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Welltower's value proposition, which connects seniors housing, post-acute, and ambulatory sites of care to dominant, financially strong health systems is being embraced by the broader healthcare delivery sector and truly differentiates us from REIT and other capital sources. A knowledge-based strategy aligned with our proprietary data and analytic capabilities is enabling Welltower to drive hundreds of basis points better relative operating performance from our senior housing assets, even in a challenging new supply and labor environment.

Shankh will go through our operating performance in greater detail, but we are encouraged by our positive results in this part of the cycle. Our strategy has enabled us to attract a next generation of senior housing operators and assets as we have sold or restructured over $8 billion of non-strategic real estate or misaligned legacy operator relationships in the last 24 months.

In a sector that has seen little capital deployed into long-term real estate assets, Welltower has completed approximately $3 billion of high-quality accretive investments and developments year-to-date, and the year is not over. In addition to the $2.2 billion ProMedica joint venture that closed this quarter, today we announced nearly $0.5 billion of new medical office investments, including an expansion of our growing portfolio with the Johns Hopkins Health System and Providence St. Joseph's Health. Keith Konkoli will tell you more about these investments.

John Goodey will take you through our third quarter results. And I hope you will agree that the investments we have made in people and technology as well as having made tough decisions has best positioned Welltower to drive shareholder value as healthcare delivery transitions to lower-cost sites of care that will improve health outcomes, particularly in view of the aging of the population. You'll be hearing more about this at our Investor Day to be held at the St. Regis Hotel in New York City on December 4.

Now over to you, Shankh.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Thank you, Tom, and good morning, everyone. I will now review our quarterly operating results and provide additional details on four topics: number one, show results and trends; two, senior housing triple-net business; three, HCR ManorCare, the ProMedica joint venture; and four, capital deployed in the medical office segment.

We remain confident in our ability to execute at this point in the cycle, especially given our unique data science capabilities and are excited about the path toward further value creation, which I will detail you for here.

In our Q2 call, we told you that we're encouraged by the return of seasonality to our occupancy trends. Our year-over-year occupancy decline went from 200 basis points in Q4 of 2017 to 190 basis points in Q1 of 2018 to 110 basis points last quarter. I'm delighted to inform you that gap is only 10 basis points in Q3, and it's actually up 10 basis points in the month of September.

And perhaps most significantly, we have been able to effectively close the occupancy gap while holding the rate growth for overall portfolio at 2.8% driven by major US markets, which is up 3.2%. This speaks to the exceptional quality of our real estate and our operating partners. We had a strong summer where we saw seasonal strength not seen over last few moving seasons because of the heightened deliveries had absorbed typical seasonal demand.

To provide you some more context, Q3 over Q2 sequential occupancy growth of 80 basis points is the best we have seen since Q3 of 2014. This allowed year-over-year revenue growth of 2.9%, which accelerated for the first time since Q3 of 2014 on a sequential basis. So clearly, we are encouraged by the trends. Having said that, I will caution you not to draw any conclusion from one quarter of numbers, but focus on longer-term trends.

Senior housing is an operating business, and we'll continue to see some volatility as with any other cyclical business. But our extremely diversified portfolio across geographies, operators, product type(ph)and acuity does provide the unique diversification benefit that others cannot even remotely replicate.

The second topic I would like to discuss is our senior housing triple-net leases. Many of you asked whether any lease will survive this cycle and how many leases will be converted into RIDEA structure. Our answer has been and remains that real estate and operator is first and structure second. We continue to believe that in the triple-net structure when a well-aligned lease exists, both operators and Welltower shareholder can make money.

In that context we're delighted to inform you that Brookdale has agreed to renew our SALI master lease for next eight years. As I mentioned in the last quarter, with $28 million of cash rent, this was a biggest exposure in our entire triple-net business. The lease leaves current base rent in place through 1/1/19 at which point rent increases at the contractual amount thereafter. Welltower has opportunity to fund some CapEx on a contractual market return, while Brookdale remains responsible to fund CapEx for the existing terms of the lease after that. We continue -- we think Brookdale which makes money from the lease today will improve performance and will drive even more profitability as it leases off from a cyclically low -- cyclically low occupancy. This renewal effectively eliminates any material lease maturities for Welltower until 2024.

This brings me to another topic and a rhetoric de jour(ph)that if an operator has low EBITDA coverage then they will walk away from a lease. That sounds a lot like the pundits who predicted that anyone with negative equity in the house coming out of the last recession return their keys to the bank. I would like you to at least consider that the operators see their cash flow in terms of EBITDARM not EBITDAR. They consider cyclically low cash flows relative to their long-term potential, have G&A and scale implication to their broader business, and often build great businesses over many years that they wouldn't necessarily want to give up right before a multi-decade silver tsunami. Majority of the business that goes through cyclical lows do not return their keys as this foregoes their ability to participate in the recovery. WELL has the unique platform with many operating partners in all major markets. We have alternating plans for every asset and are happy to execute on those plans if need be. However, we will not put any asset in our SHO portfolio unless we believe they will have superior long-term growth prospects. There are definitely other tools of alignment as we have demonstrated from the SALI example. We can also leverage structuring rights such as rent reset which drove the senior housing triple-net growth this quarter, subordination of PropCo interests or other tools that are available to us.

To the next topic. We're excited about the closing of the HCR ManorCare transaction in Q3. The integration process has started with a great fun(ph)and is on target. The only financial update we want to provide you is that ProMedica and HCR leadership now expects higher synergies than we expected previously. You will hear more about this topic directly from Randy Oostra and Steve Cavanaugh at our Investor Day on December 4. We're encouraged by the green shoots in the skilled nursing industry and already improving occupancy picture throughout the Arden Courts portfolio even before our CapEx program is executed. We continue to believe we'll create extraordinary value for our shareholders in the long term from this transaction, perhaps even more than what we anticipated.

And lastly, we're really pleased to highlight that after a long hiatus, we're in agreements to deploy about $0.5 billion of capital into very accretive medical office transaction and we're confident in some additional off-market transaction in Q4 and Q1. We mentioned to you before that we like medical office business very much, but the pricing of recent trends has not made any economic sense to us, especially given many of these portfolios include as much as 20% to 25% of hospitals, arts, and other assets that command significantly higher cap rates. We have been disciplined and invested all our efforts to build new relationships and expand existing ones, which we believe will bring additional opportunities to deploy capital in the near future.

We're extremely happy to have under contract for approximately $400 million on a very high-quality portfolio of 23 Class-A medical office properties affiliated with major high-quality healthcare systems with an average age of 10 years. Keith, who had a long-standing relationship with the principals, will provide you more details on the portfolio. While we're very encouraged by the going in cap rate and total return of this transaction, we think the IRR would be significantly enhanced by the already identified development opportunities.

In addition to the announced acquisition of high-quality medical office building on the campus of Johns Hopkins Howard County Hospital, we're also delighted to inform you that we have signed a development agreement with Johns Hopkins to develop new complementary sites of care on the land under bridge transaction and three other we currently have with the health system.

Over last two years you've heard from us how we are positioned for cash flow and NAV growth. We trust all our actions this quarter demonstrated to you that we're squarely on the path to capture the next level of value. While we cannot sound all-clear on fundamentals, we're encouraged that the outlook for value creation is getting better.

With that, I'll pass it over to Keith Konkoli, Head of our Outpatient Medical Business. Keith.

