations, sanctions, and other criminal or civil fines and penalties, 
the refund of overpayments, payment suspensions, or termination of participation in Medicare and Medicaid programs, which 
may also cause us to default under our loan and lease agreements and/or trigger cross-defaults. 

We are also subject to certain federal and state laws that regulate financial arrangements by healthcare providers, such as the 
Federal Anti-Kickback Law, the Stark laws, and certain state referral laws. The Federal Anti-Kickback Law makes it unlawful for 
any person to offer or pay (or to solicit or receive) "any remuneration ... directly or indirectly, overtly or covertly, in cash or in 
kind" for referring or recommending for purchase any item or service which is eligible for payment under the Medicare and/or 
Medicaid programs. Authorities have interpreted this statute very broadly to apply to many practices and relationships between 
healthcare providers and sources of patient referral. If we were to violate the Federal Anti-Kickback Law, we may face criminal 
penalties and civil sanctions, including fines and possible exclusion from government reimbursement programs, which may also 
cause us to default under our loan and lease agreements and/or trigger cross-defaults. Adverse consequences may also result if we 
violate federal Stark laws related to certain Medicare and Medicaid physician referrals. While we endeavor to comply with all 
laws that regulate the licensure and operation of our senior living communities, it is difficult to predict how our revenues could 
be affected if we were subject to an action alleging such violations. 

We are also subject to federal and state laws designed to protect the confidentiality of patient health information. The United States 
Department of Health and Human Services has issued rules pursuant to HIPAA relating to the privacy of such information. Rules 
that became effective in 2003 govern our use and disclosure of health information at certain HIPAA covered communities. We 
established procedures to comply with HIPAA privacy requirements at these communities. We were required to be in compliance 
with the HIPAA rule establishing administrative, physical, and technical security standards for health information by 2005. To the 
best of our knowledge, we are in compliance with these rules. In addition, states have begun to enact more comprehensive privacy 
laws and regulations addressing consumer rights to data protection or transparency. For example, the California Consumer Privacy 
Act became effective in 2020, and we expect additional federal and state legislative and regulatory efforts to regulate consumer 
privacy protection in the future. These legislative and regulatory developments will impact the design and operation of our business 
and our privacy and security efforts.

Medicare and Medicaid Programs

We rely on reimbursement from government programs, including the Medicare program and, to a lesser extent, Medicaid programs, 
for a portion of our revenues. Reimbursements from Medicare and Medicaid represented 13.1% and 2.8%, respectively, of our 
total resident fee revenues for the year ended December 31, 2019. During the period, Medicare reimbursements represented 79.1%
of our Health Care Services segment revenue, and Medicare and Medicaid reimbursements represented 20.2% of our CCRCs 
segment revenue. 

Medicare is a federal program that provides certain hospital and medical insurance benefits to persons age 65 and over and certain 
disabled persons. We receive revenue for our home health, hospice, skilled nursing, and outpatient therapy services from Medicare. 
Medicaid is a medical assistance program administered by each state,  funded with  federal and state  funds pursuant to  which 
healthcare benefits are available to certain indigent or disabled patients. We receive reimbursements under Medicaid (including 
state Medicaid waiver programs) for many of our assisted living and memory care communities. 

These government reimbursement programs are highly regulated, involve significant administrative discretion, and are subject to 
frequent and substantial legislative, administrative, and interpretive changes, which may significantly affect reimbursement rates 
and the methods and timing of payments made under these programs. Continuing efforts of government to contain healthcare costs 
could materially and adversely affect us, and reimbursement levels may not remain at levels comparable to present levels or may 
not be sufficient to cover the costs allocable to patients eligible for reimbursement. 

Medicare reimbursement for home health and skilled nursing services is subject to fixed payments under the Medicare prospective 
payment  systems.  In  accordance  with  Medicare  laws,  CMS  makes  annual  adjustments  to  Medicare  payment  rates  in  many 
prospective payment systems under what is commonly known as a "market basket update." Each year, the Medicare Payment 
16

Advisory Commission ("MedPAC"), a commission chartered by Congress to advise it on Medicare payment issues, recommends 
payment  policies  to  Congress  for  a  variety  of  Medicare  payment  systems.  Congress  is  not  obligated  to  adopt  MedPAC 
recommendations and based on previous years, there can be no assurance that Congress will adopt MedPAC's recommendations 
in any given year. 

Medicaid reimbursement rates for many of our assisted living and memory care communities also are based upon fixed payment 
systems. Generally, these rates are adjusted annually for inflation. However, those adjustments may not reflect actual increases of 
the cost of providing healthcare services. In addition, Medicaid reimbursement can be impacted negatively by state budgetary 
pressures, which may lead to reduced reimbursement or delays in receiving payments.

Audits and Investigations

As a result of our participation in the Medicare and Medicaid programs, we are subject to various government reviews, audits, 
and investigations to verify our compliance with these programs and applicable laws and regulations. CMS has engaged a number 
of  third  party  firms,  including  Recovery Audit  Contractors  (RAC),  Zone  Program  Integrity  Contractors  (ZPIC),  and  Unified 
Program Integrity Contractors (UPIC) to conduct extensive reviews of claims data to evaluate the appropriateness of billings 
submitted for payment. Audit contractors may identify overpayments based on coverage requirements, billing and coding rules, 
or other risk areas. In addition to identifying overpayments, audit contractors can refer suspected violations of law to government 
enforcement  authorities. An  adverse determination  of  government  reviews,  audits, and  investigations may  result  in citations, 
sanctions,  other  criminal  or  civil  fines  and  penalties,  the  refund  of  overpayments,  payment  suspensions,  or  termination  of 
participation in Medicare and Medicaid programs. Our costs to respond to and defend any such audits, reviews, and investigations 
may be significant and are likely to increase in the current enforcement environment, and any resulting sanctions or criminal, civil, 
or regulatory penalties could have a material adverse effect on our business, financial condition, results of operations, and cash 
flow. 

The Patient Protection and Affordable Care Act and the Healthcare Education and Reconciliation Act

To help fund the expansion of healthcare coverage to previously uninsured people, the Patient Protection and Affordable Care Act 
and the Healthcare Education and Reconciliation Act of 2010 (collectively, the "Affordable Care Act"), which became law in 2010, 
provides for certain reforms to the healthcare delivery and payment system aimed at increasing quality and reducing costs. As it 
relates to our business, the Affordable Care Act provides for reductions to the annual market basket updates for home health and 
hospice agencies  and  additional  annual  "productivity  adjustment"  reductions  to  the annual  market  basket  payment  update  as 
determined by CMS for skilled nursing facilities (beginning in federal fiscal year 2012), hospice agencies (beginning in federal 
fiscal year 2013), and home health agencies (beginning in federal fiscal year 2015). These reductions have, and could in the future, 
result in lower reimbursement than the previous year. The Affordable Care Act also provides for new transparency, reporting, and 
certification requirements for skilled nursing facilities. 

Furthermore, the Affordable Care Act mandates changes to home health and hospice benefits under Medicare. For home health, 
the Affordable Care Act mandates creation of a value-based purchasing program, development of quality measures, a decrease in 
home health reimbursement beginning with federal fiscal year 2014 that was phased-in over a four-year period, a reduction in the 
outlier cap, and reinstatement of a 3% add-on payment for home health services delivered to residents in rural areas on or after 
April 1, 2010 and before January 1, 2016. The Affordable Care Act also requires the Secretary of Health and Human Services 
("HHS") (the "Secretary") to test different models for delivery of care, some of which would involve home health services. It also 
requires the Secretary to establish a national pilot program for integrated care for patients with certain conditions, bundling payment 
for acute hospital care, physician services, outpatient hospital services, and post-acute care services, which would include home 
health. The Affordable Care Act further directed the Secretary of HHS to rebase payments for home health, which resulted in a 
decrease in home health reimbursement  that began in 2014 and was phased-in over a four-year period. The Secretary is also 
required to conduct a study to evaluate costs and quality of care among efficient home health agencies regarding access to care 
and treating Medicare beneficiaries with varying severity levels of illness and to provide a report to Congress. 

Potential efforts in the Congress to alter, amend, repeal, or replace the Affordable Care Act, or to fail to fund various aspects of 
the Affordable Care Act, create additional uncertainty about the ultimate impact of the Affordable Care Act on us and the healthcare 
industry. The healthcare reforms and changes resulting from the Affordable Care Act, as well as other similar healthcare reforms, 
including any potential change in the nature of services we provide, the methods or amount of payment we receive for such services, 
and the underlying regulatory environment, could adversely affect our business, revenues, results of operations, and cash flows. 

17

The Improving Medicare Post-Acute Care Transformation Act of 2014

The Improving Medicare Post-Acute Care Transformation Act of 2014 (the "IMPACT Act"), which became law in 2014, requires 
standardized assessment data for quality improvement, payment, and discharge planning purposes across the spectrum of post-
acute care, including home health, hospice, and skilled nursing. The IMPACT Act will require such agencies and facilities to begin 
reporting standardized patient assessment data, new quality measures, and resource use measures. Failure to report such data when 
required would subject an agency or facility to a 2% reduction in market basket prices then in effect. The IMPACT Act further 
requires  HHS  and  MedPAC  to  study  and  report  to  Congress  by  2022  regarding  alternative  post-acute  care  payment  models, 
including payment based upon individual patient characteristics and not care setting. The IMPACT Act also includes provisions 
impacting Medicare-certified hospices, including increasing survey frequency to once every 36 months, imposing a medical review 
process for facilities with a high percentage of stays in excess of 180 days, and updating the annual aggregate Medicare payment 
cap. 

The Medicare Access and CHIP Reauthorization Act of 2015

The Medicare Access and CHIP Reauthorization Act of 2015 ("MACRA") became law in 2015. The legislation, among other 
things, permanently replaced the sustainable growth rate formula previously used to determine updates to Medicare fee schedule 
payments with quality and value measurements and participation in alternate payment models; extended the Medicare Part B 
outpatient therapy cap exception process until December 31, 2017; extended the 3% add-on payment for home health services 
delivered to residents in rural areas until December 31, 2017; and set payment updates for post-acute providers at 1% after other 
adjustments required by the Affordable Care Act for 2018. As part of federal budget legislation that became law on February 9, 
2018, the Medicare Part B cap on outpatient therapy services was permanently repealed effective January 1, 2018. 

Home Health Claim Review Demonstrations

In 2016, CMS announced that it would implement a 3-year Medicare pre-claim review demonstration for home health services 
in the states of Illinois, Florida, Texas, Michigan, and Massachusetts. The pre-claim review is a process through which a request 
for provisional affirmation of coverage is submitted for review before a final claim is submitted for payment. CMS began the pre-
claim review demonstration in Illinois in August 2016, which CMS paused in April 2017. The pre-claim review demonstration 
resulted in increased administrative costs and reimbursement delays for our Illinois home health agency. In December 2018, CMS 
indicated it was continuing the process for obtaining approval under the Paperwork Reduction Act of a 5-year Medicare claim 
review demonstration for Illinois, which would be further expanded to Florida, Texas, North Carolina, and Ohio. To allow home 
health agencies to transition to the PDGM, effective January 1, 2020, CMS announced in October 2019 that it is rescheduling the 
implementation of the Home Health Review Choice Demonstration ("RCD") for the remaining states of Texas, North Carolina, 
and Florida. The demonstration is expected to begin in Texas on March 2, 2020. Following the start of the demonstration in Texas, 
the demonstration is expected to begin in North Carolina and Florida on May 4, 2020. CMS will monitor the transition to PDGM 
and assess the need for any change to this date. Under this RCD as currently proposed, providers would have an initial choice of 
three options for review: pre-claim review, post-payment review, or minimal post-payment review with a 25% payment reduction 
for all home health services. We derive a significant portion of our home health revenue from these states. If implemented, the 
claim review demonstrations could adversely affect our revenue, results of operations, and cash flows. 

Home Health Value-Based Purchasing 

On January 1, 2016, CMS implemented Home Health Value-Based Purchasing ("HHVBP"). The HHVBP model was designed to 
give Medicare certified home health agencies incentives or penalties, through payment bonuses, to give higher quality and more 
efficient care. HHVBP was rolled out to nine pilot states: Arizona, Florida, Iowa, Maryland, Massachusetts, Nebraska, North 
Carolina, Tennessee, and Washington, a majority of which we currently have home health operations. Bonuses and penalties began 
in 2018 with the maximum of plus or minus 3% and are scheduled to grow to plus or minus 8% by 2022. Payment adjustments 
are calculated based on performance in 20 measures which include current Quality of Patient Care and Patient Satisfaction star 
measures, as well as measures based on submission of data to a CMS web portal. 

The Bipartisan Budget Act of 2018

The  Bipartisan Budget Act  of  2018 (the "BBA"), enacted  in  February  2018,  includes  several  provisions impacting  Medicare 
reimbursement to home health, hospice, and outpatient therapy providers. With respect to home health providers, the BBA (1) 
will base payment on a 30-day episode of care beginning January 1, 2020, coupled with annual determinations by CMS to ensure 
budget neutrality (including taking into account provider behavior), (2) will eliminate retroactive payment adjustments based upon 
the level of therapy services required beginning January 1, 2020, (3) extends the 3% add-on payment for home health services 
provided to residents in rural areas beginning January 1, 2018, coupled with a reduction and phase out of such add-on payment 
18

over the following four fiscal years, and (4) will establish a market basket update of 1.5% for the year beginning January 1, 2020. 
With respect to hospice providers, the BBA establishes a new payment policy related to early discharges to hospice care from 
hospitals. This policy imposed a financial penalty on hospitals for each early discharge to hospice care beginning October 1, 2018. 
With respect to outpatient therapy providers, the BBA permanently repeals the Medicare Part B outpatient therapy cap effective 
January 1, 2018 and continues the targeted medical review process with a reduction of the applicable threshold triggering such 
review to $3,000 effective January 1, 2018. 

CMS Final Rule 1689-FC for Medicare Home Health Prospective Payment 

In July 2018, CMS issued proposed payment changes for Medicare home health providers for 2019 and 2020. For 2020, CMS 
estimated that the net impact of the payment provisions of the proposed changes will result in an increase of 1.3% in reimbursement 
to home health providers and finalized the methodology used to determine the rural add-on payment for 2020 through 2022 as 
well as regulations text changes regarding certifying and recertifying patient eligibility for Medicare home health services and 
remote  patient monitoring. Additionally, the  proposed rule includes  changes  to  the home  health prospective  payment  system 
("HHPPS") case-mix adjustment methodology through the use of a new PDGM for home health payments. This change affects 
home health services beginning on or after January 1, 2020 and also includes a change in the unit of payment from 60-day episodes 
of care to 30-day episodes of care. 

Environmental Matters

Under various federal, state, and local environmental laws, a current or previous owner or operator of real property, such as us, 
may be held liable in certain circumstances for the costs of investigation, removal, or remediation of certain hazardous or toxic 
substances, including, among others, petroleum and materials containing asbestos, that could be located on, in, at, or under a 
property, regardless of how such materials came to be located there. Additionally, such an owner or operator of real property may 
incur costs relating to the release of hazardous or toxic substances, including government fines and payments for personal injuries 
or damage to adjacent property. The cost of any required investigation, remediation, removal, mitigation, compliance, fines, or 
personal or property damages and our liability therefore could exceed the property's value and/or our assets' value. The presence 
of such substances, or the failure to properly dispose of or remediate the damage caused by such substances, may adversely affect 
our ability to sell such property, to attract additional residents, retain existing residents, to borrow using such property as collateral, 
or to develop or redevelop such property. Such laws impose liability for investigation, remediation, removal, and mitigation costs 
on persons who disposed of or arranged for the disposal of hazardous substances at third-party sites. Such laws and regulations 
often impose liability without regard to whether the owner or operator knew of, or was responsible for, the presence, release, or 
disposal of such substances as well as without regard to whether such release or disposal was in compliance with law at the time 
it occurred. Moreover, the imposition of such liability upon us could be joint and several, which means we could be required to 
pay for the cost of cleaning up contamination caused by others who have become insolvent or otherwise judgment proof. We do 
not believe that we have incurred such liabilities that would have a material adverse effect on our business, financial condition, 
results of operations, and cash flow. 

Our operations are subject to regulation under various federal, state, and local environmental laws, including those relating to: the 
handling, storage, transportation, treatment, and disposal of medical waste products generated at our communities; identification 
and warning of the presence of asbestos-containing materials in buildings, as well as removal of such materials; the presence of 
other substances in the indoor environment; and protection of the environment and natural resources in connection with development 
or construction of our properties. 

Some of our communities generate infectious or other hazardous medical waste due to the illness or physical condition of the 
residents,  including,  for  example,  blood-contaminated  bandages,  swabs  and  other  medical  waste  products,  and  incontinence 
products of those residents diagnosed with an infectious  disease. The  management of  infectious  medical waste, including  its 
handling,  storage,  transportation,  treatment,  and  disposal,  is  subject  to  regulation  under  various  federal,  state,  and  local 
environmental laws. These environmental laws set forth the management requirements for such waste, as well as related permit, 
record-keeping, notice, and reporting obligations. Each of our communities has an agreement with a waste management company 
for the proper disposal of all infectious medical waste. The use of such waste management companies does not immunize us from 
alleged violations of  such medical waste laws for  operations  for  which we are responsible  even if carried  out  by such waste 
management companies, nor does it immunize us from third-party claims for the cost to cleanup disposal sites at which such wastes 
have been disposed. Any finding that we are not in compliance with environmental laws could adversely affect our business, 
financial condition, results of operations, and cash flow.

Federal regulations require building owners and those exercising control over a building's management to identify and warn, via 
signs and labels, their employees and certain other employers operating in the building of potential hazards posed by workplace 
exposure to installed asbestos-containing materials and potential asbestos-containing materials in their buildings. The regulations 
19

also set forth employee training, record-keeping requirements, and sampling protocols pertaining to asbestos-containing materials 
and potential asbestos-containing materials. Significant fines can be assessed for violation of these regulations. Building owners 
and those exercising control over a building's management may be subject to an increased risk of personal injury lawsuits by 
workers and others exposed to asbestos-containing materials and potential asbestos-containing materials. The regulations may 
affect the value of a building containing asbestos-containing materials and potential asbestos-containing materials in which we 
have invested. Federal, state, and local laws and regulations also govern the removal, encapsulation, disturbance, handling, and/
or disposal of asbestos-containing materials and potential asbestos-containing materials when such materials are in poor condition 
or in the event of construction, remodeling, renovation, or demolition of a building. Such laws may impose liability for improper 
handling or a release to the environment of asbestos-containing materials and potential asbestos-containing materials and may 
provide for fines to, and for third parties to seek recovery from, owners or operators of real properties for personal injury or 
improper work exposure associated with asbestos-containing materials and potential asbestos-containing materials. 

The presence of mold, lead-based paint, contaminants in drinking water, radon, and/or other substances at any of the communities 
we own or may acquire may lead to the incurrence of costs for remediation, mitigation, or the implementation of an operations 
and maintenance plan. Furthermore, the presence of mold, lead-based paint, contaminants in drinking water, radon, and/or other 
substances at any of the communities we own or may acquire may present a risk that third parties will seek recovery from the 
owners, operators, or tenants of such properties for personal injury or property damage. In some circumstances, areas affected by 
mold may be unusable for periods of time for repairs, and even after successful remediation, the known prior presence of extensive 
mold could adversely affect the ability of a community to retain or attract residents and could adversely affect a community's 
market value. 

We believe that we are in material compliance with applicable environmental laws. 

We are unable to predict the future course of federal, state, and local environmental regulation and legislation. Changes in the 
environmental regulatory framework (including legislative or regulatory efforts designed to address climate change, such as the 
proposed "cap and trade" legislation) could have a material adverse effect on our business. Because environmental laws vary from 
state to state, expansion of our operations to states where we do not currently operate may subject us to additional restrictions on 
the manner in which we operate our communities. 

Available Information

Information regarding our community and service offerings can be found at our website, www.brookdale.com. Our Annual Report 
on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to these reports are available 
free of charge through our website as soon as reasonably practicable after we electronically file such material with, or furnish it 
to, the SEC, at the following address: www.brookdale.com/investor. The information within, or that can be accessed through, our 
website addresses is not part of this report. 

20

Item 1A. 

Risk Factors

Risks Related to Our Business and Industry

Due to the dependency of our revenues on private pay sources, events which adversely affect the ability of seniors to afford 
our resident fees (including downturns in the economy, housing market, consumer confidence, or the equity markets and 
unemployment among resident family members) could cause our occupancy, revenues, results of operations, and cash flow 
to decline.

Costs  to  seniors  associated  with  independent  and  assisted  living  services  are  not  generally  reimbursable  under  government 
reimbursement programs such as Medicare and Medicaid. Only seniors with income or assets meeting or exceeding the comparable 
median in the regions where our communities are located typically can afford to pay our monthly resident fees. Economic downturns, 
softness  in  the  housing  market,  higher  levels  of  unemployment  among  resident  family  members,  lower  levels  of  consumer 
confidence, stock market volatility, and/or changes in demographics could adversely affect the ability of seniors to afford our 
resident fees. If we are unable to retain and/or attract seniors with sufficient income, assets, or other resources required to pay the 
fees associated with independent and assisted living services  and  other  service offerings,  our  occupancy, revenues, results of 
operations, and cash flow could decline. 

Changes in the reimbursement rates, methods, or timing of payment from government reimbursement programs, including 
the Medicare and Medicaid programs, or the implementation of other measures to reduce reimbursement for our senior 
living and healthcare services could adversely affect our revenues, results of operations, and cash flow. 

We rely on reimbursement from government programs, including Medicare and Medicaid, for a portion of our revenues, and we 
cannot provide assurance that reimbursement levels will not decrease in the future, which could adversely affect our revenues, 
results of operations, and cash flow. Reimbursements from Medicare and Medicaid represented 13.1% and 2.8%, respectively, of 
our total resident fee revenues for the year ended December 31, 2019. During such period, Medicare reimbursements represented 
79.1% of our  Health  Care Services  segment revenue,  and  Medicare  and Medicaid  reimbursements  represented 20.2% of our 
CCRCs segment revenue. See "Item 1. Business-Medicare and Medicaid Programs" for more information regarding these programs, 
including the impact of recent legislation and rulemaking on such programs. 

Congress continues to discuss medical spending reduction measures, leading to a high degree of uncertainty regarding potential 
reforms to government reimbursement programs, including Medicare and Medicaid. These discussions, along with other recent 
reforms  and  continuing  efforts  to  reform  government  reimbursement  programs,  both  as  part  of  the Affordable  Care Act  and 
otherwise, could result in major changes in the healthcare delivery and reimbursement systems on both the national and state 
levels. Weak economic conditions also could adversely affect federal and state budgets, which could result in attempts to reduce 
or eliminate payments for federal and state reimbursement programs, including Medicare and Medicaid. 

Though we cannot predict what reform proposals will be adopted or finally implemented, healthcare reform and regulations may 
have a material adverse effect on our business, financial position, results of operations, and cash flow through, among other things, 
decreasing funds available for our services or increasing our operating costs. Continuing efforts of government to contain healthcare 
costs could materially and adversely affect us, and reimbursement levels may not remain at levels comparable to present levels 
or may not be sufficient to cover the costs allocable to patients eligible for reimbursement. 

The impact of ongoing healthcare reform efforts on our business cannot accurately be predicted.

The healthcare industry in the United States is subject to fundamental changes due to ongoing healthcare reform efforts and related 
political, economic, and regulatory influences. Notably, the Affordable Care Act resulted in expanded  healthcare coverage to 
millions of previously uninsured people beginning in 2014 and has resulted in significant changes to the United States healthcare 
system. To help fund this expansion, the Affordable Care Act outlines certain reductions for Medicare reimbursed services, including 
skilled nursing, home  health, hospice, and outpatient therapy services, as  well as certain other  changes to Medicare payment 
methodologies. This comprehensive healthcare legislation has resulted and will continue to result in extensive rulemaking by 
regulatory authorities, and also may be altered, amended, repealed, or replaced. It is difficult to predict the full impact of the 
Affordable Care Act due to the complexity of the law and implementing regulations, as well our inability to foresee how CMS 
and other participants in the healthcare industry will respond  to the  choices available to  them under the law. We  also cannot 
accurately predict whether any new or  pending legislative proposals  will be adopted or,  if adopted, what  effect, if any, these 
proposals would have on our business. Similarly, while we can anticipate that some of the rulemaking that will be promulgated 
by regulatory authorities will affect us and the manner in which we are reimbursed by the federal reimbursement programs, we 
cannot  accurately  predict  today  the  impact  of  those  regulations  on  our  business. The  provisions  of  the  legislation  and  other 
regulations implementing the provisions of the Affordable Care Act or any amended or replacement legislation may increase our 
21

costs, adversely affect our revenues, expose us to expanded liability, or require us to revise the ways in which we conduct our 
business. 

In addition to its impact on the delivery and payment for healthcare, the Affordable Care Act and the implementing regulations 
have resulted and may continue to result in increases to our costs to provide healthcare benefits to our employees. We also may 
be required to make additional employee-related changes to our business as a result of provisions in the Affordable Care Act or 
any amended or replacement legislation impacting the provision of health insurance by employers, which could result in additional 
expense and adversely affect our results of operations and cash flow. 

Senior housing construction and development, and increased competition, has had and may continue to have an adverse 
effect on our occupancy, revenues, results of operations, and cash flow. 

The senior living industry is highly competitive. We compete with numerous organizations, including not-for-profit entities, that 
offer  similar communities and services, such  as home health  care and  hospice agencies,  community-based  service  programs, 
retirement  communities,  convalescent  centers,  and  other  senior  living  providers.  In  general,  regulatory  and  other  barriers  to 
competitive entry in the independent living, assisted living, and memory care sectors of the senior living industry are not substantial. 
Over the last several years there has been an increase in the construction of new senior housing communities as the industry has 
attracted increased investment, and industry data shows that industry occupancy began to decrease starting in 2016 as a result of 
new openings and oversupply. During and since 2016 we have experienced an elevated rate of competitive new openings, with 
significant new competition opening in many markets, which has adversely affected our occupancy, revenues, results of operations, 
and cash flow. Such new competition that we have encountered or may encounter could limit our ability to attract new residents 
and associates, to retain existing residents and associates, and to raise or maintain resident fees or expand our business, which 
could have a material adverse effect on our occupancy, revenues, results of operations, and cash flow. 

Disruptions in the financial markets could affect our ability to obtain financing or to extend or refinance debt as it matures, 
which could negatively impact our liquidity, financial condition, and the market price of our common stock. 

The United States stock and credit markets have experienced significant price volatility, dislocations, and liquidity disruptions, 
which have caused market prices of many stocks to fluctuate substantially and the spreads on prospective debt financings to widen 
considerably. These circumstances have materially impacted liquidity in the financial markets, making terms for certain financings 
less attractive, and in some cases resulted in the unavailability of financing. Uncertainty in the stock and credit markets may 
negatively  impact  our  ability  to  access  additional  financing  (including any  refinancing  or  extension  of  our  existing  debt)  on 
reasonable terms, which may negatively affect our liquidity, financial condition, and the market price of our common stock. 

As of December 31, 2019, we had two principal corporate-level debt obligations: our secured revolving credit facility providing 
commitments of $250.0 million and our separate unsecured letter of credit facility providing for up to $47.5 million of letters of 
credit. We also had $3.5 billion principal amount of mortgage financing outstanding as of such date. If we are unable to extend or 
refinance any of these facilities or other debt prior to their scheduled maturity dates, our liquidity and financial condition could 
be adversely impacted. In addition, even if we are able to extend or refinance our maturing debt or credit or letter of credit facilities, 
the terms of the new financing may not be as favorable to us as the terms of the existing financing. 

We are heavily dependent on mortgage financing provided by Federal National Mortgage Association (Fannie Mae) and Federal 
Home Loan Mortgage Corporation (Freddie Mac), which are currently  operating under a conservatorship begun in 2008 and 
conducting business under the direction of the Federal Housing Finance Agency. Reform efforts related to Fannie Mae and Freddie 
Mac may make such financing sources less available or unavailable in the future and may cause us to seek alternative sources of 
potentially less attractive financing. There can be no assurance that such alternative sources will be available. 

A prolonged downturn in the financial markets may cause us to seek alternative sources of potentially less attractive financing 
and may require us to further adjust our business plan accordingly. These events also may make it more difficult or costly for us 
to raise capital, including through the issuance of common stock. Disruptions in the financial markets could have an adverse effect 
on our business. If we are not able to obtain additional financing on favorable terms, we also may have to forgo, delay, or abandon 
some or all of our planned capital expenditures or any development, investment, or acquisition opportunities that we identify, 
which could adversely affect our revenues, results of operations, and cash flow. 

Various factors, including general economic conditions and the spread of contagious illnesses, could adversely affect our 
financial performance and other aspects of our business.

General economic conditions, such as inflation, the consumer price index, commodity costs, fuel and other energy costs, costs of 
salaries,  wages,  benefits  and  insurance,  interest  rates,  and  tax  rates,  affect  our  facility  operating,  facility  lease,  general  and 
22

administrative and other expenses, and we have no control or limited ability to control such factors. Current global economic 
conditions and uncertainties, the potential for failures or realignments of financial institutions, and the related impact on available 
credit may affect us and our business partners, landlords, counterparties, and  residents or  prospective residents in an adverse 
manner including, but not limited to, reducing access to liquid funds or credit, increasing the cost of credit, limiting our ability to 
manage interest rate risk, increasing the risk that certain of our business partners, landlords or counterparties would be unable to 
fulfill their obligations to us, and other impacts which we are unable to fully anticipate. Our occupancy levels may be negatively 
impacted by seasonal contagious illnesses such as cold and flu, which typically more severely impact seniors than the general 
population. A severe cold and flu season or an outbreak of other contagious disease in the markets in which we operate could result 
in a regulatory ban on admissions, decreased occupancy, and otherwise adversely affect our business. 

If we are unable to generate sufficient cash flow to cover required interest and lease payments, this could result in defaults 
of the related debt or leases and cross-defaults under our other debt or lease documents, which would adversely affect our 
capital structure, financial condition, results of operations, and cash flow. 

We have significant indebtedness and lease obligations, and we intend to continue financing our communities through mortgage 
financing, long-term leases, and other types of financing, including borrowings under our revolving line of credit and future credit 
facilities we may obtain. Our required lease payments are generally subject to an escalator that is either fixed or tied to changes 
in the consumer price index or leased property revenue. We cannot give any assurance that we will generate sufficient cash flow 
from operations to cover required interest, principal, and lease payments. Any non-payment or other default under our financing 
arrangements could, subject to cure provisions, cause the lender to foreclose upon the community or communities securing such 
indebtedness or, in the case of a lease, cause the lessor to terminate the lease, each with a consequent loss of revenue and asset 
value to us. Furthermore, in some cases, indebtedness is secured by both a mortgage on a community (or communities) and a 
guaranty by us and/or one or more of our subsidiaries. In the event of a default under one of these scenarios, the lender could avoid 
judicial procedures required to foreclose on real property by declaring all amounts outstanding under the guaranty immediately 
due and payable, and requiring the respective guarantor to fulfill its obligations to make such payments. The realization of any of 
these  scenarios  would  have  an  adverse  effect  on  our  financial  condition  and  capital  structure.  Further,  because  many  of  our 
outstanding debt and lease documents contain cross-default and cross-collateralization provisions, a default by us related to one 
community could affect a significant number of our other communities and their corresponding financing arrangements and leases 
(including documents with other lenders or lessors). In the event of such a default, we may not be able to obtain a waiver from 
the lender or lessor on terms acceptable or favorable to us, or at all, which would have a negative impact on our capital structure 
and financial condition.

Our indebtedness and long-term leases could adversely affect our liquidity and our ability to operate our business.

Our level of indebtedness and our long-term leases could adversely affect our future operations and/or impact our stockholders 
for several reasons, including, without limitation:

•  We may have little or no cash flow apart from cash flow that is dedicated to the payment of any interest, principal, or amortization 

• 

required with respect to outstanding indebtedness and lease payments with respect to our long-term leases;
Increases in our outstanding indebtedness, leverage, and long-term lease obligations will increase our vulnerability to adverse 
changes in general economic and industry conditions, as well as to competitive pressure;
Increases in our outstanding indebtedness may limit our ability to obtain additional financing for working capital, capital 
expenditures, expansions, repositionings, new developments, acquisitions, general corporate, and other purposes; and
•  Our ability to pay dividends to our stockholders (should we initiate dividend payments in the future) may be limited.

• 

Our ability to make payments of principal and interest on our indebtedness and to make lease payments on our leases depends 
upon our future cash flow performance, which will be subject to general economic conditions, industry cycles, and financial, 
business, and other factors affecting our operations, many of which are beyond our control. Our business might not continue to 
generate cash flow at or above current levels. If we are unable to generate sufficient cash flow from operations in the future to 
service our debt or to make lease payments on our leases, we may be required, among other things, to seek additional financing 
in the debt or equity markets, refinance or restructure all or a portion of our indebtedness or leases, sell selected assets, reduce or 
delay planned capital expenditures, or delay or abandon desirable acquisitions. These measures might not be sufficient to enable 
us to service our debt or to make lease payments on our leases. The failure to make required payments on our debt or leases could 
result in an adverse effect on our future ability to generate revenues and our results of operations and cash flow. Any contemplated 
financing, refinancing, restructuring, or sale of assets might not be available on economically favorable terms to us. 

23

Our  debt  and  lease  documents  contain  financial  and  other  covenants,  including  covenants  that  limit  or  restrict  our 
operations and  activities (including our ability to  borrow additional funds and engage in certain transactions without 
consent  of  the  applicable  lender  or  lessor);  any  default  under  such  documents  could  result  in  the  acceleration  of  our 
indebtedness and lease obligations, the foreclosure of our mortgaged communities, the termination of our leasehold interests, 
and/or cross-defaults under our other debt or lease documents, any of which could materially and adversely impact our 
capital structure, financial condition, results of operations, cash flow, and liquidity and interfere with our ability to pursue 
our strategy.

Certain  of  our debt  and  lease  documents  contain  restrictions  and  financial covenants, such  as  those  requiring  us to  maintain 
prescribed minimum net worth and stockholders' equity levels and debt service and lease coverage ratios, and requiring us not to 
exceed prescribed leverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community, and/or 
entity basis. Net worth is generally calculated as stockholders' equity,  as calculated in accordance with accounting principles 
generally accepted in the United States, or  GAAP,  and  in certain circumstances,  reduced by  intangible  assets  or liabilities  or 
increased by deferred gains from sale-leaseback transactions and deferred entrance fee revenue. The debt service and lease coverage 
ratios are generally calculated as revenues less operating expenses, including an implied management fee and a reserve for capital 
expenditures, divided by the debt (principal and interest) or lease payment. In addition, our debt and lease documents generally 
contain non-financial covenants, such as those requiring us to comply with Medicare or Medicaid provider requirements.

Our failure to comply with applicable covenants could constitute an event of default under the applicable debt or lease documents. 
Many of our debt and lease documents contain cross-default provisions so that a default under one of these instruments could 
cause a default under other debt and lease documents (including documents with other lenders and lessors).

These restrictions and covenants may interfere with our ability to obtain financing or to engage in other business activities, which 
may inhibit our ability to pursue our strategy. In addition, certain of our outstanding indebtedness and leases limit or restrict, 
among other things, our ability and our subsidiaries' ability to borrow additional funds, engage in a change in control transaction, 
dispose of all or substantially all of our or their assets, or engage in mergers or other business combinations without consent of 
the applicable lender or lessor. In certain circumstances, the consent of the applicable lender or lessor may be based on the lender's 
or lessor's sole discretion. Our inability to obtain the consent of applicable lenders and landlords in connection with our pursuit 
of any such transactions may forestall our ability to consummate such transactions.  Furthermore,  the costs of obtaining  such 
consents may reduce the value that our stockholders may realize in any such transactions.

The substantial majority of our lease arrangements are structured as master leases. Under a master lease, numerous communities 
are leased through an indivisible lease. We typically guarantee the performance and lease payment obligations of our subsidiary 
lessees under the master leases. Due to the nature of such master leases, it is difficult to restructure the composition of our leased 
portfolios or economic terms of the leases without the consent of the applicable landlord. In addition, an event of default related 
to an individual property or limited number of properties within a master lease portfolio could result in a default on the entire 
master lease portfolio.

Furthermore, our debt and leases are secured by our communities and, in certain cases, a guaranty by us and/or one or more of 
our subsidiaries. Therefore, if an event of default has occurred under any of our debt or lease documents, subject to cure provisions 
in certain instances, the respective lender or lessor would have the right to declare all the related outstanding amounts of indebtedness 
or cash lease obligations immediately due and payable, to foreclose on our mortgaged communities, to terminate our leasehold 
interests, to foreclose on other collateral securing the indebtedness and leases, to discontinue our operation of leased communities, 
and/or to pursue other remedies available to such lender or lessor. Further, an event of default could trigger cross-default provisions 
in our other debt and lease documents (including documents with other lenders or lessors). We cannot provide assurance that we 
would be able to pay the debt or lease obligations if they became due upon acceleration following an event of default.

In addition, certain of our master leases and management agreements contain radius restrictions, which limit our ability to own, 
develop, or acquire new communities within a specified distance from certain existing communities covered by such agreements. 
These radius restrictions could negatively affect our ability to expand or develop or acquire senior housing  communities and 
operating companies.

Lease obligations and mortgage debt expose us to increased risk of loss of property, which could harm our ability to generate 
future revenues and could have an adverse tax effect.

Lease obligations and mortgage debt increase our risk of loss because defaults on leases or indebtedness secured by properties 
may result  in lease terminations by  lessors and  foreclosure actions  by  lenders.  For tax purposes,  a foreclosure  of  any  of our 
properties would be treated as a sale of the property for a purchase price equal to the outstanding balance of the debt secured by 
the mortgage. If the outstanding balance of the debt secured by the mortgage exceeds our tax basis in the property, we would 
24

recognize taxable income on foreclosure, but would not receive any cash proceeds, which could negatively impact our results of 
operations and cash flow. Further, because many of our outstanding debt and lease documents contain cross-default and cross-
collateralization provisions, a default by us related to one community could affect a significant number of our other communities 
and their corresponding financing arrangements and leases.

In addition, our leases generally provide for renewal or extension options and, in certain cases, purchase options. These options 
typically are based upon prescribed formulas but, in certain cases, may be at fair market value. We expect to renew, extend, or 
exercise purchase options with respect to our leases in the normal course of business; however, there can be no assurance that 
these rights will be exercised in the future or that we will be able to satisfy the conditions precedent to exercising any such renewal, 
extension, or purchase options. Furthermore, the terms of any such options that are based on fair market value are inherently 
uncertain and could be unacceptable or unfavorable to us depending on the circumstances at the time of exercise. If we are not 
able to renew or extend our existing leases, or purchase the communities subject to such leases, at or prior to the end of the existing 
lease terms, or if the terms of such options are unfavorable or unacceptable to us, our business, results of operations, and cash 
flow could be adversely affected.

Increases in market interest rates could significantly increase the costs of our debt obligations, which could adversely affect 
our results of operations and cash flow.

Our variable-rate debt obligations and any such obligations incurred in the future expose us to interest rate risk. Although we have 
interest rate cap agreements in place for a majority of our variable-rate debt, these agreements only limit our exposure to increases 
in interest rates above certain levels and generally must be renewed every two to three years. Increases in prevailing interest rates 
will increase our payment obligations on our existing variable-rate obligations to the extent they are unhedged and may increase 
our future borrowing and hedging costs, which would negatively impact our results of operations and cash flow.

The potential phasing out of LIBOR may increase the interest costs of our debt obligations, which could adversely affect 
our results of operations and cash flow. 

The interest rates for substantially all of our variable-rate debt obligations are calculated based on the London Interbank Offer 
Rate (LIBOR) plus a  spread, and our interest rate cap agreements are indexed to LIBOR.  LIBOR is regulated  by the  United 
Kingdom's Financial Conduct Authority, which has announced that it plans to phase-out LIBOR by the end of 2021. If LIBOR 
were to be discontinued, substantially all of our variable-rate debt agreements provide that the lender may choose an alternative 
index based on comparable information, and our interest rate cap agreements provide that the calculation agent may choose an 
alternative index. It is unclear whether LIBOR will cease to exist or if new methods of calculating LIBOR will evolve by the end 
of 2021, or whether alternative and comparable index rates will be established and adopted by our lenders and other financial 
institutions. If LIBOR ceases to exist or if the methods of calculating LIBOR change, interest rates on our variable-rate debt 
obligations may increase, which would adversely affect our results of operations and cash flow. 

Increased  competition  for,  or  a  shortage  of,  personnel,  wage  pressures  resulting  from  increased  competition,  low 
unemployment levels, minimum wage increases, changes in overtime laws, and union activity may have an adverse effect 
on our business, results of operations and cash flow.

Our success depends on our ability to retain and attract qualified management and other personnel who are responsible for the 
day-to-day operations of each of our communities. Each community has an Executive Director responsible for the overall day-
to-day operations of the community, including quality of care and service, social services, and financial performance. Depending 
upon the size and type of the community, each Executive Director is supported by key leaders, a Health and Wellness Director (or 
nursing director), and/or a Sales Director. The Health and Wellness Director or nursing director is directly responsible for day-to-
day care of residents. The Sales Director oversees the community's sales, marketing, and community outreach programs. Other 
key positions supporting each community may include individuals responsible for food service, healthcare services, activities, 
housekeeping, and maintenance.

We compete with various healthcare service providers, other senior living providers, and hospitality and food services companies 
in retaining and attracting qualified personnel. Increased competition for, or a shortage of, nurses, therapists, or other personnel, 
low levels of unemployment, or general inflationary pressures have required and may require in the future that we enhance our 
pay  and  benefits  package  to  compete  effectively  for  such  personnel.  In  addition,  we  have  experienced  and  may  continue  to 
experience wage pressures due to minimum wage increases mandated by state and local laws and the increase in the minimum 
salary threshold for overtime exemptions under the Fair Labor Standards Act, which the Department of Labor increased effective 
January 1, 2020. Such rule changes may result in higher operating costs, and we may not be able to offset the added costs resulting 

25

from competitive, inflationary or regulatory pressures by increasing the rates we charge to our residents or our service charges, 
which would negatively impact our results of operations and cash flow. 

Turnover rates of our personnel and the magnitude of the shortage of nurses, therapists, or other personnel varies substantially 
from market to market. If we fail to attract and retain qualified personnel, our ability to conduct our business operations effectively, 
our overall operating results, and cash flow could be harmed. 

In  addition, efforts by  labor  unions to  unionize  any  of  our community  personnel  could  divert  management attention,  lead to 
increases in our labor costs, and/or reduce our flexibility with respect to certain workplace rules. If we experience an increase in 
organizing activity, if onerous collective  bargaining agreement  terms  are  imposed  upon us, or  if we  otherwise  experience  an 
increase in our staffing and labor costs, our results of operations and cash flow would be negatively affected. 

Failure to maintain the security and functionality of our information systems and data, to prevent a cybersecurity attack 
or breach, or to comply with applicable privacy and consumer protection laws, including HIPAA, could adversely affect 
our business, reputation, and relationships with our residents, patients, employees, and referral sources and subject us to 
remediation costs, government inquiries, and liabilities, any of which could materially and adversely impact our revenues, 
results of operations, cash flow, and liquidity. 

We are dependent on the proper function and availability of our information systems, including hardware, software, applications, 
and electronic data storage, to store, process, and transmit our business information, including proprietary business information 
and personally identifiable information of  our  residents,  patients,  and  employees. Though  we  have  taken steps to  protect  the 
cybersecurity and physical security of our information systems and have implemented policies and procedures to comply with 
HIPAA and other privacy laws, rules, and regulations, there can be no assurance that our security measures and disaster recovery 
plan will prevent damage to, or interruption or breach of, our information systems or other unauthorized access to proprietary or 
private information. 

Because the techniques used to obtain unauthorized access to systems change frequently and may be difficult to detect for long 
periods  of  time,  we  may  be  unable  to  anticipate  these  techniques  or  implement  adequate  preventive  measures.  In  addition, 
components of our information systems that we develop or procure from third parties may contain defects in design or manufacture 
or other problems that could unexpectedly compromise the security or functionality of our information systems. Unauthorized 
parties may also attempt to gain access to our systems or facilities, or those of third parties with whom we do business, through 
fraud or other forms of deceiving our employees or contractors such as email phishing attacks. As cyber threats continue to evolve, 
we may be required to expend significant additional resources to continue to modify or enhance our cybersecurity or to investigate 
and remediate any cybersecurity vulnerabilities, attacks, or incidents. 

In addition, we rely on software support of third parties to secure and maintain our information systems. Our inability, or the 
inability of these third parties, to continue to maintain and upgrade our information systems could disrupt or reduce the efficiency 
of our operations. Costs and potential problems and interruptions associated with the implementation of new or upgraded systems 
and technology or with maintenance or adequate support of existing systems could disrupt or reduce the efficiency of our operations. 

Failure to maintain the security and functionality of our information systems, to prevent a cybersecurity attack or other unauthorized 
access to our information systems, or to comply with applicable privacy and consumer protection laws, including HIPAA, could 
expose us to a number of adverse consequences, many of which are not insurable, including: (i) interruptions to our business, (ii) 
the theft, destruction, loss, misappropriation, or release of sensitive information, including proprietary business information and 
personally  identifiable  information  of  our  residents,  patients  and  employees,  (iii)  significant  remediation  costs;  (iv)  negative 
publicity which could damage our reputation and our relationships with our residents, patients, employees, and referral sources, 
(v) litigation and potential liability under privacy, security, and consumer protection laws, including HIPAA, or other applicable 
laws, rules, or regulations, and (vi) government inquiries which may result in sanctions and other criminal or civil fines or penalties. 
Any of the foregoing could materially and adversely impact our revenues, results of operations, cash flow, and liquidity. 

We have a history of losses and we may not be able to achieve profitability.

We have incurred net losses in every year since our formation in June 2005. Given our history of losses, there can be no assurance 
that we will be able to achieve and/or maintain profitability in the future. If we do not effectively manage our liquidity, cash flow, 
and business operations going forward or otherwise achieve profitability, our stock price could be adversely affected.

26

Pending disposition transactions are, and any future disposition transactions will be, subject to various closing conditions, 
including the receipt of regulatory approvals where applicable, likely will result in reductions to our revenue and may 
negatively impact our results of operations and cash flow.

During 2020, we expect to close on the dispositions of three owned communities classified as held for sale as of December 31, 
2019 and the termination of our lease obligations on three communities for which we have provided notice of non-renewal. For 
the year, we also anticipate terminations of certain of our management arrangements with third parties as we transition to new 
operators our management on certain former unconsolidated ventures in which we sold our interest and our interim management 
on formerly leased communities. Over the longer term, we may dispose of owned or leased communities through asset sales and 
lease terminations and expirations. The closings of any such transactions, or those that we identify in the future, generally are or 
will be subject to closing conditions, which may include the receipt of regulatory approvals, and we cannot provide assurance that 
any such transactions will close or, if they do, when the actual closings will occur. The sales price for pending or future dispositions 
may not meet our expectations due to the underlying performance of such communities or conditions beyond our control, and we 
may be required to take impairment charges in connection with  such sales  if the carrying amounts of such assets  exceed  the 
proposed sales prices, which could adversely affect our financial condition and results of operations. Further, we cannot provide 
assurance that we will be successful in identifying and pursuing disposition opportunities on terms that are acceptable to us, or at 
all. We may be required to pay significant amounts to restructure or terminate leases and we may be required to take charges in 
connection with such activity, which could adversely affect our financial condition and results of operations.

