Hello, everyone. Thank you for being here. We're delighted to be at Nareit today and to join you, Tayo. As you know, Ventas is an S&P 500, $34- billion company with about $2 billion of NOI. We are focused in our business with over 1,400 assets on the large and growing demand from a senior population. And our assets are focused on senior housing, which is over half of our business. We are advantaged across the commercial real estate space because we do have incredible demographic demand that is really just lifting off, and we expect to see a step function in that over the next five to 10 years of both the over 65 and the over 80 population. Against that differentiated and compelling backdrop, we have articulated a very simple strategy, a one, two, three strategy.
It's different from the one we had 25 years ago, but equally value-creating. The first is really to capture this compelling organic growth story in senior housing. We have very low supply, a secular low in starts, while we have, 25% growth projected in the over 80 population over the next five years. And so we're very excited about that. It's adding over $100 million of NOI to our business, a year, and that's well underway, and it should continue kind of as far as the eye can see. So the first part of our strategy is executing on that, and we have the platform, and the experience, to do so, and the portfolio, I must say, to do so. I said that the story of organic growth is well underway.
2024 is an occupancy growth story, and I'm happy to say that price is also trending in tandem with our occupancy acceleration. And so from that incredible supply-demand imbalance in our favor, we saw 120 basis points of occupancy growth in our portfolio last year, 170 in the fourth quarter, 240 in Q1, and quarter to date, we're over 300 year-over-year. So that nice occupancy acceleration with price growth is what's driving the NOI growth, and we're projecting 12%-16%, same story year-over-year, NOI growth in 2024. So I mentioned this is all being executed on our platform, led by Justin, and really driven by incredible data analytics that we've developed over the last few years.
The platform and the data analytics are also driving the second prong of our strategy, which is to add external growth focused on senior housing to our portfolio. We're seeing great yields. This is one of the first times in my career where I've seen high going-in cash yields on quality assets in good markets that is also has embedded growth that leads to low-to-mid-teens unlevered IRR expectations, and we're very excited about that. Our expectation right now is about $750 million in external growth, funded with equity during the year, and $350 million of that is already closed, and we have a line of sight near- term to an additional incremental $400 million. Excited about that.
The third prong of the strategy is really just to execute and drive cash flow in the rest of our portfolio, and we're doing that. We're two points on that. We're in active discussions with Kindred and other parties about the 23 long-term acute care hospitals, or LTACHs, that are up for renewal in 2025, and we hope to give the market more clarity on that in the second quarter. It's about 5% of our NOI, and we're working to achieve a manageable outcome in the near- term. More on that, hopefully to follow. Then we also announced about $300 million expected disposition proceeds in 2024. We're at $200 million already. Last week, we closed a very attractive disposition of skilled nursing facilities at a six cap on cash NOI, $100,000 a bed.
So we're excited as we continue to execute on our disposition strategy and value creation. And so, you know, I just want to close, Tayo, on a couple of points. You know, our one, two, three strategy is also has a partner in financial strength and flexibility, so it's kind of a silent fourth. So we continue to focus on liquidity, which is great. We've done some great recent bond deals, renewal of our revolver at better pricing, and so we have virtually no maturities left in 2024. So happy about that. And we're reaffirming our guidance, including 6%-8% year-over-year growth in company same store cash growth. And excuse me.
We have a great demand-driven business, and at this moment in time, it's Ventas represents a really interesting, and I think compelling value creation opportunity, in terms of, and you must agree because you have a buy on the stock, but the growth and the multiple combination is really something that screens, you know, incredibly well for investors, and we're just getting going. So with that, I'll stop and turn it over to you for questions.
Excellent. So, I will ask one or two quick questions, and then I'll kind of open it up to anyone else that's interested in asking a question. So my first question is around point number one of the one, two, three strategy, which is this interesting internal growth opportunity you have within your senior housing portfolio. Very curious again, you recently hired a Chief Revenue Officer, and I'm very curious to understand exactly what she has done so far at the company, how you see that translating into better revenue opportunities within the SHOP portfolio, and also overall, how one thinks about just how good occupancy can get, just given this acceleration you're seeing in the year-over-year occupancy gains?
