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Healthcare Realty Trust Inc - Quarter Report: 2021 September (Form 10-Q)


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
________________________
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended September 30, 2021
or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from            to            
Commission File Number: 001-35568 (Healthcare Trust of America, Inc.)
Commission File Number: 333-190916 (Healthcare Trust of America Holdings, LP)
_________________________ 
HEALTHCARE TRUST OF AMERICA, INC.
HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
(Exact name of registrant as specified in its charter)
Maryland(Healthcare Trust of America, Inc.)20-4738467
Delaware(Healthcare Trust of America Holdings, LP)20-4738347
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
16435 N. Scottsdale Road, Suite 320,Scottsdale,Arizona85254
(480)
998-3478
(Address of Principal Executive Office and Zip Code)
(Registrant’s telephone number, including area code)
www.htareit.com
(Internet address)
N/A
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading symbol(s)Name of each exchange on which registered
Common stock, $0.01 par valueHTANew York Stock Exchange

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Sections 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    
Healthcare Trust of America, Inc.
Yes
¨ No
Healthcare Trust of America Holdings, LP
Yes
¨ No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    
Healthcare Trust of America, Inc.
Yes
¨ No
Healthcare Trust of America Holdings, LP
Yes
¨ No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Healthcare Trust of America, Inc.
Large accelerated filer Accelerated filer Non-accelerated filer
Healthcare Trust of America Holdings, LPLarge accelerated filer Accelerated filer
Non-accelerated filer
Healthcare Trust of America, Inc.Smaller reporting company Emerging growth company
Healthcare Trust of America Holdings, LPSmaller reporting company Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Healthcare Trust of America, Inc.
Healthcare Trust of America Holdings, LP
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Healthcare Trust of America, Inc.Yes
x No
Healthcare Trust of America Holdings, LPYes
x No
As of October 28, 2021, there were 220,838,102 shares of Class A common stock of Healthcare Trust of America, Inc. outstanding.




Explanatory Note
This quarterly report combines the Quarterly Reports on Form 10-Q (“Quarterly Report”) for the quarter ended September 30, 2021, of Healthcare Trust of America, Inc. (“HTA”), a Maryland corporation, and Healthcare Trust of America Holdings, LP (“HTALP”), a Delaware limited partnership. Unless otherwise indicated or unless the context requires otherwise, all references in this Quarterly Report to “we,” “us,” “our,” “the Company” or “our Company” refer to HTA and HTALP, collectively, and all references to “common stock” shall refer to the Class A common stock of HTA.
HTA operates as a real estate investment trust (“REIT”) and is the general partner of HTALP. As of September 30, 2021, HTA owned a 97.9% partnership interest in HTALP, and other limited partners, including some of HTA’s directors, executive officers and their affiliates, owned the remaining partnership interest (including the long-term incentive plan units (“LTIP” Units)) in HTALP. As the sole general partner of HTALP, HTA has the full, exclusive and complete responsibility for HTALP’s day-to-day management and control, including its compliance with the Securities and Exchange Commission (“SEC”) filing requirements.
We believe it is important to understand the few differences between HTA and HTALP in the context of how we operate as an integrated consolidated company. HTA operates as an umbrella partnership REIT structure in which HTALP and its subsidiaries hold substantially all of the assets. HTA’s only material asset is its ownership of partnership units of HTALP. As a result, HTA does not conduct business itself, other than acting as the sole general partner of HTALP, issuing public equity from time to time and guaranteeing certain debts of HTALP. HTALP conducts the operations of the business and issues publicly-traded debt, but has no publicly-traded equity. Except for net proceeds from public equity issuances by HTA, which are generally contributed to HTALP in exchange for partnership units of HTALP, HTALP generates the capital required for the business through its operations and by direct or indirect incurrence of indebtedness or through the issuance of its partnership units (“OP Units”).
Non-controlling interests, stockholders’ equity and partners’ capital are the primary areas of difference between the condensed consolidated financial statements of HTA and HTALP. Limited partnership units in HTALP are accounted for as partners’ capital in HTALP’s condensed consolidated balance sheets and as a non-controlling interest reflected within equity in HTA’s condensed consolidated balance sheets. The differences between HTA’s stockholders’ equity and HTALP’s partners’ capital are due to the differences in the equity issued by HTA and HTALP, respectively.
We believe combining the Quarterly Reports of HTA and HTALP, including the notes to the condensed consolidated financial statements, into this single Quarterly Report results in the following benefits:
enhances stockholders’ understanding of HTA and HTALP by enabling stockholders to view the business as a whole in the same manner that management views and operates the business;
eliminates duplicative disclosure and provides a more streamlined and readable presentation since a substantial portion of the disclosure in this Quarterly Report applies to both HTA and HTALP; and
creates time and cost efficiencies through the preparation of a single combined Quarterly Report instead of two separate Quarterly Reports.
In order to highlight the material differences between HTA and HTALP, this Quarterly Report includes sections that separately present and discuss areas that are materially different between HTA and HTALP, including:
the condensed consolidated financial statements;
certain accompanying notes to the condensed consolidated financial statements, including Note 8 - Debt, Note 11 - Stockholders’ Equity and Partners’ Capital, Note 13 - Per Share Data of HTA, and Note 14 - Per Unit Data of HTALP;
as defined by the National Association of Real Estate Investment Trusts (“NAREIT”), the Funds From Operations (“FFO”) and Normalized FFO in Part 1, Item 2 of this Quarterly Report;
the Controls and Procedures in Part 1, Item 4 of this Quarterly Report; and
the Certifications of the Chief Executive Officer and the Chief Financial Officer included as Exhibits 31 and 32 to this Quarterly Report.
In the sections of this Quarterly Report that combine disclosure for HTA and HTALP, this Quarterly Report refers to actions or holdings as being actions or holdings of the Company. Although HTALP (directly or indirectly through one of its subsidiaries) is generally the entity that enters into contracts, holds assets and issues or incurs debt, management believes this presentation is appropriate for the reasons set forth above and because the business of the Company is a single integrated enterprise operated through HTALP.
2



HEALTHCARE TRUST OF AMERICA, INC. AND
HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
TABLE OF CONTENTS
 
  Page
Healthcare Trust of America, Inc.
Healthcare Trust of America Holdings, LP
Notes for Healthcare Trust of America, Inc. and Healthcare Trust of America Holdings, LP





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Table of Contents
PART I - FINANCIAL INFORMATION
Item 1. Financial Statements (Unaudited)
HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands, except for share and per share data)
(Unaudited)
September 30, 2021December 31, 2020
ASSETS
Real estate investments:
Land$625,092 $596,269 
Building and improvements6,701,356 6,507,816 
Lease intangibles506,010 628,621 
Construction in progress28,878 80,178 
7,861,336 7,812,884 
Accumulated depreciation and amortization(1,747,354)(1,702,719)
Real estate investments, net
6,113,982 6,110,165 
Assets held for sale, net27,049 — 
Investment in unconsolidated joint venture63,213 64,360 
Cash and cash equivalents12,836 115,407 
Restricted cash6,628 3,358 
Receivables and other assets, net 314,977 251,728 
Right-of-use assets - operating leases, net227,564 235,223 
Other intangibles, net9,382 10,451 
Total assets $6,775,631 $6,790,692 
LIABILITIES AND EQUITY
Liabilities:
Debt $3,079,190 $3,026,999 
Accounts payable and accrued liabilities178,024 200,358 
Liabilities of assets held for sale263 — 
Derivative financial instruments - interest rate swaps9,377 14,957 
Security deposits, prepaid rent and other liabilities82,852 82,553 
Lease liabilities - operating leases195,115 198,367 
Intangible liabilities, net31,473 32,539 
Total liabilities 3,576,294 3,555,773 
Commitments and contingencies
Equity:
Preferred stock, $0.01 par value; 200,000,000 shares authorized; none issued and outstanding
— — 
Class A common stock, $0.01 par value; 1,000,000,000 shares authorized; 220,839,006 and 218,578,012 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively
2,208 2,186 
Additional paid-in capital 4,973,001 4,916,784 
Accumulated other comprehensive loss(11,327)(16,979)
Cumulative dividends in excess of earnings(1,857,714)(1,727,752)
Total stockholders’ equity3,106,168 3,174,239 
Non-controlling interests93,169 60,680 
Total equity3,199,337 3,234,919 
Total liabilities and equity $6,775,631 $6,790,692 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except for per share data)
(Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Revenues:
Rental income$189,832 $187,258 $569,676 $551,459 
Interest and other operating income
1,430 68 1,694 488 
Total revenues191,262 187,326 571,370 551,947 
Expenses:
Rental59,568 57,248 176,556 170,310 
General and administrative10,765 10,670 32,254 32,348 
Transaction137 125 299 297 
Depreciation and amortization76,056 75,892 227,307 228,484 
Interest expense
23,331 23,136 69,450 71,285 
Impairment— — 16,825 — 
Total expenses169,857 167,071 522,691 502,724 
Gain on sale of real estate, net143 — 32,896 1,991 
Loss on extinguishment of debt, net— (27,726)— (27,726)
Income from unconsolidated joint venture400 422 1,198 1,223 
Other income 94 117 401 290 
Net income (loss)$22,042 $(6,932)$83,174 $25,001 
Net (income) loss attributable to non-controlling interests
(370)105 (1,461)(438)
Net income (loss) attributable to common stockholders $21,672 $(6,827)$81,713 $24,563 
Earnings per common share - basic:
Net income (loss) attributable to common stockholders $0.10 $(0.03)$0.37 $0.11 
Earnings per common share - diluted:
Net income (loss) attributable to common stockholders $0.10 $(0.03)$0.37 $0.11 
Weighted average common shares outstanding:
Basic218,820 218,549 218,798 217,911 
Diluted222,811 218,549 222,470 221,521 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)
(In thousands)
(Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Net income (loss)$22,042 $(6,932)$83,174 $25,001 
Other comprehensive income (loss)
Change in unrealized gains (losses) on cash flow hedges1,435 2,054 5,750 (23,672)
Total other comprehensive income (loss)1,435 2,054 5,750 (23,672)
Total comprehensive income (loss) 23,477 (4,878)88,924 1,329 
Comprehensive income (loss) attributable to non-controlling interests(398)73 (1,559)(59)
Total comprehensive income (loss) attributable to common stockholders$23,079 $(4,805)$87,365 $1,270 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED STATEMENTS OF EQUITY
(In thousands)
(Unaudited)
 Class A Common StockAdditional Paid-In CapitalAccumulated Other Comprehensive Income (Loss)Cumulative Dividends in Excess of EarningsTotal Stockholders’ EquityNon-controlling InterestsTotal Equity
 SharesAmount
Balance as of December 31, 2019216,453 $2,165 $4,854,042 $4,546 $(1,502,744)$3,358,009 $72,635 $3,430,644 
Issuance of common stock, net1,675 17 50,003 — — 50,020 — 50,020 
Share-based award transactions, net
236 3,201 — — 3,203 — 3,203 
Repurchase and cancellation of common stock
(154)(2)(4,622)— — (4,624)— (4,624)
Redemption of non-controlling interest and other273 6,773 — — 6,776 (6,776)— 
Dividends declared ($0.315 per common share)
— — — — (68,867)(68,867)(1,134)(70,001)
Net income
— — — — 17,901 17,901 307 18,208 
Other comprehensive loss
— — — (22,138)— (22,138)(360)(22,498)
Balance as of March 31, 2020218,483 2,185 4,909,397 (17,592)(1,553,710)3,340,280 64,672 3,404,952 
Issuance of OP Units in HTALP— — — — — — 1,378 1,378 
Share-based award transactions, net
(1)— 2,100 — — 2,100 — 2,100 
Repurchase and cancellation of common stock
(7)— (174)— — (174)— (174)
Redemption of non-controlling interest and other40 — 1,096 — — 1,096 (1,096)— 
Dividends declared ($0.315) per common share)
— — — — (68,827)(68,827)(1,162)(69,989)
Net Income— — — — 13,489 13,489 236 13,725 
Other comprehensive loss— — — (3,176)— (3,176)(52)(3,228)
Balance as of June 30, 2020218,515 2,185 4,912,419 (20,768)(1,609,048)3,284,788 63,976 3,348,764 
Share-based award transactions, net
28 1,831 — — 1,832 — 1,832 
Repurchase and cancellation of common stock
(11)— (296)— — (296)— (296)
Redemption of non-controlling interest and other34 — 813 — — 813 (813)— 
Dividends declared ($0.320) per common share)
— — — — (69,938)(69,938)(1,133)(71,071)
Net loss— — — — (6,827)(6,827)(105)(6,932)
Other comprehensive income— — — 2,021 — 2,021 33 2,054 
Balance as of September 30, 2020218,566 $2,186 $4,914,767 $(18,747)$(1,685,813)$3,212,393 $61,958 $3,274,351 


















