stockrowWhat it does
American Healthcare REIT is a self-managed real estate investment trust, or REIT, headquartered in Irvine, California. It acquires, owns and operates healthcare real estate, focusing on senior housing, skilled nursing facilities and outpatient medical buildings. Jeff Hanson is chairman and chief executive officer.
The company serves older adults through senior housing and care facilities, and healthcare providers through leased medical buildings. Its integrated senior health campuses combine services such as independent living, assisted living, memory care and skilled nursing on one campus. That arrangement allows residents to receive different levels of care as their needs change. Its senior housing operating properties also offer combinations of housing and care services.
American Healthcare REIT owns those operating properties through a structure that uses taxable REIT subsidiaries and third-party managers. The company participates in the operating performance of the facilities and bears related operating risks. It also owns medical buildings and other healthcare properties leased to outside tenants.
As of December 31, 2025, the company owned and/or operated 337 buildings and integrated senior health campuses. It operated in the United States, the United Kingdom and the Isle of Man. Besides buying properties, it selectively develops and expands campuses and has invested in secured real estate loans.
How it makes money
American Healthcare REIT earns resident fees and service revenue from its operating properties and rental income from properties leased to healthcare tenants. In FY2025, resident fees and services revenue was $2.1 billion, compared with $1.9 billion in FY2024.
Its integrated senior health campuses generated $1.8 billion of revenue in FY2025. The campuses generally charge market rents rather than entry fees, and residents can receive housing and care services as their needs change. Senior housing operating properties generated $330.6 million of revenue in FY2025; their services include independent living, assisted living, memory care and skilled nursing. Services in this segment are primarily paid for by residents directly or through private insurance.
Both operating-property segments use the RIDEA structure. A taxable subsidiary leases the facility and engages a third-party operator, allowing the company to participate in improved operating performance while bearing the risk of a decline. Most resident leases at these properties run for one year or less, allowing operators to adjust rents to current market conditions.
The company also leases outpatient medical buildings to healthcare providers. Those leases generally recover certain expenses and capital expenditures and have fixed annual rent escalations. Its triple-net leases place property-related expenses, including maintenance, taxes, insurance and capital expenditures, on the tenant. Some properties are covered by master leases spanning multiple facilities.
As a REIT, the company generally does not pay U.S. federal income tax on REIT taxable income it distributes, but it must meet distribution and other requirements. Its taxable REIT subsidiaries are subject to regular corporate income tax.
| Product or service | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| Resident Fees and Services | $2.1 billion | 100.0% | 11.2% |
Customers and how it sells
The company’s customers include residents of its senior housing and care facilities, as well as healthcare providers that lease its medical and other properties. Integrated senior health campuses provide a range of care on a single campus. Senior housing operating properties cater to older adults with different needs, from independent living to skilled nursing.
Residents of assisted living facilities may need help with eating, bathing, dressing or medication management. Skilled nursing residents generally need more care, including access to nursing around the clock. Payments for services vary by facility: senior housing operating services are primarily paid by residents or private insurance, while skilled nursing and hospital services can also be funded by Medicare, Medicaid and other payors.
Outpatient medical tenants include hospitals and physician practices. These buildings can accommodate examination rooms and ancillary uses such as pharmacies, diagnostic centers and rehabilitation clinics.
The United States accounted for 99.7% of revenue in FY2025. The company also operated in the United Kingdom and the Isle of Man as of December 31, 2025. In 2026, the company said it acquired eight communities across East Coast markets in transactions involving LCB Senior Living, establishing a Northeast footprint.
| Region | Revenue, FY2025 | Share | Change on the year |
|---|---|---|---|
| United States | $2.3 billion | 99.7% | 9.18% |
| International | $6.5 million | 0.29% | −1.75% |
Suppliers and costs
Third-party operators manage the company’s RIDEA properties through its taxable REIT subsidiaries. The company also retains independent contractors for construction work on development projects and tenant improvements. It uses development partners and may invest through joint ventures.
Operating costs can include utilities, insurance, repairs, real estate taxes and property management. At triple-net properties, tenants are obligated to pay property-related expenses, including capital expenditures. At multi-tenant properties, the company generally expects to remain responsible for some structural and other capital improvements, such as roofs and parking facilities.