Completion  of  the  dispositions  of  communities  through  sales  or  lease  terminations  and  the  termination  of  our  management 
arrangements, including pending transactions and those we enter into in the future, likely will result in reductions to our revenue 
and may negatively impact our results of operations and cash flow. Further, if we are unable to reduce our general and administrative 
expense with respect to completed dispositions and management arrangement terminations in accordance with our expectations, 
we may not realize the expected benefits of such transactions, which could negatively impact our anticipated results of operations 
and cash flow. 

We may need additional capital to fund our operations, capital expenditure plans, and strategic priorities, and we may 
not be able to obtain it on terms acceptable to us, or at all.

Funding  our  capital  expenditure  plans,  pursuing  any  acquisition,  investment,  development,  or  potential  lease  restructuring 
opportunities that we identify, or funding investments to support our strategy may require additional capital. Financing may not 
be available to us or may be available to us only on terms that are not favorable. In addition, certain of our outstanding indebtedness 
and long-term leases restrict, among other things, our ability to incur additional debt. If we are unable to raise additional funds or 
obtain them on terms acceptable to us, we may have to delay or abandon some or all of our plans or opportunities. Further, if 
additional funds are raised through the issuance of additional equity securities, the percentage ownership of our stockholders would 
be diluted. Any newly issued equity securities may have rights, preferences, or privileges senior to those of our common stock. 

Failure to complete our capital expenditures in accordance with our plans may adversely affect our anticipated revenues, 
results of operations, and cash flow. 

Our  planned  full-year  2020  non-development  capital  expenditures  are  approximately  $190  million  net  of  anticipated  lessor 
reimbursements,  and  such  projects  include  those  related  to  maintenance,  renovations,  upgrades,  and  other  major  building 
infrastructure projects for our communities. Such projects may be needed to ensure that our communities are in appropriate physical 
condition to support our strategy and to protect the value of our community portfolio. In addition, our planned full-year 2020 
development capital expenditures are approximately $30 million, net of anticipated lessor reimbursements, and such projects 
include those for expansion, repositioning, redeveloping, and major renovation of selected existing senior living communities. 

Our capital projects are in various stages of planning and development and are subject to a number of factors over which we may 
have little or no control. These factors include the necessity of arranging separate leases, mortgage loans, or other financings to 
provide the capital required to complete these projects; difficulties or delays in obtaining zoning, land use, building, occupancy, 
licensing, certificate of need, and other required governmental permits and approvals; failure to complete construction of the 
projects on budget and on schedule; failure of third-party contractors and subcontractors to perform under their contracts; shortages 
of labor or materials that could delay projects or make them more expensive; adverse weather conditions that could delay completion 
of projects; increased costs resulting from general economic conditions or increases in the cost of materials; and increased costs 
as a result of changes in laws and regulations. 

We  cannot provide assurance that we will undertake  or  complete all  of  our  planned  capital expenditures, or  that  we will not 
experience delays in completing those projects. In addition, we may incur substantial costs prior to achieving stabilized occupancy 
for certain capital projects and cannot assure that these costs will not be greater than we have anticipated. We also cannot provide 

27

assurance that any of our capital projects will be economically successful or provide a return on investment in accordance with 
our plans or at all. Furthermore, our failure to complete, or delays in completing, our planned community-level capital expenditures 
could harm the value of our communities and our revenues, results of operations, and cash flow. 

To the extent we identify and pursue any future development, investment, or acquisition opportunities, we may encounter 
difficulties in identifying opportunities at attractive  prices  or integrating acquisitions  with  our operations, which may 
adversely affect our financial condition, results of operations, and cash flow. 

We intend to seek and pursue development, investment, and acquisition opportunities such as de novo development and acquisitions 
of senior living communities and operating companies and expansion of our healthcare services business. We may not be able to 
identify any such opportunities on attractive terms and that are compatible with our strategy. To the extent we identify any such 
opportunities and enter into definitive agreements in connection therewith, we cannot provide assurance that the transactions will 
be completed. Failure to complete transactions after we have entered into definitive agreements may result in significant expenses 
to us. 

To the extent we identify and close on any future development, investment, or acquisition opportunities, the integration of such 
communities or operating companies into our existing business may result in unforeseen difficulties, divert managerial attention, 
or require significant financial or other resources. Further, any such closings may require us to incur additional indebtedness and 
contingent liabilities and may result in unforeseen expenses or compliance issues, which may adversely affect our revenue growth, 
results of operations, and cash flow. Moreover, any future development, investment, or acquisition transactions may not generate 
any additional income for us or provide any benefit to our business. 

Competition for the acquisition of strategic assets from buyers with greater financial resources or lower costs of capital 
than us or that have lower return expectations than we do could limit our ability to compete for strategic acquisitions and 
therefore to grow our business effectively.

Several publicly-traded and non-traded real estate investment trusts, or REITs, and private equity firms have similar asset acquisition 
objectives as we do, along with greater financial resources and/or lower costs of capital than we are able to obtain. This may 
increase competition for acquisitions that would be suitable to us. There is significant competition among potential acquirers in 
the senior living industry, including publicly-traded and non-traded REITs and private equity firms, and there can be no assurance 
that we will be able to successfully complete acquisitions, which could limit our ability to grow our business. Partially as a result 
of tax law changes enacted through RIDEA, we now compete more directly with the various publicly-traded healthcare REITs 
for the acquisition of senior housing properties.

Delays in obtaining regulatory approvals could hinder our plans to continue to expand our healthcare services business, 
which could negatively impact our anticipated revenues, results of operations, and cash flow.

We intend to grow our healthcare services business,  primarily by  growing our  hospice and home  health business lines. Such 
initiatives may include further acquisitions of hospice agencies or certificates of need in our geographic footprint. In the current 
environment, it is difficult to obtain certain required regulatory approvals. Delays in obtaining required regulatory approvals could 
impede our ability to expand such services in accordance with our plans, which could negatively impact our anticipated revenues, 
results of operations, and cash flow. 

Termination, early or otherwise, or non-renewal of, or renewal on less-favorable terms, of our management arrangements 
will cause a loss in revenues and may negatively impact our results of operations and cash flow.

As of February 1, 2020, we managed 77 communities on behalf of third parties and three communities for which we have an equity 
interest, which represented approximately 17% of our total senior housing capacity. Under our management arrangements, we 
receive management fees, which are generally determined by an agreed upon percentage of gross revenues (as defined in the 
management arrangement), as well as reimbursed expenses, which represent the reimbursement of certain expenses we incur on 
behalf of the owners. A majority of our management arrangements as of December 31, 2019 are interim management arrangements 
entered into in connection with prior lease terminations that may be terminated by either party on short notice and without any 
reason, have a remaining term of approximately one year or less, or may be terminated by the owner within the next year. Generally 
either party to our management arrangements may terminate upon the occurrence of an event of default caused by the other party, 
generally subject to cure rights. Several long-term agreements also provide for early termination rights of the owner which may 
in some cases require an early termination fee. In some cases, subject to our cure rights, if any, community owners may terminate 
us as manager if any licenses or certificates necessary for operation are revoked, if we do not satisfy certain designated performance 
thresholds, or if the community is sold to an unrelated third party. Also, in some instances, a community owner may terminate the 
management agreement relating to a particular community if we are in default under other management agreements relating to 
28

other communities owned by the same owner or its affiliates. Certain of our management agreements provide that an event of 
default under the debt instruments applicable to managed communities that is caused by us may also be considered an event of 
default by us under the relevant management agreement, giving the non-Brookdale party to the management agreement the right 
to pursue the remedies provided for in the management agreement, potentially including termination of the management agreement. 
Further, in the event of default on a loan, the lender may have the ability to terminate us as manager. During 2020, we anticipate 
terminations of certain of our management arrangements with third parties as we transition to new operators our management on 
certain former unconsolidated ventures in which we sold our interest and our interim management on formerly leased communities. 
Termination, early or otherwise, or non-renewal of, or renewal on less-favorable terms, of our management arrangements will 
cause a loss in revenues and could negatively impact our results of operations and cash flows.

The geographic concentration of our communities could leave us vulnerable to an economic downturn, regulatory changes, 
acts  of  nature,  or  the  effects  of  climate  change  in those  areas,  which  could  negatively  impact  our  financial  condition, 
revenues, results of operations, and cash flow.

We have a high concentration of communities in various geographic areas, including the states of California, Florida, and Texas. 
As a result of this concentration, the conditions of local economies and real estate markets, changes in governmental rules and 
regulations, particularly with respect to assisted living and memory care communities, acts of nature, and other factors that may 
result in a decrease in demand for senior living services in these states could have an adverse effect on our financial condition, 
revenues, results of operations, and cash flow. In addition, given the location of our communities, we are particularly susceptible 
to revenue loss, cost increase, or damage caused by severe weather conditions or natural disasters such as hurricanes, wildfires, 
earthquakes, or tornados. Any significant loss due to a natural disaster may not be covered by insurance and may lead to an increase 
in the cost of insurance. Climate change may also have effects on our business by increasing the cost of property insurance or 
making coverage unavailable on acceptable terms. To the extent that significant changes in the climate occur in areas where our 
communities are located, we may experience increased frequency of severe weather conditions or natural disasters or changes in 
precipitation and temperature, all of which may result in physical damage to or a decrease in demand for properties located in 
these areas or affected by these conditions. Should the impact of climate change be material in nature, including destruction of 
our communities, or occur for lengthy periods of time, our financial condition, revenues, results of operations, or cash flow may 
be adversely affected. In addition, federal and state legislation and regulation on climate change could result in additional required 
capital expenditures to improve energy efficiency of our communities without a corresponding increase in our revenues. 

Termination of our resident agreements and vacancies in the living spaces we lease could adversely affect our occupancy, 
revenues, results of operations, and cash flow.

State regulations governing assisted living and memory care communities require written resident agreements with each resident. 
Several of these regulations also require that each resident have the right to terminate the resident agreement for any reason on 
reasonable notice. Consistent with these regulations, many of our assisted living and memory care resident agreements allow 
residents  to  terminate  their  agreements  upon  30  days'  or  less  notice.  Unlike  typical  apartment  leasing  or  independent  living 
arrangements that involve lease agreements with specified leasing periods of up to a year or longer, in many instances we cannot 
contract with our assisted living and memory care residents to stay in those living spaces for longer periods of time. Our independent 
living resident agreements generally provide for termination of the lease upon death or allow a resident to terminate his or her 
lease upon the need for a higher level of care not provided at the community. If multiple residents terminate their resident agreements 
at or around the same time, our occupancy, revenues, results of operations, and cash flow could be adversely affected. In addition, 
because of the demographics of our typical residents, including age and health, resident turnover rates in our communities are 
difficult to predict. As a result, the living spaces we lease may be unoccupied for a period of time, which could adversely affect 
our occupancy, revenues, results of operations, and cash flow.

The inability of seniors to sell real estate may delay their moving into our communities, which could negatively impact our 
occupancy rates, revenues, results of operations, and cash flow.

Downturns in the housing markets could adversely affect the ability (or perceived ability) of seniors to afford our resident fees as 
our customers frequently use the proceeds from the sale of their homes to cover the cost of our fees. Specifically, if seniors have 
a difficult time selling their homes or their homes' values decrease, these difficulties could impact their ability to relocate into our 
communities or finance their stays at our communities with private resources. A downturn in the housing market could be initiated 
or exacerbated by a rising interest rate environment. If national or local housing markets experience protracted volatility, our 
occupancy rates, revenues, results of operations, and cash flow could be negatively impacted. 

29

The transition of management or unexpected departure of our key officers could harm our business. 

We are dependent on the efforts of our senior management. During the past several years we have undergone changes in our senior 
management and may in the future experience further changes. The transition of management, the unforeseen loss or limited 
availability of the services of any of our executive leaders, or our inability to recruit and retain qualified personnel in the future, 
could, at least temporarily, have an adverse effect on our business, results of operations, and financial condition and be negatively 
perceived in the capital markets. 

Our execution of our strategy may not be successful, and initiatives undertaken to execute on our strategic priorities may 
adversely affect our business, financial condition, results of operations, cash flow, and the price of our common stock. 

The success of our strategy depends on our ability to successfully identify and implement initiatives to execute on our strategic 
priorities, as well as factors outside of our control. Such initiatives may not be successful in achieving our expectations or may 
require more time and resources than expected to implement. There can be no assurance that our strategy or initiatives undertaken 
to execute on our strategic priorities will be successful and, as a result, such initiatives may adversely affect our business, financial 
condition, results of operations, cash flow, and the price of our common stock. 

Actions of activist stockholders could cause us to incur substantial costs, divert management's attention and resources, 
and have an adverse effect on our business, results of operations, cash flow, and the market price of our common stock. 

We value constructive input from our stockholders and engage in dialogue with our stockholders regarding our governance practices, 
strategy,  and  performance.  However,  activist  stockholders  may  disagree  with  the  composition  of  our  Board  of  Directors  or 
management, our strategy, or capital allocation decisions and may seek to effect change through various strategies that range from 
private engagement to public campaigns, proxy contests, efforts to force proposals, or transactions not supported by our Board of 
Directors and litigation. Responding to these actions may be costly and time-consuming, disrupt our operations, divert the attention 
of our Board of Directors, management, and our associates and interfere with our ability to pursue our strategy and to attract and 
retain qualified Board and executive leadership. The perceived uncertainty as to our future direction that may result from actions 
of activist stockholders may also negatively impact our ability to attract and retain residents at our communities. We cannot provide 
assurance that constructive engagement with our stockholders will be successful. Any such stockholder activism may have an 
adverse effect on our business, results of operations, and cash flow and the market price of our common stock.

Environmental contamination at any of our communities could result in substantial liabilities to us, which may exceed the 
value of the underlying assets and which could materially and adversely affect our financial condition, results of operations, 
and cash flow.

Under various federal, state, and local environmental laws, a current or previous owner or operator of real property, such as us, 
may be held liable in certain circumstances for the costs of investigation, removal or remediation of, or related to the release of, 
certain hazardous or toxic substances, that could be located on, in, at, or under a property, regardless of how such materials came 
to be located there. The cost of any required investigation, remediation, removal, mitigation, compliance, fines, or personal or 
property damages and our liability therefore could exceed the property's value and/or our assets' value. In addition, the presence 
of such substances, or the failure to properly dispose of or remediate the damage caused by such substances, may adversely affect 
our ability to sell such property, to attract additional residents and retain existing residents, to borrow using such property as 
collateral, or to develop or redevelop such property. In addition, such laws impose liability, which may be joint and several, for 
investigation, remediation, removal, and mitigation costs on persons who disposed of or arranged for the disposal of hazardous 
substances at third party sites. Such laws and regulations often impose liability without regard to whether the owner or operator 
knew of, or was responsible for, the presence, release, or disposal of such substances as well as without regard to whether such 
release or disposal was in compliance with law at the time it occurred. Although we do not believe that we have incurred such 
liabilities as would have a material adverse effect on our business, financial condition, and results of operations, we could be 
subject to substantial future liability for environmental contamination that we have no knowledge about as of the date of this report 
and/or for which we may not be at fault.

Failure to comply with existing environmental laws could result in increased expenditures, litigation, and potential loss to 
our business and in our asset value, which would have an adverse effect on our financial condition, results of operations, 
and cash flow.

Our operations are subject to regulation under various federal, state, and local environmental laws, including those relating to: the 
handling, storage, transportation, treatment, and disposal of medical waste products generated at our communities; identification 
and warning of the presence of asbestos-containing materials in buildings, as well as removal of such materials; the presence of 

30

other substances in the indoor environment; and protection of the environment and natural resources in connection with development 
or construction of our properties.

Some of our communities generate infectious or other hazardous medical waste due to the illness or physical condition of the 
residents. Each of our communities has an agreement with a waste management company for the proper disposal of all infectious 
medical waste, but the use of such waste management companies does not immunize us from alleged violations of such laws for 
operations for which we are responsible even if carried out by such waste management companies, nor does it immunize us from 
third-party claims for the cost to cleanup disposal sites at which such wastes have been disposed.

Federal regulations require building owners and those exercising control over a building's management to identify and warn their 
employees and certain other employers operating in the building of potential hazards posed by workplace exposure to installed 
asbestos-containing materials and potential asbestos-containing materials in their buildings. Significant fines can be assessed for 
violation of these regulations. Building owners and those exercising control over a building's management may be subject to an 
increased risk of personal injury lawsuits. Federal, state, and local laws and regulations also govern the removal, encapsulation, 
disturbance, handling, and/or disposal of asbestos-containing materials and potential asbestos-containing materials when such 
materials are in poor condition or in the event of construction, remodeling, renovation, or demolition of a building. Such laws may 
impose liability for improper handling or a release to the environment of asbestos-containing materials and potential asbestos-
containing materials and may provide for fines to, and for third parties to seek recovery from, owners or operators of real properties 
for personal injury or improper work exposure associated with asbestos-containing materials and potential asbestos-containing 
materials.

The presence of mold, lead-based paint, contaminants in drinking water, radon, and/or other substances at any of the communities 
we own or may acquire may lead to the incurrence of costs for remediation, mitigation, or the implementation of an operations 
and  maintenance  plan  and  may  result  in  third  party  litigation  for  personal  injury  or  property  damage.  Furthermore,  in  some 
circumstances, areas affected by mold may be unusable for periods of time for repairs, and even after successful remediation, the 
known prior presence of extensive mold could adversely affect the ability of a community to retain or attract residents and could 
adversely affect a community's market value.

Although we believe that we are currently in material compliance with applicable environmental laws, if we fail to comply with 
such laws in the future, we would face increased expenditures both in terms of fines and remediation of the underlying problem(s), 
potential litigation relating to exposure to such materials, and potential decrease in value to our business and in the value of our 
underlying assets. Therefore, our failure to comply with existing environmental laws would have an adverse effect on our financial 
condition, results of operations, and cash flow.

We are unable to predict the future course of federal, state, and local environmental regulation and legislation. Changes in the 
environmental regulatory framework (including legislative or regulatory efforts designed to address climate change, such as the 
proposed "cap and trade" legislation) could have a material adverse effect on our business. In addition, because environmental 
laws vary from state to state, expansion of our operations to states where we do not currently operate may subject us to additional 
restrictions on the manner in which we operate our communities.

Significant  legal  actions  and  liability  claims  against  us  could  subject  us  to  increased  operating  costs  and  substantial 
uninsured liabilities, which may adversely affect our financial condition and results of operations.

We have been and are currently involved in litigation and claims, including putative class action claims from time to time, incidental 
to the conduct of our business which are generally comparable to other companies in the senior living and healthcare industries. 
Certain claims and lawsuits allege large damage amounts and may require significant costs to defend and resolve. As a result, we 
maintain general liability and professional liability insurance policies in amounts and with coverage and deductibles we believe 
are adequate, based on the nature and risks of our business, historical experience, and industry standards. Our current policies are 
written on a claims-made basis and provide for deductibles for each claim. Accordingly, we are, in effect, self-insured for claims 
that are less than the deductible amounts and for claims or portions of claims that are not covered by such policies. If we experience 
a greater number of losses than we anticipate, or if certain claims are not ultimately covered by insurance, our results of operations 
and financial condition could be adversely affected. 

The senior living and healthcare services businesses entail an inherent risk of liability, particularly given the demographics of our 
residents and patients, including age and health, and the services we provide. In recent years, we, as well as other participants in 
our industry, have been subject to an increasing number of claims and lawsuits alleging that our services have resulted in resident 
injury or other adverse effects. Many of these lawsuits involve large damage claims and significant legal costs. Many states continue 
to consider tort reform and how it will apply to the senior living industry. We may continue to be faced with the threat of large 

31

jury verdicts in jurisdictions that do not find favor with large senior living or healthcare providers. There can be no guarantee that 
we will not have any claims that exceed our policy limits in the future, which could subject us to substantial uninsured liabilities. 

If a successful claim is made against us and it is not covered by our insurance or exceeds the policy limits, our financial condition 
and results of operations could be materially and adversely affected. In some states, state law may prohibit or limit insurance 
coverage for the risk of punitive damages arising from professional liability and general liability claims and/or litigation. As a 
result, we may be liable for punitive damage awards in these states that either are not covered or are in excess of our insurance 
policy limits. Also, our insurance policies' deductibles, or self-insured retention, are accrued based on an actuarial projection of 
future liabilities. If these projections are inaccurate and if there is an unexpectedly large number of successful claims that result 
in liabilities in excess of our accrued reserves, our operating results could be negatively affected. Claims against us, regardless of 
their merit or eventual outcome, also could have a material adverse effect on our ability to attract residents or expand our business 
and could require our management to devote time to matters unrelated to the day-to-day operation of our business. We also have 
to renew our policies every year and negotiate acceptable terms for coverage, exposing us to the volatility of the insurance markets, 
including the possibility of rate increases. There can be no assurance that we will be able to obtain liability insurance in the future 
or, if available, that such coverage will be available on acceptable terms. 

We face periodic and routine reviews, audits, and investigations by government agencies, and any adverse findings could 
negatively impact our business, financial condition, results of operations, and cash flow. 

The senior living and healthcare industries are continuously subject to scrutiny by governmental regulators, which could result in 
reviews, audits, investigations, enforcement actions, or litigation related to regulatory compliance matters. In addition, we are 
subject to various government reviews, audits, and investigations to verify our compliance with Medicare and Medicaid programs 
and other applicable laws and regulations. CMS has engaged a number of third party firms, including Recovery Audit Contractors 
(RAC), Zone Program Integrity Contractors (ZPIC), and Unified Program Integrity Contractors (UPIC), to conduct extensive 
reviews  of  claims  data  to  evaluate  the  appropriateness  of  billings  submitted  for  payment.  Audit  contractors  may  identify 
overpayments based on coverage requirements, billing and coding rules, or other risk areas. In addition to identifying overpayments, 
audit  contractors  can  refer  suspected  violations  of  law  to  government  enforcement  authorities. An  adverse  determination  of 
government reviews, audits, and investigations may result in citations, sanctions, and other criminal or civil fines and penalties, 
the refund of overpayments, payment suspensions, and termination of participation in Medicare and Medicaid programs, and/or 
damage to the Company's business reputation. Our costs to respond to and defend any such audits, reviews, and investigations 
may be significant and are likely to increase in the current enforcement environment, and any resulting sanctions or criminal, civil, 
or regulatory penalties could have a material adverse effect on our business, financial condition, results of operations, and cash 
flow.

The cost and difficulty of complying with increasing and evolving regulation and enforcement could have an adverse effect 
on our business, results of operations, and cash flow.

The regulatory environment surrounding the senior living industry continues to evolve and intensify in the amount and type of 
laws and regulations affecting it, many of which vary from state to state. In addition, many senior living communities are subject 
to regulation and licensing by state and local health and social service agencies and other regulatory authorities. In several of the 
states there are different levels of care that can be provided based on the level of licensure. In addition, several of the states in 
which we operate, or intend to operate, assisted living and memory care communities, home health and hospice agencies, and/or 
skilled nursing facilities require a certificate of need before the community or agency can be opened or the services at an existing 
community can be expanded. These requirements, and the increased enforcement thereof, could affect our ability to expand into 
new markets, to expand our services and communities in existing markets, and if any of our presently licensed communities were 
to operate outside of its licensing authority, may subject us to penalties including closure of the community. See "Item 1. Business-
Industry Regulation" for more information regarding regulation and enforcement in our industry.

Federal, state, and local officials are increasingly focusing their efforts on enforcement of these laws and regulations. This is 
particularly true for large for-profit, multi-community providers like us. Future regulatory developments as well as mandatory 
increases in the scope and severity of deficiencies determined by survey or inspection officials could cause our operations to suffer. 
We are unable to predict the future course of federal, state, and local legislation or regulation. If regulatory requirements increase, 
whether through enactment of new laws or regulations or changes in the enforcement of existing rules, our business, results of 
operations, and cash flow could be adversely affected.

The  intensified  regulatory  and  enforcement  environment  impacts  providers  like  us  because of  the  increase  in  the  number  of 
inspections or surveys by governmental authorities and consequent citations for failure to comply with regulatory requirements. 
We also expend considerable resources to respond to federal and state investigations or other enforcement action. From time to 
time in the ordinary course of business, we receive deficiency reports from state and federal regulatory bodies resulting from such 
32

inspections or surveys. Although most inspection deficiencies are resolved  through a plan of corrective  action, the reviewing 
agency may have the authority to take further action against a licensed or certified facility, which could result in the imposition 
of fines, imposition of a provisional or conditional license, suspension or revocation of a license, suspension or denial of admissions, 
loss of certification as a provider under federal reimbursement programs, or imposition of other sanctions, including criminal 
penalties. Furthermore, certain states may allow citations in one community to impact other communities in the state. Revocation 
of a license at a given community could therefore impact our ability to obtain new licenses or to renew existing licenses at other 
communities, which may also cause us to default under our debt and lease documents and/or trigger cross-defaults. The failure to 
comply with applicable legal and regulatory requirements could result in a material adverse effect to our business as a whole.

There are various extremely complex federal and state laws governing a wide array of referral relationships and arrangements and 
prohibiting fraud by healthcare providers, including those in the senior living industry, and governmental agencies are devoting 
increasing  attention  and  resources  to  such  anti-fraud  initiatives.  Some  examples  are  the  Health  Insurance  Portability  and 
Accountability Act of 1996, or HIPAA, the Balanced Budget Act of 1997, and the False Claims Act, which gives private individuals 
the ability to bring an action on behalf of the federal government. The violation of any of these laws or regulations may result in 
the imposition of fines or other penalties that could increase our costs and otherwise jeopardize our business. 

Additionally, since we provide services and operate communities that participate in federal and/or state healthcare reimbursement 
programs, we are subject to federal and state laws that prohibit anyone from presenting, or causing to be presented, claims for 
reimbursement which are false, fraudulent or are for items or services that were not provided as claimed. Similar state laws vary 
from state to state. Violation of any of these laws can result in loss of licensure, citations, sanctions, and other criminal or civil 
fines and penalties, the refund of overpayments, payment suspensions, or termination of participation in Medicare and Medicaid 
programs, which may also cause us to default under our debt and lease documents and/or trigger cross-defaults.

We are also subject to certain federal and state laws that regulate financial arrangements by healthcare providers, such as the 
Federal Anti-Kickback Law, the Stark laws, and certain state referral laws. Authorities have interpreted the Federal Anti-Kickback 
Law very broadly to apply to many practices and relationships between healthcare providers and sources of patient referral. If we 
were to violate the Federal Anti-Kickback Law, we may face criminal penalties and civil sanctions, including fines and possible 
exclusion from government reimbursement programs, which may also cause us to default under our debt and lease documents 
and/or trigger cross-defaults. Adverse consequences may also result if we violate federal Stark laws related to certain Medicare 
and Medicaid physician referrals. While we endeavor to comply with all laws that regulate the licensure and operation of our 
business, it is difficult to predict how our revenues could be affected if we were subject to an action alleging such violations.

Compliance with the Americans with Disabilities Act, Fair Housing Act, and fire, safety, and other regulations may require 
us  to  make  unanticipated  expenditures,  which  could  increase  our  costs  and  therefore  adversely  affect  our results  of 
operations and financial condition.

Certain of our communities, or portions thereof, are subject to compliance with the Americans with Disabilities Act, or ADA. The 
ADA has separate compliance requirements for "public accommodations" and "commercial properties," but generally requires 
that buildings be made accessible to people with disabilities. Compliance with ADA requirements could require removal of access 
barriers and non-compliance could result in imposition of government fines or an award of damages to private litigants.

We must also comply with the Fair Housing Act, which prohibits us from discriminating against individuals on certain bases in 
any of our practices if it would cause such individuals to face barriers in gaining residency in any of our communities. Additionally, 
the Fair Housing Act and other state laws require that we advertise our services in such a way that we promote diversity and not 
limit it. We may be required, among other things, to change our marketing techniques to comply with these requirements.

In addition, we are required to operate our communities in compliance with applicable fire and safety regulations, building codes 
and other land use regulations, and food licensing or certification requirements as they may be adopted by governmental agencies 
and bodies from time to time. Like other healthcare facilities, senior living communities are subject to periodic survey or inspection 
by governmental authorities to assess and assure compliance with regulatory requirements. Surveys occur on a regular (often 
annual or bi-annual) schedule, and special surveys may result from a specific complaint filed by a resident, a family member, or 
one of our competitors. We may be required to make substantial capital expenditures to comply with those requirements.

Legislation was adopted in the State of Florida in March 2018 that requires skilled nursing homes and assisted living communities 
in Florida to obtain generators and fuel necessary to sustain operations and maintain comfortable temperatures in the event of a 
power outage. Our cost to comply with this legislation was approximately $19.1 million without a corresponding increase in our 
revenues. If other states or jurisdictions were to adopt similar legislation or regulation, the cost to comply with such requirements 
may be substantial and may not result in any additional revenues. 

33

The increased costs and capital expenditures that we may incur in order to comply with any of the above would result in a negative 
effect on our results of operations and financial condition.

Risks Related to Our Organization and Structure

Anti-takeover provisions in our organizational documents may delay, deter, or prevent a tender offer, merger, or acquisition 
that investors may consider favorable or prevent the removal of our current board of directors. 

Certain provisions of our amended and restated certificate of incorporation and our amended and restated bylaws may delay, deter, 
or prevent a tender offer, merger, or acquisition that investors may consider favorable or prevent the removal of our current board 
of directors. Among these anti-takeover provisions is the classified structure of our Board of Directors pursuant to which our Board 
is divided into three classes of directors and each of our directors elected at or prior to the 2018 annual meeting of stockholders 
was elected to serve a three-year term. Although we are in the process of phasing out our classified board structure, our full Board 
will not begin standing for annual elections until the 2021 annual meeting of stockholders. Until the 2021 annual meeting of 
stockholders, directors may be removed from office only for cause. Additional anti-takeover provisions in our organizational 
documents that will hinder takeover attempts include: 

• 
• 
• 

• 

blank-check preferred stock; 
provisions preventing stockholders from calling special meetings or acting by written consent; 
advance notice requirements for stockholders with respect to director nominations and actions to be taken at annual meetings; 
and 
no provision in our amended and restated certificate of incorporation for cumulative voting in the election of directors, which 
means that the holders of a majority of the outstanding shares of our common stock can elect all the directors standing for 
election. 

Additionally, our amended and restated certificate of incorporation provides that Section 203 of the Delaware General Corporation 
Law, which restricts certain business combinations with interested stockholders in certain situations, will not apply to us. 

We are a holding company with no operations and rely on our operating subsidiaries to provide us with funds necessary 
to meet our financial obligations. 

We are a holding company with no material direct operations. Our principal assets are the equity interests we directly or indirectly 
hold in our operating subsidiaries. As a result, we are dependent on loans, distributions, and other payments from our subsidiaries 
to generate the funds necessary to meet our financial obligations. Our subsidiaries are legally distinct from us and have no obligation 
to make funds available to us. 

Risks Related to Our Common Stock

The market price and trading volume of our common stock may be volatile, which could result in rapid and substantial 
losses for our stockholders. 

The market price of our common stock may be highly volatile and could be subject to wide fluctuations. In addition, the trading 
volume in our common stock may fluctuate and cause significant price variations to occur. If the market price of our common 
stock declines significantly, stockholders may be unable to resell their shares at or above their purchase price. The market price 
of our common stock may fluctuate or decline significantly in the future. Some of the factors that could negatively affect our share 
price, result in fluctuations in the price, or trading volume of our common stock include: 

• 
• 
• 

• 
• 
• 
• 
• 

• 

variations in our quarterly results of operations and cash flow;
changes in our operating performance and liquidity guidance;
the contents of published research reports about us or the senior living, healthcare, or real estate industries or the failure of 
securities analysts to cover our common stock;
additions or departures of key management personnel;
any increased indebtedness we may incur or lease obligations we may enter into in the future;
actions by institutional stockholders;
changes in market valuations of similar companies;
announcements by us or our competitors of significant contracts, acquisitions, strategic partnerships, joint ventures, or capital 
commitments;
speculation or reports by the press or investment community with respect to us or the senior living, healthcare, or real estate 
industries in general;

34

• 
• 
• 
• 

• 

proxy contests or other shareholder activism;
increases in market interest rates that may lead purchasers of our shares to demand a higher yield;
downturns in the real estate market or changes in market valuations of senior living communities;
changes or proposed changes in laws or regulations affecting the senior living and healthcare industries or enforcement of 
these laws and regulations, or announcements relating to these matters; and
general market and economic conditions. 

Future offerings of debt or equity securities by us may adversely affect the market price of our common stock.

In the future, we may attempt to increase our capital resources by offering additional debt or equity securities, including commercial 
paper, medium-term notes, senior or subordinated notes, convertible securities, series of preferred shares, or shares of our common 
stock. Upon liquidation, holders of our debt securities and preferred stock, and lenders with respect to other borrowings, would 
receive a distribution of our available assets prior to the holders of our common stock. Additional equity offerings may dilute the 
economic and voting rights of our existing stockholders or reduce the market price of our common stock, or both. Shares of our 
preferred stock, if issued, could have a preference with respect to liquidating distributions or a preference with respect to dividend 
payments that could limit our ability to pay dividends to the holders of our common stock. Because our decision to issue securities 
in any future offering will depend on market conditions and other factors beyond our control, we cannot predict or estimate the 
amount, timing, or nature of our future offerings. Thus, holders of our common stock bear the risk of our future offerings reducing 
the market price of our common stock and diluting their shareholdings in us. 

We may issue all of the shares of our common stock that are authorized but unissued (and not otherwise reserved for issuance 
under our stock incentive or purchase plans) without any action or approval by our stockholders. We may issue shares of common 
stock in connection with development, investment, and acquisition opportunities, including de novo development, acquisitions of 
senior living communities and operating companies,  and  expansion of  our healthcare  services business. Any shares  issued in 
connection with our acquisitions or otherwise would dilute the holdings of our current stockholders. 

The market price of our common stock could be negatively affected by sales of substantial amounts of our common stock 
in the public markets. 

At December 31, 2019, approximately 184.9 million shares of our common stock were outstanding (excluding unvested restricted 
shares). All of the shares of our common stock are freely transferable, except for any shares held by our "affiliates," as that term 
is defined in Rule 144 under the Securities Act of 1933, as amended, or the Securities Act, or any shares otherwise subject to the 
limitations of Rule 144. 

In addition, as of December 31, 2019, unvested equity awards with respect to approximately 7.3 million shares of our common 
stock were outstanding under our 2014 Omnibus Incentive Plan, and  we had availability to issue approximately  11.5 million
additional shares under our 2014 Omnibus Incentive Plan, our Associate Stock Purchase Plan, and our Director Stock Purchase 
Plan. The shares of our common stock issued or issuable pursuant to these plans are or will be registered under the Securities Act, 
and once any restrictions imposed on the shares and options granted under these plans expire, such shares of common stock will 
be available for sale into the public markets. 

Our ability to use net operating loss carryovers to reduce future tax payments will be limited. 

Section 382 of the Internal Revenue code contains rules that limit the ability of a company that undergoes an ownership change, 
which is generally any change in ownership of 50% of its stock over a three-year period, to utilize its net operating loss carryforward 
and certain built-in losses recognized in years after the ownership change. These rules generally operate by focusing on ownership 
changes involving stockholders owning directly or indirectly 5% or more of the stock of a company and any change in ownership 
arising from a new issuance of stock by the company. Any such annual limitations may result in our being unable to utilize all of 
our net operating loss carryforwards generated in tax years prior to 2018 before their expiration. 

Item 1B. 

Unresolved Staff Comments

None. 

35

Item 2. 

Properties

Communities

As of December 31, 2019, we operated and managed 763 communities across 45 states, with the capacity to serve approximately 
72,000 residents. As of December 31, 2019, we owned 330 communities, leased 333 communities, managed 17 communities for 
which  we  have  an  equity  interest,  and  managed  83  communities  on  behalf  of  third  parties.  Substantially  all  of  our  owned 
communities are subject to mortgage debt. The following table sets forth certain information regarding our owned, leased, and 
managed communities as of December 31, 2019. Occupancy data includes the impact of managed communities. 

Number of Communities

State
Florida
Texas
California
Colorado
North Carolina
Illinois
Ohio
Washington
Arizona
Michigan
Oregon
New York
Tennessee
Virginia
Pennsylvania
New Jersey
Kansas
Missouri
Alabama
Oklahoma
Massachusetts
Georgia
South Carolina
Indiana
Wisconsin
Connecticut
Maryland
Idaho
Minnesota
Rhode Island
Arkansas
Louisiana
New Mexico
Mississippi
Nebraska
Kentucky
Nevada
Montana
Iowa

Units

Occupancy

Owned

Leased

11,814
9,599
7,455
3,822
3,401
3,027
2,876
2,810
2,153
2,116
1,805
1,599
1,493
1,206
1,205
1,148
1,114
1,096
1,085
979
899
882
854
829
712
636
560
548
538
532
494
486
457
386
379
283
256
137
106

83%
83%
83%
81%
87%
88%
83%
88%
87%
82%
92%
87%
90%
81%
83%
89%
90%
88%
87%
91%
83%
85%
78%
74%
90%
77%
89%
88%
75%
86%
83%
85%
69%
83%
85%
76%
89%
91%
67%

36

43
56
25
11
7
2
20
14
13
9
8
10
12
7
7
7
8
2
6
3
3
5
3
4
5
2
2
6
—
1
4
6
2
5
—
2
4
1
—

32
19
24
13
50
10
15
19
13
23
15
9
10
3
3
5
10
—
—
15
3
3
7
4
7
3
1
1
12
2
—
—
1
—
—
1
—
—
—

Managed
12
19
13
9
—
3
—
—
1
1
—
3
1
2
1
1
—
3
1
5
—
4
3
1
2
1
3
—
—
1
1
—
1
—
4
—
—
1
1

Total

87
94
62
33
57
15
35
33
27
33
23
22
23
12
11
13
18
5
7
23
6
12
13
9
14
6
6
7
12
4
5
6
4
5
4
3
4
2
1

State
Delaware
Vermont
West Virginia
New Hampshire
Utah
Wyoming
Total

Corporate Offices

Number of Communities

Units

Occupancy

Owned

Leased

105
101
93
90
55
46
72,267

89%
87%
89%
98%
99%
76%
84%

2
1
1
1
—
—
330

—
—
—
—
—
—
333

Managed
—
—
—
—
1
1
100

Total

2
1
1
1
1
1
763

Our main corporate offices are leased, including our 107,713 square foot headquarters facility in Brentwood, Tennessee and our 
156,016 square foot shared service facility in Milwaukee, Wisconsin. 

Item 3. 

Legal Proceedings

The information contained in Note 18 to the consolidated financial statements contained in "Item 8. Financial Statements and 
Supplementary Data" is incorporated herein by reference. 

Item 4. 

Mine Safety Disclosures

Not applicable. 

37

PART II

Item 5. 

Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 
Securities

Market Information

Our common stock is traded on the New York Stock Exchange, or the NYSE, under the symbol "BKD". As of February 14, 2020, 
there were approximately 357 holders of record of our common stock.

Dividend Policy

On December 30, 2008, our Board of Directors voted to suspend our quarterly cash dividend indefinitely. We may determine to 
pay a regular quarterly dividend to the holders of our common stock in the future, but in the near term, we anticipate deploying 
capital to, among other uses, fund: opportunistic share repurchases, planned capital expenditures, any acquisition, investment, 
development, or potential lease restructuring opportunities that we identify, investments to support our strategy, or reductions to 
our debt and lease leverage. 

Our ability to pay and maintain cash dividends in the future will be based on many factors, including then-existing contractual 
restrictions or limitations, our ability to execute our strategy, our ability to negotiate favorable lease and other contractual terms, 
anticipated operating expense levels, our capital expenditure plans, the level of demand for our units, occupancy rates, the rates 
we charge, and our liquidity position. Some of the factors are beyond our control and a change in any such factor could affect our 
ability to pay or maintain dividends. We can give no assurance as to our ability to pay or maintain dividends in the future. As we 
have done in the past, we may also pay dividends in the future that exceed our net income for the relevant period as calculated in 
accordance with GAAP. 

38

Share Price Performance Graph

The following graph compares the five-year cumulative total return for Brookdale common stock with the comparable cumulative 
return of the S&P 500, Russell 3000, and S&P Health Care Indices. We are not a constituent company of the S&P 500 Index and 
have determined to replace the S&P 500 Index with the Russell 3000 Index because we, and companies with market capitalizations 
comparable to ours, are included in the Russell 3000 Index. The return of the S&P 500 Index is included in the graph to aid in 
comparison for the transition year. 

The graph assumes that a person invested $100 in Brookdale stock and each of the indices on December 31, 2014 and that dividends 
are reinvested. The comparisons in this graph are not intended to forecast  or be indicative of possible future performance of 
Brookdale shares or such indices. 

Brookdale Senior Living Inc.

$

100.00

$

50.34

$

33.87

$

26.45

$

18.27

$

12/14

12/15

12/16

12/17

12/18

S&P 500

Russell 3000

S&P Health Care

100.00

100.00

100.00

101.38

100.48

106.89

113.51

113.27

104.01

138.29

137.21

126.98

132.23

130.02

135.19

12/19

19.83

173.86

170.35

163.34

The performance graph and related information shall not be deemed to be filed as part of this Annual Report on Form 10-K and 
do not constitute soliciting material and shall not be deemed filed or incorporated by reference into any other filing by the Company 
under the Securities Act or the Exchange Act, except to the extent that the Company specifically incorporates them by reference 
into such filing. 

39

 
Recent Sales of Unregistered Securities

None. 

Purchases of Equity Securities by the Issuer and Affiliated Purchasers

The following table contains information regarding purchases of our common stock made during the quarter ended December 31, 
2019 by or on behalf of the Company or any ''affiliated purchaser,'' as defined by Rule 10b-18(a)(3) of the Exchange Act: 

Total
Number of
Shares
Purchased (1)

Average
Price Paid
per Share ($)

— $

685,888

118,468

804,356

$

—

6.99

6.99

6.99

Total Number of
Shares Purchased as
Part of Publicly
Announced Plans
or Programs (2)

Approximate Dollar 
Value of
Shares that May Yet Be
Purchased Under the
Plans or Programs ($ in 
thousands) (2)

— $

675,812

118,468

794,280

67,703

62,977

62,149

Period

10/1/2019 - 10/31/2019

11/1/2019 - 11/30/2019

12/1/2019 - 12/31/2019

Total

(1)  Includes 794,280 shares purchased in open market transactions pursuant to the publicly announced repurchase program 
summarized in footnote (2) below and 10,076 shares withheld to satisfy tax liabilities due upon the vesting of restricted 
stock during November 2019. The average price paid per share for such share withholding is based on the closing price 
per share on the vesting date of the restricted stock or, if such date is not a trading day, the trading day immediately prior 
to such vesting date. 

(2)  On November 1, 2016, the Company announced that its Board of Directors had approved a share repurchase program 
that authorizes the Company to purchase up to $100.0 million in the aggregate of its common stock. The share repurchase 
program is intended to be implemented through purchases made from time to time using a variety of methods, which 
may include open market purchases, privately negotiated transactions, or block trades, or by any combination of such 
methods, in accordance with applicable insider trading and other securities laws and regulations. The size, scope, and 
timing of any purchases will be based on business, market, and other conditions and factors, including price, regulatory, 
and contractual requirements, and capital availability. The repurchase program does not obligate the Company to acquire 
any particular amount of common stock and the program may be suspended, modified, or discontinued at any time at the 
Company's discretion without prior notice. Shares of stock repurchased under the program will be held as treasury shares. 
As of December 31, 2019, approximately $62.1 million remained available under the repurchase program. 

Item 6. 

Selected Financial Data

This selected financial data should be read in conjunction with the information contained in "Item 7. Management's Discussion 
and Analysis  of  Financial  Condition  and  Results  of  Operations"  and  our  consolidated  financial  statements  and  related  notes 
contained in "Item 8. Financial Statements and Supplementary Data." Our statement of operations data and balance sheet data as 
of  and  for each  of the years  in the  five-year period ended  December 31,  2019  have  been  derived  from  our  audited  financial 
statements. The results of operations for any particular period are not necessarily indicative of results for any future period. 

We completed dispositions, through sales and lease terminations, of 24 communities (2,427 units), 111 communities (10,848 units), 
108 communities (10,325 units), and 57 communities (4,039 units) during the years ended December 31, 2019, 2018, 2017, and 
2016,  respectively.  See  Note  4  to  the  consolidated  financial  statements  contained  in  "Item  8.  Financial  Statements  and 
Supplementary Data" for more information regarding our disposition and other transaction activity. 

40

(in thousands, except per share and other
operating data)

2019

For the Years Ended December 31,
2016
2017
2018

2015

Total revenue

$ 4,057,088

$ 4,531,426

$ 4,747,116

$ 4,976,980

$ 4,960,608

Facility operating expense

2,390,495

2,453,328

2,602,155

2,799,402

2,788,862

General and administrative expense

Facility operating lease expense

Depreciation and amortization
Goodwill and asset impairment (1)
Loss (gain) on facility lease termination and
modification, net

Costs incurred on behalf of managed

communities

Total operating expense

Income (loss) from operations

Interest income

Interest expense

Debt modification and extinguishment costs

Equity in earnings (loss) of unconsolidated

ventures

Gain (loss) on sale of assets, net

Other non-operating income (loss)

Income (loss) before income taxes

Benefit (provision) for income taxes

Net income (loss)

Net (income) loss attributable to

noncontrolling interest

Net income (loss) attributable to Brookdale
Senior Living Inc. common stockholders

Basic and diluted net income (loss) per share
attributable to Brookdale Senior Living Inc.
common stockholders

Weighted average shares of common stock
used in computing basic and diluted net
income (loss) per share

Other Operating Data:

Number of communities operated and

managed (at end of period)

Total units operated and managed:

Period end

Average
RevPAR (2)
Owned/leased communities occupancy rate

(weighted average)

RevPOR (3)

219,289

269,666

379,433

49,266

259,475

303,294

447,455

489,893

278,019

339,721

482,077

409,782

317,399

373,635

520,402

248,515

378,831

367,574

733,165

57,941

3,388

162,001

14,276

11,113

76,143

790,049

1,010,229

891,131

737,597

723,298

4,101,586

(44,498)

9,859

(248,341)

(5,247)

(4,544)

7,245

14,765

(270,761)

2,269

(268,492)

5,125,675
(594,249)

9,846
(280,269)
(11,677)

(8,804)

293,246

14,099
(577,808)

49,456
(528,352)

5,017,161
(270,045)

4,623
(326,154)
(12,409)

(14,827)

19,273

11,418
(588,121)

16,515
(571,606)

5,008,063
(31,083)

2,933
(385,617)
(9,170)

1,660

7,218

14,801
(399,258)
(5,378)
(404,636)

5,125,814
(165,206)

1,603
(388,764)
(7,020)

(804)

1,270

8,557
(550,364)

92,209
(458,155)

561

94

187

239

678

$ (267,931)

$ (528,258)

$ (571,419)

$ (404,397)

$ (457,477)

$

(1.44)

$

(2.82)

$

(3.07)

$

(2.18)

$

(2.48)

185,907

187,468

186,155

185,653

184,333

763

892

1,023

1,055

1,123

72,267

77,270

4,106

83.9%

4,893

$

$

84,279

94,562

3,972

84.3%

4,712

$

$

100,582

101,779

3,890

85.0%

4,578

102,768

106,122

3,845

86.0%

4,468

$

$

$

$

107,786

109,342

3,742

86.8%

4,310

$

$

(1)  During the year ended December 31, 2019, we recorded $49.3 million of non-cash impairment charges, of which $27.2 
million related to property, plant and equipment and leasehold intangibles for certain communities and $10.2 million 
related to operating lease right-of-use assets, primarily within the Assisted Living and Memory Care segment. During 
the year ended December 31, 2018, we recorded $489.9 million of non-cash impairment charges, primarily for $351.7 
million of goodwill within the Assisted Living and Memory Care segment, $78.0 million of property, plant and equipment 
and leasehold intangibles for certain communities, primarily in the Assisted Living and Memory Care segment, $33.4 
million related to investments in unconsolidated ventures, $15.6 million related to assets held for sale, and $9.1 million 

41

of intangible assets for health care licenses within the Health Care Services segment. During the year ended December 31, 
2017, we recorded $409.8 million of non-cash impairment charges, primarily for goodwill within the Assisted Living 
and Memory Care segment and property, plant and equipment and leasehold intangibles for certain communities. During 
the year ended December 31, 2016, we recorded $248.5 million of non-cash impairment charges, primarily for property, 
plant and equipment and leasehold intangibles for certain communities. During the year ended December 31, 2015, we 
recorded $57.9 million of non-cash impairment charges, primarily related to assets held for sale and property, plant and 
equipment and leasehold intangibles for certain communities. See Note 5 to the consolidated financial statements contained 
in "Item 8. Financial Statements and Supplementary Data" for more information regarding our impairment charges in 
2019, 2018, and 2017. 