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HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED STATEMENTS OF EQUITY (Cont’d)
(In thousands)
(Unaudited)
 Class A Common StockAdditional Paid-In CapitalAccumulated Other Comprehensive Income (Loss)Cumulative Dividends in Excess of EarningsTotal Stockholders’ EquityNon-controlling InterestsTotal Equity
 SharesAmount
Balance as of December 31, 2020218,578 $2,186 $4,916,784 $(16,979)$(1,727,752)$3,174,239 $60,680 $3,234,919 
Issuance of common stock, net— — — — — — — — 
Share-based award transactions, net
354 3,334 — — 3,337 — 3,337 
Repurchase and cancellation of common stock
(119)(1)(3,247)— — (3,248)— (3,248)
Redemption of non-controlling interest and other11 — 255 — — 255 (255)— 
Dividends declared ($0.320) per common share)
— — — — (70,023)(70,023)(1,183)(71,206)
Net income
— — — — 22,030 22,030 363 22,393 
Other comprehensive income— — — 2,748 — 2,748 44 2,792 
Balance as of March 31, 2021218,824 2,188 4,917,126 (14,231)(1,775,745)3,129,338 59,649 3,188,987 
Share-based award transactions, net
(6)— 2,065 — — 2,065 — 2,065 
Repurchase and cancellation of common stock
(5)— (129)— — (129)— (129)
Redemption of non-controlling interest and other13 — 291 — — 291 (291)— 
Dividends declared ($0.320) per common share)
— — — — (70,019)(70,019)(1,278)(71,297)
Net income
— — — — 38,011 38,011 728 38,739 
Other comprehensive income— — — 1,497 — 1,497 26 1,523 
Balance as of June 30, 2021218,826 2,188 4,919,353 (12,734)(1,807,753)3,101,054 58,834 3,159,888 
Issuance of common stock, net2,000 20 53,715 — — 53,735 — 53,735 
Issuance of OP Units in HTALP in connection with acquisitions— — — — — — 35,785 35,785 
Share-based award transactions, net
— — (368)— — (368)— (368)
Repurchase and cancellation of common stock
— — (12)— — (12)— (12)
Redemption of non-controlling interest and other13 — 313 — — 313 (313)— 
Dividends declared ($0.325) per common share)
— — — — (71,633)(71,633)(1,535)(73,168)
Net income
— — — — 21,672 21,672 370 22,042 
Other comprehensive income— — — 1,407 — 1,407 28 1,435 
Balance as of September 30, 2021220,839 $2,208 $4,973,001 $(11,327)$(1,857,714)$3,106,168 $93,169 $3,199,337 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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HEALTHCARE TRUST OF AMERICA, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
(Unaudited)
Nine Months Ended September 30,
 20212020
Cash flows from operating activities:
Net income $83,174 $25,001 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization
212,332 211,843 
Share-based compensation expense5,034 7,135 
Income from unconsolidated joint venture(1,198)(1,223)
Distributions from unconsolidated joint venture2,345 2,455 
Impairment16,825 — 
Gain on sale of real estate, net(32,896)(1,991)
Loss on extinguishment of debt, net— 27,726 
Changes in operating assets and liabilities:
Receivables and other assets, net(3,214)3,282 
Accounts payable and accrued liabilities(8,755)(11,787)
Security deposits, prepaid rent and other liabilities(2,029)7,227 
Net cash provided by operating activities271,618 269,668 
Cash flows from investing activities:
Investments in real estate (147,303)(52,553)
Development of real estate(48,482)(49,479)
Proceeds from the sale of real estate67,621 6,420 
Capital expenditures(78,047)(59,016)
Collection of real estate notes receivable15,405 709 
Advances on real estate notes receivable(66,526)(6,000)
Net cash used in investing activities(257,332)(159,919)
Cash flows from financing activities:
Borrowings on unsecured revolving credit facility180,000 1,329,862 
Payments on unsecured revolving credit facility(130,000)(1,429,862)
Proceeds from unsecured senior notes— 793,568 
Payments on unsecured senior notes— (300,000)
Payments on secured mortgage loans— (114,060)
Deferred financing costs— (6,532)
Debt extinguishment costs— (25,938)
Proceeds from issuance of common stock53,735 50,020 
Issuance of OP Units— 1,378 
Repurchase and cancellation of common stock(3,389)(5,094)
Dividends paid(210,047)(205,880)
Distributions paid to non-controlling interest of limited partners(3,886)(3,581)
Net cash (used in) provided by financing activities(113,587)83,881 
Net change in cash, cash equivalents and restricted cash(99,301)193,630 
Cash, cash equivalents and restricted cash - beginning of period118,765 37,616 
Cash, cash equivalents and restricted cash - end of period$19,464 $231,246 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands, except unit data)
(Unaudited)
September 30, 2021December 31, 2020
ASSETS
Real estate investments:
Land$625,092 $596,269 
Building and improvements6,701,356 6,507,816 
Lease intangibles506,010 628,621 
Construction in progress28,878 80,178 
7,861,336 7,812,884 
Accumulated depreciation and amortization(1,747,354)(1,702,719)
Real estate investments, net
6,113,982 6,110,165 
Assets held for sale, net27,049 — 
Investment in unconsolidated joint venture63,213 64,360 
Cash and cash equivalents12,836 115,407 
Restricted cash 6,628 3,358 
Receivables and other assets, net314,977 251,728 
Right-of-use assets - operating leases, net227,564 235,223 
Other intangibles, net9,382 10,451 
Total assets$6,775,631 $6,790,692 
LIABILITIES AND PARTNERS’ CAPITAL
Liabilities:
Debt$3,079,190 $3,026,999 
Accounts payable and accrued liabilities178,024 200,358 
Liabilities of assets held for sale263 — 
Derivative financial instruments - interest rate swaps9,377 14,957 
Security deposits, prepaid rent and other liabilities82,852 82,553 
Lease liabilities - operating leases195,115 198,367 
Intangible liabilities, net31,473 32,539 
Total liabilities3,576,294 3,555,773 
Commitments and contingencies
Partners’ Capital:
Limited partners’ capital, 4,721,627 and 3,519,545 OP Units issued and outstanding as of September 30, 2021 and December 31, 2020, respectively
92,899 60,410 
General partners’ capital, 220,839,006 and 218,578,012 OP Units issued and outstanding as of September 30, 2021 and December 31, 2020, respectively
3,106,438 3,174,509 
Total partners’ capital3,199,337 3,234,919 
Total liabilities and partners’ capital$6,775,631 $6,790,692 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(In thousands, except for per unit data)
(Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Revenues:
Rental income$189,832 $187,258 $569,676 $551,459 
Interest and other operating income
1,430 68 1,694 488 
Total revenues191,262 187,326 571,370 551,947 
Expenses:
Rental59,568 57,248 176,556 170,310 
General and administrative10,765 10,670 32,254 32,348 
Transaction137 125 299 297 
Depreciation and amortization76,056 75,892 227,307 228,484 
Interest expense23,331 23,136 69,450 71,285 
Impairment— — 16,825 — 
Total expenses169,857 167,071 522,691 502,724 
Gain on sale of real estate, net143 — 32,896 1,991 
Loss on extinguishment of debt, net— (27,726)— (27,726)
Income from unconsolidated joint venture400 422 1,198 1,223 
Other income 94 117 401 290 
Net income (loss)$22,042 $(6,932)$83,174 $25,001 
Net income attributable to non-controlling interests — — — — 
Net income (loss) attributable to common unitholders$22,042 $(6,932)$83,174 $25,001 
Earnings per common OP Unit - basic:
Net income (loss) attributable to common unitholders$0.10 $(0.03)$0.37 $0.11 
Earnings per common OP Unit - diluted:
Net income (loss) attributable to common unitholders$0.10 $(0.03)$0.37 $0.11 
Weighted average common OP Units outstanding: 
Basic222,811 222,101 222,470 221,521 
Diluted222,811 222,101 222,470 221,521 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(In thousands)
(Unaudited)
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Net income (loss)$22,042 $(6,932)$83,174 $25,001 
Other comprehensive income (loss)
Change in unrealized gains (losses) on cash flow hedges1,435 2,054 5,750 (23,672)
Total other comprehensive income (loss)1,435 2,054 5,750 (23,672)
Total comprehensive income (loss)23,477 (4,878)88,924 1,329 
Comprehensive income attributable to non-controlling interests— — — — 
Total comprehensive income (loss) attributable to common unitholders$23,477 $(4,878)$88,924 $1,329 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN PARTNERS CAPITAL
(In thousands)
(Unaudited)
General Partners’ CapitalLimited Partners’ CapitalTotal Partners’ Capital
 UnitsAmountUnitsAmount
Balance as of December 31, 2019216,453 $3,358,279 3,834 $72,365 $3,430,644 
Issuance of general partner OP Units1,675 50,020 — — 50,020 
Share-based award transactions, net
236 3,203 — — 3,203 
Redemption and cancellation of general partner OP Units
(154)(4,624)— — (4,624)
Redemption of limited partner OP Units and other
273 6,776 (273)(6,776)— 
Distributions declared ($0.315 per common OP Unit)
— (68,867)— (1,134)(70,001)
Net income— 17,901 — 307 18,208 
Other comprehensive loss— (22,138)— (360)(22,498)
Balance as of March 31, 2020218,483 3,340,550 3,561 64,402 3,404,952 
Issuance of limited partner OP Units47 1,378 1,378 
Share-based award transactions, net
(1)2,100 — — 2,100 
Redemption and cancellation of general partner OP Units
(7)(174)— — (174)
Redemption of limited partner OP Units and other
40 1,096 (40)(1,096)— 
Distributions declared ($0.315 per common OP Unit)
— (68,827)— (1,162)(69,989)
Net income— 13,489 — 236 13,725 
Other comprehensive loss— (3,176)— (52)(3,228)
Balance as of June 30, 2020218,515 3,285,058 3,568 63,706 3,348,764 
Share-based award transactions, net
28 1,832 — — 1,832 
Redemption and cancellation of general partner OP Units
(11)(296)— — (296)
Redemption of limited partner OP Units and other
34 813 (34)(813)— 
Distributions declared ($0.320) per common OP Unit)
— (69,938)— (1,133)(71,071)
Net loss— (6,827)— (105)(6,932)
Other comprehensive income— 2,021 — 33 2,054 
Balance as of September 30, 2020218,566 $3,212,663 3,534 $61,688 $3,274,351 




















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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN PARTNERS CAPITAL (Cont’d)
(In thousands)
(Unaudited)
General Partners’ CapitalLimited Partners’ CapitalTotal Partners’ Capital
 UnitsAmountUnitsAmount
Balance as of December 31, 2020218,578 $3,174,509 3,520 $60,410 $3,234,919 
Share-based award transactions, net
354 3,337 — — 3,337 
Redemption and cancellation of general partner OP Units
(119)(3,248)— — (3,248)
Redemption of limited partner OP Units and other
11 255 (11)(255)— 
Distributions declared ($0.320 per common OP Unit)
— (70,023)— (1,183)(71,206)
Net income
— 22,030 — 363 22,393 
Other comprehensive income— 2,748 — 44 2,792 
Balance as of March 31, 2021218,824 3,129,608 3,509 59,379 3,188,987 
Share-based award transactions, net
(6)2,065 — — 2,065 
Redemption and cancellation of general partner OP Units
(5)(129)— — (129)
Redemption of limited partner OP Units and other
13 291 (13)(291)— 
Distributions declared ($0.320 per common OP Unit)
— (70,019)— (1,278)(71,297)
Net income
— 38,011 — 728 38,739 
Other comprehensive income— 1,497 — 26 1,523 
Balance as of June 30, 2021218,826 3,101,324 3,496 58,564 3,159,888 
Issuance of general partner units2,000 53,735 — — 53,735 
Issuance of limited partner OP Units in connection with acquisitions— — 1,239 35,785 35,785 
Share-based award transactions, net
— (368)— — (368)
Redemption and cancellation of general partner OP Units
— (12)— — (12)
Redemption of limited partner OP Units and other
13 313 (13)(313)— 
Distributions declared ($0.325 per common OP Unit)
— (71,633)— (1,535)(73,168)
Net income
— 21,672 — 370 22,042 
Other comprehensive income— 1,407 — 28 1,435 
Balance as of September 30, 2021220,839 $3,106,438 4,722 $92,899 $3,199,337 
The accompanying notes are an integral part of these condensed consolidated financial statements.


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HEALTHCARE TRUST OF AMERICA HOLDINGS, LP
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
(Unaudited)
Nine Months Ended September 30,
 20212020
Cash flows from operating activities:
Net income $83,174 $25,001 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization
212,332 211,843 
Share-based compensation expense5,034 7,135 
Income from unconsolidated joint venture(1,198)(1,223)
Distributions from unconsolidated joint venture2,345 2,455 
Impairment16,825 — 
Gain on sale of real estate, net(32,896)(1,991)
Loss on extinguishment of debt, net— 27,726 
Changes in operating assets and liabilities:
Receivables and other assets, net(3,214)3,282 
Accounts payable and accrued liabilities(8,755)(11,787)
Security deposits, prepaid rent and other liabilities(2,029)7,227 
Net cash provided by operating activities271,618 269,668 
Cash flows from investing activities:
Investments in real estate (147,303)(52,553)
Development of real estate(48,482)(49,479)
Proceeds from the sale of real estate67,621 6,420 
Capital expenditures(78,047)(59,016)
Collection of real estate notes receivable15,405 709 
Advances on real estate notes receivable(66,526)(6,000)
Net cash used in investing activities(257,332)(159,919)
Cash flows from financing activities:
Borrowings on unsecured revolving credit facility180,000 1,329,862 
Payments on unsecured revolving credit facility(130,000)(1,429,862)
Proceeds from unsecured senior notes— 793,568 
Payments from unsecured senior notes— (300,000)
Payments on secured mortgage loans— (114,060)
Deferred financing costs— (6,532)
Debt extinguishment costs— (25,938)
Proceeds from issuance of general partner units53,735 50,020 
Issuance of OP Units— 1,378 
Repurchase and cancellation of general partner units(3,389)(5,094)
Distributions paid to general partner(210,047)(205,880)
Distributions paid to limited partners and redeemable non-controlling interests(3,886)(3,581)
Net cash (used in) provided by financing activities(113,587)83,881 
Net change in cash, cash equivalents and restricted cash(99,301)193,630 
Cash, cash equivalents and restricted cash - beginning of period118,765 37,616 
Cash, cash equivalents and restricted cash - end of period$19,464 $231,246 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
Unless otherwise indicated or unless the context requires otherwise the use of the words “we,” “us,” or “our” refers to Healthcare Trust of America, Inc. and Healthcare Trust of America Holdings, LP, collectively.
1. Organization and Description of Business
HTA, a Maryland corporation, and HTALP, a Delaware limited partnership, were incorporated or formed, as applicable, on April 20, 2006. HTA operates as a REIT and is the general partner of HTALP, which is the operating partnership, in an umbrella partnership, or “UPREIT” structure. HTA has qualified and intends to continue to be taxed as a REIT for federal income tax purposes under the applicable sections of the Internal Revenue Code.
We own real estate primarily consisting of medical office buildings (“MOBs”) located on or adjacent to hospital campuses or in off-campus, community core outpatient locations across 32 states within the United States, and we lease space to tenants primarily consisting of health systems, research and academic institutions, and various sized physician practices.  Through our full-service operating platform, we provide leasing, asset management, acquisitions, development and other related services for our properties.
Our primary objective is to maximize stockholder value with growth through strategic investments that provide an attractive risk-adjusted return for our stockholders by consistently increasing our cash flow. In pursuing this objective, we: (i) seek internal growth through proactive asset management, leasing, building services and property management oversight; (ii) target accretive acquisitions and developments of MOBs in markets with attractive demographics that complement our existing portfolio; and (iii) actively manage our balance sheet to maintain flexibility with conservative leverage. Additionally, from time to time we consider, on an opportunistic basis, significant portfolio acquisitions that we believe fit our core business and we expect to enhance our existing portfolio.
COVID-19 Pandemic
On March 11, 2020 the novel coronavirus disease (“COVID-19”) was declared a pandemic by the World Health Organization. As the virus continued to spread throughout the United States and other countries across the world, Federal, state and local governments took various actions including the issuance of “stay-at-home” orders, social distancing guidelines and ordering the temporary closure of non-essential businesses to limit the spread of COVID-19. While many businesses have reopened and vaccinations are becoming more widely available to the general population, the economic uncertainty created by the COVID-19 pandemic continue to present risks to the Company and the future results of our operations. Although we did not experience significant disruptions from the COVID-19 pandemic during the nine months ended September 30, 2021, should current and planned measures, including further development and delivery of vaccines and other measures intended to reduce or eliminate the spread of COVID-19, past and/or proposed economic stimulus, and other laws, acts and orders proposed or enacted by these various governmental agencies ultimately not be successful or limited in their efficacy, our business and the broader real estate industry may experience significant adverse consequences. These consequences include loss of revenues, increased expenses, increased costs of materials, difficulty in maintaining an active workforce, and constraints on our ability to secure capital or financing, among other factors.
2. Summary of Significant Accounting Policies
The summary of significant accounting policies presented below is designed to assist in understanding our condensed consolidated financial statements. Such condensed consolidated financial statements and the accompanying notes are the representations of our management, who are responsible for their integrity and objectivity. These accounting policies conform to generally accepted accounting principles in the U.S. (“GAAP”) in all material respects and have been consistently applied in preparing our accompanying condensed consolidated financial statements.
Basis of Presentation
Our accompanying condensed consolidated financial statements include our accounts and those of our subsidiaries and any consolidated variable interest entities (“VIEs”). All inter-company balances and transactions have been eliminated in the accompanying condensed consolidated financial statements. .
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
Interim Unaudited Financial Data
Our accompanying condensed consolidated financial statements have been prepared by us in accordance with GAAP in conjunction with the rules and regulations of the SEC. Certain information and footnote disclosures required for annual financial statements have been condensed or excluded pursuant to SEC rules and regulations. Accordingly, our accompanying condensed consolidated financial statements do not include all information and footnotes required by GAAP for complete financial statements. Our accompanying condensed consolidated financial statements reflect all adjustments, which are, in our opinion, of a normal recurring nature and necessary for a fair presentation of our financial position, results of operations and cash flows for the interim periods. Interim results of operations are not necessarily indicative of the results to be expected for the full year; such results may be less favorable for the full year. Our accompanying condensed consolidated financial statements should be read in conjunction with our audited consolidated financial statements and the notes thereto included in our 2020 Annual Report on Form 10-K.
Principles of Consolidation
The condensed consolidated financial statements include the accounts of our subsidiaries and consolidated joint venture arrangements. The portions of the HTALP operating partnership not owned by us are presented as non-controlling interests on the accompanying condensed consolidated balance sheets and statements of operations, condensed consolidated statements of comprehensive income, and condensed consolidated statements of equity and changes in partners’ capital. Holders of OP Units are considered to be non-controlling interest holders in HTALP and their ownership interests are reflected as equity on the accompanying condensed consolidated balance sheets. Further, a portion of the earnings and losses of HTALP are allocated to non-controlling interest holders based on their respective ownership percentages. Upon conversion of OP Units to common stock, any difference between the fair value of the common stock issued and the carrying value of the OP Units converted to common stock is recorded as a component of equity. As of September 30, 2021 and December 31, 2020, there were approximately 4.7 million and 3.5 million, respectively, of OP Units issued and outstanding held by non-controlling interest holders.
VIEs are entities where investors lack sufficient equity at risk for the entity to finance its activities without additional subordinated financial support or where equity investors, as a group, lack one of the following: (i) the power to direct the activities that most significantly impact the entity’s economic performance; (ii) the obligation to absorb the expected losses of the entity; and (iii) the right to receive the expected returns of the entity. We consolidate our investment in VIEs when we determine that we are the primary beneficiary. A primary beneficiary is one that has both: (i) the power to direct the activities of the VIE that most significantly impacts the entity’s economic performance; and (ii) the obligation to absorb losses or the right to receive benefits of the VIE that could be significant to the entity. The HTALP operating partnership and our other joint venture arrangements are VIEs because the limited partners in those partnerships, although entitled to vote on certain matters, do not possess kick-out rights or substantive participating rights. Additionally, we determined that we are the primary beneficiary of our VIEs. Accordingly, we consolidate our interests in the HTALP operating partnership and in our other joint venture arrangements. However, because we hold what is deemed a majority voting interest in the HTALP operating partnership and our other joint venture arrangements, it qualifies for the exemption from providing certain disclosure requirements associated with investments in VIEs.
In addition, from time to time, the Company acquires properties using a like-kind exchange structure pursuant to Section 1031 of the Internal Revenue Code (a “1031 exchange”) and, as such, the proceeds from a property or portfolio disposition are in the possession of an Exchange Accommodation Titleholder (“EAT”) until the 1031 exchange is completed. The EAT is classified as a VIE as it is a “thinly capitalized” entity. The Company consolidates the EAT because we are the primary beneficiary as we have the ability to control the activities that most significantly impact the EAT’s economic performance and can close out the 1031 exchange structure at any time. As of September 30, 2021, the Company had one such entity where the 1031 exchange had not completed. We will evaluate on an ongoing basis the need to consolidate entities based on the standards set forth in GAAP as described above.
Use of Estimates
The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that effect the reported amounts of assets, liabilities, revenues and expenses, and related disclosure of contingent asset and liabilities. These estimates are made and evaluated on an ongoing basis using information that is currently available as well as various other assumptions believed to be reasonable under the circumstances. Actual results could differ from those estimates, perhaps in adverse ways, and those estimates could be different under different assumptions or conditions.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
Cash, Cash Equivalents and Restricted Cash
Cash and cash equivalents consist of all highly liquid investments with a maturity of three months or less when purchased. Restricted cash is typically comprised of: (i) reserve accounts for property taxes, insurance, capital and tenant improvements; (ii) collateral accounts for debt and interest rate swaps; (iii) 1031 exchange funds; and (iv) deposits for future investments.
The following table provides a reconciliation of cash, cash equivalents and restricted cash reported within the accompanying condensed consolidated balance sheets to the combined amounts shown on the accompanying condensed consolidated statements of cash flows (in thousands):
September 30,
20212020
Cash and cash equivalents$12,836 $227,138 
Restricted cash6,628 4,108 
Total cash, cash equivalents and restricted cash$19,464 $231,246 
Revenue Recognition
Minimum annual rental revenue is recognized on a straight-line basis over the term of the related lease (including rent holidays). Differences between rental income recognized and amounts contractually due under the lease agreements are recorded as straight-line rent receivables. Tenant reimbursements, which is comprised of additional amounts recoverable from tenants for real estate taxes, common area maintenance and other certain operating expenses are recognized as revenue on a gross basis in the period in which the related recoverable expenses are incurred.  We accrue revenue corresponding to these expenses on a quarterly basis to adjust recorded amounts to our best estimate of the final annual amounts to be billed. Subsequent to year-end, on a calendar year basis, we perform reconciliations on a lease-by-lease basis and bill or credit each tenant for any differences between the estimated expenses we billed and the actual expenses that were incurred. We recognize lease termination fees when there is a signed termination letter agreement, all of the conditions of the agreement have been met, and the tenant is no longer occupying the property. Rental income is reported net of amortization of inducements.
The revenue recognition process is based on a five-step model to account for revenue arising from contracts with customers as outlined in Topic 606. We recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. We have identified all of our revenue streams and we have concluded that rental income from leasing arrangements represents a substantial portion of our revenue and is governed and evaluated with the adoption of Topic 842.
Investments in Real Estate
Depreciation expense of buildings and improvements for the three months ended September 30, 2021 and 2020 was $62.0 million and $59.2 million, respectively. Depreciation expense of buildings and improvements for the nine months ended September 30, 2021 and 2020 was $183.8 million and $176.4 million, respectively.
Leases
As a lessor, we lease space in our MOBs primarily to medical enterprises for terms generally ranging from three to seven years in length. The assets underlying these leases consist of buildings and associated land which are included as real estate investments on our accompanying condensed consolidated balance sheets. All of our leases for which we are the lessor are classified as operating leases under Topic 842.
Leases, for which we are the lessee, are classified as separate components on our accompanying condensed consolidated balance sheets. Operating leases are included as right-of-use (“ROU”) assets - operating leases, net, with a corresponding lease liability. Financing lease assets are included in receivables and other assets, net, with a corresponding lease liability in security deposits, prepaid rent and other liabilities. A lease liability is recognized for our obligation related to the lease and an ROU asset represents our right to use the underlying asset over the lease term. Refer to Note 7 - Leases in the accompanying notes to the condensed consolidated financial statements for more detail relating to our leases.
Through the duration of the coronavirus (“COVID-19”) pandemic, changes to our leases as a result of COVID-19 have been in two categories. Leases are categorized based upon the impact of the modification on its cash flows. One category is rent deferrals for which the guidance provided by the Lease Modification Q&A issued by the Financial Accounting Standards Board (“FASB”) in April 2020 was utilized, which provided relief from requiring a lease by lease analysis pursuant to Topic 842. These deferrals are generally for up to three months of rent with a payback period from three to twelve months once the deferral period has ended. Deferrals do not have an impact on cash flows over the lease term, rather, payments are made in different periods while the cash flows for the entirety of the lease term are the same. However, we have continued to recognize revenue and straight line revenue for amounts subject to deferral agreements in accordance with Topic 842. In 2020, which is the period that we believe constituted the majority of our COVID-related deferral requests, we approved deferral plans totaling approximately $11.1 million, of which approximately $10.8 million have been repaid through September 30, 2021.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
The second category is early renewals, where the Company renewed lease arrangements prior to their contractual expirations, providing concessions at the commencement of the lease in exchange for additional term, which additional term averages approximately three years. This category is treated as a modification under Topic 842, with the existing balance of the cumulative difference between rental income and payment amounts (existing straight line rent receivable) being recast over the new term, factoring in any changes attributable to the new lease arrangement and for which we performed a lease by lease analysis. Cash flows are impacted over the long term as customary free rent, at an average of three months in conjunction with these agreements, and is offset by more term and/or increased rental rates. For the nine months ended September 30, 2021, the Company has entered into very few new deferral arrangements or early renewal leases with substantive amounts of free rent or other forms of concessions at the onset of the lease term.
The Lease Modification Q&A had no material impact on our condensed consolidated financial statements as of and for the nine months ended September 30, 2021, however, its future impact to us is dependent upon the extent of lease concessions granted to tenants as a result of the COVID-19 pandemic in future periods and the elections made by us at the time of entering into any such concessions.

