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Form 10-K

(Mark One)
☒			ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the fiscal year ended: December 31, 2022
OR
☐			TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from             to

Maryland			20-4738467
(State or other jurisdiction of Incorporation or organization)			(I.R.S. Employer Identification No.)

Title of Each Class

Trading Symbol

Name of Each Exchange on Which Registered

Class A Common Stock, $0.01 par value per share

HR

New York Stock Exchange

Portions of the Registrant’s definitive Proxy Statement relating to the Annual Meeting of Stockholders to be held on June 5, 2023 are incorporated by reference into Part III of this Report.

PART I
Item 1			Business			1
Item 1A			Risk Factors			7
Item 1B			Unresolved Staff Comments			21
Item 2			Properties			22
Item 3			Legal Proceedings			22
Item 4			Mine Safety Disclosures			22
PART II
Item 5			Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities			22
Item 6			[Reserved]			24
Item 7			Management’s Discussion and Analysis of Financial Condition and Results of Operations			25
Item 7A			Quantitative and Qualitative Disclosures About Market Risk			50
Item 8			Financial Statements and Supplementary Data			51
Item 9			Changes in and Disagreements with Accountants on Accounting and Financial Disclosure			98
Item 9A			Controls and Procedures			98
Item 9B			Other Information			101
Item 9C			Disclosure Regarding Foreign Jurisdictions that Prevent Inspections			101
PART III
Item 10			Directors, Executive Officers and Corporate Governance			102
Item 11			Executive Compensation			103
Item 12			Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters			103
Item 13			Certain Relationships and Related Transactions, and Director Independence			103
Item 14			Principal Accountant Fees and Services			104
Item 15			Exhibits and Financial Statement Schedules			104
Item 16			Form 10-K Summary			108
SIGNATURES AND SCHEDULES						108

									December 31, 2022
Dollars and square feet in thousands			GROSS INVESTMENT			SQUARE FEET			NUMBER OF PROPERTIES			OCCUPANCY 1
Medical office/outpatient			$	12,570,933		36,800			656			87.2		%
Inpatient			653,648			1,528			20			91.2		%
Office			508,741			1,789			10			96.2		%
			13,733,322			40,117			686			87.7		%
Construction in progress			35,560
Land held for development			74,265
Investments in financing receivables, net 2,3			120,236			187			1			100.0		%
Financing lease right-of-use assets 3			83,824			45			1			77.8		%
Corporate property			10,418
Total real estate investments			14,057,625			40,349			688			87.8		%
Unconsolidated joint ventures 4			350,305			1,913			33			85.4		%
Total investments			$	14,407,930		42,262			721			87.7		%

1The occupancy column represents the percentage of total rentable square feet leased (including month-to-month and holdover leases). There was one property excluded from the table above that was classified as held for sale as of December 31, 2022.

2Investments in financing receivables, net includes a single-tenant net lease property in San Diego, CA in a sale-leaseback transaction totaling $112.9 million.

3Financing lease right-of-use assets includes a multi-tenant lease property in Columbus, OH in a sale-leaseback transaction totaling $16.1 million, of which $8.7 million was accounted for as an imputed lease arrangement as required under ASC 842, Leases. The remaining $7.4 million was accounted for as a financing arrangement and is included in Investments in financing receivables, net and includes its relative portion of the square feet and occupancy.

4Gross investment includes the Company's pro rata share of unconsolidated joint ventures, net of mortgage note payable. Square feet has not been adjusted by the Company's ownership percentage.

EXPIRATION YEAR			NUMBER OF LEASES			LEASED SQUARE FEET			PERCENTAGE OF LEASED SQUARE FEET
2023 (1)			1,459			5,004,436			14.2		%
2024			1,171			5,150,146			14.6		%
2025			1,020			4,442,560			12.6		%
2026			814			3,610,265			10.2		%
2027			807			4,420,368			12.5		%
2028			440			2,547,615			7.2		%
2029			381			2,484,979			7.1		%
2030			288			2,206,923			6.3		%
2031			227			1,203,587			3.5		%
2032			267			2,106,365			6.0		%
Thereafter			184			2,053,288			5.8		%
			7,058			35,230,532			100.0		%

1Includes 177 leases totaling 311,889 square feet that expired prior to December 31, 2022 and were on month-to-month terms.

•The Company (exclusive of joint ventures) acquired 28 medical office buildings for purchase prices totaling $403.6 million.

•Through its joint ventures, the Company acquired interests in five medical office buildings for purchase prices totaling $101.0 million.

•the Coronavirus Aid, Relief and Economic Security Act of 2020, along with subsequent stimulus and COVID-19 relief bills and federal spending legislation, which provided relief funding and financial aid to businesses, individuals, and healthcare providers impacted by COVID-19, including higher Medicare reimbursement rates, forgiveness of small business loans to providers for payroll and rent, and additional resources for testing and vaccine distribution;

•the expansion of Medicaid benefits and health insurance exchanges established by the Affordable Care Act, whereby individuals and small businesses purchase health insurance with assistance from federal subsidies;

•various state legislature proposals for state-funded single-payer health insurance and a limit on allowable rates of reimbursement to healthcare providers;

•the implementation of quality control, cost containment, and value-based payment system reforms for Medicaid and Medicare, such as expansion of pay-for-performance criteria, bundled provider payments, accountable care organizations, comparative effectiveness research, and lower payments for hospital readmissions;

•ongoing evaluation of and transition toward value-based reimbursement models for Medicare payments to physicians as designated under MACRA;

•annual regulatory updates to Medicare policy for healthcare providers that can broadly change reimbursement methodology under budget-neutral guidelines, with the effect of lowering payments for some services and increasing payments for others, having a varying impact, positively or negatively, on providers;

•ongoing efforts to equalize Medicare payment rates across different facility-type settings, according to Section 603 of the Bipartisan Budget Act of 2015, which lowered Medicare payment rates, effective January

•the continued adoption by providers of federal standards for the Medicare Promoting Interoperability Program;

•reforms to the physician self-referral laws, commonly referred to as the Stark Law, as adjusted in 2020 in order to promote the transition toward value-based, coordinated care among providers, although clear intent to boost referrals could still yield provider penalties;

•consideration of broad reforms to Medicare and Medicaid, including a significant expansion of Medicare coverage to the greater U.S. population;

•more stringent regulatory criteria by which federal antitrust agencies evaluate the potential for anti-competitive practices as a result of mergers and acquisitions of health systems and physicians;

•regulations requiring the publication of hospital prices for certain services, as well as hospitals’ negotiated rates with insurers for these services;

•limits on price increases in pharmaceutical drugs and the cost to Medicare beneficiaries, including the potential for setting prices according to an international standard; and

•the prohibition of “surprise billing,” or high payment rates charged to consumers for out-of-network physician services.

