1. American Tower, but for hospitals and senior living facilities instead of cell towers.

2. Prologis, but for healthcare facilities like senior living and hospitals instead of warehouses.

• Leasing of Senior Housing Properties: NHI provides real estate for independent living, assisted living, and memory care communities to third-party operators under long-term leases.
• Leasing of Skilled Nursing Facilities: NHI offers real estate for post-acute and long-term skilled nursing care facilities to operators through long-term lease agreements.

National Health Investors (NHI) is a real estate investment trust (REIT) that primarily owns and leases healthcare properties (such as senior housing and skilled nursing facilities) to various operating companies. Therefore, NHI sells primarily to other companies, which are the operators of these healthcare facilities.

Based on NHI's recent filings, its major customers (operators) by gross investment as of December 31, 2023, include:

• Ensign Group (Symbol: ENSG)
• Senior Living Communities (operated by affiliates of Atria Senior Living, which is a private company)
• Holiday Retirement (a private company)
• Five Star Senior Living (Symbol: FVE)

D. Eric Mendelsohn President, Chief Executive Officer and Director

Mr. Mendelsohn joined National Health Investors (NHI) in January 2015 as Executive Vice President of Corporate Finance, becoming interim CEO in August 2015, and CEO and President in October 2015. He has over 20 years of healthcare real estate and financing experience. Prior to joining NHI, he spent nine years with Emeritus Senior Living, most recently as Senior Vice President of Corporate Development. In this role, he was responsible for the financing and acquisition of assisted living properties, home health care companies, and administering joint venture relationships. Mr. Mendelsohn was instrumental in the $2.8 billion acquisition of Emeritus Corp. by Brookdale Senior Living. Before Emeritus, he worked as a real estate transaction officer at the University of Washington, focusing on the development, acquisition, and financing of research, clinic, and medical properties.

John L. Spaid Executive Vice President of Finance, Chief Financial Officer and Treasurer

Mr. Spaid was appointed Chief Financial Officer in November 2019 and Treasurer in February 2023, having joined NHI in March 2016 as Executive Vice President of Finance. He has over 40 years of experience in real estate, finance, and senior housing. Prior to NHI, Mr. Spaid was Senior Vice President of Financial Planning and Analysis at Emeritus Senior Living, where he supervised financial analysis and support and led multiple merger and acquisition (M&A) processes totaling over $20 billion from 2012 to 2014. From 2010 to 2011, he worked as an independent financial consultant, offering M&A, workout, and private equity consulting services. He also served as the CFO of a regional assisted living and memory care provider in Redmond, Washington, from 2008 to 2009.

Kevin Carlton Pascoe Executive Vice President of Investments and Chief Investment Officer

Mr. Pascoe joined National Health Investors in June 2010. He was promoted to Chief Investment Officer in February 2017, and also holds the title of Executive Vice President of Investments, a position he has held since January 2015. He oversees NHI's portfolio of assets, business development, relationship management with existing tenants, and conducts operational due diligence on new investment opportunities. With over 20 years of experience in healthcare real estate, his background includes serving as a Vice President at General Electric – Healthcare Financial Services from 2006 to 2010, where he focused on deal restructuring and special assets.

Michelle R. Kelly Senior Vice President Investments

Ms. Kelly joined National Health Investors Inc. in September 2017 and is currently the Senior Vice President Investments. She is responsible for identifying new business opportunities, managing existing client relationships, and strengthening NHI's brand. Michelle has over 23 years of experience financing and investing in the senior housing and skilled nursing industries. Before joining NHI, she spent more than six years at Welltower Inc., initially in asset management and later transitioning to business development. Prior to Welltower, Ms. Kelly spent over 10 years at GE Capital in its Healthcare Financial Services business, specializing in debt for seniors housing and skilled nursing, holding positions in underwriting, portfolio management, and originations. She began her career with Heller Financial.

The key risks to National Health Investors (NHI) primarily revolve around tenant stability and concentration, especially concerning a significant master lease, broader industry and regulatory challenges within healthcare real estate, and aspects of liquidity and capital costs.

