American Healthcare REIT, Inc. (AHR)
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Sep 17, 2026, 4:00 PM EDT - Market closed
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BofA NY Global Real Estate Conference 2026

Sep 15, 2026

Summary

Industry-leading FFO and NOI growth were achieved through disciplined acquisitions, operational efficiencies, and a focus on high-quality, high-barrier assets. Strategic partnerships, leadership enhancements, and a robust development pipeline support ongoing margin expansion and sector outperformance.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

For this meeting. Thank you. Welcome, everyone. Welcome to the BofA 2026 Global Real Estate Conference. My name is Farrell Granath, and I am lead coverage for the healthcare REITs on our BofA U.S. REIT team. Also in the audience, I have Jeff Spector, head of U.S. REITs, and my associate over here, Julieta. We are joined here today with Jeff Hanson, the CEO of American Healthcare REIT, as well as Gabe Willhite, COO, and Alan Peterson, VP of IR and Finance. At first, we'll turn it over for opening remarks, and then we can open it up for Q&A. I definitely encourage everyone to interject if you have any questions. Feel free to have an open conversation. Jeff, turn it over to you.

Jeff Hanson
CEO, American Healthcare REIT

Yes. Thank you, Farrell. Great to be here with everybody. In addition to the gentlemen on my right and on my left, we also have our lead independent director on my left in the back, Scott Estes, who many of you probably know served as Welltower's CFO for 12 years. So he's been an incredible value add, being on our board for the past four and a half years. In terms of AHR, those of you who may be less familiar with the company, we're a dedicated healthcare REIT that's essentially focused exclusively in our RIDEA vertical, which is obviously the high growth sector of the healthcare industry and the real estate industry in general these days. It represents well over 80% of our NOI growing rapidly. That's by design. It's been an incredible year for the company.

We continue to post industry leading internal as well as external growth, and we've managed this year particularly to scale the operating platform meaningfully, both ahead of and in conjunction with robust and disciplined external growth. In terms of performance, many of you are probably aware, in Q2, we did increase guidance, yet again. This time it was over 5%, and that translates at the midpoint into FFO per share growth this year over last year of 26%, which leads the entire industry sector by a fairly wide margin. I think that the next closest peer is 21%, and we've been able to do so, and this is what we're very proud of, while de-leveraging materially at the same time.

We took 3x net debt to EBITDA at the end of Q1 down to 2.5x , and continuing to drop again while we're driving robust external growth. I think the last thing that we would mention is the performance of the company and all the same store NOI metrics that continue in most respects to lead the industry. They're largely driven and continue to be driven by increasing revenue, expanding margins, and increasingly widening operating spreads. So the business is incredible, and we're really grateful for the way AHR is positioned.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Thank you. I think to kick this off, we have obviously seen a lot of press releases coming out, updated in news. Can we first start with your updated year to date acquisitions? We have now seen over $2 billion worth of investment flows for year to date. Can you touch on, one, what those acquisitions maybe make up of larger acquisitions as well as some of the smaller ones? Maybe how that has changed your framework of how you buy, or at least is in line with how you buy.

Jeff Hanson
CEO, American Healthcare REIT

You want to lead off, Gabe?

Gabe Willhite
COO, American Healthcare REIT

Yeah. Thank you for hitting that, Farrell. What we saw so far in 2026 is an expanding opportunity set of really great assets and unique operating partnerships that are going to take us to the next level. So of that $2 billion, the average vintage 2019, they are all very new continuum of care assets that are larger, meaning you have AL, IL, memory care all under one roof. It is easier to cross-sell between those sectors, and it drives occupancies higher and margins wider. Our main strategy for growth, because of our size, we are about a $13 billion market cap company, is do onesie, twosie acquisitions that bolt onto existing operator relationships in the markets we are already in.

The hardest part of this entire business is finding the right operators, actually having access to them, and making them better than they would be if they were not a part of your platform.

That is the key to success in senior housing in a nutshell. If you pair the right operator with the right asset, you get outsized performance. Once you have already identified the right operator, build a regional concentration. Adding one or two buildings to their existing platform is very easy, and it's a low risk way to grow their scale and to grow our business. In certain rare circumstances, there are operators who are new to us from a financial relationship, but known to us for probably decades. We have an asset management team that's been in the business for, in some cases, three decades, and they know everybody in the industry.

