Occupancy challenges brought on by the coronavirus pandemic continue to raise “substantial doubt” about Capital Senior Living’s “ability to continue as a going concern,” the company said in a quarterly report filed Monday with the Securities and Exchange Commission.

Accounting standards required the disclosure.

Capital had expressed similar concerns with its prior quarterly report, in August, as well as in May.

During its most recent earnings call, Capital said it incurred approximately $1.4 million in COVID-related costs in the third quarter, making its 2020 COVID-related cost total to date $4.6 million.

In the most recent SEC filing, the company once again said that it is implementing strategic and cash-preservation initiatives as well as other plans to try to secure adequate liquidity to meet its obligations for at least the 12 months following the issuance of its financial statements.

Capital noted agreements previously reached with real estate investment trusts Welltower, Ventas and Healthpeak Properties, which called for the early termination of master lease agreements for communities and management of communities by Capital until they are transferred to other operators.

“At September 30, 2020, five communities had transitioned to a successor operator. On November 1, 2020, subsequent to quarter-end, 14 Welltower communities transitioned to different operators,” Capital said.

Regarding the Heathpeak communities, Capital noted that one community had transitioned to a new operator in the first quarter, whereas another one transitioned to a new operator on Oct. 15, after the third quarter ended. Effective Nov. 1, the company entered into an agreement with Healthpeak to extend the end of its lease term from Oct. 31, 2020, to April 30, 2021 — subject to two possible three-month extensions — and to modify its monthly rent so that the amount owed to Healthpeak will be equal to any excess cash flows from these communities. In addition, Capital said it will earn a management fee for continuing to manage these communities.

“The company is currently evaluating the opportunity to sell certain communities that would provide positive net proceeds,” Capital said. The filing also mentioned the company’s previously announced plan to transfer operations and ownership of 18 senior living communities to Fannie Mae.

Capital said it also is using the Coronavirus Aid, Relief, and Economic Security (CARES) Act payroll tax deferral program to delay payment of a portion of payroll taxes estimated to be incurred from April through December. As of Sept. 30, the company had deferred $5 million in payroll taxes.

Capital also said it has received approximately $0.6 million in relief from state agencies as of Sept. 30 and has applied for additional federal and state funding. Nov. 6, the company accepted $8.1 million of cash for grants from the Provider Relief Fund Phase 2 general distribution. The company also has applied for grants from the Provider Relief Fund’s Phase 3 general distribution.

Total occupancy in the third quarter was 76.1%, a 5.2% year-over-year decrease that largely was due to the effects of COVID-19, Capital said in its recent earnings release. Total occupancy declined 1.5% in the third quarter compared with the previous quarter.

Same-community occupancy in the third quarter was 78%, a decrease of 4.6% compared with the third quarter of 2019 and 1.9% compared with the second quarter of 2020.