•Health benefits and 401(k) starting on the first day of employment;

•Auto-enrollment of new employees in our 401(k) plan at 3%;

•Dollar-for-dollar match on 401(k) contributions up to $2,800, encouraging higher employee savings;

•100% of long-term disability and life insurance premiums paid; and

•Tuition reimbursement up to $3,000 annually for any employee pursuing higher education.

a.Integration: Embed and integrate leading environmental, social and governance practices designed to enhance portfolio performance into the Company’s daily operations.

b.Impact: Drive positive impact across the Company while mitigating risk and creating long-term value for stakeholders, including our tenants, investors, employees, and the communities in which we live, work and invest.

c.Integrity: Conduct business with integrity, respect and excellence, earning the right to be a preferred provider of medical office properties.

The Company makes available to the public free of charge through its website the Company’s Proxy Statement, Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), as soon as reasonably practicable after the Company electronically files such reports with, or furnishes such reports to, the Securities and Exchange Commission ("SEC"). The Company’s website address is www.healthcarerealty.com.

1.the inability to successfully combine the businesses of Legacy HR and Legacy HTA in a manner that permits the Company to achieve the cost savings anticipated to result from the Merger, which would result in the anticipated benefits of the Merger not being realized in the timeframe currently anticipated or at all;

2.the complexities associated with managing the combined businesses out of different locations and integrating personnel from the two companies;

3.the additional complexities of combining two companies with different histories, cultures, markets and tenant bases;

4.the failure to retain key employees of the Company; and

5.potential unknown liabilities and unforeseen increased expenses, delays or regulatory conditions associated with the Merger.

•The construction of properties generally requires various government and other approvals that may not be received when expected, or at all, which could delay or preclude commencement of construction;

•Opportunities that the Company pursued but later abandoned could result in the expensing of pursuit costs, which could impact the Company’s consolidated results of operations;

•Construction costs could exceed original estimates, which could impact the building’s profitability to the Company;

•Operating expenses could be higher than forecasted;

•Time required to initiate and complete the construction of a property and to lease up a completed property may be greater than originally anticipated, thereby adversely affecting the Company’s cash flow and liquidity;

•Occupancy rates and rents of a completed development property may not be sufficient to make the property profitable to the Company; and

•Favorable capital sources to fund the Company’s development and redevelopment activities may not be available when needed.

•The Company’s purchase price for acquired facilities may be based upon a series of market or building-specific judgments which may be incorrect;

•The costs of any maintenance or improvements for properties might exceed estimated costs;

•The Company may incur unexpected costs in the acquisition, construction or maintenance of real estate assets that could impact its expected returns on such assets; and

•Leasing may not occur at all, within expected time frames or at expected rental rates.

•disrupt the proper functioning of the Company's networks and systems and therefore the Company's operations and/or those of certain tenants;

•result in misstated financial reports, violations of loan covenants, missed reporting deadlines, and/or missed permitting deadlines;

•result in the Company's inability to properly monitor its compliance with the rules and regulations regarding the Company's qualification as a REIT;

•result in the unauthorized access to, and destruction, loss, theft, misappropriation or release of proprietary, confidential, sensitive, or otherwise valuable information of the Company or others, which others could use to compete against the Company or which could expose it to damage claims by third-parties for disruption, destructive, or otherwise harmful purposes or outcomes;

•result in the Company's inability to maintain the building systems relied upon by the its tenants for the efficient use of their leased space;

•require significant management attention and resources to remedy any damages that result;

•subject the Company to claims for breach of contract, damages, credits, penalties, or termination of leases or other agreements; or

•damage the Company's reputation among its tenants and investors generally.

•limit the Company’s ability to adjust rapidly to changing market conditions in the event of a downturn in general economic conditions or in the real estate and/or healthcare industries;

•limit the Company's ability to adjust rapidly to changing market conditions in the event of a downturn in general economic conditions or in the real estate and/or healthcare industries;

•impair the Company’s ability to obtain additional debt financing or require potentially dilutive equity to fund obligations and carry out its business strategy; and

•result in a downgrade of the rating of the Company’s debt securities by one or more rating agencies, which would increase the costs of borrowing under the Unsecured Credit Facility and the cost of issuance of new debt securities, among other things.

•joint venture partners could have financing and investment goals or strategies that are different than those of the Company, including terms and strategies for such investment and what levels of debt place on the venture;

•the parties to a joint venture could reach an impasse on certain decisions, which could result in unexpected costs, including costs associated with litigation or arbitration;

•a joint venture partner's actions might have the result of subjecting the property or the Company to liabilities in excess of those contemplated;

•joint venture partners could have investments that are competitive with the Company's properties in certain markets;

•interests in joint ventures are often illiquid and the Company may have difficulty exiting such an investment, or may have to exit at less than fair market value;

•joint venture partners may be structured differently than the Company for tax purposes and there could be conflicts relating to the Company's REIT status; and

•joint venture partners could become insolvent, fail to fund capital contributions, or otherwise fail to fulfill their obligations as a partner, which could require the Company to invest more capital into such ventures than anticipated.

