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Omega Healthcare Investors

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FY2022 Annual Report · Omega Healthcare Investors
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2022 
Annual Report 

OMEGA  Healthcare 

INVESTORS,  INC. 

OUR COMMITMENT TO THE ENVIRONMENT 

Omega Healthcare  Investors,  Inc. ("Omega") believes  in  working  to  keep our environment cleaner and  healthier. Each  and 
every day,  we  take  steps to  preserve  the  natural  beauty of the  surroundings that we  are  privileged  to  enjoy. In  an  effort to 
further reduce  our carbon  footprint,  we  are  asking our investors to  enroll  in  voluntary electronic delivery of our shareholder 
communications.  In  addition,  we  are  also  asking  you  to  vote  your  shares  on  line.  This  not  only  reduces  the  costs 
associated  with  printing  and  mailing,  it  also  supports  our  corporate  sustainability  initiatives.  Please  see  the  instructions 
below. 

VOTE BY INTERNET -
WWW.PROXYVOTE.COM 

ELECTRONIC DELIVERY OF FUTURE 
PROXY MATERIALS 

Use  the  Internet to  transmit your voting  instructions  and  for 
electronic  delivery  of 
information  up  until  11 :59  P.M. 
Eastern  Time  the  day  before  the  cut-off  date  or  meeting 
date.  Have  your  proxy  card  in  hand  when  you  access  the 
web  site  and  follow  the  instructions  to  obtain  your  records 
and to create an  electronic voting  instruction form. 

If  you  would  like  to  reduce  the  costs  incurred  by  our 
company  in  mailing  proxy  materials,  you  can  consent  to 
receiving  all  future  proxy  statements,  proxy  cards  and 
annual  reports  electronically  via  e-mail  or  the  Internet.  To 
sign  up  for electronic delivery,  please follow the  instructions 
above  to  vote  using  the  Internet  and,  when  prompted, 
indicate that you  agree to  receive or access proxy materials 
electronically in  future  years. 

Omega's  initiative  in  reducing  its  carbon  footprint  by  promoting  electronic  delivery  of  shareholder  materials  has  had  a 
positive  effect  on  the  environment.  Based  upon  2022  statistics,  voluntary  receipt  of  a-delivery  resulted  in  the  following 
environmental savings: 

Using approximately 184 fewer tons of wood,  or 1,110 fewer trees 

Using approximately 1,180 million fewer BTUs,  or the equivalent amount of energy used to operate 
1,400 residential  refrigerators per year 

Using approximately 829,000 fewer pounds of CO2  gases, or the equivalent of 75 .3 automobiles per 
year 

Saving approximately 987,000 gallons of water 

Saving approximately 54,300 pounds of solid waste 

Reducing  hazardous air pollutants by approximately 73.7 pounds 

Environmental  impact estimates calculated using the  Environmental  Paper Network Paper Calculator. 
For more information visit www.papercalculator.org . 

2023 ANNUAL MEETING OF STOCKHOLDERS 

Monday, June 5,  2023 

10:00 AM  EDT,  Virtual 

Omega Healthcare Investors 
303 International Circle, Suite 200 
Hunt Valley,  MD 21030 

MIX 
Paper from 
responsible  sources 
Fsc• 

FSC 

OMEGA HEALTHCARE INVESTORS, INC. 

We  are  a  self-administered  real  estate  investment 
trust  (“REIT”),  providing  financing  and  capital  to 
the  long-term  healthcare  industry  with  a  particular 
focus  on  skilled  nursing  facilities  located  in  the 
United  States  and  the  United  Kingdom  (“U.K.”). 
Operating  in  accordance  with  federal  tax  laws  and 
regulations  governing  REITs,  income  is  distributed 
to  stockholders  without  federal  tax  liability  to  our 
company. 

consisted 

investments 

At  December  31,  2022,  our  domestic  and 
international 
of 
926  healthcare  facilities  containing  approximately 
89,965  operating  beds  in  42  states  and  the  U.K., 
operated  by  67  third-party  healthcare  operating 
companies. The table below sets forth the portion of 
(excluding 
our 
total 
joint  ventures) 
investments 
represented by facilities operated by each operator. 

real  estate 
in  unconsolidated 

investments 

INVESTMENT BY OPERATOR 
(in thousands) 

Maplewood Real Estate Holdings, LLC 
11.9% . . . . . . . . . . . . . . . . . . . . . . . 
Connecticut, Massachusetts, New Jersey, 
New York, Ohio, Washington D.C. 

LaVie Care Centers, LLC 
8.6%  . . . . . . . . . . . . . . . . . . . . . . . 
Florida, Louisiana, Mississippi, 
North Carolina,Pennsylvania, Virginia 

Ciena Healthcare 
8.0%  . . . . . . . . . . . . . . . . . . . . . . . 
Indiana, Michigan, North Carolina, Ohio, 
Virginia 

Saber Health Group 
6.6%  . . . . . . . . . . . . . . . . . . . . . . . 
Florida, North Carolina, Ohio, Pennsylvania 
Virginia 

CommuniCare Health Services, Inc. 
6.0%  . . . . . . . . . . . . . . . . . . . . . . . 
Indiana, Maryland, Ohio, Pennsylvania, 
Virginia, West Virginia 

Brookdale Senior Living, Inc. 
5.4%  . . . . . . . . . . . . . . . . . . . . . . . 
Arizona, California, Florida, Illinois, 
New Jersey, Oregon, Pennsylvania, Tennessee, 
Texas, Virginia, Washington 

$  1,188,015 

862,288 

Genesis HealthCare, Inc. 
4.4%  . . . . . . . . . . . . . . . . . . . . . . . 
Alabama, Arizona, Colorado, Massachusetts, 
New Hampshire, New Mexico, North Carolina, 
Rhode Island, Tennessee, Vermont, 
West Virginia 

Nexion Health Inc. 
3.2%  . . . . . . . . . . . . . . . . . . . . . . . 
Louisana, Mississippi, Texas 

802,221 

Health and Hospital Corporation 
3.0%  . . . . . . . . . . . . . . . . . . . . . . . 
Indiana 

657,306 

Healthcare Homes 
2.9%  . . . . . . . . . . . . . . . . . . . . . . . 
United Kingdom 

. . . . . . . . . . . . . . . . . . . . . . 

Other Real Estate Investments 
40.0% 
57 operators with operations in 35 states & in 
the U.K. 

436,113 

325,201 

304,698 

289,393 

4,017,261 

Grand Total 100.00%  . . . . . . . . . . . . . . 

$10,025,130 

601,671 

540,963 

Dear Stockholders, 

TO OUR STOCKHOLDERS 

As  expected,  2022  proved  to  be  another  challenging  year  for  the  senior  healthcare  industry,  as  the 
impact of  the global pandemic continued to be felt by senior care providers. While occupancy is gradually 
improving,  it  still  sits  below  pre-pandemic  levels,  and  the  tight  labor  market  remains  a  challenge  for 
operators.  These  factors  have  combined  to  impact  the  financial  capacity  of  many  of  our  operators  and, 
with  federal  support  less  forthcoming  in  2022,  it  resulted  in  several  of  our  operators  being  unable  to  pay 
their full contractual rent. 

Although  we  believe  these  pressures  will  continue  to  impact  the  industry  in  the  near-term,  we  are 
cautiously  optimistic  that  both  the  financial  stability  of  our  investment  portfolio  and  the  operating 
backdrop  are  improving.  From  a  portfolio  standpoint,  throughout  this  pandemic,  our  team  has  been 
working with troubled operators to find sustainable operating solutions, which also protect the long-term 
economics of  our investments. As we enter the third year of  the pandemic, we have either restructured or 
are in the process of  restructuring the portfolios of  a significant number of  the operators that have required 
help.  The  resolution  of  these  restructurings  is  generally  expected  to  result  in  enhanced  operator  credit 
profiles, with limited diminution in rent and rent equivalents. 

At the same time, the operating backdrop has been significantly enhanced by the actions of  a number 
of  states,  which  stepped  up  with  strong  increases  to  their  Medicaid  reimbursement  rates  in  late  2022, 
reflecting  the  inflationary  pressures  facing  the  industry.  We  are  grateful  for  the  support  from  these  states, 
and we are hopeful that the remaining states will provide similar much needed help in 2023. 

Our capacity to absorb the financial impact of  the past few years has been significantly enhanced by 
the  strength  of  our  balance  sheet.  We  ended  2022  with  almost  all  of  our  $1.45  billion  revolving  credit 
facility  available  for  use  and  nearly  $300  million  of  cash  on  the  balance  sheet.  In  addition,  we  have 
$400 million of  forward interest rate swaps with a weighted average fixed rate of  approximately 0.8675%. 
This  combination  of  factors  provides  us  with  significant  flexibility  to  address  the  $350  million  and 
$400 million of bonds that mature in 2023 and 2024, respectively. 

This balance sheet strength, along with our deep relationships within the industry, allowed Omega to 
continue  to  accretively  deploy  capital.  In  2022,  we  closed  on  over  $400  million  of  investments,  and  the 
pipeline looks strong for 2023. 

We continue to believe that the long-term secular demographic tailwinds in our industry remain intact. 
The pandemic has reaffirmed the importance of a robust and well-funded healthcare offering to support the 
elderly  and  frail,  and  we  believe  that  skilled  nursing  and  assisted  living  facilities,  as  low-cost, 
non-discretionary service providers, will continue to play a vital role in this continuum of care. 

Finally,  we  would  like  to  thank  our  operators,  our  employees  and  you,  our  capital  partners. 
Throughout this pandemic, our operators and their brave staff have worked tirelessly to protect and care for 
their residents. We are proud to be their partner. Our employees are the life blood of  our business and their 
earnest efforts throughout this pandemic have been remarkable. Lastly, we are thankful for the continued 
support of  our capital providers during this demanding period in our Company’s history. We will continue 
to  work  diligently  to  be  prudent  stewards  of  your  capital  and  to  reward  your  faith  in  Omega  Healthcare 
Investors. 

Very truly, 

C. Taylor Pickett 
Chief Executive Officer 
April 21, 2023 

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 

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

For the fiscal year ended December 31, 2022 

For the transition period from 

to 

OMEGA HEALTHCARE INVESTORS, INC. 
(Exact Name of Registrant as Specified in its Charter) 

Maryland 
(Omega Healthcare Investors, Inc.) 
(State or other jurisdiction of incorporation or
organization) 

1-11316 
(Omega Healthcare Investors, Inc.) 
(Commission file number) 

38-3041398 
(Omega Healthcare Investors, Inc.) 
(IRS Employer Identification No.) 

303 International Circle, Suite 200, Hunt Valley, MD 21030 
(Address of principal executive offices) 

(410) 427-1700 
(Telephone number, including area code) 
Securities Registered Pursuant to Section 12(b) of the Act: 

Registrant 
Omega Healthcare Investors, Inc. 

Title of Each Class 
Common Stock, $.10 Par Value 

Trading Symbol (s) 
OHI 

Name of Exchange on Which Registered 
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 twelve 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  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, 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. (Check one:) 

Large accelerated filer ☒ 
Smaller reporting company ☐ 

Accelerated filer ☐ 
Emerging growth company ☐ 

Non-accelerated filer ☐ 

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 financial accounting standards provided pursuant to Section 7(a)(2)(B) of the Securities Act. 

Yes ☐  No ☐ 
Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of  the effectiveness 
of  its internal control over financial reporting under Section 404(b) of  the Sarbanes-Oxley Act (15 U.S.C 7262(b)) by the registered public 
accounting firm that prepared or issued its audit report. 

Yes ☒  No ☐ 
If  securities  are  registered  pursuant  to  Section  12(b)  of  the  Act,  indicate  by  check  mark  whether  the  financial  statements  of  the 

registrant included in the filing reflect the correction of an error to previously issued financial statements. ☐ 

Indicate by check mark whether any of  those error corrections are restatements that required a recovery analysis of  incentive-based 

compensation received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐ 

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  the  common  stock  Omega  Healthcare  Investors,  Inc.  held  by  non-affiliates  was  $6,599,342,597  as  of 
June  30,  2022,  the  last  business  day  of  the  registrant’s  most  recently  completed  second  fiscal  quarter.  The  aggregate  market  value  was 
computed using the $28.19 closing price per share for such stock on the New York Stock Exchange on such date. 

As of February 8, 2023, there were 234,267,646 shares of Omega Healthcare Investors, Inc. common stock outstanding. 

Proxy Statement for the registrant’s 2023 Annual Meeting of  Stockholders to be filed with the Securities and Exchange Commission 

no later than 120 days after December 31, 2022, is incorporated by reference in Part III herein. 

DOCUMENTS INCORPORATED BY REFERENCE 

TABLE OF CONTENTS 

Forward-Looking Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2 

Page 

PART I 

Business 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 1. 
Item 1A.  Risk Factors 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 1B.  Unresolved Staff Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Properties  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 2. 
Item 3. 
Legal Proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 4.  Mine Safety Disclosures  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

PART II 

Item 5.  Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer 

Purchases of Equity Securities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
[Reserved]  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Item 6. 
Item 7.  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. 

Financial Statements and Supplementary Data 
Changes in and Disagreements with Accountants on Accounting and Financial 
Disclosure  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 9A.  Controls and Procedures  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 9B.  Other Information  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 9C.  Disclosure Regarding Foreign Jurisdictions that Prevent Inspections . . . . . . . . . . . . . . . 

PART III 

Item 10.  Directors, Executive Officers of the Registrant and Corporate Governance  . . . . . . . . . . 
Item 11.  Executive Compensation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 12. 

Security Ownership of Certain Beneficial Owners and Management and Related 
Stockholder Matters  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 13.  Certain Relationships and Related Transactions, and Director Independence . . . . . . . . . 
Principal Accountant Fees and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 14. 

Item 15.  Exhibits and Financial Statement Schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Item 16.  Form 10-K Summary  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

PART IV 

4 
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54 

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57 

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1 

Forward-Looking Statements 

Unless otherwise indicated or except where the context otherwise requires, the terms “we,” “us” and “our” 
and other similar terms in this Annual Report on Form 10-K refer to Omega Healthcare Investors, Inc. and its 
consolidated subsidiaries. 

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

Our  actual  results  may  differ  materially  from  those  reflected  in  the  forward-looking  statements 

contained herein as a result of a variety of factors, including, among other things: 

(1)  those  items  discussed  under  “Risk  Factors”  in  Part  I,  Item  1A  to  this  Annual  Report  on 

Form 10-K; 

(2)  uncertainties  relating  to  the  business  operations  of  the  operators  of  our  assets,  including  those 

relating to reimbursement by third-party payors, regulatory matters and occupancy levels; 

(3)  the  impact  of  the  COVID-19  pandemic  on  our  business  and  the  business  of  our  operators, 
including  without  limitation,  the  announced  termination  of  the  federally  declared  public  health 
emergency and related government and regulatory support scheduled for May 11, 2023, the levels 
of  staffing shortages, increased costs and decreased occupancy experienced by operators of  skilled 
nursing  facilities  (“SNFs”)  and  assisted  living  facilities  (“ALFs”)  in  connection  with  the 
pandemic, the ability of  our operators to comply with infection control and vaccine protocols and 
to manage facility infection rates, and the sufficiency of  government support and reimbursement 
rates to offset such costs and the conditions related thereto; 

(4)  the ability of  our operators in bankruptcy to reject unexpired lease obligations, modify the terms 
of  our mortgages and impede our ability to collect unpaid rent or interest during the pendency of 
a bankruptcy proceeding and retain security deposits for the debtor’s obligations, and other costs 
and uncertainties associated with operator bankruptcies; 

(5)  our ability to re-lease, otherwise transition, or sell underperforming assets or assets held for sale 

on a timely basis and on terms that allow us to realize the carrying value of these assets; 

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

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

(8)  competition in the financing of healthcare facilities; 

(9)  competition in the long-term healthcare industry and shifts in the perception of  various types of 

long-term care facilities, including SNFs and ALFs; 

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

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

(12) the  effect  of  economic  and  market  conditions  generally  and,  particularly,  in  the  healthcare 

industry; 

(13) changes in interest rates and the impact of inflation; 

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

(15) changes in tax laws and regulations affecting real estate investment trusts (“REITs”); 

2 

(16) the potential impact of  changes in the SNF and ALF markets or local real estate conditions on 
our ability to dispose of  assets held for sale for the anticipated proceeds or on a timely basis, or to 
redeploy the proceeds therefrom on favorable terms; 

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

(18) the  effect  of  other  factors  affecting  our  business  or  the  businesses  of  our  operators  that  are 
beyond  our  or  their  control,  including  natural  disasters,  other  health  crises  or  pandemics  and 
governmental action; particularly in the healthcare industry. 

3 

Item 1 — Business 

Overview 

PART I 

Omega  Healthcare  Investors,  Inc.  (“Parent”)  is  a  Maryland  corporation  that,  together  with  its 
consolidated  subsidiaries  (collectively,  “Omega”  or  “Company”)  has  elected  to  be  taxed  as  a  REIT  for 
federal  income  tax  purposes.  Omega  is  structured  as  an  umbrella  partnership  REIT  (“UPREIT”)  under 
which all of Omega’s assets are owned directly or indirectly by, and all of Omega’s operations are conducted 
directly  or  indirectly  through,  its  operating  partnership  subsidiary,  OHI  Healthcare  Properties  Limited 
Partnership  (collectively  with  subsidiaries,  “Omega  OP”).  As  of  December  31,  2022,  Parent  owned 
approximately 97% of  the issued and outstanding units of  partnership interest in Omega OP (“Omega OP 
Units”), and other investors owned approximately 3% of  the outstanding Omega OP Units. Omega became 
a publicly traded company listed on the New York Stock Exchange in 1992. 

Omega has one reportable segment consisting of investments in healthcare-related real estate properties 
located  in  the  United  States  (“U.S.”)  and  the  United  Kingdom  (“U.K.”).  Our  goal  is  to  provide  strong 
returns  to  our  investors,  while  serving  as  the  preferred  capital  partner  to  our  healthcare  operating 
companies and affiliates (collectively, our “operators”) so they can concentrate on providing a high level of 
care for their resident-patients. 

Property Types 

Our  core  business  is  to  provide  financing  and  capital  to  the  long-term  healthcare  industry  with  a 
particular  focus  on  skilled  nursing  facilities  (“SNFs”),  assisted  living  facilities  (“ALFs”),  and  to  a  lesser 
extent,  independent  living  facilities  (“ILFs”),  rehabilitation  and  acute  care  facilities  (“specialty  facilities”) 
and medical office buildings (“MOBs”). The following is a summary of our various property types. 

• 

Skilled  nursing  facilities  —  SNFs  provide  services  that  include  daily  nursing,  therapeutic 
rehabilitation,  social  services,  activities,  housekeeping,  nutrition,  medication  management  and 
administrative services for individuals requiring certain assistance for activities in daily living. 

•  Assisted  living  facilities  —  ALFs  provide  services  that  include  assistance  for  activities  in  daily 
living  and  permit  residents  to  maintain  some  of  their  privacy  and  independence  as  they  do  not 
require constant supervision and assistance. Services usually include daily housekeeping, laundry, 
medical  reminders  and  assistance  with  the  activities  of  daily  living,  such  as  eating,  dressing  and 
bathing. 

• 

• 

Independent  living  facilities — ILFs  are  age-restricted  multi-family  properties  with  central  dining 
facilities that provide services that include security, housekeeping, activities, nutrition and limited 
laundry services. 

Specialty  facilities  —  Specialty  facilities  consist  of  specialty  hospitals,  long-term  acute  care 
hospitals, inpatient rehabilitation facilities, behavioral health substance facilities, behavioral health 
psychiatric facility and traumatic brain injury facilities. 

•  Medical office buildings — MOBs are facilities designed specifically for healthcare providers such 

as physicians, dentists and other clinicians. 

Investment Strategy & Types 

We  maintain  a  portfolio  of  long-term  healthcare  facilities,  mortgages  and  other  real  estate  loans  on 
healthcare facilities located in the U.S. and the U.K. Our investments are generally geographically diverse 
and  operated  by  a  diverse  group  of  established,  middle-market  healthcare  operators  that  we  believe  meet 
our standards for quality and experience of  management and creditworthiness. Our criteria for evaluating 
potential investments includes but is not limited to: 

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the quality and experience of management and the creditworthiness of the operator of the facility; 

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• 

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• 
• 

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the facility’s historical and forecasted cash flow and its ability to meet operational needs, capital 
expenditure requirements and lease or debt service obligations; 
the construction quality, condition and design of the facility and its environmental impact; 
the location of the facility; 
the tax, growth, regulatory and reimbursement environment of the applicable jurisdiction; 
the  occupancy  rate  for  the  facility  and  demand  for  similar  healthcare  facilities  in  the  same  or 
nearby communities; and 
the payor mix of private, Medicare and Medicaid patients at the facility. 

As  healthcare  delivery  continues  to  evolve,  we  continuously  evaluate  potential  investments,  as  well  as 
our  assets,  operators  and  markets  to  position  our  portfolio  for  long-term  success.  Our  strategy  includes 
applying  data  analytics  to  our  investment  underwriting  and  asset  management,  as  well  as  selling  or 
transitioning assets that do not meet our portfolio criteria. 

We  prefer  to  invest  in  fee  simple  ownership  of  properties.  Due  to  regulatory,  tax  or  other 
considerations, we may pursue alternative investment structures, such as mortgages and investments in joint 
ventures. While the market for long-term care real estate acquisitions in the U.S. remained competitive in 
2022, we continued to seek and identify selective investments that are accretive to our portfolio. In addition 
to our U.S.-based investments, we expect to continue to pursue investments in alternative jurisdictions such 
as the U.K. As part of  our continuous evaluation of  our portfolio and in connection with certain operator 
workout  transactions,  we  expect  to  continue  to  opportunistically  sell  assets,  or  portfolios  of  assets,  from 
time to time. In addition, as the long-term care industry evolves and adapts to new protocols, we have made 
and  may  continue  to  make  select  ancillary  investments  in  companies  that  enhance  the  technology  and 
infrastructure of long-term care providers and our operators. 

We typically seek substantial liquidity deposits, covenants regarding minimum working capital and net 
worth,  liens  on  accounts  receivable  and  other  operating  assets,  and  various  provisions  for  cross-default, 
cross-collateralization and corporate and/or personal guarantees for our investments when appropriate. 

The following summarizes our primary investment structures. The average annualized yields described 
below  reflect  obligations  under  existing  contractual  arrangements.  However,  due  to  the  nature  of  the 
long-term  care  industry,  we  cannot  assure  that  the  operators  of  our  facilities  will  meet  their  payment 
obligations in full or when due. Therefore, the annualized yields as of  December 31, 2022, set forth below, 
are not necessarily indicative of future yields, which may be lower. 

Real Estate Assets & Leases 

Our real estate assets are primarily comprised of  land, buildings and improvements and any furniture 
and equipment contained within our facilities. Substantially all of  our leases are triple-net operating leases 
and  require  the  operator  to  pay  rent  and  all  additional  charges  incurred  in  the  operation  of  the  leased 
facility. At December 31, 2022, we had one direct financing lease. Our triple-net operating leases typically 
range from 5 to 15 years, plus renewal options. Our leases generally provide for minimum annual rents that 
are  subject  to  annual  escalators.  Leases  with  fixed  annual  rental  escalators  are  generally  recognized  on  a 
straight-line basis over the initial lease period, subject to a collectibility assessment. At December 31, 2022, 
our  average  annualized  yield  from  operating  leases  was  approximately  9.0%.  At  December  31,  2022, 
approximately 78% of  our operating leases have initial lease terms expiring after 2027. The majority of  our 
leased real estate properties are leased under provisions of  master lease agreements that govern more than 
one  facility,  and  to  a  lesser  extent,  we  lease  facilities  under  single  facility  leases.  Under  our  master  leases, 
our operators are required to make one monthly payment that represents rent on all the properties that are 
subject  to  the  master  lease.  Certain  of  our  leases  also  contain  operator  purchase  options  or  landlord  put 
options. 

Some  of  our  leases  provide  our  operators  with  advances  for  the  construction  of  facilities  or  capital 
expenditures  for  strategic  facility  enhancements.  Typically,  these  advances  require  the  operator  to  pay  a 
fixed  percentage  of  the  advances  funded  as  capital  expenditure  rent  under  the  lease.  Construction  and 
upgrades made under these lease clauses are capitalized within our real estate assets. We direct a significant 
amount of  our capital back into existing assets, which we believe sets the stage for our long-term strategic 
success. 

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Real Estate Loans 

Real  estate  loans  consist  of  mortgage  loans  and  other  real  estate  loans  which  are  primarily 
collateralized by a first, second or third mortgage lien or a leasehold mortgage on, or an assignment of  the 
partnership interest in, the related properties. Our real estate loans typically have a fixed interest rate for the 
loan  term.  We  enter  into  real  estate  loans  for  existing  facilities  and  for  the  construction  of  facilities.  At 
December  31,  2022,  our  average  annualized  yield  on  these  investments  was  approximately  10.1%.  At 
December 31, 2022, approximately 76% of our real estate loans have primary terms that expire after 2027. 

Investments in Unconsolidated Joint Ventures 

From  time  to  time,  we  also  acquire  equity  interests  in  joint  ventures  or  entities  that  support  the 
long-term  healthcare  industry  and  our  operators.  These  are  investments  in  entities  that  we  do  not 
consolidate but for which we can exercise significant influence over operating and financial policies and are 
reported  under  the  equity  method  of  accounting.  Our  investments  in  unconsolidated  entities  generally 
represent  interests  ranging  from  9%  to  51%.  Under  the  equity  method  of  accounting,  our  share  of  the 
investee’s earnings or losses is included in our consolidated results of  operations. The initial carrying value 
of  investments  in  unconsolidated  entities  is  based  on  the  amount  paid  to  purchase  the  entity  interest 
inclusive of transaction costs. 

Non-Real Estate Loans 

Non-real estate loans are loans to our operators and/or their principals that may be either unsecured or 
secured  by  the  collateral  of  the  borrower  and  are  typically  short-term  in  nature.  Collateral  under  secured 
non-real estate loans typically consists of  the working capital of  operator entities. At December 31, 2022, 
our  average  annualized  yield  on  these  investments  was  approximately  8.7%.  At  December  31,  2022, 
approximately 12% of our non-real estate loans have primary terms that expire after 2027. 

Portfolio and Investment Summary 

As  of  December  31,  2022,  our  portfolio  of  real  estate  investments  included  926  healthcare  facilities 

located in 42 states and the U.K. operated by 67 third-party operators and was made up of the following: 

•  Real  estate  assets,  subject  to  operating  leases,  that  include  664  SNFs,  169  ALFs,  20  ILFs,  16 

specialty facilities and two MOBs; 

investment in a direct financing lease on one SNF; 

real estate loans, including first lien mortgages, on 48 SNFs, two ALFs and two specialty facilities; 

investments in unconsolidated joint ventures that hold 63 ALFs and two specialty facilities; and 

2 facilities held for sale. 

• 

• 

• 

• 

Included below is a summary of  our total investment assets, excluding accumulated depreciation, as of 

December 31, 2022 and 2021 (dollars in thousands): 

As of December 31, 

2022 

2021 

Real estate assets: 

Real estate assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  8,860,264  $  9,028,745 
Investments in direct financing leases – net  . . . . . . . . . . . . . . . . . . . . . . . 
10,873 
1,180,786 
Real estate loans receivable – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
194,687 
Investments in unconsolidated joint ventures  . . . . . . . . . . . . . . . . . . . . . . 
Assets held for sale  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
203,025 
10,618,116 
Total real estate investments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
124,184 
Non-real estate loans receivable – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total investments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $10,325,155  $10,742,300 

8,503 
1,042,731 
178,920 
9,456 
10,099,874 
225,281 

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Revenues 

The following table summarizes our revenues by investment category for 2022, 2021 and 2020 (dollars 

in thousands): 

Real estate related income: 

Year Ended December 31, 

2022 

2021 

2020 

Rental income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $750,208  $  923,677  $753,427 
1,033 
Income from direct financing leases  . . . . . . . . . . . . . . . . . . . . . . . 
117,289 
Real estate loans interest income  . . . . . . . . . . . . . . . . . . . . . . . . . 
871,749 
Total real estate related revenues . . . . . . . . . . . . . . . . . . . . . . . . 
16,997 
Non-real estate loans interest income 
. . . . . . . . . . . . . . . . . . . . . . . 
3,635 
Miscellaneous income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total revenues  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $878,244  $1,062,809  $892,381 

1,029 
123,649 
1,048,355 
12,733 
1,721 

1,023 
110,322 
861,553 
13,597 
3,094 

The  table  set  forth  in  Item  2 — Properties  contains  additional  information  regarding  the  geographic 

concentration of our facilities and investments as of December 31, 2022. 

Borrowing Policies 

We generally attempt to match the maturity of  our indebtedness with the maturity of  our investment 
assets  and  employ  long-term,  fixed-rate  debt  to  the  extent  practicable  in  view  of  market  conditions  in 
existence from time to time. 

We  may  use  the  proceeds  of  new  indebtedness  to  finance  our  investments  in  additional  healthcare 
facilities. In addition, we may invest in properties subject to existing loans, secured by mortgages, deeds of 
trust or similar liens on properties. 

Policies With Respect To Certain Activities 

With  respect  to  our  capital  requirements,  we  typically  rely  on  equity  offerings,  debt  financing  and 
retention  of  cash  flow  (subject  to  provisions  in  the  Internal  Revenue  Code  of  1986,  as  amended  (the 
“Code”) concerning taxability of  undistributed REIT taxable income), or a combination of  these methods. 
Our financing alternatives include bank borrowings, publicly or privately placed debt instruments, purchase 
money  obligations  to  the  sellers  of  assets  or  securitizations,  any  of  which  may  be  issued  as  secured  or 
unsecured indebtedness. We have the authority to issue our common stock or other equity or debt securities 
in exchange for property and to repurchase or otherwise reacquire our securities. Subject to the percentage 
of  ownership limitations and gross income and asset tests necessary for REIT qualification, we may invest 
in  securities  of  other  REITs,  other  entities  engaged  in  real  estate  activities  or  securities  of  other  issuers, 
including for the purpose of exercising control over such entities. We may engage in the purchase and sale of 
investments. We do not underwrite the securities of other issuers. Our officers and directors may change any 
of  these policies without a vote of  our stockholders. In the opinion of  our management, our properties are 
adequately covered by insurance. 

Competition 

The healthcare industry is highly competitive and will likely become more competitive in the future. We 
face competition in making and pricing new investments from other public and private REITs, investment 
companies,  private  equity  and  hedge  fund  investors,  healthcare  operators,  lenders,  developers  and  other 
institutional  investors,  some  of  whom  may  have  greater  resources  and  lower  costs  of  capital  than  us.  In 
addition, a significant amount of  our rental and loan interest income is generally derived from facilities in 
states  that  require  state  approval  for  development  and  expansion  of  healthcare  facilities.  We  believe  that 
such  state  approvals  may  reduce  competition  for  our  operators  and  enhance  the  value  of  our  properties. 
Our  operators  compete  on  a  local  and  regional  basis  with  operators  of  facilities  that  provide  comparable 
services  and,  in  certain  cases,  home  and  community  health  solutions.  The  basis  of  competition  for  our 

7 

operators includes, amongst other factors, the quality of  care provided, reputation, the physical appearance 
of  a facility, price, the range of  services offered, family preference, alternatives for healthcare delivery, the 
supply of competing properties, physicians, staff, referral sources, location and the size and demographics of 
the population and surrounding areas. 

Increased  competition  makes  it  more  challenging  for  us  to  identify  and  successfully  capitalize  on 
opportunities  that  meet  our  objectives.  Our  ability  to  compete  is  also  impacted  by  national  and  local 
economic  trends,  availability  of  investment  alternatives,  availability  and  cost  of  capital,  our  financial 
condition, construction and renovation costs, existing laws and regulations, new legislation and population 
trends. 

Taxation of Omega 

Omega elected to be taxed as a REIT, under Sections 856 through 860 of  the Code, beginning with our 
taxable year ended December 31, 1992. To continue to qualify as a REIT, we must continue to meet certain 
tests that, among other things, generally require that our assets consist primarily of  real estate assets, our 
income be derived primarily from real estate assets, and that we distribute at least 90% of  our REIT taxable 
income (other than net capital gains) to our stockholders annually. Provided we maintain our qualification 
as a REIT, we generally will not be subject to U.S. federal income taxes at the corporate level on our net 
income  to  the  extent  such  net  income  is  distributed  to  our  stockholders  annually.  Even  if  we  continue  to 
qualify as a REIT, we will continue to be subject to certain federal, state and local taxes on our income and 
property. We believe that we were organized and have operated in such a manner as to qualify for taxation 
as a REIT. We intend to continue to operate in a manner that will allow us to maintain our qualification as 
a  REIT,  but  no  assurance  can  be  given  that  we  have  operated  or  will  be  able  to  continue  to  operate  in  a 
manner so as to qualify or remain qualified as a REIT. 

We  have  utilized,  and  may  continue  to  utilize,  one  or  more  taxable  REIT  subsidiaries  (“TRS”)  to 
engage in activities that REITs may be prohibited from performing, including the provision of  management 
and  other  services  to  third  parties  and  the  conduct  of  certain  nonqualifying  real  estate  transactions.  Our 
TRSs generally are taxable as regular corporations, and therefore, subject to federal, foreign, state and local 
income taxes. 

To  the  extent  that  we  do  not  distribute  all  of  our  net  capital  gain  or  distribute  at  least  90%,  but  less 
than  100%  of  our  “REIT  taxable  income,”  as  adjusted,  we  will  be  subject  to  tax  thereon  at  regular 
corporate rates. If  we were to fail to qualify as a REIT in any taxable year, as a result of  a determination 
that we failed to meet the annual distribution requirement or otherwise, we would be subject to federal and 
state income tax, and any applicable alternative minimum tax on our taxable income at regular corporate 
rates with respect to each such taxable year for which the statute of  limitations remains open. In addition, 
even if  we continue to qualify as a REIT, we could become subject to certain excise taxes. Moreover, unless 
entitled to relief  under certain statutory provisions, we also would be disqualified from treatment as a REIT 
for  the  four  taxable  years  following  the  year  during  which  qualification  is  lost.  This  treatment  would 
significantly  reduce  our  net  earnings  and  cash  flow  because  of  our  additional  tax  liability  for  the  years 
involved, which could significantly impact our financial condition. 

All of  our investments are held directly or through entities owned by Omega OP. Omega OP is a pass 
through entity for U.S. federal income tax purposes, and therefore we are required to take into account our 
allocable share of  each item of  Omega OP’s income, gain, loss, deduction, and credit for any taxable year of 
Omega  OP  ending  within  or  with  our  taxable  year,  without  regard  to  whether  we  have  received  or  will 
receive  any  distribution  from  Omega  OP.  Although  a  partnership  agreement  for  pass  through  entities 
generally  will  determine  the  allocation  of  income  and  losses  among  partners,  such  allocations  will  be 
disregarded  for  tax  purposes  if  they  do  not  comply  with  the  provisions  of  the  Code  and  Treasury 
Regulations  governing  partnership  allocations.  If  an  allocation  is  not  recognized  for  federal  income  tax 
purposes, the item subject to the allocation will be reallocated in accordance with the partners’ interests in 
the  partnership,  which  will  be  determined  by  considering  all  the  facts  and  circumstances  relating  to  the 
economic arrangement of  the partners with respect to such item. While Omega OP should generally not be 
a  taxable  entity  for  federal  income  tax  purposes,  any  state  or  local  revenue,  excise  or  franchise  taxes  that 
result from the operating activities of the Omega OP may be incurred at the entity level. 

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Investors are strongly urged to consult their own tax advisors regarding the potential tax consequences of 

an investment in us based on such investor’s particular circumstances. 

Government Regulation and Reimbursement 

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

The U.S. Department of  Health and Human Services (“HHS”) declared a public health emergency on 
January 31, 2020 following the World Health Organization’s decision to declare COVID-19 a public health 
emergency  of  international  concern.  This  declaration,  which  has  been  extended  through  its  scheduled 
expiration  date  of  May  11,  2023,  allows  HHS  to  provide  temporary  regulatory  waivers  and  new 
reimbursement rules, such as a temporary increase in the Medicaid Federal Medical Assistance Percentage 
and  other  rules  designed  to  equip  providers  with  flexibility  to  respond  to  the  COVID-19  pandemic  by 
suspending  various  Medicare  patient  coverage  criteria  and  documentation  and  care  requirements, 
including, for example, suspension of  the three-day prior hospital stay coverage requirement and expanding 
the list of  approved services which may be provided via telehealth. The three-day prior hospital stay waiver 
was  a  significant  benefit  to  the  skilled  nursing  industry  during  the  height  of  the  pandemic,  as  the 
reimbursement  associated  with  the  ability  to  skill  in  place  helped  to  offset  some  of  the  increased  costs 
connected  with  managing  the  pandemic.  These  regulatory  actions  have  contributed,  and  may  continue  to 
contribute, to a change in census volumes and skilled nursing mix that may not otherwise have occurred. 
The  public  health  emergency  declaration  is  scheduled  to  terminate  on  May  11,  2023;  however,  it  remains 
uncertain  whether  and/or  when  federal  and  state  regulators  will  resume  enforcement  of  those  regulations 
which have waived or otherwise not been enforced during the public health emergency due to the exercise of 
enforcement discretion. 

These temporary changes to regulations and reimbursement, as well as emergency legislation, including 
the  CARES  Act  enacted  on  March  27,  2020  and  discussed  below,  have  had  a  significant  impact  on  the 
operations  and  financial  condition  of  our  operators.  The  extent  of  the  COVID-19  pandemic’s  continued 
effect, including through prolonged labor shortages, slow occupancy recovery, and expense increases, on the 
Company’s and our operators’ operational and financial performance will depend on future developments, 
including  the  recovery  in  occupancy  and  availability  of  labor,  the  ability  of  our  operators  to  manage  the 
impact of  the termination of  public health emergency and temporary relief  thereunder, the sufficiency and 
timeliness of  additional governmental relief  and reimbursement rate setting in offsetting cost increases, and 
the continued efficacy of  vaccination, treatment and infection control programs relating to COVID-19, all 
of  which  developments  and  impacts  are  uncertain  and  difficult  to  predict  and  may  continue  to  adversely 
impact our business, results of operations, financial condition and cash flows. 

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

9 

Medicaid  Services  (“CMS”)  has  implemented  a  number  of  initiatives  focused  on  the  reporting  of  certain 
facility specific quality of  care indicators that could affect our operators, including publicly released quality 
ratings  for  all  of  the  nursing  homes  that  participate  in  Medicare  or  Medicaid  under  the  CMS  “Five  Star 
Quality  Rating  System.”  Facility  rankings,  ranging  from  five  stars  (“much  above  average”)  to  one  star 
(“much below average”) are updated on a monthly basis. SNFs are required to provide information for the 
CMS Nursing Home Compare website regarding staffing and quality measures. These rating changes have 
impacted  referrals  to  SNFs,  and  it  is  possible  that  changes  to  this  system  or  other  ranking  systems  could 
lead to future reimbursement policies that reward or penalize facilities on the basis of  the reported quality 
of care parameters. 

The following is a discussion of  certain U.S. laws and regulations generally applicable to our operators, 

and in certain cases, to us. 

Reimbursement Changes Related to COVID-19: 

U.S.  Federal  Stimulus  Funds  and  Financial  Assistance  for  Healthcare  Providers.  In  response  to  the 
pandemic, Congress has enacted a series of  economic stimulus and relief  measures. On March 18, 2020, the 
Families First Coronavirus Response Act (“FFCRA”) was enacted in the U.S., providing a temporary 6.2% 
increase to each qualifying state and territory’s Medicaid Federal Medical Assistance Percentage (“FMAP”) 
effective  January  1,  2020.  The  temporary  FMAP  increase  was  set  to  extend  through  the  last  day  of  the 
calendar quarter in which the public health emergency terminates. In exchange for receiving the enhanced 
federal  funding,  the  FFCRA  included  a  requirement  that  Medicaid  programs  keep  beneficiaries  enrolled 
through  the  end  of  the  month  in  which  the  public  health  emergency  terminates.  However,  as  part  of  the 
Consolidated Appropriations Act of  2023 signed into law on December 29, 2022, Congress decoupled the 
Medicaid continuous  enrollment  from  the  public  health  emergency  and  terminates  this provision  effective 
March  31,  2023.  Additionally,  starting  April  1,  2023,  states  that  comply  with  federal  rules  regarding 
conducting renewals may begin the phase-down of  the enhanced federal funding according to the following 
schedule: 6.2 percentage points through March 2023; 5 percentage points through June 2023; 2.5 percentage 
points  through  September  2023  and  1.5  percentage  points  through  December  2023.  States  cannot  restrict 
eligibility  standards,  methodologies,  and  procedures  and  states  cannot  increase  premiums  as  required  in 
FFCRA.  Primarily  due  to  the  continuous  enrollment  provision,  Medicaid  enrollment  has  grown 
substantially  compared  to  before  the  pandemic  and  the  uninsured  rate  has  dropped.  The  extent  to  which 
this  increase  in  Medicaid  enrollment  is  sustained  following  the  discontinuation  of  the  continuous 
enrollment provision is uncertain. 

In  further  response  to  the  pandemic,  the  CARES  Act  authorized  approximately  $178  billion  to  be 
distributed  through  the  Provider  Relief  Fund  to  reimburse  eligible  healthcare  providers  for  healthcare 
related expenses or lost revenues that were attributable to coronavirus. Funds have been allocated since 2020 
in targeted and general distributions, the latter over four phases. In September 2021, HHS announced the 
release of  $25.5 billion in phase four provider funding, including $17 billion of  the $178 billion previously 
authorized through the CARES Act and $8.5 billion for rural providers, including those with Medicaid and 
Medicare patients, through the American Rescue Plan Act, with payments that began in December 2021. 
The Provider Relief  Fund is administered under the broad authority and discretion of  HHS and recipients 
are  not  required  to  repay  distributions  received  to  the  extent  they  are  used  in  compliance  with  applicable 
requirements.  HHS  continues  to  evaluate  and  provide  allocations  of,  and  issue  regulation  and  guidance 
regarding,  grants  made  under  the  CARES  Act.  We  do  not  expect  our  operators  will  receive  additional 
funding from HHS. 

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

10 

commenced for many of  our operators in April 2021 and have adversely impacted operating cash flows of 
these  operators.  While  not  limited  to  healthcare  providers,  the  CARES  Act  additionally  provided  payroll 
tax  relief  for  employers,  allowing  them  to  defer  payment  of  employer  Social  Security  taxes  that  are 
otherwise owed for wage payments made after March 27, 2020 through December 31, 2020 to December 31, 
2021 with respect to 50% of  the payroll taxes owed, with the remaining 50% deferred until December 31, 
2022. 

The Budget Control Act of  2011 established a Medicare Sequestration of  2%, which is an automatic 
reduction of  certain federal spending as a budget enforcement tool. Originally, the sequester was supposed 
to be in effect from FY 2013 to FY 2021. However, most recently, the Infrastructure Investment and Jobs 
Act  extended  the  sequester  through  FY  2031.  Additional  legislation,  including  the  CARES  Act  and  the 
Protecting Medicare and American Farmers Act, suspended the application of  the sequester to Medicare 
from May 1, 2020 through March 30, 2022. It also limited Medicare reductions to 1% from April 1, 2022 
through  June  30,  2022.  The  full  2%  Medicare  sequestration  went  into  effect  as  of  July  1,  2022.  The 
sequestration  is  currently  extended  through  fiscal  year  2031,  and  gradually  increases  to  4%  from  2030 
through 2031. 

Quality  of  Care  Initiatives  and  Additional  Requirements  Related  to  COVID-19.  In  addition  to 
COVID-19 reimbursement changes, several regulatory initiatives announced from 2020 to 2022 focused on 
addressing  quality  of  care  in  long-term  care  facilities,  including  those  related  to  COVID-19  testing  and 
infection control protocols, vaccine protocols, staffing levels, reporting requirements, and visitation policies, 
as  well  as  increased  inspection  of  nursing  homes.  In  August  2021,  CMS  announced  it  was  developing  an 
emergency  regulation  requiring  staff  vaccinations  within  the  nation’s  more  than  15,000  Medicare  and 
Medicaid-participating nursing homes, and in September 2021, CMS further announced that the scope of 
the  regulation  would  be  expanded  to  include  workers  in  hospitals,  dialysis  facilities,  ambulatory  surgical 
settings, and home health agencies. In addition, recent updates to the Nursing Home Care website and the 
Five Star Quality Rating System include revisions to the inspection process, adjustment of  staffing rating 
thresholds,  the  implementation  of  new  quality  measures  and  the  inclusion  of  a  staff  turnover  percentage 
(over a 12-month period). Although the American Rescue Plan Act did not allocate specific funds directly 
to  SNF  or  ALF  providers,  certain  funds  were  allocated  to  states  who  then  distributed  a  portion  of  these 
funds  to  SNF  and  ALF  providers.  In  addition,  the  American  Rescue  Plan  Act  allocated  funds  to  quality 
improvement organizations to provide infection control and vaccination uptake support to SNFs and to the 
CDC for staffing, training and deployment of  state-based nursing home and long-term care “strike teams” 
to  assist  facilities  with  known  or  suspected  COVID-19  outbreaks.  Additionally,  the  Biden  Administration 
announced  a  focus  on  implementing  minimum  staffing  requirements  and  increased  inspections  as  part  of 
the  nursing  home  reforms  announced  in  the  2022  State  of  the  Union  Address,  and  in  July  2022,  CMS 
announced it was evaluating a proposed federal staffing mandate for SNFs. It is uncertain whether such a 
mandate will be implemented and, if  it is, whether it will be accompanied by additional funding to offset 
any increased staffing requirements for our operators; an unfunded mandate to increase staff  in SNFs may 
have a material and adverse impact on the financial condition of our operators. 

On June 16, 2020, the U.S. House of  Representatives Select Subcommittee on the Coronavirus Crisis 
announced  the  launch  of  an  investigation  into  the  COVID-19  response  of  nursing  homes  and  the  use  of 
federal  funds  by  nursing  homes  during  the  pandemic.  The  Select  Subcommittee  continued  to  be  active 
throughout  the  remainder  of  2020,  2021  and  2022.  In  March  2021,  the  Oversight  Subcommittee  of  the 
House Ways and Means Committee held a hearing on examining the impact of  private equity in the U.S. 
healthcare system, including the impact on quality of  care provided within the skilled nursing industry. The 
Biden  Administration  additionally  announced  in  March  2022  a  focus  on  reviewing  private  equity 
investment  specifically  in  the  skilled  nursing  sector.  These  initiatives,  as  well  as  additional  calls  for 
government review of  the role of  private equity in the U.S. healthcare industry, could result in additional 
requirements on our operators. 

Reimbursement Generally: 

Medicaid.  Most  of  our  SNF  operators  derive  a  substantial  portion  of  their  revenue  from  state 
Medicaid programs. Whether and to what extent the level of Medicaid reimbursement covers the actual cost 
to care for a Medicaid eligible resident varies by state. While periodic rate setting occurs and, in most cases, 

11 

has an inflationary component, the state rate setting process not always keep pace with inflation or, even if 
it does, there is a risk that is may still not be sufficient to cover all or a substantial portion of  the cost to 
care  for  Medicaid  eligible  residents.  Additionally,  rate  setting  is  also  subject  to  changes  based  on  state 
budgetary  constraints  and  political  factors,  both  of  which  could  result  in  decreased  or  insufficient 
reimbursement  to  the  industry  even  in  an  environment  where  costs  are  rising.  Since  our  operators’ profit 
margins  on  Medicaid  patients  are  generally  relatively  low,  more  than  modest  reductions  in  Medicaid 
reimbursement or an increase in the percentage of  Medicaid patients has in the past, and may in the future, 
adversely affect our operators’ results of  operations and financial condition, which in turn could adversely 
impact us. 

The  CARES  Act  and  American  Rescue  Plan  Act  contained  several  provisions  designed  to  increase 
coverage, expand benefits, and adjust federal financing for state Medicaid programs. While the CARES Act 
provided  for  a  6.2%  FMAP  add-on  to  the  Medicaid  program  during  the  PHE,  only  certain  states  passed 
any  of  that  specifically  on  to  SNF  operators  either  via  an  enhanced  rate  or  lump  sum  payments. 
Additionally,  the  American  Rescue  Plan  Act  provided  for  a  10%  FMAP  add-on  for  state  home  and 
community-based  service  expenditures  from  April  1,  2021  through  March  30,  2022  in  an  effort  to  assist 
seniors and people with disabilities to receive services safely in the community rather than in nursing homes 
and other congregate care settings. Both of  these programs came with conditions that states had to meet to 
eligible  for  the  FMAP  add-on.  There  may  be  future  initiatives  proposed  to  allocate  funding  available  for 
reimbursement away from SNFs in favor of home health agencies and community-based care. 

The risks of  insufficient Medicaid reimbursement rates along with possible initiatives to push residents 
historically cared for in SNFs to alternative settings may impact us more acutely in states where we have a 
larger  presence,  including  Florida  and  Texas,  our  states  with  the  largest  concentration  of  investments.  In 
Texas  several  of  our  operators  have  historically  experienced  lower  operating  margins  on  their  SNFs,  as 
compared  to  other  states,  as  a  result  of  lower  Medicaid  reimbursement  rates  and  higher  labor  costs.  The 
state did provide for a sizeable increase in rate during the PHE based on the FMAP add-on; however, there 
is  a  risk  that  this  increase  won’t  be  captured  in  normal  rate  setting  when  the  FMAP  add-on  expires.  In 
Florida,  added  support  to  our  operators  during  the  pandemic  has  generally  been  limited,  with 
approximately  $100  million  in  additional  FMAP  funds  announced  in  November  2021,  payable  over  a 
three-month period through increased Medicaid rates. In March 2022, a revised state budget for 2022-23, 
which  took  effect  October  1,  2022,  increased  Medicaid  reimbursement  rates  by  7.8%  to  fund,  in  part, 
increased wages for certain nursing home staff. In addition, on April 6, 2022, the State of  Florida enacted 
staffing  reforms  for  SNFs  that  may  provide  additional  flexibility  to  our  operators  in  meeting  minimum 
staffing requirements by using supplemental staff. We continue to monitor rate adjustment activity in other 
states in which we have a meaningful presence, and it is too early to assess whether rates will generally keep 
pace with increased operator costs. 

Medicare.  On  July  29,  2022,  CMS  issued  a  final  rule  regarding  the  government  fiscal  year  2023 
Medicare  payment  rates  and  quality  payment  programs  for  SNFs,  with  aggregate  Medicare  Part  A 
payments projected to increase by $904 million, or 2.7%, for fiscal year 2023 compared to fiscal year 2022. 
This  estimated  reimbursement  increase  is  attributable  to  a  3.9%  market  basket  increase  factor  plus  a 
1.5 percentage point market basket forecast error adjustment and less a 0.3 percentage point productivity 
adjustment, as well as a $780 million decrease in the SNF prospective payment system rates as a result of 
the  recalibrated  parity  adjustment  described  below,  which  is  being  phased  in  over  two  years.  The  annual 
update  is  reduced  by  two  percentage  points  for  SNFs  that  fail  to  submit  required  quality  data  to  CMS 
under  the  SNF  Quality  Reporting  Program.  CMS  has  indicated  that  these  impact  figures  did  not 
incorporate the SNF Value-Based Program reductions that are estimated to be $186 million in fiscal year 
2023. While Medicare reimbursement rate setting, which takes effect annually each October, has historically 
included forecasted inflationary adjustments, the degree to which those forecasts accurately reflect current 
inflation  rates  remains  uncertain.  Additionally,  it  remains  uncertain  whether  these  adjustments  will 
ultimately be offset by non-inflationary factors, including any adjustments related to the impact of  various 
payment models, such as those described below. 

Payments  to  providers  continue  to  be  increasingly  tied  to  quality  and  efficiency.  The  Patient  Driven 
Payment Model (“PDPM”), which was designed by CMS to improve the incentives to treat the needs of  the 
whole  patient,  became  effective  October  1,  2019.  CMS  has  stated  that  it  intended  PDPM  to  be 

12 

revenue-neutral  to  operators, with  future Medicare reimbursement reductions possible if  that was not the 
case.  In  April  2022,  CMS  issued  a  proposal  for  comment,  which  included  an  adjustment  to  obtain  that 
revenue  neutrality  as  early  as  the  2023  rate  setting  period.  After  considering  the  feedback  received  in  the 
rulemaking  cycle,  CMS  finalized  recalibration  of  the  PDPM  parity  adjustment  factor  of  4.6%  with  a 
two-year phase-in period that would reduce SNF spending by 2.3%, or approximately $780 million, in each 
of  fiscal years 2023 and 2024. Prior to COVID-19, we believed that certain of  our operators could realize 
efficiencies  and  cost  savings  from  increased  concurrent  and  group  therapy  under  PDPM  and  some  had 
reported  early  positive  results.  Given  the  ongoing  impacts  of  COVID-19,  many  operators  are  and  may 
continue to be restricted from pursuing concurrent and group therapy and unable to realize these benefits. 
Additionally,  our  operators  continue  to  adapt  to  the  reimbursement  changes  and  other  payment  reforms 
resulting from the value-based purchasing programs applicable to SNFs under the 2014 Protecting Access 
to  Medicare  Act.  These  reimbursement  changes  have  had  and  may,  together  with  any  further 
reimbursement changes to PDPM or value-based purchasing models, in the future have an adverse effect on 
the  operations  and  financial  condition  of  some  operators  and  could  adversely  impact  the  ability  of 
operators to meet their obligations to us. 

On May 27, 2020, CMS added physical therapy, occupational therapy and speech-language pathology 
to the list of  approved telehealth Providers for the Medicare Part B programs provided by a SNF as a part 
of  the COVID-19 1135 waiver provisions. The COVID-19 1135 waiver provisions also allow for the facility 
to  bill  an  originating  site  fee  to  CMS  for  telehealth  services  provided  to  Medicare  Part  B  beneficiary 
residents of  the facility when the services are provided by a physician from an alternate location, effective 
March 6, 2020 through May 11, 2023, the scheduled end of the public health emergency. 

Other Regulation: 

Office  of  the  Inspector  General  Activities.  The  Office  of  Inspector  General  (“OIG”)  of  HHS  has 
provided long-standing guidance for SNFs regarding compliance with federal fraud and abuse laws. More 
recently, the OIG has conducted increased oversight activities and issued additional guidance regarding its 
findings  related  to  identified  problems  with  the  quality  of  care  and  the  reporting  and  investigation  of 
potential abuse or neglect at group homes, nursing homes and SNFs. The OIG has additionally reviewed the 
staffing  levels  reported  by  SNFs  as  part  of  its  August  2018  and  February  2019  Work  Plan  updates,  and 
included a review of  involuntary transfers and discharges from nursing homes in the June 2019 Work Plan 
updates. In August 2020, the OIG released its findings regarding its review of  staffing levels in SNFs from 
2018.  The  OIG  recommended  that  CMS  enhance  efforts  to  ensure  nursing  homes  meet  daily  staffing 
requirements and explore ways to provide consumers with additional information on nursing homes’ daily 
staffing levels and variability. The OIG indicated that while the review was initiated before the COVID-19 
pandemic  emerged,  the  pandemic  reinforces  the  importance  of  sufficient  staffing  for  nursing  homes,  as 
inadequate staffing can make it more difficult for nursing homes to respond to infectious disease outbreaks 
like COVID-19. It is unknown what impact, if  any, enhanced scrutiny of  staffing levels by OIG and CMS 
will have on our operators. 

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

Medicare  and  Medicaid  Program  Audits.  Governmental  agencies  and  their  agents,  such  as  the 
Medicare Administrative Contractors, fiscal intermediaries and carriers, as well as the OIG, CMS and state 
Medicaid  programs,  conduct  audits  of  our  operators’ billing  practices  from  time  to  time.  CMS  contracts 

13 

with  Recovery  Audit  Contractors  on  a  contingency  basis  to  conduct  post-payment  reviews  to  detect  and 
correct improper payments in the fee-for-service Medicare program, to managed Medicare plans and in the 
Medicaid program. Regional Recovery Audit Contractor program auditors along with the OIG and DOJ 
are  expected  to  continue  their  efforts  to  evaluate  SNF  Medicare  claims  for  any  excessive  therapy  charges. 
CMS also employs Medicaid Integrity Contractors to perform post-payment audits of Medicaid claims and 
identify overpayments. In addition, the state Medicaid agencies and other contractors have increased their 
review  activities.  To  the  extent  any  of  our  operators  are  found  out  of  compliance  with  any  of  these  laws, 
regulations or programs, their financial position and results of  operations can be adversely impacted, which 
in turn could adversely impact us. 

Fraud  and  Abuse.  There  are  various  federal  and  state  civil  and  criminal  laws  and  regulations 
governing a wide array of  healthcare provider referrals, relationships and arrangements, including laws and 
regulations prohibiting fraud by healthcare providers. Many of  these complex laws raise issues that have not 
been clearly interpreted by the relevant governmental authorities and courts. 

These laws include: (i) federal and state false claims acts, which, among other things, prohibit providers 
from  filing  false  claims  or  making  false  statements  to  receive  payment  from  Medicare,  Medicaid  or  other 
federal or state healthcare programs; (ii) federal and state anti-kickback and fee-splitting statutes, including 
the Medicare and Medicaid Anti-kickback statute, which prohibit the payment or receipt of  remuneration 
to induce referrals or recommendations of  healthcare items or services, such as services provided in a SNF; 
(iii) federal and state physician self-referral laws (commonly referred to as the Stark Law), which generally 
prohibit  referrals  by  physicians  to  entities  for  designated  health  services  (some  of  which  are  provided  in 
SNFs) with which the physician or an immediate family member has a financial relationship; (iv) the federal 
Civil Monetary Penalties Law, which prohibits, among other things, the knowing presentation of  a false or 
fraudulent claim for certain healthcare services and (v) federal and state privacy laws, including the privacy 
and  security  rules  contained  in  the  Health  Insurance  Portability  and  Accountability  Act  of  1996,  which 
provide for the privacy and security of personal health information. 

Violations  of  healthcare  fraud  and  abuse  laws  carry  civil,  criminal  and  administrative  sanctions, 
including  punitive  sanctions,  monetary  penalties,  imprisonment,  denial  of  Medicare  and  Medicaid 
reimbursement  and  potential  exclusion  from  Medicare,  Medicaid  or  other  federal  or  state  healthcare 
programs.  Additionally,  there  are  criminal  provisions  that  prohibit  filing  false  claims  or  making  false 
statements  to  receive  payment  or  certification  under  Medicare  and  Medicaid,  as  well  as  failing  to  refund 
overpayments  or  improper  payments.  Violation  of  the  Anti-kickback  statute  or  Stark  Law  may  form  the 
basis for a federal False Claims Act violation. These laws are enforced by a variety of federal, state and local 
agencies and can also be enforced by private litigants through, among other things, federal and state false 
claims  acts,  which  allow  private  litigants  to  bring  qui  tam  or  whistleblower  actions,  which  have  become 
more frequent in recent years. 

Several  of  our  operators  have  responded  to  subpoenas  and  other  requests  for  information  regarding 
their  operations  in  connection  with  inquiries  by  the  DOJ  or  other  regulatory  agencies.  In  addition, 
MedEquities  Realty  Trust,  Inc.,  which  we  acquired  in  May  2019,  received  a  Civil  Investigative  Demand 
from the DOJ in connection with Lakeway Regional Medical Center, and in November 2022, the Company 
and several of its affiliates entered into a settlement agreement relating to such demand. 

Privacy.  Our operators are subject to various federal, state and local laws and regulations designed to 
protect  the  confidentiality  and  security  of  patient  health  information,  including  the  federal  Health 
Insurance Portability and Accountability Act of  1996, as amended, the Health Information Technology for 
Economic  and  Clinical  Health  Act  (“HITECH”),  and  the  corresponding  regulations  promulgated 
thereunder  (collectively  referred  to  herein  as  “HIPAA”).  The  HITECH  Act  expanded  the  scope  of  these 
provisions  by  mandating  individual  notification  in  instances  of  breaches  of  protected  health  information, 
providing  enhanced  penalties  for  HIPAA  violations,  and  granting  enforcement  authority  to  states’ 
Attorneys  General  in  addition  to  the  HHS  Office  for  Civil  Rights  (“OCR”).  Additionally,  in  a  final  rule 
issued  in  January  2013,  HHS  modified  the  standard  for  determining  whether  a  breach  has  occurred  by 
creating  a  presumption  that  any  non-permitted  acquisition,  access,  use  or  disclosure  of  protected  health 
information  is  a  breach  unless  the  covered  entity  or  business  associate  can  demonstrate  through  a  risk 
assessment that there is a low probability that the information has been compromised. 

14 

Various  states  have  similar  laws  and  regulations  that  govern  the  maintenance  and  safeguarding  of 
patient  records,  charts  and  other  information  generated  in  connection  with  the  provision  of  professional 
medical  services.  These  laws  and  regulations  require  our  operators  to  expend  the  requisite  resources  to 
secure  protected  health  information,  including  the  funding  of  costs  associated  with  technology  upgrades. 
Operators  found  in  violation  of  HIPAA  or  any  other  privacy  law  or  regulation  may  face  significant 
monetary penalties. In addition, compliance with an operator’s notification requirements in the event of  a 
breach of unsecured protected health information could cause reputational harm to an operator’s business. 

Licensing and Certification.  Our operators and facilities are subject to various federal, state and local 
licensing  and  certification  laws  and  regulations,  including  laws  and  regulations  under  Medicare  and 
Medicaid requiring operators of  SNFs and ALFs to comply with extensive standards governing operations. 
Governmental  agencies  administering  these  laws  and  regulations  regularly  inspect  our  operators’ facilities 
and  investigate  complaints.  Our  operators  and  their  managers  receive  notices  of  observed  violations  and 
deficiencies from time to time, and sanctions have been imposed from time to time on facilities operated by 
them.  In  addition,  many  states  require  certain  healthcare  providers  to  obtain  a  certificate  of  need,  which 
requires prior approval for the construction, expansion or closure of  certain healthcare facilities, which has 
the potential to impact some of our operators’ abilities to expand or change their businesses. 

Other Laws and Regulations.  Additional federal, state and local laws and regulations affect how our 
operators conduct their operations, including laws and regulations protecting consumers against deceptive 
practices  and  otherwise  generally  affecting  our  operators’  management  of  their  property  and  equipment 
and  the  conduct  of  their  operations  (including  laws  and  regulations  involving  fire,  health  and  safety;  the 
Americans  with  Disabilities  Act  (the  “ADA”),  which  imposes  certain  requirements  to  make  facilities 
accessible to persons with disabilities, the costs for which we may be directly or indirectly responsible; the 
U.S.  Patient  Protection  and  Affordable  Care  Act,  as  amended  by  the  Health  Care  and  Education 
Reconciliation  Act  of  2010  (collectively  referred  to  as  the  “Healthcare  Reform  Law”),  which  amended 
requirements  for  staff  training,  discharge  planning,  infection  prevention  and  control  programs,  and 
pharmacy  services,  among  others;  staffing;  quality  of  services,  including  care  and  food  service;  residents’ 
rights,  including  abuse  and  neglect  laws;  and  health  standards,  including  those  set  by  the  federal 
Occupational  Safety  and  Health  Administration  (in  the  U.S.).  It  is  anticipated  that  our  operators  will 
continue  to  face  additional  federal  and  state  regulatory  requirements  related  to  the  operation  of  their 
facilities in response to the COVID-19 pandemic. These requirements may continue to evolve and develop 
over lengthy periods of time. 

General  and  Professional  Liability.  Although  arbitration  agreements  have  been  effective  in  limiting 
general and professional liabilities for SNF and long-term care providers, there have been numerous lawsuits 
in  recent  years  challenging  the  validity  of  arbitration  agreements  in  long-term  care  settings.  On  July  16, 
2019,  CMS  issued  a  final  rule  lifting  the  prohibition  on  pre-dispute  arbitration  agreements  offered  to 
residents at the time of  admission provided that certain requirements are met. The rule prohibits providers 
from  requiring  residents  to  sign  binding  arbitration  agreements  as  a  condition  for  receiving  care  and 
requires  that  the  agreements  specifically  grant  residents  the  explicit  right  to  rescind  the  agreement  within 
thirty calendar days of  signing. A number of  professional liability and employment related claims have been 
filed or are threatened to be filed against long-term care providers related to COVID-19. While such claims 
may be subject to liability protection provisions within various state executive orders or legislation and/or 
federal legislation, an adverse resolution of  any of  legal proceeding or investigations against our operators 
may  involve  injunctive  relief  and/or  substantial  monetary  penalties,  either  or  both  of  which  could  have  a 
material adverse effect on our operators’ reputation, business, results of operations and cash flows. 