Real Estate Held for Sale
We consider properties held for sale once management commits to a plan to sell the property and has determined that the sale is probable and expected to occur within one year. Upon classification as held for sale, we record the property at the lower of its carrying amount or fair value, less costs to sell, and cease depreciation and amortization. The fair value is generally based on a discounted cash flow analysis, which involves management's best estimate of market participants' holding periods, market comparables, future occupancy levels, rental rates, capitalization rates, lease-up periods and capital requirements. As of September 30, 2021 we classified a single-tenant MOB located in the greater Atlanta, Georgia market as real estate held for sale on the accompanying condensed consolidated balance sheets. As of December 31, 2020, the Company had no properties classified as held for sale. The following table represents the major classes of assets and liabilities, and the balance sheet classification as of September 30, 2021 (in thousands):
September 30, 2021
Land$2,401 
Buildings and Improvements27,408 
Lease intangibles4,769 
34,578 
Accumulated depreciation and amortization(8,148)
Real estate assets held for sale, net26,430 
Receivables and other assets, net619 
Assets held for sale, net$27,049 
Security deposits, prepaid rent & other liabilities$
Intangible liabilities, net262 
Liabilities of assets held for sale$263 

Real Estate Notes Receivable
Real estate notes receivable consists of mezzanine and other real estate loans, which are generally collateralized by a pledge of the borrower’s ownership interest in the respective real estate owner and/or corporate guarantees. Real estate notes receivable are intended to be held-to-maturity and are recorded at amortized cost, net of unamortized loan origination costs and fees and allowance for credit losses. Pursuant to Topic 326 - Financial Instruments - Credit Losses, we adopted a policy to evaluate current expected credit losses at the inception of loans qualifying for treatment under Topic 326. We utilize a probability of default method approach for estimating current expected credit losses and have determined that the current risk of credit loss is remote. Accordingly, we have recorded no reserve for credit loss as of September 30, 2021.
Unconsolidated Joint Ventures
We account for our investments in unconsolidated joint ventures using the equity method of accounting because we have the ability to exercise significant influence, but not control, over the financial and operational policy decisions of the investments. Using the equity method of accounting, the initial investment is recognized at cost and subsequently adjusted for our share of the net income and any distributions from the joint venture. As of September 30, 2021 and December 31, 2020, we had a 50% interest in one such investment with a carrying value and maximum exposure to risk of $63.2 million and $64.4 million, respectively, which is recorded in investment in unconsolidated joint venture on the accompanying condensed
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
consolidated balance sheets. We record our share of net income in income from unconsolidated joint venture on the accompanying condensed consolidated statements of operations. For each of the three months ended September 30, 2021 and 2020, we recognized income of $0.4 million. For each of the nine months ended September 30, 2021 and 2020, we recognized income of $1.2 million.
Recently Issued or Adopted Accounting Pronouncements
Recently Adopted Accounting Pronouncements
S-X Rule 13-01
In March 2020, the SEC adopted amendments to Rule 3-10 of Regulation S-X and created Rule 13-01 to simplify disclosure requirements related to certain registered securities. The rule became effective on January 4, 2021, at which time we adopted S-X Rule 13-01. The adoption did not have a material effect on our financial statements and related footnotes.
Recently Issued Accounting Pronouncements
ASU 2021-01, Reference Rate Reform (Topic 848)
In January 2021, the FASB issued ASU 2021-01, which amends the scope of ASU 2020-04. The amendments of ASU 2021-01 clarify that certain optional expedients and exceptions to Topic 848 for contract modification and hedge accounting apply to derivatives that are affected by the discounting transition. For information related to the Company's current cash flow hedges, refer to Note 9 - Derivative Financial Instruments and Hedging Activities. The amendments are elective and effective immediately for contract modifications made through December 31, 2022. The Company is evaluating how the transition away from LIBOR will effect the Company and if the guidance with respect to this standard will be adopted, however, if adopted, we do not expect that this ASU will have a material impact on our financial statements.
ASU 2021-05, Leases (Topic 842): Lessors - Certain Leases with Variable Lease Payments
In July 2021, the FASB issued ASU 2021-05, which amends the lease classification requirements for lessors when classifying and accounting for a lease with variable lease payments that do not depend on a reference index or a rate. The update provides criteria, that if met, the lease would be classified and accounted for as an operating lease. The update is effective for reporting periods beginning after December 15, 2021, with early adoption permitted. At this time, the Company does not expect that the adoption of this standard will have a material impact on our financial statements.
3. Investments in Real Estate
For the nine months ended September 30, 2021, our investments had an aggregate purchase price of $189.2 million. As part of these investments, we incurred approximately $1.0 million of capitalized costs. As part of two of our acquisitions, we issued to the sellers 1.2 million OP Units with a market value at the time of issuance of approximately $35.8 million. The allocations for these investments, in which we own a controlling financial interest, are set forth below in the aggregate for the nine months ended September 30, 2021 and 2020, respectively (in thousands):
Nine Months Ended September 30,
20212020
Land$35,237 $2,817 
Building and improvements135,881 45,610 
In place leases15,294 4,651 
Below market leases(3,204)(762)
Above market leases1,252 479 
ROU assets(1,372)(242)
Net real estate assets acquired183,088 52,553 
Other, net 6,153 334 
Aggregate purchase price$189,241 $52,887 
Subsequent to September 30, 2021, we completed investments with an aggregate purchase price of $65.7 million. The
purchase price of these investments were subject to certain post-closing adjustments. Due to the recent timing of the
acquisition of these investments, we have not completed our purchase price allocation with respect to these investments and,
therefore, cannot provide disclosures at this time similar to those contained above in Note 3 - Investments in Real Estate to our
condensed consolidated financial statements.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
The acquired intangible assets and liabilities referenced above had weighted average lives of the following terms for the nine months ended September 30, 2021 and 2020, respectively (in years):
Nine Months Ended September 30,
20212020
Acquired intangible assets6.25.1
Acquired intangible liabilities9.33.4

4. Dispositions and Impairment
Dispositions
During the nine months ended September 30, 2021, we completed the disposition of 14 MOBs located in, one or more of Tennessee, Virginia and Minnesota for a gross sales price of $68.1 million, in addition to the sale of our interest in a land parcel on which the ground lessee exercised its purchase option for a gross sales price of $1.8 million, resulting in a net gain to us of approximately $32.9 million. During the nine months ended September 30, 2020, we sold part of our interest in undeveloped land in Miami, Florida for a gross sales price of $7.6 million, resulting in a net gain to us of approximately $2.0 million.
Subsequent to September 30, 2021, we completed the disposition of one MOB located in Ohio for a gross sales price of $20.2 million.
Impairment
During the nine months ended September 30, 2021, we recorded impairment charges of $16.8 million on two properties, for which the holding period was revised by the Company to be less than the previously estimated useful life, one of which was sold as of September 30, 2021. The estimated fair value as of September 30, 2021 for the remaining MOB was based on the purchase price set forth in an executed purchase option. We recorded no impairment charges during the nine months ended September 30, 2020.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
5. Intangible Assets and Liabilities
Intangible assets and liabilities consisted of the following as of September 30, 2021 and December 31, 2020, respectively (in thousands, except with respect to the weighted average remaining amortization terms):
September 30, 2021December 31, 2020
BalanceWeighted Average Remaining
Amortization in Years
BalanceWeighted Average Remaining
Amortization in Years
Assets:
In place leases
$366,987 9.5$483,779 9.7
Tenant relationships
139,023 10.6144,842 10.0
Above market leases
20,027 6.337,876 5.8
526,037 666,497 
Accumulated amortization(311,014)(427,937)
Total$215,023 9.4$238,560 9.6
Liabilities:
Below market leases$64,643 14.5$61,896 14.6
Accumulated amortization(33,170)(29,357)
Total$31,473 14.5$32,539 14.6
The following is a summary of the net intangible amortization for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands):
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Amortization recorded against rental income related to above and (below) market leases
$(694)$(712)$(1,927)$(3,431)
Amortization expense related to in place leases and tenant relationships
11,123 13,230 34,350 42,603 

6. Receivables and Other Assets
Receivables and other assets consisted of the following as of September 30, 2021 and December 31, 2020, respectively (in thousands):
September 30, 2021December 31, 2020
Tenant receivables, net
$7,460 $17,717 
Other receivables, net
6,106 6,243 
Deferred financing costs, net
1,293 2,586 
Deferred leasing costs, net
42,678 43,234 
Straight-line rent receivables, net138,162 128,070 
Prepaid expenses, deposits, equipment and other, net51,240 46,114 
Real estate notes receivable, net53,111 — 
Finance ROU asset, net14,927 7,764 
Total$314,977 $251,728 

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The following is a summary of the amortization of deferred leasing costs and financing costs for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands):
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Amortization expense related to deferred leasing costs
$2,190 $2,389 $6,617 $6,398 
Interest expense related to deferred financing costs431 431 1,293 1,293 

7. Leases
For the three months ended September 30, 2021, no new ground leases have commenced.
Lessee - Maturity of Lease Liabilities
The following table summarizes the future minimum lease obligations of our operating and finance leases as of September 30, 2021 (in thousands):
YearOperating LeasesFinance Leases
2021$2,658 $138 
202210,797 558 
202310,934 563 
202410,277 568 
20259,764 573 
20269,766 583 
Thereafter606,467 35,906 
Total undiscounted lease payments$660,663 $38,889 
Less: Interest(465,548)(23,434)
Present value of lease liabilities$195,115 $15,455 
Lessor - Lease Revenues and Maturity of Future Minimum Rents
For the three months ended September 30, 2021 and 2020, we recognized $190.6 million and $186.3 million, respectively, of rental and other lease-related income related to our operating leases, of which $43.5 million and $42.7 million, respectively, were variable lease payments. For the nine months ended September 30, 2021, and 2020, we recognized $568.4 million and $546.8 million, respectively, of rental and other lease-related income related to our operating leases, of which $130.8 million and $127.3 million, respectively, were variable lease payments.
The following table summarizes the future minimum rent contractually due under operating leases, excluding tenant reimbursements of certain costs, as of September 30, 2021 (in thousands):
YearAmount
2021$140,940 
2022550,592 
2023496,597 
2024439,632 
2025383,815 
2026334,464 
Thereafter1,220,794 
Total$3,566,834 