Well, Justin is the boss of SHOP, so he's gonna take all the number one questions.
All right. Well, so first of all, just to step back, we are pleased to be situated in markets that offer a projected net absorption of 1,000 basis points of upside over the next few years. So really strongly positioned in terms of location. Debbie mentioned the portfolio's great. We have great operators. We've grown from having 10 in 2020 to 24 today. And then the data that really powers our Ventas OI platform is 1 billion data points at this point, and it's overwhelmingly top-line driven. So our data, as it pertains to driving price and volume, is excellent. And so adding somebody that has a very strong top-line orientation, Lindsay Casillas started yesterday, so she hasn't contributed a lot yet.
What has she done for you?
So I'm expecting big results by tomorrow. But, you know, I'm really excited about Lindsay joining the team because she has a good, solid background in hospitality. She has a, you know, before that, a solid background in senior housing as well, and leading, you know, national sales efforts. Great track record. So, you know, she'll lead the SHOP performance and have a special emphasis on top-line growth.
Excellent. And then my second quick question again, is about point number two of the one, two, three strategy. And again, the $350 million of transactions that were recently completed. Two things that I thought were notable about them was, one, kind of exposure to new operators. It's kind of this new regional operator that's in play. I think historically, we've thought about your portfolio as having mostly these large national operators. So kind of curious, you know, this approach of going to like, regional sharpshooters, how you hope that contributes to better, a bottom line. And also with this operator as well, it sounds like you have done something a little different with the management contracts as well, that's more bottom- line- focused, again, in an effort to kind of drive better NOIs.
If you just kind of talk about those two key things.
So, you know, first of all, I mentioned our presence in our markets, and so we've been focused on the past several years to make sure we're positioned in the right markets that have, you know, strong affordability and strong net absorption projection moving forward. If we were in markets that didn't offer that, they're gone, you know. So we've exited those markets. We've wanted to make sure we have the right assets within the markets, you know, that are well-positioned, well-invested, and then it's who's gonna operate it.
Certainly we've added a lot of operators. As we, as we're making acquisitions, there's a decision to be made. Should we, you know, move to an existing operator, or do we, do we go with an in-place operator? We've had a couple of really good opportunities to pick up new Northeast-based regional operators, picked up Benchmark last year, LCB this year. But the decision really is not around the size of the company, it's their, their track record in a specific market. And large companies can have nice clusters and nice local track records. Regional companies can do the same, and so we're really just making a judgment call in terms of who's gonna create value with that community moving forward, and we have a lot to choose from at this stage.
Oh, great. Before I hog the spotlight, we'd like to kind of open it up for anyone that may have any additional questions. Going once.
Yeah.
All right, back to me.
Yeah.
All right, so let's talk a little bit about point three then. So this, driving strong execution and cash flow generation. Again, Debbie, I know you kind of mentioned about better clarity on Kindred t owards the kind of get closer towards the end of the year. I'm just curious, again, we've seen other companies kind of go through this process. And, you know, some people have decided to transition to a new operator, some people have decided to, you know, do a rent deferral, and then when things get better, you kind of get picked up on the other end. When you kind of...
But again, in that process, you don't kind of disrupt things by having to trans- -you know, go, transition to a new operator. So when you think about those two kind of opportunity sets of- stay with guy A or woman A -or, kind of, or transition, you know, how do you kind of think about the better way to kind of handle that?
Well, each one of these situations is bespoke, and of course, we've been dealing with Kindred renewals for 25 years. And so we have a very, well-developed playbook, and the way I really think about it is, you know, what is our goal? And our goal right now is to kind of optimize enterprise value and the NOI at the assets going forward. We would expect to think about options both with Kindred and with potential other operators, which we are doing, and that's important to getting to the best outcome. Again, each situation is unique, and I think we're well- experienced and kind of well-positioned to reach the goal that I, that I outlined.
Gotcha. That's helpful. And then kind of going back to senior housing, which kind of, again, is, like, is a critical focus-
Yes.
for the company, you know, at this point. In terms of the opportunities that you're looking at for external growth-
Mm-hmm.
How does international play into that?
Mm.
