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Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM 10-Q

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

For the quarterly period ended September 30, 2025

or

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

For the transition period from ___________ to ___________

Commission file number: 001-37815

Global Medical REIT Inc.

(Exact name of registrant as specified in its charter)

Maryland

    

46-4757266

(State or other jurisdiction of incorporation or
organization)

 

(I.R.S. Employer Identification No.)

 

 

 

 7373 Wisconsin Avenue, Suite 800

Bethesda, MD

 

20814

(Address of principal executive offices)

 

(Zip Code)

Registrant’s telephone number, including area code: (202) 524-6851

 

N/A

(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class:

    

Trading Symbol(s):

    

Name of each exchange on which registered:

Common Stock, par value $0.001 per share

 

GMRE

 

NYSE

Series A Preferred Stock, par value $0.001 per share

 

GMRE PrA

 

NYSE

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. þ Yes No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes þ   No 

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

Large accelerated filer 

þ

Accelerated filer

Non-accelerated filer

Smaller reporting company

 

 

Emerging growth company

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

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes  No

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date.

The number of shares of the registrant’s common stock outstanding at November 3, 2025 was 13,407,358

Table of Contents

TABLE OF CONTENTS

PART I   FINANCIAL INFORMATION

Item 1.

Financial Statements (Unaudited)

Condensed Consolidated Balance Sheets – September 30, 2025 and December 31, 2024

3

Condensed Consolidated Statements of Operations – Three and Nine Months Ended September 30, 2025 and 2024

4

Condensed Consolidated Statements of Comprehensive Loss – Three and Nine Months Ended September 30, 2025 and 2024

5

Condensed Consolidated Statements of Equity – Three and Nine Months Ended September 30, 2025 and 2024

6

Condensed Consolidated Statements of Cash Flows – Nine Months Ended September 30, 2025 and 2024

8

Notes to the Unaudited Condensed Consolidated Financial Statements

9

Item 2.

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

28

Item 3.

Quantitative and Qualitative Disclosures About Market Risk

46

Item 4.

Controls and Procedures

47

PART II OTHER INFORMATION

Item 1.

Legal Proceedings

47

Item 1A.

Risk Factors

47

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

48

Item 3.

Defaults Upon Senior Securities

48

Item 4.

Mine Safety Disclosures

48

Item 5.

Other Information

48

Item 6.

Exhibits

49

Signatures

50

-2-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Balance Sheets

(unaudited and in thousands, except par values)

As of

    

September 30, 2025

    

December 31, 2024

    

Assets

Investment in real estate:

Land

$

171,349

$

174,300

Building

 

1,087,622

 

1,044,019

Site improvements

 

25,065

 

23,973

Tenant improvements

 

79,979

 

69,679

Acquired lease intangible assets

 

144,696

 

138,945

 

1,508,711

 

1,450,916

Less: accumulated depreciation and amortization

 

(327,248)

 

(288,921)

Investment in real estate, net

 

1,181,463

 

1,161,995

Cash and cash equivalents

 

7,123

 

6,815

Restricted cash

 

2,717

 

2,127

Tenant receivables, net

 

7,945

 

7,424

Due from related parties

367

270

Escrow deposits

 

552

 

711

Deferred assets

 

29,205

 

28,208

Derivative asset

7,467

18,613

Goodwill

5,903

5,903

Investment in unconsolidated joint venture

1,846

2,066

Other assets

 

28,650

 

22,354

Total assets

$

1,273,238

$

1,256,486

Liabilities and Equity

Liabilities:

Credit Facility, net of unamortized debt issuance costs of $3,218 and $4,868 at September 30, 2025 and December 31, 2024, respectively

$

708,482

$

631,732

Notes payable, net of unamortized debt issuance costs of $22 at December 31, 2024

 

1,153

 

14,399

Accounts payable and accrued expenses

 

17,808

 

16,468

Dividends payable

 

12,051

 

16,520

Security deposits

 

3,512

 

3,324

Other liabilities

 

18,888

 

14,191

Acquired lease intangible liability, net

 

5,516

 

3,936

Total liabilities

 

767,410

 

700,570

Commitments and Contingencies

Equity:

Preferred stock, $0.001 par value, 10,000 shares authorized; 3,105 issued and outstanding at September 30, 2025 and December 31, 2024, respectively (liquidation preference of $77,625 at September 30, 2025 and December 31, 2024, respectively)

 

74,959

 

74,959

Common stock, $0.001 par value, 100,000 shares authorized; 13,407 shares and 13,374 shares issued and outstanding at September 30, 2025 and December 31, 2024, respectively

 

13

 

13

Additional paid-in capital

 

735,416

 

734,277

Accumulated deficit

 

(332,566)

 

(293,736)

Accumulated other comprehensive income

 

7,467

 

18,613

Total Global Medical REIT Inc. stockholders' equity

 

485,289

 

534,126

Noncontrolling interest

 

20,539

 

21,790

Total equity

 

505,828

 

555,916

Total liabilities and equity

$

1,273,238

$

1,256,486

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

-3-

Table of Contents

GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Operations

(unaudited and in thousands, except per share amounts)

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

2025

    

2024

    

2025

    

2024

    

Revenue

Rental revenue

$

37,036

$

34,175

$

109,510

$

103,458

Other income

 

193

 

89

 

306

 

166

Total revenue

 

37,229

 

34,264

 

109,816

 

103,624

Expenses

General and administrative

 

4,860

4,381

14,505

13,416

Operating expenses

 

8,224

7,437

24,025

22,056

Depreciation expense

 

11,213

9,993

32,827

30,233

Amortization expense

 

3,795

3,649

11,299

11,487

Interest expense

8,175

7,236

23,351

21,119

Total expenses

 

36,267

 

32,696

 

106,007

 

98,311

Income before other income (expense)

962

1,568

3,809

5,313

Gain (loss) on sale of investment properties

294

1,823

1,859

(1,560)

Impairment of investment property

(6,281)

(6,281)

Equity loss from unconsolidated joint venture

(33)

(123)

Net (loss) income

$

(5,058)

$

3,391

$

(736)

$

3,753

Less: Preferred stock dividends

 

(1,455)

(1,455)

(4,366)

(4,366)

Less: Net loss (income) attributable to noncontrolling interest

 

512

(145)

404

50

Net (loss) income attributable to common stockholders

$

(6,001)

$

1,791

$

(4,698)

$

(563)

Net (loss) income attributable to common stockholders per share – basic and diluted

$

(0.45)

$

0.14

$

(0.35)

$

(0.04)

Weighted average shares outstanding – basic and diluted

 

13,393

13,147

13,381

13,126

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Comprehensive Loss

(unaudited and in thousands)

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

2025

    

2024

    

2025

    

2024

    

Net (loss) income

$

(5,058)

$

3,391

$

(736)

$

3,753

Other comprehensive loss:

Decrease in fair value of interest rate swap agreements

 

(2,929)

 

(12,705)

 

(11,146)

 

(10,158)

Total other comprehensive loss

 

(2,929)

 

(12,705)

 

(11,146)

 

(10,158)

Comprehensive loss

 

(7,987)

 

(9,314)

 

(11,882)

 

(6,405)

Less: Preferred stock dividends

 

(1,455)

 

(1,455)

 

(4,366)

(4,366)

Less: Comprehensive loss attributable to noncontrolling interest

 

742

 

807

 

1,287

817

Comprehensive loss attributable to common stockholders

$

(8,700)

$

(9,962)

$

(14,961)

$

(9,954)

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Equity

(unaudited and in thousands, except per share amounts)

For the Nine Months Ended September 30, 2025:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Income

    

Equity

    

Interest

    

Equity

Balances, December 31, 2024

 

13,374

$

13

 

3,105

$

74,959

$

734,277

$

(293,736)

$

18,613

$

534,126

$

21,790

$

555,916

Net loss

 

 

 

 

 

 

(332)

 

 

(332)

 

(404)

 

(736)

LTIP Units and OP Units redeemed for common stock

33

1,141

1,141

(1,141)

Fractional shares settled

(2)

(2)

(2)

Change in fair value of interest rate swap agreements

 

 

 

 

 

 

 

(11,146)

 

(11,146)

 

 

(11,146)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

3,086

 

3,086

Dividends to common stockholders ($2.55 per share)

 

 

 

 

 

 

(34,132)

 

 

(34,132)

 

 

(34,132)

Dividends to preferred stockholders ($1.40625 per share)

 

 

 

 

 

 

(4,366)

 

 

(4,366)

 

 

(4,366)

Dividends to noncontrolling interest

 

 

 

 

 

 

 

 

 

(2,792)

 

(2,792)

Balances, September 30, 2025

 

13,407

$

13

 

3,105

$

74,959

$

735,416

$

(332,566)

$

7,467

$

485,289

$

20,539

$

505,828

For the Three Months Ended September 30, 2025:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Income

    

Equity

    

Interest

    

Equity

Balances, June 30, 2025

 

13,376

$

13

 

3,105

$

74,959

$

734,344

$

(316,510)

$

10,396

$

503,202

$

21,819

$

525,021

Net loss

 

 

 

 

 

 

(4,546)

 

 

(4,546)

 

(512)

 

(5,058)

LTIP Units and OP Units redeemed for common stock

31

1,074

1,074

(1,074)

Fractional shares settled

(2)

(2)

(2)

Change in fair value of interest rate swap agreements

(2,929)

(2,929)

(2,929)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

1,207

 

1,207

Dividends to common stockholders ($0.75 per share)

 

 

 

 

 

 

(10,055)

 

 

(10,055)

 

 

(10,055)

Dividends to preferred stockholders ($0.46875 per share)

 

 

 

 

 

 

(1,455)

 

 

(1,455)

 

 

(1,455)

Dividends to noncontrolling interest

 

 

 

 

 

 

 

 

 

(901)

 

(901)

Balances, September 30, 2025

 

13,407

$

13

 

3,105

$

74,959

$

735,416

$

(332,566)

$

7,467

$

485,289

$

20,539

$

505,828

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Equity - Continued

(unaudited and in thousands, except per share amounts)

For the Nine Months Ended September 30, 2024:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Income

    

Equity

    

Interest

    

Equity

Balances, December 31, 2023

13,113

$

13

 

3,105

$

74,959

$

722,471

$

(238,984)

$

25,125

$

583,584

$

22,230

$

605,814

Net income (loss)

 

 

 

 

 

 

3,803

 

 

3,803

 

(50)

 

3,753

Issuance of shares of common stock, net

241

10,896

10,896

10,896

LTIP Units redeemed for common stock

7

313

313

(313)

Change in fair value of interest rate swap agreements

 

 

 

 

 

 

 

(10,158)

 

(10,158)

 

 

(10,158)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

3,826

 

3,826

Dividends to common stockholders ($3.15 per share)

 

 

 

 

 

 

(41,520)

 

 

(41,520)

 

 

(41,520)

Dividends to preferred stockholders ($1.40625 per share)

 

 

 

 

 

 

(4,366)

 

 

(4,366)

 

 

(4,366)

Dividends to noncontrolling interest

 

 

 

 

 

 

 

 

 

(3,639)

 

(3,639)

Balances, September 30, 2024

 

13,361

$

13

 

3,105

$

74,959

$

733,680

$

(281,067)

$

14,967

$

542,552

$

22,054

$

564,606

For the Three Months Ended September 30, 2024:

Global

Accumulated

Medical

Additional

Other

REIT Inc.

Non-

Common Stock

Preferred Stock

Paid-in

Accumulated

Comprehensive

Stockholders’

controlling

Total

    

Shares

    

Amount

    

Shares

    

Amount

    

Capital

    

Deficit

    

Income

    

Equity

    

Interest

    

Equity

Balances, June 30, 2024

 

13,118

$

13

 

3,105

$

74,959

$

722,680

$

(268,885)

$

27,672

$

556,439

$

21,933

$

578,372

Net income

 

 

 

 

 

 

3,246

 

 

3,246

 

145

 

3,391

Issuance of shares of common stock, net

241

10,896

10,896

10,896

LTIP Units redeemed for common stock

2

104

104

(104)

Change in fair value of interest rate swap agreements

(12,705)

(12,705)

(12,705)

Stock-based compensation expense

 

 

 

 

 

 

 

 

 

1,274

 

1,274

Dividends to common stockholders ($1.05 per share)

 

 

 

 

 

 

(13,973)

 

 

(13,973)

 

 

(13,973)

Dividends to preferred stockholders ($0.46875 per share)

 

 

 

 

 

 

(1,455)

 

 

(1,455)

 

 

(1,455)

Dividends to noncontrolling interest

 

 

 

 

 

 

 

 

 

(1,194)

 

(1,194)

Balances, September 30, 2024

 

13,361

$

13

 

3,105

$

74,959

$

733,680

$

(281,067)

$

14,967

$

542,552

$

22,054

$

564,606

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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GLOBAL MEDICAL REIT INC.

Condensed Consolidated Statements of Cash Flows

(unaudited and in thousands)

Nine Months Ended September 30, 

    

2025

    

2024

    

Operating activities

Net (loss) income

$

(736)

$

3,753

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

Depreciation expense

 

32,827

 

30,233

Amortization of acquired lease intangible assets

 

10,582

 

11,174

Amortization of above market leases, net

 

505

 

782

Amortization of debt issuance costs and other

 

1,672

 

1,684

Stock-based compensation expense

 

3,086

 

3,826

Capitalized preacquisition and other costs charged to expense

58

93

Reserve for uncollectible accounts, net

822

(Gain) loss on sale of investment properties

(1,859)

1,560

Impairment of investment property

6,281

Equity loss from unconsolidated joint venture

123

Other

 

94

 

129

Changes in operating assets and liabilities:

Tenant receivables

 

(522)

 

(2,182)

Deferred assets

 

(1,094)

 

(1,008)

Other assets and liabilities

 

(1,830)

 

(1,030)

Accounts payable and accrued expenses

 

2,602

 

153

Security deposits

188

(466)

Net cash provided by operating activities

 

51,977

 

49,523

Investing activities

Purchase of land, buildings, and other tangible and intangible assets and liabilities

(70,468)

(31,279)

Net proceeds from sale of investment properties

12,695

19,230

Distribution of capital from unconsolidated joint venture

97

Escrow deposits for purchase of properties

 

290

 

(1,252)

Advances made to related parties

 

(97)

 

(211)

Capital expenditures on existing real estate investments

(7,860)

(9,972)

Leasing commissions

(1,809)

(2,935)

Net cash used in investing activities

 

(67,152)

 

(26,419)

Financing activities

Net proceeds received from common equity offerings

10,896

Escrow deposits required by third party lenders

 

231

Repayment of notes payable

 

(13,268)

(11,441)

Proceeds from Credit Facility

 

115,400

82,800

Repayment of Credit Facility

 

(40,300)

(55,400)

Dividends paid to common stockholders, and OP Unit and LTIP Unit holders

 

(41,393)

(44,759)

Dividends paid to preferred stockholders

 

(4,366)

(4,366)

Net cash provided by (used in) financing activities

 

16,073

 

(22,039)

Net increase in cash and cash equivalents and restricted cash

 

898

 

1,065

Cash and cash equivalents and restricted cash—beginning of period

 

8,942

 

6,724

Cash and cash equivalents and restricted cash—end of period

$

9,840

$

7,789

Supplemental cash flow information:

Cash payments for interest

$

22,188

$

19,525

Noncash financing and investing activities:

Accrued dividends payable

$

12,051

$

16,534

Interest rate swap agreements fair value change recognized in other comprehensive loss

$

(11,146)

$

(10,158)

LTIP Units and OP Units redeemed for common stock

$

1,141

$

313

Accrued capital expenditures and leasing commissions included in accounts payable and accrued expenses

$

1,637

$

1,956

Recognition of lease liability related to right of use asset

$

6,280

$

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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GLOBAL MEDICAL REIT INC.

Notes to the Unaudited Condensed Consolidated Financial Statements

(dollars in thousands, except per share amounts or as otherwise indicated)

Note 1 – Organization

Global Medical REIT Inc. (the “Company”) is a Maryland corporation and internally managed real estate investment trust (“REIT”) that acquires healthcare facilities and leases those facilities to physician groups and regional and national healthcare systems. The Company holds its facilities and conducts its operations through a Delaware limited partnership subsidiary, Global Medical REIT L.P. (the “Operating Partnership”). The Company serves as the sole general partner of the Operating Partnership through a wholly owned subsidiary of the Company, Global Medical REIT GP LLC, a Delaware limited liability company. As of September 30, 2025, the Company was the 92.14% limited partner of the Operating Partnership, with an aggregate of 7.86% of the Operating Partnership owned by holders of long-term incentive plan units (“LTIP Units”) and third-party limited partners who contributed properties or services to the Operating Partnership in exchange for common limited partnership units (“OP Units”).

Note 2 – Summary of Significant Accounting Policies

Basis of presentation

The accompanying condensed consolidated financial statements are unaudited and include the accounts of the Company, including the Operating Partnership and its wholly owned subsidiaries, and its equity investment in an unconsolidated joint venture. The accompanying condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) and the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). Certain information and footnote disclosures required for annual consolidated financial statements have been condensed or excluded pursuant to SEC rules and regulations. Accordingly, the accompanying condensed consolidated financial statements do not include all the information and footnotes required by GAAP for complete consolidated financial statements and should be read in conjunction with the audited consolidated financial statements and notes thereto for the year ended December 31, 2024. In the opinion of management, all adjustments of a normal and recurring nature necessary for a fair presentation of the condensed consolidated financial statements for the interim periods have been made.

