Summary of American Healthcare REIT Conference Call Company Overview - **Company**: American Healthcare REIT (NYSE:AHR) - **Type**: Mid-sized diversified healthcare REIT - **Key Investment**: Trilogy Health Services, which constitutes over 50% of the company's Net Operating Income (NOI) [2][3] Industry Insights - **Operating Environment**: The current operating environment for REITs is described as the best seen in 33 years, with significant organic earnings growth due to supply-demand imbalances in long-term care [3][4] - **Demand Growth**: The demand for long-term care is expected to grow significantly over the next 15 years, driven by the aging baby boomer population [4] - **Supply Constraints**: New construction starts in the healthcare sector have been low, leading to a multi-year period where demand will outstrip supply [4] Financial Performance - **Occupancy Rates**: As of the end of Q2, spot occupancy was approximately 87.5%, with strong growth observed in July and August [7][9] - **Revenue Per Occupied Room (REVPOR)**: There has been a focus on increasing REVPOR, which has shown significant growth, while occupancy rates have also improved [21][22] - **Medicare Advantage Growth**: The percentage of Medicare Advantage resident stays has increased to 7.2%, with expectations for continued growth as insurers push rates up due to demand for access to Trilogy facilities [13][14] Strategic Initiatives - **Dynamic Pricing**: The company is implementing dynamic pricing strategies across its portfolio, moving away from fixed rate sheets to more flexible pricing based on occupancy levels [30][31] - **Employee Retention**: Trilogy has a lower employee turnover rate (40-45%) compared to the industry average (80-100%), which is attributed to better employee satisfaction and career development opportunities [38][40][51] - **Acquisition Pipeline**: The company has over $350 million in its acquisition pipeline, focusing on high-quality assets that will provide organic earnings growth [58][60] Challenges and Risks - **Labor Shortages**: Labor remains a significant challenge in the industry, although the situation has improved recently. The company emphasizes the importance of being an attractive employer to retain staff [45][46] - **Regulatory Changes**: The company is monitoring potential changes in Medicaid reimbursement rates and the impact of lawsuits related to value-based payments in states like Ohio [77][78] Future Outlook - **Earnings Growth**: The company expects strong organic earnings growth over the next few years, even without new acquisitions, due to the performance of existing facilities [67] - **Market Conditions**: The current market conditions are favorable, with demand growth outpacing supply growth, which is expected to continue driving performance [64] Additional Notes - **AI Initiatives**: The company plans to increase spending on AI initiatives in the coming year [83] - **Same-Store NOI**: Expectations for same-store NOI in the sector are positive, with predictions for it to be higher next year [85][86]