Real property taxes on the Company's properties may increase as its properties are reassessed by taxing authorities or as property tax rates change. For example, a current California law commonly referred to as Proposition 13 generally limits annual real estate tax increases on California properties to 2% of assessed value. Accordingly, the assessed value and resulting property tax the Company pays is less than it would be if the properties were assessed at current values. The Company owns 39 properties in California, representing 11.1% of its total revenue. From time to time, proposals have been made to reduce the beneficial impact of Proposition 13, particularly with respect to commercial property, which would include medical office buildings. Most recently, an initiative qualified for California’s November 2020 statewide ballot that would generally limit Proposition 13’s protections to residential real estate. If this initiative had passed, it would have ended the beneficial effect of Proposition 13 for the Company's properties, and property tax expense could have increase substantially, adversely affecting the Company's cash flow from operations and net income. While this initiative did not pass, the Company cannot predict whether other changes to Proposition 13 may be proposed or adopted in the future.

•disruption in patient volume and revenue from pandemics, such as COVID-19;

•trends in the method of delivery of healthcare services, such as telehealth;

•transition to value-based care and reimbursement of providers;

•competition among healthcare providers;

•consolidation among healthcare providers, health insurers, hospitals and health systems;

•a rise in government-funded health insurance coverage;

•pressure on providers' operating profit margins from lower reimbursement rates, lower admissions growth, and higher expense growth;

•availability of capital;

•credit downgrades;

•liability insurance expense;

•rising pharmaceutical drug expense;

•regulatory and government reimbursement uncertainty related to the Medicare and Medicaid programs;

•a trend toward government regulation of pharmaceutical pricing;

•government regulation of hospitals' and health insurers' pricing transparency;

•federal court decisions on cases challenging the legality of the Affordable Care Act, in whole or in part;

•site-neutral rate-setting for Medicare services across different care settings;

•heightened health information technology security standards and the meaningful use of electronic health records by healthcare providers; and

•potential tax law changes affecting providers.

•provisions under Subtitle 8 of Title 3 of the MGCL that permit the Board of Directors, without stockholders’ approval and regardless of what is currently provided in the Company's Articles of Incorporation or bylaws, to implement certain takeover defenses;

•“business combination” provisions that, subject to limitations, prohibit certain business combinations, asset transfers and equity security issuances or reclassifications between the Company and an “interested stockholder” (defined generally as any person who beneficially owns, directly or indirectly, 10% or more of the voting power of the Company's outstanding voting stock or an affiliate or associate of the Company who, at any time within the two-year period immediately prior to the date in question, was the beneficial owner, directly or indirectly, of 10% or more of the Company's then outstanding stock) or an affiliate of an interested stockholder for five years after the most recent date on which the stockholder becomes an interested stockholder, and thereafter may impose supermajority voting requirements unless certain minimum price conditions are satisfied; and

•“control share” provisions that provide that holders of “control shares” of the Company (defined as shares which, when aggregated with other shares controlled by the stockholder, entitle the stockholder to exercise one of three increasing ranges of voting power in electing directors) acquired in a “control share acquisition” (defined as the direct or indirect acquisition of ownership or control of issued and outstanding “control shares”) have no voting rights except to the extent approved by Company stockholders by the affirmative vote of at least two-thirds of all the votes entitled to be cast on the matter, excluding all interested shares.

PLAN CATEGORY			NUMBER OF SECURITIES TO BE ISSUED upon exercise of outstanding options, warrants, and rights 1			WEIGHTED AVERAGE EXERCISE PRICE of outstanding options, warrants, and rights 1			NUMBER OF SECURITIES REMAINING AVAILABLE  for future issuance under equity  compensation plans (excluding securities reflected in the first column)
Equity compensation plans approved by security holders			340,976			—			9,214,187
Equity compensation plans not approved by security holders			—			—			—
Total			340,976			—			9,214,187

1The outstanding options relate only to Legacy HR's 2000 Employee Stock Purchase Plan (the "Legacy HR Employee Stock Purchase Plan"), which was terminated in November 2022. No new options will be issued under the Legacy HR Employee Stock Purchase Plan and existing options will expire in March 2024. The Company is unable to ascertain with specificity the number of securities to be issued upon exercise of outstanding rights under the Legacy HR Employee Stock Purchase Plan or the weighted average exercise price of outstanding rights under that plan. The Legacy HR Employee Stock Purchase Plan provides that shares of common stock may be purchased at a per share price equal to 85% of the fair market value of the common stock at the beginning of the offering period or a purchase date applicable to such offering period, whichever is lower.

PERIOD			TOTAL NUMBER OF SHARES PURCHASED			AVERAGE PRICE PAID per share			TOTAL NUMBER OF SHARES purchased as part of publicly announced plans or programs			MAXIMUM NUMBER OF SHARES that may yet be purchased under the plans or programs
January 1 - January 31			—			$	—		—			—
February 1 - February 28			6,727			30.67			—			—
March 1 - March 31			—			—			—			—
April 1 - April 30			—			—			—			—
May 1 - May 31			—			—			—			—
June 1 - June 30			—			—			—			—
July 1 - July 31			—			—			—			—
August 1 - August 31			—			—			—			—
September 1 - September 30			2,018			24.14			—			—
October 1 - October 31			—			—			—			—
November 1 - November 30			—			—			—			—
December 1 - December 31			129,147			19.37			—			—
Total			137,892

•The Company incurred substantial expenses related to the Merger;

•The Company may be unable to integrate the businesses of Legacy HR and Legacy HTA successfully and realize the anticipated synergies and related benefits of the Merger or do so within the anticipated timeframe;

•The Company may be unable to retain key employees;

•The trading price of shares of common stock of the Company may be affected by factors different from those that affected the price of shares of Legacy HR's common stock or Legacy HTA’s common stock before the Merger; and

•The Company cannot assure you that it will be able to continue paying dividends at or above the rates paid by Legacy HR and Legacy HTA.

