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Hospitals trust Medical Properties to provide the leases under which their facilities operate. The self-administers real estate investment trust owns about 50 health care facilities, including acute-care, physical rehabilitation, and regional and community hospitals in more than 20 states. Almost half are in California and Texas; California alone represents approximately 45% of the REIT's annual revenue. It leases the facilities to some 15 hospital operators under long-term triple-net leases, where the tenant bears most of the operating costs. Prime Healtcare Services and Vibra Healthcare are the REIT's largest clients; together they account for more than half of its revenue.

Nationwide Health Properties is a real estate investment trust (REIT) that invests in residential care facilities and medical office buildings throughout the US. It owns a portfolio of more than 600 properties, including senior housing facilities and long-term care facilities, which it leases to health care operators. Most of the REIT's properties are leased under long-term triple-net leases, under which the tenant pays for all expenses including property taxes, maintenance, and insurance. Nationwide Health Properties' largest tenants are Brookdale Senior Living and Hearthstone Senior Services, each accounting for more than 10% of total revenues.

Omega Healthcare Investors can put an end to the burdens of real-estate management. The self-administered real estate investment trust (REIT) invests in health care facilities throughout the US. It owns some 300 properties, primarily long-term care facilities, in about 30 states. The REIT specializes in sales/leaseback transactions, in which it purchases properties owned by health care providers and leases them back to those companies (thereby freeing the health care companies from the responsibilities of real estate management). Sun Healthcare, CommuniCare Health Services, and Advocat are Omega Healthcare's largest tenants.

Sabra Health Care REIT doesn't mind a little healthy competition in the real estate sector. The company, which plans to qualify as a health care real estate investment trust (REIT) beginning in 2011, owns and seeks to acquire health care properties throughout the US. Its portfolio consists of more than 80 skilled nursing centers, as well as several assisted and independent living centers and mental health centers. The facilities house about 10,000 beds and are located in 21 states. Substantially all of the properties are leased to and operated by subsidiaries of Sun Healthcare Group, which spun off its real estate assets to form Sabra Health Care REIT in 2010.

Ventas, Inc. owns about 600 health care properties, including some 250 senior housing communities, about 200 skilled nursing facilities, and some 150 hospitals and medical office buildings. Its properties are located throughout the US and in two Canadian provinces; California and Illinois are its largest markets. Ventas leases more than a third of its properties to long-term care providers Sunrise Senior Living, Brookdale Senior Living, and Kindred Healthcare.

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