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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
8. Debt
Debt consisted of the following as of September 30, 2021 and December 31, 2020, respectively (in thousands):
September 30, 2021December 31, 2020
Unsecured revolving credit facility$50,000 $— 
Unsecured term loans500,000 500,000 
Unsecured senior notes2,550,000 2,550,000 
Fixed rate mortgages — — 
$3,100,000 $3,050,000 
Deferred financing costs, net(16,921)(19,157)
Premium, net(3,889)(3,844)
Total $3,079,190 $3,026,999 
Unsecured Credit Agreement
Unsecured Revolving Credit Facility due 2022
Our amended and restated $1.3 billion unsecured credit agreement (the “Unsecured Credit Agreement”) includes an unsecured revolving credit facility of $1.0 billion and an unsecured term loan of $300.0 million. The maximum principal amount of the Unsecured Credit Agreement may be increased by up to $750.0 million, subject to certain conditions, for a total principal amount of $2.05 billion if so increased. The unsecured revolving credit agreement and unsecured term loan had original maturities of June 30, 2022 and February 1, 2023, respectively. Subsequent to September 30, 2021, the Unsecured Credit Agreement was amended and restated in its entirety, by the Third Amended and Restated Revolving Credit and Term Loan Agreement referenced below, extending maturities to October 31, 2025.
Borrowings under the unsecured revolving credit facility accrue interest at a rate equal to adjusted LIBOR, plus a margin ranging from 0.83% to 1.55% per annum based on our credit rating. We also pay a facility fee ranging from 0.13% to 0.30% per annum on the aggregate commitments under the unsecured revolving credit facility. As of September 30, 2021, we had $50.0 million outstanding under this unsecured revolving credit facility at an interest rate of 1.13% per annum. The margin associated with our borrowings was 1.00% per annum and the facility fee was 0.20% per annum.
Unsecured Term Loan due 2023
Under the Unsecured Credit Agreement as noted above, we have a $300.0 million unsecured term loan, guaranteed by HTA. Borrowings under this unsecured term loan accrue interest equal to adjusted LIBOR, plus a margin ranging from 0.90% to 1.75% per annum based on our credit rating. The margin associated with our borrowings as of September 30, 2021 was 1.10% per annum. We have interest rate swaps hedging the floating interest rate, which resulted in a fixed rate of 2.52% per annum, based on our current credit rating. As of September 30, 2021, we had $300.0 million under this unsecured term loan outstanding.
Third Amended and Restated Revolving Credit and Term Loan Agreement
On October 6, 2021, we entered into a third amended and restated revolving credit and term loan agreement (the “Credit Agreement”), which includes an unsecured revolving credit facility in an aggregate maximum principal amount of $1.0 billion (the “Revolver”) and a term loan facility in an aggregate maximum principal amount of $300.0 million (the “Term Loan”). The Credit Agreement amends and restates, in its entirety, the Unsecured Credit Agreement referenced above and extends the maturities of the unsecured revolving credit facility and the unsecured term loan to October 31, 2025. Borrowings under the Revolver will bear interest at a per annum rate equal to LIBOR plus a margin ranging from 0.725% to 1.60% based on our credit rating. We are also required to pay a facility fee on the aggregate commitments under the Revolver at a per annum rate ranging from 0.125% to 0.30% based on our credit rating. Borrowings under the Term Loan will bear interest at a per annum rate equal to LIBOR plus a margin ranging from 0.80% to 1.60% based on our credit rating. Accrued interest under the Credit Agreement is payable quarterly and at maturity. The Credit Agreement also provides for borrowing at a base rate plus a margin ranging from 0.00% to 0.40% with respect to the Revolver and a base rate plus a margin of 0.00% to 0.60% with respect to the Term Loan, each based on our credit rating. The Credit Agreement includes customary LIBOR replacement terms and contains a sustainability-linked feature, which allows for a reduction in pricing upon our realization of certain sustainability ratings. The other terms of the Credit Agreement prior to the amendment thereof remain substantially unchanged.
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$200.0 Million Unsecured Term Loan due 2024
Borrowings under the unsecured term loan accrue interest at a rate equal to LIBOR, plus a margin ranging from 0.75% to 1.65% per annum based on our credit rating. The margin associated with our borrowings as of September 30, 2021 was 1.00% per annum. We have interest rate swaps hedging the floating index rate, which resulted in a fixed interest rate at 2.32% per annum, based on our current credit rating. As of September 30, 2021, we had $200.0 million under this unsecured term loan outstanding. This loan matures on January 15, 2024.
$600.0 Million Unsecured Senior Notes due 2026
In September 2019, in connection with the $650.0 million unsecured senior notes due 2030 referenced below, HTALP issued $250.0 million as additional unsecured senior notes to the $350.0 million aggregate principal of senior notes issued on July 12, 2016, all of which are guaranteed by HTA. These unsecured senior notes are registered under the Securities Act, and bear interest at 3.50% per annum which is payable semi-annually. Additionally, these unsecured senior notes were offered at 103.66% and 99.72%, respectively, of the principal amount thereof, with an effective yield to maturity of 2.89% and 3.53% per annum, respectively. As of September 30, 2021, we had $600.0 million of these unsecured senior notes outstanding that mature on August 1, 2026.
$500.0 Million Unsecured Senior Notes due 2027
In 2017, HTALP issued $500.0 million of unsecured senior notes that are guaranteed by HTA. These unsecured senior notes are registered under the Securities Act, and bear interest at 3.75% per annum which is payable semi-annually. Additionally, these unsecured senior notes were offered at 99.49% of the principal amount thereof, with an effective yield to maturity of 3.81% per annum. As of September 30, 2021, we had $500.0 million of these unsecured senior notes outstanding that mature on July 1, 2027.
$650.0 million Unsecured Senior Notes due 2030
In September 2019, in connection with the $250.0 million additional unsecured senior notes due 2026 referenced above, HTALP issued $650.0 million of unsecured senior notes that are guaranteed by HTA. These unsecured senior notes are registered under the Securities Act, and bear interest at 3.10% per annum which is payable semi-annually. Additionally, these unsecured senior notes were offered at 99.66% of the principal amount thereof, with an effective yield to maturity of 3.14% per annum. As of September 30, 2021, we had $650.0 million of these unsecured senior notes outstanding that mature on February 15, 2030.
$800.0 million Unsecured Senior Notes due 2031
In September 2020, HTALP issued $800.0 million of unsecured senior notes that are guaranteed by HTA. These unsecured senior notes are registered under the Securities Act, and bear interest at 2.00% per annum which is payable semi-annually. Additionally, these unsecured senior notes were offered at 99.20% of the principal amount thereof, with an effective yield to maturity of 2.09% per annum. As of September 30, 2021, we had $800.0 million of these unsecured senior notes outstanding that mature on March 15, 2031.
Future Debt Maturities
The following table summarizes the debt maturities and scheduled principal repayments of our indebtedness as of September 30, 2021 (in thousands):
YearAmount
2021$— 
202250,000 
2023300,000 
2024200,000 
2025— 
Thereafter2,550,000 
Total$3,100,000 
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
Deferred Financing Costs
As of September 30, 2021, the future amortization of our deferred financing costs is as follows (in thousands):
YearAmount
2021$831 
20222,985 
20232,489 
20242,096 
20252,084 
Thereafter6,436 
Total$16,921 

Debt Covenants
We are required by the terms of our applicable loan agreements to meet various affirmative and negative covenants that we believe are customary for these types of facilities, such as limitations on the incurrence of debt by us and our subsidiaries that own unencumbered assets, limitations on the nature of HTALP’s business, and limitations on distributions by HTALP and its subsidiaries that own unencumbered assets. Our loan agreements also impose various financial covenants on us, such as a maximum ratio of total indebtedness to total asset value, a minimum ratio of EBITDA to fixed charges, a minimum tangible net worth covenant, a maximum ratio of unsecured indebtedness to unencumbered asset value, rent coverage ratios and a minimum ratio of unencumbered Net Operating Income to unsecured interest expense. As of September 30, 2021, we believe that we were in compliance with all such financial covenants and reporting requirements. In addition, certain of our loan agreements include events of default provisions that we believe are customary for these types of facilities, including restricting us from making dividend distributions to our stockholders in the event we are in default thereunder, except to the extent necessary for us to maintain our REIT status. We have also concluded as of September 30, 2021, that we were not aware of non-compliance with any financial or non-financial covenants in light of the ongoing COVID-19 pandemic.
9. Derivative Financial Instruments and Hedging Activities
Risk Management Objective of Using Derivative Financial Instruments
We may use derivative financial instruments, including interest rate swaps, caps, options, floors and other interest rate derivative contracts, to hedge all or a portion of the interest rate risk associated with our borrowings. The principal objective of such arrangements is to minimize the risks and/or costs associated with our operating and financial structure as well as to hedge specific anticipated transactions. We do not intend to utilize derivatives for speculative or other purposes other than interest rate risk management. The use of derivative financial instruments carries certain risks, including the risk that the counterparties to these contractual arrangements are not able to perform under the agreements. To mitigate this risk, we only enter into derivative financial instruments with counterparties with high credit ratings and with major financial institutions with which we and our affiliates may also have other financial relationships. We do not anticipate that any of the counterparties will fail to meet their obligations. We record counterparty credit risk valuation adjustments on interest rate swap derivative assets in order to properly reflect the credit quality of the counterparty. In addition, the fair value of derivative financial instruments designated as cash flow hedges are adjusted to reflect the impact of our credit quality.
Cash Flow Hedges of Interest Rate Risk
Our objectives in using interest rate derivatives are to add stability to interest expense and to manage our exposure to interest rate movements. To accomplish this objective, we primarily use interest rate swaps and treasury locks as part of our interest rate risk management strategy. Interest rate swaps designated as cash flow hedges involve the receipt of variable rate amounts from a counterparty in exchange for us making fixed rate payments over the life of the agreements without an exchange of the underlying notional amount. A treasury lock is a synthetic forward sale of a U.S. treasury note, which is settled in cash based upon the difference between an agreed upon treasury rate and the prevailing treasury rate at settlement. Such treasury locks are entered into to effectively fix the treasury component of an upcoming debt issuance.
Amounts reported in accumulated other comprehensive income in the accompanying condensed consolidated balance sheets related to derivatives will be reclassified to interest expense as interest payments are made on our variable rate debt. During the next twelve months, we estimate that an additional $6.6 million will be reclassified from other comprehensive income in the accompanying condensed consolidated balance sheets as an increase to interest related to derivative financial instruments in the accompanying condensed consolidated statements of operations.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
As of September 30, 2021, we had the following outstanding interest rate derivatives that were designated as cash flow hedges of interest rate risk (in thousands, except number of instruments):
Interest Rate SwapsSeptember 30, 2021
Number of instruments
Notional amount$500,000 

The table below presents the fair value of our derivative financial instruments designated as cash flow hedges as well as the classification in the accompanying condensed consolidated balance sheets as of September 30, 2021 and December 31, 2020, respectively (in thousands):
 Asset DerivativesLiability Derivatives
  Fair Value at:Fair Value at:
Derivatives Designated as Hedging Instruments:Balance Sheet
Location
September 30, 2021December 31, 2020Balance Sheet
Location
September 30, 2021December 31, 2020
Interest rate swapsReceivables and other assets$— $— Derivative financial instruments$9,377 $14,957 
The table below presents the gain or loss recognized on our derivative financial instruments designated as cash flow hedges as well as the classification in the accompanying condensed consolidated statements of operations for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands):
Three Months Ended September 30,Nine Months Ended September 30,
Effect of Derivative InstrumentsLocation in Statement of Operations and Comprehensive Income (Loss)2021202020212020
Gain (loss) recognized in OCIChange in unrealized losses on cash flow hedges$(273)$521 $740 $(25,932)
Gain (loss) reclassified from accumulated OCI into incomeInterest expense(1,708)(1,533)(5,010)(2,260)

Credit Risk Related Contingent Features
We have agreements with each of our derivative counterparties that contain a provision that if we default on any of our indebtedness, including a default where repayment of the indebtedness has not been accelerated by the lender, then we could also be declared in default on our derivative obligations.
We also have agreements with each of our derivative counterparties that incorporate provisions from our indebtedness with a lender affiliate of the derivative counterparty requiring it to maintain certain minimum financial covenant ratios on our indebtedness. Failure to comply with the covenant provisions would result in us being in default on any derivative instrument obligations covered by these agreements.
As of September 30, 2021, the fair value of derivatives in a net liability position, including accrued interest, but excluding any adjustment for nonperformance risk related to these agreements, was $9.6 million. As of September 30, 2021, we have not posted any collateral related to these agreements and we were not in breach of any of the provisions of these agreements. If we had breached any of the provisions of these agreements, we could have been required to settle our obligations under these agreements.
10. Commitments and Contingencies
Litigation
We engage in litigation from time to time with various parties as a routine part of our business, including tenant defaults. However, we are not presently subject to any material litigation nor, to our knowledge, is any material litigation threatened against us, which if determined unfavorably to us, would have a material adverse effect on our condensed consolidated financial position, results of operations or cash flows. 
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Environmental Matters
We routinely monitor our properties for the presence of hazardous or toxic substances. While there can be no assurance that a material environmental liability does not exist at our properties, we are not currently aware of any environmental liability with respect to our properties that would have a material effect on our condensed consolidated financial position, results of operations or cash flows. Further, we are not aware of any material environmental liability or any unasserted claim or assessment with respect to an environmental liability at our properties that we believe would require additional disclosure or the recording of a loss contingency.
Unfunded Loan Commitments
Unfunded loan commitments include amounts undrawn on mezzanine loans. As of September 30, 2021, unfunded loan commitments totaled $15.4 million.
Other
Our other commitments and contingencies include the usual obligations of real estate owners and operators in the normal course of business. In our opinion, these matters are not expected to have a material adverse effect on our condensed consolidated financial position, results of operations or cash flows.
11. Stockholders’ Equity and Partners’ Capital
HTALP’s operating partnership agreement provides that it will distribute cash flow from operations and net sale proceeds to its partners in accordance with their overall ownership interests at such times and in such amounts as the general partner thereof determines. Dividend distributions are made such that a holder of one OP Unit in HTALP will receive distributions from HTALP in an amount equal to the dividend distributions paid to the holder of one share of our common stock. In addition, for each share of common stock issued or redeemed by HTA, HTALP issues or redeems a corresponding number of OP Units.
Common Stock Offerings
In March 2021, we entered into equity distribution agreements with various sales agents with respect to our at-the-market (“ATM”) offering program of common stock with an aggregate sales amount of up to $750.0 million, which replaced our prior ATM offering program that expired in February 2021. As of September 30, 2021, $750.0 million remained available for issuance by us under our current ATM.
During the nine months ended September 30, 2021, we issued 2.0 million shares of our common stock under our prior ATM program for net proceeds of approximately $53.7 million, adjusted for costs to borrow, equating to a net price to us of $26.87 per share of common stock.
Additionally, we have three outstanding forward sale arrangements pursuant to forward equity agreements under our prior ATM program, with total anticipated net proceeds of $218.8 million based on an average initial forward price of $29.49, subject to adjustments as provided in the forward equity agreements. All three of the arrangements have been extended and mature on December 31, 2021. Refer to Note 13 - Per Share Data of HTA to these condensed consolidated financial statements for a more detailed discussion related to our forward equity agreements.
Stock Repurchase Plan
In September 2020, our Board of Directors approved the reactivation of a stock repurchase plan authorizing us to purchase up to $300.0 million of our common stock from time to time prior to the expiration thereof on September 22, 2023. As of September 30, 2021, the remaining amount of common stock available for repurchase under our stock repurchase plan was $300.0 million.
Common Stock Dividends
See our accompanying condensed consolidated statements of equity and condensed statements of changes in partners’ capital for the dividends declared during the three and nine months ended September 30, 2021 and 2020. As of September 30, 2021, declared, but unpaid, dividends totaling $73.3 million were included in accounts payable and accrued liabilities. On November 4, 2021, our Board of Directors announced a quarterly cash dividend of $0.325 per share of common stock and per OP Unit to be paid on January 11, 2022 to stockholders and unitholders of record on January 4, 2022.
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Incentive Plan
On April 29, 2021, our Board of Directors approved and adopted the Amended and Restated 2006 Incentive Plan (the “Plan”), which was approved by our Stockholders on July 7, 2021 at our Annual Meeting of Stockholders. The Plan permits the grant of incentive awards to our employees, officers, non-employee directors and consultants as selected by our Board of Directors and authorizes us to grant awards in any of the following forms: options; stock appreciation rights; restricted stock; restricted or deferred stock units; performance awards; dividend equivalents; and other stock-based and cash-based awards. The aggregate number of awards reserved and available for issuance under the Plan is 10,000,000 shares. As of September 30, 2021, there were 9,854,721 awards available for grant under the Plan.
Restricted Common Stock
For the three and nine months ended September 30, 2021, we recognized compensation expense of $0.3 million and $5.0 million, respectively. For the three and nine months ended September 30, 2020, we recognized compensation expense of $1.8 million and $7.1 million, respectively. Substantially all compensation expense was recorded in general and administrative expenses in the accompanying condensed consolidated statements of operations.
As of September 30, 2021, we had $8.3 million of unrecognized compensation expense, net of estimated forfeitures, which we will recognize over a remaining weighted average period of 1.7 years.
The following is a summary of our restricted common stock activity as of September 30, 2021 and 2020, respectively:
September 30, 2021September 30, 2020
Restricted Common StockWeighted
Average Grant
Date Fair Value
Restricted Common StockWeighted
Average Grant
Date Fair Value
Beginning balance436,399 $28.27 600,987 $28.04 
Granted499,567 27.63 273,503 29.83 
Vested(295,494)27.48 (420,863)28.95 
Forfeited(152,087)27.31 (11,398)28.88 
Ending balance488,385 $28.39 442,229 $28.26 