When a rare opportunity to partner with a Kensington comes up, who has never had a REIT capital partner before, and they have options on who they pick, we stand out because we're the preferred capital partner for an operator like that, because we're focused on the quality of care first, the resident experience, the employee experience, and we're aligned on what matters most. We saw Kensington as that. By the way, that's an $873 million deal. Super infill locations that are incredibly hard to replicate with a typical entitlement process and a land assemblage process that took five to eight years. That's us playing offense and defense at the same time, right? You're growing a portfolio with a great asset, but you're also buying assets that are going to have a long runway for growth and have a wide competitive moat, just really hard to compete.

That Kensington deal, I think, is a great example of how we're going to execute, and like I said, $873 million of which about $570 million is closed. The remainder is supposed to close at the end of the year. It's not just a one-time transaction. Kensington has developed seven of the eight assets that we bought. They have three more that are in the pipeline. We would love to be a partner with them on future developments one way or another, and we look for that in every operator relationship, not just a one-time transaction where it's getting the assets and growing for growth's sake. It's building a strategic relationship that can add value to AHR's platform over time.

Jeff Hanson
CEO, American Healthcare REIT

I'd add the LCB or the Berkshire, that synonymous portfolio that we took down in early August, and LCB manages. They built five of the eight. They manage seven of the eight for us, and there are a lot of commonalities between both the Kensington and the Berkshire deal.

Gabe Willhite
COO, American Healthcare REIT

That's right.

Jeff Hanson
CEO, American Healthcare REIT

A, in terms of the process, relationships, longstanding decades-long relationships, went not just up to the senior management team in both those deals, but actually up to our board. We were outbid on both those deals, but we were deemed not the highest price, but the best partner.

Dave Faeder at Kensington's on the public record stating that, so we appreciate that. The second thing is, it's not just Kensington that's in fortress or high barrier to entry markets. This is some of the best SHOP asset quality that I've seen in a 32-year career. So is the LCB product or the Berkshire product. Those were all built either in 2020, 2022, or 2023. LCB also has, as Kensington does, very deep core Class A luxury senior housing development capability that we would love to grow with as well.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Well, before we dive in a lot deeper on the development and acquisition side, I also wanted to touch on other recent press releases and news updates, namely in your leadership transition as well as recent hires. Can you just give us an overview of some of the moving pieces that we've seen be announced as well as future plans for AHR's leadership?

Jeff Hanson
CEO, American Healthcare REIT

Yeah. Look, there's a lot of exciting things happening. A lot has been compressed into a compressed period of time over the last several weeks, but the reality is it was work in progress since the beginning of the year. The strategy doesn't change at all. The strategy was right. What changes is our ability as a company to execute at much broader scale. Gabe was appointed President and Chief Operating Officer. He already held the COO role. I came back in as the Chairman and CEO, a role that I filled for 16 of the last 21 years as Danny retired after his health issue. We recently announced that we brought Aric Chang in. He starts October 1st from Public Storage. Many of you will know that's an S&P 500 operating REIT.

It was important to us to pull our next generation CFO, not from a traditional property REIT configuration, because we're too dynamic of an operating business. Aric is going to be a phenomenal next gen CFO for the company. He starts October 1st. Danny hasn't gone anywhere, by the way. He's still a highly valued advisor to the management team, and he remains on the board as one of the co-founders of the company. We also hired two very important division heads, both of whom report to Gabe. They started on the same day two weeks ago. One is Ann Lacey from Artemis. She built their SHOP asset management platform. She heads up as our EVP of SHOP Strategic Asset Management, the same function.

Importantly, she came with deep financial acumen from seven or eight years with one of the best performing SHOP investors in the country. As importantly, she was in critical operating roles for 11 years with Sunrise Senior Living before that. She has the perfect blend that we've actually built our entire asset management vertical around, which represents one of our competitive advantages with operators, both new and existing. The last, do you want to go into our new CTO?

Gabe Willhite
COO, American Healthcare REIT

Yeah. Our CTO, John Crozier, comes from Kilroy. Before that, the Irvine Company. Has deep experience across real estate asset classes, which I think is pretty important to the story today. I don't think I'm going out on a limb here by saying a lot of people have commented on the lack of sophistication from the senior housing investment community and the lack of resources maybe from a tech stack side for the operators. We're trying to bridge that gap better than anybody has done before. Not just on investments, although that tech and that data is important to make better investment decisions, utilize data that's not just available to everybody through a subscription to NIC MAP, which is not a very high barrier to entry.