U.K. Regulations.  The U.K. also imposes very high levels of  regulation on our U.K.-based operators. 
In  England,  where  all  of  our  operators  are  based,  the  Care  Quality  Commission  has  regulatory  oversight 
authority over the health and social care sectors and is responsible for approving, registering and inspecting 
our  operators  and  the  properties  where  they  provide  services.  There  is  also  a  detailed  legislative  and 
regulatory framework in the U.K. designed to protect the vulnerable (whether by virtue of  age or physical 
and/or  mental  impairment)  and  to  prevent  abuse.  Each  of  these  regulatory  regimes  carries  significant 
enforcement powers, including the ability to criminally prosecute offending operators and facilities, impose 
fines or revoke registrations. Additionally, under the purview of  the Competition and Markets Authority, 
local  authorities  are  tasked  with  providing  and  funding  the  care  needs  of  eligible  residents  within  the 
applicable local authority area. There is ongoing debate and uncertainty within the U.K. as to how growing 

15 

care needs will be met and funded in the future, and it is not clear at this stage what, if  any, or the extent of 
such, impact will be on our U.K-based operators. 

Additionally, there has been significant legislation passed and guidance issued in the U.K. in respect of 
the COVID-19 pandemic. Much of  the legislation or guidance set out the additional precautions, measures 
or restrictions which were required in the care sector, including infection control measures and vaccination 
requirements for care sector workers. As the U.K. transitions to a post-COVID-19 pandemic position with 
lessened  regulation  across  the  U.K  as  a  whole,  the  care  sector  remains  subject  to  specific  COVID-19 
guidance and requirements issued by the Care Quality Commission and the U.K. government’s Department 
for  Health  and  Social  Care,  including  in  relation  to  infection  control  measures,  the  use  of  personal 
protective equipment and testing. As a result, our U.K. operators still face significantly increased regulatory 
burdens  under  which  they  must  deliver  services  and  continue  to  experience  significant  impacts  on  their 
operations and financial condition, which has been somewhat offset by the level of stimulus provided. 

Environmental, Social and Governance (“ESG”) 

We  prioritize  environmental,  social  and  governance  initiatives  that  matter  most  to  our  business  and 
shareholders. Our Nominating and Corporate Governance Committee of  our Board of  Directors has been 
charged with primary oversight of  our sustainability efforts. The Company has established an ESG Steering 
Committee, with senior representation from all divisions of  the company, that is responsible for advancing 
the  Company’s  governance,  sustainability,  and  social  programs,  including  diversity  and  inclusion.  The 
Nominating and Corporate Governance Committee exercises oversight of the ESG Steering Committee. 

As a triple-net landlord, our third-party operators maintain operational control and responsibility for 
our  real  estate  on  a  day-to-day  basis.  While  our  ability  to  mandate  environmental  changes  to  their 
operations is limited, our tenants are contractually bound to preserve and maintain our properties in good 
working  order  and  condition.  In  connection  with  this,  they  are  required  to  meet  or  exceed  annual 
expenditure thresholds on capital improvements and enhancements of  our properties, which in some cases 
may facilitate improvements in the environmental performance of  our properties and reduces energy usage, 
water usage, and direct and indirect greenhouse gas emissions. Beginning in 2021, we have also implemented 
a  capital  expenditure  sustainability  initiative  to  encourage  operators  to  invest  in  financially  beneficial  and 
environmentally enhancing investment projects. The goal is to incentivize operators to invest in sustainable 
capital projects that provide a favorable return on investment while reducing the environmental footprint of 
these operations. Our due diligence on real estate acquisitions generally includes environmental assessments 
as  part  of  our  analysis  to  understand  the  environmental  condition  of  the  property,  and  to  determine 
whether the property meets certain environmental standards. Similarly, during the due diligence process, we 
seek to evaluate the risk of  physical, natural disaster or extreme weather patterns on the properties we are 
looking to acquire and to assess their compliance with building codes, which often results in remediations 
that incorporate sustainable improvements into our properties. 

We  are  committed  to  providing  a  positive  and  engaging  work  environment  for  our  employees  and 
taking an active role in the betterment of  the communities in which our employees live and work. See also 
“Human Capital Management” immediately below. 

Additional information regarding our ESG programs and initiatives is available in the ESG section of 
our  website  at  www.omegahealthcare.com.  Information  on  our  website,  including  our  Corporate  ESG 
Report or sections thereof, is not incorporated by reference into this Annual Report. 

Human Capital Management 

Our success is based on the focused passion and dedication of  our people. We believe our employees’ 
commitment to Omega provides better service to our tenants and stakeholders, supports an inclusive and 
collegial  working  environment  and  generates  long-term  value  for  our  shareholders  and  the  communities 
which we serve. As of  February 1, 2023, we had 52 employees including the executive officers listed below, 
none of  whom is subject to a collective bargaining agreement. Due to the size and nature of  our business, 
our future performance depends to a significant degree upon the continued contributions of  our executive 
management  team  and  other  key  employees.  As  such,  the  ability  to  attract,  develop  and  retain  qualified 
personnel will continue to be important to the Company’s long-term success. 

16 

We have a long-standing commitment to being an equal opportunity employer. Additionally, in 2021, 
we  reinforced  our  diversity  and  inclusion  commitment  by  signing  the  CEO  Action  for  Diversity  and 
Inclusion  Pledge,  one  of  the  largest  CEO-driven  business  commitments  to  act  on  and  advance  diversity, 
equity and inclusion in the workplace. The Company has expanded its recruitment practices to reach more 
diverse  candidates  for  employment  and  Board  positions  and  has  developed  an  internship  program  with  a 
focus  on  increasing  diversity  in  the  pipeline  of  eligible  employees.  The  Company  requires  employees  and 
Board  members  to  certify  its  Code  of  Business  Conduct  &  Ethics  periodically,  and  from  time  to  time, 
conducts compliance training for all employees and Directors, including diversity and inclusion training. As 
of  February  1,  2023,  at  the  executive  level,  one  of  the  Company’s  four  executive  officers  is  a  woman  and 
brings ethnic diversity to the team, and on the senior management team, 25% are women and 25% bring 
ethnic diversity to the team. We regularly conduct pay equity reviews as we seek for women and men, on 
average, at various roles and levels of  the Company, to be paid equitably for their roles and contributions to 
our success. 

We  are  committed  to  providing  a  positive  and  engaging  work  environment  for  our  employees  and 
taking  an  active  role  in  the  betterment  of  the  communities  in  which  our  employees  live  and  work.  Our 
full-time  employees  are  provided  a  competitive  benefits  program,  including  comprehensive  healthcare 
benefits and a 401(k) plan with a matching contribution from the Company, the opportunity to participate 
in our employee stock purchase program, bonus and incentive pay opportunities, competitive paid time-off 
benefits and paid parental leave, wellness programs, continuing education and development opportunities, 
and periodic engagement surveys. In addition, we believe that giving back to our community is an extension 
of  our mission to improve the lives of  our stockholders, our employees, and their families. The Company 
has implemented a matching program for charitable contributions of  employees, provides annual charitable 
donations  to  our  local  Baltimore  community  and  has  implemented  a  scholarship,  mentorship  and 
internship program with a local, historically Black university. 

Information about our Executive Officers 

Biographical information regarding our executive officers and their ages as of  February 1, 2023 are set 

forth below: 

C. Taylor Pickett (61) is our Chief  Executive Officer and has served in this capacity since June 2001. 
Mr.  Pickett  has  also  served  as  Director  of  the  Company  since  May  30,  2002.  Mr.  Pickett  has  also  been  a 
member  of  the  board  of  trustees  of  Corporate  Office  Properties  Trust,  an  office  REIT  focusing  on  U.S. 
government  agencies  and  defense  contractors,  since  November  2013.  From  January  1993  to  June  2001, 
Mr. Pickett served as a member of  the senior management team of  Integrated Health Services, Inc., most 
recently  as  Executive  Vice  President  and  Chief  Financial  Officer.  Prior  to  joining  Integrated  Health 
Services, Inc. Mr. Pickett held various positions at PHH Corporation and KPMG Peat Marwick. 

Daniel J. Booth (59) is our Chief  Operating Officer and has served in this capacity since October 2001. 
From 1993 to October 2001, Mr. Booth served as a member of  the management team of  Integrated Health 
Services,  Inc.,  most  recently  serving  as  Senior  Vice  President,  Finance.  Prior  to  joining  Integrated  Health 
Services,  Inc.,  Mr.  Booth  served  as  a  Vice  President  in  the  Healthcare  Lending  Division  of  Maryland 
National Bank (now Bank of America). 

Robert  O.  Stephenson  (59)  is  our  Chief  Financial  Officer  and  has  served  in  this  capacity  since 
August 2001. From 1996 to July 2001, Mr. Stephenson served as the Senior Vice President and Treasurer of 
Integrated  Health  Services,  Inc.  Prior  to  joining  Integrated  Health  Services,  Inc.,  Mr.  Stephenson  held 
various positions at CSX Intermodal, Inc., Martin Marietta Corporation and Electronic Data Systems. 

Gail D. Makode (47) is our Chief  Legal Officer, General Counsel and has served in this capacity since 
September 2019. Previously, she served as Senior Vice President, General Counsel and Corporate Secretary 
of  IES  Holdings,  Inc.,  from  October  2012  to  September  2019.  Prior  to  IES,  she  served  in  various  legal 
capacities  at  MBIA  Inc.,  including  as  General  Counsel  and  Member  of  the  Board  at  MBIA  Insurance 
Corporation  and  Chief  Compliance  Officer  of  MBIA  Inc.,  from  2006  to  2012.  Earlier  in  her  career,  she 
served  as  Vice  President  and  Counsel  for  Deutsche  Bank  AG,  and  as  an  associate  at  Cleary,  Gottlieb, 
Steen,  &  Hamilton,  where  she  specialized  in  public  and  private  securities  offerings  and  mergers  and 
acquisitions. 

17 

Available Information 

Our  website  address  is  www.omegahealthcare.com.  Our  Annual  Reports  on  Form  10-K,  Quarterly 
Reports  on  Form  10-Q,  Current  Reports  on  Form  8-K  and  any  amendments  to  those  reports  filed  or 
furnished pursuant to Section 13(a) or 15(d) of  the Securities Exchange Act of  1934 (the “Exchange Act”) 
are available on our website, free of charge, as soon as reasonably practicable after we electronically file such 
materials  with,  or  furnish  them  to,  the  U.S.  Securities  and  Exchange  Commission  (“SEC”).  Additionally, 
the  SEC  maintains  a  website  that  contains  reports,  proxy  and  information  statements,  and  other 
information regarding issuers that file electronically with the SEC, including us, at www.sec.gov. 

18 

Item 1A — Risk Factors 

This  section  discusses  material  risk  factors  that  may  affect  our  business,  operations  and  financial 
condition. It does not describe all risks and uncertainties applicable to us, our industry or ownership of  our 
securities. If  any of  the following risks, or any other risks and uncertainties that are not addressed below or 
that we have not yet identified, actually occur, we could be materially adversely affected and the value of our 
securities could decline. 

Risks Related to the Operators of Our Facilities 

Our  financial  position  could  be  weakened  and  our  ability  to  make  distributions  and  fulfill  our 
obligations with respect to our indebtedness could be limited if  our operators, or a portion thereof, become 
unable  to  meet  their  obligations  to  us  or  fail  to  renew  or  extend  their  relationship  with  us  as  their  lease 
terms expire or their mortgages mature, or if  we become unable to lease or re-lease our facilities or make 
mortgage loans on economically favorable terms. We have no operational control over our operators. 

The bankruptcy or insolvency of our operators could limit or delay our ability to recover on our investments. 

We  are  exposed  to  the  risk  that  a  distressed  or  insolvent  operator  may  not  be  able  to  meet  its  lease, 
loan, mortgage or other obligations to us or other third parties. This risk is heightened during a period of 
economic or political instability. Although each of  our lease and loan agreements typically provides us with 
the  right  to  terminate,  evict  an  operator,  foreclose  on  our  collateral,  demand  immediate  payment  and 
exercise  other  remedies  upon  the  bankruptcy  or  insolvency  of  an  operator,  title  11  of  the  U.S.  Code  (the 
“Bankruptcy Code”) would limit or, at a minimum, delay our ability to collect unpaid pre-bankruptcy rents 
and  mortgage  payments  and  to  pursue  other  remedies  against  a  bankrupt  operator.  While  we  sometimes 
have third-party guarantees of  an operator’s lease or loan obligations, such guarantees can be expensive to 
enforce, and have their own risks of collection as against the guarantors. 

Leases.  A bankruptcy filing by one of  our lessee operators would typically prevent us from collecting 
unpaid  pre-bankruptcy  rents  or  evicting  the  operator,  absent  approval  of  the  bankruptcy  court.  The 
Bankruptcy  Code  provides  a  lessee  with  the  option  to  assume  or  reject  an  unexpired  lease  within  certain 
specified  periods  of  time.  Generally,  a  lessee  is  required  to  pay  all  rent  that  becomes  payable  between  the 
date  of  its  bankruptcy  filing  and  the  date  of  the  assumption  or  rejection  of  the  lease  (although  such 
payments will likely be delayed as a result of  the bankruptcy filing). If  one of  our lessee operators chooses 
to assume its lease with us, the operator must promptly cure all monetary defaults existing under the lease 
(including  payment  of  unpaid  pre-bankruptcy  rents)  and  provide  adequate  assurance  of  its  ability  to 
perform its future lease obligations. Even where a lessee operator assumes its lease with us, it will first often 
threaten  to  reject  that  lease  to  obtain  better  lease  terms  from  us,  and  we  sometimes  have  to  consider 
making, or we do make, such economic concessions to avoid rejection of  the lease and our taking a closed 
facility back. If  one of  our lessee operators opts to reject its lease with us, we would have a claim against 
such  operator  for  unpaid  and  future  rents  payable  under  the  lease,  but  such  claim  would  be  subject  to  a 
statutory “cap” under the Bankruptcy Code, and would likely result in a recovery substantially less than the 
face  value  of  such  claim.  Although  the  operator’s  rejection  of  the  lease  would  permit  us  to  recover 
possession of  the leased facility, we would likely face losses, costs and delays associated with repairs and/or 
maintenance of  the facility and then re-leasing the facility to a new operator, or costs associated with selling 
the facility. In any event, re-leasing a facility or selling it could take a material amount of  time, and the pool 
of  interested  and  qualified  tenants  or  buyers  will  be  limited  due  to  the  unique  nature  of  our  properties, 
which may depress values and our eventual recovery. Finally, whether a lease operator in bankruptcy ends 
up  assuming  or  rejecting  our  lease,  we  will  incur  legal  and  collection  costs,  which  can  be  difficult  or 
impossible to recover. 

Several other factors could impact our rights under leases with bankrupt operators. First, the operator 
could  seek  to  assign  its  lease  with  us  to  a  third  party.  The  Bankruptcy  Code  disregards  anti-assignment 
provisions  in  leases  to  permit  the  assignment  of  unexpired  leases  to  third  parties  (provided  all  monetary 
defaults  under  the  lease  are  promptly  cured  and  the  assignee  can  demonstrate  its  ability  to  perform  its 
obligations under the lease). Second, in instances in which we have entered into a master lease agreement 
with an operator that operates more than one facility, the bankruptcy court could determine that the master 
lease was comprised of  separate, divisible leases (each of  which could be separately assumed or rejected), 

19 

rather than a single, integrated lease (which would have to be assumed or rejected in its entirety). Finally, 
the  bankruptcy  court  could  re-characterize  our  lease  agreement  as  a  disguised  financing  arrangement, 
which  could  require  us  to  receive  bankruptcy  court  approval  to  foreclose  or  pursue  other  remedies  with 
respect to the facility. 

Mortgages.  A bankruptcy filing by an operator to which we have made a loan secured by a mortgage 
would  typically  prevent  us  from  collecting  unpaid  pre-bankruptcy  mortgage  payments  and  foreclosing  on 
our collateral, absent approval of  the bankruptcy court. As an initial matter, we could ask the bankruptcy 
court to order the operator to make periodic payments or provide other financial assurances to us during 
the  bankruptcy  case  (known  as  “adequate  protection”),  but  the  ultimate  decision  regarding  “adequate 
protection”  (including  the  timing  and  amount  of  any  “adequate  protection”  payments)  rests  with  the 
bankruptcy court. In addition, we would need bankruptcy court approval before commencing or continuing 
any  foreclosure  action  against  the  operator’s  collateral  (including  a  facility).  The  bankruptcy  court  could 
withhold  such  approval,  especially  if  the  operator  can  demonstrate  that  the  facility  or  other  collateral  is 
necessary for an effective reorganization and that we have a sufficient “equity cushion” in the facility or that 
we are otherwise protected from any diminution in value of  the collateral. If  the bankruptcy court does not 
either  grant  us  “adequate  protection” or  permit  us  to  foreclose  on  our  collateral,  we  may  not  receive  any 
loan  payments  until  after  the  bankruptcy  court  confirms  a  plan  of  reorganization  for  the  operator.  In 
addition,  in  any  bankruptcy  case  of  an  operator  to  which  we  have  made  a  loan,  the  operator  may  seek 
bankruptcy court approval to pay us (i) over a longer period of  time than the terms of  our loan, (ii) at a 
different interest rate, and/or (iii) for only the value of  the collateral, instead of  the full amount of  the loan. 
Finally, even if  the bankruptcy court permits us to foreclose on the facility, we would still be subject to the 
losses,  costs  and  other  risks  associated  with  a  foreclosure  sale,  including  possible  successor  liability  under 
government  programs,  indemnification  obligations  and  suspension  or  delay  of  third-party  payments. 
Should such events occur, our income and cash flow from operations would be adversely affected. 

Failure  by  our  operators  to  comply  with  government  regulations  may  adversely  impact  their  ability  to  make 
debt or lease payments to us. 

Our operators are subject to numerous federal, state and local laws and regulations in the U.S. and, for 
certain operators, in the U.K., including those described in Item 1. Business — Government Regulation and 
Reimbursement. Laws and regulations impacting our operators include, without limitation, those relating to 
reimbursement  (including  Medicare  and  Medicaid  reimbursement  programs  in  the  U.S.),  quality  of  care 
initiatives, licensing and certification of  our operators, fraud and abuse laws and regulations, privacy and 
security laws. Other federal, state and local laws and regulations also affect how our operators conduct their 
operations.  We  cannot  predict  the  effect  that  the  costs  of  complying  with  these  laws  may  have  on  the 
revenues of  our operators, and thus their ability to meet their obligations to us. In addition, requirements 
applicable  to  our  operators  are  subject  to  frequent  and  substantial  changes  (sometimes  applied 
retroactively)  resulting  from  new  legislation,  adoption  of  rules  and  regulations,  and  administrative  and 
judicial interpretations of  existing law, and any changes in the regulatory framework could have a material 
adverse  effect  on  our  tenants,  operators,  guarantors  and  managers.  Any  of  these  changes  may  be  more 
pronounced  following  federal  and  state  leadership  changes  and  particularly  following  a  change  in 
presidential  administrations.  The  ultimate  timing  or  effect  of  these  changes  cannot  be  predicted.  These 
changes  may  have  a  dramatic  effect  on  our  operators’  costs  of  doing  business  and  on  the  amount  of 
reimbursement  by  both  government  and  other  third-party  payors.  The  failure  of  any  of  our  operators  to 
comply  with  these  laws,  requirements  and  regulations  could  adversely  affect  their  ability  to  meet  their 
obligations  to  us.  If  we  fail  to  effectively  implement  or  appropriately  adjust  our  operational  and  strategic 
initiatives with respect to the implementation of  new laws and regulations, or do not do so as effectively as 
our competitors, our results of operations may be materially adversely affected. 

Our  U.S.  operators  depend  on  reimbursement  from  governmental  and  other  third-party  payors,  and 
reimbursement  rates  from  such  payors  may  be  reduced  or  modified,  including  through  reductions  to  the 
Medicare and Medicaid programs. 

Changes in the reimbursement rate or methods of  payment from governmental and other third-party 
payors, including the Medicare and Medicaid programs, or the implementation of  other measures to reduce 
reimbursements for services provided by our operators has in the past, and could in the future, result in a 

20 

substantial reduction in our operators’ revenues and operating margins. Reimbursement from governmental 
and  other  third-party  payors  could  be  reduced  as  part  of  spending  cuts  and  tax  reform  initiatives  that 
impact  Medicare,  Medicaid  or  Medicare  Advantage  Plans,  or  as  part  of  retroactive  adjustments  during 
claims settlement processes or as a result of  post-payment audits. Further, alternative payment models, as 
well as other regulatory initiatives, have the potential to affect Medicare payments to SNFs, including, but 
not  limited  to,  provisions  changing  the  payment  methodology,  setting  reimbursement  caps,  implementing 
value-based  purchasing  and  payment  bundling,  and  studying  the  appropriateness  of  restrictions  on 
payments for healthcare acquired conditions. In some cases, states have enacted or are considering enacting 
measures designed to reduce Medicaid expenditures or freeze Medicaid rates, to allocate funding available 
for  reimbursement  away  from  SNFs  in  favor  of  home  health  agencies  and  community-based  care,  and  to 
make changes to private healthcare insurance. Several commercial payors have expressed an intent to pursue 
certain  value-based  purchasing  models  and  initiatives.  Since  our  operators’  profit  margins  on  Medicaid 
patients are generally relatively low, more than modest reductions in Medicaid reimbursement to our SNF 
operators  and  an  increase  in  the  number  of  Medicaid  patients  could  place  some  operators  in  financial 
distress,  which  in  turn  could  adversely  affect  us.  If  funding  for  Medicare  and/or  Medicaid  is  reduced,  it 
could have a material adverse effect on our operators’ results of  operations and financial condition, which 
could adversely affect our operators’ ability to meet their obligations to us. Significant limits on the scope of 
services  reimbursed  and  on  reimbursement  rates,  as  well  as  changes  in  reimbursement  policies  or  other 
measures  altering  payment  methodologies  for  services  provided  by  our  operators,  could  have  a  material 
adverse  effect  on  our  operators’  results  of  operations  and  financial  condition,  which  could  cause  the 
revenues of our operators to decline and negatively impact their ability to meet their obligations to us. 

We may be unable to find a replacement operator for one or more of our leased properties. 

From time to time, we need to find a replacement operator for one or more of  our leased properties for 
a  variety  of  reasons,  including  upon  the  expiration  of  the  lease  term  or  the  occurrence  of  an  operator 
default.  While  we  are  attempting  to  locate  one  or  more  replacement  operators,  we  sometimes  experience 
and may in the future experience a decrease or cessation of  rental payments on the applicable property or 
properties.  We  cannot  assure  you  that  any  of  our  current  or  future  operators  will  elect  to  renew  their 
respective leases with us upon expiration of  the terms thereof. Similarly, we cannot assure you that we will 
be able to locate a suitable replacement operator or, if  we are successful in locating a replacement operator, 
that  the  rental  payments  from  the  new  operator  would  not  be  significantly  less  than  the  existing  rental 
payments. Our ability to locate a suitable replacement operator may be significantly delayed or limited by 
various state licensing, receivership, certificate of  need or other laws, as well as by Medicare and Medicaid 
change-of-ownership rules. We also may incur substantial additional expenses in connection with any such 
licensing, receivership or change-of-ownership proceedings. Any such delays, limitations and expenses could 
materially  delay  or  impact  our  ability  to  collect  rent,  obtain  possession  of  leased  properties  or  otherwise 
exercise remedies for default. 

Our operators may be subject to significant legal actions that could result in their increased operating costs and 
substantial  uninsured  liabilities,  which  may  affect  their  ability  to  meet  their  obligations  to  us;  and  we  may 
become party to such legal actions. 

Our operators may be subject to claims for damages relating to the services that they provide. While we 
are unable to predict the scope of  future federal, state and local regulations and legislation, including the 
Medicare and Medicaid statutes and regulations, we believe that long-term care providers will continue to 
be the focus of  governmental investigations, particularly in the area of  Medicare/Medicaid false claims and 
in the use of  COVID-19 related funds and compliance with infection control and quality standards. We can 
give  no  assurance  that  the  insurance  coverage  maintained  by  our  operators  will  cover  all  claims  made 
against them or continue to be available at a reasonable cost, if  at all. In some states, insurance coverage for 
the risk of  punitive damages arising from professional and general liability claims and/or litigation may not, 
in  certain  cases,  be  available  to  operators  due  to  state  law  prohibitions  or  limitations  of  availability.  As  a 
result, our operators operating in these states may be liable for punitive damage awards that are either not 
covered or are in excess of their insurance policy limits. 

Any  adverse  determination  in  a  legal  proceeding  or  governmental  investigation,  whether  currently 
asserted  or  arising  in  the  future,  could  have  a  material  adverse  effect  on  an  operator’s  financial  condition 

21 

and  its  ability  to  meet  its  obligations  to  us,  which,  in  turn,  could  have  a  material  adverse  effect  on  our 
business, financial condition, results of operations and ability to make distributions to our stockholders. 

In addition, we may in some circumstances be named as a defendant in litigation involving the services 
provided by our operators. In the past, we and several of  our wholly-owned subsidiaries have been named 
as  defendants  in  professional  liability  and  general  liability  claims  related  to  our  owned  and  operated 
facilities, and we could be named as defendants in similar suits in the future. In these suits, patients of  our 
operators have alleged significant damages, including punitive damages, against the defendants. Although 
we generally have no involvement in the services provided by our operators, and our standard lease and loan 
agreements generally require our operators to indemnify us and carry insurance to cover us in certain cases, 
a significant judgment against us in such litigation could exceed our and our operators’ insurance coverage, 
which would require us to make payments to cover the judgment. 

Increased competition as well as increased operating costs result in lower revenues for some of  our operators 
and may affect the ability of our operators to meet their obligations to us. 

The  long-term  healthcare  industry  is  highly  competitive,  and  we  expect  that  it  may  become  more 
competitive in the future. Our operators are competing with numerous other companies providing similar 
healthcare services or alternatives such as home health agencies, life care at home, community-based service 
programs,  retirement  communities  and  convalescent  centers.  Our  operators  compete  on  a  number  of 
different  levels  including  the  quality  of  care  provided,  reputation,  the  physical  appearance  of  a  facility, 
price,  the  range  of  services  offered,  family  preference,  alternatives  for  healthcare  delivery,  the  supply  of 
competing  properties,  physicians,  staff,  referral  sources,  location  and  the  size  and  demographics  of  the 
population in the surrounding areas. Our operators may encounter increased competition in the future that 
could  limit  their  ability  to  attract  residents  or  expand  their  businesses  and  therefore  affect  their  ability  to 
pay their lease or mortgage payments and meet their obligations to us. 

In addition, the market for qualified personnel is highly competitive and our operators may experience 
difficulties  in  attracting  and  retaining  such  personnel,  in  particular  due  to  labor  constraints  and,  in  some 
cases, wage increases, which have been elevated since the beginning of  the COVID-19 pandemic and may 
continue  to  remain  elevated.  Increases  in  labor  costs  could  affect  our  operators’  ability  to  meet  their 
obligations to us, which could be particularly acute in certain states that have established minimum staffing 
requirements. 

We may be unable to successfully foreclose on the collateral securing our mortgage loans, and even if  we are 
successful in our foreclosure efforts, we may be unable to successfully find a replacement operator, or operate 
or occupy the underlying real estate, which may adversely affect our ability to recover our investments. 

If  an operator defaults under one of  our mortgage loans, we may foreclose on the loan or otherwise 
protect  our  interest  by  acquiring  title  to  the  property.  In  such  a  scenario,  we  may  be  required  to  make 
substantial improvements or repairs to maximize the facility’s investment potential. Operators may contest 
enforcement  of  foreclosure  or  other  remedies,  seek  bankruptcy  protection  against  our  exercise  of 
enforcement  or  other  remedies  and/or  bring  claims  for  lender  liability  in  response  to  actions  to  enforce 
mortgage obligations. Even if  we are able to successfully foreclose on the collateral securing our mortgage 
loans,  we  may  be  unable  to  expeditiously  find  a  replacement  operator,  if  at  all,  or  otherwise  successfully 
operate or occupy the property, which could adversely affect our ability to recover our investment. 

Inflation could adversely impact our operators and our results of operations. 

Inflation, both real or anticipated, as well as any resulting governmental policies, could adversely affect 
the economy and the costs of  labor, goods and services to our operators or borrowers. Our long-term leases 
and loans typically contain provisions such as rent and interest escalators that are designed to mitigate the 
adverse impact of  inflation on Omega’s results of  operations. However, these provisions may have limited 
effectiveness  at  mitigating  the  risk  of  high  levels  of  inflation  due  to  contractual  limits  on  escalation  that 
exist  in  substantially  all  of  our  escalation  provisions.  Our  leases  are  triple-net  and  typically  require  the 
operator to pay all property operating expenses, and therefore, increases in property-level expenses at our 
leased  properties  generally  do  not  directly  affect  us.  However,  increased  operating  costs  resulting  from 

22 

inflation  have  had,  and  may  continue  to  have,  an  adverse  impact  on  our  operators  and  borrowers  if 
increases in their operating expenses exceed increases in their reimbursements, which has affected, and may 
continue to adversely affect, our operators’ or borrowers’ ability to pay rent or other obligations owed to us. 

An increase in our operators’ expenses and a failure of  their reimbursements to increase at least with 

inflation could adversely impact our operators’ and our financial condition and our results of operations. 

Uninsured losses or losses in excess of  our operators’ insurance coverage could adversely affect our financial 
position and our cash flow. 

Under the terms of  our leases, our operators are generally required to maintain comprehensive general 
liability, fire, flood, earthquake, boiler and machinery, nursing home or long-term care professional liability 
and  extended  coverage  insurance  with  respect  to  our  properties  with  policy  specifications  set  forth  in  the 
leases or other written agreements between us and the operator. However, our properties may be adversely 
affected by casualty or other losses which exceed insurance coverages and reserves. In addition, we cannot 
provide  any  assurances  that  our  tenants  will  maintain  the  required  coverages,  that  we  will  continue  to 
require the same levels of  insurance under our leases, or that such insurance will be available at a reasonable 
cost  in  the  future  or  that  the  policies  maintained  will  fully  cover  all  losses  on  our  properties  upon  the 
occurrence of  a catastrophic event. We also cannot make any guaranty as to the future financial viability of 
the  insurers  that  underwrite  the  policies  maintained  by  our  tenants,  or,  alternatively  if  our  tenants  utilize 
captive or self-insurance programs, that such programs will be adequately funded. 

Should an uninsured loss or a loss in excess of  insured limits occur, we could lose both our investment 
in, and anticipated profits and cash flows from, the property and disputes over insurance claims could arise. 
Even if  it were practicable to restore the property to its condition prior to the damage caused by a major 
casualty,  the  operations  of  the  affected  property  would  likely  be  suspended  for  a  considerable  period  of 
time. 

Our development and redevelopment projects may not yield anticipated returns. 

We  consider  and,  when  appropriate,  invest  in  various  development  and  redevelopment  projects.  In 
deciding whether to make an investment in a particular project, we make certain assumptions regarding the 
expected future performance of  the property. Our assumptions are subject to risks generally associated with 
development and redevelopment projects, including, among others, that: 

•  Our operators may not be able to complete the project on schedule or within budgeted amounts; 

•  Our operators may encounter delays in obtaining or fail to obtain all necessary zoning, land use, 
building,  occupancy,  environmental  and  other  governmental  permits  and  authorizations,  or 
underestimate the costs necessary to develop or redevelop the property to market standards; 

•  Volatility in the price of construction materials or labor may increase project costs; 

• 

The builders may fail to perform or satisfy the expectations of our operators; 

•  We may incorrectly forecast risks associated with development in new geographic regions; 

•  Demand  for  our  project  may  decrease  prior  to  completion,  due  to  competition  from  other 

developments; and 

•  New facilities may take longer than expected to reach stabilized operating levels, if at all. 

If  any of  the risks described above occur, our development and redevelopment projects may not yield 

anticipated returns, which could have a material adverse effect on us. 

Risks Related to Us and Our Operations 

The  COVID-19  pandemic  and  measures  intended  to  prevent  its  spread,  as  well  as  a  future  variant  of 
COVID-19 or unrelated pandemic, could have a material adverse effect on our business, results of  operations, 
cash flows and financial condition. 

The COVID-19 pandemic has significantly and adversely impacted SNFs and long-term care providers 
due to the higher rates of  virus transmission and fatality among the elderly and frail populations that these 

23 

facilities serve, as well as reduced revenue due to lower occupancy and increased expenses and uncertainties 
regarding  the  continuing  availability  of  sufficient  government  support  and  sufficiency  of  Medicare  and 
Medicaid reimbursement rates to address longer-term cost increases faced by operators. As a result, many 
of  our  operators  have  been,  and  may  continue  to  be,  significantly  impacted  by  the  pandemic.  See  Part  II 
Item  7 — Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of 
Operations — Overview. 

Our facilities, on average, experienced declines, in some cases that are material, in occupancy levels as a 
result  of  the  pandemic.  Occupancy  in  our  facilities  has  generally  improved  on  average  since  early  2021; 
however,  average  occupancy  has  not  returned  to  pre-pandemic  levels.  It  remains  unclear  when  and  the 
extent  to  which  demand  and  occupancy  levels  will  return  to  pre-COVID-19  levels.  We  believe  these 
challenges  to  occupancy  recovery  may  be  in  part  due  to  staffing  shortages,  which  in  some  cases  have 
required operators to limit admissions, as well as COVID-19 related fatalities at the facilities, the delay of 
SNF placement and/or utilization of  alternative care settings for those with lower level of  care needs, the 
suspension and/or postponement of  elective hospital procedures, fewer discharges from hospitals to SNFs 
and higher hospital readmittances from SNFs. 

While  certain  states  have  provided  pandemic-related  relief  measures  and/or  reimbursement  increases, 
there remains uncertainty as to how widespread these measures will continue to be and to what extent they 
may  be  distributed  to  and  benefit  our  operators,  especially  when  the  federally  declared  public  health 
emergency expires as scheduled on May 11, 2023, or previously released federal funds to states have been 
fully  utilized.  Likewise,  while  certain  states  may  in  the  course  of  routine  rate-setting  of  Medicaid  rates 
address inflationary factors and other expense-related items, there can be no assurance that these changes 
will be sufficient to offset existing increased inflation and expenses or that all states will address these items. 
See the “Government Regulation and Reimbursement” section for additional information. Further, to the 
extent  the  cost  and  occupancy  impacts  on  our  operators  continue  or  accelerate  and  are  not  offset  by 
continued  government  relief  that  is  sufficient  and  timely,  we  anticipate  that  the  operating  results  of 
additional operators may be materially and adversely affected, some may be unwilling or unable to pay their 
contractual  obligations  to  us  in  full  or  on  a  timely  basis  and  we  may  be  unable  to  restructure  such 
obligations on terms as favorable to us as those currently in place. 

There  are  a  number  of  uncertainties  we  face  as  we  consider  the  continuing  impact  of  COVID-19  on 
our  business,  including  how  long  census  disruption  and  related  cost  increases  will  last,  as  well  as  the  rate 
and  impact  of  future  virus  transmission  in  our  facilities,  continued  efficacy  of  vaccination  programs  in 
reducing the spread and severity of  COVID-19 in our facilities, the impact of  genetic mutations of  the virus 
into  new  variants  on  our  facilities,  and  the  extent  to  which  funding  support  from  the  federal  government 
and  the  states  will  offset  these  incremental  costs  as  well  as  lost  revenues.  Notwithstanding  vaccination 
programs,  we  expect  that  heightened  clinical  protocols  for  infection  control  within  facilities  will  continue; 
however, we do not know if  future reimbursement rates or equipment provided by governmental agencies 
will be sufficient to cover the increased costs of enhanced infection control and monitoring. 

Continued uncertainty exists relating to our other operators’ ability to meet their payments obligations 
generally  or  meet  their  payment  obligations  to  us  due  to  these  factors.  To  the  extent  our  operators  are 
unable  to  meet  their  payment  obligations,  we  may  record  additional  impairment  charges  with  respect  to 
straight-line rent receivables associated with any such operator or with respect to outstanding loans and our 
financial  condition  could  be  adversely  impacted.  See  “Our  assets,  including  our  real  estate  and  loans,  are 
subject to impairment charges, and our valuation and reserve estimates are based on assumptions and may 
be subject to adjustment” in Item 1A contained in Part I of this Annual Report on Form 10-K. 

The  COVID-19  pandemic  has  from  time  to  time  also  caused,  and  may  continue  to  cause,  severe 
economic,  market  and  other  disruptions  worldwide.  We  cannot  assure  you  that  conditions  in  the  bank 
lending, capital and other financial markets will not deteriorate or fluctuate as a result of  the COVID-19 
pandemic  or  due  to  a  future  variant  of  COVID-19  or  a  future  unrelated  pandemic,  or  that  our  access  to 
capital  and  other  sources  of  funding  will  not  become  constrained,  which  could  adversely  affect  the 
availability  and  terms  of  future  borrowings,  renewals  or  refinancing.  In  addition,  our  employees  may  be 
impacted directly or indirectly by the pandemic, and we may be required to make changes to our internal 
controls as a result of  changes in our business processes or personnel; any such changes may increase our 
operational and financial reporting risks. 

24 

The  extent  of  the  COVID-19  pandemic’s  effect  on  our  and  our  operators’ operational  and  financial 
performance will depend on future developments, including the ability to control the spread of the outbreak 
generally  and  in  our  facilities,  and  the  delivery  and  efficacy  of  and  participation  in  vaccination  programs 
and other treatments for COVID-19, government funds and other support for the senior care sector and the 
efficacy of  other policies and measures that may mitigate the impact of  the pandemic, as well as the future 
demand  for  needs-based  skilled  nursing  care  and  senior  living  facilities,  all  of  which  are  uncertain  and 
difficult  to  predict.  Due  to  these  uncertainties,  we  are  not  able  at  this  time  to  estimate  the  effect  of  these 
factors on our business, but the adverse impact on our business, results of  operations, financial condition 
and cash flows could be material. 

There are no assurances of our ability to pay dividends in the future. 

Our  ability  to  pay  dividends  may  be  adversely  affected  upon  the  occurrence  of  any  of  the  risks 
described  herein.  Our  payment  of  dividends  is  subject  to  compliance  with  restrictions  contained  in  our 
credit agreements, the indentures governing our senior notes and any preferred stock that our Board may 
from time to time designate and authorize for issuance. All dividends will be paid at the discretion of  our 
Board  and  will  depend  upon  our  earnings,  our  financial  condition,  maintenance  of  our  REIT  status  and 
such  other  factors  as  our  Board  may  deem  relevant  from  time  to  time.  There  are  no  assurances  of  our 
ability to pay dividends in the future. In addition, our dividends in the past have included, and may in the 
future include a return of capital. 

We rely on external sources of  capital to fund future capital needs, and if  we encounter difficulty in obtaining 
such capital, we may not be able to make future investments necessary to grow our business or meet maturing 
commitments. 

As  a  REIT  under  the  Code,  we  are  required  to,  among  other  things,  distribute  at  least  90%  of  our 
REIT taxable income each year to our stockholders. Because of  this distribution requirement, we may not 
be  able  to  fund,  from  cash  retained  from  operations,  all  future  capital  needs,  including  capital  needed  to 
make  investments  and  to  satisfy  or  refinance  maturing  commitments.  As  a  result,  we  rely  on  external 
sources of  capital, including debt and equity financing. If  we are unable to obtain needed capital at all or 
only on unfavorable terms from these sources, we might not be able to make the investments needed to grow 
our business, or to meet our obligations and commitments as they mature, which could negatively affect the 
ratings of  our debt and even, in extreme circumstances, affect our ability to continue operations. We may 
not be in a position to take advantage of  future investment opportunities in the event that we are unable to 
access the capital markets on a timely basis or we are only able to obtain financing on unfavorable terms. 

Our  ability  to  raise  capital  through  equity  sales  is  dependent,  in  part,  on  the  market  price  of  our  common 
stock,  and  our  failure  to  meet  market  expectations  with  respect  to  our  business,  or  other  factors  we  do  not 
control, could negatively impact such market price and availability of equity capital. 

As with other publicly-traded companies, the availability of  equity capital will depend, in part, on the 
market price of  our common stock which, in turn, will depend upon various market conditions and other 
factors, some of which we cannot control, that may change from time to time including: 

• 

• 

• 

• 

• 

• 

the extent of investor interest; 

the general reputation of  REITs and the attractiveness of  their equity securities in comparison to 
other equity securities, including securities issued by other real estate-based companies; 

the financial performance of us and our operators; 

concentrations in our investment portfolio by tenant and facility type; 

concerns about our tenants’ financial condition due to uncertainty regarding reimbursement from 
governmental and other third-party payor programs; 

our  credit  ratings  and  analyst  reports  on  us  and  the  REIT  industry  in  general,  including 
recommendations, and our ability to meet our guidance estimates or analysts’ estimates; 

25 

• 

• 

• 

general  economic,  global  and  market  conditions,  including  changes  in  interest  rates  on  fixed 
income  securities,  which  may  lead  prospective  purchasers  of  our  common  stock  to  demand  a 
higher  annual  yield  from  future  distributions,  or  the  impacts  of  a  future  pandemic  or  global 
conflicts on our operators; 

our  failure  to  maintain  or  increase  our  dividend,  which  is  dependent,  to  a  large  part,  on  the 
increase in funds from operations, which in turn depends upon increased revenues from additional 
investments and rental increases; and 

other  factors  such  as  governmental  regulatory  action  and  changes  in  REIT  tax  laws,  as  well  as 
changes in litigation and regulatory proceedings. 

The market value of  the equity securities of  a REIT is generally based upon the market’s perception of 
the REIT’s growth potential and its current and potential future earnings and cash distributions. Our failure 
to  meet  the  market’s  expectation  with  regard  to  future  earnings  and  cash  distributions  would  likely 
adversely affect the market price of  our common stock and, as a result, the availability of  equity capital to 
us. 

We  are  subject  to  risks  associated  with  debt  financing,  including  changes  in  our  credit  ratings,  which  could 
negatively  impact  our  business  and  limit  our  ability  to  make  distributions  to  our  stockholders  and  to  repay 
maturing debt. 

The financing required to make future investments and satisfy maturing commitments may be provided 
by  borrowings  under  our  credit  facilities,  private  or  public  offerings  of  debt  or  equity,  the  assumption  of 
secured indebtedness, mortgage financing on a portion of our owned portfolio or through joint ventures. To 
the extent we must obtain debt financing from external sources to fund our capital requirements, we cannot 
guarantee  such  financing  will  be  available  on  favorable  terms,  if  at  all.  In  addition,  if  we  are  unable  to 
refinance  or  extend  principal  payments  due  at  maturity  or  pay  them  with  proceeds  from  other  capital 
transactions, our cash flow may not be sufficient to make distributions to our stockholders and repay our 
maturing debt. Furthermore, if  prevailing interest rates, changes in our debt credit ratings or other factors 
at  the  time  of  refinancing  result  in  higher  interest  rates  upon  refinancing,  the  interest  expense  relating  to 
that  refinanced  indebtedness  would  increase,  which  could  reduce  our  profitability  and  the  amount  of 
dividends  we  are  able  to  pay.  Factors  that  may  affect  our  credit  ratings  include,  among  other  things,  our 
financial performance, our success in raising sufficient equity capital, adverse changes in our debt and fixed 
charge coverage ratios, our capital structure and level of  indebtedness and pending or future changes in the 
regulatory  framework  applicable  to  our  operators  and  our  industry.  Further,  additional  debt  financing 
increases  the  amount  of  our  leverage.  The  degree  of  leverage  could  have  important  consequences  to 
stockholders, including affecting our investment grade ratings and our ability to obtain additional financing 
in the future, and making us more vulnerable to a downturn in our results of  operations or the economy 
generally. 

The interest rate of  our credit facilities, term loan facilities and derivatives contracts are priced using LIBOR 
and are subject to risks associated with the transition from LIBOR to an alternative reference rate. 

London Inter-bank Offered Rate (“LIBOR”) is the basic rate of interest used in lending between banks 
on  the  London  interbank  market  and  is  widely  used  as  a  reference  for  setting  the  interest  rate  on  loans 
globally.  We  typically  use  LIBOR  as  a  reference  rate  in  credit  facilities,  term  loan  facilities  and  derivative 
contracts. In July 2017, the U.K.’s Financial Conduct Authority (“FCA”) that regulates LIBOR announced 
that it intends to stop compelling banks to submit rates for the calculation of  LIBOR after 2021, and while 
the  transition  period  for  many  LIBOR  tenors  has  been  extended  to  June  2023,  the  U.S.  Federal  Reserve 
advised  banks  to  stop  new  LIBOR  issuances  by  the  end  of  2021.  At  this  time,  no  consensus  exists  as  to 
which reference rate or rates or benchmarks may become acceptable alternatives to LIBOR. The Alternative 
Reference  Rates  Committee,  a  steering  committee  composed  of  U.S.  financial  market  participants,  has 
identified  the  secured  overnight  financing  rate,  or  SOFR,  as  the  recommended  alternative  rate  for  all 
LIBOR. At this time, it is impossible to predict whether the SOFR or another reference rate will become an 
accepted alternative to LIBOR. Any changes in the methods by which LIBOR is determined or regulatory 
activity related to LIBOR’s phaseout could cause LIBOR to perform differently than in the past or cease to 

26 

exist.  Further,  the  consequences  of  these  developments,  or  any  alternative  reference  rate  that  is  adopted, 
cannot  be  entirely  predicted  but  could  include  an  increase  in  the  cost  of  our  variable  rate  borrowings,  of 
which we had $91.1 million of  borrowings outstanding as of  December 31, 2022 and $400 million notional 
value derivative instruments that are indexed to LIBOR. For some instruments, the method of  transitioning 
to an alternative rate may be challenging, as this may require negotiation with the respective counterparty. 

We may be subject to additional risks in connection with our acquisitions of long-term care facilities. 

We may be subject to additional risks in connection with our acquisitions of  long-term care facilities, 

including but not limited to the following: 

• 

• 

• 

• 

• 

• 

our limited prior business experience with certain of the operators of the facilities we have recently 
acquired or may acquire in the future; 

the  facilities  may  underperform  due  to  various  factors,  including  unfavorable  terms  and 
conditions of  the lease agreements that we assume, disruptions caused by the management of  the 
operators  of  the  facilities  or  changes  in  economic  conditions  impacting  the  facilities  and/or  the 
operators; 

large acquisitions or investments could place significant additional demands on, and require us to 
expand,  our  management,  resources  and  personnel,  as  well  as  to  adapt  our  administrative, 
accounting and operational systems to integrate and manage the long-term care facilities we have 
acquired or may acquire in a timely manner; 

diversion of our management’s attention away from other business concerns; 

exposure to any undisclosed or unknown potential liabilities relating to the facilities; and 

potential underinsured losses on the facilities. 

We  cannot  assure  you  that  we  will  be  able  to  manage  our  recently  acquired  facilities,  or  the  future 
growth  in  our  business,  without  encountering  difficulties  or  that  any  such  difficulties  will  not  have  a 
material adverse effect on us. Our growth could also increase our capital requirements, which may require us 
to issue potentially dilutive equity securities and incur additional debt. 

Our  assets,  including  our  real  estate  and  loans,  are  subject  to  impairment  charges,  and  our  valuation  and 
reserve estimates are based on assumptions and may be subject to adjustment. 

Our  asset  portfolio  primarily  consists  of  real  estate  and  mortgage  loans,  which  are  subject  to 
write-downs in value. From time to time, we close facilities and actively market such facilities for sale. To the 
extent  we  are  unable  to  sell  these  properties  for  our  book  value,  we  may  be  required  to  take  a  non-cash 
impairment  charge  or  loss  on  the  sale,  either  of  which  would  reduce  our  net  income.  In  addition,  we 
periodically, but not less than annually, evaluate our real estate investments and other assets for impairment 
indicators,  and  we  establish  general  and  specific  reserves  for  our  issued  loans  at  least  quarterly.  The 
quarterly  evaluation  of  our  investments  for  impairment  may  result  in  significant  fluctuations  in  our 
provision  for  credit  losses  or  real  estate  impairments  from  quarter  to  quarter,  impacting  our  results  of 
operations.  Judgments  regarding  the  existence  of  impairment  indicators  or  loan  reserves  are  based  on  a 
number of factors, including market conditions, operator performance and legal structure, and these factors 
may involve estimates. If  we determine that a significant impairment has occurred, we are required to make 
an  adjustment  to  the  net  carrying  value  of  the  asset,  which  could  have  a  material  adverse  effect  on  our 
results  of  operations.  Our  estimates  of  loan  reserves,  and  other  accounting  estimates,  are  inherently 
uncertain and may be subject to future adjustment, leading potentially to an increase in reserves. 

Our indebtedness could adversely affect our financial condition. 

We have a material amount of indebtedness and we may increase our indebtedness in the future. Our level 

and type of indebtedness could have important consequences for our stockholders. For example, it could: 

• 

increase  our  vulnerability  to  adverse  changes  in  general  economic,  industry  and  competitive 
conditions; 

27 

• 

• 

• 

• 

• 

• 

• 

• 

limit  our  ability  to  borrow  additional  funds,  on  satisfactory  terms  or  at  all,  for  working  capital, 
capital  expenditures,  acquisitions,  debt  service  requirements,  execution  of  our  business  plan  or 
other general corporate purposes; 

increase our cost of borrowing; 

require us to dedicate a substantial portion of  our cash flow from operations to make payments 
on  our  indebtedness,  thereby  reducing  the  availability  of  our  cash  flow  to  fund  working  capital, 
capital expenditures and other general corporate purposes; 

limit  our  ability  to  make  material  acquisitions  or  take  advantage  of  business  opportunities  that 
may arise; 

limit  our  ability  to  make  distributions  to  our  stockholders,  which  may  cause  us  to  lose  our 
qualification as a REIT under the Code or to become subject to federal corporate income tax on 
any REIT taxable income that we do not distribute; 

expose  us  to  fluctuations  in  interest  rates,  to  the  extent  our  borrowings  bear  variable  rates  of 
interest; 

limit  our  flexibility  in  planning  for,  or  reacting  to,  changes  in  our  business  and  the  industry  in 
which we operate; and 

place us at a competitive disadvantage compared to our competitors that have less debt. 

Further, we have the ability to incur substantial additional debt, including secured debt, which could 
intensify the risks above. In addition, if  we are unable to refinance any of  our floating rate debt, we would 
continue to be subject to interest rate risk. The short-term nature of some of our debt also subjects us to the 
risk that market conditions may be unfavorable or may prevent us from refinancing our debt at or prior to 
their existing maturities. In addition, our cash flow from operations may not be sufficient to repay all of our 
outstanding debt as it becomes due, and we may not be able to borrow money, sell assets or otherwise raise 
funds on acceptable terms, if at all, to refinance our debt. 

Covenants  in  our  debt  documents  limit  our  operational  flexibility,  and  a  covenant  breach  could  materially 
adversely affect our operations. 

The  terms  of  our  credit  agreements  and  note  indentures  require  us  to  comply  with  a  number  of 
customary financial and other covenants that may limit our management’s discretion by restricting our ability 
to, among other things, incur additional debt, redeem our capital stock, enter into certain transactions with 
affiliates, pay dividends and make other distributions, make investments and other restricted payments, engage 
in mergers and consolidations, create liens, sell assets or engage in new lines of business. In addition, our credit 
facilities  require  us  to  maintain  compliance  with  specified  financial  covenants,  including  those  relating  to 
maximum  total  leverage,  maximum  secured  leverage,  maximum  unsecured  leverage,  minimum  fixed  charge 
coverage,  minimum  consolidated  tangible  net  worth  and  minimum  unsecured  interest  coverage.  Any 
additional financing we may obtain could contain similar or more restrictive covenants. Our continued ability 
to incur indebtedness, conduct our operations, and take advantage of  business opportunities as they arise is 
subject to compliance with these financial and other covenants. Breaches of  these covenants could result in 
defaults under the instruments governing the applicable indebtedness, in addition to any other indebtedness 
cross-defaulted  against  such  instruments.  Any  such  breach  could  materially  adversely  affect  our  business, 
results of operations and financial condition. 

We  are  subject  to  particular  risks  associated  with  real  estate  ownership,  which  could  result  in  unanticipated 
losses or expenses. 

Our business is subject to many risks that are associated with the ownership of real estate. For example, 
if our operators do not renew their leases, we may be unable to re-lease the facilities at favorable rental rates, 
if  at  all.  Other  risks  that  are  associated  with  real  estate  acquisition  and  ownership  include,  without 
limitation, the following: 

• 

general liability, property and casualty losses, some of which may be uninsured; 

28 

• 

• 

• 

• 

• 

• 

• 

the  inability  to  purchase  or  sell  our  assets  rapidly  to  respond  to  changing  economic  conditions, 
due to the illiquid nature of real estate and the real estate market; 

leases that are not renewed or are renewed at lower rental amounts at expiration; 

contingent rent escalators tied to changes in the Consumer Price Index or other parameters; 

the exercise of purchase options by operators resulting in a reduction of our rental revenue; 

costs relating to maintenance and repair of our facilities and the need to make expenditures due to 
changes in governmental regulations, including the Americans with Disabilities Act; 

environmental  hazards  created  by  prior  owners  or  occupants,  existing  tenants,  mortgagors  or 
other persons for which we may be liable; and 

acts of God or terrorism affecting our properties. 

Our real estate investments are relatively illiquid. 

Real  estate  investments  are  relatively  illiquid  and  generally  cannot  be  sold  quickly.  The  real  estate 
market is affected by many factors which are beyond our control, including general economic conditions, 
availability of  financing, interest rates and supply and demand. Additional factors that are specific to our 
industry also tend to limit our ability to vary our portfolio promptly in response to changes in economic or 
other conditions. For example, all of  our properties are “special purpose” properties that cannot be readily 
converted into general residential, retail or office use. In addition, transfers of  operations of  nursing homes 
and  other  healthcare-related  facilities  are  subject  to  extensive  regulatory  approvals.  We  cannot  predict 
whether we will be able to sell any property for the price or on the terms set by us or whether any price or 
other terms offered by a prospective purchaser would be acceptable to us. We also cannot predict the length 
of  time needed to find a willing purchaser and to close the sale of  a property, or that we will have funds 
available  to  make  necessary  repairs  and  improvements  to  a  property  held  for  sale.  To  the  extent  we  are 
unable to sell any properties for our book value, we may be required to take a non-cash impairment charge 
or loss on the sale, either of which would reduce our net income. 

We  face  possible  risks  and  costs  associated  with  severe  weather  conditions,  natural  disasters  or  the  physical 
effects of climate change. 

A  large  number  of  our  properties  are  located  in  areas  particularly  susceptible  to  revenue  loss,  cost 
increase  or  damage  caused  by  severe  weather  conditions  or  natural  disasters  such  as  hurricanes, 
earthquakes, tornadoes, fires and floods, as well as the effects of  climate change. To the extent that climate 
change impacts changes in weather patterns, our markets could experience more frequent and severe natural 
disasters.  Operationally,  such  events  could  cause  a  major  power  outage,  leading  to  a  disruption  of  our 
operators’ operations or require them to incur additional cost associated with evacuation plans. Over time, 
any  of  these  conditions  could  result  in  increased  operator  costs,  delays  in  construction,  resulting  in 
increased  construction  costs,  or  in  the  inability  of  our  operators  to  operate  our  facilities  at  all.  Climate 
change  and  severe  weather  may  also  have  indirect  effects  on  our  business  by  increasing  the  cost  to  our 
operators  of,  or  decreasing  the  availability  to  our  operators  of,  property  insurance  on  terms  they  find 
acceptable,  and  by  increasing  the  cost  of  energy,  maintenance,  repair  of  water  and/or  wind  damage,  and 
snow  removal  at  our  properties.  In  the  event  of  a  loss  in  excess  of  insured  limits,  we  could  lose  our 
incremental capital invested in the affected property. 

Although  Congress  has  not  yet  enacted  comprehensive  federal  legislation  to  address  climate  change, 
numerous  states  and  municipalities  have  adopted  laws  and  policies  on  climate  change  and  emission 
reduction  targets.  Changes  in  federal,  state  and  local  legislation  and  regulation  based  on  concerns  about 
climate  change  could  result  in  increased  capital  expenditures  on  our  existing  properties  and  our  new 
development properties (for example, to improve their energy efficiency and/or resistance to severe weather) 
without a corresponding increase in revenue, resulting in adverse impacts to our net income. There can be 
no  assurance  that  climate  change  and  severe  weather  will  not  have  a  material  adverse  effect  on  our 
properties, operations, or business. 

29 

As an owner or lender with respect to real property, we may be exposed to possible environmental liabilities. 

Under  various  federal,  state  and  local  environmental  laws,  ordinances  and  regulations,  a  current  or 
previous owner of  real property or a secured lender may be liable in certain circumstances for the costs of 
investigation, removal or remediation of  certain hazardous or toxic substances at such property, as well as 
certain  other  potential  related  costs,  including  government  fines  and  damages  for  injuries  to  persons  and 
adjacent  property.  Such  laws  often  impose  liability  without  regard  to  whether  the  owner  knew  of,  or  was 
responsible  for,  the  presence  or  disposal  of  such  substances.  As  a  result,  liability  may  be  imposed  on  the 
owner in connection with the activities of an operator of the property, and the owner’s liability could exceed 
the value of the property and/or the assets of the owner. In addition, the presence of such substances, or the 
failure  to  properly  dispose  of  or  remediate  such  substances,  may  adversely  affect  an  operators’ ability  to 
attract additional residents and our ability to sell or rent such property or to borrow using such property as 
collateral which, in turn, could negatively impact our revenues. 

Although our leases and mortgage loans generally require the lessee and the mortgagor to indemnify 
us for certain environmental liabilities, they may be unable to fulfill their indemnification obligations to us, 
and the scope of  such obligations may be limited. For instance, most of  our leases do not require the lessee 
to indemnify us for environmental liabilities arising before the lessee took possession of the premises. 

The  industry  in  which  we  operate  is  highly  competitive.  Increasing  investor  interest  in  our  sector  and 
consolidation at the operator level or REIT level could increase competition and reduce our profitability. 

Our business is highly competitive and we expect that it may become more competitive in the future. 
We compete for healthcare facility investments with other healthcare investors, including other REITs, some 
of  which have greater resources and lower costs of  capital than we do. Increased competition makes it more 
challenging for us to identify and successfully capitalize on opportunities that meet our business goals. If  we 
cannot  capitalize  on  our  development  pipeline,  identify  and  purchase  a  sufficient  quantity  of  healthcare 
facilities at favorable prices, or are unable to finance such acquisitions on commercially favorable terms, our 
business, results of  operations and financial condition may be materially adversely affected. In addition, if 
our  cost  of  capital  should  increase  relative  to  the  cost  of  capital  of  our  competitors,  the  spread  that  we 
realize  on  our  investments  may  decline  if  competitive  pressures  limit  or  prevent  us  from  charging  higher 
lease or mortgage rates. 

Our  charter  and  bylaws  contain  significant  anti-takeover  provisions  which  could  delay,  defer  or  prevent  a 
change  in  control  or  other  transactions  that  could  provide  our  stockholders  with  the  opportunity  to  realize  a 
premium over the then-prevailing market price of our common stock. 

Our  charter  and  bylaws  contain  various  procedural  and  other  requirements  which  could  make  it 
difficult  for  stockholders  to  effect  certain  corporate  actions.  Our  Board  of  Directors  (“Board”)  has  the 
authority to issue additional shares of  preferred stock and to fix the preferences, rights and limitations of 
the  preferred  stock  without  stockholder  approval.  In  addition,  our  charter  contains  limitations  on  the 
ownership of  our capital stock intended to ensure we continue to meet the requirements for qualification as 
a  REIT.  For  example,  our  charter,  among  other  restrictions,  prohibits  the  beneficial  or  constructive 
ownership  (as  defined  for  federal  income  tax  purposes)  by  any  person  of  more  than  9.8%  in  value  or  in 
number  of  shares  of  the  outstanding  shares  of  any  class  or  series  of  our  capital  stock,  unless  our  Board 
grants an exemption or modifies the ownership limit for such person and certain conditions are satisfied. 
These  provisions  could  discourage  unsolicited  acquisition  proposals  or  make  it  more  difficult  for  a  third 
party to gain control of  us, which could adversely affect the market price of  our securities and/or result in 
the  delay,  deferral  or  prevention  of  a  change  in  control  or  other  transactions  that  could  provide  our 
stockholders  with  the  opportunity  to  realize  a  premium  over  the  then-prevailing  market  price  of  our 
common stock. 

Ownership of  property outside the U.S. may subject us to different or greater risks than those associated with 
our U.S. investments, including currency fluctuations. 

We have investments in the U.K. and may from time to time may seek to acquire other properties in the 
U.K.  or  otherwise  outside  the  U.S.  International  development,  investment,  ownership  and  operating 
activities  involve  risks  that  are  different  from  those  we  face  with  respect  to  our  U.S.  properties  and 

30 

operations.  These  risks  include,  but  are  not  limited  to,  any  international  currency  gain  recognized  with 
respect to changes in exchange rates may not qualify under the income tests that we must satisfy annually in 
order to qualify and maintain our status as a REIT; fluctuations in the exchange rates between USD and 
the  British  Pound  Sterling  (“GBP”),  or  other  foreign  currencies  in  which  we  may  transact  in  the  future, 
which  we  may  be  unable  to  protect  against  through  hedging;  changes  in  foreign  political,  regulatory,  and 
economic conditions, including increases in energy prices, such as those experienced in the U.K. resulting in 
part from the conflict in Ukraine and sanctions imposed on Russia; challenges in managing international 
operations and enforcing obligations in other countries; challenges of  complying with a variety of  foreign 
laws and regulations, including  those  relating to real estate, healthcare operations, taxes, employment and 
legal  proceedings;  differences  in  lending  practices  and  the  willingness  of  domestic  or  foreign  lenders  to 
provide  financing;  regional  or  country-specific  business  cycles  and  economic  instability;  and  changes  in 
applicable  laws  and  regulations  in  the  U.S.  that  affect  foreign  operations.  If  we  are  unable  to  successfully 
manage  the  risks  associated  with  international  expansion  and  operations,  our  results  of  operations  and 
financial condition may be adversely affected. 

On January 31, 2020, the U.K. withdrew from the European Union (“E.U.”), commonly referred to as 
“Brexit.” Changes in economic conditions in the U.K. relating to Brexit may subject the operators of  our 
facilities  in  the  U.K.  to  increased  risk,  including  potential  disruptions  in  supply,  increases  in  costs  or 
difficulty  staffing.  In  addition,  the  uncertainty  related  to  Brexit  has  caused  foreign  exchange  rate 
fluctuations in the past, including the strengthening of  the USD relative to the Euro and GBP immediately 
following  the  announcement  of  Brexit,  and  may  continue  to  do  so  in  the  future,  which  could  materially 
adversely affect our business, financial condition and results of  operations. Furthermore, Brexit could lead 
to legal uncertainty or the imposition of additional legal or regulatory requirements on the Company, which 
could  have  adverse  consequences  on  our  business,  financial  condition  and  results  of  operations.  To  date, 
one of  the key effects of  Brexit on the U.K. market is increased difficulty recruiting suitably qualified staff 
members within properties, as historically the E.U. and freedom of  movement provided a reliable personnel 
resource  for  the  U.K.  market.  The  employment  pool  within  the  U.K.  is  further  impacted  by  vaccination 
requirements for those working in the sector, meaning that those in certain roles who refuse to be vaccinated 
may not be employed (unless exempt from the requirement). 

Our  assets  are  concentrated  in  the  long-term  care  industry  and  face  geographic  and  operator  concentration 
risk. 

Our assets are generally not diversified by industry and face risks associated with the long-term care 
industry. In addition, at December 31, 2022, one operator represented greater than 10% of  our investments, 
and the three states in which we had our highest concentration of  investments were Florida (11.5%), Texas 
(10.3%)  and  Indiana  (6.6%).  As  a  result,  we  are  subject  to  increased  exposure  to  adverse  conditions 
affecting  these  operators  and  regions,  with  regional  risks  including  unfavorable  Medicaid  reimbursements 
rates for SNFs, downturns in the local economies, local real estate conditions, staffing challenges, increased 
competition  or  decreased  demand  for  our  facilities,  regional  climate  events,  and  unfavorable  legislative  or 
regulatory developments, which could adversely affect our business and results of operations. 

Our  primary  assets  are  the  units  of  partnership  interest  in  Omega  OP  and,  as  a  result,  we  will  depend  on 
distributions from Omega OP to pay dividends and expenses. 

The Company is a holding company and has no material assets other than units of  partnership interest 
in  Omega  OP.  We  intend  to  cause  the  partnership  to  make  distributions  to  its  partners,  including  the 
Company,  in  an  amount  sufficient  to  allow  us  to  qualify  as  a  REIT  for  U.S.  federal  income  tax  purposes 
and to pay all of  our expenses. To the extent we need funds and the partnership is restricted from making 
distributions  under  applicable  law  or  otherwise,  or  if  the  partnership  is  otherwise  unable  to  provide  such 
funds,  the  failure  to  make  such  distributions  could  materially  adversely  affect  our  liquidity  and  financial 
condition. 

Members of our management and Board hold partnership interests in Omega OP, and their interests may differ 
from those of our public stockholders. 

Some  members  of  our  management  and  Board  hold  partnership  interests  in  Omega  OP.  Those 
unitholders may have conflicting interests with holders of the Company’s common stock. For example, such 

31 

unitholders  of  Omega  OP  Units  may  have  different  tax  positions  from  the  Company  or  holders  of  our 
common  stock,  which  could  influence  their  decisions  in  their  capacities  as  members  of  management 
regarding  whether  and  when  to  dispose  of  assets,  whether  and  when  to  incur  new  or  refinance  existing 
indebtedness and how to structure future transactions. 