Whether it's the U.K., whether it's Canada-
Mm-hmm.
Or elsewhere?
I mean, we have a great portfolio of senior housing in Canada. It's a jewel. It's 96% occupied, so that market's been very good to us. The opportunities for growth in the U.S. are just exceptional right now.
Mm-hmm.
And we also have assets in the U.K., and Justin has experience there, so we're open to that. But the dominant thematic is U.S. senior housing, with very specific characteristics.
Yeah, the characteristics being, you know, I'll just list a few. So, you know, going into year, yields of seven to eight, unlevered IRRs of low to mid-teens, buying below replacement costs, buying combination campuses that either offer assisted living, assisted living, independent living, and memory care together, or assisted living and memory care, combination need-driven campuses, in markets that have strong net absorption as well.
Generally, these communities are on the newer side, have occupancies that are mid-80s percent or so, so lots of runway in terms of occupancy, but also price opportunity, and are leaders in their respective markets. It is a unique opportunity to buy in the U.S., have yield and growth-
Mm-hmm.
Mm-hmm
... combined, and it's really leading our pipeline at this stage.
Mm-hmm.
As we think about this long runway of debt maturities in senior housing, that, again, everyone's expecting to create opportunities, you know, should we be getting excited about the idea of, I think this year, you have, like, $750 million of acquisitions? Do we get excited about, you know, hitting the billion-dollar mark, you know, a year from now? Because historically, it's not been unusual for you to have multibillion-dollar years of acquisition.
Right. So, you know, I'd like to remind everyone that this one, two, three strategy that Debbie was mentioning, clearly, we've been getting our SHOP platform in order and ready for this for over a period of time, and it's we're really well- positioned to be, you know, one of the very best owners of senior housing. But the growth part really just started recently. You know, we announced the opportunity externally in February. We've been executing quickly. We have closed $350 million. We see another $400 million coming, and so, and the debt maturities you mentioned, there's $19 billion over the next two years that are facing the senior housing sector.
So there's pressure on existing owners, and although the fundamentals are great, they are facing a debt maturity, which could cause a lower LTV, higher debt costs, more capital to be put in. And so that's creating opportunities. And so it seems early- You know, with the $750 million, and we'll look to try to do more over time.
Gotcha. Opening up to the audience again, if there are any additional questions.
Mm-hmm. I mean, one other thing I'd like to touch on, too, in looking at the investment criteria is affordability. I think what is often, you know, misunderstood about senior housing is, A, how affordable it is and how similar the cost is to living as a widow or widower in a suburban home, where you have to pay taxes and insurance and upkeep and meals and you know, insurance. And so, affordability is really high, particularly as you get to the baby boomer generation. That is the wealthiest generation in history. And so that is one of the investment criteria we use. But again, I think surprisingly, the product is very consumer- driven. It provides an incredible value to seniors and their families, and it is highly affordable, and so we're continuing to focus on that, as we continue to invest.
Yes, we have a question.
Thank you. Paula Poskon, STOV Advisory Services . How are you thinking about your technology budget over the coming years when you're thinking about such tremendous growth in the seniors population, but also tremendously promising technology, right? And clearly will help on the labor side, but, you know, how do you think about underwriting that expense going on?
Yeah. So, you know, the technology in our setting is one of the big opportunities. Senior housing, you know, has not really been on the forefront, you know, typically, you know, in that regard. I do believe that's changing. I was walking down the hallway of our new-- one of our new communities a couple weeks ago, next to the robot that was vacuuming. Yes, that's a good indicator. There's really good safety monitoring that's predictive, you know, that's used in our communities. Energy savings-
-is a huge investment for us, and that, that pays back, but you're using AI to just to manage the, the energy consumption really across the board in the, in the communities. So it's, it's a big area of opportunity. And I do, you know, in some, some ways, think we're at the beginning, but it's been a priority investment.
If I could just do a follow-up. Do you think that becomes a differentiator for you as a large company between the haves and the have-nots, that they just won't be able to keep up, and that creates a whole new, maybe, set of sellers?
