American Healthcare REIT lifts 2026 outlook on Q3 operating gains

American Healthcare REIT raised its 2026 guidance for normalized funds from operations (NFFO), a REIT earnings measure, to $2.23 to $2.26 per diluted share after third-quarter NFFO rose 31.8% to $0.58.

CFO Aric Chang reported the result on the November 6 earnings call.

Chairman and CEO Jeff Hanson said total portfolio same-store net operating income (NOI), which measures earnings from the existing portfolio, rose 13.8%. That marked the company’s 11th consecutive quarter of double-digit growth.

The company completed $1.69 billion of investments during the third quarter. More than $1 billion in awarded deals remains outside revised guidance; Chang said proceeds from unsettled forward share sales will fund those investments.

President and Chief Operating Officer Gabe Willhite said: “Our goal is not to remain at 90% occupied in our portfolio.” He said the company still sees room for occupancy gains and remains focused on revenue management.

What changed in the 2026 outlook?

• Full-year NFFO: The range increased from $2.15 to $2.19 to $2.23 to $2.26. Chang said the midpoint implies more than 30% growth from 2025.
• Total portfolio: Same-store NOI growth guidance rose to 12% to 14%.
• Segments: Trilogy now targets 14.5% to 16.5%, while the senior housing operating portfolio (SHOP) targets 23% to 26%. The SHOP midpoint rose by five percentage points.

Management’s revised forecast includes transactions and capital-markets activity completed through the call date, but excludes acquisitions beyond those already closed year to date. General and administrative expense guidance remains unchanged.

The revision lifts profit and property-earnings expectations without counting any new awards.

How did senior housing operations perform?

SHOP same-store NOI increased 28.2% year over year and 9.1% from the prior quarter. Average same-store occupancy reached 90%. Revenue per occupied room rose 5.4% year over year, while expense per occupied room increased 0.8%. The segment’s same-store NOI margin expanded 350 basis points to 23.5%.

Willhite attributed part of the revenue gain to pricing and reduced rent concessions. Concessions fell 34% year over year as operators focused on rates and occupancy increased.

At Trilogy, same-store NOI grew 15.7% year over year and average occupancy rose to 91.2%. Revenue rose 4.8%, operating expenses rose 2.2%, and controllable costs fell 3.7%. Willhite said employee-benefit savings helped expenses, but described that saving as more of a one-time item. Trilogy continues to seek efficiencies.

Higher rates and tighter costs drove stronger margins as occupancy climbed.

What is the investment pipeline and how is it funded?

Year-to-date investments reached $2.1 billion, Chief Investment Officer Stefan Oh said. Among those transactions, American Healthcare REIT closed six Kensington Senior Living communities for about $572 million.

The deal forms part of an eight-property portfolio with an aggregate contract price of about $873 million. Oh expects the remaining two properties to close by year-end.

The company also acquired eight communities for approximately $696 million, bringing LCB Senior Living onto its platform. Oh said those acquisitions cut the SHOP portfolio’s average age to 18.1 years from 22.9 years at the end of 2025.

Oh expects some of the awarded pipeline to close late in the fourth quarter, with the remainder in the first quarter of 2027. Deal flow remains strong, and the company targets newer assets in high-barrier markets and select secondary markets.

At quarter-end, net debt to annualized adjusted EBITDA (adjusted earnings before interest, taxes, depreciation and amortization) fell to 1.9 times. Chang said the company had about $1.3 billion in gross proceeds available under unsettled forward sales agreements and $850 million of credit-line capacity.

He said the company was fully funded for the awarded pipeline and additional opportunities, with no plan to raise capital for the pipeline currently visible.

Available funding covers the visible pipeline, with no current plan to raise capital.

Where is capital going next?

Hanson said future capital deployment and external growth are focused on SHOP and Trilogy.

The company has sold 30 outpatient medical assets and reduced that portfolio’s NOI contribution from 35% to roughly 10%. Hanson expects American Healthcare REIT to remain a net seller.

Willhite said the company continually evaluates senior housing assets for possible sales but had no 2027 property sales to announce.

Management expects Trilogy to build three to five new campuses annually. More than 30 campuses have excess land or a direct path to additional land for possible expansions.

American Healthcare REIT (NYSE:AHR) is a self-managed real estate investment trust focused on owning and operating healthcare-related properties. It provides real estate infrastructure for healthcare providers and senior-care operators through a diversified portfolio.

Its properties include outpatient medical office buildings, integrated senior health campuses, skilled nursing facilities, senior housing communities and other healthcare facilities serving patients, residents and medical professionals.

The strategy points to a smaller outpatient footprint and continued investment in senior housing.