You've identified the correct problem, so here's the machinery that addresses it.
Start with a standby management agreement. You pre-negotiate with a second licensed operator who agrees, for a fee, to step in as manager on your default trigger, and you get their consent to be named in the lease. States differ on whether that transition needs a new license, an interim permit, or a court-appointed receiver with agency sign-off, and in some states the receivership route is the only fast one. That's a question for healthcare regulatory counsel in the state where the building sits, and it should be answered before you sign, not after the operator misses rent.
The lease covenants that matter: an affirmative obligation to cooperate with license transfer and to sign transfer applications on request, monthly census and payor-mix reporting rather than quarterly, resident records held in a form you can access, and a covenant that the operator keeps the resident trust funds segregated. Deposits on a $1.32M rent roll are commonly six to twelve months, and cash is worth more than a letter of credit from an entity that's already stressed.
On your 1.15x, find out whether that's on EBITDARM or EBITDAR and whether the operator's management fee has been added back. A 5 percent management fee on $10M of revenue is $500k, and adding it back turns a 1.0x into a 1.4x on paper. Ask for the rent roll by resident with care level, and the trailing 12 payroll by pay period. Coverage falls before census does, because operators cut agency staffing first and that shows up as a survey deficiency two quarters later.
Also ask what capex the operator has deferred. A triple net tenant heading for trouble stops replacing HVAC and roofing about a year before they stop paying rent, and you inherit that bill in the same month you're paying a standby operator.