Our  investments  in  joint  ventures  could  be  adversely  affected  by  shared  decision-making  authority,  our  joint 
venture partners’ financial condition, and our exposure to potential losses from the actions of  our joint venture 
partners. 

As of  December 31, 2022, we have ownership interests in two consolidated joint ventures and several 

unconsolidated joint ventures. These joint ventures involve additional risks, including the following: 

•  We  may  be  unable  to  take  actions  that  are  opposed  by  our  joint  venture  partners  under 
arrangements  that  require  us  to  share  decision-making  authority  over  major  decisions  affecting 
the ownership or operation of  the joint venture and any property owned by the joint venture, such 
as the sale or financing of  the property, our ability to sell or transfer our interest in a joint venture 
or the making of additional capital contributions for the benefit of the property; 

• 

For joint ventures in which we have a noncontrolling interest, our joint venture partners may take 
actions that we oppose; 

•  Our  joint  venture  partners  may  become  bankrupt  or  fail  to  fund  their  share  of  required  capital 
contributions,  which  could  delay  construction  or  development  of  a  property  or  increase  our 
financial commitment to the joint venture; 

•  Our  joint  venture  partners  may  have  business  interests  or  goals  with  respect  to  a  property  that 
conflict  with  our  business  interests  and  goals,  including  with  respect  to  the  timing,  terms  and 
strategies for investment, which could increase the likelihood of  disputes regarding the ownership, 
management or disposition of the property; 

•  Disagreements  with  our  joint  venture  partners  could  result  in  litigation  or  arbitration  that 
increases our expenses, distracts our officers and directors, and disrupts the day-to-day operations 
of the property, including by delaying important decisions until the dispute is resolved; and 

•  We may suffer losses resulting from actions taken by our joint venture partners with respect to our 

joint venture investments. 

Risks Related to Taxation 

Qualifying  as  a  REIT  involves  highly  technical  and  complex  provisions  of  the  Code;  failure  to  qualify  as  a 
REIT  would  subject  us  to  increased  taxes  and  impair  our  ability  to  expand  our  business  and  make 
distributions; and complying with REIT requirements may affect our profitability. 

We were organized to qualify for taxation as a REIT under Sections 856 through 860 of  the Code. See 
Item  1 — Business — Taxation  of  Omega.  Qualification  as  a  REIT  involves  the  application  of  technical 
and  intricate  Code  provisions  for  which  there  are  only  limited  judicial  and  administrative  interpretations, 
and which involve the determination of  various factual matters and circumstances not entirely within our 
control.  We  cannot  assure  that  we  will  at  all  times  satisfy  these  rules  and  tests.  Even  a  technical  or 
inadvertent violation could jeopardize our REIT qualification. 

If  we were to fail to qualify as a REIT in any taxable year, as a result of  a determination that we failed 
to meet the annual distribution requirement or otherwise, we would be subject to federal corporate income 
tax, and any applicable alternative minimum tax with respect to each such taxable year for which the statute 
of  limitations remains open, as well certain excise taxes on nonqualified REIT income, or disqualification 
from treatment as a REIT for the four taxable years following the year during which qualification is lost. 
This  treatment  would  significantly  reduce  our  net  earnings  and  cash  flow  because  of  our  additional  tax 
liability for the years involved, which could significantly impact our financial condition. We generally must 
distribute annually at least 90% of  our taxable income to our stockholders to maintain our REIT status. To 
the extent that we do not distribute all of  our net capital gain or distribute at least 90%, but less than 100% 

32 

of our “REIT taxable income,” as adjusted, we will be subject to tax thereon at regular corporate rates. As a 
result of  all these factors, our failure to maintain our qualification as a REIT could impair our ability to 
expand our business and raise capital, and would substantially reduce our ability to make distributions to 
you. 

To  qualify  as  a  REIT  for  federal  income  tax  purposes,  we  must  continually  satisfy  tests  concerning, 
among  other  things,  the  nature  and  diversification  of  our  assets,  the  sources  of  our  income  and  the 
amounts  we  distribute  to  our  stockholders.  Thus,  we  may  be  required  to  liquidate  otherwise  attractive 
investments from our portfolio or be unable to pursue investments that would be otherwise advantageous to 
us, to satisfy the asset and income tests or to qualify under certain statutory relief  provisions. We may also 
be required to make distributions to stockholders at disadvantageous times or when we do not have funds 
readily available for distribution (e.g., if  we have assets which generate mismatches between taxable income 
and available cash). Having to comply with the distribution requirement could cause us to: (i) sell assets in 
adverse  market  conditions;  (ii)  borrow  on  unfavorable  terms;  or  (iii)  distribute  amounts  that  would 
otherwise  be  invested  in  future  acquisitions,  capital  expenditures  or  repayment  of  debt.  As  a  result, 
satisfying the REIT requirements could have an adverse effect on our business results and profitability. 

There is a risk of changes in the tax law applicable to REITs. 

The  Internal  Revenue  Service,  the  U.S.  Treasury  Department  and  Congress  frequently  review  U.S. 
federal income tax legislation, regulations and other guidance. We cannot predict whether, when or to what 
extent  new  U.S.  federal  tax  laws,  regulations,  interpretations  or  rulings  will  be  adopted.  Any  legislative 
action  may  prospectively  or  retroactively  modify  our  tax  treatment  and,  therefore,  may  adversely  affect 
taxation of us, our properties, or our shareholders. 

Risks Related to Our Stock and Capital Structure 

Our issuance of additional capital stock, warrants or debt securities, whether or not convertible, may reduce the 
market price for our outstanding securities, including our common stock, and dilute the ownership interests of 
existing stockholders, and we may issue securities with greater dividend, liquidation and other rights than our 
common stock. 

We cannot predict the effect, if any, that future sales of our capital stock, warrants or debt securities, or 
the availability of  our securities for future sale, will have on the market price of  our securities, including our 
common  stock.  Sales  of  substantial  amounts  of  our  common  stock  or  preferred  shares,  warrants  or  debt 
securities  convertible  into  or  exercisable  or  exchangeable  for  common  stock  in  the  public  market,  or  the 
perception that such sales might occur, could negatively impact the market price of  our stock and the terms 
upon  which  we  may  obtain  additional  equity  financing  in  the  future.  Our  Board  has  the  authority  to 
designate and issue preferred stock that may have dividend, liquidation and other rights that are senior to 
those of our common stock. 

Any  debt  securities,  preferred  shares,  warrants  or  other  rights  to  acquire  shares  or  convertible  or 
exchangeable  securities  that  we  issue  in  the  future  may  have  some  rights,  preferences  and  privileges  more 
favorable  than  those  of  our  common  stock  and  may  result  in  dilution  to  owners  of  our  common  stock. 
Holders of  our common stock are not entitled to preemptive rights or other protections against dilution. 
Our  preferred  shares,  if  issued,  could  have  a  preference  on  liquidating  distributions  or  a  preference  on 
dividend  payments  that  could  limit  our  ability  pay  dividends  or  other  distributions  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, our stockholders bear the risk that our future offerings could reduce 
the per share trading price of our common stock and dilute their interest in us. 

33 

General Risk Factors 

Our  success  depends  in  part  on  our  ability  to  retain  key  personnel  and  our  ability  to  attract  or  retain  other 
qualified personnel. 

Our  future  performance  depends  to  a  significant  degree  upon  the  continued  contributions  of  our 
executive management team and other key employees, the loss of  whom could have an adverse impact on 
our operations. Although we have entered into employment agreements with the members of  our executive 
management  team,  these  agreements  may  not  assure  their  continued  service.  In  addition,  our  failure  to 
successfully  attract,  hire,  retain  and  train  the  people  we  need  may  impede  our  ability  to  implement  our 
business strategy. 

We  rely  on  information  technology  in  our  operations,  and  any  material  failure,  inadequacy,  interruption  or 
security failure of that technology could harm our business. 

We rely on information technology networks and systems, including the Internet, to process, transmit 
and  store  electronic  information,  and  to  manage  or  support  a  variety  of  business  processes,  including 
financial transactions and records, personal identifying information, tenant and lease data. In addition, we 
may  from  time  to  time  offer  technology  services  to  tenants,  which  may  involve  storage  of  customer  or 
resident  data.  We  purchase  some  of  our  information  technology  from  vendors,  on  whom  our  systems 
depend.  We  generally  rely  on  third-party  systems,  software,  tools  and  monitoring  to  provide  security  for 
processing,  transmission  and  storage  of  confidential  tenant  and  other  customer  information,  such  as 
individually identifiable information, including information relating to financial accounts. It is possible that 
our  safety  and  security  measures  will  not  be  able  to  prevent  the  systems’  improper  functioning  or  the 
improper access or disclosure of  personally identifiable information such as in the event of  cyber-attacks. 
Security  breaches,  including  physical  or  electronic  break-ins,  computer  viruses,  attacks  by  hackers  and 
similar  breaches,  can  create  system  disruptions,  shutdowns  or  unauthorized  disclosure  of  confidential 
information. Any failure to maintain proper function, security and availability of  our information systems, 
and  the  privacy  of  the  data  we  store,  or  failure  to  comply  with  related  regulations,  could  interrupt  our 
operations,  damage  our  reputation,  subject  us  to  liability  claims  or  regulatory  penalties  and  could  have  a 
material  adverse  effect  on  our  business,  financial  condition  and  results  of  operations.  The  regulatory 
environment related to cyber and information security, data collection and privacy is increasingly rigorous, 
with  new  and  constantly  changing  requirements  applicable  to  our  business  or  to  which  we  may  become 
subject, including E.U. data protection legislation, such as they General Data Protection Regulation, or the 
GDPR,  and  the  U.K.’s  Data  Protection  Act,  which  impose  significant  data  protection  requirements  and 
penalties for noncompliance. Compliance with any of  these requirements may result in additional costs and 
could impact how we conduct in business in new jurisdictions. 

Failure to maintain effective internal control over financial reporting could have a material adverse effect on 
our business, results of operations, financial condition and stock price. 

We  are  required  to  provide  a  report  by  management  on  internal  control  over  financial  reporting, 
including  management’s  assessment  of  the  effectiveness  of  such  control.  Changes  to  our  business  will 
necessitate  ongoing  changes  to  our  internal  control  systems  and  processes,  and  internal  control  over 
financial  reporting  may  not  prevent  or  detect  misstatements  due  to  inherent  limitations,  including  the 
possibility of  human error, the circumvention or overriding of  controls, or fraud. Therefore, even effective 
internal  controls  can  provide  only  reasonable  assurance  with  respect  to  the  preparation  and  fair 
presentation  of  financial  statements.  If  we  fail  to  maintain  the  adequacy  of  our  internal  controls  or  to 
implement required new or improved controls, our business, results of  operations and financial condition 
could be materially adversely harmed, we could fail to meet our reporting obligations and there could be a 
material  adverse  effect  on  our  stock  price.  In  addition,  we  may  be  adversely  impacted  by  new  accounting 
pronouncements which change our lease recognition or other accounting practices or otherwise alter how 
we  report  our  financial  results,  or  which  require  that  we  change  our  internal  control  and  operating 
procedures, which we may be unable to do in a timely manner. 

Item 1B — Unresolved Staff Comments 

None. 

34 

Item 2 — Properties 

At December 31, 2022, our real estate investments include SNFs and ALFs and to a lesser extent ILFs, 
specialty  facilities  and  MOBs,  in  the  form  of  (i)  owned  facilities  that  are  leased  to  operators  or  their 
affiliates, (ii) investments in direct financing leases to operators or their affiliates and (iii) real estate loans, 
including mortgages on facilities that are operated by the mortgagors or their affiliates. Our facilities related 
to these investments are located in 42 states and the U.K. 

The following table presents the concentration of  our gross real estate assets, assets held for sale, gross 
investment in direct financing leases and gross mortgage notes receivables (included within our real estate 
loans receivable) by state and the U.K. as of December 31, 2022: 

Location 

Florida  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Texas  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Indiana  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
California  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
United Kingdom  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Michigan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Pennsylvania  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Virginia  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
North Carolina  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Remaining States  . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Number of 
Operating Beds 

Number of 
Facilities 

Gross 
Investment 
(in thousands) 

% of 
Gross 
Investment 

12,022 
10,957 
6,937 
4,322 
4,894 
4,791 
3,598 
4,399 
3,668 
4,676 
29,701 
89,965 

98 
111 
70 
52 
43 
92 
38 
46 
28 
45 
303 
926 

$1,104,417 
987,456 
638,275 
568,726 
541,412 
522,457 
501,496 
498,297 
424,099 
406,736 
3,419,191 
$9,612,562 

11.5% 
10.3% 
6.6% 
5.9% 
5.6% 
5.4% 
5.2% 
5.2% 
4.4% 
4.2% 
35.7% 
100.0% 

Item 3 — Legal Proceedings 

See Note 20 — Commitments and Contingencies to the Consolidated Financial Statements — Part IV, 

Item 15, which is hereby incorporated by reference in response to this item. 

Item 4 — Mine Safety Disclosures 

None. 

35 

PART II 

Item 5 — Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of 
Equity Securities 

Market Information 

Shares  of  Omega  Healthcare  Investors,  Inc.  (together  with  its  consolidated  subsidiaries,  collectively, 
“Omega”  or  the  “Company”)  common  stock  are  traded  on  the  New  York  Stock  Exchange  under  the 
symbol  “OHI.”  As  of  February  8,  2023,  there  were  2,744  registered  holders  and  234,267,646  shares  of 
Omega common stock outstanding. 

Performance Graph 

The graph and table below compare the cumulative total return of  Omega, the FTSE NAREIT Equity 
Health Care Index (Ticker: FN11-FTX), the FTSE NAREIT All REITs Index (Ticker: FNAR), the S&P 
500 Index, and the Russell 2000 from January 1, 2018 to December 31, 2022. We have included the FTSE 
NAREIT Equity Health Care Index and the FTSE NAREIT All REITs Index because we believe that they 
are  representative  of  the  industry  in  which  we  compete  and  are  relevant  to  an  assessment  of  our 
performance. Total cumulative return is based on a $100 investment in Omega common stock and in each of 
the indices at the close of  trading on December 31, 2017 and assumes quarterly reinvestment of  dividends. 
Stockholder returns over the indicated periods should not be considered indicative of  future stock prices or 
stockholder returns. 

12/31/2017 

12/31/2018 

12/31/2019 

12/31/2020 

12/31/2021 

12/31/2022 

Omega Healthcare Investors, Inc. . . . . 
FTSE NAREIT Health Care Index  . . 
FTSE NAREIT All REITs Index . . . . 
S&P 500 Index . . . . . . . . . . . . . . . . . 
Russell 2000 Index  . . . . . . . . . . . . . . 

$100.00 
$100.00 
$100.00 
$100.00 
$100.00 

$139.43 
$107.58 
$  95.90 
$  95.62 
$  88.99 

$180.05 
$130.39 
$122.82 
$125.72 
$111.70 

$167.47 
$117.53 
$115.62 
$148.85 
$134.00 

$147.73 
$136.71 
$161.73 
$191.58 
$153.85 

$152.44 
$106.39 
$121.13 
$156.88 
$122.41 

Issuer Purchases of Equity Securities 

On  January  27,  2022,  the  Company  authorized  the  repurchase  of  up  to  $500  million  of  our 
outstanding  common  stock  from  time  to  time  through  March  2025.  The  Company  is  authorized  to 
repurchase shares of its common stock in open market and privately negotiated transactions or in any other 
manner as determined by the Company’s management and in accordance with applicable law. The timing 
and  amount  of  stock  repurchases  will  be  determined,  in  management’s  discretion,  based  on  a  variety  of 
factors, including but not limited to market conditions, other capital management needs and opportunities, 

36 

and corporate and regulatory considerations. The Company has no obligation to repurchase any amount of 
its  common  stock,  and  such  repurchases,  if  any,  may  be  discontinued  at  any  time.  During  2022,  we 
repurchased  5.2  million  shares  of  our  common  stock  at  an  average  price  per  share  of  $27.32  and  an 
aggregate repurchase cost of  $142.3 million (including the cost of  commissions). We did not repurchase any 
shares during the fourth quarter of 2022. 

Unregistered Sales of Equity Securities 

From  time  to  time,  Omega  issues  shares  of  common  stock  in  reliance  on  the  private  placement 
exemption  under  Section  4(a)(2)  of  the  Securities  Act  of  1933,  as  amended,  in  exchange  for  units  of 
partnership  interest  in  OHI  Healthcare  Properties  Limited  Partnership  (collectively  with  subsidiaries, 
“Omega  OP”).  During  the  quarter  ended December 31, 2022, Omega did not issue any shares  of  Omega 
common stock. 

Item 6 — [Reserved] 

Item 7 — Management’s Discussion and Analysis of Financial Condition and Results of Operations 

The  following  discussion  and  analysis  is  based  primarily  on  the  consolidated  financial  statements  of 
Omega Healthcare Investors, Inc. presented in conformity with U.S. generally accepted accounting principles 
(“GAAP”)  for  the  periods  presented  and  should  be  read  together  with  the  notes  thereto  contained  in  this 
Annual Report on Form 10-K. Other important factors are identified in “Forward-Looking Statements” and 
“Item 1A — Risk Factors” above. 

Our  Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations  is 

organized as follows: 

• 

Business Overview 

•  Outlook, Trends and Other Conditions 

• 

2022 and Recent Highlights 

•  Results from Operations 

• 

• 

• 

Funds from Operations 

Liquidity and Capital Resources 

Supplemental Guarantor Information 

•  Critical Accounting Policies and Estimates 

Business Overview 

Omega  Healthcare  Investors,  Inc.  (“Parent”)  is  a  Maryland  corporation  that,  together  with  its 
consolidated  subsidiaries  has  elected  to  be  taxed  as  a  REIT  for  federal  income  tax  purposes.  Omega  is 
structured  as  an  umbrella  partnership  REIT  (“UPREIT”)  under  which  all  of  Omega’s  assets  are  owned 
directly  or  indirectly  by,  and  all  of  Omega’s  operations  are  conducted  directly  or  indirectly  through,  its 
operating partnership subsidiary, Omega OP. As of  December 31, 2022, Parent owned approximately 97% 
of  the issued and outstanding units of  partnership interest in Omega OP (“Omega OP Units”), and other 
investors owned approximately 3% of the outstanding Omega OP Units. 

Omega has one reportable segment consisting of investments in healthcare-related real estate properties 
located  in  the  United  States  (“U.S.”)  and  the  United  Kingdom  (“U.K.”).  Our  core  business  is  to  provide 
financing  and  capital  to  the  long-term  healthcare  industry  with  a  particular  focus  on  skilled  nursing 
facilities  (“SNFs”),  assisted  living  facilities  (“ALFs”),  and  to  a  lesser  extent,  independent  living  facilities 
(“ILFs”),  rehabilitation  and  acute  care  facilities  (“specialty  facilities”)  and  medical  office  buildings 
(“MOBs”).  Our  core  portfolio  consists  of  our  long-term  leases  and  real  estate  loans  with  healthcare 
operating  companies  and  affiliates  (collectively,  our  “operators”).  Real  estate  loans  consist  of  mortgage 
loans and other real estate loans which are primarily collateralized by a first, second or third mortgage lien 
or  a  leasehold  mortgage  on,  or  an  assignment  of  the  partnership  interest  in  the  related  properties.  In 

37 

addition  to  our  core  investments,  we  make  loans  to  operators  and/or  their  principals.  These  loans,  which 
may be either unsecured or secured by the collateral of  the borrower, are classified as non-real estate loans. 
From time to time, we also acquire equity interests in joint ventures or entities that support the long-term 
healthcare industry and our operators. 

Our  portfolio  of  real  estate  investments  (including  properties  associated  with  mortgages,  direct 
financing  leases,  assets  held  for  sale  and  consolidated  joint  ventures)  at  December  31,  2022,  included 
926 healthcare facilities, located in 42 states and the U.K. that are operated by 67 third-party operators. Our 
real  estate  investment  in  these  facilities  totaled  approximately  $9.5  billion  at  December  31,  2022,  with 
approximately 97% of  our real estate investments related to long-term healthcare facilities. The portfolio is 
made  up  of  (i)  665  SNFs,  (ii)  169  ALFs,  (iii)  20  ILFs,  (iv)  16  specialty  facilities,  (v)  two  MOBs,  (vi)  real 
estate loans, including mortgages on 48 SNFs, two ALFs and two specialty facilities and (vii) two facilities 
that  are  held  for  sale.  At  December  31,  2022,  we  also  held  other  real  estate  loans  (excluding  mortgages) 
receivable of  $394.6 million and non-real estate loans receivable of  $225.3 million, consisting primarily of 
secured  loans  to  third-party  operators  of  our  facilities,  and  $178.9  million  of  investments  in  six 
unconsolidated joint ventures. 

As healthcare delivery continues to evolve, we continuously evaluate potential investments, our assets, 
operators and markets to position our portfolio for long-term success. Our strategy includes applying data 
analytics  to  our  investment  underwriting  and  asset  management,  as  well  as  selling  or  transitioning  assets 
that do not meet our portfolio criteria. 

Outlook, Trends and Other Conditions 

The COVID-19 pandemic has significantly and adversely impacted SNFs and long-term care providers 
due to the higher rates of  virus transmission and fatality among the elderly and frail populations that these 
facilities  serve;  in  addition,  the  pandemic  contributed  to  occupancy  declines,  labor  shortages  and  cost 
increases  which  continue  to  significantly  impact  our  operators.  As  discussed  further  in  “Collectibility 
Issues” below, during the year we have had several operators that have failed to make contractual payments 
under  their  lease  and  loan  agreements,  and  we  have  agreed  to  short-term  deferrals,  lease  and  portfolio 
restructurings and/or allowed the application of  security deposits or letters of  credit to pay rent for several 
operators. 

We believe these operators were impacted by, among other things, reduced revenue as a result of  lower 
occupancy and increased expenses resulting from the COVID-19 pandemic and uncertainties regarding the 
continuing availability of sufficient government support and adequate reimbursement levels. These increases 
have been offset to some extent by increases in reimbursements due to increased skilling in place, which has 
been necessitated by pandemic-related protocols and may decrease when such protocols subside or when the 
federally declared public health emergency expires as scheduled on May 11, 2023. We believe these increases 
primarily stem from elevated labor costs, including increased use of overtime and bonus pay and reliance on 
agency  staffing  due  to  staffing  shortages,  as  well  as  a  significant  increase  in  both  the  cost  and  usage  of 
personal  protective  equipment  (“PPE”),  testing  equipment  and  processes  and  supplies,  as  well  as 
implementation of  new infection control protocols and vaccination programs. In addition, operators who 
do  not  achieve  full  compliance  with  applicable  vaccination  and  infection  control  requirements  may  face 
potential survey issues and penalties. At this time, there is significant uncertainty regarding the impact of 
such developments. 

We  remain  cautious  as  the  COVID-19  pandemic  continues  to  have  a  significant  impact  on  our 
operators  and  their  financial  conditions,  particularly  given  the  trend  of  reduced  pandemic-related  federal 
support  to  our  operators  beginning  in  2021,  the  persistence  of  staffing  shortages  that  continue  to  impact 
our  operators’  occupancy  levels  and  profitability,  uncertainty  as  to  whether  Medicare  and  Medicaid 
reimbursement rates will be sufficient to address longer-term cost increases faced by operators, factors that 
may  impact  future  virus  transmission  in  our  facilities,  including  vaccination  rates  and  efficacy  of  the 
vaccine  for  staff  members  and  residents  at  our  facilities  and  genetic  mutations  of  the  virus  into  new 
variants, and the commencement in December 2021 of repayment of deferred FICA obligations. 

We  believe  that  the  incidence  and  severity  of  COVID-19  among  our  operators’  residents  and 
employees,  based  on  reporting  by  our  operators,  tend  to  correlate  with  levels  of  incidence  and  severity 
experienced  by  the  applicable  community  in  which  such  operators’ are  located,  and  it  remains  uncertain 
whether certain of our facilities will be impacted by future community spread of the virus. 

38 

Our facilities, on average, experienced declines, in some cases that are material, in occupancy levels as a 
result  of  the  pandemic.  Occupancy  in  our  facilities  has  generally  improved  on  average  since  early  2021; 
however,  average  occupancy  has  not  returned  to  pre-pandemic  levels.  It  remains  unclear  when  and  the 
extent  to  which  demand  and  occupancy  levels  will  return  to  pre-COVID-19  levels.  We  believe  these 
challenges  to  occupancy  recovery  may  be  in  part  due  to  staffing  shortages,  which  in  some  cases  have 
required operators to limit admissions, as well as COVID-19 related fatalities at the facilities, the delay of 
SNF placement and/or utilization of  alternative care settings for those with lower level of  care needs, the 
suspension and/or postponement of  elective hospital procedures, fewer discharges from hospitals to SNFs 
and higher hospital readmittances from SNFs. 

While substantial government support was allocated to SNFs and to a lesser extent to ALFs in 2020, 
federal relief  efforts have been limited since 2021 as have been relief  efforts in certain states. The additional 
6.2% FMAP reimbursement in connection with the pandemic is being phased out in 2023 pursuant to the 
Consolidated  Appropriations  Act  of  2023  as  further  discussed  under  “Government  Regulation — 
Reimbursement Changes Related to COVID-19” under “Item 1 — Business.” The additional 6.2% FMAP 
provided some of  our operators with significant support, based on which states they are located in, and the 
phase out of  such support may adversely affect their operations to the extent that expenses are not reduced 
or  other  support  is  not  provided.  We  believe  further  government  support  will  be  needed  to  continue  to 
offset  these  impacts  on  operators,  which  could  be  in  the  form  of  direct  support  or  reimbursement  rate 
adjustments to reflect sustained cost changes experienced by operators. It is unclear whether and to what 
extent  such  government  support  will  continue  to  be  sufficient  and  timely  to  offset  these  impacts.  In 
particular,  while  $25.5  billion  in  federal  funding  for  healthcare  providers  impacted  by  COVID-19  was 
announced in September 2021 with distributions beginning in late 2021 pursuant to the Public Health and 
Social  Services  Emergency  Fund  (“Provider  Relief  Fund”),  we  do  not  expect  additional  Provider  Relief 
Funds to be allocated to healthcare operators or our operators, and it remains uncertain whether additional 
Medicaid funds under the American Rescue Plan Act of  2021 (the “American Rescue Plan Act”) or other 
changes  in  Medicare  or  Medicaid  reimbursement  rates  in  the  U.S.,  or  U.K.  reimbursement  and  relief 
programs  for  our  U.K.  operators,  will  ultimately  support  reimbursement  to  our  operators.  While  certain 
states  have  provided  pandemic-related  relief  measures  and/or  reimbursement  increases,  there  remains 
uncertainty  as  to  how  widespread  these  measures  will  continue  to  be  and  to  what  extent  they  may  be 
distributed  to  and  benefit  our  operators,  especially  when  the  federally  declared  public  health  emergency 
expires as scheduled on May 11, 2023 or previously released federal funds to states have been fully utilized. 
Likewise,  while  certain  states  may  in  the  course  of  routine  rate-setting  of  Medicaid  rates  address 
inflationary  factors  and  other  expense-related  items,  there  can  be  no  assurance  that  these  changes  will  be 
sufficient to offset existing increased inflation and expenses or that all states will address these items. See the 
“Government  Regulation  and  Reimbursement” section  for  additional  information.  Further,  to  the  extent 
the  cost  and  occupancy  impacts  on  our  operators  continue  or  accelerate  and  are  not  offset  by  continued 
government  relief  or  reimbursement  rates  that  are  sufficient  and  timely,  we  anticipate  that  the  operating 
results of  additional operators may be materially and adversely affected, some may be unwilling or unable 
to pay their contractual obligations to us in full or on a timely basis and we may be unable to restructure 
such obligations on terms as favorable to us as those currently in place. 

There  are  a  number  of  uncertainties  we  face  as  we  consider  the  continuing  impact  of  COVID-19  on 
our business, including how long census disruption and elevated COVID-19 costs will last, the ability of our 
operators  to  manage  the  impact  of  the  termination  of  public  health  emergency  and  temporary  relief 
thereunder,  the  continued  efficacy  of  vaccination  programs  in  reducing  the  spread  and  severity  of 
COVID-19 in our facilities, the impact of  genetic mutations of  the virus into new variants on our facilities, 
and the extent to which funding support from the federal government, the states and the U.K. will continue 
to offset these incremental costs as well as lost revenues. Notwithstanding vaccination programs, we expect 
that  heightened  clinical  protocols  for  infection  control  within  facilities  will  continue  for  some  period; 
however, we do not know if  future reimbursement rates or equipment provided by governmental agencies 
will be sufficient to cover the increased costs of enhanced infection control and monitoring. 

While  we  continue  to  believe  that  longer  term  demographics  will  drive  increasing  demand  for 
needs-based skilled nursing care, we expect the uncertainties to our business described above to persist at 
least  for  the  near  term  until  we  can  gain  more  information  as  to  the  level  of  costs  our  operators  will 
continue  to  experience  and  for  how  long,  and  the  level  of  additional  governmental  support  that  will  be 

39 

available  to  them,  the  potential  support  our  operators  may  request  from  us  and  the  future  demand  for 
needs-based skilled nursing care and senior living facilities. We continue to monitor the rate of  occupancy 
recovery at many of  our operators, and it remains uncertain whether and when demand, staffing availability 
and occupancy levels will return to pre-COVID-19 levels. 

In  addition  to  the  impacts  of  COVID-19  discussed  above,  our  operators  have  been  and  are  likely  to 
continue  to  be  adversely  affected  by  labor  shortages  and  increased  labor  costs  as  well  as  other 
inflation-related cost increases. In addition, our operations have also been and are likely to continue to be 
impacted  by  increased  competition  for  the  acquisition  of  facilities  in  the  U.S.,  which  has  decreased  the 
number  of  investment  opportunities  that  would  be  accretive  to  our  portfolio.  As  part  of  our  continuous 
evaluation of  our portfolio and in connection with certain operator restructuring transactions, we expect to 
continue to opportunistically sell assets, or portfolios of assets, from time to time. 

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

2022 and Recent Highlights 

Investments 

•  We acquired 41 facilities for an aggregate consideration of  $225.2 million in 2022. The initial cash 
yield  (the  initial  annual  contractual  cash  rent  divided  by  the  purchase  price)  on  these  asset 
acquisitions was between 8% and 9.5%. 

•  We invested $64.4 million under our construction-in-progress and capital improvement programs 

in 2022. 

•  We financed $56.2 million of  new real estate loans with a weighted average interest rate of  12% in 
2022. Our 2022 new real estate loans primarily relate to two new loans that we entered into during 
the year. We also advanced $60.0 million under existing real estate loans in 2022. 

•  During 2022, Ciena Healthcare (“Ciena”) made $158.5 million of  early principal payments under 
its mortgage loans. In connection with the partial repayments, the maturity date of  all the Ciena 
mortgage  notes  was  extended  to  June  30,  2030  (with  exception  of  two  loans  with  an  aggregate 
principal balance of $40.4 million with maturity dates in 2023). 

Dispositions and Impairments 

• 

• 

In 2022, we sold 66 facilities for approximately $759.0 million in net cash proceeds, recognizing a net 
gain of  approximately $360.0 million. Our sales during 2022 were primarily driven by restructuring 
transactions associated with facilities formerly leased to the following operators: Gulf  Coast Health 
Care  LLC  (together  with  certain  affiliates  “Gulf  Coast”) — 22  facilities,  Guardian  Healthcare 
(“Guardian”) — nine facilities, and Agemo Holdings, LLC (“Agemo”) — 22 facilities. 

In December 2022, in connection with restructuring negotiations with LaVie Care Centers, LLC 
(“LaVie,” f/k/a Consulate Health Care), we sold 11 facilities previously leased to LaVie for a sales 
price of  $129.8 million. Omega provided $104.8 million in senior seller financing, collateralized by 
first lien mortgages on the 11 facilities, to fund a portion of  the purchase price. The senior note 
has  a  December  29,  2027  maturity  date  and  bears  interest  at  8%  with  required  monthly  interest 
payments (due in arrears beginning February 1, 2023), with no principal payments are due until 
the  maturity  date.  The  remaining  consideration  received  under  the  purchase  agreement  is  the 
assumption of  a $25.0 million liability, incurred by Omega as part of  the transaction, by the buyer 
from Omega. The 11-facility sale does not meet the contract criteria to be recognized as a sale for 
accounting  purposes  and  we  will  continue  to  account  for  these  facilities  on  our  Consolidated 
Balance  Sheets  and  depreciate  the  facilities  until  the  sale  recognition  requirements  are  met.  A 
contract liability will be recognized on our Consolidated Balance Sheets within accrued expenses 
and other liabilities for the $25.0 million liability assumed, which will be relieved when the sale is 

40 

recognized.  The  loan  receivable  associated  with  the  seller  financing  will  not  be  recorded  on  our 
Consolidated  Balance  Sheets  until  the  sale  is  recognized,  and  any  cash  interest  received  will  be 
deferred and recorded as a contract liability within accrued expenses and other liabilities on our 
Consolidated Balance Sheets. No interest income or gain or loss will be recognized until the sale 
recognition requirements are met. 

• 

In  2022,  we  recorded  impairments  on  real  estate  properties  of  approximately  $38.5  million  on 
22 facilities. Of  the $38.5 million, $3.5 million related to two facilities that were classified as held 
for  sale  and  $35.0  million  related  to  20  held-for-use  facilities  of  which  $17.2  million  relates  to 
12  facilities  leased  to  and  operated  by  LaVie  that  are  expected  to  be  impacted  by  the  on-going 
restructuring negotiations. 

Financing Activities 

• 

In January 2022, our Board of  Directors authorized the repurchase of  up to $500 million of  our 
outstanding  common  stock  from  time  to  time  through  March  2025.  For  the  year  ended 
December  31,  2022,  we  repurchased  5.2  million  shares  of  our  outstanding  common  stock  at  an 
average price of $27.32 per share. 

•  We  sold  0.3  million  shares  of  common  stock  under  our  Dividend  Reinvestment  and  Common 
Stock  Purchase  Plan  (“DRSPP”)  during  the  year  ended  December  31,  2022.  Aggregate  net 
proceeds from these sales generated $9.2 million during 2022. 

Other Highlights 

•  During  2022,  we  made  $126.1  million  of  new  non-real  estate  loans  with  a  weighted  average 
interest  rate  of  10.2%.  We  also  advanced  $124.8  million  under  existing  non-real  estate  loans.  Of 
the $124.8 million, an aggregate $105.9 million related to two revolving working capital loans that 
also had aggregate repayments of $80.0 million during 2022. 

• 

In  2022,  Omega  was  included  in  the  Bloomberg  Gender-Equality  Index  (GEI) — one  of  only 
418 companies worldwide, and fewer than 15 U.S. REITs, to be included in the 2022 index. 

Collectibility Issues 

•  During the year ended December 31, 2022, we placed nine operators on a cash basis of  revenue 
recognition. These include LaVie, Maplewood Senior Living (along with affiliates, “Maplewood”), 
and  operators  representing  0.4%  (“0.4%  Operator”),  1.2%  (“1.2%  Operator”)  and  2.0%  (“2.0% 
Operator”) of  total revenue (excluding the impact of  write-offs), respectively, for the year ended 
December  31,  2022.  In  connection  with  placing  these  operators  on  a  cash  basis,  we  recognized 
$119.8  million  in  total  straight-line  accounts  receivable  write-offs  through  rental  income.  As  of 
December  31,  2022,  20  operators  are  on  a  cash  basis.  These  operators  represent  an  aggregate 
36.5% of  our total revenues (excluding the impact of  write-offs) for the year ended December 31, 
2022. 

•  During  the  year  ended  December  31,  2022,  we  allowed  ten  operators  to  defer  $27.0  million  of 
contractual  rent  and  interest.  The  deferrals  primarily  related  to  the  following  operators:  Agemo, 
Guardian,  the  3.7%  Operator  (defined  below)  and  the  1.2%  Operator.  Additionally,  we  allowed 
seven operators to apply collateral, such as security deposits or letters of credit, to contractual rent 
and interest during the year ended December 31, 2022. The total collateral applied to contractual 
rent and interest was $11.0 million for the year ended December 31, 2022. These applications of 
collateral  to  contractual  rent  and  interest  primarily  relate  to  the  2.0%  Operator  and  the  1.2% 
Operator. 

41 

•  Agemo,  a  cash  basis  operator,  continued  to  not  pay  contractual  rent  and  interest  due  under  its 
lease and loan agreements during the year ended December 31, 2022. We have not recorded any 
rental  income  or  interest  income  related  to  Agemo  during  the  year  ended  December  31,  2022. 
Subsequent  to  year  end,  we  entered  into  a  restructuring  agreement  with  Agemo.  See  Note  5 — 
Contractual  Receivables  and  Other  Receivables  and  Lease  Inducements  to  the  Consolidated 
Financial Statements — Part I, Item 15 hereto for additional details. 

•  Guardian did not make rent and interest payments under its lease and loan agreements during the 
first  quarter  of  2022,  but  it  resumed  making  contractual  rent  and  interest  payments  during  the 
second quarter of  2022, and it continued making such payments in the third and fourth quarters 
of 2022, in accordance with the restructuring terms discussed further below. Guardian is on a cash 
basis of revenue recognition for lease purposes, and we recorded rental income of $11.3 million for 
the year ended December 31, 2022 for contractual rent payments that were received. Additionally, 
Guardian’s  mortgage  loan  is  on  non-accrual  status  and  is  being  accounted  for  under  the  cost 
recovery method and therefore the $6.0 million of  interest payments that we received during the 
year ended December 31, 2022 were applied directly against the principal balance outstanding. In 
the  second  quarter  of  2022,  we  agreed  to  a  formal  restructuring  agreement,  master  lease 
amendments  and  mortgage  loan  amendments  with  Guardian.  As  part  of  the  restructuring 
agreement  and  related  agreements,  Omega  agreed  to,  among  other  things,  allow  for  the 
retrospective deferral of  $18.0 million of  aggregate contractual rent and interest, with repayment 
required  after  September  30,  2024,  and  reduce  the  combined  rent  and  mortgage  interest  to  an 
aggregate of $24.0 million per year effective as of July 1, 2022. 

• 

In the fourth quarter of  2022, Omega began the process of  restructuring our portfolio with LaVie, 
which  primarily  consists  of  two  master  lease  agreements  and  two  term  loan  agreements.  On 
December  30,  2022,  we  sold  11  facilities  previously  subject  to  one  of  two  lease  agreements  with 
LaVie.  See  further  discussion  on  the  sale  and  the  accounting  treatment  in  Dispositions  and 
Impairments above. Concurrent with the sale, we also amended the lease agreement impacted by 
the sale and our loan agreements with LaVie. As part of  the lease amendments, Omega agreed to, 
among  other  terms,  remove  the  11  sold  facilities  from  the  lease  agreement  and  reduce  monthly 
contractual rent from $8.3 million to $7.3 million. We amended the loans to, among other terms, 
extend  the  loan  maturities  to  November  30,  2036  to  align  with  the  lease  term,  and  starting  in 
January  2023,  reduce  the  interest  rates  to  2%,  remove  the  requirement  to  make  any  principal 
payments until the maturity dates and to convert from monthly cash interest payments to interest 
paid-in-kind.  The  restructuring  discussions  are  still  ongoing  and  subject  to  change,  but  we 
anticipate  additional  restructuring  activity  related  to  this  operator  in  2023.  As  a  result  of  the 
restructuring activities during 2022 and future expected restructuring activities, during the fourth 
quarter  of  2022,  we  placed  LaVie  on  a  cash  basis  of  revenue  recognition  as  collection  of 
substantially all contractual lease payments due from them was deemed no longer probable. As a 
result,  we  wrote-off  approximately  $58.0  million  of  straight-line  rent  receivables  and  lease 
inducements to rental income during the fourth quarter of  2022. In the first quarter of  2023, as 
part of  the restructuring, we have agreed to a partial rent deferral in the first four months of  2023. 
In  doing  so,  we  agreed  to  allow  LaVie  to  defer  up  to  $10.0  million  of  contractual  rent  from 
January 2023 through April 2023 under one of  our lease agreements for 32 facilities. Omega is in 
discussions  to  allow  LaVie  to  defer  up  to  $9.1  million  of  contractual  rent  from  January  2023 
through  April  2023  under  another  lease  agreement  for  41  facilities.  In  January  2023,  as  a  result, 
LaVie  deferred  the  full  contractual  payment  of  $2.5  million  under  the  32-facility  lease  and  paid 
$2.5 million of the $4.7 million of contractual rent due under the 41-facility lease. 

•  During the fourth quarter of  2022, we placed Maplewood on a cash basis of  revenue recognition as 
collection  of  substantially  all  contractual  lease  payments  due  from  them  was  deemed  no  longer 
probable based on the proposed restructuring of  our lease and loan agreements with Maplewood. 
As  a  result,  we  wrote-off  approximately  $29.3  million  of  straight-line  rent  receivables  and  lease 
inducements to rental income during the fourth quarter of 2022. Subsequent to year end, we entered 
into a restructuring agreement with Maplewood. See Note 5 — Contractual Receivables and Other 
Receivables  and  Lease  Inducements  to  the  Consolidated  Financial  Statements — Part  I,  Item  15 
hereto for additional details surrounding the restructuring. 

42 

• 

• 

In December 2022, we agreed to allow Healthcare Homes Limited (“Healthcare Homes”), a U.K. 
based  operator,  the  ability  to  defer  up  to  £6.7  million  of  contractual  rent  from  January  2023 
through  April  2023  with  regular  payments  scheduled  to  resume  in  May  2023.  The  deferred  rent 
balance  accrues  interest  monthly  at  a  rate  of  8%  per  annum  and  must  be  fully  repaid  by 
December  31,  2024.  Healthcare  Homes  has  had  near-term  liquidity  issues  in  connection  with 
increased staffing and utility costs. Healthcare Homes remains current as of  December 31, 2022 
and is on a straight-line basis of revenue recognition. 

From January through March 2022, an operator (the “3.7% Operator”) representing 3.7% of  total 
revenue (excluding the impact of  write-offs) for the year ended December 31, 2022, did not pay its 
contractual  amounts  due  under  its  lease  agreement.  In  March  2022,  the  lease  with  the  3.7% 
Operator was amended to allow for a short-term rent deferral for January through March 2022. 
The 3.7% Operator paid the contractual amount due under its lease agreement from April through 
December 2022. Omega holds a $1.0 million letter of  credit and a $150 thousand security deposit 
from the 3.7% Operator. The 3.7% Operator remains current on its $25.0 million revolving credit 
facility, which is fully drawn as of  December 31, 2022 and is secured by a first lien on the 3.7% 
Operator’s  accounts  receivable.  The  3.7%  Operator  remains  on  a  straight-line  basis  of  revenue 
recognition. 

Dividends 

•  Quarterly cash dividends paid during 2022 aggregated to $2.68 per share. On January 26, 2023, the 
Board  of  Directors  declared  a  cash  dividend  of  $0.67  per  share.  The  dividend  will  be  paid  on 
February 15, 2023 to stockholders of record as of the close of business on February 6, 2023. 

Results of Operations 

The  following  is  our  discussion  of  the  consolidated  results  of  operations  for  the  year  ended 
December 31, 2022 as compared to the year ended December 31, 2021. For a discussion of  our results of 
operation  for  the  year  ended  December  31,  2021  as  compared  to  the  year  ended  December  31,  2020,  see 
“Item 7 — Management’s Discussion and Analysis of  Financial Condition and Results of  Operations” of 
our Form 10-K for the year ended December 31, 2021 (“2021 Form 10-K”). 

Comparison of results of operations for the years ended December 31, 2022 and 2021 (dollars in thousands): 

Year Ended December 31, 

2022 

2021 

Increase/(Decrease) 

Revenues: 

Rental income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $750,208  $923,677 
1,029 
. . . . . . . . . . . . . . . . . . . 
Income from direct financing leases 
136,382 
Interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
1,721 
Miscellaneous income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1,023 
123,919 
3,094 

$(173,469) 
(6) 
(12,463) 
1,373 

Expenses: 

Depreciation and amortization  . . . . . . . . . . . . . . . . . . . . . . . 
General and administrative  . . . . . . . . . . . . . . . . . . . . . . . . . 
Real estate taxes  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Acquisition, merger and transition related costs  . . . . . . . . . . . 
Impairment on real estate properties  . . . . . . . . . . . . . . . . . . . 
Recovery on direct financing leases  . . . . . . . . . . . . . . . . . . . . 
Provision for credit losses . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Interest expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

332,407 
69,397 
15,500 
42,006 
38,451 
— 
68,663 
233,244 

342,014 
64,628 
12,260 
1,814 
44,658 
(717) 
77,733 
234,604 

(9,607) 
4,769 
3,240 
40,192 
(6,207) 
717 
(9,070) 
(1,360) 

43 

Other income (expense): 

Year Ended December 31, 

2022 

2021 

Increase/(Decrease) 

Other expense – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  (1,997)  $ 
Loss on debt extinguishment  . . . . . . . . . . . . . . . . . . . . . . . . 
Gain on assets sold – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Income tax expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Income from unconsolidated joint ventures  . . . . . . . . . . . . . . . . 

(389) 
359,951 
(4,561) 
7,261 

(581) 
(30,763) 
161,609 
(3,840) 
16,062 

$  (1,416) 
30,374 
198,342 
(721) 
(8,801) 

Revenues 

Following is a description of  certain of  the changes in revenues for the year ended December 31, 2022 

compared to 2021: 

• 

• 

The decrease in rental income was primarily the result of  (i) a $85.7 million decrease as a result of 
a net increase in straight-line rent receivable and lease inducement write-offs in 2022 primarily due 
to  placing  operators  LaVie,  Maplewood  and  seven  other  operators  on  a  cash  basis  for  revenue 
recognition  due  to  collectibility  concerns,  (ii)  a  $67.2  million  net  decrease  in  rental  income  from 
13 cash basis operators, including Agemo, as a result of  not recording straight-line lease revenue 
and/or  receiving  less  cash  rent  payments  period  over  period  from  these  operators,  (iii)  a 
$36.8  million  decrease  due  to  recognizing  no  rental  income  related  to  Gulf  Coast,  a  cash  basis 
operator, in 2022, as we received no contractual payments in the first quarter related to the lease 
with this operator, and we sold or transitioned 23 of  the facilities subject to the Gulf  Coast lease 
in March and April 2022 and (iv) a $7.1 million decrease related to facility sales, transitions and 
lease  terminations,  partially  offset  by  (i)  a  $18.3  million  increase  related  to  facility  acquisitions 
made in 2022 and (ii) a $3.1 million increase related to a lease extension with one operator. 

The  decrease  in  interest  income  was  primarily  due  to  (i)  a  $17.0  million  decrease  related  to 
principal payments received during 2021 and 2022, including those on the Ciena mortgage loans 
discussed  above,  and  (ii)  a  $12.4  million  decrease  related  to  loans  placed  on  non-accrual  status, 
primarily the Guardian mortgage loan, during 2021 and 2022, partially offset by a $16.9 million 
increase  related  to  new  and  refinanced  loans  and  additional  funding  to  existing  operators  made 
throughout 2021 and 2022. As noted above, in 2022, we funded $116.2 million for new or existing 
real estate loans and $250.9 million for new or existing non-real estate loans. 

Expenses 

Following is a description of  certain of  the changes in our expenses for the year ended December 31, 

2022 compared to 2021: 

• 

• 

• 

• 

The  decrease  in  depreciation  and  amortization  expense  primarily  relates  to  facility  sales  and 
facilities  reclassified  to  assets  held  for  sale,  such  as  the  22  Gulf  Coast  facilities  and  22  Agemo 
facilities that were sold during 2022, partially offset by facility acquisitions and capital additions. 

The  increase  in  general  and  administrative  (“G&A”)  expense  primarily  relates  to  a  $5.9  million 
increase in stock-based compensation expense (see Note 19 — Stock-Based Compensation to the 
Consolidated Financial Statements for a full summary of stock-compensation movements over the 
last  three  years)  partially  offset  by  a  $2.6  million  decrease  in  payroll  and  benefits  and  severance 
expenses. 

The increase in acquisition, merger and transition related costs primarily relates to costs incurred 
related  to  the  transition  of  facilities  with  LaVie  (as  discussed  further  in  “Collectibility  Issues” 
above) and other troubled operators. 

The  2022  impairments  were  recognized  in  connection  with  two  facilities  that  were  classified  as 
held-for-sale for which the carrying values exceeded the estimated fair values less costs to sell and 
20  held-for-use  facilities  for  which  the  carrying  value  exceeded  the  fair  value.  The  2021 
impairments  were  recognized  in  connection  with  13  facilities  that  were  classified  as  held-for-sale 

44 

for  which  the  carrying  values  exceeded  the  estimated  fair  values  less  costs  to  sell  and  one 
held-for-use facility because of  the closure of  the facility in the first quarter. The 2022 and 2021 
impairments  were  primarily  the  result  of  decisions  to  exit  certain  non-strategic  facilities  and/or 
operators. 

• 

The decrease in provision for credit losses primarily relates to a net decrease in aggregate specific 
provisions recorded in 2022 compared to specific provisions recorded in 2021, partially offset by 
increases in the general reserve recorded primarily resulting from increases in loss rates utilized in 
the  estimate  of  expected  losses  for  loans  (see  Note  9 — Allowance  for  Credit  Losses  to  the 
Consolidated  Financial  Statements  for  a  full  summary  of  allowance  movements  over  the  last 
three years). 

Other Income (Expenses) 

The increase in total other income (expense) was primarily due to (i) a $198.3 million increase in gain 
on assets sold resulting from the sale of  66 facilities in 2022 compared to the sale of  48 facilities in 2021 as 
we  continue  to  exit  certain  facilities,  operator  relationships  and/or  states  to  improve  the  strength  of  our 
overall portfolio and (ii) a $30.4 million decrease in loss on debt extinguishment primarily related to fees, 
premiums, and expenses related to the early redemption of  $350 million of  principal of  the 4.375% Senior 
Notes due 2023 during the first quarter of 2021. 

Income Tax Expense 

As a REIT, we generally are not subject to federal income taxes on the REIT taxable income that we 
distribute  to  stockholders,  subject  to  certain  exceptions.  For  tax  year  2022,  we  made  common  dividend 
payments of  $632.9 million to satisfy REIT requirements relating to qualifying income. We have elected to 
treat certain of  our active subsidiaries as TRSs. Our domestic TRSs are subject to federal, state and local 
income taxes at the applicable corporate rates. Our foreign TRSs are subject to foreign income taxes. As of 
December 31, 2022, one of  our TRSs that is subject to income taxes at the applicable corporate rates had a 
net  operating  loss  (“NOL”)  carry-forward  of  approximately  $10.2  million.  Also,  in  connection  with  the 
acquisition  of  one  U.K.  entity  in  the  first  quarter  of  2022,  we  acquired  foreign  net  operating  losses  of 
$55.0  million  resulting  in  an  NOL  deferred  tax  asset  of  $13.4  million  (see  Note  3 — Real  Estate  Asset 
Acquisitions  and  Development  and  Note  17 — Taxes).  The  $10.2  million  NOL  carry-forward  was  fully 
reserved as of December 31, 2022, with a valuation allowance due to uncertainties regarding realization. 

Under U.S. current law, NOL carry-forwards generated up through December 31, 2017 may be carried 
forward for no more than 20 years, and our NOL carry-forwards generated in our taxable years ended after 
December 31, 2017 may be carried forward indefinitely. 

For the year ended December 31, 2022, we recorded approximately $1.2 million of  federal, state and 
local income tax provision and approximately $3.4 million of  tax provision for foreign income taxes. These 
amounts do not include any gross receipts or franchise taxes payable to certain states and municipalities. 

Income from Unconsolidated Joint Ventures 

The  decrease  in  income  from  unconsolidated  joint  ventures  was  primarily  due  to  one  of  the  joint 

ventures realizing a $14.9 million gain on sale of real estate investments during 2021. 

Funds From Operations 

We  use  funds  from  operations  (“Nareit  FFO”),  a  non-GAAP  financial  measure,  as  one  of  several 
criteria  to  measure  the  operating  performance  of  our  business.  We  calculate  and  report  Nareit  FFO  in 
accordance with the definition of  Funds from Operations and interpretive guidelines issued by the National 
Association of Real Estate Investment Trusts (“Nareit”). Nareit FFO is defined as net income (computed in 
accordance with GAAP), adjusted for the effects of  asset dispositions and certain non-cash items, primarily 
depreciation  and  amortization  and  impairment  on  real  estate  assets,  and  after  adjustments  for 
unconsolidated partnerships and joint ventures and changes in the fair value of  warrants. Adjustments for 
unconsolidated partnerships and joint ventures are calculated to reflect funds from operations on the same 
basis. Revenue recognized based on the application of  security deposits and letters of  credit or based on the 
ability to offset against other financial instruments is included within Nareit FFO. We believe that Nareit 

45 

FFO  is  an  important  supplemental  measure  of  our  operating  performance.  As  real  estate  assets  (except 
land) are depreciated under GAAP, such accounting presentation implies that the value of  real estate assets 
diminishes predictably over time, while real estate values instead have historically risen or fallen with market 
conditions. Nareit FFO was designed by the real estate industry to address this issue. Nareit FFO herein is 
not  necessarily  comparable  to  Nareit  FFO  of  other  REITs  that  do  not  use  the  same  definition  or 
implementation guidelines or interpret the standards differently from us. 

We further believe that by excluding the effect of  depreciation, amortization, impairment on real estate 
assets and gains or losses from sales of  real estate, all of  which are based on historical costs and which may 
be  of  limited  relevance  in  evaluating  current  performance,  Nareit  FFO  can  facilitate  comparisons  of 
operating performance between periods and between other REITs. We offer this measure to assist the users 
of  our financial statements in evaluating our financial performance under GAAP, and Nareit FFO should 
not  be  considered  a  measure  of  liquidity,  an  alternative  to  net  income  or  an  indicator  of  any  other 
performance  measure  determined  in  accordance  with  GAAP.  Investors  and  potential  investors  in  our 
securities should not rely on this measure as a substitute for any GAAP measure, including net income. 

The  following  table  presents  our  Nareit  FFO  reconciliation  for  the  years  ended  December  31,  2022, 

2021 and 2020: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Net income(1)(2)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $ 438,841  $ 428,302  $163,545 
(19,113) 

Deduct gain from real estate dispositions  . . . . . . . . . . . . . . . . . . . 
Deduct gain from real estate dispositions – unconsolidated joint 

(359,951) 

(161,609) 

ventures 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Elimination of non-cash items included in net income: 

Depreciation and amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . 
Depreciation – unconsolidated joint ventures  . . . . . . . . . . . . . . . . 
Add back impairments on real estate properties . . . . . . . . . . . . . . . 
Add back impairments on real estate properties – unconsolidated 

(93) 
78,797 

(14,880) 
251,813 

(5,894) 
138,538 

332,407 
10,881 
38,451 

342,014 
12,285 
44,658 

329,924 
14,000 
72,494 

Add back unrealized loss on warrants 

joint ventures  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . 

— 
988 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $ 460,536  $ 655,243  $555,944 

4,430 
43 

— 
— 

Nareit FFO 

(1)  The years ended December 31, 2022 and 2021 include the application of  $11.0 million and $11.8 million, respectively, of  security 

deposits (letter of credit and cash deposits) in revenue. 

(2)  The year ended December 31, 2021 includes $21.3 million of  revenue related to Gulf  Coast recognized based on our ability to 

offset uncollected rent against the interest and principal of certain debt obligations of Omega. 

The $194.7 million decrease in Nareit FFO for the year ended December 31, 2022 compared to 2021 is 
primarily driven by the overall decrease in total revenue, which is discussed in more detail in the Results of 
Operations above. 

Liquidity and Capital Resources 

Sources and Uses 

Our primary sources of  cash include rental income and interest payment receipts on our loans, existing 
availability under our Revolving Credit Facility, proceeds from our DRSPP and the 2021 ATM Program, 
facility  sales,  and  proceeds  from  mortgage  and  other  investment  payoffs.  We  anticipate  that  these  sources 
will  be  adequate  to  meet  our  principal  cash  flow  needs  through  the  next  twelve  months,  which  include: 
funding dividends and distributions to our stockholders and non-controlling interest members, making debt 
service  payments  (including  principal  and  interest),  funding  real  estate  investments  (including  facility 

46 

acquisitions,  capital  improvement  programs  and  other  capital  expenditures),  funding  new  and  committed 
loan investments and paying normal recurring G&A expenses (primarily consisting of employee payroll and 
benefits and expenses relating to third parties for legal, consulting and audit services). 

Capital Structure 

At December 31, 2022, we had total assets of  $9.4 billion, total equity of  $3.8 billion and total debt of 

$5.3 billion, with such debt representing approximately 58.4% of total capitalization. 

Debt 

At December 31, 2022, the weighted-average annual interest rate of our debt was 4.1%. Additionally, as 
of  December  31,  2022,  98%  of  our  debt  with  outstanding  principal  balances  has  fixed  interest  payments. 
Our high percentage of  fixed interest debt has kept our interest expense relatively flat year over year despite 
rising interest rates. As of December 31, 2022, Omega’s debt obligations consisted of the following: 

•  A  $1.45  billion  Revolving  Credit  Facility  that  bears  interest  at  LIBOR  (or  in  the  case  of  loans 
denominated  in  GBP,  the  Sterling  overnight  index  average  reference  rate  plus  an  adjustment  of 
0.1193% per annum) plus an applicable percentage (with a range of  95 to 185 basis points) based 
on our credit ratings. The Revolving Credit Facility matures on April 30, 2025, subject to Omega’s 
option to extend such maturity date for two six-month periods. As of  December 31, 2022, Omega 
had $19.2 million outstanding on the Revolving Credit Facility. 

•  A $50.0 million OP Term Loan that bears interest at LIBOR plus an applicable percentage (with a 
range  of  85  to  185  basis  points)  based  on  our  credit  ratings.  The  OP  Term  Loan  matures  on 
April  30,  2025,  subject  to  Omega  OP’s  option  to  extend  such  maturity  date  for  two  six-month 
periods. 

• 

• 

$4.9  billion  of  senior  unsecured  notes  with  staggered  maturity  dates  in  2023,  2024,  2025,  2026, 
2027, 2028, 2029, 2031 and 2033. These notes bear fixed interest rates between 3.25% and 5.25% 
per annum. 

$366.6 million of  secured borrowings consisting of  HUD Mortgages and two term loans. We had 
$344.7 million of  outstanding HUD Mortgages as of  December 31, 2022, with weighted average 
interest rates of 3.01% per annum that mature from 2046 to 2052. 

As of  December 31, 2022, we had long-term credit ratings of  Baa3 from Moody’s and BBB- from S&P 
Global and Fitch. Credit ratings impact our ability to access capital and directly impact our cost of  capital 
as well. For example, our Revolving Credit Facility accrues interest and fees at a rate per annum equal to 
LIBOR plus a margin that depends upon our credit rating. A downgrade in credit ratings by Moody’s and 
S&P Global may have a negative impact on the interest rates and fees for our Revolving Credit Facility. 

Our credit facilities that reference LIBOR contain customary LIBOR replacement language, including, 

but not limited to, the use of rates based on the secured overnight financing rate. 

Certain  of  our  other  secured  and  unsecured  borrowings  are  subject  to  customary  affirmative  and 
negative  covenants,  including  financial  covenants.  As  of  December  31,  2022  and  2021,  we  were  in 
compliance with all affirmative and negative covenants, including financial covenants, for our secured and 
unsecured borrowings. 

As of  December 31, 2022 we have five forward starting swaps totaling $400 million that are indexed to 
3-month  LIBOR.  We  designated  the  forward  starting  swaps  as  cash  flow  hedges  of  interest  rate  risk 
associated  with  interest  payments  on  a  forecasted  issuance  of  fixed  rate  long-term  debt.  The  swaps  are 
effective on August 1, 2023 and expire on August 1, 2033 and were issued at a weighted average fixed rate of 
approximately 0.8675%. The fair value associated with these swaps was $93.0 million as of  December 31, 
2022. 

47 

Equity 

At December 31, 2022, we had 234.3 million shares of  common stock outstanding and our shares had 
a market value of $6.5 billion. As of December 31, 2022, we had the following equity programs in place that 
we can utilize to raise capital: 

• 

The  2021  ATM  Program  under  which  shares  of  common  stock  having  an  aggregate  gross  sales 
price of  up to $1.0 billion may be sold from time to time. The 2021 ATM Program has a forward 
sale  provision  that  generally  allows  Omega  to  lock  in  a  price  on  the  sale  of  shares  of  common 
stock when sold by the forward sellers but defer receiving the net proceeds from such sales until 
the  shares  of  our  common  stock  are  issued  at  settlement  on  a  later  date.  We  did  not  utilize  the 
forward  provisions  under  the  2021  ATM  Program  during  2022.  We  have  $929.9  million  of  sales 
remaining under the 2021 ATM Program as of December 31, 2022. 

•  We have a DRSPP that allows for the reinvestment of  dividends and the optional purchase of  our 

common stock. 

Dividends 

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

Material Cash Requirements 

The following table shows our material cash requirements, described below, as of December 31, 2022: 

Payments due by period 

Total 

Less than 
1 year 

Years 2 – 3 

Years 4 – 5 

(in thousands) 

More than 
5 years 

Debt(1) 
Interest payments on long-term debt . . . . . . . 
Operating lease and other obligations(2) . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . .  $5,335,865  $359,898  $  905,185  $1,317,191  $2,753,591 
379,095 
1,234,702 
34,418 
43,889 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . .  $6,614,456  $584,808  $1,278,889  $1,583,655  $3,167,104 

263,075 
3,389 

222,918 
1,992 

369,614 
4,090 

(1)  The  $5.3  billion  of  debt  outstanding  includes:  (i)  $50  million  under  the  OP  Term  Loan  due  April  2025,  (ii)  $350  million  of 
4.375%  Senior  Notes  due  August  2023,  (iii)  $400  million  of  4.95%  Senior  Notes  due  April  2024,  (iv)  $400  million  of  4.50% 
Senior  Notes  due  January  2025,  (v)  $600  million  of  5.25%  Senior  Notes  due  January  2026,  (vi)  $700  million  of  4.5%  Senior 
Notes due April 2027, (vii) $550 million of 4.75% Senior Notes due January 2028, (viii) $500 million of 3.625% Senior Notes due 
October  2029,  (ix)  $700  million  of  3.375%  Senior  Notes  due  February  2031,  (x)  $700  million  of  3.25%  Senior  Notes  due 
April 2033, (xi) $2.2 million of  8.0% per annum debt held at a consolidated joint venture due February 2023, (xii) $19.8 million 
of  9.63% per  annum debt held at a  consolidated joint venture due February 2024 and (xiii) $344.7 million of  HUD debt at a 
3.01% weighted average interest rate due between 2046 and 2052. Other than the $50 million outstanding under the OP Term 
Loan, the $344.7 million of  HUD debt and the $22.0 million of  debt held at consolidated joint ventures, Parent is the obligor of 
all outstanding debt. 

(2) 

In  connection  with  the  adoption  of  Topic  842,  we  recognized  lease  liabilities  in  connection  with  ground  and/or  facility  leases. 
Certain  operators  pay  these  obligations  directly  to  the  landlord.  We  recognize  rental  income  for  ground  and/or  facility  leases 
where the operator reimburses us, or pays the obligation directly to the landlord on our behalf. 

48 

Capital Expenditures and Funding Commitments 

In addition to the obligations in the table above, as of  December 31, 2022, we also had $210.9 million 
of  commitments to fund the construction of  new leased and mortgaged facilities, capital improvements and 
other  commitments.  Additionally,  we  have  commitments  to  fund  $71.4  million  of  advancements  under 
existing non-real estate loans. These commitments are expected to be funded over the next several years and 
are dependent upon the operators’ election to use the commitments. 

Other Arrangements 

We own interests in certain unconsolidated joint ventures as described in Note 11 to the Consolidated 
Financial  Statements — Investments  in  Joint  Ventures.  Our  risk  of  loss  is  generally  limited  to  our 
investment in the joint venture and any outstanding loans receivable. 

We  also  hold  variable  interests  in  certain  unconsolidated  entities  through  our  loan  and  other 
investments.  See  disclosures  regarding  our  risk  of  loss  associated  with  these  entities  with  Note  10  to  the 
Consolidated Financial Statements — Variable Interest Entities. 

We  use  derivative  instruments  to  hedge  interest  rate  and  foreign  currency  exchange  rate  exposure  as 
discussed in Note 15 to the Consolidated Financial Statements — Derivatives and Hedging. We have seen 
significant  increases  in  fair  value  of  our  hedging  instruments  in  2022,  primarily  due  to  macroeconomic 
factors impacting interest rates and foreign currency rates. 

Cash Flow Summary 

The  following  is  a  summary  of  our  sources  and  uses  of  cash  flows  for  the  year  ended  December  31, 

2022 as compared to the year ended December 31, 2021 (dollars in thousands): 

Year Ended December 31, 

2022 

2021 

Increase/(Decrease) 

Net cash provided by (used in): 

Operating activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $ 625,727  $ 722,136 
(524,173) 
Investing activities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(341,117) 
Financing activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

442,853 
(789,447) 

$  (96,409) 
967,026 
(448,330) 

For a discussion of  our consolidated cash flows for the year ended December 31, 2021 as compared to 
the  year  ended  December  31,  2020,  see  “Item  7 — Management’s  Discussion  and  Analysis  of  Financial 
Condition and Results of Operations” of our 2021 Form 10-K. 

