Key Highlights:
Reported GAAP net income attributable to controlling interest of $23.7 million, or $0.13 per diluted share, for the three months ended March 31, 2026.
Reported Normalized Funds From Operations attributable to common stockholders ("NFFO") of $0.50 per diluted share for the three months ended March 31, 2026, representing over 30% growth compared to the same period in 2025.
Achieved total portfolio Same-Store Net Operating Income ("NOI") growth of 12.1% for the three months ended March 31, 2026, compared to the same period in 2025.
Achieved Same-Store NOI growth of 19.7% and 14.5% for the three months ended March 31, 2026, from its senior housing operating properties ("SHOP") and integrated senior health campuses ("ISHC") segments, respectively, compared to the same period in 2025.
During the three months ended March 31, 2026, the Company acquired approximately $162.8 million of new investments within its SHOP segment.
During the three months ended March 31, 2026, the Company entered into forward sale agreements pursuant to its at-the-market equity offering program ("ATM Program"), to sell 7,028,164 shares of common stock for approximately $357.4 million in gross proceeds. Subsequent to quarter end, the Company entered into additional forward sale agreements pursuant to its ATM Program to sell 2,561,583 shares of common stock for approximately $123.7 million in gross proceeds, assuming full physical settlement.
During the three months ended March 31, 2026, the Company issued 3,974,731 shares of common stock to physically settle sales under previously announced forward sale agreements pursuant to its ATM Program and its November 2025 equity offering for gross proceeds of approximately $191.2 million. Subsequent to quarter end, the Company issued an additional 2,755,996 shares of common stock to physically settle sales under forward sale agreements from its ATM Program for gross proceeds of approximately $134.0 million. As of May 7, 2026, pursuant to its ATM Program, the Company had unsettled forward sale agreements outstanding relating to 10,498,207 shares of common stock that would result in approximately $527.4 million in gross proceeds assuming full physical settlement.
Reported a 0.4x improvement in Net Debt-to-Annualized Adjusted EBITDA from 3.4x as of December 31, 2025 to 3.0x as of March 31, 2026.
The Company is increasing total portfolio Same-Store NOI growth guidance to 9.0% to 12.0% and NFFO per diluted share guidance to $2.03 to $2.09 for the year ending December 31, 2026.
"Our first quarter results reflect another exceptionally strong period across our core metrics, including our ninth consecutive quarter of double-digit Same-Store NOI growth, efficient capital formation and accretive deployment, a strengthened balance sheet, and a raise to our full year 2026 Same-Store NOI growth and NFFO per share guidance," said Jeff Hanson, Chairman, Interim Chief Executive Officer and President. "These results reflect AHR's mission to deliver higher-quality care and superior resident and patient outcomes while serving as the most sought-after and trusted capital partner for the best operators in our industry."
First Quarter 2026 Results
The Company's Same-Store NOI growth results for the three months ended March 31, 2026 are detailed below. Same-Store NOI growth in the first quarter of 2026, compared to the same period in 2025, was led by the Company's operating portfolio, comprised of its ISHC and SHOP segments, through disciplined revenue management and effective expense control by its regional operating partners.
Three Months Ended March 31, 2026 Relative to Three Months Ended March 31, 2025
Segment
Same-Store NOI Growth
ISHC
14.5
%
SHOP
19.7
%
Outpatient Medical
1.6
%
Triple-Net Leased Properties
4.6
%
Total Portfolio
12.1
%
"Our senior housing portfolio delivered strong operating performance this quarter, with Trilogy once again distinguishing itself as a leader in the sector through the strength of its differentiated operating model," said Gabe Willhite, the Company's Chief Operating Officer. "The consistency and quality of Trilogy's results underscore the durability of its approach and its ability to drive sustained superior performance. Across the broader senior housing portfolio, we were able to drive continued NOI expansion by actively managing a range of operational and pricing levers, dynamically balancing them to optimize profitability and maximize total NOI. We remain confident in our ability to build on this momentum and deliver sustained earnings growth as we continue executing on these strategies."
