American Healthcare Reit, Inc. (AHR)

A. Company Overview

American Healthcare REIT, Inc., a Maryland corporation, operates as a self-managed real estate investment trust (REIT) with a specific focus on acquiring, owning, and operating a diversified portfolio of clinical healthcare real estate. The company primarily emphasizes properties associated with senior housing, skilled nursing facilities (SNFs), outpatient medical (OM) buildings, and other healthcare-related assets. The organization has established a comprehensive management platform and employs approximately 121 individuals as of its last fiscal year-end, December 31, 2025.

American Healthcare REIT distinguishes itself by utilizing the RIDEA (REIT Investment Diversification and Empowerment Act) structure for its integrated senior health campuses (ISHC) and senior housing operating properties (SHOP). This structure allows the company to optimize operational performance while mitigating some risk exposure. The company’s portfolio not only includes direct property ownership but also incorporates originating and acquiring secured loans, with potential future expansions into other real estate-related investments on an opportunistic basis.

The company has experienced significant growth and expansion in its capital structure, marked by its underwritten public offering completed in February 2024, which yielded over $772 million. This offering allowed for the listing of its common stock on the New York Stock Exchange under the symbol “AHR.”

B. Business Objectives and Growth Strategies

American Healthcare REIT is committed to several business objectives designed to enhance earnings and cash flows while concurrently increasing the value of its portfolio. Key growth strategies include:

• Targeted Acquisitions: Engaging in disciplined acquisitions that expand the diversity of its real estate assets.
• Selective Development: Continuing to develop integrated senior health campuses in conjunction with experienced development partners.
• Organic Growth: Focusing on generating robust organic growth from its ISHC and SHOP properties, benefiting from low competition and rising demand attributed to an aging population.
• Balance Sheet Strategy: Actively positioning its balance sheet to support further growth.

C. Investment Strategy

The investment strategy of American Healthcare REIT aims to secure properties that generate immediate income while also participating in long-term appreciation. The company’s approach includes:

• Direct and joint investments in properties.
• Opportunities for disposing of non-core assets.
• Assessing a variety of investment structures, including direct purchases, joint ventures, and other real estate investments to ensure compliance with applicable investment company regulations.

A strict criterion guides property acquisitions, emphasizing quality, strategic location, market dynamics, robust local health systems, and predictable capital requirements. Investments are expected to yield stable cash flow and appreciation potential, ensuring alignment with the company’s broader goals.

D. Real Estate Investments

American Healthcare REIT’s focus on real estate investments primarily encompasses:

• Integrated Senior Health Campuses (ISHC): These facilities provide a broad spectrum of care, enabling residents to age in place.
• Outpatient Medical Buildings: Properties designed for healthcare functions that require specialized infrastructure.
• Senior Housing Operating Properties (SHOP): Facilities targeted at various segments of the elderly, facilitating assisted living, memory care, and skilled nursing.
• Triple-Net Leased Properties: Facilities leased to tenants under agreements where tenants bear maintenance costs and other expenses.

As of the close of 2025, the portfolio included 147 ISHC, 74 OM buildings, and 97 facilities within the SHOP segment, emphasizing a comprehensive reach into critical areas of the healthcare market.

E. Development and Construction Activities

American Healthcare REIT selectively pursues development opportunities within its portfolio, primarily through collaborations with partners like Trilogy Investors, LLC. This strategy is aligned with market conditions and strategic financial planning to potentially lower acquisition costs through development rather than outright purchases. The firm retains independent contractors for construction activities, ensuring quality execution aligned with healthcare standards.

F. Joint Ventures

The company has strategically engaged in joint ventures to diversify its investment portfolio and access unique investment opportunities that align with its operational goals. These can be both leveraged and unleveraged partnerships, focusing on real estate properties that meet the REIT's investment criteria.

G. Financing Policies

American Healthcare REIT employs both unsecured and secured debt to fund property acquisitions and additional investments. The company intends to secure favorable financing terms while managing risks associated with market fluctuations and interest rate variations through derivative financial instruments. This comprehensive approach aims to facilitate ongoing refinancing in response to varying economic circumstances.

H. Tax Status and Distribution Policy

The company has elected to be taxed as a REIT, adhering to federal income tax regulations and meeting various compliance requirements to maintain this status. It is mandated to distribute at least 90% of its taxable income to shareholders, which fosters a focus on cash flow generation and operational efficiency. Regular evaluation by the board of directors determines distribution amounts, influenced by financial conditions and investment performance.

I. Competitive Landscape

American Healthcare REIT operates in a competitive market, contending with various organizations in the acquisition and management of healthcare-related properties. The company's success relies on factors such as economic trends, availability of favorable investment opportunities, and the operational abilities of its tenants within the healthcare sector.

J. Government Regulations

The company’s portfolio is subject to a complex array of federal, state, and local regulations, particularly those affecting healthcare operators. Dependencies on the compliance of operators with healthcare statutes influence the operational efficacy of American Healthcare REIT’s facilities, driving a focus on thorough due diligence during property acquisitions.