Cash, cash equivalents and restricted cash totaled $300.6 million as of  December 31, 2022, an increase 
of  $276.2  million  as  compared  to  the  balance  at  December  31,  2021.  The  following  is  a  discussion  of 
changes  in  cash,  cash  equivalents  and  restricted  cash  due  to  operating,  investing  and  financing  activities, 
which are presented in our Consolidated Statements of Cash Flows. 

Operating  Activities — The  decrease  in  net  cash  provided  by  operating  activities  is  primarily  driven  by  a 
decrease of  $144.9 million of  net income, net of  $155.4 million of  non-cash items, primarily due to a year 
over  year  reduction  in  rental  income  and  interest  income,  as  discussed  in  our  material  changes  analysis 
under Results of  Operations above. The decrease was partially offset by a $48.4 million change in the net 
movements of the operating assets and liabilities. 

Investing  Activities — The  change  in  cash  used  in  investing  activities  related  primarily  to  (i)  a 
$440.5  million  increase  in  proceeds  from  the  sales  of  real  estate  investments  driven  by  an  attractive  real 
estate market in which Omega elected to sell non-strategic assets, (ii) a $391.6 million decrease in real estate 
acquisitions,  primarily  related  to  the  acquisition  of  24  senior  living  facilities  from  Healthpeak  in  the  first 
quarter  of  2021,  (iii)  a  $75.7  million  decrease  in  capital  improvements  to  real  estate  investments  and 
construction in progress (including $68.0 million related to the purchase of  a real estate property located in 
Washington,  D.C.  in  the  third  quarter  of  2021  that  Omega,  in  conjunction  with  Maplewood,  plans  to 
redevelop), (iv) a $68.9 million increase in loan repayments, net of  placements which is primarily driven by 
higher repayments in 2022 and (v) a $10.4 million decrease in investments in unconsolidated joint ventures 

49 

primarily related to Second Spring II LLC, a new joint venture investment in 2021. Offsetting these changes 
were: (i) a $14.5 million decrease in distributions from unconsolidated joint ventures in excess of  earnings 
primarily related to the Second Spring Healthcare Investments joint venture due to significant facility sales 
in the first quarter of 2021 and (ii) a $4.7 million decrease in receipts from insurance proceeds. 

Financing  Activities — The  change  in  cash  used  in  financing  activities  was  primarily  related  to  (i)  a 
$265.9  million  decrease  in  cash  proceeds  from  the  issuance  of  common  stock  in  2022  due  to  decreased 
issuances  under  our  DRSPP  and  our  2021  ATM  program,  as  compared  to  the  same  period  in  2021, 
(ii)  $142.3  million  of  repurchases  of  shares  of  common  stock  in  2022  as  a  result  of  implementing  a 
$500  million  repurchase  program  in  January  2022,  (iii)  a  $88.7  million  decrease  in  proceeds  from  other 
long-term  borrowings,  net  of  repayments  and  (iv)  a  $9.6  million  increase  in  redemptions  of  OP  units, 
partially  offset  by  (i)  a  $48.6  million  decrease  in  payment  of  financing  related  costs  due  to  fees  and 
premiums paid in the first quarter of  2021 related to the early redemption of  $350 million of  principal of 
the  4.375%  senior  notes  due  2023,  (ii)  a  $4.8  million  decrease  in  dividends  paid  primarily  resulting  from 
share  repurchases  throughout  2022  and  (iii)  a  $4.7  million  decrease  in  distributions  to  Omega  OP  Unit 
holders. 

Supplemental Guarantor Information 

Parent  has  issued  approximately  $4.9  billion  aggregate  principal  of  senior  notes  outstanding  at 
December 31, 2022 that were registered under the Securities Act of  1933, as amended. The senior notes are 
guaranteed by Omega OP. 

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

Omega OP is currently the sole guarantor of  our senior notes. The guarantees by Omega OP of  our 
senior notes are full and unconditional and joint and several with respect to the payment of  the principal 
and  premium  and  interest  on  our  senior  notes.  The  guarantees  of  Omega  OP  are  senior  unsecured 
obligations  of  Omega  OP  that  rank  equal  with  all  existing  and  future  senior  debt  of  Omega  OP  and  are 
senior to all subordinated debt. However, the guarantees are effectively subordinated to any secured debt of 
Omega OP. As of  December 31, 2022, there were no significant restrictions on the ability of  Omega OP to 
make distributions to Omega. 

Critical Accounting Policies and Estimates 

The preparation of  financial statements in conformity with GAAP in the U.S. requires management to 
make estimates and assumptions that affect the reported amounts of  assets and liabilities and the reported 
amounts of  revenues and expenses. Our significant accounting policies are described in Note 2 — Summary 
of  Significant Accounting Policies to the Consolidated Financial Statements. These policies were followed 
in  preparing  the  Consolidated  Financial  Statements  for  all  periods  presented.  Actual  results  could  differ 
from those estimates. 

50 

We  have  identified  the  following  accounting  policies  that  we  believe  are  critical  accounting  policies. 
These  critical  accounting  policies  are  those  that  have  the  most  impact  on  the  reporting  of  our  financial 
condition  and  those  requiring  significant  assumptions,  judgments  and  estimates.  With  respect  to  these 
critical  accounting  policies,  we  believe  the  application  of  assumptions,  judgments  and  estimates  is 
consistently applied and produces financial information that fairly presents the results of  operations for all 
periods presented. The following table presents information about our critical accounting policies, as well as 
the material assumptions used to develop each estimate: 

Nature of Critical Accounting Estimate 

Assumptions/Approach Used 

Revenue Recognition 
income  from  our  operating 
Rental 
leases 
is  generally  recognized  on  a 
straight-line  basis  over  the  lease  term 
when  we  have  determined  that  the 
collectibility  of  substantially  all  of  the 
lease  payments  are  probable.  If  we 
determine  that  it  is  not  probable  that 
substantially  all  of  the  lease  payments 
will  be  collected,  we  account  for  the 
revenue under the lease on a cash basis. 

We  assess  the  probability  of  collecting  substantially  all 
payments under our leases based on several factors, including, 
among  other  things,  payment  history  of  the  lessee,  the 
financial  strength  of  the  lessee  and  any  guarantors,  historical 
operations and operating trends, current and future economic 
conditions  and  expectations  of  performance  (which  includes 
known  substantial  doubt  about  an  operator’s  ability  to 
continue as a going concern). If our evaluation of these factors 
indicates  it  is  probable  that  we  will  be  unable  to  collect 
substantially  all  rents,  we  place  that  operator  on  a  cash  basis 
and limit our rental income to the lesser of  lease income on a 
straight-line  basis  plus  variable  rents  when  they  become 
accruable or cash collected. As a result of  placing an operator 
on a cash basis, we may recognize a charge to rental income for 
any contractual rent receivable, straight-line rent receivable and 
lease inducements. 

rent 

As  of  December  31,  2022  and  2021,  we  had  outstanding 
$166.1  million  and 
straight-line 
receivables  of 
$148.5  million,  respectively,  and 
inducements  of 
lease 
$6.0  million  and  $93.8  million,  respectively.  During  2022,  we 
wrote-off  approximately  $119.8  million  of  contractual 
receivables, straight-line rent receivables and lease inducements 
to rental income primarily as a result of  placing nine operators 
on  a  cash-basis.  During  2021,  we  wrote-off  approximately 
$36.0  million  of  contractual  receivables,  straight-line  rent 
receivables  and  lease  inducements  to  rental  income  primarily 
as  a  result  of  placing  six  operators  on  a  cash-basis.  If  we 
change  our  conclusion  regarding  the  probability  of  collecting 
rent  payments  required  by  a  lessee,  we  may  recognize  an 
adjustment to rental income in the period we make a change to 
our prior conclusion. Changes in the assessment of  probability 
are  accounted  for  on  a  cumulative  basis  as  if  the  lease  had 
always been accounted for based on the current determination 
of  the 
in 
increased volatility of rental income. 

likelihood  of  collection,  potentially  resulting 

51 

in 

the 

estimating 

Assumptions/Approach Used 

Nature of Critical Accounting Estimate 
Real Estate Investment Impairment 
Assessing  impairment  of  real  property  We  evaluate  our  real  estate  investments  for  impairment 
involves  subjectivity  in  determining  if 
indicators at each reporting period, including the evaluation of 
indicators  of  impairment  are  present  our  assets’ useful  lives.  The  judgment  regarding  the  existence 
future  of  impairment indicators is based on factors such as, but not 
and 
limited to, market conditions, operator performance including 
undiscounted cash flows. The estimated 
the  current  payment  status  of  contractual  obligations  and 
future  undiscounted  cash  flows  are 
generally  based  on  the  related  lease 
the  ability  to  meet  future  contractual 
expectations  of 
which relates to one or more properties  obligations, legal structure, as well as our intent with respect to 
and  may  include  cash  flows  from  the  holding or disposing of  the asset. If  indicators of  impairment 
eventual  disposition  of  the  asset.  In  are  present,  we  evaluate  the  carrying  value  of  the  related  real 
estate  investments  in  relation  to  our  estimate  of  future 
some  instances,  there  may  be  various 
potential  outcomes  for  a  real  estate  undiscounted  cash  flows  of  the  underlying  facilities  to 
investment and its potential future cash  determine  if  an  impairment  charge  is  necessary.  This  analysis 
requires us to use judgment in determining whether indicators 
flows. 
undiscounted  future  cash  flows  used  to  of  impairment  exist,  probabilities  of  potential  outcomes  and 
to  estimate  the  expected  future  undiscounted  cash  flows  or 
are 
assess 
impact  our 
estimated  fair  values  of  the  facility  which 
probability-weighted 
on 
management’s  best  estimates  as  of  the  assessment of impairment, if any. 
date  of  evaluation.  These  estimates  can 
the 
have  a  significant 
undiscounted cash flows. 

During  2022,  we  recorded 
impairments  on  real  estate 
properties  of  approximately  $38.5  million  on  22  facilities. 
During  2021,  we  recorded 
impairments  on  real  estate 
properties of approximately $44.7 million on 14 facilities. 

recoverability 
based 

impact  on 

instances, 

these 

the 

the 

In 

real 

that  our 

Asset Acquisitions 
estate  The  allocation  of  the  purchase  price  to  the  related  real  estate 
We  believe 
acquisitions  are  typically  considered  acquired  (tangible  assets  and  intangible  assets  and  liabilities) 
involves subjectivity as such allocations are based on a relative 
asset  acquisitions.  The  assets  acquired 
fair  value  analysis.  In  determining  the  fair  values  that  drive 
and  liabilities  assumed  are  recognized 
such analysis, we estimate the fair value of  each component of 
by allocating the cost of  the acquisition, 
land, 
the  real  estate  acquired  which  generally 
including 
the 
transaction  costs, 
individual assets acquired and liabilities  buildings and site improvements, furniture and equipment, and 
the  above  or  below  market  component  of  in-place  leases. 
assumed  on  a  relative  fair  value  basis. 
Tangible  assets  consist  primarily  of  Significant  assumptions  used  to  determine  such  fair  values 
include  comparable  land  sales,  capitalization  rates,  discount 
land,  building  and  site  improvements 
rates,  market  rental  rates  and  property  operating  data,  all  of 
and 
and 
equipment. 
and  which can be impacted by expectations about future market or 
Identifiable 
intangible 
economic  conditions.  Our  estimates  of  the  values  of  these 
liabilities primarily consist of  the above 
components  affect 
or below market component of  in-place 
the  amount  of  depreciation  and 
amortization  we  record  over  the  estimated  useful  life  of  the 
leases. 
property or the term of the lease. 

furniture 

includes 

assets 

to 

During  2022  and  2021,  we  acquired  real  estate  assets  of 
approximately  $225.2  million  and  $604.0  million,  respectively. 
These  transactions  were  accounted  for  as  asset  acquisitions 
and  the  purchase  price  of  each  was  allocated  based  on  the 
relative  fair  values  of  the  assets  acquired  and  liabilities 
assumed. 

52 

Nature of Critical Accounting Estimate 
Allowance  for  Credit  Losses  on  Real 
Estate  Loans,  Non-real  Estate  Loans 
and Direct Financing Leases 
For  purposes  of  determining  our 
allowance for credit loss, we pool financial 
assets 
risk 
have 
characteristics. We aggregate our financial 
assets by financial instrument type and by 
internal  risk  rating.  Our  internal  ratings 
range between 1 and 7. An internal rating 
of  1  reflects  the  lowest  likelihood  of  loss 
and a 7 reflects  the  highest  likelihood  of 
loss. 

similar 

that 

We  have  a  limited  history  of  incurred 
losses  and  consequently  have  elected  to 
employ  external  data  to  perform  our 
expected credit loss calculation. We utilize 
a  probability  of  default  (“PD”)  and  loss 
given default (“LGD”) methodology. 

Periodically,  the  Company  may  identify 
an  individual  loan  for  impairment.  When 
we identify a loan impairment, the loan is 
written  down  to  the  present  value  of  the 
expected future cash flows. In cases where 
expected future cash flows are not readily 
determinable, the loan is written down to 
the fair value of  the underlying collateral. 
We  may  base  our  valuation  on  a  loan’s 
observable market price, if  any, or the fair 
value of collateral, net of sales costs, if the 
repayment  of  the  loan  is  expected  to  be 
provided  solely  by 
the 
collateral. 

the  sale  of 

Assumptions/Approach Used 

We assess our internal credit ratings on a quarterly basis. Our 
internal  credit  ratings  consider  several  factors  including  the 
collateral  and/or  security,  the  performance  of  borrowers 
underlying facilities, if applicable, available credit support (e.g., 
guarantees), borrowings with third parties, and other ancillary 
business ventures and real estate operations of the borrower. 
Our  model’s  historic  inputs  consider  PD  and  LGD  data  for 
residential  care  facilities  published  by  the  Federal  Housing 
Administration  (“FHA”)  along  with  Standards  &  Poor’s 
one-year  global  corporate  default  rates.  Our  historical  loss 
rates revert to historical averages after 36 periods. Our model’s 
current conditions and supportable forecasts consider internal 
credit ratings, current and projected U.S. unemployment rates 
published  by  the  U.S.  Bureau  of  Labor  Statistics  and  the 
Federal  Reserve  Bank  of  St.  Louis  and  the  weighted  average 
life to maturity of  the underlying financial asset. During 2022 
and  2021,  we  recorded  a  provision  for  credit  losses  of 
approximately $68.7 million and $77.7 million, respectively. As 
of  December 31, 2022 and 2021, we had a total allowance for 
credit loss of  $188.4 million and $144.5 million, respectively. A 
10%  increase  or  decrease  in  the  FHA  default  rates  as  of 
December 31, 2022 would result in an additional provision or 
recovery  for  credit  losses  of  $10.1  million  or  $9.3  million, 
respectively.  If  the  weighted  average  yield  to  maturity  on  our 
portfolio  increases  or  decreases  by  10%,  this  will  result  in  an 
additional  provision  or  recovery 
losses  of 
$4.6 million or $5.4 million, respectively. 

for  credit 

Item 7A — Quantitative and Qualitative Disclosures About Market Risk 

We  are  exposed  to  various  market  risks,  including  the  potential  loss  arising  from  adverse  changes  in 
interest rates and foreign currency exchange rates. We seek to mitigate the effects of  fluctuations in interest 
rates  by  matching  the  terms  of  new  investments  with  new  long-term  fixed  rate  borrowings  to  the  extent 
possible.  We  also  use  financial  derivative  instruments  to  hedge  our  interest  rate  exposure  as  well  as  our 
foreign  currency  exchange  rate  exposure.  We  do  not  enter  into  our  market  risk  sensitive  financial 
instruments  and  related  derivative  positions  (if  any)  for  trading  or  speculative  purposes.  The  following 
disclosures  discuss  potential  fluctuations  in  interest  rates  and  foreign  currency  exchange  rates  and  are 
subjective  in  nature  and  are  dependent  on  a  number  of  important  assumptions,  including  estimates  of 
future  cash  flows,  risks,  discount  rates  and  relevant  comparable  market  information  associated  with  each 
financial instrument. Readers are cautioned that many of  the statements contained in these paragraphs are 
forward-looking  and  should  be  read 
in  conjunction  with  our  disclosures  under  the  heading 
“Forward-Looking  Statements” set  forth  above.  The  use  of  different  market  assumptions  and  estimation 
methodologies  may  have  a  material  effect  on  the  reported  estimated  fair  value  amounts.  Accordingly,  the 
estimates  presented  below  are  not  necessarily  indicative  of  the  amounts  we  would  realize  in  a  current 
market exchange. 

53 

Interest Rate Risk 

We  borrow  debt  at  a  combination  of  variable  and  fixed  rates.  Movements  in  interest  rates  on  our 
variable rate borrowings would change our future earnings and cash flows but not significantly affect the 
fair value of  those instruments. During the year ended December 31, 2022, we incurred interest expense of 
$4.1 million related to variable rate borrowings outstanding under our Revolving Credit Facility, OP Term 
Loan  and  two  other  term  loans.  Assuming  no  changes  in  outstanding  balances,  a  1%  increase  in  interest 
rates  would  not  have  significantly  impacted  the  annual  interest  expense  on  our  Revolving  Credit  Facility, 
OP Term Loan and two other term loans. 

A change in interest rates will not affect the interest expense associated with our long-term fixed rate 
borrowings but will affect the fair value of  our long-term fixed rate borrowings. The estimated fair value of 
our  total  long-term  fixed-rate  borrowings  at  December  31,  2022  was  approximately  $4.7  billion.  A 
one  percent  increase  in  interest  rates  would  result  in  a  decrease  in  the  fair  value  of  long-term  fixed-rate 
borrowings by approximately $212.0 million at December 31, 2022. 

At  December  31,  2022,  we  have  $400  million  of  forward  interest  rate  swaps  outstanding  that  are 
recorded at fair value in other assets on our Consolidated Balance Sheets. The forward-starting swaps hedge 
the interest rate risk associated with interest payments on a forecasted issuance of fixed rate long-term debt. 

Foreign Currency Risk 

We are exposed to foreign currency risk through our investments in the U.K. Increases or decreases in 
the value of  the British Pound Sterling relative to the U.S. Dollar impact the amount of  net income we earn 
from our investments in the U.K. Based solely on our results for the year ended December 31, 2022, if  the 
applicable  exchange  rate  was  to  increase  or  decrease  by  10%,  our  net  income  from  our  consolidated 
U.K.-based investments would increase or decrease, as applicable by $1.4 million. 

To  hedge  a  portion  of  our  net  investments  in  the  U.K.,  at  December  31,  2022,  we  have  six  foreign 
currency  forward  contracts  with  notional  amounts  totaling  £250.0  million,  four  of  which  mature  on 
March 8, 2024 and two of which mature on May 21, 2029. 

Item 8 — Financial Statements and Supplementary Data 

The  consolidated  financial  statements  listed  under  Item  15 — Exhibits  and  Financial  Statement 
Schedules and the report of  Ernst & Young LLP, Independent Registered Public Accounting Firm, on such 
financial statements are filed as part of  this report beginning on page F-1. There have been no retrospective 
changes to our Consolidated Statements of  Operations for any of  the quarters within the two most recent 
fiscal years that are individually or in the aggregate material. 

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 

In connection with the preparation of our Form 10-K as of and for the year ended December 31, 2022, 
management evaluated the effectiveness of  the design and operation of  disclosure controls and procedures 
of  the Company as of  December 31, 2022. Based on this evaluation, the Chief  Executive Officer and Chief 
Financial Officer of  the Company concluded that the disclosure controls and procedures of  the Company 
were effective at the reasonable assurance level as of December 31, 2022. 

54 

Management’s Report on Internal Control over Financial Reporting 

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over 
financial reporting. The 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 GAAP and includes those policies and procedures that: 

• 

• 

• 

Pertain  to  the  maintenance  of  records  that  in  reasonable  detail  accurately  and  fairly  reflect  the 
transactions and dispositions of the assets of the company; 

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 

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. 

All  internal  control  systems,  no  matter  how  well  designed,  have  inherent  limitations  and  can  provide 
only  reasonable,  not  absolute,  assurance  that  the  objectives  of  the  control  system  are  met.  Further,  the 
design  of  a  control  system  must  reflect  the  fact  that  there  are  resource  constraints,  and  the  benefits  of 
controls must be considered relative to their costs. Because of  the inherent limitations in all control systems, 
no evaluation  of  controls  can provide  absolute assurance  that all control  issues and instances of  fraud,  if 
any, within our company have been detected. Therefore, even those systems determined to be effective can 
provide only reasonable assurance with respect to financial statement preparation and presentation. 

In connection with the preparation of  this Form 10-K, our management assessed the effectiveness of 
the  Company’s  internal  control  over  financial  reporting  as  of  December  31,  2022.  In  making  that 
assessment, our management used the criteria set forth by the Committee of  Sponsoring Organizations of 
the  Treadway  Commission  (“COSO”)  in  Internal  Control-Integrated  Framework  (“2013  framework”). 
Based  on  management’s  assessment,  management  believes  that,  as  of  December  31,  2022,  the  Company’s 
internal control over financial reporting was effective based on those criteria. 

The  independent  registered  public  accounting  firm’s  attestation  reports  regarding  the  Company’s 
internal  control  over  financial  reporting  is  included  in  the  2022  financial  statements  under  the  caption 
entitled Report of Independent Registered Public Accounting Firm and is incorporated herein by reference. 

Changes in Internal Control Over Financial Reporting 

There were no changes in the Company’s internal control over financial reporting during the quarter 
ended  December  31,  2022  identified  in  connection  with  the  evaluation  of  their  disclosure  controls  and 
procedures  described  above  that  have  materially  affected,  or  are  reasonably  likely  to  materially  affect,  its 
internal control over financial reporting. 

Item 9B — Other Information 

None. 

Item 9C — Disclosure Regarding Foreign Jurisdictions that Prevent Inspections 

Not Applicable. 

55 

PART III 

Item 10 — Directors, Executive Officers of the Registrant and Corporate Governance 

The information required by this item is incorporated herein by reference to our Company’s definitive 
proxy  statement  for  the  2023  Annual  Meeting  of  Stockholders,  to  be  filed  with  the  SEC  pursuant  to 
Regulation 14A. 

For  information  regarding  executive  officers  of  our  Company,  see  Item  1 — Business — Information 

about our Executive Officers. 

Code of Business Conduct and Ethics 

We have adopted a written Code of  Business Conduct and Ethics (“Code of  Ethics”) that applies to all 
of  our  directors  and  employees,  including  our  chief  executive  officer,  chief  financial  officer,  chief 
accounting  officer  and  controller.  A  copy  of  our  Code  of  Ethics  is  available  on  our  website  at 
www.omegahealthcare.com. Any amendment to our Code of  Ethics or any waiver of  our Code of  Ethics 
that  is  required  to  be  disclosed  will  be  provided  on  our  website  at  www.omegahealthcare.com  promptly 
following the date of such amendment or waiver. 

Item 11 — Executive Compensation 

The information required by this item is incorporated herein by reference to our Company’s definitive 
proxy  statement  for  the  2023  Annual  Meeting  of  Stockholders,  to  be  filed  with  the  SEC  pursuant  to 
Regulation 14A. 

Item  12 — Security  Ownership  of  Certain  Beneficial  Owners  and  Management  and  Related  Stockholder 
Matters 

The information required by this item is incorporated herein by reference to our Company’s definitive 
proxy  statement  for  the  2023  Annual  Meeting  of  Stockholders,  to  be  filed  with  the  SEC  pursuant  to 
Regulation 14A, except as set forth below. 

The  following  table  provides  information  about  shares  available  for  future  issuance  under  our  equity 

compensation plans as of December 31, 2022: 

Equity Compensation Plan Information 

Plan category 

(a) 
Number of securities to 
be issued upon exercise 
of outstanding options, 
warrants and rights(1) 

(b) 
Weighted-average 
exercise price of 
outstanding options, 
warrants and rights(2) 

(c) 
Number of securities 
remaining available for 
future issuance under 
equity compensation plans 
excluding securities 
reflected in column (a)(3) 

Equity compensation plans approved by 

security holders . . . . . . . . . . . . . . . . . . 

4,145,974 

Equity compensation plans not approved 

by security holders . . . . . . . . . . . . . . . . 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . 

— 
4,145,974 

$  — 

— 
$  — 

2,093,354 

— 
2,093,354 

(1)  Reflects (i) 353,185 time-based restricted stock units (“RSUs”) and profit interest units (“PIUs”), (ii) 3,145,918 shares related to 
performance-based RSUs (“PRSUs”) and performance-based PIUs that could be issued if  certain performance conditions are 
achieved and (iii) 646,871 shares in respect of outstanding deferred stock units. 

(2)  No exercise price is payable with respect to the RSUs and PRSUs. 

(3)  Reflects  (i)  1,621,463  shares  of  common  stock  under  our  2018  Stock  Incentive  Plan  and  (ii)  471,891  shares  of  common  stock 

under the Omega Healthcare Investors, Inc. Employee Stock Purchase Plan. 

56 

Item 13 — Certain Relationships and Related Transactions, and Director Independence 

The information required by this item is incorporated herein by reference to our Company’s definitive 
proxy  statement  for  the  2023  Annual  Meeting  of  Stockholders,  to  be  filed  with  the  SEC  pursuant  to 
Regulation 14A. 

Item 14 — Principal Accountant Fees and Services 

The information required by this item is incorporated herein by reference to our Company’s definitive 
proxy  statement  for  the  2023  Annual  Meeting  of  Stockholders,  to  be  filed  with  the  SEC  pursuant  to 
Regulation 14A. 

57 

PART IV 

Item 15 — Exhibits and Financial Statement Schedules 

(a)(1) Listing of Consolidated Financial Statements 

Title of Document 

Reports of Independent Registered Public Accounting Firm (PCAOB ID: 42)  . . . . . . . 
Consolidated Balance Sheets as of December 31, 2022 and 2021 . . . . . . . . . . . . . . 
Consolidated Statements of Operations for the three years ended December 31, 

Page 
Number 

F-1 
F-4 

2022. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

F-5 

Consolidated Statements of Comprehensive Income for the three years ended 

December 31, 2022 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Consolidated Statements of Equity for the three years ended December 31, 2022  . . 
Consolidated Statements of Cash Flows for the three years ended December 31, 

2022. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . 

Notes to Consolidated Financial Statements 

F-6 
F-7 

F-8 
F-9 

(a)(2)  Financial  Statement  Schedules.  The  following  consolidated  financial  statement  schedules  are 

included herein: 

Schedule III — Real Estate and Accumulated Depreciation  . . . . . . . . . . . . . . . . . . . 
Schedule IV — Mortgage Loans on Real Estate  . . . . . . . . . . . . . . . . . . . . . . . . . . . 

F-72 
F-74 

All  other  schedules  for  which  provision  is  made  in  the  applicable  accounting  regulation  of  the 
Securities and Exchange Commission are not required under the related instructions or are inapplicable or 
have  been  omitted  because  sufficient  information  has  been  included  in  the  notes  to  the  Consolidated 
Financial Statements. 

(a)(3) Exhibits — See “Index to Exhibits” beginning on Page I-1 of this report. 

Item 16 — Form 10-K Summary 

None. 

58 

Report of Independent Registered Public Accounting Firm 

To the Stockholders and the Board of Directors of Omega Healthcare Investors, Inc. 

Opinion on the Financial Statements 

We  have  audited  the  accompanying  consolidated  balance  sheets  of  Omega  Healthcare  Investors,  Inc.  (the 
Company)  as  of  December  31,  2022  and  2021,  the  related  consolidated  statements  of  operations, 
comprehensive  income,  changes  in  equity  and  cash  flows  for  each  of  the  three  years  in  the  period  ended 
December  31,  2022,  and  the  related  notes  and  financial  statement  schedules  listed  in  the  Index  at 
Item  15(a)(2)  (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, 2022 and 2021, and the results of  its operations and its cash flows for each of 
the  three  years  in  the  period  ended  December  31,  2022,  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, 2022, 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 14, 2023 expressed an unqualified opinion thereon. 

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. 

Critical Audit Matter 

The  critical  audit  matter  communicated  below  is  a  matter  arising  from  the  current  period  audit  of  the 
financial  statements  that  was communicated  or required  to be communicated  to the audit committee and 
that: (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our 
especially  challenging,  subjective  or  complex  judgments.  The  communication  of  the  critical  audit  matter 
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  matter  below,  providing  a  separate  opinion  on  the  critical  audit 
matter or on the accounts or disclosures to which it relates. 

F-1 

Description of the Matter 

Collectibility of future lease payments 
During 2022, the Company recognized rental income of  $750.2 million 
and  recorded  straight-line  rent  and  lease  inducement  receivables  of 
$172.1  million  at  December  31,  2022.  As  described  in  Note  2  to  the 
consolidated  financial  statements,  the  timing  and  pattern  of  rental 
income  recognition  for  operating  leases  is  affected  by  the  Company’s 
determination  as  to  whether  the  collectibility  of  substantially  all  lease 
payments is probable. 

involved 

judgment 

Auditing the Company’s accounting for rental income is complex due to 
in  the  Company’s  determination  of  the 
the 
collectibility  of  future  lease  payments.  The  determination  involves 
consideration  of  the  lessee’s  payment  history,  an  assessment  of  the 
financial  strength  of  the  lessee  and  any  guarantors,  where  applicable, 
historical operations and operating trends, current and future economic 
conditions,  and  expectations  of  performance  (which  includes  known 
substantial  doubt  about  an  operator’s  ability  to  continue  as  a  going 
concern). 

How  We  Addressed  the  Matter  We  obtained  an  understanding,  evaluated  the  design  and  tested  the 
operating  effectiveness  of  the  Company’s  controls  over  the  recognition 
in Our Audit 
of  rental  income,  including  controls  over  management’s  assessment  of 
the  collectibility  of  future  lease  payments.  For  example,  we  tested 
controls  over  management’s  consideration  of  the  factors  used  in 
assessing collectibility and controls over the completeness and accuracy 
of the data used in management’s analyses. 

To  test  the  rental  income  recognized,  we  performed  audit  procedures 
that included, among others, evaluating the collectibility of  future lease 
payments.  For  example,  we  assessed  the  lessee’s  payment  history, 
historical operating results of  the properties, and factors contributing to 
the  financial  strength  of  the  lessee,  including  current  and  future 
economic  conditions,  as  well  as  management’s  assessment  of  the 
expectation  of  performance  of  a  sample  of  operators.  We  also 
considered  whether  other  information  obtained  throughout  the  course 
of  our  audit  procedures  corroborated  or  contradicted  management’s 
analysis.  In  addition,  we  tested  the  completeness  and  accuracy  of  the 
data that was used in management’s analyses. 

/s/ Ernst & Young LLP 

We have served as the Company’s auditor since 1992. 

Baltimore, Maryland 
February 14, 2023 

F-2 

Report of Independent Registered Public Accounting Firm 

To the Stockholders and Board of Directors of Omega Healthcare Investors, Inc. 

Opinion on Internal Control over Financial Reporting 

We  have  audited  Omega  Healthcare  Investors,  Inc.’s  internal  control  over  financial  reporting  as  of 
December 31, 2022, 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,  Omega  Healthcare  Investors,  Inc.  (the  Company)  maintained,  in  all  material 
respects,  effective  internal  control  over  financial  reporting  as  of  December  31,  2022,  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  Omega Healthcare Investors, Inc. as of 
December  31,  2022  and  2021,  the  related  consolidated  statements  of  operations,  comprehensive  income, 
changes in equity and cash flows for each of the three years in the period ended December 31, 2022, and the 
related  notes  and  financial  statement  schedules  listed  in  the  Index  at  Item  15(a)(2)  and  our  report  dated 
February 14, 2023 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 Report on 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 Limitations 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 

Baltimore, Maryland 
February 14, 2023 

F-3 

OMEGA HEALTHCARE INVESTORS, INC. 
CONSOLIDATED BALANCE SHEETS 
(in thousands, except per share amounts) 

Real estate assets 

ASSETS 

Buildings and improvements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Land  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Furniture and equipment  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Construction in progress  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total real estate assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Less accumulated depreciation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Real estate assets – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Investments in direct financing leases – net  . . . . . . . . . . . . . . . . . . . . . . . . . 
Real estate loans receivable – net 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Investments in unconsolidated joint ventures  . . . . . . . . . . . . . . . . . . . . . . . . 
Assets held for sale  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total real estate investments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Non-real estate loans receivable – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Cash and cash equivalents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Restricted cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Contractual receivables – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other receivables and lease inducements  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Goodwill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
LIABILITIES AND EQUITY 
Revolving credit facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Secured borrowings 
Senior notes and other unsecured borrowings – net 
. . . . . . . . . . . . . . . . . . . 
Accrued expenses and other liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Total investments 

Equity: 
Preferred stock $1.00 par value authorized – 20,000 shares, issued and 

December 31, 

2022 

2021 

$ 7,347,853  $ 7,515,658 
919,180 
519,845 
74,062 
9,028,745 
(2,181,528) 
6,847,217 
10,873 
1,180,786 
194,687 
203,025 
8,436,588 
124,184 
8,560,772 
20,534 
3,877 
11,259 
251,815 
651,417 
138,804 
$ 9,405,163  $ 9,638,478 

923,605 
499,902 
88,904 
8,860,264 
(2,322,773) 
6,537,491 
8,503 
1,042,731 
178,920 
9,456 
7,777,101 
225,281 
8,002,382 
297,103 
3,541 
8,228 
177,798 
643,151 
272,960 

$ 

19,246  $ 
366,596 
4,900,992 
315,047 
5,601,881 

— 
362,081 
4,891,455 
276,716 
5,530,252 

outstanding – none  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

— 

— 

Common stock $0.10 par value authorized – 350,000 shares, issued and 

outstanding – 234,252 shares as of December 31, 2022 and 239,061 shares as 
of December 31, 2021  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Additional paid-in capital  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Cumulative net earnings  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Cumulative dividends paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Accumulated other comprehensive income (loss)  . . . . . . . . . . . . . . . . . . . . . 
Total stockholders’ equity  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Noncontrolling interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total equity  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total liabilities and equity 

23,425 
6,314,203 
3,438,401 
(6,186,986) 
20,325 
3,609,368 
193,914 
3,803,282 

23,906 
6,427,566 
3,011,474 
(5,553,908) 
(2,200) 
3,906,838 
201,388 
4,108,226 
$ 9,405,163  $ 9,638,478 

See accompanying notes. 
F-4 

OMEGA HEALTHCARE INVESTORS, INC. 
CONSOLIDATED STATEMENTS OF OPERATIONS 
(in thousands, except per share amounts) 

Year Ended December 31, 

2022 

2021 

2020 

Revenues 

Rental income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Income from direct financing leases . . . . . . . . . . . . . . . . . . . . . . . 
Interest income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Miscellaneous income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Total revenues 
Expenses 

Depreciation and amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . 
General and administrative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Real estate taxes  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Acquisition, merger and transition related costs  . . . . . . . . . . . . . . 
Impairment on real estate properties  . . . . . . . . . . . . . . . . . . . . . . 
Recovery on direct financing leases  . . . . . . . . . . . . . . . . . . . . . . . 
Provision for credit losses  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total expenses  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other income (expense) 

Other expense – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Loss on debt extinguishment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gain on assets sold – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total other income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Income before income tax expense and income from unconsolidated joint 
ventures  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Income tax expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . 
Income from unconsolidated joint ventures 
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net income attributable to noncontrolling interest  . . . . . . . . . . . . . . 
Net income available to common stockholders  . . . . . . . . . . . . . . . . . . 

Earnings per common share available to common stockholders: 
Basic: 

$750,208  $  923,677  $753,427 
1,033 
134,286 
3,635 
892,381 

1,029 
136,382 
1,721 
1,062,809 

1,023 
123,919 
3,094 
878,244 

332,407 
69,397 
15,500 
42,006 
38,451 
— 
68,663 
233,244 
799,668 

(1,997) 
(389) 
359,951 
357,565 

342,014 
64,628 
12,260 
1,814 
44,658 
(717) 
77,733 
234,604 
776,994 

(581) 
(30,763) 
161,609 
130,265 

329,924 
59,889 
12,316 
2,018 
72,494 
(3,079) 
37,997 
223,389 
734,948 

(879) 
(13,340) 
19,113 
4,894 

436,141 
(4,561) 
7,261 
438,841 
(11,914) 

162,327 
(4,925) 
6,143 
163,545 
(4,218) 
$426,927  $  416,739  $159,327 

416,080 
(3,840) 
16,062 
428,302 
(11,563) 

Net income available to common stockholders  . . . . . . . . . . . . . . . 

$ 

1.81  $ 

1.76  $ 

0.70 

Diluted: 

Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$ 

1.80  $ 

1.75  $ 

0.70 

See accompanying notes. 
F-5 

OMEGA HEALTHCARE INVESTORS, INC. 
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME 
(in thousands) 

Year Ended December 31, 

2022 

2021 

2020 

Net income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $438,841  $428,302  $163,545 
Other comprehensive income (loss): 

Foreign currency translation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Cash flow hedges  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total other comprehensive income . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Comprehensive income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Comprehensive income attributable to noncontrolling interest . . . . . . 

7,762 
20,087 
27,849 
191,394 
(4,977) 
Comprehensive income attributable to common stockholders . . . . . . . . . .  $449,452  $427,307  $186,417 

(32,770) 
55,949 
23,179 
462,020 
(12,568) 

(1,842) 
12,689 
10,847 
439,149 
(11,842) 

See accompanying notes. 
F-6 

OMEGA HEALTHCARE INVESTORS, INC. 
CONSOLIDATED STATEMENTS OF EQUITY 
(in thousands, except per share amounts) 

Common  Additional  Cumulative 
Paid-in 
Capital 

Stock 
Par Value 

Net 
Earnings 

Accumulated 
Other 
Comprehensive 
Income (Loss) 

Total 
Stockholders’ 
Equity 

Cumulative 
Dividends 

Noncontrolling 
Interest 

Total 
Equity 

Balance at December 31, 2019 

. . . . . . . . . .  $22,663  $5,992,733  $2,463,436  $(4,303,546) 

$(39,858) 

$4,135,428 

$201,166 

$4,336,594 

Cumulative effect of accounting change (see 

Note 2)  . . . . . . . . . . . . . . . . . . . . 

— 

— 

(28,028) 

— 

— 

(28,028) 

(757) 

(28,785) 

Balance at January 1, 2020 

. . . . . . . . . . . . 

22,663 

5,992,733 

2,435,408 

(4,303,546) 

(39,858) 

4,107,400 

200,409 

4,307,809 

Stock related compensation  . . . . . . . . . . 

Issuance of common stock  . . . . . . . . . . . 

— 

452 

19,064 

151,409 

Common dividends declared ($2.68 per 

share)  . . . . . . . . . . . . . . . . . . . . . 

Vesting/exercising of OP units  . . . . . . . . . 

Conversion and redemption of Omega OP 

Units to common stock  . . . . . . . . . . . 

Omega OP Units distributions . . . . . . . . . 

Other comprehensive income 

. . . . . . . . . 

Net income 

. . . . . . . . . . . . . . . . . . . 

— 

— 

4 

— 

— 

— 

— 

(11,551) 

1,232 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

159,327 

— 

— 

(612,551) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

27,090 

— 

19,064 

151,861 

(612,551) 

(11,551) 

1,236 

— 

27,090 

159,327 

— 

— 

— 

11,551 

(1,236) 

(20,970) 

759 

4,218 

19,064 

151,861 

(612,551) 

— 

— 

(20,970) 

27,849 

163,545 

Balance at December 31, 2020 

. . . . . . . . . . 

23,119 

6,152,887 

2,594,735 

(4,916,097) 

(12,768) 

3,841,876 

194,731 

4,036,607 

Stock related compensation  . . . . . . . . . . 

Issuance of common stock  . . . . . . . . . . . 

— 

783 

21,578 

273,228 

Common dividends declared ($2.68 per 

share)  . . . . . . . . . . . . . . . . . . . . . 

Vesting/exercising of OP units  . . . . . . . . . 

Conversion and redemption of Omega OP 

Units to common stock  . . . . . . . . . . . 

Omega OP Units distributions . . . . . . . . . 

Other comprehensive income 

. . . . . . . . . 

Net income 

. . . . . . . . . . . . . . . . . . . 

— 

— 

4 

— 

— 

— 

— 

(21,623) 

1,496 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

416,739 

— 

— 

(637,811) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

10,568 

— 

21,578 

274,011 

(637,811) 

(21,623) 

1,500 

— 

10,568 

416,739 

— 

— 

— 

21,623 

(1,579) 

(25,229) 

279 

11,563 

21,578 

274,011 

(637,811) 

— 

(79) 

(25,229) 

10,847 

428,302 

Balance at December 31, 2021 

. . . . . . . . . . 

23,906 

6,427,566 

3,011,474 

(5,553,908) 

(2,200) 

3,906,838 

201,388 

4,108,226 

Stock related compensation  . . . . . . . . . . 

Issuance of common stock  . . . . . . . . . . . 

— 

40 

27,487 

8,072 

Repurchase of common stock  . . . . . . . . . 

(521) 

(141,746) 

Common dividends declared ($2.68 per 

share)  . . . . . . . . . . . . . . . . . . . . . 

Vesting/exercising of OP units  . . . . . . . . . 

Conversion and redemption of Omega OP 

Units to common stock  . . . . . . . . . . . 

Omega OP Units distributions . . . . . . . . . 

Capital contributions from noncontrolling 

holder in consolidated JV  . . . . . . . . . . 

Other comprehensive income 

. . . . . . . . . 

Net income 

. . . . . . . . . . . . . . . . . . . 

— 

— 

— 

— 

— 

— 

— 

— 

(7,176) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

426,927 

— 

— 

— 

(633,078) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

27,487 

8,112 

(142,267) 

(633,078) 

(7,176) 

— 

— 

— 

22,525 

— 

22,525 

426,927 

— 

— 

— 

— 

27,487 

8,112 

(142,267) 

(633,078) 

7,176 

— 

(9,704) 

(20,498) 

(9,704) 

(20,498) 

2,984 

654 

11,914 

2,984 

23,179 

438,841 

Balance at December 31, 2022 

. . . . . . . . . .  $23,425  $6,314,203  $3,438,401  $(6,186,986) 

$ 20,325 

$3,609,368 

$193,914 

$3,803,282 

See accompanying notes. 
F-7 

OMEGA HEALTHCARE INVESTORS, INC. 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
(in thousands) 

Year Ended December 31, 
2021 

2020 

2022 

Cash flows from operating activities 
Net income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Adjustment to reconcile net income to net cash provided by operating activities: 

$ 438,841 

$  428,302 

$  163,545 

Depreciation and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . 
Impairment on real estate properties 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Recovery on direct financing leases 
Provision for rental income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Provision for credit losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Amortization of deferred financing costs and loss on debt extinguishment 
. . . . . . 
Accretion of direct financing leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Stock-based compensation expense  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Gain on assets sold – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Amortization of acquired in-place leases – net  .  .  .  .  .  .  .  . . . . . . . . . . . . . . . 
Effective yield payable (receivable) on mortgage notes  .  .  . . . . . . . . . . . . . . . . 
.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Interest paid-in-kind 
Income from unconsolidated joint ventures  .  . . . . . . . . . . . . . . . . . . . . . . . 

Change in operating assets and liabilities – net: 

Contractual receivables  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Straight-line rent receivables  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Lease inducements 
Other operating assets and liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Net cash provided by operating activities 
Cash flows from investing activities 

Acquisition of a business, net of cash acquired  .  .  .  .  .  .  . . . . . . . . . . . . . . . . 
Acquisition of real estate  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Acquisition deposit – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net proceeds from sale of real estate investments  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 
Investments in construction in progress  . . . . . . . . . . . . . . . . . . . . . . . . . . 
Proceeds from sale of direct financing lease and related trust  .  .  .  . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Placement of loan principal 
Collection of loan principal 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Investments in unconsolidated joint ventures  .  .  .  . . . . . . . . . . . . . . . . . . . . 
.  .  .  .  .  .  .  . 
Distributions from unconsolidated joint ventures in excess of earnings 
Capital improvements to real estate investments 
.  . . . . . . . . . . . . . . . . . . . . 
Receipts from insurance proceeds  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net cash provided by (used in) investing activities .  .  .  .  .  .  .  .  .  .  .  .  . . . . . . . . . . . . 
Cash flows from financing activities 

. . . . . . . . . . . . . . . . . . . . . . . . . . . 
Proceeds from long-term borrowings 
Payments of long-term borrowings 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Payments of financing related costs  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net proceeds from issuance of common stock  . . . . . . . . . . . . . . . . . . . . . . 
Repurchase of common stock  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Dividends paid 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Noncontrolling members’ contributions to consolidated joint venture  .  .  .  . . . . . . 
Redemption of Omega OP Units 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Distributions to Omega OP Unit Holders . . . . . . . . . . . . . . . . . . . . . . . . . 
Net cash used in financing activities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Effect of foreign currency translation on cash, cash equivalents and restricted cash  .  .  .  .  . 
Increase (decrease) in cash, cash equivalents and restricted cash  .  . . . . . . . . . . . . . . . 
Cash, cash equivalents and restricted cash at beginning of period  .  .  .  .  .  .  .  .  .  .  . . . . . 
.  . . . . . . . . . . . . . . . . . 
Cash, cash equivalents and restricted cash at end of period 

332,407 
38,451 
— 
124,758 
68,663 
13,337 
83 
27,302 
(359,951) 
(5,662) 
2,050 
(9,423) 
455 

3,031 
(61,044) 
5,957 
6,472 
625,727 

— 
(229,987) 
— 
759,047 
(17,130) 
— 
(371,987) 
345,665 
(113) 
3,328 
(47,221) 
1,251 
442,853 

342,014 
44,658 
(717) 
38,806 
77,733 
43,051 
55 
21,415 
(161,609) 
(9,516) 
1,526 
(7,496) 
(2,060) 

(23,169) 
(52,206) 
(13,733) 
(4,918) 
722,136 

— 
(615,873) 
(5,730) 
318,529 
(95,064) 
717 
(251,457) 
156,276 
(10,484) 
17,868 
(44,948) 
5,993 
(524,173) 

329,924 
75,972 
(3,079) 
146,608 
37,997 
11,608 
30 
18,822 
(19,113) 
(14,187) 
(719) 
(7,718) 
(1,315) 

5,709 
(28,968) 
(22,443) 
15,583 
708,256 

(5,058) 
(105,663) 
(2,500) 
180,851 
(75,111) 
15,414 
(230,368) 
159,733 
(2,471) 
6,291 
(31,072) 
897 
(89,057) 

597,403 
(589,292) 
(389) 
8,112 
(142,267) 
(632,893) 
81 
(9,704) 
(20,498) 
(789,447) 
(2,900) 
276,233 
24,411 
$ 300,644 

2,275,128 
(2,178,311) 
(48,989) 
274,011 
— 
(637,648) 
— 
(79) 
(25,229) 
(341,117) 
7 
(143,147) 
167,558 
24,411 

$ 

1,852,209 
(1,838,155) 
(18,183) 
151,861 
— 
(612,310) 
— 
— 
(20,970) 
(485,548) 
527 
134,178 
33,380 
$  167,558 

See accompanying notes. 
F-8 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS 

NOTE 1 — ORGANIZATION 

Omega  Healthcare  Investors,  Inc.  (“Parent”),  is  a  Maryland  corporation  that,  together  with  its 
in 
consolidated  subsidiaries  (collectively,  “Omega”,  the  “Company”,  “we”,  “our”,  “us”) 
healthcare-related  real  estate  properties  located  in  the  United  States  (“U.S.”)  and  the  United  Kingdom 
(“U.K.”). Our core business is to provide financing and capital to the long-term healthcare industry with a 
particular  focus  on  skilled  nursing  facilities  (“SNFs”),  assisted  living  facilities  (“ALFs”),  and  to  a  lesser 
extent,  independent  living  facilities  (“ILFs”),  rehabilitation  and  acute  care  facilities  (“specialty  facilities”) 
and medical office buildings (“MOBs”). Our core portfolio consists of  our long-term “triple-net” leases and 
real  estate  loans  with  healthcare  operating  companies  and  affiliates  (collectively,  our  “operators”).  In 
addition to our core investments, we make loans to operators and/or their principals. From time to time, we 
also acquire equity interests in joint ventures or entities that support the long-term healthcare industry and 
our operators. 

invests 

Omega  has  elected  to  be  taxed  as  a  real  estate  investment  trust  (“REIT”)  for  federal  income  tax 
purposes  and  is  structured  as  an  umbrella  partnership  REIT  (“UPREIT”)  under  which  all  of  Omega’s 
assets are owned directly or indirectly by, and all of  Omega’s operations are conducted directly or indirectly 
through, its operating partnership subsidiary, OHI Healthcare Properties Limited Partnership (collectively 
with  subsidiaries,  “Omega  OP”).  Omega  has  exclusive  control  over  Omega  OP’s  day-to-day  management 
pursuant  to  the  partnership  agreement  governing  Omega  OP.  As  of  December  31,  2022,  Parent  owned 
approximately 97% of  the issued and outstanding units of  partnership interest in Omega OP (“Omega OP 
Units”), and other investors owned approximately 3% of the outstanding Omega OP Units. 

NOTE 2 — SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES 

Accounting Estimates 

The  preparation  of  financial  statements  in  conformity  with  U.S.  generally  accepted  accounting 
principles  (“GAAP”)  requires  management  to  make  estimates  and  assumptions  that  affect  the  reported 
amounts  of  assets  and  liabilities,  the  disclosure  of  contingent  assets  and  liabilities  at  the  date  of  the 
financial  statements  and  the  reported  amounts  of  revenues  and  expenses  during  the  reporting  period. 
Actual results could differ from those estimates. 

Consolidation 

Omega’s consolidated financial statements include the accounts of  (i) Parent, (ii) all direct and indirect 
wholly-owned subsidiaries of  Omega, including Omega OP, (iii) other entities in which Omega or Omega 
OP has a majority voting interest and control and (iv) variable interest entities (“VIEs”) of  which Omega is 
the primary beneficiary. All intercompany transactions and balances have been eliminated in consolidation, 
and  Omega’s  net  earnings  are  reduced  by  the  portion  of  net  earnings  attributable  to  noncontrolling 
interests. 

GAAP requires us to identify entities for which control is achieved through means other than voting 
rights  and  to  determine  which  business  enterprise,  if  any,  is  the  primary  beneficiary  of  VIEs.  A  VIE  is 
broadly  defined  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. We may change our original assessment of  a VIE upon subsequent events such as the modification 
of contractual arrangements that affects the characteristics or adequacy of the entity’s equity investments at 
risk and the disposition of all or a portion of an interest held by the primary beneficiary. 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Our variable interests in VIEs may be in the form of  equity ownership, leases, guarantees and/or loans 
with  our  operators.  We  analyze  our  agreements  and  investments  to  determine  whether  our  operators  or 
unconsolidated joint ventures are VIEs and, if so, whether we are the primary beneficiary. 

We consolidate a VIE when we determine that we are its primary beneficiary. We identify the primary 
beneficiary of  a VIE as the enterprise that has both: (i) the power to direct the activities of  the VIE that 
most significantly impact the entity’s economic performance; and (ii) the obligation to absorb losses or the 
right to receive benefits of  the VIE that could be significant to the entity. Factors considered in determining 
whether  we  are  the  primary  beneficiary  of  an  entity  include:  (i)  our  voting  rights,  if  any;  (ii)  our 
involvement  in  day-to-day  capital  and  operating  decisions;  (iii)  our  risk  and  reward  sharing;  (iv)  the 
financial  condition  of  the  operator  or  joint  venture  and  (iv)  our  representation  on  the  VIE’s  board  of 
directors.  We  perform  this  analysis  on  an  ongoing  basis.  As  of  December  31,  2022,  we  have  one  joint 
venture that is a consolidated VIE as we have concluded that we are the primary beneficiary through our 
equity  investment  in  the  entity.  We  also  have  consolidated  VIEs  related  to  the  Exchange  Accommodation 
Titleholders  (“EATs”)  discussed  in  Note  3 — Real  Estate  Asset  Acquisitions  and  Development.  As  of 
December 31, 2021, we did not have any VIEs that we consolidated. 

Revenue Recognition 

Rental Income 

Rental  income  from  operating  leases  is  recognized  on  a  straight-line  basis,  inclusive  of  fixed  annual 
escalators  and  lease  inducements,  over  the  lease  term  when  we  have  determined  that  the  collectibility  of 
substantially all of  the lease payments is probable. Certain of  our operating leases contain provisions for an 
increase based on the change in pre-determined formulas from year to year (e.g., increases in the Consumer 
Price Index). We do not include in our measurement of  our lease receivables these variable increases until 
the  specific  events  that  trigger  the  variable  payments  have  occurred.  Our  leased  real  estate  properties  are 
leased  under  provisions  of  single  or  master  leases  with  initial  terms  typically  ranging  from  5  to  15  years. 
Some of  our leases have options to extend, terminate or purchase the facilities, which are considered when 
determining the lease term. 

We  assess  the  probability  of  collecting  substantially  all  payments  due  under  our  leases  on  several 
factors,  including,  among  other  things,  payment  history,  the  financial  strength  of  the  lessee  and  any 
guarantors,  as  applicable,  historical  operations  and  operating  trends,  current  and  future  economic 
conditions, and expectations of  performance (which includes known substantial doubt about an operator’s 
ability to continue as a going concern). If  our evaluation of  these factors indicates it is probable that we will 
be unable to collect substantially all rents, we recognize a charge to rental income to write off  straight-line 
rent  receivables  and  limit  our  rental  income  to  the  lesser  of  lease  income  on  a  straight-line  basis  plus 
variable rents when they become accruable or cash collected. Provisions for uncollectible lease payments are 
recognized as a direct reduction to rental income. If  we change our conclusion regarding the probability of 
collecting  rent  payments  required  by  a  lessee,  we  may  recognize  an  adjustment  to  rental  income  in  the 
period  we  make  a  change  to  our  prior  conclusion,  potentially  resulting  in  increased  volatility  of  rental 
income. 

Under the terms of  our leases, the lessee is responsible for all maintenance, repairs, taxes and insurance 
on the leased properties. Certain of  our operating leases require the operators to reimburse us for property 
taxes  and  other  expenditures  that  are  not  considered  components  of  the  lease  and  therefore  no 
consideration is allocated to them as they do not result in the transfer of  a good or service to the operators. 
We have determined that all of  our leases qualify for the practical expedient, under Accounting Standards 
Codification  (“ASC”)  842,  Leases  (“Topic  842”),  to  not  separate  the  lease  and  non-lease  components 
because (i) the lease components are operating leases and (ii) the timing and pattern of  recognition of  the 
non-lease components are the same as the lease components. 

Certain operators are obligated to pay directly their obligations under their leases for real estate taxes, 
insurance and certain other expenses. These obligations, which have been assumed by the tenants under the 
terms of  their respective leases, are not reflected in our consolidated financial statements. To the extent any 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

tenant responsible for these obligations under their respective lease defaults on its lease or if  it is deemed 
probable that the tenant will fail to pay for such costs, we would record a liability for such obligation. 

We  have  elected  to  exclude  sales  and  other  similar  taxes  from  the  measurement  of  lease  revenue  and 

expense. 

Loan Interest Income 

Interest income is recognized as earned over the term of the related real estate and non-real estate loans 
receivable. Interest income is recorded on an accrual basis to the extent that such amounts are expected to 
be collected using the effective interest method. In applying the effective interest method, the effective yield 
on a loan is determined based on its contractual payment terms, adjusted for prepayment terms. 

Direct Financing Lease Income 

As of  December 31, 2022, we have one lease for a facility that is classified as a direct financing lease. 
For leases accounted for as direct financing leases, we record the present value of  the future minimum lease 
payments (utilizing a constant interest rate over the term of  the lease agreement) as a receivable and record 
interest income based on the contractual terms of  the lease agreement. Costs related to originating direct 
financing  leases  are  deferred  and  amortized  on  a  straight-line  basis  as  a  reduction  to  income  from  direct 
financing leases over the term of the direct financing leases. 

Real Estate Sales 

We  recognize  gains  on  the  disposition  of  real  estate  when  the  recognition  criteria  have  been  met, 
generally  at  the  time  the  risks  and  rewards  and  title  have  transferred,  and  we  no  longer  have  substantial 
continuing involvement with the real estate sold. Gains on the sale of  real estate are recognized pursuant to 
provisions  under  Accounting  Standards  Codification  (“ASC”)  610-20,  Gains  and  Losses  from  the 
Derecognition of  Nonfinancial Assets. Under ASC 610-20, we determine whether the transaction is a sale 
to  a  customer  or  non-customer.  As  a  REIT,  we  do  not  sell  real  estate  within  the  ordinary  course  of  our 
business and therefore, expect that our sale transactions will not be contracts with customers. ASC 610-20 
refers  to  the  revenue  recognition  principles  under  ASC  606,  Revenue  from  Contracts  with  Customers. 
Under ASC 610-20, if  we determine we do not have a controlling financial interest in the entity that holds 
the asset and the arrangement meets the criteria to be accounted for as a contract, we will dispose of  the 
asset and recognize a gain or loss on the sale of the real estate when control of the underlying asset transfers 
to the buyer. If  we determine a sale has not occurred under ASC 610-20, we continue to record the asset on 
the  Consolidated  Balance  Sheets  and  related  depreciation  expense  on  the  Consolidated  Statements  of 
Operations. 

Fair Value Measurement 

The Company measures and discloses the fair value of  nonfinancial and financial assets and liabilities 
utilizing a hierarchy of  valuation techniques based on whether the inputs to a fair value measurement are 
considered  to  be  observable  or  unobservable  in  a  marketplace.  Observable  inputs  reflect  market  data 
obtained from independent sources, while unobservable inputs reflect the Company’s market assumptions. 
This  hierarchy  requires  the  use  of  observable  market  data  when  available.  These  inputs  have  created  the 
following fair value hierarchy: 

• 

• 

• 

Level 1 — quoted prices for identical instruments in active markets; 

Level  2 — quoted  prices  for  similar  instruments  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. 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The Company measures fair value using a set of  standardized procedures that are outlined herein for 
all  assets  and  liabilities  which  are  required  to  be  measured  at  fair  value.  When  available,  the  Company 
utilizes quoted market prices from an independent third-party source to determine fair value and classifies 
such  items  in  Level  1.  In  some  instances  where  a  market  price  is  available,  but  the  instrument  is  in  an 
inactive  or  over-the-counter  market,  the  Company  consistently  applies  the  dealer  (market  maker)  pricing 
estimate and classifies such items in Level 2. 

If  quoted market prices or inputs are not available, fair value measurements are based upon valuation 
models  that  utilize  current  market  or  independently  sourced  market  inputs,  such  as  interest  rates,  option 
volatilities,  credit  spreads  and/or  market  capitalization  rates.  Items  valued  using  such  internally-generated 
valuation  techniques  are  classified  according  to  the  lowest  level  input  that  is  significant  to  the  fair  value 
measurement. As a result, these items could be classified in either Level 2 or Level 3 even though there may 
be some significant inputs that are readily observable. Internal fair value models and techniques used by the 
Company include discounted cash flow and Monte Carlo valuation models. 

Risks and Uncertainties including COVID-19 

The Company is subject to certain risks and uncertainties affecting the healthcare industry, including 
those stemming from the novel coronavirus (“COVID-19”) global pandemic, which has disproportionately 
impacted  the  senior  care  sector,  as  well  as  those  stemming  from  healthcare  legislation  and  changing 
regulation by federal, state and local governments. Additionally, we are subject to risks and uncertainties as 
a  result  of  changes  affecting  operators  of  nursing  home  facilities  due  to  the  actions  of  governmental 
agencies and insurers to limit the rising cost of healthcare services. 

Real Estate Acquisitions 

Upon acquisition of  real estate properties, we evaluate the acquisition to determine if  it is a business 
combination  or  an  asset  acquisition.  Our  real  estate  acquisitions  are  generally  accounted  for  as  asset 
acquisitions  as  substantially  all  of  the  fair  value  of  the  gross  assets  acquired  is  concentrated  in  a  single 
identifiable asset or group of similar identifiable assets. 

If the acquisition is determined to be an asset acquisition, the Company records the purchase price and 
other related costs incurred to the acquired tangible assets and identified intangible assets and liabilities on 
a relative fair value basis. In addition, costs incurred for asset acquisitions including transaction costs, are 
capitalized. 

If  the acquisition is determined to be a business combination, we record the purchase of  properties to 
net  tangible  and  identified  intangible  assets  acquired  and  liabilities  assumed  at  fair  value.  Goodwill  is 
measured  as  the  excess  of  the  fair  value  of  the  consideration  transferred  over  the  fair  value  of  the 
identifiable net assets. Transaction costs are expensed as incurred as part of a business combination. 

In  making  estimates  of  fair  value  for  purposes  of  recording  asset  acquisitions  and  business 
combinations,  we  utilize  a  number  of  sources,  including  independent  appraisals  that  may  be  obtained  in 
connection  with  the  acquisition  or  financing  of  the  respective  property  and  other  market  data.  The 
Company determines the fair value of acquired assets and liabilities as follows: 

• 

• 

• 

Land is determined based on third-party appraisals which typically include market comparables. 

Buildings and site improvements acquired are valued using a combination of  discounted cash flow 
projections that assume certain future revenues and costs and consider capitalization and discount 
rates using current market conditions as well as the residual approach. 

Furniture  and  fixtures  are  determined  based  on  third-party  appraisals  which  typically  utilize  a 
replacement cost approach. 

•  Mortgages and other investments are valued using a discounted cash flow analysis, using interest 

rates being offered for similar loans to borrowers with similar credit ratings. 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

• 

• 

Investments in joint ventures are valued based on the fair value of  the joint ventures’ assets and 
liabilities.  Differences,  if  any,  between  the  Company’s  basis  and  the  joint  venture’s  basis  are 
generally  amortized  over  the  lives  of  the  related  assets  and  liabilities,  and  such  amortization  is 
included in the Company’s share of earnings (losses) of the joint venture. 

Intangible assets and liabilities acquired are valued using a combination of  discounted cash flow 
projections  as  well  as  other  valuation  techniques  based  on  current  market  conditions  for  the 
intangible  asset  or  liability  being  acquired.  When  evaluating  below  market  leases  we  consider 
extension options controlled by the lessee in our evaluation. 

•  Other  assets  acquired  and  liabilities  assumed  are  typically  valued  at  stated  amounts,  which 

approximate fair value on the date of the acquisition. 

•  Assumed  debt  balances  are  valued  by  discounting  the  remaining  contractual  cash  flows  using  a 

current market rate of interest. 

•  Noncontrolling interests are valued using a stock price on the acquisition date. 

Real Estate Properties 

Real estate properties are carried at initial recorded value less accumulated depreciation. The costs of 
significant  improvements,  renovations  and  replacements,  including  interest  are  capitalized.  Our  interest 
expense  reflected  in  the  Consolidated  Statements  of  Operations  has  been  reduced  by  the  amounts 
capitalized. For the years ended December 31, 2022, 2021 and 2020, we capitalized $3.2 million, $1.5 million 
and  $10.0  million,  respectively,  of  interest  to  our  projects  under  development.  In  addition,  we  capitalize 
leasehold  improvements  when  certain  criteria  are  met,  including  when  we  supervise  construction  and  will 
own the improvement. Expenditures for maintenance and repairs are expensed as they are incurred. 

Depreciation  is  computed  on  a  straight-line  basis  over  the  estimated  useful  lives  ranging  from  20  to 
40  years  for  buildings,  eight  to  15  years  for  site  improvements,  and  three  to  ten  years  for  furniture  and 
equipment.  Leasehold  interests  are  amortized  over  the  shorter  of  the  estimated  useful  life  or  term  of  the 
lease. 

Management  evaluates  our  real  estate  properties  for  impairment  indicators  at  each  reporting  period, 
including  the  evaluation  of  our  assets’ useful  lives.  The  judgment  regarding  the  existence  of  impairment 
indicators  is  based  on  factors  such  as,  but  not  limited  to,  market  conditions,  operator  performance 
including  the  current  payment  status  of  contractual  obligations  and  expectations  of  the  ability  to  meet 
future contractual obligations, legal structure, as well as our intent with respect to holding or disposing of 
the asset. If  indicators of  impairment are present, management evaluates the carrying value of  the related 
real  estate  investments  in  relation  to  management’s  estimate  of  future  undiscounted  cash  flows  of  the 
underlying facilities. The estimated future undiscounted cash flows are generally based on the related lease 
which  relates  to  one  or  more  properties  and  may  include  cash  flows  from  the  eventual  disposition  of  the 
asset.  In  some  instances,  there  may  be  various  potential  outcomes  for  a  real  estate  investment  and  its 
potential  future  cash  flows.  In  these  instances,  the  undiscounted  future  cash  flows  used  to  assess  the 
recoverability of  the assets are probability-weighted based on management’s best estimates as of  the date of 
evaluation. Impairment losses related to long-lived assets are recognized when expected future undiscounted 
cash flows based on our intended use of  the property are determined to be less than the carrying values of 
the assets. An adjustment is made to the net carrying value of  the real estate investments for the excess of 
carrying value over fair value. The fair value of  the real estate investment is determined based on current 
market  conditions  and  considers  matters  such  as  rental  rates  and  occupancies  for  comparable  properties, 
recent sales data for comparable properties, and, where applicable, contracts or the results of  negotiations 
with purchasers or prospective purchasers. Additionally, our evaluation of  fair value may consider valuing 
the property as a nursing home or other healthcare facility as well as alternative uses. All impairments are 
taken  as  a  period  cost  at  that  time,  and  depreciation  is  adjusted  going  forward  to  reflect  the  new  value 
assigned  to  the  asset.  Management’s  impairment  evaluation  process,  and  when  applicable,  impairment 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

calculations involve estimation of  the future cash flows from management’s intended use of  the property as 
well  as  the  fair  value  of  the  property.  Changes  in  the  facts  and  circumstances  that  drive  management’s 
assumptions  may  result  in  an  impairment  to  our  assets  in  a  future  period  that  could  be  material  to  our 
results of operations. 