•The Company's expected results may not be achieved;

•The Company’s revenues depend on the ability of its tenants under its leases to generate sufficient income from their operations to make rental payments to the Company;

•Pandemics, such as COVID-19 and other pandemics that may occur in the future, and measures intended to prevent their spread or mitigate their severity could have a material adverse effect on the Company's business, results of operations, cash flows and financial condition;

•Owning real estate and indirect interests in real estate is subject to inherent risks;

•The Company may incur impairment charges on its real estate properties or other assets;

•The Company has properties subject to purchase options that expose it to reinvestment risk and reduction in expected investment returns;

•If the Company is unable to promptly re-let its properties, if the rates upon such re-letting are significantly lower than the previous rates or if the Company is required to undertake significant expenditures or make significant leasing concessions to attract new tenants, then the Company’s business, consolidated financial condition and results of operations would be adversely affected;

•Certain of the Company’s properties are special purpose healthcare facilities and may not be easily adaptable to other uses;

•The Company has, and in the future may have more, exposure to fixed rent escalators, which could lag behind inflation and the growth in operating expenses such as real estate taxes, utilities, insurance, and maintenance expense;

•The Company’s real estate investments are illiquid and the Company may not be able to sell properties strategically targeted for disposition;

•The Company is subject to risks associated with the development and redevelopment of properties;

•The Company may make material acquisitions and undertake developments and redevelopments that may involve the expenditure of significant funds and may not perform in accordance with management’s expectations;

•The Company is exposed to risks associated with geographic concentration;

•Many of the Company’s leases are dependent on the viability of associated health systems. Revenue concentrations relating to these leases expose the Company to risks related to the financial condition of the associated health systems;

•Many of the Company’s properties are held under ground leases. These ground leases contain provisions that may limit the Company’s ability to lease, sell, or finance these properties;

•The Company may experience uninsured or underinsured losses;

•Damage from catastrophic weather and other natural events, whether caused by climate change or otherwise, could result in losses to the Company; and

•The Company faces risks associated with security breaches through cyber attacks, cyber intrusions, or otherwise, as well as other significant disruptions of its information technology networks and related systems.

•The Company has incurred significant debt obligations and may incur additional debt and increase leverage in the future;

•Covenants in the Company’s debt instruments limit its operational flexibility, and a breach of these covenants could materially affect the Company’s consolidated financial condition and results of operations;

•If lenders under the Unsecured Credit Facility fail to meet their funding commitments, the Company’s operations and consolidated financial position would be negatively impacted;

•The unavailability of equity and debt capital, volatility in the credit markets, increases in interest rates, or changes in the Company’s debt ratings could have an adverse effect on the Company’s ability to meet its debt payments, make dividend payments to stockholders or engage in acquisition and development activity;

•Increases in interest rates could have a material adverse effect on the Company's cost of capital;

•The Company's swap agreements may not effectively reduce its exposure to changes in interest rates;

•The Company has entered into joint venture agreements that limit its flexibility with respect to jointly owned properties and expects to enter into additional such agreements in the future;

•The U.S. federal income tax treatment of the cash that the Company might receive from cash settlement of a forward equity agreement is unclear and could jeopardize the Company's ability to meet the REIT qualification requirements; and

•In case of our bankruptcy or insolvency, any forward equity agreements will automatically terminate, and the Company would not receive the expected proceeds from any forward sale of shares of its common stock.

•The Company's property taxes could increase due to reassessment or property tax rate changes;

•Trends in the healthcare service industry may negatively affect the demand for the Company’s properties, lease revenues and the values of its investments;

•The costs of complying with governmental laws and regulations may adversely affect the Company's results of operations;

•Qualifying as a REIT involves highly technical and complex provisions of the Internal Revenue Code;

•If the Company fails to remain qualified as a REIT, the Company will be subject to significant adverse consequences, including adversely affecting the value of its common stock;

•The Company’s articles of incorporation, as well as provisions of the Maryland General Corporation Law ("MGCL"), contain limits and restrictions on transferability of the Company’s common stock which may have adverse effects on the value of the Company’s common stock;

•Complying with the REIT requirements may cause the Company to forego otherwise attractive opportunities;

•The prohibited transactions tax may limit the Company's ability to sell properties;

•New legislation or administrative or judicial action, in each instance potentially with retroactive effect, could make it more difficult or impossible for the Company to qualify as a REIT; and

•New and increased transfer tax rates may reduce the value of the Company’s properties.

•Liquidity and Capital Resources

•Trends and Matters Impacting Operating Results

•Results of Operations

•Non-GAAP Financial Measures and Key Performance Indicators

•Application of Critical Accounting Policies to Accounting Estimates

Dollars in thousands			ASSOCIATED HEALTH SYSTEM/TENANCY 1			DATE ACQUIRED			PURCHASE PRICE			SQUARE FOOTAGE			MILES TO CAMPUS
Dallas, TX 2			Texas Health Resources			2/11/2022			$	8,175		18,000			0.19
San Francisco, CA 3			Kaiser/Sutter Health			3/7/2022			114,000			166,396			0.90 to 3.30
Atlanta, GA			Wellstar Health			4/7/2022			6,912			21,535			0.00
Denver, CO			Centura Health			4/13/2022			6,320			12,207			2.40
Colorado Springs, CO 4			Centura Health			4/13/2022			13,680			25,800			0.80 to 1.70
Seattle, WA			UW Medicine			4/28/2022			8,350			13,256			0.05
Houston, TX			CommonSpirit			4/28/2022			36,250			76,781			1.70
Los Angeles, CA			Cedars-Sinai Health Systems			4/29/2022			35,000			34,282			0.11
Oklahoma, OK			Mercy Health			4/29/2022			11,100			34,944			0.18
Raleigh, NC 3			WakeMed/None			5/31/2022			27,500			85,113			0.25 to 12.30
Tampa. FL 4			BayCare Health			6/9/2022			18,650			55,788			0.23
Seattle, WA			Evergreen Health			8/1/2022			4,850			10,593			0.24
Raleigh, NC			WakeMed Health			8/9/2022			3,783			11,345			0.24
Jacksonville, FL			Ascension Health			8/9/2022			18,195			34,133			0.03
Atlanta, GA			Wellstar Health			8/10/2022			11,800			43,496			0.11
Denver, CO			Centura Health			8/11/2022			14,800			34,785			2.10
Raleigh, NC			Duke Health			8/18/2022			11,375			31,318			0.19
Nashville, TN			Ascension Health			9/15/2022			21,000			61,932			0.80
Austin, TX			HCA Healthcare			9/29/2022			5,450			15,000			0.03
Jacksonville, FL 2			Ascension Health			10/12/2022			3,600			6,200			0.10
Houston, TX			Memorial Hermann Health			11/21/2022			5,500			28,369			0.00
Austin, TX 5			Ascension Health			12/28/2022			888			2,219			0.01
Denver, CO			None			12/28/2022			16,400			39,692			3.01
Total investments in real estate									$	403,578		863,184