Reverse Stock Split

In August 2025, the Company’s board of directors (the “Board”) approved a reverse stock split of the Company’s outstanding and authorized shares of common stock at a ratio of one-for-five (the “Reverse Stock Split”). The Reverse Stock Split was completed on September 19, 2025. As a result of the Reverse Stock Split, on September 19, 2025, every five issued and outstanding shares of the Company’s common stock was converted into one share of its common stock, with a corresponding reverse split of the LTIP Units and OP Units. The par value of each share of the Company’s common stock remained unchanged. All common share and per common share amounts in these condensed consolidated financial statements and notes thereto and applicable disclosures have been retrospectively adjusted for all periods presented to reflect the Reverse Stock Split. Refer to Note 5 – “Equity” and Note 7 – “Stock Based Compensation” for additional details on the Reverse Stock Split.

Principles of Consolidation

The accompanying condensed consolidated financial statements include the accounts of the Company, its wholly owned subsidiaries, and its equity investment in an unconsolidated joint venture. The Company presents the portion of any equity it does not own but controls (and thus consolidates) as noncontrolling interest. Noncontrolling interest in the Company includes the LTIP Units that have been granted to directors, officers and affiliates of the Company and the OP Units held by third parties. Refer to Note 5 – “Equity” and Note 7 – “Stock-Based Compensation” for additional information regarding the OP Units and LTIP Units.

The Company classifies noncontrolling interest as a component of consolidated equity on its Condensed Consolidated Balance Sheets, separate from the Company’s total equity. The Company’s net income or loss is allocated to noncontrolling interests based on the respective ownership or voting percentage in the Operating Partnership associated with such noncontrolling interests and is removed from consolidated income or loss on the Condensed Consolidated Statements of Operations in order to derive net income or loss attributable to common stockholders. The noncontrolling ownership percentage is calculated by dividing the aggregate number of LTIP Units and OP Units by the total number of units and shares outstanding.

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Use of Estimates

The preparation of the condensed consolidated financial statements in conformity with GAAP requires the Company to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and footnotes. Actual results could differ from those estimates.

Investment in Real Estate

The Company determines when an acquisition meets the definition of a business or alternatively should be accounted for as an asset acquisition in accordance with Accounting Standard Codification (“ASC”) Topic 805 “Business Combinations” (“ASC Topic 805”), which requires that, when substantially all of the fair value of an acquisition is concentrated in a single identifiable asset or a group of similar identifiable assets, the asset or group of similar identifiable assets does not meet the definition of a business and therefore is required to be accounted for as an asset acquisition. Transaction costs are capitalized for asset acquisitions and expensed as incurred for business combinations.

For asset acquisitions that are “owner occupied” (meaning that the seller either is the tenant or controls the tenant), the purchase price, including capitalized acquisition costs, will be allocated to land and building based on their relative fair values with no value allocated to intangible assets or liabilities. For asset acquisitions where there is a lease in place but that are not “owner occupied,” the Company will allocate the purchase price to tangible assets and any intangible assets acquired or liabilities assumed based on their relative fair values. Fair value is determined based upon the guidance of ASC Topic 820, “Fair Value Measurements and Disclosures,” and generally are determined using Level 2 inputs, such as rent comparables, sales comparables, and broker indications. Although Level 3 inputs are utilized, they are minor in comparison to the Level 2 data used for the primary assumptions. The determination of fair value involves the use of significant judgment and estimates. We make estimates to determine the fair value of the tangible and intangible assets acquired and liabilities assumed using information obtained from multiple sources, including preacquisition due diligence, and we routinely utilize the assistance of a third-party appraiser.

Revenue Recognition

The Company’s operations primarily consist of rental revenue earned from tenants under leasing arrangements which provide for minimum rent and escalations. The leases have been accounted for as operating leases. For operating leases with contingent rental escalators, revenue is recorded based on the contractual cash rental payments due during the period. Revenue from leases with fixed annual rental escalators are recognized on a straight-line basis over the initial lease term, subject to a collectability assessment, with the difference between the contractual rental receipts and the straight-line amounts recorded as a “deferred rent receivable.” Additionally, the Company recognizes as a component of rental revenue “expense recoveries” revenue, which represents revenue recognized related to tenant reimbursement of real estate taxes, insurance, and certain other operating expenses (“tenant reimbursements”). The Company recognizes these reimbursements and related expenses on a gross basis in its Condensed Consolidated Statements of Operations.

Impairment of Long-Lived Assets

The Company evaluates its real estate assets for impairment at each reporting date or whenever events or circumstances indicate that its carrying amount may not be recoverable. If an impairment indicator exists, the Company compares the expected future undiscounted cash flows against the carrying amount of the asset. If the sum of the estimated undiscounted cash flows is less than the carrying amount of the asset, the Company would record an impairment loss for the difference between the estimated fair value and the carrying amount of the asset.

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Cash and Cash Equivalents and Restricted Cash

The Company considers all demand deposits, cashier’s checks, money market accounts, and certificates of deposit with a maturity of three months or less to be cash equivalents. Amounts included in restricted cash represent certain security deposits received from tenants at the inception of their leases and funds held by the Company related to certain tenant reimbursements. The following table provides a reconciliation of the Company’s cash and cash equivalents and restricted cash that sums to the total of those amounts at the end of the periods presented on the Company’s accompanying Condensed Consolidated Statements of Cash Flows:

As of September 30, 

    

2025

    

2024

Cash and cash equivalents

 

$

7,123

 

$

5,723

Restricted cash

2,717

2,066

Total cash and cash equivalents and restricted cash

 

$

9,840

 

$

7,789

Tenant Receivables, Net

The tenant receivable balance as of September 30, 2025 and December 31, 2024 was $7,945 and $7,424, respectively. The balance as of September 30, 2025 consisted of $3,823 in funds owed from the Company’s tenants for rent that the Company had earned but had not yet received, $3,924 of tenant reimbursements, $110 for a loan that was made to one of the Company’s tenants, and $88 of miscellaneous receivables. The balance as of December 31, 2024 consisted of $2,838 in funds owed from the Company’s tenants for rent that the Company had earned but had not yet received, $4,014 of tenant reimbursements, $119 for a loan that was made to one of the Company’s tenants, and $453 of miscellaneous receivables.

Receivables arising from operating leases are accounted for in accordance with ASC Topic 842 “Leases” (“ASC Topic 842”). The Company assesses the likelihood of losses resulting from tenant defaults, or the inability of tenants to make contractual rent and tenant reimbursements at each reporting date. The Company also monitors the liquidity and creditworthiness of its tenants and operators on a continuous basis. If the likelihood of a tenant paying its lease payments is determined to no longer be probable, all tenant receivables, including deferred rent, are written off against revenue and any future revenue for that tenant is recognized only upon receipt of cash. In addition, as of September 30, 2025 and December 31, 2024, the Company had a portfolio level reserve of $350 on those leases that were probable of collection to ensure that the tenant lease receivables were not overstated.  

Escrow Deposits

The escrow balance as of September 30, 2025 and December 31, 2024 was $552 and $711, respectively. Escrow deposits include funds held in escrow to be used for the acquisition of properties in the future and for the payment of taxes and insurance.

Deferred Assets

The deferred assets balance as of September 30, 2025 and December 31, 2024 was $29,205 and $28,208, respectively. The balance as of September 30, 2025 consisted of $28,780 in deferred rent receivables resulting from the recognition of revenue from leases with fixed annual rental escalations on a straight-line basis and $425 of other deferred costs. The balance as of December 31, 2024 consisted of $28,009 in deferred rent receivables resulting from the recognition of revenue from leases with fixed annual rental escalations on a straight-line basis and $199 of other deferred costs.

Other Assets

The other assets balance as of September 30, 2025 and December 31, 2024 was $28,650 and $22,354, respectively. The balance as of September 30, 2025 consisted of $13,222 in right of use assets, $4,894 in capitalized construction in process costs, $2,506 in prepaid assets, $7,695 in net capitalized leasing commissions, and $333 in net capitalized software costs and miscellaneous assets. The balance as of December 31, 2024 consisted of $7,271 in right of use assets, $6,729 in capitalized construction in process costs, $1,451 in prepaid assets, $6,535 in net capitalized leasing commissions, and $368 in net capitalized software costs and miscellaneous assets. Refer to Note 8 – “Leases” for additional details on right of use assets.

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Derivative Instruments - Interest Rate Swaps

As of September 30, 2025 and December 31, 2024, the Company's balance related to interest rate swap derivative instruments that were designated as cash flow hedges of interest rate risk was an asset of $7,467 and $18,613, respectively. In accordance with the Company’s risk management strategy, the purpose of the interest rate swaps is to manage interest rate risk for certain of the Company’s variable-rate debt. The interest rate swaps involve the Company’s receipt of variable-rate amounts from the counterparties in exchange for the Company making fixed-rate payments over the life of the agreements. The Company accounts for derivative instruments in accordance with the provisions of ASC Topic 815, “Derivatives and Hedging.” Refer to Note 4 – “Credit Facility, Notes Payable and Derivative Instruments” for additional details.

Goodwill

As of September 30, 2025 and December 31, 2024, the Company’s goodwill balance was $5,903. Goodwill represents the excess of consideration paid over the fair value of underlying identifiable net assets of businesses acquired. Goodwill has an indefinite life and is not amortized, but is tested for impairment on an annual basis, or more frequently if events or changes in circumstances indicate that the asset might be impaired. The Company’s policy is to perform its annual goodwill impairment evaluation as of the first day of the fourth quarter of its fiscal year. The Company has one reporting unit.  

Assets Held for Sale and Sales of Real Estate

The Company classifies a property as held for sale when the following criteria are met: (i) management, having the authority to approve action, commits to a plan to sell the property in its present condition, (ii) the sale of the property is at a price reasonable in relation to its current fair value and (iii) the sale is probable and expected to be completed within one year. At that time, the Company presents the assets and obligations associated with the real estate held for sale separately in its Condensed Consolidated Balance Sheets and ceases recording depreciation and amortization expense related to that asset.  Real estate held for sale is reported at the lower of its carrying amount or its estimated fair value less estimated costs to sell. None of the Company’s properties were classified as held for sale as of September 30, 2025 or December 31, 2024.

Upon the disposition of a property, the Company recognizes a gain or loss at a point in time when the Company determines control of the underlying asset has been transferred to the buyer. The Company’s performance obligation is generally satisfied at the closing of the transaction. Any continuing involvement is analyzed as a separate performance obligation in the contract, and a portion of the sales price is allocated to each performance obligation. There is significant judgment applied to estimate the amount of variable consideration, if any, identified within the sales price and assess its probability of occurrence based on current market information, historical transactions, and forecasted information that is reasonably available.

For sales of real estate (or assets classified as held for sale), the Company evaluates whether the disposition is a strategic shift that will have a major effect on the Company’s operations and financial results, and, if so, it will be classified as discontinued operations in the Company’s consolidated financial statements for all periods presented.  

Other Liabilities

The other liabilities balance as of September 30, 2025 and December 31, 2024 was $18,888 and $14,191, respectively. The balance as of September 30, 2025 consisted of $13,505 for right of use liabilities and $5,383 of prepaid rent. The balance as of December 31, 2024 consisted of $7,461 for right of use liabilities and $6,730 of prepaid rent. Refer to Note 8 – “Leases” for additional details on right of use liabilities.

Unconsolidated Joint Venture

In December 2024, the Company entered into an agreement to sell certain assets to a newly formed joint venture, GII Global Medical Holdings LLC (the “Joint Venture”), with the Company, through its Operating Partnership, and Heitman Global Real Estate REIT LLC (“Heitman”) and their respective subsidiaries. The Company retained an ownership interest of 12.5% in the Joint Venture with Heitman retaining the remaining 87.5% interest. Heitman, through its voting interest, controls the entity. Accordingly, the Company accounts for its interest in the Joint Venture using the equity method of accounting. Under the equity method, the Company initially recorded the investment at cost and subsequently adjusts the investment for the Company’s share of the equity in earnings or losses, as well as for any cash contributions and distributions.

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The Company’s net equity investment in the unconsolidated Joint Venture is included in the "Investment in unconsolidated joint venture" line item on the Company’s Condensed Consolidated Balance Sheets. The Company’s share of net income or loss from the Joint Venture is included in the "Equity income (loss) from unconsolidated joint venture" line item on the Company’s Condensed Consolidated Statements of Operations.

Segment Reporting

In December 2024, the Company adopted ASU No. 2023-07, “Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures.” The Company adopted ASU 2023-07 for its fiscal year 2024 annual financial statements and interim financial statements thereafter. The Company acquires healthcare facilities and leases those facilities to physician groups and regional and national healthcare systems and derives its revenue primarily from the leasing of those facilities. The Company operates and manages its business as one reportable operating segment. Resources are allocated and financial performance is assessed by the Company’s Chief Executive Officer, its chief operating decision maker, or the CODM. The CODM is provided with and reviews total consolidated assets and consolidated net income or loss and uses this information to assess the performance of the Company’s portfolio and makes operating decisions accordingly. There are no significant segment operating expenses that require disclosure other than the expense categories on the Company’s Consolidated Statements of Operations.

Note 3 – Property Portfolio

Summary of Properties Acquired and Sold During the Nine Months Ended September 30, 2025

During the nine months ended September 30, 2025, the Company completed the acquisition of a five-property portfolio of medical real estate. For this acquisition, substantially all of the fair value was concentrated in a single identifiable asset or group of similar identifiable assets and, therefore, this acquisition represented an asset acquisition. Accordingly, transaction costs for this acquisition were capitalized.

During the nine months ended September 30, 2025, the Company completed five dispositions. In February 2025, the Company sold a medical office building located in Derby, Kansas receiving gross proceeds of $1.0 million, resulting in a gain of $17 thousand. In March 2025, the Company sold a medical office building located in Coos Bay, Oregon receiving gross proceeds of $7.2 million, resulting in a gain of $1.3 million. In April 2025, the Company sold a medical office building in Chipley, Florida receiving gross proceeds of $1.4 million, resulting in a gain of $0.2 million. In August 2025, the Company sold a medical office building in Germantown, Tennessee receiving gross proceeds of $1.9 million, resulting in a gain of $0.3 million. In September 2025, the Company sold an office building in Aurora, Illinois receiving gross proceeds of $1.9 million, resulting in no gain or loss on sale.

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A rollforward of the gross investment in land, building, improvements, and acquired lease intangible assets as of September 30, 2025 is as follows:

Site

Tenant

Acquired Lease

Gross Investment in

   

Land

   

Building

   

Improvements

   

Improvements

   

Intangible Assets

   

Real Estate

Balances as of December 31, 2024

$

174,300

$

1,044,019

$

23,973

$

69,679

$

138,945

$

1,450,916

Facility Acquired – Date Acquired:

Carondelet - 2/7/25

13,327

1,274

1,725

16,326

Silverbell - 2/7/25

8,482

973

1,368

10,823

Slippery Rock - 2/7/25

3,511

455

593

572

5,131

Clive - 4/1/25

11,400

507

1,595

2,218

15,720

Des Moines - 4/1/25

18,917

182

3,289

3,519

25,907

Capitalized costs(1)

 

4,224

464

3,412

 

8,100

Total Additions:

59,861

1,608

11,136

9,402

82,007

Facility Sold – Date Sold:

Derby - 2/18/25

(146)

(1,250)

(118)

(73)

(372)

(1,959)

Coos Bay - 3/19/25

(861)

(5,096)

(56)

(49)

(410)

(6,472)

Chipley - 4/30/25

(170)

(875)

(34)

(111)

(189)

(1,379)

2999 Germantown - 8/7/25

(253)

(1,593)

(1,846)

Aurora - 9/4/25

(339)

(2,345)

(308)

(603)

(2,680)

(6,275)

Total Dispositions:

(1,769)

(11,159)

(516)

(836)

(3,651)

(17,931)

Impairment of investment property(2)

(1,182)

(5,099)

(6,281)

Balances as of September 30, 2025

$

171,349

$

1,087,622

$

25,065

$

79,979

$

144,696

$

1,508,711

(1)Represents capital projects that were completed and placed in service during the nine months ended September 30, 2025 related to the Company’s existing facilities.
(2)In August 2025, the Company entered into an agreement to sell its facility located in Aurora, Illinois. The Company recognized an impairment loss of $6.3 million during the nine months ended September 30, 2025 to reduce the carrying value of the asset to its fair value. The fair value was determined to be the contractual sales price less commissions and fees. The sale of the facility was completed in September 2025.

Depreciation expense was $11,213 and $32,827 for the three and nine months ended September 30, 2025, respectively, and $9,993 and $30,233 for the three and nine months ended September 30, 2024, respectively.

