1、2018Annual Report to ShareholdersHEALTHCARE REALTY ANNUAL REPORT TO SHAREHOLDERS|1Healthcare Realty completed another prosperous year in 2018,centered on the steady growth of our medical office and outpatient facilities.This dependable growth has been cultivated over the past three decades from a st
2、eadfast discipline of owning and operating a distinct portfolio of hospital-centric outpatient facilities affili-ated with respected healthcare providers in strong de-mographic markets.As the healthcare industry evolves to meet rising demand from an aging population,our strategy remains on point,dif
3、ferentiated by our selec-tive investment criteria,low business risk profile and conservative balance sheet.The operational performance of Healthcare Realtys medical office portfolio in 2018 continued to outpace the sector.Same store net operating income(NOI)increased an average of 3%during the year,
4、bolstered by strong leasing fundamentals,including key drivers such as cash leasing spreads,tenant retention,contrac-tual rent increases and expense controls.The steady internal growth of our multi-tenant medical office buildings,year to year,exemplifies our commitment to the pursuit of reliable,lon
5、g-term cash flows and increasing shareholder value.A shift in capital costs during the year altered new investment prospects for most REITs,including Healthcare Realty.We entered 2018 with a healthy balance sheet and a well-positioned portfolio,which allowed us to rely on growth from existing cash f
6、lows and avoid capital issuance.Importantly,in a period of rising capital costs,we deliberately matched asset sales with targeted acquisitions,improving the safety of our portfolio,increasing the potential for higher growth,and holding leverage steady.Healthcare Realtys normalized funds from operati