12. Fair Value of Financial Instruments
Financial Instruments Reported at Fair Value - Recurring
The table below presents the carrying amounts and fair values of our financial instruments on a recurring basis as of September 30, 2021 and December 31, 2020, respectively (in thousands):
September 30, 2021December 31, 2020
Carrying AmountFair ValueCarrying AmountFair Value
Level 2 - Assets:
Real estate notes receivable, net $53,111 $53,083 $— $— 
Derivative financial instruments — — — — 
Level 2 - Liabilities:
Derivative financial instruments $9,377 $9,377 $14,957 $14,957 
Debt 3,079,190 3,211,226 3,026,999 3,258,573 
The carrying amounts of cash and cash equivalents, tenant and other receivables, restricted cash, accounts payable, and accrued liabilities approximate fair value. Fair values for real estate notes receivable are estimated based on rates currently prevailing for similar instruments of similar maturities and are based primarily on Level 2 inputs. Although we have determined that the majority of the inputs used to value our cash flow hedges fall within Level 2 of the fair value hierarchy, the credit valuation adjustments associated with these instruments utilize Level 3 inputs, such as estimates of current credit spreads to evaluate the likelihood of default by us and our counterparties. However, we have assessed the significance of the impact of the credit valuation adjustments on the overall valuation of our cash flow hedge positions and have determined that the credit valuation adjustments are not significant to their overall valuation. As a result, we have determined that our cash flow hedge valuations in their entirety are classified in Level 2 of the fair value hierarchy.  For further discussion of the assumptions considered, refer to Note 2 - Summary of Significant Accounting Policies.
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Financial Instruments Reported at Fair Value - Non-Recurring
We also have assets that under certain conditions are subject to measurement at fair value on a non-recurring basis. This category generally includes assets subject to impairment.
The table below presents our assets measured at fair value on a non-recurring basis as of September 30, 2021 and December 31, 2020 (in thousands):
September 30, 2021December 31, 2020
Fair ValueFair Value
Level 2 - Assets:
MOB (1)
$26,768 $— 
(1) During the nine months ended September 30, 2021, we recognized $16.8 million of impairment charges to the carrying value of two MOBs, one of which was sold as of September 30, 2021. The estimated fair value as of September 30, 2021 for the remaining MOB was based on the purchase price set forth in an executed purchase option, less estimated closing costs.
13. Per Share Data of HTA
During the nine months ended September 30, 2021, we issued 2.0 million shares of our common stock under our ATM for net proceeds of approximately $53.7 million, adjusted for costs to borrow equating to a net price to us of $26.87 per share of common stock.
Additionally, we have three outstanding forward sale arrangements pursuant to forward equity agreements, with total anticipated net proceeds of $218.8 million, based on an average initial forward price of $29.49, subject to adjustments as provided in the forward equity agreements. All three of the arrangements have been extended and mature on December 31, 2021.
To account for the forward equity agreements, we considered the accounting guidance governing financial instruments and derivatives and concluded that our forward equity agreements were not liabilities as they did not embody obligations to repurchase our shares of common stock nor did they embody obligations to issue a variable number of shares for which the monetary value was predominately fixed, varying with something other than the fair value of the shares, or varying inversely in relation to the fair value of our shares. We also evaluated whether the agreements met the derivatives and hedging guidance scope exception to be accounted for as equity instruments and concluded that the agreements can be classified as an equity contract based on the following assessment: (i) none of the agreements’ exercise contingencies were based on observable markets or indices besides those related to the market for our own stock price and operations; and (ii) none of the settlement provisions precluded the agreements from being indexed to our own common stock.
In addition, we considered the potential dilution resulting from the forward equity agreements mentioned above on our earnings per common share calculations. We use the treasury method to determine the dilution resulting from the forward equity agreements during the period of time prior to settlement. The impact to our weighted-average shares - diluted was anti-dilutive in nature and, thus, approximately 96,000 and 324,000 shares were excluded from the calculation for the three and nine months ended September 30, 2021. For the three and nine months ended September 30, 2020, the impact to our weighted-average shares - diluted was anti-dilutive in nature and, thus, approximately 1.1 million and 0.8 million shares, respectively, were excluded from the calculation.
We include unvested share-based payment awards that contain non-forfeitable rights to dividends or dividend equivalents as “participating securities” pursuant to the two-class method. The resulting classes are our common stock and restricted stock. Our forward equity agreements are not considered a participating security and, therefore, are not included in the computation of earnings per share using the two-class method. For the three and nine months ended September 30, 2021 and 2020, all of our earnings were distributed and the calculated earnings per share amount would be the same for all classes.
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HEALTHCARE TRUST OF AMERICA, INC. AND HEALTHCARE TRUST OF AMERICA HOLDINGS, LP NOTES TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS – (Continued)
The following is the reconciliation of the numerator and denominator used in basic and diluted earnings per share of HTA for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands, except per share data):
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Numerator:
Net income (loss)$22,042 $(6,932)$83,174 $25,001 
Net loss (income) attributable to non-controlling interests(370)105 (1,461)(438)
Net income (loss) attributable to common stockholders$21,672 $(6,827)$81,713 $24,563 
Denominator:
Weighted average shares outstanding - basic218,820 218,549 218,798 217,911 
Dilutive shares - OP Units convertible into common stock 3,991 — 3,672 3,610 
Adjusted weighted average shares outstanding - diluted222,811 218,549 222,470 221,521 
Earnings per common share - basic
Net income (loss) attributable to common stockholders$0.10 $(0.03)$0.37 $0.11 
Earnings per common share - diluted
Net income (loss) attributable to common stockholders$0.10 $(0.03)$0.37 $0.11 

14. Per Unit Data of HTALP
During the nine months ended September 30, 2021, we issued 2.0 million shares of our common stock under our ATM for net proceeds of approximately $53.7 million, adjusted for costs to borrow equating to a net price to us of $26.87 per share of common stock.
Additionally, we have three outstanding forward sale arrangements pursuant to forward equity agreements, with total anticipated net proceeds of $218.8 million, based on an average initial forward price of $29.49, subject to adjustments as provided in the forward equity agreements. All three of the arrangements have been extended and mature on December 31, 2021. Refer to Note 13 - Per Share Data of HTA to these condensed consolidated financial statements for a more detailed discussion related to our forward equity agreements executed in 2019 and March 2020.
The following is the reconciliation of the numerator and denominator used in basic and diluted earnings per unit of HTALP for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands, except per unit data):
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Numerator:
Net income (loss) $22,042 $(6,932)$83,174 $25,001 
Net income attributable to non-controlling interests— — — — 
Net income (loss) attributable to common unitholders$22,042 $(6,932)$83,174 $25,001 
Denominator:
Weighted average OP Units outstanding - basic222,811 222,101 222,470 221,521 
Dilutive units - OP Units convertible into common units— — — — 
Adjusted weighted average units outstanding - diluted222,811 222,101 222,470 221,521 
Earnings per common unit - basic:
Net income (loss) attributable to common unitholders$0.10 $(0.03)$0.37 $0.11 
Earnings per common unit - diluted:
Net income (loss) attributable to common unitholders$0.10 $(0.03)$0.37 $0.11 

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15. Supplemental Cash Flow Information
The following is the supplemental cash flow information for the nine months ended September 30, 2021 and 2020, respectively (in thousands):
Nine Months Ended September 30,
20212020
Supplemental Disclosure of Cash Flow Information:
Interest paid, net of capitalized interest$79,119 $81,889 
Cash paid for operating leases10,968 8,922 
Supplemental Disclosure of Noncash Investing and Financing Activities:
Accrued capital expenditures
$15,600 $13,139 
Dividend distributions declared, but not paid
73,307 71,072 
Issuance of OP Units in HTALP in connection with acquisitions35,785 — 
Redemption of non-controlling interest 859 8,685 
ROU assets obtained in exchange for lease obligations
7,353 696 