Thank you very much, Shankh, and good morning everyone. I appreciate the opportunity to be able to spend a few minutes on our outpatient medical business. I recently joined Welltower, after spending nearly 20 years with Duke Realty. At Duke, I oversaw all facets of the medical office business including development, leasing, asset, and property management until the sale in June of 2017. Having led the very successful accident Duke, I took the time to evaluate the right next opportunity.

Keith Konkoli -- Senior Vice President-Real Estate Services

Thank you very much, Shankh, and good morning everyone. I appreciate the opportunity to be able to spend a few minutes on our Outpatient Medical business.

I recently joined Welltower after spending nearly 20 years with Duke Realty. At Duke, I oversaw all facets of the medical office business, including development, leasing, asset and property management until the sale in June 2017. Having led the very successful exit at Duke, I took the time to evaluate the right next opportunity. It was important to me to join a forward-thinking company and was very intrigued by Welltower's mission to partner with health systems to reduce costs and improve delivery of care across the continuum using creative real estate solutions. I feel fortunate to have the opportunity to be part of this team.

I've spent my 180 days getting to know the portfolio, the team, and the systems that Welltower built over the last 17 years. I'm happy to report that we have a fantastic, high-quality portfolio that is affiliated with some of the best healthcare providers in the country. Naturally, as with any large portfolio, we have work to do, but we have a best-in-class team that can tackle any challenge and have built systems to provide best-in-class service to our tenants and health system providers as we drive growth in our future.

Our team truly understands how to operate a real estate portfolio in a way that balances client satisfaction and value creation. We've built our portfolio by taking a very disciplined approach, sitting on the sidelines when pricing expectations became realistic and stepping up our activity as we find the right, high-quality accretive opportunities. I believe one of the most exciting things about our portfolio is the embedded opportunity. We have been very purposeful in partnering with financially strong, leading health systems that will be the drivers of change in the evolving healthcare environment.

Shankh highlighted some of our recent activity in the outpatient medical space. Specifically he mentioned the 23-property portfolio that we'll be closing shortly. I'm particularly excited about this acquisition as it strengthens our relationship with several of Welltower's existing partners and introduces new partners into our fold. These represent some of the most financially strong, successful, and forward-thinking health systems in the nation, all of whom have a history of partnering with third-party capital. I've had the pleasure of working with all of these systems in my time at Duke Realty and look forward to making the full power of the Welltower platform available to them.

Shankh also mentioned our impending acquisition, adding a fourth building and over 160,000 square feet to our Johns Hopkins affiliated portfolio. This Class-A building is in partnership with one of the nation's leading institutions and an outstanding network of distinguished physicians. In parallel, and Shankh also mentioned this, we recently signed a development agreement with Johns Hopkins Howard County General Hospital, calls for the exploration and development of alternative sites of care focused on meeting the hospital's growing need to care for the aging population. This builds on our existing Johns Hopkins relationship and demonstrates how we are using our platform to help health systems implement their real estate strategy to meet the health and -- the public health and clinical needs of their patient populations. I look forward to talking to you more about these transactions at our Investor Day.

And lastly, I would note that we believe the multiple recent partnerships that we've announced are the precursor to future growth in the segment. Our discussions with the best US health systems continue to advance and the pace of the dialog is increasing. Our partners look to us to help facilitate their broader real estate strategy and make connections with the best-in-class operators in adjacent sectors such as seniors housing and post-acute.

With that I'd like to turn it over to John Goodey who will take us through the financial highlights of the third quarter.

John Goodey -- Executive Vice President-Chief Financial Officer

Thank you, Keith, and good morning, everyone. It's my pleasure to provide you with the financial highlights of our third quarter 2018.

As you have just heard from my colleagues, Q3 has been a successful and very active quarter for Welltower whether it be in investing, portfolio management, or improving our income quality and balance sheet.

This quarter was particularly active in investments completed. In aggregate, we invested $2.2 billion in acquisitions in joint ventures in Q3 at the blended rate of 7.9%. We also placed three development projects into service posting $96 million at a blended stabilized yield of 8.5%. Alongside these, we completed $256 million of dispositions and received $60 million in loan payoffs.

I'd like to expand on Tom's comments as to the continued increase in the quality of our income line. Over the last five years, we have divested $8 million of assets as we refined our portfolio toward future earnings, stability and growth. In that same time period, we have recycled this capital and invested in and developed over $16 million of high-quality assets with financially strong best-in-class partners, often in premium locations such as New York, L.A., London, and Toronto. In addition, we've also significantly reduced our earnings from our loan portfolio.

Welltower, as an organization, continues to improve our operational excellence, and I would like to thank our colleagues that worked judiciously on this everyday. These efforts enabled us to report G&A costs for the quarter was $28.8 million, a continued reduction over prior year levels. Our overall Q3 same-store NOI growth was 1.6% for the quarter, slightly above the midpoint of our full year guidance. All our business segments grew in Q3. Senior housing operations same-store NOI These efforts enabled us to report G&A costs for the quarter of $28.8 million, a continued reduction over prior year levels. Our overall Q3 same-story NOI growth was 1.6% for the quarter, slightly above the midpoint of our full-year guidance. All our business segments grew in Q3.

Seniors Housing operation's same-store NOI grew by 0.3%, and as you heard from Shankh, we are encouraged by the recent occupancy improvements. Seniors Housing triple-net growth was strong at 4.2% with both outpatient, medical, and long-term post-acute growth at 2.1%. Today we're able to report a normalized third quarter 2018 FFO result of $1.04 per share. As in the past, we do not include one-off items such as lease modification or loan repayment fees in our normalized numbers.

Last quarter was also very active for Welltower on the balance sheet and capital front. Our Q3 2018 closing balance sheet position was strong with $191 million of cash and equivalents and $1.7 billion of capacity available under our primary unsecured credit facility. Our leverage metrics were slightly above trends. However, expected dispositions will reduce this number significantly in the coming quarter or two, and I would reiterate that over time our plans sees our leverage returning to levels generally seen prior to the acquisition of QCP.

In July, we closed on a new $3.7 billion unsecured credit facility with improved pricing across both our line of credit and our term loan facility. In August 2018, Welltower successfully placed an aggregate $1.3 billion of senior unsecured notes across five, 10, and 30 year tenants with an average maturity of 15.4 years and a blended yield of 4.4%, again demonstrating our strategy of managing our balance sheet in a long-term, durable way. In addition, during Q3 we raised $232 million through our ATM and DRIP programs at an average price of $66.07 per share.

I would now like to turn to our guidance increase for the full year 2018. We are increasing our normalized FFO range to $4.02 to $4.07 per share from $3.99 to $4.06 per share prior. This is based upon updated current operational performance expectations with the full year 2018 overall expected adjusted same-store NOI guidance range remaining at approximately 1% to 2% and the reduction in anticipated disposition proceeds from $2.4 billion to $2.2 billion at a blended yield of 6% overall in 2018. As usual, our guidance includes only announced acquisitions and includes all dispositions anticipated in 2018. On November 21, 2018, Welltower will pay its 190th consecutive cash dividend of $0.87. This represents a current yield of approximately 5.3%.

With that, I will hand back to Tom for final comments. Tom.