Focus on different data that if everybody's focused on one data set and you have better, more accurate, more real-time data that's coming from somewhere else, you have a competitive advantage in investment selection. Also going much further than what just the initiation of the transaction with an operator is, which is actually finding the deal and closing the deal. It's now what do you do? Now how do you outperform operationally? Our focus is a little bit different than most. We don't think one national operator that has great resources is the best way to play in the space. We think the regional operators, headquarters basically drivable to all the assets they manage for you, is a better way to do it. They drive the culture in the buildings. They care about it. It's easier for them to recruit.

They provide advancement opportunities for their best employees within their buildings, just moving to different locations in that regional density. That's a lesson learned from owning Trilogy for almost 11 years, right? What has really worked at Trilogy? How did they outperform? How do we copy that playbook throughout our SHOP playbook? What do the regional operators, that's all the good stuff they give you. What's the cost associated with that? Otherwise, everybody would be doing it. One, they're smaller. They don't have the resources to have their own CTO to build out their data and analytics platform. Two, they might not even know what to do with that data once you give it to them or have the resources to do something about it. So two ways that we're fixing that.

One is John Crozier, our CTO, who's going to draw on a far broader background than just senior housing to deliver the competitive advantage we need. Two, we've got the Trilogy platform supporting the whole thing.

That's absolutely unique in the space to have alignment like we have with Trilogy at their scale. They operate 150 buildings for us. One of the things that they're really good at is innovation and not having pride that right now this is the best it's going to get. That innovative idea can come from literally anywhere in Trilogy, and they'll test it out in one building, three buildings, and then roll it out to 150 within their ecosystem. But what if we roll that to 250 within our ecosystem at AHR more globally? That's a real platform value advantage. We've created financial alignment with the Trilogy management team to do just that.

We have probably the best-in-class alignment to NOI growth for the management company, and that is the LTIP that they have is based on real NOI, not just top-line revenue, which I think is table stakes at this point if you are in seniors. If people are not talking about real NOI incentives, then I think it is borderline uninvestable. But the way that we pay that NOI-based LTIP is in AHR currency. We created the first management incentive plan that is equity-based with our equity. They participate in the value creation from growing Trilogy's NOI, which is great for all of us. It is the right incentive. But two, they have this real financial incentive for our other SHOP operators to outperform. If they need help implementing a software that Trilogy has developed, like their revenue management software, the operator might not have somebody to do that.

A Trilogy employee can actually work with them and help them integrate their systems so that they can leverage Trilogy's tech and also accomplish the mission of doing something with the data that you already have.

Jeff Hanson
CEO, American Healthcare REIT

Yeah, and I will add one brief thing. The same store metrics that I am sure most of you are familiar with as it relates to AHR, they are good numbers, but they are not just good numbers. They are a deep signal to us that the synergistic operating ecosystem that we have created that is AHR is actually working and it is firing on cylinders.

Gabe Willhite
COO, American Healthcare REIT

That is right.

Jeff Hanson
CEO, American Healthcare REIT

The reality is we are still at the very early stages, and you have an operator that is as good as Trilogy over the past 30 some odd years, and they are really an operating laboratory at scale for us. The real value proposition, they are not just an investment, they are probably one of our most strategic assets. Those of you that are familiar with the company understand just how true this is. The real goal is to take what we know works well through that operating laboratory and propagating it across the other 11 operators that we have.

Gabe Willhite
COO, American Healthcare REIT

That is right.

Jeff Hanson
CEO, American Healthcare REIT

We have a thin operator base in terms of total number by design.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Just to dive in a little bit deeper, I think Trilogy is such a unique product. I was hoping that you can go through, and you were already alluding to what I was going to ask, but when thinking about your initial relationship with the IPO, the next steps when you were able to buy out your full ownership, and then also with that potential of doing future development on Trilogy campuses and then the rollout through your SHOP platform as well. Can you walk us through either where you are in different stages of that process? Where as you were already speaking about the Trilogy platform, but even on the development side, what you see as the future for Trilogy.

