Executive Summary

Q3 2025 delivered another strong quarter: revenue rose to $572.9M (+9.4% YoY; +5.6% QoQ), GAAP diluted EPS was $0.33, NAREIT FFO/share was $0.54, and NFFO/share was $0.44 .
Material beat vs consensus: revenue beat by ~$20.8M and FFO/share beat; Primary EPS also exceeded the Street, supported by >20% Same-Store NOI growth in operating segments (ISHC +21.7%, SHOP +25.3%) . Consensus values from S&P Global shown below.
Guidance raised across the board: FY25 NFFO/share to $1.69–$1.72 (prior $1.64–$1.68), total portfolio SS NOI to 13–15% (prior 11–14%), with segment upgrades (ISHC, SHOP, OM, and triple-net) .
Balance sheet improved and external growth active: Net Debt/Annualized Adjusted EBITDA improved to 3.5x (from 3.7x in Q2), while AHR closed ~$210.8M of acquisitions in Q3 and >$575M YTD, and highlighted >$450M awarded pipeline — catalysts for continued estimate revisions and stock reaction .

What Went Well and What Went Wrong

What Went Well

Operating momentum: total portfolio Same-Store NOI grew 16.4% YoY, led by ISHC (+21.7%) and SHOP (+25.3%), with SHOP RevPOR up mid‑single digits and spot occupancy above 90% .
Guidance and leverage: management raised FY25 guidance across key metrics and improved Net Debt/Annualized Adjusted EBITDA to 3.5x (from 3.7x), reinforcing funding capacity for pipeline execution .
Management confidence and secular tailwinds: “the best operating environment for long-term care I have seen in my entire 33-year career,” said CEO Danny Prosky, citing strong pricing power and >90% occupancy in Trilogy and SHOP .

What Went Wrong

Outpatient Medical softness: OM Same-Store NOI growth remained low (+2.9% YoY) with cash NOI margins down vs prior year; OM ending occupancy was 86.5%, below last year .
Trilogy margin seasonality: ISHC margins ticked down sequentially on timing of seasonal costs (flu vaccines, employee health insurance), though management expects margin expansion over time .
Triple-net flat: Triple-net Same-Store NOI was essentially unchanged (+0.1% YoY), reflecting a transition focus toward operating segments for higher growth .

Financial Results

P&L and Per-Share Metrics

Metric	Q3 2024	Q2 2025	Q3 2025
Revenue ($USD Millions)	$523.814	$542.503	$572.937
Diluted EPS ($)	$(0.03)	$0.06	$0.33
NAREIT FFO/share ($)	$0.27	$0.41	$0.54
Normalized FFO/share ($)	$0.36	$0.42	$0.44

Consensus vs Actual (Q3 2025)

Metric	Actual	Consensus
Revenue ($USD Millions)	$572.937	$552.144*
Primary EPS ($)	$0.33	0.1425*
FFO/share (REIT) ($)	$0.54	0.4193*

Values with asterisks are retrieved from S&P Global (Capital IQ) and may use differing definitions than company-reported GAAP diluted EPS.

Segment Same-Store NOI Growth (YoY)

Segment	Q1 2025	Q2 2025	Q3 2025
ISHC	19.8%	18.3%	21.7%
Outpatient Medical	2.0%	1.4%	2.9%
SHOP	30.7%	23.0%	25.3%
Triple-Net Leased	(1.4%)	1.4%	0.1%
Total Portfolio	15.1%	13.9%	16.4%

KPIs (Occupancy and RevPOR)

KPI	Q3 2024	Q2 2025	Q3 2025
SHOP Avg Occupancy (%)	85.2%	85.7%	87.6%
SHOP RevPOR ($)	$5,006	$5,347	$5,354
ISHC Avg Occupancy (%)	87.4%	88.9%	90.2%
ISHC Quality Mix (%)	73.7%	76.7%	75.6%
Trilogy Medicare Advantage share of resident days (%)	5.8%	7.2%	7.2%

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Net income/share (diluted)	FY 2025	$0.33–$0.37	$0.47–$0.50	Raised
NAREIT FFO/share (diluted)	FY 2025	$1.57–$1.61	$1.71–$1.74	Raised
Normalized FFO/share (diluted)	FY 2025	$1.64–$1.68	$1.69–$1.72	Raised
Total Portfolio SS NOI Growth	FY 2025	11%–14%	13%–15%	Raised
ISHC SS NOI Growth	FY 2025	15%–19%	17%–20%	Raised
OM SS NOI Growth	FY 2025	1%–1.5%	2%–2.4%	Raised
SHOP SS NOI Growth	FY 2025	20%–24%	24%–26%	Raised
Triple-Net SS NOI Growth	FY 2025	(0.8%)–(0.3%)	(0.3%)–0.3%	Raised
Interest Expense ($M)	FY 2025	$85–$90	$85–$88	Narrowed
G&A ($M)	FY 2025	$56–$58	$56–$58	Maintained
Other Income ($M)	FY 2025	$2–$4	$3.5–$4.5	Raised
Development Spend ($M)	FY 2025	$80–$100	~$80 for starts & on‑going projects	Narrowed
Dividend/Distribution	Q3 2025	$0.25/share (declared)	$0.25/share (paid 10/17/25)	Maintained

