American Healthcare REIT (AHR) Citi’s 30th Annual Global Property CEO Conference 2025 summary

Company overview and strategy

• Operates as a mid-sized, diversified healthcare REIT with $4.5B equity market cap and $6B enterprise value, focusing on clinical healthcare real estate including outpatient medical, assisted living, and skilled nursing facilities.

• Differentiates itself with a high percentage of managed long-term care assets under a management structure, allowing NOI growth to flow directly to the company as asset performance improves.

• Celebrated one-year anniversary of IPO in February, with a long-term presence in the sector and leadership with decades of experience.

• Positioned for multi-year growth driven by demographic trends, especially the aging baby boomer population, with demand for long-term care outpacing new supply.

• Emphasizes a multi-year growth story, not just a one-year outlook, due to persistent supply-demand imbalance in senior care real estate.

Earnings growth and portfolio performance

• Guided for 12% earnings growth per share in 2025, with expectations for continued strong growth in subsequent years.

• Majority of earnings growth now comes from organic sources, particularly managed long-term care, rather than traditional external growth.

• Occupancy and revenue per occupied room (RevPOR) are growing faster than expenses, supporting NOI margin expansion.

• External growth remains accretive due to improved cost of capital, with several transactions already announced and more expected.

• Even without external growth, strong organic earnings growth is expected for several years.

Trilogy platform and development

• Largest investment is in Trilogy, a portfolio of nearly 130 Integrated Senior Health Campuses across five states, offering skilled nursing, assisted living, and independent living.

• Trilogy’s model emphasizes higher acuity care, with most admissions coming from hospital discharges and a strong focus on Medicare, Medicare Advantage, and private pay.

• Private pay, assisted living, and independent living segments have grown faster than skilled nursing, supported by a robust development pipeline averaging $150M annually.

• Development includes new campuses and expansions, especially independent living villas, which are typically pre-leased and quickly occupied.

• Regularly exercises purchase options on Trilogy-operated assets, acquiring them at attractive yields and low risk.