Ventas Inc (VTR) — Q4 2024 Earnings Call Transcript

Thank you, Gail, and good morning, everyone, and welcome to the Ventas fourth quarter and 2024 results conference call. Yesterday, we issued our full year and fourth quarter 2024 earnings release presentation materials and supplemental information package which are available on the Ventas website at ir.ventasreit.com. As a reminder, remarks today may include forward-looking statements and other matters. Forward-looking statements are subject to risks and uncertainties in a variety of topics that may cause actual results to differ materially from those contemplated in such statements. For a more detailed discussion of those factors, please refer to our earnings release for this quarter and to our most recent SEC filings, all of which are available on the Ventas website. Certain non-GAAP financial measures will also be discussed on this call. And for a reconciliation of these measures to the most closely comparable GAAP measures, please refer to our supplemental information package posted on the Investor Relations website. And with that, I'll turn the call over to Debra Cafaro, Chairman and CEO of Ventas.

Thank you, Bill. I want to welcome all of our shareholders and other participants to the Ventas fourth quarter and full year 2024 earnings call. Ventas really delivered in 2024. Today, I'm happy to discuss our strong results, investment activity, and growth powered by our increasing participation in the unprecedented multiyear growth opportunity in senior housing. With our momentum, I'm also pleased to introduce our favorable expectations for 2025. Building on our strong results and positive outlook, we've also increased our quarterly dividend to stockholders by 7%. We continue to focus on creating value for our stakeholders from our advantage position within the longevity economy as we enable exceptional environments that benefit a large and growing aging population. The company effectively executed on its one, two, three strategy in 2024 and I'd like to thank my colleagues for their commitment and excellence. During the year, we took advantage of the unprecedented multiyear growth opportunity in senior housing. We delivered significant senior housing NOI growth from our portfolio, made value-creating investments focused on senior housing, and drove cash flow throughout our portfolio. Let's discuss 2024 results. Ventas delivered full year normalized FFO per share of $3.19, above the high end of our guidance range. Shop same-store cash NOI grew nearly 16%, the third year in a row of double-digit growth. As Justin Hutchens forecast at the beginning of the year, 2024 was a year of occupancy outperformance, with year-over-year occupancy increasing 300 basis points in our same-store communities. Compelling secular demand, minimal supply, well-positioned communities in favorable markets, and Ventas' advantage platform came together to deliver results. I also want to recognize the care providers for their outstanding service to residents and their families, including their extraordinary actions during the recent California fires. In 2024, we also completed over $2 billion in accretive investments focused on senior housing. These investments met our well-defined operational and financial criteria and were selected from a much bigger pipeline of opportunities. Using our competitive advantages in senior housing, which includes data analytics, operator relationships, and our experienced knowledgeable team, these investments funded with equity increased our participation in the multiyear growth opportunity through expansion of our senior housing portfolio. They added accretion, improved our FFO per share growth rate, accelerated deleveraging, and created value. As a result of both organic and external growth in SHOP, in 2024, our scale grew significantly to $2.2 billion in annualized EBITDA, SHOP reached 43% of our NOI, and our leverage improved to enter our long-term targeted range. With nearly 8% total company same-store cash NOI growth in 2024, we also achieved the third prong of our strategy, driving cash flow growth throughout the portfolio. Compounding NOI growth from outpatient medical research and our triple net lease portfolios supplemented our strong SHOP performance. We also increased our Ventas Investment Management platform or VIM during the year. Started in 2020, VIM has over $5 billion in assets under management. Looking forward, we are excited about the opportunities ahead. To create value for stockholders, we intend to continue to drive SHOP growth and expand our SHOP footprint with accretive investments focused on senior housing. As a result, we expect our SHOP business to represent over 50% of our NOI by year-end. Our 2025 guidance anticipates normalized FFO per share growth of 7% at the midpoint led by SHOP. If achieved, this profile would put us in the upper echelon. And even as we focus on growth, we also expect to further enhance our financial strength and flexibility during the year. All the while, we'll maintain our commitment to enabling exceptional environments that benefit a large and growing aging population. So our value proposition for investors in 2025 is clear. Deliver top-tier 2025 FFO per share growth, property NOI growth, and investment growth, further improve our balance sheet, and top it off with a 7% increase in our quarterly dividend. We are optimistic about 2025 and beyond. Conditions remain favorable for our continued success. And the company continues to build its competitive advantages. We are in it to win it. We are still in the early innings of this multiyear growth opportunity in senior housing. As the over-80 population is surging, construction starts have fallen to historic lows and new developments generally are not feasible. We also expect to continue to benefit from compelling secular demand, a favorable pricing environment, robust attractive investment opportunities, positive operating leverage as occupancies rise, and a terrific experienced team whose ranks continue to grow with top talent.

