10 unchanged sentences
For example, the Budget Control Act of 2011 requires automatic spending reductions to reduce the federal deficit, imposing Medicare spending reductions of up to 2% per fiscal year, with a uniform percentage across all Medicare programs.
−Removed: CMS began imposing a 2% reduction on Medicare claims in 2013, and these reductions have been extended through 2030.
+Added: CMS began imposing a 2% reduction on Medicare claims in 2013, with temporary suspensions and 1% cuts in 2020 – 2022.
+Added: These reductions have been extended through 2030.
Net revenue realizable under third–party payor agreements can change after examination and retroactive adjustment by payors during the claims settlement processes or as a result of post–payment audits.
9 unchanged sentences
The industry trend toward value-based purchasing may negatively impact our revenues.
−Removed: There continues to be a growing trend in the healthcare industry among both government and commercial payors toward value-based purchasing of healthcare services.
Value-based purchasing programs emphasize quality and efficiency of services, rather than volume of services.
27 unchanged sentences
We may, therefore, make expenditures related to the provision of services for which we are not paid.
+Added: The status of our lease with National Health Investors, Inc.
+Added: creates uncertainties and risks to our future operations.
+Added: A significant portion of our skilled nursing and independent living facilities are subject to a long-term Master Agreement to Lease with National Health Investors, Inc.
+Added: (“NHI”), which we refer to as the Master Lease.
+Added: On July 29, 2025, NHI notified us of alleged non-compliance with certain non-monetary provisions of the Master Lease.
+Added: On September 8, 2025, NHI formally alleged that the tenant under the lease, our wholly owned subsidiary NHC/OP, L.P., is in default as a result of alleged non-compliance with four non-monetary provisions, and indicated that failure to cure the alleged defaults within the applicable cure period would constitute an “Event of Default,” entitling NHI to pursue any remedies available under the agreement, including termination.
+Added: We dispute that any default has occurred and we continue to communicate with NHI to resolve these matters.
+Added: For a further discussion of our response to NHI’s allegations, please see Note 6 - Long-Term Leases to Interim Condensed Consolidated Financial Statements included in this Form 10-Q.
+Added: In October 2025, we provided NHI with a notice of our intent to exercise our right to extend the Master Lease for an additional five-year term beginning January 1, 2027.
+Added: Under the Master Lease, the base rent for any renewal term is to be the fair rental value of the leased property as negotiated between the parties, without regard to improvements we made voluntarily at our expense.
+Added: There is no assurance, however, that we will reach agreement with NHI on the base rent or other renewal terms.
+Added: Further, if NHI asserts that an “Event of Default” has occurred or raises other objections to our extension notice, NHI may seek to terminate our occupancy of the leased properties.
+Added: Failure to resolve the current disputes with NHI or a failure to secure renewal of the Master Lease on acceptable terms could result in the loss of our right to occupy and operate some or all of the affected facilities, or subject us to damages, acceleration of rent, or other remedies in favor of NHI.
+Added: Even if a default is ultimately determined not to have occurred, the process of resolving such disputes may result in significant legal and other expenses and could distract management from other priorities.
+Added: The loss of these facilities or an increase in lease-related expenses could have a material adverse effect on our business, future results of operations, cash flows, financial condition, and liquidity.
The cost to replace or retain qualified nurses, health care professionals and other key personnel may adversely affect our financial performance, and we may not be able to comply with certain states ’ staffing requirements.
13 unchanged sentences
CMS continues to increase its quality measure thresholds, which is regularly increased every six months, making it more difficult to achieve upward and five-star ratings.
−Removed: CMS increased its quality measure thresholds in 2022, making it more difficult for facilities to obtain or maintain four-and-five-star ratings.
CMS places a strong emphasis on registered nurse (“RN”) staffing.
9 unchanged sentences
In April 2024, CMS issued the Staffing Rule, establishing minimum staffing standards for SNFs.
−Removed: The Staffing Rule contains three primary staffing requirements which are phased in over the next several years.
−Removed: Due to pending legislation in both the House of Representatives and the Senate, industry litigation filed to dispute the Staffing Rule's validity and enforceability, as well as the long phase-in of the requirements, the exact effects of the Staffing Rule cannot be determined.
−Removed: Future developments may significantly alter or even halt the implementation of the Staffing Rule.
−Removed: However, we expect that the Staffing Rule in its current form will have adverse financial consequences upon our business.
+Added: The Staffing Rule contains three primary staffing requirements which would be phased in over the next several years.
+Added: Implementation of the Staffing Rule was impaired by the passage of the One Big Beautiful Bill Act (“OBBB”) on July 4, 2025, which prohibited HHS from implementing, administering, or enforcing the Staffing Rule until October 1, 2034.
+Added: Future developments may significantly alter the implementation of the Staffing Rule.
Disasters and similar events, which may increase as a result of climate change, may seriously harm our business.
25 unchanged sentences
The failure to obtain any required license or certificate of need could impair our ability to operate or expand our business.
−Removed: During 2024, we expanded our operations with the acquisition of the White Oak Senior Living portfolio.
−Removed: This growth has placed and will continue to place significant demands on our management resources.
−Removed: Our ability to manage our growth effectively and to successfully integrate this acquisition into our existing business will require us to expand our operation, financial and management information systems.
Upkeep of healthcare properties is capital intensive, requiring us to continually direct financial resources to the maintenance and enhancement of our physical plant and equipment.
107 unchanged sentences
We are required to comply with laws governing the transmission and privacy and security of health information.
−Removed: The Health Insurance Portability and Accountability Act of 1996, or ("HIPAA"), requires the use of uniform electronic data transmission standards for healthcare claims and payment transactions submitted or received electronically.
+Added: HIPAA requires the use of uniform electronic data transmission standards for healthcare claims and payment transactions submitted or received electronically.
In addition, as required by HIPAA, the HHS has issued privacy and security regulations that extensively regulate the use and disclosure of individually identifiable health information (known as Protected Health Information, or PHI) and require covered entities, including healthcare providers and health plans, and vendors known as "business associates," to implement administrative, physical and technical safeguards to protect the security of PHI.
134 unchanged sentences
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.