Tom DeRosa -- Chief Executive Officer

Thanks, John. So, as you've heard from Shankh, Keith, and John, broad strategic overhaul that we initiated at the start of 2017 prepared us well to manage the current operating dynamics of the Senior Housing business. So if we're bumping along the bottom of the cycle now, our positive Q3 financial results and improvement in operating metrics should give you some level of comfort. The fact that we've been able to identify approximately $3 billion in new strategic and accretive investments year-to-date demonstrates that we are further well positioned for earnings growth as the cycle turns.

Now, Regina, please open up the line for questions.

Questions and Answers:

Operator

(Operator Instructions). Our first question will come from the line of Steve Sakwa with Evercore ISI. Please go ahead.

Steve Sakwa -- Evercore ISI -- Analyst

Thanks. Good morning, everybody. I guess I wanted to maybe just touch on the senior housing operating platform and kind of, A, your expectations on sort of when that business turns. It sounds like it's picking up. But as you sort of look out, how do you sort of look at the supply picture? And then I don't know if Shankh or Tim, I know the pool changed a little bit this quarter from last quarter, and I'm just trying to see if you could give us a little bit more detail on how some of the maybe changing pool dynamics impacted same-store growth this quarter.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Sure. So Steve, obviously, let's talk about -- you have three questions there. So we'll talk one at a time. First of all, change. If you look at, we don't talk about specific operators. We have very strong same-store policies that you have to wait if there's an operator change, you have to wait for five quarters for assets to come in.

Without getting into the specific details, I think there is some implication you guys think that we have restructured our other relationship and that's driving same-store. I would point out that if you go to the last quarter's call, Tim walked you through how the decline on those pools that we have changed actually hurt our earnings. The second point I would point out that if you look at page three of the supplemental and look at the total occupancy growth of the international business, you will see that there was a 100 basis points of occupancy increase. For same-store, it's only 80 basis points. So that tells you it's a broad-based strength we have seen, and obviously it's a $1 billion business for us. So five assets going in and out really doesn't change the fact. But I'm trying to look -- point you to the page three of the supplemental where you see overall our SHO business and you will see there has been more increase relative to the same-store.

And going back people to 2019 supply question, this is a very broad topic and probably not suited for this call. We have a Investor Day coming up. We can tell you we will have a very detailed discussion about this particular topic. I wanted to tell you how we see supply. It is just not market level supply. We have a data science team that is very, very granular. We have built a metric called ACU, which is adjusted competition unit, which is based on not only the number of supply but also the covariance of different products, drive time, exponential decay of drive time, and other mission-learning algorithms into it. We have very specific view of how many of the new supply will impact the property or the shock(ph)factor. We'll walk you through at the same-store all those details at our Investor Day. Needless to say that you are hearing that we're encouraged about the outlook. We're not necessarily saying and we're calling for a bottom in any industry, but we're definitely encouraged by the outlook, and we'll have a more broader discussion about this topic on our Investor Day.

Operator

Our next question will come from the line of Juan Sanabria with Bank of America. Please go ahead.

Juan Sanabria -- Bank of America Merrill Lynch -- Analyst

Hi, just maybe a broader question for Tom. You kind of highlighted that you see yourself different versus all the other REITs out there. Do you consider yourself a REIT? And if not, what's the key difference?

Tom DeRosa -- Chief Executive Officer

I consider the company a healthcare delivery platform that's very real estate heavy. REIT is not an industry, it's a tax election. And because we are a very property-heavy company, it makes sense for us to elect REIT tax status. So I don't think I have that much in common with other REITs in other sectors, because they invest in different property types. We invested in healthcare assets. But our business model is much more than buying and managing real estate assets. In a fund-like operating structure, we are intimately involved in the operations of this business, whether it be our senior housing business, whether it be our medical office business. But I would remind you that REIT is not an industry. It's a tax election.

Juan Sanabria -- Bank of America Merrill Lynch -- Analyst

Got it. Thank you for that clarification. And just on the FFO guidance, are you including the MOB acquisitions that are scheduled to close in the fourth quarter? And what was the cap rate on those acquisitions, that $400 million portfolio?

Tom DeRosa -- Chief Executive Officer

Now I'll touch on the FFO aspect of it and Shankh can comment -- or Keith on the actual transaction. There is no impact from the acquisitions. From a modeling standpoint you should consider them occurring at the end of the year and having no material impact on '18 numbers.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

On the cap rate, we have told you several times that we are not a cap rate buyer or a cap seller. We're a total return buyer and total return seller. I'm not going to talk about the cap rate because the deal hasn't closed, and we have confidentiality agreement with the seller, but we will tell you that we said that we do not believe that there -- it makes any sense to buy real estate less than 7% unlevered IRR, and we believe that will hit 7% unlevered IRR in this particular portfolio.

Juan Sanabria -- Bank of America Merrill Lynch -- Analyst

Thank you.

Operator

Your next question will come from the line of Vikram Malhotra with Morgan Stanley. Please go ahead.

Vikram Malhotra -- Morgan Stanley -- Analyst

Thanks for taking the question. Shankh, just to clarify on the SALI leaves. Can you just clarify was there any cut to rent, any restructuring to the bump? And when you said the CapEx investment, is that sort of a -- is that sort of like a 7% market return?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So the Brookdale is right now in a quiet period, so it's very hard for us to just talk about specifics. And we're very -- we don't want to -- as a operating partner wouldn't want to get into that. I had mentioned on the call and -- once Brookdale is through their quiet period, I'm happy to walk you through all those. I think your market return comments that you've seen in other restructuring with Brookdale is pretty much spot on. You might be -- you are in that zip code, but you might be too low.

The second question is, I already mentioned. The rent is the same as it is. (inaudible) changed and is slightly higher, but I just don't want to talk about that on the call. Once Brookdale goes through it's quiet period, we're happy to answer any questions. The whole discussion is what I want you to focus on is even at that level, we mentioned that Brookdale actually makes money. In any triple-net relationship or even in our idea, the focus of Welltower is not to grab all the economics we can but have a healthy, thriving operator where they can make money and we can make money. Here Brookdale makes money as we are sitting at a cyclically low occupancy, and as they lease up these buildings, we think they will make significantly more money, which is always good for us.

Vikram Malhotra -- Morgan Stanley -- Analyst

Okay, great. And then just to clarify on the senior housing side. I know it's tough to call '19 if it's a turn or not. Certainly, the results are encouraging. But I want to maybe focus on the expense side. The comps were very hard. I think last year you had a 0.8% increase year-over-year in expenses and the expenses sort of get easier, but can you just walk us through how you think about the structure today going into '19, like are there other levers you can pull to control other parts of the expenses assuming labor continues to be a headwind?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So labor continues to be a headwind. I'm glad that you actually noticed that we had a very, very tough comp. Q3 of 2017 were a 4.1% NOI increase on back of a very low expense comp. Obviously, the expense growth this year is not just a factor of expense this year but also a factor of what happened Q3 of last year. And so that is absolutely the right observation. With that Mercedes will add some comments on how we think about expenses, but we think that headwind continues.

Mercedes Kerr -- Executive Vice President-Business & Relationship Management

We've often talked about the initiatives that we have undertaken at Welltower to try to bring expense savings to our operators, and we're doubling down on some of those efforts. I think top of our mind right now is labor. It's something that is impacting a lot of industries naturally, and certainly in seniors housing which is such a labor intensive business. So we're very focused on trying to bring efficiencies to our operators and trying to help them with our scale.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Just to add one point, I just want you to understand the big part of minimum wage increases have been flowing through our numbers. San Francisco went to $15 this year. That's flowing through the numbers. So from here on, you will see more of a inflationary increase. LA will hit $15 next summer. So you do have this, but I will say looking at a more medium to long term, a lot of the minimum wage $15 driven growth had been flowing through our numbers for next four, five years. We feel encouraged about the long-term, but we're obviously as Mercedes said, we're managing in the near term.