As of September 30, 2025, the Company had aggregate capital improvement commitments and obligations to improve, expand, and maintain the Company’s existing facilities of approximately $24,200. Many of these amounts are subject to contingencies that make it difficult to predict when they will be utilized, if at all. In accordance with the terms of the Company’s leases, capital improvement obligations in the next twelve months are expected to total approximately $9,800.

Summary of Properties Acquired and Sold During the Year Ended December 31, 2024

During the year ended December 31, 2024, the Company completed the acquisition of a 15-property portfolio. For this acquisition, substantially all of the fair value was concentrated in a single identifiable asset or group of similar identifiable assets and, therefore, this acquisition represented an asset acquisition. Accordingly, transaction costs for this acquisition were capitalized.

During the year ended December 31, 2024, the Company completed seven dispositions. In June 2024, the Company sold an in-patient rehabilitation facility located in Mishawaka, Indiana receiving gross proceeds of $8.1 million, resulting in a loss of $3.4 million. In July 2024, the Company sold a medical office building located in Panama City, Florida receiving gross proceeds of $11.0 million, resulting in a gain of $1.7 million. In September 2024, the Company sold a medical office building located in Panama City Beach, Florida receiving gross proceeds of $1.1 million, resulting in a gain of $0.1 million. In December 2024, the Company sold two medical office buildings located in Carson City, Nevada receiving gross proceeds of $1.0 million, resulting in a loss of $2.4 million. In December 2024, the Company sold three medical office buildings located in Ellijay, Georgia receiving gross proceeds of $4.3 million, resulting in a gain of $0.7 million. In December 2024, in connection with the formation of the Joint Venture, the Company sold two assets to the Joint Venture consisting of a medical office building located in High Point, North Carolina receiving gross proceeds of $28.0 million resulting in gain of $6.2 million and a medical office building located in Fort Worth, Texas receiving gross proceeds of $7.2 million, resulting in a gain of $1.3 million.  

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A rollforward of the gross investment in land, building, improvements, and acquired lease intangible assets as of December 31, 2024 is as follows:

Site

Tenant

Acquired Lease

Gross Investment in

    

Land

    

Building

   

Improvements

   

Improvements

   

Intangible Assets

   

Real Estate

Balances as of December 31, 2023

$

164,315

$

1,035,705

$

21,974

$

66,358

$

138,617

$

1,426,969

Facility Acquired – Date Acquired:

Minot – 7/11/24

935

7,324

144

103

676

9,182

Clinton – 7/11/24

938

4,829

188

256

657

 

6,868

Westland – 7/11/24

921

3,630

157

99

540

5,347

Cerritos – 7/11/24

3,424

1,244

107

106

392

5,273

Spartanburg – 7/11/24

890

2,613

168

390

517

4,578

Conway – 10/2/24

2,430

7,415

188

372

897

11,302

Little Rock – 10/2/24

1,449

6,579

164

284

741

9,217

Russellville – 10/2/24

1,086

4,022

218

205

491

6,022

Sarasota – 10/2/24

643

4,133

548

712

6,036

Venice – 10/2/24

1,102

2,830

123

187

426

4,668

Ruskin – 10/2/24

242

1,443

28

45

175

1,933

6807 Bradenton – 10/2/24

1,225

626

22

68

180

2,121

2101 Bradenton – 10/2/24

967

1,372

52

64

235

2,690

2203 Bradenton – 10/2/24

408

913

35

37

132

1,525

6002 Bradenton – 10/2/24

1,679

2,985

112

190

463

5,429

Capitalized costs(1)

 

5,494

1,481

4,828

11,803

Total Additions:

18,339

57,452

3,187

7,782

7,234

93,994

Facility Sold – Date Sold:

Mishawaka – 6/27/24

(1,924)

(10,084)

(75)

(1,798)

(2,223)

(16,104)

Panama City – 7/12/24

(1,117)

(7,201)

(165)

(841)

(1,141)

(10,465)

Panama City Beach – 9/19/24

(272)

(606)

(21)

(84)

(149)

(1,132)

Carson City – 12/6/2024

(760)

(3,268)

(4,028)

Ellijay – 12/17/2024

(777)

(2,929)

(136)

(408)

(870)

(5,120)

High Point – 12/20/2024(2)

(1,749)

(20,417)

(504)

(869)

(1,656)

(25,195)

Fort Worth – 12/20/2024(2)

(1,487)

(3,333)

(251)

(445)

(787)

(6,303)

Total Dispositions:

(8,086)

(47,838)

(1,152)

(4,445)

(6,826)

(68,347)

Impairment of investment property(3)

(268)

(1,300)

(36)

(16)

(80)

(1,700)

Balances as of December 31, 2024

$

174,300

$

1,044,019

$

23,973

$

69,679

$

138,945

$

1,450,916

(1)

Represents capital projects that were completed and placed in service during the year ended December 31, 2024 related to the Company’s existing facilities.

(2)

These two facilities were sold to the Joint Venture in connection with its formation.

(3)

In December 2024, the Company entered into an agreement to sell its facility located in Derby, Kansas. The Company recognized an impairment loss of $1.7 million during the year ended December 31, 2024 to reduce the carrying value of the asset to its fair value. The fair value was determined to be the contractual sales price less commissions and fees.

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Lease Intangible Assets and Liabilities

The following is a summary of the carrying amount of lease intangible assets and liabilities as of the dates presented:

As of September 30, 2025

Accumulated

    

Cost

    

Amortization

    

Net

Assets

In-place leases

$

82,590

$

(55,958)

$

26,632

Above market leases

 

24,024

 

(14,544)

 

9,480

Leasing costs

 

38,082

 

(24,000)

 

14,082

$

144,696

$

(94,502)

$

50,194

Liability

Below market leases

$

17,335

$

(11,819)

$

5,516

As of December 31, 2024

    

    

Accumulated

    

Cost

Amortization

Net

Assets

 

  

 

  

 

  

In-place leases

$

77,698

$

(50,714)

$

26,984

Above market leases

 

24,599

 

(13,201)

 

11,398

Leasing costs

 

36,648

 

(21,326)

 

15,322

$

138,945

$

(85,241)

$

53,704

Liability

 

 

 

Below market leases

$

14,073

$

(10,137)

$

3,936

The following is a summary of the acquired lease intangible amortization:

Three Months Ended

Nine Months Ended

September 30, 

September 30, 

    

2025

    

2024

    

2025

    

2024

    

Amortization expense related to in-place leases

$

2,423

$

2,431

$

7,232

$

7,707

Amortization expense related to leasing costs

$

1,113

$

1,114

$

3,350

$

3,467

Decrease in rental revenue related to above market leases

$

714

$

793

$

2,204

$

2,425

Increase in rental revenue related to below market leases

$

(601)

$

(511)

$

(1,699)

$

(1,643)

As of September 30, 2025, scheduled future aggregate net amortization of the acquired lease intangible assets and liabilities for each year ended December 31 is listed below:

    

    

Net Decrease

Net Increase

in Revenue

in Expense

2025 (three months remaining)

$

(224)

$

4,129

2026

 

(321)

 

13,633

2027

 

(320)

 

9,361

2028

 

(890)

 

5,805

2029

(945)

3,677

Thereafter

 

(1,264)

 

4,109

Total

$

(3,964)

$

40,714

As of September 30, 2025, the weighted average amortization periods for asset lease intangibles and liability lease intangibles were 3.0 years and 2.4 years, respectively.

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Note 4 – Credit Facility, Notes Payable and Derivative Instruments

Credit Facility

As of September 30, 2025, the Company, the Operating Partnership, as borrower, and certain of its subsidiaries were parties to an amended and restated $900 million unsecured syndicated credit facility with JPMorgan Chase Bank, N.A. (“JPMorgan”), as administrative agent (the “Credit Facility”). The Credit Facility consisted of (i) $500 million of term loans, which included (a) a $350 million term loan (“Term Loan A”) and (b) a $150 million term loan (“Term Loan B,” and, together with Term Loan A, the “Term Loans”), and (ii) a $400 million revolver (the “Revolver”). The Credit Facility also included a $500 million accordion feature. Term Loan A had a maturity date in May 2026, Term Loan B matures in February 2028, and the Revolver had a maturity date in August 2026, with two, six-month extension options. Interest rates on amounts outstanding under the Credit Facility equaled the term Secured Overnight Financing Rate (“SOFR”) plus a related spread adjustment of 10 basis points and a borrowing spread based on the current pricing grid in the Credit Facility.

On October 8, 2025, the Company amended and restated the Credit Facility (the “Amended and Restated Credit Facility”) to among other things: (i) extend the initial maturity date of the Revolver to October 2029 with two, six-month extension options; and (ii) extend the maturity of Term Loan A, dividing it into three term loans structured as follows:

$100 million term loan maturing in October 2029 (“Term Loan A-1”);
$100 million term loan maturing in October 2030 (“Term Loan A-2”); and
$150 million term loan maturing in April 2031 (“Term Loan A-3”); and

(iii) remove the previous 0.10% (10 basis point) SOFR credit spread adjustment on all Amended and Restated Credit Facility borrowings.  All other material terms of the Credit Facility remain unchanged in the Amended and Restated Credit Facility.

The Operating Partnership is subject to a number of financial covenants under the Credit Facility, including, among other things, the following as of the end of each fiscal quarter, (i) a maximum consolidated unsecured leverage ratio of less than 60%, (ii) a maximum consolidated secured leverage ratio of less than 30%, (iii) a maximum consolidated secured recourse leverage ratio of less than 10%, (iv) a minimum fixed charge coverage ratio of 1.50:1.00, (v) a minimum unsecured interest coverage ratio of 1.50:1.00, (vi) a maximum consolidated leverage ratio of less than 60%, (vii) a maximum cash investment in joint ventures of 10% of total asset value and (viii) a minimum net worth of $573 million plus 75% of all net proceeds raised through equity offerings subsequent to March 31, 2022. As of September 30, 2025, management believed it complied with all of the financial and non-financial covenants contained in the Credit Facility.

The Company has entered into interest rate swaps and forward starting interest rate swaps to hedge its interest rate risk on the Term Loans through their respective maturities. For additional information related to the interest rate swaps, see the “Derivative Instruments - Interest Rate Swaps” section herein.

During the nine months ended September 30, 2025, the Company borrowed $115,400 under the Credit Facility and repaid $40,300, for a net amount borrowed of $75,100. During the nine months ended September 30, 2024, the Company borrowed $82,800 under the Credit Facility and repaid $55,400, for a net amount borrowed of $27,400. Interest expense incurred on the Credit Facility was $7,499, and $21,197 for the three and nine months ended September 30, 2025, respectively, and $6,526 and $18,766 for the three and nine months ended September 30, 2024, respectively.

As of September 30, 2025 and December 31, 2024, the Company had the following outstanding borrowings under the Credit Facility:

    

September 30, 2025

    

December 31, 2024

Revolver

$

211,700

$

136,600

Term Loan A

350,000

350,000

Term Loan B

 

150,000

 

150,000

Credit Facility, gross

711,700

636,600

Less: Unamortized debt issuance costs

 

(3,218)

 

(4,868)

Credit Facility, net

$

708,482

$

631,732

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Costs incurred related to the Credit Facility, net of accumulated amortization, are netted against the Company’s “Credit Facility, net of unamortized debt issuance costs” balance in the accompanying Condensed Consolidated Balance Sheets. Amortization expense incurred related to debt issuance costs was $550 and $1,650 for the three and nine months ended September 30, 2025, respectively, and $550 and $1,649 for the three and nine months ended September 30, 2024, respectively, and is included in the “Interest Expense” line item in the accompanying Condensed Consolidated Statements of Operations.

Notes Payable, Net of Debt Issuance Costs

The Company, through certain of its wholly owned subsidiaries, entered into or assumed loans in connection with the acquisitions of the Rosedale and Toledo facilities. As of September 30, 2025 and December 31, 2024, the Company had the following outstanding borrowings under these loans:

    

September 30, 2025

    

December 31, 2024

Rosedale loan (1)

$

$

13,158

Toledo loan (2)

1,153

1,263

Notes payable, gross

1,153

14,421

Unamortized debt issuance costs

 

 

(22)

Notes payable, net

$

1,153

$

14,399

(1)The Rosedale loan had an annual interest rate of 3.85% and matured on July 31, 2025.
(2)The Toledo loan has an annual interest rate of 5.0% and matures on July 30, 2033.

Amortization expense incurred related to debt issuance costs was $4 and $22 for the three and nine months ended September 30, 2025, respectively, and $9 and $35 for the three and nine months ended September 30, 2024, respectively, and is included in the “Interest Expense” line item in the accompanying Condensed Consolidated Statements of Operations.

The Company made principal payments of $13,268 and $11,441 during the nine months ended September 30, 2025 and 2024, respectively. Interest expense incurred on these loans was $55 and $346 for the three and nine months ended September 30, 2025, respectively, and $151 and $669 for the three and nine months ended September 30, 2024, respectively.

As of September 30, 2025, scheduled principal payments due for each year ended December 31 were as follows:

2025 (three months remaining)

$

-

2026

117

2027

124

2028

131

2029

139

Thereafter

642

Total

$

1,153

Derivative Instruments - Interest Rate Swaps

As of September 30, 2025, the Company had nine interest rate swaps that are used to manage its interest rate risk by fixing the SOFR component of the Term Loans through their maturities. Five of the Company’s interest rate swaps related to Term Loan A with a combined notional value of $350 million that fix the SOFR component on Term Loan A through April 2026 at 1.36%. Four of the Company’s interest rate swaps related to Term Loan B with a combined notional value of $150 million that fix the SOFR component on Term Loan B through January 2028 at 2.54%.

The Company records the swaps either as an asset or a liability measured at its fair value at each reporting period. When hedge accounting is applied, the change in the fair value of derivatives designated and that qualify as cash flow hedges is (i) recorded in accumulated other comprehensive income in the equity section of the Company’s Condensed Consolidated Balance Sheets and (ii) subsequently reclassified into earnings as interest expense for the period that the hedged forecasted transactions affect earnings. If specific hedge accounting criteria are not met, changes in the Company’s derivative instruments’ fair value are recognized currently as an adjustment to net income. As of September 30, 2025 and December 31, 2024, all of the Company’s swaps met the criteria for hedge accounting.

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The Company’s interest rate swaps are not traded on an exchange. The Company’s interest rate swaps are recorded at fair value based on a variety of observable inputs including contractual terms, interest rate curves, yield curves, measure of volatility, and correlations of such inputs. The Company measures its derivatives at fair value on a recurring basis based on the expected size of future cash flows on a discounted basis and incorporates a measure of non-performance risk. The fair values are based on Level 2 inputs within the framework of ASC Topic 820. The Company considers its own credit risk, as well as the credit risk of its counterparties, when evaluating the fair value of its derivative instruments.

The fair value of the Company’s interest rate swaps was an asset of $7,467 and $18,613 as of September 30, 2025 and December 31, 2024, respectively. The balances are included in the “Derivative Asset” line item on the Company’s Condensed Consolidated Balance Sheets as of September 30, 2025 and December 31, 2024, respectively.

The table below details the components of the amounts presented on the accompanying Condensed Consolidated Statements of Comprehensive Loss recognized on the Company’s interest rate swaps designated as cash flow hedges for the three and nine months ended September 30, 2025 and 2024:

Three Months Ended September 30, 

Nine Months Ended September 30, 

    

2025

    

2024

    

2025

    

2024

Amount of (gain) loss recognized in other comprehensive loss

$

(404)

$

8,197

$

1,249

$

(3,233)

Amount of gain reclassified from accumulated other comprehensive income into interest expense

 

3,333

 

4,508

 

9,897

 

13,391

Total change in accumulated other comprehensive income

$

2,929

$

12,705

$

11,146

$

10,158

During the next twelve months, the Company estimates that an additional $6,387 will be reclassified as a decrease to interest expense. Additionally, during the three and nine months ended September 30, 2025, the Company recorded total interest expense in its Condensed Consolidated Statements of Operations of $8,175 and $23,351, respectively.

In addition to the nine interest rate swaps that were in place as of September 30, 2025, in connection with the Amended and Restated Credit Facility, on October 7, 2025, the Company entered into seven new forward starting interest rate swaps with a combined notional value of $350 million to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities.

Weighted-Average Interest Rate and Term

The weighted average interest rate and term of the Company’s debt was 4.06% and 1.3 years at September 30, 2025, compared to 3.75% and 2.0 years as of December 31, 2024.

Note 5 – Equity

Preferred Stock

The Company’s charter authorizes the issuance of 10,000 shares of preferred stock, par value $0.001 per share. As of September 30, 2025 and December 31, 2024, there were 3,105 shares of Series A Cumulative Redeemable Preferred Stock (“Series A Preferred Stock”), issued and outstanding. The Series A Preferred Stock has a liquidation preference of $25 per share.

Preferred stock dividend activity for the nine months ended September 30, 2025 is summarized in the following table:

    

    

Applicable

    

    

Quarterly

    

Dividends

Date Announced

Record Date

Quarter

Payment Date

Dividend

per Share

December 4, 2024

January 15, 2025

Q4 2024

January 31, 2025

$

1,455

$

0.46875

February 27, 2025

April 15, 2025

Q1 2025

April 30, 2025

$

1,455

$

0.46875

May 28, 2025

July 15, 2025

Q2 2025

July 31, 2025

$

1,455

$

0.46875

September 3, 2025

October 15, 2025

Q3 2025

October 31, 2025

$

1,455

(1)

$

0.46875

(1)

Two months of this amount, equal to $970, was accrued at September 30, 2025.