(2)  RevPAR, or average monthly senior housing resident  fee revenues per available unit, is defined by  the Company as 
resident fee revenues for the corresponding portfolio for the period (excluding Health Care Services segment revenue 
and entrance fee amortization, and, for the 2019 period, the additional resident fee revenue recognized as a result of the 
application of the new lease accounting standard under Accounting Standards Codification ("ASC") 842, Leases ("ASC 
842")), divided by the weighted average number of available units in the corresponding portfolio for the period, divided 
by the number of months in the period. 

(3)  RevPOR, or average monthly senior housing resident fee revenues per occupied unit, is defined by the Company as 
resident fee revenues for the corresponding portfolio for the period (excluding Health Care Services segment revenue 
and entrance fee amortization, and, for the 2019 period, the additional resident fee revenue recognized as a result of the 
application of the new lease accounting standard under ASC 842), divided by the weighted average number of occupied 
units in the corresponding portfolio for the period, divided by the number of months in the period. 

As of December 31,

(in thousands)

2019

2018

2017

2016

2015

Cash and cash equivalents

$

240,227

$

398,267

$

222,647

$

216,397

$

88,029

Marketable securities
Total assets (1)
Total long-term debt and line of credit

Total financing lease obligations
Total operating lease obligations (1)
Total equity

68,567

7,194,433

3,555,123

834,580

1,470,765

14,855

6,467,260

3,640,180

874,476

—

291,796

7,675,449

3,870,737

1,271,554

—

—

—

9,217,687

10,048,564

3,559,647

2,485,520

—

3,942,825

2,489,588

—

698,725

1,018,413

1,530,291

2,077,732

2,458,727

(1)  Our adoption of ASC 842 resulted in the recognition of operating lease liabilities of $1.6 billion and right-of-use assets 
of $1.3 billion on the consolidated balance sheet for our existing community, office, and equipment operating leases as 
of January 1, 2019. See Note 2 to the consolidated financial statements contained in "Item 8. Financial Statements and 
Supplementary Data" for more information regarding the adoption of ASC 842. 

Item 7. 

Management's Discussion and Analysis of Financial Condition and Results of Operations

This discussion and analysis should be read in conjunction with the information contained in "Item 6. Selected Financial Data" 
and  our  historical  consolidated  financial  statements  and  related  notes  contained  in  "Item  8.  Financial  Statements  and 
Supplementary Data." In addition to historical information, this discussion and analysis may contain forward-looking statements 
that  involve  risks,  uncertainties,  and  assumptions,  which  could  cause  actual  results  to  differ  materially  from  management's 
expectations. Please see additional risks and uncertainties described in "Safe Harbor Statement Under the Private Securities 
Litigation Reform Act of 1995" for more information. Factors that could cause such differences include those described in this 
section and "Item 1A. Risk Factors" of this Annual Report on Form 10-K.

Executive Overview and Recent Developments

Our Business

As of February 1, 2020, we are the largest operator of senior living communities in the United States based on total capacity, with 
743 communities in 45 states and the ability to serve approximately 65,000 residents. We offer our residents access to a broad 
continuum of services across the most attractive sectors of the senior living industry. We operate and manage independent living, 

42

assisted living, memory care, and continuing care retirement communities ("CCRCs"). We also offer a range of home health, 
hospice, and outpatient therapy services to more than 20,000 patients as of that date. 

Our community and service offerings combine housing with hospitality and healthcare services. Our senior living communities 
offer residents a supportive home-like setting,  assistance  with ADLs  such  as  eating, bathing, dressing, toileting, transferring/
walking, and, in certain communities, licensed skilled nursing services. We also provide home health, hospice, and outpatient 
therapy services to residents of many of our communities and to seniors living outside of our communities. By providing residents 
with a range of service options as their needs change, we provide greater continuity of care, enabling seniors to age-in-place, which 
we believe enables them to maintain residency with us for a longer period of time. The ability of residents to age-in-place is also 
beneficial to our residents and their families who are concerned with care decisions for their elderly relatives. 

Strategy

Our goal is to be the first choice in senior living by being the nation's most trusted and effective senior living provider and employer. 
We believe there are significant opportunities to deliver stockholder value as we execute on our strategy to achieve this goal. We 
continue to execute our core operational strategy that we initiated in early 2018, and we believe successful execution on that 
strategy provides the best opportunity for us to create stockholder value. We have supplemented our operational strategy with 
initiatives intended to complement and enhance our core operational efforts and to position us for future growth and success as 
we encounter changes and trends in demographics, technology, and healthcare delivery methods. Our refined strategy is focused 
on these priorities: 

•  Continued Operational Improvement and Simplification. We are focused on our core senior living communities and intend 
to continue to drive improvements in our senior living portfolio by winning locally. Through our "win locally" initiative, we 
intend to provide choices for high quality care and personalized service by caring associates while leveraging our industry-
leading scale and experience. Such efforts include improvements to our sales and marketing process, prioritizing communities 
with the most opportunities for improvement, and ensuring that our communities are ready for new competition. We also 
continue to focus on attracting, engaging, developing, and retaining the best associates by maintaining a compelling value 
proposition in the areas of compensation, leadership, career development, and meaningful work. We believe engaged associates 
lead to an enhanced resident experience, lower turnover, and, ultimately, improved operations. To sharpen our focus on our 
core senior living operations, we are (and have been) executing on initiatives to reduce the complexity of our business and 
to ensure appropriate risk-reward tradeoffs in our highly regulated product lines. Such initiatives include exiting our entry 
fee CCRC business and continuing to optimize our management services business. 

• 

Senior Living Portfolio. Since initiating our operational turnaround strategy in early 2018, we have continued our portfolio 
optimization initiative through which we have disposed  of owned  and  leased communities  and  restructured leases.  Such 
transactions have  included restructuring our leases with our three largest landlords, sales  of 36 owned communities,  and 
dispositions of substantially all of our interests in unconsolidated ventures  (including our equity interests in 14  entry fee 
CCRCs). As we emerge from our disposition phase, we intend to (i) increase our ownership percentage in our senior housing 
portfolio through acquiring leased or managed communities and exiting underperforming leases when possible, (ii) expand 
our footprint and services in core markets where we have, or can achieve, a clear leadership position, (iii) formalize and 
execute an ongoing capital recycling program, including opportunistically selling certain communities to invest in expansion 
of our existing communities and the acquisition or development of newer communities with lower capital expenditure needs, 
and (iv) pivot back to portfolio growth through targeted development, investment, and acquisition opportunities such as de 
novo development and selective acquisitions of senior living communities and operating companies. We will continue to 
invest in our development capital expenditures program through which we expand, renovate, reposition, and redevelop selected 
existing  senior  living  communities  where  economically  advantageous.  For  2020,  we  expect  to  continue  to  pursue  non-
development capital expenditures at higher-than-typical amounts, but at significantly less than 2019 amounts. Beginning in 
2021, we expect our annual community-level capital expenditures to be between $2,000 and $2,500 per weighted average 
unit. 

•  Expansion of Healthcare and Service Platform. Our vision is to enable those we serve to live well by offering the most 
integrated and highest-quality healthcare and wellness platform in the senior living industry. We intend to pilot a more integrated 
healthcare service model in certain markets in 2020. We also intend to pursue initiatives designed to accelerate growth in our 
healthcare services business, primarily by growing our hospice and home health business lines, and to grow our private duty 
business.  Such  initiatives  may  include  further  acquisitions  of  hospice  agencies  or  certificates  of  need  in  our  geographic 
footprint, further expansion of our services to seniors living outside our communities, implementation of improvements to 
our  sales  and  marketing  efforts  associated  with  our  healthcare  services  business,  and  pursuit  of  additional  or  expanded 
relationships with managed care providers. We believe the successful execution of these initiatives will increase our revenues 
and improve the results of operations of our Health Care Services segment and that the overall implementation of our integrated 

43

healthcare  strategy  will  benefit  our  core  senior  housing  business  by  increasing  move-ins,  improving  resident  health  and 
wellbeing, and increasing our average length of stay and occupancy. 

•  Driving Innovation and Leveraging Technology. We are engaged in a variety of innovation initiatives and over time plan 
to pilot and test new ideas, technologies, and operating models in order to enhance our residents' experience, improve outcomes, 
and increase average length of stay and occupancy. With our technology platform, we also expect to identify solutions to 
reduce complexity, increase productivity, lower costs, and increase our ability to partner with third parties. 

Transaction Activity and Impact of Dispositions on Results of Operations

Overview

Since launching our core operational strategy in February 2018, we have continued our portfolio optimization initiative through 
which we have disposed of owned and leased communities and restructured leases. We undertook this initiative to simplify and 
streamline our business, increase the quality and durability of our cash flow, improve our liquidity, reduce our debt and lease 
leverage, and to increase our ownership in our consolidated community portfolio. Such activities included our transactions with 
Ventas and Welltower announced during 2018 and our transactions with Healthpeak announced on October 1, 2019. 

As a result of these initiatives and other lease restructuring, expiration, and termination activity, and other transactions, since 
January 1, 2018 through February 1, 2020 we have:

• 
• 
• 
• 

• 
• 

restructured our triple-net lease portfolios with our three largest lessors;
terminated our triple-net lease obligations on an aggregate of 99 communities;
acquired 32 formerly-leased or managed communities;
disposed of an aggregate of 36 owned communities generating $288.3 million of proceeds, net of related debt and transaction 
costs; 
sold substantially all of our interests in unconsolidated ventures, including our entry fee CCRC venture; and
reduced our management of communities on behalf of former unconsolidated ventures and third parties.

As of February 1, 2020, we owned 356 communities, representing a majority of our consolidated community portfolio, and leased 
307 communities. We also managed 77 communities on behalf of third parties and three communities for which we have an equity 
interest. The charts below show the foregoing changes in our portfolio from January 1, 2018 to February 1, 2020. 

During the remainder of the year ending December 31, 2020, we expect to close on the dispositions of three owned communities 
(495 units) classified as held for sale as of December 31, 2019 and the termination of our lease obligation on three communities 
(205 units) for which we have provided notice of non-renewal. We also anticipate terminations of certain of our management 
arrangements with third parties as we transition to new operators our management on certain former unconsolidated ventures in 
which we sold our interest and our interim management on formerly leased communities. The closings of the various pending and 
expected transactions are, or will be, subject to the satisfaction of various closing conditions, including (where applicable) the 
receipt of regulatory approvals. However, there can be no assurance that the transactions will close or, if they do, when the actual 
closings will occur. 

44

Summaries of the foregoing transactions, and their impact on our results of operations, are below. See also Note 4 to the consolidated 
financial  statements  contained  in  "Item  8.  Financial  Statements  and  Supplementary  Data"  for  more  information  about  the 
transactions. 

Completed and Planned Dispositions of Owned Communities

During the year ended December 31, 2019, we completed the sale of 14 owned communities (1,629 units) for cash proceeds of 
$85.4 million, net of transaction costs. We utilized a portion of the cash proceeds from the asset sales to repay approximately $5.1 
million of associated mortgage debt and debt prepayment penalties. 

During the year ended December 31, 2018, we completed the sale of 22 owned communities (1,819 units) for cash proceeds of 
$380.7 million, net of transaction costs. We utilized a portion of the cash proceeds from the asset sales to repay approximately 
$174.0 million of associated mortgage debt and debt prepayment penalties. 

During the year ended December 31, 2017, we completed the sale of three owned communities (311 units) for cash proceeds of 
$8.2 million, net of transaction costs. 

As of December 31, 2019, three communities were classified as held for sale, resulting in $42.7 million being recorded as assets 
held for sale and $28.9 million of associated mortgage debt being included in the current portion of long-term debt within the 
consolidated balance sheet.

2019 Healthpeak CCRC Venture and Master Lease Transactions

On October 1, 2019, we entered into definitive agreements, including a Master Transactions and Cooperation Agreement (the 
"MTCA") and an Equity Interest Purchase Agreement (the "Purchase Agreement"), providing for a multi-part transaction with 
Healthpeak. The parties subsequently amended the agreements to include one additional entry fee CCRC community as part of 
the sale of our interest in our unconsolidated entry fee CCRC venture with Healthpeak (the "CCRC Venture") (rather than removing 
the CCRC from the CCRC Venture for joint marketing and sale). The components of the multi-part transaction include:

•  CCRC Venture Transaction. Pursuant to the Purchase Agreement, on January 31, 2020, Healthpeak acquired our 51% ownership 
interest in the CCRC Venture, which held 14 entry fee CCRCs (6,383 units) for a total purchase price of $295.2 million 
(representing an aggregate valuation of $1.06 billion less portfolio debt, subject to a net working capital adjustment), which 
remains subject to a post-closing net working capital adjustment. At the closing, the parties terminated our existing management 
agreements with the 14 entry fee CCRCs, Healthpeak paid us a $100.0 million management agreement termination fee, and 
we transitioned operations of the entry fee CCRCs to a new operator. Prior to the January 31, 2020 closing, the parties moved 
two entry fee CCRCs (889 units) into a new unconsolidated venture on substantially the same terms as the CCRC Venture to 
accommodate the sale of such two communities at a future date. 

•  Master Lease Transactions. Pursuant to the MTCA, on January 31, 2020, the parties amended and restated our existing master 
lease pursuant to which we continue to lease 25 communities (2,711 units) from Healthpeak, and we acquired 18 communities 
(2,014 units) from Healthpeak, at which time the 18 communities were removed from the master lease. At the closing, we 
paid $405.5 million to acquire such communities and to reduce our annual rent under the amended and restated master lease. 
We funded the community acquisitions with $192.6 million of non-recourse mortgage financing and the proceeds from the 
multi-part transaction. The Company expects to obtain approximately $30.0 million of additional non-recourse mortgage 
financing on the communities. In addition, Healthpeak has agreed to transition one leased community (159 units) to a successor 
operator. With respect to the continuing 24 communities (2,552 units), the amended and restated master lease: (i) has an initial 
term to expire on December 31, 2027, subject to two extension options at our election for ten years each, which must be 
exercised with respect to the entire pool of leased communities; (ii) the initial annual base rent for the 24 communities is 
approximately $41.7 million and is subject to an escalator of 2.4% per annum on April 1st of each year; and (iii) Healthpeak 
has agreed to make available up to $35 million for capital expenditures for a five-year period related to the 24 communities 
at an initial lease rate of 7.0%. 

We anticipate that the sale of our interest in the CCRC Venture will utilize a portion of our carryforward tax losses to shield the 
expected taxable investment gain on such transaction. 

The net proceeds will improve the Company's capital structure flexibility and may be used, among other uses, for opportunistic 
share repurchases, to pursue potential lease restructuring opportunities that we identify, and to fund investments to support our 
strategy. 

45

We expect the sales of the two remaining entry fee CCRCs to occur over the next 15 months; however, there can be no assurance 
that the transactions will close or, if they do, when the actual closings will occur. Subsequent to these transactions, we will have 
exited substantially all of our entry fee CCRC operations. 

2018 Welltower Lease and RIDEA Venture Restructuring

Pursuant to transactions we entered into with Welltower on June 27, 2018, our triple-net lease obligations on 37 communities 
(4,095 units) were terminated effective June 30, 2018. We paid Welltower an aggregate lease termination fee of $58.0 million. In 
addition, effective June 30, 2018, we sold our 20% equity interest in our Welltower RIDEA venture to Welltower for net proceeds 
of $33.5 million. We also elected not to renew two master leases with Welltower which matured on September 30, 2018 (11
communities; 1,128 units). In addition, the parties separately agreed to allow us to terminate leases with respect to, and to remove 
from the remaining Welltower leased portfolio, a number of communities with annual aggregate base rent up to $5.0 million upon 
Welltower's sale of such communities, and we would receive a corresponding 6.25% rent credit on Welltower's disposition proceeds. 
As of December 31, 2019, no leases have been terminated in accordance with the agreement. 

As of February 1, 2020, we continue to operate 74 communities (3,683 units) under triple-net leases with Welltower, and our 
remaining lease agreements with Welltower contain an objective change of control standard that allows us to engage in certain 
change of control and other transactions without the need to obtain Welltower's consent, subject to the satisfaction of certain 
conditions. 

2018 Ventas Lease Portfolio Restructuring

On April 26, 2018, we entered into several agreements to restructure a portfolio of 128 communities (10,567 units) we leased from 
Ventas as of such date, including a Master Lease and Security Agreement (the "Ventas Master Lease"). The Ventas Master Lease 
amended and restated prior leases comprising an aggregate portfolio of 107 communities (8,459 units) into the Ventas Master 
Lease. Under the Ventas Master Lease and other agreements entered into on April 26, 2018, the 21 additional communities (2,107
units) leased by us from Ventas pursuant to separate lease agreements have been or will be combined automatically into the Ventas 
Master Lease upon the first to occur of Ventas' election or the repayment of, or receipt of lender consent with respect to, mortgage 
debt underlying such communities (18 of which have been and three of which will be combined into the Ventas Master Lease). 
We and Ventas agreed to observe, perform, and enforce such separate leases as if they had been combined into the Ventas Master 
Lease effective April 26, 2018, to the extent not in conflict with any mortgage debt underlying such communities. The transaction 
agreements with Ventas further provide that the Ventas Master Lease and certain other agreements between us and Ventas are 
subject to cross-default provisions. 

The initial term of the Ventas Master Lease ends December 31, 2025, with two 10-year extension options available to us. In the 
event we consummate a change of control transaction on or before December 31, 2025, the initial term of the Ventas Master Lease 
will be extended automatically through December 31, 2029. The Ventas Master Lease and separate lease agreements with Ventas, 
which are guaranteed at the parent level by us, provided for total rent in 2018 of $175.0 million for the 128 communities, including 
the pro-rata portion of an $8.0 million annual rent credit for 2018. We received an annual rent credit of $8.0 million in 2019. We 
will receive an annual rent credit of $7.0 million in 2020 and $5.0 million thereafter; provided, that if we consummate a change 
of control transaction prior to 2021, the annual rent credit will be reduced to $5.0 million. Effective on January 1, 2019 and in 
succeeding years, the annual minimum rent is subject to an escalator equal to the lesser of 2.25% or four times the Consumer Price 
Index ("CPI") increase for the prior year (or zero if there was a CPI decrease).

The Ventas  Master  Lease  requires  us  to  spend  (or  escrow  with Ventas)  a  minimum  of  $2,000  per  unit  per  24-month  period 
commencing with the 24-month period ended December 31, 2019 and thereafter each 24-month period ending December 31 during 
the lease term, subject to annual increases commensurate with the escalator beginning with the second  lease year of the first 
extension term (if any). If we consummate a change of control transaction, we will be required within 36 months following the 
closing of  such transaction to invest  (or  escrow  with Ventas) an  aggregate  of  $30.0 million  in the communities  for  revenue-
enhancing capital projects.

Under the definitive agreements with Ventas, we, at the parent level, must satisfy certain financial covenants (including tangible 
net worth and leverage ratios) and may consummate a change of control transaction without the need for consent of Ventas so 
long as certain objective conditions are satisfied, including the post-transaction guarantor's satisfying certain enhanced minimum 
tangible net worth and maximum leverage ratio, having minimum levels of operational experience and reputation in the senior 
living industry, and paying a change of control fee of $25.0 million to Ventas.

46

Pursuant to the Ventas Master Lease, we have exercised our right to direct Ventas to market for sale certain communities. Ventas 
is obligated to use commercially reasonable, diligent efforts to sell such communities on or before December 31, 2020 (subject 
to extension for regulatory purposes); provided, that Ventas' obligation to sell any such community will be subject to Ventas' 
receiving a purchase price in excess of a mutually agreed upon minimum sale price and to certain other customary closing conditions. 
Upon any such sale, such communities will be removed from the Ventas Master Lease, and the annual minimum rent under the 
Ventas Master Lease will be reduced by the amount of the net sale proceeds received by Ventas multiplied by 6.25%. During 2019, 
seven communities (358 units) were sold by Ventas and removed from the Ventas Master Lease, and the annual minimum rent 
under the Ventas Master Lease was prospectively reduced by $1.7 million. 

We recognized a $125.7 million non-cash loss on lease modification in the year ended December 31, 2018, primarily for the 
extensions of the triple-net lease obligations for communities with lease terms that are unfavorable to us given current market 
conditions  on the  amendment date  in exchange  for modifications  to  the change  of  control  provisions  and  financial  covenant 
provisions of the community leases. 

2017 Healthpeak Multi-Part Transaction 

We entered into definitive agreements for a multi-part transaction with Healthpeak effective November 1, 2017, including an 
Amended  and  Restated  Master  Lease  and  Security Agreement  (the  "Former  Healthpeak  Master  Lease”).  Pursuant  to  such 
agreements, we and Healthpeak amended and restated triple-net leases covering substantially all of the communities we leased 
from Healthpeak as of November 1, 2017 into the Former Healthpeak Master Lease.

During the year ended December 31, 2018, we acquired two communities (208 units) that were formerly leased from Healthpeak 
for an aggregate purchase price of $35.4 million, and leases with respect to 33 communities (3,123 units) were terminated, and 
such communities were removed from the Former Healthpeak Master Lease. The continuing 43 leased communities under the 
Former Healthpeak Master Lease had the same lease rates and expiration and renewal terms as the applicable prior instruments, 
except that effective January 1, 2018, we received a $2.5 million annual rent reduction for two communities. The Former Healthpeak 
Master Lease also provided that we may engage in certain change in control and other transactions without the need to obtain 
Healthpeak's consent, subject to the satisfaction of certain conditions. 

In addition, pursuant to the multi-part transaction agreement, Healthpeak acquired our 10% ownership interest in one of our RIDEA 
ventures with Healthpeak in December 2017 for $32.1 million and our 10% ownership interest in the remaining RIDEA venture 
with Healthpeak in March 2018 for $62.3 million. We provided management services to 59 communities (9,585 units) on behalf 
of the two RIDEA ventures as of November 1, 2017. Pursuant to the multi-part transaction agreement, we acquired one managed 
community (137 units) for an aggregate purchase price of $32.1 million in January 2018 and three managed communities (650
units) for an aggregate purchase price of $207.4 million in April 2018 and retained management of 18 of such communities (3,276
units)  for  a  term  set  to  expire  in  2030,  subject  to  certain  early  termination  rights.  Healthpeak  transitioned  operations  and/or 
management of 37 of such communities since November 2017. 

Additional Healthpeak Lease Terminations

During the year ended December 31, 2017, triple-net leases with respect to 26 communities (2,128 units) were terminated pursuant 
to agreements we entered into with Healthpeak on November 1, 2016. 

Blackstone Venture

On March 29, 2017, we and affiliates of Blackstone Real Estate Advisors VIII L.P. (collectively, "Blackstone") formed a venture 
(the "Blackstone Venture") that acquired 64 senior housing communities for a purchase price of $1.1 billion. We had previously 
leased the 64 communities from Healthpeak under long-term lease agreements with a remaining average lease term of approximately 
12 years. At the closing, the Blackstone Venture purchased the 64-community portfolio from Healthpeak subject to the existing 
leases, and we contributed our leasehold interests for 62 communities and a total of $179.2 million in cash to purchase a 15%
equity interest in the Blackstone Venture, terminate leases, and fund our share of closing costs. As of the formation date, we 
continued to operate two of the communities under lease agreements and began managing 60 of the communities on behalf of the 
venture under a management agreement with the venture. Two of the communities were managed by a third party for the venture. 
During the third quarter of 2018, leases for the two communities owned by the Blackstone Venture were terminated, and we sold 
our 15% equity interest in the Blackstone Venture to Blackstone. We paid Blackstone an aggregate fee of $2.0 million to complete 
the multi-part transaction. 

47

Additional Acquisitions Pursuant to Purchase Option

On January 22, 2020, we acquired eight leased communities (336 units) from National Health Investors, Inc. ("NHI") pursuant to 
our exercise of a purchase option for a purchase price of $39.3 million. We funded the community acquisitions with cash on hand 
and expect to obtain approximately $28.0 million of non-recourse mortgage financing on the communities.

Summary of Financial Impact of Completed and Planned Dispositions

The following tables set forth, for the periods indicated, the amounts included within our consolidated financial data for the 243
communities that we disposed through sales and lease terminations during the years ended December 31, 2019, 2018, and 2017
through the respective disposition dates: 

(in thousands)

Resident fees

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing resident fees

Facility operating expense

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing facility operating expense

Cash lease payments

(in thousands)

Resident fees

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing resident fees

Facility operating expense

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing facility operating expense

Cash lease payments

Year Ended December 31, 2019

Amounts
Attributable to
Completed
Dispositions

Actual Results
Less Amounts
Attributable to
Completed
Dispositions

Actual Results

544,558

$

— $

$

$

$

$

$

1,815,938

402,175

2,762,671

340,817

1,297,302

330,103

1,968,222

377,714

$

$

$

$

20,891

33,189

544,558

1,795,047

368,986

54,080

$

2,708,591

— $

18,249

34,128

52,377

1,694

$

$

340,817

1,279,053

295,975

1,915,845

376,020

Year Ended December 31, 2018

Amounts
Attributable to
Completed
Dispositions

Actual Results
Less Amounts
Attributable to
Completed
Dispositions

Actual Results

$

$

$

$

$

599,977

$

81,280

$

1,995,851

416,408

3,012,236

359,368

1,366,869

324,196

2,050,433

457,388

$

$

$

$

256,038

53,215

390,533

48,154

187,411

50,971

286,536

84,041

$

$

$

$

518,697

1,739,813

363,193

2,621,703

311,214

1,179,458

273,225

1,763,897

373,347

48

(in thousands)

Resident fees

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing resident fees

Facility operating expense

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing facility operating expense

Cash lease payments

Year Ended December 31, 2017

Amounts
Attributable to
Completed
Dispositions

Actual Results
Less Amounts
Attributable to
Completed
Dispositions

Actual Results

$

$

$

$

$

654,196

$

152,190

$

2,210,688

468,994

3,333,878

$

382,779

$

1,461,630

362,832

2,207,241

552,903

$

$

476,677

113,493

742,360

90,134

336,314

103,130

529,578

178,187

$

$

$

$

502,006

1,734,011

355,501

2,591,518

292,645

1,125,316

259,702

1,677,663

374,716

The following table sets forth the number of communities and units in our senior housing segments disposed through sales and 
lease terminations during the years ended December 31, 2019, 2018, and 2017: 

Number of communities

Independent Living

Assisted Living and Memory Care

CCRCs

Total

Total units

Independent Living

Assisted Living and Memory Care

CCRCs

Total

Years Ended December 31,

2019

2018

2017

—

20

4

24

—

1,600

827

2,427

17

91

3

111

2,864

7,437

547

10,848

10

86

12

108

2,078

5,858

2,389

10,325

The results of operations of the three communities classified as held for sale as of December 31, 2019 are reported in the following 
segments within the consolidated financial statements: Assisted Living and Memory Care (one community; 78 units) and CCRCs 
(two communities; 417 units). The following table sets forth the amounts included within our consolidated financial data for these 
three communities for the year ended December 31, 2019: 

(in thousands)

Resident fees

Assisted Living and Memory Care

CCRCs

Senior housing resident fees

Facility operating expense

Assisted Living and Memory Care

CCRCs

Senior housing facility operating expense

49

Amounts
Attributable to
Planned Dispositions

$

$

$

$

2,119

26,671

28,790

2,463

27,401

29,864

Other Recent Developments

Impact of New Lease Accounting Standard

We adopted ASC 842 effective January 1, 2019. Adoption of the new lease standard and its application to residency agreements 
and costs related thereto resulted in the recognition of additional resident fees and facility operating expense for the year ended 
December 31, 2019, which were non-cash and are non-recurring in future years. The result was a non-cash net impact to net income 
(loss) and Adjusted EBITDA of negative $23.1 million, with an offsetting positive impact in changes in working capital for the 
year ended December 31, 2019. Adoption of the new lease standard had no impact on the amount of net cash provided by (used 
in) operating activities and Adjusted Free Cash Flow for the year ended December 31, 2019. 

Increased Competitive Pressures

Data from NIC shows that industry occupancy began to decrease starting in 2016 as a result of new openings and oversupply. 
During and since 2016, we have experienced an elevated rate of competitive new openings, with significant new competition 
opening in many markets, which has adversely affected our occupancy, revenues, results of operations, and cash flow. Elevated 
rates of competitive new openings and pressures on our occupancy and rate growth continued through 2019. On an industry basis, 
data from NIC shows that net absorption of units, a marker of demand, for the third quarter of 2019 was the highest single quarter 
since 2006. Projections from NIC, as applied to our product mix, suggest that annual absorption will be around equilibrium with 
new supply during 2020. We believe that a number of trends will contribute to the continued growth of the senior living industry 
in coming years.

Capital Expenditures

During 2018, we completed an intensive review of our community-level capital expenditure needs with a focus on ensuring that 
our communities are in appropriate physical condition to support our strategy and determining what additional investments are 
needed to protect the value of our community portfolio. Our total community-level capital expenditures were $238.7 million for 
2019, which was an increase of $97.7 million from  2018, and  $34.8 million  of which was reimbursed by  our  lessors. In  the 
aggregate, we expect our full-year 2020 non-development capital expenditures, net of anticipated lessor reimbursements, to be 
approximately $190 million, which includes a decrease of approximately $50 million in our community-level capital expenditures 
relative to 2019, as we have completed a significant portion of the major building infrastructure projects identified in our 2018 
review.

During 2019, we made continued progress on our development capital expenditure program through which we expand, renovate, 
reposition, and  redevelop selected  existing senior  living communities where  economically  advantageous.  For  the  year  ended 
December 31, 2019, we invested $24.6 million in our development capital expenditure program, which included the completion 
of eleven expansion or conversion projects to generate 61 net new units. We currently have seven development capital expenditure 
projects that have been approved, most of which have begun construction and are expected to generate 26 net new units. Our 
planned full-year 2020 development capital expenditures are approximately $30 million, net of anticipated lessor reimbursements. 

We anticipate that our 2020 capital expenditures will be funded from cash on hand, cash flows from operations, reimbursements 
from lessors, and, if necessary, amounts drawn on our secured credit facility. 

Tax Reform

On December 22, 2017, the President signed the Tax Cuts and Jobs Act ("Tax Act") into law. The Tax Act reformed the United 
States corporate income tax code, including a reduction to the federal corporate income tax rate from 35% to 21% effective January 
1, 2018. The Tax Act also eliminated alternative minimum tax ("AMT") and the 20-year carryforward limitation for net operating 
losses incurred after December 31, 2017, and imposes a limit on the usage of net operating losses incurred after such date equal 
to 80% of taxable income in any given year. The 80% usage limit will not have an economic impact on the Company until its 
current net operating losses are either utilized or expired. In addition, the Tax Act limits the annual deductibility of a corporation's 
net interest expense unless it elects to be exempt from such deductibility limitation under  the real property  trade or  business 
exception. The Company elected the real property trade or business exception with the 2018 tax return. As such, the Company is 
required to apply the alternative depreciation system ("ADS") to all  current and future residential real property and qualified 
improvement property assets. This change impacts the current and future tax depreciation deductions and impacted the Company's 
valuation allowance accordingly. Additional information that may affect the Company's provisional amounts would include further 
clarification and guidance on how the Internal Revenue Service will implement tax reform and further clarification and guidance 
on how state taxing authorities will implement tax reform and the related effect on the Company's state and local income tax 
returns, state and local net operating losses and corresponding valuation allowances. 

50

Results of Operations

As of December 31, 2019, our total operations included 763 communities with a capacity to serve approximately 72,000 residents. 
As of that date we owned 330 communities (30,160 units), leased 333 communities (24,021 units), managed 17 communities 
(7,307 units) for which we have an equity interest, and managed 83 communities (10,779 units) on behalf of third parties. The 
following discussion should be read in conjunction with our consolidated financial statements and the related notes, which are 
included in "Item 8. Financial Statements and Supplementary Data" of this Annual Report on Form 10-K. The results of operations 
for any particular period are not necessarily indicative of results for any future period. Transactions completed during the period 
of January 1, 2018 to December 31, 2019 significantly affect the comparability of our results of operations, and summaries of 
such  transactions  and  their  impact  on  our  results  of  operations  are  discussed  above  in  "Transaction Activity  and  Impact  of 
Dispositions on Results of Operations." 

This section uses the operating measures defined below. Our adoption and application of the new lease accounting standard has 
impacted our results for the year ended December 31, 2019 due to our recognition of additional resident fee revenue and facility 
operating expense, which is non-cash and is non-recurring in future years. To aid in comparability between periods, presentations 
of our results on a same community basis and RevPAR and RevPOR exclude the impact of the lease accounting standard. 

•  Operating results and data presented on a same community basis reflect results and data of the same store communities 
(utilizing our methodology for determining same store communities which generally excludes assets held for sale, acquisitions, 
and  dispositions  since  the  beginning  of  the  prior  year,  and  certain  communities  that  have  undergone  or  are  undergoing 
expansion, redevelopment, and repositioning projects) and, for the 2019 period, exclude the additional resident fee revenue 
and facility operating expense recognized as a result of application of ASC 842. 

•  RevPAR, or average monthly senior housing resident fee revenue per available unit, is defined as resident fee revenue for 
the corresponding portfolio for the period (excluding Health Care Services segment revenue and entrance fee amortization, 
and, for the 2019 period, the additional resident fee revenue recognized as a result of the application of ASC 842), divided 
by the weighted average number of available units in the corresponding portfolio for the period, divided by the number of 
months in the period. 

•  RevPOR, or average monthly senior housing resident fee revenue per occupied unit, is defined as resident fee revenue for 
the corresponding portfolio for the period (excluding Health Care Services segment revenue and entrance fee amortization, 
and, for the 2019 period, the additional resident fee revenue recognized as a result of the application of ASC 842), divided 
by the weighted average number of occupied units in the corresponding portfolio for the period, divided by the number of 
months in the period. 

This section includes the non-GAAP performance measure Adjusted EBITDA. See "Non-GAAP Financial Measures" below for 
our  definition of  the measure and  other important  information  regarding such  measure, including  reconciliations  to the most 
comparable  GAAP  measures.  During  the  first  quarter  of  2019,  we  modified  our  definition  of Adjusted  EBITDA  to  exclude 
transaction and organizational restructuring costs, and amounts for all periods herein reflect application of the modified definition. 

Discussion of our financial condition and results of operations for the year ended December 31, 2019 compared to the year ended 
December 31, 2018 is presented below. Discussion of our financial condition and results of operations for year ended December 31, 
2018 compared to the year ended December 31, 2017 can be found in "Item 7. Management's Discussion and Analysis of Financial 
Condition and Results of Operations" in our Annual Report on Form 10-K for the year ended December 31, 2018, filed with the 
SEC on February 14, 2019.

51

Comparison of Year Ended December 31, 2019 and 2018 

Summary Operating Results

The following table summarizes our overall operating results for the years ended December 31, 2019 and 2018. 

(in thousands)

Total revenue

Facility operating expense

Net income (loss)

Adjusted EBITDA

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

$ 4,057,088

$ 4,531,426

$

(474,338)

2,390,495

2,453,328

(268,492)

(528,352)

401,169

537,681

(62,833)

(259,860)

(136,512)

(10.5)%

(2.6)%

(49.2)%

(25.4)%

The decrease in total revenue was primarily attributable to the disposition of 135 communities through sales of owned communities 
and lease terminations since the beginning of the prior year, which resulted in $336.5 million less in resident fees during the year 
ended December 31, 2019 compared to the prior year. Additionally, Management Services segment revenue, including management 
fees and reimbursed costs incurred on behalf of managed communities, decreased $235.1 million primarily due to terminations 
of management agreements subsequent to the beginning of the prior year. The decrease in total revenue was partially offset by a 
1.9% increase in same community resident fee revenue and RevPAR, resulting from a 2.9% increase in same community RevPOR 
and an 80 basis points decrease in same community weighted average occupancy.

The decrease in facility operating expense was primarily attributable to the disposition of communities since the beginning of the 
prior year, which resulted in $234.2 million less in facility operating expense during the year ended December 31, 2019. The 
decrease was partially offset by a 5.1% increase in same community facility operating expense, which was primarily due to an 
increase in labor expense arising from planned wage rate increases and an increase in employee benefit expense and increases in 
insurance and advertising costs compared to the prior year.

In addition to the foregoing factors, we recognized incremental resident fee revenue and facility operating expense of approximately 
$26.4 million and $49.5 million, respectively, during the year ended December 31, 2019 as a result of the application of the new 
lease accounting standard effective January 1, 2019. Same community resident fee revenue and facility operating expense excludes 
approximately $23.8 million and $45.0 million, respectively, of such revenue and  expenses, which was non-cash and is non-
recurring in subsequent years.

The improvement to net income (loss) was primarily attributable to a decrease in non-cash goodwill and asset impairment charges 
recorded and a decrease in loss on facility lease termination and modification compared to the prior year, offset by a decrease in 
net gain on sale of assets and the revenue and facility operating expense factors previously discussed. Goodwill and asset impairment 
expense was $49.3 million for the year ended December 31, 2019 compared to $489.9 million for the prior year when we impaired 
Assisted Living and Memory Care segment goodwill for $351.7 million. We recognized a loss on lease termination and modification 
of $162.0 million for the year ended December 31, 2018 primarily as a result of the restructuring or termination of community 
leases with Ventas and Welltower compared to a loss of $3.4 million for the year ended December 31, 2019. Net gain on sale of 
assets was $7.2 million for the year ended December 31, 2019 compared to a net gain on sale of assets of $293.2 million for the 
prior year related to sales of communities, sales of investments in unconsolidated ventures, and termination of financing leases.

The decrease in Adjusted EBITDA was primarily attributable to the revenue and facility operating expense factors previously 
discussed,  offset  by  $19.1  million,  or  9.3%,  less  in  general  and  administrative  expenses  (excluding  non-cash  stock-based 
compensation expense and transaction and organizational restructuring costs) and $35.8 million, or 11.0%, less in cash facility 
operating lease payments.

52

Operating Results - Senior Housing Segments 

The following table summarizes the operating results and data of our three senior housing segments (Independent Living, Assisted 
Living and Memory Care, and CCRCs) on a combined basis for the years ended December 31, 2019 and 2018 including operating 
results and data on a same community basis. See management's discussion and analysis of the operating results on an individual 
segment basis on the following pages. 

(in thousands, except communities, units, occupancy, RevPAR,
and RevPOR)

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

Resident fees

Facility operating expense

$ 2,762,671

$ 3,012,236

$ (249,565)

$ 1,968,222

$ 2,050,433

$ (82,211)

Number of communities (period end)

Number of units (period end)

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

Same Community Operating Results and Data

Resident fees

Facility operating expense

Number of communities

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

663

54,181

55,501

4,106

83.9%

4,893

$

$

687

56,492

63,170

3,972

84.3%

4,712

$

$

(24)

(2,311)

(7,669)

134

(40) bps

181

$

$

$ 2,479,349

$ 2,433,847

$ 45,502

$ 1,707,900

$ 1,625,026

$ 82,874

637

49,777

4,148

84.5%

4,910

$

$

637

49,797

4,070

85.3%

4,770

$

$

$

$

—

(20)

78

(80) bps

140

(8.3)%

(4.0)%

(3.5)%

(4.1)%

(12.1)%

3.4 %

n/a

3.8 %

1.9 %

5.1 %

—

—

1.9 %

n/a

2.9 %

53

Independent Living Segment

The following table summarizes the operating results and data for our Independent Living segment for the years ended December 31, 
2019 and 2018, including operating results and data on a same community basis. 

(in thousands, except communities, units, occupancy, RevPAR,
and RevPOR)

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

Resident fees

Facility operating expense

Number of communities (period end)

Number of units (period end)

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

Same Community Operating Results and Data

Resident fees

Facility operating expense

Number of communities

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

$

$

544,558

340,817

68

12,514

12,474

3,580

89.2%

4,014

474,656

286,328

62

11,061

3,576

89.7%

3,986

$

$

$

$

$

$

$

$

$

$

$

$

$

$

599,977

$ (55,419)

359,368

$ (18,551)

68

12,419

14,164

3,530

88.8%

3,977

462,918

274,558

62

11,076

3,483

89.6%

3,889

$

$

$

$

$

$

—

95

(1,690)

50

40 bps

37

11,738

11,770

—

(15)

93

10 bps

97

(9.2)%

(5.2)%

—

0.8 %

(11.9)%

1.4 %

n/a

0.9 %

2.5 %

4.3 %

—

(0.1)%

2.7 %

n/a

2.5 %

The decrease in the segment's resident fees was primarily attributable to the disposition of 17 communities since the beginning of 
the prior year, which resulted in $81.3 million less in resident fees during the year ended December 31, 2019. The decrease in 
resident fees was partially offset by the increase in the segment's same community RevPAR, comprised of a 2.5% increase in same 
community RevPOR and a 10 basis points increase in same community weighted average occupancy. The increase in the segment’s 
same community RevPOR was primarily the  result of  in-place  rent increases. Additionally, the decrease  in resident  fees  was 
partially offset by $2.8 million of incremental revenue for one community acquired subsequent to the beginning of the prior year.

The decrease in the segment's facility operating expense was primarily attributable to the disposition of communities since the 
beginning of the prior year, which resulted in $48.2 million less in facility operating expense during the year ended December 31, 
2019. The decrease in facility operating expense was partially offset by an increase in the segment's same community facility 
operating expense, including an increase in labor expense arising from planned wage rate increases and an increase in employee 
benefit expense. There was also an increase in property insurance and advertising costs compared to the prior year. The decrease
in facility operating expense was partially offset by $2.2 million of incremental facility operating expense for one community 
acquired subsequent to the beginning of the prior year.

In addition to the foregoing factors, we recognized incremental resident fee revenue and facility operating expense for this segment 
of approximately $8.7 million and $12.7 million, respectively, during the year ended December 31, 2019 as a result of the application 
of the new lease accounting standard effective January 1, 2019. Same  community resident fee revenue and  facility operating 
expense for this segment excludes approximately $7.7 million and $11.2 million, respectively, of such revenue and expenses.

54

Assisted Living and Memory Care Segment

The following table summarizes the operating results and data for our Assisted Living and Memory Care segment for the years 
ended December 31, 2019 and 2018, including operating results and data on a same community basis. 

(in thousands, except communities, units, occupancy, RevPAR,
and RevPOR)

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

Resident fees

Facility operating expense

$ 1,815,938

$ 1,995,851

$ (179,913)

$ 1,297,302

$ 1,366,869

$ (69,567)

Number of communities (period end)

Number of units (period end)

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

Same Community Operating Results and Data

Resident fees

Facility operating expense

Number of communities

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

573

35,956

36,560

4,106

82.6%

4,971

$

$

593

37,500

42,229

3,939

83.0%

4,747

$

$

(20)

(1,544)

(5,669)

167

(40) bps

224

$

$

$ 1,718,958

$ 1,684,822

$ 34,136

$ 1,198,347

$ 1,137,011

$ 61,336

558

34,460

4,157

83.1%

5,005

$

$

558

34,463

4,074

84.1%

4,844

$

$

$

$

—

(3)

83

(100) bps

161

(9.0)%

(5.1)%

(3.4)%

(4.1)%

(13.4)%

4.2 %

n/a

4.7 %

2.0 %

5.4 %

—

—

2.0 %

n/a

3.3 %

The decrease in the segment's resident fees was primarily attributable to the disposition of 111 communities since the beginning 
of the prior year, which resulted in $235.1 million less in resident fees during the year ended December 31, 2019. The decrease 
in resident fees was partially offset by the increase in the segment's same community RevPAR, comprised of a 3.3% increase in 
same community RevPOR and a 100 basis points decrease in same community weighted average occupancy. The increase in the 
segment's same  community RevPOR  was primarily the result  of in-place  rent  increases. The  decrease  in  the  segment's  same 
community weighted average occupancy reflects the impact of new competition in our markets. The decrease in resident fees was 
partially offset by $3.0 million of incremental revenue for two communities acquired subsequent to the beginning of the prior 
year. 

The decrease in the segment's facility operating expense was primarily attributable to the disposition of communities since the 
beginning of the prior year, which resulted in $169.2 million less in facility operating expense during the year ended December 31, 
2019. The decrease in facility operating expense was partially offset by an increase in the segment's same community facility 
operating expense, including an increase in labor expense arising from planned wage rate increases and an increase in employee 
benefit expense. There was also an increase in insurance and advertising costs compared to the prior year. The decrease in facility 
operating expense was partially offset by $1.7 million of incremental facility operating expense for two communities acquired 
subsequent to the beginning of the prior year.

In addition to the foregoing factors, we recognized incremental resident fee revenue and facility operating expense for this segment 
of  approximately  $14.7 million and  $31.6  million,  respectively,  during  the  year ended  December 31,  2019  as  a  result  of  the 
application of the new lease accounting standard effective January 1, 2019. Same community resident fee revenue and facility 
operating expense for this segment excludes approximately $13.9 million and $29.8 million, respectively, of such revenue and 
expenses.

55

CCRCs Segment

The following table summarizes the operating results and data for our CCRCs segment for the years ended December 31, 2019
and 2018, including operating results and data on a same community basis. 