Assets Held for Sale 

We consider properties to be assets held for sale when (1) management commits to a plan to sell the 
property;  (2)  it  is  unlikely  that  the  disposal  plan  will  be  significantly  modified  or  discontinued;  (3)  the 
property is available for immediate sale in its present condition; (4) actions required to complete the sale of 
the property have been initiated; (5) sale of  the property is probable and we expect the completed sale will 
occur within one year; and (6) the property is actively being marketed for sale at a price that is reasonable 
given  our  estimate  of  current  market  value.  Upon  designation  of  a  property  as  an  asset  held  for  sale,  we 
record the property’s value at the lower of  its carrying value or its estimated fair value, less estimated costs 
to sell, and we cease depreciation. 

Lessee Accounting 

Omega leases real estate (corporate headquarters and certain other facilities), office equipment and is 
party to certain ground leases on our owned facilities. We determine if an arrangement is or contains a lease 
at inception. Leases are classified as either finance or operating at inception of  the lease. Short-term leases, 
defined as leases with an initial term of  12 months or less that do not contain a purchase option, are not 
recorded on the balance sheet. Lease expense for short-term leases is recognized on a straight-line basis over 
the lease term. As of December 31, 2022 and 2021, all of the leases where we are the lessee were classified as 
operating leases. 

We have leases that contain both lease and non-lease components and have elected, as an accounting 
policy,  to  not  separate  lease  components  and  non-lease  components.  Operating  and  finance  lease 
right-of-use (“ROU”) assets and liabilities are recognized at the commencement date based on the present 
value of lease payments over the lease term. Our ROU assets and lease liabilities are included in other assets 
and  accrued  expenses  and  other  liabilities,  respectively,  on  our  Consolidated  Balance  Sheets.  The  lease 
liability  is  calculated  as  the  present  value  of  the  remaining  minimum  rental  payments  for  existing  leases 
using either the rate implicit in the lease or, if  none exists, the Company’s incremental borrowing rate, as the 
discount  rate.  Certain  leases  have  options  to  extend,  terminate  or  purchase  the  asset  and  have  been 
considered in our analysis of the lease term and the measurement of the ROU assets and lease liabilities. 

On  a  quarterly  basis,  we  record  our  lease  liabilities  at  the  present  value  of  the  future  lease  payments 
using  the  discount  rate  determined  at  lease  commencement.  Rental  expense  from  operating  leases  is 
generally recognized on a straight-line basis over the lease term. Lease expense derived from our operating 
leases is recorded in general and administrative in our Consolidated Statements of  Operations. We do not 
include in our measurement of  our lease liability certain variable payments, including changes in an index 
until the specific events that trigger the variable payments have occurred. 

We record on a straight-line basis rental income and ground lease expense for those assets we lease and 

are reimbursed by our operators and/or are paid for directly by our operators. 

In-Place Leases 

In-place  lease  assets  and  liabilities  result  when  we  assume  a  lease  as  part  of  an  asset  acquisition  or 
business combination. The fair value of  in-place leases consists of  the following components, as applicable 
(1)  the  estimated  cost  to  replace  the  leases  and  (2)  the  above  or  below  market  cash  flow  of  the  leases, 
determined  by  comparing  the  projected  cash  flows  of  the  leases  in  place  at  the  time  of  acquisition  to 
projected cash flows of comparable market-rate leases. 

Above  market  leases,  net  of  accumulated  amortization,  are  included  in  other  assets  on  our 
Consolidated  Balance  Sheets.  Below  market  leases,  net  of  accumulated  amortization,  are  included  in 
accrued expenses and other liabilities on our Consolidated Balance Sheets. The net amortization related to 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

the  above  and  below  market  leases  is  included  in  our  Consolidated  Statements  of  Operations  as  an 
adjustment  to  rental  income  over  the  estimated  remaining  term  of  the  underlying  leases.  Should  a  tenant 
terminate  the  lease,  the  unamortized  portion  of  the  lease  intangible  is  recognized  immediately  as  an 
adjustment to rental income. 

Allowance for Credit Losses 

The  allowance  for  credit  losses  reflects  our  current  estimate  of  the  potential  credit  losses  on  our  real 
estate  loans,  non-real  estate  loans,  and  our  investment  in  direct  financing  leases  and  is  recorded  as  a 
valuation account as a direct offset against these financial instruments on our Consolidated Balance Sheets. 
Expected  credit  losses  inherent  in  non-cancelable  unfunded  loan  commitments  are  accounted  for  as 
separate  liabilities  included  in  accrued  expenses  and  other  liabilities  on  the  Consolidated  Balance  Sheets. 
The  Company  has  elected  to  not  measure  an  allowance  for  credit  losses  on  accrued  interest  receivables 
related  to  all  of  its  real  estate  loans  and  non-real  estate  loans  because  we  write  off  uncollectible  accrued 
interest receivable in a timely manner pursuant to our non-accrual policy, described below. Changes to the 
allowance for credit losses on loans resulting from quarterly evaluations are recorded through provision for 
credit losses on the Consolidated Statements of Operations. 

We assess the creditworthiness of  our borrowers on a quarterly basis. For purposes of  determining our 
allowance  for  credit  loss,  we  pool  financial  assets  that  have  similar  risk  characteristics.  We  aggregate  our 
financial  assets  by  financial  instrument  type  (i.e.  real  estate  loan,  non-real  estate  loan,  etc.)  and  by  our 
internal  risk  rating.  Our  internal  credit  ratings  consider  several  factors  including  the  collateral  and/or 
security,  the  performance  of  borrowers  underlying  facilities,  if  applicable,  available  credit  support  (e.g., 
guarantees), borrowings with third parties, and other ancillary business ventures and real estate operations 
of  the  borrower.  Our  internal  ratings  range  between  1  and  7.  An  internal  rating  of  1  reflects  the  lowest 
likelihood of  loss and a 7 reflects the highest likelihood of  loss. The characteristics associated with each risk 
rating is as follows: 

•  Risk Rating 1 through 3 — Instruments with minimal to marginally acceptable risk. 

•  Risk Rating 4 — Instruments with potential weaknesses identified (Special mention). 

•  Risk  Rating  5 — Instruments  with  well-defined  weaknesses  that  may  result  in  possible  losses 

(Substandard). 

•  Risk  Rating  6 — Instruments  that  are  unlikely  to  be  repaid  in  full  and  will  probably  result  in 

losses (Doubtful). 

•  Risk Rating 7 — Instrument that will not be repaid in full and losses will occur (Loss). 

We have a limited history of  incurred losses and consequently have elected to employ external data to 
perform  our  expected  credit  loss  calculation.  We  utilize  a  probability  of  default  (“PD”)  and  loss  given 
default (“LGD”) methodology. Our model’s historic inputs consider PD and LGD data for residential care 
facilities published by the Federal Housing Administration along with Standards & Poor’s one-year global 
corporate default rates. Our historical loss rates revert to historical averages after 36 months. Our model’s 
current  conditions  and  supportable  forecasts  consider  internal  credit  ratings,  current  and  projected  U.S. 
unemployment rates published by the U.S. Bureau of  Labor Statistics and the Federal Reserve Bank of  St. 
Louis and the weighted average life to maturity of the underlying financial asset. 

Periodically,  the  Company  may  identify  an  individual  loan  for  impairment.  A  loan  is  considered 
impaired when, based on current information and events, it is probable that we will be unable to collect all 
amounts  due  as  scheduled  according  to  the  contractual  terms  of  the  loan  agreements.  Our  assessment  of 
collectibility  considers  several  factors,  including,  among  other  things,  payment  history,  the  financial 
strength of  the borrower and any guarantors, historical operations and operating trends, current and future 
economic  conditions,  expectations  of  performance  (which  includes  known  substantial  doubt  about  an 
operator’s  ability  to  continue  as  a  going  concern)  and  the  fair  value  of  the  underlying  collateral  of  the 
agreement, a Level 3 measurement, if  any. Consistent with this definition, all loans on non-accrual status 

F-15 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

may be deemed impaired. To the extent circumstances improve and the risk of  collectibility is diminished, 
we  will  return  these  loans  to  full  accrual  status.  When  we  identify  a  loan  impairment,  the  loan  is  written 
down to the present value of  the expected future cash flows or to the fair value of  the underlying collateral. 
Financial  instruments  are  charged  off  against  the  allowance  for  credit  losses  when  collectibility  is 
determined to be permanently impaired. 

We account for impaired loans using (a) the cost-recovery method, and/or (b) the cash basis method. 
We  generally  utilize  the  cost-recovery  method  for  impaired  loans  for  which  impairment  reserves  were 
recorded.  Under  the  cost-recovery  method,  we  apply  cash  received  against  the  outstanding  loan  balance 
prior  to  recording  interest  income.  Under  the  cash  basis  method,  we  apply  cash  received  to  principal  or 
interest income based on the terms of the agreement. 

Investments in Unconsolidated Joint Ventures 

We  account  for  our  investments  in  unconsolidated  joint  ventures  using  the  equity  method  of 

accounting as we exercise significant influence, but do not control the entities. 

Under the equity method of  accounting, the net equity investments of  the Company are reflected in 
the accompanying Consolidated Balance Sheets and the Company’s share of net income and comprehensive 
income from the joint ventures are included in the accompanying Consolidated Statements of  Operations 
and Consolidated Statements of Comprehensive Income, respectively. 

On  a  periodic  basis,  management  assesses  whether  there  are  any  indicators  that  the  value  of  the 
Company’s investments in the unconsolidated joint ventures may be other-than-temporarily-impaired. An 
investment is impaired only if management’s estimate of the value of the investment is less than the carrying 
value  of  the  investment,  and  such  a  decline  in  value  is  deemed  to  be  other  than-temporary.  To  the  extent 
impairment has occurred, the loss is measured as the excess of  the carrying amount of  the investment over 
the estimated fair value of  the investment. The estimated fair value of  the investment is determined using a 
discounted  cash  flow  model  which  is  a  Level  3  valuation.  We  consider  a  number  of  assumptions  that  are 
subject  to  economic  and  market  uncertainties  including,  among  others,  rental  rates,  operating  costs, 
capitalization rates, holding periods and discount rates. 

No impairment losses on our investments in unconsolidated joint ventures were recognized for the last 

three fiscal years. 

Cash and Cash Equivalents 

Cash and cash equivalents consist of  cash on hand and highly liquid investments with a maturity date 
of  three  months  or  less  when  purchased.  These  investments  are  stated  at  cost,  which  approximates  fair 
value. The majority of  our cash, cash equivalents and restricted cash are held at major commercial banks. 
Certain cash account balances exceed FDIC insurance limits of  $250,000 per account and, as a result, there 
is a concentration of  credit risk related to amounts in excess of  the insurance limits. We regularly monitor 
the financial stability of  these financial institutions and believe that we are not exposed to any significant 
credit risk in cash, cash equivalents or restricted cash. 

Restricted Cash 

Restricted cash consists primarily of  liquidity deposits escrowed for tenant obligations required by us 
pursuant to certain contractual terms and other deposits required by the U.S. Department of  Housing and 
Urban Development (“HUD”) in connection with our mortgage borrowings guaranteed by HUD. 

Deposits 

We  obtain  liquidity  deposits  and  other  deposits,  security  deposits  and  letters  of  credit  from  certain 
operators  pursuant  to  our  lease  and  mortgage  agreements.  These  generally  represent  the  rental  and/or 
mortgage interest for periods ranging from three to six months with respect to certain of  our investments or 
the required deposits in connection with our HUD borrowings. At December 31, 2022 and 2021, we held 

F-16 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

$3.5  million  and  $3.9  million,  respectively,  in  liquidity  and  other  deposits  and  $40.3  million  and 
$46.1  million,  respectively,  in  security  deposits.  We  also  had  the  ability  to  draw  on  $36.5  million  and 
$38.1 million of letters of credit at December 31, 2022 and 2021, respectively. 

The liquidity deposits and other deposits, security deposits and the letters of  credit may be used in the 
event of  lease and/or loan defaults, subject to applicable limitations under bankruptcy law with respect to 
operators filing under Chapter 11 of  the U.S. Bankruptcy Code. Liquidity deposits and other deposits are 
recorded  as  restricted  cash  on  our  Consolidated  Balance  Sheets  with  the  offset  recorded  as  a  liability  in 
accrued expenses and other liabilities on our Consolidated Balance Sheets. Security deposits related to cash 
received  from  the  operators  are  primarily  recorded  in  cash  and  cash  equivalents  on  our  Consolidated 
Balance  Sheets  with  a  corresponding  offset  in  accrued  expenses  and  other  liabilities  on  our  Consolidated 
Balance  Sheets.  Additional  security  for  rental  and  loan  interest  revenue  from  operators  is  provided  by 
covenants  regarding  minimum  working  capital  and  net  worth,  liens  on  accounts  receivable  and  other 
operating assets of  the operators, provisions for cross-default, provisions for cross-collateralization and by 
corporate or personal guarantees. 

Goodwill Impairment 

We test goodwill for potential impairment at least annually in the fourth quarter, or more frequently if 
an event or other circumstance indicates that we may not be able to recover the carrying amount of  the net 
assets  of  the  reporting  unit.  In  evaluating  goodwill  for  impairment,  we  may  assess  qualitative  factors  to 
determine whether it is more likely than not that the fair value of  a reporting unit is less than its carrying 
amount. If  we bypass the qualitative assessment, or if  we conclude that it is more likely than not that the 
fair value of  a reporting unit is less than its carrying value, then we perform a quantitative impairment test 
by comparing the fair value of a reporting unit with its carrying amount. 

In evaluating goodwill for impairment, we assess qualitative factors such as a significant decline in real 
estate valuations, current macroeconomic conditions, state of the equity and capital markets and our overall 
financial  and  operating  performance  or  a  significant  decline  in  the  value  of  our  market  capitalization,  to 
determine whether it is more likely than not that the fair value of  our reporting unit is less than its carrying 
amount. Goodwill is not deductible for tax purposes. We have had no goodwill impairment charges for the 
last three fiscal years. 

Income Taxes 

Omega  and  its  wholly-owned  subsidiaries  were  organized  to  qualify  for  taxation  as  a  REIT  under 
Section 856 through 860 of  the Internal Revenue Code (“Code”). As long as we qualify as a REIT, we will 
not  be  subject  to  federal  income  taxes  on  the  REIT  taxable  income  that  we  distributed  to  stockholders, 
subject  to  certain  exceptions.  However,  with  respect  to  certain  of  our  subsidiaries  that  have  elected  to  be 
treated as taxable REIT subsidiaries (“TRSs”), we record income tax expense or benefit, as those entities 
are  subject  to  federal  income  tax  similar  to  regular  corporations.  Omega  OP  is  a  pass-through  entity  for 
U.S. federal income tax purposes. 

We account for deferred income taxes using the asset and liability method and recognize deferred tax 
assets  and  liabilities  for  the  expected  future  tax  consequences  of  events  that  have  been  included  in  our 
financial  statements  or  tax  returns.  Under  this  method,  we  determine  deferred  tax  assets  and  liabilities 
based on the differences between the financial reporting and tax bases of  assets and liabilities using enacted 
tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in 
the  deferred  tax  liability  that  results  from  a  change  in  circumstances,  and  that  causes  us  to  change  our 
judgment  about  expected  future  tax  consequences  of  events,  is  included  in  the  tax  provision  when  such 
changes  occur.  Deferred  income  taxes  also  reflect  the  impact  of  operating  loss  and  tax  credit 
carry-forwards. A valuation allowance is provided if  we believe it is more likely than not that all or some 
portion of  the deferred tax asset will not be realized. Any increase or decrease in the valuation allowance 
that  results  from  a  change  in  circumstances,  and  that  causes  us  to  change  our  judgment  about  the 
realizability of the related deferred tax asset, is included in the tax provision when such changes occur. 

F-17 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

We  are  subject  to  certain  state  and  local  income  tax,  franchise  taxes  and  foreign  taxes.  The  expense 
associated  with  these  taxes  are  included  in  income  tax  expense  on  the  Consolidated  Statements  of 
Operations. 

Stock-Based Compensation 

We  recognize  stock-based  compensation  expense  adjusted  for  estimated  forfeitures  to  employees  and 
directors,  in  general  and  administrative  in  our  Consolidated  Statements  of  Operations  on  a  straight-line 
basis over the requisite service period of the awards. 

Deferred Financing Costs and Original Issuance Premium and/or Discounts for Debt Issuance 

External costs incurred from the placement of our debt are capitalized and amortized on a straight-line 
basis over the terms of  the related borrowings which approximates the effective interest method. Deferred 
financing  costs  related  to  our  revolving  line  of  credit  are  included  in  other  assets  on  our  Consolidated 
Balance  Sheets  and  deferred  financing  costs  related  to  our  other  borrowings  are  included  as  a  direct 
deduction from the carrying amount of  the related liability on our Consolidated Balance Sheets. Original 
issuance  premium  or  discounts  reflect  the  difference  between  the  face  amount  of  the  debt  issued  and  the 
cash proceeds received and are amortized on a straight-line basis over the term of  the related borrowings. 
All  premiums  and  discounts  are  recorded  as  an  addition  to  or  reduction  from  debt  on  our  Consolidated 
Balance  Sheets.  Amortization  of  deferred  financing  costs  and  original  issuance  premiums  or  discounts 
totaled  $12.9  million,  $12.3  million  and  $10.1  million  for  the  years  ended  December  31,  2022,  2021  and 
2020,  respectively,  and  are  recorded  in  interest  expense  on  our  Consolidated  Statements  of  Operations. 
When  financings  are  terminated,  unamortized  deferred  financing  costs  and  unamortized  premiums  or 
discounts, as well as charges incurred for the termination, are recognized as expense or income at the time 
the  termination  is  made.  Gains  and  losses  from  the  extinguishment  of  debt  are  presented  in  loss  on  debt 
extinguishment on our Consolidated Statements of Operations. 

Earnings Per Share 

The  computation  of  basic  earnings  per  share/unit  (“EPS”)  is  computed  by  dividing  net  income 
available to common stockholders by the weighted-average number of  shares of  common stock outstanding 
during the relevant period. Diluted EPS is computed using the treasury stock method, which is net income 
divided  by  the  total  weighted-average  number  of  common  outstanding  shares  plus  the  effect  of  dilutive 
common  equivalent  shares  during  the  respective  period.  Dilutive  common  shares  reflect  the  assumed 
issuance  of  additional  common  shares  pursuant  to  certain  of  our  share-based  compensation  plans, 
including restricted stock and profit interest units, performance restricted stock and profit interest units, the 
assumed issuance of additional shares related to Omega OP Units held by outside investors. 

Noncontrolling Interests and Redeemable Limited Partnership Unitholder Interests 

Noncontrolling interests is the portion of  equity not attributable to the respective reporting entity. We 
present  the  portion  of  any  equity  that  we  do  not  own  in  consolidated  entities  as  noncontrolling  interests 
and classify those interests as a component of  total equity, separate from total stockholders’ equity on our 
Consolidated  Balance  Sheets.  We  include  net  income  attributable  to  the  noncontrolling  interests  in  net 
income in our Consolidated Statements of Operations. 

As  our  ownership  of  a  controlled  subsidiary  increases  or  decreases,  any  difference  between  the 
aggregate consideration paid to acquire the noncontrolling interests and our noncontrolling interest balance 
is  recorded  as  a  component  of  equity  in  additional  paid-in  capital,  so  long  as  we  maintain  a  controlling 
ownership interest. 

The  noncontrolling  interest  for  Omega  represents  the  outstanding  Omega  OP  Units  held  by  outside 
investors  and  interests  in  a  consolidated  real  estate  joint  venture  not  fully  owned  by  Omega.  Each  of  the 
Omega OP Units (other than the Omega OP Units owned by Omega) is redeemable at the election of  the 
Omega OP Unit holder for cash equal to the then-fair market value of  one share of  Omega common stock, 

F-18 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

par value $0.10 per share (“Omega Common Stock”), subject to Omega’s election to exchange the Omega 
OP  Units  tendered  for  redemption  for  unregistered  shares  of  Omega  Common  Stock  on  a  one-for-one 
basis, subject to adjustment as set forth in Omega OP’s partnership agreement. As of  December 31, 2022, 
Omega  owns  approximately  97%  of  the  issued  and  outstanding  Omega  OP  Units,  and  investors  own 
approximately 3% of the outstanding Omega OP Units. 

Foreign Operations 

The U.S. dollar (“USD”) is the functional currency for our consolidated subsidiaries operating in the 
U.S. The functional currency for our consolidated subsidiaries operating in the U.K. is the British Pound 
(“GBP”).  Total  revenues  from  our  consolidated  U.K.  operating  subsidiaries  were  $47.7  million, 
$38.1  million  and  $34.8  million  for  the  years  ended  December  31,  2022,  2021  and  2020,  respectively.  Our 
consolidated U.K. operating subsidiaries held long-lived assets of  $453.4 million and $387.2 million as of 
December 31, 2022 and 2021, respectively. 

For  our  consolidated  subsidiaries  whose  functional  currency  is  not  the  USD,  we  translate  their 
financial statements into the USD. We translate the balance sheet accounts at the exchange rate in effect as 
of  the  financial  statement  date.  The  income  statement  accounts  are  translated  using  an  average  exchange 
rate  for  the  period.  Gains  and  losses  resulting  from  translation  are  included  in  accumulated  other 
comprehensive income (loss) (“AOCI”), as a separate component of  equity and a proportionate amount of 
gain or loss is allocated to noncontrolling interests, if applicable. 

We  and  certain  of  our  consolidated  subsidiaries  may  have  intercompany  and  third-party  debt  that  is 
not  denominated  in  the  entity’s  functional  currency.  When  the  debt  is  remeasured  against  the  functional 
currency of  the entity, a gain or loss can result. The resulting adjustment is reflected in results of  operations 
within  other  expense — net,  unless  it  is  intercompany  debt  that  is  deemed  to  be  long-term  in  nature  in 
which case the adjustments are included in AOCI and a proportionate amount of gain or loss is allocated to 
noncontrolling interests, if applicable. 

Derivative Instruments 

We are exposed to, among other risks, the impact of  changes in foreign currency exchange rates as a 
result of  our investments in the U.K. and interest rate risk related to our capital structure. As a matter of 
policy,  we  do  not  use  derivatives  for  trading  or  speculative  purposes.  Our  risk  management  program  is 
designed  to  manage  the  exposure  and  volatility  arising  from  these  risks,  and  utilizes  foreign  currency 
forward contracts, interest rate swaps and debt issued in foreign currencies to offset a portion of these risks. 

To  qualify  for  hedge  accounting,  derivative  instruments  used  for  risk  management  purposes  must 
effectively reduce the risk exposure that they are designed to hedge. We formally document all relationships 
between hedging instruments and hedged items, as well as our risk-management objectives and strategy for 
undertaking various hedge transactions. This process includes designating all derivatives that are part of  a 
hedging  relationship  to  specific  forecasted  transactions  as  well  as  recognized  liabilities  or  assets  on  the 
Consolidated Balance Sheets. In addition, at the inception of  a qualifying cash flow hedging relationship, 
the underlying transaction or transactions, must be, and are expected to remain, probable of  occurring in 
accordance  with  the  Company’s  related  assertions.  The  Company  recognizes  all  derivative  instruments, 
including  embedded  derivatives  required  to  be  bifurcated,  as  assets  or  liabilities  on  the  Consolidated 
Balance Sheets at fair value which is determined using a market approach and Level 2 inputs. Changes in 
the fair value of  derivative instruments that are not designated in hedging relationships or that do not meet 
the  criteria  of  hedge  accounting  are  recognized  in  the  Consolidated  Statements  of  Operations.  For 
derivatives  designated  in  qualifying  cash  flow  hedging  relationships,  the  gain  or  loss  on  the  derivative  is 
recognized  in  AOCI  as  a  separate  component  of  equity  and  a  proportionate  amount  of  gain  or  loss  is 
allocated to noncontrolling interest, if applicable. 

If  it  is  determined  that  a  derivative  instrument  ceases  to  be  highly  effective  as  a  hedge,  or  that  it  is 
probable  the  underlying  forecasted  transaction  will  not  occur,  the  Company  discontinues  its  cash  flow 
hedge  accounting  prospectively  and  records  the  appropriate  adjustment  to  earnings  based  on  the  current 

F-19 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

fair  value  of  the  derivative  instrument.  For  net  investment  hedge  accounting,  upon  sale  or  liquidation  of 
our U.K. investment, the cumulative balance of  the remeasurement value is reclassified to the Consolidated 
Statements of Operations. 

Segments 

We conduct our operations and report financial results as one business segment. The presentation of 
financial  results  as  one  reportable  segment  is  consistent  with  the  way  we  operate  our  business  and  is 
consistent with the manner in which our Chief  Operating Decision Maker (CODM), our Chief  Executive 
Officer, evaluates performance and makes resource and operating decisions for the business. 

Reclassifications 

Certain  line  items  on  our  Consolidated  Balance  Sheets,  Consolidated  Statements  of  Operations  and 
Consolidated  Statements  of  Cash  Flows  have  been  reclassified  to  conform  to  the  current  period 
presentation. 

Effective  for  the  fourth  quarter  of  2022,  Mortgage  notes  receivable — net  has  been  renamed  Real 
estate  loans  receivable — net,  Other  investments — net  has  been  renamed  Non-real  estate  loans 
receivable — net, and certain loans have been reclassified out of  Other Investments — net into Real estate 
loans receivable — net. Specifically, other real estate loans collateralized by second or third mortgage liens, 
a  leasehold  mortgage  on,  or  an  assignment  of  partnership  interest  in  the  related  properties  that  were 
previously presented in Other Investments — net are now presented in Real estate loans receivable — net. 
See the table below for the prior presentation compared to the current presentation. 

Mortgage notes receivable, gross  . . . 
Allowance for credit losses on 

mortgage notes receivable  . . . . . . 
Mortgage notes receivable – net  . . 
Other investments, gross  . . . . . . . . . 

Prior 
Presentation 
December 31, 
2021 
(in thousands) 
$  908,687  Mortgage notes receivable, gross  . . 

Current 
Presentation 
December 31, 
2021 
(in thousands) 
$  908,687 

Allowance for credit losses on 

mortgage notes receivable  . . . . . 
(73,601) 
$  835,086 
Mortgage notes receivable, net  . . 
$  539,278  Leasehold mortgages and other real 
estate loans, gross  . . . . . . . . . . . 

Allowance for credit losses on other 

Allowance for credit losses on 

investments  . . . . . . . . . . . . . . . . 

(69,394) 

Other investments – net  . . . . . . . . . 

$  469,884 

leasehold mortgages and other 
real estate loans  . . . . . . . . . . . . 
Leasehold mortgages and other 

real estate loans – net  . . . . . . . 
Real estate loans receivable – 

Total  . . . . . . . . . . . . . . . . . . . . . . 

$1,304,970 

net  . . . . . . . . . . . . . . . . . . 

$1,180,786 

Non-real estate loans receivable, 

gross  . . . . . . . . . . . . . . . . . . . . 

$  184,605 

Allowance for credit losses on 

non-real estate loans receivable  . . 
Non-real estate loans 

(60,421) 

receivable – net  . . . . . . . . . . . 

$  124,184 

Total . . . . . . . . . . . . . . . . . . . . . . 

$1,304,970 

F-20 

(73,601) 
835,086 

354,673 

(8,973) 

345,700 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

We previously reported assets held for sale of  $261.2 million on the Consolidated Balance Sheet as of 
December 31, 2021. $58.1 million of these assets no longer qualify as held for sale and have been reclassified 
to assets held for use within the applicable line items in real estate assets — net on the Consolidated Balance 
Sheet  as  of  December  31,  2021.  See  further  discussion  on  the  held  for  sale  reclassification  in 
Note 4 — Assets Held for Sale. 

Recently Adopted Accounting Pronouncements 

ASU — 2021-05, Leases (Topic 842): Lessors — Certain Leases with Variable Lease Payments 

On July 19, 2021, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards 
Update (“ASU”) 2021-05. This guidance requires lessors to classify leases with variable lease payments, that 
do not depend on an index or rate, as an operating lease on the commencement date of the lease if specified 
criteria  are  met.  The  guidance  is  effective  for  fiscal  years  beginning  after  December  15,  2021,  including 
interim  periods  within  those  fiscal  years.  Early  adoption  is  permitted.  We  early  adopted  this  guidance 
prospectively  effective  July  1,  2021.  The  adoption  of  the  guidance  did  not  have  an  impact  on  our 
consolidated financial statements. 

ASU — 2022-02,  Financial  Instruments — Credit  Losses  (Topic  326):  Troubled  Debt  Restructurings  and 
Vintage Disclosures 

On March 31, 2022, the FASB issued ASU 2022-02, which eliminates the recognition and measurement 
guidance  for  troubled  debt  restructurings  (“TDRs”)  and  requires  additional  disclosures  for  certain  loan 
modifications. ASU 2022-02 also requires entities to disclose gross write-offs of  financing receivables and 
net  investments  in  leases  by  year  of  origination.  Omega  elected  to  early  adopt  ASU  2022-02  on  a 
prospective  basis  effective  January  1,  2022.  During  2022,  we  had  three  loan  modifications  with  two 
borrowers  experiencing  financial  difficulty  pursuant  to  ASU  2022-02,  Guardian  Healthcare  (“Guardian”) 
and LaVie Care Centers, LLC (“LaVie,” f/k/a Consulate Health Care), that require additional disclosures. 
The  required  disclosures  for  these  loans  are  included  in  Note  5 — Contractual  Receivables  and  Other 
Receivables and Lease Inducements, Note 7 — Real Estate Loans Receivable and Note 8 — Non-real Estate 
Loans Receivable. We have disclosed our gross write-offs of financing receivables and direct financing leases 
by year of origination in Note 9 — Allowance for Credit Losses. 

ASU — 2020-04, Financial Instruments — Reference Rate Reform (Topic 848) 

On March 12, 2020, the FASB issued ASU 2020-04, which contains optional practical expedients for a 
limited period of  time to ease the potential burden in accounting for (or recognizing the effects of) reference 
rate reform on financial reporting for contracts, hedging relationships, and other transactions that reference 
the London Interbank Offered Rate (“LIBOR”). The guidance may be elected over time until December 31, 
2022, as reference rate reform activities occur. In December 2022, the FASB issued ASU 2022-06, Reference 
Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848, which extended the practical expedients 
under  ASU  2020-04  to  December  31,  2024.  The  Company  has  several  derivative  instruments  (See 
Note  15 — Derivatives  and  Hedging),  a  $1.45  billion  senior  unsecured  multicurrency  revolving  credit 
facility,  and  a  $50  million  senior  unsecured  term  loan  facility  (See  Note  14 — Borrowing  Arrangements) 
that  reference  LIBOR.  Beginning  in  the  first  quarter  of  2020,  we  elected  to  apply  the  hedge  accounting 
expedients related to probability and the assessments of  effectiveness for future LIBOR indexed cash flows 
to  assume  that  the  index  upon  which  future  hedged  transactions  will  be  based  matches  the  index  on  the 
corresponding  derivatives.  Application  of  these  expedients  preserves  the  presentation  of  derivatives 
consistent  with  past  presentation.  Our  credit  facilities  that  reference  LIBOR  contain  customary  LIBOR 
replacement  language,  including,  but  not  limited  to,  the  use  of  rates  based  on  the  secured  overnight 
financing  rate.  The  Company  is  evaluating:  (i)  how  the  transition  away  from  LIBOR  will  impact  the 
Company, (ii) whether any additional optional expedients provided by the standards will be adopted, and 
(iii) the impact that adopting ASU 2020-04 will have on our consolidated financial statements. 

F-21 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

ASU — 2016-13, Financial Instruments — Credit Losses (Topic 326) 

In June 2016, the FASB issued ASU 2016-13, which changed the impairment model for most financial 
assets.  The  new  model  uses  a  forward-looking  expected  loss  method,  which  will  generally  result  in  earlier 
recognition of  allowances for credit losses. The new approach requires the calculation of  expected lifetime 
credit losses and is applied to financial assets measured at amortized cost, including loans, as well as certain 
off-balance sheet credit exposures such as unfunded loan commitments. The allowance for credit loss on the 
loans  is  a  valuation  amount  that  is  deducted  from  the  amortized  cost  basis  of  the  loans  not  held  at  fair 
value to present the net amount expected to be collected over the contractual term of the loans. 

ASU  2016-13  specifically  excludes  from  its  scope  receivables  arising  from  operating  leases  accounted 
for  under  Topic  842.  We  adopted  ASU  2016-13  on  January  1,  2020  using  the  modified  retrospective 
approach and we recorded an initial $28.8 million allowance for expected credit losses with a corresponding 
adjustment to equity. 

NOTE 3 — REAL ESTATE ASSET ACQUISITIONS AND DEVELOPMENT 

2022 Acquisitions 

The following table summarizes the significant asset acquisitions that occurred in 2022: 

Number of 
Facilities 

Total Real Estate 
Assets Acquired 

Period 

SNF  ALF  Country/State 

1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  — 
Q1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  — 
1 
Q1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  —  27 
Q1 
1  — 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Q1 
4 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  — 
Q3 
6 
Q4 
1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
7  34 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

U.K. 
U.K. 
U.K. 
MD 
U.K. 
PA, NC 

(in millions) 
$  8.7(2) 
5.0 
86.6(2) 
8.2(3) 
28.2 
88.5(4) 

$225.2 

Initial
Annual 
Cash Yield(1) 

8.0% 
8.0% 
8.0% 
9.5% 
8.0% 
9.0% 

(1) 

Initial annual cash yield reflects the initial annual contractual cash rent divided by the purchase price. 

(2)  The  total  consideration  paid  for  the  one-facility  U.K.  acquisition  and  the  27-facility  U.K.  acquisition  was  $8.2  million  and 
$100.0 million, respectively. In connection with these acquisitions, we allocated $0.5 million of  the purchase consideration to a 
deferred tax liability related to the one-facility U.K. acquisition, and $13.4 million to a deferred tax asset related to the 27-facility 
U.K. acquisition. See Note 17 — Taxes for additional information. 

(3)  Total consideration for the one-facility Maryland acquisition was paid on December 30, 2021, but the closing of  the acquisition 

did not occur until January 1, 2022. 

(4)  During  the  fourth  quarter  of  2022,  we  acquired  seven  facilities  using  a  reverse  like-kind  exchange  structure  pursuant  to 
Section 1031 of  the Code (a “reverse 1031 exchange”). As of  December 31, 2022, we had completed the reverse 1031 exchange 
for three of  the acquired facilities and the remaining four acquired facilities remained in the possession of  the EATs. The EATs 
were classified as VIEs as they do not have sufficient equity investment at risk to permit the entity to finance its activities. The 
Company consolidated the EATs because it had the ability to control the activities that most significantly impacted the economic 
performance  of  the  EATs  and  was,  therefore,  the  primary  beneficiary  of  the  EATs.  The  properties  held  by  the  EATs  were 
reflected as real estate with a carrying value of  $55.2 million as of  December 31, 2022. The EATs also held cash of  $23.9 million 
as of December 31, 2022. 

F-22 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

2021 Acquisitions and Other 

The following table summarizes the significant asset acquisitions that occurred in 2021: 

Number of 
Facilities 

Period 

SNF  ALF  Specialty 

Country/ 
State 

7  AZ, CA, FL, IL, NJ, OR, PA, TN, TX, VA, WA 

Q1  . . . . .  —  17 
Q1  . . . . . 
Q3  . . . . .  — 
Total 

6  —  — 
2  — 
7 

6  19 

. . . 

FL 
U.K. 

Total Real Estate 
Assets Acquired(1) 

(in millions) 

Initial
Annual 
Cash Yield(2) 

$511.3 
83.1 
9.6 
$604.0 

8.43% 
9.25% 
7.89% 

(1)  Excludes $10.6 million of  land acquisitions, $58.6 million of  non-cash acquisitions of  facilities previously subject to mortgage 
loans  with  Omega  in  which  principal  amounts  under  the  loan  agreements  were  reduced  or  settled  in  exchange  for  title  to  the 
facilities  (See  Note  7 — Real  Estate  Loans  Receivable),  and  $1.2  million  of  transaction  costs  incurred  related  to  the  non-cash 
acquisitions. 
Initial annual cash yield reflects the initial annual contractual cash rent divided by the purchase price. 

(2) 

On  January  20,  2021,  we  acquired  24  senior  living  facilities  from  Healthpeak  Properties,  Inc.  for 
$511.3 million. The acquisition involved the assumption of  an in-place master lease with Brookdale Senior 
Living Inc. We recognized approximately $45.0 million of  rental income for the year ended December 31, 
2021 under this master lease, which includes 24 facilities representing 2,552 operating units. 

2020 Acquisitions 

The following table summarizes the significant transactions that occurred in 2020: 

Period 

Number of 
Facilities 

SNF  ALF 

Country/ 
State 

Total Real Estate 
Assets Acquired 

(in millions) 

Initial
Annual 
Cash Yield(1) 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  — 
Q1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Q1 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Q2 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Q4 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2 
1  — 
1  — 
1 
6 
3 
8 

U.K 
IN 
OH 
VA 

$  12.1 
7.0 
6.9 
78.4 
$104.4 

8.00% 
9.50% 
9.50% 
9.50% 

(1) 

Initial annual cash yield reflects the initial annual contractual cash rent divided by the purchase price. 

Construction in progress and capital expenditure investments 

We  invested  $64.4  million,  $140.0  million  and  $106.2  million,  respectively  under  our  construction  in 

progress and capital improvement programs during the years ended December 31, 2022, 2021 and 2020. 

In the second quarter of  2021, we placed a $41.1 million construction project for a new build ALF in 
New Jersey into service and began recognizing revenue associated with this project in the third quarter of 
2021. The lease for this facility provides for an annual cash yield of  7% of  the amount funded in the first 
year  following  the  completion  of  construction  increasing  to  8%  in  year  two  with  2.5%  annual  escalators 
thereafter. 

During the third quarter of  2021, we purchased a real estate property located in Washington, D.C. (not 
reflected in the table above) for approximately $68.0 million and plan to redevelop the property into a 174 
bed  ALF.  Concurrent  with  the  acquisition,  we  entered  into  a  single  facility  lease  for  this  property  with 
Maplewood Senior Living (along with affiliates, “Maplewood”) through August 31, 2045. For accounting 
purposes,  the lease will commence upon the substantial completion of  construction of  the ALF, which is 
currently expected to be in 2025. The lease provides for the accrual of  financing costs at a rate of  5% per 

F-23 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

annum during the construction phase. The lease provides for an annual cash yield of  6% in the first year 
following  the  completion  of  construction,  increasing  to  7%  in  year  two  and  8%  in  year  three  with  2.5% 
annual  escalators  thereafter.  We  are  committed  to  a  maximum  funding  of  $177.7  million  for  the 
redevelopment  of  the  real  estate  property,  subject  to  ordinary  development  related  cost  changes  (see 
Note 20 — Commitments and Contingencies). 

NOTE 4 — ASSETS HELD FOR SALE, DISPOSITIONS AND IMPAIRMENTS 

We  periodically  sell  facilities  to  reduce  our  concentration  in  certain  operators,  geographies  and 

non-strategic assets or due to the exercise of a tenant purchase option. 

The following is a summary of our assets held for sale: 

Number of facilities held for sale  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . . . . . . . 
Amount of assets held for sale (in thousands) 

December 31,  December 31, 

2022 

2 
$9,456 

2021 

28 
$203,025 

In  the  fourth  quarter  of  2022,  we  reclassified  13  facilities  with  aggregate  net  book  values  of 
$58.1 million, from assets held for sale to assets held for use within the applicable line items in real estate 
assets — net.  Of  the  $58.1  million  reclassified  net  of  $20.8  million  of  accumulated  depreciation, 
$67.5 million relates to buildings, $2.8 million relates to land and $8.6 relates to furniture and equipment. 
We  originally  reclassified  these  facilities  as  held  for  sale  in  the  fourth  quarter  of  2021,  but  we  no  longer 
believe  these  facilities  qualify  as  assets  held  for  sale.  We  recorded  a  $3.2  million  cumulative  catch-up 
adjustment  to  depreciation  and  amortization  expense  related  to  these  facilities  concurrent  with  the 
reclassification in the fourth quarter of 2022. 

One of  the two facilities that were classified as held for sale as of  December 31, 2022 was subsequently 

sold during the first quarter of 2023 for gross cash proceeds of $19.5 million. 

Asset Sales 

2022 Activity 

During  the  year  ended  December  31,  2022,  we  sold  66  facilities  subject  to  operating  leases  for 
approximately $759.0 million in net cash proceeds, recognizing a net gain of  approximately $360.0 million. 
Our  2022  sales  were  primarily  driven  by  restructuring  transactions  and  negotiations  related  to  our  lease 
agreements  with  the  following  operators:  Gulf  Coast  Health  Care  LLC  (together  with  certain  affiliates 
“Gulf  Coast”),  Guardian  Healthcare  (“Guardian”)  and  Agemo  Holdings,  LLC  (“Agemo”).  In  addition, 
during the fourth quarter of  2022, we sold 11 facilities previously leased to and operated by LaVie which 
did not meet the contract criteria to be recognized under ASC 610-20, further discussed below, and as such 
are not included in the amounts above. 

In  the  first  quarter  of  2022,  we  sold  22  facilities  that  were  previously  leased  and  operated  by  Gulf 
Coast. The net cash proceeds from the sale, including related costs accrued for as of  the end of  the fourth 
quarter,  were  $304.9  million,  and  we  recognized  a  net  gain  of  $114.5  million.  The  agreement  includes  an 
earnout  clause  pursuant  to  which  the  buyer  is  obligated  to  pay  an  additional  $18.7  million  to  Omega  if 
certain  financial  metrics  are  achieved  at  the  facilities  in  the  three  years  following  the  sale.  As  we  have 
determined  it  is  not  probable  that  we  will  receive  any  additional  funds,  we  have  not  recorded  any  income 
related to the earnout clause. 

During the first and second quarter of  2022, we sold nine total facilities that were leased to Guardian 

for $39.5 million in net proceeds, which resulted in a net gain of $13.7 million. 

In the third and fourth quarter of  2022, we sold 22 facilities that were previously leased to Agemo for 

$358.7 million in net proceeds, which resulted in a net gain of $218.9 million. 

F-24 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

In December 2022, in connection with restructuring negotiations with LaVie, we sold 11 facilities to a 
third party previously leased to LaVie for a sales price of  $129.8 million. Omega provided $104.8 million in 
senior  seller  financing,  collateralized  by  first  lien  mortgages  on  the  11  facilities,  to  fund  a  portion  of  the 
purchase  price.  The  senior  note  has  a  December  29,  2027  maturity  date  and  bears  interest  at  8%  with 
required  monthly  interest  payments  (due  in  arrears  beginning  February  1,  2023),  with  no  principal 
payments due until the maturity date. The remaining consideration received under the purchase agreement 
is the assumption of  a $25.0 million liability by the buyer from Omega. The 11-facility sale does not meet 
the contract criteria to be recognized under ASC 610-20 and we will continue to account for these facilities 
on our Consolidated Balance Sheets and depreciate the facilities until the recognition requirements under 
ASC 610-20 are met. A contract liability was recorded and related expense of  $25.0 million was recognized 
on  our  Consolidated  Balance  Sheets  within  accrued  expenses  and  other  liabilities  and  Consolidated 
Statements of  Operations within acquisition, merger and transition costs, respectively. The liability will be 
relieved  once  the  sale  is  recognized.  The  loan  receivable  associated  with  the  seller  financing  will  not  be 
recorded on our Consolidated Balance Sheets until the sale is recognized, and any cash interest received will 
be  deferred  and  recorded  as  a  contract  liability  within  accrued  expenses  and  other  liabilities  on  our 
Consolidated Balance Sheets. 

2021 Activity 

During the year ended December 31, 2021, we sold 48 facilities for approximately $318.5 million in net 

cash proceeds, recognizing a net gain of approximately $161.6 million. 

2020 Activity 

During the year ended December 31, 2020, we sold 43 facilities for approximately $180.9 million in net 

cash proceeds, recognizing a net gain of approximately $19.1 million. 

Real Estate Impairments 

2022 Activity 

During the year ended December 31, 2022, we recorded impairments of  approximately $38.5 million 
on 22 facilities. Of  the $38.5 million, $3.5 million related to two facilities that were classified as held for sale 
(and  subsequently  sold)  for  which  the  carrying  values  exceeded  the  estimated  fair  values  less  costs  to  sell, 
and $35.0 million related to 20 held-for-use facilities for which the carrying value exceeded the fair value, of 
which $17.2 million relates to 12 facilities leased to and operated by LaVie that are expected to be impacted 
by  the  on-going  restructuring  negotiations.  $10.0  million  of  the  2022  impairments  recorded  on  four 
held-for-use facilities relate to the 2.0% Operator discussed in Note 5 — Contractual Receivables and Other 
Receivables and Lease Inducements. 

2021 Activity 

During the year ended December 31, 2021, we recorded impairments of  approximately $44.7 million 
on  14  facilities  which  were  sold  or  classified  as  held  for  sale  for  which  the  carrying  values  exceeded  the 
estimated fair values less costs to sell. 

2020 Activity 

During the year ended December 31, 2020, we recorded impairments of  approximately $76.0 million 
on 25 facilities. Our impairments were offset by approximately $3.5 million of  insurance proceeds received 
related to a facility that was previously destroyed and impaired. Of  the $76.0 million, $41.5 million related 
to  14  facilities  which  were  sold  or  classified  as  held  for  sale  for  which  the  carrying  values  exceeded  the 
estimated fair values less costs to sell, and $34.5 million related to 11 held-for-use facilities for which it was 
determined that the carrying value exceeded the fair value. The $34.5 million relates to facilities subject to a 

F-25 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

lease  with  Daybreak  Ventures,  LLC  (“Daybreak”)  (see  Note  5 — Contractual  Receivables  and  Other 
Receivables  and  Lease  Inducements),  which  were  planned  for  resale  or  transitioned  to  another  existing 
operator and it was determined that the new cash flows were not sufficient to support the carrying value of 
the facility. 

To  estimate  the  fair  value  of  the  facilities,  for  the  impairments  noted  above,  we  utilized  a  market 
approach which considered binding sale agreements (a Level 1 input) or non-binding offers from unrelated 
third parties and/or broker quotes (a Level 3 input). 

NOTE  5 — CONTRACTUAL  RECEIVABLES  AND  OTHER  RECEIVABLES  AND  LEASE 
INDUCEMENTS 

Contractual  receivables  relate  to  the  amounts  currently  owed  to  us  under  the  terms  of  our  lease  and 
loan  agreements.  Effective  yield  interest  receivables  relate  to  the  difference  between  the  interest  income 
recognized on an effective yield basis over the term of  the loan agreement and the interest currently due to 
us according to the contractual agreement. Straight-line rent receivables relate to the difference between the 
rental  revenue  recognized  on  a  straight-line  basis  and  the  amounts  currently  due  to  us  according  to  the 
contractual agreement. Lease inducements result from value provided by us to the lessee, at the inception, 
modification  or  renewal  of  the  lease,  and  are  amortized  as  a  reduction  of  rental  income  over  the 
non-cancellable lease term. 

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

December 31,  December 31, 

2022 

2021 

(in thousands) 

Contractual receivables – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$  8,228 

$  11,259 

Effective yield interest receivables  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Straight-line rent receivables 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Lease inducements  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other receivables and lease inducements . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$  5,696 
166,061 
6,041 
$177,798 

$  9,590 
148,455 
93,770 
$251,815 

Cash basis operators and straight-line receivable write-offs 

We  review  our  collectibility  assumptions  related  to  our  operator  leases  on  an  ongoing  basis.  During 
the years ended December 31, 2022, 2021 and 2020, we placed nine, six and four additional operators on a 
cash basis of  revenue recognition, respectively, as collection of  substantially all contractual lease payments 
due from them was no longer deemed probable. In connection with placing these operators on a cash basis, 
we recognized $119.8 million, $36.0 million and $129.5 million in total straight-line accounts receivable and 
lease  inducement  write-offs  through  rental  income  during  the  years  ended  December  31,  2022,  2021  and 
2020, respectively. As of  December 31, 2022, we had 20 operators on a cash basis for revenue recognition, 
which  represent  36.5%,  39.2%  and  41.5%  of  our  total  revenues  (excluding  the  impact  of  write-offs)  for 
the  years  ended  December  31,  2022,  2021  and  2020,  respectively.  As  of  December  31,  2021,  we  had  14 
operators on a cash basis for revenue recognition, which represent 18.6% and 22.7% of  our total revenues 
(excluding the impact of write-offs) for the years ended December 31, 2021 and 2020, respectively. 

During the years ended December 31, 2022, 2021 and 2020, we also wrote-off $3.2 million, $1.3 million 
and $3.6 million of  straight-line rent receivable balances through rental income as a result of  transitioning 
facilities between existing operators. 

Operator updates 

Agemo 

Agemo  was  formed  in  May  2018  by  Signature  Healthcare,  LLC,  as  part  of  an  out-of-court 
restructuring agreement, to be the holding company of  their leases and loans with Omega. As part of  that 

F-26 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

restructuring agreement, we agreed to, among other things, allow for the deferral of  $6.3 million of  rent per 
annum for a 3-year period (the “Agemo Rent Deferral”). 

We  placed  Agemo  on  a  cash  basis  of  revenue  recognition  during  the  third  quarter  of  2020  as  we 
received information regarding substantial doubt of their ability to continue as a going concern. As a result, 
we wrote-off  approximately $13.4 million of  contractual rent receivables and $61.9 million of  straight-line 
rent receivables and lease inducements. 

Agemo  continued  to  make  their  rental  and  interest  payments  to  us  until  July  2021.  After  July  2021, 
Agemo made one month of  contractual rent and interest payments for the remainder of  fiscal year 2021. 
During the third and fourth quarters of  2021, we recorded $8.7 million of  revenue by collecting rental and 
interest  payments  and  we  recorded  $8.5  million  of  revenue  by  drawing  on  a  letter  of  credit  and  through 
application of  collateral held by Omega. On September 30, 2021, the Company entered into a forbearance 
agreement  related  to  Agemo’s  defaults  under  its  lease  and  loan  agreements  (the  “Agemo  Forbearance 
Agreement”),  which  was  amended  to  extend  the  forbearance  period  through  January  2022  and  the  lease 
agreement was amended to extend the Agemo Rent Deferral through January 2022. 

Agemo  continued  to  not  pay  contractual  rent  and  interest  due  under  its  lease  and  loan  agreements 
during the year ended December 31, 2022. No rental income was recorded related to Agemo during the year 
ended  December  31,  2022.  Additionally,  no  interest  income  was  recognized  during  the  year  ended 
December 31, 2022 on the two loans with Agemo because these loans are on non-accrual status and we are 
utilizing the cost recovery method, under which any payments, if  received, are applied against the principal 
amount. See Note 8 — Non-real Estate Loans Receivable for additional details on our loans with Agemo. 
For  the  years  ended  December  31,  2021  and  2020,  Agemo  generated  approximately  3.9%  and  5.6%, 
respectively, of our total revenues (excluding the impact of write-offs). 

The Agemo Forbearance Agreement has been amended multiple times throughout 2022 and the most 
recent 2022 amendment on December 30, 2022 extended the forbearance period through January 31, 2023. 
In 2022, the Agemo Rent Deferral period was also extended multiple times, and the most recent amendment 
extended  the  deferral  through  April  2022,  after  which  time  the  deferral  period  terminated,  with  the 
Company  remaining  subject  to  the  Agemo  Forbearance  Agreement  through  January  31,  2023.  As  of 
December  31,  2022,  the  aggregate  rent  deferred  under  the  Agemo  lease  agreement  was  $25.2  million.  As 
discussed in Note 4 — Assets Held for Sale, Dispositions and Impairments, we sold 22 facilities, subject to 
the Agemo lease agreement, during 2022. 

In the first quarter of  2023, Omega and Agemo entered into a restructuring agreement, an amended 
and  restated  master  lease  and  a  replacement  loan  agreement  for  two  replacement  loans.  As  part  of  the 
restructuring agreement and related agreements, Omega agreed to, among other things: 

• 

• 

• 

• 

Forgive  and  release  Agemo  from  previously  written  off  past  due  rent  and  interest  obligations 
related  to  certain  periods  prior  to  the  2018  Restructuring  and  from  August  2021  through 
January 2023, with contractual rent under the lease agreement and contractual interest under the 
loan agreements scheduled to resume on April 1, 2023; 

reduce monthly contractual base rent from $4.8 million to $1.9 million following the sales of  the 
22  facilities,  previously  leased  and  operated  by  Agemo,  that  occurred  in  the  third  and  fourth 
quarters of 2022 (See Note 4 — Assets Held For Sale, Dispositions and Impairments); 

extend  the  initial  Agemo  lease  term  from  December  31,  2030,  to  December  31,  2036  with  three 
consecutive tenant 10-year extension options; and 

refinance and restructure the $25.0 million secured working capital loan (the “Agemo WC Loan”), 
the $32.0 million term loan (the “Agemo Term Loan”) and the aggregate deferred rent balance of 
$25.2  million  into  two  replacement  loans  to  Agemo  that  mature  on  December  31,  2036,  with 
aggregate principal of $82.2 million and an annual interest rate of 5.71%. 

F-27 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Guardian 

Guardian  did  not  make  rent  and  interest  payments  under  its  lease  and  mortgage  loan  agreements 
during  the  fourth  quarter  of  2021.  As  a  result  of  Guardian’s  non-payment  of  contractual  rent  and  the 
anticipated  restructuring  of  its  agreements,  in  the  fourth  quarter  of  2021,  we  placed  Guardian  on  a  cash 
basis of  revenue recognition and wrote-off  approximately $14.0 million of  straight-line rent receivables and 
lease  inducements  through  rental  income.  In  the  fourth  quarter  of  2021,  we  began  negotiations  to 
restructure  Guardian’s  lease  and  loan  agreements.  In  connection  with  the  restructuring  negotiations,  on 
December  30,  2021,  we  acquired  2  facilities,  previously  subject  to  the  Guardian  mortgage  loan,  in 
consideration for a reduction of $8.7 million in the mortgage principal and added the facilities to the master 
lease agreement. 

Guardian  continued  to  not  pay  contractual  rent  and  interest  due  under  its  lease  and  mortgage  loan 
agreements  during  the  first  quarter  of  2022.  During  the  first  and  second  quarters  of  2022,  we  completed 
significant  restructuring  activities  related  to  the  Guardian  lease  and  loan  portfolio.  In  the  first  quarter  of 
2022,  we  transitioned  eight  facilities  previously  leased  to  Guardian  to  two  other  operators  as  part  of  the 
planned restructuring. Additionally, during the six months ended June 30, 2022, we sold nine facilities to a 
third party that were previously leased to Guardian and three facilities previously subject to the Guardian 
mortgage loan. In the second quarter of  2022, we agreed to a formal restructuring agreement, master lease 
amendments and mortgage loan amendments with Guardian. As part of  the restructuring agreement and 
related agreements, Omega agreed to, among other things: 

• 

• 

• 

Extend the lease and loan maturity dates from January 31, 2027 to December 31, 2031 and allow 
Guardian  the  option  to  extend  the  maturity  date  for  both  the  lease  and  loan  through 
September 30, 2034, subject to certain conditions; 

reduce  the  combined  rent  and  mortgage  interest  to  an  aggregate  $24.0  million  per  year  as  of 
July  1,  2022  ($15.0  million  in  rent  and  $9.0  million  in  interest)  with  annual  escalators  of  2.25% 
beginning in January 2023; and 

allow  Guardian  to  retrospectively  defer  $18.0  million  of  aggregate  contractual  rent  and  interest 
that  it  failed  to  pay  from  October  2021  through  March  2022  (consisting  of  $12.2  million  of 
deferred  rent  and  $5.8  million  of  deferred  interest),  with  repayment  required  beginning  after 
September 30, 2024, based on certain financial metrics, and in full by December 31, 2031, or the 
earlier termination of the lease for any reason. 

Following  the  execution  of  the  restructuring  agreement,  Guardian  resumed  paying  contractual  rent 
and  interest  during  the  second  quarter  of  2022  and  continued  such  payments  in  the  third  and  fourth 
quarters  of  2022,  in  accordance  with  the  restructuring  terms.  For  the  year  ended  December  31,  2022,  we 
recorded rental income of  $11.3 million for the contractual rent payments that were received. Additionally, 
as  discussed  further  in  Note  7 — Real  Estate  Loans  Receivable,  no  mortgage  interest  income  has  been 
recognized on the Guardian mortgage loan during the year ended December 31, 2022, as we are accounting 
for this loan under the cost recovery method. Revenue from Guardian represents approximately 1.1%, 2.5% 
and  3.5%  of  our  total  revenues  (excluding  the  impact  of  straight-line  write-offs)  for  the  years  ended 
December 31, 2022, 2021 and 2020, respectively. 

As of December 31, 2022, we have $7.4 million of letters of credit from Guardian as collateral. 

LaVie 

In  the  fourth  quarter  of  2022,  Omega  began  the  process  of  restructuring  our  portfolio  with  LaVie, 
which primarily consists of  two master lease agreements and two term loan agreements. On December 30, 
2022,  we  sold  11  facilities  previously  subject  to  one  of  the  two  leases  agreements  with  LaVie.  See  further 
discussion  on  the  sale  and  the  accounting  treatment  in  Note  4  -Assets  Held  For  Sale,  Dispositions  and 
Impairments. Concurrent with the sale, we also amended the lease agreement impacted by the sale and our 
loan agreements with LaVie. The amendments to the loan agreements are discussed in Note 8 — Non-Real 

F-28 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Estate Loans. With the lease amendment and other related documents, Omega and LaVie agreed to, among 
other terms: 

•  Remove the 11 sold facilities from the lease agreement and reduce monthly contractual rent due 

under all agreements from $8.3 million to $7.3 million; 

• 

• 

provide Omega the ability to enact a one-time rent reset on one of  the lease agreements, if  LaVie’s 
coverage exceeds a threshold, after February 1, 2027; and 

require Omega to pay LaVie a $35.0 million termination fee in connection with transitioning the 
11  facilities  sold  in  the  fourth  quarter  and  the  additional  facilities  sold  in  the  restructure 
($25.0 million was assumed by the third-party buyer of the 11 facilities). 

The  restructuring  discussions  are  still  ongoing  and  subject  to  change,  but  we  anticipate  additional 
restructuring activity related to this operator in 2023. As a result of  the restructuring activities during 2022 
and future expected restructuring activities, during the fourth quarter of  2022, we placed LaVie on a cash 
basis of  revenue recognition and wrote-off  approximately $58.0 million of  straight-line rent receivables and 
lease  inducements.  Revenue  from  LaVie  represents  approximately  11.1%,  9.5%  and  9.4%  of  our  total 
revenues (excluding the impact of  straight-line write-offs) for the years ended December 31, 2022, 2021 and 
2020, respectively. 

In the first quarter of  2023, as part of  the restructuring, we have agreed to a partial rent deferral in the 
first four months of  2023. In doing so, we agreed to allow LaVie to defer up to $10.0 million of  contractual 
rent from January 2023 through April 2023 under one of  our lease agreements for 32 facilities. Omega is in 
discussions  to  allow  LaVie  to  defer  up  to  $9.1  million  of  contractual  rent  from  January  2023  through 
April 2023 under another lease agreement for 41 facilities. In January 2023, as a result, LaVie deferred the 
full contractual payment of  $2.5 million under the 32-facility lease and paid $2.5 million of  the $4.7 million 
of contractual rent due under the 41-facility lease. 

Maplewood 

During  the  year  ended  December  31,  2020,  we  received  a  one-time  rent  payment  of  approximately 
$55.4  million  from  Maplewood,  in  conjunction  with  the  restructuring  of  its  master  lease  and  loans  with 
Omega  (see  Note  8 — Non-real  Estate  Loans  Receivable).  This  payment  was  accounted  for  as  an 
adjustment to straight-line rent receivables and was being amortized over the remaining term of  the master 
lease prior to Maplewood being placed on a cash basis of revenue recognition in the fourth quarter of 2022. 

During  the  fourth  quarter  of  2022,  Omega  began  discussions  with  Maplewood  to  restructure  their 
portfolio, which includes a lease agreement and $250.5 million revolving credit facility. During the fourth 
quarter of  2022, we placed Maplewood on a cash basis of  revenue recognition and wrote-off  approximately 
$29.3 million of  straight-line rent receivables and lease inducements. Revenue from Maplewood represents 
approximately 8.9%, 7.9% and 5.3% of  our total revenues (excluding the impact of  straight-line write-offs) 
for the years ended December 31, 2022, 2021 and 2020, respectively. 

In the first quarter of  2023, we agreed to a formal restructuring agreement, master lease amendments 
and  loan  amendments  with  Maplewood.  As  part  of  the  restructuring  agreement  and  related  agreements, 
Omega agreed to, among other things: 

• 

• 

Extend  the  maturity  date  of  the  master  lease  from  December  2033  to  December  2037  with  two 
consecutive 5-year tenant extension options; 

fix  contractual  rent  at  $69.3  million  per  annum  (December  2022  rent  annualized)  and  defer  the 
2.5%  annual  escalators  under  our  lease  agreement  through  December  31,  2025,  with  mandatory 
repayments to be made subject to certain metrics and due in full by the maturity date; 

• 

fund $22.5 million of capital expenditures through December 31, 2025; 

F-29 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

• 

• 

• 

• 

extend the maturity date of  the secured revolving credit facility from June 2030 to June 2035 with 
one borrower 2-year extension option; 

increase the capacity of  the secured revolving credit facility from $250.5 million to $320.0 million, 
inclusive of payment-in-kind (“PIK”) interest applied to principal; 

convert  the  7%  per  annum  cash  interest  due  on  the  secured  revolving  credit  facility  to  all  PIK 
interest  in  2023,  1%  cash  interest  and  6%  PIK  interest  in  2024,  4%  cash  interest  and  3%  PIK 
interest in 2025 and through the maturity date; and 

reduce  Maplewood’s  share  of  any  future  potential  sales  proceeds  (in  excess  of  our  gross 
investment) by the unpaid deferred rent balance and the $22.5 million of capital expenditures. 

Gulf Coast 

During the second quarter of  2021, Gulf  Coast stopped paying contractual rent under its master lease 
agreement because of  on-going liquidity issues. Gulf  Coast operated 24 facilities subject to a master lease 
with Omega and represented approximately 3.3% and 2.8% of  Omega’s total revenues (excluding the impact 
of write-offs) for the years ended December 31, 2021 and 2020, respectively. 

As a result of  Gulf  Coast’s default under its master lease agreement, in August 2021, we exercised our 
right to accelerate the full amount of  rent due under Gulf  Coast’s master lease agreement. On October 14, 
2021, Gulf  Coast commenced voluntary cases under Chapter 11 of  the U.S. Bankruptcy Code in the U.S. 
Bankruptcy  Court  for  the  District  of  Delaware  (the  “Bankruptcy  Court”).  As  described  in  Gulf  Coast’s 
filings  with  the  Bankruptcy  Court,  we  entered  into  a  Restructuring  Support  Agreement  (the  “Support 
Agreement”) that forms the basis for Gulf  Coast’s restructuring and liquidation. The Support Agreement 
established a timeline for the implementation of  Gulf  Coast’s restructuring and liquidation, including the 
transition  of  management  of  the  operations  of  the  facilities  to  a  third-party  operator.  As  part  of  the 
Support  Agreement,  we  committed  to  provide  up  to  $25  million  of  senior  secured  debtor-in-possession 
(“DIP”) financing to Gulf  Coast, which is discussed in further detail in Note 8 — Non-real Estate Loans 
Receivable.  In  November  2021,  Gulf  Coast  entered  into  management  and  operations  transfer  agreements 
(“MOTAs”)  with  a  new  manager  (“New  Manager”),  pursuant  to  which  the  management  of  23  of  the  24 
facilities subject to the master lease with Omega were performed by New Manager during an interim period 
until  the  license  for  the  facilities  subject  to  the  MOTAs  could  be  obtained  by  a  new  operator  (“New 
Operator”).  During  the  interim  period,  no  rent  was  being  paid  by  Gulf  Coast,  and  we  have  provided  a 
$20 million working capital loan to New Manager, discussed in further detail in Note 8 — Non-real Estate 
Loans Receivable. The Bankruptcy Court approved the MOTAs on November 24, 2021 and the operations 
were  transitioned  effective  December  1,  2021.  On  June  27,  2022,  the  Bankruptcy  Court  entered  its  order 
confirming  Gulf  Coast’s  bankruptcy  plan  which  provided  for,  among  other  things,  an  allowed  claim  of 
$49.0 million in relation to the accelerated rent due under Gulf  Coast’s master lease agreement. Payment of 
the  allowed  claim  has  been  redirected,  with  Omega’s  approval,  under  the  Plan  to  Gulf  Coast’s  unsecured 
creditors. 