Thank you, Debra. I'll give updates on our strategy to deliver profitable organic growth in our senior housing portfolio and execute on value-creating external growth. We had a very exciting and successful year on both fronts. Starting with organic growth, 2024 marked the third year in a row of double-digit same-store SHOP NOI growth. I'm very happy with the execution of our Ventas OI-driven SHOP platform initiatives and collaborative relationships with our high-performing operators. Our occupancy-led results were delivered by contributions across geographies and asset types. Total SHOP same-store cash NOI growth was 16%, which is at the high end of the guidance range. Full-year same-store SHOP occupancy grew by 300 basis points versus our initial guidance of 250. In the fourth quarter, our US same-store NOI grew 20% and occupancy grew 370 basis points. We are outperforming our markets in occupancy growth. Our US SHOP communities in the next top 99 markets grew 350 basis points, beating the NIC benchmark by 140 basis points. These results were broad-based across assisted living and independent living. Moving forward, we are highly optimistic about our senior housing business across multiple dimensions. The supply and demand dynamics in our sector are exceptionally favorable. In the next five years, the US will experience an unprecedented surge in the senior population as the baby boomer generation begins turning 80. This 80-plus age group is projected to grow by 28% during this period, driving significant demand for senior housing. Meanwhile, new construction in our markets remains constrained, with inventory growth at the lowest number on record and new construction starts at an all-time low. These combined factors create an extraordinary net absorption opportunity in the upcoming years unlike anything we have seen before. We just finished the first lap of a long race. As supply-demand characteristics are projected to remain compelling over the next several years, Ventas is in a strong position to continue to drive growth in our SHOP portfolio. We have favorable competitive positioning driven by Ventas OI with proprietary data analytics and experiential insights that underscore portfolio actions and optimize performance. Our expanding network of 29 SHOP operators has consistently delivered tremendous growth while capturing market share in their respective regions. We are committed to working closely together with them to capture the immense opportunities ahead and offer a differentiated approach through collaboration and the aligned goal of delivering exceptional care services and performance. We continue to execute on our community refresh program, improving the living and working environments of our communities and therefore improving competitive positioning. We have completed 228 projects at year-end, including over 150 refreshed employee break rooms and over 4,500 modernized resident units. We are on pace to complete another 50 refresh projects by the key selling season this year, which should further enhance our ability to drive NOI. Speaking of driving NOI, as previously announced, we are excited to expand our SHOP portfolio by converting 45 large-scale senior housing communities comprising about 5,700 units from the triple-net structure to SHOP. This is a great opportunity to reposition low-occupied communities located in markets with strong projected net absorption. We have plans to transition these communities to five proven high-performing operators with a strong track record of both transitioning and improving operating performance. We plan to execute the Ventas OI playbook to drive occupancy, pricing, environmental improvements, and ultimately double the NOI of the 77% occupied portfolio. Assuming this conversion occurs by the end of the year, we project our SHOP footprint to increase by 8% in the number of units and our SHOP portfolio to increase to account for over 50% of our enterprise NOI. Looking forward to 2025, we are excited to continue our multi-year growth trajectory as we embark on our fourth consecutive year of double-digit NOI growth in our same-store SHOP portfolio. Same-store SHOP is expected to grow NOI 11 to 16%. The midpoint of our range is driven by revenue growth of about 8%, average occupancy growth of about 270 basis points, and continued strength in pricing driving RevPAR of around 4.5%. Furthermore, we expect operating expense growth of 5%. Per usual, the results will be highly dependent on a successful key selling season, and we are assuming a relatively stable inflationary outlook. Once again, we are expecting the US to be the growth engine with continued accelerating occupancy performance with over 300 basis points of growth. January occupancy is off to a strong start. Summarizing organic SHOP growth, we are coming off a strong year of occupancy-driven results, and we're excited about the opportunities ahead as we continue to unleash the power of our advantage SHOP platform. Moving on to part two of our strategy, we continue to execute on value-creating external growth focused on senior housing in the fourth quarter and throughout 2024. For the full year, we closed on $1.9 billion of senior housing investments, including $1.4 billion in the fourth quarter alone. These investments fit squarely with our investment criteria including 7 to 8% expected year one NOI yield, low to mid-teens unlevered IRRs, and significant discounts to replacement cost. This investment activity meaningfully expands our SHOP portfolio with the addition of 52 new communities in markets with strong projected net absorption. Communities are high performing with upside, including average in-place occupancy of 90%. Even with this accelerated pace of external growth, we are maintaining our underwriting discipline. In 2024, we reviewed approximately $18 billion of senior housing opportunities, pursuing approximately $5 billion, and ultimately closing on nearly $2 billion. We have a rigorous data-driven process that ensures we are pursuing the best deals for Ventas and investing within our right market, right asset, right operator framework. Our experienced team remains focused on executing our excellent growth plans and we intend to expand the team. We expect our pipeline to continue to present a large set of compelling investment opportunities with potential deals coming from a range of owners and a variety of reasons for selling including debt and fund maturities. Our investment activity also includes a range of seller profiles with transactions coming from a balanced mix of owner-operators, private equity, developers, and other institutional capital. Looking forward to 2025, we expect to keep our external growth momentum, including line of sight on $1 billion of senior housing investments which are already in advanced stages. And we expect to be weighted in the first half of the year. Ventas is a senior housing partner of choice with sellers, brokers, and the entire investment community. This remains true even as there may be more competition for assets as others are seeing the favorable risk-reward in senior housing. Our industry experience, platform capabilities to manage scale, data science, and transaction track record should help to propel our growth prospects moving forward. Our investment team capabilities are second to none. And we are continuously building on our strengths. With that in mind, I'm very excited to announce Alex Russo joining our team as Senior Managing Director of Investments. During his 18-year career at Lazard, Alex has demonstrated exceptional financial and investment acumen and I expect he will be an instrumental addition to the team as we continue to execute on our value-creating external growth focused on senior housing. Now I'll hand the call to Robert Probst.