1Includes buildings located on-campus, adjacent and off-campus that are anchored by healthcare systems or located within two miles of a hospital campus.

2Represents a single-tenant property.

3Includes three properties.

4Includes two properties.

5The Company acquired additional ownership in an existing building bringing the Company's ownership to 71.4%.

Dollars in thousands			ASSOCIATED HEALTH SYSTEM/TENANCY 1			DATE ACQUIRED			PURCHASE PRICE			SQUARE FOOTAGE			MILES TO CAMPUS			COMPANY OWNERSHIP %
San Francisco, CA 2			MarinHealth/Kaiser			3/7/2022			$	67,175		110,865			0.00 to 3.30			50		%
Los Angeles, CA 3			Valley Presbyterian Health			3/7/2022			33,800			103,259			1.30			50		%
Total Joint Venture acquisitions									$	100,975		214,124

1Includes buildings located on-campus, adjacent and off-campus that are anchored by healthcare systems or located within two miles of a hospital campus.

2Includes three properties.

3Includes two properties.

•$60.8 million toward development and redevelopment of properties;

•$46.4 million toward first generation tenant improvements and planned capital expenditures for acquisitions;

•$33.6 million toward second generation tenant improvements; and

•$48.9 million toward capital expenditures.

Dollars in thousands			DATE DISPOSED			SALES PRICE			SQUARE FOOTAGE
Loveland, CO 1, 6			2/24/2022			$	84,950		150,291
San Antonio, TX 1			4/15/2022			25,500			201,523
GA, FL, PA 2			7/29/2022			133,100			316,739
GA, FL, TX 4			8/4/2022			160,917			343,545
Los Angeles, CA 2, 7			8/5/2022			134,845			283,780
Dallas, TX 4, 8			8/30/2022			114,290			189,385
Indianapolis, IN 3			8/31/2022			238,845			506,406
Dallas, TX 1			10/4/2022			104,025			291,328
Houston, TX			10/21/2022			32,000			134,910
College Station, TX			11/10/2022			49,177			122,942
El Paso, TX			12/22/2022			55,326			110,465
Atlanta, GA 5			12/22/2022			91,243			348,416
St. Louis, MO			12/28/2022			18,000			69,394
Total dispositions						$	1,242,218		3,069,124

1Includes two properties.

2Includes four properties.

3Includes five properties.

4Includes six properties.

5Includes nine properties.

6The Company deferred the tax gain through a 1031 exchange and reinvested the proceeds.

7Values and square feet are represented at 100%. The Company retained a 20% ownership interest in the joint venture that purchased these properties.

8Values and square feet are represented at 100%. The Company retained a 40% ownership interest in the joint venture that purchased these properties.

			WEIGHTED AVERAGE SALE PRICE per share			SHARES PRICED			SHARES SETTLED			SHARES REMAINING TO BE SETTLED			NET PROCEEDS in millions
2022			$	31.73		—			727,400			—			$	22.3

(dollars in millions)			TRANSACTION DATE			PRINCIPAL REPAYMENT			ENCUMBERED SQUARE FEET			CONTRACTUAL INTEREST RATE
Repayments in full:
Los Angeles, CA			2/18/2022			$	(11.0)		56,762			4.70		%
Loveland, CO			2/24/2022			(5.8)			80,153			6.17		%
						$	(16.8)		136,915			5.21		%

Series of Old HR Notes						Tenders and Consents Received as of the Expiration Date			Percentage of Total Outstanding Principal Amount of Such Series of Old HR Notes
3.875		%	Senior Notes due 2025			$235,016,000			94.01		%
3.625		%	Senior Notes due 2028			$290,246,000			96.75		%
2.400		%	Senior Notes due 2030			$297,507,000			99.17		%
2.050		%	Senior Notes due 2031			$298,858,000			99.62		%

			COUPON						PRINCIPAL OUTSTANDING AS OF
Dollars in thousands						FACE VALUE			12/31/2022			12/31/2021
Senior Notes due 2026			3.50%			$	600,000		$	600,000		$	—
Senior Notes due 2027			3.75%			500,000			500,000			—
Senior Notes due 2030			3.10%			650,000			650,000			—
Senior Notes due 2031			2.00%			800,000			800,000			—
						$	2,550,000		$	2,550,000		$	—

•Legacy HR’s existing $700.0 million revolving credit facility under the Amended and Restated Credit Agreement, dated as of May 31, 2019 (as amended, restated, replaced, supplemented, or otherwise modified from time to time prior to July 20, 2022, the “Existing HR Revolving Credit Agreement”), by and among Legacy HR, the lenders party thereto from time to time and their assignees, as lenders, and Wells Fargo Bank, National Association, as the administrative agent (the “WF Administrative Agent”), was terminated, all outstanding obligations in respect thereof were deemed paid in full and all commitments thereunder were permanently reduced to zero and terminated.