As a result of  Gulf  Coast’s non-payment of  contractual rent, in the second quarter of  2021, we placed 
Gulf  Coast  on  a  cash  basis  of  revenue  recognition  and  wrote-off  straight-line  rent  receivable  balances  of 
$17.4  million  through  rental  income.  Subsequent  to  placing  Gulf  Coast  on  a  cash  basis  of  revenue 
recognition in June 2021, we recognized $24.6 million of  rental income over the remaining period of  2021, 
based  on  our  ability  to  offset  any  uncollected  rent  receivables  against  Gulf  Coast’s  security  deposit  and 
against  certain  debt  obligations  of  Omega,  as  discussed  further  below.  We  held  a  security  deposit  of 
$3.3 million from Gulf  Coast, which we applied against Gulf  Coast’s obligations in the second and third 
quarters of  2021. In relation to Gulf  Coast, a subsidiary of  Omega (“Omega Obligor”) is the obligor on 
five  notes  due  to  third  parties  with  aggregate  outstanding  principal  of  $20.0  million  (collectively,  the 
“Subordinated Debt”) that bear interest at 9% per annum with a maturity date of  December 21, 2021 (see 
Note  14 — Borrowing  Activities  and  Arrangements).  Under  the  terms  of  the  Subordinated  Debt,  to  the 
extent Gulf  Coast fails to pay rent when due to us under its master lease, Gulf  Coast’s unpaid rent can be 

F-30 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

used to offset Omega Obligor’s obligations under the Subordinated Debt (on a quarterly basis with respect 
to  interest  and,  under  some  circumstances,  on  an  annual  basis  with  respect  to  principal).  As  of 
December 31, 2021, we have offset $1.3 million of  accrued interest and $20.0 million of  principal under the 
Subordinated  Debt  against  the  uncollected  rent  under  the  master  lease  with  Gulf  Coast.  Following  the 
application  of  these  offsets,  Omega  has  no  further  obligations  under  the  Subordinated  Debt.  See 
Note 20 — Commitments and Contingencies for additional discussion regarding an ongoing lawsuit related 
to the Subordinated Debt. 

As  discussed  in  Note  4 — Assets  Held  For  Sale,  Dispositions  and  Impairments,  we  sold  22  facilities 
that were previously leased and operated by Gulf  Coast in the first quarter of  2022. We transitioned one 
facility that was previously leased and operated by Gulf  Coast to another operator in the second quarter of 
2022. 

Daybreak 

Daybreak previously leased and operated 58 facilities from Omega. During the third quarter of  2017, 
we placed Daybreak on a cash basis for revenue recognition as a result of  nonpayment of  funds owed to us. 
We  elected  to  terminate  our  relationship  with  Daybreak  and  we  transitioned  31  Daybreak  facilities  to 
existing  operators  during  2020.  The  total  annual  contractual  rent  from  the  31  transitioned  facilities  was 
approximately  $12.4  million.  In  2021,  we  transitioned  14  additional  facilities  to  existing  operators  with 
annual contractual rent of  approximately $4.0 million and sold the remaining four Daybreak facilities. The 
transition and sale of these facilities completed our exit from our relationship with Daybreak. 

Genesis Healthcare, Inc. 

During  the  year  ended  December  31,  2020,  we  wrote-off  approximately  $64.9  million  of  contractual 
receivables, straight-line rent receivables, and lease inducements through rental income in 2020 as a result of 
placing Genesis Healthcare, Inc. (“Genesis”) on a cash basis based on information the Company received 
from Genesis during the third quarter of  2020 regarding substantial doubt as to their ability to continue as 
a going concern. Genesis represents approximately 6.6%, 5.9% and 7.6%, respectively, of  our total revenues 
(excluding  the  impact  of  write-offs)  for  the  years  ended  December  31,  2022,  2021  and  2020.  Genesis 
continued to make their rental and interest payments to us during the years ended December 31, 2022, 2021 
and 2020. 

3.7% Operator 

From January through March 2022, an operator (the “3.7% Operator”) representing 3.7%, 3.4% and 
3.1% of  total revenue (excluding the impact of  write-offs) for the years ended December 31, 2022, 2021 and 
2020, respectively, did not pay its contractual amounts due under its lease agreement. In March 2022, the 
lease  with  the  3.7%  Operator  was  amended  to  allow  for  a  short-term  rent  deferral  for  January  through 
March  2022.  The  deferred  rent  balance  accrues  interest  monthly  at  a  rate  of  5%  per  annum.  The  3.7% 
Operator  paid  the  contractual  amount  due  under  its  lease  agreement  from  April  2022  through 
December 2022. Omega holds a $1.0 million letter of  credit and a $150 thousand security deposit from the 
3.7% Operator as collateral under its lease agreement. The 3.7% Operator remains on a straight-line basis of 
revenue recognition. 

We have a revolving credit facility with the 3.7% Operator, that was amended in the fourth quarter of 
2022  to  increase  the  capacity  to  $25.0  million,  that  is  fully  drawn  as  of  December  31,  2022.  The  credit 
facility is secured by a first lien on the accounts receivable of  the 3.7% Operator. The 3.7% Operator paid 
contractual  interest  under  the  facility  from  January  through  December  2022.  See  Note  8 — Non-Real 
Estate Loans Receivable for additional details. 

1.2% Operator 

In March 2022, an operator (the “1.2% Operator”), representing 1.2%, 2.1% and 2.5% of  total revenue 
(excluding the impact of  write-offs) for the years ended December 31, 2022, 2021 and 2020, respectively, did 

F-31 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

not  pay  its  contractual  amounts  due  under  its  lease  agreement.  In  April  2022,  the  lease  with  the  1.2% 
Operator was amended to allow the operator to apply its $2.0 million security deposit toward payment of 
March  2022  rent  and  to  allow  for  a  short-term  rent  deferral  for  April  2022  with  regular  rent  payments 
required to resume in May 2022. The 1.2% Operator paid contractual rent in May 2022, but it failed to pay 
the full contractual rent for June 2022 on a timely basis. We placed the 1.2% Operator on a cash basis of 
revenue  recognition  during  the  second  quarter  of  2022  and  wrote-off  approximately  $8.3  million  of 
straight-line rent receivables. During the third and fourth quarters of  2022, the 1.2% Operator made partial 
contractual rent payments totaling $4.0 million. We are in discussions to sell or release to another operator 
a portion of the facilities included in the 1.2% Operator’s master lease. 

2.0% Operator 

In June 2022, an operator (the “2.0% Operator”), representing 2.0%, 2.1% and 2.2% of  total revenue 
(excluding  the  impact  of  write-offs)  for  the  years  ended  December  31,  2022,  2021  and  2020,  respectively, 
short-paid the contractual rent amount due under its lease agreement by $0.6 million. In July 2022, we drew 
the  full  $5.4  million  letter  of  credit  that  was  held  as  collateral  from  the  2.0%  Operator  and  applied 
$0.6 million of  the proceeds to pay the unpaid portion of  June 2022 rent. In the third quarter of  2022, the 
2.0% Operator continued to short-pay the contractual amount due under its lease agreement. As such, we 
applied  $3.3  million  of  the  remaining  proceeds  of  the  letter  of  credit  to  pay  the  unpaid  portion  of  July, 
August  and  September  2022  rent.  We  placed  the  2.0%  Operator  on  a  cash  basis  of  revenue  recognition 
during the third quarter of  2022 and wrote-off  approximately $10.5 million of  straight-line rent receivables 
and lease inducements. In the fourth quarter of  2022, the 2.0% Operator paid $2.2 million in contractual 
rent  and  we  applied  the  remaining  $1.5  million  of  collateral  against  the  remaining  unpaid  rent.  As  of 
February  1,  2023,  we  have  transitioned  19  of  the  23  facilities  previously  included  in  the  2.0%  Operator’s 
master  lease  to  other  operators  and  are  in  discussions  to  re-lease  the  remaining  four  facilities  to  another 
operator. 

0.4% Operator 

In June 2022, we placed an operator (the “0.4% Operator”), representing 0.4%, 0.5% and 0.6% of  total 
revenue  (excluding  the  impact  of  write-offs)  for  the  years  ended  December  31,  2022,  2021  and  2020, 
respectively,  on  a  cash  basis  of  revenue  recognition.  The  change  in  our  evaluation  of  the  collectibility  of 
future rent payments due from the 0.4% Operator was a result of  information received from the operator 
during  the  second  quarter  of  2022  regarding  substantial  doubt  as  to  its  ability  to  continue  as  a  going 
concern. As a result of  placing the 0.4% Operator on a cash basis, we wrote-off  approximately $2.1 million 
of  straight-line  rent  receivables  through  rental  income.  For  the  year  ended  December  31,  2022,  the  0.4% 
Operator failed to pay four months of rent representing $2.0 million. 

0.9% Operator 

In November and December 2022, an operator that was already on a cash basis of  revenue recognition 
(the  “0.9%  Operator”),  representing  0.9%,  1.0%  and  1.0%  of  total  revenue  (excluding  the  impact  of 
write-offs) for the years ended December 31, 2022, 2021 and 2020, respectively, did not pay its contractual 
amounts due under its lease and loan agreements. 

Healthcare Homes Limited 

In  December  2022,  we  agreed  to  allow  Healthcare  Homes  Limited  (“Healthcare  Homes”),  a  U.K. 
based operator representing 2.9%, 2.4% and 2.3% of  total revenue (excluding the impact of  write-offs) for 
the years ended December 31, 2022, 2021 and 2020, respectively, the ability to defer up to £6.7 million of 
contractual  rent  from  January  2023  through  April  2023  with  regular  payments  required  to  resume  in 
May 2023. The deferred rent balance accrues interest monthly at a rate of  8% per annum and must be fully 
repaid  by  December  31,  2024.  Healthcare  Homes  remains  current  as  of  December  31,  2022  and  is  on  a 
straight-line basis of revenue recognition. 

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OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Other Operators 

During the year ended December 31, 2022, in addition to the operators specifically discussed above, we 
allowed four other operators, representing an aggregate 2.7%, 3.2% and 3.6% of total revenue (excluding the 
impact  of  write-offs)  for  the  years  ended  December  31,  2022,  2021  and  2020,  respectively,  to  apply  an 
aggregate of  $3.4 million of  their security deposits to pay rent to accommodate short term liquidity issues, 
with regular rent payments required to resume shortly thereafter. These operators also are required to begin 
replenishing  their  security  deposits  in  2023.  Additionally,  we  granted  three  of  these  operators  short-term 
deferrals  for  a  portion  of  their  respective  rent  due  during  the  year  ended  December  31,  2022.  As  of 
December  31,  2022,  three  of  the  four  operators  that  were  allowed  to  apply  security  deposits  to  rent  are 
current on their respective lease obligations after taking into account rent deferrals and/or the application of 
security  deposits.  The  one  operator  that  is  not  current  on  contractual  obligations  is  on  a  cash  basis  of 
revenue recognition as of December 31, 2022. 

Lease Inducements 

For  the  years  ended  December  31,  2021  and  2020,  we  provided  fundings  of  $22.3  million,  and 
$34.1 million, respectively, to our operators subject to operating leases, which were accounted for as lease 
inducements and will be amortized as a reduction to rental income over the remaining term of the leases. Of 
the  $22.3  million  funded  in  2021,  $20  million  was  paid  to  LaVie  and  $2.3  million  was  paid  to  four  other 
existing  operators.  Of  the  $34.1  million  funded  in  2020,  $23.9  million  was  paid  to  Maplewood  for 
development and start-up related costs and the remaining $10.2 million was paid to three other operators. 

NOTE 6 — LEASES 

Lease Income 

The following table summarizes the Company’s rental income from operating leases: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Rental income – operating leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $735,247  $911,701  $741,681 
Variable lease income – operating leases  . . . . . . . . . . . . . . . . . . . . . . . 
11,746 
Total rental income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $750,208  $923,677  $753,427 

14,961 

11,976 

Our variable lease income primarily represents the reimbursement of  real estate taxes and ground lease 

expenses by operators that Omega pays directly. 

The following amounts reflect the future minimum lease payments due to us for the remainder of  the 

initial terms of our operating leases as of December 31, 2022: 

2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  729,902 
761,895 
2024 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
759,887 
2025 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
769,715 
2026 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
732,901 
2027 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Thereafter 
3,345,742 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $7,100,042 

(in thousands) 

Lease Costs 

As of  December 31, 2022, the Company is a lessee under ground leases and/or facility leases related to 
10 SNFs, one ALF and two offices. For the years ended December 31, 2022, 2021 and 2020, the expenses 

F-33 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

associated  with  these  operating  leases  were  $2.2  million,  respectively  and  are  included  within  general  and 
administrative expense on the Statements of Operations. 

The following table summarizes the balance sheet information related to leases where the Company is a 

lessee: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Other assets – right of use assets 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$17,849 

Accrued expenses and other liabilities – lease liabilities  . . . . . . . . . . . . . . . . . . 

$19,130 

$16,117 

$17,180 

Direct Financing Leases 

The components of investments in direct financing leases consist of the following: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Minimum lease payments receivable  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Less unearned income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Investment in direct financing leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . 
Investment in direct financing leases – net  . . . . . . . . . . . . . . . . . . . . . . . . . 

Less allowance for credit losses on direct financing leases 

$23,756 
(12,437) 
11,319 
(2,816) 
$  8,503 

$ 24,863 
(13,460) 
11,403 
(530) 
$ 10,873 

Properties subject to direct financing leases  . . . . . . . . . . . . . . . . . . . . . . . . . . 

Number of direct financing leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1 

1 

1 

1 

During the year ended December 31, 2021, we received $0.7 million from a bankruptcy court created 
Distribution Trust related to a direct financing lease with a former operator which is recorded in recovery 
on direct financing leases on our Consolidated Statement of Operations. 

NOTE 7 — REAL ESTATE LOANS RECEIVABLE 

Real  estate  loans  consist  of  mortgage  loans  and  other  real  estate  loans  which  are  primarily 
collateralized by a first, second or third mortgage lien or a leasehold mortgage on, or an assignment of  the 
partnership  interest  in  the  related  properties.  As  of  December  31,  2022,  our  real  estate  loans  receivable 
consists  of  seven  fixed  rate  mortgages  on  52  long-term  care  facilities  and  12  other  real  estate  loans.  The 
mortgage  notes  relate  to  facilities  located  in  six  states  that  are  operated  by  six  independent  healthcare 
operating companies. The other real estate loans are with four of  our operators as of  December 31, 2022. 
We monitor compliance with the loans and when necessary have initiated collection, foreclosure and other 
proceedings with respect to certain outstanding real estate loans. 

F-34 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The principal amounts outstanding of real estate loans receivable, net of allowances, were as follows: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Mortgage notes due 2030; interest at 10.96%(1) . . . . . . . . . . . . . . . . . . . . . . . .  $  506,321  $  653,564 
103,762 
Mortgage note due 2031; interest at 11.02%  . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other mortgage notes outstanding(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
151,361 
908,687 
Mortgage notes receivable – gross  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(73,601) 
Allowance for credit losses on mortgage notes receivable  . . . . . . . . . . . . . . . . . 
835,086 
Mortgage notes receivable – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
201,613 
Other real estate loan due 2030; interest at 7.00%  . . . . . . . . . . . . . . . . . . . . . . 
Other real estate loans due 2024; interest at 13.17%(1)  . . . . . . . . . . . . . . . . . . . 
90,752 
Other real estate loans due 2022-2025; interest at 12.03%(1)  . . . . . . . . . . . . . . . 
9,992 
40,232 
Other real estate loan due 2024; interest at 12.00%  . . . . . . . . . . . . . . . . . . . . . 
Other real estate loans outstanding(3) 
12,084 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
354,673 
Leasehold mortgages and other real estate loans – gross . . . . . . . . . . . . . . . . 
(8,973) 
Allowance for credit losses on leasehold mortgages and other real estate loans  . . 
345,700 
Leasehold mortgages and other real estate loans – net  . . . . . . . . . . . . . . . . . 
Total real estate loans receivable – net . . . . . . . . . . . . . . . . . . . . . . . . . . .  $1,042,731  $1,180,786 

76,049 
149,153 
731,523 
(83,393) 
648,130 
250,500 
98,440 
43,628 
— 
20,000 
412,568 
(17,967) 
394,601 

(1)  Approximates the weighted average interest rate on facilities as of December 31, 2022. 

(2)  Other  mortgage  notes  outstanding  have  a  weighted  average  interest  rate  of  8.85%  per  annum  as  of  December  31,  2022  and 

maturity dates ranging from 2023 through 2032 (with $6.5 million maturing in 2023). 

(3)  As of December 31, 2022, includes one real estate loan with an interest rate of 12.00% and a maturity date of December 2, 2027. 

Interest income on real estate loans is included within interest income on the Consolidated Statements 

of Operations and is summarized as follows: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Mortgage notes – interest income  . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  74,233  $  91,661  $  89,422 
Leasehold mortgages and other real estate loans – interest income 
27,867 
. . . . . . . . . . . . . . . . . . . . . . . .  $110,322  $123,649  $117,289 
Total real estate loans interest income 

36,089 

31,988 

. . . . 

Mortgage Notes due 2030 

On  June  30,  2022,  Ciena  Healthcare  (“Ciena”)  repaid  $57.1  million  under  the  $415.0  million 
amortizing mortgage (the “Ciena Master Mortgage”), $15.1 million under the $44.7 million mortgage and 
$41.5 million under four additional mortgages. Concurrent with these repayments, we released the mortgage 
liens  on  six  facilities  in  exchange  for  the  partial  repayment  and  extended  the  maturity  date  of  all  of  the 
Ciena mortgage notes to June 30, 2030 (with exception of  two loans with an aggregate principal balance of 
$40.4 million with maturity dates in 2023). 

On September 9, 2022, Ciena repaid $35.3 million under the Ciena Master Mortgage and $9.5 million 
under  three  additional  mortgages.  Concurrently  with  these  partial  repayments,  we  released  the  mortgage 
liens on two facilities in exchange for such partial repayments. 

F-35 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

At December 31, 2022, the $506.3 million of Mortgage Notes with Ciena consisted of the following: 

• 

$415 million Ciena Master Mortgage that matures in 2030. The Ciena Master Mortgage note bore 
an initial interest rate of  9.0% per annum which increases by 0.225% per annum. In May 2020, we 
amended the Ciena Master Mortgage to increase the interest rate by 54 basis points from 10.13% 
per annum to 10.67% per annum and we sold eight SNFs and one ALF located in Michigan to 
Ciena for $83.5 million (as discussed below). As of  December 31, 2022, the outstanding principal 
balance of  the Ciena Master Mortgage note is $279.0 million and it is secured by 20 facilities. The 
interest rate on the Ciena Master Mortgage was 11.35% at December 31, 2022. 

•  Additional  borrowings  in  the  form  of  incremental  facility  mortgages,  construction  and/or 
improvement  mortgages  with  maturities  through  2030  (with  exception  to  one  construction 
mortgage  with  principal  of  $19.1  million  that  matures  in  2023)  with  initial  annual  interest  rates 
ranging  between  8.5%  and  10%  and  fixed  annual  escalators  of  2%  or  2.5%  over  the  prior  year’s 
interest rate, or a fixed increase of  0.225% per annum. As of  December 31, 2022, the outstanding 
principal  balance  of  these  mortgage  notes  which  are  secured  by  three  facilities  is  $94.3  million. 
During  the  second  quarter  of  2021,  one  construction  mortgage,  included  in  the  mortgage  notes 
described above, with an original maturity date of 2021 was extended to 2029 and converted into a 
facility mortgage. During the third quarter of  2021, we acquired a facility which was previously 
subject to a $13.9 million construction mortgage, also included in the notes described above, and 
subsequently leased the property back to Ciena. 

• 

• 

• 

$44.7 million mortgage note related to five SNFs located in Michigan. The mortgage note matures 
on  June  30,  2030  and  bore  an  initial  annual  interest  rate  of  9.5%  which  increases  each  year  by 
0.225%.  The  interest  rate  on  the  mortgage  note  was  10.4%  at  December  31,  2022.  During  the 
second quarter of  2022, we released the mortgage lien on one facility under this mortgage loan in 
exchange  for  a  $15.1  million  repayment  (as  discussed  above).  As  of  December  31,  2022,  the 
outstanding  principal  balance  of  this  mortgage  note  is  $28.6  million  and  it  is  secured  by  four 
SNFs.  Additionally,  the  Company  committed  to  fund  an  additional  $9.6  million  to  Ciena  if 
certain performance metrics are achieved by the portfolio. 

$83.5 million mortgage note related to eight SNFs and one ALF located in Michigan. These nine 
facilities were formerly leased to Ciena and were sold to Ciena by issuance of  a first mortgage on 
May 1, 2020. The mortgage note matures on June 30, 2030 and bore an initial annual interest rate 
of  10.31% which increases each year by 2%. The interest rate on the mortgage note was 10.73% at 
December 31, 2022. As of  December 31, 2022, the outstanding principal balance of  this mortgage 
note is $83.1 million. 

$21.3  million  mortgage  note  related  to  one  SNF  located  in  Ohio.  The  mortgage  note  had  an 
original maturity date of  March 31, 2022 and bore an initial annual interest rate of  9.5%. During 
the year ended December 31, 2022, we amended the mortgage note to extend the maturity date to 
December 31, 2023 and to increase the interest rate to 9.74% beginning April 1, 2022 and to 9.98% 
beginning  April  1,  2023.  As  of  December  31,  2022,  the  outstanding  principal  balance  of  this 
mortgage note is $21.3 million. 

The  mortgage  notes  with  Ciena  are  cross-defaulted  and  cross-collateralized  with  our  existing  master 

lease and other non-real estate loans with Ciena. 

Mortgage Note due 2031 

On  January  17,  2014,  we  entered  into  a  $112.5  million  first  mortgage  loan  with  Guardian.  The  loan 
was  originally  secured  by  seven  SNFs  and  two  ALFs  located  in  Pennsylvania  and  Ohio.  The  mortgage  is 
cross-defaulted and cross-collateralized with our existing master lease with the operator. In March 2018, we 
extended  the  maturity  date  to  January  31,  2027  and  provided  an  option  to  extend  the  maturity  for  a  five 
year period through January 31, 2032 and a second option to extend the maturity through September 30, 
2034. 

F-36 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

In the third quarter of  2021, we reduced the risk rating on the mortgage loan from a 4 to a 5, primarily 
due to the increased likelihood of a restructuring that would result in the modification of the mortgage loan 
terms.  As  discussed  in  Note  5 — Contractual  Receivables  and  Other  Receivables  and  Lease  Inducements, 
Guardian failed to pay contractual rent and interest to us during the fourth quarter of  2021. The mortgage 
loan was placed on non-accrual status for interest recognition in October 2021 and is being accounted for 
under the cost recovery method. On December 30, 2021, we acquired two facilities, previously subject to the 
Guardian  mortgage  loan,  in  consideration  for  a  reduction  of  $8.7  million  in  the  mortgage  principal  and 
added the facilities to the master lease agreement. Following Guardian’s non-payment of  rent and interest 
during the fourth quarter of  2021 and further negotiations with Guardian in the fourth quarter, we elected 
to further reduce the risk rating on the loan from a 5 to a 6 in the fourth quarter of 2021 and to evaluate the 
risk of  loss on the loan on an individual basis. As the fair value of  the 7 properties that collateralized the 
mortgage  loan  were  estimated  to  be  less  than  the  remaining  principal  as  of  December  31,  2021  of 
$103.8  million,  we  reserved  an  additional  $38.2  million  through  provision  for  credit  losses  in  the  fourth 
quarter of  2021. The total reserve as of  December 31, 2021, related to the mortgage loan was $47.1 million 
and  reduced  the  loan  carrying  value  to  the  estimated  fair  value  of  the  collateral  of  $56.7  million  as  of 
December  31,  2021.  We  also  fully  reserved  approximately  $1.0  million  of  contractual  interest  receivable 
related to the mortgage loan with Guardian in the fourth quarter of 2021. 

Guardian  continued  to  not  pay  contractual  rent  and  interest  due  under  its  lease  and  mortgage  loan 
agreements during the first quarter of  2022. On February 15, 2022, Guardian completed the sale of  three 
facilities subject to the Guardian mortgage loan with Omega. Concurrent with the sale, Omega agreed to 
release  the  mortgage  liens  on  these  facilities  in  exchange  for  a  partial  paydown  of  $21.7  million.  In 
connection  with  the  partial  paydown,  we  recorded  a  $5.1  million  recovery  for  credit  losses  in  the  first 
quarter  of  2022  related  to  the  Guardian  mortgage  loan.  In  the  second  quarter  of  2022,  we  agreed  to  a 
formal  restructuring  agreement  and  amendments  to  the  master  lease  and  mortgage  loan  with  Guardian, 
which  among  other  adjustments,  extended  the  loan  maturity  and  allowed  for  the  deferral  of  certain 
contractual  interest  as  discussed  in  Note  5 — Contractual  Receivables  and  Other  Receivables  and  Lease 
Inducements.  These  amendments  were  treated  as  a  loan  modification.  Following  the  execution  of  the 
restructuring agreement, Guardian resumed paying contractual rent and interest during the second quarter 
of  2022  and  continued  such  payments  in  the  third  and  fourth  quarters  of  2022,  in  accordance  with  the 
restructuring  terms.  In  the  third  and  fourth  quarters  of  2022,  we  reserved  an  additional  $0.3  million,  in 
aggregate,  through  provision  for  credit  losses  due  to  a  decrease  in  the  estimated  fair  value  of  the  four 
facilities that are collateral under the mortgage. 

As  of  December  31,  2022,  the  amortized  cost  basis  of  the  Guardian  mortgage  loan  is  $76.0  million, 
which represents 6.6% of  the total amortized cost basis of  all real estate loan receivables. The total reserve 
as  of  December  31,  2022  related  to  the  mortgage  loan  was  $40.8  million  and  reduced  the  loan  carrying 
value  to  the  estimated  fair  value  of  the  collateral  of  $35.2  million  as  of  December  31,  2022.  As  of 
December  31,  2022,  the  mortgage  loan  is  secured  by  three  SNFs  and  one  ALF  located  in  Pennsylvania. 
During the year ended December 31, 2022, we received $6.0 million of  interest payments that were applied 
directly against the principal balance outstanding using the cost recovery method. 

Other mortgage notes outstanding 

As  of  December  31,  2022,  our  other  mortgage  notes  outstanding  represents  4  mortgage  loans  to  4 
operators  with  liens  on  11  facilities.  Included  below  are  new  mortgage  loans  within  this  bucket  that  were 
entered into during the years ended December 31, 2022, and 2021. 

Mortgage Note due 2032; interest at 10.50% 

On  July  1,  2021,  we  financed  six  SNFs  in  Ohio  and  amended  an  existing  $6.4  million  mortgage, 
inclusive of  two Ohio SNFs, to include the six facilities in a consolidated $72.4 million mortgage for eight 
Ohio facilities bearing interest at an initial rate of  10.5% per annum. In conjunction with this transaction, 
we  also  acquired  three  Maryland  facilities  that  were  previously  subject  to  a  mortgage  issued  by  Omega 

F-37 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

bearing interest at 13.75% per annum with a principal balance of  $36.0 million that was included in other 
mortgage  notes  outstanding.  The  purchase  price  for  these  three  facilities  was  equal  to  the  remaining 
mortgage  principal  amount,  and  the  three  acquired  Maryland  facilities  were  subsequently  leased  back  to 
the  seller  for  a  term  expiring  on  December  31,  2032,  assuming  Omega  exercises  the  options  under  the 
agreement. The base rent in the initial year is approximately $5.0 million and includes annual escalators of 
2.5%. As of December 31, 2022, the outstanding principal balance of this mortgage note is $72.4 million. 

Mortgage Note due 2025; interest at 7.85% 

In connection with the MedEquities Merger on May 17, 2019, the Company acquired a first mortgage 
lien issued to Lakeway Realty, L.L.C, an unconsolidated joint venture discussed in Note 11 — Investments 
in Joint Ventures, in the original principal amount of  approximately $73.0 million bearing interest at 8% per 
annum  based  on  a  25-year  amortization  schedule  and  maturing  on  March  20,  2025.  We  determined  the 
acquisition date fair value of  the acquired mortgage was $69.1 million. As of  December 31, 2022 and 2021, 
this mortgage has a carrying value of $63.8 million and $65.5 million, respectively. 

Other real estate loan due 2030 

On July 31, 2020, we entered into a $220.5 million secured revolving credit facility with Maplewood as 
a  part  of  an  overall  restructuring  with  this  operator.  $132.1  million  of  the  facility  was  drawn  at  closing 
which was used to repay our prior secured revolving credit facilities with aggregate capacity of $65.0 million 
with Maplewood, as well as other lease obligations owed to us, of  which approximately $55.4 million was 
scheduled to be repaid at termination of  the master lease. Loan proceeds under the new credit facility may 
also be used to fund Maplewood’s working capital needs. Advances made under this facility bear interest at 
a fixed rate of  7% per annum and the facility matures on June 30, 2030. On June 22, 2022, we amended the 
secured revolving credit facility with Maplewood to increase the maximum commitment under the facility 
from  $220.5  million  to  $250.5  million.  Maplewood  was  determined  to  be  a  VIE  when  this  loan  was 
originated  in  2020.  Our  balances  and  risk  of  loss  associated  with  Maplewood  are  included  within  our 
disclosures in Note 10 — Variable Interest Entities. As discussed in Note 5 — Contractual Receivables and 
Other Receivables and Lease Inducements, we began negotiations to restructure and amend Maplewood’s 
lease and loan agreements during the fourth quarter of  2022. As a result of  the anticipated restructuring, 
we placed the Maplewood revolving credit facility on non-accrual status for interest recognition during the 
fourth  quarter  of  2022  due  to  the  anticipated  restructuring  of  its  lease  and  loan  agreement.  As  of 
December 31, 2022, $250.5 million remains outstanding on this credit facility to Maplewood. 

As discussed in Note 5 — Contractual Receivables and Other Receivables and Lease Inducements, in 
the  first  quarter  of  2023,  Omega  entered  into  a  restructuring  agreement  and  a  loan  amendment  that 
modified the senior revolving credit facility. As part of  the restructuring agreement and loan amendment, 
Omega agreed to extend the maturity date to June 2035, increase the capacity of  the senior revolving credit 
facility from $250.5 million to $320.0 million, including PIK interest applied to the principal, and to convert 
the 7% cash interest due on the senior revolving credit facility to all PIK interest in 2023, 1% cash interest 
and 6% PIK interest in 2024, 4% cash interest and 3% PIK interest in 2025 and through the maturity date. 

Other real estate loans due 2024 

Our  other  investment  notes  due  in  2024  consists  of  two  secured  term  loans  with  Genesis  with  initial 
borrowings  of  $48.0  million  and  $16.0  million  at  issuance.  The  $48.0  million  term  loan  was  issued  in 
July  2016  (the  “2016  Term  Loan”),  with  subsequent  amendments  in  2018,  2019  and  2021,  and  currently 
bears interest at a fixed rate of  14% per annum, of  which 9% per annum is paid-in-kind. The 2016 Term 
Loan  was  initially  scheduled  to  mature  on  July  29,  2020,  but  through  the  amendments  noted  above,  the 
maturity date of  this loan was extended to January 1, 2024. The $16.0 million secured term loan was issued 
on March 6, 2018 (the “2018 Term Loan”), and amended in 2021, and bears interest at a fixed rate of  10% 
per annum, of  which 5% per annum is paid-in-kind. The 2018 Term Loan was initially scheduled to mature 
on July 29, 2020, but through the amendments noted above was extended to January 1, 2024. Both the 2016 

F-38 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

and  2018  Term  Loans  are  on  an  accrual  status  as  of  December  31,  2022.  Both  the  2016  and  2018  Term 
Loans  are  secured  by  a  first  priority  lien  on  and  security  interest  in  certain  collateral  of  Genesis.  As  of 
December 31, 2022, there was approximately $78.1 million and $20.3 million outstanding on the 2016 and 
2018 Term Loans, respectively. 

Other real estate loans due 2022-2025 

On June 28, 2022, we entered into a $35.6 million mezzanine loan with an existing operator related to 
new operations undertaken by the operator. The loan bears interest at a fixed rate of  12% per annum and 
matures on June 30, 2025. The loan also requires quarterly principal payments of  $1.0 million commencing 
on January 1, 2023 and additional payments contingent on the operator’s achievement of  certain metrics. 
The loan is secured by a leasehold mortgage and a pledge of the operator’s equity interest in a joint venture. 

Other real estate loan due 2024 

Our other investment note due in 2024 consisted of  a $60.0 million mezzanine loan, with an operator, 
that was acquired and financed in 2016 and subsequently amended and refinanced in May 2018. The loan 
was amended again in 2022. As amended, the mezzanine loan bore interest at a fixed interest rate of  12% 
per  annum  and  contractually  matured  on  May  31,  2024.  During  the  third  quarter  of  2022,  this  loan  was 
fully repaid. 

Other real estate loans outstanding 

Preferred Equity Investment in Joint Venture — $20 million 

On June 2, 2022, we made a $20.0 million preferred equity investment, which is treated as a loan for 
accounting purposes, in a new real estate joint venture that was formed to acquire an acute care hospital in 
New York. Omega’s preferred equity investment bears a 12% return per annum and must be mandatorily 
redeemed  by  the  joint  venture  at  the  earlier  of  December  2027  or  the  occurrence  of  certain  significant 
events  within  the  joint  venture.  We  have  determined  that  the  joint  venture  is  a  VIE,  but  we  are  not  the 
primary beneficiary as we do not have the power to direct the activities that most significantly impact the 
joint venture’s economic performance. As such, this $20.0 million preferred equity investment is included in 
the unconsolidated VIE table presented in Note 10 — Variable Interest Entities. 

F-39 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

NOTE 8 — NON-REAL ESTATE LOANS RECEIVABLE 

Our non-real estate loans consist of  fixed and variable rate loans to operators and/or principals. These 
loans may be either unsecured or secured by the collateral of  the borrower, which may include the working 
capital of  the borrower. As of  December 31, 2022, we had 29 loans with 15 different borrowers. A summary 
of our non-real estate loans is as follows: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Notes due 2024-2025; interest at 8.12%(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Notes due 2022-2028; interest at 10.44%(1)(2)  . . . . . . . . . . . . . . . . . . . . . . . . . 
Notes due 2036; interest at 8.13%(1) 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Note due 2027; interest at 12.00%  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Note due 2024; interest at 7.50% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other notes outstanding(3)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Non-real estate loans receivable – gross  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Allowance for credit losses on other investments . . . . . . . . . . . . . . . . . . . . . . . 
Total non-real estate loans receivable – net  . . . . . . . . . . . . . . . . . . . . . . . . . 

$  55,791 
55,981 
32,539 
39,653 
47,999 
77,186 
309,149 
(83,868) 
$225,281 

$  55,791 
22,142 
2,690 
— 
15,000 
88,982 
184,605 
(60,421) 
$124,184 

(1)  Approximate weighted average interest rate as of December 31, 2022. 
(2) 

Includes  one  loan  with  a  principal  balance  of  $1.5  million  that  was  to  mature  in  2022  but  remains  outstanding  as  of 
December 31, 2022. We are in negotiations to extend the loan. 

(3)  Other notes outstanding have a weighted average interest rate of  7.18% as of  December 31, 2022 with maturity dates ranging 
from 2022 through 2028 (with $10.8 million maturing in 2023). We have two loans within other notes outstanding with aggregate 
principal of $9.8 million that were to mature in 2022, but remain outstanding as of December 31, 2022. We are in negotiations to 
extend a $4.4 million loan to 2024 and we have fully reserved the other $5.4 million loan. 

For the years ended December 31, 2022, 2021 and 2020, non-real estate loans generated interest income 
of  $13.6  million,  $12.7  million  and  $17.0  million,  respectively.  Interest  income  on  non-real  estate  loans  is 
included within interest income on the Consolidated Statements of Operations. 

Notes due 2024-2025 

Notes due in 2024-2025 consist of  a $32 million secured term loan (the “Agemo Term Loan”) and a 
$25.0 million secured working capital loan (the “Agemo WC Loan”) with Agemo. The Agemo Term Loan 
was  acquired  in  2016  and  bears  interest  at  9%  per  annum.  The  Agemo  Term  Loan  matures  on 
December  31,  2024  and  is  secured  by  a  security  interest  in  certain  collateral  of  Agemo.  The  Agemo  WC 
Loan was issued on May 7, 2018 and bears interest at 7% per annum. The Agemo WC Loan matures on 
April 30, 2025 and is primarily secured by a collateral package that includes a second lien on the accounts 
receivable  of  Agemo.  The  proceeds  of  the  Agemo  WC  Loan  were  used  to  pay  operating  expenses, 
settlement payments, fees, taxes and other costs approved by the Company. 

During the third quarter of  2020, we evaluated both loans for impairment upon receiving information 
from  Agemo  regarding  substantial  doubt  of  its  ability  to  continue  as  a  going  concern.  Based  on  our 
evaluation, we recorded a provision for credit loss of $22.7 million in the third quarter of 2020 to reduce the 
carrying  value  of  the  loans  to  the  fair  value  of  the  underlying  collateral.  We  also  fully  reserved 
approximately $3.8 million of  contractual interest receivable related to the Agemo Term Loan in the third 
quarter of 2020 (see Note 9 — Allowance for Credit Losses). 

As  discussed  in  Note  5 — Contractual  Receivables  and  Other  Receivables  and  Lease  Inducements, 
Agemo  failed  to  pay  contractual  rent  and  interest  to  us  from  August  2021  through  October  2021  and  in 
December  2021.  In  the  third  quarter  of  2021,  we  recorded  an  additional  provision  for  credit  loss  of 
$16.7 million related to these loans as a result of  a reduction in the fair value of  the underlying collateral 

F-40 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

assets.  The  reduction  in  fair  value  of  the  collateral  assets  was  primarily  driven  by  the  application  of 
Agemo’s  $9.3  million  letter  of  credit  that  supported  the  value  of  the  Agemo  Term  Loan  to  Omega’s 
uncollected receivables and a reduction in Agemo’s working capital accessible to Omega as collateral, after 
considering other liens on the assets. Additionally, the loan has been placed on non-accrual status and we 
will use the cost recovery method and will apply any interest and fees received directly against the principal 
of  the loan. During the year ended December 31, 2021, we received $1.2 million of  interest payments which 
was applied against the principal. 

Agemo  continued  to  not  pay  contractual  rent  and  interest  due  under  its  lease  and  loan  agreements 
throughout 2022. During the year ended December 31, 2022, we recorded additional provisions for credit 
losses  of  $10.8  million  related  to  the  Agemo  WC  Loan  because  of  reductions  in  the  fair  value  of  the 
underlying collateral assets supporting the current carrying values. At December 31, 2022, the total carrying 
value  of  our  loans  outstanding  with  Agemo,  net  of  allowances  for  credit  losses,  is  approximately 
$5.9 million. 

As discussed in Note 5 — Contractual Receivables and Other Receivables and Lease Inducements, in 
the first quarter of  2023, Omega entered into a restructuring agreement and a replacement loan agreement 
that  modified  the  existing  Agemo  loans.  Under  the  restructuring  agreement,  previously  written  off 
contractual unpaid interest related to the Agemo WC Loan and the Agemo Term Loan was forgiven. The 
outstanding principal of  the Agemo Term Loan was rolled into a $32.0 million loan (“Agemo Replacement 
Loan  A”).  The  outstanding  principal  of  the  Agemo  WC  Loan  and  the  aggregate  rent  deferred  and 
outstanding  under  the  Agemo  lease  agreement  will  be  combined  into  a  $50.2  million  loan  (“Agemo 
Replacement  Loan  B”  and  with  Agemo  Replacement  Loan  A,  the  “Agemo  Replacement  Loans”).  The 
Agemo  Replacement  Loans  bear  interest  at  5.71%  per  annum  and  mature  on  December  31,  2036.  No 
interest  payments  will  accrue  or  are  required  to  be  paid  until  March  1,  2023,  contingent  upon  Agemo’s 
compliance with certain conditions of  the restructuring agreement. After three years, Agemo is required to 
make principal payments on the Agemo Replacement Loans dependent on certain cash flow metrics. 

Notes due 2022-2028 

Notes  due  2022-2028  consists  of  eight  loans  with  the  same  operator  that  are  primarily  short-term 
revolving  lines  of  credit  that  are  collateralized  by  the  accounts  receivable  of  certain  operations  of  the 
operator. The most significant of the outstanding loans is a short-term $90.0 million revolving line of credit 
that  we  entered  into  on  June  28,  2022  in  connection  with  the  $35.6  million  mezzanine  loan  discussed  in 
Note  7 — Real  Estate  Loans  Receivable  above.  The  loan  proceeds  were  used  by  this  operator  to  finance 
working capital requirements of  new operations in a new state to the operator. The line of  credit consists of 
two  $45.0  million  tranches  that  bear  interest  at  fixed  rates  of  10%  per  annum  and  12%  per  annum  and 
mature  on  June  30,  2023  and  June  1,  2023  (or  earlier  based  on  certain  state  reimbursement  conditions), 
respectively.  The  revolving  line  of  credit  is  secured  by  a  first  priority  interest  on  the  operator’s  accounts 
receivable  related  to  the  new  operations.  As  of  December  31,  2022,  the  outstanding  principal  under  this 
revolving line of credit was $33.0 million. 

Notes due 2036 

On  September  1,  2021,  we  entered  into  an  $8.3  million  term  loan  with  LaVie  to  be  funded  through 
monthly  advances  in  the  amount  of  $0.7  million  from  September  2021  through  August  2022.  This  term 
loan  bears  interest  at  a  fixed  rate  of  7%  per  annum  (which  may  be  paid-in-kind  for  the  first  year  of  the 
loan),  matures  on  March  31,  2031  and  requires  monthly  principal  payments  of  $0.1  million  commencing 
September 1, 2022. The loan is secured by a guarantee from LaVie’s parent entities. 

On March 25, 2022, we entered into a $25.0 million term loan with LaVie that bears interest at a fixed 
rate  of  8.5%  per  annum  and  matures  on  March  31,  2032.  This  term  loan  requires  quarterly  principal 
payments  of  $1.3  million  commencing  January  1,  2028  and  is  secured  by  a  second  priority  lien  on  the 
operator’s accounts receivable. 

F-41 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

During the fourth quarter of  2022, we amended these loans with LaVie to, among other terms, extend 
the loan maturities to November 30, 2036 to align with the lease term, and starting in January 2023, reduce 
the interest rates to 2%, remove the requirement to make any principal payments until the maturity dates 
and  to  convert  from  monthly  cash  interest  payments  to  interest  paid-in-kind.  These  amendments  were 
treated as loan modifications. In the fourth quarter of  2022, we reduced the risk rating on these loans from 
a 5 to a 6, primarily due to the modifications of  the loan terms. Given the modifications, we evaluated the 
risk  of  loss  on  these  loans  on  an  individual  basis  based  on  the  fair  value  of  the  collateral.  Based  on  our 
evaluation of  the collateral, during the fourth quarter of  2022, we recognized provisions for credit losses of 
$7.5 million related to the $8.3 million term loan (to fully reserve the loan balance) and $15.8 million related 
to the $25.0 million term loan. Following the sale of  11 facilities in the fourth quarter of  2022, discussed in 
Note  4 — Assets  Held  for  Sale,  Dispositions  and  Impairments,  the  remaining  accounts  receivable 
outstanding  that  collateralize  the  $25.0  million  term  loan  was  insufficient  to  support  the  current 
outstanding balance, and as a result, we recorded the additional reserves to reduce the carrying value of  the 
$25.0  million  loan  to  the  fair  value  of  the  collateral.  Additionally,  the  loans  were  placed  on  non-accrual 
status and we will use the cost recovery method and will apply any interest and fees received directly against 
the  principal  of  the  loans.  During  the  year  ended  December  31,  2022,  we  applied  $0.4  million  of  interest 
payments received to the $25.0 million term loan principal balance outstanding and $0.1 million of  interest 
payments received to the $8.3 million term loan principal balance outstanding. As of  December 31, 2022, 
the  amortized  cost  basis  of  these  loans  was  $32.5  million,  which  represents  10.5%  of  the  total  amortized 
cost basis of  all non-real estate loan receivables. The total reserve as of  December 31, 2022 related to the 
LaVie loans was $25.0 million. 

Note due 2027 

On September 1, 2022, we entered into a $40.0 million mezzanine loan with a new operator. The loan 
bears interest at a fixed rate of  12% per annum and matures on September 14, 2027. The loan also requires 
semi-annual principal payments of  $1.7 million in January and July, commencing on January 1, 2023, and 
additional payments contingent on the occurrence of  certain conditions. The loan is secured by an equity 
interest in subsidiaries of the operator. In February 2023, this loan was repaid. 

Note due 2024 

On July 8, 2019, the Company entered into a $15 million unsecured revolving credit facility agreement 
with a principal of  an operator that bears interest at a fixed rate of  7.5% per annum and originally matured 
on  July  8,  2022.  During  2022,  this  revolving  credit  facility  was  amended  multiple  times  to  increase  the 
maximum  principal  to  $48  million,  extend  the  maturity  date  to  December  31,  2024  and  require  monthly 
principal payments of  $0.5 million beginning in July 2022, which increase to $1.0 million in January 2023, 
to $1.5 million in August 2023 and to $2.5 million in December 2023. No principal payment amounts were 
required for the months of November and December 2022. 

Other notes outstanding 

As of  December 31, 2022, our other notes outstanding represents 15 loans to operators that primarily 
consists of  term loans and working capital loans or revolving credit facilities. Many of  these loans are not 
individually significant and the use of  proceeds of  these loans can vary. Included below are the significant 
new loans entered into during the years ended December 31, 2022, 2021 and 2020 and significant updates to 
any existing loans. 

Working Capital Loan — $20 million 

In November 2021, we entered into a $20.0 million working capital loan (the “$20.0 million WC loan”) 
with  an  operator  that  managed,  on  an  interim  basis  for  a  4-month  period,  the  operations  of  23  facilities 
formerly leased to Gulf  Coast. The $20.0 million WC loan bears interest at 3% per annum. The maturity 
date of  the $20.0 million WC loan was the earlier of  (i) December 31, 2022, (ii) the date of  the termination 

F-42 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

of  one  or  more  of  the  MOTAs,  or  (iii)  the  date  that  New  Manager  requests  that  the  loan  be  terminated. 
Advances under the working capital loan are not required to be repaid until maturity. The $20.0 million WC 
loan is secured by the accounts receivables of these facilities during the interim period of operation. 

During the year ended December 31, 2022, we recognized provisions for credit losses of  $5.2 million 
related to the $20.0 million WC loan, which resulted in the loan being fully reserved. Following the sale of 
22  facilities,  discussed  in  Note  4 — Assets  Held  for  Sale,  Dispositions  and  Impairments,  the  remaining 
accounts  receivable  outstanding  that  collateralize  the  loan  was  insufficient  to  support  the  current 
outstanding balance, and as a result, we recorded the additional reserves to reduce the carrying value of  the 
loan to the fair value of  the collateral. The $20.0 million WC Loan was placed on non-accrual status during 
the third quarter of  2022 and is being accounted for under the cost recovery method. As of  December 31, 
2022, the outstanding principal under this loan was $5.4 million. 

Gulf Coast — DIP Facility 

As discussed in Note 5 — Contractual Receivables and Other Receivables and Lease Inducements, in 
October 2021, we provided an up to $25.0 million senior secured DIP facility (the “DIP Facility”) with Gulf 
Coast,  in  order  to  provide  liquidity  for  the  operations  of  the  Gulf  Coast  facilities  during  its  Chapter  11 
cases. A portion of  the funding under the DIP Facility was tied to certain milestones and other conditions, 
including the transition of  the management of  the operations of  the facilities. At December 31, 2021, these 
milestones  and  conditions  had  been  met  and  the  full  capacity  of  the  DIP  Facility  was  available  to  be 
borrowed upon by Gulf  Coast. The DIP Facility bears interest at LIBOR (subject to a 1% floor) plus 12% 
per annum and has an unused commitment fee equal to .50% of  the average daily balance of  the undrawn 
commitments. Interest and fees are payable monthly and the principal is due at maturity, unless the amount 
outstanding thereunder is accelerated prior to maturity. The DIP financing is guaranteed by all debtors in 
Gulf  Coast’s  Chapter  11  cases  and  is  secured  by  liens  on  substantially  all  of  their  assets,  including 
post-petition  accounts  receivable,  subject  in  certain  cases  to  other  priorities  or  exceptions.  As  of 
December 31, 2021, $20.5 million was outstanding under the DIP Facility, which was fully reserved for as 
discussed further below. 

Given the uncertainty and complexity surrounding the bankruptcy process and the deteriorated credit 
of  Gulf  Coast, we evaluated the DIP facility on an individual basis and elected to measure the risk of  loss 
on the DIP Facility based on the fair value of  the collateral. Based on the cash forecasts provided by Gulf 
Coast as part of  the Support Agreement and on-going monthly reporting, we estimated that the collateral 
will  have  insufficient  value  to  support  the  loan  at  maturity  and  that  we  will  be  unable  to  collect  on 
substantially all principal amounts advanced to Gulf  Coast under the DIP Facility. Upon funding, we fully 
reserved all principal amounts advanced under the DIP Facility. In the fourth quarter of  2021, we recorded 
reserves of  $20.0 million (the principal outstanding after considering interest payments applied to principal 
discussed below) related to the DIP facility through the provision for credit losses on December 31, 2021. 
See further discussion within Note 9 — Allowance for Credit Losses. Additionally, we have placed the loan 
on  non-accrual  status  and  used  the  cost  recovery  method  to  apply  any  interest  and  fees  received  directly 
against  the  principal  of  the  loan.  During  the  year  ended  December  31,  2021,  we  received  $0.5  million  of 
interest and fee payments that we applied against the outstanding principal and recognized a recovery for 
credit loss equal to the amount of payments applied against the principal. 

During the year ended December 31, 2022, we recorded an additional net provision for credit losses of 
$0.2 million related to the DIP Facility, which reflects the full reserve of  additional advances of  $2.2 million 
made  under  the  facility  during  2022  and  a  $2.0  million  recovery  for  interest  and  fee  payments  received 
during 2022 that were  applied  against the outstanding principal. The DIP facility matured  on August  15, 
2022, which resulted in a write-off of the loan and reserve balances. 

Revolving Credit Facility — $25 million 

On October 1, 2021, the Company amended the terms of  a $15 million revolving credit facility with an 
operator  (the  3.7%  Operator  discussed  in  Note  5 — Contractual  Receivables  and  Other  Receivables  and 
Lease Inducements) that was previously issued in December 2020 and had a maturity date of  December 1, 

F-43 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

2022. The amendment increased the maximum principal of  $20 million, reduced the interest rate to 5% for 
the first year and 6% thereafter and extended the maturity date to September 30, 2024. The credit facility is 
secured  by  a  first  lien  on  the  accounts  receivable  of  the  3.7%  Operator.  Following  the  amendment  in  the 
fourth quarter, the 3.7% Operator drew $7.8 million under the credit facility during the fourth quarter of 
2021.  This  revolving  credit  facility  was  further  amended  in  the  fourth  quarter  of  2022  to  increase  the 
maximum principal to $25 million, with any borrowed amount in excess of  $20 million to be repaid no later 
than  June  30,  2023.  During  2022,  the  3.7%  Operator  drew  $9.0  million  under  the  facility  and  the  line  of 
credit of $25.0 million was fully drawn as of December 31, 2022. 

As  discussed  in  Note  5 — Contractual  Receivables  and  Other  Receivables  and  Lease  Inducements, 
from January through March 2022, the 3.7% Operator paid contractual interest under the credit facility but 
failed  to  pay  contractual  rent  due  under  its  lease  agreement.  In  March  2022,  the  lease  with  the  3.7% 
Operator was amended to allow for a short-term rent deferral for January through March 2022. The 3.7% 
Operator  paid  the  contractual  amount  due  under  its  lease  and  loan  agreements  from  April  2022  through 
December 2022. 

Promissory Notes — $20 million 

In the fourth quarter of  2022, the Company entered into three unsecured loans with a principal of  an 
operator with principal amounts of  $17.0 million, $2.5 million and $0.5 million. The loans bear interest at 
9% and mature on September 30, 2027. All three loans require quarterly principal payments commencing 
on January 3, 2023. 

Second Spring Healthcare Investments 

On  April  17,  2020,  we  provided  a  $17.6  million  unsecured  loan  to  a  subsidiary  of  Second  Spring 
Healthcare  Investments  (an  entity  in  which  we  have  an  approximate  15%  ownership  interest,  see 
Note  11 — Investments  in  Joint  Ventures)  bearing  interest  at  the  greater  of  the  prime  interest  rate  or 
3-month LIBOR plus 2.75% per annum which was due on demand. This loan was repaid in 2021. 

F-44 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

NOTE 9 — ALLOWANCE FOR CREDIT LOSSES 

In the fourth quarter of  2022, we revised the presentation of  certain loans subject to our allowance for 
credit losses as discussed in Note 2 — Summary of  Significant Accounting Policies. The disclosures below 
have  been  reclassified  to  conform  to  the  revised  presentation.  A  rollforward  of  our  allowance  for  credit 
losses,  summarized  by  financial  instrument  type  and  internal  credit  risk  rating,  for  the  years  ended 
December 31, 2022, 2021 and 2020 is as follows: 

Provision (recovery)  Write-offs charged 

Allowance for 
Credit Loss as of 
December 31, 
2021 

for Credit Loss 
for the year ended 
December 31, 
2022 

against allowance  Allowance for Credit 
for the year ended 
December 30, 
2022 

Loss as of 
December 31, 
2022 

(in thousands) 

$  — 

$ 

Rating 

Financial Statement 
Line Item 

1 . . .  Real estate loans receivable 

2 . . .  Real estate loans receivable 

3 . . .  Real estate loans receivable 

4 . . .  Real estate loans receivable 

5 . . .  Real estate loans receivable 

6 . . .  Real estate loans receivable 

Sub-total 

3 . . .  Investment in direct financing leases 

5 . . .  Investment in direct financing leases 

Sub-total 

2 . . .  Non-real estate loans receivable 

3 . . .  Non-real estate loans receivable 

4 . . .  Non-real estate loans receivable 

5 . . .  Non-real estate loans receivable 

6 . . .  Non-real estate loans receivable 

Sub-total 

2 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet real estate loan commitments 

4 . . .  Off-balance sheet non-real estate loan commitments 

4 . . .  Off-balance sheet real estate loan commitments 

6 . . .  Off-balance sheet non-real estate loan commitments 

Sub-total 

Total 

$ 

— 

14 

5,367 

20,577 

136 

56,480 

82,574 

530 

— 

530 

29 

1,206 

56 

7,861 

51,269 

60,421 

7 

207 

251 

216 

117 

143 

941 

$ 

162 

143 

9,743 

13,089 

(136) 

248 

23,249 

(530) 

2,816 

2,286 

830 

873 

578 

10,758(2) 

— 

— 

— 

— 

(4,463)(1) 

(4,463) 

— 

— 

— 

— 

— 

— 

— 

28,460(3)(4) 

(18,052)(5) 

41,499 

(18,052) 

200 

(178) 

(251) 

(216) 

(33) 

2,107(5) 

1,629 

— 

— 

— 

— 

— 

(2,250)(5) 

(2,250) 

162 

157 

15,110 

33,666 

— 

52,265 

101,360 

— 

2,816 

2,816 

859 

2,079 

634 

18,619 

61,677 

83,868 

207 

29 

— 

— 

84 

— 

320 

$144,466 

$68,663 

$(24,765) 

$188,364 

(1)  During  the  third  quarter  of  2022,  we  wrote-off  the  loan  balance  and  reserve  for  one  real  estate  loan  with  a  rating  of  6  that 

expired during the third quarter which had previously been fully reserved. 

(2)  Reflects additional provisions of  $10.8 million recorded on the Agemo WC Loan during the year ended December 31, 2022. See 

Note 8 — Non-real Estate Loans Receivable for additional information on the Agemo WC Loan. 

(3)  Reflects aggregate provisions of  $23.3 million recorded on the LaVie $25.0 million term loan and on the $8.3 million term loan 
during the fourth quarter of 2022. See Note 8 — Non-real Estate Loans Receivable for additional information on the LaVie term 
loans. 

(4)  Reflects an additional provision of  $5.2 million recorded on the $20 million WC loan during the year ended December 31, 2022 

as discussed in Note 8 — Non-real Estate Loans Receivable. 

(5) 

In the second quarter of  2022, we recorded an additional reserve of  $2.2 million related to the remaining commitment under the 
DIP facility as we were notified of  the operator’s intent to draw the funds in the third quarter of  2022. In the third quarter of 
2022,  the  remaining  commitment  under  the  facility  was  drawn  and  the  facility  expired  and  as  a  result  we  wrote-off  the  loan 
balance and related reserves as we do not expect to collect amounts under the facility following the expiration. 

F-45 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Rating 

Financial Statement 
Line Item 

Allowance for 
Credit Loss at 
December 31, 
2020 

for Credit Loss 
for the year ended 
December 31, 
2021 

Provision (recovery)  Write-offs charged 
against allowance 
for the year ended  Credit Loss as of 

Allowance for 

December 30, 
2021 

December 31, 
2021 

2 . . .  Real estate loans receivable 

$ 

86 

$ 

(72) 

$ — 

$ 

14 

(in thousands) 

3 . . .  Real estate loans receivable 

4 . . .  Real estate loans receivable 

5 . . .  Real estate loans receivable 

6 . . .  Real estate loans receivable 

Sub-total 

3 . . .  Investment in direct financing leases 

Sub-total 

2 . . .  Non-real estate loans receivable 

3 . . .  Non-real estate loans receivable 

4 . . .  Non-real estate loans receivable 

5 . . .  Non-real estate loans receivable 

6 . . .  Non-real estate loans receivable 

Sub-total 

2 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet real estate loan commitments 

4 . . .  Off-balance sheet non-real estate loan commitments 

4 . . .  Off-balance sheet real estate loan commitments 

6 . . .  Off-balance sheet non-real estate loan commitments 

4,652 

28,206 

434 

4,905 

38,283 

694 

694 

94 

1,415 

23,056 

1,854 

— 

26,419 

116 

209 

2,096 

— 

24 

— 

715 

(7,629)(1) 

(298) 

51,575(1) 

44,291 

(164) 

(164) 

(65) 

(209) 

(23,000)(2) 

6,102(3) 

51,269(2)(4) 

34,097 

(109) 

(2) 

(1,845) 

216 

93 

143 

Sub-total 

Total 

2,445 

$67,841 

(1,504) 

$ 76,720 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(95) 

— 

(95) 

— 

— 

— 

— 

— 

— 

— 

5,367 

20,577 

136 

56,480 

82,574 

530 

530 

29 

1,206 

56 

7,861 

51,269 

60,421 

7 

207 

251 

216 

117 

143 

941 

$(95) 

$144,466 

(1)  Amount reflects the movement of  reserves associated with our mortgage loan with Guardian due to a reduction of  our internal 
risk  rating  on  the  loan  from a 4 to a 6  during  2021.  As  discussed  in  Note  7 — Real  Estate  Loans  Receivable,  we  elected  to 
evaluate the risk of  loss on the loan on an individual basis, which resulted in recording an additional $38.2 million reserve on the 
mortgage loan. This amount also reflects $4.5 million of  additional allowance recorded in the second quarter of  2021 to fully 
impair one real estate loan receivable with a rating of  4 that was subsequently reduced to a rating of  6 in the third quarter of 
2021. 

(2)  Amount reflects the movement of  $22.7 million of  reserves from non-real estate loans receivable with a rating of  4 to non-real 
estate loans receivable with a rating of  6 as a result of  a reduction of  our internal credit rating from a 4 to a 6 on the Agemo 
Term  Loan  during  the  third  quarter  of  2021.  Concurrent  with  reducing  the  risk  rating  on  the  Agemo  Term  Loan  to  a  6,  we 
recorded  an  additional  provision  of  $8.8  million  to  fully  reserve  the  remaining  carrying  value  of  the  Agemo  Term  Loan.  See 
Note 8 — Non-real Estate Loans Receivable for additional information on the conditions that drove the additional Agemo Term 
Loan provision and rating reduction. 

(3)  The provision includes an additional $7.9 million allowance recorded on the Agemo WC Loan during the third quarter of  2021. 
We  also  reduced  the  internal  rating  on  the  Agemo  WC  Loan  from a 4 to a 5  during  the  third  quarter  of  2021.  See 
Note 8 — Non-real Estate Loans Receivable for additional information on the conditions that drove the additional Agemo WC 
Loan provision and rating reduction. 

(4)  Amount  reflects  $20.0  million  of  additional  allowance  recorded  in  the  fourth  quarter  of  2021  to  fully  reserve  the  remaining 
carrying  value  of  the  DIP  Facility.  See  Note  8 — Non-real  Estate  Loans  Receivable  for  additional  information  on  the  DIP 
Facility. 

F-46 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Allowance 
for Credit 
Loss at 

Allowance 
for Credit 
Loss at 

Provision 
(recovery) 
for Credit 
Loss for the 
year ended 

Write-offs 
charged 
against 
allowance 
for the 
year ended 

Allowance 
for Credit 
Loss as of 

Rating 

Financial Statement 
Line Item 

December 31,  January 1,  December 31,  December 30,  December 31, 

2019 

2020 

2020 

2020 

2020 

(in thousands) 

2 . . .  Real estate loans receivable 

$  — 

$  — 

$ 

86 

$  — 

$ 

86 

3 . . .  Real estate loans receivable 

4 . . .  Real estate loans receivable 

5 . . .  Real estate loans receivable 

6 . . .  Real estate loans receivable 

Sub-total 

3 . . . 

Investment in direct financing leases 

Sub-total 

2 . . .  Non-real estate loans receivable 

3 . . .  Non-real estate loans receivable 

4 . . .  Non-real estate loans receivable 

5 . . .  Non-real estate loans receivable 

Sub-total 

2 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet non-real estate loan commitments 

3 . . .  Off-balance sheet real estate loan commitments 

4 . . .  Off-balance sheet real estate loan commitments 

Sub-total 

Total 

— 

— 

— 

4,905 

4,905 

217 

217 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

1,721 

21,419 

1,150 

364 

2,931 

6,787 

(716) 

(364) 

24,654 

8,724 

611 

611 

195 

614 

1,031 

1,580 

3,420 

— 

— 

— 

100 

100 

83 

83 

(101) 

801 

22,025 

274 

22,999 

116 

209 

2,096 

(76) 

2,345 

— 

— 

— 

— 

— 

(217) 

(217) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

4,652 

28,206 

434 

4,905 

38,283 

694 

694 

94 

1,415 

23,056 

1,854 

26,419 

116 

209 

2,096 

24 

2,445 

$5,122 

$28,785 

$34,151 

$(217) 

$67,841 

F-47 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Included  below  is  a  summary  of  the  amortized  cost  basis  of  our  financial  instruments  by  year  of 

origination and internal risk rating and a summary of our gross write-offs by year of origination: 

Rating 

Financial Statement 
Line Item 

2022 

2021 

2020 

2019 

2018 

2017 

(in thousands) 

Balance as of 
2016 &  Revolving  December 31, 
older 

Loans 

2022 

1  .  .  .  Real estate loans receivable 

$  20,000  $ 

—  $ 

—  $  —  $ 

—  $  —  $  63,811  $ 

2  .  .  .  Real estate loans receivable 

— 

— 

21,325 

— 

3  .  .  .  Real estate loans receivable 

35,600 

72,420 

— 

6,655 

— 

— 

— 

— 

— 

1,373 

250,500 

366,548 

4  .  .  .  Real estate loans receivable 

186 

27,736 

89,559 

5,099  127,571  11,280  322,005 

5  .  .  .  Real estate loans receivable 

6  .  .  .  Real estate loans receivable 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

88,971 

— 

— 

— 

583,436 

— 

88,971 

Sub-total 

55,786  100,156  110,884  11,754  127,571  11,280  476,160 

250,500 

1,144,091 

— 

— 

$ 

83,811 

21,325 

5  .  .  .  Investment in direct financing leases 

Sub-total 

2  .  .  .  Non-real estate loans receivable 

3  .  .  .  Non-real estate loans receivable 

4  .  .  .  Non-real estate loans receivable 

5  .  .  .  Non-real estate loans receivable 

— 

— 

33,000 

63,704 

2,299 

— 

— 

— 

— 

— 

— 

— 

6  .  .  .  Non-real estate loans receivable 

24,640 

7,899 

123,643 

7,899 

Sub-total 

Total 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

5,131 

10,800 

4,260 

— 

— 

— 

24,548 

4,425 

9,391 

39,773 

— 

— 

— 

— 

— 

— 

— 

— 

11,319 

11,319 

— 

— 

— 

— 

56,299 

9,550 

1,000 

25,000 

— 

— 

31,243 

5,351 

11,319 

11,319 

89,299 

89,185 

32,559 

24,548 

73,558 

32,243 

96,200 

309,149 

$179,429  $108,055  $110,884  $21,145  $167,344  $11,280  $519,722  $346,700 

$1,464,559 

Year to date gross write-offs 

$ 

—  $ (20,302)  $ 

—  $  —  $  (4,463)  $  —  $ 

—  $ 

— 

$ 

(24,765) 

Interest Receivable on Real Estate Loans and Non-real Estate Loans 

We  have  elected  the  practical  expedient  to  exclude  interest  receivable  from  our  allowance  for  credit 
losses. As of  December 31, 2022 and 2021, we have excluded $8.2 million and $11.1 million, respectively, of 
contractual  interest  receivables  and  $5.7  million  and  $9.6  million,  respectively,  of  effective  yield  interest 
receivables from our allowance for credit losses. We write-off  interest receivable to provision for credit losses 
in  the  period  we  determine  the  interest  is  no  longer  considered  collectible.  For  the  years  ended 
December  31,  2021  and  2020,  we  wrote-off  interest  receivables  of  $1.0  million  (related  to  the  Guardian 
mortgage loan, see Note 7 — Real Estate Loans Receivable) and $3.8 million (related to the Agemo Term 
Loan,  see  Note  8 — Non-real  Estate  Loans  Receivable)  through  the  provision  for  credit  losses.  This 
write-off is not reflected in the roll forward of the allowance for credit losses above. 

