Ventas Inc (VTR) — Q1 2025 Earnings Call Transcript

Thank you, Annie, and good morning, everyone, and welcome to the Ventas First Quarter 2025 Results Conference Call. Yesterday, we issued our first quarter 2025 earnings release, presentation materials, and supplemental information package, which are available on the Ventas website. As a reminder, remarks today may include forward-looking statements and other matters. Forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those contemplated. For a detailed discussion of those factors, please refer to our earnings release and our most recent SEC filings, all available on our website. We will also discuss certain non-GAAP financial measures. 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 Deborah Acuffaro, Chairman and CEO of Ventas.

Thank you, BJ. I’d like to welcome all of our shareholders and participants to the Ventas 2025 earnings call. Today, we’ll highlight our positive financial performance, growth, increasing investment activity, and our advantaged position capitalizing on the multiyear NOI growth opportunity in senior housing. As we execute on our 123 Strategy, the value proposition for Ventas remains clear. We are focused on delivering superior, multiyear growth fueled by internal and external expansion in our senior housing business, which benefits from secular, demographically driven demand and catalyzed by our advantaged platform. We expect to be a top grower in the REIT space, projecting 7% normalized FFO per share growth in 2025. We possess a strong financial profile that is improving, and we offer a 3% dividend yield that contributes to total return. Our strong first quarter results highlight our strength and favorable positioning across the broader real estate and corporate landscape. Ventas delivered $0.84 of normalized FFO per share in the first quarter, an increase of approximately 8% powered by our senior housing operating portfolio. SHOP’s 14% year-over-year cash same-store NOI growth resulted from meaningful increases in occupancy and rate. Compelling demand supply fundamentals have combined with our operational and portfolio initiatives to create an unprecedented opportunity for us to generate multiyear organic NOI growth. Demand remains strong as the over-80 population is experiencing its highest ever growth, and more residents and their families are choosing senior living for its benefits. The over-80 population is increasing by about half a million people this year and next year, with that number jumping to 900,000 a year between 2027 and 2030. Meanwhile, the number of new senior housing units started in the first quarter of 2025 was the lowest on record, at only 1,287 units. Current supply constraints are likely to be extended due to hard cost increases and labor scarcity, coupled with the step function in senior population growth, which creates strong and long tailwinds for NOI and occupancy growth in senior housing. Our senior housing portfolio is positioned to capitalize on this unprecedented opportunity with communities in markets that have over a thousand basis points of expected net absorption in the coming years, and resident affordability is outstanding. We continue to increase participation in the NOI growth opportunity through our acquisition strategy focused on senior housing. Our investment momentum has continued into 2025, and we see compelling opportunities ahead. We have already closed much of our original billion-dollar investment guidance in attractive senior housing communities, and we are increasing our full-year volume expectations to $1.5 billion. These investments should enhance our future growth profile, and our value for shareholders. Even more encouraging, our pipeline is expanding as more sellers bring assets to market. Our skilled investment team has grown, and we continue to leverage our data, financial and relationship advantages to capture attractive opportunities. Within senior housing, we are eager to deploy capital whenever we can achieve compelling risk-adjusted returns and create value. The balance of our portfolio, led by our Lillibridge-managed outpatient medical business, continues to perform well, delivering solid compounding growth while benefiting from increases in the over-65 age group and trends favoring lower-cost care settings. We are committed to financial strength and flexibility, having improved our credit profile, leverage, and liquidity year-to-date. At this early stage of 2025, we remain pleased to reaffirm our normalized FFO per share guidance of 7% growth and confirm that our SHOP business will represent over half of our NOI by year-end. While aware of the current macroeconomic backdrop's uncertainty, Ventas occupies an enviable position in today’s environment. Both sides of the senior housing demand-supply imbalance are tipped in our favor, and conditions should improve materially over time. We have the potential to further increase SHOP revenue from both rate and occupancy growth. Our business model is minimally impacted by tariffs and global trade disruptions. We have access to attractively priced capital, excellent liquidity, a strong balance sheet, and we are well positioned as a preferred acquirer, enabling us to capture our fair share of attractive investments. Coupled with our experience and platform, we are in an excellent position to outperform, and the whole Ventas team is committed to succeeding. Justin, I’m happy to turn the call over to you.