We are certainly a great owner of this type of asset, because we do invest in it. We invest in the operations. We invest in the real estate. A big part of our business plan has been to make sure we're competing at market or reposition communities. We have over 200 communities that have had a refresh over the last two years. And obviously, they're performing really well. They're outperforming market. But you have to have, you know, the financial strength of the company that we have and the platform we have to be able to do that. So it's certainly a competitive advantage.
Thank you for your question.
Yes, sir.
Can you elaborate a little bit on your view on energy transition risks and physical values?
Well, we have a net zero by 2040 at Ventas, so we're very proud of that. And we have invested a lot in energy savings, as Justin just talked about, across our 1,400 assets. And it has been good for business and good for the environment, and we believe that we can and should do both.
Physical risk?
Physical risk, we spend a lot of time on. We have a grid, obviously, and it helps be a decision-- one of the decision factors in our investment and our disposition criteria. The challenge that all of us face in real estate is the frequency and severity of events that are more broad-based than they used to be. So we have to be somewhere, and our biggest mitigant is that we're in 48 states. We don't have any market or any building that poses outsized risk to the company, and we are spread out so that we... That is the biggest way that we manage that risk, because, like I said, you have to be somewhere, and we're everywhere. So I hope that answers your question. All right.
Yes, if I could just stick with the ESG theme again. You do have two new board members, now. One board member joined the investment committee, another board member joined the nominating governance and corporate responsibility committee.
Yes.
Just curious, again, about, you know, the addition of these two new board members, what you ultimately hope they kind of bring to Ventas in regards to improving your overall-
Yes.
your overall ESG policies?
Well, let's take that as a G question.
Okay.
Right? On governance. At Ventas, we have a history of very good governance, very rigorous independence and other aspects of selection, creation of the board, which works on behalf of shareholders, really to deliver long-term returns. We have delivered 18% annual returns for 24 years, so they're doing something right. Hopefully, the two new guys don't mess it up. No, in all seriousness, and then we added two well-respected REIT investors to our board this year. They bring a new perspective, and again, all aligned with the board and management to create value for shareholders, and we believe they're gonna be contributors.
Excellent.
Mm-hmm.
Any further questions? Let's talk outside of SHOP for a quick second-
Okay.
-If you don't mind. So there's still a piece of your business, the medical office business.
Yes.
And also, your life sciences portfolio.
We've rebranded those.
Yes.
Outpatient Medical and Research.
Outpatient Medical and Research, OM&R. Just curious, again, if you could talk a little bit about fundamentals in that space-
Yes
... and how you kind of see that also contributing toward your bottom, your bottom line. Does OM&R become a, you know, a source of capital if you kind of really are much more focused on SHOP going forward?
Thank you, Tayo. I was getting lonely up here.
Too long for you.
Yes, so OM&R is 30% of our business, outpatient medical, about 20% of the NOI, our research business, 10%. What we love about that business is the steady compounding growth that we get out of that portfolio. Our customers, in both cases, are highly rated health systems or universities with long-term leases on campus, in both cases, and they attract tenancy that fills out our buildings. It's, it's quite simple. And so we have an in-house property management and leasing group called Little Bridge, that manages these assets. A leader in Pete Bulgarelli, who joined us five or so years ago, who's been driving outstanding performance. And so as a, if you call it, complement to the senior housing growth, that nice 3% every year is a, is a nice, I feel like, balancing part of the portfolio.
Could also be a source on the margin for capital recycling, to reinvest in senior housing, which is something we've been doing this year, but we like the portfolio as it stands.
Gotcha. S enior, back to senior housing then.
Oh, dear!
So, just as strong as fundamentals have kind of been in the past kind of year or two, I think again, we're still at a point where, you know, occupancy is not back to what it was pre-pandemic. We're still not at a point where NOI margins were back to pre-pandemic levels. I guess when you look at your crystal ball, do you see that happening where we can kinda get back to those highs? Do you see us going beyond those highs, and why?
So let's take the last part first. There is a-- Because of the supply-demand, there is a very long runway to reach. The first milestone would be pre-pandemic occupancy and margin. Then, as Justin said, we think there's 1,000 basis points of market potential for net absorption, or 10 percentage points of occupancy upside in the next few years. And so we believe that we can meet and potentially exceed the low 90s occupancy, which is what the last peak was in 2014, which you and I enjoyed together. And that was after a period of time in the financial crisis where starts were very low.
