[AHR] American Healthcare REIT Thesis 2026: Senior Housing Cycle Drives Outpatient Medical Capital Return

Key Takeaways

• AHR FY2025 revenue ~$2.20-2.35B (+5-10% YoY) with adj. core FFO/share ~$1.55-1.70 reflecting continued post-2024 ~$1.55-1.65B aggregate Senior Housing Operating Partnerships (SHOP) revenue (~70%+ aggregate revenue mix; selected primary US senior housing + selected various aggregate Trilogy + selected various aggregate Integrated Senior Health Campuses) + selected continued post-2024 ~$300-340M aggregate Outpatient Medical revenue (~14% aggregate revenue mix) + selected continued post-2024 ~$200-240M aggregate Triple-Net Leased Senior Housing + Skilled Nursing revenue (~10% aggregate revenue mix) + selected continued post-2024 ~$120-145M aggregate Other revenue (~6% aggregate revenue mix) under continued President + CEO Danny Prosky since 2022 (~3-year tenure as American Healthcare REIT CEO; selected post-February 2024 NYSE IPO).
• Senior Housing cycle (~+10-12% same-property NOI growth): ~$1.55-1.65B Senior Housing Operating Partnerships (SHOP) revenue (~70%+ revenue mix); selected primary US senior housing (Independent Living + Assisted Living + Memory Care) + selected primary Integrated Senior Health Campuses (Trilogy Investors); selected ~325+ aggregate senior housing communities (selected primary post-2014 Trilogy + selected various aggregate post-2024 selected various aggregate Integrated Senior Health Campuses); selected various aggregate ~+10-12% aggregate same-property NOI growth + selected various aggregate ~85-87% aggregate occupancy.
• Outpatient Medical + Triple-Net Leased Senior Housing: ~$300-340M Outpatient Medical revenue (~14% revenue mix; selected primary US Outpatient Medical Office Buildings) + ~$200-240M Triple-Net Leased Senior Housing + Skilled Nursing revenue (~10% revenue mix); selected continued post-2024 ~$5-6B aggregate Outpatient Medical aggregate gross book value + selected various aggregate ~+2-3% aggregate Outpatient Medical NOI growth.
• Capital return + balance sheet: $1.10 annual dividend FY2025 ($0.275/quarter; ~+0% growth post-February 2024 NYSE IPO dividend initiation; ~1-year continuous dividend track post-February 2024); minimal opportunistic buybacks; aggregate capital return ~$170-180M FY2025; net leverage ratio ~5.5-6.0x net debt-to-adj. EBITDA (selected continued post-2024 selected various aggregate REIT-level + property-level debt); non-investment grade B1/BB credit rating.
• FY2026 thesis catalysts: Senior Housing cycle (~+10-12% same-property NOI growth) + Outpatient Medical + Triple-Net Leased Senior Housing + Skilled Nursing + ~$1.10 annual dividend + ~1-year continuous dividend track + ~$170-180M aggregate annual capital return + selected projected post-2026 selected various aggregate deleveraging trajectory.

Company Background

American Healthcare REIT, Inc. (NYSE: AHR) is one of the largest US healthcare-focused REITs, founded 2021 as American Healthcare REIT post-merger of Griffin-American Healthcare REIT III + Griffin-American Healthcare REIT IV in Irvine California (4-year heritage post-merger; selected continued post-2014 Trilogy Investors + selected various aggregate Griffin Capital aggregate origin); selected post-February 2024 NYSE IPO ($845M+ aggregate IPO proceeds February 2024). Selected post-February 2024-2025 selected various aggregate ~$2B+ aggregate cumulative tuck-in M&A platform expansion (selected post-2014 Trilogy Investors Integrated Senior Health Campuses + selected post-February 2024 selected various aggregate Trilogy + selected various aggregate post-2024 selected various aggregate Integrated Senior Health Campuses + selected various aggregate consolidations); selected post-2022 Danny Prosky CEO appointment (selected continued post-2022 selected various aggregate American Healthcare REIT post-merger CEO); HQ Irvine California; ~150-200+ employees globally + selected ~16,000+ aggregate Trilogy Integrated Senior Health Campuses operator employees.

AHR operates 4 primary business segments: Senior Housing Operating Partnerships (SHOP) 70%+ revenue ($1.55-1.65B — selected primary US senior housing + selected various aggregate Trilogy Integrated Senior Health Campuses) + Outpatient Medical 14% revenue ($300-340M — selected primary US Outpatient Medical Office Buildings) + Triple-Net Leased Senior Housing + Skilled Nursing 10% revenue ($200-240M — selected primary triple-net leased senior housing + skilled nursing facility) + Other 6% revenue ($120-145M). Geographic mix: US 95%+ revenue ($2.10-2.25B) + selected various international 5% ($110-115M; selected primary UK + selected various aggregate Isle of Man).

Capital return: $1.10 annual dividend FY2025 ($0.275/quarter; ~+0% growth post-February 2024 NYSE IPO dividend initiation; ~1-year continuous dividend track post-February 2024); minimal opportunistic buybacks; aggregate capital return ~$170-180M FY2025; net leverage ratio ~5.5-6.0x net debt-to-adj. EBITDA; non-investment grade B1/BB credit rating.

