American Healthcare REIT (AHR) Citi’s Miami Global Property CEO Conference 2026 summary

Market fundamentals and growth outlook

• Senior housing and long-term care segments show strong supply-demand fundamentals, supporting robust organic earnings growth and favorable cost of capital, enabling external growth opportunities.

• Guidance indicates nearly 18% NFFO per share growth at the midpoint, with a safe balance sheet at 3.4x net debt to EBITDA.

• Sector benefits from demographic tailwinds, with 10,000 people turning 80 daily and limited new construction (less than 1% of stock under construction), supporting sustained growth.

• Occupancy in RIDEA segments grew by 270-280 basis points last year, with continued demand expected as baby boomers age.

Revenue mix, reimbursement, and operator strategy

• Trilogy segment leverages a mix of private pay, Medicare Advantage, and Medicaid, with private pay skilled nursing rates showing pricing power.

• Trilogy partners selectively with Medicare Advantage plans offering the highest reimbursement, achieving over 8.5% growth in that business.

• Shifting resident mix toward higher-reimbursement sources (Medicare, Medicare Advantage) is driving daily rate growth and reducing Medicaid exposure.

• Trilogy’s integrated campus model (skilled nursing, assisted living, memory care, independent living) creates operational synergies and higher occupancy.

Operator selection, alignment, and scaling

• Operator selection precedes real estate acquisition, with a rigorous, multi-year underwriting process focused on regional expertise and performance.

• Management contracts with Trilogy are heavily incentive-based, aligned with EBITDA growth, and paid in stock, fostering strong operator alignment.

• Trilogy’s scale and resources are leveraged to support regional operators, facilitating best practice sharing and helping them scale to meet projected demand shortfalls.