Jeff Hanson
CEO, American Healthcare REIT

Yeah. Their development capabilities are exceptional. Gabe, I'll take a certain part of that, but go ahead at a high level.

Gabe Willhite
COO, American Healthcare REIT

Yeah. The vast majority of their 150 that they operate for us were actually developed themselves because it's a unique asset type with unique requirements, so they're purpose-built. The prototype we're on now, I think, is prototype 4, maybe 5, depends on who you ask. It's value engineered so that, one, the costs are not too high.

And of course, right? But it's also value engineered operationally. A lot of times, if you're doing a development deal, it's designed by somebody who is designing without senior housing in mind, or they like the idea of senior housing, but they don't understand, hey, if I put too many units on a straight hallway to nowhere, then it's going to screw up my staffing ratios, and now it's going to be less profitable because of a physical plant design issue. So Trilogy has solved that because they're true operators operators. How do we tap into that and go beyond just Trilogy, I think is an interesting question that just put a pin in for right now. Within Trilogy, we're developing three to five new campuses a year in the states that they're in. Those new campuses have expansion opportunities after they're already up and running.

It de-risks the entire development proposition when you don't build so big and guess what the demand is going to be. You build potentially a little bit smaller and have excess land to develop product where the need dictates the product should be. So you can add independent living villas, which will be on the tour. You should sign up for it if you haven't already. Or you could expand memory care, you could expand AL, you could expand SNF. You have optionality on where the demand is showing up and what you want to do with it. So that expansion opportunity is the part that's probably the most interesting right now. We did a deep dive across our entire SHOP portfolio. Most of those operators are not focused on development expansions, right?

But where we have very high demand, meaning high occupancies, we have high rates, and we have excess land, that is an opportunity to expand the existing SHOP portfolio. We have identified several of those opportunities that we are pursuing right now, and Trilogy's development team is managing those developments for us, actually working with the architects to optimize for operations. They come back, we got the designs, and Trilogy is like, not this one, not this one. Do it this way. Can you go over here? Real valuable feedback to make them more profitable and make the developments make sense. That is something that I think we can continue to look at and expand on beyond. The first start was the low-hanging fruit.

Is where we actually owned land. Step two is let us see where we can buy adjacent land and do even more expansions and get even more benefit out of Trilogy's development capabilities.

Jeff Hanson
CEO, American Healthcare REIT

General rule of thumb is $150 million-$200 million in new development commitments annually within the Trilogy ecosystem. The one thing that Gabe didn't mention, that I will mention briefly, is not only wing expansions or general expansions of existing SHOP assets, but they are also running all of our CapEx.

Which they are extremely sophisticated capabilities for all of our SHOP portfolio. We are really extracting synergies.

The way that Gabe structured their incentives with our stock, our stock is the currency through an LTIP, is deeply incentivizing them to do so. They're sharing everything with our operators.

Gabe Willhite
COO, American Healthcare REIT

Yeah. Can we unpack that for a minute? Why is that important? So at some point, your building is going to become so dated that you're going to be at a competitive disadvantage. What we saw Trilogy doing over and over and over again was this five-year and even longer plan of here's the ones that need X, Y, and Z update. Here's the pacing of how those updates should be done. A lot of times in the industry, you'll see the buildings that are performing the best get no CapEx because they say, Oh, you don't need it. So they become dated. The employees there feel slighted like, Oh, our reward for success is that we have the 1990s yellow walls and maroon carpets and stuff like that? It doesn't make any sense.

I get why people end up there, but if you're thinking long-term growth and long-term value, and how do we keep our best employees engaged and performing at a high level, that's all part of what they do. So Trilogy now can do that for our entire SHOP portfolio, have regular refresh plans, but also identify the opportunities where you might be able to have a big rate increase opportunity by putting some CapEx into the building and kind of repositioning it as well. That's probably the next frontier for good value add investments as well.

Jeff Hanson
CEO, American Healthcare REIT

Can you break down the returns expected on the ground up versus the expansions?