Transactional Activity
During the three months ended March 31, 2026, the Company:
Acquired five new SHOP assets for approximately $117.5 million, as previously announced. The properties are located in California and Missouri, and will be managed and operated by two of the Company's existing regional operating partners.
Acquired two new SHOP assets for approximately $45.3 million. The properties are located in Kansas and will be managed and operated by one of the Company's existing regional operating partners.
Subsequent to the quarter ended March 31, 2026, the Company:
Acquired six new SHOP assets for approximately $86.4 million. The properties are located in Georgia and South Carolina and will be managed and operated by one of the Company's existing regional operating partners.
Sold two Non-Core Properties for approximately $8.1 million within its Outpatient Medical and Triple-Net Leased Properties segments.
Following the Company's completed transaction activity during the three months ended March 31, 2026, and subsequent to quarter end, the Company's investments pipeline consists of over $650 million which includes newly awarded deals and deals in the pipeline previously disclosed in the Company's Fourth Quarter 2025 Earnings Release that have yet to close. While the Company expects to close the deals in its investments pipeline by the end of 2026, it cannot guarantee when or if these closings will take place. Therefore, the Company is not including any additional transaction activity, including the awarded deals in its investments pipeline, in its 2026 guidance, beyond the transactions disclosed as completed.
Development Activity
The Company completed three and started two development projects during the three months ended March 31, 2026.The Company's total in-process development and expansion pipeline is expected to cost approximately $173.9 million, of which $52.4 million had been funded as of March 31, 2026.
Capital Markets and Balance Sheet Activity
As of March 31, 2026, the Company had total consolidated indebtedness of $1.53 billion and approximately $1.31 billion of total liquidity, comprised of cash and cash equivalents, undrawn capacity on its lines of credit, and expected gross proceeds from unsettled forward sale agreements, assuming full physical settlement. The Company's Net-Debt-to-Annualized Adjusted EBITDA as of March 31, 2026, was 3.0x.
During the three months ended March 31, 2026, the Company entered into forward sale agreements pursuant to its ATM Program, to sell 7,028,164 shares of common stock for approximately $357.4 million in gross proceeds, assuming full physical settlement. Subsequent to quarter end, the Company entered into additional forward sale agreements pursuant to its ATM Program to sell 2,561,583 shares of common stock for approximately $123.7 million in gross proceeds, assuming full physical settlement.
During the three months ended March 31, 2026, the Company issued 3,974,731 shares of common stock to settle sales under previously discussed forward sale agreements from its ATM Program and its November 2025 equity offering for gross proceeds of approximately $191.2 million. Subsequent to quarter end, the Company issued an additional 2,755,996 shares of common stock to settle sales under forward sale agreements from its ATM Program for gross proceeds of approximately $134.0 million. As of May 7, 2026, pursuant to its ATM Program, the Company had unsettled forward sale agreements outstanding relating to 10,498,207 shares of common stock that would result in approximately $527.4 million in gross proceeds assuming full physical settlement.
Additionally, subsequent to quarter end, the Company amended its credit facility by increasing the size of the unsecured revolving credit facility portion from $600 million to $800 million, thereby increasing the total aggregate credit facility including term loan to $1.35 billion. The revolving portion of the credit facility now matures on April 1, 2030, and may be extended for two 6-month periods, subject to certain conditions. Further, the Company may increase the aggregate incremental amount of the entire credit facility from $1.35 billion to $1.85 billion, subject to certain terms and conditions. The Company's existing unsecured term loan facility within the credit facility in the initial aggregate amount of $550 million remains unchanged.
"Our proactive hands-on asset management approach has led to solid financial performance at the start of 2026, allowing us to increase our Same-Store NOI growth and NFFO per diluted share guidance for the year," said Brian Peay, the Company's Chief Financial Officer. "Our updated Same-Store NOI growth guidance at the midpoint would suggest a third consecutive double-digit growth year for AHR. Additionally, we have supplemented that organic growth with accretive acquisitions utilizing capital we have sourced through our equity offering programs at attractive prices. With well over $1 billion available on our existing ATM program we plan to continue to utilize forward sale agreements to the extent that the stock continues to trade well, in addition to using the capacity on our line of credit, thereby de-risking the execution of new investments in our pipeline that we expect to close by the end of the year."
