Since its formation in June 2014 when it was spun out from The Ensign Group as a publicly traded REIT, CareTrust REIT has largely taken part in small one- to three-property acquisitions with prices as small as $6.6 million but never larger than $18 million. Then the REIT surprised us (and others we presume) by announcing a $175 million acquisition of 14 senior care properties, valued at $139,110 per bed/unit. The portfolio, owned and operated by Liberty Nursing Centers, includes 1,102 operating skilled nursing beds and 156 assisted living and independent living units throughout the state of Ohio. Stepping in to operate these facilities will be Indiana-based Pristine Senior Living, which will enter into a triple-net master lease with CareTrust for the portfolio. The lease will carry an initial term of 15 years with two five-year renewal options and CPI-based escalators, with a zero floor and a 3.0% cap. The portfolio should generate initial annual rental revenue to CareTrust of $17.2 million. Also, the seller agreed to transfer two additional Ohio skilled nursing facilities, both of which are leased from unrelated third parties, to Pristine. So why all of a sudden does CareTrust make this big of a move? Being on the small side of the other healthcare REITs, they certainly feel some pressure to grow, lower their cost of capital and diversify from its Ensign holdings. And we wonder whether they are looking at some of the deals that Ensign has consummated already this year—19 acquisitions of some 43 facilities so far in 2015.