REIT: Definition and Healthcare Context
Full name: Real Estate Investment Trust (Healthcare Context)
A Real Estate Investment Trust (REIT) in the healthcare context is a publicly traded or private investment vehicle that owns the real estate — buildings, land, and facility infrastructure — used by nursing homes, hospitals, senior housing, and other health care providers. Healthcare REITs typically do not operate care facilities directly; instead they lease properties to operators under long-term triple-net leases in which the tenant bears maintenance, insurance, and property tax costs. Federal law (Internal Revenue Code § 856) governs REIT structure and requires distributing at least 90% of taxable income to shareholders as dividends. CMS began collecting and publishing REIT ownership information in nursing home ownership disclosure data, creating transparency into the separation between property ownership and facility operation.
- Source file
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- Published
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- Snapshot
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- Re-check
- CMS: Nursing Home Ownership data
- Data as of
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How it’s used
- Fonteum NH Ownership Concentration study: the disclosed ownership organizations behind US nursing homes — including the real-estate and holding entities that lease facilities to operators — are analyzed across the 14,425 skilled nursing facilities in CMS's PECOS SNF All Owners file, published at /research/nursing-home-ownership-concentration-2026.
- CMS Care Compare (nursing homes): REIT ownership status is reflected in Care Compare through the SNF All Owners dataset, which CMS publishes for transparency into the full ownership and management chain of each facility.
- CMS Provider of Services (POS) File: the POS file provides the CCN backbone for joining facility-level ownership records — including REIT entities — to Care Compare quality data.
Frequently asked questions
- What is a healthcare REIT?
- A healthcare REIT is a real estate investment trust that owns the physical facilities — buildings and land — used by nursing homes, hospitals, and senior care providers, leasing them back to operators under long-term contracts.
- Why do REITs raise concerns in nursing home care?
- When a REIT owns the facility and leases to an operator, the operator faces rent obligations that may compete with staffing budgets. Research has associated REIT-involved nursing homes with lower staffing and quality metrics.
- How does REIT ownership differ from chain ownership?
- Chain ownership refers to corporate control of multiple facilities by a single operator. REIT ownership refers to real estate ownership that is separate from the entity that manages and operates the facility.