Thank you, Justin. I'll share some highlights of our 2024 performance, and close with our 2025 outlook. I'll start by saying we are pleased with all we accomplished in 2024. We finished 2024 strong with attributable net income per share of $0.19. 2024 normalized FFO per share of $0.81 in the fourth quarter and $3.19 for the full year represents a 7% year-over-year increase in both periods. The result exceeded the high end of our full-year normalized FFO guidance range led by SHOP same-store growth and execution on our accretive senior housing investment pipeline. Our total company same-store cash NOI grew nearly 8% year-over-year in 2024, reflecting broad-based property NOI growth across our portfolio led by 16% growth in SHOP. Our outpatient medical and research business delivered continued compounding growth of 3% in 2024, in line with our expectations. For the full year, research grew 4.6%, and outpatient medical increased 2.6%. As Justin described, we closed on approximately $1.9 billion of senior housing investments, funded all equity. We raised $2.2 billion of total equity in 2024 and year-to-date 2025 including approximately $1.2 billion raised since the third quarter at an average share price of $62.90. We currently have $250 million of unsettled forward equity available to fund senior housing investments in 2025. Consistent with our strategy, SHOP growth in all equity-funded senior housing investments have further strengthened our balance sheet. At 6.0 times, our Q4 net debt to EBITDA is a 90 basis point improvement year-over-year. It has now entered our long-term target leverage range of 5 to 6 times. We expect continued leverage improvement in 2025 driven by senior housing growth. We ended 2024 with robust liquidity of nearly $4 billion, which included proceeds from our third quarter 2024 senior note issuance which we subsequently used to pay down $1 billion of maturing debt in the first quarter of 2025. Let's conclude with our full-year 2025 outlook. For 2025, we expect net income attributable to common stockholders of $0.48 per share at the midpoint. We expect normalized FFO to range from $3.35 to $3.46 per share or $3.41 per share at the midpoint which represents 7% year-over-year growth. In line with the SHOP growth we posted in 2024. The $0.22 normalized FFO per share increase is driven by NOI growth in the SHOP business and accretive senior housing investment activity, partially offset by higher net interest expense FX, and dilution from a higher share price. Our 2025 total company same-store cash NOI guidance approximates 6.75% year-over-year growth at the midpoint led by SHOP. Our guidance includes senior housing investments of approximately $1 billion in 2025, clear line of sight and weighted to close in the first half of the year. We intend to principally equity fund these investments and have already raised $250 million via equity forwards. For the year, we also expect to raise $200 million through capital recycling efforts. Specific to increased net interest expense, our midpoint of guidance assumes an increase of $0.08 compared to 2024, from refinancing, maturing debt at a higher rate, and lower cash balances year-over-year. A more fulsome discussion of our 2025 guidance assumptions can be found in our Q4 supplemental and earnings presentation posted to our website. To close, we are really pleased with our 2024 performance, are executing on our growth strategy, and delivering advantage growth in normalized FFO per share. The entire Ventas team is determined to continue this momentum in 2025. With that, I'll turn the call back to the operator.

