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Introduction & Market Context
American Healthcare REIT Inc. (NYSE:AHR) released its first quarter 2025 supplemental presentation on May 9, 2025, revealing strong performance across its diversified healthcare real estate portfolio. The company’s stock responded positively, rising 5.87% to $34.10 on the day of the release, continuing its impressive momentum after delivering a 133% return to investors over the past year.
The healthcare REIT, which operates a portfolio of 294 properties across integrated senior health campuses, outpatient medical facilities, senior housing, and triple-net leased properties, demonstrated significant growth in key performance metrics, particularly in its senior housing segments.
Quarterly Performance Highlights
American Healthcare REIT reported substantial improvements in its financial performance for Q1 2025, with total portfolio same-store net operating income (NOI) growing 15.1% year-over-year. Normalized funds from operations (NFFO) per diluted share increased 26.7% to $0.38, while NAREIT FFO per diluted share rose 16.7% to $0.35 compared to Q1 2024.
The company’s portfolio overview reveals a well-diversified revenue stream, with Integrated Senior Health Campuses (ISHC) contributing 59.2% of consolidated annualized cash NOI, followed by Outpatient Medical (TASE:BLWV) at 20.0%, Senior Housing (NASDAQ:DHC) Operating Properties (SHOP) at 11.9%, and Triple-Net Leased Properties at 7.4%.
As shown in the following comprehensive financial overview:
Occupancy improvements were a key driver of the strong performance, with the ISHC segment reaching 88.5% occupancy (up from 85.6% in Q1 2024) and SHOP properties achieving 85.5% occupancy (up from 82.5%). These gains, combined with effective expense management, contributed to margin expansion across multiple segments.
Segment Performance Analysis
The ISHC segment, which represents American Healthcare REIT’s largest revenue contributor, delivered exceptional results with same-store NOI growth of 19.8% year-over-year. This performance was driven by occupancy improvements, revenue growth, and margin expansion from 16.8% to 18.4%.
The detailed breakdown of the ISHC segment performance shows:
The revenue mix within the ISHC segment demonstrates a diverse payor base, with Medicare, Medicaid, and private pay sources all contributing significantly. The quality mix increased to 77.5%, indicating a favorable payor composition. Average daily rates increased across all payor types, with Medicare rates showing particularly strong growth from $662.55 to $696.40.
The following chart illustrates the ISHC revenue distribution by payor type:
The SHOP segment delivered the strongest same-store NOI growth at 30.7%, reflecting robust demand for senior housing. Occupancy improved from 84.0% to 86.6% in same-store properties, while NOI margins expanded significantly from 15.8% to 19.0%. Revenue per occupied room (RevPOR) also increased from approximately $4,700 to $5,200.
The detailed performance metrics for the SHOP segment reveal:
The Outpatient Medical segment showed more modest growth, with same-store NOI increasing 2.0% year-over-year. This segment maintained high occupancy at 92.2% for same-store properties and strong tenant retention of 84.4% over the trailing 12 months. The segment’s stable performance reflects the long-term nature of medical office leases and the high credit quality of tenants.
Strategic Initiatives & Development
American Healthcare REIT continues to optimize its portfolio through strategic acquisitions, dispositions, and development projects. In Q1 2025, the company completed an ISHC lease buyout for $16.1 million while disposing of selected SHOP and ISHC properties for combined gross proceeds of $10.0 million.
The company’s development pipeline includes projects totaling $60.0 million in expected costs, with $19.7 million spent to date. These developments are expected to enhance the company’s growth profile as they come online.
The geographic distribution of American Healthcare REIT’s ISHC and SHOP properties demonstrates its strategic focus on diversification across multiple states, with Trilogy Management Services serving as a major operating partner with 127 properties across the Midwest:
2025 Guidance & Outlook
American Healthcare REIT provided optimistic guidance for fiscal year 2025, projecting normalized FFO attributable to common stockholders between $250.6 million and $260.0 million. The company expects total portfolio same-store NOI growth of 9.0% to 13.0% for the full year.
Segment-level guidance varies, with ISHC projected to grow 12.0% to 16.0%, SHOP expected to deliver 20.0% to 24.0% growth, Outpatient Medical forecasted between -1.0% and 1.0%, and Triple-Net Leased Properties anticipated to decline slightly by 0.5% to 1.5%.
The detailed 2025 guidance highlights the company’s confidence in continued strong performance:
CEO Danny Prosky’s optimism about the industry’s long-term prospects appears well-founded based on the Q1 results. In the previous earnings call, he noted, "This continues to be one of the most favorable fundamental backdrops for long-term care that I’ve observed during my thirty-three year career in the healthcare REIT industry."
The company’s financial position remains solid, with a net debt-to-annualized adjusted EBITDA ratio of 4.5x, improved from the 8.5x reported a year earlier, reflecting the company’s focus on strengthening its balance sheet.
American Healthcare REIT’s strong Q1 2025 performance, coupled with positive occupancy trends and margin expansion in its key segments, positions the company well to capitalize on favorable demographic trends in the senior housing market while maintaining a diversified portfolio across healthcare real estate segments.
Full presentation:
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