(in thousands, except communities, units, occupancy, RevPAR,
and RevPOR)

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

Resident fees

Facility operating expense

Number of communities (period end)

Number of units (period end)

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

Same Community Operating Results and Data

Resident fees

Facility operating expense

Number of communities

Total average units

RevPAR

Occupancy rate (weighted average)

RevPOR

$

$

402,175

330,103

22

5,711

6,467

5,123

81.3%

6,298

285,735

223,225

17

4,256

5,562

82.4%

6,748

$

$

$

$

$

$

$

$

$

$

$

$

$

$

416,408

$ (14,233)

324,196

$

5,907

26

6,573

6,777

5,100

83.2%

6,132

286,107

213,457

17

4,258

5,570

84.2%

6,611

$

$

$

$

$

$

(4)

(862)

(310)

23

(190) bps

166

(372)

9,768

—

(2)

(8)

(180) bps

137

(3.4)%

1.8 %

(15.4)%

(13.1)%

(4.6)%

0.5 %

n/a

2.7 %

(0.1)%

4.6 %

—

—

(0.1)%

n/a

2.1 %

The decrease in the segment's resident fees was primarily attributable to the disposition of seven communities since the beginning 
of the prior year period, which resulted in $20.0 million less in resident fees during the year ended December 31, 2019. Additionally, 
there was a decrease in the segment's same community RevPAR, comprised of a 2.1% increase in same community RevPOR, 
primarily the result of in-place rent increases, and a 180 basis points decrease in same community weighted average occupancy, 
reflecting the impact of new competition in our markets. The decrease in resident fees was partially offset by $4.3 million of 
incremental revenue for one community acquired subsequent to the beginning of the prior year. 

The increase in the segment's facility operating expense was primarily attributable to an increase in the segment's same community 
facility operating expense, including an increase in labor expense arising from planned wage rate increases and an increase in 
employee benefit expense. There was also an increase in insurance costs compared to the prior year and $3.1 million of additional 
facility operating expense for one community acquired subsequent to the beginning of the prior year period. The increase in facility 
operating expense was partially offset by the disposition of communities since the beginning of the prior year, which resulted in 
$16.8 million less in facility operating expense during the year ended December 31, 2019.

In addition to the foregoing factors, we recognized incremental resident fee revenue and facility operating expense for this segment 
of approximately $3.0 million and $5.3 million, respectively, during the year ended December 31, 2019 as a result of the application 
of the new lease accounting standard effective January 1, 2019. Same  community resident fee revenue and  facility operating 
expense for this segment excludes approximately $2.2 million and $3.9 million, respectively, of such revenue and expenses. 

56

Operating Results - Health Care Services Segment

The following table summarizes the operating results and data for our Health Care Services segment for the years ended 
December 31, 2019 and 2018. 

(in thousands, except census and treatment codes)

Resident fees

Facility operating expense

Home health average daily census

Hospice average daily census

Outpatient therapy treatment codes

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

$

$

447,260

422,273

$

$

436,975

402,895

$

$

10,285

19,378

15,457

1,580

680,879

15,238

1,359

683,348

219

221

(2,469)

2.4 %

4.8 %

1.4 %

16.3 %

(0.4)%

The increase in the segment's resident fees was primarily attributable to an increase in volume for hospice services. An increase 
in hospice revenue of $15.4 million was partially offset by a decrease in home health revenue of $4.6 million, primarily attributable 
to sales force turnover, customer relations issues related to the centralized intake initiative, unfavorable case-mix, and community 
dispositions.

The increase in the segment's facility operating expense was primarily attributable to an increase in labor costs arising from wage 
rate increases and the expansion of our hospice services.

On October 31, 2019, the Centers for Medicare and Medicaid Services ("CMS") issued a final rule that included routine updates 
to home health payment rates and sets forth the implementation of the Patient-Driven Grouping Model ("PDGM"), an alternate 
home health case-mix adjustment methodology with a 30-day unit of payment, which became effective beginning January 1, 2020. 
The final rule also will phase out requests for anticipated payment ("RAP") over 2020 with the full elimination of RAPs in 2021. 
We expect the implementation of PDGM to have a negative impact to revenue in 2020, which we expect will be largely offset by 
lower facility operating expenses. 

Operating Results - Management Services Segment

The  following  table  summarizes  the  operating  results  and  data  for  our  Management  Services  segment  for  the  years  ended 
December 31, 2019 and 2018. 

(in thousands, except communities, units, and occupancy)

Management fees

Reimbursed costs incurred on behalf of managed
communities

$

$

Number of communities (period end)

Number of units (period end)

Total average units

Occupancy rate (weighted average)

Year Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

57,108

$

71,986

$ (14,878)

(20.7)%

790,049

$ 1,010,229

$ (220,180)

(21.8)%

100

18,086

21,769

205

27,787

31,392

(105)

(9,701)

(9,623)

83.3%

83.9%

(60) bps

(51.2)%

(34.9)%

(30.7)%

n/a

The decrease in management fees was primarily attributable to the transition of management arrangements on 129 net communities 
since  the  beginning  of  the  prior  year  period,  generally  for  interim  management  arrangements  on  formerly  leased  or  owned 
communities and management arrangements on certain former unconsolidated ventures in which we sold our interest. Management 
fees of $57.1 million for the year ended December 31, 2019 include $8.9 million of management fees attributable to communities 
for which our management agreements were terminated during such period and approximately $28.6 million of management fees 
attributable to communities that we expect the terminations of our management agreements to occur (or have occurred) during 
2020, including management agreements on communities owned by the CCRC Venture, interim management arrangements on 
formerly leased communities, and management arrangements on certain former unconsolidated ventures in which we sold our 

57

interest. Pursuant to the MTCA with Healthpeak, on January 31, 2020, Healthpeak paid us a $100.0 million management agreement 
termination fee, and we transitioned operations of 14 entry fee CCRCs (6,383 units) to a new operator.

The  decrease  in  reimbursed  costs  incurred  on  behalf  of  managed  communities  was  primarily  attributable  to  terminations  of 
management agreements subsequent to the beginning of the prior year. 

Operating Results - Other Income and Expense Items

The following table summarizes other income and expense items in our operating results for the years ended December 31, 2019
and 2018.

(in thousands)

Years Ended
December 31,

Increase (Decrease)

2019

2018

Amount

Percent

General and administrative expense

$

219,289

$

259,475

$

Facility operating lease expense

Depreciation and amortization

Goodwill and asset impairment

Loss (gain) on facility lease termination and modification, net

Costs incurred on behalf of managed communities

Interest income

Interest expense

Debt modification and extinguishment costs

Equity in earnings (loss) of unconsolidated ventures

Gain (loss) on sale of assets, net

Other non-operating income (loss)

Benefit (provision) for income taxes

269,666

379,433

49,266

3,388

303,294

447,455

489,893

162,001

790,049

1,010,229

9,859

9,846

(248,341)

(280,269)

(5,247)

(4,544)

7,245

14,765

2,269

(11,677)

(8,804)

293,246

14,099

49,456

(40,186)

(33,628)

(68,022)

(440,627)

(158,613)

(220,180)

13

(31,928)

(6,430)

(4,260)

(286,001)

666

(47,187)

(15.5)%

(11.1)%

(15.2)%

(89.9)%

(97.9)%

(21.8)%

0.1 %

(11.4)%

(55.1)%

(48.4)%

(97.5)%

4.7 %

(95.4)%

General and Administrative Expense. The decrease in general and administrative expense was primarily attributable to a decrease 
in transaction and organizational restructuring costs, a reduction in our corporate associate headcount since the beginning of the 
prior year as we scaled our general and administrative costs in connection with community dispositions, and lower professional 
fees. Transaction and organizational restructuring costs decreased $18.1 million compared to the prior period, to $10.0 million for 
the year ended December 31, 2019 primarily due to lower severance and retention costs. Transaction costs include those directly 
related to acquisition, disposition, financing and leasing activity, our assessment of options and alternatives to enhance stockholder 
value, and stockholder relations advisory matters, and are primarily comprised of legal, finance, consulting, professional fees and 
other third party costs. Organizational restructuring costs include those related to our efforts to reduce general and administrative 
expense and  our senior  leadership changes,  including severance  and  retention  costs.  For the year  ended December 31,  2019, 
transaction costs related to stockholder advisory matters was $5.9 million. 

Facility Operating Lease Expense. The decrease in facility operating lease expense was primarily due to lease termination activity 
since the beginning of the prior year.

Depreciation and Amortization. The decrease in depreciation and amortization expense was primarily due to disposition activity 
through sales and lease terminations since the beginning of the prior year.

Goodwill and Asset Impairment. During the year ended December 31, 2019, we recorded $49.3 million of non-cash impairment 
charges, of which $27.2 million related to property, plant and equipment and leasehold intangibles for certain communities and 
$10.2 million related to operating lease right-of-use assets, primarily within the Assisted Living and Memory Care segment. During 
the prior year, we recorded $489.9 million of non-cash impairment charges. The prior year impairment charges primarily consisted 
of $351.7 million of goodwill impairment within the Assisted Living and Memory Care segment, $78.0 million of impairment of 
property, plant and equipment and leasehold intangibles for certain communities, primarily in the Assisted Living and Memory 
Care segment, $33.4 million of impairment of our investments in unconsolidated ventures, and $15.6 million for assets held for 
sale. 

58

Loss (Gain) on Facility Lease Termination and Modification, Net. During the year ended December 31, 2019, we recorded a $3.4 
million loss on facility lease termination and modification, net for the termination of leases for ten communities. The $162.0 
million loss on facility lease termination and modification, net during the year ended December 31, 2018 was primarily due to a 
$125.7 million loss on the restructuring of community leases with Ventas and $36.3 million of net losses on community lease 
termination activity.

Costs  Incurred  on  Behalf of Managed  Communities.  The  decrease  in  costs  incurred on  behalf of  managed  communities was 
primarily due to terminations of management agreements subsequent to the beginning of the prior year period.

Interest Expense. The decrease in interest expense was primarily due to financing lease termination activity and a decrease in 
interest expense on long-term debt, reflecting the impact of the repayment of debt since the beginning of the prior year period and 
lower interest rates.

Equity in Earnings (Loss) of Unconsolidated Ventures. The decrease in equity in loss of unconsolidated ventures was primarily 
due to the sale of investments in unconsolidated ventures since the beginning of the prior year period.

Gain (Loss) on Sale of Assets, Net. The decrease in gain on sale of assets, net was primarily due to fewer owned community and 
unconsolidated venture dispositions completed in 2019 compared to the prior year. In 2018, we recognized gains of $293.2 million 
for sales of communities, sales of investments in unconsolidated ventures, and terminations of financing leases.

Benefit (Provision) for Income Taxes. The difference between our effective tax rate for the years ended December 31, 2019 and 
2018 was primarily due to the non-deductible impairment of goodwill that occurred in the year ended December 31, 2018 and the 
adjustment from stock-based compensation which was greater in the year ended December 31, 2018 compared to the year ended 
December 31, 2019. Offsetting these items was an increase in our valuation allowance that occurred in the year ended December 31, 
2019. 

We recorded an aggregate deferred federal, state, and local tax benefit of $63.0 million as a result of the operating loss for the year 
ended December 31, 2019, offset by an increase in the valuation allowance of $60.4 million. The change in the valuation allowance 
for the year ended December 31, 2019 resulted from anticipated reversal of future tax liabilities offset by future tax deductions. 
We recorded an aggregate deferred federal, state, and local tax benefit of $52.4 million as a result of the operating loss for the year 
ended December 31, 2018, which included an increase in the valuation allowance of $0.3 million. 

We evaluate our deferred tax assets each quarter to determine if a valuation allowance is required based on whether it is more 
likely than not that some portion of the deferred tax asset would not be realized. Our valuation allowance as of December 31, 2019
and December 31, 2018 was $408.9 million and $336.4 million, respectively. 

We recorded interest charges related to our tax contingency reserve for cash tax positions for the year ended December 31, 2019
and 2018 which are included in provision for income tax for the period. Tax returns for years 2015 through 2018 are subject to 
future  examination  by  tax  authorities.  In  addition,  the  net  operating  losses  from  prior  years  are  subject  to  adjustment  under 
examination. 

Liquidity and Capital Resources

This section includes the non-GAAP liquidity measure Adjusted Free Cash Flow. See "Non-GAAP Financial Measures" below 
for our definition of the measure and other important information regarding such measure, including reconciliations to the most 
comparable GAAP measures. During the first quarter of 2019, we modified our definition of Adjusted Free Cash Flow to no longer 
adjust net cash provided by (used in) operating activities for changes in working capital items other than prepaid insurance premiums 
financed with notes payable and lease liability for lease termination  and  modification. Amounts for  all  periods  herein  reflect 
application of the modified definition.

59

Liquidity and Indebtedness

The following is a summary of cash flows from operating, investing, and financing activities, as reflected in the consolidated 
statements of cash flows, and our Adjusted Free Cash Flow: 

(in thousands)

Year Ended December 31,

Increase (Decrease)

2019

2018

Amount

Percent

Net cash provided by (used in) operating activities

$

216,412

$

203,961

$

12,451

Net cash provided by (used in) investing activities

Net cash provided by (used in) financing activities

Net increase (decrease) in cash, cash equivalents, and

restricted cash

Cash, cash equivalents, and restricted cash at beginning of

year

Cash, cash equivalents, and restricted cash at end of year

Adjusted Free Cash Flow

(225,539)

(139,394)

288,774

(325,063)

(514,313)

(185,669)

6.1 %

NM

(57.1)%

(148,521)

167,672

(316,193)

NM

450,218

282,546

301,697

$

450,218

$

167,672
(148,521)

59.3 %

(33.0)%

(76,404) $

4,118

$

(80,522)

NM

$

$

The increase in net cash provided by operating activities was primarily attributable to $54.6 million of cash paid to terminate 
community operating leases during the prior year and a $20.9 million increase in capital expenditure reimbursements from lessors 
for operating leases during 2019. These changes were partially offset by the impact of disposition activity, through sales and lease 
terminations, since the beginning of the prior year and an increase in same community facility operating expense during 2019.

The change in net cash provided by (used in) investing activities was primarily attributable to a $407.1 million decrease in net 
proceeds from the sale of assets, an increase of $171.4 million in purchases of marketable securities, a $159.3 million decrease in 
proceeds from sales and maturities of marketable securities, and a $78.6 million increase in cash paid for capital expenditures 
during 2019. These changes were partially offset by $271.3 million of cash paid for the acquisition of communities during 2018
and a $32.5 million increase in cash proceeds from notes receivable during 2019. 

The decrease in net cash used in financing activities was primarily attributable to a $468.8 million decrease in repayment of debt 
and financing lease obligations compared to 2018, including the impact of our cash settlement of the aggregate principal amount 
of the $316.3 million of 2.75% convertible senior notes during June 2018, and $12.5 million of cash paid to terminate community 
financing leases during 2018. These changes were partially offset by a $284.9 million decrease in debt proceeds compared to 2018
and a $19.7 million increase in cash paid for share repurchases during 2019.

The  decrease  in Adjusted  Free  Cash  Flow  was  primarily  attributable  to  a  $53.5  million  increase  in  non-development  capital 
expenditures, net, and an increase in same community facility operating expense during 2019. 

Our principal sources of liquidity have historically been from: 

• 
• 
• 
• 
• 
• 
• 

cash balances on hand, cash equivalents, and marketable securities;
cash flows from operations;
proceeds from our credit facilities;
funds generated through unconsolidated venture arrangements;
proceeds from mortgage financing, refinancing of various assets, or sale-leaseback transactions;
funds raised in the debt or equity markets; and
proceeds from the disposition of assets. 

Over the longer-term, we expect to continue to fund our business through these principal sources of liquidity. 

Our liquidity requirements have historically arisen from: 

•  working capital;
• 

operating  costs  such  as  employee  compensation  and  related  benefits,  severance  costs,  general  and  administrative 
expense, and supply costs;
debt service and lease payments;
acquisition consideration, lease termination and restructuring costs, and transaction and integration costs;
60

• 
• 

• 

• 
• 
• 
• 

capital expenditures and improvements, including the expansion, renovation, redevelopment, and repositioning of our 
current communities and the development of new communities;
cash collateral required to be posted in connection with our financial instruments and insurance programs;
purchases of common stock under our share repurchase authorizations;
other corporate initiatives (including integration, information systems, branding, and other strategic projects); and
prior to 2009, dividend payments. 

Over the near-term, we expect that our liquidity requirements will primarily arise from: 

•  working capital;
• 

operating  costs  such  as  employee  compensation  and  related  benefits,  severance  costs,  general  and  administrative 
expense, and supply costs;
debt service and lease payments;
acquisition consideration;
transaction costs and expansion of our healthcare services;
capital expenditures and improvements, including the expansion, renovation, redevelopment, and repositioning of our 
existing communities;
cash collateral required to be posted in connection with our financial instruments and insurance programs;
purchases of common stock under our share repurchase authorization; and
other corporate initiatives (including information systems and other strategic projects). 

• 
• 
• 
• 

• 
• 
• 

We are highly leveraged and have significant debt and lease obligations. As of December 31, 2019, we had two principal corporate-
level debt obligations: our secured credit facility providing commitments of $250.0 million and our separate unsecured facility 
providing for up to $47.5 million of letters of credit.

As of December 31, 2019, we had $3.6 billion of debt outstanding, excluding lease obligations, at a weighted average interest rate 
of 4.7%. As of such date, 95.5%, or $3.4 billion, of our total debt obligations represented non-recourse property-level mortgage 
financings, $89.4 million of letters of credit had been issued under our secured credit facility and separate unsecured letter of credit 
facility, and no balance was drawn on our secured credit facility. As of December 31, 2019, the current portion of long-term debt 
was  $339.4  million,  including  $28.9  million  of  mortgage  debt  related  to  three  communities  classified  as  held  for  sale  as  of 
December 31, 2019. 

As of December 31, 2019, we had $1.5 billion and $834.6 million of operating and financing lease obligations, respectively. For 
the year ending December 31, 2020, we will be required to make approximately $294.5 million and $74.9 million of cash payments 
in connection with our existing operating and financing leases, respectively (after giving effect to the transactions with Healthpeak 
and NHI completed in January 2020). 

Pursuant to the MTCA with Healthpeak, on January 31, 2020, we paid $405.5 million to acquire 18 communities and to reduce 
our annual rent under the amended and restated master lease. We funded the community acquisitions with $192.6 million of non-
recourse mortgage financing and a portion of the proceeds from the multi-part transaction, which included cash proceeds of $295.2 
million for the sale of our equity interest in the CCRC Venture and a $100.0 million management agreement termination fee. The 
Company expects to obtain approximately $30.0 million of additional non-recourse mortgage financing on the communities. The 
remaining net proceeds will improve the Company's capital structure flexibility and may be used, among other uses, for opportunistic 
share repurchases, to pursue potential lease restructuring opportunities that we identify, and to fund investments to support our 
strategy.

On January 22, 2020, we acquired eight leased communities (336 units) from NHI pursuant to our exercise of a purchase option 
for a purchase price of $39.3 million. We funded the community acquisitions with cash on hand and expect to obtain approximately 
$28.0 million of non-recourse mortgage financing on the communities. 

Total liquidity of $481.3 million as of December 31, 2019 included  $240.2 million  of unrestricted  cash and cash  equivalents 
(excluding restricted cash and lease security deposits of $110.6 million in the aggregate), $68.6 million of marketable securities, 
and $172.5 million of availability on our secured credit facility. Total liquidity as of December 31, 2019 decreased $111.2 million
from total liquidity of $592.5 million as of December 31, 2018. The decrease was primarily attributable to our $97.7 million in 
additional investments in our communities in 2019 and $24.0 million paid for share repurchases.

As of December 31, 2019, our current liabilities exceeded current assets by $450.8 million. Our current liabilities include $339.4 
million of the current portion of long-term debt and we have historically refinanced or extended maturities of debt obligations as 
they become current liabilities. Our current liabilities also include $256.7 million of operating and financing lease obligations 
61

recognized on our consolidated balance sheet, including $193.6 million for the  current portion of  operating  lease obligations 
recognized on our consolidated balance sheet as a result of the application of ASC 842. Excluding the current portion of these 
long-term obligations, our current assets exceeded current liabilities by $145.3 million. Our operations generally result in a very 
low level of current assets primarily stemming from our deployment of cash to pay down long-term liabilities, to fund capital 
expenditures, and to pursue transaction opportunities. 

Capital Expenditures

Our capital expenditures are comprised of community-level, corporate, and development capital expenditures. Community-level 
capital expenditures include recurring expenditures (routine maintenance of communities over $1,500 per occurrence, including 
for unit turnovers (subject to a $500 floor)) and community renovations, apartment upgrades, and other major building infrastructure 
projects. Corporate capital expenditures include those for information technology systems and equipment, the expansion of our 
support platform and healthcare services programs, and the remediation or replacement of assets as a result of casualty losses. 
Development capital expenditures include community expansions, major community redevelopment and repositioning projects, 
and the development of new communities. 

With  our development capital expenditures program,  we  intend  to expand, renovate, redevelop,  and  reposition  certain of our 
communities where economically advantageous. Certain of our communities may benefit from additions and expansions or from 
adding a new level of service for residents to meet the evolving needs of our customers. These development projects include 
converting space from one level of care to another, reconfiguration of existing units, the addition of services that are not currently 
present, or physical plant modifications. 

The following table summarizes our capital expenditures for the year ended December 31, 2019 for our consolidated business: 

(in millions)
Community-level capital expenditures, net (1)
Corporate (2)

Non-development capital expenditures, net (3)

Development capital expenditures, net

Total capital expenditures, net

Actual 2019

203.9

31.9

235.8

24.6

260.4

$

$

(1)  Reflects the amount invested, net of lessor reimbursements of $34.8 million. 

(2)  Includes $6.1 million of remediation costs at our communities resulting from hurricanes and $5.3 million for the acquisition 
of emergency power generators at certain Florida communities during 2019 in order to comply with legislation adopted in 
Florida requiring  skilled nursing homes and  assisted  living and  memory  care  communities  to obtain  generators and  fuel 
necessary to sustain operations and maintain comfortable temperatures in the event of a power outage.

(3)  Amount is included in Adjusted Free Cash Flow. 

During 2018, we completed an intensive review of our community-level capital expenditure needs with a focus on ensuring that 
our communities are in appropriate physical condition to support our strategy and determining what additional investments are 
needed to protect the value of our community portfolio. Our total community-level capital expenditures were $238.7 million for 
2019, which was an increase of $97.7  million from  2018,  and $34.8 million of which  was reimbursed by  our  lessors. In  the 
aggregate, we expect our full-year 2020 non-development capital expenditures, net of anticipated lessor reimbursements, to be 
approximately $190 million, which includes a decrease of approximately $50 million in our community-level capital expenditures 
relative to 2019, as we have completed a significant portion of the major building infrastructure projects identified in our 2018 
review. 

During 2019, we made continued progress on our development capital expenditure program through which we expand, renovate, 
reposition, and  redevelop selected  existing  senior  living communities where  economically advantageous.  For  the year  ended 
December 31, 2019, we invested $24.6 million in our development capital expenditure program, which included the completion 
of 11 expansion or conversion projects to generate 61 net new units. We currently have seven development capital expenditure 
projects that have been approved, most of which have begun construction and are expected to generate 26 net new units. Our 
planned full-year 2020 development capital expenditures are approximately $30 million, net of anticipated lessor reimbursements. 

62

We anticipate that our 2020 capital expenditures will be funded from cash on hand, cash flows from operations, reimbursements 
from lessors, and, if necessary, amounts drawn on our secured credit facility. 

Funding our planned capital expenditures, pursuing any acquisition, investment, development, or potential lease restructuring 
opportunities that we identify, or funding investments to support our strategy may require additional capital. We expect to continue 
to assess our financing alternatives periodically and access the capital markets opportunistically. If our existing resources are 
insufficient to satisfy our liquidity requirements, we may need to sell additional equity or debt securities. Any such sale of additional 
equity securities will dilute the percentage ownership of our existing stockholders, and we cannot be certain that additional public 
or private financing will be available in amounts or on terms acceptable to us, if at all. Any newly issued equity securities may 
have rights, preferences or privileges senior to those of our common stock. If we are unable to raise additional funds or obtain 
them on terms acceptable to us, we may have to delay or abandon our plans. 

We currently estimate that our existing cash flows from operations, together with cash on hand, amounts available under our 
secured credit facility, and proceeds from anticipated dispositions of owned communities and financings, and refinancings of 
various  assets,  will  be  sufficient  to  fund  our  liquidity  needs  for  at  least  the  next  12  months,  assuming  a  relatively  stable 
macroeconomic environment. 

Our actual liquidity and capital funding requirements depend on numerous factors, including our operating results, our actual level 
of capital expenditures, general economic conditions, and the cost of capital. Volatility in the credit and financial markets may 
have an adverse impact on our liquidity by making it more difficult for us to obtain financing or refinancing. Shortfalls in cash 
flows from operating results or other principal sources of liquidity may have an adverse impact on our ability to fund our planned 
capital expenditures, or to pursue any acquisition, investment, development, or potential lease restructuring opportunities that we 
identify, or to fund investments to support our strategy. In order to continue some of these activities at historical or planned levels, 
we may incur additional indebtedness or lease financing to provide additional funding. There can be no assurance that any such 
additional financing will be available or on terms that are acceptable to us. 

Credit Facilities

On December 5, 2018, we entered into a Fifth Amended and Restated Credit Agreement with Capital One, National Association, 
as administrative agent, lender, and swingline lender and the other lenders from time to time parties thereto (the "Credit Agreement"). 
The Credit Agreement provides commitments for a $250 million revolving credit facility with a $60 million sublimit for letters 
of credit and a $50 million swingline feature. We have a one-time right under the Credit Agreement to increase commitments on 
the revolving credit facility by an additional $100 million, subject to obtaining commitments for the amount of such increase from 
acceptable lenders. The Credit Agreement provides us a one-time right to reduce the amount of the revolving credit commitments, 
and we may terminate the revolving credit facility at any time, in each case without payment of a premium or penalty. The Credit 
Agreement matures on January 3, 2024. Amounts drawn under the facility bear interest at 90-day LIBOR plus an applicable margin. 
The applicable margin varies based on the percentage of the total commitment drawn, with a 2.25% margin at utilization equal to 
or lower than 35%, a 2.75% margin at utilization greater than 35% but less than or equal to 50%, and a 3.25% margin at utilization 
greater than 50%. A quarterly commitment fee is payable on the unused portion of the facility at 0.25% per annum when the 
outstanding amount of obligations (including revolving credit and swingline loans and letter of credit obligations) is greater than 
or equal to 50% of the revolving credit commitment amount or 0.35% per annum when such outstanding amount is less than 50% 
of the revolving credit commitment amount. 

The credit facility is secured by first priority mortgages on certain of our communities. In addition, the Credit Agreement permits 
us to pledge the equity interests in subsidiaries that own other communities and grant negative pledges in connection therewith 
(rather than mortgaging such communities), provided that not more than 10% of the borrowing base may result from communities 
subject to negative pledges. Availability under the revolving credit facility will vary from time to time based on borrowing base 
calculations related to the appraised value and performance of the communities securing the credit facility and our consolidated 
fixed charge coverage ratio. During 2019, we entered into an amendment to the Credit Agreement that provides for availability 
calculations to be made at additional consolidated fixed charge coverage ratio thresholds. 

The Credit Agreement contains typical affirmative and negative covenants, including financial covenants with respect to minimum 
consolidated fixed charge coverage and minimum consolidated tangible net worth. Amounts drawn on the credit facility may be 
used for general corporate purposes. 

As of December 31, 2019, no borrowings were outstanding on the revolving credit facility, $41.9 million of letters of credit were 
outstanding, and the revolving credit facility had $172.5 million of availability. We also had a separate unsecured letter of credit 
facility providing for up to $47.5 million of letters of credit as of December 31, 2019 under which $47.5 million had been issued 
as of that date.

63

Long-Term Leases

As of December 31, 2019, we operated 333 communities under long-term leases (242 operating leases and 91 financing leases). 
The substantial majority of our lease arrangements are structured as master leases. Under a master lease, numerous communities 
are leased through an indivisible lease. We typically guarantee the performance and lease payment obligations of our subsidiary 
lessees under the master leases. Due to the nature of such master leases, it is difficult to restructure the composition of our leased 
portfolios or economic terms of the leases without the consent of the applicable landlord. In addition, an event of default related 
to an individual property or limited number of properties within a master lease portfolio may result in a default on the entire master 
lease portfolio.

The leases relating to these communities are generally fixed rate leases with annual escalators that are either fixed or based upon 
changes in the consumer price index or leased property revenue. We are responsible for all operating costs, including repairs, 
property taxes, and insurance. As of December 31, 2019, the weighted average remaining lease term of our operating and financing 
leases was 6.9 and 8.4 years, respectively. The lease terms generally provide for renewal or extension options from 5 to 20 years, 
and, in some instances, purchase options.

The  community  leases  contain  other  customary  terms,  which  may  include  assignment  and  change  of  control  restrictions, 
maintenance and capital expenditure obligations, termination provisions, and financial covenants, such as those requiring us to 
maintain prescribed minimum net worth and stockholders' equity levels and lease coverage ratios, and not to exceed prescribed 
leverage ratios as further described below. In addition, our lease documents generally contain non-financial covenants, such as 
those requiring us to comply with Medicare or Medicaid provider requirements. Certain leases contain cure provisions, which 
generally allow us to post an additional lease security deposit if the required covenant is not met.

In addition, certain of our master leases and management agreements contain radius restrictions, which limit our ability to own, 
develop, or acquire new communities within a specified distance from certain existing communities covered by such agreements. 
These radius restrictions could negatively affect our ability to expand, develop, or acquire senior housing communities and operating 
companies.

For the year ended December 31, 2019, our cash lease payments for our financing leases and operating leases were $88.6 million 
and $307.8 million, respectively. For the year ending December 31, 2020, we will be required to make approximately $74.9 million
and $294.5 million of cash lease payments in connection with our existing financing leases and our operating leases, respectively 
(after giving effect to the transactions with Healthpeak and NHI completed in January 2020). Our capital expenditure plans for 
2020 include required minimum spend of approximately $17 million for capital expenditures under certain of our community 
leases. Additionally, we are required to spend an average of approximately $17 million per year for each of the following four 
years and approximately $33 million thereafter under the initial lease terms of such leases.

Debt and Lease Covenants

Certain  of  our debt  and  lease  documents  contain  restrictions  and  financial covenants, such  as  those  requiring  us to  maintain 
prescribed minimum net worth and stockholders' equity levels and debt service and lease coverage ratios, and requiring us not to 
exceed prescribed leverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community, and/or 
entity basis. Net worth is generally calculated as stockholders' equity  as calculated in accordance with GAAP,  and in certain 
circumstances, reduced by intangible assets  or  liabilities  or increased  by  deferred gains from  sale-leaseback transactions and 
deferred entrance fee revenue. The debt service  and  lease coverage ratios  are generally  calculated as  revenues  less  operating 
expenses, including an implied management fee and a reserve for capital expenditures, divided by the debt (principal and interest) 
or lease payment. In addition, our debt and lease documents generally contain non-financial covenants, such as those requiring 
us to comply with Medicare or Medicaid provider requirements. 

Our failure to comply with applicable covenants could constitute an event of default under the applicable debt or lease documents. 
Many of our debt and lease documents contain cross-default provisions so that a default under one of these instruments could 
cause a default under other debt and lease documents (including documents with other lenders and lessors).

Furthermore, our debt and leases are secured by our communities and, in certain cases, a guaranty by us and/or one or more of 
our subsidiaries. Therefore, if an event of default has occurred under any of our debt or lease documents, subject to cure provisions 
in certain instances, the respective lender or lessor would have the right to declare all the related outstanding amounts of indebtedness 
or cash lease obligations immediately due and payable, to foreclose on our mortgaged communities, to terminate our leasehold 
interests, to foreclose on other collateral securing the indebtedness and leases, to discontinue our operation of leased communities, 
and/or to pursue other remedies available to such lender or lessor. Further, an event of default could trigger cross-default provisions 
64

in our other debt and lease documents (including documents with other lenders or lessors). We cannot provide assurance that we 
would be able to pay the debt or lease obligations if they became due upon acceleration following an event of default.

As of December 31, 2019, we are in compliance with the financial covenants of our debt agreements and long-term leases.

Derivative Instruments

In the normal course of business, we enter into interest rate agreements with major financial institutions to effectively manage our 
risk above certain interest rates on variable rate debt. As of December 31, 2019, $1.1 billion of our debt is variable rate debt subject 
to interest rate cap agreements. The remaining $103.7 million of our long-term variable rate debt is not subject to any interest rate 
cap agreements.

Contractual Commitments

The following table presents a summary of our material indebtedness, including the related interest payments, lease, and other 
contractual commitments, as of December 31, 2019 (before giving effect to the transactions with Healthpeak and NHI completed 
in January 2020).

(in millions)

Total

2020

2021

2022

2023

2024

Thereafter

Payments Due during the Year Ending December 31,

Contractual Obligations:

Long-term debt and line of 

credit obligations (1)

Financing lease obligations (2)
Operating lease obligations (3)

Total contractual
obligations

Total commercial

$ 4,456.4

$

500.1

$

475.7

$

443.6

$

338.5

$

396.9

$

2,301.6

771.7

2,002.6

84.9

313.1

85.9

298.5

87.1

294.5

88.5

290.2

90.3

277.3

335.0

529.0

$ 7,230.7

$

898.1

$

860.1

$

825.2

$

717.2

$

764.5

$

3,165.6

construction commitments $

21.3

$

19.7

$

1.6

$

— $

— $

— $

—

(1)  Includes  contractual  interest  for  all  fixed-rate  obligations  and  assumes  interest  on  variable  rate  instruments  at  the 

December 31, 2019 rate.

(2)  Reflects future cash lease payments after giving effect to fixed payments (including in-substance fixed payments) and 
variable  payments  estimated  utilizing  the applicable index  or  rate as  of  December 31,  2019. The cash  payments  for 
financing lease obligations exclude $556.7 million of financing lease obligations recognized on our consolidated balance 
sheet for purchase option liabilities (for which $39.3 million of cash was paid on January 22, 2020 for the acquisition of 
eight leased communities pursuant to our exercise of a purchase option) and for sale-leaseback transactions in which we 
have not transferred control of the underlying asset. 

(3)  Reflects future cash payments after giving effect to fixed payments (including in-substance fixed payments) and variable 

payments estimated utilizing the applicable index or rate as of December 31, 2019. 

Pursuant to the MTCA with Healthpeak, on January 31, 2020, we paid $405.5 million to acquire 18 communities and to reduce 
our annual rent under the amended and restated master lease. Additionally, the parties amended and restated our existing master 
lease pursuant to which we continue to lease 25 communities (2,711 units) from Healthpeak. We funded the community acquisitions 
with $192.6 million of non-recourse mortgage financing and the proceeds from the multi-part transaction. As a result of the MTCA 
transactions with Healthpeak that closed January 31, 2020, we eliminated future cash lease payments of $28.7 million, $30.1 
million, $26.8 million, $21.7 million, $8.4 million, and $117.8 million for each of the years ending December 31, 2020, 2021, 
2022, 2023, and 2024, and thereafter, respectively. Additionally, our expected long-term debt obligations (including related interest 
payments) increased by $6.0 million, $7.1 million, $7.1 million, $7.1 million, $7.2 million, and $227.9 million for each of the 
years ending December 31, 2020, 2021, 2022, 2023, and 2024, and thereafter, respectively, for the $192.6 million of non-recourse 
mortgage financing used to fund a portion of our acquisition of 18 communities from Healthpeak on January 31, 2020. The impact 
of these transactions completed in January 2020 are not reflected within the table above as of December 31, 2019. 

The foregoing amounts exclude outstanding letters of credit aggregating to $89.4 million as of December 31, 2019.

65

Impacts of Inflation

Resident fees and management fees are our primary sources of revenue. These revenues are affected by the amount of the monthly 
resident fee rates we charge and community occupancy rates. The rates charged at communities are highly dependent on local 
market conditions and the competitive environment in which the communities operate. Substantially all of our senior housing 
residency agreements allow for adjustments in the monthly fee payable every 12 or 13 months which enables us to seek increases 
in monthly fees due to inflation, increased levels of care, or other factors. Any pricing increases would be subject to market and 
competitive conditions and could result in a decrease in occupancy in the communities. We believe, however, that our ability to 
periodically adjust the monthly fee serves to reduce the adverse effect of inflation. In addition, salaries, wages, and the costs of 
benefits are a principal element of facility operating expense and are also dependent upon local market conditions and general 
inflationary pressures. There can be no assurance that monthly resident fee rates can be increased, or that costs will not increase, 
above inflation rates whether due to inflation or other causes. 

Increases in prevailing interest rates as a result of inflation or other factors will increase our payment obligations on our variable-
rate obligations to the extent they are unhedged and may increase our future borrowing and hedging costs. Although we have 
interest rate cap agreements in place for a majority of our variable-rate debt, these agreements only limit our exposure to increases 
in interest rates above certain levels and generally must be renewed every two to three years. As of December 31, 2019, $103.7 
million of our outstanding variable-rate indebtedness is not subject to interest rate cap agreements. 

Off-Balance Sheet Arrangements

As of December 31,  2019, we do not have an interest  in any off-balance  sheet  arrangements  as  defined  in  Item 303(a)(4)  of 
Regulation S-K that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial 
condition,  revenues  or  expenses,  results  of  operations,  liquidity,  capital  expenditures,  or  capital  resources  that  is  material  to 
investors. 

We own an interest in certain unconsolidated ventures as described under Note 6 to the consolidated financial statements contained 
in "Item 8. Financial Statements and Supplementary Data." Except in limited circumstances, our risk of loss is limited to our 
investment in each venture. The equity method of accounting has been applied in the accompanying financial statements with 
respect to our investment in unconsolidated ventures. 

Critical Accounting Estimates

The preparation of our financial statements in conformity with accounting principles generally accepted in the United States, or 
GAAP, requires us to make estimates, assumptions, and judgments that affect the reported amounts of assets and liabilities at the 
date of the consolidated financial statements and revenues and expenses during the periods reported.  We believe the following 
accounting estimates are the most critical as they require assumptions to be made that were uncertain at the time the estimate was 
made and changes  in the estimate, or different estimates that  could  have  been  selected, could have a material impact on our 
consolidated results of operations or financial condition. These estimates are based on our best judgment about current and future 
conditions, but actual results could differ from those estimates. Our significant accounting policies are discussed in Note 2 to the 
consolidated financial statements contained in "Item 8. Financial Statements and Supplementary Data." 

Long-lived Asset Impairment

As of December 31, 2019, our long-lived assets were comprised primarily of $5.1 billion and $1.2 billion of net property, plant 
and equipment and leasehold intangibles and operating lease right-of-use assets, respectively. 

We test long-lived assets for recoverability annually during our fourth quarter or whenever events or changes in circumstances 
indicate the carrying amount of an asset group may not be recoverable. Recoverability of an asset group is assessed by comparing 
its carrying amount to the estimated future undiscounted net cash flows expected to be generated by the asset group through 
operation or disposition, calculated utilizing the lowest level of identifiable cash flows. If this comparison indicates that the carrying 
amount of an asset group is not recoverable, we are required to recognize an impairment loss. The impairment loss is measured 
by the amount by which the carrying amount of the asset exceeds its estimated fair value. 

In estimating the recoverability of property, plant and equipment and leasehold intangibles and lease right-of-use assets for purposes 
of our impairment testing, we utilize future cash flow projections that are generally developed internally. Any estimates of future 
cash flow projections necessarily involve predicting unknown future circumstances and events and require significant management 
judgments and estimates. In arriving at our cash flow projections, we consider our historic operating results, approved budgets 
66

and business  plans, future demographic  factors, expected  growth  rates,  estimated  asset  holding periods,  and  other factors. In 
estimating  the  future  cash  flows  of  asset  groups  for  purposes  of  our  long-lived  asset  impairment  test,  we  make  certain  key 
assumptions. Those assumptions include future revenues, facility operating expenses, and cash flows, including sales proceeds 
that we would receive upon a sale of the assets using estimated capitalization rates in the case of communities. We corroborate 
the estimated capitalization rates we use in these calculations with capitalization rates observable from recent market transactions. 

Determining the future cash flows of an asset group involves the use of significant estimates and assumptions that are unpredictable 
and inherently uncertain. These estimates and assumptions include revenue and expense growth rates and operating margins used 
to calculate projected future cash flows. Future events may indicate differences from management's current judgments and estimates 
which could, in turn, result in future impairments. Future events that may result in impairment charges include differences in the 
projected occupancy rates or monthly service fee rates, changes in the cost structure of existing communities, and our decision to 
dispose of assets, either through sales or lease terminations. Significant adverse changes in our future revenues and/or operating 
margins, significant changes in the market for senior housing, or the valuation of the real estate of senior living communities, as 
well as other events and circumstances, including, but not limited to, increased competition and changing economic or market 
conditions, could result in changes in estimated future cash flows and the determination that additional assets are impaired. 

During 2019, we evaluated long-lived depreciable assets and lease right-of-use assets and determined that the undiscounted cash 
flows exceeded the carrying amount of these assets for all except a small number of communities. Estimated fair values were 
determined for these certain properties and we recorded asset impairment charges of $27.2 million for property, plant and equipment 
and leasehold intangibles and $10.2 million for operating lease right-of-use assets during the year ended in December 31, 2019. 
These impairment charges are primarily due to our decision to dispose of assets, either through sales or lease terminations, or 
lower than expected performance of the underlying communities and equal the amount by which the carrying amounts of the assets 
exceed the estimated fair value. 

During 2018 and 2017, we evaluated long-lived depreciable assets and determined in each year that the undiscounted cash flows 
exceeded the carrying amount of these assets for all except a small number of communities. Estimated fair values were determined 
for these certain properties and we recorded asset impairment charges of $78.0 million and $164.4 million for 2018 and 2017, 
respectively, for property, plant and equipment, and leasehold intangibles. These impairment charges are primarily due to our 
decision to dispose of assets, either through sales or lease terminations, or lower than expected performance of the underlying 
communities and equal the amount by which the carrying amount of the assets exceed the estimated fair value. 

Our impairment loss assessment contains uncertainties because it requires us to apply judgment to estimate whether there have 
been changes in circumstances that indicate the carrying amount may not be recoverable, the recoverability of asset groups, and, 
if necessary, the fair value of our assets. As we periodically perform this assessment, changes in our estimates and assumptions 
may cause us to realize material impairment charges in the future. Although we make every reasonable effort to ensure the accuracy 
of our estimate of the future cash flows of assets, future changes in the assumptions used to make these estimates could result in 
the recording of an impairment loss.

Goodwill Impairment

As  of  December 31,  2019,  we  had  a  goodwill  balance  of  $154.1  million.  Goodwill  recorded  in  connection  with  business 
combinations is allocated to the respective reporting unit and included in our application of the provisions of ASC 350, Intangibles 
– Goodwill and Other ("ASC 350").

We test goodwill for impairment annually during our fourth quarter, or more frequently if indicators of impairment arise. Factors 
we consider important in our analysis of whether an indicator of impairment exists include a significant decline in our stock price 
or market capitalization for a sustained period since the last testing date, significant underperformance relative to historical or 
projected future operating results, and significant negative industry or economic trends. We are not required to calculate the fair 
value of a reporting unit unless we determine, based on a qualitative assessment, that it is more likely than not that its fair value 
is less than its carrying amount. The quantitative goodwill impairment test is based upon a comparison of the estimated fair value 
of the reporting unit to which the goodwill has been assigned with the reporting unit's carrying amount. The fair values used in 
the quantitative goodwill impairment test are estimated based upon discounted future cash flow projections for the reporting unit. 
These cash flow projections are based upon a number of estimates and assumptions such as revenue and expense growth rates, 
capitalization rates, and discount rates. We also consider market-based measures such as earnings multiples in our analysis of 
estimated fair values of our reporting units. If the quantitative goodwill impairment test results in a reporting unit's carrying amount 
exceeding its estimated fair value, an impairment charge will be recorded based on the difference, with the impairment charge 
limited to the amount of goodwill allocated to the reporting unit.

67

In estimating the fair value of our reporting units for purposes of our quantitative goodwill impairment testing, we utilize the 
income approach, which includes future cash flow projections that are developed internally. Any estimates of future cash flow 
projections necessarily involve predicting unknown future circumstances and events and require significant management judgments 
and estimates. In arriving at our cash flow projections, we consider our historic operating results, approved budgets and business 
plans, future demographic factors, expected growth rates, and other factors. In using the income approach to estimate the fair value 
of reporting units for purposes of our goodwill impairment testing, we make certain key assumptions. Those assumptions include 
future revenues, facility operating expenses, and cash flows, including sales proceeds that we would receive upon a sale of the 
assets, using estimated capitalization rates in the case of communities. We corroborate the estimated capitalization rates we use 
in these calculations with capitalization rates observable from recent market transactions. Future cash flows are discounted at a 
rate that is consistent with a weighted average cost of capital from a market participant perspective. The weighted average cost 
of capital is an estimate of the overall after-tax rate of return required by equity and debt holders of a business enterprise. 

Goodwill allocated to our Independent Living and Health Care Services reporting units is $27.3 million and $126.8 million as of 
December 31, 2019, respectively. Our annual goodwill impairment analysis did not result in any impairment charges during the 
year ended December 31, 2019. Based on the results of the 2019 annual quantitative goodwill impairment test, we estimated that 
the fair value of our Health Care Services reporting unit exceeded its carrying amount by approximately 19%. 

During 2018, we identified qualitative indicators of impairment of our goodwill, including a significant decline in our stock price 
and market capitalization for a sustained period during the three months ended March 31, 2018. As a result, we performed an 
interim quantitative goodwill impairment test as of March 31, 2018, which included a comparison of the estimated fair value of 
each reporting unit to which the goodwill has been assigned with the reporting unit's carrying amount. In estimating the fair value 
of the reporting units for purposes of the quantitative goodwill impairment test, we utilized an income approach, which included 
future cash flow projections that are developed internally. Based on the results of the quantitative goodwill impairment test, we 
determined that the carrying amount of our Assisted Living and Memory Care segment exceeded its estimated fair value by more 
than the $351.7 million carrying amount of goodwill as of March 31, 2018. As a result, we recorded a non-cash impairment charge 
of $351.7 million to goodwill within the Assisted Living and Memory Care segment for the three months ended March 31, 2018.

During the three months ended September 30, 2017, we identified qualitative indicators of impairment of our goodwill, including 
a significant decline in our stock price and market capitalization for a sustained period since  the last testing  date, significant 
underperformance relative to historical and projected operating results, and an increased competitive environment in the senior 
living industry. Based upon our qualitative assessment,  we  performed an  interim  quantitative goodwill  impairment test as  of 
September 30, 2017, which included a comparison of the estimated fair value of each reporting unit to which the goodwill has 
been assigned with the reporting unit's carrying amount. Based on the results of the quantitative goodwill impairment test, we 
determined that the carrying amount of our Assisted Living and Memory Care reporting unit exceeded its estimated fair value by 
$205.0 million as of September 30, 2017. As a result, we recorded a non-cash impairment charge of $205.0 million to goodwill 
within the Assisted Living and Memory Care operating segment for the three months ended September 30, 2017. 