Gabe Willhite
COO, American Healthcare REIT

I can just jump on that one. This is all in our supplemental, by the way, if you want to look at. We actually disclose every single project that's going on. If you look at the independent living villas, those have a little bit of a lower cash yield, call it high single digits. But they get to operational profitability far faster. The great part about those villas is you don't build them unless the building's really ripping and doing well. You've got the excess land, and you can pre-lease them. You build a model home, and you pre-lease them, so you don't have the operational drag that you would of a typical senior housing development where you're going to lose some money before you actually start to make some money. You already have the staff there. You already have the sales team there.

It's ready to go. Those are from a path to profitability, returns on investment perspective, probably the best opportunities in Trilogy, not to mention from a quality of life perspective. The people that are in that product love it. It's like, I don't know, it's kind of like a fraternity or sorority row for old people.

Jeff Hanson
CEO, American Healthcare REIT

Excuse me. That's a new one.

Gabe Willhite
COO, American Healthcare REIT

Well, they probably start drinking the same time of the day, 3:00. That social aspect of it is interesting and good for them. The occupancies there are frequently the highest in our portfolio in the mid-90s. The expansion projects have the highest ROI, but there's just not that many of them, and they're kind of inexpensive. A typical wing expansion could be $1 million or a couple million dollars. It's hard to get a lot of value deployed that way and a lot of capital deployed that way. The main campuses are, call it low double-digit returns, still really strong. How are they doing that? Well, they're playing in markets that others couldn't because of what we talked about earlier from a size perspective and efficiency perspective. They also, like we said, have financial engineered the building, and they're just good at it.

They also are their own GC on projects now, which further takes the cost down. It is just a machine that has been evolving over 25 to 30 years of development, gets really efficient.

Jeff Hanson
CEO, American Healthcare REIT

I think the most important takeaway there at a high level is the risk-adjusted return reality. It is already good development returns relative to any other asset class redeveloped.

But it is de-risked because they have got this down to like a franchise level, cookie cutter.

Gabe Willhite
COO, American Healthcare REIT

Yeah.

Jeff Hanson
CEO, American Healthcare REIT

30-year tried and true approach, where they have got SWAT teams of, I do not what do they call them, opening teams?

Gabe Willhite
COO, American Healthcare REIT

Yeah.

Jeff Hanson
CEO, American Healthcare REIT

That they send, that descend on new communities that are opened, and they-

Gabe Willhite
COO, American Healthcare REIT

That's right.

Jeff Hanson
CEO, American Healthcare REIT

-stabilize it.

Gabe Willhite
COO, American Healthcare REIT

Yeah. The most important part of the success of a new development is who's the CEO of that building, the executive director. How do you ensure that they're going to be good if they're coming in from nowhere? Well, in Trilogy, you ensure they're good because you take somebody who's already crushing it in one of your other buildings, and they feel like that's a reward. Like, man, this is amazing that the company has that amount of faith in me to let me operate a brand-new building, and look at how beautiful this thing is. That's a real accomplishment for them. So you backfill that ED with somebody who's been brought up through Trilogy's administrator in training program. So you're filling with people who are already a cultural fit, who you've already tested out, who you know are good, and that de-risks the whole proposition as well.

That's where the regional densification really starts to show its value, is in the human capital side of the equation.

Jeff Hanson
CEO, American Healthcare REIT

How long does it take to stabilize, and is that happening faster now?

Gabe Willhite
COO, American Healthcare REIT

A little faster, yeah.

Jeff Hanson
CEO, American Healthcare REIT

What would you say? I mean, two years-

Gabe Willhite
COO, American Healthcare REIT

Yeah.

Jeff Hanson
CEO, American Healthcare REIT

-almost full stabilization before. Now, probably 18 months, closer to 18 months.

Gabe Willhite
COO, American Healthcare REIT

That is right. That is what we are assuming is a two-year lease-up period. Can be faster on the AL side, and the IL side is definitely seeming to be faster than what we predicted. The interesting thing about Trilogy and its development, and I am sure, Farrell, you have 100 other questions. I know because I have seen some of them. If you think that this world is headed towards disruption from new supply. If you think that is what causes the music to stop on seniors, the skilled nursing business is not going to be impacted by that. There is no development in skilled nursing. If you look at the NIC data, there might be like three, and it is us, it is Trilogy. Three buildings, I mean. The number of units that are online in America in skilled nursing are actually decreasing.