Okay. So your first question comes from the line of Omotayo Okusanya with Deutsche Bank. Please go ahead. Yes. Good morning. So my question actually is about the medical office building side of things. Just looking at the quarter, some occupancy declines, it appears. But in your 2025 guidance, you have pretty strong same-store NOI growth. So I'm just curious what the kind of trajectory is in that business, whether you're expecting occupancy gains, you know, refilling of some of that space that may have vacated in the year. How do we kind of think about the fourth quarter results relative to the 2025 guidance?

Yeah. Thanks, Omotayo, for the question. You know, really, it started in 2024. We actually did more leasing. We had 15% more leasing than the prior year. You know, as you cycle through that, you destruction and they start coming online, start seeing meaningful results in your NOI. You look at 2025, we've already done 34% of our leasing plan, which is a terrific start for mid-February. So our plans for 2025 assume occupancy gains and the corresponding NOI growth.

Gotcha. Okay. That's helpful. Then if I may ask one about the senior housing, again, everyone's very aware of what's happening in regards to demographic tailwinds and clearly showing up in your results. Curious at this point is what Ventas OI is telling you guys in regards to strategically you should be doing anything different to kind of capitalize on those demographic tailwinds, especially now you're kind of at the point where, again, occupancy is getting higher and things of that sort and demand supply demand fundamentals clearly are in your favor.

Hi. It's Justin. Yeah. So, you know, the whole basis for Ventas OI is to really help us to focus on, you know, markets and operators. And the data from a market standpoint is extremely helpful because, you know, it really underscores all the decisions we make. It's the most important aspect of our investment decisions, disposition decisions, the decision to invest in particular assets. And the key point really is it's hyper-locally focused. And that really gives us comfort and confidence that if we make that investment, we take certain actions that's deliver growth opportunity, and it's gonna have sustained opportunity to perform well over time. And that's really the power of the platform. It's looking ahead, you know, near mid long term, and ensuring that we're as well positioned.

Alright. Congrats on the other quarter and the outlook.

Thanks. It's Nick Joseph here with Michael. Just have a touch base on the acquisition strategy, targeting more stabilized assets. So something you could talk about kind of the return profile of those where you can kind of push rate versus the occupancy upside and what sort of, kind of going in yield and stabilized IRRs you could get there?