Full Year 2026 Guidance
The Company is increasing NFFO per diluted share and Same-Store NOI growth guidance for the year ending December 31, 2026. The Company's 2026 guidance does not assume any additional transaction or capital markets activity beyond the transactions or activity disclosed herein as completed. Guidance ranges are detailed below:
Full Year 2026 Guidance
Metric
Midpoint
Current FY 2026 Range
Prior FY 2026 Range
Net income per diluted share
$0.54
$0.51 to $0.57
$0.75 to $0.81
NAREIT FFO per diluted share
$1.96
$1.93 to $1.99
$1.93 to $1.99
NFFO per diluted share
$2.06
$2.03 to $2.09
$1.99 to $2.05
Total Portfolio SS NOI Growth
10.5 %
9.0% to 12.0%
7.0% to 11.0%
Segment-Level SS NOI Growth:
ISHC
13.0 %
11.0% to 15.0%
8.0% to 12.0%
SHOP
17.0 %
15.0% to 19.0%
15.0% to 19.0%
Outpatient Medical
1.0 %
0.0% to 2.0%
0.0% to 2.0%
Triple-Net Leased Properties
2.5 %
2.0% to 3.0%
2.0% to 3.0%
Certain of the assumptions underlying the Company's 2026 guidance can be found within the Non-GAAP reconciliations in this earnings release and in the appendix of the Company's First Quarter 2026 Supplemental Financial Information ("Supplemental"). A reconciliation of net income (loss) calculated in accordance with GAAP to NAREIT FFO and NFFO can be found within the Non-GAAP reconciliations in this earnings release. Non-GAAP financial measures and other terms, as used in this earnings release, are also defined and further explained in the Supplemental. The Company is unable to provide, without unreasonable effort, guidance for the most comparable GAAP financial measures of total revenues and property operating and maintenance expenses. Additionally, a reconciliation of the forward-looking non-GAAP financial measures of Same-Store NOI growth to the comparable GAAP financial measures cannot be provided without unreasonable effort because the Company is unable to reasonably predict certain items contained in the GAAP measures, including non-recurring and infrequent items that are not indicative of the Company's ongoing operations. Such items include, but are not limited to, impairment on depreciated real estate assets, net gain or loss on sale of real estate assets, stock-based compensation, casualty loss, non-Same-Store revenue and non-Same-Store operating expenses. These items are uncertain, depend on various factors and could have a material impact on the Company's GAAP results for the guidance period.
Distributions
As previously announced, the Company's Board of Directors declared a cash distribution for the quarter ended March 31, 2026 of $0.25 per share of its common stock. The first quarter distribution was paid in cash on April 17, 2026, to stockholders of record as of March 31, 2026.
Supplemental Information
The Company has disclosed supplemental information regarding its portfolio, financial position and results of operations as of, and for the three months ended, March 31, 2026, and certain other information, which is available on the Investor Relations section of the Company's website at https://ir.americanhealthcarereit.com.
Conference Call and Webcast Information
The Company will host a webcast and conference call at 1:00 p.m. Eastern Time on May 8, 2026. During the conference call, Company executives will review first quarter 2026 results, discuss recent events and conduct a question-and-answer period.
To join via webcast, investors may use the following link: https://events.q4inc.com/attendee/173789053.
To join the live telephone conference call, please dial one of the following numbers at least five minutes prior to the start time:
United States (Local): +1 585 542 9983United States (Toll-Free): +1 833 461 5787International Dial-Ins: https://help.events.q4inc.com/eahc/international-dial-in-numbers Meeting ID: 173789053
A digital replay of the call will be available on the Investor Relations section of the Company's website at https://ir.americanhealthcarereit.com shortly after the conclusion of the call.
