American Healthcare REIT (AHR) Nareit REITweek: 2025 Investor Conference summary

Company overview and market positioning

• Focuses on clinical healthcare real estate, primarily senior housing, with $6B equity market cap and $7B enterprise value, operating about 300 buildings.

• 70% of portfolio is managed (RIDEA), allowing direct participation in bottom-line earnings rather than fixed lease income.

• Senior housing demand is set to accelerate as baby boomers turn 80, with limited new supply due to high construction costs and interest rates.

• Double-digit same-store NOI growth has been achieved for the past two years, with expectations for continued outsized growth.

Portfolio strategy and operator relationships

• Trilogy, the largest operator, manages about 60% of NOI, focusing on integrated senior health campuses with a mix of skilled nursing, assisted living, and independent living.

• SHOP (Senior Housing Operating Portfolio) represents 11-12% of NOI and is the fastest-growing segment, with 30% same-store NOI growth in Q1 year-over-year.

• Emphasis on regional operators for better performance, leveraging Trilogy’s platform to support smaller partners and share best practices.

• Acquisition pipeline is over $300M, focused on managed segments and newer, larger buildings, often acquired below replacement cost.

Financial performance and capital allocation

• 2024 performance was strong, leading to raised 2025 guidance; Trilogy same-store NOI growth guided at 13-14%, SHOP at low 20%.

• Earnings per share midpoint increased from $1.41 to $1.61, with significant deleveraging from 9x to 4.5x debt to EBITDA.

• Funding for acquisitions comes from retained earnings, asset sales, and an ATM equity program, maintaining a disciplined balance sheet.