Vikram Malhotra -- Morgan Stanley -- Analyst

Okay, great. Thank you.

Operator

Our next question comes from the line of Steve Valiquette with Barclays. Please go ahead.

Steve Valiquette -- Barclays -- Analyst

Thanks. Good morning, everyone. Congrats on the results. So there was an announcement in the industry during the quarter about this additional $3 billion of senior housing development in various urban centers in the US. It wasn't a huge number in the grand scheme of things, but the headlines just seemed to draw some attention. And I guess from your perspective, I'm just curious if that's sort of activity was already contemplated in your development plans when thinking about your focus on urban markets in particular over the next several years. Just want to get your thoughts around the -- kind of the competitor development announcements that are being made. Thanks.

Tom DeRosa -- Chief Executive Officer

Thanks, Steve. I think that announcement by (inaudible) clearly validates a thesis that we've been articulating for a few years -- have been at for a few years. I think there is demand for a next generation of senior living product in major metro areas. You take a city like New York, which is made up of many villages that are densely populated that have an aging population, there's room for lots of senior housing property to be brought to this market. But I would -- I would say it's a next-gen product. I don't see any of the product in a market like New York today being sufficient to meet the needs of the upper end of this population. I'm going to tell you I've dealt with it myself personally, and there really are no options on the island of Manhattan today. The first viable option will be what we will open in end of 2019, early '20, and on our Investor Day you're actually going to have a chance to go into that building. It's coming out of the ground. So in summary, Steve, I'd say that we have a number of plans to bring that type of asset into the major metro centers. So stay tuned.

Steve Valiquette -- Barclays -- Analyst

Okay. That's helpful color. Thanks.

Operator

Your next question comes from the line of Jonathan Hughes with Raymond James. Please go ahead.

Jonathan Hughes -- Raymond James -- Analyst

Hey, good morning. Thanks for the time. I'll skip the SHOP question. It sounds like you'll address those in December. But this past summer, I recall you saying getting excited about maybe buying more senior housing assets. Shankh, I know you don't focus on cap rates, but could you maybe talk about where potential deals or marketed deals, senior housing deals out there are being priced? What sellers are asking as compared to your replacement cost analysis or your 7% required IRR thresholds?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So from our perspective, look, we're product agnostic, as I mentioned. Obviously different products requires different level of risk-adjusted return. So I don't want you to think that a 7% is a hard and fast number. We talked about 7% in terms of minimum return required for investing capital.

Having said that, the senior housing market is a very, very robust market. We're seeing a lot of participants are coming in, lot of core capital is being priced. So obviously if you think about the auction tent(ph), they're very densely populated and the risk of the prices are very high. If you look at our investment philosophy and we give you these numbers on our supplemental quarter after quarter after quarter. We are not in those auction tents(ph). We have a relationship-based investment strategy. We almost pretty much 80% to 100% of what(ph)acquisition comes from our existing relationships. We are not in those auction tents(ph), but they're very densely populated and we see cap rates in the levels that we can make sense, but we're very disciplined capital allocator. So when it will make sense, we'll be there.

Mercedes Kerr -- Executive Vice President-Business & Relationship Management

Yeah, Shankh, and I would -- this is Mercedes. I would add one more comment, and that is I think for the first time really we're starting to see a real distinction between Class-A and Class-B assets in seniors housing in terms of cap rates, and that capital that Shankh talked about really very interested in that Class-A quality, which is I think generally what makes up the Welltower portfolio. But -- so we're happy to be sitting on the assets that we have and that we bought them perhaps on that distinction in cap rate wasn't as pronounced as it is today.

Jonathan Hughes -- Raymond James -- Analyst

Got it. And then just one more for me, and I know I asked this last quarter, but what's the trend on new and renewal leasing spreads within SHOP? I know it's stable in the low-single digit range on an overall basis, but maybe what are you seeing on new versus expiring and adjusting for acuity if that's at all possible. Thanks.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So that is such a broad swath of numbers across so many operators, it's very hard to predict. It's dependent on, as you said, operators' acuity as well as location. We're seeing significant positive spread to negative spread, right. So it's just -- it's very hard to generalize that comment. It is sort of a distribution that has no midpoint point that I can talk about. So I'll just stay away from it. I just want you to look at the revenue growth. And if you're looking for more of a median outcome, that revenue growth picture that we give to you should tell you where it's going to play out.

Jonathan Hughes -- Raymond James -- Analyst

Okay. I'll jump off. Thanks for the time.

Tom DeRosa -- Chief Executive Officer

Thanks.

Operator

Our next question comes from the line of Rich Anderson with Mizuho Securities. Please go ahead.

Rich Anderson -- Mizuho Securities -- Analyst

Thanks, good morning. So, yeah, I'm aware there are certain things you want us to focus on, but if you'll forgive me, I'd like to ask a couple questions that I'm focused on. On the cap rate question on medical office, you give a cap rate for the Johns Hopkins one, not a cap rate for the larger $400 million transaction. Is that something that the seller is requesting? Is the actual number below or above the 4.9% that you're willing to provide in the Johns Hopkins? Can you just sort of frame it a little bit for us?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So we have a confi with the seller that we can't disclose it before the deal closes, but it's above to answer your question specifically. It is not that hard to think about what drives and IRR. We're already telling you that's a very well leased portfolio. You know what the bump generally looks like. So if I'm telling you that we can solve for an unlevered 7%, that gives you a general number. We'll give you the number next quarter once the deal is closed.

Rich Anderson -- Mizuho Securities -- Analyst

That's -- that's good enough. Perfectly good answer. Thank you for that. On the Brookdale assets pulled out of the same-store pool, I know you're not -- you have your reasons for taking them out. HCP discloses how those transitioned assets have performed, including into their same-store. Could you say if those transactions assets without putting numbers around them or sort of dialing down performance as the transitions are under way, or are they held up relatively well over the transition process?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Yeah. So we talked about -- obviously we have a same store policy that an asset that obviously needs to wait for five quarters when this kind of transition happens, etc. However, Tim walked you through last quarter what is the implication of that decline in cash flow in those assets, which I was trying to allude to you. So you have those numbers. They're just in the last transcript.

Rich Anderson -- Mizuho Securities -- Analyst

All right, I'll take a look. Tom, question for you. You have your team in place now for your process or so since you took over as CEO. I'm wondering if you can comment at all on succession. Is that -- is that sort of -- I assume a process that's very much structured within the four walls of Welltower. Any comment you can give on that would be great.

Tom DeRosa -- Chief Executive Officer

Well, we don't comment on succession. Are you suggesting that it's time for me to go?

Rich Anderson -- Mizuho Securities -- Analyst

Not -- I've had such a great response, but I'll let you talk it.

Tom DeRosa -- Chief Executive Officer

I'd love to hear you. No, Rich, so we have a deep, young, diverse, energized bench of people here that I would stack up against any company that is structured like ours. The last thing I would tell you, hand over my heart, you should be worried about the depth of management at Welltower. This is a tremendous team and I'd invite you to spend some time in with us, whether it's in our offices in Toledo or whether it's our offices here in New York or in LA or in London, and I think you'll be very pleasantly surprised.