1. Tenant Concentration and the National HealthCare Corporation (NHC) Master Lease Renegotiation: A significant portion of NHI's revenue depends on a limited number of tenants, creating a concentration risk. The most prominent example is the ongoing, critical negotiation of the master lease with National HealthCare Corporation (NHC), which is set to expire at the end of 2026. The outcome of these discussions is uncertain and could substantially impact NHI's cash flow. While a successful renegotiation or re-leasing to another operator could potentially increase NHI's Funds From Operations (FFO) per share, a negative outcome could significantly affect NHC's earnings and, by extension, NHI's rental income. The operating success of NHI's tenants, managers, and borrowers is vital for the collection of lease and interest income, and there's a risk of tenant or borrower bankruptcy or insolvency proceedings.
2. Industry Headwinds and Regulatory / Reimbursement Changes in Healthcare Real Estate: The broader healthcare real estate sector, particularly senior housing, faces persistent industry headwinds, including tight and competitive operating margins in segments like the Senior Housing Operating Portfolio (SHOP). External risks also include the ongoing impact of public health crises such as COVID-19 on tenants and the economy, which can affect NHI's ability to collect income. Furthermore, governmental regulations and changes in reimbursement rates from payors like Medicare and Medicaid can significantly impact the financial health of NHI's tenants and borrowers, consequently affecting NHI's business. Increased liability claims and insurance costs also contribute to these industry-wide challenges.
3. Liquidity and Cost of Capital: NHI has demonstrated a constrained liquidity position, as indicated by its quick and current ratios (approximately 0.68 and 0.66, respectively, in 2025), meaning short-term assets do not adequately cover short-term or long-term liabilities. The cost of capital is identified as a key risk. Challenges associated with reinvesting cash in real estate investments, potential debt incurrence, and the necessity of meeting debt covenants are also significant financial considerations. Additionally, inflation and increased interest rates can adversely affect the company's financial position and the cost of its capital.

• Accelerated Shift Towards Home-Based Care and Aging-in-Place: The expansion of telehealth, remote monitoring technologies, and "hospital-at-home" programs represents a clear emerging threat to traditional congregate care settings, including skilled nursing facilities and senior housing properties that form a significant portion of NHI's portfolio. As technology enables more complex care to be delivered cost-effectively in a patient's home, and as consumer preference for aging in place grows, the long-term demand for physical institutional beds may diminish, akin to how streaming services disrupted physical rental stores by offering an alternative delivery model.
• Persistent and Severe Healthcare Labor Shortages: The healthcare sector, particularly skilled nursing and senior housing, faces acute and worsening labor shortages across various roles (e.g., nurses, CNAs, caregivers). This scarcity drives up labor costs, forces operators to rely on expensive agency staff, impacts occupancy rates, and strains their ability to provide quality care while maintaining profitability. For NHI, this directly threatens the financial viability of its tenants, increasing the risk of lease defaults, rent concessions, and potential impairments or decreased valuations for the properties they own, as the operational challenges for facility operators become unsustainable.

National Health Investors (NHI) operates primarily in the healthcare real estate sector, with its main products and services revolving around investments in various healthcare properties. These include senior housing, skilled nursing facilities, and medical office buildings. The addressable markets for these services are substantial within the United States.

U.S. Senior Living Market

The U.S. senior living market was estimated at approximately USD 907.59 billion in 2024 and is projected to grow to USD 1.33 trillion by 2033, demonstrating a compound annual growth rate (CAGR) of 4.42% from 2025 to 2033. Another estimate indicates the market size reached approximately USD 111.20 billion in 2024 and is forecast to reach around USD 201.03 billion by 2034, with a CAGR of 6.10% between 2025 and 2034. The market was valued at USD 923.20 billion in 2023 and is projected to reach approximately USD 1.22 trillion by 2030, growing at a CAGR of 4.16%. In 2025, the market is valued at USD 72.11 billion and is forecast to reach USD 96.55 billion by 2030, with a CAGR of 6.01%.