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The use of the words “we,” “us,” or “our” refers to HTA and HTALP, collectively.
The following discussion should be read in conjunction with our condensed consolidated financial statements and notes appearing elsewhere in this Quarterly Report, as well as with the audited consolidated financial statements, accompanying notes and Management’s Discussion and Analysis of Financial Condition and Results of Operations included in our 2020 Annual Report on Form 10-K.
The information set forth below is intended to provide readers with an understanding of our financial condition, changes in financial condition and results of operations.
Forward-Looking Statements;
Executive Summary;
Company Highlights;
Critical Accounting Policies;
Recently Issued or Adopted Accounting Pronouncements;
Factors Which May Influence Results of Operations;
Results of Operations;
Non-GAAP Financial Measures;
Liquidity and Capital Resources;
Commitments and Contingencies;
Debt Service Requirements;
Off-Balance Sheet Arrangements; and
Inflation.
Forward-Looking Statements
Certain statements contained in this Quarterly Report constitute forward-looking statements within the meaning of the safe harbor from civil liability provided for such statements by the Private Securities Litigation Reform Act of 1995 (set forth in Section 27A of the Securities Act and Section 21E of the Securities Exchange Act of 1934, as amended (“Exchange Act”)). Such statements include, in particular, statements about our plans, strategies, prospects and estimates regarding future MOB market performance. Additionally, such statements are subject to certain risks and uncertainties, as well as known and unknown risks, which could cause actual results to differ materially and in adverse ways from those projected or anticipated. Therefore, such statements are not intended to be a guarantee of our performance in future periods. Forward-looking statements are generally identifiable by the use of such terms as “expect,” “project,” “may,” “should,” “could,” “would,” “intend,” “plan,” “anticipate,” “estimate,” “believe,” “continue,” “opinion,” “predict,” “potential,” “pro forma” or the negative of such terms and other comparable terminology. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date this Quarterly Report is filed with the SEC. We cannot guarantee the accuracy of any such forward-looking statements contained in this Quarterly Report, and we do not intend to publicly update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, except as required by law.
Any such forward-looking statements reflect our current views about future events, are subject to unknown risks, uncertainties, and other factors, and are based on a number of assumptions involving judgments with respect to, among other things, future economic, competitive and market conditions, all of which are difficult or impossible to predict accurately. To the extent that our assumptions differ from actual results, our ability to meet such forward-looking statements, including our ability to generate positive cash flow from operations, provide dividends to stockholders and maintain the value of our real estate properties, may be significantly hindered. Factors that might impair our ability to meet such forward-looking statements include, without limitation, those discussed in Part I, Item 1A - Risk Factors in our 2020 Annual Report on Form 10-K, which is incorporated herein and those discussed in Part II, Item 1A. Risk Factors in this Quarterly Report on Form 10-Q.
Forward-looking statements express expectations of future events. All forward-looking statements are inherently uncertain as they are based on various expectations and assumptions concerning future events and they are subject to numerous known and unknown risks and uncertainties that could cause actual events or results to differ materially from those projected. Due to these inherent uncertainties, our stockholders are urged not to place undue reliance on forward-looking statements. Forward-looking statements speak only as of the date made. In addition, we undertake no obligation to update or revise forward-looking statements to reflect changed assumptions, the occurrence of unanticipated events or changes to projections over time, except as required by law.
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These risks and uncertainties should be considered in evaluating forward-looking statements and undue reliance should not be placed on such statements. Additional information concerning us and our business, including additional factors that could materially affect our financial results, is included herein and in our other filings with the SEC.
Executive Summary
We are the largest publicly-traded REIT focused on MOBs in the U.S. as measured by the gross leasable area ("GLA") of our MOBs. We conduct substantially all of our operations through HTALP. We invest in MOBs that we believe will serve the future of healthcare delivery and MOBs that are primarily located on health system campuses, near university medical centers, or in core community outpatient locations. We also focus on key markets that have certain demographic and macro-economic trends and where we can utilize our institutional full-service operating platform to generate strong tenant and health system relationships and operating cost efficiencies. Our primary objective is to maximize stockholder value with disciplined growth through strategic investments that provide an attractive risk-adjusted return for our stockholders by consistently increasing our cash flow. In pursuing this objective, we: (i) seek internal growth through proactive asset management, leasing, building services and property management oversight; (ii) target accretive acquisitions and developments of MOBs in markets with attractive demographics that complement our existing portfolio; and (iii) actively manage our balance sheet to maintain flexibility with conservative leverage.  Additionally, from time to time we consider, on an opportunistic basis, significant portfolio acquisitions that we believe fit our core business and could enhance our existing portfolio.
Since 2006, we have invested $7.7 billion primarily in MOBs, development projects, land and other healthcare real estate assets consisting of approximately 25.8 million square feet of GLA throughout the U.S. Approximately 67% of our portfolio is located on the campuses of, or adjacent to, nationally and regionally recognized healthcare systems. Our portfolio is diversified geographically across 32 states, with no state having more than 21% of our total GLA as of September 30, 2021. We are concentrated in 20 to 25 key markets that are generally experiencing higher economic and demographic trends than other markets that we expect will drive demand for MOBs. As of September 30, 2021, we had approximately 1 million square feet of GLA in ten of our top 20 markets and approximately 94% of our portfolio, based on GLA, is located in the top 75 Metropolitan Statistical Area ("MSAs"), with Dallas, Houston, Boston, Miami and Indianapolis being our largest markets by annualized base rent.
Company Highlights
Portfolio Operating Performance
For the three months ended September 30, 2021, our total revenue was $191.3 million, compared to $187.3 million for the three months ended September 30, 2020. For the nine months ended September 30, 2021, our total revenue was $571.4 million, compared to $551.9 million for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, our net income was $22.0 million, compared to $(6.9) million, for the three months ended September 30, 2020. For the nine months ended September 30, 2021, our net income was $83.2 million, compared to $25.0 million for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, our net income attributable to common stockholders was $0.10 per diluted share, or $21.7 million, compared to $(0.03) per diluted share, or $(6.8) million, for the three months ended September 30, 2020. For the nine months ended September 30, 2021, our net income attributable to common stockholders was $0.37 per diluted share, or $81.7 million, compared to $0.11 per diluted share, or $24.6 million, for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, HTA’s FFO, as defined by NAREIT, was $97.3 million, or $0.44 per diluted share, compared to $0.31 per diluted share, or $68.5 million, for the three months ended September 30, 2020. For the nine months ended September 30, 2021, HTA’s FFO was $291.9 million, or $1.31 per diluted share, compared to $1.13 per diluted share, or $249.4 million, for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, HTALP’s FFO was $97.7 million, or $0.44 per diluted OP Unit, compared to $0.31 per diluted OP Unit, or $68.4 million, for the three months ended September 30, 2020. For the nine months ended September 30, 2021, HTALP’s FFO was $293.4 million, or $1.32 per diluted OP Unit, compared to $1.13 per diluted OP Unit, or $249.8 million, for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, HTA’s and HTALP’s Normalized FFO was $0.44 per diluted share and OP Unit, or $97.8 million, compared to $0.43 per diluted share and OP Unit, or $96.2 million for the three months ended September 30, 2020. For the nine months ended September 30, 2021, HTA’s and HTALP’s Normalized FFO was $1.32 per diluted share and OP Unit, or $293.7 million, compared to $1.28 per diluted share and OP Unit, or $282.9 million for the nine months ended September 30, 2020.
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For additional information on FFO and Normalized FFO, see “FFO and Normalized FFO” below, which includes a reconciliation to net income attributable to common stockholders/unitholders and an explanation of why we present this non-GAAP financial measure.
For the three months ended September 30, 2021, our Net Operating Income (“NOI”) was $131.7 million, compared to $130.1 million for the three months ended September 30, 2020. For the nine months ended September 30, 2021, our NOI was $394.8 million, compared to $381.6 million for the nine months ended September 30, 2020.
For the three months ended September 30, 2021, our Same-Property Cash NOI increased 2.5%, or $2.8 million, to $115.2 million, compared to $112.3 million for the three months ended September 30, 2020. For the nine months ended September 30, 2021, our Same-Property Cash NOI increased 2.1%, or $6.9 million, to $345.2 million, compared to $338.2 million for the nine months ended September 30, 2020.
For additional information on our NOI and Same-Property Cash NOI, see “NOI, Cash NOI and Same-Property Cash NOI” below, which includes a reconciliation from net income and an explanation of why we present these non-GAAP financial measures.
Key Market Focused Strategy and Investments
Over the last decade, we have been an active investor in the medical office sector. This has enabled us to create a high quality portfolio focused on MOBs serving the future of healthcare with scale and significance in 20 to 25 key markets.
Our investment strategy includes alignment with key healthcare systems, hospitals, and leading academic medical universities. We are the largest owner of on-campus or adjacent MOBs in the country, with approximately 17.4 million square feet of GLA, or 67%, of our portfolio located in these locations. The remaining 33% of our portfolio is located in core community outpatient locations where healthcare is increasingly being delivered.
Over the past decade, our investments have been focused in our 20 to 25 key markets which we believe will outperform the broader U.S. markets from an economic and demographic perspective. As of September 30, 2021, approximately 94% of our portfolio’s GLA is located in the top 75 MSAs. Our key markets represent top MSAs with strong growth metrics in jobs, household income and population, as well as low unemployment and mature healthcare infrastructures. Many of our key markets are also supported by strong university systems.
Our key market focus has enabled us to establish scale across 20 to 25 key markets and effectively utilize our asset management and leasing platform to deliver consistent same store growth and additional yield on investments, as well as cost effective service to tenants. As of September 30, 2021, we had approximately 1 million square feet of GLA in ten of our top 20 markets and approximately 0.5 million square feet of GLA in 17 of our top 20 markets.
During the nine months ended September 30, 2021, we closed on $187.5 million worth of medical office investments totaling approximately 626,000 square feet of GLA. In addition, we funded $54.0 million of investments in real estate notes receivable.
Internal Growth through Proactive In-House Property Management and Leasing
We believe we have one of the largest full-service operating platforms in the medical office sector that consists of our in-house asset management and leasing platform which allows us to better manage and service our existing portfolio. In each of these markets, we have established a strong in-house asset management and leasing platform that has allowed us to develop valuable relationships with health systems, physician practices, universities, and regional development firms that have led to investment and leasing opportunities for us. Our full-service operating platform has also enabled us to focus on generating cost efficiencies as we gain scale across individual markets and regions.
As of September 30, 2021, our in-house asset management and leasing platform operated approximately 24.8 million square feet of GLA, or 96% of our total portfolio.
As of September 30, 2021, our leased rate (which includes leases which have been executed, but which have not yet commenced) was 89.7% by GLA and our occupancy rate was 88.0% by GLA.
We entered into new and renewal leases on approximately 0.7 million and 2.0 million square feet of GLA, or approximately 2.6% and 7.9% of the GLA of our total portfolio, during the three and nine months ended September 30, 2021, respectively.
During the three and nine months ended September 30, 2021, tenant retention for the Same-Property portfolio was 83% and 76%, respectively. Tenant retention is defined as the sum of the total leased GLA of tenants that renewed a lease during the period over the total GLA of leases that renewed or expired during the period.
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Financial Strategy and Balance Sheet Flexibility
As of September 30, 2021, we had total leverage, measured by debt less cash and cash equivalents to total capitalization, of 31.4%. Total liquidity was approximately $1.2 billion, inclusive of $950.0 million available on our unsecured revolving credit facility, $218.8 million of forward equity agreements, cash and cash equivalents of $12.8 million and $1.7 million of restricted cash for funds held in a 1031 exchange account as of September 30, 2021.
As of September 30, 2021, the weighted average remaining term of our debt portfolio was 6.4 years.
Critical Accounting Policies
The complete list of our critical accounting policies was disclosed in our 2020 Annual Report on Form 10-K. Additionally, in light of the COVID-19 pandemic, we believe we have included all relevant information when determining our management estimates and that these estimates are in line with our established policies. For further information on other significant accounting policies that impact us, see Note 2 - Summary of Significant Accounting Policies in the accompanying condensed consolidated financial statements.
Recently Issued or Adopted Accounting Pronouncements
For detail on recently issued accounting pronouncements see Note 2 - Summary of Significant Accounting Policies in the accompanying condensed consolidated financial statements.
Factors Which May Influence Results of Operations
The novel coronavirus, or COVID-19 pandemic, continues to impact economies and markets worldwide. All our buildings have remained in operation throughout the course of the pandemic. However, we addressed periodic requests from a number of our tenants about their ability to defer payment of a portion of their rents for a limited duration. We evaluated each such request on a case by case basis. In 2020, which is the period that we believe constituted the majority of our COVID-related deferral requests, we approved deferral plans totaling approximately $11.1 million, of which approximately $10.8 million of these deferrals have been repaid through September 30, 2021. There are no material outstanding requests for assistance from tenants. Payments of rent deferrals are generally expected to be repaid within the next 3 to 6 months. As of September 30, 2021, we have not granted unilateral rent forgiveness in connection with our deferral program, however, we may do so in the future if conditions and the specific economics warrant the use of such measures.
In addition, in 2020 we entered into certain lease modifications in the form of early renewals where we provide concessions in the form of free rent, which averaged three months at the inception of the lease, in exchange for additional term, which, averaged approximately three years. During the nine months ended September 30, 2021, we have not entered into any material deferral arrangements or early renewal leases with substantive amounts of free rent or other forms of concession at the onset of the applicable lease as a result of COVID-19. Although we did not experience significant disruptions from the COVID-19 pandemic during the nine months ended September 30, 2021, should current and planned measures, including further development and delivery of vaccines and other measures intended to reduce or eliminate the spread of COVID-19, past and/or proposed economic stimulus, and other laws, acts and orders proposed or enacted by federal, state and local agencies or foreign governments, ultimately not be successful or limited in their efficacy, our business and the broader real estate industry may experience significant adverse consequences. These consequences include loss of revenues, increased expenses, increased costs of materials, difficulty in maintaining an active workforce, and constraints on our ability to secure capital or financing, among other factors.
Other than the above, we are not aware of any material trends or uncertainties, other than national economic conditions affecting real estate generally and the risk factors previously discussed in Part I, Item 1A - Risk Factors, in our 2020 Annual Report on Form 10-K, and this Quarterly Report on Form 10-Q under Item 1A. Risk Factors below, that may reasonably be expected to have a material impact, favorable or unfavorable, on revenues or income from the investment, management and operation of our properties.
Rental Income
The amount of rental income generated by our properties depends principally on our ability to maintain the occupancy rates of currently leased space and to lease currently available space and space that will become available from unscheduled lease terminations at the then applicable rental rates. Negative trends in one or more of these factors, including the ultimate collections of such rents, could adversely affect our rental income in future periods.
Investment Activity
During the nine months ended September 30, 2021, we had investments with an aggregate gross purchase price of $189.2 million. During the nine months ended September 30, 2020, we had investments with an aggregate gross purchase price of $52.9 million. Subsequent to The amount of any future acquisitions or dispositions could have a significant impact on our results of operations in future periods.
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Results of Operations
Comparison of the Three and Nine Months Ended September 30, 2021 and 2020
As of September 30, 2021 and 2020, we owned and operated approximately 25.8 million and 25.1 million square feet of GLA, respectively, with a leased rate of 89.7% and 90.1%, respectively (including leases which have been executed, but which have not yet commenced), and an occupancy rate of 88.0% and 89.5%, respectively. All explanations are applicable to both HTA and HTALP unless otherwise noted.
Comparison of the three months ended September 30, 2021 and 2020, respectively, is set forth below (in thousands):
Three Months Ended September 30,
20212020Change% Change
Revenues:
Rental income$189,832 $187,258 $2,574 1.4 %
Interest and other operating income1,430 68 1,362 NM
Total revenues191,262 187,326 3,936 2.1 
Expenses:
Rental59,568 57,248 2,320 4.1 
General and administrative10,765 10,670 95 0.9 
Transaction137 125 12 9.6 
Depreciation and amortization76,056 75,892 164 0.2 
Interest expense23,331 23,136 195 0.8 
Total expenses169,857 167,071 2,786 1.7 
Gain on sale of real estate, net143 — 143 NM
Loss on extinguishment of debt, net— (27,726)27,726 100.0 
Income from unconsolidated joint venture400 422 (22)(5.2)
Other income94 117 (23)(19.7)
Net income (loss)$22,042 $(6,932)$28,974 NM
NOI$131,694 $130,078 $1,616 1.2 %
Same-Property Cash NOI $115,158 $112,316 $2,842 2.5 %
Comparison of the nine months ended September 30, 2021 and 2020, respectively, is set forth below (in thousands):
Nine Months Ended September 30,
20212020Change% Change
Revenues:
Rental income$569,676 $551,459 $18,217 3.3 %
Interest and other operating income1,694 488 1,206 NM
Total revenues571,370 551,947 19,423 3.5 
Expenses:
Rental176,556 170,310 6,246 3.7 
General and administrative32,254 32,348 (94)(0.3)
Transaction299 297 0.7 
Depreciation and amortization227,307 228,484 (1,177)(0.5)
Interest expense69,450 71,285 (1,835)(2.6)
Impairment16,825 — 16,825 NM
Total expenses522,691 502,724 19,967 4.0 
Gain on sale of real estate, net32,896 1,991 30,905 NM
Loss on extinguishment of debt, net— (27,726)27,726 NM
Income from unconsolidated joint venture1,198 1,223 (25)(2.0)
Other income401 290 111 38.3 
Net income$83,174 $25,001 $58,173 NM
NOI$394,814 $381,637 $13,177 3.5 %
Same-Property Cash NOI$345,158 $338,209 $6,949 2.1 %
*NM- not meaningful.