Rich Anderson -- Mizuho Securities -- Analyst

Okay. I'm sure I would. And then last question. You adjust your FFO range, but you don't adjust your sort of individual same-store ranges. Obviously you're not going to get to 1.5% on the SHOP original guidance at the top end. Any reason for that? You're in the range and so you just leave those ranges alone? Or is there some sort of some possibility you can produce a massive number in the fourth quarter to make the top end of the SHOP range reasonable to still be out there?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So we talked about -- this is probably the fourth year we're talking about this that we do not change individual ranges through the year. And so we're not going to make -- the problem of doing that once you create that precedent, then people keep doing -- asking that question. We think about our portfolio as overall portfolio, that is overall a cash flow that you should think about. And what you're hearing from us that we're excited about the cash flow growth, we don't predict quarter-to-quarter numbers, but we expect fourth quarter will be better than three quarters you have seen in the SHOP business.

Rich Anderson -- Mizuho Securities -- Analyst

Okay, fair enough. Thank you.

Operator

Your next question comes from the line of Karin Ford with MUFG Securities. Please go ahead.

Karin Ford -- MUFG Securities -- Analyst

Hi, good morning. Tom, just wanted to ask you if you see any potential implications of the mid-term elections on your business. There's word out there that Congress may try to take another crack at Obamacare. How are you feeling about the political environment today?

Tom DeRosa -- Chief Executive Officer

Gosh, really that's some question, Karin. I really don't want to get into politics. I do think though this -- the questions about the midterm elections are clouding so many things across our business and every business right now, Karin. I mean I can't predict what's going to happen. But what I do believe is that we will continue to see Washington try to reduce the cost of healthcare and that is by moving healthcare to lower-cost settings and doing -- and really making it a mandate to drive better outcomes. It's not just about cutting costs, but how do we improve the health and wellness. And I -- and I underscore the word wellness, because Washington is starting to wake up that our healthcare system shouldn't just wait for someone to be sick and show up in the emergency room. We need to prevent people from actually ever coming to the emergency room. So whether they're the Democrats are in power or whether it's the Republicans, I'd like to think we still live in a world, and I question that every day, that sanity will prevail. That's the best answer I can give you, Karin. I'd like to talk about it after the elections.

Karin Ford -- MUFG Securities -- Analyst

Appreciate that very much. Thanks. My second question is just on the senior housing triple-net portfolio. It looked like EBITDAR coverage sequentially upticked a basis point. Is that solely due to the Brandywine and the Brookdale restructuring? Or do you think it could mark an inflection for future senior housing coverage trends?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So I think I went through a very long discussions of why -- how you guys should think about, at least consider that the EBITDARM coverage is as important if not more important than the EBITDAR coverage. We do think the business in the -- like our SHOP business, the occupancy levels in the triple-net business is very low relative to the long-term potential. So obviously as those occupancies go up, the coverage will improve. And so that's only I can tell you. I'm not going to sit here and predict quarter-to-quarter coverage, because it just depends on so many things that come in and out and -- but we're not focused on a number. We're focused on driving profitability for us as well as our operating partners.

Karin Ford -- MUFG Securities -- Analyst

Okay, thank you.

Operator

Your next question comes from the line of Smedes Rose with Citi. Please go ahead.

Smedes Rose -- Citi -- Analyst

Hi, thanks. I wanted to ask a little bit more, and I'm sorry I might have missed some of your comments just on the Johns Hopkins relationship. And is your agreement with them I guess exclusive to build these alternate care sites? And could you maybe just talk a little bit about what that -- what those are exactly and what sort of returns or development yields you would be looking for those and how much capital you'd be investing to develop those?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So alternative sites of care, we mean all sorts of our business that you have seen. It could be in medical office, it could be a seniors housing, it could be a post-acute type. How much capital, again we don't sit here and predict how much capital, at what rates. We only deploy capital if we can make money and we can obviously enhance the strategic merits of our partners as well as our goal to increase our energy and our cash flow. Mark, do you want to add something to this.

Mark Shaver -- Senior Vice President-Strategy

Yes. Smedes, thank you for the questions, Mark Shaver. The acquisition of the Medical Pavilion gives us four assets with Hopkins Howard County in that geographic market including, if you recall, we have a 30-acre campus that we acquired in 2015 that has two buildings. And so as Hopkins, like many other leading systems are looking to move care out of the hospital into the community, there's specific incentives that Hopkins has to drive care in lower cost settings. As Shankh said, we're working, early days in terms of identifying and developing which sites of care we can develop with them, either on their campus at Howard County General or our 30-acre Knoll North Campus. So there's more to come with that, but it's all reflective to Tom's comments of health systems needing to continue to develop alternative sites of care at lower cost.

Smedes Rose -- Citi -- Analyst

Okay, thanks. And then I just -- I mean I'd be interested in your comments around ProMedica with their ratings from the agencies being downgraded after your announced venture with them. Because a big part of the second quarter call was talking about the A-rate credit and just how do you think about them now or just do you feel like your rents are structured such that it's not -- it's less of a concern or just sort of any thoughts around that?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

So we talked about if you go back and see that it isn't -- we talked about investment grade credit and mostly what we talked about is where the claim -- the rent claim sits in the capital structure. We have obviously a great system and we have the corporate guarantee. We don't specifically talk about ProMedica's ratings. ProMedica's bonds publicly trade. You can go and look at what that had an impact or not on those bonds. But the only thing I would tell you that eventually ratings will be driven by cash flow. And if you listen to my comments, you will see that I mentioned we would expect higher-than-anticipated synergy or discussed synergies. That would mean to obviously if you think through that that would mean higher level of cash flow. And as ratings follow cash flow, you can come to your own conclusion. But because ProMedica's bonds trade in the public market, we're not going to sit here and talk about specifically about that.

Michael Billerman -- Citi -- Analyst

Hey, Shankh, it's Michael Billerman speaking. Just as you think about the initial yield versus you talked about underwriting everything at a minimum of 7% IRR. How does like the John Hopkins outpatient medical building where you go in at a 4.9% have -- what's the underwriting to get to a 7% unleveraged IRR? How should we be thinking about what you're putting in there for an asset that's 100% leased I assume under a long-term lease?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Yeah. So you're correct about the lease. We will not get the 7% unlevered IRRs if we buy an asset that's 4.93% cap rate, which it is. But this is why I said you look at the development agreement we signed. This building sits right next to our Charter(ph)building that has 5 acres of land. This particular building has 10 acres of land. And we told you we just signed a development agreement with them. So do we think we'll get to 7% or higher IRR from the whole relationship? We do. That's what we are focused on.

Michael Billerman -- Citi -- Analyst

So it's not in each individual transaction. It's a holistic view about what benefits, making a strategic investment at a low yield on one hand, what benefits you may get on the other.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

I want you to think about this as a covered land play. So we have -- if you bought just land, obviously that is a negative NOI because you have to pay taxes and utilities and all those things. This is a covered land play. So you're obviously getting pretty decent income. We've bought these assets. These are absolute Class-A assets where we wanted the best system at higher cap rate than majority of the transactions you have seen. But we're still not satisfied with that. And we are going to get to our required return using the development and sort of discuss the land aspect of the deal, and the fact that it sits right next to our Charter building.