You have a little bit of the government risk in reimbursement, which you have to factor into the whole risk-adjusted equation. We can dive into how Trilogy manages that through Medicare Advantage plans and others. Then they are capturing a much higher rate of growth and inflationary on the rate side there. If you are really worried about new supply, Trilogy's model has the most durable competitive advantage of probably any product in America in seniors because of the way that they built both different acuity levels under one roof.

Jeff Hanson
CEO, American Healthcare REIT

Also, as you have said many times, all skilled is not created equal. This is high-quality post-acute. 20% of their total post-acute revenue is coming from private pay. As many of you know, that are familiar with Trilogy and have done the tours previously, a full 40% of all their AL campus new move-ins are right out of their post-acute.

Gabe Willhite
COO, American Healthcare REIT

Yeah.

Jeff Hanson
CEO, American Healthcare REIT

The synergistic ecosystem in Trilogy can't be overstated, and that's why they're driving same-store NOI growth that's exceeding most SHOP portfolios.

Gabe Willhite
COO, American Healthcare REIT

Yes, it's over 16%. I think most SHOP owners would be happy with that.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

I think you're reading my mind. I was about to dive into, especially the skilled side of Trilogy and why that makes it a unique product type. But also, if you screen against some of the larger peers who are more pure play SHOP, your margins are at different levels. And I would say I wanted to point out the Trilogy same store margin reaching post-pandemic highs at 21.1%. Can you break down what kind of drives the margin compared to maybe peers who are in the 30s? What does the portfolio mix do to a margin, but what is also the opportunity outside of that margin, what we're seeing today?

Gabe Willhite
COO, American Healthcare REIT

Yeah, maybe I'll start, and you can add in. So like Jeff said, not all skilled nursing is created equal. Not all senior housing is created equal either. I think people are not diving in enough on the difference in that continuum of care within definitionally senior housing. So if you start at active adult on one end of very discretionary, no care being delivered, to independent living, which is mainly activities and meals being a part of the equation, to assisted living, which now you actually need help with an activity of daily living, bathing, eating, using the bathroom, those sorts of things. It's a real needs-based decision, and memory care even more so. It's a safety issue if you're on your own, right? So we live in the highest acuity level of this spectrum within SHOP, and Trilogy the same.

Trilogy adds this other layer of skilled nursing onto the whole thing. Because you are in a higher acuity level, you are spending money on employees to actually take care of the people. You necessarily have a lower margin than somebody who is just providing housing. If your sole focus is, I think highest margin is the best senior housing, what you are really saying is, I think the most discretionary senior housing is the best senior housing, and that has risks associated with it that not everybody is appreciating.

What happened during the global financial crisis to the most discretionary side of the senior housing continuum of care? Well, it was the most impacted by occupancy losses. Because if somebody cannot sell their house for as much as they thought it was worth six months ago, they are going to wait to sell their house until they think it is more valuable.

With assisted living, you have a lower margin, so I think assisted living margin in the 20%-30% range is a good target for that. The independent living margin in maybe over 40% or 35%-40%, maybe even a little above in some areas, is a good range for that. But what you get with the assisted living and Trilogy higher acuity is more defensive assets that are more durable through recessionary times and potentially could be more valuable now if you think that pricing power is going to be here for a long time because we are supply constrained. Then you probably want to be invested in the product whose demand is the strongest and the most inelastic.

That is the higher acuity of senior housing, right? Otherwise, you kind of top out where the prices go because now you start making a different decision. Maybe I should just go live in an apartment. Maybe I should just stay at my house. On the need-based side, you do not have quite that luxury. It is more a requirement that I move into here. So that is why our portfolio leans that way. That is why we are willing to accept that lower margin. I think margins are still growing from here.

Jeff Hanson
CEO, American Healthcare REIT

Yes.

Gabe Willhite
COO, American Healthcare REIT

It is not like we are happy. Oh, yeah, great. Read the supplemental. It is a great margin. That is what it is going to be for the next five years. They are getting better and better and better. Revenue growth is outpacing expense growth. So that trend is going to continue. But we like playing offense and defense at the same time. So buying these assets that are going to have the longest runway, have the most durability. I am pretty confident our portfolio will not be the first to show cracks.

Jeff Hanson
CEO, American Healthcare REIT

Sorry. On the margins, that growth is going to be mostly revenue driven?