During the years ended December 31, 2022, 2021 and 2020, we recognized $17.2 million, $25.9 million 
and $22.7 million, respectively, of  interest income related to loans on non-accrual status as of  December 31, 
2022. 

NOTE 10 — VARIABLE INTEREST ENTITIES 

We hold variable interests in several VIEs through our investing and financing activities, which are not 
consolidated, as we have concluded that we are not the primary beneficiary of  these entities as we do not 
have  the  power  to  direct  activities  that  most  significantly  impact  the  VIE’s  economic  performance  and/or 
the  variable  interest  we  hold  does  not  obligate  us  to  absorb  losses  or  provide  us  with  the  right  to  receive 
benefits from the VIE which could potentially be significant. 

F-48 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Below is a summary of  our assets, liabilities, collateral, and maximum exposure to loss associated with 

these unconsolidated VIEs as of December 31, 2022 and 2021: 

December 31, 
2022 

December 31, 
2021 

(in thousands) 

Assets 

Real estate assets – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  982,721  $ 1,144,851 
191,016 
Assets held for sale  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
201,613 
Real estate loans receivable – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
29,155 
Non-real estate loans receivable – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
1,227 
Contractual receivables – net  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
22,795 
Other receivables and lease inducements 
. . . . . . . . . . . . . . . . . . . . . . . . . 
Other assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
— 
Total assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
1,590,657 
Liabilities 

— 
270,500 
5,929 
114 
— 
1,499 
1,260,763 

Net in-place lease liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Security deposit  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Contingent liability  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Collateral 

(280) 
(4,828) 
(43,915) 
(1,499) 
(50,522) 

(305) 
(4,715) 
(43,915) 
— 
(48,935) 

— 
Letters of credit  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(48,000) 
Personal guarantee  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Other collateral(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(1,335,867) 
Total collateral  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(1,383,867) 
Maximum exposure to loss  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  179,520  $  157,855 

— 
(48,000) 
(982,721) 
(1,030,721) 

(1)  Amount excludes accounts receivable amounts that Omega has a security interest in as collateral under the two working capital 
loans with operators that are unconsolidated VIEs. The fair value of  the accounts receivable available to Omega was $5.9 million 
and $29.2 million as of December 31, 2022 and December 31, 2021, respectively. 

In determining our maximum exposure to loss from these VIEs, we considered the underlying carrying 
value  of  the  real  estate  subject  to  leases  with  these  operators  and  other  collateral,  if  any,  supporting  our 
other  investments,  which  may  include  accounts  receivable,  security  deposits,  letters  of  credit  or  personal 
guarantees, if any, as well as other liabilities recognized with respect to these operators. 

The table below reflects our total revenues from the operators that are considered VIEs for the years 

ended December 31, 2022, 2021 and 2020: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Revenue 

Rental income(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $53,158  $120,381  $30,055 
11,864 
Interest income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $69,614  $135,717  $41,919 

15,336 

16,456 

(1)  The rental income for the year ended December 31, 2022, reflects the write-off  of  approximately $29.3 million of  straight-line 
rent receivables and lease inducements related to Maplewood (see Note 5 — Contractual Receivables and Other Receivables and 
Lease  Inducements).  The  rental  income  for  the  year  ended  December  31,  2020,  reflects  the  write-off  of  approximately 
$75.3  million  of  contractual  rent  receivables,  straight-line  rent  receivables  and  lease  inducements  related  to  Agemo  (see 
Note 5 — Contractual Receivables and Other Receivables and Lease Inducements). 

F-49 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Consolidated VIEs 

During  the  first  quarter  of  2022,  we  entered  into  a  joint  venture,  which  owns  two  ALFs,  for  a 
$3.2 million cash contribution, representing 52.4% of  the outstanding equity of  the joint venture. We also 
sold an ALF to the joint venture for $7.7 million in net proceeds during the first quarter of  2022. The joint 
venture  is  a  VIE,  and  we  have  concluded  that  we  are  the  primary  beneficiary  of  this  VIE  based  on  a 
combination of our ability to direct the activities that most significantly impact the joint venture’s economic 
performance  and  our  rights  to  receive  residual  returns  or  the  obligation  to  absorb  losses  arising  from  the 
joint  venture.  Accordingly,  this  joint  venture  has  been  consolidated.  Omega  is  not  required  to  make  any 
additional  capital  contributions  to  the  joint  venture.  As  of  December  31,  2022,  this  joint  venture  has 
$25.8  million  of  total  assets  and  $19.8  million  of  total  liabilities,  which  are  included  in  our  Consolidated 
Balance  Sheets.  As  a  result  of  consolidating  the  joint  venture,  in  the  first  quarter  of  2022,  we  recorded  a 
$2.9 million noncontrolling interest to reflect the contributions of  the minority interest holder of  the joint 
venture. No gain or loss was recognized on the initial consolidation of  the VIE or upon the sale of  the ALF 
to the joint venture. 

In  addition,  as  discussed  in  Note  3 — Real  Estate  Asset  Acquisitions  and  Development,  we 
consolidated the EATs that are classified as VIEs. See further discussion of  EATs that are consolidated in 
Note 3 — Real Estate Asset Acquisitions and Development. 

F-50 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

NOTE 11 — INVESTMENTS IN JOINT VENTURES 

Unconsolidated Joint Ventures 

Omega  owns  an  interest  in  a  number  of  joint  ventures  which  generally  invest  in  the  long-term 
healthcare  industry.  The  following  is  a  summary  of  our  investments  in  unconsolidated  joint  ventures 
(dollars in thousands): 

Entity 

% 

Date 

Investment(1) 

Ownership Initial Investment 

Carrying Amount 

Facility 
Type 

Facilities at 
12/31/2022 

December 31,  December 31, 

2022 

2021 

Second Spring Healthcare 

Investments(2)  . . . . . . . . 
. . 

Second Spring II LLC(3) 

15% 
15% 

11/1/2016 
3/10/2021 

Lakeway Realty, L.L.C.(4) . . 
Cindat Joint Venture(5) 
. . . 
OMG Senior Housing, 

LLC . . . . . . . . . . . . . . . 
OH CHS SNP, Inc.  . . . . . . 

51% 
49% 

5/17/2019 
12/18/2019 

50% 
9% 

12/6/2019 
12/20/2019 

$  50,032 
10,330 

SNF 
SNF 
Specialty 
facility 
73,834 
105,688  ALF 

— 
— 

1 
63 

Specialty 
facility 

— 

1,013  N/A 

1 
N/A 

$240,897 

$  10,975 
— 

$  11,355 
8 

70,151 
97,382 

71,286 
111,792 

— 
412 
$178,920 

— 
246 
$194,687 

(1)  Our investment includes our transaction costs, if any. 

(2)  The  Company  made  a  loan  of  $17.6  million  in  April  2020  to  the  venture  which  is  included  in  other  investments.  See 
Note 8 — Non-real Estate Loans Receivable. During the first quarter of  2021, this joint venture sold 16 SNFs to an unrelated 
third  party  for  approximately  $328  million  in  net  proceeds  and  recognized  a  gain  on  sale  of  approximately  $102.2  million 
($14.9 million of  which represents the Company’s share of  the gain). During the first quarter of  2021, this joint venture also sold 
five  SNFs  to  Second  Spring  II  LLC  for  approximately  $70.8  million  in  net  proceeds.  During  2020,  this  joint  venture  sold  16 
SNFs  subject  to  an  operating  lease  for  approximately  $259.1  million  in  net  cash  proceeds  and  recognized  a  gain  on  sale  of 
approximately $40.4 million ($5.9 million of which represents the Company’s share of the gain). 

(3)  We acquired a 15% interest in Second Spring II LLC for approximately $10.3 million. During the first quarter of  2021, this joint 
venture acquired five SNFs from Second Spring Healthcare Investments for approximately $70.8 million. During the second and 
third quarters of 2021, this joint venture sold five SNFs to an unrelated third party for approximately $65 million in net proceeds 
and recognized a loss on sale of approximately $0.4 million ($0.1 million of which represents the Company’s share of the loss). 

(4)  We acquired an interest in a joint venture that owns the Lakeway Regional Medical Center (the “Lakeway Hospital”) in Lakeway, 
Texas.  Our  initial  basis  difference  of  approximately  $69.9  million  is  being  amortized  on  a  straight-line  basis  over  40  years  to 
income  (loss)  from  unconsolidated  joint  ventures  in  the  Consolidated  Statements  of  Operations.  The  lessee  of  the  Lakeway 
Hospital has an option to purchase the facility from the joint venture. The lessee also has a right of  first refusal and a right of 
first offer in the event the joint venture intends to sell or otherwise transfer Lakeway Hospital. 

(5)  We acquired a 49% interest in Cindat Ice Portfolio JV, GP Limited, Cindat Ice Portfolio Holdings, LP and Cindat Ice Portfolio 
Lender, LP. Cindat Ice Portfolio Holdings, LP owns 63 care homes leased to two operators in the U.K. pursuant to operating 
leases. Cindat Ice Portfolio Lender, LP holds loans to a third-party operator. Our investment in Cindat Joint Venture consists 
primarily of  real estate. Our initial basis difference of  approximately $35 million is being amortized on a straight-line basis over 
approximately 40 years to income (loss) from unconsolidated joint ventures in the Consolidated Statements of Operations. 

F-51 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The following table reflects our income (loss) from unconsolidated joint ventures for the years 

ended December 31, 2022, 2021 and 2020: 

Entity 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Second Spring Healthcare Investments(1)  . . . . . . . . . . . . . . . . . . . . . . . . . .  $1,170  $12,323  $2,807 
— 
Second Spring II LLC  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2,483 
Lakeway Realty, L.L.C.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
1,812 
Cindat Joint Venture  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(497) 
OMG Senior Housing, LLC  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
OH CHS SNP, Inc.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(462) 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $7,261  $16,062  $6,143 

(2) 
2,637 
3,910 
(508) 
54 

(757) 
2,562 
2,478 
(417) 
(127) 

(1)  The income from this unconsolidated joint venture for the year ended December 31, 2021 includes a $14.9 million gain on sale of 

real estate investments. 

Asset Management Fees 

We receive asset management fees from certain joint ventures for services provided. For the years ended 
December  31,  2022,  2021  and  2020,  we  recognized  approximately  $0.7  million,  $0.8  million  and 
$1.2 million, respectively, of  asset management fees. These fees are included in miscellaneous income in the 
accompanying Consolidated Statements of Operations. 

Other Equity Investments 

In the third quarter of  2021, we made an investment of  $20.0 million in SafelyYou, Inc. (“SafelyYou”), 
a technology company that has developed artificial intelligence-enabled video that detects and helps prevent 
resident falls in ALFs and SNFs. Through our investment, we obtained preferred shares representing 5% of 
the  outstanding  equity  of  SafelyYou  and  warrants  to  purchase  SafelyYou  common  stock  representing  an 
additional  5%  of  outstanding  equity  as  of  the  date  of  our  investment.  SafelyYou  has  committed,  for  a 
specified period, to using the proceeds of  our investment to install its technology in our facilities or other 
facilities of  our operators. The vesting of  the warrants is contingent upon SafelyYou’s attainment of  certain 
installation targets in our facilities. To the extent these installation targets are not attained, the investment 
funds associated with the unvested warrants would be returned to Omega. The investment in the preferred 
shares  and  warrants  are  recorded  within  other  assets  on  the  Consolidated  Balance  Sheets.  As  of 
December  31,  2022,  10%  of  the  SafelyYou  warrants  have  vested  as  a  result  of  certain  installation  targets 
being met. 

NOTE 12 — GOODWILL AND OTHER INTANGIBLES 

The following is a summary of our goodwill: 

Balance as of December 31, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Foreign currency translation  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Sale of subsidiary(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Balance as of December 31, 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(in thousands) 

$651,417 
(1,571) 
(6,695) 
$643,151 

(1) 

In the fourth quarter of  2022, we sold a senior living focused technology company acquired by Omega in 2020, for a 6% equity 
investment in the acquiring entity that offers a suite of  technology services to senior living facilities. In connection with the sale, 
we  recognized  a  $1.2  million  gain  in  other  expense  (income) — net.  We  included  $6.7  million  of  goodwill  in  the  net  assets 
disposed  in  connection  with  the  transaction.  Our  investment  in  the  acquiring  entity  is  included  within  other  assets  in  the 
consolidated balance sheet as December 31, 2022. 

F-52 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The following is a summary of our lease intangibles as of December 31, 2022 and 2021: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Assets: 

Above market leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Accumulated amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net above market leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$  5,929 
(4,484) 
$  1,445 

$  5,929 
(4,313) 
$  1,616 

Liabilities: 

Below market leases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Accumulated amortization  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net below market leases  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$ 66,433 
(44,595) 
$ 21,838 

$ 66,324 
(38,091) 
$ 28,233 

Above  market  leases,  net  of  accumulated  amortization,  are  included  in  other  assets  on  our 
Consolidated  Balance  Sheets.  Below  market  leases,  net  of  accumulated  amortization,  are  included  in 
accrued expenses and other liabilities on our Consolidated Balance Sheets. The net amortization related to 
the  above  and  below  market  leases  is  included  in  our  Consolidated  Statements  of  Operations  as  an 
adjustment to rental income. 

For the years ended December 31, 2022, 2021 and 2020, our net amortization related to intangibles was 
$5.7  million,  $9.5  million  and  $14.2  million,  respectively.  The  estimated  net  amortization  related  to  these 
intangibles  for  the  subsequent  five  years  is  as  follows:  2023 — $3.4  million;  2024 — $3.2  million; 
2025 — $3.2  million;  2026 — $2.7  million;  2027 — $2.4  million  and  $5.5  million  thereafter.  As  of 
December  31,  2022,  the  weighted  average  remaining  amortization  period  of  above  market  lease  assets  is 
approximately ten years and of below market lease liabilities is approximately seven years. 

NOTE 13 — CONCENTRATION OF RISK 

As of  December 31, 2022, our portfolio of  real estate investments (including properties associated with 
mortgages,  direct  financing  leases,  assets  held  for  sale  and  consolidated  joint  ventures)  consisted  of  926 
healthcare  facilities,  located  in  42  states  and  the  U.K.  and  operated  by  67  third-party  operators.  Our 
investment  in  these  facilities,  net  of  impairments  and  allowances,  totaled  approximately  $9.5  billion  at 
December 31, 2022, with approximately 97% of  our real estate investments related to long-term healthcare 
facilities.  Our  portfolio  is  made  up  of  (i)  665  SNFs,  169  ALFs,  20  ILFs,  16  specialty  facilities  and  two 
MOBs, (ii) fixed rate mortgages on 48 SNFs, two ALFs and two specialty facilities, and (iii) two facilities 
that  are  held  for  sale.  At  December  31,  2022,  we  also  held  other  real  estate  loans  (excluding  mortgages) 
receivable of  $394.6 million and non-real estate loans receivable of  $225.3 million, consisting primarily of 
secured  loans  to  third-party  operators  of  our  facilities,  and  $178.9  million  of  investments  in  six 
unconsolidated joint ventures. 

At  December  31,  2022,  we  had  investments  with  one  operator/or  manager  that  approximated  or 
exceeded 10% of  our total investments: Maplewood. At December 31, 2021, we had investments with two 
operators/or  managers  that  approximated  or  exceeded  10%  of  our  total  investments:  Maplewood  and 
LaVie.  Maplewood  generated  approximately  8.9%,  7.9%  and  5.3%  of  our  total  revenues  (excluding  the 
impact of  write-offs) for the years ended December 31, 2022, 2021 and 2020, respectively. LaVie generated 
approximately 11.1%, 9.5% and 9.4% of  our total revenues (excluding the impact of  write-offs) for the years 
ended December 31, 2022, 2021 and 2020, respectively. 

At December 31, 2022, the three states in which we had our highest concentration of  investments were 

Florida (11.5%), Texas (10.3%) and Indiana (6.6%). 

F-53 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

NOTE 14 — BORROWING ARRANGEMENTS 

The following is a summary of our long-term borrowings: 

Annual 
Interest Rate 
as of 

Maturity 

December 31,  December 31,  December 31, 
2022 

2022 

2021 

Secured borrowings: 

HUD mortgages(1)(2)  . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2046-2052 
2023 term loan(4)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2023 
2024 term loan(5)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2024 
Total secured borrowings  . . . . . . . . . . . . . . . . . . . . . . . . 

3.01%(3) 
8.00% 
9.63% 

$  344,708 
2,161 
19,727 
366,596 

$  359,806 
2,275 
— 
362,081 

(in thousands) 

Unsecured borrowings: 

Revolving credit facility(6)(7)  . . . . . . . . . . . . . . . . . . . . . . . . 

2025 

5.58% 

Senior notes and other unsecured borrowings: 

2023 notes(6)(8)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2024 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2025 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2026 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2027 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2028 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2029 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2031 notes(6)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2033 notes(6)(9)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
OP term loan(10)(11)  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Deferred financing costs – net  . . . . . . . . . . . . . . . . . . . . . 
Discount – net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
.  .  .  . 
Total unsecured borrowings – net  . . . . . . . . . . . . . . . . . . . 
Total secured and unsecured borrowings – net(12)(13)  . . . . . . . . . . . . 

Total senior notes and other unsecured borrowings – net 

2023 
2024 
2025 
2026 
2027 
2028 
2029 
2031 
2033 
2025 

4.375% 
4.950% 
4.500% 
5.250% 
4.500% 
4.750% 
3.625% 
3.375% 
3.250% 
5.83% 

19,246 
19,246 

— 
— 

350,000 
400,000 
400,000 
600,000 
700,000 
550,000 
500,000 
700,000 
700,000 
50,000 
(22,276) 
(26,732) 
4,900,992 
4,920,238 
$5,286,834 

350,000 
400,000 
400,000 
600,000 
700,000 
550,000 
500,000 
700,000 
700,000 
50,000 
(26,980) 
(31,565) 
4,891,455 
4,891,455 
$5,253,536 

(1)  Reflects  the  weighted  average  annual  contractual  interest  rate  on  the  mortgages  at  December  31,  2022.  Secured  by  real  estate 

assets with a net carrying value of $482.2 million as of December 31, 2022. 

(2)  Wholly owned subsidiaries of Omega OP are the obligor on these borrowings. 
(3)  Excludes fees of approximately 0.65% for mortgage insurance premiums. 
(4)  Borrowing is the debt of a consolidated joint venture. 
(5)  Borrowing is the debt of  the consolidated joint venture discussed in Note 10 — Variable Interest Entities which was formed in 

the first quarter of 2022. The borrowing is secured by two ALFs, which are owned by the joint venture. 

(8) 

(6)  Guaranteed by Omega OP. 
(7)  As  of  December  31,  2022,  borrowings  under  Omega’s  $1.45  billion  senior  unsecured  multicurrency  revolving  credit  facility 
consisted of  £16.0 million British Pounds Sterling (“GBP”). The applicable interest rate on the US Dollar tranche and on the 
GBP borrowings under the alternative currency tranche of  the credit facility were 5.58% and 4.75% as of  December 31, 2022, 
respectively. 
In  March  2021,  we  used  a  portion  of  the  proceeds  from  the  2033  Senior  Notes  offering  to  fund  the  tender  offer  to  redeem 
$350 million of  the 4.375% Senior Notes due 2023. In connection with this transaction, we recorded approximately $30.6 million 
in  related  fees,  premiums,  and  expenses  for  the  year  ended  December  31,  2021,  which  were  recorded  as  Loss  on  debt 
extinguishment in our Consolidated Statement of Operations. 
In  March  2021,  we  used  the  proceeds  from  this  offering  to  pay  down  outstanding  borrowings  on  the  2017  Revolving  Credit 
Facility, repay the Sterling term loan, and fund the tender offer to purchase $350 million of  the 4.375% Senior Notes due 2023 
and the payment of accrued interest and related fees, premiums and expenses. 

(9) 

(10)  Omega OP is the obligor on this borrowing. 
(11)  The interest rate swaps, that were cash flow hedges of  Omega OP’s $50.0 million senior unsecured term loan facility’s (the “OP 

term loan”) interest payments and that effectively fixed the interest rate at 3.29%, matured on February 10, 2022. 

(12)  All borrowings are direct borrowings of Parent unless otherwise noted. 
(13)  Certain of  our other secured and unsecured borrowings are subject to customary affirmative and negative covenants, including 
financial covenants. As of  December 31, 2022 and December 31, 2021, we were in compliance with all applicable covenants for 
our borrowings. 

F-54 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Secured Borrowings 

HUD Mortgage Debt 

On October 31, 2019, we assumed approximately $389 million in mortgage loans guaranteed by HUD. 
The HUD loans have maturity dates between 2046 and 2052 with fixed interest rates ranging from 2.82% 
per annum to 3.24% per annum. The HUD loans may be prepaid subject to an initial penalty of  10% of  the 
remaining principal balances in the first year and the prepayment penalty decreases each subsequent year by 
1% until no penalty is required. 

On August 26, 2020, we paid approximately $13.7 million to retire two mortgage loans guaranteed by 
HUD that were assumed in 2019 and had an average interest rate of  3.08% per annum with maturities in 
2051  and  2052.  The  payoff  included  a  $0.9  million  prepayment  fee  which  is  included  in  loss  on  debt 
extinguishment on our Consolidated Statements of Operations. 

On  August  31,  2022,  we  paid  approximately  $7.9  million  to  retire  one  mortgage  loan  guaranteed  by 
HUD that was assumed in 2019 and had a fixed interest rate of  2.92% per annum with a maturity date in 
2051. The payoff  included a $0.4 million prepayment fee which is included in loss on debt extinguishment 
on our Consolidated Statements of Operations. 

All  HUD  loans  are  subject  to  the  regulatory  agreements  that  require  escrow  reserve  funds  to  be 
deposited with the loan servicer for mortgage insurance premiums, property taxes, debt service and capital 
replacement  expenditures.  As  of  December  31,  2022,  the  Company  has  total  escrow  reserves  of 
$27.7 million with the loan servicer that is reported within other assets on the Consolidated Balance Sheets. 

Unsecured Borrowings 

Revolving Credit Facility 

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

The Revolving Credit Facility bears interest at LIBOR (or in the case of  loans denominated in GBP, 
the  Sterling  overnight  index  average  reference  rate  plus  an  adjustment  of  0.1193%  per annum,  and in  the 
loans  denominated  in  Euros,  the  Euro  interbank  offered  rate,  or  EURIBOR)  plus  an 
case  of 
applicable percentage (with a range of  95 to 185 basis points) based on our credit ratings. The Revolving 
Credit Facility matures on April 30, 2025, subject to Omega’s option to extend such maturity date for two 
six-month  periods.  The  Revolving  Credit  Facility  may  be  drawn  in  Euros,  GBP,  Canadian  Dollars 
(collectively,  “Alternative  Currencies”)  or  USD,  with  a  $1.15  billion  tranche  available  in  USD  and  a 
$300  million  tranche  available  in  Alternative  Currencies.  For  purposes  of  the  Revolving  Credit  Facility, 
references  to  LIBOR  include  the  Canadian  dealer  offered  rates  for  amounts  offered  in  Canadian  Dollars 
and any other Alternative Currency rate approved in accordance with the terms of  the 2021 Omega Credit 
Agreement  for  amounts  offered  in  any  other  non-LIBOR  quoted  currency,  as  applicable.  The  Revolving 
Credit Facility includes customary LIBOR replacement language, including, but not limited to, the use of 
rates  for  U.S.  dollar-denominated  borrowings  based  on  the  secured  overnight  financing  rate  (“SOFR”) 
recommended  by  the  Alternative  Reference  Rates  Committee,  a  steering  committee  comprised  of  U.S. 
financial market participants, as a replacement rate for LIBOR. SOFR is a broad measure of  the cost of 
borrowing  cash  in  the  overnight  U.S.  Treasury  repo  market,  and  is  administered  by  the  Federal  Reserve 
Bank of New York. 

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

F-55 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

OP Term Loan 

On  April  30,  2021,  Omega  OP  entered  into  a  credit  agreement  (the  “2021  Omega  OP  Credit 
Agreement”) providing it with a new $50 million senior unsecured term loan facility (the “OP Term Loan”). 
The  OP  Term  Loan  replaces  the  $50  million  senior  unsecured  term  loan  obtained  in  2017  (the  “2017  OP 
Term  Loan”)  and  the  related  credit  agreement.  The  OP  Term  Loan  bears  interest  at  LIBOR  plus  an 
applicable  percentage  (with  a  range  of  85  to  185  basis  points)  based  on  our  credit  ratings.  The  OP  Term 
Loan  includes  customary  LIBOR  replacement  language,  including,  but  not  limited  to,  the  use  of  rates 
based on SOFR. The OP Term Loan matures on April 30, 2025, subject to Omega OP’s option to extend 
such maturity date for two, six-month periods. 

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

2017 Omega Credit Facilities 

On May 25, 2017, Omega entered into a credit agreement (the “2017 Omega Credit Agreement”) for a 
new $1.8 billion senior unsecured revolving and term loan credit facility, consisting of  a $1.25 billion senior 
unsecured  multicurrency  revolving  credit  facility  (the  “2017  Revolving  Credit  Facility”),  a  $425  million 
senior  unsecured  U.S.  Dollar  term  loan  facility  (the  “U.S.  Term  Loan”),  and  a  £100  million  senior 
unsecured British Pound Sterling term loan facility (the “Sterling Term Loan” and, together with the 2017 
Revolving Credit Facility and the U.S. Term Loan Facility, collectively, the “2017 Omega Credit Facilities”). 
The 2017 Revolving Credit Facility bore interest at LIBOR plus an applicable percentage (with a range of 
100 to 195 basis points) based on our ratings from Standard & Poor’s, Moody’s and/or Fitch Ratings. The 
U.S.  Term  Loan  Facility  and  the  Sterling  Term  Loan  Facility  bore  interest  at  LIBOR  plus  an 
applicable percentage (with a range of  90 to 190 basis points) based on our ratings from Standard & Poor’s, 
Moody’s and/or Fitch Ratings. 

In  2020,  we  repaid  the  outstanding  balance  on  our  U.S.  Term  Loan  and  wrote-off  $0.8  million  of 
unamortized deferred costs to loss on debt extinguishment on our Consolidated Statements of  Operations. 
In 2021, we repaid the outstanding balance on our 2017 Revolving Credit Facility and Sterling Term Loan 
using  a  portion  of  the  proceeds  from  the  2033  Senior  Notes  offering  and  wrote-off  $0.2  million  of 
unamortized  deferred  costs  relating  to  the  Sterling  Term  Loan  to  loss  on  debt  extinguishment  on  our 
Consolidated Statements of  Operations. In April 2021, the 2017 Revolving Credit Facility was replaced by 
the Revolving Credit Facility. 

2017 OP Term Loan 

On  May  25,  2017,  Omega  OP  entered  into  a  credit  agreement  (the  “2017  Omega  OP  Credit 
Agreement”) providing it with a new $100 million senior unsecured term loan facility (the “2017 OP Term 
Loan”). The 2017 OP Term Loan bore interest at LIBOR plus an applicable percentage (with a range of  90 
to  190  basis  points)  based  on  our  ratings  from  Standard  &  Poor’s,  Moody’s  and/or  Fitch  Ratings.  In 
April 2021, the 2017 OP Term loan was replaced by the OP Term Loan. 

Amended 2015 Term Loan Facility 

On May 25, 2017, Omega entered into an amended and restated credit agreement (the “Amended 2015 
Credit  Agreement”),  which  amended  and  restated  our  previous  $250  million  senior  unsecured  term  loan 
facility (the “Amended 2015 Term Loan Facility”). The Amended 2015 Term Loan Facility bore interest at 
LIBOR plus an applicable percentage (with a range of  140 to 235 basis points) based on our ratings from 
Standard  &  Poor’s,  Moody’s  and/or  Fitch  Ratings.  We  repaid  the  Amended  2015  Term  Loan  Facility  in 
October  2020  with  proceeds  from  the  senior  notes  issuance  and  wrote-off  $0.7  million  of  unamortized 
deferred costs to loss on debt extinguishment on our Consolidated Statements of Operations. 

Subordinated Debt 

In  connection  with  a  2010  acquisition,  we  assumed  five  separate  $4.0  million  subordinated  notes 
bearing  interest  at  9%  per  annum  that  mature  on  December  21,  2021.  Interest  on  these  notes  is  due 

F-56 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

quarterly with the principal balance due at maturity. As discussed in Note 5 — Contractual Receivables and 
Other  Receivables  and  Lease  Inducements,  to  the  extent  that  the  operator  of  the  facilities  (Gulf  Coast) 
failed to pay rent when due to us under our existing master lease, we had the right to offset the amounts 
owed to us against the amounts we owe to the lender under the notes. As of  December 31, 2021, we offset 
$1.3  million  of  accrued  interest  and  $20.0  million  of  principal  under  the  Subordinated  Debt  against  the 
uncollected receivables of  Gulf  Coast. Following the application of  these offsets, Omega believes it has no 
further  obligations  under  the  Subordinated  Debt.  See  Note  20 — Commitments  and  Contingencies  for 
additional discussion regarding an ongoing lawsuit related to the Subordinated Debt. 

General 

Parent and Omega OP, on a combined basis, have no material assets, liabilities or operations other than 
financing  activities  (including  borrowings  under  the  senior  unsecured  revolving  and  term  loan  credit 
facility,  OP  term  loan  and  the  outstanding  senior  notes)  and  their  investments  in  non-guarantor 
subsidiaries. Substantially all of our assets are held by non-guarantor subsidiaries. 

The required principal payments, excluding the premium or discount and deferred financing costs on 
our  secured  and  unsecured  borrowings,  for  each  of  the  five  years  following  December  31,  2022  and  the 
aggregate due thereafter are set forth below: 

2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  359,898 
427,723 
2024 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
477,462 
2025 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
608,466 
2026 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
2027 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
708,725 
Thereafter 
2,753,591 
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $5,335,865 

(in thousands) 

NOTE 15 — DERIVATIVES AND HEDGING 

Cash Flow Hedges of Interest Rate Risk 

We enter into interest rate swaps in order to maintain a capital structure containing targeted amounts 
of  fixed  and  floating-rate  debt  and  manage  interest  rate  risk.  Interest  rate  swaps  designated  as  cash  flow 
hedges involve the receipt of variable amounts from a counterparty in exchange for our fixed-rate payments. 
These interest rate swap agreements are used to hedge the variable cash flows associated with variable-rate 
debt. 

As  a  result  of  exposure  to  interest  rate  movements  associated  with  the  Amended  2015  Term  Loan 
Facility, on December 16, 2015, we entered into various forward-starting interest rate swap arrangements, 
which  effectively  converted  $250  million  of  our  variable-rate  debt  based  on  one-month  LIBOR  to  an 
aggregate fixed rate of  approximately 3.80% effective December 30, 2016. The effective fixed rate achieved 
by the combination of  the Amended 2015 Term Loan Facility and the interest rate swaps could fluctuate up 
by 55 basis points or down by 40 basis points based on future changes to our credit ratings. Each of  these 
swaps  had  a  scheduled  maturity  date  of  December  15,  2022.  In  October  2020,  we  terminated  these 
$250.0 million of  notional value interest rate swaps in connection with the repayment of  the Amended 2015 
Term  Loan  Facility  and  paid  our  swap  counterparties  $10.3  million  which  is  recorded  in  loss  on  debt 
extinguishment on our Consolidated Statements of Operations. 

On March 27, 2020, we entered into five forward starting swaps totaling $400 million that are indexed 
to  3-month  LIBOR.  We  designated  the  forward  starting  swaps  as  cash  flow  hedges  of  interest  rate  risk 
associated with interest payments on a forecasted issuance of  fixed rate long-term debt, initially expected to 

F-57 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

occur within the next five years. The swaps are effective on August 1, 2023 and expire on August 1, 2033 
and were issued at a weighted average fixed rate of  approximately 0.8675%. In March 2021, in conjunction 
with  the  issuance  of  $700  million  aggregate  principal  amount  of  our  3.25%  Senior  Notes  due  2033,  we 
discontinued hedge accounting for these five forward starting swaps. Simultaneously, we re-designated these 
swaps  in  new  cash  flow  hedging  relationships  of  interest  rate  risk  associated  with  interest  payments  on 
another forecasted issuance of long-term debt. We are hedging our exposure to the variability in future cash 
flows for forecasted transactions over a maximum period of  46 months (excluding forecasted transactions 
related to the payment of variable interest on existing financial instruments). 

In addition to the forward swaps discussed above, we also assumed various interest rate swap contracts 
in  connection  with  the  MedEquities  Merger  on  May  17,  2019.  We  designated  the  interest  rate  swap 
contracts as cash flow hedges of  interest rate risk associated with the 2017 Omega OP Credit Agreement. 
The assumed interest rate swap contracts effectively converted $75 million of  our 2017 Omega OP Credit 
Agreement  to  an  aggregate  fixed  rate  of  approximately  3.29%  through  February  10,  2022.  The  effective 
fixed rate achieved by the combination of the 2017 Omega OP Credit Agreement and the interest rate swaps 
could  fluctuate  up  by  55  basis  points  or  down  by  45  basis  points  based  on  future  changes  to  our  credit 
ratings.  In  October  2020,  we  terminated  $25.0  million  of  notional  value  interest  rate  swaps  in  connection 
with the partial repayment and paid our swap counterparty $0.6 million which is recorded in loss on debt 
extinguishment on our Consolidated Statements of  Operations. On February 10, 2022, the two remaining 
interest  rate  swaps  with  aggregate  notional  amounts  of  $50.0  million  matured.  These  interest  rate  swap 
contracts  were  designated  as  hedges  against  our  exposure  to  changes  in  interest  payment  cash  flow 
fluctuations  in  the  variable  interest  rates  on  the  OP  Term  Loan.  The  OP  Term  Loan  is  unhedged  for  the 
period after February 10, 2022 through its maturity on April 30, 2025. 

Foreign Currency Forward Contracts and Debt Designated as Net Investment Hedges 

We use debt denominated in GBP and foreign currency forward contracts to hedge a portion of  our 
net investments, including certain intercompany loans, in the U.K. against fluctuations in foreign exchange 
rates. 

GBP  denominated  borrowings  under  the  Sterling  term  loan  and  the  2017  Revolving  Credit  Facility 
were previously used to hedge a portion of  our investments in the U.K. against fluctuations in GBP against 
the USD. The GBP denominated borrowings under both debt instruments were deemed an effective hedge 
from  issuance  in  May  2017  until  the  settlement  of  the  Sterling  term  loan  and  the  repayment  of  the  GBP 
denominated borrowings under the 2017 Revolving Credit Facility in March 2021. 

Concurrent with the settlement of  the GBP denominated debt, we entered into four foreign currency 
forwards with notional amounts totaling £174.0 million, that mature on March 8, 2024, to hedge a portion 
of  our  net  investments  in  the  U.K.,  including  an  intercompany  loan  and  an  investment  in  our  U.K.  joint 
venture, effectively replacing the terminated net investment hedge. 

On May 17, 2022, we entered into two new foreign currency forward contracts with notional amounts 
totaling  £76.0  million  and  a  GBP-USD  forward  rate  of  1.3071,  each  of  which  mature  on  May  21,  2029. 
These currency forward contracts hedge a portion of  our net investments in U.K. subsidiaries, including an 
intercompany loan. 

F-58 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The location and the fair value of  derivative instruments designated as hedges, at the respective balance 

sheet dates, were as follows: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

Cash flow hedges: 

Other assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Accrued expenses and other liabilities  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$92,990 
$  — 

$32,849 
96 
$ 

Net investment hedges: 

Other assets  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$34,977 

$  6,754 

The  fair  value  of  the  interest  rate  swaps  and  foreign  currency  forwards  is  derived  from  observable 
market data such as yield curves and foreign exchange rates and represents a Level 2 measurement on the 
fair value hierarchy. 

NOTE 16 — FINANCIAL INSTRUMENTS 

The  net  carrying  amount  of  cash  and  cash  equivalents,  restricted  cash,  contractual  receivables,  other 
assets and accrued expenses and other liabilities reported in the Consolidated Balance Sheets approximates 
fair value because of the short maturity of these instruments (Level 1). 

At  December  31,  2022  and  2021,  the  net  carrying  amounts  and  fair  values  of  other  financial 

instruments were as follows: 

December 31, 2022 
Fair 
Value 

Carrying 
Amount 

December 31, 2021 
Fair 
Value 

Carrying 
Amount 

(in thousands) 

Assets: 

Investments in direct financing leases – net . . . . . .  $ 
Real estate loans receivable – net  . . . . . . . . . . . . . 
Non-real estate loans receivable – net . . . . . . . . . . 

10,873 
1,220,888 
125,491 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $1,276,515  $1,317,891  $1,315,843  $1,357,252 

1,042,731 
225,281 

1,180,786 
124,184 

1,080,890 
228,498 

10,873  $ 

8,503  $ 

8,503  $ 

Liabilities: 

—  $ 

Revolving credit facility  . . . . . . . . . . . . . . . . . . .  $ 
2023 term loan  . . . . . . . . . . . . . . . . . . . . . . . . . 
2024 term loan  . . . . . . . . . . . . . . . . . . . . . . . . . 
OP term loan  . . . . . . . . . . . . . . . . . . . . . . . . . . 
4.375% notes due 2023 – net  . . . . . . . . . . . . . . . . 
4.95% notes due 2024 – net . . . . . . . . . . . . . . . . . 
4.50% notes due 2025 – net . . . . . . . . . . . . . . . . . 
5.25% notes due 2026 – net . . . . . . . . . . . . . . . . . 
4.50% notes due 2027 – net . . . . . . . . . . . . . . . . . 
4.75% notes due 2028 – net . . . . . . . . . . . . . . . . . 
3.625% notes due 2029 – net  . . . . . . . . . . . . . . . . 
3.375% notes due 2031 – net  . . . . . . . . . . . . . . . . 
3.25% notes due 2033 – net . . . . . . . . . . . . . . . . . 
HUD mortgages – net  . . . . . . . . . . . . . . . . . . . . 

— 
2,275 
— 
50,000 
365,243 
427,184 
427,440 
667,524 
766,003 
607,249 
519,430 
705,810 
683,151 
394,284 
Total  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $5,286,834  $4,702,055  $5,253,536  $5,615,593 

19,246  $ 
2,275 
19,750 
50,000 
347,998 
394,256 
388,920 
589,104 
657,468 
507,425 
411,090 
540,386 
507,976 
266,161 

19,246  $ 
2,161 
19,727 
49,762 
349,669 
398,736 
398,446 
597,848 
693,837 
544,916 
491,890 
685,382 
690,506 
344,708 

2,275 
— 
49,661 
349,100 
397,725 
397,685 
597,142 
692,374 
543,908 
490,681 
683,592 
689,587 
359,806 

Fair value estimates are subjective in nature and are dependent on a number of important assumptions, 
including estimates of  future cash flows, risks, discount rates and relevant comparable market information 

F-59 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

associated with each financial instrument (see Note 2 — Summary of  Significant Accounting Policies). The 
use  of  different  market  assumptions  and  estimation  methodologies  may  have  a  material  effect  on  the 
reported estimated fair value amounts. 

The  following  methods  and  assumptions  were  used  in  estimating  fair  value  disclosures  for  financial 

instruments. 

•  Real estate loans receivable: The fair value of  the real estate loans receivable are estimated using a 
discounted cash flow analysis, using interest rates being offered for similar loans to borrowers with 
similar credit ratings (Level 3). 

•  Non-real estate loans receivable: Non-real estate loans receivable are primarily comprised of  notes 
receivable. The fair values of  notes receivable are estimated using a discounted cash flow analysis, 
using  interest  rates  being  offered  for  similar  loans  to  borrowers  with  similar  credit  ratings 
(Level 3). 

•  Revolving credit facility, OP term loan, 2023 term loan and 2024 term loan: The carrying amount 
of  these  approximate  fair  value  because  the  borrowings  are  interest  rate  adjusted.  Differences 
between carrying value and the fair value in the table above are due to the inclusion of  deferred 
financing costs in the carrying value. 

• 

Senior  notes:  The  fair  value  of  the  senior  unsecured  notes  payable  was  estimated  based  on 
(Level 1) publicly available trading prices. 

•  HUD  mortgages:  The  fair  value  of  our  borrowings  under  HUD  debt  agreements  are  estimated 
using  an  expected  present  value  technique  based  on  quotes  obtained  by  HUD  debt  brokers 
(Level 2). 

NOTE 17 — TAXES 

Omega and Omega OP, including their wholly-owned subsidiaries were organized, have operated, and 
intend  to  continue  to  operate  in  a  manner  that  enables  Omega  to  qualify  for  taxation  as  a  REIT  under 
Sections 856 through 860 of  the Code. On a quarterly and annual basis we perform several analyses to test 
our  compliance  within  the  REIT  taxation  rules.  If  we  fail  to  meet  the  requirements  for  qualification  as  a 
REIT in any tax year, we will be subject to federal income tax on our taxable income at regular corporate 
rates and may not be able to qualify as a REIT for the four subsequent years, unless we qualify for certain 
relief provisions that are available in the event we fail to satisfy any of the requirements. 

We  are  also  subject  to  federal  taxation  of  100%  of  the  net  income  derived  from  the  sale  or  other 
disposition of  property, other than foreclosure property, that we held primarily for sale to customers in the 
ordinary course of  a trade or business. We believe that we do not hold assets for sale to customers in the 
ordinary course of  business and that none of  the assets currently held for sale or that have been sold would 
be considered a prohibited transaction within the REIT taxation rules. 

As  a  REIT  under  the  Code,  we  generally  will  not  be  subject  to  federal  income  taxes  on  the  REIT 
taxable income that we distribute to stockholders, subject to certain exceptions. In 2022, 2021 and 2020, we 
distributed dividends in excess of our taxable income. 

We  currently  own  stock  in  certain  subsidiary  REITs.  These  subsidiary  entities  are  required  to 
individually  satisfy  all  of  the  rules  for  qualification  as  a  REIT.  If  we  fail  to  meet  the  requirements  for 
qualification  as  a  REIT  for  any  of  the  subsidiary  REITs,  it  may  cause  the  Parent  REIT  to  fail  the 
requirements for qualification as a REIT also. 

We have elected to treat certain of  our active subsidiaries as TRSs. Our domestic TRSs are subject to 
federal,  state  and  local  income  taxes  at  the  applicable  corporate  rates.  Our  foreign  TRSs  are  subject  to 
foreign  income  taxes  and  may  be  subject  to  current-year  income  inclusion  relating  to  ownership  of  a 
controlled foreign corporation for U.S. income tax purposes. As of  December 31, 2022, one of  our TRSs 
that  is  subject  to  income  taxes  at  the  applicable  corporate  rates  had  a  net  operating  loss  (“NOL”) 

F-60 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

carry-forward  of  approximately  $10.2  million.  Our  NOL  carry-forward  was  fully  reserved  as  of 
December  31,  2022,  with  a  valuation  allowance  due  to  uncertainties  regarding  realization.  Under  current 
law,  NOL  carry-forwards  generated  up  through  December  31,  2017  may  be  carried  forward  for  no  more 
than 20 years, and NOL carry-forwards generated in taxable years ended after December 31, 2017, may be 
carried forward indefinitely. We do not anticipate that such changes will materially impact the computation 
of Omega’s taxable income, or the taxable income of any Omega entity, including our TRSs. 

As  discussed  in  Note  3 — Real  Estate  Asset  Acquisitions  and  Development,  in  connection  with  the 
acquisition  of  one  U.K.  entity  in  the  first  quarter  of  2022,  we  acquired  foreign  net  operating  losses  of 
$55.0 million resulting in a NOL deferred tax asset of  $13.4 million. The NOLs have no expiration date and 
may  be  available  to  offset  future  taxable  income.  We  believe  these  foreign  NOLs  are  realizable  under  a 
“more likely than not” measurement and have not recorded a valuation allowance against the deferred tax 
asset. 

The following is a summary of our provision for income taxes: 

Provision for federal, state and local income taxes(1)  . . . . . . . . . . . . . . . . . . . . . . . 
Provision for foreign income taxes(2)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total provision for income taxes(3)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Year Ended December 31, 

2022 

2021 

2020 

(in millions) 
$1.4 
2.4 
$3.8 

$1.2 
3.4 
$4.6 

$1.3 
3.6 
$4.9 

(1)  For  the  years  ended  December  31,  2022,  2021  and  2020,  income  before  income  tax  expense  and  income  from  unconsolidated 

joint ventures from domestic operations was $418.5 million, $403.9 million and $151.5 million, respectively. 

(2)  For  the  years  ended  December  31,  2022,  2021  and  2020,  income  before  income  tax  expense  and  income  from  unconsolidated 

joint ventures from foreign operations was $17.6 million, $12.2 million and $10.8 million, respectively. 

(3)  The above amounts do not include gross income receipts or franchise taxes payable to certain states and municipalities. 

The following is a summary of deferred tax assets and liabilities: 

December 31,  December 31, 

2022 

2021 

(in thousands) 

U.S. Federal net operating loss carryforward  . . . . . . . . . . . . . . . . . . . . . . . . . 
Valuation allowance on deferred tax asset . . . . . . . . . . . . . . . . . . . . . . . . . . 
Foreign net operating loss carryforward  . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Foreign deferred tax liability(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net deferred tax asset (liability)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$  2,138 
(2,138) 
11,268 
(5,373) 
$  5,895 

$ 2,221 
(2,221) 
— 
(8,200) 
$(8,200) 

(1)  The deferred tax liability primarily resulted from inherited basis differences resulting from our acquisition of  entities in the U.K. 
Subsequent adjustments to these accounts result from GAAP to tax differences related to depreciation, indexation and revenue 
recognition. 

NOTE 18 — STOCKHOLDERS’ EQUITY 

Stock Repurchase Program 

On March 20, 2020, Omega’s Board of  Directors authorized the repurchase of  up to $200 million of 
its outstanding common stock from time to time over the twelve months ending March 20, 2021. Omega 
did  not  repurchase  any  of  its  outstanding  common  stock  under  this  announced  program  during  2020  or 
2021. 

F-61 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

On  January  27,  2022,  the  Company  authorized  the  repurchase  of  up  to  $500  million  of  our 
outstanding  common  stock  from  time  to  time  through  March  2025.  The  Company  is  authorized  to 
repurchase shares of its common stock in open market and privately negotiated transactions or in any other 
manner as determined by the Company’s management and in accordance with applicable law. The timing 
and  amount  of  stock  repurchases  will  be  determined,  in  management’s  discretion,  based  on  a  variety  of 
factors, including but not limited to market conditions, other capital management needs and opportunities, 
and corporate and regulatory considerations. The Company has no obligation to repurchase any amount of 
its  common  stock,  and  such  repurchases,  if  any,  may  be  discontinued  at  any  time.  Under  Maryland  law, 
shares  repurchased  become  authorized  but  unissued  shares.  The  Company  reduced  the  common  stock  at 
par  value  and  to  the  extent  the  cost  acquired  exceeds  par  value,  it  is  recorded  through  additional  paid-in 
capital on our Consolidated Balance Sheets and Consolidated Statements of  Equity. During the year ended 
December 31, 2022, the Company repurchased 5.2 million shares of  our outstanding common stock at an 
average price of  $27.32 per share, for a total repurchase cost of  $142.3 million. The average price per share 
and repurchase cost includes the cost of commissions. 

At-The-Market Offering Program 

On September 3, 2015, we entered into separate Equity Distribution Agreements with several financial 
institutions  to  sell  $500  million  of  shares  of  our  common  stock  from  time  to  time  through  an 
“at-the-market” (“ATM”)  offering  program  (the  “2015  ATM  Program”).  Sales  of  the  shares,  if  any,  were 
made by means of  ordinary brokers’ transactions on the New York Stock Exchange at market prices, or as 
otherwise agreed with the applicable Manager. We paid each Manager compensation for sales of  the shares 
up  to  2%  of  the  gross  sales  price  per  share  for  shares  sold  through  such  Manager  under  the  applicable 
Equity Shelf Agreements. 

During  the  second  quarter  of  2021,  we  terminated  the  2015  ATM  Program  and  entered  into  a  new 
ATM  Equity  Offering  Sales  Agreement  pursuant  to  which  shares  of  common  stock  having  an  aggregate 
gross  sales  price  of  up  to  $1.0  billion  (the  “2021  ATM  Program”)  may  be  sold  from  time  to  time  (i)  by 
Omega through several financial institutions acting as a sales agent or directly to the financial institutions as 
principals,  or  (ii)  by  several  financial  institutions  acting  as  forward  sellers  on  behalf  of  any  forward 
purchasers pursuant to a forward sale agreement. Under the 2021 ATM Program, compensation for sales of 
the  shares  will  not  exceed  2%  of  the  gross  sales  price  per  share  for  shares  sold  through  each  financial 
institution.  The  use  of  forward  sales  under  the  2021  ATM  Program  generally  allows  Omega  to  lock  in  a 
price  on  the  sale  of  shares  of  common  stock  when  sold  by  the  forward  sellers  but  defer  receiving  the  net 
proceeds from such sales until the shares of  our common stock are issued at settlement on a later date. We 
did not utilize the forward provisions under the 2021 ATM Program during 2021 or 2022. The following is a 
summary  of  the  shares  issued  under  the  2021  and  2015  ATM  Programs  for  each  of  the  years  ended 
December 31, 2020, 2021, and 2022 (in millions except average price per share): 

Period Ended 

Shares issued 

Average Net Price 
Per Share(1) 

Gross Proceeds  Commissions  Net Proceeds 

December 31, 2020 . . . . . . . . . . . . 
December 31, 2021 . . . . . . . . . . . . 
December 31, 2022 . . . . . . . . . . . . 

4.2 
4.2 
— 

$36.16 
36.53 
— 

$155.1 
155.1 
— 

$2.5 
3.4 
— 

$152.6 
151.7 
— 

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

F-62 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Dividend Reinvestment and Common Stock Purchase Plan 

We have a Dividend Reinvestment and Common Stock Purchase Plan (the “DRSPP”) that allows for 
the  reinvestment  of  dividends  and  the  optional  purchase  of  our  common  stock.  On  March  23,  2020,  we 
temporarily suspended the DRSPP and on December 17, 2020, we reinstated the DRSPP. The table below 
presents  information  regarding  the  shares  issued  under  the  DRSPP  for  each  of  the  years  ended 
December 31, 2020, 2021, and 2022 (in millions): 

Period Ended 

Shares issued  Gross Proceeds 

December 31, 2020  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
December 31, 2021  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
December 31, 2022  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

0.1 
3.4 
0.3 

$  3.7 
126.7 
9.2 

Dividends 

The Board of Directors has declared common stock dividends as set forth below: 

Record Date 

Payment Date 

Dividend per 
Common Share 

February 7, 2022 . . . . . . . . . . . . . . . . .  February 15, 2022  . . . . . . . . . . . . . . . . . . . 
May 2, 2022  . . . . . . . . . . . . . . . . . . . .  May 13, 2022. . . . . . . . . . . . . . . . . . . . . . . 
August 1, 2022  . . . . . . . . . . . . . . . . . .  August 15, 2022 . . . . . . . . . . . . . . . . . . . . . 
November 1, 2022  . . . . . . . . . . . . . . . .  November 15, 2022  . . . . . . . . . . . . . . . . . . 
February 6, 2023 . . . . . . . . . . . . . . . . .  February 15, 2023  . . . . . . . . . . . . . . . . . . . 

$0.67 
0.67 
0.67 
0.67 
0.67 

Per Share Distributions 

Per  share  distributions  by  our  Company  were  characterized  in  the  following  manner  for  income  tax 

purposes (unaudited): 

Common 

Year Ended December 31, 

2022 

2021 

2020 

Ordinary income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $1.264  $1.987  $1.961 
0.654 
Return of capital  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
0.065 
Capital gains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total dividends paid  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $2.680  $2.680  $2.680 

0.095 
1.321 

0.117 
0.576 

Pursuant to Treasury Regulation Section 1.1061-6(c), Omega Healthcare Investors Inc. is disclosing the 
following  information  to  its  shareholders.  “One  Year  Amounts  Disclosure” is  zero  percent  of  the  capital 
gain  distributions  allocated  to  each  shareholder  and  “Three  Year  Amounts  Disclosure” is  zero  percent  of 
the  capital  gain  distributions  allocated  to  each  shareholder.  All  capital  gain  distributions  reported  are 
related to Section 1231 gain. 

For additional information regarding dividends, see Note 17 — Taxes. 

F-63 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Accumulated Other Comprehensive Income (Loss) 

The following is a summary of  our accumulated other comprehensive income (loss), net of  tax where 

applicable: 

As of and for the 
Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Foreign Currency Translation: 

Beginning balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $(24,012)  $(18,427)  $(35,100) 
16,595 
Translation (loss) gain  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
78 
Realized (loss) gain  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
(18,427) 
Ending balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(59,622) 
(1,370) 
(85,004) 

(6,302) 
717 
(24,012) 

Derivative Instruments: 
Cash flow hedges:  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Beginning balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Unrealized gain  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Realized gain (loss)(1)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Ending balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Net investment hedges:  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Beginning balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Unrealized gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Ending balance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Total accumulated other comprehensive income (loss) before noncontrolling 
interest  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Add: portion included in noncontrolling interest  . . . . . . . . . . . . . . . . 

30,407 
51,761 
4,188 
86,356 

17,718 
9,788 
2,901 
30,407 

(2,369) 
34,712 
(14,625) 
17,718 

(9,588) 
28,222 
18,634 

(13,331) 
3,743 
(9,588) 

(4,420) 
(8,911) 
(13,331) 

(14,040) 
1,272 
Total accumulated other comprehensive income (loss) for Omega  . . . . . . .  $ 20,325  $  (2,200)  $(12,768) 

(3,193) 
993 

19,986 
339 

(1)  Expenses related to our effective cash flow hedges are recorded within interest expense. As noted in Note 15 — Derivatives and 
Hedging,  we  terminated  $250.0  million  of  notional  value  interest  rate  swaps  in  October  2020  and  reclassified  the  remaining 
balance in AOCI to loss on debt extinguishment on the Consolidated Statements of Operations. 

NOTE 19 — STOCK-BASED COMPENSATION 

At December 31, 2022, we maintained several stock-based compensation plans as described below. For 
the  years  ended  December  31,  2022,  2021  and  2020,  we  recognized  stock-based  compensation  of 
$27.3 million, $21.4 million and $18.8 million, respectively, related to these plans. 

Time-Based Restricted Equity Awards 

Restricted  stock,  restricted  stock  units  (“RSUs”)  and  profits  interest  units  (“PIUs”)  are  subject  to 
forfeiture if  the holder’s service to us terminates prior to vesting, subject to certain exceptions for certain 
qualifying  terminations  of  service  or  a  change  in  control  of  the  Company.  Prior  to  vesting,  ownership  of 
the shares/units cannot be transferred. The restricted stock has the same dividend and voting rights as our 
common  stock.  RSUs  accrue  dividend  equivalents  but  have  no  voting  rights.  PIUs  accrue  distributions, 
which are equivalent to dividend equivalents, but have no voting rights. Once vested, each RSU is settled by 
the issuance of  one share of  Omega common stock and each PIU is settled by the issuance of  one Omega 
OP Unit, subject to certain conditions. Restricted stock and RSUs are valued at the price of  our common 
stock  on  the  date  of  grant.  The  PIUs  are  valued  using  a  Monte  Carlo  model  to  estimate  fair  value.  We 
expense the cost of these awards ratably over their vesting period. 

F-64 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Performance-Based Restricted Equity Awards 

Performance-based restricted equity awards include performance restricted stock units (“PRSUs”) and 
PIUs. PRSUs and PIUs are subject to forfeiture if  the performance requirements are not achieved or if  the 
holder’s  service  to  us  terminates  prior  to  vesting,  subject  to  certain  exceptions  for  certain  qualifying 
terminations  of  employment  or  a  change  in  control  of  the  Company.  PRSUs  and  PIUs  have  varying 
degrees  of  performance  requirements  to  achieve  vesting,  and  each  PRSU  and  PIU  award  represents  the 
right  to  a  variable  number  of  shares  of  common  stock  or  partnership  units.  Each  PIU  once  earned  is 
convertible into one Omega OP Unit in Omega OP, subject to certain conditions. The vesting requirements 
are based on either the (i) total shareholder return (“TSR”) of  Omega or (ii) Omega’s TSR relative to other 
REITs  in  the  FTSE  NAREIT  Equity  Health  Care  Index  (“Relative  TSR”).  We  expense  the  cost  of  these 
awards ratably over their service period. 

Prior to vesting and the distribution of  shares or Omega OP Units, ownership of  the PRSUs or PIUs 
cannot be transferred. Dividend equivalents on the PRSUs are accrued and paid to the extent the applicable 
performance  requirements  are  met.  While  each  PIU  is  unearned,  the  employee  receives  a  partnership 
distribution  equal  to  10%  of  the  quarterly  approved  regular  periodic  distributions  per  Omega  OP  Unit. 
Partnership distributions (which in the case of  normal periodic distributions is equal to the total approved 
quarterly dividend on Omega’s common stock), less the 10% already paid, on the PIUs accumulate, and if 
the PIUs are earned, the accumulated distributions are paid. We used a Monte Carlo model to estimate the 
fair value for the PRSUs and PIUs granted to the employees. The following are the significant assumptions 
used in estimating the value of the awards for grants made on the following dates: 

Closing price on date of grant  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Dividend yield . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Risk free interest rate at time of grant  . . . . . . . . . . . . . . . . . . . . . . . . . 
Expected volatility  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

January 1, 
2022 

January 1, 
2021 

January 1, 
2020 

$29.59 

$36.32 

$42.35 

9.06% 
0.98% 
38.74% 

7.38% 
0.18% 
42.55% 

6.33% 
1.65% 
21.77% 

F-65 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

The following table summarizes the activity in restricted stock, RSUs, PRSUs, and PIUs for the years 

ended December 31, 2020, 2021 and 2022: 

Time-Based 

Performance-Based 

Number of 

Weighted -
Average Grant-

Number of 

Weighted -

Total 

Average Grant- Compensation 

Shares/Omega  Date Fair Value  Shares/Omega  Date Fair Value 

OP Units 

per Share 

OP Units 

per Share 

Cost(1) 
(in millions) 

Non-vested at December 31, 2019  . . . . . 
. . . . . . . . . . . . 
Granted during 2020 
Cancelled during 2020 
. . . . . . . . . . . 
Vested during 2020  . . . . . . . . . . . . . . 
Non-vested at December 31, 2020  . . . . . 
. . . . . . . . . . . . 
Granted during 2021 
. . . . . . . . . . . 
Cancelled during 2021 
Forfeited during 2021  . . . . . . . . . . . . 
Vested during 2021  . . . . . . . . . . . . . . 
Non-vested at December 31, 2021  . . . . . 
. . . . . . . . . . . . 
Granted during 2022 
Cancelled during 2022 
. . . . . . . . . . . 
Forfeited during 2022  . . . . . . . . . . . . 
Vested during 2022(2)  . . . . . . . . . . . . 
Non-vested at December 31, 2022  . . . . . 

298,592 
158,572 
(2,006) 
(184,480) 
270,678 
210,429 
(14,157) 
— 
(148,538) 
318,412 
256,818 
(2,000) 
— 
(165,206) 
408,024 

31.44 
39.88 
42.05 
29.28 
37.78 
36.52 
36.58 
— 
34.30 
38.62 
29.40 
29.59 
— 
40.91 
$31.93 

2,401,087 
1,208,537 
(54,076) 
(658,052) 
2,897,496 
1,232,178 
(188,128) 
(746,357) 
(973,142) 
2,222,047 
1,620,330 
(5,232) 
(621,199) 
— 
3,215,946 

13.01 
17.11 
16.52 
14.85 
14.24 
18.76 
18.01 
14.83 
10.33 
17.94 
14.73 
11.90 
13.68 
— 
$17.16 

$27.00 

$30.80 

$31.40 

(1)  Total compensation cost to be recognized on the awards based on grant date fair value. 
(2)  PRSUs are shown as vesting in the year that the Compensation Committee determines the level of  achievement of  the applicable 

performance measures. 

As of  December 31, 2022, unrecognized compensation costs related to unvested awards to employees is 

as follows: 

• 

• 

• 

• 

$5.4  million  on  RSUs  and  PIUs  expected  to  be  recognized  over  a  weighted  average  period  of 
approximately 34 months. 

$0.7  million  on  RSUs  and  PIUs  expected  to  be  recognized  over  a  weighted  average  period  of 
approximately 12 months. 

$14.0 million on TSR PRSUs and PIUs expected to be recognized over a weighted average period 
of approximately 45 months. 

$17.1  million  on  Relative  TSR  PRSUs  and  PIUs  expected  to  be  recognized  over  a  weighted 
average period of approximately 45 months. 

In  addition,  we  have  a  deferred  stock  compensation  plan  that  allows  employees  and  directors  the 
ability to defer the receipt of  stock awards (units). The deferred stock awards (units) participate in future 
dividend  equivalents  as  well  as  the  change  in  the  value  of  the  Company’s  common  stock.  As  of 
December 31, 2022 and 2021, the Company had 646,871 and 630,623 deferred stock units outstanding. 

Tax Withholding for Stock Compensation Plans 

Stock  withheld  to  pay  tax  withholdings  for  equity  instruments  granted  under  stock-based  payment 
arrangements  for  the  years  ended  December  31,  2022,  2021  and  2020,  was  $1.1  million,  $4.6  million  and 
$4.7 million, respectively. 

F-66 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Shares Available for Issuance for Compensation Purposes 

On June 8, 2018, at the Annual Meeting of  Stockholders, our stockholders approved the 2018 Stock 
Incentive  Plan  (the  “2018  Plan”),  which  amended  and  restated  the  Company’s  2013  Stock  Incentive  Plan 
(the “2013 Plan”). The 2018 Plan is a comprehensive incentive compensation plan that allows for various 
types of  equity-based compensation, including RSUs (including PRSUs), stock awards (including restricted 
stock),  deferred  RSUs,  incentive  stock  options,  non-qualified  stock  options,  stock  appreciation  rights, 
(including 
dividend  equivalent 
performance-based cash awards), PIUs and other stock-based awards. The 2018 Plan increased the number 
of shares of common stock available for issuance under the 2013 Plan by 4.5 million. 

rights,  performance  unit  awards,  certain  cash-based  awards 

As  of  December  31,  2022,  approximately  1.6  million  shares  of  common  stock  were  reserved  for 

issuance to our employees, directors and consultants under our stock incentive plans. 

NOTE 20 — COMMITMENTS AND CONTINGENCIES 

Litigation 

Shareholder Litigation 

The Company and certain of  its officers, C. Taylor Pickett, Robert O. Stephenson, and Daniel J. Booth, 
are  defendants  in  a  purported  securities  class  action  lawsuit  pending  in  the  U.S.  District  Court  for  the 
Southern District of  New York (the “Securities Class Action”). Brought by lead plaintiff  Royce Setzer and 
additional  plaintiff  Earl  Holtzman,  the  Securities  Class  Action  purports  to  assert  claims  for  violations  of 
Section  10(b)  of  the  Securities  Exchange  Act  of  1934,  as  amended  (the  “Exchange  Act”)  and  Rule  10b-5 
promulgated  thereunder,  as  well  as  Section  20(a)  of  the  Exchange  Act,  and  seeks  monetary  damages, 
interest, fees and expenses of attorneys and experts, and other relief. The Securities Class Action alleges that 
the defendants violated the Exchange Act by making materially false and/or misleading statements, and by 
failing to disclose material adverse facts about the Company’s business, operations, and prospects, including 
the financial and operating results of  one of  the Company’s operators, the ability of  such operator to make 
timely  rent  payments,  and  the  impairment  of  certain  of  the  Company’s  leases  and  the  uncollectibility  of 
certain receivables.  The initial complaint was dismissed with prejudice  by the U.S. District Court, but the 
dismissal  was  overturned  by  the  U.S.  Court  of  Appeals  for  the  Second  Circuit  in  2020.  Thereafter,  the 
plaintiffs  filed  a  Second  Consolidated  Amended  Complaint  in  August  2020.  In  November  2020,  the 
Company  and  the  officers  named  in  the  Securities  Class  Action  filed  a  Motion  to  Dismiss  the  Second 
Consolidated Amended Complaint. On September 28, 2021, the Court issued an order denying the motion 
to dismiss insofar as it requested dismissal of  the entire action on grounds of  loss causation, and granting it 
insofar as it sought dismissal of any claims arising out of defendants’ statements in February 2017. 