Yeah. Sure. So we find this to be a very unique opportunity right now where you can invest in high-quality assets that have the combination of delivering yield and growth. Haven't really seen this before. Our opportunities to invest in a variety of different senior housing. We mentioned we had $18 billion that we started to look at. We only pursued $5 billion of that and really that's because we're being extremely focused on the criteria that we set forth, which is help us to ensure that we're getting the combination we're looking for. Yield growth, and then ultimately, a high-quality, high-performing asset. So the asset that we're pursuing, first and foremost, it's high performing. These are market leaders. They're 90% occupied but that doesn't mean they don't have occupancy upside. You know, they're in markets that have strong absorption. And there's another 10% occupancy opportunity. Plus pricing opportunity, which should only improve as scarcity value increases and that will come as occupancy continues to grow. We're buying larger communities that have a mix of IL and AL and memory care services. We're in markets that have strong absorption and strong affordability and the unlevered IRRs are low to mid-teens. And that's factoring in, you know, obviously, growth and we tend to use accounts cap rates. So you can have an assurance that it's growth that's really driving that IRR. So we like this opportunity. We're continuing with the same investment criteria in 2025 that we used last year. We mentioned the billion that we're pursuing and that's lining up well with that criteria.

Thanks. That's very helpful. I'm interested in the impact of those acquisitions both identified and also potential in 2025. Could it meaningfully move the needle, or is it more kind of future growth that we would see on a per-share basis?

Hey, Nick. It's Bob. Yeah. Good news. These acquisitions are accretive from the get-go. All equity funded. Last year, we did nearly $1.4 billion in the fourth quarter. So a lot of the activity last year was fourth quarter weighted. And it was 7 to 8% yields. It's accretive. So that's certainly part of 7% year-over-year growth in normalized FFO per share. The line of sight to the new billion will have lesser contribution, obviously, just giving timing in the year. But, again, we'll continue to strive to do what we did last year.

Thank you. Maybe just to circle back to that last question and talking about the $1 billion acquisition guide. I'm curious what deal flow looks like at this point right now versus maybe this time last year and the fourth quarter? And then maybe how the competitive environment is changing and the room for you all to drive acquisitions in the second half of 2025.

Yeah. Well, first of all, the pipeline is bigger than it was this time last year. And you know, remember, we started last year's guide at $350 million. We ended up $2 billion. This year, we have confidence around a billion already. So you know, that in itself kind of demonstrates the pipeline, but we're seeing more activity. We're seeing more competition. There's certain new players at the table and some that have been around before coming back to the sector again. But it's important that we emphasize why we have a competitive advantage in this asset class. And there's a few reasons. One is the platform itself. You know, the Ventas OI, the data analytics, the experience and capital to well-positioned assets, and then making sure that we are picking the right operators. And one of the reasons I'm so proud of the amount of operators we have is because we are picking operators that have track records in their particular asset classes and in their markets. And we have the scale to manage a platform of multiple operators. It's not about how many, it's about delivering within local markets, and we can manage that. So that's a differentiator amongst most of the market that pursues senior housing. This is a platform that's taken many years to grow. It's even turbocharged, I think, in recent periods as we've reentered the competitive opportunity within senior housing and we think we'll do well and we'll look forward to continue to execute.

Good morning. Hoping you could talk a little bit about the R&I business and your views on risks around NIH funding changes as a result of policies by the new administration and the impact or lack thereof on Ventas' assets.

Good morning, Juan. It's Debra. So I'll just briefly touch on that. As you know, because SHOP is growing at such an accelerated pace within our enterprise, our consolidated research portfolio is about 8% of our total NOI with 18 distinct universities. And the US leads the world in biomedical research in part because of funding from the NIH. So we generally feel positive about the long-term prospects of biomedical research in the US. And there is, as you note, some noise around the NIH grants at the moment. But at the present time, any changes have been halted and therefore the grant recipients should continue to receive their full funding. And these institutions generally have a very, very, very, very large research budget of which NIH funding is a minority portion. And of that, the only proposed changes are to a small portion of that. So that hopefully frames it up for you.

Very helpful. Thank you. And then just as my follow-up, maybe you could provide a little color on the $200 million that's for capital recycling via dispositions, the strategy there. You talked about maybe selectively selling skilled nursing before. Is that kind of still on the bucket and what yields we should expect on that $200 million?