Michael Billerman -- Citi -- Analyst

And on HCR ManorCare, I'm pretty sure that when you announced the deal on ProMedica, Tom, you told us we shouldn't look at this as a skilled nursing deal. We have to look at this as a A-rated health system deal. So while I know you don't--

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Investment grade--

Tom DeRosa -- Chief Executive Officer

Yeah. We said investment grade and we told you, in fact when we had the group here in our offices that we expected that they could be downgraded to BBB plus, and they were downgraded to BBB plus by Fitch and Moody's. S&P took them to BBB.

Michael Billerman -- Citi -- Analyst

Okay. Thank you.

Operator

Our next question will come from the line of Todd Stender with Wells Fargo. Please go ahead.

Todd Stender -- Wells Fargo -- Analyst

Hi, thanks. Just shifting to dispositions. The guidance implies $800 million in Q4, but the cap rate would be in the mid-4% range, unless that's being dragged down by some other non-yielding properties. I wondered if you could just go through maybe the Q4 stuff.

Tom DeRosa -- Chief Executive Officer

Yeah. Todd, you're correct. So it's got -- of the total $750 million in assets to be sold and in the fourth quarter about $225 million are non-yielding and the remaining have 6.4% yield on them. So it's about $520 million of normal course dispositions at a 6.4% yield and then $225 million and zero yield.

Todd Stender -- Wells Fargo -- Analyst

Is it more QCP stuff or what's in that stuff?

Tom DeRosa -- Chief Executive Officer

The zero yield?

Todd Stender -- Wells Fargo -- Analyst

Yeah.

Tim McHugh -- Senior Vice President-Corporate Finance

Yeah. So just going back to the original transaction when we closed on it, there was -- going back to when QCP was in its early restructuring with ManorCare, they designated about $500 million in assets as to be sold. ManorCare stop paying rent on those, and all the proceeds from sale would go to QCP. So we essentially -- that agreement came to us when we bought the portfolio. So, at the time of the -- of closing we disclosed we had a little less than $400 million of these remaining, and we sold about $170 million of them during the third quarter and we've got $220 million remaining.

Todd Stender -- Wells Fargo -- Analyst

Got it. Thank you, Tim. And then just shifting gears, the MOB portfolio deal you have under contract, is that something you've had under contract for a while? You needed your cost of equity to improve? Or did this come along recently? We just haven't seen that many portfolio deals this calendar year. Maybe you could just go through how long you've been eyeing that.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Obviously, we did not wait for our equity to come back. That's not how a real transaction works. If you think about, we mentioned that Keith has a long-standing relationship with obviously the principals of the farms(ph)who joined the portfolio, and I don't think at this point I can say much more than that. When the deal closes, we're happy to walk you through. But this is a normal deal going through a normal sort of channel. When you first bid, then you go through due diligence, then it takes time for the documentation, and a PSA or NPSA, and then it takes time to close. I mean that's just the way it is. No different for this particular portfolio.

Todd Stender -- Wells Fargo -- Analyst

Thank you, Shankh.

Operator

Your next question comes from the line of Lukas Hartwich with Green Street Advisors. Please go ahead.

Lukas Hartwich -- Green Street Advisors -- Analyst

Thanks. Good morning, guys. Post-acute coverage is still at market, but it has come down a decent amount last couple quarters. I was just hoping you could provide some color around that?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Yeah. Lukas, as you know we have handful of LTAC assets left and that obviously there's a lot going on in that business. So they drove significantly that coverage down. The coverage for -- EBITDAR coverage for assets is still at 1.7%, 1.8% level. So we're not worry about that. But the change is primarily driven by that.

Lukas Hartwich -- Green Street Advisors -- Analyst

Perfect. Thank you.

Operator

Your next question comes from the line of Jordan Sadler with KeyBanc Capital Markets. Please go ahead.

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Thank you. Good morning. Just wanted to touch on balance sheet. I think your leverage, net debt-to-EBITDA ticked up to about 6x. I'm curious, I would imagine it's going to come down a little bit by year-end as a result of the sales you have teed up. But can you maybe just refresh us on sort of what leverage targets might look like as we look forward and what you're thinking on leverage and balance sheet in the current environment?

Tom DeRosa -- Chief Executive Officer

Yeah. Jordan I'll start that and then John can comment on the strategic side. The 5.98x that we printed this quarter that EBITDA can get a little skewed by timing and transactions, so I'm glad you asked that because we -- for 25 days of the quarter, we didn't have ProMedica or the entire QCP transaction on cash flow. The way we present that to EBITDA is an annualization of the quarter, since essentially it's just a simple times four.

The 25 days of additional income we'll get in the fourth quarter brings down that leverage 0.17x. It comes down to 5.81x and then the remaining $225 million of QCP non-yielding assets which essentially is a liquidation, right. There's no EBITDA, and so it's just going to be cash. It's going to bring it down another 0.1 of a turn.

So our run rate leverage right now it's reflected in our kind of 3Q earnings, and then in fact it's a little bit of drag from those non-yielding but it is 5.71x. So it's not as much of a gap when you think about -- when we talked about kind of mid-5.6x being the pro forma leverage. We're almost there right now.

John Goodey -- Executive Vice President-Chief Financial Officer

Yeah, I was going to reinforce, Jordan, that we're nearly or very close to where we said the pro forma would be when we announced the QCP acquisition. You heard in my prepared remarks that overall we see our trajectory over time going back to levels generally in the order that we saw prior to the acquisition. I'd note, obviously last quarter we were at 5.4x times leverage. So that gives you some guidance to what we contextualize as sort of normal course.

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Okay. And then just a follow-up on QCP. I noticed I'm just trying to piece the numbers together a little bit. I think in the original presentation you had 74 non-core assets to be sold prior to year-end for $475 million. I would imagine, maybe a couple of those probably closed before you guys got the deal done. But I'm just -- you guys sold 19 in the quarter. I think you have 40 teed up. That would be 59. So there's -- that's a difference of about 15 assets, 16 assets. And then you guys sold some non-core QCP assets. I'm just curious will there be additional non-core sales from the QCP portfolio to come?

Tom DeRosa -- Chief Executive Officer

No, Jordan, we don't expect that at this time. We've sold -- so in the quarter, we sold a post-acute portfolio. We'll sell another building in fourth quarter. That's in our guidance. And between those two assets, of the $28 million of non-ProMedica NOI that came with the QCP portfolio that's roughly half of it. So there's very little left of non-ProMedica income from that transaction, and we expect to keep the rest of it for the foreseeable future.

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Okay, thanks.

Operator

Your next question comes from the line of Chad Vanacore with Stifel. Please go ahead.

Chad Vanacore -- Stifel -- Analyst

Hi, good morning. So I was just wondering why the reduced guidance expectations by $200 million? Is that a change in what you consider non-core? Is that merely timing and we'll see some dispositions pushed into 2019?

Tim McHugh -- Senior Vice President-Corporate Finance

Yeah, that's a great question, Chad. That's merely timing. We just wanted to give -- what we wanted in our guidance was what we expect to close in the year-end or early '19. And from an earnings standpoint, I just want to make the point that we raised more than $225 million of equity in the quarter that wasn't in our initial guidance. So from an accretion or dilution perspective of moving those off of our dispositions, we're still actually in a net dilution perspective from the equity raise versus pushing out of dispositions. So that not in our -- in short, that was not accretive to our guidance.

Chad Vanacore -- Stifel -- Analyst

All right. Thanks, Tim. And then just thinking about guidance, increased CapEx assumptions by about $6 million in FY '18, how much of that is Brandywine conversion versus the MOB acquisitions they've made and then what's a good run rate given the increase in operating assets that you have?