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The holders of the Series A Preferred Stock are entitled to receive dividend payments only when, as and if declared by the Board (or a duly authorized committee of the Board). Dividends will accrue or be payable in cash from the original issue date, on a cumulative basis, quarterly in arrears on each dividend payment date at a fixed rate per annum equal to 7.50% of the liquidation preference of $25.00 per share (equivalent to $1.875 per share on an annual basis). The Series A Preferred Stock may be partially or fully redeemed by the Company. Dividends on the Series A Preferred Stock are cumulative and accrue whether or not (i) funds are legally available for the payment of those dividends, (ii) the Company has earnings or (iii) those dividends are declared by the Board. The quarterly dividend payment dates on the Series A Preferred Stock are January 31, April 30, July 31 and October 31 of each year. During each of the nine-month periods ended September 30, 2025 and 2024, the Company paid preferred dividends of $4,366.

Common Stock

After the impact of the Reverse Stock Split, the Company had 100,000 authorized shares of common stock, $0.001 par value and as of September 30, 2025 and December 31, 2024, there were 13,407 and 13,374 outstanding shares of common stock, respectively.

Common stock dividend activity for the nine months ended September 30, 2025 is summarized in the following table:

    

    

Applicable

    

    

Dividend

    

Dividends

Date Announced

Record Date

Quarter

Payment Date

Amount(1)

per Share(2)

December 4, 2024

 

December 20, 2024

 

Q4 2024

 

January 8, 2025

$

15,164

$

1.05

February 27, 2025

 

March 21, 2025

 

Q1 2025

 

April 9, 2025

$

15,234

$

1.05

May 28, 2025

 

June 20, 2025

 

Q2 2025

 

July 9, 2025

$

10,890

$

0.75

September 3, 2025

 

September 29, 2025

 

Q3 2025

 

October 15, 2025

$

10,914

$

0.75

(1)Includes distributions on outstanding LTIP Units and OP Units.
(2)Adjusted to reflect the impact of the Reverse Stock Split.

During the nine months ended September 30, 2025 and 2024, the Company paid total dividends on its common stock, LTIP Units and OP Units in the aggregate amount of $41,393 and $44,759, respectively.

As of September 30, 2025 and December 31, 2024, the Company had accrued dividend balances of $167 and $386 for dividends payable on the aggregate annual and long-term LTIP Units that are subject to retroactive receipt of dividends on the amount of LTIP Units ultimately earned. During the nine months ended September 30, 2025, $114 dividends were reversed and $105 of dividends were paid related to these units. During the nine months ended September 30, 2024, $237 of dividends were accrued and $127 of dividends were paid related to these units.

The amount of the dividends paid to the Company’s stockholders is determined by the Board and is dependent on a number of factors, including funds available for payment of dividends, the Company’s financial condition and capital expenditure requirements, except that, in accordance with the Company’s organizational documents and Maryland law, the Company may not make dividend distributions that would: (i) cause it to be unable to pay its debts as they become due in the usual course of business; (ii) cause its total assets to be less than the sum of its total liabilities plus senior liquidation preferences; or (iii) jeopardize its ability to maintain its qualification as a REIT.

Capital Raising Activity

In January 2024, the Company and the Operating Partnership implemented a $300 million “at-the-market” equity offering program, pursuant to which the Company may offer and sell (including through forward sales), from time to time, shares of its common stock (the “2024 ATM Program”). No shares were sold under the 2024 ATM Program during the nine months ended September 30, 2025.

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Common Stock Repurchase Program

In August 2025, the Board approved a $50 million common stock repurchase program (the “Stock Repurchase Program”). Under the Stock Repurchase Program, the Company may purchase up to $50 million of its outstanding shares of common stock from time to time in the open market, including through block purchases, through privately negotiated transactions or pursuant to any Rule 10b5-1 trading plan, in accordance with applicable securities laws. The specific timing, price and size of purchases will depend on prevailing stock prices, general economic and market conditions and other considerations. The Stock Repurchase Program does not obligate the Company to repurchase any dollar amount or number of shares of its common stock and may be suspended or discontinued at any time. No shares were repurchased during the nine months ended September 30, 2025.

Reverse Stock Split

In August 2025, the Board approved the Reverse Stock Split. The Reverse Stock Split was completed on September 19, 2025. As a result of the Reverse Stock Split, on September 19, 2025, every five issued and outstanding shares of the Company’s common stock was converted into one share of its common stock, with a proportionate reduction in the Company’s (i) authorized shares of common stock from 500 million shares to 100 million shares, (ii) outstanding equity awards, (iii) number of shares remaining available for issuance under the Company’s 2016 Equity Incentive Plan, as amended, and (iv) outstanding common units of the Operating Partnership. The par value of each share of the Company’s common stock remained unchanged. Trading in the Company’s common stock on a split adjusted basis began at the market open on September 22, 2025. The Reverse Stock Split reduced the number of shares outstanding on September 19, 2025 from 67,037 to 13,407, excluding fractional shares. All common share and per common share amounts in these condensed consolidated financial statements and notes thereto and applicable disclosures have been retrospectively adjusted for all periods presented to reflect the Reverse Stock Split. Additionally, for all previously reported periods the Company’s Common Stock balance decreased by approximately 55 thousand and Additional Paid-In Capital balance increased by the same amount, resulting in no change in the Company’s total equity balances.

The Company’s common stock continues to be traded on the New York Stock Exchange under the symbol “GMRE” but was assigned a new CUSIP number. No fractional shares were issued in connection with the Reverse Stock Split. Instead, each stockholder that otherwise would have received fractional shares received, in lieu of such fractional shares, cash in an amount based on the closing price of the Company’s common stock on the New York Stock Exchange on September 19, 2025. The Reverse Stock Split resulted in approximately 60 fractional shares, for which cash payments totaling approximately two thousand dollars were paid in lieu of issuing such fractional shares. The two thousand dollars paid was treated as a reduction of the Company’s Additional Paid-In Capital balance as of September 30, 2025. The Reverse Stock Split applied to all of the outstanding shares of the Company’s common stock as of September 19, 2025, and therefore did not affect any stockholder’s ownership percentage of shares of the Company’s common stock, except for de minimis changes resulting from the payment of cash in lieu of fractional shares.

OP Units

During the nine months ended September 30, 2025, the Operating Partnership did not issue any OP Units and redeemed five OP Units (adjusted to reflect the impact of the Reverse Stock Split). During the year ended December 31, 2024, the Operating Partnership did not issue or redeem any OP Units.

The OP Unit value at issuance and redemption is based on the Company’s closing share price on the date of the respective transaction and is included as a component of noncontrolling interest equity in the Company’s Condensed Consolidated Balance Sheets as of September 30, 2025 and December 31, 2024. The Company has sufficient shares of common stock authorized pursuant to its charter to cover the redemption of outstanding OP Units.

Note 6 – Related Party Transactions

Related Party Balances

The amounts due from related parties as of September 30, 2025 and December 31, 2024 were $367 and $270, respectively. These balances primarily consist of taxes paid on behalf of LTIP Unit and OP Unit holders that are reimbursable to the Company as well as funds owed to the Company from the Joint Venture for management fees earned by the Company. The Company had no amounts due to related parties as of September 30, 2025 and December 31, 2024.

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Note 7 – Stock-Based Compensation

2016 Equity Incentive Plan

The 2016 Equity Incentive Plan, as amended (the “Plan”), is intended to assist the Company and its affiliates in recruiting and retaining employees of the Company, members of the Board, executive officers of the Company, and individuals who provide services to the Company and its affiliates.

All share and LTIP Unit amounts have been adjusted to reflect the impact of the Reverse Stock Split.

The Plan is intended to permit the grant of both qualified and non-qualified options and the grant of stock appreciation rights, restricted stock, unrestricted stock, awards of restricted stock units, performance awards and other equity-based awards (including LTIP Units). Based on the grants outstanding as of September 30, 2025, there were 271 shares of common stock that remain available to be granted under the Plan. Units subject to awards under the Plan that are forfeited, cancelled, lapsed, or otherwise expired (excluding shares withheld to satisfy exercise prices or tax withholding obligations) are available for grant.

Time-Based Grants

During the nine months ended September 30, 2025, the Company granted the following LTIP Units:

Number of

Date

Description

Units Issued

Vesting Dates

February 26, 2025

Final awards under the 2024 Annual Incentive Plan

25

50% on February 26, 2025; and

50% on February 26, 2026

February 26, 2025

Time-based awards under the 2025 Long-Term Incentive Plan

41

100% on February 26, 2028

May 14, 2025

Annual awards to independent directors

12

100% on May 14, 2026

June 23, 2025

New Chief Executive Officer and President signing grant (1)

32

100% on June 23, 2028

(1)Represents a one-time award of LTIP Units in connection with the appointment of the Company’s new Chief Executive Officer and President, effective June 23, 2025. The number of LTIP Units was based on the volume-weighted average closing price (VWAP) of the Company’s common stock reported on the New York Stock Exchange for the 20 trading days ending on the grant date.

During the nine months ended September 30, 2025, certain participants redeemed an aggregate of 28 vested LTIP Units for the Company’s common stock. A detail of the Company’s outstanding time-based LTIP Units as of September 30, 2025 is as follows:

Vested units

    

544

Unvested units

 

157

LTIP Units outstanding as of September 30, 2025

 

701

Performance Based Awards

The Board has approved annual performance-based LTIP awards (“Annual Awards”) and long-term performance-based LTIP awards (“Long-Term Awards” and together with the Annual Awards, “Performance Awards”) to the executive officers and other employees of the Company. As described below, the Annual Awards have one-year performance periods and the Long-Term Awards have three-year performance periods. In addition to meeting specified performance metrics, vesting in the Performance Awards is subject to service requirements.

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During the nine months ended September 30, 2025, two 2023 Long-Term Awards and seven 2024 Long-Term Awards were forfeited. A detail of the Performance Awards under the 2023, 2024 and 2025 programs as of September 30, 2025 is as follows:

2023 Long-Term Awards

 

29

2024 Long-Term Awards

39

2025 Annual Awards (1)

36

2025 Long-Term Awards (2)

33

Total target Performance Awards as of September 30, 2025

 

137

(1)   Approved by the Board on February 26, 2025, with the exception of five awards for the new Chief Executive Officer and President approved by the Board on June 20, 2025 with an award date of June 23, 2025. The number of target LTIP Units was based on the average closing price of the Company’s common stock reported on the New York Stock Exchange over the 15 trading days preceding the award date.

(2)Approved by the Board on February 26, 2025. The number of target LTIP Units was based on the fair value of the Long-Term Awards as determined by an independent valuation consultant.

Annual Awards. The Annual Awards are subject to the terms and conditions of LTIP Annual Award Agreements (“LTIP Annual Award Agreements”) between the Company and each grantee.

The Compensation Committee of the Board (the “Compensation Committee”) and the Board established performance goals for the year ending December 31, 2025, as set forth in the 2025 LTIP Annual Award Agreements (the “Performance Goals”) that will be used to determine the number of LTIP Units earned by each grantee. Cumulative stock-based compensation expense during the three and nine months ended September 30, 2025 reflects management’s estimate of the probability of the number of these awards that will be earned. As soon as reasonably practicable following the end of the performance period, the Compensation Committee and the Board will determine the extent to which the Company has achieved each of the Performance Goals (expressed as a percentage) and, based on such determination, will calculate the number of LTIP Units that each grantee is entitled to receive. Each grantee may earn up to 150% of the number of his/her target LTIP Units. Any 2025 Annual Award LTIP Units that are not earned will be forfeited and cancelled.

Vesting. LTIP Units that are earned as of the end of the applicable performance period will vest in two installments as follows: 50% of the earned LTIP Units will become vested on the valuation date of the awards (which is expected to occur in February 2026) and 50% of the earned LTIP Units become vested on the one year anniversary of the initial vesting date. Vesting may be accelerated under certain circumstances such as a “change-in-control” transaction or a “qualified termination” event.

Distributions. Distributions equal to the dividends declared and paid by the Company will accrue during the applicable performance period on the estimated number of LTIP Units that the grantee could earn and will be paid with respect to all of the earned LTIP Units at the conclusion of the applicable performance period, in cash or by the issuance of additional LTIP Units at the discretion of the Compensation Committee.

Long-Term Awards. The Long-Term Awards are subject to the terms and conditions of their related LTIP Long-Term Award Agreements (collectively the “LTIP Long-Term Award Agreements”) between the Company and each grantee. The number of LTIP Units that each grantee earns under the LTIP Long-Term Award Agreements will be determined following the conclusion of a three-year performance period based on the Company’s (i) total stockholder return (“TSR”), which is determined based on a combination of appreciation in stock price and dividends paid during the performance period, and (ii) relative stockholder return (“RSR”), which is determined by comparing the Company’s TSR with the TSRs of the companies that comprise the Dow Jones U.S. Real Estate Health Care Index (the “Index”). Each grantee may earn up to 200% of the number of target LTIP Units covered by the grantee’s Long-Term Award. Any target LTIP Units that are not earned will be forfeited and cancelled. The number of LTIP Units earned under the Long-Term Awards will be determined as soon as reasonably practicable following the end of the applicable three-year performance period based on the Company’s TSR on an absolute basis (as to 50% of the Long-Term Award) and RSR (as to 50% of the Long-Term Award).

Vesting. LTIP Units that are earned as of the end of the applicable three-year performance period will vest in two installments as follows: 50% of the earned LTIP Units will vest upon the day prior to the third anniversary of the respective grant dates and the remaining 50% will vest on the one year anniversary of the initial vesting date. Vesting may be accelerated under certain circumstances such as a “change-in-control” transaction or a “qualified termination” event.

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Distributions. Pursuant to the LTIP Long-Term Award Agreements, distributions equal to the dividends declared and paid by the Company will accrue during the applicable performance period on the estimated number of LTIP Units that the grantee could earn and will be paid with respect to all of the earned LTIP Units at the conclusion of the applicable performance period, in cash or by the issuance of additional LTIP Units at the discretion of the Compensation Committee.

Stock-Based Compensation Expense

Compensation expense for LTIP Unit grants, Annual Awards, and Long-Term Awards is based on the grant date fair value of the units/awards, with no subsequent remeasurement required.

As the Long-Term Awards involve market-based performance conditions, the Company utilizes a Monte Carlo simulation to provide a grant date fair value for expense recognition. The Monte Carlo simulation is a generally accepted statistical technique used, in this instance, to simulate a range of possible future stock prices for the Company and the members of the Index over the Performance Periods. The purpose of this modeling is to use a probabilistic approach for estimating the fair value of the performance share award.

The assumptions used in the Monte Carlo simulation include beginning average stock price, valuation date stock price, expected volatilities, correlation coefficients, risk-free rate of interest, and expected dividend yield. The beginning average stock price is the beginning average stock price for the Company and each member of the Index for the 15 trading days leading up to the grant date of the Long-Term Award. The valuation date stock price is the closing stock price of the Company and each of the peer companies in the Index on the grant dates of the Long-Term Awards. The expected volatilities are modeled using the historical volatilities for the Company and the members of the Index. The correlation coefficients are calculated using the same data as the historical volatilities. The risk-free rate of interest is taken from the U.S. Treasury website and relates to the expected life of the remaining performance period on valuation or revaluation. Lastly, the dividend yield assumption is 0.0%, which is mathematically equivalent to reinvesting dividends in the issuing entity, which is part of the Company’s award agreement assumptions.

Below are details regarding certain of the assumptions for the Long-Term Awards using Monte Carlo simulations:

2025 Long-Term

2024 Long-Term

2023 Long-Term

    

Awards

    

Awards

    

Awards

    

Fair value

$

46.60

$

46.85

$

58.35

 

Target awards

 

33

 

39

 

29

 

Volatility

 

28.67

%  

 

28.12

%  

 

43.54

%  

Risk-free rate

 

4.00

%  

 

4.38

%  

 

4.35

%  

Dividend assumption

 

reinvested

 

reinvested

 

reinvested

 

Expected term in years

 

3

 

3

 

3

 

The Company incurred stock compensation expense of $1,207 and $3,086 for the three ands nine months ended September 30, 2025, respectively, and $1,274 and $3,826 for the three and nine months ended September 30, 2024, respectively, related to the grants awarded under the Plan. Compensation expense is included within “General and Administrative” expense in the Company’s Condensed Consolidated Statements of Operations.

As of September 30, 2025, total unamortized compensation expense related to these awards of approximately $6.7 million is expected to be recognized over a weighted average remaining period of 1.7 years.