•Legacy HR’s existing $200.0 million term loan facility and existing $150.0 million term loan facility under the Amended and Restated Term Loan Agreement, dated as of May 31, 2019 (as amended, restated, replaced, supplemented, or otherwise modified from time to time prior to July 20, 2022, the “Existing HR Term Loan Agreement”), by and among Legacy HR, the lenders party thereto from time to time and their assignees, as lenders, and the WF Administrative Agent, in each, case, were deemed continued and assumed by the Borrower under the Unsecured Credit Facility, and the Existing HR Term Loan Agreement was terminated.

◦The existing $200.0 million term loan facility was amended to: (a) conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility; (b) include two one-year extension options, resulting in a latest final maturity in May 2026; and (c) reprice to align with the pricing for the Borrower’s other term loan facilities under the Unsecured Credit Facility; and

◦The existing $150.0 million term loan facility was amended to conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility, and the existing maturity in June 2026 remains unchanged under the Unsecured Credit Facility.

•Legacy HTA’s and the OP’s existing $1.0 billion revolving credit facility was upsized to $1.5 billion (the “Revolver”) pursuant to the Unsecured Credit Facility. The Revolver currently matures in October 2025, and the Unsecured Credit Facility adds an additional one-year extension option for the Revolver, for a total of two one-year extension options.

•Legacy HTA’s and the OP’s existing $300.0 million term loan facility was deemed continued pursuant to the Unsecured Credit Facility and was amended to conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility. The existing maturity in October 2025 remains unchanged under the Unsecured Credit Facility.

•Legacy HTA’s and the OP’s existing $200.0 million term loan facility was deemed continued pursuant to the Unsecured Credit Facility and was amended to (a) conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility; (b) extend the maturity from January 2024 to July 20, 2027; and (c) reprice to align with the pricing for the Borrower’s other term loan facilities under the Unsecured Credit Facility.

•The Unsecured Credit Facility provides for a new $350.0 million delayed-draw term loan facility that is available to be drawn for 12 months after July 20, 2022 and has an initial maturity date of July 20, 2023, with two one-year extension options. As of December 31, 2022, the $350.0 million Unsecured Credit Facility was drawn in full. The terms of any delayed draw term loans funded thereunder conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility, and the pricing for such delayed draw term loans aligns with the pricing for the Borrower’s other term loan facilities under the Unsecured Credit Facility.

•The Unsecured Credit Facility provides for a new $300.0 million term loan facility that was funded on July 20, 2022 and has a maturity date of January 20, 2028, with no extension options. The terms of such term loan facility conform to the terms of the Borrower’s other term loan facilities under the Unsecured Credit Facility, and the pricing for such term loan facility aligns with the pricing for the Borrower’s other term loan facilities under the Unsecured Credit Facility.

EXPIRATION DATE			AMOUNT			WEIGHTED AVERAGE RATE
January 31, 2023			$	300,000		1.42		%
January 15, 2024			200,000			1.21		%
May 1, 2026			100,000			2.15		%
December 1, 2026			150,000			3.84		%
June 1, 2027			150,000			4.13		%
December 1, 2027			250,000			3.79		%
			$	1,150,000		2.63		%

			PRINCIPAL BALANCE			CARRYING BALANCE 1			WEIGHTED YEARS TO MATURITY 2			CONTRACTUAL RATE			EFFECTIVE RATE
Senior Notes due 2025			$	250,000		$	249,115		2.3			3.88		%	4.12		%
Senior Notes due 2026 3			600,000			571,587			3.6			3.50		%	4.94		%
Senior Notes due 2027 3			500,000			479,553			4.5			3.75		%	4.76		%
Senior Notes due 2028			300,000			296,852			5.0			3.63		%	3.85		%
Senior Notes due 2030 3			650,000			565,402			7.1			3.10		%	5.30		%
Senior Notes due 2030			299,500			296,385			7.2			2.40		%	2.72		%
Senior Notes due 2031			300,000			295,547			8.2			2.05		%	2.25		%
Senior Notes due 2031 3			800,000			632,693			8.2			2.00		%	5.13		%
Total Senior Notes Outstanding			3,699,500			3,387,134			5.9			2.97		%	4.43		%
$1.5 billion unsecured credit facility 4 5			385,000			385,000			4.8			SOFR + 0.95%			5.27		%
$350 million unsecured term loan 5			350,000			349,114			2.6			SOFR + 1.05%			5.17		%
$200 million unsecured term loan			200,000			199,670			3.4			SOFR + 1.05%			5.17		%
$150 million unsecured term loan			150,000			149,495			3.4			SOFR + 1.05%			5.17		%
$300 million unsecured term loan 3			300,000			299,936			3.8			SOFR + 1.05%			5.17		%
$200 million unsecured term loan 3			200,000			199,362			4.5			SOFR + 1.05%			5.17		%
$300 million unsecured term loan 5			300,000			297,869			5.0			SOFR + 1.05%			5.17		%
Mortgage notes payable			84,122			84,247			2.0			4.07		%	3.97		%
Total Outstanding Notes and Bonds Payable			$	5,668,622		$	5,351,827		5.0			3.72		%	4.69		%

1Balances are reflected net of discounts and debt issuance costs and include premiums.

2Includes extension options.

3Debt instruments assumed as part of the Merger with Legacy HTA on July 20, 2022. Amounts shown represent fair value adjustments.

4As of December 31, 2022, the Company had $385.0 million borrowed under the Unsecured Credit Facility with a remaining borrowing capacity of $1.1 billion.

5On July 20, 2022, the Company entered into the Unsecured Credit Facility which included a $1.5 billion revolving credit facility, replacing Legacy HR's $700.0 million credit facility.

•The Company (exclusive of joint ventures) acquired 28 medical office buildings for purchase prices totaling $403.6 million, resulting in cash consideration paid of $399.2 million.

•Through joint ventures, the Company acquired interests in five medical office buildings for purchase prices totaling $101.0 million, resulting in cash consideration paid of $99.2 million. The Company funded 50% of the consideration for these acquisitions.