Determining the fair value of a reporting unit involves the use of significant estimates and assumptions that are unpredictable and 
inherently uncertain. These estimates and assumptions include revenue and expense growth rates and operating margins used to 
calculate projected future cash flows and risk-adjusted discount rates. Future events may indicate differences from management's 
current judgments and estimates which could, in turn, result in future impairments. Future events that may result in impairment 
charges include differences in the projected occupancy rates or monthly service fee rates, changes in the cost structure of existing 
communities, changes in reimbursement rates from Medicare for healthcare services, and changes in healthcare reform. Significant 
adverse changes in our future revenues and/or operating margins, significant changes  in the market  for senior housing or  the 
valuation of the real estate of senior living communities, as well as other events and circumstances, including, but not limited to, 
increased competition, changes in reimbursement rates from Medicare for healthcare services, and changing economic or market 
conditions, including market control premiums, could result in changes in fair value and the determination that additional goodwill 
is impaired.

Our impairment loss assessment contains uncertainties because it requires us to apply judgment to estimate whether there has been 
a decline in the fair value of our reporting units, including estimating future cash flows, and if necessary, the fair value of our 
assets and liabilities. As we periodically perform this assessment, changes in our estimates and assumptions may cause us to realize 
material impairment charges in the future. Although we make every reasonable effort to ensure the accuracy of our estimate of 
the fair value of our reporting units, future changes in the assumptions used to make these estimates could result in the recording 
of an impairment loss.

68

Self-Insurance Liability Accruals

We are subject to various legal proceedings and claims that arise in the ordinary course of our business. Although we maintain 
general liability and professional liability insurance policies for our owned, leased, and managed communities under a master 
insurance program, our current policies provide for deductibles for each and every claim. As a result, we are effectively self-
insured for claims that are less than the deductible amounts. In addition, we maintain a high-deductible workers compensation 
program. Third-party insurers are responsible for claim costs above program deductibles and retentions.

Outstanding losses and expenses for general liability, professional liability, and workers compensation are estimated based on the 
recommendations of independent actuaries and management's estimates. The actuarial methods develop estimates of the future 
ultimate claim costs based on the claims incurred as of the balance sheet date. We review the adequacy of our accruals related to 
these liabilities on an ongoing basis, using historical claims, actuarial valuations, third-party administrator estimates, consultants, 
advice from legal counsel,  and industry data, and  adjust  accruals  periodically. Estimated  costs related to  these  self-insurance 
programs are accrued based on known claims and projected claims incurred but not yet reported. These estimates require significant 
judgment, and as a result these estimates are uncertain and our actual exposure may be different from our estimates. Subsequent 
changes in actual experience are monitored and estimates are updated as information becomes available. 

As of December 31, 2019 we accrued reserves of $155.8 million for these programs. During the years ended December 31, 2019, 
2018, and 2017, we reduced our estimate of the amount of accrued liabilities for these programs based on recent claims experience. 
The reductions in these accrued reserves decreased operating expenses by $11.3 million, $14.6 million, and $9.9 million, for the 
years ended December 31, 2019, 2018, and 2017 respectively. 

New Accounting Pronouncements

See Note 2 to the consolidated financial statements contained in "Item 8. Financial Statement and Supplementary Data" for a 
discussion of new accounting pronouncements. 

Non-GAAP Financial Measures

This Annual Report on Form 10-K contains the financial measures Adjusted EBITDA and Adjusted Free Cash Flow, which are 
not calculated in accordance with U.S. generally accepted accounting principles ("GAAP"). Presentations of these non-GAAP 
financial measures are intended to aid investors in better understanding the factors and  trends affecting  our performance and 
liquidity.  However,  investors  should  not  consider  these  non-GAAP  financial  measures  as  a  substitute  for  financial  measures 
determined in accordance with GAAP, including net income (loss), income (loss) from operations, or net cash provided by (used 
in) operating activities. We caution investors that amounts presented in accordance with our definitions of these non-GAAP financial 
measures may not be comparable to similar measures disclosed by other companies because not all companies calculate non-
GAAP measures in the same manner. We urge investors to review the reconciliations included below of these non-GAAP financial 
measures from the most comparable financial measures determined in accordance with GAAP. 

Adjusted EBITDA

Adjusted EBITDA is a non-GAAP performance measure that we define as net income (loss) excluding: benefit/provision for 
income taxes, non-operating income/expense items, and depreciation and amortization; and further adjusted to exclude income/
expense  associated  with  non-cash,  non-operational,  transactional,  cost  reduction,  or  organizational  restructuring  items  that 
management does not consider as part of our underlying core operating performance and that management believes impact the 
comparability of performance between periods. For the periods presented herein, such other items included non-cash impairment 
charges, gain/loss on facility lease termination and modification, operating lease expense adjustment, amortization of deferred 
gain,  change  in  future  service  obligation,  non-cash  stock-based  compensation  expense,  and  transaction  and  organizational 
restructuring costs. Transaction costs include those directly related to acquisition, disposition, financing, and leasing activity, our 
assessment of options and alternatives to enhance stockholder value, and stockholder relations advisory matters, and are primarily 
comprised of legal, finance, consulting, professional fees, and other third party costs. Organizational restructuring costs include 
those related to our efforts to reduce general and administrative expense and our senior leadership changes, including severance 
and retention costs. During the first quarter of 2019, we modified our definition of Adjusted EBITDA to exclude transaction and 
organizational restructuring costs, and amounts for all periods herein reflect application of the modified definition.

We believe that presentation of Adjusted EBITDA as a performance measure is useful to investors because (i) it is one of the 
metrics used by our management for budgeting and other planning purposes, to review our historic and prospective core operating 
performance, and to make day-to-day operating decisions; (ii) it provides an assessment of operational factors that management 
can impact in the short-term, namely revenues and the controllable cost structure of the organization, by eliminating items related 
69

to our financing and capital structure and other items that management does not consider as part of our underlying core operating 
performance and that management believes impact the comparability of performance between periods; and (iii) we believe that 
this measure is used by research analysts and investors to evaluate our operating results and to value companies in our industry. 

Adjusted EBITDA has material limitations as a performance measure, including: (i) excluded interest and income tax are necessary 
to operate our business under our current financing and capital structure; (ii) excluded depreciation, amortization, and impairment 
charges may represent the wear and tear and/or reduction in value of our communities, goodwill, and other assets and may be 
indicative of future needs for capital expenditures; and (iii) we may incur income/expense similar to those for which adjustments 
are made, such as gain/loss on sale of assets or facility lease termination and modification, debt modification and extinguishment 
costs, non-cash stock-based compensation expense, and transaction and other costs, and such income/expense may significantly 
affect our operating results.

The table below reconciles Adjusted EBITDA from our net income (loss).

(in thousands)

Net income (loss)

Provision (benefit) for income taxes

Equity in (earnings) loss of unconsolidated ventures

Debt modification and extinguishment costs

Loss (gain) on sale of assets, net

Other non-operating (income) loss

Interest expense

Interest income

Income (loss) from operations

Depreciation and amortization

Goodwill and asset impairment

Loss (gain) on facility lease termination and modification, net

Operating lease expense adjustment

Amortization of deferred gain

Non-cash stock-based compensation expense

Transaction and organizational restructuring costs

Adjusted EBITDA (1)

Years Ended December 31,

2019

2018

$

(268,492) $

(528,352)

(2,269)

4,544

5,247

(7,245)

(14,765)

248,341

(9,859)

(44,498)

379,433

49,266

3,388

(19,453)

—

23,026

10,007

(49,456)

8,804

11,677

(293,246)

(14,099)

280,269

(9,846)

(594,249)

447,455

489,893

162,001

(17,218)

(4,358)

26,067

28,090

$

401,169

$

537,681

(1)  Adjusted EBITDA for the year ended December 31, 2019 includes a negative non-recurring net impact of $23.1 million

from the application of the new lease accounting standard effective January 1, 2019. 

Adjusted Free Cash Flow

Adjusted Free Cash Flow is a non-GAAP liquidity measure that we define as net cash provided by (used in) operating activities 
before: distributions from unconsolidated ventures from cumulative share of net earnings, changes in prepaid insurance premiums 
financed with notes payable, changes in operating lease liability for lease termination and modification, cash paid/received for 
gain/loss on facility lease termination and modification, and lessor capital expenditure reimbursements under operating leases; 
plus: property  insurance  proceeds  and  proceeds  from refundable  entrance  fees,  net  of  refunds;  less:  non-development  capital 
expenditures and payment of financing lease obligations. Non-development capital expenditures are comprised of corporate and 
community-level capital expenditures, including those related to maintenance, renovations, upgrades, and other major building 
infrastructure projects for our communities and is presented net of lessor reimbursements. Non-development capital expenditures 
do not include capital expenditures for community expansions, major community redevelopment and repositioning projects, and 
the development of new communities. During the first quarter of 2019, we modified our definition of Adjusted Free Cash Flow 
to no longer adjust net cash provided by (used in) operating activities for changes in working capital items other than prepaid 
insurance premiums financed with notes payable and lease liability for lease termination and modification, and amounts for all 
periods herein reflect application of the modified definition. 

70

We believe that presentation of Adjusted Free Cash flow as a liquidity measure is useful to investors because (i) it is one of the 
metrics used by our management for budgeting and other planning purposes, to review our historic and prospective sources of 
operating liquidity, and to review our ability to service our outstanding indebtedness, pay dividends to stockholders, engage in 
share repurchases, and make capital expenditures, including development capital expenditures; (ii) it is used as a metric in our 
performance-based compensation programs; and (iii) it provides an indicator to management to determine if adjustments to current 
spending decisions are needed. 

Adjusted Free Cash Flow has material limitations as a liquidity measure, including: (i) it does not represent cash available for 
dividends, share repurchases, or discretionary expenditures since certain non-discretionary expenditures, including mandatory 
debt principal payments, are not reflected in this measure; (ii) the cash portion of non-recurring charges related to gain/loss on 
facility lease termination and modification generally represent charges/gains that may significantly affect our liquidity; and (iii) 
the impact of timing of cash expenditures, including the timing of non-development capital expenditures, limits the usefulness of 
the measure for short-term comparisons. 

The table below reconciles our Adjusted Free Cash Flow from our net cash provided by (used in) operating activities. 

(in thousands)

Net cash provided by (used in) operating activities

Net cash provided by (used in) investing activities

Net cash provided by (used in) financing activities

Net increase (decrease) in cash, cash equivalents, and restricted cash

Net cash provided by (used in) operating activities

Distributions from unconsolidated ventures from cumulative share of net earnings

Changes in operating lease liability related to lease termination

Cash paid for loss on facility operating lease termination and modification, net

Changes in assets and liabilities for lessor capital expenditure reimbursements under
operating leases

Non-development capital expenditures, net

Property insurance proceeds

Payment of financing lease obligations

Proceeds from refundable entrance fees, net of refunds

Adjusted Free Cash Flow

Years Ended December 31,

2019

2018

216,412

$

(225,539)

(139,394)

203,961

288,774

(325,063)

(148,521) $

167,672

216,412

$

203,961

(3,472)

—

—

(31,305)
(235,797)

—
(22,242)

—
(76,404) $

(2,896)

33,596

21,044

(10,400)
(182,249)

1,292
(59,808)
(422)

4,118

$

$

$

$

(1)  The calculation of Adjusted Free Cash Flow includes transaction and organizational restructuring costs of $10.0 million

and $28.1 million for the years ended December 31, 2019 and 2018, respectively. 

Item 7A. 

Quantitative and Qualitative Disclosures About Market Risk

We are subject to market risks from changes in interest rates charged on our credit facilities and other variable-rate indebtedness. 
The impact on earnings and the value of our long-term debt and lease payments are subject to change as a result of movements 
in market rates and prices. As of December 31, 2019, we had approximately $2.3 billion of long-term fixed rate debt and $1.2 
billion of long-term variable rate debt. For the year ended December 31, 2019, our total fixed-rate debt and variable-rate debt 
outstanding had a weighted average interest rate of 4.7%.

In the normal course of business, we enter into certain interest rate cap agreements with major financial institutions to effectively 
manage our risk above certain interest rates on variable rate debt. As of December 31, 2019, $2.3 billion, or 65.3%, of our long-
term debt has fixed rates. As of December 31, 2019, $1.1 billion, or 31.8%, of our long-term debt is variable rate debt subject to 
interest rate cap agreements. The remaining $103.7 million, or 2.9%, of our long-term debt is variable rate debt not subject to any 
interest rate cap agreements. Our outstanding variable rate debt is indexed to LIBOR, and accordingly our annual interest expense 
related to variable rate debt is directly affected by movements in LIBOR. After consideration of hedging instruments currently in 
place, increases in LIBOR of 100, 200 and 500 basis points would have resulted in additional annual interest expense of $12.6 
million,  $25.2 million  and $38.8 million,  respectively.  Certain of  the Company's  variable  debt  instruments  include  springing 

71

provisions that obligate the Company to acquire additional interest rate caps in the event that LIBOR increases above certain 
levels, and the implementation of those provisions would result in additional mitigation of interest costs. 

72

Item 8. 

Financial Statements and Supplementary Data

BROOKDALE SENIOR LIVING INC.

INDEX TO FINANCIAL STATEMENTS

Report of Independent Registered Public Accounting Firm

Report of Independent Registered Public Accounting Firm

Consolidated Balance Sheets as of December 31, 2019 and 2018

Consolidated Statements of Operations for the Years Ended December 31, 2019, 2018, and 2017

Consolidated Statements of Equity for the Years Ended December 31, 2019, 2018, and 2017

Consolidated Statements of Cash Flows for the Years Ended December 31, 2019, 2018, and 2017

Notes to Consolidated Financial Statements

Schedule II — Valuation and Qualifying Accounts

PAGE

74

77

78

79

80

81

83

120

73

Report of Independent Registered Public Accounting Firm

The Board of Directors and Stockholders of Brookdale Senior Living Inc.

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Brookdale Senior Living Inc. (the Company) as of December 31, 
2019 and 2018, the related consolidated statements of operations, equity, and cash flows for each of the three years in the period 
ended December 31, 2019, and the related notes and financial statement schedule included in the Index at Item 15 (collectively 
referred to as the consolidated financial statements). In our opinion, the consolidated financial statements present fairly, in all 
material respects, the financial position of the Company at December 31, 2019 and 2018, and the results of its operations and its 
cash flows for each of the three years in the period ended December 31, 2019, in conformity with U.S. generally accepted accounting 
principles. 

We  also have audited, in accordance with the  standards  of the  Public  Company Accounting  Oversight Board (United  States) 
(PCAOB), the Company's  internal control over financial reporting  as of  December 31, 2019,  based  on criteria  established  in 
Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 
framework), and our report dated February 19, 2020 expressed an unqualified opinion thereon.

Adoption of ASU No. 2016-02

As discussed in Note 2 to the consolidated financial statements, the Company changed its method of accounting for leases in 2019 
due to the adoption of Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842), and the related amendments.

Basis for Opinion 

These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on 
the Company's financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are 
required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable 
rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the 
audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error 
or fraud. Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether 
due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, 
evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting 
principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial 
statements. We believe that our audits provide a reasonable basis for our opinion. 

74

Critical Audit Matters

The critical audit matters communicated below are matters arising from the current period audit of the financial statements that 
were communicated or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are 
material  to  the  financial  statements  and  (2)  involved  our  especially  challenging,  subjective,  or  complex  judgments.  The 
communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as 
a whole, and we are not, by communicating the critical audit matters below, providing separate opinions on the critical audit matters 
or on the accounts or disclosures to which they relate.

Evaluation of Goodwill for Impairment

Description
of the Matter

As of December 31, 2019, the Company's consolidated balance sheet included goodwill of $154.1 million. As 
discussed in Notes 2 and 5 to the consolidated financial statements, goodwill is qualitatively, and when necessary 
quantitatively, tested for impairment at least annually during the fourth quarter at the reporting unit level.

Auditing management's evaluation of goodwill allocated to the health care services reporting unit for impairment 
was complex and involved a high degree of subjectivity due to the significant estimation required to estimate 
the fair value of the health care services reporting unit. In particular, the fair value estimate was sensitive to 
significant  assumptions  including  the  estimation  of  revenue  and  expense  growth  rates,  discount  rates,  and 
earnings multiples, which are affected by expectations about future market or economic conditions.

How We
Addressed
the Matter in
Our Audit

We obtained an understanding, evaluated the design, and tested the operating effectiveness of controls over the 
Company's goodwill impairment review process, including controls over management's review of the significant 
assumptions described above.

To  test  the  estimated  fair  value  of  the  Company's  health  care  services  reporting  unit,  we  performed  audit 
procedures that included, among others, assessing the methodologies used to estimate fair value, testing the 
significant assumptions used to develop the fair value estimate, and testing the underlying data used by the 
Company  in its analysis for completeness and accuracy. We  compared  the  significant assumptions  used by 
management to current industry and economic trends, and evaluated whether changes to the Company's business 
and  other  relevant  factors  would  affect  the  significant  assumptions.  The  evaluation  of  the  Company's 
methodology and key assumptions was performed with the assistance of our valuation specialists. We assessed 
the historical accuracy of the Company's estimates and performed sensitivity analyses of significant assumptions 
to evaluate the changes in the fair value of the health care services reporting unit that would result from changes 
in the significant assumptions. 

75

 
Description
of the Matter

Evaluation of Property, Plant and Equipment and Leasehold Intangibles, Net and Operating Lease Right-
of-Use Assets for Impairment

As of December 31, 2019, the Company's consolidated balance sheet included property, plant and equipment 
and leasehold intangibles, net and operating lease right-of-use assets of $5.1 billion and $1.2 billion, respectively. 
As discussed  in  Notes  2 and  5  to the consolidated  financial  statements,  property,  plant  and  equipment  and 
leasehold  intangibles,  net  and  operating  lease  right-of-use  assets  are  routinely  evaluated  for  indicators  of 
impairment. For property, plant and equipment and leasehold intangibles, net and operating lease right-of-use 
assets with indicators of impairment, the Company compares the estimated undiscounted future cash flows of 
each long-lived asset group to its carrying amount. If the long-lived asset group's carrying amount exceeds its 
estimated  undiscounted  future cash  flows,  the fair  value of  the  long-lived  asset group  is  then  estimated  by 
management and compared to its carrying amount. An impairment charge is recognized on these long-lived 
assets when carrying amount exceeds fair value.

Auditing management's evaluation of property, plant and equipment and leasehold intangibles, net and operating 
lease right-of-use assets for impairment was complex and involved a high degree of subjectivity due to the 
significant estimation required to determine the estimated undiscounted future cash flows and fair values of 
long-lived asset groups where indicators of impairment were determined to be present. In particular, the future 
cash flows and fair value estimates were sensitive to significant assumptions including the estimation of revenue 
and expense growth rates and capitalization rates, which are affected by expectations about future market or 
economic conditions.

How We
Addressed
the Matter in
Our Audit

We obtained an understanding, evaluated the design and tested the operating effectiveness of controls over the 
Company's process to evaluate property, plant and equipment and leasehold intangibles, net and operating lease 
right-of-use assets for impairment, including controls over management's review of the significant assumptions 
described above.

To test the Company's evaluation of long-lived asset groups for impairment, we performed audit procedures 
that included, among others, assessing the methodologies used to estimate future cash flows and estimate fair 
values, testing the significant assumptions used to develop the estimates of future cash flows and fair values, 
and testing the completeness and accuracy of the underlying data used by the Company in its analysis. We 
compared  the  significant  assumptions  used  by  management  to  current  industry  and  economic  trends  and 
evaluated whether changes to the Company's business and other relevant factors would affect the significant 
assumptions. The  evaluation  of  the  Company's  methodology and  key  assumptions  was  performed  with  the 
assistance of our valuation specialists. We assessed  the historical  accuracy of the Company's estimates  and 
performed sensitivity analyses of significant assumptions to evaluate the changes in the undiscounted future 
cash flows and fair values of the long-lived asset groups that would result from changes in the key assumptions.

/s/ Ernst & Young LLP

We have served as the Company's auditor since 1993
Chicago, Illinois
February 19, 2020

76

Report of Independent Registered Public Accounting Firm

The Board of Directors and Stockholders of Brookdale Senior Living Inc.

Opinion on Internal Control over Financial Reporting 

We have audited Brookdale Senior Living Inc.'s (the Company) internal control over financial reporting as of December 31, 2019, 
based on criteria established in Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizations of 
the Treadway Commission (2013 framework) (the COSO criteria). In our opinion, the Company maintained, in all material respects, 
effective internal control over financial reporting as of December 31, 2019, based on the COSO criteria.

We  also have audited, in accordance with the  standards  of the  Public  Company Accounting  Oversight Board (United States) 
(PCAOB), the consolidated balance sheets of the Company as of December 31, 2019 and 2018, the related consolidated statements 
of operations, equity, and cash flows for each of the three years in the period ended December 31, 2019, and the related notes and 
financial statement schedule included in the Index at Item 15 and our report dated February 19, 2020 expressed an unqualified 
opinion thereon.

Basis for Opinion 

The Company's management is responsible for maintaining effective internal control over financial reporting and for its assessment 
of the effectiveness of internal control over financial reporting included in the accompanying Management's Assessment of Internal 
Control over Financial Reporting. Our responsibility is to express an opinion on the Company's internal control over financial 
reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with 
respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities 
and Exchange Commission and the PCAOB. 

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the 
audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material 
respects. 

Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness 
exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing 
such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for 
our opinion. 

Definition and Limitation of Internal Control over Financial Reporting 

A company's internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability 
of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted 
accounting principles. A company's internal control over financial reporting includes those policies and procedures that (1) pertain 
to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets 
of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial 
statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are 
being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable 
assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company's assets that 
could have a material effect on the financial statements.

Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements. Also, 
projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because 
of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

/s/ Ernst & Young LLP

Chicago, Illinois
February 19, 2020

77

BROOKDALE SENIOR LIVING INC.
CONSOLIDATED BALANCE SHEETS
(In thousands, except stock amounts) 

Assets
Current assets

Cash and cash equivalents
Marketable securities
Restricted cash
Accounts receivable, net
Assets held for sale
Prepaid expenses and other current assets, net

Total current assets

Property, plant and equipment and leasehold intangibles, net
Operating lease right-of-use assets
Restricted cash
Investment in unconsolidated ventures
Goodwill
Other intangible assets, net
Other assets, net
Total assets
Liabilities and Equity
Current liabilities

Current portion of long-term debt
Current portion of financing lease obligations
Current portion of operating lease obligations
Trade accounts payable
Accrued expenses
Refundable fees and deferred revenue

Total current liabilities

Long-term debt, less current portion
Financing lease obligations, less current portion
Operating lease obligations, less current portion
Deferred liabilities
Deferred tax liability
Other liabilities

Total liabilities

$

$

$

December 31,

2019

2018

$

$

$

240,227
68,567
26,856
133,613
42,671
84,241
596,175
5,109,834
1,159,738
34,614
21,210
154,131
35,198
83,533
7,194,433

339,413
63,146
193,587
104,721
266,703
79,402
1,046,972
3,215,710
771,434
1,277,178
7,569
15,397
161,448
6,495,708

398,267
14,855
27,683
133,905
93,117
106,189
774,016
5,275,427
—
24,268
27,528
154,131
51,472
160,418
6,467,260

294,426
23,135
—
95,049
298,227
62,494
773,331
3,345,754
851,341
—
262,761
18,371
197,289
5,448,847

Preferred stock, $0.01 par value, 50,000,000 shares authorized at December 31, 2019 and December 31,

2018; no shares issued and outstanding

—

—

Common stock, $0.01 par value, 400,000,000 shares authorized at December 31, 2019 and December
31, 2018; 199,593,343 and 196,815,254 shares issued and 192,128,586 and 192,356,051 shares
outstanding (including 7,252,459 and 5,756,435 unvested restricted shares), respectively

Additional paid-in-capital

Treasury stock, at cost; 7,464,757 and 4,459,203 shares at December 31, 2019 and December 31, 2018,

respectively

Accumulated deficit

Total Brookdale Senior Living Inc. stockholders' equity

Noncontrolling interest
Total equity
Total liabilities and equity

1,996
4,172,099

1,968
4,151,147

(84,651)
(3,393,088)
696,356
2,369
698,725
7,194,433

$

(64,940)
(3,069,272)
1,018,903
(490)
1,018,413
6,467,260

$

See accompanying notes to consolidated financial statements.

78

BROOKDALE SENIOR LIVING INC.
CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except per share data)

Revenue

Resident fees

Management fees

Reimbursed costs incurred on behalf of managed communities

Total revenue

Expense

Facility operating expense (excluding facility depreciation and

amortization of $349,215, $407,427 and $430,288, respectively)

General and administrative expense (including non-cash stock-based

compensation expense of $23,026, $26,067 and $27,832, respectively)

Facility operating lease expense

Depreciation and amortization

Goodwill and asset impairment

Loss (gain) on facility lease termination and modification, net

Costs incurred on behalf of managed communities

Total operating expense

Income (loss) from operations

Interest income

Interest expense:

Debt

Financing lease obligations

Amortization of deferred financing costs and debt discount

Change in fair value of derivatives

Debt modification and extinguishment costs

Equity in earnings (loss) of unconsolidated ventures

Gain (loss) on sale of assets, net

Other non-operating income (loss)

Income (loss) before income taxes

Benefit (provision) for income taxes

Net income (loss)

Net (income) loss attributable to noncontrolling interest

Net income (loss) attributable to Brookdale Senior Living Inc. common

stockholders

Basic and diluted net income (loss) per share attributable to Brookdale

Senior Living Inc. common stockholders

$

$

For the Years Ended December 31,
2018
2019

2017

$

3,209,931

$

3,449,211

$

3,780,140

57,108

790,049

4,057,088

71,986

1,010,229

4,531,426

75,845

891,131

4,747,116

2,390,495

2,453,328

2,602,155

219,289

269,666

379,433

49,266

3,388

790,049

4,101,586

259,475

303,294

447,455

489,893

162,001

1,010,229

5,125,675

(44,498)

(594,249)

278,019

339,721

482,077

409,782

14,276

891,131

5,017,161

(270,045)

9,859

9,846

4,623

(177,718)
(66,353)
(4,057)
(213)
(5,247)
(4,544)

7,245

14,765
(270,761)

2,269
(268,492)

561

(188,505)
(83,604)
(7,757)
(403)
(11,677)
(8,804)

293,246

14,099
(577,808)

49,456
(528,352)

94

(172,635)
(140,664)
(12,681)
(174)
(12,409)
(14,827)

19,273

11,418
(588,121)

16,515
(571,606)

187

(267,931) $

(528,258) $

(571,419)

(1.44) $

(2.82) $

(3.07)

Weighted average shares used in computing basic and diluted net loss per

share

185,907

187,468

186,155

See accompanying notes to consolidated financial statements.

79

BROOKDALE SENIOR LIVING INC.
CONSOLIDATED STATEMENTS OF EQUITY
(In thousands)

Total equity, balance at beginning of period

$ 1,018,413

$ 1,530,291

$ 2,077,732

For the Years Ended December 31,
2018

2019

2017

Common stock:

Balance at beginning of period

Issuance of common stock under Associate Stock Purchase Plan

Restricted stock, net

Shares withheld for employee taxes

Other, net

Balance at end of period
Additional paid-in-capital:

Balance at beginning of period

Compensation expense related to restricted stock grants

Issuance of common stock under Associate Stock Purchase Plan

Restricted stock, net

Shares withheld for employee taxes

Other, net

Balance at end of period

Treasury stock:

Balance at beginning of period

Purchase of treasury stock

Balance at end of period

Accumulated deficit:

Balance at beginning of period

Cumulative effect of change in accounting principle (Note 2)

Net income (loss)

Other, net

Balance at end of period
Noncontrolling interest:

Balance at beginning of period

Net income (loss) attributable to noncontrolling interest

Noncontrolling interest contribution

Noncontrolling interest distribution

Balance at end of period

Total equity, balance at end of period

Common stock share activity

Outstanding shares of common stock:

Balance at beginning of period

Issuance of common stock under Associate Stock Purchase Plan

Restricted stock, net

Shares withheld for employee taxes

Purchase of treasury stock

Balance at end of period

$

1,968

$

1,913

$

1,900

2

31
(5)

—

1

26
(4)

32

2

14
(3)

—

$

1,996

$

1,968

$

1,913

$ 4,151,147
23,026

$ 4,126,549
26,067

$ 4,102,397
27,832

1,160

(31)

(3,308)

105

1,468

(26)

(3,057)

146

2,039

(14)

(5,886)

181

$ 4,172,099

$ 4,151,147

$ 4,126,549

$

$

(64,940) $

(56,440) $

(56,440)

(19,711)

(8,500)

—

(84,651) $

(64,940) $

(56,440)

$(3,069,272) $(2,541,294) $(1,969,875)

(55,885)
(267,931)

—
(528,258)

—
(571,419)

—

—
$(3,393,088) $(3,069,272) $(2,541,294)

280

$

(490) $

(437) $

(561)

6,566

(3,146)

(94)

41

—

(250)

(187)

—

—

$

$

2,369

$

(490) $

(437)

698,725

$ 1,018,413

$ 1,530,291

192,356

191,276

190,046

181

3,073

(476)

(3,005)

207

2,593

(439)

(1,281)

181

1,421

(372)

—

192,129

192,356

191,276

See accompanying notes to consolidated financial statements.

80

BROOKDALE SENIOR LIVING INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)

Cash Flows from Operating Activities

Net income (loss)

Adjustments to reconcile net income (loss) to net cash provided by (used in)
operating activities:

Debt modification and extinguishment costs

Depreciation and amortization, net

Goodwill and asset impairment

Equity in (earnings) loss of unconsolidated ventures

Distributions from unconsolidated ventures from cumulative share of net earnings

Amortization of deferred gain
Amortization of entrance fees

Proceeds from deferred entrance fee revenue

Deferred income tax (benefit) provision

Operating lease expense adjustment

Change in fair value of derivatives

Loss (gain) on sale of assets, net

Loss (gain) on facility lease termination and modification, net

Non-cash stock-based compensation expense

Non-cash interest expense on financing lease obligations

Non-cash management contract termination gain

Other

Changes in operating assets and liabilities:

Accounts receivable, net

Prepaid expenses and other assets, net

Trade accounts payable and accrued expenses

Refundable fees and deferred revenue

Operating lease assets and liabilities for lessor capital expenditure
reimbursements

Operating lease assets and liabilities for lease termination

Net cash provided by (used in) operating activities

Cash Flows from Investing Activities

Change in lease security deposits and lease acquisition deposits, net

Purchase of marketable securities

Sale and maturities of marketable securities

Capital expenditures, net of related payables

Acquisition of assets, net of related payables and cash received

Investment in unconsolidated ventures

Distributions received from unconsolidated ventures

Proceeds from sale of assets, net

Proceeds from notes receivable

Property insurance proceeds

For the Years Ended December 31,

2019

2018

2017

$

(268,492) $

(528,352) $

(571,606)

5,247

383,490

49,266

4,544

3,472

—
(1,634)

3,544

(2,654)

(19,453)

213

11,677

455,212

489,893

8,804

2,896
(4,358)
(1,670)

3,218

(52,367)

(17,218)

403

12,409

494,758

409,782

14,827

8,258
(4,366)
(2,901)

5,712

(15,309)

(20,990)

174

(7,245)

(293,246)

(19,273)

3,388

23,026

—

(969)

(8,700)

292

55,873

(12,984)

(25,117)

31,305

—

216,412

(859)

(186,224)

134,000

(304,092)

(497)

(4,346)

9,635

92,735

34,109

—

140,957

26,067

10,894

(8,724)

(1,292)

(4,964)

26,762

(37,307)

(128)

10,400
(33,596)

203,961

1,163

(14,823)

293,273

(225,473)

(271,771)

(9,124)

12,850

499,807

1,580

1,292

14,276

27,832

17,744

—

(8,819)

12,747

21,970

(4,527)

(14,339)

—

—

378,359

(2,113)

(341,187)

50,000

(213,887)

(5,196)

(199,017)

29,035

70,507

975

8,550

Net cash provided by (used in) investing activities

(225,539)

288,774

(602,333)

81

 
 
Cash Flows from Financing Activities

Proceeds from debt

Repayment of debt and financing lease obligations

Proceeds from line of credit

Repayment of line of credit

Purchase of treasury stock, net of related payables

Payment of financing costs, net of related payables

Proceeds from refundable entrance fees, net of refunds

Payments for lease termination

Payments of employee taxes for withheld shares

Other

Net cash provided by (used in) financing activities

Net increase (decrease) in cash, cash equivalents, and restricted cash

Cash, cash equivalents, and restricted cash at beginning of period

321,996
(427,923)

—

—
(23,955)
(7,309)

—

—
(3,313)

1,110
(139,394)
(148,521)

450,218

606,921
(896,744)

200,000
(200,000)
(4,256)
(16,317)
(422)
(12,548)
(3,061)

1,364
(325,063)

167,672

282,546

1,307,205
(1,054,161)

100,000
(100,000)

—
(17,269)
(2,179)
(552)
(5,889)

2,043

229,198

5,224

277,322

Cash, cash equivalents, and restricted cash at end of period

$

301,697

$

450,218

$

282,546

See accompanying notes to consolidated financial statements.

82

BROOKDALE SENIOR LIVING INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

1.       Description of Business

Brookdale Senior Living Inc. ("Brookdale" or the "Company") is an operator of senior living communities throughout the United 
States. The Company is committed to providing senior living solutions primarily within properties that are designed, purpose-
built, and operated to provide quality service, care, and living accommodations for residents. The Company operates and manages 
independent living, assisted living, memory care, and continuing care retirement communities ("CCRCs"). The Company also 
offers a range of home health, hospice, and outpatient therapy services to residents of many of its communities and to seniors 
living outside of its communities.

The Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; 
and Management Services. 

2.       Summary of Significant Accounting Policies

The consolidated financial statements have been prepared on the accrual basis of accounting in accordance with U.S. generally 
accepted  accounting  principles  ("GAAP"). Except  for  the  changes  for  the  impact  of  the  recently  adopted  accounting 
pronouncements discussed in this Note, the Company has consistently applied its accounting policies to all periods presented in 
these consolidated financial statements. The significant accounting policies are summarized below:

Principles of Consolidation

The consolidated financial statements include the accounts of Brookdale and its consolidated subsidiaries. The ownership interest 
of  consolidated  entities  not  wholly-owned  by  the  Company  are  presented  as  noncontrolling  interests  in  the  accompanying 
consolidated financial statements. Intercompany balances and transactions have been eliminated in consolidation, and net income 
(loss) is reduced by the portion of net income (loss) attributable to noncontrolling interests. The Company reports investments in 
unconsolidated entities over whose operating and financial policies it has the ability to exercise significant influence under the 
equity method of accounting.

The Company continually evaluates its potential variable interest entity ("VIE") relationships under certain criteria as provided 
for in Financial Accounting Standards Board ("FASB") Accounting Standards Codification ("ASC") 810, Consolidation ("ASC 
810"). ASC 810 broadly defines a VIE as an entity with one or more of the following characteristics: (a) the total equity investment 
at risk is insufficient to finance the entity's activities without additional subordinated financial support; (b) as a group, the holders 
of the equity investment at risk lack (i) the ability to make decisions about the entity's activities through voting or similar rights, 
(ii) the obligation to absorb the expected losses of the entity, or (iii) the right to receive the expected residual returns of the entity; 
or (c) the equity investors have voting rights that are not proportional to their economic interests, and substantially all of the entity's 
activities either involve, or are conducted on behalf of, an investor that has disproportionately few voting rights. The Company 
performs this analysis on an ongoing basis and consolidates any VIEs for which the Company is determined to be the primary 
beneficiary, as determined by the Company's power to direct the VIE's activities and the obligation to absorb its losses or the right 
to receive its benefits, which are potentially significant to the VIE. Refer to Note 6 for more information about the Company's 
VIE relationships.

Use of Estimates

The preparation of the consolidated financial statements and related disclosures in conformity with GAAP requires management 
to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and accompanying 
notes. Estimates are used for, but not limited to, revenue, goodwill and asset impairments, self-insurance reserves, performance-
based compensation, the allowance for credit losses, depreciation and amortization, leasing transactions, income taxes, and other 
contingencies. Although these estimates are based on management's best knowledge of current events and actions that the Company 
may undertake in the future, actual results may differ from the original estimates.

Revenue Recognition

Resident Fees

Resident fee revenue is reported at the amount that reflects the consideration the Company expects to receive in exchange for the 
services provided. These amounts are due from residents or third-party payors and include variable consideration for retroactive 
83

adjustments from estimated  reimbursements, if any,  under  reimbursement  programs. Performance  obligations  are determined 
based on the nature of the services provided. Resident fee revenue is recognized as performance obligations are satisfied.

Under the Company's senior living residency agreements, which are generally for a contractual term of 30 days to one year, the 
Company provides senior living services to residents for a stated daily or monthly fee. The Company has elected the lessor practical 
expedient within ASC 842, Leases ("ASC 842") and recognizes, measures, presents, and discloses the revenue for services under 
the Company's senior living residency agreements based upon the predominant component, either the lease or nonlease component, 
of the contracts. The Company has determined that the services included under the Company's independent living, assisted living, 
and memory care residency agreements have the same timing and pattern of transfer and are performance obligations that are 
satisfied over time. The Company recognizes revenue under ASC 606, Revenue Recognition from Contracts with Customers ("ASC 
606") for its independent living, assisted living, and memory care residency agreements for which it has estimated that the nonlease 
components of such residency agreements are the predominant component of the contract. 

The Company enters into contracts to provide home health, hospice, and outpatient therapy services. Each service provided under 
the contract is capable of being distinct, and thus, the services are considered individual and separate performance obligations. 
The performance obligations are satisfied as services are provided and revenue is recognized as services are provided.

The Company receives payment for services under various third-party payor programs which include Medicare, Medicaid, and 
other  third-party  payors.  Estimates  for  settlements  with  third-party  payors  for  retroactive  adjustments  from  estimated 
reimbursements due to audits, reviews, or investigations are included in the determination of the estimated transaction price for 
providing services. The Company estimates the transaction price based on the terms of the contract with the payor, correspondence 
with the payor, and historical payment trends. Changes to these estimates for retroactive adjustments are recognized in the period 
the change or adjustment becomes known or when final settlements are determined.

Management Services

The Company manages certain communities under contracts which provide periodic management fee payments to the Company 
and reimbursement for costs and expense related to such communities. Management fees are generally determined by an agreed 
upon percentage of gross revenues (as defined in the management agreement). Certain management contracts also provide for an 
annual incentive fee to be paid to the Company upon achievement of certain metrics identified in the contract. The Company has 
determined that all community management activities are a single performance obligation, which is satisfied over time as the 
services are rendered. The Company estimates the amount of incentive fee revenue expected to be earned, if any, during the annual 
contract period and revenue is recognized as services are provided. The Company's estimate of the transaction price for management 
services also includes the amount of reimbursement due from the owners of the communities for services provided and related 
costs incurred. Such revenue is included in "reimbursed costs incurred on behalf of managed communities" on the consolidated 
statements of operations. The related costs are included in "costs incurred on behalf of managed communities" on the consolidated 
statements of operations.

Lease Accounting

Refer to the Company's revenue recognition policy for discussion of the accounting policy for residency agreements, which include 
a lease component.

The following is the Company's lease accounting policy subsequent to the adoption of ASC 842 on January 1, 2019. Refer to 
Recently Adopted Accounting Pronouncements in this Note 2 for significant changes that resulted from the adoption. The Company, 
as lessee, recognizes a right-of-use asset and a lease liability on the Company's consolidated balance sheet for its community, 
office, and equipment leases. As of the commencement date of a lease, a lease liability and corresponding right-of-use asset is 
established on the Company's consolidated balance sheet at the present value of future minimum lease payments. The Company's 
community leases generally contain fixed annual rent escalators or annual rent escalators based on an index, such as the consumer 
price index. The future minimum lease payments recognized on the consolidated balance sheet include fixed payments (including 
in-substance fixed payments) and variable payments estimated utilizing the index or rate on the lease commencement date. The 
Company recognizes lease expense as incurred for additional variable payments. For the Company's leases that do not contain an 
implicit rate, the Company utilizes its estimated incremental borrowing rate to determine the present value of lease payments 
based on information available at commencement of the lease. The Company's estimated incremental borrowing rate reflects the 
fixed rate at which the Company could borrow a similar amount for the same term on a collateralized basis. The Company elected 
the short-term lease exception policy which permits leases with an initial term of 12 months or less to not be recorded on the 
Company's consolidated balance sheet and instead to be recognized as lease expense as incurred. 

84

The Company, as lessee, makes a determination with respect to each of its community, office, and equipment leases as to whether 
each should be accounted for as an operating lease or financing lease. The classification criteria is based on estimates regarding 
the fair value of the leased asset, minimum lease payments, effective cost of funds, economic life of the asset, and certain other 
terms in the lease agreements. 

Lease right-of-use assets are reviewed for impairment whenever changes in circumstances indicate that the carrying amount of 
an asset may not be recoverable. Recoverability of right-of-use assets are assessed by a comparison of the carrying amount of the 
asset to the estimated future undiscounted net cash flows expected to be generated by the asset, calculated utilizing the lowest 
level of identifiable cash flows. If estimated future undiscounted net cash flows are less than the carrying amount of the asset then 
the fair value of the asset is estimated. The impairment expense is determined by comparing the estimated fair value of the asset 
to its carrying amount, with any amount in excess of fair value recognized as an expense in the current period. Undiscounted cash 
flow projections and estimates of fair value amounts are based on a number of assumptions such as revenue and expense growth 
rates and estimated lease coverage ratios (Level 3).

Operating Leases

The Company recognizes operating lease  expense  for actual rent  paid, generally plus or  minus a straight-line  adjustment for 
estimated minimum lease escalators if applicable. The right-of-use asset is generally reduced each period by an amount equal to 
the difference between the operating lease expense and the amount of expense on the lease liability utilizing the effective interest 
method. Subsequent to the impairment of an operating lease right-of-use asset, the Company recognizes operating lease expense 
consisting of the reduction of the right-of-use asset on a straight-line basis over the remaining lease term and the amount of expense 
on the lease liability utilizing the effective interest method.

Financing Leases

Financing lease right-of-use assets are recognized within property, plant and equipment and leasehold intangibles, net on  the 
Company's consolidated balance sheets. The Company recognizes interest expense on the financing lease liabilities utilizing the 
effective interest method. The right-of-use asset is generally amortized to depreciation and amortization expense on a straight-
line basis over the lease term unless the lease contains an option to purchase the underlying asset that the Company is reasonably 
certain to exercise. If the Company is reasonably certain to exercise the purchase option, the asset is amortized over the useful 
life. 

Sale-Leaseback Transactions

For transactions in which an owned community is sold and leased back from the buyer (sale-leaseback transactions), the Company 
recognizes  an asset  sale  and  lease accounting  is applied  if  the  Company  has  transferred  control  of  the community.  For  such 
transactions, the Company removes the transferred assets from the consolidated balance sheet and a gain or loss on the sale is 
recognized for the difference between the carrying amount of the asset and the transaction price for the sale transaction.

For sale leaseback transactions in which the Company has not transferred control of the underlying asset, the Company does not 
recognize an asset sale or derecognize the underlying asset until control is transferred. For such transactions, the Company continues 
to recognize the assets within property, plant and equipment and leasehold intangibles, net and continues to depreciate the asset 
over its useful life. Additionally, the Company accounts for any amounts received as a financing lease liability and the Company 
recognizes interest expense on the financing lease liability utilizing the effective interest method with the interest expense limited 
to an amount that is not greater than the cash payments on the financing lease liability over the term of the lease. 

Gain (Loss) on Sale of Assets 

The Company regularly enters into real estate transactions which may include the disposal of certain communities, including the 
associated real estate. The Company recognizes gain or loss from real estate sales when the transfer of control is complete.

The Company recognizes gain or loss from the sale of equity method investments when the transfer of control is complete and 
the Company has no continuing involvement with the transferred financial assets.

Purchase Accounting

For the acquisition of assets that do not meet the definition of a business, the Company accounts for the transaction as an asset 
acquisition at the purchase price, including acquisition costs, allocated among the acquired assets and assumed liabilities, including 
identified intangible assets and liabilities, based upon the relative fair values using Level 3 inputs at the date of acquisition. 

85

For acquisitions of a business, the Company accounts for the transaction as a business combination pursuant to the acquisition 
method and assets acquired and liabilities assumed, including identified intangible assets and liabilities, are recorded at fair value. 
In determining the allocation of the purchase price of companies and communities to net tangible and identified intangible assets 
acquired and liabilities assumed, the Company makes estimates of fair value using information obtained as a result of pre-acquisition 
due diligence, marketing, leasing activities, and/or independent appraisals. 

In connection with a business combination, the excess of the fair value of liabilities assumed and common stock issued and cash 
paid  over  the  fair  value  of  identifiable  assets  acquired  is  allocated  to  goodwill.  Transaction  costs  associated  with  business 
combinations  are  expensed  as  incurred.  See  "Recently Adopted Accounting  Pronouncements"  within  this  footnote  for  more 
information related to the adoption of ASU 2017-01,  Business Combinations: Clarifying  the  Definition of a Business ("ASU 
2017-01"). 

Deferred Financing Costs

Third-party fees and costs incurred to obtain debt are recorded as a direct adjustment to the carrying amount of debt and amortized 
on a straight-line basis, which approximates the effective yield method, over the term of the related debt. Unamortized deferred 
financing fees are written-off if the associated debt is retired before the maturity date. Upon the refinancing of mortgage debt or 
amendment of the line of credit, unamortized deferred financing fees and additional financing costs incurred are accounted for in 
accordance with ASC 470-50, Debt Modifications and Extinguishments.

Stock-Based Compensation

Measurement of the cost of employee services received in exchange for stock compensation is based on the grant-date fair value 
of the employee stock awards, which is based on the quoted price of the Company's common shares on the grant date for the 
majority of the Company's awards. Generally, this cost is recognized as compensation expense ratably over the employee's requisite 
service period. The Company recognizes forfeitures as they occur and any previously recognized compensation expense is reversed 
for forfeited awards. Awards that vest over a requisite service period, other than those with performance or market conditions, 
generally vest ratably in annual installments over a period of three to four years. Incremental compensation costs arising from 
subsequent modifications of awards after the grant date are recognized when incurred.

Certain of the Company's employee stock awards  vest only  upon the achievement  of performance  conditions. The Company 
recognizes  compensation  cost  only  when  achievement  of  performance  conditions  is  considered  probable.  Consequently,  the 
Company’s  determination  of  the  amount  of  stock  compensation  expense  requires  judgment  in  estimating  the  probability  of 
achievement of these performance conditions. Performance conditioned awards that vest dependent upon attainment of various 
levels of performance that equal or exceed threshold levels generally vest based upon performance at the end of a three-year 
performance period. The number of shares that ultimately vest can range from 0% to 125% of the stock awards granted depending 
on the level of achievement of the performance criteria. 