Note 8 – Leases

The Company operates as both a lessor and a lessee. As a lessor, the Company is required under ASC Topic 842 to account for leases using an approach that is substantially similar to ASC Topic 840’s guidance for operating leases and other leases such as sales-type leases and direct financing leases. In addition, ASC Topic 842 requires lessors to capitalize and amortize only incremental direct leasing costs. As a lessee, the Company is required under the new standard to apply a dual approach, classifying leases, such as ground leases, as either finance or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. ASC Topic 842 also requires lessees to record a right of use asset and a lease liability for all leases with an initial term

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of greater than a year regardless of their classification. The Company has also elected the practical expedient not to recognize right of use assets and lease liabilities for leases with a term of a year or less.

Information as Lessor

To generate positive cash flow, as a lessor, the Company leases its facilities to tenants in exchange for fixed monthly payments that cover rent, property taxes, insurance and certain cost recoveries, primarily common area maintenance (“CAM”). The Company’s leases were determined to be operating leases and have a portfolio-average-lease-years remaining of approximately 10 years. Payments from the Company’s tenants for CAM are considered nonlease components that are separated from lease components and are generally accounted for in accordance with the revenue recognition standard. However, the Company qualified for and elected the practical expedient related to combining the components because the lease component is classified as an operating lease and the timing and pattern of transfer of CAM income, which is not the predominant component, is the same as the lease component, for all asset classes. As such, consideration for CAM is accounted for as part of the overall consideration in the lease. Payments from customers for property taxes and insurance are considered non-components of the lease and therefore no consideration is allocated to them because they do not transfer a good or service to the customer. Fixed contractual payments from the Company’s leases are recognized on a straight-line basis over the terms of the respective leases. This means that, with respect to a particular lease, actual amounts billed in accordance with the lease during any given period may be higher or lower than the amount of rental revenue recognized for the period. Straight-line rental revenue is commenced when the tenant assumes control of the leased premises. Accrued straight-line rents receivable represents the amount by which straight-line rental revenue exceeds rents currently billed in accordance with lease agreements.

Some of the Company’s leases are subject to annual changes in the Consumer Price Index (“CPI”). Although increases in CPI are not estimated as part of the Company’s measurement of straight-line rental revenue, for leases with base rent increases based on CPI, the amount of rent revenue recognized is adjusted in the period the changes in CPI are measured and effective. Additionally, some of the Company’s leases have extension options.

Initial direct costs, primarily commissions related to the leasing of our facilities are capitalized when material as incurred. Capitalized leasing costs are amortized on a straight-line basis over the remaining useful life of the respective leases. All other costs to negotiate or arrange a lease are expensed as incurred.

Lease-related receivables, which include accounts receivable and accrued straight-line rents receivable, are reduced for credit losses, if applicable. The Company regularly evaluates the collectability of its lease-related receivables. The Company’s evaluation of collectability primarily consists of reviewing past due account balances and considering such factors as the credit quality of our tenant, historical trends of the tenant and changes in tenant payment terms. If the Company’s assumptions regarding the collectability of lease-related receivables prove incorrect, the Company could experience credit losses in excess of what was recognized in rental and other revenues.

The Company recognized $37,036 and $109,510 of rental revenue related to operating lease payments for the three and nine months ended September 30, 2025, respectively, and $34,175 and $103,458 of rental revenue related to operating lease payments for the three and nine months ended September 30, 2024, respectively. Of these amounts, $1,774 and $5,595 relate to variable rental revenue for the three and nine months ended September 30, 2025, respectively, and $1,891 and $5,817 relate to variable rental revenue for the three and nine months ended September 30, 2024, respectively.

The aggregate annual cash to be received by the Company on the noncancelable operating leases related to its portfolio as of September 30, 2025 is as follows for the subsequent years ended December 31:

2025 (three months remaining)

    

$

31,909

2026

 

123,754

2027

 

111,173

2028

 

100,060

2029

86,352

Thereafter

 

290,226

Total

$

743,474

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Information as Lessee    

The Company recorded a right of use asset and liability during the nine months ended September 30, 2025 for the five acquisitions completed during that period that have buildings located on land that is subject to ground leases. The Company used a discount rate of approximately 5.9% to record the right of use asset and liability for these ground leases, which approximated its incremental borrowing rate at the date of acquisition. During the three and nine months ended September 30, 2025, the Company incurred interest expense of $67 and $136, respectively, from ground leases that were classified as financing leases. Including these buildings, the Company has ten buildings located on land that is subject to ground leases with a weighted average remaining term of approximately 44 years. Rental payments on these leases are adjusted periodically based on either the CPI or on a pre-determined schedule. The monthly payments on a pre-determined schedule are recognized on a straight-line basis over the terms of the respective leases. Changes in the CPI are not estimated as part of our measurement of straight-line rental expense. Some of the Company’s ground leases contain extension options and, where we determined it was reasonably certain that an extension would occur, they were included in our calculation of the right of use asset and liability. The Company recognized approximately $100 and $256 of ground lease expense during the three and nine months ended September 30, 2025, respectively, of which $99 and $233 was paid in cash. The Company recognized approximately $51 and $161 of ground lease expense during the three and nine months ended September 30, 2024, respectively, of which $58 and $110 was paid in cash.

The following table sets forth the undiscounted cash flows of our scheduled obligations for future lease payments on operating ground leases at September 30, 2025, and a reconciliation of those cash flows to the operating lease liability at September 30, 2025:

2025 (three months remaining)

    

$

280

2026

 

1,134

2027

 

1,150

2028

 

1,174

2029

1,193

Thereafter

 

27,200

Total

32,131

Discount

 

(18,626)

Lease liability

$

13,505

Tenant Concentration

During the nine months ended September 30, 2025, the Company’s rental revenues were derived from 315 tenants leasing 191 buildings. During this period there were no tenants with rental revenue that exceeded 10% of the Company’s rental revenue.    

Note 9 – Commitments and Contingencies

Litigation

The Company is not presently subject to any material litigation nor, to its knowledge, is any material litigation threatened against the Company, which if determined unfavorably to the Company, would have a material adverse effect on the Company’s financial position, results of operations, or cash flows.

Environmental Matters

The Company follows a policy of monitoring its properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at its properties, the Company is not currently aware of any environmental liability with respect to its properties that would have a material effect on its financial position, results of operations, or cash flows. Additionally, the Company is not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability that management believes would require additional disclosure or the recording of a loss contingency.

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Note 10 – Subsequent Events

On October 8, 2025, the Company entered into the Amended and Restated Credit Facility, which contains the following material amendments to the Company’s Credit Facility:

 

Extends the initial maturity date of the existing $400 million Revolver component of the Credit Facility to October 2029 with two, six-month extension options available at the Company’s election to extend the maturity to October 2030; and

Extends the maturity of the existing $350 million Term Loan A, dividing it into three term loans structured as follows:

$100 million term loan maturing in October 2029 (“Term Loan A-1”);
$100 million term loan maturing in October 2030 (“Term Loan A-2”); and
$150 million term loan maturing in April 2031 (“Term Loan A-3”); and

Removes the previous 0.10% (10 basis point) SOFR credit spread adjustment on all Amended and Restated Credit Facility borrowings.

The Credit Facility’s pricing grid, $150 million Term Loan B that matures in February 2028, and $500 million accordion remain unchanged.

In connection with the Amended and Restated Credit Facility, on October 7, 2025, the Company entered into $350 million of new forward starting interest rate swaps to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities.

The existing $350 million Term Loan A fixed rate SOFR swaps remain in place, resulting in an all-in fixed interest rate of 2.85% on this debt through the swap maturities in April 2026.

At closing of the Amended and Restated Credit Facility, the weighted average term of the Company’s debt, including the drawn Revolver component, was 4.4 years.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion should be read in conjunction with our financial statements, including the notes to those financial statements, included elsewhere in this Quarterly Report on Form 10-Q (this “Report”). Some of the statements we make in this section are forward-looking statements within the meaning of the federal securities laws. For a complete discussion of forward-looking statements, see the section below entitled “Special Note Regarding Forward-Looking Statements.” Certain risk factors may cause actual results, performance, or achievements to differ materially from those expressed or implied by the following discussion. For a discussion of such risk factors, see Item 1A. Risk Factors of our Annual Report on Form 10-K for the year ended December 31, 2024, that was filed with the U.S. Securities and Exchange Commission (the “SEC” or the “Commission”) on February 28, 2025 and Item 1A. Risk Factors in this Quarterly Report on Form 10-Q. Unless otherwise indicated, all dollar and share amounts in the following discussion are presented in thousands.

Special Note Regarding Forward-Looking Statements

This Report contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 (set forth in Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)). In particular, statements pertaining to our trends, liquidity, capital resources, and the healthcare industry and the healthcare real estate markets and opportunity, among others, contain forward-looking statements. You can identify forward-looking statements by the use of forward-looking terminology including, but not limited to, “believes,” “expects,” “may,” “will,” “should,” “seeks,” “approximately,” “intends,” “plans,” “estimates” or “anticipates” or the negative of these words and phrases or similar words or phrases which are predictions of or indicate future events or trends and which do not relate solely to historical matters. You can also identify forward-looking statements by discussions of strategy, plans or intentions.

Forward-looking statements involve numerous risks and uncertainties and you should not rely on them as predictions of future events. Forward-looking statements depend on assumptions, data or methods which may be incorrect or imprecise and we may not be able to realize them. We do not guarantee that the transactions and events described will happen as described (or that they will happen at all). The following factors, among others, could cause actual results and future events to differ materially from those set forth or contemplated in the forward-looking statements:

difficulties in identifying healthcare facilities to acquire (due to increased cost of capital, competition or otherwise) and completing such acquisitions;
defaults on or non-renewal of leases by tenants;
our ability to collect rents;
increases in interest rates and increased operating costs;
macroeconomic and geopolitical factors, including, but not limited to, inflationary pressures, tariffs and international trade policies, elevated interest rates, distress in the banking sector, global supply chain disruptions and ongoing geopolitical conflicts and war;
changes in current healthcare and healthcare real estate trends and costs, including wage inflation;
an epidemic or pandemic (such as the COVID-19 epidemic), and the measures that international, federal, state and local governments, agencies, law enforcement and/or health authorities implement to address it;
our ability to satisfy the covenants in our existing and any future debt agreements;
our ability to refinance our existing debt when needed or on favorable terms;
decreased rental rates or increased vacancy rates, including expected rent levels on acquired properties;
adverse economic or real estate conditions or developments, either nationally or in the markets in which our facilities are located;

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our failure to generate sufficient cash flows to service our outstanding obligations;
our ability to satisfy our short and long-term liquidity requirements;
our ability to deploy the debt and equity capital we raise;
our ability to hedge our interest rate risk;
our ability to raise additional equity and debt capital on attractive terms or at all;
our ability to make distributions on shares of our common and preferred stock or to redeem our preferred stock;
expectations regarding the timing and/or completion of any acquisition;
expectations regarding the timing and/or completion of dispositions, and the expected use of proceeds therefrom;
our use of joint ventures may limit our returns on and our flexibility with jointly-owned investments;
general volatility of the market price of our common and preferred stock;
changes in our business or our investment or financing strategy;
our dependence upon key personnel, whose continued service is not guaranteed;
our ability to identify, hire and retain highly qualified personnel in the future;
the degree and nature of our competition;
changes in healthcare laws, governmental regulations, tax laws and similar matters;
changes in expected trends in Medicare, Medicaid and commercial insurance reimbursement trends, including changes in Medicaid reimbursement rates pursuant to the One Big Beautiful Bill Act (the “OBBBA”);
competition for investment opportunities;
our failure to successfully integrate acquired healthcare facilities;
our expected capital and tenant improvement expenditures;
changes in accounting policies generally accepted in the United States of America (“GAAP”);
lack of, or insufficient amounts of, insurance;
other factors affecting the real estate industry generally;
changes in the tax treatment of our distributions;
our failure to maintain our qualification as a real estate investment trust (“REIT”) for U.S. federal income tax purposes;
our ability to qualify for the safe harbor from the 100% prohibited transactions tax under the REIT rules with respect to our property dispositions; and
limitations imposed on our business due to, and our ability to satisfy, complex rules relating to REIT qualification for U.S. federal income tax purposes.

See Item 1A. Risk Factors in our Annual Report on Form 10-K for the year ended December 31, 2024 and Item 1A. Risk Factors in this Quarterly Report on Form 10-Q for further discussion of these and other risks, as well as the risks, uncertainties and other

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factors discussed in this Report and identified in other documents we may file with the SEC from time to time. You should carefully consider these risks before making any investment decisions in our company. New risks and uncertainties may also emerge from time to time that could materially and adversely affect us. While forward-looking statements reflect our good faith beliefs, they are not guarantees of future performance. We disclaim any obligation to update or revise any forward-looking statement to reflect changes in underlying assumptions or factors, of new information, data or methods, future events or other changes after the date of this Report, except as required by applicable law. You should not place undue reliance on any forward-looking statements that are based on information currently available to us or the third parties making the forward-looking statements.

Objective of MD&A

Management’s Discussion and Analysis (“MD&A”) is a narrative explanation of the financial statements and other statistical data that we believe will enhance a reader’s understanding of our financial condition, changes in financial condition and results of operations.

The objectives of MD&A are:

a.To provide a narrative explanation of our financial statements that enables investors to see the Company from management’s perspective;
b.To enhance the overall financial disclosure and provide the context within which financial information should be analyzed; and
c.To provide information about the quality of, and potential variability of, our earnings and cash flow so that investors can ascertain the likelihood that past performance is indicative of future performance.

Overview

Global Medical REIT Inc. (the “Company,” “us,” “we,” or “our”) is a Maryland corporation and internally managed REIT that acquires healthcare facilities and leases those facilities to physician groups and regional and national healthcare systems. We hold our facilities and conduct our operations through a Delaware limited partnership subsidiary, Global Medical REIT L.P. (the “Operating Partnership”). Our wholly owned subsidiary, Global Medical REIT GP LLC, is the sole general partner of our Operating Partnership and, as of September 30, 2025, we owned 92.14% of the outstanding common operating partnership units (“OP Units”) of our Operating Partnership, with an aggregate of 7.86% of the Operating Partnership owned by holders of long-term incentive plan units (“LTIP Units”) and third-party limited partners who contributed properties or services to the Operating Partnership in exchange for OP Units.

Our revenues are derived from the rental and operating expense reimbursement payments we receive from our tenants, and most of our leases are medium to long-term triple net leases with contractual rent escalation provisions. Our primary expenses are depreciation, interest, and general and administrative expenses. We finance our acquisitions with a mixture of debt and equity primarily from our cash from operations, borrowings under our credit facility, and stock issuances.

Business Overview and Strategy

Our business strategy is to invest in healthcare properties that provide an attractive rate of return relative to our cost of capital and are operated by profitable physician groups, regional or national healthcare systems or combinations thereof. We believe this strategy allows us to attain our goals of providing stockholders with (i) attractive dividends and (ii) stock price appreciation. To implement this strategy, we seek to invest:

in medical office buildings and other decentralized components of the healthcare delivery system because we believe that healthcare delivery trends in the U.S. are increasingly moving away from centralized hospital locations;
in small to mid-sized healthcare facilities located in secondary markets and suburbs of primary markets and that provide services needed for an aging population, such as cardiovascular treatment, rehabilitation, eye surgery, gastroenterology, oncology treatment and orthopedics. We believe these facilities and markets are typically overlooked by larger REITs and other healthcare investors but contain tenant credit profiles that are like those of larger, more expensive facilities in primary markets; and

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to a lesser extent, in opportunistic acquisitions, including behavioral and mental health facilities that are operated by national or regional operators and are located in markets that demonstrate a need for such services.

Most of our healthcare facilities are leased to single-tenants under triple-net leases. Our portfolio also contains some multi-tenant properties with gross lease or modified gross lease structures. In addition, we have an interest in an unconsolidated joint venture that owns two healthcare facilities.

Corporate Sustainability and Social Responsibility

Our business values integrate environmental sustainability, social responsibility, and strong governance practices throughout our Company. Our Board of Directors’ (the “Board”) approach to these practices is viewed through the lens of reducing and controlling the Company’s risk profile.

Our Board continues to lead our sustainability efforts, and our Board has a standing committee focused on such efforts. The primary purpose of this committee is to assist the Board in fulfilling its responsibilities to provide oversight and support of our efforts and goals regarding sustainability matters by overseeing: (1) our general sustainability strategy and policies as set by our management, (2) communications with our employees, investors, and other stakeholders with respect to sustainability matters, (3) developments relating to, and improving our understanding of, sustainability matters, (4) our compliance with certain sustainability-related legal and regulatory requirements, and (5) coordination with our other Board committees on sustainability matters of common import.

In June 2024, we released our third Corporate Social Responsibility Report, which detailed our progress and areas of focus in the sustainability realm. The contents of our Corporate Social Responsibility Report are not incorporated by reference into this Report or in any other report or document we file with the SEC.

Our commitment to employee engagement remains a high-priority, as we continue to make accommodations for health, safety, and work-life balance, including at our headquarters which is LEED platinum certified and includes a fitness center, café and roof-top lounge.

