Leases
As Lessee
We have entered into hospital property, office and equipment rental agreements with various lessors including related parties. The following tables disclose information about our leases of property and equipment (in thousands):
| | | | | | | | | | | | | | | | | | | | | |
| | | Year Ended December 31, |
| | | | | 2025 | | 2024 | | 2023 |
| | | | | | | | | |
| Operating lease cost | | | | | $ | 4,389 | | | $ | 2,070 | | | $ | 2,657 | |
| | | | | | | | | |
| Finance lease cost: | | | | | | | | | |
| Amortization of right-of-use assets | | | | | 13,215 | | | 10,867 | | | 10,053 | |
| Interest on lease liabilities | | | | | 20,777 | | | 16,686 | | | 12,100 | |
| Total finance lease cost | | | | | 33,992 | | | 27,553 | | | 22,153 | |
| | | | | | | | | |
| Cash paid for amounts included in the measurement of lease liabilities: | | | | | | | | | |
| Operating cash flows from operating leases | | | | | 3,999 | | | 2,341 | | | 2,479 | |
| Operating cash flows from finance leases | | | | | 20,777 | | | 16,203 | | | 12,131 | |
| Financing cash flows from finance leases | | | | | 5,244 | | | 4,973 | | | 3,495 | |
| Net cash paid for amounts included in the measurement of lease liabilities | | | | | 30,020 | | | 23,517 | | | 18,105 | |
| | | | | | | | | |
| Right-of-use assets obtained in exchange for lease obligations: | | | | | | | | | |
| Operating leases | | | | | 683 | | | 16,728 | | | 52 | |
| Finance leases | | | | | 29,023 | | | 53,229 | | | 25,449 | |
| Total right-of-use assets obtained in exchange for lease obligations | | | | | $ | 29,706 | | | $ | 69,957 | | | $ | 25,501 | |
| | | | | | | | | |
| Weighted average remaining lease term (years): | | | | | | | | | |
| Operating leases | | | | | 17 | | 17 | | 9 |
| Finance leases | | | | | 22 | | 22 | | 21 |
| | | | | | | | | | | | | | | | | |
| Weighted average discount rate: | | | | | |
| Operating leases | 11 | % | | 10 | % | | 5 | % |
| Finance leases | 10 | % | | 10 | % | | 8 | % |
For the year ended December 31, 2025, the Company opened two facilities throughout the year. For both facilities, the Company recognized financing right-of-use (ROU) assets of $14.2 million related to the hospital property and equipment leases entered into as a result of the openings.
For the year ended December 31, 2024, the Company opened four facilities throughout the year. For three facilities, the Company recognized financing right-of-use (ROU) assets of $53.2 million related to the hospital property and equipment leases entered into as a result of the openings. For one facility, we recognized operating ROU assets of $16.7 million related to the hospital property lease entered into as a result of the facility opening. The recognized operating ROU asset also increased the weighted average discount rate.
Due to the closures of two facilities in January 2023 and two facilities in January 2024, we remeasured the one lease associated with a facility, recording a reduction to financing lease liabilities and financing right-of-use assets of $11.4
million as of December 31, 2023. After remeasurement, we recognized an impairment loss of $24.6 million for the year ended December 31, 2023 for the remaining carrying value of the right-of-use assets associated with the four facilities.
The following table shows minimum lease payments for the next five years (in thousands):
| | | | | | | | | | | | | | | | | | | | | | | | | | |
| | Operating leases | | Finance leases |
| Minimum lease payments for the next five years: | | Third-parties | | Related parties | | Third-parties | | Related parties |
| | | | | | | | |
| 2026 | | $ | 2,112 | | | $ | 2,208 | | | $ | 6,201 | | | $ | 20,433 | |
| 2027 | | 2,138 | | | 2,265 | | | 4,793 | | | 20,813 | |
| 2028 | | 2,185 | | | 2,324 | | | 4,537 | | | 21,202 | |
| 2029 | | 1,930 | | | 2,384 | | | 4,432 | | | 21,600 | |
| 2030 | | 1,532 | | | 2,446 | | | 3,940 | | | 22,008 | |
| Thereafter | | 3,491 | | | 54,398 | | | 43,587 | | | 546,420 | |
| Total minimum lease payments | | 13,388 | | | 66,025 | | | 67,490 | | | 652,476 | |
| Less interest | | (2,127) | | | (45,097) | | | (24,283) | | | (419,729) | |
| Total lease liabilities | | $ | 11,261 | | | $ | 20,928 | | | $ | 43,207 | | | $ | 232,747 | |
As Lessor
We lease space to tenants under operating leases in an office building purchased in December 2025, see Note 3 for more details on the acquisition. The remaining rental terms range from approximately less than one to six years. The leases provide for the payment of fixed base rents payable monthly. For the year ended December 31, 2025, lease income is included in Hospital division revenue in the consolidated statements of operations.
The following table shows future undiscounted cash flows under our contractual operating leases as of December 31, 2025 (in thousands):
| | | | | | | | |
| Year ended December 31, | | Amount |
| | |
| 2026 | | $ | 734 | |
| 2027 | | 580 | |
| 2028 | | 512 | |
| 2029 | | 375 | |
| 2030 | | 151 | |
| Thereafter | | 89 | |
| Total | | $ | 2,441 | |