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Rental Income
For the three and nine months ended September 30, 2021 and 2020, respectively, rental income was comprised of the following (in thousands):
 Three Months Ended September 30,
 20212020Change% Change
Contractual rental income $181,275 $176,708 $4,567 2.6 %
Straight-line rent and amortization of above and (below) market leases
4,545 7,298 (2,753)(37.7)
Other rental revenue4,012 3,252 760 23.4 
Total rental income$189,832 $187,258 $2,574 1.4 %
Nine Months Ended September 30,
20212020Change% Change
Contractual rental income$543,568 $521,175 $22,393 4.3 %
Straight-line rent and amortization of above and (below) market leases
14,919 19,410 (4,491)(23.1)
Other rental revenue11,189 10,874 315 2.9 
Total rental income$569,676 $551,459 $18,217 3.3 %
Contractual rental income, which includes expense reimbursements, increased $4.6 million and $22.4 million for the three and nine months ended September 30, 2021, compared to the three and nine months ended September 30, 2020. The increases were primarily due to additional contractual rental income of $6.5 million and $15.6 million from our 2020 and 2021 acquisitions, and contractual rent increases for the three and nine months ended September 30, 2021, partially offset by $2.8 million and $4.8 million of reduced contractual rental income as a result of the buildings we sold during 2020 and 2021 for the three and nine months ended September 30, 2021, respectively. In addition, during the nine months ended September 30, 2020, we recorded a non-recurring charge of $4.7 million of bad debt as a reduction in revenue.
Average starting and expiring base rents for new and renewal leases consisted of the following for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands, except in average base rents per square foot of GLA):
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
New and renewal leases:
Average starting base rents$23.89 $26.45 $24.50 $27.04 
Average expiring base rents20.35 24.70 21.74 25.84 
Square feet of GLA670 1,101 2,022 3,287 
Lease rates can vary across markets, and lease rates that are considered above or below current market rent may change over time. Leases that expired in 2021 had rents that we believed were at market rates. In general, leasing concessions vary depending on lease type, term, geography, and supply/demand dynamics.
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Tenant improvements, leasing commissions and tenant concessions for new and renewal leases consisted of the following for the three and nine months ended September 30, 2021 and 2020, respectively (in per square foot of GLA):
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
New leases:
Tenant improvements$43.87 $21.02 $34.35 $38.16 
Leasing commissions
6.47 2.05 4.90 2.86 
Tenant concessions6.61 2.59 6.67 3.70 
Renewal leases:
Tenant improvements$11.04 $4.43 $6.99 $5.58 
Leasing commissions
2.27 2.07 2.17 2.87 
Tenant concessions0.14 0.94 0.15 1.99 
The average term for new and renewal leases executed consisted of the following for the three and nine months ended September 30, 2021 and 2020, respectively (in years):
 Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
New leases7.14.46.27.9
Renewal leases4.57.74.15.4
Rental Expenses
For the three months ended September 30, 2021 and 2020, rental expenses attributable to our properties were $59.6 million and $57.2 million, respectively. For the nine months ended September 30, 2021 and 2020, rental expenses attributable to our properties were $176.6 million and $170.3 million, respectively. These increases in rental expenses were primarily due to $2.4 million and $5.1 million of additional rental expenses associated with our 2020 and 2021 acquisitions for the three and nine months ended September 30, 2021, respectively.
General and Administrative Expenses
For the three months ended September 30, 2021 and 2020, general and administrative expenses were $10.8 million and $10.7 million, respectively. For each of the nine months ended September 30, 2021 and 2020, general and administrative expenses were $32.3 million. For the three months ended September 30, 2021, general and administrative expenses included a reduction of approximately $(2.1) million in stock compensation expense principally related to the resignation of our former CEO net of new award activity with the appointments of our interim CEO and new board chairman, offset by approximately $0.5 million of incremental legal costs related to the whistleblower investigation, and increased costs related to our leasing efforts, travel-related expenses, professional services and other administrative costs.
Depreciation and Amortization Expense
For the three months ended September 30, 2021 and 2020, depreciation and amortization expense was $76.1 million and $75.9 million, respectively. For the nine months ended September 30, 2021 and 2020, depreciation and amortization expense was $227.3 million and $228.5 million, respectively. The slight variances were associated with our 2020 and 2021 acquisitions, offset by buildings we disposed of during 2020 and 2021.
Interest Expense
For the three months ended September 30, 2021 and 2020, interest expense was $23.3 million and $23.1 million, respectively. For the nine months ended September 30, 2021 and 2020, interest expense was $69.5 million and $71.3 million, respectively. The decreases in year-to-date interest expense is primarily due to lower average interest rates as compared to the same period in 2020.
To achieve our objectives, we borrow at both fixed and variable rates. From time to time, we also enter into derivative financial instruments, such as interest rate swaps, in order to mitigate our interest rate risk on a related financial instrument. We do not enter into derivative or interest rate transactions for speculative purposes.
Impairment
For the nine months ended September 30, 2021, we recorded impairment charges of $16.8 million on two properties related to: (i) a purchase option included in a lease agreement that was exercised for a contractual sale price less than its carrying value; and (ii) an executed sales agreement for a sale price less than its carrying value. We recorded no impairment charges during the nine months ended September 30, 2020.
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Gain on Sale of Real Estate, net
For the nine months ended September 30, 2021, we realized a net gain of approximately $32.9 million, primarily as a result of the sale of a 13 property portfolio located in one or more of Tennessee and Virginia. For the nine months ended September 30, 2020, we realized a net gain of approximately $2.0 million on the sale of part of our interest in undeveloped land in Miami, Florida.
Net Income
For the three months ended September 30, 2021 and 2020, net income was $22.0 million and $(6.9) million, respectively. For the nine months ended September 30, 2021 and 2020, net income was $83.2 million and $25.0 million, respectively. The increases are primarily the result of gains associated with disposition of assets in non-key markets, as well as continued growth in our operations due to accretive acquisitions and improved operating efficiencies. Additionally, during the three and nine months ended September 30, 2020, we recorded a net loss on extinguishment of debt of approximately $27.7 million.
NOI and Same-Property Cash NOI
For the three months ended September 30, 2021 and 2020, NOI was $131.7 million and $130.1 million, respectively. For the nine months ended September 30, 2021 and 2020, NOI was $394.8 million and $381.6 million, respectively. The increases in NOI was primarily due to additional NOI from our 2020 and 2021 acquisitions of $5.0 million and $12.4 million for the three and nine months ended September 30, 2021, respectively, partially offset by $1.5 million and $2.7 million of reduced NOI as a result of the buildings we sold during 2020 and 2021 for the three and nine months ended September 30, 2021, respectively, and a reduction in straight-line rent from properties we owned for more than a year.
Same-Property Cash NOI increased 2.5% to $115.2 million for the three months ended September 30, 2021 compared to the three months ended September 30, 2020. Same-Property Cash NOI increased 2.1% to $345.2 million for the nine months ended September 30, 2021 compared to nine months ended September 30, 2020. The increases were primarily the result of rent escalations and improved operating efficiencies, offset by a slight decrease in average occupancy.
Non-GAAP Financial Measures
FFO and Normalized FFO
We compute FFO in accordance with the current standards established by NAREIT. NAREIT defines FFO as net income or loss attributable to common stockholders/unitholders (computed in accordance with GAAP), excluding gains or losses from sales of real estate property and impairment write-downs of depreciable assets, plus depreciation and amortization related to investments in real estate, and after adjustments for unconsolidated partnerships and joint ventures. Since FFO excludes depreciation and amortization unique to real estate, among other items, it provides a perspective not immediately apparent from net income or loss attributable to common stockholders/unitholders.
We also compute Normalized FFO, which excludes from FFO: (i) transaction expenses; (ii) gain or loss on extinguishment of debt; (iii) non-controlling income or loss from OP Units included in diluted shares (only applicable to the Company); and (iv) other normalizing adjustments, which include items that are unusual and infrequent in nature. Our methodology for calculating Normalized FFO may be different from the methods utilized by other REITs and, accordingly, may not be comparable to other REITs.
We present FFO and Normalized FFO because we consider them important supplemental measures of our operating performance and believe they are frequently used by securities analysts, investors and other interested parties in the evaluation of REITs. Historical cost accounting assumes that the value of real estate assets diminishes ratably over time. Since real estate values have historically risen or fallen based on market conditions, many industry investors have considered the presentation of operating results for real estate companies that use historical cost accounting to be insufficient by themselves. FFO and Normalized FFO should not be considered as alternatives to net income or loss attributable to common stockholders/unitholders (computed in accordance with GAAP) as indicators of our financial performance, nor are they indicative of cash available to fund cash needs. FFO and Normalized FFO should be reviewed in connection with other GAAP measurements.
In addition, the amounts included in the calculation of FFO and Normalized FFO are generally the same for HTALP and HTA, except for net income or loss attributable to common stockholders/unitholders, non-controlling income or loss from OP Units included in diluted shares (only applicable to the Company) and the weighted average shares of our common stock or HTALP OP Units outstanding.
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The following is the reconciliation of HTA’s FFO and Normalized FFO to net income attributable to common stockholders for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands, except per share data):
 Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Net income (loss) attributable to common stockholders$21,672 $(6,827)$81,713 $24,563 
Depreciation and amortization expense related to investments in real estate
75,264 74,848 224,814 225,354 
Gain on sale of real estate, net(143)— (32,896)(1,991)
Impairment
— — 16,825 — 
Proportionate share of joint venture depreciation and amortization
487 468 1,462 1,443 
FFO attributable to common stockholders$97,280 $68,489 $291,918 $249,369 
Transaction expenses 137 125 299 297 
Loss on extinguishment of debt, net— 27,726 — 27,726 
Non-controlling income from OP Units included in diluted shares370 (105)1,461 438 
Other normalizing adjustments (1)
— — — 5,031 
Normalized FFO attributable to common stockholders$97,787 $96,235 $293,678 $282,861 
Net income (loss) attributable to common stockholders per diluted share $0.10 $(0.03)$0.37 $0.11 
FFO adjustments per diluted share, net
0.34 0.34 0.94 1.02 
FFO attributable to common stockholders per diluted share
$0.44 $0.31 $1.31 $1.13 
Normalized FFO adjustments per diluted share, net
0.00 0.12 0.01 0.15 
Normalized FFO attributable to common stockholders per diluted share
$0.44 $0.43 $1.32 $1.28 
Weighted average diluted common shares outstanding
222,811 222,101 222,470 221,521 
(1) For the nine months ended September 30, 2020, other normalizing adjustments includes the following: non-recurring bad debt of $4,672 thousand; incremental hazard pay to facilities employees of $314 thousand; and incremental personal protective equipment of $45 thousand.
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The following is the reconciliation of HTALP’s FFO and Normalized FFO to net income attributable to common unitholders for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands, except per unit data):
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Net income (loss) attributable to common unitholders$22,042 $(6,932)$83,174 $25,001 
Depreciation and amortization expense related to investments in real estate
75,264 74,848 224,814 225,354 
Gain on sale of real estate, net(143)— (32,896)(1,991)
Impairment
— — 16,825 — 
Proportionate share of joint venture depreciation and amortization
487 468 1,462 1,443 
FFO attributable to common unitholders$97,650 $68,384 $293,379 $249,807 
Transaction expenses 137 125 299 297 
Loss on extinguishment of debt, net— 27,726 — 27,726 
Other normalizing adjustments (1)
— — — 5,031 
Normalized FFO attributable to common unitholders$97,787 $96,235 $293,678 $282,861 
Net income (loss) attributable to common unitholders per diluted share $0.10 $(0.03)$0.37 $0.11 
FFO adjustments per diluted OP Unit, net 0.34 0.34 0.95 1.02 
FFO attributable to common unitholders per diluted OP Unit $0.44 $0.31 $1.32 $1.13 
Normalized FFO adjustments per diluted OP Unit, net 0.00 0.12 0.00 0.15 
Normalized FFO attributable to common unitholders per diluted OP Unit $0.44 $0.43 $1.32 $1.28 
Weighted average diluted common OP Units outstanding 222,811 222,101 222,470 221,521 
(1) For the nine months ended September 30, 2020, other normalizing adjustments includes the following: non-recurring bad debt of $4,672 thousand; incremental hazard pay to facilities employees of $314 thousand; and incremental personal protective equipment of $45 thousand.
NOI, Cash NOI and Same-Property Cash NOI
NOI is a non-GAAP financial measure that is defined as net income or loss (computed in accordance with GAAP) before: (i) general and administrative expenses; (ii) transaction expenses; (iii) depreciation and amortization expense; (iv) impairment; (v) interest expense; (vi) gain or loss on sales of real estate; (vii) gain or loss on extinguishment of debt; (viii) income or loss from unconsolidated joint venture; and (ix) other income or expense. We believe that NOI provides an accurate measure of the operating performance of our operating assets because NOI excludes certain items that are not associated with the management of our properties. Additionally, we believe that NOI is a widely accepted measure of comparative operating performance of REITs. However, our use of the term NOI may not be comparable to that of other REITs as they may have different methodologies for computing this amount. NOI should not be considered as an alternative to net income or loss (computed in accordance with GAAP) as an indicator of our financial performance. NOI should be reviewed in connection with other GAAP measurements.
Cash NOI is a non-GAAP financial measure which excludes from NOI: (i) straight-line rent adjustments; (ii) amortization of below and above market leases/leasehold interests and other GAAP adjustments; (iii) notes receivable interest income; and (iv) other normalizing adjustments. Contractual base rent, contractual rent increases, contractual rent concessions and changes in occupancy or lease rates upon commencement and expiration of leases are a primary driver of our revenue performance. We believe that Cash NOI, which removes the impact of straight-line rent adjustments, provides another measurement of the operating performance of our operating assets. Additionally, we believe that Cash NOI is a widely accepted measure of comparative operating performance of REITs. However, our use of the term Cash NOI may not be comparable to that of other REITs as they may have different methodologies for computing this amount. Cash NOI should not be considered as an alternative to net income or loss (computed in accordance with GAAP) as an indicator of our financial performance. Cash NOI should be reviewed in connection with other GAAP measurements.
To facilitate the comparison of Cash NOI between periods, we calculate comparable amounts for a subset of our owned and operational properties referred to as “Same-Property”. Same-Property Cash NOI excludes (i) properties which have not been owned and operated by us during the entire span of all periods presented and disposed properties, (ii) our share of unconsolidated joint ventures, (iii) development, redevelopment and land parcels, (iv) properties intended for disposition in the near term which have (a) been approved by the Board of Directors, (b) is actively marketed for sale, and (c) an offer has been received at prices we would transact and the sales process is ongoing, and (v) certain non-routine items. Same-Property Cash
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NOI should not be considered as an alternative to net income or loss (computed in accordance with GAAP) as an indicator of our financial performance. Same-Property Cash NOI should be reviewed in connection with other GAAP measurements.
The following is the reconciliation of HTA’s and HTALP’s NOI, Cash NOI and Same-Property Cash NOI to net income for the three and nine months ended September 30, 2021 and 2020, respectively (in thousands):
Three Months Ended September 30,Nine Months Ended September 30,
 2021202020212020
Net income (loss) $22,042 $(6,932)$83,174 $25,001 
General and administrative expenses10,765 10,670 32,254 32,348 
Transaction expenses 137 125 299 297 
Depreciation and amortization expense
76,056 75,892 227,307 228,484 
Impairment
— — 16,825 — 
Interest expense
23,331 23,136 69,450 71,285 
Gain on sale of real estate, net(143)— (32,896)(1,991)
Loss on extinguishment of debt, net
— 27,726 — 27,726 
Income from unconsolidated joint venture(400)(422)(1,198)(1,223)
Other income(94)(117)(401)(290)
NOI$131,694 $130,078 $394,814 $381,637 
Straight-line rent adjustments, net (3,012)(5,711)(10,408)(12,673)
Amortization of (below) and above market leases/leasehold interests, net and other GAAP adjustments (538)(113)(1,413)(2,203)
Notes receivable interest income
(1,264)(11)(1,273)(152)
Other normalizing adjustments (1)
— — — 5,031 
Cash NOI $126,880 $124,243 $381,720 $371,640 
Acquisitions not owned/operated for all periods presented and disposed properties Cash NOI
(5,245)(2,245)(15,775)(8,158)
Redevelopment Cash NOI (116)(1,043)(803)(3,612)
Intended for sale Cash NOI (6,361)(8,639)(19,984)(21,661)
Same-Property Cash NOI (2)
$115,158 $112,316 $345,158 $338,209 
(1) For the nine months ended September 30, 2020, other normalizing adjustments includes the following: non-recurring bad debt of $4,672 thousand, incremental hazard pay to facilities employees of $314 thousand, and incremental personal protective equipment of $45 thousand.
(2) Same-Property includes 421 and 414 buildings for the three and nine months ended September 30, 2021 and 2020, respectively.
Liquidity and Capital Resources
Our primary sources of cash include: (i) cash flow from operations; (ii) borrowings under our unsecured revolving credit facility; (iii) net proceeds from the issuances of debt and equity securities; and (iv) proceeds from our dispositions. During the next 12 months our primary uses of cash are expected to include: (a) the funding of acquisitions of MOBs, development properties and other facilities that serve the healthcare industry; (b) capital expenditures; (c) the payment of operating expenses; (d) debt service payments, including principal payments; and (e) the payment of dividends to our stockholders. We anticipate cash flow from operations, restricted cash and reserve accounts and our unsecured revolving credit facility, if needed, will be sufficient to fund our operating expenses, capital expenditures and dividends to stockholders. Investments and maturing indebtedness may require funds from borrowings under our unsecured revolving credit facility, the issuance of debt and/or equity securities or proceeds from sales of real estate.
As of September 30, 2021, we had total liquidity of $1.2 billion, inclusive of $950.0 million available on our unsecured revolving credit facility, $218.8 million of unsettled forward equity agreements, cash and cash equivalents of $12.8 million and $1.7 million of restricted cash for funds held in a 1031 exchange account. We believe that we have sufficient liquidity and opportunities to obtain additional liquidity at our disposal to sustain operations for the foreseeable future.
On October 6, 2021, we entered into a third amended and restated revolving credit and term loan agreement (the “Credit Agreement”), which includes an unsecured revolving credit facility in an aggregate maximum principal amount of $1.0 billion (the “Revolver”) and a term loan facility in an aggregate maximum principal amount of $300.0 million (the “Term Loan”). The Credit Agreement amends and restates, in its entirety, the unsecured credit agreement referenced above, reduces our overall borrowing costs, and extends the maturities of the existing unsecured revolving credit facility to October 31, 2025.
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As of September 30, 2021, we had unencumbered assets with a gross book value of $8.0 billion. The unencumbered properties may be used as collateral to secure additional financings in future periods or refinance our current debt as it becomes due. Our ability to raise funds from future debt and equity issuances is dependent on our investment grade credit ratings, general economic and market conditions, and our operating performance.
When we acquire a property, we prepare a capital plan that contemplates the estimated capital needs of that investment. In addition to operating expenses, capital needs may also include costs of refurbishment, tenant improvements or other major capital expenditures. The capital plan for each investment will be adjusted through ongoing, regular reviews of our portfolio or as necessary to respond to unanticipated additional capital needs. Capital expenditures for the remainder of the year will be primarily targeted towards planned maintenance activities and other capital improvements that are either of an immediate need to preserve liquidity, or strategically necessary for revenue generation purposes. Currently these expenditures are estimated at approximately $20 million to $25 million per quarter. Although we cannot provide assurance that we will not exceed these estimated expenditure levels, we believe our liquidity of $1.2 billion allows us the flexibility to fund such capital expenditures as may be necessary or advisable.
If we experience lower occupancy levels, reduced rental rates, reduced revenues as a result of asset sales, or increased capital expenditures and leasing costs compared to historical levels due to competitive market conditions for new and renewal leases, the effect would be a reduction of net cash provided by operating activities. If such a reduction of net cash provided by operating activities is realized, we may have a cash flow deficit in subsequent periods. Our estimate of net cash available is based on various assumptions which are difficult to predict, including the levels of our leasing activity and related leasing costs. Any changes in these assumptions could impact our financial results and our ability to fund working capital and unanticipated cash needs.
Cash Flows
The following is a summary of our cash flows for the nine months ended September 30, 2021 and 2020, respectively (in thousands):
Nine Months Ended September 30,
20212020Change
Cash, cash equivalents and restricted cash - beginning of period $118,765 $37,616 $81,149 
Net cash provided by operating activities271,618 269,668 1,950 
Net cash used in investing activities (257,332)(159,919)(97,413)
Net cash used in financing activities(113,587)83,881 (197,468)
Cash, cash equivalents and restricted cash - end of period $19,464 $231,246 $(211,782)
Net cash provided by operating activities increased in 2021 primarily due to the impact of our 2020 and 2021 acquisitions and contractual rent increases, partially offset by our 2020 and 2021 dispositions. We anticipate cash flows from operating activities to increase as a result of the growth in our portfolio through new acquisitions and continued leasing activity in our existing portfolio.
For the nine months ended September 30, 2021, net cash used in investing activities primarily related to investments in real estate of $147.3 million, capital expenditures of $78.0 million, advances on real estate notes receivable of $66.5 million, and development of real estate of $48.5 million, partially offset by proceeds from the sale of real estate of $67.6 million and collection of real estate notes receivable of $15.4 million. For the nine months ended September 30, 2020, net cash used in investing activities primarily related to capital expenditures of $59.0 million, investments in real estate of $52.6 million, development of real estate of $49.5 million, and funding of a real estate loan of $6.0 million, partially offset by proceeds from the sale of real estate of $6.4 million.
For the nine months ended September 30, 2021, net cash used in financing activities primarily related to dividends paid to holders of our common stock of $210.0 million, distributions paid to non-controlling interest of limited partners of $3.9 million, and the repurchase and cancellation of common stock of $3.4 million, partially offset by proceeds from issuance of common stock of $53.7 million, and by net borrowings under our revolving credit facility of $50.0 million. For the nine months ended September 30, 2020, net cash provided by financing activities primarily related to proceeds from unsecured senior notes of $793.6 million and proceeds from issuance of common stock of $50.0 million partially offset by payments on unsecured senior notes of $300.0 million, dividends paid to holders of our common stock of $205.9 million, payments on our secured mortgage loans of $114.1 million, and net payments on our unsecured revolving credit facility of $100.0 million.
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Dividends
The amount of dividends we pay to our stockholders is determined by our Board of Directors, in their sole discretion, and is dependent on a number of factors, including funds available, our financial condition, capital expenditure requirements and annual dividend distribution requirements needed to maintain our status as a REIT under the Internal Revenue Code of 1986, as amended. We have paid monthly or quarterly dividends since February 2007, and if our investments produce sufficient cash flow, we expect to continue to pay dividends to our stockholders. Because our cash available for dividend distributions in any year may be less than 90% of our taxable income for the year, we may obtain the necessary funds through borrowings, issuing new securities or selling assets to pay out enough of our taxable income to satisfy our dividend distribution requirement. Our organizational documents do not establish a limit on dividends that may constitute a return of capital for federal income tax purposes. The dividend we pay to our stockholders is equal to the distributions received from HTALP in accordance with the terms of the HTALP partnership agreement. It is our intention to continue to pay dividends. However, our Board of Directors may reduce our dividend rate and we cannot guarantee the timing and amount of dividends that we may pay in the future, if any.
For the nine months ended September 30, 2021, we paid cash dividends of $210.0 million on our common stock. In October 2021 for the quarter ended September 30, 2021, we paid cash dividends on our common stock of $71.8 million.
Financing
We have historically maintained a low leveraged balance sheet and intend to continue to maintain this structure in the long term. However, our total leverage may fluctuate on a short-term basis as we execute our business strategy. As of September 30, 2021, our leverage ratio, measured by debt less cash and cash equivalents to total capitalization, was 31.4%.
As of September 30, 2021, we had debt outstanding of $3.1 billion and the weighted average interest rate therein was 2.86% per annum, inclusive of the impact of our cash flow hedges. The following is a summary of our unsecured and secured debt. See Note 8 - Debt in the accompanying condensed consolidated financial statements for a further discussion of our debt.
Unsecured Revolving Credit Facility
As of September 30, 2021, $950.0 million was available on our $1.0 billion unsecured revolving credit facility originally maturing in June 2022. Subsequent to September 30, 2021, the unsecured revolving credit facility was amended and restated, extending maturity to October 2025.
Unsecured Term Loans
As of September 30, 2021, we had $500.0 million of unsecured term loans outstanding, comprised of $300.0 million under our Unsecured Credit Agreement originally maturing in 2023 and extended to 2025 subsequent to September 30, 2021, and $200.0 million under our unsecured term loan maturing in 2024.
Unsecured Senior Notes
As of September 30, 2021, we had $2.55 billion of unsecured senior notes outstanding, comprised of $600.0 million of senior notes maturing in 2026, $500.0 million of senior notes maturing in 2027, $650.0 million of senior notes maturing in 2030 and $800.0 million of senior notes maturing in 2031.
Commitments and Contingencies
As of September 30, 2021, we had unfunded loan commitments totaling $15.4 million. See Note 10 - Commitments and Contingencies in the accompanying condensed consolidated financial statements for a further discussion of our commitments and contingencies.
Debt Service Requirements
We are required by the terms of our applicable loan agreements to meet certain financial covenants, such as minimum net worth and liquidity, and reporting requirements, among others. As of September 30, 2021, we believe that we were in compliance with all such covenants and we are not aware of any covenants that it is reasonably likely that we would not be able to meet in accordance with our loan agreements.
Off-Balance Sheet Arrangements
As of and during the nine months ended September 30, 2021, we had no material off-balance sheet arrangements that have had or are reasonably likely to have a current or future effect on our financial condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources.
Inflation
We are exposed to inflation risk as income from future long-term leases is the primary source of our cash flows from operations. There are provisions in the majority of our tenant leases that protect us from the impact of normal inflation. These provisions include rent escalations, reimbursement billings for operating expense pass-through charges and real estate tax and insurance reimbursements on a per square foot allowance. However, due to the long-term nature of our leases, among other factors, the leases may not reset frequently enough to cover inflation.
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Item 3. Quantitative and Qualitative Disclosures About Market Risk
There have been no material changes from the quantitative and qualitative disclosures about market risk previously disclosed in our 2020 Annual Report on Form 10-K. On March 5, 2021, the United Kingdom Financial Conduct Authority (“FCA”), a regulator of financial services firms and financial markets in the United Kingdom, formally announced the cessation of LIBOR as of June 30, 2023. The Alternative Reference Rates Committee, a group of private-market participant convened by the U.S. Federal Reserve Board and the New York Federal Reserve, has recommended Secured Overnight Financing Rate (“SOFR”) as a more robust reference rate alternative to U.S. dollar LIBOR. Concurrent with the FCA’s announcement, the International Swaps and Derivatives Association (“ISDA”) determined that the announcement constituted an index cessation event and consequently the fallback spread adjustments were fixed and published, with the spread adjustment between U.S. dollar 1-Month LIBOR and SOFR at 0.11%. Borrowings under our Unsecured Credit Agreement and our $200 million unsecured term loan accrue interest at a rate equal to LIBOR, plus a margin, as specified in Note 8 - Debt. On October 6, 2021, we entered into a third amended and restated revolving credit and term loan agreement, extending the maturities under the existing Unsecured Credit Agreement to October 31, 2025. However, the credit agreement, as amended, includes customary LIBOR replacement terms. The $200 million unsecured term loan matures on January 15, 2024, however, the loan agreement includes provisions for an alternative rate of interest in the event LIBOR is no longer a widely recognized benchmark rate. As of September 30, 2021, the fallback rate under SOFR was 0.16%. Comparatively, the U.S. dollar 1-Month LIBOR rate as of September 30, 2021 was 0.08%. Consequently, we do not anticipate the transition from LIBOR will have a material impact on our financial statements or results of operations.
Item 4. Controls and Procedures
Healthcare Trust of America, Inc.
HTA’s management is responsible for establishing and maintaining disclosure controls and procedures that are designed to ensure that information required to be disclosed in its reports under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC rules and forms, and that such information is accumulated and communicated to management, including HTA’s Chief Executive Officer (as the principal executive officer) and Chief Financial Officer (as the principal financial officer and principal accounting officer), to allow timely decisions regarding required disclosures.
As of September 30, 2021, an evaluation was conducted by HTA under the supervision and with the participation of its management, including HTA’s Chief Executive Officer and Chief Financial Officer, of the effectiveness of its disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act). Based on this evaluation, HTA’s Chief Executive Officer and Chief Financial Officer each concluded that HTA’s disclosure controls and procedures were effective as of September 30, 2021.
There were no changes in our internal control over financial reporting that occurred during the quarter ended September 30, 2021 that have materially affected, or are reasonably believed to be likely to materially affect, our internal control over financial reporting. This determination was reached after careful evaluation of the effects COVID-19 has had on our operations.
November 5, 2021
Healthcare Trust of America Holdings, LP
HTALP’s management is responsible for establishing and maintaining disclosure controls and procedures that are designed to ensure that information required to be disclosed in its reports under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC rules and forms, and that such information is accumulated and communicated to management, including HTA’s Chief Executive Officer (as the principal executive officer) and Chief Financial Officer (as the principal financial officer and principal accounting officer), to allow timely decisions regarding required disclosures.
As of September 30, 2021, an evaluation was conducted by HTALP under the supervision and with the participation of its management, including HTA’s Chief Executive Officer and Chief Financial Officer, of the effectiveness of its disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act). Based on this evaluation, HTA’s Chief Executive Officer and Chief Financial Officer, on behalf of HTA in its capacity as general partner of HTALP, each concluded that HTALP’s disclosure controls and procedures were effective as of September 30, 2021.
There were no changes in HTALP’s internal control over financial reporting that occurred during the quarter ended September 30, 2021 that have materially affected, or are reasonably believed to be likely to materially affect, HTALP’s internal control over financial reporting. This determination was reached after careful evaluation of the effects COVID-19 has had on our operations.
November 5, 2021
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PART II - OTHER INFORMATION
Item 1. Legal Proceedings
We are subject to claims and litigation arising in the ordinary course of business. We do not believe any liability from any reasonably foreseeable disposition of such claims and litigation, individually or in the aggregate, would have a material adverse effect on our accompanying condensed consolidated financial statements.
Item 1A. Risk Factors
The following supplements the risk factors disclosed in Part I, Item 1A - Risk Factors of our Annual Report on Form 10-K for the year ended December 31, 2020 (our “2020 Form 10-K”). The following risk factor disclosure should be read in conjunction with the risk factors described in our 2020 Form 10-K. The discussion of risk factors, as so supplemented, sets forth the material risk factors that could materially affect our business, financial condition or future results. The risks described in our 2020 Form 10-K and this Quarterly Report on Form 10-Q are not the only risks we face. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial may also materially and adversely impact our business, financial condition, results of operations and cash flows.
Our success depends to a significant degree upon the continued contributions of our Board members, our interim Chief Executive Officer and other key personnel, each of whom would be difficult to replace. If we are unable to employ a satisfactory successor to our interim Chief Executive Officer or if we were to lose the benefit of the experience, efforts and abilities of one or more of these individuals, our operating results could suffer.
Our ability to achieve our investment objectives and to pay distributions is dependent upon the performance of our Board of Directors, our executive officers and our other employees. A special committee of our Board is currently engaged in a search process to identify and employ a successor to our interim Chief Executive Officer who was appointed following the resignation of our former Chairman and Chief Executive Officer effective August 2, 2021. If we are unable to employ a satisfactory replacement Chief Executive Officer or are unable to do so on a timely basis, our operating results could suffer. Our Board of Directors establishes important policies, governance objectives and strategic goals, and our management team serves a critical role in the identification and acquisition of investments, the determination and finalization of our financing arrangements, the asset management of our investments, and the operation of our day-to-day activities. Our stockholders will have no opportunity to evaluate the terms of transactions or other economic or financial data concerning our investments that are not described in our 2020 From 10-K or other filings with the Securities and Exchange Commission. We rely primarily on the management ability of our executive officers and the governance by the members of our Board of Directors, each of whom would be difficult to replace. We do not have any key-person life insurance on our executive officers. Although we have entered into employment agreements with each of our executive officers, these employment agreements contain various termination and resignation rights. If we were to lose the benefit of the experience, efforts and abilities of these executives, without satisfactory replacements, our operating results could suffer. In addition, if any member of our Board of Directors were to resign, we would lose the benefit of such director’s governance expertise and experience, and familiarity with us and the sector within which we operate. As a result of the foregoing, we may be unable to achieve our investment objectives or to pay distributions to our stockholders.
Our recently substantially completed internal investigation into circumstances relating to reports pursuant to our whistleblower policy could result in adverse consequences that would adversely affect our financial condition or results of operations.
We, with the assistance of outside legal counsel, and our board’s audit committee, with the assistance of independent legal counsel, recently substantially completed an internal investigation into circumstances relating to reports pursuant to our whistleblower policy. On November 4, 2021, we filed a Current Report on Form 8-K in which we reported on the results of the internal investigation. Although we concluded that the matters that were the subject of the ongoing investigation have not had a material adverse impact on the Company’s financial condition or results of operations, we cannot exclude the possibility of unanticipated adverse consequences of the internal investigation, including, but not limited to, the possibility that the Securities and Exchange Commission or other governmental authorities or regulators may commence investigations into the facts underlying our internal investigation; the consequences of any such government investigations, including the imposition of civil or criminal penalties; the risk that we may become subject to shareholder lawsuits, the defense of which may be costly; potential reputational harm resulting from the facts underlying the internal investigation; the possibility that executives or other employees may resign or be terminated; the impact of the investigation on historical financial statements; the effect of the internal investigation on our conclusions regarding the effectiveness of our internal control over financial reporting and our disclosure controls and procedures and on our ability to timely file the reports we are required to file with the Securities and Exchange Commission.
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Significant stockholders may attempt to effect changes at our company or acquire control over our company, which could impact the pursuit of business strategies and adversely affect our results of operations and financial condition.
We recently received communications from an investor regarding our governance and strategic direction. Other investors could take steps to involve themselves in our governance and strategic direction. Activist investors may attempt to effect changes in our strategic direction and how we are governed, or to acquire control over the company. Some investors seek to increase short-term stockholder value by advocating corporate actions such as financial restructuring, increased borrowing, special dividends, stock repurchases, or even sales of assets or the entire company. While we welcome varying opinions from all shareholders, activist campaigns that contest or conflict with our strategic direction could have an adverse effect on our results of operations and financial condition as responding to proxy contests and other actions by activist shareholders can disrupt our operations, be costly and time-consuming, and divert the attention of our board and senior management from the pursuit of business strategies. In addition, perceived uncertainties as to our future direction as a result of changes to the composition of our board may lead to the perception of a change in the direction of the business, instability or lack of continuity which may be exploited by our competitors, may cause concern to our current or potential customers, may result in the loss of potential business opportunities and may make it more difficult to attract and retain qualified personnel and business partners. These types of actions could cause significant fluctuations in our stock price based on temporary or speculative market perceptions or other factors that do not necessarily reflect the underlying fundamentals and prospects of our business.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Purchases of Equity Securities by the Issuer and Affiliated Purchasers
During the three months ended September 30, 2021, we repurchased shares of our common stock as follows:
Period
Total Number of
Shares Purchased (1) (2)
Average Price
Paid per Share (1) (2)
Total Number of
Shares Purchased
as Part of
Publicly Announced
Plan or Program
Maximum Approximate Dollar Value of Shares that May Yet be Purchased Under the Plans or Programs
July 1, 2021 to July 31, 2021426 $27.25 — — 
August 1, 2021 to August 31, 2021— — — — 
September 1, 2021 to September 30, 2021— — — — 
(1) Purchases represent shares of common stock withheld by us to satisfy withholding obligations on the vesting of restricted shares. The price paid per share was the then closing price of our common stock on the NYSE.
(2) For each share of common stock redeemed by HTA, HTALP redeems a corresponding number of OP Units in the HTALP operating partnership. Therefore, the OP Units in the HTALP operating partnership repurchased by HTALP are the same as the shares of common stock repurchased by HTA as shown above.