Forward-Looking Statements
Certain statements contained in this press release, including statements relating to the Company's expectations regarding its performance, interest expense savings, balance sheet, net income or loss attributable to common stockholders and per diluted share, NAREIT FFO attributable to common stockholders and per diluted share, NFFO attributable to common stockholders and per diluted share, total portfolio Same-Store NOI growth, segment-level Same-Store NOI growth, occupancy, NOI growth, revenue growth, purchases and sales of assets, development plans, and the settlement of forward sale agreements may be considered forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. The Company intends for all such forward-looking statements to be covered by the applicable safe harbor provisions for forward-looking statements contained in those acts. Such forward-looking statements generally can be identified by the use of forward-looking terminology, such as "may," "will," "can," "expect," "intend," "anticipate," "estimate," "believe," "continue," "possible," "initiatives," "focus," "seek," "objective," "goal," "strategy," "plan," "potential," "potentially," "preparing," "projected," "future," "long-term," "once," "should," "could," "would," "might," "uncertainty" or other similar words. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. Any such forward-looking statements are based on current expectations, estimates and projections about the industry and markets in which the Company operates, and beliefs of, and assumptions made by, the Company's management and involve known and unknown risks and uncertainties that could cause actual results to differ materially from those expressed or implied therein, including, without limitation, changing macroeconomic conditions, domestic legal and fiscal policies, and geopolitical conditions and other risks disclosed in the Company's Annual Report on Form 10-K for the year ended December 31, 2025, filed on February 27, 2026, and subsequent periodic reports filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any obligation to update or revise any forward-looking statements contained in this release.
Non-GAAP Financial Measures
The Company's reported results are presented in accordance with GAAP. The Company also discloses the following non-GAAP financial measures: EBITDA, Adjusted EBITDA, Net Debt-to-Annualized Adjusted EBITDA, NAREIT FFO, NFFO, NOI and Same-Store NOI. The Company believes these non-GAAP financial measures are useful supplemental measures of its operating performance and used by investors and analysts to compare the operating performance of the Company between periods and to other REITs or companies on a consistent basis without having to account for differences caused by unanticipated and/or incalculable items. Definitions of the non-GAAP financial measures used herein and reconciliations to the most directly comparable financial measure calculated in accordance with GAAP can be found at the end of this earnings release. See below and "Definitions" for further information regarding the Company's non-GAAP financial measures.
EBITDA and Adjusted EBITDA
Management uses earnings before interest, taxes, depreciation and amortization ("EBITDA") and Adjusted EBITDA to facilitate internal and external comparisons to our historical operating results and in making operating decisions. EBITDA and Adjusted EBITDA are widely used by investors, lenders, credit and equity analysts in the valuation, comparison, and investment recommendations of companies. Additionally, EBITDA and Adjusted EBITDA are utilized by our Board of Directors to evaluate management. Neither EBITDA nor Adjusted EBITDA represents net income (loss) or cash flows provided by operating activities as determined in accordance with GAAP and should not be considered as alternative measures of profitability or liquidity. Finally, the EBITDA and Adjusted EBITDA may not be comparable to similarly entitled items reported by other REITs or other companies. In addition, management uses Net Debt-to-Annualized Adjusted EBITDA as a measure of our ability to service our debt.
NAREIT Funds from Operations (FFO) and Normalized Funds from Operations (NFFO)
We believe that the use of FFO, which excludes the impact of real estate-related depreciation and amortization and impairments, provides a further understanding of our operating performance to investors, industry analysts and our management, and when compared year over year, reflects the impact on our operations from trends in occupancy rates, rental rates, operating costs, general and administrative expenses and interest costs, which may not be immediately apparent from net income (loss) as determined in accordance with GAAP. However, FFO and NFFO should not be construed to be (i) more relevant or accurate than the current GAAP methodology in calculating net income (loss) as an indicator of our operating performance, (ii) more relevant or accurate than GAAP cash flows from operations as an indicator of our liquidity or (iii) indicative of funds available to fund our cash needs, including our ability to make distributions to our stockholders. The method utilized to evaluate the value and performance of real estate under GAAP should be construed as a more relevant measure of operational performance and considered more prominently than the non-GAAP FFO and NFFO measures and the adjustments to GAAP in calculating FFO and NFFO. Presentation of this information is intended to provide useful information to investors, industry analysts and management as they compare the operating performance metrics used by the REIT industry, although it should be noted that some REITs may use different methods of calculating funds from operations and normalized funds from operations, so comparisons with such REITs may not be meaningful.