Certain of the Company's employee stock awards vest only upon the achievement of a market condition where the measurement 
period is three years and vesting of the awards is based on the Company's level of attainment of a specified total stockholder return 
relative  to  the  percentage  appreciation  of  a  specified  index  of  companies  for  the  respective  three-year  measurement  period. 
Compensation expense for awards with market conditions is recognized over the service period, which is generally four years, 
and the actual achievement of the market condition does not impact  expense recognition. The Company  uses a Monte Carlo 
valuation model to estimate the grant date fair value of such awards. Depending on the results achieved during the three-year 
measurement period, the number of shares that ultimately vest may range from 0% to 150% of the stock awards granted. The 
expected volatility of the Company's common stock at the date of grant was estimated based on a historical average volatility rate 
for the approximate three-year performance period and for awards granted in 2019, the expected weighted average volatility was 
45.2%. The risk-free interest rate assumption was based on observed interest rates consistent with the approximate three-year 
measurement period, and for awards granted in 2019 the weighted average risk free interest rate was 2.4%. 

For all share-based awards with graded vesting other than performance conditioned awards, the Company records compensation 
expense for the entire award on a straight-line basis (or, if applicable, on the accelerated method) over the requisite service period. 
For performance conditioned awards, total compensation expense is recognized over the requisite service period for each separately 
vesting tranche of the award as if the award is, in substance, multiple awards once the performance condition is deemed probable 
of achievement. Performance conditions are evaluated quarterly. If such conditions are not ultimately met or it is not probable the 
conditions will be achieved, no compensation expense for performance conditioned awards is recognized and any  previously 
recognized compensation expense is reversed.

86

Income Taxes

The Company accounts for income taxes under the asset and liability approach which requires recognition of deferred tax assets 
and liabilities for the differences between the financial reporting and tax basis of assets and liabilities using the tax rates in effect 
for the year in which the differences are expected to affect taxable income. A valuation allowance reduces deferred tax assets when 
it is more likely than not that some portion or all of the deferred tax assets will not be realized. When it is determined that it is 
more likely than not that the Company will be able to realize deferred tax assets in the future in excess of the net recorded amount, 
an adjustment to the deferred tax asset is made and reflected in income. This determination is made by considering various factors, 
including the reversal and timing of existing temporary differences, tax planning strategies, and estimates of future taxable income 
exclusive of the reversal of temporary differences. 

Fair Value of Financial Instruments

Fair value measurements are based on a three-level valuation hierarchy for disclosure of fair value measurements. The valuation 
hierarchy is based upon the transparency of inputs to the valuation of an asset or liability as of the measurement date. Categorization 
within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The three 
levels are defined as follows:

Level 1 – quoted prices (unadjusted) for identical assets or liabilities in active markets;
Level 2 – quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar instruments in 
markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable 
in active markets; and 
Level 3 – fair value measurements derived from valuation techniques in which one or more significant inputs or significant value 
drivers are unobservable.

Cash, Cash Equivalents, and Restricted Cash

Cash, cash equivalents, and restricted cash are reflected in the accompanying consolidated balance sheets at amounts considered 
by  management to reasonably  approximate fair value  due  to  their  short  maturity  of  90  days or  less.  Restricted  cash  consists 
principally of deposits required by certain lenders and lessors pursuant to the applicable agreement and consists of the following: 

(in thousands)

Current:

December 31,

2019

2018

Real estate tax and property insurance escrows

$

16,299

$

Replacement reserve escrows

Resident deposits

Other

Subtotal

Long term:

Insurance deposits

CCRCs escrows

Debt service reserve

Subtotal

Total

Marketable Securities

9,071

475

1,011

26,856

23,692

10,641

281

34,614

$

61,470

$

18,177

8,273

489

744

27,683

14,370

9,618

280

24,268

51,951

Marketable securities are investments in commercial paper and short-term corporate bond instruments with maturities of greater 
than 90 days as of their acquisition date by the Company. 

Accounts Receivable, Net

Accounts receivable are reported net of an allowance for credit losses to represent the Company's estimate of inherent losses at 
the balance sheet date. The allowance for credit losses was $7.8 million and $7.9 million as of December 31, 2019 and 2018, 

87

 
 
 
 
 
respectively. The adequacy of the Company's allowance for credit losses is reviewed on an ongoing basis, using historical payment 
trends, write-off experience, analyses of receivable portfolios by payor source and aging of receivables, as well as a review of 
specific accounts, and adjustments are made to the allowance as necessary. 

Billings for services under third-party payor programs are recorded net of estimated retroactive adjustments, if any. Retroactive 
adjustments are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods or as 
final settlements are determined. Contractual or cost related adjustments from Medicare or Medicaid are accrued when assessed 
(without regard to when the assessment is paid or withheld). Subsequent adjustments to these accrued amounts are recorded in 
net revenues when known. A reserve for estimated retroactive adjustments was $17.9 million and $16.9 million as of December 
31, 2019 and 2018, respectively. 

Assets Held for Sale

The Company designates communities as held for sale when certain criteria are met, including when management has committed 
to a plan to sell the community and the sale is probable within one year of the reporting date. The Company records these assets 
on the consolidated balance sheet at the lesser of the carrying amount and fair value less estimated selling costs. If the carrying 
amount is greater than the fair value less the estimated selling costs, the Company records an impairment charge. The Company 
evaluates the fair value of the assets held for sale each period to determine if it has changed. The long-lived assets are not depreciated 
while classified as held for sale. 

Property, Plant and Equipment and Leasehold Intangibles, Net

Property, plant and equipment and leasehold intangibles, net are recorded at cost. Depreciation and amortization is computed using 
the straight-line method over the estimated useful lives of the assets, which are as follows:

Asset Category

Buildings and improvements

Furniture and equipment

Resident lease intangibles

Estimated
Useful Life
(in years)

40

3 – 10

1 – 3

Expenditures for ordinary maintenance and repairs are expensed to operations as incurred. Renovations and improvements, which 
improve and/or extend the useful life of the asset, are capitalized and depreciated over the estimated useful life of the renovations 
or improvements. For communities subject to operating or financing leases, leasehold improvements are depreciated over the 
shorter of the estimated useful life of the assets or the term of the lease. For financing leases that have a purchase option the 
Company is reasonably certain to exercise, the leasehold improvements are depreciated over their estimated useful life. Facility 
operating expense excludes facility depreciation and amortization. 

Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of an 
asset group may not be recoverable. Recoverability of an asset group is assessed by comparing its carrying amount to the estimated 
future undiscounted net cash flows expected to be generated by the asset group through operation or disposition, calculated utilizing 
the lowest level of identifiable cash flows. If this comparison indicates that the carrying amount of an asset group is not recoverable, 
the Company is required to recognize an impairment loss. The impairment loss is measured by the amount by which the carrying 
amount of the asset exceeds its estimated fair value, with any amount in excess of fair value recognized as an expense in the current 
period. Undiscounted cash flow projections and estimates of fair value amounts are based on a number of assumptions such as 
revenue and expense growth rates, estimated holding periods, and estimated capitalization rates (Level 3). 

Investment in Unconsolidated Ventures

In accordance with ASC 810, Consolidation, the general partner or managing member of a venture consolidates the venture unless 
the limited partners or other members have either (1) the substantive ability to dissolve the venture or otherwise remove the general 
partner or managing member without cause or (2) substantive participating rights in significant decisions of the venture, including 
authorizing operating and capital decisions of the venture, including budgets, in the ordinary course of business. 

The initial carrying amount of investments in unconsolidated ventures is based on the amount paid to purchase the investment 
interest contributed to the unconsolidated ventures. The Company's reported share of earnings of an unconsolidated venture is 

88

adjusted for the impact, if any, of basis differences between its carrying amount of the equity investment and its share of the 
venture's underlying assets.

Distributions received from an investee are recognized as a reduction in the carrying amount of the investment. If distributions 
are received from an investee that would reduce the carrying amount of an equity method investment below zero, the Company 
evaluates the facts and circumstances of the distributions to determine the appropriate accounting for the excess distribution, 
including an evaluation  of the  source of  the  proceeds  and  implicit  or explicit  commitments to  fund  the  investee. The excess 
distribution is either recorded as a gain on investment, or in instances where the source of proceeds is from financing activities or 
the Company has a significant commitment to fund the investee, the excess distribution would result in an equity method liability 
and the Company would continue to record its share of the investee's earnings and losses. 

The Company evaluates realization of its investment in ventures accounted for using the equity method if circumstances indicate 
that the Company's investment is other than temporarily impaired. A current fair value of an investment that is less than its carrying 
amount may indicate a loss in value of the investment. If the Company determines that an equity method investment is other than 
temporarily impaired, it is recorded at its fair value with an impairment charge recognized in asset impairment expense for the 
difference between its carrying amount and fair value based on Level 3 inputs.

Goodwill and Intangible Assets

The Company tests goodwill for impairment annually during the fourth quarter or more frequently if indicators of impairment 
arise. Factors the Company considers important in its analysis of whether an indicator of impairment exists include a significant 
decline  in  the  Company's  stock  price  or  market  capitalization  for  a  sustained  period  since  the  last  testing  date,  significant 
underperformance relative to historical or projected future operating results, and significant negative industry or economic trends. 
The Company first assesses qualitative factors to determine if it is more likely than not that the fair value of a reporting unit is 
less than its carrying amount. If so, the Company performs a quantitative goodwill impairment test based upon a comparison of 
the estimated fair value of the reporting unit to which the goodwill has been assigned with the reporting unit's carrying amount. 
The fair values used in the quantitative goodwill impairment test are estimated using Level 3 inputs based upon discounted future 
cash flow projections for the reporting unit. These cash flow projections are based upon a number of estimates and assumptions 
such as revenue and expense growth rates, capitalization rates, and discount rates. The Company also considers market-based 
measures such as earnings multiples in its analysis of estimated fair values of its reporting units. If the quantitative goodwill 
impairment test results in a reporting unit's carrying amount exceeding its estimated fair value, an impairment charge will be 
recorded based on the difference, with the impairment charge limited to the amount of goodwill allocated to the reporting unit.

Acquired intangible assets are initially valued at fair market value using generally accepted valuation methods appropriate for the 
type of intangible asset. Intangible assets with definite lives are amortized over their estimated useful lives and all intangible assets 
are reviewed for impairment if indicators of impairment arise. The evaluation of impairment for definite-lived intangibles is based 
upon a comparison of the carrying amount of the asset to the estimated future undiscounted net cash flows expected to be generated 
by the asset (Level 3 input). If estimated future undiscounted net cash flows are less than the carrying amount of the asset, then 
the fair value of the asset is estimated. The impairment expense is determined by comparing the estimated fair value of the intangible 
asset to its carrying amount, with any shortfall from fair value recognized as an expense in the current period.

Indefinite-lived  intangible  assets  are not  amortized  but are  tested  for  impairment  annually  during  the  fourth  quarter  or  more 
frequently if indicators of impairment arise. The impairment test consists of a comparison of the estimated fair value using Level 
3 inputs of the indefinite-lived intangible asset with its carrying amount. If the carrying amount exceeds its fair value, an impairment 
charge is recognized for that difference.

Self-Insurance Liability Accruals

The Company is subject to various legal proceedings and claims that arise in the ordinary course of its business. Although the 
Company maintains general liability and professional liability insurance policies for its owned, leased, and managed communities 
under a master insurance program, the Company's current policies provide for deductibles for each and every claim. As a result, 
the Company is, in effect, self-insured for claims that are less than the deductible amounts. In addition, the Company maintains 
a high deductible workers compensation program and a self-insured employee medical program. 

The Company reviews the adequacy of its accruals related to these liabilities on an ongoing basis using historical claims, actuarial 
valuations, third-party administrator estimates, consultants, advice from legal counsel, and industry data, and adjusts accruals 
periodically. Estimated costs related to these self-insurance programs are accrued based on known claims and projected claims 
incurred but not yet reported. Subsequent changes in actual experience are monitored, and estimates are updated as information 
becomes available.

89

Treasury Stock

The Company accounts for treasury stock under the cost method and includes treasury stock as a component of stockholders' 
equity. 

Recently Adopted Accounting Pronouncements

In February 2016, the FASB issued ASU 2016-02, Leases ("ASU 2016-02"), which amends the former accounting principles for 
the recognition, measurement, presentation, and disclosure of leases for both lessees and lessors. ASU 2016-02 requires a lessee 
to recognize a right-of-use asset and a lease liability on the consolidated balance sheet for most leases. Additionally, ASU 2016-02 
made targeted changes to lessor accounting, including changes to align certain aspects with the revenue recognition model, and 
enhanced disclosure of lease arrangements. In July 2018, the FASB issued ASU 2018-11, Leases, Targeted Improvements ("ASU 
2018-11"), which provides entities with a transition method option to not restate comparative periods presented, but to recognize 
a cumulative-effect adjustment to the opening balance of retained earnings in the period of adoption, and a practical expedient 
allowing lessors to not separate nonlease components from the associated lease components when certain criteria are met. The 
Company adopted these lease accounting standards effective January 1, 2019 and utilized the modified retrospective transition 
method  with  no  adjustments  to  comparative  periods  presented. Additionally,  the  Company  elected  the  package  of  practical 
expedients within ASU 2016-02 that allows an entity to not reassess, as of January 1, 2019, its prior conclusions on whether an 
existing contract contains a lease, lease classification for existing leases, and whether costs incurred for existing leases qualify as 
initial  direct  costs. The  Company  did  not  elect  the  hindsight  practical  expedient  which  would  have  allowed  it  to  revisit  key 
assumptions, such as lease term, that were made when it originally entered into the lease. 

The Company's adoption of ASU 2016-02 resulted in the recognition of operating lease liabilities of $1.6 billion and right-of-use 
assets of $1.3 billion on the consolidated balance sheet for its existing community, office, and equipment operating leases based 
on the remaining  present  value of  the minimum  lease  payments  as  of  January  1, 2019. The  future  minimum lease payments 
recognized  on  the  consolidated  balance  sheet  included  fixed  payments  (including  in-substance  fixed  payments)  and  variable 
payments estimated utilizing the index or rate as of January 1, 2019. Such right-of-use asset amounts were recognized based upon 
the amount of the recognized lease liabilities, adjusted for accrued lease payments, intangible assets, and the recognition of right-
of-use asset impairments. As of December 31, 2018, the Company had a net liability of $231.4 million recognized on its consolidated 
balance sheet for accrued lease payments and intangible assets for operating leases. Additionally, $58.1 million of previously 
unrecognized right-of-use asset impairments were recognized as a cumulative effect adjustment to beginning accumulated deficit 
as of January 1, 2019. As a result of the Company's election of the package of practical expedients within ASU 2016-02, there 
were no changes to the classification of the Company's existing operating and financing leases as of January 1, 2019 and there 
were no changes to the amounts recognized on its consolidated balance sheet for its existing financing leases as of January 1, 
2019. Additionally, the application of ASU 2016-02 resulted in a $10.2 million increase to the amount of asset impairment expense 
recognized for operating lease right-of-use assets for the year ended December 31, 2019.

Subsequent to the adoption of ASU 2016-02, lessors are required to separately recognize and measure the lease component of a 
contract with a customer utilizing the provisions of ASC 842 and the nonlease components utilizing the provisions of ASC 606. 
To separately account for the components, the transaction price is allocated among the components based upon the estimated 
stand-alone selling prices of the components. Additionally, certain components of a contract which were previously included within 
the lease element recognized in accordance with ASC 840, Leases ("ASC 840") prior to the adoption of ASU 2016-02 (such as 
common area maintenance services, other basic services, and executory costs) are recognized as nonlease components subject to 
the provisions of ASC 606 subsequent to the adoption of ASU 2016-02. However, entities are permitted to elect the practical 
expedient under ASU 2018-11 allowing lessors to not separate nonlease components from the associated lease components when 
certain criteria are met. Entities that elect to utilize the lease/nonlease component combination practical expedient under ASU 
2018-11 upon initial application of ASC 842 are required to apply the practical expedient to all new and existing transactions 
within a class of underlying assets that qualify for the expedient as of the initial application date.

For the year ended December 31, 2018, the Company recognized revenue for housing services under independent living, assisted 
living, and memory care residency agreements in accordance with the provisions of the former lease accounting standard, ASC 
840, and the Company recognized revenue for assistance with activities of daily living ("ADLs"), memory care services, healthcare, 
and personalized health services under independent living, assisted living, and memory care residency agreements in accordance 
with the provisions of ASC 606.

Upon adoption of ASU 2016-02 and ASU 2018-11, the Company elected the lessor practical expedient within ASU 2018-11 and 
recognizes,  measures,  presents,  and  discloses  the  revenue  for  housing  services  under  the  Company's  senior  living  residency 

90

agreements based upon the predominant component, either the lease or nonlease component, of the contracts rather than allocating 
the consideration and separately accounting for it under ASC 842 and ASC 606. 

The nonlease components of the Company's independent living, assisted living, and memory care residency agreements are the 
predominant component of the contract for the Company's existing agreements as of January 1, 2019. As a result of the Company's 
election of the package of practical expedients within ASU 2016-02, the Company continued to recognize revenue for existing 
contracts as of December 31, 2018 over the lease term. In addition, ASU 2016-02 has changed the definition of initial direct costs 
of a lease, with the initial direct costs that are initially deferred and recognized over the term of the lease limited to costs that are 
both incremental and direct. The Company concluded that the contract origination costs recognized on the consolidated balance 
sheet as of December 31, 2018 were in excess of the initial direct costs that would have been deferred under the provisions of 
ASU 2016-02. As a result of the Company's election of the package of practical expedients, the contract origination costs recognized 
on the consolidated balance sheet as of December 31, 2018 continued to be amortized during 2019 over the lease term. Additionally, 
the Company concluded that certain costs previously deferred upon new contract origination are recognized within facility operating 
expense in 2019 as incurred.

In addition to the previously unrecognized right-of-use asset impairment of $58.1 million, the Company recognized cumulative 
effect adjustments to beginning accumulated deficit as of January 1, 2019 for the impact of the adoption of accounting standards 
by its equity method investees and the deferred tax impact of these adjustments. The recognition of the right-of-use assets and 
corresponding liabilities and the removal of the deferred tax position related to these leases as of December 31, 2018 had a $0.3 
million impact on the Company's net deferred tax position. A deferred tax asset of $14.1 million and an increase to the valuation 
allowance of $13.8 million was recorded against accumulated deficit reflecting the tax impact of the previously unrecognized 
right-of-use asset impairments.

The adoption of the new accounting standards resulted in the following adjustments to the Company's consolidated balance sheet 
as of January 1, 2019:

(in millions)

Assets

Prepaid expenses and other current assets, net

Property, plant and equipment and leasehold intangibles, net

Operating lease right-of-use assets

Investment in unconsolidated ventures

Other intangible assets, net

Other assets, net

Total assets

Liabilities and Equity

Refundable fees and deferred revenue

Operating lease obligations

Deferred liabilities

Other liabilities

Total liabilities

Total equity

Total liabilities and equity

$

$

$

$

67

(11)

1,329

(2)

(5)

(73)

1,305

43

1,618

(257)

(43)

1,361

(56)

1,305

In January 2017, the FASB issued ASU 2017-01, Business Combinations: Clarifying the Definition of a Business ("ASU 2017-01"), 
which clarifies the definition of a business to assist companies in determining whether transactions should be accounted for as an 
asset acquisition or a business combination. Under ASU 2017-01, if substantially all of the fair value of the assets acquired is 
concentrated in a single identifiable asset or a group of similar identifiable assets, the set is not a business and the transaction is 
accounted for as an asset acquisition. Transaction costs associated with asset acquisitions are capitalized while those associated 
with business combinations are expensed as incurred. The Company adopted ASU 2017-01 on a prospective basis on January 1, 
2018. The changes to the definition of a business may result in certain future acquisitions of real estate, communities, or senior 
housing operating companies being accounted for as asset acquisitions.

In November 2016, the FASB issued ASU 2016-18, Statement of Cash Flows: Restricted Cash, a consensus of the FASB Emerging 
Issues Task Force ("ASU 2016-18"), which intends to address the diversity in practice that exists in the classification and presentation 
91

of changes in restricted cash on the statement of cash flows. The amendments require that a statement of cash flows explain the 
change during the period in the total of cash, cash equivalents, and amounts generally described as restricted cash or restricted 
cash equivalents. The amendments are effective for fiscal years, and interim periods within those fiscal years, beginning after 
December 15, 2017. The Company adopted ASU 2016-18 on January 1, 2018 and the changes required by ASU 2016-18 were 
applied retrospectively to all periods presented. The Company has identified that the inclusion of the change in restricted cash 
within the retrospective presentation of the statements of cash flows resulted in a $1.0 million increase to the amount of net cash 
used in investing activities for the year ended December 31, 2017.

In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows – Classification of Certain Cash Receipts and Cash 
Payments ("ASU 2016-15"), which clarifies how cash receipts and cash payments in certain transactions are presented in the 
statement of cash flows. Among other clarifications on the classification of certain transactions within the statement of cash flows, 
the  amendments  in ASU 2016-15 provide that  debt  prepayment  and  extinguishment costs will  be  classified  within  financing 
activities within the statement of cash flows. ASU 2016-15 is effective for the Company for the fiscal years, and interim periods 
within those fiscal years, beginning after December 15, 2017. The Company adopted ASU 2016-15 on January 1, 2018 and the 
changes in classification within the statement of cash flows were applied retrospectively to all periods presented. The Company's 
retrospective application resulted in an $11.7 million increase to the amount of net cash provided by operating activities and an 
$11.7 million decrease to the amount of net cash provided by financing activities for the year ended December 31, 2017. 

In May 2014, the FASB issued ASU 2014-09, Revenue from Contracts with Customers ("ASU 2014-09"), which affects any entity 
that either enters into contracts with customers to transfer goods or services or enters into contracts for the transfer of nonfinancial 
assets. The five step model defined by ASU 2014-09 requires the Company to (i) identify the contracts with the customer, (ii) 
identify the performance obligations in the contract, (iii) determine the transaction price, (iv) allocate the transaction price to the 
performance obligations in the contract, and (v) recognize revenue when each performance obligation is satisfied. Revenue is 
recognized when promised goods or services are transferred to the customer in an amount that reflects the consideration expected 
in exchange for those goods or services. Additionally, ASU 2014-09 requires enhanced disclosure of revenue arrangements. ASU 
2014-09 may be applied retrospectively to each  prior period  (full  retrospective)  or retrospectively  with the cumulative effect 
recognized as of the date of initial application (modified retrospective). ASU 2014-09, as amended, was effective for the Company's 
fiscal year beginning January 1, 2018, and the Company adopted the new standard under the modified retrospective approach. 
Under the modified retrospective approach, the guidance is applied to the most current period presented, recognizing the cumulative 
effect of the adoption change as an adjustment to beginning retained earnings. The Company has determined that the adoption of 
ASU 2014-09 did not result in an adjustment to retained earnings as of January 1, 2018. 

The Company has determined that the application of ASU 2014-09 resulted in a change to the amounts of resident fee revenue 
and facility operating expense  with no  net impact to  the  amount  of  income  from  operations,  for  the  impact of implicit  price 
concessions on the estimation of the transaction price. The Company recognized $3.4 billion of resident fee revenue and $2.5 
billion of facility operating expense for the year ended December 31, 2018. The impact to resident fee revenue and facility operating 
expense as a result of applying ASC 606 was a decrease of $8.4 million for the year ended December 31, 2018.

The Company has determined that the application of ASU 2014-09 resulted in no significant change to the annual amount of 
revenue recognized for  management fees  under the Company's community management  agreements; however,  the  Company 
recognizes an estimated amount of incentive fee revenue earlier during the annual contract period. The Company has determined 
that the application of ASU 2014-09 resulted in a change to the amounts presented for revenue recognized for reimbursed costs 
incurred on behalf of managed communities and reimbursed costs incurred on behalf of managed communities with no net impact 
to the amount of income from operations, as a result of the combination of all community operations management activities as a 
single performance obligation for each contract. The Company recognized $1.0 billion of revenue for reimbursed costs incurred 
on behalf of managed communities and $1.0 billion of reimbursed costs incurred on behalf of managed communities for the year 
ended December 31, 2018, in accordance with ASU 2014-09. The impact to revenue for reimbursed costs incurred on behalf of 
managed communities and reimbursed costs incurred on behalf of managed communities as a result of applying ASC 606 was an 
increase of $46.1 million for the year ended December 31, 2018.

Additionally, real estate sales are within the scope of ASU 2014-09, as amended by ASU 2017-05, Other Income - Gains and 
Losses from the Derecognition of Nonfinancial Assets ("ASU 2017-05"), which clarifies the scope of subtopic 610-20 and adds 
guidance for partial sales of nonfinancial assets. Under ASU 2014-09 and ASU 2017-05, the income recognition for real estate 
sales is largely based on  the transfer of  control versus  continuing  involvement under  the former  guidance. As  a  result, more 
transactions may qualify as sales of real estate and gains or losses may be recognized sooner. The Company adopted ASU 2014-09, 
as amended by ASU 2017-05, under the modified retrospective approach as of January 1, 2018 and now applies the five step 
revenue model to all subsequent sales of real estate. 

92

Recently Issued Accounting Pronouncements Not Yet Adopted

In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial 
Instruments  ("ASU  2016-13"),  which  replaces  the  current  incurred  loss  impairment  methodology  for  credit  losses  with  a 
methodology that reflects expected credit losses and requires consideration of a broader range of reasonable  and  supportable 
information to inform credit loss estimates. The Company will be required to use a forward-looking expected credit loss model 
for accounts receivable and other financial instruments. ASU 2016-13 is effective for fiscal years, and interim periods within those 
fiscal years, beginning after December 15, 2019, with early adoption permitted for fiscal years beginning after December 15, 2018. 
The Company adopted ASU 2016-13 effective January 1, 2020 and will recognize any cumulative effect of the adoption as an 
adjustment to beginning retained earnings with no adjustments to comparative periods presented. The impact of the adoption of 
ASU 2016-13 did not have a material effect to its consolidated financial statements and disclosures.

Reclassifications

Certain prior period amounts have been reclassified to conform to the current financial statement presentation, with no effect on 
the Company's consolidated financial position or results of operations. 

3.       Earnings Per Share

Basic earnings per share ("EPS") is calculated by dividing net income (loss) by the weighted average number of shares of common 
stock  outstanding. Diluted  EPS  includes  the  components  of  basic  EPS  and  also  gives  effect  to  dilutive  common  stock 
equivalents. Under the treasury stock method, diluted EPS reflects the potential dilution that could occur if securities or other 
instruments that are convertible into common stock were exercised or could result in the issuance of common stock. Potentially 
dilutive common stock equivalents include unvested restricted stock, vested and unvested restricted stock units, and convertible 
debt instruments and warrants. 

During the years ended December 31, 2019, 2018, and 2017, the Company reported a consolidated net loss. As a result of the net 
loss, unvested restricted stock, restricted stock units, and convertible debt instruments and warrants were antidilutive for each year 
and were not included in the computation of diluted weighted average shares. The weighted average restricted stock and restricted 
stock units excluded from the calculations of diluted net loss per share were 7.5 million, 6.4 million, and 5.2 million for the years 
ended December 31, 2019, 2018, and 2017, respectively.

For the years ended December 31, 2018 and 2017, the calculation of diluted weighted average shares excludes the impact of 
conversion of the principal amount of $316.3 million of the Company's 2.75% convertible senior notes which were repaid in cash 
at their maturity on June 15, 2018. Refer to Note 9 for more information about the Company's former convertible notes. As of 
December 31, 2017, the maximum number of shares issuable upon conversion of the notes was approximately 13.8 million (after 
giving effect to additional make-whole shares issuable upon conversion in connection with the occurrence of certain events). As 
of December 31, 2017, the maximum number of shares issuable upon conversion of the notes in excess of the amount of principal 
that would be settled in cash was approximately 3.0 million. In addition, the calculation of diluted weighted average shares excludes 
the impact of the exercise of warrants to acquire the Company's common stock. As of December 31, 2018 and 2017, the number 
of shares issuable upon exercise of the warrants was approximately  0.5 million and 10.8  million, respectively. The option  to 
exercise the remaining outstanding warrants expired unexercised during 2019.

4.       Acquisitions, Dispositions, and Other Significant Transactions

During 2017 through 2019, the Company disposed of an aggregate of 39 owned communities (3 in 2017, 22 in 2018, and 14 in 
2019). The Company also entered into agreements with Welltower Inc. ("Welltower") and Ventas, Inc. ("Ventas") in 2018 and 
continued to execute on the transactions with Healthpeak Properties Inc. ("Healthpeak") (f/k/a HCP, Inc.) announced in 2016 and 
2017, which together restructured a significant portion of the Company's triple-net lease obligations with the Company's largest 
lessors. As a result of such transactions, as well as other lease expirations and terminations, the Company's triple-net lease obligations 
on 204 communities were terminated from 2017 to 2019 (105 in 2017, 89 in 2018, and 10 in 2019). During this period the Company 
also sold its ownership interests in eight unconsolidated ventures and acquired six communities that it previously leased or managed. 
As of December 31, 2019, the Company owned 330 communities, leased 333 communities, managed 17 communities for which 
the Company had an equity interest, and managed 83 communities on behalf of third parties. 

93

The following table sets forth the amounts included within the Company's consolidated financial statements for the 243 communities 
that it disposed through sales and lease terminations for the years ended December 31, 2019, 2018, and 2017 through the respective 
disposition dates: 

(in thousands)

Resident fees

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing resident fees

Facility operating expense

Independent Living

Assisted Living and Memory Care

CCRCs

Senior housing facility operating expense

Year Ended December 31,

2019

2018

2017

$

— $

81,280

$

20,891

33,189

54,080

—

18,249

34,128

52,377

256,038

53,215

390,533

48,154

187,411

50,971

286,536

152,190

476,677

113,493

742,360

90,134

336,314

103,130

529,578

178,187

Cash lease payments

$

1,694

$

84,041

$

As of December 31, 2019, three owned communities were classified as held for sale, resulting in $42.7 million being recorded as 
assets held for sale and $28.9 million of mortgage debt being included in the current portion of long-term debt within the consolidated 
balance sheet with respect to such communities. Two of such communities are in the CCRCs segment and one is in the Assisted 
Living and Memory Care segment. The closings of the various pending and expected transactions described below are, or will be, 
subject to the satisfaction of various closing conditions, including (where applicable) the receipt of regulatory approvals. However, 
there can be no assurance that the transactions will close or, if they do, when the actual closings will occur.

Completed Dispositions of Owned Communities

During the year ended December 31, 2019, the Company completed the sale of 14 owned communities for cash proceeds of $85.4 
million, net of transaction costs, and recognized a net gain on sale of assets of $5.5 million. The Company utilized a portion of 
the cash proceeds from the asset sales to repay approximately $5.1 million of associated mortgage debt and debt prepayment 
penalties. 

During the year ended December 31, 2018, the Company completed the sale of 22 owned communities for cash proceeds of $380.7 
million, net of transaction costs, and recognized a net gain on sale of assets of $188.6 million. The Company utilized a portion of 
the cash proceeds from the asset sales to repay approximately $174.0 million of associated mortgage debt and debt prepayment 
penalties. 

During the year ended December 31, 2017, the Company completed the sale of three owned communities for cash proceeds of 
$8.2 million, net of transaction costs. 

2019 Healthpeak CCRC Venture and Master Lease Transactions

On October 1, 2019, the Company entered into definitive agreements, including a Master Transactions and Cooperation Agreement 
(the "MTCA") and an Equity Interest Purchase Agreement (the "Purchase Agreement"), providing for a multi-part transaction 
with Healthpeak. The parties subsequently amended the agreements to include one additional entry fee CCRC community as part 
of the sale of the Company's interest in its unconsolidated entry fee CCRC Venture with Healthpeak (the "CCRC Venture") (rather 
than removing the CCRC from the CCRC Venture for joint marketing and sale). The components of the multi-part transaction 
include:

•  CCRC Venture Transaction. Pursuant to the Purchase Agreement, on January 31, 2020, Healthpeak acquired the Company's 
51% ownership interest in the CCRC venture, which held 14 entry fee CCRCs for a total purchase price of $295.2 million
(representing an aggregate valuation of $1.06 billion less portfolio debt, subject to a net working capital adjustment), 
which  remains  subject  to  a  post-closing  net  working  capital  adjustment. At  the  closing,  the  parties  terminated  the 
Company's existing management agreements  with  the 14  entry fee CCRCs, Healthpeak paid the Company a $100.0 
million management agreement termination fee, and the Company transitioned operations of the entry fee CCRCs to a 
new operator. Prior to the January 31, 2020 closing, the parties moved two entry fee CCRCs into a new unconsolidated 

94

venture on substantially the same terms as the CCRC Venture to accommodate the sale of such two communities at a 
future date.

•  Master Lease Transactions. Pursuant to the MTCA, on January 31, 2020, the parties amended and restated the existing 
master lease pursuant to which the Company continues to lease 25 communities from Healthpeak, and the Company 
acquired 18 communities from Healthpeak, at which time the 18 communities were removed from the master lease. At 
the closing, the Company paid $405.5 million to acquire such communities and to reduce its annual rent under the amended 
and restated master lease. The Company funded the community acquisitions with $192.6 million of non-recourse mortgage 
financing and the proceeds from the multi-part transaction. In addition, Healthpeak has agreed to transition one leased 
community to a successor operator. With respect to the continuing 24 communities, the Company's amended and restated 
master lease: (i) has an initial term to expire on December 31, 2027, subject to two extension options at the Company's 
election for ten years each, which must be exercised with respect to the entire pool of leased communities; (ii) the initial 
annual base rent for the 24 communities is $41.7 million and is subject to an escalator of 2.4% per annum on April 1st 
of each year; and (iii) Healthpeak has agreed to make available up to $35 million for capital expenditures for a five-year 
period related to the 24 communities at an initial lease rate of 7.0%.

The Company expects the sales of the two remaining entry fee CCRCs to occur over the next 15 months; however, there can be 
no assurance that the transactions will close or, if they do, when the actual closings will occur. Subsequent to these transactions, 
the Company will have exited substantially all of its entry fee CCRC operations.

2018 Welltower Lease and RIDEA Venture Restructuring

On June 27, 2018, the Company announced that it had entered into definitive agreements with Welltower. The components of the 
agreements include:

• 

Lease  Terminations. The  Company  and  Welltower  agreed  to  an  early  termination  of  the  Company's  triple-net  lease 
obligations on 37 communities effective June 30, 2018. The communities were part of two lease portfolios due to mature 
in 2020 (10 communities) and 2028 (27 communities). The Company paid Welltower an aggregate lease termination fee 
of $58.0 million. The Company agreed to manage the foregoing 37 communities on an interim basis until the communities 
have been transitioned to new managers, and such communities are reported in the Management Services segment during 
such interim period. The Company recognized a $22.6 million loss on lease termination during the year ended December 
31, 2018 for the amount by which the aggregate lease termination fee exceeded the net carrying amount of the Company's 
assets and liabilities under operating and financing leases as of the lease termination date. 

•  Future Lease Terminations. The parties separately agreed to allow the Company to terminate leases with respect to, and 
to remove from the remaining Welltower leased portfolio, a number of communities with annual aggregate base rent up 
to $5.0 million upon Welltower's sale of such communities, and the Company would receive a corresponding 6.25% rent 
credit on Welltower's disposition proceeds. As of December 31, 2019, no leases have been terminated in accordance with 
the agreement.

•  RIDEA Restructuring. The Company sold its 20% equity interest in its existing Welltower RIDEA venture to Welltower, 
effective June 30, 2018 for net proceeds of $33.5 million (for which the Company recognized a $14.7 million gain on 
sale). The Company agreed to continue to manage the communities in the venture on an interim basis until the communities 
have been transitioned to new managers, and such communities are reported in the Management Services segment during 
such interim period.

The Company also elected not to renew two master leases with Welltower which matured on September 30, 2018 (11 communities). 
The Company continues to operate 74 communities under triple-net leases with Welltower, and the Company's remaining lease 
agreements with Welltower contain a change of control standard that allows the Company to engage in certain change of control 
and other transactions without the need to obtain Welltower's consent, subject to the satisfaction of certain conditions. 

2018 Ventas Lease Portfolio Restructuring

On April 26, 2018, the Company entered into several agreements to restructure a portfolio of 128 communities it leased from 
Ventas as of such date, including a Master Lease and Security Agreement (the "Ventas Master Lease"). The Ventas Master Lease 
amended and restated prior leases comprising an aggregate portfolio of 107 communities into the Ventas Master Lease. Under the 
Ventas Master Lease and other agreements entered into on April 26, 2018, the 21 additional communities leased by the Company 
from Ventas pursuant to separate lease agreements have been or will be combined automatically into the Ventas Master Lease 
upon the first to occur of Ventas' election or the repayment of, or receipt of lender consent with respect to, mortgage debt underlying 
95

such communities, 18 of which have been and three will be combined into the Ventas Master Lease. The Company and Ventas 
agreed to observe, perform, and enforce such separate leases as if they had been combined into the Ventas Master Lease effective 
April 26, 2018, to the extent not in conflict with any mortgage debt underlying such communities. The transaction agreements 
with Ventas further provide that the Ventas Master Lease and certain other agreements between the Company and Ventas are 
subject to cross-default provisions.

The initial term of the Ventas Master Lease ends December 31, 2025, with two 10-year extension options available to the Company. 
In the event of the consummation of a change of control transaction of the Company on or before December 31, 2025, the initial 
term of the Ventas Master Lease will be extended automatically through December 31, 2029. The Ventas Master Lease and separate 
lease agreements with Ventas, which are guaranteed at the parent level by the Company, provided for total rent in 2018 of $175.0 
million for the 128 communities, including the pro-rata portion of an $8.0 million annual rent credit for 2018. The Company has 
received or will receive an annual rent credit of $8.0 million in 2019, $7.0 million in 2020, and $5.0 million thereafter; provided, 
that if a change of control of the Company occurs prior to 2021, the annual rent credit will be reduced to $5.0 million. Effective 
on January 1, 2019 and in succeeding years, the annual minimum rent is subject to an escalator equal to the lesser of 2.25% or 
four times the Consumer Price Index ("CPI") increase for the prior year (or zero if there was a CPI decrease). 

The Ventas Master Lease requires the Company to spend (or escrow with Ventas) a minimum of $2,000 per unit per 24-month 
period commencing with the 24-month period ended December 31, 2019 and thereafter each 24-month period ending December 
31 during the lease term, subject to annual increases commensurate with the escalator beginning with the second lease year of the 
first extension term (if any). If a change of control of  the Company occurs,  the Company will be required within 36  months 
following the closing of such transaction to invest (or escrow with Ventas) an aggregate of $30.0 million in the communities for 
revenue-enhancing capital projects. 

Under the definitive agreements with Ventas, the Company, at the parent level, must satisfy certain financial covenants (including 
tangible net worth and leverage ratios) and may consummate a change of control transaction without the need for consent of Ventas 
so long as certain objective conditions are satisfied, including the post-transaction guarantor's satisfying certain enhanced minimum 
tangible net worth and maximum leverage ratio, having minimum levels of operational experience and reputation in the senior 
living industry, and paying a change of control fee of $25.0 million to Ventas. 

Pursuant to the Ventas Master lease, the Company has exercised its right to direct Ventas to market for sale certain communities. 
Ventas is obligated to use commercially reasonable, diligent efforts to sell such communities on or before December 31, 2020 
(subject to extension for regulatory purposes); provided, that Ventas' obligation to sell any such community will be subject to 
Ventas' receiving a purchase price in excess of a mutually agreed upon minimum sale price and to certain other customary closing 
conditions. Upon any such sale, such communities will be removed from the Ventas Master Lease, and the annual minimum rent 
under the Ventas Master Lease will be reduced by the amount of the net sale proceeds received by Ventas multiplied by 6.25%. 
During 2019, seven of such communities were sold by Ventas and removed from the Ventas Master Lease, and the annual minimum 
rent under the Ventas Master Lease was prospectively reduced by $1.7 million. 

The Company estimated the fair value of each of the elements of the restructuring transactions. The fair value of the future lease 
payments is based upon historical and forecasted community cash flows and market data, including a management fee rate of 5% 
of revenue and a market supported lease coverage ratio (Level 3 inputs). The Company recognized a $125.7 million non-cash loss 
on lease modification in the year ended December 31, 2018, primarily for the extensions of the triple-net lease obligations for 
communities with lease terms that are unfavorable to the Company given current market conditions on the amendment date in 
exchange for modifications to the change of control provisions and financial covenant provisions of the community leases. 

2017 Healthpeak Multi-Part Transaction

On November 2, 2017, the Company announced that it had entered into a definitive agreement for a multi-part transaction with 
Healthpeak. As part of such transaction, the Company entered into an Amended and Restated Master Lease and Security Agreement 
("Former  Healthpeak  Master  Lease")  with  Healthpeak  effective  as  of  November  1,  2017. The  components  of  the  multi-part 
transaction include: 

•  Master Lease Transactions. The Company and Healthpeak amended and restated triple-net leases covering substantially 
all of the communities the Company leased from Healthpeak as of November 1, 2017 into the Former Healthpeak Master 
Lease.  During  the  year  ended  December  31,  2018,  the  Company  acquired  two  communities  formerly  leased  for  an 
aggregate  purchase  price  of  $35.4  million  and  leases  with  respect  to  33  communities  were  terminated,  and  such 
communities were removed from the Former Healthpeak Master Lease, which completed the terminations of leases as 
provided in the Former Healthpeak Master Lease. The Company agreed to manage communities for which leases were 
terminated on an interim basis until the communities were transitioned to new managers, and such communities are 

96

reported in  the Management  Services  segment  during  such  interim  period. As of  December 31,  2019,  the  Company 
continued to lease 43 communities pursuant to the terms of the Former Healthpeak Master Lease, which had the same 
lease rates and expiration and renewal terms as the applicable prior instruments, except that effective January 1, 2018, 
the Company received a $2.5 million annual rent reduction for two communities. The Former Healthpeak Master Lease 
also provides that the Company may engage in certain change in control and other transactions without the need to obtain 
Healthpeak's consent, subject to the satisfaction of certain conditions. 

•  RIDEA Ventures Restructuring. Pursuant to the multi-part transaction agreement, Healthpeak acquired the Company's 
10% ownership interest in one of the Company's RIDEA ventures with Healthpeak in December 2017 for $32.1 million
(for which the  Company  recognized a  $7.2  million gain on  sale)  and  the  Company's  10%  ownership  interest  in  the 
remaining RIDEA venture with Healthpeak in March 2018 for $62.3 million (for which the Company recognized a $41.7 
million gain on sale). The Company provided management services to 59 communities on behalf of the two RIDEA 
ventures as of November 1, 2017. Pursuant to the multi-part transaction agreement, the Company acquired one community 
for an aggregate purchase price of $32.1 million in January 2018 and three communities for an aggregate purchase price 
of  $207.4  million  in April  2018  and  retained  management  of  18  of  such  communities.  The  amended  and  restated 
management agreements for such 18 communities have a term set to expire in 2030, subject to certain early termination 
rights. In addition, Healthpeak was entitled to sell or transition operations and/or management of 37 of such communities. 
Management agreements for all 37 such communities were terminated by Healthpeak since November of 2017 (for which 
the Company recognized a $9.7 million non-cash management contract termination gain). 

The Company financed the foregoing community acquisitions with non-recourse mortgage financing and proceeds from the sales 
of its ownership interest in the unconsolidated ventures. See Note 9 for more information regarding the non-recourse first mortgage 
financing. 

In addition, the Company obtained future annual cash rent reductions and waived management termination fees in the multi-part 
transaction. As a result of the multi-part transaction, the Company reduced its lease liabilities by $9.7 million for the future annual 
cash rent reductions and recognized a $9.7 million deferred liability for the consideration received from Healthpeak in advance 
of the termination of the management agreements for the 37 communities. 

As a result of the modification of the remaining lease term for communities subject to leases (under ASC 840), the Company 
reduced the carrying amount of lease obligations and assets under leases by $145.6 million in 2017. During the year ended December 
31, 2018, the results and financial position of the 33 communities for which leases were terminated were deconsolidated from the 
Company prospectively upon termination of the lease obligations. The Company derecognized the $332.8 million carrying amount 
of the assets under financing leases and the $378.3 million carrying amount of financing lease obligations for 20 communities 
which were previously subject to sale-leaseback transactions in which the Company was deemed to have continuing involvement. 
The Company recognized a sale for these 20 communities and recorded a non-cash gain on sale of assets of $44.2 million for the 
year ended December 31, 2018. Additionally, the Company recognized a non-cash gain on lease termination of $1.5 million for 
the year ended December 31, 2018, for the derecognition of the net carrying amount of the Company's assets and liabilities under 
operating and financing leases at the lease termination date. 

Blackstone Venture

On March 29, 2017, the Company and affiliates of Blackstone Real Estate Advisors VIII L.P. (collectively, "Blackstone") formed 
a venture (the "Blackstone Venture") that acquired 64 senior housing communities for a purchase price of $1.1 billion. The Company 
had previously leased the 64 communities from Healthpeak under long-term lease agreements with a remaining average lease 
term of approximately 12 years. At the closing, the Blackstone Venture purchased the 64-community portfolio from Healthpeak 
subject to the existing leases, and the Company contributed its leasehold interests for 62 communities and a total of $179.2 million
in cash to purchase a 15% equity interest in the Blackstone Venture, terminate leases, and fund its share of closing costs. As of 
the formation date, the Company continued to operate two of the communities under lease agreements and began managing 60 
of the communities on behalf of the venture under a management agreement with the venture. Two of the communities were 
managed by a third party for the venture. The results and financial position of the 62 communities for which leases were terminated 
were deconsolidated from the Company prospectively upon formation of the Blackstone Venture. The Company accounted for 
the venture under the equity method of accounting. 

Initially,  the  Company  determined  that  the  contributed  carrying  amount  of  the  Company's  investment  was  $66.8  million, 
representing the amount by which the $179.2 million cash contribution exceeded the carrying amount of the Company's liabilities 
under operating and financing leases contributed by the Company net of the carrying amount of the assets under such operating 
and financing leases. However, the Company estimated  the fair value of its 15% equity  interest in the Blackstone Venture at 
inception to be $47.1 million (using Level 3 inputs). As a result, the Company recorded a $19.7 million charge within goodwill 
97

and asset impairment expense for the three months ended March 31, 2017 for the amount of the contributed carrying amount in 
excess of the estimated fair value of the Company's investment. 

During 2018, the Company recorded a $33.4 million non-cash impairment charge within goodwill and asset impairment expense 
to reflect the amount by which the carrying amount of the investment exceeded the estimated fair value (using Level 3 inputs).

Additionally, these transactions related to the Blackstone Venture required the Company to record a significant increase to the 
Company's existing tax valuation allowance, after considering the change in the Company's future reversal of estimated timing 
differences resulting from these transactions, primarily due to removing the deferred positions related to the contributed leases. 
During 2017, the Company recorded a provision for income taxes to establish an additional $85.0 million of valuation allowance 
against its federal and state net operating loss carryforwards and tax credits as the Company anticipates these carryforwards and 
credits will not be utilized prior to expiration. See Note 16 for more information about the Company's deferred income taxes.

During 2018, leases for the two communities owned by the Blackstone Venture were terminated and the Company sold its 15%
equity interest in the Blackstone Venture to Blackstone. The Company paid Blackstone an aggregate fee of $2.0 million to complete 
the multi-part transaction and recognized a $3.8 million gain on sale of assets for the amount by which the net carrying amount 
of the Company's assets and liabilities disposed of exceeded the aggregate transaction cost. 