U.S. Skilled Nursing Facility Market

The U.S. market for skilled nursing facilities is estimated to be worth USD 202.4 billion in 2025 and is anticipated to reach USD 279.9 billion by 2035, with spending projected to rise at a CAGR of 3.3% between 2025 and 2035. In 2024, the market was estimated at USD 199.72 billion and is expected to reach USD 290.02 billion by 2033, growing at a CAGR of 4.39% from 2025 to 2033. Earlier, the market size was valued at USD 227.5 billion in 2022 and was expected to expand at a CAGR of 3.99% from 2023 to 2030. Another report shows the market size was USD 180.95 billion in 2023 and is projected to reach around USD 253.77 billion by 2033, with a CAGR of 3.44% during the forecast period of 2024 to 2033.

U.S. Medical Office Buildings (MOB) Market

The medical office buildings market in the United States is expected to reach a projected revenue of US$ 22,042.6 million (approximately USD 22 billion) by 2030, with a CAGR of 6.6% from 2024 to 2030. In 2023, the U.S. medical office buildings market generated a revenue of USD 14,083.8 million. The U.S. market for medical office buildings is projected to achieve a market value of USD 16,712.1 million by 2031, dominating the North America Medical Office Buildings Market. Investment activity in MOBs in 2024 was USD 14.4 billion. The U.S. has 42,260 medical office buildings, representing 1.6 billion square feet.

National Health Investors (NHI) is expected to drive future revenue growth over the next two to three years through several key strategies:

1. Expansion of the Senior Housing Operating Portfolio (SHOP) Segment: NHI is actively growing its Senior Housing Operating Portfolio (SHOP) through property transitions and new acquisitions. This strategy has already resulted in a significant increase in consolidated SHOP Net Operating Income (NOI), with expectations for SHOP NOI to more than double by 2026, reaching at least 20% of total adjusted NOI.
2. Strategic Acquisitions and Investments: The company has a strong pipeline of investment opportunities, primarily focused on private-pay senior housing. Acquisitions are anticipated to be a substantial contributor to NHI's growth over the next several years, with significant investment activity already completed in 2025 and additional deals expected to close.
3. Occupancy Improvement and Rent Escalations in Senior Housing: NHI is focusing on enhancing occupancy rates and increasing "street rates" within its senior housing portfolio. This focus is projected to lead to improved revenue per occupied room (RevPOR) growth and expanded margins. The company's guidance for 2025 includes an anticipated same-store SHOP NOI growth in the range of 7% to 9% over 2024.
4. Collection of Deferred Rents and Lease Escalators: Future revenue growth is also expected from the ongoing collection of deferred rents and the fulfillment of existing lease commitments. Additionally, negotiated lease step-ups and percentage revenue rents contribute to the overall increase in rental income.

Share Repurchases

• In 2022, National Health Investors (NHI) announced a $240 million share repurchase plan.
• In June 2024, NHI's Board authorized a share repurchase program of up to $5.0 million, with an additional $2.5 million authorized in September 2024.
• During the three months ended September 30, 2024, the company repurchased 801,287 shares of its common stock for approximately $4.8 million.

Share Issuance

• In August 2024, NHI priced an upsized public offering of 2,400,000 shares of common stock at $71.25 per share, with proceeds intended for working capital, acquisitions, debt repayment, and mortgage investments.
• In the fourth quarter of 2024, NHI partially settled forward equity sale agreements, issuing approximately 1.8 million shares for net proceeds of about $122.4 million.
• As of December 31, 2024, approximately $119 million remained available for settlement from the $262 million raised on a forward basis in 2024.

Outbound Investments

• NHI closed on $237.5 million in new investments during 2024, marking its most active year for investments since 2019.
• Notable acquisitions in 2024 included a portfolio of ten assisted living and memory care communities in North Carolina for $121.0 million and an additional community in Georgia for $6.9 million.
• For 2025, NHI's guidance includes $225 million in new investments, and the company invested $174.9 million in the first quarter of 2025, with an additional pipeline of approximately $264 million.

Capital Expenditures

• Annual capital expenditures were $142.197 million in 2024, a significant increase from $41.824 million in 2023 and $6.4 million in 2022.
• Expected capital expenditures were $74.484 million for Q1 2025 and $56.5 million for Q2 2025.
• Capital expenditures have been primarily focused on improving existing communities, particularly within the senior housing operating portfolio (SHOP).