But the senior population only grew 7% in total in those next five years. Now, we have starts being similarly low or lower, and we have the over 80 population growing 25% in the next five years. So, Justin, do you wanna elaborate really on-
Yeah.
-your expectations?
There's a few, a few stats. So one, in 2027, we expect, another 800,000+ 80-year-olds. It'll be the fastest growth we've had. It's when the baby boomer population starts turning 80. The highest-
That's when my mom turns 80.
Okay. We'll welcome her if needed.
1940-
Um.
1947, yeah.
So, the highest number of deliveries we've ever had in terms of units is 56,000. So we're at 16x the highest number of units delivered in terms of 80+ population now at 27. So really compelling demand. So when I'm talking about the next few years, that hasn't even gotten to that point yet. One other stat that NIC just put out, National Investment Center for Senior Housing, is that senior housing communities. So first of all, starts are at an all-time low. Secondly, those that are starting, very few, are taking three years from groundbreaking to opening, so they're slower than they have been in the past. And so they were talking about, you know, three to four-year window in terms of this great net absorption opportunity. It's probably longer in light of that. So we were really excited about the tailwinds.
Clearly, we're already seeing evidence of that, with our occupancy up 300 basis points year-over-year, 360 in the U.S. But there's a long way to go and a lot of upside ahead.
Gotcha. On anything that investors should be thinking about from a regulatory perspective, again, senior housing is private pay.
Yes.
But I think, again, we've kind of seen on the skilled nursing side, a lot of kind of concern about quality of care, minimum staffing rules. You know, this is also a very care setting as well. So how should we kind of think through about any potential regulatory changes that could happen?
Mm-hmm. Well, senior housing is a consumer-driven, consumer-paid product, and it attracts residents from the value that it provides for care, longevity, etc., socialization. It is state-regulated and has been since inception, and that's one reason it trades at attractive cap rates. It's more real estate-y part of the healthcare continuum. And I would say that we feel good about the current, you know, regulatory regime. That's a state-by-state regime that has been effective, frankly, in regulating senior living since inception. Very low likelihood of federal regulation over, coming over the top of that.
Mm-hmm.
Very hard to do. And so the one point I would like to emphasize, though, is that as long-term players and participants and investors in the space, you know, quality of care and the quality of operators and making sure that we are delivering the kind of care that seniors and their families expect is a very high value for us. And, that's true regardless of regulation.
Gotcha.
And it leads to better financial results as well.
Excellent. Any other questions?
You're so shy today.
All right,
Putting all the work on Tayo.
That's all. That's okay.
Yeah.
I think to close out, we're going to play a really quick game, where I'm going to ask you three yes or no questions.
Oh, uh-oh.
Number one, by the end of the year, will rates be higher or lower?
Is this to me?
Does, well-
Yeah.
Anyone on the-
Lower.
Anyone on the panel?
Lower.
Higher.
You think rates will be higher, Debbie? Okay.
Rates or REITs?
Rates, rates, rates.
Oh, rates.
Interest rates.
Lower.
Rates.
I thought you said REITs, too.
That's going to be my last question.
Rates lower, REITs higher.
Yeah, exactly. Exactly.
All right. And, by the end of the year, do you actually expect your SHOP occupancy to be higher or lower?
Higher.
Higher. By the end of the year-
Yeah.
By the end of the year, do you expect your NOI margin in the SHOP portfolio to be higher or lower?
To be higher.
Excellent. I guess the last question I can answer that.
Those were yes or no.
That's easy, yeah. Exactly.
Go ahead.
And then I guess, to kind of wrap things up, you know, I just wanted to kind of say thank you all very much, for being here today. Thank you for the insightful presentation. And, again, it's, you know, we have a buy rating on the name, and, again, my yes or no, we, I definitely think we expect the stock to be higher by the end of the year.
All right.
Well, we appreciate you, and thank you all for being here. We appreciate your interest in Ventas.
Thanks.
Excellent. Thank you.