Yes. And you've been writing about this. So you know it well, which is, you know, we have had a strategy of disposing of the skilled nursing facilities we acquired a year or two ago, and we've done quite a bit of that and have about $150 million pending. And would expect that to be the big part of the $200 million to which Bob referred. And we'll recycle that capital into senior housing investments.

Morning. Thanks for taking the question. Congrats on a strong quarter. Maybe just first on the SHOP side. Can you clarify in your guide, are you baking in sort of a typical seasonal pattern in 2025 kind of dipping in one Q and then from three Q to four Q or are you baking in something different?

Yeah. Sure. So we do consider kind of a historically normal seasonal pattern in our guide. And we have said we're off to a strong start in January. We'll also be the first to admit that we had very strong counter-seasonal results last year, so the new normal could change as demand's picking up. But it doesn't really change one important fact and that is that we have a heavy reliance on the key selling season. And obviously think we're well-positioned to do well, but that's always the most important season because that's where a lot of the net moving activity happens.

Got it. So just to clarify, you're baking in typical, like, dips and pickups, etcetera, as we go through the just as you've seen historically.

Right. So it doesn't seem like we're anywhere close. You know, and it varies by market. There's a wide range of rents that think are needed. It could be it's being worked from 20 to 50% higher depending on the market you're looking at. We're not seeing development starts not really a big debt financing source for development. And it's on multiple fronts and that the barriers are on multiple fronts. Anywhere from land cost, material cost, labor cost, and then just the price that's needed really to justify the spend. And it's a ways off, you know, based on what we're seeing now.

Hey. Thanks for the time. My first question is on capital expenditures. The $285 million in FAD CapEx, it's up about 15% year over year. Is that this level should we expect this level to continue for the next few years, and is the Brookdale repositioning Brookdale included in this figure, or is that a separate kind of redevelopment CapEx bucket above the FAD CapEx?

Yeah. I'll take that one. It's Bob. So we were about $250 million in 2024 on FAD CapEx. The guide at $285 million, call it $30 million higher, is really two-thirds more units from all the activity we just talked about, whether it's investments or conversions from triple net. And one-third just inflation. It kind of describes the difference. So I would expect as we continue to buy more assets and make conversions, including the Brookdale, that, you know, that will continue at a higher level. But it's really principally volume-based for units.

Thanks. I just wanted to see if you could give a bit of a refresher here about how to think about RevPAR growth in senior housing. So you, you know, you talk about the 7% January rent increases. And then for the year, I think the guidance is 4.5% on RevPAR. So what's sort of the difference there, imagine something on new lease pricing and how should we think about, you know, I guess, the ability for that dynamic to change.

Yeah. Justin is gonna answer that. I mean, generally, it's about two there's a kind of a two-thirds relationship between the RevPAR and the January increases. But I'll let Justin unpack that a little bit for you.

Yep. Great. It's a great question. It's a big topic. Because it's not simple. So, you know, first of all, in the US headline number is actually 8% in the US in terms of rent increases. That's similar to what we did exactly what we did last year. We feel good about, you know, the US rent increases. The rest of the year, we'll have anniversary rent increases and usually that's, you know, kind of in a range around 6 to 8% or so. And here's how it works. And so you have a rent increase. The rent increase in January is really only impacting about half the population. There's a percentage of the population that were new move-ins, you know, in the fourth quarter and aren't getting an increase. And then you have anniversary increases the rest of the year, so they'll blend in over time. Assisted living and memory care, you have level of care revenue. And that level of care revenue is like 20%. It's memory care. Rose over time during the length of stay of the resident. When they're replaced with a new resident, that new resident's coming at a lower acuity and therefore paying a lower level of care charge. And so you have that that's kind of a that's a drag on your potential RevPAR. Another thing that is an area that about opportunity really for the sector is to see move-in rents actually equal in-house rent increases. And, you know, we expect to see the improvement in that metric over time, but generally, it lags. And so that's how you're getting to that two-thirds result that Debra's describing. And, you know, but we think that having said that, there's a lot of opportunity given the affordability of the market, the demand at the doorstep, and the fact that occupancies are going up and scarcity value is being created.

Thank you.