Climate Change Risk

We take climate change and the risks associated with climate change seriously, including both physical and transitional risks. We utilize software to help us identify and measure the potential climate risk exposure for our properties. The software analysis summarizes the climate change-related risks, groups them by onset potential and identifies opportunities for risk mitigation. We assess energy efficiency and sustainability when evaluating investment opportunities and have begun to monitor our portfolio for climate risk factors. We utilize utility and energy audits that are performed by third-party engineering consultants during the due diligence phase of our acquisitions. The energy consumption data that we collect is used to calculate our facilities’ carbon emission levels. Capturing and tracking this information may help inform future mitigation and remediation efforts when possible. To that end, we continue to explore ways to mitigate climate risk, should it be present, in our acquisition strategy, as well as ways to contribute to the reduction of climate impact through proactive asset management that looks for ways to incorporate renewable energy resources and energy utilization reduction.

We stand with our communities, tenants, and stockholders in supporting meaningful solutions that address this global challenge and contribute to the sustainability of our business objectives.

Impact of Elevated Interest Rates and Inflation

During 2025, the U.S. Federal Reserve (the “Fed”) continued lowering the Federal Funds Rate with the most recent cut in October 2025 bringing the target range to 3.75% to 4.00%. The 10-Year U.S. Treasury yield and Secured Overnight Financing Rate (“SOFR”) have also trended lower during 2025, with the 10-year U.S. Treasury yield and one-month SOFR at 4.15% and 4.13% as of September 30, 2025, respectively.

 

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Although interest rates have trended lower during 2025, interest rates are significantly higher than in 2021, when we entered into interest rate swaps with respect to our $350 million term loan (“Term Loan A”) on our Second Amended and Restated Credit Facility (the “Credit Facility”). These interest rate swaps fixed the SOFR component of our interest rate on our Term Loan A at 1.36%; however, these swaps are set to expire in April 2026 (the original maturity date of Term Loan A).  In connection with the Amended and Restated Credit Facility (defined below), we entered into $350 million of new forward-starting interest rate swaps that will be effective in May 2026 to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities at rates ranging from 3.24% to 3.32%. The current elevated interest rate environment has already resulted in material increases in our interest expense with respect to our floating-rate indebtedness and, beginning on the effective date of our new interest rate swaps, will materially increase our interest expense with respect to our fixed-rate indebtedness.  

In summary, beginning on the effective date of our new interest rate swaps in May 2026, the impact of rising interest rates over the past several years will begin to affect our interest expense on our fixed-rate indebtedness, which is expected to negatively affect the Company’s net income. Additionally, any increase in the U.S. inflation rate may prompt the Fed to pause any future decreases to the Fed Funds Rate or increase the Fed Funds Rate, which may lead to an increase in our interest expense on our floating rate indebtedness.  

Continuing Impact of Healthcare Wage Inflation

The COVID-19 epidemic affected the healthcare industry in many ways. Many stories exist about U.S. healthcare workers, especially nurses, experiencing burnout due to the length and severity of the epidemic, and this has caused many nurses and other medical professionals to switch jobs within the medical profession or quit their professions altogether. This phenomenon has led to material increases in labor costs for healthcare systems, especially hospital systems, as some employers have had to rely on higher cost contract nursing labor to sustain their businesses. Although reliance on contract nursing and overall healthcare wage inflation moderated during 2024, the overall increase in healthcare labor costs remains. Whether enhanced technology and cost-saving measures and increased reimbursements from payors will help offset these costs remains to be seen.  

Reverse Stock Split

In August 2025, the Board approved a reverse stock split of our outstanding shares of common stock at a ratio of one-for-five (the “Reverse Stock Split”). The Reverse Stock Split was completed on September 19, 2025. As a result of the Reverse Stock Split, on September 19, 2025, every five issued and outstanding shares of our common stock was converted into one share of our common stock, with a proportionate reduction in our (i) authorized shares of common stock from 500 million to 100 million, (ii) outstanding equity awards, (iii) number of shares remaining available for issuance under our 2016 Equity Incentive Plan, as amended, and (iv) outstanding common units of the Operating Partnership. The par value of each share of our common stock remained unchanged. Trading in our common stock on a split adjusted basis began at the market open on September 22, 2025. No fractional shares were issued in connection with the Reverse Stock Split. Instead, each stockholder that otherwise would have received fractional shares received, in lieu of such fractional shares, cash in an amount based on the closing price of our common stock on the New York Stock Exchange on September 19, 2025. The Reverse Stock Split resulted in approximately 60 fractional shares, for which cash payments totaling approximately two thousand dollars were paid in lieu of issuing such fractional shares. All common share and per common share amounts in the accompanying condensed consolidated financial statements and notes thereto and applicable disclosures have been retrospectively adjusted for all periods presented to reflect the Reverse Stock Split.  

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Executive Summary

The following table summarizes the primary changes in our business and operations during the periods presented. All per share, per share and unit, and weighted average share and unit amounts have been adjusted to reflect the impact of the Reverse Stock Split.

    

Three Months Ended September 30, 

    

Nine Months Ended September 30, 

    

2025

2024

    

2025

    

2024

(in thousands, except per share and unit amounts)

Rental revenue

$

37,036

$

34,175

$

109,510

$

103,458

Depreciation and amortization expense

$

15,008

$

13,642

$

44,126

$

41,720

Interest expense

$

8,175

$

7,236

$

23,351

$

21,119

General and administrative expense

$

4,860

$

4,381

$

14,505

$

13,416

Gain (loss) on sale of investment properties

$

294

$

1,823

$

1,859

$

(1,560)

Net (loss) income attributable to common stockholders per share

$

(0.45)

$

0.14

$

(0.35)

$

(0.04)

FFO attributable to common stockholders and noncontrolling interest per share and unit(1)

$

1.00

$

0.96

$

3.00

$

3.00

AFFO attributable to common stockholders and noncontrolling interest per share and unit(1)

$

1.12

$

1.08

$

3.37

$

3.35

Dividends per share of common stock(2)

$

0.75

$

1.05

$

2.55

$

3.15

Weighted average common stock outstanding

13,393

13,147

 

13,381

 

13,126

Weighted average OP Units outstanding

447

449

 

448

 

449

Weighted average LTIP Units outstanding

714

634

 

683

 

611

Total weighted average shares and units outstanding

14,554

14,230

 

14,512

 

14,186

(1)See “—Non-GAAP Financial Measures,” for a description of our non-GAAP financial measures and a reconciliation of our non-GAAP financial measures.
(2)On May 28, 2025, the Board reduced the quarterly dividend on the Company’s common stock from $1.05 per share to $0.75 per share.

    

As of

 

September 30, 

December 31, 

 

    

2025

    

2024

 

(dollars in thousands)

 

Investment in real estate, gross

$

1,508,711

$

1,450,916

Total debt, net

$

709,635

$

646,131

Weighted average interest rate

 

4.06

%  

 

3.75

%

Total equity (including noncontrolling interest)

$

505,828

$

555,916

Net leasable square feet

 

5,178,421

 

4,756,108

Our Properties

As of September 30, 2025, we had gross investments of approximately $1.5 billion in real estate, consisting of 191 buildings with an aggregate of approximately 5.2 million leasable square feet and approximately $118 million of annualized base rent. This data does not include amounts for properties held in our unconsolidated joint venture.

Completed Acquisitions During the Nine Months Ended September 30, 2025

In October 2024, we entered into a purchase agreement to acquire a five-property portfolio (the “five-property portfolio”) of medical real estate for an aggregate purchase price of $69.6 million. In February 2025, we completed the acquisition of three properties in the five-property portfolio encompassing an aggregate of 188,874 leasable square feet for an aggregate purchase price of $31.5 million with aggregate annualized base rent of $2.7 million. In April 2025, we completed the acquisition of the remaining two properties in the five-property portfolio encompassing an aggregate of 297,724 leasable square feet for an aggregate purchase price of $38.1 million with

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aggregate annualized base rent of $3.6 million. In total, the five-property portfolio had a purchase price of $69.6 million with 486,598 leasable square feet and annualized base rent of $6.3 million.

Completed Property Dispositions During the Nine Months Ended September 30, 2025  

During the nine months ended September 30, 2025, we completed five dispositions that generated aggregate gross proceeds of $13.4 million, resulting in an aggregate gain of $1.9 million.

Impairment of Investment Property

During the nine months ended September 30, 2025, we recognized an impairment loss of $6.3 million related to our Aurora, Illinois facility.

Capital Activity

Equity Issuances

In January 2024, the Company and the Operating Partnership implemented a $300 million “at-the-market” equity offering program, pursuant to which we may offer and sell (including through forward sales), from time to time, shares of our common stock (the “2024 ATM Program”). No shares were sold under the 2024 ATM Program during the nine months ended September 30, 2025.

Common Stock Repurchase Program

In August 2025, the Board approved a $50 million common stock repurchase program (the “Stock Repurchase Program”). Under the Stock Repurchase Program, we may purchase up to $50 million of our outstanding shares of common stock from time to time in the open market, including through block purchases, through privately negotiated transactions or pursuant to any Rule 10b5-1 trading plan, in accordance with applicable securities laws. The specific timing, price and size of purchases will depend on prevailing stock prices, general economic and market conditions and other considerations. The Stock Repurchase Program does not obligate us to repurchase any dollar amount or number of shares of our common stock and may be suspended or discontinued at any time. No shares were repurchased during the nine months ended September 30, 2025.

Debt Activity

During the nine months ended September 30, 2025, we borrowed $115.4 million under the Credit Facility and repaid $40.3 million, for a net amount borrowed of $75.1 million. During the nine months ended September 30, 2024, we borrowed $82.8 million under the Credit Facility and repaid $55.4 million, for a net amount borrowed of $27.4 million. As of September 30, 2025, the net outstanding Credit Facility balance was $708.5 million and as of November 3, 2025, we had unutilized borrowing capacity under the revolver component of the Credit Facility (the “Revolver”) of $171 million.

Joint Venture

In connection with the formation of the joint venture (the “Joint Venture”) in December 2024, we sold two of our assets to the Joint Venture and received gross proceeds of $35.2 million. We used $2.1 million of the gross proceeds to finance our initial 12.5% capital investment in the Joint Venture. In connection with the acquisition of these properties, the Joint Venture entered into a mortgage loan with a principal amount of $17.6 million. We account for our interest in the Joint Venture using the equity method of accounting.

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Recent Developments

Closing of the Amended and Restated Credit Facility

On October 8, 2025, the Company, the Operating Partnership, as borrower, and certain subsidiaries of the Operating Partnership entered into a third amended and restated credit agreement (the “Amended and Restated Credit Facility”) with JPMorgan Chase Bank, N.A., as administrative agent, which contains the following material amendments to the Company’s Credit Facility:

Extends the initial maturity date of the existing $400 million Revolver to October 2029 with two, six-month extension options available at the Company’s election to extend the maturity to October 2030; and

Extends the maturity of the existing $350 million Term Loan A, dividing it into three term loans structured as follows:

$100 million term loan maturing in October 2029 (“Term Loan A-1”);
$100 million term loan maturing in October 2030 (“Term Loan A-2”); and
$150 million term loan maturing in April 2031 (“Term Loan A-3”); and

Removes the previous 0.10% (10 basis point) SOFR credit spread adjustment on all credit facility borrowings.

The Credit Facility’s pricing grid, $150 million Term Loan B that matures in February 2028, and $500 million accordion remain unchanged.

In connection with the Amended and Restated Credit Facility, on October 7, 2025, the Company entered into $350 million of new forward starting interest rate swaps to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities.

The existing $350 million Term Loan A fixed rate SOFR swaps remain in place, resulting in an all-in fixed interest rate of 2.85% on this debt through the swap maturities in April 2026.

Trends Which May Influence Our Results of Operations

We believe the following trends may positively impact our results of operations:

An aging population. According to the 2020 U.S. Census, the nation’s 65-and-older population has grown rapidly since 2010, driven by the aging of Baby Boomers born between 1946 and 1964. The 65-and-older population grew by over a third during the past decade, and by 3.2% from 2018 to 2019. We believe this segment of the U.S. population will utilize many of the services provided at our healthcare facilities such as orthopedics, cardiac, gastroenterology and rehabilitation.

A continuing shift towards outpatient care. According to the American Hospital Association, patients are demanding more outpatient operations. We believe this shift in patient preference from inpatient to outpatient facilities will benefit our tenants as most of our properties consist of outpatient facilities.

Physician practice group and hospital consolidation. We believe the trend towards physician group consolidation will serve to strengthen the credit quality of our tenants if our tenants merge or are consolidated with larger health systems.

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We believe the following trends may negatively impact our results of operations:

Interest rates remain at elevated levels. During 2025, the Fed continued lowering the Federal Funds Rate with the most recent cut in October 2025 bringing the target range to 3.75% to 4.00%. The 10-Year U.S. Treasury yield and SOFR have also trended lower during 2025, with the 10-year U.S. Treasury yield and one-month SOFR at 4.15% and 4.13% as of September 30, 2025, respectively. Although interest rates have trended lower during 2025, rates have increased materially over the last several years. Beginning on the effective date of our new interest rate swaps in May 2026, these elevated rates will begin to have a negative effect on the interest expense on our fixed-rate indebtedness, with the swapped SOFR rate on our Term Loan A increasing from 1.36% to a range of 3.24% to 3.32%. Additionally, any increase in the U.S. inflation rate may prompt the Fed to pause any future decreases to the Fed Funds Rate or increase the Fed Funds Rate, which may lead to an increase in our interest expense on our floating rate indebtedness.  

Continued elevated interest rates and recent market volatility have contributed to decreases in the common stock prices of many REITs, including the price of the Company’s common stock. A continued low stock price and elevated interest rates have caused the Company’s cost of capital to remain elevated, which, in turn, has significantly reduced the ability to acquire assets that meet the Company’s investment requirements.  

Healthcare Wage Inflation. The COVID-19 epidemic affected the healthcare industry in many ways. Many stories exist about U.S. healthcare workers, especially nurses, experiencing burnout due to the length and severity of the epidemic, and this has caused many nurses and other medical professionals to switch jobs within the medical profession or quit their professions altogether. This phenomenon has led to material increases in labor costs for healthcare systems, especially hospital systems, as some employers have had to rely on higher cost contract nursing labor to sustain their businesses. Although reliance on contract nursing and overall healthcare wage inflation moderated during 2024, the overall increase in healthcare labor costs remains. Whether enhanced technology and cost-saving measures and increased reimbursements from payors will help offset these costs remains to be seen.  

Changes in third party reimbursement methods and policies. The price of healthcare services has been increasing, and, as a result, we believe that third-party payors, such as Medicare and commercial insurance companies, will continue to scrutinize and reduce the types of healthcare services eligible for, and the amounts of, reimbursement under their health insurance plans. For example, on July 4, 2025, President Trump signed into law the OBBBA. The OBBBA mandates significant cuts to Medicaid funding and tightens eligibility requirements for Medicaid recipients. Additionally, many employer-based insurance plans continue to increase the percentage of insurance premiums for which covered individuals are responsible, which makes healthcare services more expensive for individuals. These trends were exacerbated by the COVID-19 epidemic, as medical expenditures increased significantly during the epidemic and have not yet returned to pre-COVID-19 levels. If these trends continue, our tenants’ businesses will continue to be negatively affected, which may impact their ability to pay rent to us.

Critical Accounting Estimates

The preparation of financial statements in conformity with GAAP requires our management to use judgment in the application of accounting policies, including making estimates and assumptions. We base estimates on the best information available to us at the time, our experience and on various other assumptions believed to be reasonable under the circumstances. These estimates affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. If our judgment or interpretation of the facts and circumstances relating to various transactions or other matters had been different, it is possible that different accounting would have been applied, resulting in a different presentation of our financial statements. From time to time, we re-evaluate our estimates and assumptions. In the event estimates or assumptions prove to be different from actual results, adjustments are made in subsequent periods to reflect more current estimates and assumptions about matters that are inherently uncertain. Please refer to our Annual Report on Form 10-K for the year ended December 31, 2024, filed with the Commission on February 28, 2025, for further information regarding the critical accounting policies that affect our more significant estimates and judgments used in the preparation of our condensed consolidated financial statements included in Part I, Item 1 of this Report.

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Consolidated Results of Operations

Three Months Ended September 30, 2025 Compared to Three Months Ended September 30, 2024

Three Months Ended September 30,

    

2025

    

2024

    

$ Change

(in thousands)

Revenue

 

  

 

 

  

Rental revenue

$

37,036

$

34,175

$

2,861

Other income

 

193

 

89

 

104

Total revenue

 

37,229

 

34,264

 

2,965

Expenses

General and administrative

 

4,860

 

4,381

 

479

Operating expenses

 

8,224

 

7,437

 

787

Depreciation expense

 

11,213

 

9,993

 

1,220

Amortization expense

 

3,795

 

3,649

 

146

Interest expense

8,175

7,236

939

Total expenses

 

36,267

 

32,696

 

3,571

Income before other income (expense)

962

1,568

(606)

Gain on sale of investment properties

294

1,823

(1,529)

Impairment of investment property

(6,281)

(6,281)

Equity loss from unconsolidated joint venture

(33)

(33)

Net (loss) income

$

(5,058)

$

3,391

$

(8,449)

Revenue

Total Revenue

Total revenue for the three months ended September 30, 2025 was $37.2 million, compared to $34.3 million for the same period in 2024, an increase of $2.9 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the three months ended September 30, 2025, partially offset by dispositions during that period. Within that increase, $5.2 million in revenue was recognized from net lease expense recoveries during the three months ended September 30, 2025, compared to $4.8 million for the same period in 2024.