Additional Healthpeak Lease Terminations

During the year ended December 31, 2017, triple-net leases with respect to 26 communities were terminated pursuant to agreements 
we  entered  into  with  Healthpeak  on  November  1,  2016. As  a  result  of  such  lease  terminations,  during  2017  the  Company 
derecognized the $145.3 million carrying value of the assets under financing leases and the $156.7 million carrying value of 
financing lease obligations for 21 communities which were previously subject to sale-leaseback transactions in which the Company 
was deemed to have continuing involvement for accounting purposes, and recorded an $11.4 million gain on sale of assets. 

5.       Fair Value Measurements

Cash, Cash Equivalents, and Restricted Cash

Cash, cash equivalents, and restricted cash are reflected in the accompanying consolidated balance sheets at amounts considered 
by management to reasonably approximate fair value due to their short maturity of 90 days or less.

Marketable Securities

As of December 31, 2019, marketable securities of $68.6 million are stated at fair value based on valuations provided by third-
party pricing services and are classified within Level 2 of the valuation hierarchy.

Interest Rate Derivatives

The Company's derivative assets include interest rate caps that effectively manage the risk above certain interest rates for a portion 
of the Company's variable rate debt. The derivative positions are valued using models developed internally  by the respective 
counterparty that use as their basis readily available observable market parameters (such as forward yield curves) and are classified 
within Level 2 of the valuation hierarchy. The Company considers the credit risk of its counterparties when evaluating the fair 
value of its derivatives. The following table summarizes the Company's interest rate cap instruments as of December 31, 2019: 

(in thousands)

Current notional balance

Weighted average fixed cap rate

Earliest maturity date

Latest maturity date

Estimated asset fair value (included in other assets, net at December 31, 2019)

Estimated asset fair value (included in other assets, net at December 31, 2018)

$ 1,272,486

4.70%

2020

2023

6

150

$

$

98

Debt

The Company estimates the fair value of its debt using a discounted cash flow analysis based upon the Company's current borrowing 
rate for debt with similar maturities and collateral securing the indebtedness. The Company had outstanding long-term debt with 
a  carrying  amount  of  approximately  $3.6  billion  as  of  both  December 31,  2019  and  2018.  Fair  value  of  the  long-term  debt 
approximates carrying amount in all periods presented. The Company's fair value of long-term debt disclosure is classified within 
Level 2 of the valuation hierarchy. 

Goodwill and Asset Impairment Expense

The following is a summary of goodwill and asset impairment expense.

(in millions)

Goodwill (Note 8)

Property, plant and equipment and leasehold intangibles, net (Note 7)

Operating lease right-of-use assets (Note 11)

Investment in unconsolidated ventures (Note 6)

Other intangible assets, net (Note 8)

Assets held for sale (Note 4)

Other assets

Goodwill and asset impairment

Goodwill

For the Years Ended December 31,

2019

2018

2017

$

— $

351.7

$

27.2

10.2

—

10.2

1.3

0.4

78.0

—

33.4

9.1

15.6

2.1

205.0

164.4

—

25.8

14.6

—

—

$

49.3

$

489.9

$

409.8

During the three months ended September 30, 2017, the Company identified qualitative indicators of impairment of goodwill, 
including a significant decline in the Company's stock price and market capitalization for a sustained period since the last testing 
date, significant underperformance relative to historical and projected operating results, and an increased competitive environment 
in the senior living industry. Based upon the Company's qualitative assessment, the Company performed an interim quantitative 
goodwill impairment test as of September 30, 2017, which included a comparison of the estimated fair value of each reporting 
unit to which the goodwill has been assigned with the reporting unit's carrying amount.

In estimating the fair value of the reporting units for purposes of the quantitative goodwill impairment test, the Company utilized 
an income approach, which included future cash flow projections that are developed internally. Any estimates of future cash flow 
projections necessarily involve predicting unknown future circumstances and events and require significant management judgments 
and estimates. In arriving at the cash flow projections, the Company considered its historic operating results, approved budgets 
and business plans, future demographic factors, expected growth rates, and other factors. In using the income approach to estimate 
the fair value of reporting units for purposes of its goodwill impairment test, the Company made certain key assumptions. Those 
assumptions include future revenues, facility operating expenses, and cash flows, including sales proceeds that the Company 
would receive upon a sale of the communities using estimated capitalization rates, all of which are considered Level 3 inputs in 
the valuation hierarchy. The Company corroborated the estimated capitalization rates used in these calculations with capitalization 
rates observable from recent market transactions. Future cash flows are discounted at a rate that is consistent with a weighted 
average cost of capital from a market participant perspective. The weighted average cost of capital is an estimate of the overall 
after-tax rate of return required by equity and debt holders of a business enterprise. The Company also considered market based 
measures such as earnings multiples in its analysis of estimated fair values of its reporting units. 

Based on the results of the Company's quantitative goodwill impairment test, the Company determined that the carrying amount 
of the Company's Assisted Living and Memory Care reporting  unit exceeded its estimated fair value by $205.0 million as of 
September 30, 2017. As a result, the Company recorded a non-cash impairment charge of $205.0 million to goodwill within the 
Assisted Living and Memory Care segment for the three months ended September 30, 2017. The Company concluded that the 
remaining goodwill for all reporting units was not impaired as of October 1, 2017 (the Company's annual measurement date) and 
as of December 31, 2017. 

During the three months ended March 31, 2018, the Company identified qualitative indicators of impairment of goodwill, including 
a significant decline in the Company's stock price and market capitalization for a sustained period during the three months ended 
March 31, 2018. As a result, the Company performed an interim quantitative goodwill impairment test as of March 31, 2018, 

99

which included a comparison of the estimated fair value of each reporting unit to which the goodwill has been assigned with the 
reporting  unit's carrying amount. In  estimating the fair value  of  the reporting  units  for  purposes of the quantitative  goodwill 
impairment  test,  the  Company  utilized  an  income  approach,  which  included  future  cash  flow  projections  that  are  developed 
internally. Based on the results of the Company's quantitative goodwill impairment test, the Company determined that the carrying 
amount of the Company's Assisted Living and Memory Care reporting unit exceeded its estimated fair value by more than the 
$351.7 million carrying amount as of March 31, 2018. As a result, the Company recorded a non-cash impairment charge of $351.7 
million to goodwill within the Assisted Living and Memory Care segment for the three months ended March 31, 2018. 

The Company concluded that the remaining goodwill for all reporting units was not impaired as of October 1, 2019 and 2018 (the 
Company's annual measurement date) and as of December 31, 2019 and 2018. Goodwill allocated to the Company's Independent 
Living and Health Care Services reporting units is approximately $27.3 million and $126.8 million, respectively, as of December 31, 
2019 and 2018. 

Determining the fair value of the Company's reporting units involves the use of significant estimates and assumptions that are 
unpredictable and inherently uncertain. These estimates and assumptions include revenue and expense growth rates and operating 
margins used to calculate projected future cash flows and risk-adjusted discount rates. Future events may indicate differences from 
management's current judgments and estimates which could, in turn, result in future impairments. Future events that may result 
in impairment charges include differences in the projected occupancy rates or monthly service fee rates, changes in the cost structure 
of existing communities, changes in reimbursement rates from Medicare for healthcare services, and changes in healthcare reform. 
Significant adverse changes in the Company's future revenues and/or operating margins, significant changes in the market for 
senior housing or the valuation of the real estate of senior living communities, as well as other events and circumstances, including, 
but not limited to, increased competition, changes in reimbursement rates from Medicare for healthcare services, and changing 
economic or market conditions, including market control premiums, could result in changes in fair value and the determination 
that additional goodwill is impaired.

Property, Plant and Equipment and Leasehold Intangibles, Net

During the years ended December 31, 2019, 2018 and 2017, the Company evaluated property, plant and equipment and leasehold 
intangibles  for  impairment  and  identified  properties  with  a  carrying  amount  of  the  assets  in  excess  of  the  estimated  future 
undiscounted net cash flows expected to be generated by the assets. The Company compared the estimated fair value of the assets 
to their carrying amount for these identified properties and recorded an impairment charge for the excess of carrying amount over 
fair value. The Company recorded property, plant and equipment and leasehold intangibles non-cash impairment charges in its 
operating results of $27.2 million, $78.0 million, and $164.4 million for the years ended December 31, 2019, 2018, and 2017, 
respectively, primarily within the Assisted Living and Memory Care segment. 

The fair values of the property, plant and equipment of these communities were primarily determined utilizing a direct capitalization 
method  considering  stabilized  facility  operating  income  and  market  capitalization  rates.  These  fair  value  measurements  are 
considered Level 3 measurements within the valuation hierarchy. The range of capitalization rates utilized was 6.5% to 9.0%, 
depending upon the property type, geographical location, and the quality of the respective community. The Company corroborated 
the estimated fair values with a sales comparison approach with information observable from recent market transactions. These 
impairment charges are primarily due to lower than expected operating performance at these properties or the Company's decision 
to dispose of assets, either through sales or lease terminations, and reflect the amount by which the carrying amounts of the assets 
exceeded their estimated fair value. 

Investment in Unconsolidated Ventures

The Company evaluates realization of its investment in ventures accounted for using the equity method if circumstances indicate 
that the Company's investment is other than temporarily impaired. During the years ended December 31, 2018 and 2017, the 
Company  recorded  $33.4  million  and  $25.8  million,  respectively,  of  non-cash  impairment  charges  related  to  investments  in 
unconsolidated  ventures.  These  impairment  charges  are  primarily  due  to  lower  than  expected  operating  performance  at  the 
communities owned by the unconsolidated ventures and reflect the amount by which the carrying amounts of the investments 
exceeded their estimated fair value. Refer to Note 4 for more information about the impairment of the Blackstone Venture. During 
the year ended December 31, 2019, the Company did not record impairment expense related to its investment in unconsolidated 
ventures. 

Other Intangible Assets

During the years ended December 31, 2019, 2018, and 2017, the Company identified indicators of impairment for the Company's 
home health care licenses, primarily due to significant underperformance relative to historical and projected operating results, the 
100

impact of lower reimbursement rates from Medicare for home health care services, and an increased competitive environment in 
the  home  health care  industry. The  Company  performed  a  quantitative impairment  test, which  included  a  comparison  of  the 
estimated fair value of the Company's home health care licenses to the carrying amount. In estimating the fair value of the home 
health licenses for purposes of the quantitative impairment test, the Company utilized an income approach, which included future 
cash flow projections that are developed internally. Any estimates of future cash flow projections necessarily involve predicting 
unknown future circumstances and events and require significant management judgments and estimates. In arriving at the cash 
flow projections, the Company considered its historic operating results, approved budgets and business plans, future demographic 
factors, expected growth rates, and other factors, all of which are considered Level 3 inputs in the valuation hierarchy. Based on 
the results of the Company's quantitative impairment test, the Company determined that the carrying amount of certain of the 
Company's  home  health  care  licenses  exceeded  their  estimated  fair  value. As  a  result,  the  Company  recorded  a  non-cash 
impairment charge of $7.6 million, $9.1 million, and $14.6 million for the  years ended December 31, 2019, 2018, and 2017, 
respectively, to intangible assets within the Health Care Services segment.

Assets Held for Sale

During the years ended December 31, 2019 and 2018, the Company recognized $1.3 million and $15.6 million, respectively, of 
impairment charges related to assets held for sale. These impairment charges are primarily due to the excess of carrying amount 
over the estimated selling price less costs to dispose. The Company determines the fair value of the communities based primarily 
on purchase and sale agreements from prospective purchasers (Level 2 input). Refer to Note 4 for more information about the 
Company's community dispositions and assets held for sale.

Operating Lease Right-of-Use Assets

During the year ended December 31, 2019, the Company evaluated operating lease right-of-use assets for impairment and identified 
communities with a carrying amount of the assets in excess of the estimated future undiscounted net cash flows expected to be 
generated by the assets. The Company compared the estimated fair value of the assets to their carrying amount for these identified 
communities and recorded an impairment charge for the excess of carrying amount over fair value. As a result, the Company 
recorded a non-cash impairment charge of $10.2 million for the year ended December 31, 2019 to operating lease right-of-use 
assets, primarily within the Assisted Living and Memory Care segment. 

The Company's adoption of ASU 2016-02 resulted in the recognition of the right-of-use assets for the operating leases for 25
communities to be recognized on the consolidated balance sheet as of January 1, 2019 at the estimated fair value of $56.6 million, 
and $58.1 million of previously unrecognized right-of-use asset impairments were recognized as a cumulative effect adjustment 
to accumulated deficit as the Company determined that the long-lived assets of such communities were not recoverable as of such 
date. 

The fair value of the right-of-use assets was estimated utilizing a discounted cash flow approach based upon historical and projected 
community cash flows and market data, including management fees and a market supported lease coverage ratio, all of which are 
considered Level 3 inputs. The Company corroborated the estimated management fee rates and lease coverage ratios used in these 
estimates with management fee rates and lease coverage ratios observable from recent market transactions. The estimated future 
cash flows were discounted at a rate that is consistent with a weighted average cost of capital from a market participant perspective. 
See Note 2 for more information regarding the recognition of right-of-use assets for operating leases upon the adoption of ASU 
2016-02.

6.       Investment in Unconsolidated Ventures

As of December 31, 2019, the Company held a 51% equity interest, and Healthpeak owned a 49% interest, in the CCRC Venture, 
which owned and operated sixteen entry fee CCRCs. The Company's interests in the CCRC Venture were accounted for under the 
equity method of accounting. Refer to Note 4 for information on the Company's sale of the equity interest in the CCRC Venture 
on January 31, 2020. 

101

Summarized financial information of all unconsolidated ventures accounted for under the equity method was as follows (reflecting 
the period of the Company's ownership of an equity interest):

(in millions)
Statement of Operations Information

Resident fee revenue

Facility operating expense

Net income (loss)

(in millions)
Balance Sheet Information

Current assets

Noncurrent assets

Current liabilities

Noncurrent liabilities

For the Years Ended December 31,
2017
2018

2019

$

$

$

436
(330)

(9) $

$

793
(592)

(39) $

1,354
(946)
(81)

As of December 31,
2018
2019

$

$

68

$

1,100

537

735

$

66

1,148

563

715

During the year ended December 31, 2016, the CCRC Venture obtained non-recourse mortgage financing on certain communities 
and received proceeds of $434.5 million. The CCRC Venture distributed the net proceeds to its investors and the Company received 
proceeds of $221.6 million. As a result of the distribution, the Company's carrying amount of its equity method investment in the 
CCRC Venture property company was reduced below zero and the Company has recorded a $66.2 million and $56.6 million equity 
method liability within other liabilities within the consolidated balance sheets as of December 31, 2019 and 2018, respectively.

As of December 31, 2019, the CCRC Venture's operating company ("Opco") was identified as a VIE. As of December 31, 2019, 
the equity members of the CCRC Venture's Opco shared certain operating rights, and the Company acted as manager to the CCRC 
Venture Opco. However, the Company did not consolidate this VIE because it did not have the ability to control the activities that 
most significantly impact this VIE's economic performance. The assets of the CCRC Venture Opco primarily consisted of the 
CCRCs that it owned and leased, resident fees receivable, notes receivable, and cash and cash equivalents. The obligations of the 
CCRC Venture Opco primarily consisted of community lease obligations, mortgage debt, accounts payable, accrued expenses, 
and refundable entrance fees. 

The carrying amount of the Company's investment in unconsolidated venture and maximum exposure to loss as a result of the 
Company's involvement with the CCRC Venture's Opco was $14.3 million as of December 31, 2019. The Company is not required 
to provide financial support, through a liquidity arrangement or otherwise, to the CCRC Venture's Opco. 

Refer to Note 5 for information on impairment expense for investments in unconsolidated ventures. 

7.       Property, Plant and Equipment and Leasehold Intangibles, Net

As of December 31, 2019 and 2018, net property, plant and equipment and leasehold intangibles, which include assets under 
financing leases, consisted of the following: 

(in thousands)

Land

Buildings and improvements

Furniture and equipment

Resident and leasehold operating intangibles

Construction in progress

Assets under financing leases and leasehold improvements

Property, plant and equipment and leasehold intangibles

Accumulated depreciation and amortization

As of December 31,

2019

2018

$

450,894

$

455,623

4,790,769

4,749,877

859,849

317,111

80,729

805,190

477,827

57,636

1,847,493

1,776,649

8,346,845
(3,237,011)

8,322,802
(3,047,375)

Property, plant and equipment and leasehold intangibles, net

$

5,109,834

$

5,275,427

102

Assets under financing leases and leasehold improvements includes $0.6 billion and $0.7 billion of financing lease right-of-use 
assets, net of accumulated amortization, as of December 31, 2019 and 2018, respectively. Refer to Note 11 for further information 
on the Company's financing leases. 

Long-lived assets with definite useful lives are depreciated or amortized on a straight-line basis over their estimated useful lives 
(or, in certain cases, the shorter of their estimated useful lives or the lease term) and are tested for impairment whenever indicators 
of impairment arise. Refer to Note 5 for information on impairment expense for property, plant and equipment and leasehold 
intangibles. 

For the years ended December 31, 2019, 2018, and 2017, the Company recognized depreciation and amortization expense on its 
property, plant and equipment and leasehold intangibles of $377.6 million, $444.3 million, and $479.4 million, respectively.

8.       Goodwill and Other Intangible Assets, Net

The following is a summary of the carrying amount of goodwill presented on a reportable segment basis as of both December 31, 
2019 and 2018.

(in thousands)

Independent Living

Assisted Living and Memory Care

Health Care Services

Total

Gross
Carrying
Amount

Dispositions
and Other
Reductions

Accumulated
Impairment

Net

$

$

28,141

$

(820) $

— $

27,321

605,469

126,810

760,420

$

(48,817)

(556,652)

—
(49,637) $

—

(556,652) $

—

126,810

154,131

Refer to Note 5 for information on impairment expense for goodwill in 2018 and 2017.

The following is a summary of other intangible assets.

(in thousands)

Health care licenses

Trade names

Total

(in thousands)

Community purchase options

Health care licenses

Trade names

Management contracts

Total

December 31, 2019

Gross
Carrying
Amount

Accumulated
Amortization

Net

$

35,198

$

— $

35,198

27,800

62,998

(27,800)

(27,800)

—

35,198

December 31, 2018

Gross
Carrying
Amount

Accumulated
Amortization

Net

$

$

4,738

$

42,323

27,800

9,610

— $

—

(26,295)

(6,704)

4,738

42,323

1,505

2,906

84,471

$

(32,999) $

51,472

Amortization expense related to definite-lived intangible assets for the years ended December 31, 2019, 2018, and 2017 was $1.8 
million, $3.1 million, and $5.6 million, respectively. Health care licenses are indefinite-lived intangible assets and are not subject 
to amortization. Upon the adoption of ASC 842, the community purchase options were included within operating lease right-of-
use assets in the consolidated balance sheets. Refer to Note 5 for information on impairment expense for other intangible assets. 

103

9.       Debt

Long-term debt consists of the following:

(in thousands)

Mortgage notes payable due 2020 through 2047; weighted average interest rate of 4.72% in

2019, less debt discount and deferred financing costs of $17.0 million and $18.6 million as
of December 31, 2019 and 2018, respectively (weighted average interest rate of 4.75% in
2018)

Other notes payable, weighted average interest rate of 5.77% for the year ended December
31, 2019 (weighted average interest rate of 5.85% in 2018) and maturity dates ranging
from 2020 to 2021

Total long-term debt

Current portion

Total long-term debt, less current portion

December 31,

2019

2018

$

3,496,735

$

3,579,931

58,388

3,555,123

339,413

60,249

3,640,180

294,426

$

3,215,710

$

3,345,754

As of December 31, 2019 and 2018, the current portion of long-term debt within the Company's consolidated financial statements 
includes $28.9 million and $31.2 million, respectively, of mortgage notes payable secured by communities classified as held for 
sale. This debt is expected to be repaid with the proceeds from the sales. Refer to Note 4 for more information about the Company's 
assets held for sale. 

The annual aggregate scheduled maturities of long-term debt outstanding as of December 31, 2019 are as follows (in thousands):

Year Ending December 31,

2020

2021

2022

2023

2024

Thereafter

Total obligations

Less amount representing debt discount and deferred financing costs, net

Total

Credit Facilities

Long-term
Debt

$

341,802

335,541

323,581

233,159

297,916

2,040,122

3,572,121
(16,998)

$ 3,555,123

On December 5, 2018, the Company entered into a Fifth Amended and Restated Credit Agreement with Capital One, National 
Association, as administrative agent, lender and swingline lender and the other lenders from time to time parties thereto (the "Credit 
Agreement"). The Credit Agreement provides commitments for a $250 million revolving credit facility with a $60 million sublimit 
for letters of credit and a $50 million swingline feature. The Company has a one-time right under the Credit Agreement to increase 
commitments on the revolving credit facility by an additional $100 million, subject to obtaining commitments for the amount of 
such increase from acceptable lenders. The Credit Agreement provides the Company a one-time right to reduce the amount of the 
revolving credit commitments, and the Company may terminate the revolving credit facility at any time, in each case without 
payment of a premium or penalty. The Credit Agreement matures on January 3, 2024. Amounts drawn under the facility will bear 
interest at 90-day LIBOR plus an applicable margin. The applicable margin varies based on the percentage of the total commitment 
drawn, with a 2.25% margin at utilization equal to or lower than 35%, a 2.75% margin at utilization greater than 35% but less than 
or equal to 50%, and a 3.25% margin at utilization greater than 50%. A quarterly commitment fee is payable on the unused portion 
of the facility at 0.25% per annum when the outstanding amount of obligations (including revolving credit and swingline loans 
and letter of credit obligations) is greater than or equal to 50% of the revolving credit commitment amount or 0.35% per annum 
when such outstanding amount is less than 50% of the revolving credit commitment amount. 

104

The credit facility is secured by first priority mortgages on certain of the Company's communities. In addition, the Credit Agreement 
permits the Company to pledge the equity interests in subsidiaries that own other communities and grant negative pledges in 
connection therewith (rather than mortgaging such communities), provided that not more than 10% of the borrowing base may 
result from communities subject to negative pledges. Availability under the revolving credit facility will vary from time to time 
based on borrowing base calculations related to the appraised value and performance of the communities securing the credit facility 
and the Company's consolidated fixed charge coverage ratio. During 2019, the Company entered into an amendment to the Credit 
Agreement that provides for availability calculations to be made at additional consolidated fixed charge coverage ratio thresholds. 

The Credit Agreement contains typical affirmative and negative covenants, including financial covenants with respect to minimum 
consolidated fixed charge coverage and minimum consolidated tangible net worth. Amounts drawn on the credit facility may be 
used for general corporate purposes.

As of December 31, 2019, no borrowings were outstanding on the revolving credit facility, $41.9 million of letters of credit were 
outstanding, and the revolving credit facility had $172.5 million of availability. The Company also had a separate unsecured letter 
of credit facility providing for up to $47.5 million of letters of credit as of December 31, 2019 under which $47.5 million had been 
issued as of that date. 

2019 Financings

During the second quarter of 2019, the Company obtained $111.1 million of debt secured by the non-recourse first mortgages on 
14 communities. Sixty percent of the principal amount bears interest at a fixed rate of 4.52%, and the remaining forty percent of 
the principal amount bears interest at a variable rate equal to the 30-day LIBOR plus a margin of 223 basis points. The debt matures 
in June 2029. The $111.1 million of proceeds from the financing along with cash on hand were utilized to repay $155.5 million
of outstanding mortgage debt maturing in 2019. 

During the third quarter of 2019, the Company obtained $160.3 million of debt secured by the non-recourse first mortgages on 
five communities. Seventy-five percent of the principal amount bears interest at a fixed rate of 3.35%, and the remaining twenty-
five percent of the principal amount bears interest at a variable rate equal to the 30-day LIBOR plus a margin of 217 basis points. 
The debt matures in September 2029. The $160.3 million of proceeds from the financing were utilized to repay $139.2 million of 
outstanding mortgage debt maturing in 2020 and 2023.

During the year ended December 31, 2019, the Company recorded $5.2 million of debt modification and extinguishment costs on 
the consolidated statement of operations, primarily related to third party fees directly related to debt modifications.

2018 Financings

During the second quarter of 2018, the Company obtained $247.6 million of debt secured by the non-recourse first mortgages on 
11 communities. Sixty percent of the principal amount bears interest at a fixed rate of 4.55%, and the remaining forty percent of 
the principal amount bears interest at a variable rate equal to the 30-day LIBOR plus a margin of 189 basis points. The debt matures 
in May 2028. The $247.6 million of proceeds from the financing were primarily utilized to fund the acquisition of five communities 
from Healthpeak and to repay $43.0 million of outstanding mortgage debt scheduled to mature in May 2018. See Note 4 for more 
information regarding the acquisitions of communities from Healthpeak.

During the fourth quarter of 2018, the Company obtained $327.0 million of debt secured by the non-recourse first mortgages on 
28 communities. Sixty-five percent of the principal amount bears interest at a fixed rate of 5.08%, and the remaining thirty-five
percent of the principal amount bears interest at a variable rate equal to the 30-day LIBOR plus a margin of 216 basis points. The 
debt  matures in  December  2028. The $327.0  million of  proceeds  from  the  financing  were utilized  to  repay  $60.4 million  of 
outstanding mortgage debt scheduled to mature on January 1, 2019.

During  the  fourth  quarter  of  2018,  the  Company  repaid  $307.4  million  of  outstanding  principal  balance  on  11  existing  loan 
portfolios. The Company repaid $171.4 million to facilitate the sale of communities classified as assets  held for sale and the 
remaining repayments were primarily to facilitate the release of communities from their existing loan portfolios so that they could 
be added to the collateral pool for the Company's credit facility which was refinanced in December 2018. 

During the year ended December 31, 2018, the Company recorded $11.7 million of debt modification and extinguishment costs 
on the consolidated statement of operations, primarily related to third party fees directly related to debt modifications.

105

Convertible Debt

In June 2011, the Company completed a registered offering of $316.3 million aggregate principal amount of 2.75% convertible 
senior notes due June 15, 2018 (the "Notes"). The Company repaid $316.3 million in cash to settle the Notes at their maturity on 
June 15, 2018. 

Financial Covenants

Certain of the Company's debt documents contain restrictions and financial covenants, such as those requiring the Company to 
maintain prescribed minimum net worth and stockholders' equity levels and debt service ratios, and requiring the Company not 
to exceed prescribed leverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community, and/or 
entity basis. In addition, the Company's debt documents generally contain non-financial covenants, such as those requiring the 
Company to comply with Medicare or Medicaid provider requirements. 

The  Company's  failure  to  comply  with  applicable  covenants  could  constitute  an  event  of  default  under  the  applicable  debt 
documents. Many of the Company's debt documents contain cross-default provisions so that a default under one of these instruments 
could cause a default under other debt and lease documents (including documents with other lenders or lessors). Furthermore, the 
Company's debt is secured by its communities and, in certain cases, a guaranty by the Company and/or one or more of its subsidiaries. 

As of December 31, 2019, the Company is in compliance with the financial covenants of its outstanding debt agreements.

10.       Accrued Expenses

Accrued expenses consist of the following: 

(in thousands)

Salaries and wages

Insurance reserves

Vacation

Real estate taxes

Interest

Accrued utilities

Taxes payable

Other

Total

11.       Leases

As of December 31,

2019

2018

$

86,476

$

63,230

37,415

25,979

16,196

7,601

1,360

28,446

88,425

61,150

37,109

25,302

15,458

8,883

2,782

59,118

$

266,703

$

298,227

As of December 31, 2019, the Company operated 333 communities under long-term leases (242 operating leases and 91 financing 
leases). The substantial majority  of the Company's lease  arrangements  are structured  as  master leases.  Under a  master  lease, 
numerous communities are leased through an indivisible lease. The Company typically guarantees the performance and lease 
payment obligations of its subsidiary lessees under the master leases. An event of default related to an individual property or 
limited number of properties within a master lease portfolio may result in a default on the entire master lease portfolio. 

The leases relating to these communities are generally fixed rate leases with annual escalators that are either fixed or based upon 
changes in the consumer price index or the leased property revenue. The Company is responsible for all operating costs, including 
repairs, property taxes, and insurance. As of December 31, 2019, the weighted average remaining lease term of the Company's 
operating and financing leases was 6.9 and 8.4 years, respectively. The leases generally provide for renewal or extension options 
from 5 to 20 years and in some instances, purchase options. For accounting purposes, renewal or extension options are included 
in the lease term when it is reasonably certain that the Company will exercise the option. Generally, renewal or extension options 
are not included in the lease term for accounting purposes. 

The  community  leases  contain  other  customary  terms,  which  may  include  assignment  and  change  of  control  restrictions, 
maintenance and capital expenditure obligations,  termination provisions, and financial covenants, such as  those requiring the 
Company to maintain prescribed minimum net worth and stockholders' equity levels and lease coverage ratios, and not to exceed 

106

prescribed leverage ratios, in each case on a consolidated, portfolio-wide, multi-community, single-community and/or entity basis. 
In addition, the Company's lease documents generally contain non-financial covenants, such as those requiring the Company to 
comply with Medicare or Medicaid provider requirements. 

The  Company's  failure  to  comply  with  applicable  covenants  could  constitute  an  event  of  default  under  the  applicable  lease 
documents. Many of the Company's lease documents contain cross-default provisions so that a default under one of these instruments 
could cause a default under other lease and debt documents (including documents with other lenders and lessors). Certain leases 
contain cure provisions, which generally allow the Company to post an additional lease security deposit if the required covenant 
is not met. Furthermore, the Company's leases are secured by its communities and, in certain cases, a guaranty by the Company 
and/or one or more of its subsidiaries.

As of December 31, 2019, the Company is in compliance with the financial covenants of its long-term leases.

A summary of operating and financing lease expense (including the respective presentation on the consolidated statements of 
operations) and cash flows from leasing transactions is as follows: 

Operating Leases (in thousands)

Facility operating expense

Facility lease expense

Operating lease expense

Operating lease expense adjustment (1)
Changes in operating lease assets and liabilities for lessor capital expenditure reimbursements

Operating cash flows from operating leases

Non-cash recognition of right-of-use assets obtained in exchange for new operating lease obligations

Year Ended
December 31, 2019

$

$

$

18,677

269,666

288,343

19,453

(31,305)

276,491

28,846

(1) Represents the difference between cash paid and expense recognized. See Note 2 for the Company's accounting policy on 

the recognition of lease expense. 

Financing Leases (in thousands)

Depreciation and amortization

Interest expense: financing lease obligations

Financing lease expense

Operating cash flows from financing leases

Financing cash flows from financing leases

Changes in financing lease assets and liabilities for lessor capital expenditure reimbursement

Total cash flows from financing leases

Year Ended
December 31, 2019

$

$

$

$

46,646

66,353

112,999

66,353

22,242
(3,504)

85,091

A summary of facility lease expense and the impact of operating lease expense adjustment, under ASC 840, and deferred gains 
are as follows:

(in thousands)

Cash basis payment - operating leases

Operating lease expense adjustment

Amortization of deferred gain

Facility lease expense

For the Years Ended December 31,

2018

2017

$

$

324,870

$

(17,218)

(4,358)

303,294

$

365,077

(20,990)

(4,366)

339,721

As of December 31, 2019, the weighted average discount rate of the Company's operating and financing leases was 8.6% and 
7.9%, respectively. As the Company's community leases do not contain an implicit rate, the Company utilized its incremental 
107

borrowing rate based on information available on January 1, 2019 (the date of the adoption of ASC 842) to determine the present 
value of lease payments for operating leases that commenced prior to that date. 

The aggregate amounts of future minimum lease payments, including community, office, and equipment leases, recognized on 
the consolidated balance sheet as of December 31, 2019 are as follows (in thousands): 

Year Ending December 31,

2020

2021

2022

2023

2024

Thereafter

Total lease payments

Purchase option liability and non-cash gain on future sale of property

Imputed interest and variable lease payments

Total lease obligations

Operating
Leases

Financing
Leases

$

313,106

$

298,505

294,513

290,175

277,329

528,969

2,002,597

—

84,858

85,917

87,120

88,460

90,297

335,039

771,691

556,667

(531,832)

(493,778)

$ 1,470,765

$

834,580

The aggregate amounts of future minimum operating lease payments, including community, office, and equipment leases, not 
recognized on the consolidated balance sheet under ASC 840 as of December 31, 2018 are as follows (in thousands):

Year Ending December 31,

Operating Leases

2019

2020

2021

2022

2023

Thereafter

Total lease payments

12.       Self-Insurance

$

310,340

307,493

290,661

291,113

285,723

786,647

$

2,271,977

The  Company  obtains  various  insurance  coverages,  including  general  and  professional  liability  and  workers  compensation 
programs, from commercial carriers at stated amounts as defined in the applicable policy. Losses related to deductible amounts 
are accrued based on the Company's estimate of expected losses plus incurred but not reported claims. 

As of December 31, 2019 and 2018, the Company accrued reserves of $155.8 million and $155.6 million, respectively, for these 
programs, of  which $92.5 million and $94.5 million is  classified as  long-term liabilities as  of  December 31,  2019  and 2018, 
respectively. As of December 31, 2019 and 2018, the Company accrued $22.7 million and $13.1 million, respectively, of estimated 
amounts receivable from the insurance companies under these insurance programs. During the years ended December 31, 2019, 
2018, and 2017, the Company reduced its estimate of the amount of accrued liabilities for these programs based on recent claims 
experience. The reduction in these accrued reserves decreased operating expenses by $11.3 million, $14.6 million, and $9.9 million, 
for the years ended December 31, 2019, 2018, and 2017, respectively. 

The Company has secured self-insured retention risk under workers' compensation programs with restricted cash deposits of $24.0 
million and $14.7 million as of December 31, 2019 and 2018, respectively. Letters of credit securing the programs aggregated to 
$55.6 million and $71.8 million as of December 31, 2019 and 2018, respectively. In addition, the Company also had deposits of 
$12.3 million and $13.7 million, as of December 31, 2019 and 2018, respectively, to fund claims paid under a high deductible, 
collateralized insurance policy. 

108

13.       Retirement Plans

The Company maintains a 401(k) retirement savings plan for all employees that meet minimum employment criteria. Such plan 
provides that the participants may defer eligible compensation subject to certain Internal Revenue Code maximum amounts. The 
Company makes matching contributions in amounts equal to 25.0% of the employee's contribution to such plan, for contributions 
up  to  a  maximum  of  4.0%  of  compensation. An  additional  matching  contribution  of  12.5%,  subject  to  the  same  limit  on 
compensation, may be made at the  discretion  of  the  Company  based  upon  the Company's performance.  For the years ended 
December 31, 2019, 2018, and 2017, the Company's expense for such plan was $8.0 million, $8.3 million, and $10.1 million, 
respectively. 

14.       Stock-Based Compensation

The following table sets forth information about the Company's restricted stock awards (excluding restricted stock units): 

(share amounts in thousands, except value per share)

Outstanding on January 1, 2017

Granted

Vested

Cancelled/forfeited

Outstanding on December 31, 2017

Granted

Vested

Cancelled/forfeited

Outstanding on December 31, 2018

Granted

Vested

Cancelled/forfeited

Outstanding on December 31, 2019

Number of
Shares

4,608

$

2,569
(1,276)
(1,131)

4,770

3,880
(1,579)
(1,315)

5,756

4,381
(1,571)
(1,314)

7,252

Weighted
Average
Grant Date
Fair Value

20.29

14.65

22.20

18.95

17.13

9.39

19.12

13.19

11.78

7.81

13.71

11.18

9.08

As of December 31, 2019, there was $43.1 million of total unrecognized compensation cost related to outstanding, unvested share-
based compensation awards. That cost is expected to be recognized over a weighted average period of 2.5 years and is based on 
grant date fair value. 

During 2019, grants of restricted shares under the Company's 2014 Omnibus Incentive Plan were as follows:

(share amounts in thousands, except value per share)

Three months ended March 31, 2019

Three months ended June 30, 2019

Three months ended September 30, 2019

Three months ended December 31, 2019

Shares
Granted

Value Per
Share

Total Value

4,047

142

136

56

$

$

$

$

7.87

6.51

7.55

7.32

$

$

$

$

31,857

922

1,028

413

The Company has an employee stock purchase plan for all eligible employees. Under the plan, eligible employees of the Company 
can purchase shares of the Company's common stock on a quarterly basis at a  discounted price through accumulated payroll 
deductions. Each participating employee may elect to deduct up to 15% of his or her base pay each quarter and no more than 200 
shares may be purchased by a participating employee each quarter. Subject to certain limitations specified in the plan, on the last 
trading date of each calendar quarter, the amount deducted from each participant's pay over the course of the quarter will be used 
to purchase whole shares of the Company's common stock at a purchase price equal to 90% of the closing market price on the 
New York Stock Exchange on that date. The Company reserved 1,800,000 shares of common stock for issuance under the plan. 
The impact on the Company's consolidated financial statements is not material.

109

15.       Share Repurchase Program

On November 1, 2016, the Company announced that its Board of Directors had approved a share repurchase program that authorizes 
the Company to purchase up to $100.0 million in the aggregate of the Company's common stock. The share repurchase program 
is intended to be implemented through purchases made from time to time using a variety of methods, which may include open 
market purchases, privately negotiated transactions, or block trades, or by any combination of these methods, in accordance with 
applicable insider trading and other securities laws and regulations.

The size, scope, and timing of any purchases will be based on business, market, and other conditions and factors, including price, 
regulatory,  and  contractual  requirements  or  consents,  and  capital  availability.  The  repurchase  program  does  not  obligate  the 
Company to acquire any particular amount of common stock and the program may be suspended, modified, or discontinued at 
any time at the Company's discretion without prior notice. Shares of stock repurchased under the program will be held as treasury 
shares.

During the year ended December 31, 2019, the Company repurchased 3,005,554 shares at an average price paid per share of $6.56, 
for  an  aggregate  purchase  price  of  approximately  $19.7  million.  During  the  year  ended  December 31,  2018,  the  Company 
repurchased 1,280,802 shares at an average price paid per share of $6.64, for an aggregate purchase price of approximately $8.5 
million. No shares were purchased pursuant to this authorization during the year ended December 31, 2017. As of December 31, 
2019, approximately $62.1 million remains available under the share repurchase program. 

16.       Income Taxes

The benefit (provision) for income taxes is comprised of the following: 

(in thousands)

Federal:

Current

Deferred

Total Federal

State:

Current

Deferred (included in Federal above)

Total State

Total

For the Years Ended December 31,

2019

2018

2017

$

64

$

(113) $

2,654

2,718

(449)

—

(449)

52,367

52,254

(2,798)

—

(2,798)

2,200

15,310

17,510

(995)

—

(995)

$

2,269

$

49,456

$

16,515

A reconciliation of the benefit (provision) for income taxes to the amount computed at the U.S. Federal statutory rate of 21% for 
the years ended December 31, 2019 and 2018 and 35% for the year ended December 31, 2017, is as follows: 

(in thousands)

Tax benefit at U.S. statutory rate

State taxes, net of federal income tax

Valuation allowance

Goodwill impairment

Impact of the Tax Act

Stock compensation

Meals and entertainment

Tax credits

Other

Total

For the Years Ended December 31,

2019

2018

2017

$

56,742

$

121,320

$

205,777

10,423

(60,376)

—

—

(2,639)

(416)

(106)

(1,359)

21,576

5,713

(88,265)

(6,042)

(4,717)

(493)

688

(324)

$

2,269

$

49,456

$

24,891

(246,037)

(78,515)

114,716

(4,093)

(726)

1,908

(1,406)

16,515

110

Significant components of the Company's deferred tax assets and liabilities are as follows: 

(in thousands)

Deferred income tax assets:

Financing lease obligations

Operating lease obligations

Operating loss carryforwards

Deferred lease liability

Accrued expenses

Tax credits

Capital loss carryforward

Intangible assets

Other

Total gross deferred income tax asset

Valuation allowance

Net deferred income tax assets

Deferred income tax liabilities:

Property, plant and equipment

Operating lease right-of-use assets

Investment in unconsolidated ventures

Total gross deferred income tax liability

Net deferred tax liability

As of December 31,

2019

2018

$

156,913

$

165,703

406,172

330,983

—

54,154

50,356

40,723

11,160

8,098

1,058,559

(408,903)

649,656

(303,853)

(328,100)

(33,100)

(665,053)

—

298,255

63,263

61,309

50,462

41,413

10,133

2,872

693,410

(336,417)

356,993

(334,145)

—

(41,219)

(375,364)

$

(15,397) $

(18,371)

On December 22, 2017, the President signed into law the Tax Cuts and Jobs Act ("Tax Act"). The Tax Act reformed the United 
States corporate income tax code, including a reduction to the federal corporate income tax rate from 35% to 21% effective January 
1, 2018. The Tax Act also eliminated alternative minimum tax ("AMT") and the 20-year carryforward limitation for net operating 
losses incurred after December 31, 2017, and imposes a limit on the usage of net operating losses incurred after such date equal 
to 80% of taxable income in any given year. The 80% usage limit will not have an economic impact on the Company until its 
current net operating losses are either utilized or expired. In addition, the Tax Act limits the annual deductibility of a corporation's 
net interest expense unless it elects to be exempt from such deductibility  limitation under  the real property  trade or  business 
exception. The Company elected the real property trade or business exception with the 2018 tax return. As such, the Company 
will be required to apply the alternative depreciation system ("ADS") to all current and future residential real property and qualified 
improvement property assets. This change impacts the current and future tax depreciation deductions and impacted the Company's 
valuation allowance accordingly. Additional information that may affect the Company's provisional amounts would include further 
clarification and guidance on how the Internal Revenue Service will implement tax reform and further clarification and guidance 
on how state taxing authorities will implement tax reform and the related effect on the Company's state and local income tax 
returns, state and local net operating losses, and corresponding valuation allowances. 

A summary of the effect of the Tax Act is as follows: 

(in thousands)

Rate change - decrease in net deferred tax assets

Rate change - decrease in valuation allowance

Impact on net operating loss usage

Reduction of deferred tax asset - AMT credits

Total impact of the Tax Act on the Company's deferred taxes position

Realization of AMT credits

Net impact of the Tax Act on the Company's effective tax rate

111

For the Year Ended
December 31, 2017

$

$

108,070
(172,235)
(50,551)

2,361
(112,355)
(2,361)
(114,716)

As of both December 31, 2019 and 2018, the Company had federal net operating loss carryforwards generated in 2017 and prior 
of approximately $1.2 billion which are available to offset future taxable income from 2020 through 2037. Additionally, as of 
December 31, 2019 and 2018, the Company had federal net operating loss carryforwards generated after 2017 of $174.9 million
and $33.5 million, respectively, which have an indefinite life, but with usage limited to 80% of taxable income in any given year. 
The Company had capital loss carryforwards of $161.6 million as of December 31, 2019, which is available to offset future capital 
gains through 2023. The Company determined that a valuation allowance  was required after consideration of  the Company's 
estimated future reversal of  existing timing differences as  of  December 31,  2019 and 2018. The Company  does not consider 
estimates of future taxable income in its determination due to the existence of cumulative historical operating losses. For the year 
ended December 31,  2019,  the Company  recorded  a  provision  of  approximately  $60.4  million  from  operations  to reflect  the 
required valuation allowance of $408.9 million as of December 31, 2019. 

A summary of the change in the Company's valuation allowance is as follows: 

(in thousands)

For the Years Ended December 31,

2019

2018

Increase in valuation allowance before consideration of the Tax Act

$

60,376

$

(5,713)

Increase due to the adoption of ASC 842

Other decrease during the year

Total increase (decrease) in valuation allowance before consideration of the Tax Act

Impact of the Tax Act on net operating loss usage

Total increase (decrease) in valuation allowance

13,790

(1,680)

72,486

—

$

72,486

$

—

—

(5,713)

6,042

329

The  Company  has  recorded  valuation  allowances  of  $318.4  million  and  $245.3  million  as  of  December 31,  2019  and  2018, 
respectively, against its federal and state net operating losses. The Company has recorded a valuation allowance against its capital 
loss carryforward of $40.7 million and $41.4 million as of December 31, 2019 and 2018, respectively. In accordance with ASC 
740, Income Taxes, the Company has not considered the impact of the multi-part transaction with Healthpeak, including the sale 
of the Company's equity interest in the CCRC Venture, when determining the amount of valuation allowance to record against its 
net operating losses and capital loss carryforward as of December 31, 2019. The Company anticipates that the sale of its CCRC 
Venture will utilize all or a portion of the capital loss carryforward and a portion of its net operating losses. The Company also 
recorded a valuation allowance against federal and state credits of $49.8 million as of both December 31, 2019 and 2018. 

As of December 31, 2019 and 2018, the Company had gross tax affected unrecognized tax benefits of $18.3 million and $18.5 
million, respectively, of which, if recognized, would result in an income tax benefit recorded in the consolidated statement of 
operations. Interest and penalties related to these tax positions are classified as tax expense in the Company's consolidated financial 
statements. Total interest and penalties reserved is $0.1 million as of both December 31, 2019 and 2018. As of December 31, 2019, 
the Company's tax returns for years 2015 through 2018 are subject to future examination by tax authorities. In addition, the net 
operating losses from prior years are subject to adjustment under examination. The Company does not expect that unrecognized 
tax benefits for tax positions taken with respect to 2019 and prior years will significantly change in 2020. 

