CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024
Cash flows from operating activities:
Net loss	$ (264,665)	$ (282,809)
Adjustments to reconcile net loss to cash provided by operating activities:
Depreciation and amortization	199,915	207,449
Net amortization of debt discounts, premiums and issuance costs	66,094	76,642
Payment of accreted interest on senior secured notes	(86,992)	0
Straight line rental income	(759)	(1,605)
Amortization of acquired real estate leases and other intangible assets, net	83	84
Loss on modification or early extinguishment of debt	40,388	209
Impairment of assets	162,708	41,718
(Gain) loss on sale of properties	(103,971)	18,976
Gain on insurance recoveries	(7,522)	0
Other non-cash adjustments, net	(10)	(405)
Unconsolidated joint venture distributions	250	1,231
Equity in net (earnings) losses of investees	(9,652)	9,882
Change in assets and liabilities:
Deferred leasing costs, net	(3,273)	(2,199)
Other assets	(11,173)	2,828
Accrued interest	(10,684)	(258)
Other liabilities	29,755	22,285
Net cash provided by operating activities	492	94,028
Cash flows from investing activities:
Real estate improvements	(114,389)	(134,966)
Proceeds from sale of properties, net	349,382	27,845
Investment in AlerisLife Inc.	0	(15,459)
Equity method investment distributions	48,400	0
Contributions to unconsolidated joint ventures	(8,500)	0
Proceeds from insurance recoveries	1,308	1,698
Purchase of interest rate cap	(47)	0
Net cash provided by (used in) investing activities	276,154	(120,882)
Cash flows from financing activities:
Proceeds from issuance of senior secured notes, net	369,375	0
Proceeds from mortgage notes payable	343,157	120,000
Redemption of senior secured notes	(483,368)	0
Redemption of senior unsecured notes	(380,000)	(60,000)
Repayment of other debt	(2,728)	(2,388)
Early extinguishment of debt settled in cash	(35,804)	0
Payment of debt issuance costs	(19,206)	(8,203)
Repurchase of common shares	(1,063)	(902)
Distributions to shareholders	(7,240)	(7,214)
Net cash (used in) provided by financing activities	(216,877)	41,293
Increase in cash and cash equivalents and restricted cash	59,769	14,439
Cash and cash equivalents and restricted cash at beginning of period	149,854	246,961
Cash and cash equivalents and restricted cash at end of period	$ 209,623	$ 261,400

DIVERSIFIED HEALTHCARE TRUST 10-Q