Net Operating Income (NOI)
We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are appropriate supplemental performance measures to reflect the performance of our operating assets because NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI exclude certain items that are not associated with the operations of the properties. We believe that NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are widely accepted measures of comparative operating performance in the real estate community and are useful to investors in understanding the profitability and operating performance of our property portfolio. However, our use of the terms NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI may not be comparable to that of other real estate companies as they may have different methodologies for computing these amounts.
NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI are not equivalent to our net income (loss) as determined under GAAP and may not be a useful measure in measuring operational income or cash flows. Furthermore, NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be considered as alternatives to net income (loss) as an indication of our operating performance or as an alternative to cash flows from operations as an indication of our liquidity. NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should not be construed to be more relevant or accurate than the GAAP methodology in calculating net income (loss). NOI, Cash NOI, Pro-Rata Cash NOI and Same-Store NOI should be reviewed in conjunction with other measurements as an indication of our performance.
About American Healthcare REIT, Inc.
American Healthcare REIT, Inc. (NYSE:AHR) is a real estate investment trust that acquires, owns and operates a diversified portfolio of clinical healthcare real estate, focusing primarily on senior housing communities, skilled nursing facilities, and outpatient medical buildings across the United States, and in the United Kingdom and the Isle of Man.
AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
As of March 31, 2026 and 2025
(In thousands, except share and per share amounts) (Unaudited)
March 31, 2026
December 31,2025
ASSETS
Real estate investments, net
$
4,319,911
$
4,183,419
Debt security investment, net
92,304
92,136
Cash and cash equivalents
119,380
114,836
Restricted cash
37,504
36,917
Accounts and other receivables, net
241,594
204,313
Identified intangible assets, net
250,424
253,236
Goodwill
234,942
234,942
Operating lease right-of-use assets, net
130,405
135,399
Other assets, net
172,194
171,028
Total assets
$
5,598,658
$
5,426,226
LIABILITIES AND EQUITY
Liabilities:
Mortgage loans payable, net
$
962,375
$
966,925
Lines of credit and term loan, net
549,818
549,761
Accounts payable and accrued liabilities
340,265
317,742
Identified intangible liabilities, net
1,978
2,110
Financing obligations
33,675
33,902
Operating lease liabilities
130,806
135,603
Security deposits, prepaid rent and other liabilities
58,386
59,568
Total liabilities
2,077,303
2,065,611
Commitments and contingencies
Equity:
Stockholders' equity:
Preferred stock, $0.01 par value per share; 200,000,000 shares authorized; none issued and outstanding
—
—
Common stock, $0.01 par value per share; 700,000,000 shares authorized; 189,942,357 and 185,911,442 shares issued and outstanding as of March 31, 2026 and December 31, 2025, respectively
1,894
1,852
Additional paid-in capital
5,065,446
4,880,169
Accumulated deficit
(1,583,441)
(1,559,279)
Accumulated other comprehensive loss
(2,224)
(2,104)
Total stockholders' equity
3,481,675
3,320,638
Noncontrolling interests
39,680
39,977
Total equity
3,521,355
3,360,615
Total liabilities and equity
$
5,598,658
$
5,426,226
AMERICAN HEALTHCARE REIT, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (LOSS)
For the Three Months Ended March 31, 2026 and 2025
(In thousands, except share and per share amounts) (Unaudited)
Three Months Ended March 31,
2026
2025
Revenues:
Resident fees and services
$
609,767
$
497,176
Real estate revenue
41,007
43,427
Total revenues
650,774
540,603
Expenses:
Property operating expenses
512,171
432,423
Rental expenses
13,100
13,643
General and administrative
17,605
13,155
Transaction, transition and restructuring costs
1,971
1,837
Depreciation and amortization
67,062
41,114
Total expenses
611,909
502,172
Other income (expense):