Tim McHugh -- Senior Vice President-Corporate Finance

Yeah. I think on the -- I'll just comment on your observation on the 2018. We actually -- some of that is outpatient related, not tied to the properties we're talking about acquiring. We moved forward some projects that were going to be occurring in '19 into 2018 that made up give or take around $3 million of that. And then about a $1 million of it was tied to -- or they had conversions and just some extra projects than we got in '18.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

And I will answer the second part of your question. As you think about CapEx, just think through there are two abnormal items in our CapEx: one is the vintage related CapEx spends. Call it about $55 million flowing through our numbers; and then is the four Sunrise buildings we bought from SNH. You'll recall what we said we bought those assets at and what SNH said they sold the assets, those same assets add to the $25 million difference and that is the $25 million CapEx that we talked about. These are the two abnormal numbers that are flowing through this year and sort of first half of next year. So that will significantly negate the CapEx required due to the increase of our SHO as a percent of our portfolio.

Chad Vanacore -- Stifel -- Analyst

All right. Well, then, Shankh, if we think about this quarter, is that a fairly good run rate for CapEx or should we expect that to go up or down--

Shankh Mitra -- Executive Vice President-Chief Investment Officer

No, it's not, because the whole vintage situation is still playing through. The Sunrise situation is starting to play through. So you're going to get eventually probably 2020 will be a better sort of 15 run rate. But I'm hopeful maybe toward the end of 2019 it starts to happen. So we have elevated CapEx because of those two transactions. It's a very large number relative to our overall CapEx budget.

Chad Vanacore -- Stifel -- Analyst

All right. Then just one quick update on the Brookdale repositioning. You had about 60 assets or so. Have you transitioned any of those assets at this point, or is the whole portfolio left to be done?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

No, it's in the process, as we talked about, like obviously license transfer takes time, and particularly in California and Washington, they're all in process. They're actually teed up to close in next -- some of them have closed and some of them are teed up to close in call it next 90 to 120 days. They're exactly on plan and we're very encouraged that our future operators of those assets are working very collaboratively with Brookdale. And we have been able to retain a lot of the staff. So we're very encouraged. It's still early to comment. But we're very -- we're grateful for the support Brookdale has provided us. We're also very encouraged by the new operators who are getting involved in the transaction and the process.

Chad Vanacore -- Stifel -- Analyst

Is it fair to think that we won't see any impact in the fourth quarter? It's really a 2019 impact.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

You are seeing the impact. It's flowing through earnings, right. There is no impact on the same-store because those assets will not even be in same-store--

Chad Vanacore -- Stifel -- Analyst

I'm not talking about the same-store. I'm talking about the whole portfolio.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

And if you're talking about earnings, then yes you are seeing that dragging down earnings. And Tim walked you through the quantum of every one of them last quarter.

Chad Vanacore -- Stifel -- Analyst

All right, thanks.

Operator

Your next question comes from the line of Michael Carroll with RBC Capital Markets. Please go ahead.

Michael Carroll -- RBC Capital Markets -- Analyst

Yeah, thanks. Shankh, I wanted to touch on your prepared remarks regarding QCP. I believe you said that you saw occupancy pickup sooner than you expected without the CapEx being invested within that portfolio. Can you kind of quantify the occupancy pickup and the reasons why you think that trended higher?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

I specifically talked about Arden Courts, which is the memory care business. Remember that we bought 150 skilled nursing assets or post-acute assets and 55 Arden Courts assets. My comment was very specific to Arden Courts, which as you know we talked about that we'll go through -- and obviously both sides of the business will get significant CapEx.

My comment specifically is we have seen occupancy increase in the Arden Courts business. It's too early to comment, how much why that happened. But it is not very hard to imagine why that happened, right. You are seeing across the board in the senior housing spectrum. I mean look at our entire RIDEA portfolio. It's a $1 billion plus business. It's almost high 550, 600 assets. That sort of gives you a sense of the industry, obviously high quality end of the industry, but there is occupancy growth.

So we have seen a lot of the seasonal patterns of the business has been really eaten up by new deliveries. As deliveries are starting to come down, the impact obviously is getting on the margin better.

Michael Carroll -- RBC Capital Markets -- Analyst

Okay, great. And then you also mentioned that you expect to see stronger synergies than you thought previously. Can you highlight what those synergies are?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

I walked you through all the different aspects of the synergy two quarters ago and as I mentioned that, Randy and Steve will be on our Investor Day, and they will talk about this particular topic. I don't think it's appropriate for me to get through a blow-by-blow. Their bonds are public bonds. I don't want to talk about it, but we expect better number across the board in all those synergies, and perhaps one or two new categories of synergies.

Michael Carroll -- RBC Capital Markets -- Analyst

Okay, great. Thank you.

Operator

Your next question comes from the line of Mike Mueller with JPMorgan. Please go ahead.

Analyst -- -- Analyst

Thanks. This is Sarah from JPMorgan on the line for Mike. So question, your development pipeline today is about 70% senior housing and 30% office. Do you see that mix changing materially over the next two to five years?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

It's opportunity driven, Sarah. I mean we are not trying to target a mix. It's purely driven by opportunity. So I would not look for any trends quarter to quarter because it's purely deal driven and opportunity driven, so no. We're very, very focused on developments on both sides of our business. It's just whatever comes into a quarter, how big the size of that billing that matters. So I will not look for a trend or think there is any specific way or toward the number that we're trying to steer it.

Analyst -- -- Analyst

Okay, thank you.

Operator

Your next question comes from the line of Daniel Bernstein with Capital One. Please go ahead.

Daniel Bernstein -- Capital One -- Analyst

Hey, good morning. Just wanted to see if you could talk a little bit more about the earlier comment of the alignment of interest in a triple-net lease and maybe go into that a little bit more. And in the context of coming out of NIC, we didn't really hear too much in the way of enthusiasm from operators for triple-net lease. So maybe you could comment about what you're seeing out there in terms of the inclination of operators who want to lease versus RIDEA?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Danny, you didn't attend my panel. I talked about that for an hour.

Daniel Bernstein -- Capital One -- Analyst

Yeah, you know I did miss your panel. I heard about it, but I just--

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Okay. So -- now I really know. I'm honest. So look at the end of the day I think there's too much focus on whether it's RIDEA, it's triple-net, and how different tools. Idea is very simple. We need our operators to be making money. We want the thriving operators. At the end of the day, I want you to understand this is people business, right. We want our operators to invest in their people, in their system, and that enhances the value of a real estate.

So whether we can do that in a Welltower lease, whether we can do that with other alignment features, I think I mentioned additional four in the call already, so I'm not going to repeat myself, or we do a pure equity transaction called RIDEA that's a moot point, OK.

So we want -- at the end of the day what we want you to know that we are very, very focused. We think it's an operating business under the senior housing -- obviously senior housing operating sign, and we want our operators to do very well. And we think that enhances the value of our real estate, and we think there are several ways to get there. That's just not only one path.

Tom DeRosa -- Chief Executive Officer

So look then, at the end of the day, I think there is too much focus on, but there's an idea that should be met and how different tools, idea is very simple. We need our operators to be making money, we wanted thriving operators. At the end of the day, I wanted to understand this is people business, right? We want our operators to invest in the people in the assistant and that enhances the value of real estate.