Gabe Willhite
COO, American Healthcare REIT

Yeah, I think that is right. I think it is mainly rate driven. Although when you have a certain amount of fixed costs to run the building, as occupancy grows, you are spreading it across a wider base. So your exp for your expense per occupied room, it could actually be negative in some cases, like the growth rate, I mean.

Jeff Hanson
CEO, American Healthcare REIT

Our margin expansion in our SHOP portfolio was just over 240 basis points Q2- over- Q2 of last year. Trilogy was just under 180 basis points.

Gabe Willhite
COO, American Healthcare REIT

Really strong.

Jeff Hanson
CEO, American Healthcare REIT

Strong margin expansion. 330 basis point spread between revenue and OpEx in SHOP, and Trilogy was somewhere in the low 2s or the mid 2s.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Now when we are thinking about, we started the conversation thinking about the $2 billion worth of investments that you have pretty much put to work year to date. Thinking about now the universe that you are evaluating, especially with this new hire of a CTO, and really focused when we continue to hear this theme of data-driven decision making.

Jeff Hanson
CEO, American Healthcare REIT

Right.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Also now with your densification regional operators, what is the opportunity set, especially on the investment landscape? Has this continued to expand? Are you getting more efficient in your ability to evaluate opportunities or more coming to you versus you going out and seeking?

Jeff Hanson
CEO, American Healthcare REIT

Yeah, look, I mean, the opportunity set has expanded significantly for everybody. To say that velocity in terms of acquisition opportunity and deals this year over last year is 2x is probably a material understatement. The opportunity set is expanding for everybody. The interesting thing is we started seeing, you did not ask about pricing, but we originally started seeing cap rates compress materially in Q3 and Q4 of last year, a little spilled over into Q1. We were very concerned that that would continue throughout the year and having serious discussions internally about external growth, quote, unquote. We have been pleasantly surprised to see that cap rates and pricing have held pretty static for many months this year.

And we're still doing the entire $2.7 billion in deals that we're doing this year is right in line with initial yields that we've been quoting to everybody, stabilized yields and so forth. So the opportunity set's great. As Gabe said, I think at the front end, everything that we've acquired in that $2.7 billion, that includes pipeline, is vintage 2019. So this is newer state-of-the-art product. Not all of it, but a lot of it, particularly Kensington, is in fortress markets in terms of barrier to entry because there isn't developable land. You've got to assemble it and then take it through entitlement. LCB was another highly strategic, larger $700 million transaction we did this year that I mentioned in northeastern markets. All 2020, 2022, 2023 vintage.

High barrier to entry markets, high RevPAR.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

And continues to be your focus.

Jeff Hanson
CEO, American Healthcare REIT

Yeah.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Entering into those spaces.

Gabe Willhite
COO, American Healthcare REIT

Yeah.

Jeff Hanson
CEO, American Healthcare REIT

Yes.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Well, I know we have just reached the end of time. I have three rapid-fire questions to conclude the meeting. The first one is: If long-term rates stay higher for longer, which has the biggest impact on your sector? Higher refinancing costs, lower transaction activity, or less new supply?

Jeff Hanson
CEO, American Healthcare REIT

What do you think, Gabe?

Gabe Willhite
COO, American Healthcare REIT

For us, we do not use a lot of debt right now. We have a really strong balance sheet. I think the big takeaway is less new supply. That is nice. I would add-

Jeff Hanson
CEO, American Healthcare REIT

Higher for longer.

Gabe Willhite
COO, American Healthcare REIT

-yeah. Less competition from leverage buyers.

Jeff Hanson
CEO, American Healthcare REIT

Yeah.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Over the next three years, will third-party capital become a more important source of growth for public REITs than balance sheet capital? Yes or no?

Jeff Hanson
CEO, American Healthcare REIT

Not for us.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Or just for your public REITs in general? You don't know. That's fine. For your sector, will 2027 same-store NOI growth be higher, the same, or lower than 2026? For the sector, not AHR.

Gabe Willhite
COO, American Healthcare REIT

Yeah. For the sector, I think it will be pretty similar.

Farrell Granath
Lead Coverage for Healthcare REITs, BofA

Okay. Wonderful. Thank you very much.

Jeff Hanson
CEO, American Healthcare REIT

Thanks, Farrell. Appreciate it, everybody.