A reconciliation of the unrecognized tax benefits is as follows:

(in thousands)

Balance at January 1,

Additions for tax positions related to the current year

Reductions for tax positions related to prior years

Balance at December 31,

For the Years Ended December 31,

2019

2018

18,507

$

18,461

—
(181)

80
(34)

18,326

$

18,507

$

$

112

17.       Supplemental Disclosure of Cash Flow Information

(in thousands)
Supplemental Disclosure of Cash Flow Information:

Interest paid

Income taxes paid, net of refunds

Capital expenditures, net of related payables

Capital expenditures - non-development, net

Capital expenditures - development, net

Capital expenditures - non-development - reimbursable

Capital expenditures - development - reimbursable

Trade accounts payable

Net cash paid

Acquisition of assets, net of related payables and cash received:

Property, plant and equipment and leasehold intangibles, net

Other intangible assets, net

Financing lease obligations

Other liabilities

Net cash paid

Proceeds from sale of assets, net:

Prepaid expenses and other assets, net

Assets held for sale

Property, plant and equipment and leasehold intangibles, net

Investments in unconsolidated ventures

Long-term debt

Financing lease obligations

Refundable fees and deferred revenue

Other liabilities

Loss (gain) on sale of assets, net

Loss (gain) on facility lease termination and modification, net

Net cash received

Lease termination and modification, net:

Prepaid expenses and other assets, net

Property, plant and equipment and leasehold intangibles, net

Financing lease obligations

Deferred liabilities

Loss (gain) on sale of assets, net

Loss (gain) on facility lease termination and modification, net

Net cash paid (1)

Formation of the Blackstone Venture:

Prepaid expenses and other assets

Property, plant and equipment and leasehold intangibles, net

Investments in unconsolidated ventures

Financing lease obligations

Deferred liabilities

Other liabilities

Net cash paid

113

For the Years Ended December 31,
2017
2018

2019

244,469

1,534

$

$

260,706

2,058

$

$

294,758

1,038

235,797

$

182,249

$

186,467

24,595

34,809

—

8,891

304,092

44

453

—

—

$

$

24,687

12,165

1,709

4,663

8,823

18,054

8,132

(7,589)

225,473

$

213,887

237,563

$

(4,345)

36,120

2,433

—

5,196

—

—

497

$

271,771

$

5,196

(4,422) $

(4,950) $

(79,054)

(197,111)

(379)

(156)

—

—

—

(1,479)

(7,245)

—

(93,098)

(58,179)

—

93,514

8,632

1,139

(249,754)

—

(92,735) $

(499,807) $

— $

(2,804) $

—

—

—

—

—

(87,464)

58,099

70,835

(5,761)

34,283

— $

67,188

$

(17,072)

(20,952)

(155,723)

(52,548)

8,547

157,963

30,771

(1,058)

(19,273)

(1,162)

(70,507)

—

—

—

—

—

—

—

— $

— $

(8,173)

—

—

—

—

—

—

—

—

—

—

(768,897)

66,816

879,959

7,504

1,998

— $

— $

179,207

$

$

$

$

$

$

$

$

$

$

$

$

Supplemental Schedule of Non-Cash Operating, Investing and Financing Activities:

Purchase of treasury stock:

Treasury stock

Accounts payable

Net

Assets designated as held for sale:

Prepaid expenses and other assets, net

Assets held for sale

Property, plant and equipment and leasehold intangibles, net

Net

Lease termination and modification, net:

Prepaid expenses and other assets, net

Property, plant and equipment and leasehold intangibles, net

Financing lease obligations

Operating lease right-of-use assets

Operating lease obligations

Deferred liabilities

Other liabilities

Loss (gain) on sale of assets, net

Loss (gain) on facility lease termination and modification, net

$

$

$

$

$

— $

—

— $

4,244

$

(4,244)

— $

— $

(517) $

28,608

(28,608)

198,445

(197,928)

— $

— $

(636) $

(248) $

—

—

—

199

(29,544)

29,345

—

—

(132,733)

165,918

(145,645)

147,886

(1,963)

—

(10,698)

10,640

—

(731)

—

3,388

—

—

(122,304)

(620)

(37,731)

127,718

—

—

7,447

(9,688)

—

—

—

Net

$

— $

— $

(1) 

The net cash paid to terminate community leases is presented within the consolidated statements of cash flows based upon 
the lease classification of the terminated leases. Net cash paid of $54.6 million for the termination of operating leases is 
presented within net cash provided by operating activities and net cash paid of $12.5 million for the termination of financing 
leases is presented within net cash used in financing activities for the year ended December 31, 2018. 

During 2019, the Company and its venture partner contributed cash in an aggregate amount of $13.3 million to a consolidated 
venture which owns two senior housing communities, as of December 31, 2019. The Company obtained a $6.6 million promissory 
note receivable from its venture partner secured by a 50% equity interest in the venture in a non-cash exchange for the Company 
funding the $13.3 million aggregate contribution in cash. At the closing of the sale of a senior housing community during 2019 
by the consolidated venture, the consolidated venture distributed $6.3 million to the partners with the Company receiving a $3.1 
million repayment on the promissory note in a non-cash exchange. 

Refer to Note 2 for a schedule of the non-cash adjustments to the Company's consolidated balance sheet as of January 1, 2019 as 
a result of the adoption of new accounting standards and Note 11 for a schedule of the non-cash recognition of right-of-use assets 
obtained in exchange for new operating lease obligations. 

Restricted cash consists principally of escrow deposits for real estate taxes, property insurance, and capital expenditures required 
by  certain  lenders  under  mortgage  debt  agreements  and  deposits  as  security  for  self-insured  retention  risk  under  workers' 
compensation programs and property insurance programs. The following table provides a reconciliation of cash, cash equivalents, 
and restricted cash reported within the consolidated statement of cash flows that sums to the total of the same such amounts shown 
in the consolidated statement of cash flows.

(in thousands)

Reconciliation of cash, cash equivalents, and restricted cash:

Cash and cash equivalents

Restricted cash

Long-term restricted cash

Total cash, cash equivalents, and restricted cash shown in the consolidated

statements of cash flows

114

December 31,
2019

December 31,
2018

$

$

240,227

$

26,856

34,614

398,267

27,683

24,268

301,697

$

450,218

18.       Commitments and Contingencies

Litigation

The Company has been and is currently involved in litigation and claims, including putative class action claims from time to time, 
incidental to the conduct of its business which are generally comparable to other companies in the senior living and healthcare 
industries. Certain claims and lawsuits allege large damage amounts and may require significant costs to defend and resolve. As 
a result, the Company maintains general liability and professional liability insurance policies in amounts and with coverage and 
deductibles the Company believes are adequate, based on the nature and risks of its business, historical experience, and industry 
standards. The Company's current policies provide for deductibles for each claim. Accordingly, the Company is, in effect, self-
insured for claims that are less than the deductible amounts and for claims or portions of claims that are not covered by such 
policies. 

Similarly, the senior living and healthcare industries are continuously subject to scrutiny by governmental regulators, which could 
result in reviews, audits, investigations, enforcement activities, or litigation related to regulatory compliance matters. In addition, 
as a result of the Company's participation in the Medicare and Medicaid programs, the Company is subject to various governmental 
reviews, audits, and investigations, including but not limited to audits under various government programs, such as the Recovery 
Audit  Contractors  (RAC),  Zone  Program  Integrity  Contractors  (ZPIC),  and  Unified  Program  Integrity  Contractors  (UPIC) 
programs.  The  costs  to  respond  to  and  defend  such  reviews,  audits,  and  investigations  may  be  significant,  and  an  adverse 
determination could result in citations, sanctions, and other criminal or civil fines and penalties, the refund of overpayments, 
payment suspensions, termination of participation in Medicare and Medicaid programs, and/or damage to the Company's business 
reputation. 

Other

The Company has employment or letter agreements with certain officers of the Company and has adopted policies to which certain 
officers of the Company are eligible to participate, which grant these employees the right to receive a portion or multiple of their 
base salary, pro-rata bonus, bonus, and/or continuation of certain benefits, for a defined period of time, in the event of certain 
terminations of the officers' employment, as described in those agreements and policies. 

19.       Revenue

Disaggregation of Revenue

The Company disaggregates its revenue from contracts with customers by payor source, as the Company believes it best depicts 
how the nature, amount, timing, and uncertainty of its revenue and cash flows are affected by economic factors. Resident fee 
revenue by payor source and reportable segment is as follows:

(in thousands)

Private pay

Government reimbursement

Other third-party payor programs

Total resident fee revenue

(in thousands)

Private pay

Government reimbursement

Other third-party payor programs

Total resident fee revenue

$

$

$

$

Year Ended December 31, 2019

Independent
Living

542,112

2,446

—

Assisted Living
and Memory
Care
1,748,364

$

CCRCs

Health Care
Services

Total

$

281,197

$

753

$

2,572,426

67,574

—

81,054

39,924

357,963

88,544

509,037

128,468

544,558

$

1,815,938

$

402,175

$

447,260

$

3,209,931

Year Ended December 31, 2018

Independent
Living

596,852

3,125

—

Assisted Living
and Memory
Care
1,923,676

$

CCRCs

Health Care
Services

Total

$

288,682

$

693

$

2,809,903

72,175

—

87,028

40,698

359,881

76,401

522,209

117,099

599,977

$

1,995,851

$

416,408

$

436,975

$

3,449,211

115

The Company has not further disaggregated management fee revenues and revenue for reimbursed costs incurred on behalf of 
managed communities as the economic factors affecting the nature, timing, amount, and uncertainty of revenue and cash flows 
do not significantly vary within each respective revenue category. 

Contract Balances

The payment terms and conditions within the Company's revenue-generating contracts vary by contract type and payor source, 
although terms generally include payment to be made within 30 days.

Resident fee revenue for recurring and routine monthly services is generally billed monthly in advance under the Company's 
independent  living,  assisted  living,  and  memory  care  residency  agreements.  Resident  fee  revenue  for  standalone  or  certain 
healthcare services is generally billed monthly in arrears. Additionally, non-refundable community fees are generally billed and 
collected in advance or upon move-in of a resident under independent living, assisted living, and memory care residency agreements. 
Amounts  of  revenue  that  are  collected  from  residents  in  advance  are  recognized  as  deferred  revenue  until  the  performance 
obligations are satisfied. The Company had total deferred revenue (included within refundable fees and deferred revenue, deferred 
liabilities, and other liabilities within the consolidated balance sheets) of $72.5 million and $106.4 million, including $38.9 million
and $50.6 million of monthly resident fees billed and received in advance, as of December 31, 2019 and 2018, respectively. For 
the years ended December 31, 2019 and 2018, the Company recognized $94.6 million and $82.1 million, respectively, of revenue 
that was included in the deferred revenue balance as of January 1, 2019 and 2018, respectively. The Company applies the practical 
expedient in ASC 606-10-50-14 and does not disclose amounts for remaining performance obligations that have original expected 
durations of one year or less. 

For the years ended December 31, 2019 and 2018, the Company recognized $15.2 million and $17.6 million, respectively, of 
charges within facility operating expense within the consolidated statements of operations for additions to the allowance for credit 
losses.

20.       Segment Information

The Company has five reportable segments: Independent Living; Assisted Living and Memory Care; CCRCs; Health Care Services; 
and Management Services. Operating segments are defined as components of an enterprise that engage in business activities from 
which it may earn revenues and incur expenses; for which separate financial information is available; and whose operating results 
are regularly reviewed  by the chief operating  decision  maker  to  assess  the performance of  the  individual  segment  and  make 
decisions about resources to be allocated to the segment. 

Independent Living. The Company's Independent Living segment includes owned or leased communities that are primarily designed 
for middle to upper income seniors who desire an upscale residential environment providing the highest quality of service. The 
majority  of  the  Company's  independent  living  communities  consist of  both  independent  and  assisted  living  units  in  a  single 
community, which allows residents to age-in-place by providing them with a broad continuum of senior independent and assisted 
living services. 

Assisted  Living  and  Memory  Care. The  Company's  Assisted  Living  and  Memory  Care  segment  includes  owned  or  leased 
communities that offer housing and 24-hour assistance with ADLs to mid-acuity frail and elderly residents. Assisted living and 
memory care communities include both freestanding, multi-story communities and freestanding, single story communities. The 
Company also provides memory care services at freestanding memory care communities that are specially designed for residents 
with Alzheimer's disease and other dementias. 

CCRCs. The Company's CCRCs segment includes large owned or leased communities that offer a variety of living arrangements 
and services to accommodate all levels of physical ability and health. Most of the Company's CCRCs have independent living, 
assisted living, and skilled nursing available on one campus or within the immediate market, and some also include memory care 
services. 

Health Care Services. The Company's Health Care Services segment includes the home health, hospice, and outpatient therapy 
services, as well as education and wellness programs, provided to residents of many of the Company's communities and to seniors 
living outside of the Company's communities. The Health Care Services segment does not include the skilled nursing and inpatient 
healthcare services provided in the Company's skilled nursing units, which are included in the Company's CCRCs segment. 

Management Services. The Company's Management Services segment includes communities operated by the Company pursuant 
to management agreements. In some of the cases, the controlling financial interest in the community is held by third parties and, 
in  other  cases,  the  community  is  owned  in  a  venture  structure  in  which  the  Company  has  an  ownership  interest.  Under  the 
116

management agreements for these communities, the Company receives management fees as well as reimbursed expenses, which 
represent the reimbursement of expenses it incurs on behalf of the owners. 

The accounting policies of the Company's reportable segments are the same as those described in the summary of significant 
accounting policies in Note 2. 

The following table sets forth selected segment financial data: 

(in thousands)

Revenue:

Independent Living (1)
Assisted Living and Memory Care (1)
CCRCs (1)
Health Care Services (1)
Management Services (2)
Total revenue

Segment Operating Income (3):

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Management Services

Total segment operating income

General and administrative (including non-cash stock-based compensation

expense)

Facility lease expense:

Independent Living

Assisted Living and Memory Care

CCRCs

Corporate and Management Services

Depreciation and amortization:

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Corporate and Management Services

Goodwill and asset impairment:

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Corporate and Management Services

Loss (gain) on facility lease termination and modification, net

Income (loss) from operations

Total interest expense:

Independent Living

Assisted Living and Memory Care

117

For the Years Ended December 31,

2019

2018

2017

$

544,558

$

599,977

$

654,196

1,815,938

1,995,851

2,210,688

402,175

447,260

847,157

4,057,088

203,741

518,636

72,072

24,987

57,108

$

$

416,408

436,975

1,082,215

468,994

446,262

966,976

4,531,426

$

4,747,116

240,609

$

628,982

92,212

34,080

71,986

271,417

749,058

106,162

51,348

75,845

876,544

1,067,869

1,253,830

219,289

259,475

278,019

81,680

157,823

24,248

5,915

81,745

222,574

44,163

2,247

28,704

1,812

32,229

4,983

7,578

2,664

93,496

178,716

24,856

6,226

91,899

261,365

53,551

3,201

37,439

2,013

436,892

6,669

9,055

35,264

117,131

185,971

29,464

7,155

95,226

290,344

44,294

3,723

48,490

2,968

342,788

18,083

14,599

31,344

3,388
(44,498) $

162,001
(594,249) $

14,276
(270,045)

46,713

$

58,783

$

166,097

174,459

55,436

207,861

$

$

$

$

CCRCs

Health Care Services

Corporate and Management Services

Total capital expenditures for property, plant and equipment, and leasehold

intangibles:

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Corporate and Management Services

(in thousands)

Total assets:

Independent Living

Assisted Living and Memory Care

CCRCs

Health Care Services

Corporate and Management Services

Total assets

27,426

—

8,105

26,746

—

20,281

27,665

892

34,300

$

248,341

$

280,269

$

326,154

$

78,831

$

51,510

$

157,845

33,535

484

24,506

125,750

26,615

902

16,033

47,309

119,717

24,297

755

29,398

$

295,201

$

220,810

$

221,476

As of December 31,

2019

2018

$

1,441,652

$

1,104,774

4,157,610

3,684,170

742,809

256,715

595,647

707,819

254,950

715,547

$

7,194,433

$

6,467,260

(1)  All revenue is earned from external third parties in the United States.

(2)  Management services segment revenue includes reimbursements for which the Company is the primary obligor of costs 

incurred on behalf of managed communities.

(3)  Segment operating income is defined as segment revenues less segment facility operating expenses (excluding facility 

depreciation and amortization) and costs incurred on behalf of managed communities.

21.       Quarterly Results of Operations (Unaudited)

The following is a summary of quarterly results of operations for each of the fiscal quarters in 2019 and 2018:

(in thousands, except per share amounts)

Revenues

Goodwill and asset impairment

Loss (gain) on facility lease termination and
modification, net

Income (loss) from operations

Gain (loss) on sale of assets, net

Income (loss) before income taxes

Net income (loss)

Net income (loss) attributable to Brookdale Senior

Living Inc. common stockholders

Weighted average basic and diluted income (loss) per

share

March 31,
2019

For the Quarters Ended
June 30,
2019

September 30,
2019

December 31,
2019

$

1,042,044

$

1,019,457

$

1,008,949

$

986,638

391

209

16,661
(702)
(41,927)
(42,606)

3,769

1,797

2,211

2,846
(55,422)
(56,055)

2,094

43,012

—
(20,222)

579
(80,308)
(78,508)

1,382
(43,148)

4,522
(93,104)
(91,323)

(42,595)

(55,470)

(78,458)

(91,408)

$

(0.23) $

(0.30) $

(0.42) $

(0.49)

118

(in thousands, except per share amounts)

Revenues

March 31,
2018

For the Quarters Ended
June 30,
2018

September 30,
2018

December 31,
2018

$

1,187,234

$

1,155,200

$

1,120,062

$

1,068,930

Goodwill and asset impairment

430,363

16,103

Loss (gain) on facility lease termination and
modification, net

Income (loss) from operations

Gain (loss) on sale of assets, net

Income (loss) before income taxes

Net income (loss)

Net income (loss) attributable to Brookdale Senior

Living Inc. common stockholders

Weighted average basic and diluted income (loss) per

share

—

(413,831)

43,431

(441,649)

(457,234)

146,467

(137,589)

23,322

(181,055)

(165,509)

5,500

2,337

3,626

9,833

(54,903)

(37,140)

37,927

13,197

(46,455)

216,660

99,799

131,531

(457,188)

(165,488)

(37,121)

131,539

$

(2.45) $

(0.88) $

(0.20) $

0.70

119

SCHEDULE II
VALUATION AND QUALIFYING ACCOUNTS
December 31, 2019 
(In thousands)

Description

Accounts Receivable Allowance:

Year ended December 31, 2017
Year ended December 31, 2018 (1)
Year ended December 31, 2019

Deferred Tax Valuation Allowance:

Year ended December 31, 2017

Year ended December 31, 2018

Year ended December 31, 2019

Additions

Balance at
beginning of
period

Charged to
costs and
expenses

Charged
to other
accounts

Deductions

$

$

$

$

$

$

27,044

9,853

7,941

264,305

336,087

336,417

$

$

$

$

$

$

25,370

17,597

15,166

$

$

$

555

2,779

4,182

71,782 (2) $
330 (3) $
60,376 (4) $

—

—
$
13,790 (5) $

$

$

$

$

(29,857)
(22,288)
(19,476)

—

—
(1,680)

Balance at
end of
period

$

$

$

$

$

$

23,112

7,941

7,813

336,087

336,417

408,903

(1)  As a result of the Company's adoption of ASC 606 as of January 1, 2018, the revenue and related estimated uncollectible 
amounts owed to us by third-party payors that were historically classified as an allowance for doubtful accounts are now 
considered a price concession in determining net resident fees. Accordingly, the Company reports uncollectible balances due 
from third-party payors as a reduction of the transaction price and therefore, as a reduction in net resident fees. Historically 
these  amounts  were  classified  as  allowances  for  doubtful  accounts  and  charged  to  facility  operating  expense  within  the 
Company's consolidated statements of operations. This change in presentation resulted in a $13.3 million reduction in the 
balance as of the beginning of the period for the year ended December 31, 2018. 

(2)  Adjustment to valuation allowance for federal and state net operating losses of $294,568 partially offset by a reduction of 

$222,786 resulting from the Tax Act.

(3)  Reduction of valuation allowance for federal and state net operating losses and federal credits of $5,919 partially offset by 

additional valuation allowance for federal credits of $207 and adjustments resulting from the Tax Act of $6,042. 

(4)  Additional valuation allowance for federal and state net operating losses of $60,376.

(5)  Additional valuation allowance of $13,790 charged to accumulated deficit upon the adoption of ASC 842.

120

Item 9. 

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

None. 

Item 9A. 

Controls and Procedures

Evaluation of Disclosure Controls and Procedures

The Company maintains disclosure controls and procedures (as defined under Rules 13a-15(e) and 15d-15(e) of the Securities 
Exchange Act of 1934, as amended). Our management, under the supervision of and with the participation of our Chief Executive 
Officer and Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures. Based on such 
evaluation, our Chief Executive Officer and Chief Financial Officer each concluded that, as of December 31, 2019, our disclosure 
controls and procedures were effective. 

Management's Assessment of Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as defined in 
Exchange Act Rule 13a-15(f). Under the supervision and with the participation of our management, including our Chief Executive 
Officer and Chief Financial Officer, we conducted an evaluation of the effectiveness of our internal control over financial reporting 
based on the framework in Internal Control - Integrated Framework issued by the Committee of Sponsoring Organizations of the 
Treadway Commission (2013 framework). Because of its inherent limitations, internal control over financial reporting may not 
prevent or detect misstatements. Therefore, even those systems determined to be effective can only provide reasonable assurance 
with respect to financial statement preparation and presentation. 

Based on the Company's evaluation, management concluded that our internal control over financial reporting was effective as of 
December 31, 2019. Management reviewed the results of their assessment with our Audit Committee. The effectiveness of our 
internal control  over  financial reporting  as  of December 31,  2019  has  been  audited  by  Ernst  & Young  LLP,  the  independent 
registered public accounting firm that audited our consolidated financial statements included in this Annual Report on Form 10-
K, as stated in their report which is included in Item 8 of this Annual Report on Form 10-K and incorporated herein by reference. 

Internal Control Over Financial Reporting

There has not been any change in our internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 
15d-15(f) under the Exchange Act) during the fiscal quarter ended December 31, 2019 that has materially affected, or is reasonably 
likely to materially affect, our internal control over financial reporting. 

Item 9B. 

Other Information

None.

121

Item 10. 

Directors, Executive Officers and Corporate Governance

PART III

To the extent not set forth herein, the information required by this item is incorporated by reference from the discussions under 
the headings "Election of Directors," "Corporate Governance," and "Executive Officers" in our Definitive Proxy Statement for 
the 2020 Annual Meeting of Stockholders or in an amendment to this Annual Report on Form 10-K, to be filed with the SEC 
within 120 days of December 31, 2019. 

Our Board of Directors has adopted a Code of Business Conduct and Ethics that applies to all employees, directors, and officers, 
including our principal executive officer, our principal financial officer, our principal accounting officer or controller, or persons 
performing similar functions, as well as a Code of Ethics for Chief Executive and Senior Financial Officers, which applies to our 
President and Chief Executive Officer, Chief Financial Officer, Chief Accounting Officer, and Treasurer, both of which are available 
on our website at www.brookdale.com/investor. Any amendment to, or waiver from, a provision of such codes of ethics granted 
to a principal executive officer, principal financial officer, principal accounting officer or controller, or person performing similar 
functions, or to any executive officer or director, will be posted on our website. 

Item 11. 

Executive Compensation

The information required by this item is incorporated by reference from the discussions under the headings "Director Compensation" 
and "Executive Compensation" in our Definitive Proxy Statement for the 2020 Annual Meeting of Stockholders or in an amendment 
to this Annual Report on Form 10-K, to be filed with the SEC within 120 days of December 31, 2019. 

Item 12. 

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

To the extent not set forth herein, the information required by this item regarding security ownership of certain beneficial owners 
and management is incorporated by reference from the discussion under the heading "Security Ownership of Certain Beneficial 
Owners and Management" in our Definitive Proxy Statement for the 2020 Annual Meeting of Stockholders or in an amendment 
to this Annual Report on Form 10-K, to be filed with the SEC within 120 days of December 31, 2019.

The following table provides certain information as of December 31, 2019 with respect to our equity compensation plans (after 
giving effect to shares issued and/or vesting on such date):

Equity Compensation Plan Information

Number of securities to
be issued upon exercise
of outstanding options,
warrants and rights
(a) (1)

Weighted average
exercise price of
outstanding options,
warrants and rights
(b)

Number of securities
remaining available for
future issuance under
equity compensation
plans (excluding
securities reflected in
column (a))
(c)

—

—

—

—

—

—

11,497,326

35,936

11,533,262

Plan category

Equity compensation plans approved by 

security holders (2)

Equity compensation plans not approved 

by security holders (3)

Total

(1)  As of December 31, 2019, an aggregate of 7,252,459 shares of unvested restricted stock and an aggregate of 3,580 vested 
restricted stock units were outstanding under our 2014 Omnibus Incentive Plan. Pursuant to SEC guidance, such shares of 
restricted stock and restricted stock units are not reflected in the table above. Our 2014 Omnibus Incentive Plan allows awards 
to be made in the form of stock options, stock appreciation rights, restricted shares, restricted stock units, unrestricted shares, 
performance awards, and other stock-based awards.

(2)  The number of shares remaining available for future issuance under equity compensation plans approved by security holders 
consists of 11,042,465 shares remaining available for future issuance under our 2014 Omnibus Incentive Plan and 454,861
shares remaining available for future issuance under our Associate Stock Purchase Plan.

122

(3)  Represents  shares  remaining  available  for  future  issuance  under  our  Director  Stock  Purchase  Plan.  Under  the  existing 
compensation program for the members of our Board of Directors, each non-employee director has the opportunity to elect 
to receive either immediately vested shares or restricted stock units in lieu of up to 50% of his or her quarterly cash compensation. 
Any immediately vested shares that are elected to be received will be issued pursuant to the Director Stock Purchase Plan. 
Under the director compensation program, all cash amounts are payable quarterly in arrears, with payments to be made on 
April 1, July 1, October 1 and January 1. Any immediately vested shares that a director elects to receive under the Director 
Stock Purchase Plan will be issued at the same time that cash payments are made. The number of shares to be issued will be 
based on the closing price of our common stock on the date of issuance (i.e., April 1, July 1, October 1 and January 1), or if 
such date is not a trading date, on the previous trading day's closing price. Fractional amounts will be paid in cash. The Board 
of Directors initially reserved 100,000 shares of our common stock for issuance under the Director Stock Purchase Plan.

Item 13. 

Certain Relationships and Related Transactions, and Director Independence

The information required by this item is incorporated by reference from the discussions under the headings "Certain Relationships 
and  Related Transactions"  and  "Director  Independence"  in  our  Definitive  Proxy  Statement  for  the  2020 Annual  Meeting  of 
Stockholders or in an amendment to this Annual Report on Form 10-K, to be filed with the SEC within 120 days of December 31, 
2019. 

Item 14. 

Principal Accounting Fees and Services

The  information  required  by  this  item  is  incorporated  by  reference  from  the  discussion  under  the  heading  "Ratification  of 
Appointment of Independent Registered Public Accounting Firm for 2020" in our Definitive Proxy Statement for the 2020 Annual 
Meeting of Stockholders or in an amendment to this Annual Report on Form 10-K, to be filed with the SEC within 120 days of 
December 31, 2019. 

123

PART IV

Item 15.  

Exhibits, Financial Statement Schedules

The following documents are filed as part of this report:

1) 

Our Audited Consolidated Financial Statements

Report of the Independent Registered Public Accounting Firm

Report of the Independent Registered Public Accounting Firm

Consolidated Balance Sheets as of December 31, 2019 and 2018 

Consolidated Statements of Operations for the Years Ended December 31, 2019, 2018, and 2017 

Consolidated Statements of Equity for the Years Ended December 31, 2019, 2018, and 2017

Consolidated Statements of Cash Flows for the Years Ended December 31, 2019, 2018, and 2017 

Notes to Consolidated Financial Statements

Schedule II – Valuation and Qualifying Accounts

2) 

Exhibits:

Exhibit No.
3.1

Description
Amended and Restated Certificate of Incorporation of the Company, as amended (incorporated by reference 
to Exhibit 3.1 to the Company's Quarterly Report on Form 10-Q filed on November 5, 2019 (File No. 
001-32641)).

3.2

4.1

4.2

10.1.1

10.1.2

10.1.3

10.1.4

10.1.5

10.2.1

10.2.2

Amended and Restated Bylaws of the Company dated October 29, 2019 (incorporated by reference to Exhibit 
3.3 to the Company's Current Report on Form 8-K filed on October 29, 2019 (File No. 001-32641)).

Form of Certificate for common stock (incorporated by reference to Exhibit 4.1 to the Company's 
Registration Statement on Form S-1 (Amendment No. 3) filed on November 7, 2005 (File No. 333-127372)).

Description of the Company's common stock.

Amended and Restated Master Transactions and Cooperation Agreement dated effective as of October 1, 
2019, by and between the Company and HCP, Inc. (now known as Healthpeak Properties, Inc., 
("Healthpeak")).†

Equity Interest Purchase Agreement dated effective as of October 1, 2019, by and among certain subsidiaries 
of the Company and certain subsidiaries of Healthpeak, and the Company and Healthpeak for the limited 
purposes stated therein.†

Amendment No. 1 to Equity Interest Purchase Agreement dated as of October 29, 2019 by and among certain 
subsidiaries of the Company and certain subsidiaries of Healthpeak.

First Amendment to Amended and Restated Master Transactions and Cooperation Agreement dated as of 
January 31, 2020, by and among the Company and Healthpeak.

Amendment No. 2 to the Equity Interest Purchase Agreement dated as of January 31, 2020, by and among 
certain subsidiaries of the Company and certain subsidiaries of Healthpeak.

Master Lease and Security Agreement dated as of April 26, 2018 by and between certain of the Company's 
affiliates named therein as lessees and certain of the affiliates of Ventas, Inc. named therein as lessors (the 
"Master Lease") (incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q 
filed on August 7, 2018 (File No. 001-32641)).††

Amendment No. 1 effective September 1, 2018 to Master Lease by and between certain of the Company's 
affiliates named therein as lessees and certain of the affiliates of Ventas, Inc. named therein as lessors 
(incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q filed on 
November 6, 2018 (File No. 001-32641)).††

124

10.2.3

10.2.4

10.2.5

10.2.6

10.2.7

10.3.1

10.3.2

10.4

10.5

10.6.1

10.6.2

10.7

10.8

10.9

10.10

10.11

Amendment No. 2 effective as of April 22, 2019 to Master Lease by and between certain affiliates of the 
Company named therein as Tenant and certain affiliates of Ventas, Inc. named therein as landlord 
(incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q filed on August 
6, 2019 (File No. 001-32641)).†

Amendment No. 3 effective as of May 1, 2019 to Master Lease by and between certain affiliates of the 
Company named therein as Tenant and certain affiliates of Ventas, Inc. named therein as landlord 
(incorporated by reference to Exhibit 10.2 to the Company’s Quarterly Report on Form 10-Q filed on 
November 5, 2019 (File No. 001-32641)).

Amendment No. 4 effective as of September 26, 2019 to Master Lease by and between certain affiliates of the 
Company named therein as Tenant and certain affiliates of Ventas, Inc. named therein as landlord 
(incorporated by reference to Exhibit 10.3 to the Company’s Quarterly Report on Form 10-Q filed on 
November 5, 2019 (File No. 001-32641)).†

Amendment No. 5 effective as of December 9, 2019 to Master Lease by and between certain affiliates of the 
Company named therein as Tenant and certain affiliates of Ventas, Inc. named therein as landlord.

Guaranty of Master Lease dated as of April 26, 2018 by and between the Company and certain of its affiliates 
named therein and Ventas, Inc. and certain of its affiliates named therein (incorporated by reference to Exhibit 
10.2 to the Company’s Quarterly Report on Form 10-Q filed on August 7, 2018 (File No. 001-32641)).††

Fifth Amended and Restated Credit Agreement dated as of December 5, 2018, among certain subsidiaries of 
the Company, Capital One, National Association, as administrative agent, lender and swingline lender, and 
the other lenders from time to time parties thereto (incorporated by reference to Exhibit 10.1 to the 
Company's Current Report on Form 8-K filed on December 11, 2018 (File No. 001-32641)).

First Amendment to Credit Agreement and Other Credit Documents dated August 16, 2019 by and among the 
Company as Guarantor, certain subsidiaries of the Company as Borrowers, Capital One, National Association, 
as Administrative Agent, Lender and Swingline Lender, and the other Lenders party thereto (incorporated by 
reference to Exhibit 10.1 to the Company’s Quarterly Report on Form 10-Q filed on November 5, 2019 (File 
No. 001-32641)).

Master Credit Facility Agreement (Senior Housing) dated as of August 31, 2017, by and between Jones Lang 
LaSalle Multifamily, LLC and the Company's subsidiaries named as borrowers therein (incorporated by 
reference to Exhibit 10.3 to the Company's Quarterly Report on Form 10-Q filed on November 7, 2017 (File 
No. 001-32641)).

Employment Agreement dated as of March 1, 2018 by and between the Company and Lucinda M. Baier 
(incorporated by reference to Exhibit 10.49 to the Company's Amendment No. 1 to Annual Report on Form 
10-K/A filed on April 24, 2018 (File No. 001-32641)).*

Amended and Restated Brookdale Senior Living Inc. 2014 Omnibus Incentive Plan (incorporated by 
reference to Exhibit 10.1 to the Company's Current Report on Form 8-K filed on October 29, 2019 (File No. 
001-32641)) (the "Omnibus Incentive Plan").*

Amendment No. 1 to Omnibus Incentive Plan effective February 12, 2020.*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (Time-Vesting Form for Executive 
Committee Members) (incorporated by reference to Exhibit 10.1 to the Company's Quarterly Report on Form 
10-Q filed on May 10, 2016 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (Time-Vesting Form for Executive 
Vice Presidents) (incorporated by reference to Exhibit 10.2 to the Company's Quarterly Report on Form 10-Q 
filed on May 10, 2016 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (Performance-Vesting Form for 
Executive Committee Members) (incorporated by reference to Exhibit 10.3 to the Company's Quarterly 
Report on Form 10-Q filed on May 10, 2016 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (Performance-Vesting Form for 
Executive Vice Presidents) (incorporated by reference to Exhibit 10.4 to the Company's Quarterly Report on 
Form 10-Q filed on May 10, 2016 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2017 Time-Vesting Form for 
Executive Committee Members) (incorporated by reference to Exhibit 10.1 to the Company's Quarterly 
Report on Form 10-Q filed on May 10, 2017 (File No. 001-32641)).*

125

10.12

10.13

10.14

10.15

10.16

10.17

10.18

10.19

10.20

10.21

10.22

10.23

10.24.1

10.24.2

10.24.3

10.25.1

10.25.2

10.25.3

10.26

10.27

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2017 Time-Vesting Form for 
Executive Vice Presidents) (incorporated by reference to Exhibit 10.2 to the Company's Quarterly Report on 
Form 10-Q filed on May 10, 2017 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2017 Performance-Vesting Form for 
Executive Committee Members) (incorporated by reference to Exhibit 10.3 to the Company's Quarterly 
Report on Form 10-Q filed on May 10, 2017 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2017 Performance-Vesting Form for 
Executive Vice Presidents) (incorporated by reference to Exhibit 10.4 to the Company's Quarterly Report on 
Form 10-Q filed on May 10, 2017 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2018 Time-Vesting Form) 
(incorporated by reference to Exhibit 10.47 to the Company's Amendment No. 1 to Annual Report on Form 
10-K/A filed on April 24, 2018 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2018 Cliff-Vesting Form) 
(incorporated by reference to Exhibit 10.48 to the Company's Amendment No. 1 to Annual Report on Form 
10-K/A filed on April 24, 2018 (File No. 001-32641)).*

Restricted Share Agreement under the Omnibus Incentive Plan dated as of March 5, 2018 by and between the 
Company and Lucinda M. Baier (Time-Vesting) (incorporated by reference to Exhibit 10.50 to the Company's 
Amendment No. 1 to Annual Report on Form 10-K/A filed on April 24, 2018 (File No. 001-32641)).*

Restricted Share Agreement under the Omnibus Incentive Plan dated as of March 5, 2018 by and between the 
Company and Lucinda M. Baier (Performance-Vesting) (incorporated by reference to Exhibit 10.51 to the 
Company's Amendment No. 1 to Annual Report on Form 10-K/A filed on April 24, 2018 (File No. 
001-32641)).*

Restricted Share Agreement under the Omnibus Incentive Plan dated as of September 10, 2018 by and 
between the Company and Steven E. Swain (Performance Vesting) (incorporated by reference to Exhibit 10.3 
to the Company’s Quarterly Report on Form 10-Q filed on November 6, 2018 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2019 Time-Based Vesting Form for 
Executive Officers) (incorporated by reference to Exhibit 10.37 to the Company's Amendment No. 1 to 
Annual Report on Form 10-K/A on April 29, 2019 (File No. 001-32641)).*

Form of Restricted Share Agreement under the Omnibus Incentive Plan (2019 Performance-Based Vesting 
Form for Executive Officers) (incorporated by reference to Exhibit 10.38 to the Company's Amendment No. 1 
to Annual Report on Form 10-K/A on April 29, 2019 (File No. 001-32641)).*

Form of Outside Director Restricted Stock Unit Agreement under the Omnibus Incentive Plan (incorporated 
by reference to Exhibit 10.1 to the Company's Quarterly Report on Form 10-Q filed on August 9, 2016 (File 
No. 001-32641)).*

Form of 2019 Outside Director Restricted Share Agreement under the Omnibus Incentive Plan.*

Brookdale Senior Living Inc. Associate Stock Purchase Plan (incorporated by reference to Exhibit 10.1 to the 
Company's Current Report on Form 8-K filed on June 11, 2008 (File No. 001-32641)) (the "Associate Stock 
Purchase Plan").*

First Amendment to Associate Stock Purchase Plan, effective as of December 12, 2013 (incorporated by 
reference to Exhibit 10.1 to the Company's Current Report on Form 8-K filed on December 18, 2013 (File 
No. 001-32641)).*

Second Amendment to Associate Stock Purchase Plan effective as of February 13, 2020.*

Amended and Restated Tier I Severance Pay Policy dated April 15, 2018 (incorporated by reference to 
Exhibit 10.52 to the Company's Amendment No. 1 to Annual Report on Form 10-K filed on April 24, 2018 
(File No. 001-32641)).*

Amendment No. 1 to Amended and Restated Tier I Severance Pay Policy.*

Form of Severance Letter Under the Amended and Restated Tier I Severance Pay Policy (incorporated by 
reference to Exhibit 10.2 to the Company’s Quarterly Report on Form 10-Q filed on August 6, 2010 (File No. 
001-32641)).*

Severance Letter Agreement dated September 25, 2019 by and between the Company and Todd Kaestner.*

Form of Indemnification Agreement for Directors and Officers (incorporated by reference to Exhibit 10.16 to 
the Company's Annual Report on Form 10-K filed on February 28, 2011 (File No. 001-32641)).*

126

10.28

21

23

31.1

31.2

32

101.SCH

101.CAL

101.DEF

101.LAB

101.PRE

104

Summary of Brookdale Senior Living Inc. Director Stock Purchase Plan (incorporated by reference to Exhibit 
99.1 to the Company's Registration Statement on Form S-8 filed on June 30, 2009 (File No. 333-160354)).*

Subsidiaries of the Registrant.

Consent of Ernst & Young LLP.

Certification of Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

Certification of Chief Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

Certification of Chief Executive Officer and Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as 
adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

Inline XBRL Taxonomy Extension Schema Document.

Inline XBRL Taxonomy Extension Calculation Linkbase Document.

Inline XBRL Taxonomy Extension Definition Linkbase Document.

Inline XBRL Taxonomy Extension Label Linkbase Document.

Inline XBRL Taxonomy Extension Presentation Linkbase Document.

The cover page from the Company's Annual Report on Form 10-K for the year ended December 31, 2019,
formatted in Inline XBRL (included in Exhibit 101).

*  Management Contract or Compensatory Plan

†  Portions of this exhibit have been omitted pursuant to Item 601(b)(10)(iv) of Regulation S-K. 

††  Portions of this exhibit have been omitted pursuant to a request for confidential treatment, which has been granted by the 

SEC. 

Item 16.  

Form 10-K Summary

None. 

127

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this 
report to be signed on its behalf by the undersigned, thereunto duly authorized.

SIGNATURES

BROOKDALE SENIOR LIVING INC.

By:

/s/ Lucinda M. Baier

Name: Lucinda M. Baier

Title:

Date:

President and Chief Executive Officer

February 19, 2020

Pursuant to the requirements of the Securities Exchange Act of 1934, this Report has been signed below by the following persons 
on behalf of the registrant and in the capacities and on the dates indicated.

Signature

Title

Date

/s/ Guy P. Sansone

Non-Executive Chairman of the Board

February 19, 2020

Guy P. Sansone

/s/ Lucinda M. Baier

President, Chief Executive Officer and Director

February 19, 2020

Lucinda M. Baier

(Principal Executive Officer)

/s/ Steven E. Swain

Executive Vice President and Chief Financial Officer

February 19, 2020

Steven E. Swain

(Principal Financial Officer)

/s/ Dawn L. Kussow

Senior Vice President and Chief Accounting Officer

February 19, 2020

Dawn L. Kussow

(Principal Accounting Officer)

/s/ Marcus E. Bromley

Director

Marcus E. Bromley

/s/ Frank M. Bumstead

Director

Frank M. Bumstead

/s/ Victoria L. Freed

Director

Victoria L. Freed

/s/ Rita Johnson-Mills

Director

Rita Johnson-Mills

/s/ Denise W. Warren

Director

Denise W. Warren

/s/ Lee S. Wielansky

Director

Lee S. Wielansky

February 19, 2020

February 19, 2020

February 19, 2020

February 19, 2020

February 19, 2020

February 19, 2020

128

 
 
 
 
 
EXHIBIT 31.1

CERTIFICATION OF CHIEF EXECUTIVE OFFICER

PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Lucinda M. Baier, certify that:

1. 

I have reviewed this Annual Report on Form 10-K of Brookdale Senior Living Inc.;

2.  Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact 
necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading 
with respect to the period covered by this report;

3.  Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all 
material respects the financial condition, results of operations and cash flows of the registrant as of, and  for, the periods 
presented in this report;

4.  The registrant's  other certifying  officer(s)  and  I  are  responsible for  establishing  and  maintaining  disclosure  controls  and 
procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over  financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed 
under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, 
is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)  Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 
designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the 
preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)  Evaluated  the  effectiveness  of  the  registrant's  disclosure  controls  and  procedures  and  presented  in  this  report  our 
conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this 
report based on such evaluation; and

(d)  Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the 
registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially 
affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.  The registrant's other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over 
financial  reporting,  to  the  registrant's  auditors  and  the  audit  committee  of  the  registrant's  board  of  directors  (or  persons 
performing the equivalent functions):

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting 
which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial 
information; and

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role in the 

registrant's internal control over financial reporting.

Date: 

February 19, 2020

/s/ Lucinda M. Baier
Lucinda M. Baier
President and Chief Executive Officer

 
 
EXHIBIT 31.2

CERTIFICATION OF CHIEF FINANCIAL OFFICER

PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Steven E. Swain, certify that:

1. 

I have reviewed this Annual Report on Form 10-K of Brookdale Senior Living Inc.;

2.  Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact 
necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading 
with respect to the period covered by this report;

3.  Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all 
material respects the financial condition, results of operations and cash flows of the registrant as of, and  for, the periods 
presented in this report;

4.  The registrant's  other certifying  officer(s)  and  I  are  responsible for  establishing  and  maintaining  disclosure  controls  and 
procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over  financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed 
under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, 
is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)  Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 
designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the 
preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)  Evaluated  the  effectiveness  of  the  registrant's  disclosure  controls  and  procedures  and  presented  in  this  report  our 
conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this 
report based on such evaluation; and

(d)  Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the 
registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially 
affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.  The registrant's other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over 
financial  reporting,  to  the  registrant's  auditors  and  the  audit  committee  of  the  registrant's  board  of  directors  (or  persons 
performing the equivalent functions):

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting 
which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial 
information; and

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role in the 

registrant's internal control over financial reporting.

Date: 

February 19, 2020

/s/ Steven E. Swain
Steven E. Swain
Executive Vice President and Chief Financial
Officer

 
 
EXHIBIT 32

CERTIFICATION OF CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL
OFFICER PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED
PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Annual Report on Form 10-K of Brookdale Senior Living Inc. (the "Company") for the fiscal year ended 
December 31, 2019, as filed with the Securities and Exchange Commission on the date hereof (the "Report"), Lucinda M. Baier, 
as President and Chief Executive Officer of the Company, and Steven E. Swain, as Executive Vice President and Chief Financial 
Officer of the Company, each hereby certifies, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley 
Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of 

operations of the Company.

/s/ Lucinda M. Baier
Name:
Title:
Date:

Lucinda M. Baier
President and Chief Executive Officer
February 19, 2020

/s/ Steven E. Swain
Name:
Title:
Date:

Steven E. Swain
Executive Vice President and Chief Financial Officer
February 19, 2020

  [This Page Intentionally Left Blank] 

BOARD OF DIRECTORS

Guy P. Sansone, Non-Executive Chairman of the Board 
Chairman and CEO, 
H2 Health

Victoria L. Freed, Director 2, 4
Senior Vice President of Sales, Trade Support and Service, 
Royal Caribbean International

Lucinda M. Baier, Director
President and Chief Executive Officer,
Brookdale Senior Living Inc.

Rita Johnson-Mills, Director 3, 4
Founder and Chief Executive Officer, 
RJM Enterprises

Dr. Jordan R. Asher, Director 3
Chief Physician Executive and Senior Vice President,
Sentara Healthcare

Denise W. Warren, Director 1, 2
Executive Vice President and Chief Operating Officer, 
WakeMed Health & Hospitals

Marcus E. Bromley, Director 1, 3
Former Chairman and Chief Executive Officer,
Gables Residential Trust

Lee S. Wielansky, Director 1, 3  
Chairman and Chief Executive Officer,
Opportunistic Equities

Frank M. Bumstead, Director 2, 4
Principal Shareholder,
Flood, Bumstead, McCready & McCarthy, Inc.

(1) Audit Committee (2) Compensation Committee  
(3) Investment Committee (4) Nominating and Corporate 
Governance Committee 

EXECUTIVE OFFICERS

Lucinda M. Baier
President and Chief Executive Officer 

Anna-Gene O’Neal
Division President  — Health Care Services

George T. Hicks
Executive Vice President — Finance and Treasurer

Mary Sue Patchett
Executive Vice President — Strategic Operations

Diane Johnson May
Executive Vice President — Human Resources

Steven E. Swain
Executive Vice President and Chief Financial Officer

H. Todd Kaestner
Executive Vice President — Asset Management  
and Division President — Entry Fee

Cindy R. Kent
Executive Vice President and President of Senior Living

Chad C. White
Executive Vice President, General Counsel and Secretary

CORPORATE DATA

Corporate Office
111 Westwood Place
Brentwood, TN 37027
(615) 221-2250
www.brookdale.com

Transfer Agent
American Stock Transfer & Trust Company
6201 15th Avenue
Brooklyn, NY 11219
(800) 937-5449

Stock Listing
NYSE: BKD
Brookdale Investor Relations Contact
Kathy MacDonald
(615) 505-1968

Registered Public Accounting Firm
Ernst & Young LLP
155 North Wacker Drive
Chicago, IL 60606

2020 Annual Meeting
June 30, 2020 | 10:00 a.m. CDT
Brookdale Senior Living
111 Westwood Place
Brentwood, TN 37027
(615) 221-2250

Governance
Brookdale’s corporate governance guidelines, code of 
business conduct and ethics, the charters of the principal 
board committees and other governance information can 
be accessed through the Investor Relations portion of its 
website, brookdale.com/investor.

354 registered record holders as of May 11, 2020

Our Mission

Enriching the lives of those we serve with 
compassion, respect, excellence and integrity

Our Vision

To be the nation’s first choice in senior living

Our Cornerstones

•  More than a job, a passion  

Have fun and celebrate life every day.

•   Doing the right thing takes courage.  

 Provide meaningful rewards for associates, 
Residents and shareholders.

•   We succeed through partnership.  

Work together as one team.

•   Built on a foundation of trust  

Listen, understand, partner and solve.

Corporate Headquarters
111 Westwood Place
Brentwood, TN 37027
(615) 221-2250

For more information, visit our website: brookdale.com

©2020 Brookdale Senior Living Inc. All rights reserved.
BROOKDALE SENIOR LIVING and BRINGING NEW LIFE TO SENIOR LIVING 
are the registered trademarks of Brookdale Senior Living Inc.

346856  MS

Bringing New Life to Senior Living®