Item 6. Exhibits
The exhibits listed on the Exhibit Index are included, and incorporated by reference, in this Quarterly Report.
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EXHIBIT INDEX
Pursuant to Item 601(a)(2) of Regulation S-K, this Exhibit Index immediately precedes the exhibits.
The following exhibits are included, or incorporated by reference, in this Quarterly Report for the quarter ended September 30, 2021 (and are numbered in accordance with Item 601 of Regulation S-K).
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
1.15
1.16
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1.17
1.18
5.1
10.1†
10.2
10.3
23.1
31.1*
31.2*
31.3*
31.4*
32.1**
32.2**
32.3**
32.4**
101.INS*Inline XBRL Instance Document.
101.SCH*Inline XBRL Taxonomy Extension Schema Document.
101.CAL*Inline XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEF*Inline XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB*Inline XBRL Taxonomy Extension Label Linkbase Document.
101.PRE*Inline XBRL Taxonomy Extension Presentation Linkbase Document.
104Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101).
*Filed herewith.
**Furnished herewith.
Compensatory plan or arrangement.

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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
Healthcare Trust of America, Inc.
By:/s/ Peter N. FossInterim President and Chief Executive Officer
Peter N. Foss(Principal Executive Officer)
Date:November 5, 2021
By:/s/ Robert A. MilliganChief Financial Officer
 Robert A. Milligan(Principal Financial Officer and Principal Accounting Officer)
Date:November 5, 2021
Healthcare Trust of America Holdings, LP
By:Healthcare Trust of America, Inc.,
its General Partner
By:/s/ Peter N. FossInterim President and Chief Executive Officer
Peter N. Foss(Principal Executive Officer)
Date:November 5, 2021
By:/s/ Robert A. MilliganChief Financial Officer
 Robert A. Milligan(Principal Financial Officer and Principal Accounting Officer)
Date:November 5, 2021

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