Senior Housing Cycle (~+10-12% Same-Property NOI Growth)

The Senior Housing cycle is AHR's foundation thesis: ~$1.55-1.65B Senior Housing Operating Partnerships (SHOP) revenue (~70%+ revenue mix) + selected primary US senior housing (Independent Living + Assisted Living + Memory Care) + selected primary Integrated Senior Health Campuses (Trilogy Investors) + selected ~325+ aggregate senior housing communities + selected various aggregate ~+10-12% aggregate same-property NOI growth + selected various aggregate ~85-87% aggregate occupancy. Selected primary AHR Senior Housing platform: ~325+ aggregate senior housing communities + selected post-2014 Trilogy Investors Integrated Senior Health Campuses + selected various aggregate ~$10-12B aggregate Senior Housing aggregate gross book value + selected various aggregate ~85-87% aggregate occupancy.

FY2025 Senior Housing dynamics ($1.55-1.65B aggregate Senior Housing Operating Partnerships revenue): selected continued post-2024 ~+10-12% aggregate same-property NOI growth + ~$1.55-1.65B aggregate revenue + selected various aggregate ~85-87% aggregate occupancy + selected various aggregate Trilogy Integrated Senior Health Campuses + selected various aggregate ~325+ aggregate senior housing communities. Selected post-2024 ~$0.10-0.20 incremental annual core FFO/share contribution as Senior Housing cycle drives incremental margin + Senior Housing Operating Partnerships revenue.

FY2026 catalyst: continued Senior Housing cycle + ~$0.10-0.20 incremental annual core FFO/share contribution under continued President + CEO Danny Prosky leadership (~3-year tenure). Selected aggregate ~$1.65-1.80B aggregate Senior Housing Operating Partnerships revenue + selected various ~+8-10% aggregate same-property NOI growth + selected various aggregate ~85-87% aggregate occupancy + selected various aggregate ~+1-3% aggregate occupancy expansion. Risks: Welltower + Ventas + Healthpeak Properties + Brookdale Senior Living + Sunrise Senior Living + selected various aggregate US senior housing REIT + selected various aggregate competitive displacement + selected various aggregate Centers for Medicare & Medicaid Services (CMS) reimbursement considerations + Skilled Nursing reimbursement considerations.

Outpatient Medical + Triple-Net Leased Senior Housing

The Outpatient Medical + Triple-Net Leased Senior Housing is AHR's primary growth thesis: ~$300-340M Outpatient Medical revenue (~14% revenue mix) + selected primary US Outpatient Medical Office Buildings + ~$200-240M Triple-Net Leased Senior Housing + Skilled Nursing revenue (~10% revenue mix) + selected continued post-2024 ~$5-6B aggregate Outpatient Medical aggregate gross book value + selected various aggregate ~+2-3% aggregate Outpatient Medical NOI growth.

FY2025 Outpatient Medical + Triple-Net Leased dynamics: ~$300-340M aggregate Outpatient Medical revenue + ~$200-240M aggregate Triple-Net Leased Senior Housing + Skilled Nursing revenue + selected continued post-2024 ~$5-6B aggregate Outpatient Medical aggregate gross book value + selected various aggregate ~+2-3% aggregate Outpatient Medical NOI growth. Selected post-2024 ~$0.05-0.10 incremental annual core FFO/share contribution as Outpatient Medical + Triple-Net Leased drives incremental margin + Outpatient Medical revenue.

FY2026 catalyst: continued Outpatient Medical + Triple-Net Leased + ~$0.05-0.10 incremental core FFO/share contribution. Selected aggregate ~$310-355M aggregate Outpatient Medical revenue + ~$210-250M aggregate Triple-Net Leased + selected various ~+2-3% aggregate Outpatient Medical NOI growth + selected various aggregate ~$5-6B aggregate Outpatient Medical aggregate gross book value. Risks: Healthpeak Properties + Ventas + Welltower + Healthcare Realty Trust (post-Healthcare Trust of America merger) + selected various aggregate US healthcare REIT + selected various aggregate competitive displacement.

Capital Return + Dividend Track

Capital return + dividend track: $1.10 annual dividend FY2025 ($0.275/quarter; ~+0% growth post-February 2024 NYSE IPO dividend initiation; ~1-year continuous dividend track post-February 2024) + minimal opportunistic buybacks + aggregate capital return ~$170-180M FY2025 + net leverage ratio ~5.5-6.0x net debt-to-adj. EBITDA + non-investment grade B1/BB credit rating.

FY2026 catalyst: continued $1.10-1.20 aggregate dividend (+0-10% aggregate selected dividend acceleration) + selected continued ~$170-180M aggregate annual capital return + selected projected post-2026 selected various aggregate deleveraging trajectory. Selected ~1-year continuous dividend track + selected post-February 2024 NYSE IPO + selected ~5.5-6.0x net leverage support continued capital return + R&D + tuck-in M&A capacity. Selected projected post-2026 selected various aggregate net leverage trajectory toward ~5.0-5.5x.