															ESTIMATED REMAINING FUNDINGS			ESTIMATED TOTAL INVESTMENT			APPROXIMATE SQUARE FEET
Dollars in thousands			NUMBER OF PROPERTIES						TOTAL FUNDED DURING THE YEAR			TOTAL AMOUNT FUNDED
Development Activity
Nashville, TN			1						$	23,513		$	25,359		$	18,641		$	44,000		106,194
Orlando, FL 1			2						9,477			16,633			$	48,367		65,000			156,566
Raleigh, NC			1						4,807			13,625			$	35,675		49,300			120,694
Orlando, FL			1						1,470			1,470			$	24,430		25,900			45,000
Total									$	39,267		$	57,087		$	127,113		$	184,200		428,454
Redevelopment Activity
Tacoma, WA			1						$	7,930		$	12,253		$	247		$	12,500		56,000
Dallas, TX			1						4,672			12,132			5,368			17,500			217,114
Washington, DC			3						1,113			2,857			18,343			21,200			259,290
Total									$	13,715		$	27,242		$	23,958		$	51,200		532,404

1This project is funded through a construction note receivable.

			NUMBER OF PROPERTIES						GROSS REAL ESTATE INVESTMENT AS OF DECEMBER 31, 2022
YEAR EXERCISABLE			MOB			INPATIENT			FAIR MARKET VALUE METHOD 1			NON FAIR MARKET VALUE METHOD 2			TOTAL
Current 3			3			2			$	100,366		$	—		$	100,366
2023			2			—			36,171			—			36,171
2024			—			—			—			—			—
2025			6			1			88,412			44,459			132,871
2026			5			1			179,929			—			179,929
2027			4			—			110,125			—			110,125
2028			2			2			109,399			—			109,399
2029			2			1			81,794			—			81,794
2030			—			—			—			—			—
2031			3			1			108,769			—			108,769
2032			2			—			24,628			—			24,628
2033 and thereafter 4			10			—			334,634			—			334,634
Total			39			8			$	1,174,227		$	44,459		$	1,218,686

1The purchase option price includes a fair market value component that is determined by an appraisal process.

2Includes properties with stated purchase prices or prices based on fixed capitalization rates.

3These purchase options have been exercisable for an average of 15.6 years.

4 Includes two medical office buildings that are recorded in the line item Investment in financing receivable, net on the Company's Consolidated Balance Sheet.

•Acquisitions in 2021 and 2022 contributed $49.2 million.

•Leasing activity contributed $16.3 million.

•Dispositions in 2021 and 2022 resulted in a decrease of $23.6 million.

•Impact from the Merger contributed $345.2 million.

•Two financing receivables acquired during 2021 contributed $3.9 million.

•Interest from notes receivables assumed in the Merger totaling $3.4 million.

•Acquisitions in 2021 and 2022 resulted in an increase of $19.6 million.

•Increases in portfolio operating expenses as follows:

◦Utilities expense of $4.0 million;

◦Compensation of $2.3 million;

◦Leasing commission amortization of $1.9 million;

◦Janitorial expense of $1.2 million;

◦Maintenance and repair expense of $0.8 million;

◦Property tax of $0.6 million;

◦Security of $0.5 million;

◦Administrative and other legal expense of $0.5 million; and

◦Insurance expense of $0.4 million.

•Dispositions in 2021 and 2022 resulted in a decrease of $11.9 million.

•Impact from the Merger resulted in an increase of $111.9 million.

•Compensation expense increased $6.3 million, including $3.5 million of non-cash expense.

•Net increases, including professional fees, audit services, travel and other administrative costs of $4.9 million.

•Impact from the Merger resulted in an increase of $7.4 million.

•Acquisitions in 2021 and 2022 resulted in increases of $25.9 million.

•Various building and tenant improvement expenditures caused increases of $10.1 million.

•Dispositions in 2021 and 2022 resulted in decreases of $7.8 million.

•Assets that became fully depreciated resulted in decreases of $10.4 million.

•Impact from the Merger, including purchase accounting fair value adjustments, resulted in an increase of $232.6 million.

									CHANGE
Dollars in thousands			2022			2021			$			%
Contractual interest			$	118,085		$	48,740		$	69,345		142.3		%
Net discount/premium accretion			18,227			105			18,122			17,259.0		%
Debt issuance costs amortization			4,256			2,873			1,383			48.1		%
Amortization of interest rate swap settlement			168			168			—			—		%
Amortization of treasury hedge settlement			427			427			—			—		%
Fair value derivative			4,057			—			4,057			N/A
Interest cost capitalization			(1,409)			(221)			(1,188)			537.6		%
Interest on lease liabilities			2,880			1,032			1,848			179.1		%
Total interest expense			$	146,691		$	53,124		$	93,567		176.1		%

•Senior notes and unsecured term loans assumed in the Merger accounted for an increase of approximately $51.9 million.

•New unsecured term loans executed with the Unsecured Credit Facility accounted for an increase of approximately $9.9 million.

•The Unsecured Credit Facility accounted for an increase of approximately $15.4 million due to an increased weighted average balance outstanding and an increase in the weighted average interest rate.

•Active interest rate derivatives accounted for a decrease of $6.7 million.

•Mortgage note repayments, net of assumptions, accounted for a decrease of approximately $1.2 million.