Earnings Call Themes & Trends

Topic	Previous Mentions (Q1 & Q2)	Current Period (Q3)	Trend
Operating environment & demand	Early innings of multi‑year long‑term care demand; pipeline >$300M; ~87.5% SHOP spot occupancy at Q2 end	CEO: “best operating environment…in 33 years”; SHOP spot occupancy above 90%	Strengthening
Medicare Advantage & quality mix	Medicare Advantage rising (5.8%→7.2% of resident days); higher rates than private/Medicaid	MA share 7.2%; optimizing MA contracts; ADR growth lever	Positive mix shift
Revenue management technology	Trilogy centralized revenue mgmt; rolling out dashboards/tools to SHOP operators (pilot phase)	Continued pilot across operators; platform value in pricing, sales, SEO, training	Scaling best practices
OM portfolio strategy	OM guidance raised modestly; continued dispositions; nadir likely; retention ~81%	Growth tick up; remaining OM assets more institutional; still prioritizing operating segments	Stable-to-improving
External growth & capital	Closed ~$255M by Q2; robust pipeline; ATM funding	Closed ~$211M in Q3; >$575M YTD; >$450M awarded pipeline; new WellQuest partnership	Active/Accretive
Balance sheet & leverage	Net Debt/EBITDA improved to 3.7x in Q2	Further improved to 3.5x in Q3	Improving

Management Commentary

Danny Prosky (CEO): “I maintain my conviction that this is the best operating environment for long-term care that I have seen in my entire 33-year career…Trilogy and shop same-store occupancies are currently above 90% and continue to trend in a positive direction.”
Gabe Willhite (COO): “We delivered sector-leading same-store NOI growth…occupancy averaged 90.2% in Q3, up more than 270 basis points from last year, while average daily rate increased roughly 7%.”
Brian Peay (CFO): “Our updated guidance at the midpoint now reflects expectations for over 20% growth in NFFO per share in 2025 compared to 2024…we expect to achieve this while maintaining capacity to pursue attractive investments…and continuing to improve our leverage metrics.”
Stefan Oh (CIO): “We completed approximately $211 million of acquisitions [in Q3]…and closed approximately $286 million subsequent to quarter end…bringing year-to-date closed acquisitions to over $575 million.”

Q&A Highlights

Occupancy upside and pricing: Management sees continued ability to price 200 bps above inflation and supports further occupancy gains, while acknowledging seasonal holiday/winter dips; expects positive long‑term trends .
Competitive landscape & deal flow: Off‑market sourcing via operators (WellQuest, Great Lakes) reduces head‑to‑head REIT competition; more assets coming to market as performance improves, including PE sellers .
Medicare Advantage and ADR: MA share at Trilogy rose; priority is optimizing contracts for higher reimbursement; ADR growth can outpace inflation even if Medicare national rate growth moderates .
Platform leverage: Extending Trilogy’s revenue management and development capabilities (expansions/villas) across other operators to support scalable growth and margin improvement .
Outpatient Medical outlook: OM retaining tenants and early renewals improve trajectory; remaining OM assets are higher quality; AHR continues to recycle capital toward operating segments .

Estimates Context

Q3 2025 revenue and FFO/share exceeded consensus; Primary EPS also above the Street. See table above for specific consensus vs actual figures. Values marked with asterisks are retrieved from S&P Global (Capital IQ); definitions may differ from GAAP diluted EPS, and “Primary EPS” is a S&P construct that can differ from company reporting.
- Revenue: $572.9M actual vs $552.1M consensus* .
- FFO/share: $0.54 actual vs $0.4193 consensus* .
- EPS: $0.33 GAAP diluted vs 0.1425 Primary EPS consensus* . Values with asterisks are retrieved from S&P Global.

Key Takeaways for Investors

Momentum sustained: Strong demand, >90% spot occupancy, and disciplined pricing continue to drive double‑digit SS NOI growth in ISHC and SHOP — supports upward estimate revisions and multiple resilience .
Guidance reset higher: Broad FY25 guidance raises (NFFO/share, FFO/share, SS NOI) plus narrowed interest expense/G&A parameters increase visibility into earnings trajectory .
Balance sheet flexibility: Net Debt/EBITDA at 3.5x and proven ATM/forward equity execution provide dry powder to close >$450M awarded pipeline without stressing leverage metrics .
Platform advantages: Extending Trilogy’s revenue management and development know‑how to other operators should drive incremental pricing/occupancy improvements and margin expansion over the next 12–24 months .
Mix optimization: Rising Medicare Advantage and improved Quality Mix at Trilogy provide revenue/margin tailwinds; focus on higher‑acuity SHOP and ISHC assets supports durable organic growth .
OM steadying: OM guidance modestly raised; remaining portfolio skewed to larger/institutional assets; ongoing recycling funds higher‑return operating segments .
Near‑term trading setup: Positive surprise on revenue/FFO/share and multi‑metric guidance raise, with continued pipeline conversion and leverage improvement, are constructive catalysts for estimate revisions and sentiment.

Distributions: AHR paid a $0.25/share cash distribution for Q3 on or about October 17, 2025, to holders of record as of September 30, 2025 .

American Healthcare REIT, Inc. (AHR)·Q3 2025 Earnings Summary