Key Core Metrics

• FY2025 revenue ~$2.20-2.35B (+5-10% YoY) vs $2.10B FY2024; adj. core FFO/share ~$1.55-1.70
• 4 segments: Senior Housing Operating Partnerships (SHOP) ~70%+ ($1.55-1.65B), Outpatient Medical ~14% ($300-340M), Triple-Net Leased Senior Housing + Skilled Nursing ~10% ($200-240M), Other ~6% ($120-145M)
• Geographic mix: US ~95%+ + selected various international ~5%
• Senior Housing: ~325+ aggregate senior housing communities; ~85-87% aggregate occupancy; ~+10-12% aggregate same-property NOI growth
• Outpatient Medical: ~$5-6B aggregate gross book value; ~+2-3% aggregate Outpatient Medical NOI growth
• ~155-160M diluted shares; ~$170-180M total capital return FY2025
• ~$1.10 annual dividend FY2025 (~1-year continuous dividend track post-February 2024 NYSE IPO)
• Minimal opportunistic buybacks
• Net leverage ratio ~5.5-6.0x net debt-to-adj. EBITDA
• Non-investment grade B1/BB credit rating
• President + CEO Danny Prosky (since 2022, ~3-year tenure); CFO Brian Peay
• Selected post-February 2024 NYSE IPO ($845M+ proceeds)

Market Evaluation

AHR trades as a US healthcare-focused REIT levered to Senior Housing cycle (~+10-12% same-property NOI growth) + Outpatient Medical + Triple-Net Leased Senior Housing + Skilled Nursing + selected ~1-year continuous dividend track post-February 2024 NYSE IPO. Bull case: ~$1.55-1.65B Senior Housing Operating Partnerships + ~$300-340M Outpatient Medical + ~$200-240M Triple-Net Leased + ~325+ aggregate senior housing communities + ~85-87% aggregate occupancy + ~+10-12% aggregate same-property NOI growth + ~$1.10 dividend (~1-year track) drive ~$1.70-1.90 adj. core FFO/share FY2026 (+10-15% YoY). Bear case: Welltower + Ventas + Healthpeak Properties + Brookdale Senior Living + Sunrise Senior Living + Healthcare Realty Trust competitive displacement + Centers for Medicare & Medicaid Services (CMS) reimbursement considerations + Skilled Nursing reimbursement considerations + sustained ~5.5-6.0x net leverage trigger material core FFO compression. Base case: Senior Housing cycle + Outpatient Medical + Triple-Net Leased + ~5.5-6.0x net leverage discipline support continued ~$1.70-1.90 adj. core FFO/share + ~$170-200M aggregate capital return FY2026.

Senior Housing Cycle Drives Outpatient Medical Capital Return Deep Dive

Selected continued post-2024 ~$1.55-1.65B aggregate Senior Housing Operating Partnerships (SHOP) revenue (~70%+ revenue mix; selected primary US senior housing + selected various aggregate Trilogy + selected various aggregate Integrated Senior Health Campuses) + selected continued post-2024 ~$300-340M aggregate Outpatient Medical revenue (~14% revenue mix) + selected continued post-2024 ~$200-240M aggregate Triple-Net Leased Senior Housing + Skilled Nursing revenue (~10% revenue mix) + selected continued post-2024 ~$120-145M aggregate Other revenue (~6% revenue mix) + selected continued post-2024 ~325+ aggregate senior housing communities + selected continued post-2024 ~85-87% aggregate occupancy + selected continued post-2024 ~+10-12% aggregate same-property NOI growth + selected continued post-2024 ~$5-6B aggregate Outpatient Medical aggregate gross book value + selected continued post-2014 Trilogy Investors Integrated Senior Health Campuses + selected continued post-February 2024 NYSE IPO + selected $1.10 annual dividend (+0% growth post-February 2024 NYSE IPO; ~1-year continuous dividend track post-February 2024) + selected ~5.5-6.0x net leverage + non-investment grade B1/BB credit rating drive AHR's primary FY2026 thesis. President + CEO Danny Prosky (~3-year tenure) leadership continues post-2022 CEO appointment focus on Senior Housing cycle + Outpatient Medical + Triple-Net Leased Senior Housing + Skilled Nursing + capital return discipline + selected continued post-February 2024 NYSE IPO investor stewardship. Risks: Welltower + Ventas + Healthpeak Properties + Brookdale Senior Living + Sunrise Senior Living + Healthcare Realty Trust (post-Healthcare Trust of America merger) + selected various aggregate US senior housing REIT + selected various aggregate competitive displacement + Centers for Medicare & Medicaid Services (CMS) reimbursement considerations + Skilled Nursing reimbursement considerations + sustained ~5.5-6.0x net leverage + selected post-2014 Trilogy Investors Integrated Senior Health Campuses operator considerations + selected post-February 2024 NYSE IPO continuity considerations + selected post-2022 Danny Prosky CEO transition continuity considerations.