Expenses

General and Administrative

General and administrative expenses for the three months ended September 30, 2025 were $4.9 million, compared to $4.4 million for the same period in 2024, an increase of $0.5 million. The increase primarily resulted from an increase in general corporate expenses, including costs related to our Reverse Stock Split, partially offset by a decrease in non-cash LTIP compensation expense, which was $1.2 million for the three months ended September 30, 2025, compared to $1.3 million for the same period in 2024.

Operating Expenses

Operating expenses for the three months ended September 30, 2025 were $8.2 million, compared to $7.4 million for the same period in 2024, an increase of $0.8 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the three months ended September 30, 2025, partially offset by dispositions during that period and a net reduction in costs at other properties. Included in these amounts were $5.2 million of recoverable property operating expenses incurred during the three months ended September 30, 2025, compared to $4.8 million for the same period in 2024. In addition, our operating expenses included $1.7 million of property operating expenses from gross leases for the three months ended September 30, 2025, compared to $1.6 million for the same period in 2024.

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Depreciation Expense

Depreciation expense for the three months ended September 30, 2025 was $11.2 million, compared to $10.0 million for the same period in 2024, an increase of $1.2 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the three months ended September 30, 2025, partially offset by dispositions during that period.

Amortization Expense

Amortization expense for the three months ended September 30, 2025 was $3.8 million, compared to $3.6 million for the same period in 2024, an increase of $0.2 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the three months ended September 30, 2025, partially offset by dispositions during that period.

Interest Expense

Interest expense for the three months ended September 30, 2025 was $8.2 million, compared to $7.2 million for the same period in 2024, an increase of $1.0 million. The increase was primarily due to higher average borrowings and higher interest rates during the three months ended September 30, 2025, compared to the same period in 2024.

The weighted average interest rate of our debt for the three months ended September 30, 2025 was 4.12% compared to 3.97% for the same period in 2024. Additionally, the weighted average interest rate and term of our debt was 4.06% and 1.3 years at September 30, 2025.

Income Before Other Income (Expense)

Income before other income (expense) for the three months ended September 30 2025 was $1.0 million, compared to $1.6 million for the same period in 2024, a decrease of $0.6 million.

Gain on Sale of Investment Properties  

During the three months ended September 30, 2025, we completed two dispositions resulting in an aggregate gain of $0.3 million. During the three months ended September 30, 2024, we completed two dispositions resulting in an aggregate gain of $1.8 million.

Impairment of Investment Property

In August 2025, we entered into an agreement to sell our facility located in Aurora, Illinois. We recognized an impairment loss of $6.3 million during the three months ended September 30, 2025 to reduce the carrying value of the asset to its fair value, which was determined to be the contractual sales price less commissions and fees. The sale of this facility was completed in September 2025.

Equity Loss from Unconsolidated Joint Venture

During the three months ended September 30, 2025, we recognized a loss from the Joint Venture of $33 thousand, which represented our 12.5% ownership interest in the net loss of the Joint Venture during that period.

Net (Loss) Income

Net loss for the three months ended September 30, 2025 was $5.1 million, compared to net income of $3.4 million for the same period in 2024, a decrease of $8.5 million.

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Nine Months Ended September 30, 2025 Compared to Nine Months Ended September 30, 2024

Nine Months Ended September 30, 

2025

2024

$ Change

(in thousands)

Revenue

 

  

 

  

  

Rental revenue

$

109,510

$

103,458

$

6,052

Other income

 

306

 

166

 

140

Total revenue

 

109,816

 

103,624

 

6,192

Expenses

 

  

 

 

  

General and administrative

 

14,505

 

13,416

 

1,089

Operating expenses

 

24,025

 

22,056

 

1,969

Depreciation expense

 

32,827

 

30,233

 

2,594

Amortization expense

 

11,299

 

11,487

 

(188)

Interest expense

 

23,351

 

21,119

 

2,232

Total expenses

 

106,007

 

98,311

 

7,696

Income before other income (expense)

3,809

5,313

(1,504)

Gain (loss) on sale of investment properties

1,859

(1,560)

3,419

Impairment of investment property

(6,281)

(6,281)

Equity loss from unconsolidated joint venture

(123)

(123)

Net (loss) income

$

(736)

$

3,753

$

(4,489)

Revenue

Total Revenue

Total revenue for the nine months ended September 30, 2025 was $109.8 million, compared to $103.6 million for the same period in 2024, an increase of $6.2 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the nine months ended September 30, 2025, partially offset by dispositions during that period. Within that increase, $15.8 million in revenue was recognized from net lease expense recoveries during the nine months ended September 30, 2025, compared to $14.7 million for the same period in 2024. Additionally, the prior year period included the recognition of reserves for $0.8 million of rent and the write-off of $0.1 million of deferred rent.

Expenses

General and Administrative

General and administrative expenses for the nine months ended September 30, 2025 were $14.5 million, compared to $13.4 million for the same period in 2024, an increase of $1.1 million. The increase primarily resulted from costs incurred during the current period in connection with our CEO transition, partially offset by a decrease in non-cash LTIP compensation expense, which was $3.1 million for the nine months ended September 30, 2025, compared to $3.8 million for the same period in 2024.

Operating Expenses

Operating expenses for the nine months ended September 30, 2025 were $24.0 million, compared to $22.1 million for the same period in 2024, an increase of $1.9 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the nine months ended September 30, 2025, partially offset by dispositions during that period and a net reduction in costs at other properties. Included in these amounts were $15.8 million of recoverable property operating expenses incurred during the nine months ended September 30, 2025, compared to $14.7 million for the same period in 2024. In addition, our operating expenses included $4.9 million of property operating expenses from gross leases for the nine months ended September 30, 2025, compared to $4.0 million for the same period in 2024.

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Depreciation Expense

Depreciation expense for the nine months ended September 30, 2025 was $32.8 million, compared to $30.2 million for the same period in 2024, an increase of $2.6 million. The increase primarily resulted from the impact of acquisitions that were completed subsequent to September 30, 2024 and through the nine months ended September 30, 2025, partially offset by dispositions during that period.

Amortization Expense

Amortization expense for the nine months ended September 30, 2025 was $11.3 million, compared to $11.5 million for the same period in 2024, a decrease of $0.2 million. The decrease primarily resulted from the impact of dispositions that were completed subsequent to September 30, 2024 and through the nine months ended September 30, 2025, partially offset by acquisitions that were completed during that period.

Interest Expense

Interest expense for the nine months ended September 30, 2025 was $23.4 million, compared to $21.1 million for the same period in 2024, an increase of $2.3 million. The increase was primarily due to higher average borrowings and higher interest rates during the nine months ended September 30, 2025, compared to the same period in 2024.

The weighted average interest rate of our debt for the nine months ended September 30, 2025 was 4.00% compared to 3.93% for the same period in 2024. Additionally, the weighted average interest rate and term of our debt was 4.06% and 1.3 years at September 30, 2025.

Income Before Other Income (Expense)

Income before other income (expense) for the nine months ended September 30, 2025 was $3.8 million, compared to $5.3 million for the same period in 2024, a decrease of $1.5 million.

Gain (Loss) on Sale of Investment Properties

During the nine months ended September 30, 2025, we completed five dispositions resulting in an aggregate gain of $1.9 million. During the nine months ended September 30, 2024, we completed three dispositions resulting in an aggregate loss of $1.6 million.

Impairment of Investment Property

In August 2025, we entered into an agreement to sell our facility located in Aurora, Illinois. We recognized an impairment loss of $6.3 million during the nine months ended September 30, 2025 to reduce the carrying value of the asset to its fair value, which was determined to be the contractual sales price less commissions and fees. The sale of this facility was completed in September 2025.

Equity Loss from Unconsolidated Joint Venture

During the nine months ended September 30, 2025, we recognized a loss from the Joint Venture of $123 thousand, which represented our 12.5% ownership interest in the net loss of the Joint Venture during that period.

Net (Loss) Income

Net loss for the nine months ended September 30, 2025 was $0.7 million, compared to net income $3.8 million for the same period in 2024, a decrease of $4.5 million.

Assets and Liabilities

As of September 30, 2025 and December 31, 2024, our principal assets consisted of investments in real estate, net, of $1.2 billion. We completed five acquisitions and five dispositions during the nine months ended September 30, 2025. Our liquid assets

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consisted primarily of cash and cash equivalents and restricted cash of $9.8 million and $8.9 million, as of September 30, 2025 and December 31, 2024, respectively.

The increase in our cash and cash equivalents and restricted cash balances to $9.8 million as of September 30, 2025, compared to $8.9 million as of December 31, 2024, was primarily due to net borrowings on our Credit Facility, net proceeds received from the sale of investment properties, and net cash provided by operating activities, partially offset by funds used to acquire investment properties, the payment of dividends to common and preferred stockholders as well as holders of OP Units and LTIP Units, funds used to repay notes payable, and funds used for capital expenditures on existing real estate investments and leasing commissions.

The increase in our total liabilities to $767.4 million as of September 30, 2025 compared to $700.6 million as of December 31, 2024, was primarily the result of higher net borrowings outstanding on our Credit Facility, partially offset by a lower notes payable balance.

Liquidity and Capital Resources

General

Our short-term (up to 12 months) liquidity requirements include:

Interest expense and scheduled principal payments on outstanding indebtedness;
General and administrative expenses, including cash severance costs owed to Mr. Busch pursuant to the Transition and Separation Agreement and General Release of Claims, dated January 8, 2025;
Property operating expenses;
Property acquisitions;
Distributions on our common and preferred stock and OP Units and LTIP Units; and
Capital and tenant improvements and leasing costs.

On May 28, 2025, the Board reduced the Company’s quarterly common stock dividend from $1.05 per share to $0.75 per share (on a split-adjusted basis). We believe the reduction to the dividend best positions the Company for future growth, strengthens the balance sheet, and provides investors with an attractively yielding, well-covered dividend.

In 2025, we are contractually obligated to pay, or have capital commitments for, principal and interest payments on our outstanding debt and ground and operating lease expenses. In addition, if we decide to redeem our preferred stock in full, we would have to pay the liquidation preference of $77.6 million plus accrued dividends, fees and expenses.

Our long-term (beyond 12 months) liquidity requirements consist primarily of funds necessary to pay for acquisitions, capital and tenant improvements and leasing costs at our properties, scheduled debt maturities, general and administrative expenses, including cash severance costs owed to Mr. Busch pursuant to the Transition and Separation Agreement, operating expenses, and distributions. Beyond 2025, we are contractually obligated to pay, or have capital commitments for, principal and interest payments on our outstanding debt and ground and operating lease expenses.

We expect to satisfy our short and long-term liquidity needs through various internal and external sources, including cash flow from operations, debt financing, sales of additional equity securities, the issuance of OP Units in connection with acquisitions of additional properties, proceeds from select property dispositions and recapitalization transactions.

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Internal Sources of Liquidity

Our primary internal sources of liquidity include cash flow from operations and proceeds from select property dispositions and recapitalization transactions.  

External Sources of Liquidity

Our primary external sources of liquidity include net proceeds received from equity issuances, including the issuance of OP Units in connection with acquisitions of additional properties, and debt financing, including borrowings under our Amended and Restated Credit Facility and secured term loans.

Equity Issuances

In January 2024, the Company and the Operating Partnership implemented the 2024 ATM Program, pursuant to which we may offer and sell (including through forward sales), from time to time, shares of our common stock. No shares were sold under the 2024 ATM Program during the nine months ended September 30, 2025 or from October 1, 2025 through November 3, 2025.

Common Stock Repurchase Program  

As described in “Capital Activity – Common Stock Repurchase Program,” in August 2025, the Board approved the Stock Repurchase Program. Under the Stock Repurchase Program, we may purchase up to $50 million of our outstanding shares of common stock from time to time in the open market, including through block purchases, through privately negotiated transactions or pursuant to any Rule 10b5-1 trading plan, in accordance with applicable securities laws. The specific timing, price and size of purchases will depend on prevailing stock prices, general economic and market conditions and other considerations. The Stock Repurchase Program does not obligate us to repurchase any dollar amount or number of shares of our common stock and may be suspended or discontinued at any time. No shares were repurchased during the nine months ended September 30, 2025 or from October 1, 2025 through November 3, 2025.

Debt Financing

Amended and Restated Credit Facility. As described in “Recent Developments – Closing of the Amended and Restated Credit Facility,” the Company entered into an Amended and Restated Credit Facility on October 8, 2025. The Amended and Restated Credit Facility consists of (i) the $350 million Term Loan A, (ii) the $150 million Term Loan B, and (iii) the $400 million Revolver. The Amended and Restated Credit Facility also contains a $500 million accordion feature. As of November 3, 2025, we had unutilized borrowing capacity under the Amended and Restated Credit Facility of $171 million.

The Amended and Restated Credit Facility is an unsecured facility and contains the following material amendments to the Company’s previous Credit Facility:

Extends the initial maturity date of the existing $400 million Revolver component of the credit facility to October 2029 with two, six-month extension options available at the Company’s election to extend the maturity to October 2030; and

Extends the maturity of the existing $350 million Term Loan A, dividing it into three term loans structured as follows:

$100 million term loan maturing in October 2029 (“Term Loan A-1”);
$100 million term loan maturing in October 2030 (“Term Loan A-2”); and
$150 million term loan maturing in April 2031 (“Term Loan A-3”); and

Removes the previous 0.10% (10 basis point) SOFR credit spread adjustment on all credit facility borrowings.

The Credit Facility’s pricing grid, $150 million Term Loan B that matures in February 2028, and $500 million accordion remain unchanged.

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In connection with the Amended and Restated Credit Facility, on October 7, 2025, the Company entered into $350 million of new forward starting interest rate swaps to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities.

The existing $350 million Term Loan A fixed rate SOFR swaps remain in place, resulting in an all-in fixed interest rate of 2.85% on this debt through the swap maturities in April 2026.

At closing of the Amended and Restated Credit Facility, the weighted average term of the Company’s debt, including the drawn Revolver component, was 4.4 years.

We are subject to a number of financial covenants under the Credit Facility, including, among other things, the following as of the end of each fiscal quarter, (i) a maximum consolidated unsecured leverage ratio of less than 60%, (ii) a maximum consolidated secured leverage ratio of less than 30%, (iii) a maximum consolidated secured recourse leverage ratio of less than 10%, (iv) a minimum fixed charge coverage ratio of 1.50:1.00, (v) a minimum unsecured interest coverage ratio of 1.50:1.00, (vi) a maximum consolidated leverage ratio of less than 60%, (vii) a maximum cash investment in joint ventures of 10% of total asset value and (viii) a minimum net worth of $573 million plus 75% of all net proceeds raised through equity offerings subsequent to March 31, 2022. As of September 30, 2025, management believed it complied with all of the financial and non-financial covenants contained in the Credit Facility.

Other Fixed Debt. We have $1.2 million in gross notes payable as of September 30, 2025. This debt is comprised of one instrument.

Hedging Instruments. As of September 30, 2025, we had nine interest rate swaps that are used to manage our interest rate risk. Five of our interest rate swaps related to Term Loan A with a combined notional value of $350 million that fix the SOFR component on Term Loan A through April 2026 at 1.36%. Four of our interest rate swaps related to Term Loan B with a combined notional value of $150 million that fix the SOFR component on Term Loan B through January 2028 at 2.54%.

As described in “Recent Developments – Closing of the Amended and Restated Credit Facility,” in connection with the Amended and Restated Credit Facility, the Company entered into $350 million of forward starting interest rate swaps (seven swaps in total) to fully hedge the SOFR component of the three Term Loan A tranches through their respective maturities as follows:

Term Loan A Tranches

Interest Rate Swap Term

Fixed Base Rate

Effective Interest Rate(1)

$100 million Term Loan A-1

May 2026 through October 2029

3.24%

4.75%

$100 million Term Loan A-2

May 2026 through October 2030

3.28%

4.80%

$150 million Term Loan A-3

May 2026 through April 2031

3.32%

4.84%

(1)Rates consist of the fixed SOFR base rate plus a borrowing spread of 1.45% based on a leverage ratio of between 45% and 50% and is calculated using 365/360 method.

Total Fixed Debt. Our fixed debt totaled $501.2 million on a gross basis at September 30, 2025, with a weighted average interest rate of 3.31% based on our interest rate swaps and at current leverage. The weighted average maturity of our fixed debt was 1.1 years at September 30, 2025.

Cash Flow Information

Net cash provided by operating activities for the nine months ended September 30, 2025 was $52.0 million, compared to $49.5 million for the same period in 2024. During the 2025 period, there was an increase in depreciation expense and the changes in operating asset and liability accounts offset each other.

Net cash used in investing activities for the nine months ended September 30, 2025 was $67.2 million, compared to $26.4 million for the same period in 2024. During the 2025 period, we used more funds to acquire investment properties and received less net proceeds from the sale of investment properties, partially offset by less funds used for capital expenditures on existing real estate investments and leasing commissions.

