Tenant Financial Health Declines: The financial stability of NHI's tenants, primarily senior housing operators and skilled nursing facilities, directly impacts its rental income. Deterioration in tenant operating performance or liquidity could lead to rent defaults, lease restructurings, or bankruptcies, significantly reducing NHI's revenue.

Rising Interest Rates Impact Debt Costs: As a real estate investment trust (REIT), NHI utilizes debt to finance property acquisitions and operations. Increases in benchmark interest rates would raise NHI's borrowing costs, potentially compressing its net interest margin and reducing its funds from operations (FFO).

Healthcare Regulatory Changes: The healthcare industry is heavily regulated at federal and state levels. Changes in Medicare/Medicaid reimbursement policies, staffing mandates, licensing requirements, or other healthcare legislation could negatively impact the profitability of NHI's tenants, thereby affecting their ability to pay rent.