The company’s cash requirements include property operating expenses, general and administrative expenses, debt principal and interest, acquisitions, development, capital expenditures and distributions. It uses operating cash flow, equity issuance, credit lines and property-sale proceeds as sources of liquidity. Higher insurance premiums, taxes, utilities and supply costs can reduce financial results; where costs are passed to tenants, increases can contribute to tenant defaults.
- Revenue$2.3B
- Cost of revenue−$1.8B
- Selling, general and administrative−$58.7M
- Other operating costs−$192.7M
- Operating income$163.8M
Competitive position
American Healthcare REIT competes with other real estate investors to acquire and dispose of senior health campuses, outpatient medical buildings, senior housing, skilled nursing facilities and other healthcare properties. Its tenants and operators also compete locally and regionally for patients and residents. No individual competitors are named.
Competition for investments depends on the availability and cost of capital, construction costs, investment opportunities, transaction terms and regulation. At the property level, operators compete on price, services, quality of care, reputation, location, property condition and local demographics.
The company seeks markets with barriers to new construction, including limited land, zoning restrictions and certificate-of-need requirements. It also seeks properties associated with established health systems and operators. The company says it shares revenue management tools developed with Trilogy across its operator network and uses data, analytics and asset managers to support operators.
Our reading: Construction restrictions can provide some protection against new local supply, but their strength depends on the individual market and can also constrain the company’s own expansion. Our reading: The operating platform and relationships may help the company improve facilities and find acquisitions, but their durability depends on execution by both the company and its operating partners.
Growth opportunities
American Healthcare REIT seeks to grow through acquisitions, selective development and expansion of senior health campuses, and improvements in existing properties. It also considers joint ventures and disposals of non-core properties. The company believes an aging population and limited new supply support demand for its long-term care portfolio.
During 2025, the company expanded its integrated senior health campus segment by $458,086,000, primarily through acquisitions, development and expansions. It acquired $589,000,000 of senior housing facilities for its operating-properties segment during the same year.
The company said it closed approximately $1.69 billion of new investments across 17 senior housing communities in the third quarter of 2026. These included eight East Coast communities acquired for approximately $696 million in transactions involving LCB Senior Living. It also said it had closed on six Kensington Senior Living communities for approximately $572 million, part of an eight-community portfolio with an aggregate contract purchase price of approximately $873 million.
The company said its awarded acquisition pipeline stood at over $1 billion. It also expects Trilogy to develop three to five campuses a year and has identified campuses with excess land or a path to acquiring it for potential expansions. These plans and pipeline opportunities depend on execution and are not completed acquisitions.
- $1.3BFY2021
- $1.6BFY2022
- $1.9BFY2023
- $2.1BFY2024
- $2.3BFY2025
Structural risks
- Operating exposure: Through taxable subsidiaries, the company bears operating risks at its RIDEA facilities, including resident quality-of-care claims and government reimbursement matters. Lower occupancy or a decline in operating performance can affect results.
- Tenant and operator financial health: Financial deterioration, insolvency or bankruptcy of a major tenant, operator or borrower could materially affect the company. Economic weakness can lead to defaults, rent concessions or lower occupancy.
- Healthcare regulation and reimbursement: Changes in laws, lost licenses or failure to obtain licenses could impair tenants’ rent payments or operators’ ability to run facilities. Reimbursement that does not keep pace with care costs could also affect tenant operations and property profitability.
- Property values and costs: Changing market conditions can reduce real estate values or cause sales at a loss. Higher insurance, taxes, utilities and supply costs can reduce results or strain tenants when passed through.
- Financing and REIT status: The company uses debt and equity to fund its activities. Additional indebtedness could adversely affect it, while failure to maintain REIT qualification could expose its taxable income to regular corporate tax and restrict future qualification.
Bottom line
Our reading
American Healthcare REIT combines property ownership with direct exposure to the performance of senior housing and care operations. Its growth rests on acquisitions, development and operators’ ability to improve properties, while its principal exposures include occupancy, care and property costs, reimbursement and regulation. The leased portfolio works differently: there, tenant financial health and the ability to pay rent remain central.