			YEAR ENDED DECEMBER 31,
Amounts in thousands, except per share data			2022			2021			2020
Net income attributable to common stockholders			$	40,897		$	66,659		$	72,195
Gain on sales of real estate assets			(270,271)			(55,940)			(70,361)
Impairments			54,427			17,101			—
Real estate depreciation and amortization			459,211			208,155			194,574
Non-controlling income from operating partnership units			(5)			—			—
Proportionate share of unconsolidated joint ventures			12,722			5,541			564
FFO attributable to common stockholders			296,981			241,516			196,972
Acquisition and pursuit costs 1			3,229			3,930			2,561
Merger-related costs			103,380			—			—
Fair value of debt instruments			21,248			—			—
Lease intangible amortization 3			1,028			162			690
Non-routine legal costs/forfeited earnest money received 2			771			(35)			—
Debt financing costs 4			3,145			283			21,920
Unconsolidated JV normalizing items 5			330			225			16
Normalized FFO attributable to common stockholders			430,112			246,081			222,159
Non-real estate depreciation and amortization			2,217			2,397			3,154
Non-cash interest expense amortization 6			5,129			3,182			3,691
Provision for bad debt, net			516			73			207
Straight-line rent income, net			(20,124)			(4,303)			(2,245)
Share-based compensation			14,294			10,729			9,922
Proportionate share of unconsolidated joint ventures			(1,206)			(1,357)			27
Normalized FFO adjusted for non-cash items			430,938			256,802			236,915
2nd Generation tenant improvements			(33,620)			(26,363)			(26,209)
Leasing commissions paid			(22,929)			(11,742)			(10,369)
Capital expenditures			(48,913)			(19,582)			(21,758)
Maintenance capital expenditures			(105,462)			(57,687)			(58,336)
FAD attributable to common stockholders			$	325,476		$	199,115		$	178,579
FFO per common share - diluted			$	1.17		$	1.68		$	1.46
Normalized FFO per common share - diluted			$	1.69		$	1.71		$	1.65
Weighted average common shares outstanding - diluted 7			254,622			143,618			134,835

1Acquisition and pursuit costs include third party and travel costs related to the pursuit of acquisitions and developments.

2Non-routine legal costs include expenses related to disputes with a contractor and a tenant relating to a violation of use restrictions. Forfeited earnest money received related to a disposition that did not close.

3Includes above or below market lease intangibles that are identified upon building acquisitions.

4Amount for 2020 includes the loss on extinguishment of debt on the extinguishment of the Senior Notes due 2023 of $21.5 million and double interest incurred on the timing of issuance of the Senior Notes due 2031 and the redemption of the Senior Notes due 2023 of $0.4 million.

5Includes the Company's proportionate share of acquisition and pursuit costs related to unconsolidated joint ventures.

6Includes the amortization of deferred financing costs, discounts and premiums, and non-cash financing receivable amortization.

7The Company utilizes the treasury stock method which includes the dilutive effect of nonvested share-based awards outstanding of 748,385, 907,393, and 828,506 for the years ended December 31, 2022, 2021, and 2020, respectively.

			YEAR ENDED DECEMBER 31,
Dollars in thousands			2022			2021			PERCENTAGE GROWTH
Net income attributable to common stockholders			$	40,897		$	66,659
Other income (expense)			(64,519)			15,089
General and administrative expense			52,734			34,152
Depreciation and amortization expense			453,082			202,714
Other expenses 1			120,576			14,164
Straight-line rent revenue			(23,498)			(5,801)
Joint venture properties			15,222			8,299
Other revenue 2			(16,577)			(8,117)
Cash NOI			577,917			327,159			76.6		%
Pre-merger Legacy HTA NOI			281,780			497,354
Proforma Cash NOI			859,697			824,513			4.3		%
Cash NOI not included in same store			(127,391)			(101,823)			25.1		%
Same store and redevelopment cash NOI			732,306			722,690			1.3		%
Redevelopment NOI			(9,743)			(17,737)			(45.1)		%
Same store cash NOI			$	722,563		$	704,953		2.5		%

2Includes management fee income, interest, above and below market lease intangible amortization, lease inducement amortization, lease terminations and tenant improvement overage amortization.

			AS OF DECEMBER 31, 2022
Dollars and square feet in thousands			PROPERTY COUNT			GROSS INVESTMENT 1			SQUARE FEET			OCCUPANCY
Same store properties			593			$	11,933,696		35,227			89.3		%
Acquisitions			74			1,259,600			3,399			87.1		%
Development completions			6			172,845			410			86.8		%
Redevelopment			15			307,229			1,314			59.4		%
Total owned real estate properties			688			$	13,673,370		40,350			87.8		%

1Gross investment excludes land held for development, construction in progress, corporate property, and investment in financing receivables. Gross investment also includes a $8.7 million imputed lease included in the financing lease right-of-use assets.

Acquisition-related costs include finder’s fees, advisory, legal, accounting, valuation, other professional or consulting fees, and certain general and administrative costs. Acquisition-related costs are expensed in the period incurred for acquisitions accounted for as a business combination under Accounting Standards Codification Topic 805, Business Combinations. These costs associated with asset acquisitions are capitalized in accordance with GAAP.

•Management, having the authority to approve the action, commits to a plan to sell the property or disposal group;

•The property or disposal group is available for immediate sale (i.e., a seller currently has the intent and ability to transfer the property or disposal group to a buyer) in its present condition, subject only to conditions that are usual and customary for sales of such properties or disposal groups;

•An active program to locate a buyer and other actions required to complete the plan to sell have been initiated;

•The sale of the property or disposal group is probable (i.e., likely to occur) and the transfer is expected to qualify for recognition as a completed sale within one year, with certain exceptions;

•The property or disposal group is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and

•Actions necessary to complete the plan indicate that it is unlikely significant changes to the plan will be made or that the plan will be withdrawn.

									IMPACT ON EARNINGS AND CASH FLOW
Dollars in thousands			OUTSTANDING PRINCIPAL BALANCE as of Dec. 31, 2022			CALCULATED ANNUAL INTEREST			ASSUMING 10% INCREASE  in market interest rates			ASSUMING 10% DECREASE in market interest rates
Variable Rate Debt
Unsecured Credit Facility			$	385,000		$	20,290		$	(2,029)		$	2,029
Unsecured Term Loan due 2025			350,000			18,095			(1,810)			1,810
Unsecured Term Loan due 2026			200,000			10,340			(1,034)			1,034
Unsecured Term Loan due 2026			300,000			15,510			(1,551)			1,551
Unsecured Term Loan due 2026			150,000			7,755			(776)			776
Unsecured Term Loan due 2027			200,000			10,340			(1,034)			1,034
Unsecured Term Loan due 2028			300,000			15,510			(1,551)			1,551
			$	1,885,000		$	97,840		$	(9,785)		$	9,785