Following a mediation, the plaintiffs and defendants reached an agreement in principle on a settlement 
of  the Securities Class Action and thereafter executed a stipulation of  settlement dated December 9, 2022 
(“Settlement”),  subject  to  the  approval  of  the  District  Court.  On  December  27,  2022,  the  District  Court 
granted  preliminary  approval  of  the  settlement,  and  scheduled  a  hearing  for  April  25,  2023  on  final 
approval of  the Settlement. Pursuant to the preliminary approval order, and subject to final approval by the 
District Court, the Settlement payment of  $30.75 million has been transmitted to an escrow account by the 
Company’s directors and officers insurers. The Settlement does not include any admission of  wrongdoing 
or liability on the part of  the Company or the individual defendants, and upon final approval by the Court, 
provides for a dismissal of, and a release of  all claims against the defendants by a class of  persons and/or 
entities  who  purchased  or  otherwise  acquired  Company  securities  from  February  8,  2017  through 
October 31, 2017. The Company recorded a $31 million legal reserve related to the Securities Class Action 
in  the  third  quarter  of  2022,  which  is  included  within  accrued  expenses  and  other  liabilities  on  the 
Consolidated  Balance  Sheets.  As  the  Settlement  proceeds  are  to  be  paid  by  insurance,  the  Company 
concurrently recorded a receivable for $31 million within other assets on the Consolidated Balance Sheet, 
and consequently there is no impact to the Consolidated Statements of Operations related to this matter. 

F-67 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Certain  derivative  actions  have  also  been  brought  against  the  officers  named  in  the  Securities 
Class  Action,  and  certain  current  and  former  directors  of  the  Company,  alleging  claims  relating  to  the 
matters at issue in the Securities Class Action. These derivative actions are currently stayed pending certain 
developments in the Securities Class Action. 

In  2018,  Stourbridge  Investments  LLC,  a  purported  stockholder  of  the  Company,  filed  a  derivative 
action purportedly on behalf  of  the Company in the U.S. District Court for the Southern District of  New 
York,  alleging  violations  of  Section  14(a)  of  the  Exchange  Act  and  state-law  claims  including  breach  of 
fiduciary  duty.  The  complaint  alleges,  among  other  things,  that  the  named  defendants  are  responsible  for 
the  Company’s  failure  to  disclose  the  financial  condition  of  Orianna  Health  Systems,  the  alleged 
non-disclosures  that  are  also  the  subject  of  the  Securities  Class  Action  described  above.  The  plaintiff  did 
not make a demand on the Company to bring the action prior to filing it, but rather alleges that demand 
would have been futile. The case has been stayed pending the entry of  judgment or a voluntary dismissal 
with prejudice in the Securities Class Action. 

In 2019, purported stockholder Phillip Swan by his counsel, and stockholders Tom Bradley and Sarah 
Smith  by  their  counsel,  filed  derivative  actions  in  the  Baltimore  City  Circuit  Court  of  Maryland, 
purportedly on behalf  of  the Company,  asserting claims for breach  of  fiduciary  duty, waste  of  corporate 
assets  and  unjust  enrichment  against  the  named  defendants.  Those  actions  have  been  consolidated  and 
stayed in the Maryland court pending completion of  fact discovery in the Securities Class Action. Prior to 
filing  suit,  each  of  these  stockholders  had  made  demands  on  the  Board  of  Directors  in  2018  that  the 
Company  bring  such  lawsuits.  After  an  investigation  and  due  consideration,  and  in  the  exercise  of  its 
business judgment, the Board of  Directors determined that it is not in the best interests of  the Company to 
commence litigation against any current or former officers or directors based on the matters raised in the 
demands. 

In addition, in late 2020, Robert Wojcik, a purported shareholder of  the Company, filed a derivative 
action  in  the  U.S.  District  Court  for  the  District  of  Maryland,  purportedly  on  behalf  of  the  Company, 
asserting violations of  Section 14(a) of  the Exchange Act, Sections 10(b) and 21D of  the Exchange Act, as 
well as claims for breach of  fiduciary duty, unjust enrichment, abuse of  control, gross mismanagement, and 
waste of corporate assets. Wojcik also did not make a demand on the Company prior to filing suit. The case 
has  been  stayed  pending  the  entry  of  judgment  or  a  voluntary  dismissal  with  prejudice  in  the  Securities 
Class Action. 

Other 

Gulf Coast Subordinated Debt 

In  August  2021,  we  filed  suit  in  the  Circuit  Court  for  Baltimore  County  (the  “Court”)  against  the 
holders  of  certain  Subordinated  Debt  (the  “Debt  Holders”)  associated  with  our  Gulf  Coast  master  lease 
agreement, following an assertion by the holders that our prior exercise of  offset rights in connection with 
Gulf  Coast’s non-payment of  rent had resulted in defaults under the terms of  the Subordinated Debt. The 
suit seeks a declaratory judgment to, among other items, declare that the aggregate amount of  unpaid rent 
due from Gulf  Coast under the master lease agreement exceeds all amounts which otherwise would be due 
and owing by an indirect subsidiary of  Omega (“Omega Obligor”) under the Subordinated Debt, and that 
all principal and interest due and owing under the Subordinated Debt may be (and was) offset in full as of 
December  31,  2021.  In  October  2021,  the  defendants  in  the  case  filed  a  motion  to  dismiss  for  lack  of 
personal jurisdiction. On November 3, 2022, the Court granted the noteholders’ motion to dismiss for lack 
of  personal  jurisdiction,  and  Omega  filed  a  timely  appeal  of  the  ruling.  While  Omega  believes  Omega 
Obligor is entitled to the enforcement of  the offset rights sought in the action, Omega cannot predict the 
outcome  of  the  declaratory  judgment  action,  irrespective  of  whether  (a)  it  is  ultimately  litigated  in  the 
Court if  Omega Obligor prevails in its appeal or (b) if  the order granting the motion to dismiss for lack of 
personal jurisdiction is affirmed. 

On  or  about  January  19,  2023,  the  Debt  Holders  served  a  lawsuit  against  the  Omega  Obligor  in  the 
Superior Court of  the State of  Delaware, asserting claims for (i) breach of  the instruments evidencing the 

F-68 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Subordinated Debt, (ii) declaratory judgment, and (iii) unjust enrichment, all claims that are factually based 
on  the  claims  that  are  the  subject  of  Omega  Obligor’s  suit  in  the  Court  and  that  are  now  on  appeal.  On 
February 8, 2023, Omega Obligor filed a motion to dismiss or, in the alternative, to stay this action pending 
the  outcome  of  the  above  referenced  lawsuit  in  Maryland.  The  motion  is  presently  pending  before  the 
Delaware  state  court.  Omega  believes  that  the  claims  are  baseless  and  is  evaluating  procedural  and 
substantive legal options in connection with this recently filed suit. 

Lakeway Realty, L.L.C. 

In  September  2016,  MedEquities  received  a  Civil  Investigative  Demand  (“CID”)  from  the  U.S. 
Department  of  Justice  (“DOJ”),  which  indicates  that  it  is  conducting  an  investigation  regarding  alleged 
violations  of  the  False  Claims  Act,  Stark  Law  and  Anti-Kickback  Statute  in  connection  with  claims  that 
may have been submitted to Medicare and other federal payors for services rendered to patients at Lakeway 
Hospital or by providers with financial relationships with Lakeway Hospital (the “Potential Claims”). As a 
result of  the acquisition of  MedEquities, the Company owns a 51% interest in an unconsolidated limited 
liability  company  that  owns  Lakeway  Hospital,  Lakeway  Realty,  L.L.C.  The  CID  requested  certain 
documents  and  information  related  to  the  acquisition  and  ownership  of  Lakeway  Hospital  through 
Lakeway  Realty,  L.L.C.  The  Company  has  learned  that  the  DOJ  is  investigating,  among  other  items, 
MedEquities’  conduct  in  connection  with  its  investigation  of  financial  relationships  related  to  Lakeway 
Hospital,  including  allegations  by  the  DOJ  that  these  relationships  violate  and  continue  to  violate  the 
Anti-Kickback Statute and, as a result, related claims submitted to federal payors violated and continue to 
violate the False Claims Act. 

On September 29, 2020, the DOJ announced it had reached a settlement of  a False Claims Act case 
with  Lakeway  Regional  Medical  Center  wherein  Lakeway  Regional  Medical  Center  agreed  to  pay 
$1.1  million  for  inducing  certain  physicians  to  refer  patients  by  offering  a  low  risk  and  high  return 
investment in the form of  a joint venture to purchase and then lease back the hospital to Lakeway Regional 
Medical  Center.  A  MedEquities  subsidiary  was  a  party  to  this  transaction  but  was  not  included  in 
settlement  discussions,  and  we  understand  that  the  settlement  did  not  fully  resolve  the  investigation 
referenced in the CID. 

As  of  November  7,  2022,  Lakeway  Realty,  L.L.C.,  one  of  its  members,  MRT  of  Lakeway  TX-ACH, 
LLC, and Omega (together, “Defendants”), the U.S., the State of  Texas and certain named relators entered 
into  a  settlement  agreement  pursuant  to  which  Defendants  were  released  from  the  Potential  Claims  from 
March  2,  2015  through  August  31,  2016,  in  exchange  for  Omega’s  agreement  to  pay  approximately 
$3.1 million. Defendants admitted no liability associated with the Potential Claims. In the second quarter of 
2022, the Company recorded a $3.0 million legal reserve related to this matter, which is included in other 
(expense)  income — net  on  the  Consolidated  Statements  of  Operations.  The  settlement  was  paid  in  the 
fourth quarter of 2022 and Omega has no remaining legal reserves related to this matter as of December 31, 
2022. 

In  addition  to  the  matters  above,  we  are  subject  to  various  other  legal  proceedings,  claims  and  other 
actions arising out of  the normal course of  business. While any legal proceeding or claim has an element of 
uncertainty,  management  believes  that  the  outcome  of  each  lawsuit,  claim  or  legal  proceeding  that  is 
pending or threatened, or all of  them combined, will not have a material adverse effect on our consolidated 
financial position or results of operations. 

Indemnification Agreements 

In connection with certain facility transitions, we have agreed to indemnify certain operators in certain 
events.  As  of  December  31,  2022,  our  maximum  funding  commitment  under  these  indemnification 
agreements was approximately $5.1 million. Claims under these indemnification agreements generally may 
be  made  within  18  months  to  72  months  of  the  transition  date.  These  indemnification  agreements  were 
provided to certain operators in connection with facility transitions and generally would be applicable in the 
event that the prior operators do not perform under their transition agreements. 

F-69 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

Commitments 

We  have  committed  to  fund  the  construction  of  new  leased  and  mortgaged  facilities,  capital 
improvements and other commitments. We expect the funding of  these commitments to be completed over 
the next several years. Our remaining commitments at December 31, 2022, are outlined in the table below 
(in thousands): 

. . . . . . . . . . . . . . . . . . . .  $  7,269 
Construction and capital expenditure mortgage loan commitments 
Lessor construction and capital commitments under lease agreements(1)  . . . . . . . . . . . . . . . . . 
203,655 
Non-real estate loan commitments(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
71,353 
Total remaining commitments(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $282,277 

(1) 

Includes $93.3 million related to our $177.7 million commitment relating to the redevelopment of  the real estate property located 
in Washington, D.C. discussed in Note 3 — Real Estate Asset Acquisitions and Development. 

(2)  This  amount  includes  $57.0  million  related  to  the  $90.0  million  short-term  revolving  line  of  credit  discussed  in 

Note 8 — Non-real Estate Loans Receivable. 
Includes finance costs. 

(3) 

NOTE  21 — SUPPLEMENTAL  DISCLOSURE  TO  CONSOLIDATED  STATEMENTS  OF  CASH 
FLOWS 

The following are supplemental disclosures to the consolidated statements of  cash flows for the years 

ended December 31, 2022, 2021 and 2020: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands) 

Reconciliation of cash and cash equivalents and restricted cash: 

Cash and cash equivalents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $297,103  $  20,534  $ 163,535 
Restricted cash  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
4,023 
Cash, cash equivalents and restricted cash at end of year  . . . . . . . . .  $300,644  $  24,411  $ 167,558 

3,541 

3,877 

Supplemental information: 

Interest paid during the year, net of amounts capitalized  . . . . . . . . .  $220,748  $214,406  $ 216,206 

Taxes paid during the year  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  5,793  $  6,288  $ 

6,974 

Non cash investing activities 

—  $ 
Non-cash acquisition of business  . . . . . . . . . . . . . . . . . . . . . . . . .  $ 
Non-cash acquisition of real estate  . . . . . . . . . . . . . . . . . . . . . . . .  $  (9,818)  $ (58,595)  $ 
Non-cash proceeds from sale of real estate investments  . . . . . . . . . .  $ 
—  $ 
Non-cash proceeds from sale of business  . . . . . . . . . . . . . . . . . . . .  $  7,532  $ 
Non-cash placement of loan principal  . . . . . . . . . . . . . . . . . . . . . .  $ 
Non-cash collection of loan principal  . . . . . . . . . . . . . . . . . . . . . .  $ 
Non-cash investment in other investments  . . . . . . . . . . . . . . . . . . .  $  (7,532)  $ 

(1,826) 
— 
—  $  83,910 
— 
—  $ 
—  $  (7,000)  $(208,075) 
—  $  65,595  $  68,025 
— 

—  $ 

—  $ 

Non cash financing activities 

Non-cash (repayment) borrowing of other long-term borrowings  . . .  $ 
Non-cash contribution from noncontrolling member in consolidated 

—  $ (20,000)  $ 

6,459 

joint venture  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  $  2,903  $ 

— 
Change in fair value of cash flow hedges  . . . . . . . . . . . . . . . . . . . .  $  88,460  $  23,457  $  19,788 
8,911 
Remeasurement of debt denominated in a foreign currency  . . . . . . .  $  (4,077)  $  3,010  $ 

—  $ 

F-70 

OMEGA HEALTHCARE INVESTORS, INC. 
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued) 

NOTE 22 — EARNINGS PER SHARE 

The following tables set forth the computation of basic and diluted earnings per share: 

Year Ended December 31, 

2022 

2021 

2020 

(in thousands, except per share amounts) 

Numerator: 

Net income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Deduct: net income attributable to noncontrolling interests . . . . . . . . 
. . . . . . . . . . . . . . . . 
Net income available to common stockholders 

$438,841  $428,302  $163,545 
(4,218) 
(11,563) 
$426,927  $416,739  $159,327 

(11,914) 

Denominator: 

Denominator for basic earnings per share  . . . . . . . . . . . . . . . . . . . . 
Effect of dilutive securities:  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Common stock equivalents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Noncontrolling interest – Omega OP Units  . . . . . . . . . . . . . . . . . 
. . . . . . . . . . . . . . . . . . 

Denominator for diluted earnings per share 

236,256 

236,933 

227,741 

1,198 
6,836 
244,290 

785 
6,620 
244,338 

1,239 
6,124 
235,104 

Earnings per share – basic: 

Net income available to common stockholders 

. . . . . . . . . . . . . . . . 

$ 

1.81  $ 

1.76  $ 

0.70 

Earnings per share – diluted: 

Net income  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$ 

1.80  $ 

1.75  $ 

0.70 

F-71 

OMEGA HEALTHCARE INVESTORS, INC. 
SCHEDULE III — REAL ESTATE AND ACCUMULATED DEPRECIATION 
(in thousands) 
December 31, 2022 
Cost Capitalized 
Subsequent to 
Acquisition 

Gross Amount at 
Which Carried at 
Close of Period(3)(5) 

Initial Cost to 
Company 

Description(1) 

Encumbrances 

Land 

Buildings and 
Improvements  Improvements  Cost 

Carrying 

Other(6) 

Land(8) 

Buildings and 
Improvements 

Total 

Accumulated 
Date of 
Depreciation(4)  Construction  Acquired(7) 

Date 

Life on Which 
Depreciation
in Latest 
Income Statements 
is Computed 

.

.

.

.

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.
. 
Alabama (SNF)  .
.
.  .  . 
Arizona (ALF, ILF, SNF) 
Arkansas (ALF, SNF)  .
. 
.
.
.
California (ALF, SH, SNF)  .  .  . 
. 
Colorado (ILF, SNF) 
. 
Connecticut (ALF) 
.
.
. 
Florida (ALF, ILF, SNF)  .
. 
Georgia (ALF, SNF) .
.
. 
Idaho (SNF)  .
.
Illinois (ALF) 
. 
.
Indiana (ALF, ILF, IRF, MOB,
.

SH, SNF) .
.
. 
Iowa (ALF, SNF)  .
. 
Kansas (SNF) 
.
.
. 
Kentucky (ALF, SNF)  .
. 
Louisiana (ALF, SNF)  .
. 
. 
.
Maryland (SNF) 
Massachusetts (ALF, SNF)  .  .  . 
.
. 
Michigan (SNF) 
.
.  . 
Minnesota (ALF, ILF, SNF) 
. 
Mississippi (SNF)  .
.
.
. 
.
Missouri (SNF)  .
. 
Montana (SNF) .
. 
Nebraska (SNF) 
.
.
. 
Nevada (BHS, SH, SNF)  .
.
.  . 
New Hampshire (ALF, SNF) 
. 
.
.
New Jersey (ALF)  .
. 
.
.
New Mexico (SNF) 
.
. 
New York (ALF) 
.
.
North Carolina (ALF, SNF) 
.  . 
Ohio (ALF, BHP, BHS, SH,
.
.
.
Oklahoma (SNF)  .
.
Oregon (ALF, ILF, SNF)  .
Pennsylvania (ALF, ILF,
.
.
.
Rhode Island (SNF)  .
.
South Carolina (SNF)  .
.
Tennessee (ALF, BHP, SNF) 
Texas (ALF, BHS, ILF, IRF,
.
MOB, SH, SNF) .
United Kingdom (ALF) 
.
Vermont (SNF)  .
.
.
Virginia (ALF, SNF) .
.
.
Washington (ALF, SNF)  .
.
Washington DC (ALF) .
.
.
West Virginia (SNF)  .
.
.
.
Wisconsin (SNF) 

. 
. 
.
. 
.  . 

. 
. 
. 
. 
. 
. 
. 
. 

SNF) 

SNF) 

. 
. 
. 

.
.
.
.

.
.
.
.

.
.

.
.

.
.

.
.

.
.

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.

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.

.

.

.

.

.

.

.

.

.

.

.

.

.

(2) 

(2) 

(2) 

(2) 

$ 

$ 

1,817  $ 
11,502 
2,893 
81,970 
11,279 
25,063 
122,046 
3,740 
5,735 
1,830 
48,429 

33,356 
121,240 
59,094 
464,633 
88,830 
252,417 
1,017,770 
47,689 
47,530 
13,967 
585,487 

$  12,916 
3,653 
8,517 
7,925 
7,790 
7,116 
20,143 
768 
1,514 
1,536 
11,739 

$  — 
— 
— 
— 
— 
1,320 
— 
— 
— 
— 
— 

—  $  1,817  $ 
— 
(36) 
(479) 
— 
— 

11,502 
2,893 
81,970 
11,279 
25,063 
(55,540)  121,106 
3,740 
5,193 
1,830 
48,408 

— 
(542) 
— 
(7,380) 

46,272  $ 
124,893 
67,575 
472,079 
96,620 
260,853 
983,313 
48,457 
49,044 
15,503 
589,867 

48,089 
136,395 
70,468 
554,049 
107,899 
285,916 
1,104,419 
52,197 
54,237 
17,333 
638,275 

2,343 
4,092 
15,556 
6,577 
15,144 
23,621 
380 
10,502 
8,803 
4,584 
1,319 
750 
8,811 
1,782 
12,953 
6,008 
118,606 
30,935 
32,147 

2,296 
7,331 
30,072 

3,299 
8,480 
12,976 
80,905 

122,941 
318 
35,435 
16,582 
68,017 
1,973 
399 

59,310 
38,693 
130,819 
93,709 
111,651 
143,172 
16,120 
52,585 
191,448 
86,316 
11,698 
14,892 
92,797 
19,837 
58,199 
45,285 
176,921 
367,008 
419,651 

19,934 
125,133 
393,156 

23,487 
76,912 
268,846 
839,069 

465,187 
6,005 
376,943 
194,121 
— 
66,946 
4,581 

— 
14,219 
7,517 
4,877 
4,985 
20,052 
— 
5,972 
827 
13,910 
432 
— 
8,350 
1,463 
1,576 
1,318 
1,841 
9,171 
18,460 

— 
9,913 
18,026 

3,805 
2,860 
7,227 
37,918 

11,923 
602 
12,659 
5,837 
12,901 
7,062 
2,153 

— 
— 
— 
448 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
1,559 
— 
40,543 
336 
345 

— 
— 
— 

— 
— 
— 
197 

— 
— 
— 
— 
3,877 
— 
— 

— 
2,343 
— 
4,092 
— 
15,556 
(4,690) 
6,577 
— 
15,144 
(693) 
23,621 
— 
380 
— 
10,502 
— 
8,803 
(23,425) 
4,424 
— 
1,319 
— 
750 
— 
8,811 
— 
1,782 
— 
12,953 
6,008 
— 
—  118,606 
30,935 
32,147 

(714) 
(22,937) 

— 
— 
(19,006) 

2,296 
7,331 
30,067 

— 
— 
— 
(40,543) 

3,299 
8,480 
12,976 
79,902 

(77,593)  109,243 
318 
35,261 
16,582 
68,017 
1,973 
399 

— 
(939) 
(2) 
— 
— 
— 

59,310 
52,912 
138,336 
94,344 
116,636 
162,531 
16,120 
58,557 
192,275 
76,961 
12,130 
14,892 
101,147 
21,300 
61,334 
46,603 
219,305 
375,801 
415,519 

19,934 
135,046 
392,181 

27,292 
79,772 
276,073 
837,644 

413,215 
6,607 
388,837 
199,956 
16,778 
74,008 
6,734 

61,653 
57,004 
153,892 
100,921 
131,780 
186,152 
16,500 
69,059 
201,078 
81,385 
13,449 
15,642 
109,958 
23,082 
74,287 
52,611 
337,911 
406,736 
447,666 

22,230 
142,377 
422,248 

30,591 
88,252 
289,049 
917,546 

522,458 
6,925 
424,098 
216,538 
84,795 
75,981 
7,133 

$(40,830)  1960 – 1982  1992 – 1997  31 years – 33 years 
(31,171)  1949 – 1999  2005 – 2021  25 years – 40 years 
(43,108)  1967 – 1988  1992 – 2014  25 years – 31 years 
(141,641)  1938 – 2013  1997 – 2021  5 years – 35 years 
(50,881)  1925 – 1975  1998 – 2016  20 years – 39 years 
(65,116)  1968 – 2019  2010 – 2017  30 years – 33 years 
(265,779)  1942 – 2018  1993 – 2021  2 years – 39 years 
(16,072)  1967 – 1997  1998 – 2016  30 years – 40 years 
(21,697)  1920 – 2008  1997 – 2014  25 years – 39 years 
(1,429) 

25 years 

2021 

1999 

(198,490)  1942 – 2015  1992 – 2020  20 years – 40 years 

25 years 

2011 
2014 

25 years 
33 years 

(20,796)  1961 – 1998  2010 – 2014  23 years – 33 years 
(24,740)  1957 – 1977  2005 – 2011 
(53,921)  1964 – 2002  1999 – 2016  20 years – 33 years 
(31,207)  1957 – 2020  1997 – 2019  22 years – 39 years 
(36,628)  1921 – 1985  2008 – 2022  25 years – 30 years 
(63,139)  1964 – 2017  1997 – 2014  20 years – 33 years 
(7,835)  1964 – 1973 
(20,777)  1966 – 1983 
(43,425)  1965 – 2008  2009 – 2019  20 years – 30 years 
(22,560)  1955 – 1994  1999 – 2019  25 years – 33 years 
(3,594)  1963 – 1971 
2005 
(5,534)  1966 – 1969  2012 – 2015  20 years – 33 years 
(33,334)  1972 – 2012  2009 – 2017  25 years – 33 years 
(11,907)  1963 – 1999  1998 – 2006  33 years – 39 years 
(4,346)  1999 – 2021  2019 – 2021 
(13,530)  1960 – 1985 
(22,665) 
(104,222)  1964 – 2019  1994 – 2022  25 years – 36 years 
(109,899)  1929 – 2021  1994 – 2020  25 years – 39 years 

25 years 
33 years 
25 years 

2005 
2015 

33 years 

2020 

(10,790)  1965 – 1993  2010 – 2013  20 years – 33 years 
(23,639)  1959 – 2007  2005 – 2021  25 years – 33 years 
(121,187)  1873 – 2012  2004 – 2022  20 years – 39 years 

2006 

(15,843)  1965 – 1981 
(26,687)  1959 – 2007  2014 – 2016  20 years – 33 years 
(108,446)  1968 – 2018  1992 – 2021  20 years – 31 years 
(238,519)  1949 – 2019  1997 – 2021  20 years – 40 years 

39 years 

(81,496)  1650 – 2012  2015 – 2022  25 years – 30 years 
(3,432) 
(89,062)  1964 – 2017  2010 – 2021  25 years – 40 years 
(42,743)  1951 – 2004  1999 – 2022  25 years – 33 years 

39 years 

2004 

1971 

— 

N/A 

2021 

N/A 

(47,534)  1961 – 1996  1994 – 2011  25 years – 39 years 
(3,122) 

33 years 

2005 

1974 

Total  .

.

.

.

.

.

.

.

.

.

.

.

.

. 

$1,012,241  $7,722,444 

$331,473 

$48,625 

$(254,519) $995,698  $7,864,566  $8,860,264  $(2,322,773) 

(1)  The  real  estate  included  in  this  schedule  is  being  used  in  either  the  operation  of  skilled  nursing  facilities  (“SNF”),  assisted  living  facilities  (“ALF”), 
independent  living  facilities  (“ILF”),  specialty  facilities  (consisting  of  behavioral  health  substance  facilities  (“BHS”),  behavioral  health  psychology 
facilities (“BHP”), independent rehabilitation facilities (“IRF”) and specialty hospitals (“SH”)) or medical office buildings (“MOB”), located in the states 
or country indicated. 

(2)  Certain of the real estate indicated are security for the HUD loan borrowings totaling $344.7 million at December 31, 2022. 

F-72 

OMEGA HEALTHCARE INVESTORS, INC. 
SCHEDULE III — REAL ESTATE AND ACCUMULATED DEPRECIATION  (continued) 
(in thousands) 
December 31, 2022 

Balance at beginning of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$8,985,994 

$8,702,154 

$9,028,745 

Acquisitions(a) 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Impairment  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Improvements  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

125,060 

(69,913) 

88,130 

Disposals/other  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(427,117) 

742,486 

(44,673) 

60,953 

(432,175) 

225,336 

(38,451) 

60,931 

(416,297) 

Balance at close of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$8,702,154 

$9,028,745 

$8,860,264 

Year Ended December 31, 

2020 

2021 

2022 

(a) 

Includes  approximately  $19.1  million,  $58.6  million  and  $8.2  million  of  non-cash  consideration  exchanged  and/or  valuation  adjustments  during 
the years ended December 31, 2020, 2021 and 2022, respectively. 

(3) 

(4) 

Year Ended December 31, 

2020 

2021 

2022 

Balance at beginning of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$1,787,425 

$1,996,914 

$2,181,528 

Provisions for depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

329,508 

Dispositions/other 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(120,019) 

341,497 

(156,883) 

331,963 

(190,718) 

Balance at close of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$1,996,914 

$2,181,528 

$2,322,773 

(5)  The reported amount of our real estate at December 31, 2022 is greater than the tax basis of the real estate by approximately $73 million (unaudited). 
(6)  Reflects bed sales, impairments (including the write-off of accumulated depreciation), land easements and impacts from foreign currency exchange rates. 
(7)  To the extent that we acquired an entity previously owning the underlying facility, the acquisition date reflects the date that the entity acquired the facility. 
Includes  $72.1  million  of  construction  in  progress  related  to  land,  all  other  amounts  related  to  construction  in  progress  are  reflected  in  buildings  and 
(8) 
improvements. 

F-73 

1 

2 

3 

4 

5 

6 

7 

8 

9 

OMEGA HEALTHCARE INVESTORS, INC. 
SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE 
(in thousands) 
December 31, 2022 

Interest 
Rate 

Fixed/
Variable 

Final 
Maturity
Date 

Periodic Payment
Terms 

Prior Liens 

Face Amount 
of Mortgages 

Carrying
Amount of 
Loans Subject
to Delinquent
Principal
or Interest 

Carrying
Amount of 
Mortgages(3)(4)(6) 

Grouping 

Description(1) 

First Mortgages 

Michigan (20 SNFs) 

.

.

.

.

.

.

.

. 

11.35% 

F(2) 

2030 

Michigan (4 SNFs)  .

.

.

.

.

.

.

.

. 

10.40% 

F(2) 

2030 

Michigan (2 SNFs)  .

.

.

.

.

.

.

.

. 

10.63% 

F(2) 

2030 

Interest plus approximately $56.3 of 
principal payable monthly with 
$271,997 due at maturity 

Interest plus approximately $5.8 of 
principal payable monthly with $27,909 
due at maturity 

Interest plus approximately $3.6 of 
principal payable monthly with $10,381 
due at maturity 

None 

$415,000 

$279,029 

$  — 

None 

44,200 

28,631 

None 

11,000 

10,826 

10.50% 

11.02% 

F(2) 

F(2) 

2032 

2031 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

None 

None 

72,420 

82,017 

72,420 

35,234 

Ohio (8 SNFs) 

.

.

.

.

.

.

Pennsylvania (3 SNFs and 1 
.
.
.
ALF)  .

.

.

.

.

.

.

.

Texas (1 specialty facility)  .

Massachusetts (1 specialty 
.
facility)  .

.

.

.

.

.

.

.

Tennessee (1 SNF) 

Michigan (1 SNF) 

10 

Ohio (1 SNF)  .

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.

.

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.

.

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.

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.

.

.

.

.

. 

. 

. 

. 

. 

. 

. 

7.85% 

F 

2025 

9.00% 

F 

2023 

8.35% 

F 

9.57% 

9.74% 

11  Michigan (8 SNFs and 1 ALF) 

.  .  . 

10.73% 

Capital Expenditure Mortgages 

12  Michigan  .

13  Michigan  .

14  Michigan  .

15  Michigan  .

16  Michigan  .

17  Michigan  .

18  Michigan  .

19  Michigan  .

20  Michigan  .

21  Michigan  .

22  Michigan  .

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.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

Construction Mortgages 

10.75% 

12.49% 

12.18% 

9.50% 

11.89% 

11.02% 

10.40% 

10.23% 

9.55% 

9.98% 

9.74% 

Interest plus approximately $150.1 of 
principal payable monthly with $59,546 
due at maturity 

Interest plus approximately $60.0 of 
principal payable monthly with $6,197 
due at maturity 

Past due 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest plus approximately $16.4 of 
principal payable monthly with $80,918 
due at maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

Interest payable monthly until maturity 

None 

72,960 

63,811 

None 

9,000 

— 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

None 

6,377 

14,045 

21,325 

83,454 

3,490 

4,220 

4,120 

248 

5,445 

1,472 

14,045 

21,325 

83,030 

3,480 

4,220 

4,112 

186 

5,318 

15,203 

15,094 

500 

5,450 

2,900 

9,771 

325 

500 

5,188 

2,542 

9,518 

195 

2015 

2030 

2023 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

2030 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

F(2) 

23  Michigan (1 SNF) 

.

.

.

.

.

.

.

.

. 

9.73% 

F(2) 

2023 

Interest paid-in-kind monthly until 
maturity 

None 

25,683 

19,082 

Allowance for credit loss on 
mortgage loans(7)  .
.

.

.

.

.

.

.

.

. 

— 

(31,128) 

(1)  Loans included in this schedule represent first mortgages, capital expenditure mortgages and construction mortgages on facilities used in the delivery of 

long-term healthcare of which such facilities are located in the states indicated. 
Interest on the loans escalates annually at a fixed rate. 

(2) 
(3)  The aggregate cost for federal income tax purposes is approximately $731.5 million (unaudited). 

$909,153 

$648,130 

$1,472 

F-74 

— 

— 

— 

(5)—

— 

(5)—

1,472(5) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

OMEGA HEALTHCARE INVESTORS, INC. 
SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE (continued) 
(in thousands) 
December 31, 2022 

(4) 

Balance at beginning of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
Additions during period – new mortgage loans or additional fundings(a)  . . . . . . . . . . . . . 
Deductions during period – collection of principal/other(b) 

. . . . . . . . . . . . . . . . . . . . 

Allowance for credit loss on mortgage loans  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Year Ended December 31, 

2020 

$773,563 

149,957 

(9,867) 

(28,340) 

2021 

2022 

$ 885,313 

$ 835,086 

93,891 

(103,761) 

(40,357) 

12,977 

(190,141) 

(9,792) 

Balance at close of period  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$885,313 

$ 835,086 

$ 648,130 

(a)  The  2020  amount  includes  $0.6  million  of  non-cash  interest  paid-in-kind  and  $86.9  million  of  non-cash  placement  of  mortgage  capital.  The 
2021  amount  includes  $0.2  million  of  non-cash  interest  paid-in-kind  and  $7.0  million  of  non-cash  placement  of  mortgage  principal.  The 
2022 amount includes $1.2 million of non-cash interest paid-in-kind. 

(b)  The 2021 amount includes $58.6 million of  non-cash principal reductions. The 2022 amount includes $6.0 million of  interest payments that were 

directly applied against the principal balance outstanding using the cost recovery method. 

(5)  Mortgage written down to the fair value of the underlying collateral. 
(6)  Mortgages included in the schedule which were extended during 2022 aggregated approximately $541.6 million. 
(7)  The allowance for credit loss on mortgage loans represents the allowance calculated utilizing a PD and LGD methodology. For mortgages that the risk of 

loss was evaluated on an individual basis, the allowance is included as a reduction to the carrying amount of the mortgage. 

F-75 

EXHIBIT 
NUMBER 

DESCRIPTION 

INDEX TO EXHIBITS TO 2022 FORM 10-K 

3.1 

3.2 

3.3 

3.4 

3.5 

4.0 

4.1 

4.1A 

4.1B 

4.1C 

4.1D 

4.1E 

4.1F 

Articles  of  Amendment  and  Restatement  of  Omega  Healthcare  Investors,  Inc.,  as  amended. 
(Incorporated  by  reference  to  Exhibit  4.1  to  the  Company’s  Registration  Statement  on 
Form S-3ASR, filed September 3, 2015). 

Articles Supplementary of  Omega Healthcare Investors, Inc. filed with the State Department 
of  Assessments and Taxation of Maryland on November 5, 2019 (Incorporated by reference to 
Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q, filed November 8, 2019). 

Amended  and  Restated  Bylaws  of  Omega  Healthcare  Investors,  Inc.  as  of  October  21,  2022 
(Incorporated by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K, filed 
October 21, 2022). 

Certificate  of  Limited  Partnership  of  OHI  Healthcare  Properties  Limited  Partnership 
(Incorporated by reference to Exhibit 3.121 to the Company’s Form S-4, filed April 16, 2015). 

Second  Amended  and  Restated  Agreement  of  Limited  Partnership  by  and  among  Omega 
Healthcare  Investors,  Inc.,  OHI  Healthcare  Properties  Holdco,  Inc.,  and  Aviv  Healthcare 
Properties Limited Partnership (Incorporated by reference to Exhibit 10.11 to the Company’s 
Current Report on Form 8-K, filed April 3, 2015). 

See Exhibits 3.1 to 3.5. 

Indenture,  dated  as  of  March  11,  2014,  by  and  among  the  Company,  the  guarantors  named 
therein, and U.S. Bank National Association (Incorporated by reference to Exhibit 4.1 to the 
Company’s Current Report on Form 8-K, filed March 11, 2014). 

First  Supplemental  Indenture,  dated  as  of  June  27,  2014,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.4  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  6, 
2014). 

Second Supplemental Indenture, dated as of November 25, 2014, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association, and that certain 
Third Supplemental Indenture, dated as of  January 23, 2015, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4B to the Company’s Annual Report on Form 10-K, filed February 27, 
2015). 

Fourth  Supplemental  Indenture,  dated  effective  as  of  March  2,  2015,  among  the  Company, 
each  of  the  subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association 
(Incorporated by reference to Exhibit 4.3B to the Company’s Quarterly Report on Form 10-Q, 
filed May 8, 2015). 

Fifth  Supplemental  Indenture,  dated  as  of  April  1,  2015,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.3C  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  May  8, 
2015). 

Sixth Supplemental Indenture, dated as of  August 4, 2015, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.3 to the Company’s Quarterly Report on Form 10-Q, filed November 6, 
2015). 

Seventh Supplemental Indenture, dated as of  November 9, 2015, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.2F to the Company’s Annual Report on Form 10-K, filed February 29, 
2016). 

I-1 

4.1G 

4.1H 

4.1I 

4.1J 

4.1K 

4.1L 

4.1M 

4.2 

4.2A 

4.2B 

4.2C 

4.2D 

Eighth Supplemental Indenture, dated as of  March 29, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.2 to the Company’s Quarterly Report on Form 10-Q, filed May 6, 2016). 

Ninth  Supplemental  Indenture,  dated  as  of  May  13,  2016,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.2  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  5, 
2016). 

Tenth Supplemental Indenture, dated as of  August 9, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.2 to the Company’s Quarterly Report on Form 10-Q, filed November 8, 
2016). 

Eleventh Supplemental Indenture, dated as of  November 10, 2016, among the Company, each 
of  the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated 
by  reference  to  Exhibit  4.2J  to  the  Company’s  Annual  Report  on  Form  10-K,  filed 
February 24, 2017). 

Twelfth  Supplemental  Indenture,  dated  as  of  March  17,  2017,  among  the  Company,  each  of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.2 to the Company’s Quarterly Report on Form 10-Q, filed May 5, 2017). 

Thirteenth Supplemental Indenture, dated as of  May 11, 2017, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference  to  Exhibit  4.1  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  9, 
2017). 

Fourteenth Supplemental Indenture, dated as of  May 25, 2017, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.1A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture,  dated  as  of  September  11,  2014,  by  and  among  the  Company,  the  subsidiary 
guarantors named therein, and U.S. Bank National Association (Incorporated by reference to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed September 11, 2014). 

First Supplemental Indenture, dated as of  November 25, 2014, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association, and that certain 
Second Supplemental Indenture, dated as of  January 23, 2015, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.5A to the Company’s Annual Report on Form 10-K, filed February 27, 
2015). 

Third Supplemental Indenture, dated effective as of  March 2, 2015, among the Company, each 
of  the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated 
by  reference  to  Exhibit  4.2B  to  the  Company’s  Registration  Statement  on  Form  S-4,  filed 
April 16, 2015). 

Fourth Supplemental Indenture, dated as of  April 1, 2015, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.2B  to  the  Company’s  Registration  Statement  on  Form  S-4,  filed 
April 16, 2015). 

Fifth Supplemental Indenture, dated as of  August 4, 2015, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4 to the Company’s Quarterly Report on Form 10-Q, filed November 6, 
2015). 

I-2 

4.2E 

4.2F 

4.2G 

4.2H 

4.2I 

4.2J 

4.2K 

4.2L 

4.3 

4.3A 

4.3B 

4.3C 

4.3D 

Sixth  Supplemental  Indenture,  dated  as  of  November  9,  2015,  among  the  Company,  each  of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.3E to the Company’s Annual Report on Form 10-K, filed February 29, 
2016). 

Seventh  Supplemental  Indenture,  dated  as  of  March  29,  2016,  among  the  Company,  each  of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.3 to the Company’s Quarterly Report on Form 10-Q, filed May 6, 2016). 

Eighth Supplemental Indenture, dated as of  May 13, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.3  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  5, 
2016). 

Ninth Supplemental Indenture, dated as of  August 9, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.3 to the Company’s Quarterly Report on Form 10-Q, filed November 8, 
2016). 

Tenth Supplemental Indenture, dated as of  November 10, 2016, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.3I to the Company’s Annual Report on Form 10-K, filed February 24, 
2017). 

Eleventh Supplemental Indenture, dated as of  March 17, 2017, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.3 to the Company’s Quarterly Report on Form 10-Q, filed May 5, 2017). 

Twelfth Supplemental Indenture, dated as of  May 11, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.2  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  9, 
2017). 

Thirteenth Supplemental Indenture, dated as of  May 25, 2017, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.2A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture, dated as of  March 18, 2015, by and among the Company, the subsidiary guarantors 
named therein and U.S. Bank National Association (Incorporated by reference to Exhibit 4.1 
to the Company’s Current Report on Form 8-K, filed March 24, 2015). 

First  Supplemental  Indenture,  dated  as  of  April  1,  2015,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.5A  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  May  8, 
2015). 

Second Supplemental Indenture, dated as of  August 4, 2015, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.2A  to  the  Company’s  Registration  Statement  on  Form  S-4,  filed 
October 6, 2015). 

Third Supplemental Indenture, dated as of  November 9, 2015, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference  to  Exhibit  4.2B  to  the  Amendment  to  the  Company’s  Registration  Statement  on 
Form S-4/A, filed November 12, 2015). 

Fourth Supplemental Indenture, dated as of  March 29, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4 to the Company’s Quarterly Report on Form 10-Q, filed May 6, 2016). 

I-3 

4.3E 

4.3F 

4.3G 

4.3H 

4.3I 

4.3J 

4.4 

4.4A 

4.4B 

4.4C 

4.4D 

4.4E 

4.4F 

Fifth  Supplemental  Indenture,  dated  as  of  May  13,  2016,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.4  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  5, 
2016). 

Sixth Supplemental Indenture, dated as of  August 9, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4 to the Company’s Quarterly Report on Form 10-Q, filed November 8, 
2016). 

Seventh Supplemental Indenture, dated as of  November 10, 2016, among the Company, each 
of  the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated 
by  reference  to  Exhibit  4.4G  to  the  Company’s  Annual  Report  on  Form  10-K,  filed 
February 24, 2017). 

Eighth Supplemental Indenture, dated as of  March 17, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4 to the Company’s Quarterly Report on Form 10-Q, filed May 5, 2017). 

Ninth  Supplemental  Indenture,  dated  as  of  May  11,  2017,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.3  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  9, 
2017). 

Tenth  Supplemental  Indenture,  dated  as  of  May  25,  2017,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.3A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture,  dated  as  of  September  23,  2015,  by  and  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein,  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed September 29, 
2015). 

First  Supplemental  Indenture,  dated  as  of  November  9,  2015,  among  the  Company,  each  of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference  to  Exhibit  4.1A  to  the  Company’s  Registration  Statement  on  Form  S-4,  filed 
November 12, 2015). 

Second Supplemental Indenture, dated as of March 29, 2016, among the Company, each of the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.5 to the Company’s Quarterly Report on Form 10-Q, filed May 6, 2016). 

Third  Supplemental  Indenture,  dated  as  of  May  13,  2016,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.5  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  5, 
2016). 

Fourth Supplemental Indenture, dated as of  August 9, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.5 to the Company’s Quarterly Report on Form 10-Q, filed November 8, 
2016). 

Fifth Supplemental Indenture, dated as of  November 10, 2016, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.5E to the Company’s Annual Report on Form 10-K, filed February 24, 
2017). 

Sixth Supplemental Indenture, dated as of  March 17, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.5 to the Company’s Quarterly Report on Form 10-Q, filed May 5, 2017). 

I-4 

4.4G 

4.4H 

4.5 

4.5A 

4.5B 

4.5C 

4.5D 

4.5E 

4.6 

4.6A 

4.6B 

4.7 

4.8 

Seventh Supplemental Indenture, dated as of  May 11, 2017 among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.4  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  9, 
2017). 

Eighth Supplemental Indenture, dated as of  May 25, 2017 among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.4A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture,  dated  as  of  July  12,  2016,  by  and  among  the  Company,  each  of  the  subsidiary 
guarantors  listed  therein,  and  U.S.  Bank  National  Association  (Incorporated  by  reference  to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed July 12, 2016). 

First Supplemental Indenture, dated as of  August 9, 2016, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.6A  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed 
November 8, 2016). 

Second Supplemental Indenture, dated as of November 10, 2016, among the Company, each of 
the subsidiary guarantors listed therein and U.S. Bank National Association (Incorporated by 
reference to Exhibit 4.6B to the Company’s Annual Report on Form 10-K, filed February 24, 
2017). 

Third Supplemental Indenture, dated as of  March 17, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.6 to the Company’s Quarterly Report on Form 10-Q, filed May 5, 2017). 

Fourth Supplemental Indenture, dated as of  May 11, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference  to  Exhibit  4.5  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  9, 
2017). 

Fifth  Supplemental  Indenture,  dated  as  of  May  25,  2017,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.5A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture,  dated  as  of  April  4,  2017,  by  and  among  the  Company,  each  of  the  subsidiary 
guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by  reference  to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed April 4, 2017). 

First  Supplemental  Indenture,  dated  as  of  May  11,  2017,  among  the  Company,  each  of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.6A to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Second Supplemental Indenture, dated as of  May 25, 2017, among the Company, each of  the 
subsidiary  guarantors  listed  therein  and  U.S.  Bank  National  Association  (Incorporated  by 
reference to Exhibit 4.6B to the Company’s Quarterly Report on Form 10-Q, filed August 9, 
2017). 

Indenture, dated as of  September 20, 2019, among the Company, OHI Healthcare Properties 
Limited  Partnership  and  U.S.  Bank  National  Association  (Incorporated  by  reference  to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed September 20, 2019). 

Indenture,  dated  as  of  October  9,  2020,  among  the  Company,  OHI  Healthcare  Properties 
Limited  Partnership  and  U.S.  Bank  National  Association  (Incorporated  by  reference  to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed October 9, 2020). 

I-5 

4.8A 

4.9 

4.10 

10.1 

10.2 

10.3 

10.4 

10.5 

10.6 

10.6A 

10.6B 

10.6C 

10.6D 

10.6E 

10.6F 

10.6G 

First  Supplemental  Indenture,  dated  as  of  October  30,  2020,  among  the  Company,  OHI 
Healthcare Properties Limited Partnership and U.S. Bank National Association (Incorporated 
by  reference  to  Exhibit  4.2  to  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed 
November 3, 2020). 

Indenture,  dated  as  of  March  10,  2021,  among  the  Company,  OHI  Healthcare  Properties 
Limited  Partnership  and  U.S.  Bank  National  Association  (Incorporated  by  reference  to 
Exhibit 4.1 to the Company’s Current Report on Form 8-K, filed March 10, 2021). 

Description of Securities registered under Section 12 of the Securities Exchange Act of 1934.* 

Form  of  Directors  and  Officers  Indemnification  Agreement  (Incorporated  by  reference  to 
Exhibit 10.1 to the Company’s Annual Report on Form 10-K, filed February 23, 2018). 

Amended  and  Restated  Deferred  Stock  Plan,  dated  October  16,  2012,  and  forms  of  related 
agreements (Incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report on 
Form 10-Q, filed November 7, 2012). 

Credit Agreement, dated as of  April 30, 2021, among the Company, certain subsidiaries of  the 
Company  identified  therein  as  guarantors,  the  lenders  named  therein  and  Bank  of  America, 
N.A., as administrative agent for such lenders (Incorporated by reference to Exhibit 10.1 to the 
Company’s Current Report on Form 8-K, filed May 4, 2021). 

Credit  Agreement,  dated  as  of  April  30,  2021,  among  OHI  Healthcare  Properties  Limited 
Partnership, the lenders named therein and Bank of America, N.A., as administrative agent for 
such lenders (Incorporated by reference to Exhibit 10.2 to the Company’s Current Report on 
Form 8-K, filed May 4, 2021). 

At-the  Market  Equity  Offering  Sales  Agreement,  dated  May  20,  2021,  among  the  Company, 
the Sales Agents, the Forward Sellers and the Forward Purchasers (Incorporated by reference 
to Exhibit 1.1 to the Company’s Current Report on Form 8-K, filed May 20, 2021). 

Omega  Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.1 to the Company’s Current Report on Form 8-K, filed June 11, 2018).+ 

2019  Form  of  Time-Based  Restricted  Stock  Units  Agreement  pursuant  to  the  Omega 
Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8A of the Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2019 Form of Time-Based Profits Interest Units Agreement pursuant to the Omega Healthcare 
Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to  Exhibit  10.8B  of  the 
Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2019  Form  of  TSR-Based  Performance  Restricted  Stock  Units  Agreement  pursuant  to  the 
Omega  Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8C of the Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2019  Form  of  TSR-Based  Performance  Profits  Interest  Units  Agreement  pursuant  to  the 
Omega  Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8D of the Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2019  Form  of  Relative  TSR-Based  Performance  Restricted  Stock  Units  Agreement  pursuant 
to the Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (Incorporated by reference 
to Exhibit 10.8E of the Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2019 Form of  Relative TSR-Based Performance Profits Interest Units Agreement pursuant to 
the Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (Incorporated by reference to 
Exhibit 10.8F of the Company’s Annual Report on Form 10-K filed February 26, 2019).+ 

2020  Form  of  Time-Based  Restricted  Stock  Units  Agreement  pursuant  to  the  Omega 
Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8G of the Company’s Annual Report on Form 10-K filed February 28, 2020).+ 

I-6 

10.6H 

10.6I 

10.6J 

10.6K 

10.6L 

10.6M 

10.6N 

10.6O 

10.6P 

10.6Q 

10.6R 

10.7 

10.8 

10.9 

2020 Form of Time-Based Profits Interest Units Agreement pursuant to the Omega Healthcare 
Investors, Inc.  2018  Stock  Incentive Plan (Incorporated by reference to Exhibit 10.8H of  the 
Company’s Annual Report on Form 10-K filed February 28, 2020).+ 

2020  Form  of  TSR-Based  Performance  Restricted  Stock  Units  Agreement  pursuant  to  the 
Omega  Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8I of the Company’s Annual Report on Form 10-K filed February 28, 2020).+ 

2020  Form  of  TSR-Based  Performance  Profits  Interest  Units  Agreement  pursuant  to  the 
Omega  Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (Incorporated  by  reference  to 
Exhibit 10.8J of the Company’s Annual Report on Form 10-K filed February 28, 2020).+ 

2020  Form  of  Relative  TSR-Based  Performance  Restricted  Stock  Units  Agreement  pursuant 
to the Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (Incorporated by reference 
to Exhibit 10.8K of the Company’s Annual Report on Form 10-K filed February 28, 2020). + 

2020 Form of  Relative TSR-Based Performance Profits Interest Units Agreement pursuant to 
the Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (Incorporated by reference to 
Exhibit 10.8L of the Company’s Annual Report on Form 10-K filed February 28, 2020). + 

Form  of  Time-Based  Restricted  Stock  Units  Agreement  pursuant  to  the  Omega  Healthcare 
Investors,  Inc.  2018  Stock  Incentive  Plan  (commencing  2022)  (Incorporated  by  reference  to 
Exhibit 10.6M to the Company’s Annual Report on Form 10-K, filed February 17, 2022).+ 

Form  of  Time-Based  Profits  Interest  Units  Agreement  pursuant  to  the  Omega  Healthcare 
Investors,  Inc.  2018  Stock  Incentive  Plan  (commencing  2022)  (Incorporated  by  reference  to 
Exhibit 10.6N to the Company’s Annual Report on Form 10-K, filed February 17, 2022).+ 

Form of  TSR-Based Performance Restricted Stock Units Agreement pursuant to the Omega 
Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (commencing  2022)  (Incorporated  by 
reference to Exhibit 10.6O to the Company’s Annual Report on Form 10-K, filed February 17, 
2022).+ 

Form  of  TSR-Based  Performance  Profits  Interest  Units  Agreement  pursuant  to  the  Omega 
Healthcare  Investors,  Inc.  2018  Stock  Incentive  Plan  (commencing  2022)  (Incorporated  by 
reference to Exhibit 10.6P to the Company’s Annual Report on Form 10-K, filed February 17, 
2022).+ 

Form of  Relative TSR-Based Performance Restricted Stock Units Agreement pursuant to the 
Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (commencing 2022) (Incorporated 
by  reference  to  Exhibit  10.6Q  to  the  Company’s  Annual  Report  on  Form  10-K,  filed 
February 17, 2022).+ 

Form  of  Relative  TSR-Based  Performance  Profits  Interest  Units  Agreement  pursuant  to  the 
Omega Healthcare Investors, Inc. 2018 Stock Incentive Plan (commencing 2022) (Incorporated 
by  reference  to  Exhibit  10.6R  to  the  Company’s  Annual  Report  on  Form  10-K,  filed 
February 17, 2022).+ 

Form  of  Officer  Deferred  Performance  Restricted  Stock  Unit  Agreement  (Incorporated  by 
reference  to  Exhibit  10.2  of  the  Company’s  Quarterly  Report  on  Form  10-Q,  filed  August  5, 
2013).+ 

Form  of  Employment  Agreement  for  Company’s  executive  officers,  other  than  Ms.  Makode, 
effective as of  January 1, 2020 for the Company’s executive officers (Incorporated by reference 
to Exhibit 10.1 to the Company’s Current Report on Form 8-K, filed December 20, 2019).+ 

Employment  Agreement,  effective  as  of  January  1,  2020,  between  the  Company  and  Gail 
Makode  (Incorporated  by  reference  to  Exhibit  10.2  of  the  Company’s  Current  Report  on 
Form 8-K, filed December 20, 2019).+ 

10.10 

Form of Annual Amendment to Employment Agreement for the Company’s executive officers.+* 

I-7 

10.11 

21.1 

22.1 

23.1 

31.1 

31.2 

32.1 

32.2 

101 

Omega  Healthcare  Investors,  Inc.  Deferred  Cash  Compensation  Plan  with  form  of  Deferral 
Agreement  pursuant  to  the  Omega  Healthcare  Investors,  Inc.  Deferred  Cash  Compensation 
Plan (June 30, 2018) (Incorporated by reference to Exhibit 10.2 to Omega Healthcare Investor 
Inc.’s Form 10-Q filed August 8, 2018).+ 

Subsidiaries of the Registrant.* 

Subsidiary guarantors of guaranteed securities.* 

Consent of  Independent Registered Public Accounting Firm for Omega Healthcare Investors, 
Inc.* 

Rule  13a-14(a)/15d-14(a)  Certification  of  Chief  Executive  Officer  of  Omega  Healthcare 
Investors, Inc.* 

Rule  13a-14(a)/15d-14(a)  Certification  of  Chief  Financial  Officer  of  Omega  Healthcare 
Investors, Inc.* 

Section 1350 Certification of the Chief Executive Officer of Omega Healthcare Investors, Inc.* 

Section 1350 Certification of the Chief Financial Officer of Omega Healthcare Investors, Inc.* 

The following financial statements from the Company’s Annual Report on Form 10-K for the 
year  ended  December  31,  2022,  formatted  in  Inline  XBRL:  (i)  Consolidated  Balance  Sheets, 
(ii)  Consolidated  Statements  of  Operations,  (iii)  Consolidated  Statements  of  Comprehensive 
Income, (iv) Consolidated Statements of  Equity, (v) Consolidated Statements of  Cash Flows, 
and  (vi)  Notes  to  Consolidated  Financial  Statements,  tagged  as  blocks  of  text  and  including 
detailed tags. 

104 

Cover Page Interactive Data File (embedded within the Inline XBRL document and contained 
in Exhibit 101). 

Exhibits that are filed or furnished herewith. 

* 
+  Management contract or compensatory plan, contract or arrangement. 

I-8 

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 

Date: February 14, 2023 

OMEGA HEALTHCARE INVESTORS, INC. 
Registrant 
By:  /s/ C. Taylor Pickett 
C. Taylor Pickett 
Chief Executive Officer 

I-9 

Pursuant to the requirements of  the Securities Exchange Act of  1934, this report has been signed by 
the following persons on behalf  of  the Omega Healthcare Investors, Inc., for itself  and in the capacities on 
the date indicated. 

Signatures 

Title 

Date 

/s/ C. Taylor Pickett 
C. Taylor Pickett 

/s/ Robert O. Stephenson 
Robert O. Stephenson 

/s/ Neal A. Ballew 
Neal A. Ballew 

/s/ Craig R. Callen 
Craig R. Callen 

/s/ Kapila K. Anand 
Kapila K. Anand 

/s/ Dr. Lisa C. Egbuonu-Davis 
Dr. Lisa C. Egbuonu-Davis 

/s/ Barbara B. Hill 
Barbara B. Hill 

/s/ Kevin J. Jacobs 
Kevin J. Jacobs 

/s/ C. Taylor Pickett 
C. Taylor Pickett 

/s/ Stephen D. Plavin 
Stephen D. Plavin 

/s/ Burke W. Whitman 
Burke W. Whitman 

Chief Executive Officer 
(Principal Executive Officer) 

Chief Financial Officer 
(Principal Financial Officer) 

Chief Accounting Officer 
(Principal Accounting Officer) 

February 14, 2023 

February 14, 2023 

February 14, 2023 

Chair of the Board 

February 14, 2023 

February 14, 2023 

February 14, 2023 

February 14, 2023 

February 14, 2023 

February 14, 2023 

February 14, 2023 

February 14, 2023 

Director 

Director 

Director 

Director 

Director 

Director 

Director 

I-10 

Exhibit 23.1 

Consent of Independent Registered Public Accounting Firm 

We consent to the incorporation by reference in the following Registration Statements: 

(1)  Form S-8 Registration Statements (File Nos. 333-225595, 333-189144 and 333-117656) related to 
the 2018 Stock Incentive Plan (formerly known as the 2013 Stock Incentive Plan and 2004 Stock 
Incentive Plan) of Omega Healthcare Investors, Inc.; 

(2)  Form  S-3  Registration  Statement  (File  No.  333-256084)  related  to  the  registration  of  preferred 

stock, common stock, warrants, and units of Omega Healthcare Investors, Inc.; 

(3)  Form S-3 Registration Statement (File No. 333-261519) pertaining to the debt securities, common 
stock, preferred stock, and guarantees of debt securities of Omega Healthcare Investors, Inc.; and 

(4)  Form  S-8  Registration  Statement  (File  No.  333-234599)  pertaining  to  the  Omega  Healthcare 

Investors, Inc. Employee Stock Purchase Plan. 

of  our reports dated February 14, 2023, with respect to the consolidated financial statements and schedules 
of  Omega  Healthcare  Investors,  Inc.  and  the  effectiveness  of  internal  control  over  financial  reporting  of 
Omega  Healthcare  Investors,  Inc.,  included  in  this  Annual  Report  (Form  10-K)  of  Omega  Healthcare 
Investors, Inc. for the year ended December 31, 2022. 

/s/ Ernst & Young LLP 

Baltimore, Maryland 
February 14, 2023 

Exhibit 31.1 

RULE 13a-14(a)/15d-14(a) CERTIFICATION OF CHIEF EXECUTIVE OFFICER 

I, C. Taylor Pickett, certify that: 

Certification 

1. 

I have reviewed this Annual Report on Form 10-K of Omega Healthcare Investors, 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  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  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 14, 2023 

/S/ C. TAYLOR PICKETT 
C. Taylor Pickett 
Chief Executive Officer 

RULE 13a-14(a)/15d-14(a) CERTIFICATION OF CHIEF FINANCIAL OFFICER 

Exhibit 31.2 

I, Robert O. Stephenson, certify that: 

Certifications 

1. 

I have reviewed this Annual Report on Form 10-K of Omega Healthcare Investors, 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  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  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 14, 2023 

/S/ ROBERT O. STEPHENSON 
Robert O. Stephenson 
Chief Financial Officer 

Exhibit 32.1 

SECTION 1350 CERTIFICATION 
OF THE CHIEF EXECUTIVE OFFICER 

I,  C.  Taylor  Pickett,  Chief  Executive  Officer  of  Omega  Healthcare  Investors,  Inc.  (the  “Company”), 
hereby certify, pursuant to Section 906 of  the Sarbanes-Oxley Act of  2002, 18 U.S.C. Section 1350, that to 
the best of my knowledge: 

(1)  the  Annual  Report  on  Form  10-K  of  the  Company  for  the  year  ended  December  31,  2022  (the 
“Report”)  fully  complies  with  the  requirements  of  Section  13(a)  or  15(d)  of  the  Securities 
Exchange Act of 1934, as amended; and 

(2)  the  information  contained  in  the  Report  fairly  presents,  in  all  material  respects,  the  financial 

condition and results of operations of the Company. 

Date: February 14, 2023 

/S/ C. TAYLOR PICKETT 
C. Taylor Pickett 
Chief Executive Officer 

Exhibit 32.2 

SECTION 1350 CERTIFICATION 
OF THE CHIEF FINANCIAL OFFICER 

I,  Robert  O.  Stephenson,  Chief  Financial  Officer  of  Omega  Healthcare  Investors,  Inc.  (the 
“Company”),  hereby  certify,  pursuant  to  Section  906  of  the  Sarbanes-Oxley  Act  of  2002,  18  U.S.C. 
Section 1350, that, to the best of my knowledge: 

(1)  the  Annual  Report  on  Form  10-K  of  the  Company  for  the  year  ended  December  31,  2022  (the 
“Report”)  fully  complies  with  the  requirements  of  Section  13(a)  or  15(d)  of  the  Securities 
Exchange Act of 1934, as amended; and 

(2)  the  information  contained  in  the  Report  fairly  presents,  in  all  material  respects,  the  financial 

condition and results of operations of the Company. 

Date: February 14, 2023 

/S/ ROBERT O. STEPHENSON 
Robert O. Stephenson 
Chief Financial Officer 

STOCKHOLDER INFORMATION 

Executive Officers and Directors as of April 21, 
2023 
C. Taylor Pickett (1) 
Chief Executive Officer 
Director 
Daniel J. Booth 
Chief Operating Officer 
Gail D. Makode 
Chief Legal Officer 
Robert O. Stephenson 
Chief Financial Officer 
Kapila K. Anand (1), (3) 
Director 
Craig R. Callen (1), (3), (4) 
Chair of the Board 
Dr. Lisa C. Egbuonu-Davis (4) 
Director 
Barbara B. Hill (2), (4) 
Director 
Kevin Jacobs (1), (3) 
Director 
Stephen D. Plavin (2), (4) 
Director 
Burke W. Whitman (2), (3) 
Director 

(1)  Member of Investment Committee 
(2)  Member of Compensation Committee 
(3)  Member of Audit Committee 
(4)  Member of Nominating and Corporate 

Governance Committee 

Dividend Reinvestment and Stock Purchase Plan 

The  Dividend  Reinvestment  and  Stock 
Purchase Plan provides investors and shareholders 
with a convenient method for reinvesting dividends 
and  purchasing  shares  of  Common  Stock  directly 
from  the  Company  without  paying  any  service 
charges or brokerage commissions. 

Please  see  www.omegahealthcare.com  and 
click  on  “DRSP  (Dividend  Reinvestment  and 
Stock  Purchase  Plan)” in  the  “Stock  Data” menu 
on the “Investor Relations” page for plan features. 

Please call 800-368-5948 for information about the 
Plan,  and  to  request  a  prospectus  and  enrollment 
forms. Alternatively, Plan materials can be downloaded 
directly at www.computershare.com/investor. 

Auditors 

Ernst & Young LLP 
Baltimore, Maryland 

Transfer Agent and Registrar 

Postal correspondence should be mailed to: 

Computershare 
P.O. Box 43006 
Providence, RI 02940-3006 

Overnight correspondence should be sent to: 

Computershare 
150 Royall Street, Suite 101 
Canton, MA 02021 

Exchange Listing 

New York Stock Exchange (Symbol: OHI) 

Corporate Office 

303 International Circle 
Suite 200 
Hunt Valley, MD 21030 
(410) 427-1700 Phone 

Annual Meeting 

The Annual Meeting of  the Stockholders will 
be held virtually at 10:00 A.M. EDT June 5, 2023. 
All  stockholders  are 
to  participate. 
Instructions  for  logging  into  our  virtual  Annual 
Meeting will be included in your proxy materials. 

invited 

Publications Available 

To  view  a  copy  of  press  releases  or  the  most 
recent financial results, please visit the Company’s 
web site at www.omegahealthcare.com. 

Member 

National  Association 

of  Real  Estate 

Investment Trusts, Inc. 

NYSE Certification 

The  Chief  Executive  Officer’s 

annual 
certification  pursuant  to  §303.12(a)  of  the  New 
York  Stock  Exchange  Listed  Company  Manual 
was  submitted  to  the  New  York  Stock  Exchange 
on  July  11,  2022.  There  are  no  qualifications  to 
that certification. 

303 International Circle, Suite 200 
Hunt Valley, MD 21030 
Phone (410) 427-1700