So whether we can do that in a well-covered lease, we then can do that with other alignment features. I think I mentioned additional 4 in the call already. So I'm not going to repeat myself, or we do a pure equity transaction call idea as a moved point, right?

So we want, at the end of the day what we wanted to know that we are very, very focused, we think it's an operating business and the obviously seen how is been operating side and we want our operators to do very well, and we think that enhances the value for real estate and we think there are several ways to get there. That just not only one path.

Daniel Bernstein -- Capital One -- Analyst

Okay, OK. I mean there is a difference in the risk profile. I think investors perceive a difference in risk between the operating and the (inaudible) and we could talk about it some more offline. The other question I had was on the Columbia, Maryland property that you're buying which is my backyard. When you get to kind of from the cap rate to the 7% IRR, you talked about it more of a land play. What are you thinking in terms of the buildable square feet? Or if you've gone that far at this point?

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Yeah. We're not going to make a comment on that. I think I said that there's significant land right on our building right next door. There's land obviously there. There is 30 acres of land in our Knoll asset that Mark mentioned we bought. So there could be significant expansion of this relationship in those places as Hopkins figure out what their needs are.

This is not just we're going to build a building, right. We'll build a building with our partner to meet their need. But if you think about -- and I would encourage you, if it's in your backyard go and look at the land. You will realize this is a covered land play.

Daniel Bernstein -- Capital One -- Analyst

Okay. Okay. I appreciate it. Thanks.

Operator

Your next question comes from the line of Eric Fleming with SunTrust. Please go ahead.

Eric Fleming -- SunTrust -- Analyst

Good morning. I had a question on managed care, specifically you've got Anthem out there talking about their Medicare Advantage and some of the rules that are coming in 2019 and how they're increasing their interest in the senior housing. Is that something you guys are looking to expand, any payor relationships or is that something with the ProMedica relationship that could be an opportunity for you?

Mark Shaver -- Senior Vice President-Strategy

Yeah. This is -- this is Mark, Eric. So, yes, absolutely, so nationally we see a rapid acceleration of Medicare Advantage, some of the payment methodologies being more value-based. In the post-acute it's PDPM which we've mentioned a fair amount when we did the ProMedica partnership that our partners both at ManorCare and ProMedica are pretty bullish that the new methodologies should lead to better enhanced care and from a reimbursement perspective Shankh used the term green shoot that there's increased reimbursement on that side.

I think you'll hear us in the future talk a bit more about opportunities with payers. Our senior housing platform is providing a great amount of care to a senior population and increasingly they're becoming greater sites of care and greater linkage both to the delivery system partners but also to payers. So there's more to come in that aspect for sure.

Eric Fleming -- SunTrust -- Analyst

Thanks.

Operator

Our final question will come from the line of Tayo Okusanya with Jefferies. Please go ahead. Tayo, your line maybe on mute. If you're on a speakerphone, please pick up your handset.

Tayo Okusanya -- Jefferies -- Analyst

Hello?

Tom DeRosa -- Chief Executive Officer

Hello.

We can hear you.

Mercedes Kerr -- Executive Vice President-Business & Relationship Management

We can hear you.

Tayo Okusanya -- Jefferies -- Analyst

Hello.

Tom DeRosa -- Chief Executive Officer

Yeah, so we hear you.

Tayo Okusanya -- Jefferies -- Analyst

Okay. Sorry about that. There were probably some phone issues. The MOB transactions that were done during the quarter, could you just talk a little bit about -- a bunch of the pure-play MOB guys are actually pulling back on acquisitions, but you guys seem to be finding some really good opportunities. Could you just talk about what may be different about what you're looking at versus what they may be looking at?

Keith Konkoli -- Senior Vice President-Real Estate Services

Yeah. So this is Keith Konkoli speaking. And I'll just I guess reiterate what I said earlier in my comments. We're really focused on looking for opportunities and to do more health system business. So as we've -- as we've looked around the market and we've evaluated what's available and we look at the broader opportunity across all of the different spectrums of ways that we can help deliver care in a lower cost setting, we've just -- we believe that we've found some unique situations that we believe will be a accretive as we are -- as we continue to look to grow our portfolio.

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Tayo, that is not any different from what we have seen in your senior housing business, and if you'll go back I'll not be surprised if you asked the same question on senior housing three, four years ago, right. We have a relationship-driven investment strategy, and we're -- obviously we are very well known to have executed that on the senior housing side, and we're executing that on the medical office side too.

Tom DeRosa -- Chief Executive Officer

We spend a lot more time in the offices of the leadership of the major health systema in the United States than we do trying to put ourselves in the way of properties that are being auctioned off by different brokers. We are generating, new business opportunities for our shareholders by knowing the needs of the health system and connecting the other assets that we are traditionally -- have an expertise in, like seniors housing and post-acute to their broader healthcare delivery networks. That is our unique investment thesis that this quarter you should see some indication that that investment thesis is working.

Keith Konkoli -- Senior Vice President-Real Estate Services

Yeah. And just to follow up on that, when I was with Duke, we really -- we were a very singly focused medical office, at least the division that I was responsible for. And we didn't have a lot of synergies across the business between the industrial space and the medical office space. The real opportunity here and what really excites me about this business is we have those synergies that enable us to really be able to serve our clients in a very, very effective way.

Tayo Okusanya -- Jefferies -- Analyst

Got it. So the accretion you just talked about a second ago, Keith, I shouldn't necessarily kind of think about that just accretion based on the MOB asset. It's accretion that will accrue to the entire ecosystem you're building in one way or another.

Keith Konkoli -- Senior Vice President-Real Estate Services

Absolutely. Yeah, absolutely, it is -- that's the thought.

Tom DeRosa -- Chief Executive Officer

These are relationship -- this is a relationship investing model with the health system.

Tayo Okusanya -- Jefferies -- Analyst

Interesting. All right, that's all I had. Thank you.

Operator

Thank you for dialing into the Welltower earnings conference call. We appreciate your participation and ask that you please disconnect.

Duration: 77 minutes

Call participants:

Tim McHugh -- Senior Vice President-Corporate Finance

Tom DeRosa -- Chief Executive Officer

Shankh Mitra -- Executive Vice President-Chief Investment Officer

Keith Konkoli -- Senior Vice President-Real Estate Services

John Goodey -- Executive Vice President-Chief Financial Officer

Steve Sakwa -- Evercore ISI -- Analyst

Juan Sanabria -- Bank of America Merrill Lynch -- Analyst

Vikram Malhotra -- Morgan Stanley -- Analyst

Mercedes Kerr -- Executive Vice President-Business & Relationship Management

Steve Valiquette -- Barclays -- Analyst

Jonathan Hughes -- Raymond James -- Analyst

Rich Anderson -- Mizuho Securities -- Analyst

Karin Ford -- MUFG Securities -- Analyst

Smedes Rose -- Citi -- Analyst

Mark Shaver -- Senior Vice President-Strategy

Michael Billerman -- Citi -- Analyst

Todd Stender -- Wells Fargo -- Analyst

Lukas Hartwich -- Green Street Advisors -- Analyst

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Chad Vanacore -- Stifel -- Analyst

Michael Carroll -- RBC Capital Markets -- Analyst

Analyst -- -- Analyst

Daniel Bernstein -- Capital One -- Analyst

Eric Fleming -- SunTrust -- Analyst

Tayo Okusanya -- Jefferies -- Analyst

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