Five months after ProMedica acquired HCR ManorCare, the Ohio hospital system’s debt has ballooned.

ProMedica’s long-term debts have more than quadrupled since the deal, reaching $1.9 billion at the end of 2018, compared to about $429 million the previous year.

About $1.2 billion of that debt is attributable to the ManorCare purchase that closed in July, Chief Financial Officer Mike Browning said.

Welltower and ProMedica formed an 80-20 venture, in which the ManorCare owner pays monthly rent to the REIT.