Net cash provided by financing activities for the nine months ended September 30, 2025 was $16.1 million, compared to net cash used in financing activities of $22.0 million for the same period in 2024. During the 2025 period, we had higher net borrowings on

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our Credit Facility and lower payment of dividends to common and preferred stockholders as well as holders of OP Units and LTIP Units, partially offset by no proceeds received from common equity offerings and more funds used to repay notes payable.

Non-GAAP Financial Measures

Management considers certain non-GAAP financial measures to be useful supplemental measures of the Company's operating performance. A non-GAAP financial measure is generally defined as one that purports to measure financial performance, financial position or cash flows, but excludes or includes amounts that would not be so adjusted in the most comparable measure determined in accordance with GAAP. The Company reports non-GAAP financial measures because these measures are observed by management to also be among the most predominant measures used by the REIT industry and by industry analysts to evaluate REITs. For these reasons, management deems it appropriate to disclose and discuss these non-GAAP financial measures. Set forth below are descriptions of the non-GAAP financial measures management considers relevant to the Company's business and useful to investors, as well as reconciliations of those measures to the most directly comparable GAAP financial measure.

The non-GAAP financial measures presented herein are not necessarily identical to those presented by other real estate companies due to the fact that not all real estate companies use the same definitions. These measures should not be considered as alternatives to net income, as indicators of the Company's financial performance, or as alternatives to cash flow from operating activities as measures of the Company's liquidity, nor are these measures necessarily indicative of sufficient cash flow to fund all of the Company's needs. Management believes that in order to facilitate a clear understanding of the Company's historical consolidated operating results, these measures should be examined in conjunction with net income and cash flows from operations as presented in the Condensed Consolidated Financial Statements and other financial data included elsewhere in this Report.

Funds from Operations and Adjusted Funds from Operations and Funds Available for Distribution

Funds from operations attributable to common stockholders and noncontrolling interest (“FFO”) and adjusted funds from operations attributable to common stockholders and noncontrolling interest (“AFFO”) and funds available for distribution attributable to common stockholders and noncontrolling interest (“FAD”) are non-GAAP financial measures within the meaning of the rules of the SEC. The Company considers FFO and AFFO and FAD to be important supplemental measures of its operating performance and believes FFO is frequently used by securities analysts, investors, and other interested parties in the evaluation of REITs, many of which present FFO when reporting their results.

In accordance with the National Association of Real Estate Investment Trusts’ (“NAREIT”) definition, FFO means net income or loss computed in accordance with GAAP before noncontrolling interests of holders of OP Units and LTIP Units, excluding gains (or losses) from sales of property and extraordinary items, property impairment losses, less preferred stock dividends, plus real estate-related depreciation and amortization (excluding amortization of debt issuance costs and the amortization of above and below market leases), and after adjustments for unconsolidated partnerships and joint ventures calculated to reflect FFO on the same basis. Because FFO excludes real estate-related depreciation and amortization (other than amortization of debt issuance costs and above and below market lease amortization expense), the Company believes that FFO provides a performance measure that, when compared period-over-period, reflects the impact to operations from trends in occupancy rates, rental rates, operating costs, development activities and interest costs, providing perspective not immediately apparent from the closest GAAP measurement, net income or loss.

AFFO is a non-GAAP measure used by many investors and analysts to measure a real estate company’s operating performance by removing the effect of items that do not reflect ongoing property operations. Management calculates AFFO by modifying the NAREIT computation of FFO by adjusting it for certain cash and non-cash items and certain recurring and non-recurring items. For the Company these items include recurring acquisition and disposition costs, loss on the extinguishment of debt, recurring straight line deferred rental revenue, recurring stock-based compensation expense, recurring amortization of above and below market leases, recurring amortization of debt issuance costs, severance and transition related expense, costs related to our reverse stock split, and other items related to unconsolidated partnerships and joint ventures.

We calculate FAD by subtracting from AFFO capital expenditures, including tenant improvements, and leasing commissions. Management believes FAD is useful in analyzing the portion of cash flow that is available for distribution to stockholders and unitholders. Investors, analysts and the Company utilize FAD as an indicator of common dividend potential.

Management believes that reporting AFFO in addition to FFO and FAD is a useful supplemental measure for the investment community to use when evaluating the operating performance of the Company on a comparative basis.

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A reconciliation of net income to FFO and AFFO and FAD for the three and nine months ended September 30, 2025 and 2024 is as follows. All per share, per share and unit, and weighted average share and unit amounts have been adjusted to reflect the impact of the Reverse Stock Split.

Three Months Ended September 30, 

    

Nine Months Ended September 30, 

    

2025

    

2024

    

2025

    

2024

    

(unaudited, in thousands except per share and unit amounts)

Net (loss) income

$

(5,058)

$

3,391

$

(736)

$

3,753

Less: Preferred stock dividends

 

(1,455)

 

(1,455)

 

(4,366)

 

(4,366)

Depreciation and amortization expense

14,983

13,618

44,055

41,611

Depreciation and amortization expense from unconsolidated joint venture

73

195

(Gain) loss on sale of investment properties

(294)

(1,823)

(1,859)

1,560

Impairment of investment property

6,281

6,281

FFO attributable to common stockholders and noncontrolling interest

$

14,530

$

13,731

$

43,570

$

42,558

Amortization of above market leases, net

 

113

282

505

782

Straight line deferred rental revenue

 

(332)

(501)

(868)

(1,264)

Stock-based compensation expense

 

1,207

1,274

3,086

3,826

Amortization of debt issuance costs and other

 

554

559

1,672

1,684

Severance and transition related expense

671

Reverse stock split expense

170

170

Other adjustments from unconsolidated joint venture

51

AFFO attributable to common stockholders and noncontrolling interest

$

16,242

$

15,345

$

48,857

$

47,586

Net (loss) income attributable to common stockholders per share – basic and diluted

$

(0.45)

$

0.14

$

(0.35)

$

(0.04)

FFO attributable to common stockholders and noncontrolling interest per share and unit

$

1.00

$

0.96

$

3.00

$

3.00

AFFO attributable to common stockholders and noncontrolling interest per share and unit

$

1.12

$

1.08

$

3.37

$

3.35

Weighted Average Shares and Units Outstanding – basic and diluted

 

14,554

14,230

14,512

14,186

Weighted Average Shares and Units Outstanding:

Weighted Average Common Shares

 

13,393

13,147

13,381

13,126

Weighted Average OP Units

 

447

449

448

449

Weighted Average LTIP Units

 

714

634

683

611

Weighted Average Shares and Units Outstanding – basic and diluted

 

14,554

 

14,230

 

14,512

 

14,186

AFFO attributable to common stockholders and noncontrolling interest

$

16,242

$

15,345

$

48,857

$

47,586

Tenant improvements

(1,601)

(1,375)

(3,183)

(4,183)

Leasing commissions

(1,136)

(390)

(1,809)

(2,935)

Building capital

(1,683)

(3,447)

(4,677)

(5,789)

FAD attributable to common stockholders and noncontrolling interest

$

11,822

$

10,133

$

39,188

$

34,679

Earnings Before Interest, Taxes, Depreciation and Amortization for Real Estate (EBITDAre and Adjusted EBITDAre)

The Company calculates EBITDAre in accordance with standards established by NAREIT and defines EBITDAre as net income or loss computed in accordance with GAAP plus depreciation and amortization, interest expense, gain or loss on the sale of

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investment properties, property impairment losses, and adjustments for unconsolidated partnerships and joint ventures to reflect EBITDAre on the same basis, as applicable. The Company defines Adjusted EBITDAre as EBITDAre plus loss on extinguishment of debt, non-cash stock compensation expense, non-cash intangible amortization related to above and below market leases, severance and transition related expense, expenses related to our reverse stock split, transaction expense, adjustments related to our investments in unconsolidated joint ventures, and other normalizing items. Management considers EBITDAre and Adjusted EBITDAre important measures because they provide additional information to allow management, investors, and our current and potential creditors to evaluate and compare our core operating results and our ability to service debt.

A reconciliation of net income to EBITDAre and Adjusted EBITDAre for the three and nine months ended September 30, 2025 and 2024 is as follows:

Three Months Ended September 30,

Nine Months Ended September 30,

2025

    

2024

2025

    

2024

(unaudited and in thousands)

Net (loss) income

$

(5,058)

$

3,391

$

(736)

$

3,753

Interest expense

 

8,175

 

7,236

23,351

21,119

Depreciation and amortization expense

15,008

13,642

44,126

41,720

Unconsolidated joint venture EBITDAre adjustments (1)

112

311

(Gain) loss on sale of investment properties

(294)

(1,823)

(1,859)

1,560

Impairment of investment property

6,281

6,281

EBITDAre

$

24,224

$

22,446

$

71,474

$

68,152

Stock-based compensation expense

 

1,207

 

1,274

3,086

3,826

Amortization of above market leases, net

 

113

 

282

505

782

Severance and transition related expense

671

Reverse stock split expense

170

170

Interest rate swap mark-to-market at unconsolidated joint venture

55

Adjusted EBITDAre

$

25,714

$

24,002

$

75,961

$

72,760

(1)Includes joint venture interest, depreciation and amortization, and gain on sale of investment properties, if applicable, included in joint venture net income or loss.

Item 3. Quantitative and Qualitative Disclosures About Market Risk.

Market risk includes risks that arise from changes in interest rates, foreign currency exchange rates, commodity prices, equity prices and other market changes that affect market sensitive instruments. In pursuing our business and investment objectives, we expect that the primary market risk to which we will be exposed is interest rate risk.

We may be exposed to the effects of interest rate changes primarily as a result of debt used to acquire healthcare facilities, including borrowings under the Amended and Restated Credit Facility. The analysis below presents the sensitivity of the value of our variable rate financial obligations to selected changes in market interest rates. The range of changes chosen reflects our view of changes which are reasonably possible over a one-year period.

As of September 30, 2025, we had $211.7 million of unhedged borrowings outstanding under the Revolver (before the netting of unamortized debt issuance costs) that bears interest at a variable rate. See “Management’s Discussion and Analysis of Financial Condition and Results of Operation—Liquidity and Capital Resources,” for a detailed discussion of our Amended and Restated Credit Facility. At September 30, 2025, SOFR on our outstanding floating-rate borrowings was 4.16%. Assuming no increase in the amount of our variable interest rate debt, if SOFR increased 100 basis points, our cash flow would decrease by approximately $2.1 million annually. Assuming no increase in the amount of our variable rate debt, if SOFR were reduced 100 basis points, our cash flow would increase by approximately $2.1 million annually.

Our interest rate risk management objectives are to limit the impact of interest rate changes on earnings and cash flows and to lower overall borrowing costs. To achieve our objectives, we may borrow at fixed rates or floating rates. See “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources—Hedging Instruments,” for a description of our interest rate swaps.

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We may enter into additional derivative financial instruments, including interest rate swaps and caps, in order to mitigate our interest rate risk on our future borrowings. We will not enter into derivative transactions for speculative purposes.

In addition to changes in interest rates, the value of our investments is subject to fluctuations based on changes in local and regional economic conditions and changes in the creditworthiness of tenants/operators and borrowers, which may affect our ability to refinance our debt if necessary.

Item 4. Controls and Procedures.

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) of the Exchange Act that are designed to ensure that information required to be disclosed in our reports filed or submitted to the SEC under the Exchange Act is recorded, processed, summarized and reported within the time periods specified by the SEC’s rules and forms, and that information is accumulated and communicated to management, including the principal executive and financial officer as appropriate, to allow timely decisions regarding required disclosures. Our principal executive officer and principal financial officer evaluated the effectiveness of disclosure controls and procedures as of September 30, 2025 pursuant to Rule 13a-15(b) under the Exchange Act. Based on that evaluation, our principal executive officer and principal financial officer concluded that, as of the end of the period covered by this Report, the Company’s disclosure controls and procedures were effective to ensure that information required to be included in our periodic SEC filings is recorded, processed, summarized, and reported within the time periods specified in the SEC rules and forms.

Our management, including our principal executive officer and principal financial officer, does not expect that our disclosure controls and procedures or our internal controls will prevent all error and all fraud. A control system, no matter how well conceived and operated, 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. Due to 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.

Changes in Internal Control over Financial Reporting

No changes were made to our internal control over financial reporting during our most recently completed fiscal quarter that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

PART II OTHER INFORMATION

Item 1. Legal Proceedings

We are not involved in any pending legal proceeding or litigation and, to the best of our knowledge, no governmental authority is contemplating any proceeding to which we are a party or to which any of our properties is subject, which would reasonably be likely to have a material adverse effect on our financial condition or results of operations. From time to time, we may become involved in litigation relating to claims arising out of our operations in the normal course of business. There can be no assurance that these matters that arise in the future, individually or in the aggregate, will not have a material adverse effect on our financial condition or results of operations in any future period.

Item 1A. Risk Factors

The following supplements and updates the risk factors in Part I, Item 1A. Risk Factors in our Annual Report on Form 10-K for the year ended December 31, 2024. Some statements in this Quarterly Report on Form 10-Q, including statements in the following risk factor, constitute forward-looking statements. Please refer to Part I, Item 2 of this Quarterly Report on Form 10-Q entitled “Special Note Regarding Forward-Looking Statements.”

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Global trade disruption, significant introductions of trade barriers and bilateral trade frictions, together with any future downturns in the global economy resulting therefrom, could adversely affect our performance.

The U.S. government has recently announced significant changes in its approach to international trade policy and has announced efforts to renegotiate certain existing trade agreements with foreign countries. In addition, the U.S. government has recently imposed tariffs on certain foreign goods and has indicated a willingness to impose tariffs on imports of other products. Some foreign governments, including China, have instituted retaliatory tariffs on certain U.S. goods and have indicated a willingness to impose additional tariffs on U.S. products. Global trade disruption, significant introductions of trade barriers and bilateral trade frictions, together with any future downturns in the global economy resulting therefrom, could adversely affect our performance.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

On August 28, 2025, the Company issued 5,000 shares of its common stock (on a split-adjusted basis) to Janney Montgomery Scott (“Janney”) in connection with Janney’s redemption of 5,000 OP Units (on a split-adjusted basis) issued to Janney by the Operating Partnership on September 18, 2017, October 4, 2017, and December 1, 2017, in connection with Janney’s performance of certain advisory services to the Company. Pursuant to the terms of the Operating Partnership’s partnership agreement, OP Units may be redeemed by the holder after a one-year holding period for either cash or shares of common stock of the Company, such form of redemption consideration to be determined at the sole discretion of the Company. The issuance of these shares of common stock was effected in reliance upon the exemption from registration under Section 4(a)(2) of the Securities Act of 1933, as amended.

Item 3. Defaults Upon Senior Securities

None.

Item 4. Mine Safety Disclosures

Not applicable.

Item 5. Other Information

None.

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Item 6. Exhibits

(a)Exhibits

Exhibit No.

    

Description

3.1

Articles of Restatement of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q as filed with the SEC on August 8, 2018).

3.2

Articles of Amendment of Global Medical REIT Inc. (incorporated herein by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K as filed with the SEC on September 19, 2025).

3.3

Fourth Amended and Restated Bylaws of Global Medical REIT Inc., adopted as of December 7, 2022 (incorporated herein by reference to Exhibit 3.2 to the Company’s Current Report on Form 8-K as filed with the SEC on December 7, 2022).

4.1

Specimen of Common Stock Certificate (incorporated herein by reference to Exhibit 4.1 to the Company’s Registration Statement on Form S-11/A as filed with the SEC on June 15, 2016).

4.2

Specimen of 7.50% Series A Cumulative Redeemable Preferred Stock Certificate (incorporated herein by reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K as filed with the SEC on September 14, 2017).

31.1*

Certification of Principal Executive Officer pursuant to Rules 13a-14(a) and 15d-14(a) promulgated under the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

31.2*

Certification of Principal Financial and Accounting Officer pursuant to Rules 13a-14(a) and 15d-14(a) promulgated under the Securities Exchange Act of 1934, as amended, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

32.1**

Certification of Principal Executive Officer and Principal Financial and Accounting Officer, pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

101.INS *

Inline XBRL Instance Document

101.SCH *

Inline XBRL Taxonomy Schema

101.CAL *

Inline XBRL Taxonomy Calculation Linkbase

101.DEF *

Inline XBRL Taxonomy Definition Linkbase

101.LAB *

Inline XBRL Taxonomy Label Linkbase

101.PRE *

Inline XBRL Taxonomy Presentation Linkbase

104

Cover Page Interactive Data File (embedded within the Inline XBRL document and contained in Exhibit 101)

*

Filed herewith.

**

Furnished herewith. Such certification shall not be deemed “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934, as amended.

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Table of Contents

SIGNATURES

Pursuant to the requirements 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.

GLOBAL MEDICAL REIT INC.

Date: November 5, 2025

By:

/s/ Mark O. Decker. Jr.

Mark O. Decker, Jr.

Chief Executive Officer (Principal Executive Officer)

Date: November 5, 2025

By:

/s/ Robert J. Kiernan

Robert J. Kiernan

Chief Financial Officer (Principal Financial and Accounting Officer)

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