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American Healthcare REIT(AHR) - 2024 Q1 - Earnings Call Transcript

Financial Data and Key Metrics - The company reported 0.30perfullydilutedshareofnormalizedfundsfromoperationsinQ12024,drivenbya130.30 per fully diluted share of normalized funds from operations in Q1 2024, driven by a 13% same-store net operating income (NOI) growth in the combined portfolio [30] - Same-store NOI growth for the SHOP segment was 33.5% year-over-year, while the integrated Senior Health campuses segment saw a 19.9% increase [30] - The company raised 773 million through an offering of 64.4 million shares and used the proceeds to pay down 722millionofhighinterestfloatingratedebt,improvingthenetdebttoannualizedadjustedEBITDAratiobyovertwotimes[31]LiquidityattheendofQ12024stoodatapproximately722 million of high-interest floating-rate debt, improving the net debt to annualized adjusted EBITDA ratio by over two times [31] - Liquidity at the end of Q1 2024 stood at approximately 915 million, including cash on hand and undrawn credit lines [33] Business Line Performance - The integrated senior health campuses segment saw a 20% increase in same-store NOI in Q1 2024, driven by a 160 basis points increase in occupancy to 86.2% [18] - The SHOP segment achieved an 85.7% occupancy rate in Q1 2024, up from 78.6% in Q1 2023, resulting in a 700 basis points improvement year-over-year [21] - NOI margins in the SHOP segment increased by 360 basis points to 18.4% in Q1 2024, driving a 30% year-over-year increase in same-store NOI [21] - The outpatient medical segment is expected to see flat to slightly negative NOI growth in 2024, while the triple-net lease segment is projected to grow by 1% to 3% [34] Market Performance - The company closed on the acquisition of 14 properties in Oregon, containing 856 beds, at an attractive pricing of 110,000perbed[14]Thecompanyexpectstosellanadditional110,000 per bed [14] - The company expects to sell an additional 45 million to 50millionofnoncoreassetsin2024,withpotentialformoredependingonmarketconditions[38]ThecompanyisfocusingongrowingitsSHOPportfolio,withtheOregontransactionbeingakeyexampleofthisstrategy[44]StrategicDirectionandIndustryCompetitionThecompanyisfocusingonthreemainareas:qualitycareforresidents,strongoperatingperformance,andmeasuredcapitalallocationtotakeadvantageofattractiveriskadjustedreturnsinthemarket[16]Thecompanybelievesthesupply/demandimbalanceinthelongtermcaresector,drivenbydemographictrendsandlimitednewsupply,createsapositiveenvironmentforgrowth[13]Thecompanyisleveragingitsexpertiseinassetmanagementtooptimizeunderperformingpropertiesanddriveoperationalgains[20]ManagementCommentaryonOperatingEnvironmentandFutureOutlookThecompanyismaintainingitsfullyearguidanceforsamestoreNOIgrowthof550 million of non-core assets in 2024, with potential for more depending on market conditions [38] - The company is focusing on growing its SHOP portfolio, with the Oregon transaction being a key example of this strategy [44] Strategic Direction and Industry Competition - The company is focusing on three main areas: quality care for residents, strong operating performance, and measured capital allocation to take advantage of attractive risk-adjusted returns in the market [16] - The company believes the supply/demand imbalance in the long-term care sector, driven by demographic trends and limited new supply, creates a positive environment for growth [13] - The company is leveraging its expertise in asset management to optimize underperforming properties and drive operational gains [20] Management Commentary on Operating Environment and Future Outlook - The company is maintaining its full-year guidance for same-store NOI growth of 5% to 7% in 2024, with expectations of 8% to 10% growth in the integrated senior health campuses segment and 25% to 30% growth in the SHOP segment [34] - The company is cautious about updating guidance too early in the year but remains bullish on the demographic tailwinds and limited new supply in the industry [48] - The company expects to continue seeing strong occupancy and NOI growth, particularly in the SHOP and integrated senior health campuses segments [19][22] Other Important Information - The company has successfully reduced agency labor expenses in the SHOP segment, returning staffing levels to pre-pandemic norms [23] - The company is monitoring the potential impact of new CMS staffing requirements for skilled nursing facilities but expects minimal impact due to its partnership with Trilogy, which already exceeds the minimum staffing requirements [25][27] - The company is exploring opportunities to acquire properties opportunistically, with a focus on Trilogy and the SHOP segment [44] Q&A Session Summary Question: Guidance and Same-Store Pool - The company confirmed that the guidance provided six weeks ago already accounted for the current same-store pool, and the increase in properties did not significantly alter the guidance [41] Question: Acquisition Environment - The company sees the best risk-adjusted returns within Trilogy and the SHOP segment, with the Oregon transaction being a key example of growth opportunities [44] Question: Same-Store NOI Guidance Deceleration - The company explained that the strong Q1 performance was driven by significant occupancy gains, but it is cautious about assuming the same trajectory for the rest of the year [48][49] Question: Trilogy Buyout Funding and Timing - The company has flexibility in funding the Trilogy buyout, potentially using cash, preferred equity, or a mix, with timing dependent on market conditions and asset sales [52][53] Question: SHOP RevPAR Growth - The company expects SHOP RevPAR growth to accelerate throughout the year, driven by higher occupancy and reduced concessions [59][60] Question: Transaction Environment and Cap Rates - The company has been selling non-core outpatient medical buildings at cap rates in the mid-6s to low 7s, with a focus on achieving attractive pricing [61] Question: Trilogy Staffing Levels - Trilogy already exceeds the minimum staffing requirements, with a significant operational advantage through its internal Flex Force labor pool [65][66] Question: Near-Term Trilogy Investments - The company is focusing on lease buyouts and independent living villa projects, with plans to slow down new campus developments due to capital constraints [69][71] Question: Triple-Net Lease NOI Growth - The company expects triple-net lease NOI growth to moderate to 1% to 3% in 2024, after benefiting from one-time factors in Q1 [91][92] Question: Oregon SHOP Portfolio - The company was the original lender on the Oregon SHOP portfolio and found minimal deferred maintenance, with no significant CapEx required [94][95] Question: Trilogy Interest Purchase - The company paid 32 million for the Trilogy interest, a pre-negotiated price that reflects the growth in Trilogy's value over the years [97][98]