American Healthcare REIT: 3 Key Takeaways for Long-Term Investors

On its third-quarter 2026 earnings call, held on Nov. 6, 2026, American Healthcare REIT (NYSE:AHR) announced an increase to its full-year normalized funds from operations (NFFO) guidance, a cash-flow performance metric for real estate investment trusts. For long-term investors, operational efficiency across senior housing properties is driving compounding cash flows. Three things management said stand out.

1. Expanding Operating Spreads Drive SHOP Margin Growth

In the Senior Housing Operating Portfolio (SHOP), where American Healthcare REIT retains direct operational exposure, revenue per occupied room grew much faster than operating expenses per room. That widening spread expanded operating margins and drove substantially higher same-store net operating income (NOI)--property cash flow after operating costs--across the segment.

Same-store revenue grew 9%, driven by accelerating RevPOR growth of 5.4% year-over-year. And notably, ExPOR grew just 0.8%. So the RevPOR to ExPOR spread expanded to roughly 460 basis points.
-- Gabriel Willhite, President and Chief Operating Officer

2. Relationship-Driven Sourcing Secures High-Quality Infill Assets

Rather than competing in public auctions where asset prices are bid up, management relies on direct relationships with operators to acquire properties. This off-market strategy allows the real estate investment trust (REIT) to buy newer senior housing communities in supply-constrained infill markets without overpaying.

The opportunity reached us through a limited channel process rather than a broadly marketed auction, and we were not the highest bidder. Kensington as both owner and operator selected AHR based on alignment and long-term partnership.
-- Stefan Oh, Chief Investment Officer

3. Disciplined Balance Sheet Management Expands Capital Capacity

Management reduced net debt relative to earnings before interest, taxes, depreciation, and amortization (EBITDA), expanding its funding capacity. By match-funding acquisitions through unsettled forward equity sales, the company supports its pipeline while preserving financial flexibility.

Net debt to annualized adjusted EBITDA improved to 1.9x, 0.5 turn lower sequentially and 1.6 turns lower than a year ago.
-- Aric Chang, Chief Financial Officer

Looking Ahead

Aging demographics provide structural growth tailwinds for senior housing communities. Management relies on proprietary technology tools and regional operator partnerships to turn sector fundamentals into operational execution.

We're going to lean in and be innovators in the space, use the information that we have and use our new tech team to help drive total portfolio performance.
-- Gabriel Willhite, President and Chief Operating Officer

Capital deployment remains focused on disciplined match-funding for acquisitions in high-barrier markets while maintaining low leverage.

We believe AHR is increasingly positioned at the intersection of historically strong sector fundamentals and an integrated operating and capital allocation platform built to convert those fundamentals into superior long-term shareholder value.
-- Jeffrey Hanson, Chairman and Chief Executive Officer

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