Thank you, Debbie. I’ll provide updates on first quarter senior housing performance and our investments. I’m pleased to report that we delivered excellent results on both fronts. SHOP delivered double-digit NOI growth for the eleventh consecutive quarter as we continue to execute through the OI platform. Our efforts support real-time community-specific strategies that align with market demand and importantly are executed in partnership with our best-in-class operators. Total SHOP same store cash NOI growth was 13.6%. Revenue growth was 7.4%, led by occupancy and rate. We saw solid underlying pricing from internal rent increases averaging 7%, and street rates are trending favorably. Expenses were roughly in line at 5%, and labor expenses were favorable. Same store SHOP occupancy grew by 290 basis points led by the U.S., with occupancy growth of 330 basis points and NOI growth of 16%. The U.S. significantly outperformed NIC on both rate and occupancy year-over-year growth. The incremental margin was about 50% for the first quarter driven by operating leverage as we grow occupancy. Demand and move-ins in the quarter were strong, and year-over-year occupancy was very good. However, we faced some seasonality with elevated clinical move-outs in March, causing our starting point for occupancy to be a bit lower than expected for the second quarter. This aspect of our business is unfortunate, as it involves the passing of residents, and is unpredictable. However, the key determinant of full-year occupancy is the timing and slope of the key selling season, which begins now. We are excited about the upcoming months as we expect strong move-ins in the second quarter. Looking at the balance of the year, we anticipate another excellent year for SHOP performance, reaffirming our full-year guidance of cash NOI growth of 11% to 16%. Highlighting our approach to enhancing our portfolio composition, I’ve worked with my capable team through deliberate actions over time to ensure we are situated in the right markets, with the right assets and operators. These actions, underpinned by our OI data analytics platform, include acquisitions, dispositions, conversions from triple net to SHOP, transitions to new operators, OI-driven operational improvements, and CapEx investments to strengthen our competitive position. Our journey to curate the portfolio has been ongoing, and we believe the best is yet to come. Our portfolio is positioned with significant embedded occupancy and NOI growth potential. By design, two-thirds of the portfolio is in the low 80% occupancy, with considerable upside opportunity. For example, we are converting 45 Brookdale communities from triple net to SHOP with new operators later this year. These communities are performing well year-to-date and offer significant upside, with expectations to double the NOI from approximately 50 million to 100 million plus over time. The five operators we chose for the transitions are enthusiastic and engaged in the process. We have expanded our operator base from 10 to 33, enhancing our capacity for growth in high-demand markets. It is crucial to grow our operator relationships, given that 75% of senior housing operators manage fewer than 50 communities in this highly fragmented sector. Our community refresh program has progressed as planned, completing over 250 projects in the past two and a half years. However, there’s more to do, with an additional 100 projects expected to complete by year-end. This will strengthen our competitive positioning and prepare us for outsized NOI growth over time. Looking ahead, our enhanced portfolio composition provides a powerful foundation to capitalize on historical demand growth in senior housing. With a deep bench of high-quality operators, a growing presence in key markets, and a well-positioned asset base undergoing continual improvement, we are strategically positioned to deliver strong, sustainable performance. Moving on to investments, we continue to capitalize on our competitive position, as Ventas is a senior housing partner of choice with sellers, brokers, and the broader investment community. We’ve executed on our run of value-creating external growth focused on senior housing this first quarter. We’ve closed approximately 900 million in senior housing investments year-to-date and 2.8 billion since the beginning of last year, most completed in the last six months. These investments meet our key criteria of 7% to 8% expected year one NOI yields, low to mid-teens unlevered IRRs, accretive growth, and pricing well below replacement costs. This activity significantly expands our SHOP portfolio, adding 20 newly constructed communities across eight states, including 11 in high-demand Texas markets with strong net absorption potential and over 1,500 basis points of uncapped net demand in the upcoming years. The expected year one NOI yields are around 7.2% on average, and the 10-year unlevered IRR is in the low to mid-teens. We’ve also noted strong initial post-closing performance from the 1.8 billion in senior housing acquisitions closed in 2024, with actual NOI in line with underwriting at a blended yield of 7.7% in the first quarter of 2025. Our investment pipeline is active and growing, having reviewed approximately 30 billion of senior housing investments, bid on 9 billion, and closed on 2.8 billion since last year. About 75% of our closed transactions were relationship-driven and sourced off-market. We remain flexible and opportunistic, targeting a diverse set of senior housing investments across markets, asset types, operators, and return profiles. Reflecting our strong pipeline, we are raising our full-year investment guidance to 1.5 billion. In summary, we had a strong start to the year, showcasing solid execution across our senior housing platform. We remain focused on advancing parts one and two of our strategy: first, driving profitable organic growth through enhancements in performance, optimal pricing, occupancy, and leveraging our data-driven Ventas OI platform alongside our high-performing operators; and second, capturing value through external growth via targeted acquisitions that align with our strategic and financial criteria. With favorable demand trends, a well-positioned portfolio, and a robust investment pipeline, we are confident in our ability to create long-term value and sustain our leadership position in the senior housing sector. Bob?

Thank you, Justin. I’m pleased to report that we’re off to a strong start for the year. I’ll review our first quarter performance, discuss our reaffirmed 2025 guidance, and close with our balance sheet, liquidity, and capital markets activities. Starting with our overall performance, we reported normalized FFO of $0.84 per share, representing nearly 8% year-over-year growth. Our total company’s same-store cash NOI grew by 7%, led by SHOP, which increased approximately 14%. Our outpatient medical and research business, or OMAR, reported same-store cash NOI growth of 1.3% year-over-year. Adjusting for cash fees received in outpatient medical, OMAR’s same-store cash NOI increased by 2.5% year-over-year. OMAR grew by 3% after adjusting for the fees previously mentioned, as fundamentals remain solid. OMAR occupancy increased by 30 basis points year-over-year, with first quarter new leasing increasing 9% and a strong tenant retention of 85%. The research portfolio’s same-store cash NOI contracted modestly year-over-year due to a $200,000 reduction in NOI explained by lower occupancy. Pete and his team continue to see a solid research leasing pipeline, including from universities. We reaffirm our full-year OMAR same-store cash NOI guidance range of 2% to 3%. This brings us to our 2025 full-year outlook. After a good start to the year, we reaffirm our previously issued guidance for full year 2025, including our earnings per share measures and property same-store cash NOI ranges for each segment. Our normalized FFO midpoint of $3.41 represents outstanding 7% year-over-year growth. This FFO increase continues to be led by SHOP organic growth and accretive senior housing investment activity, partially offset by higher net interest expense, FX, and dilution from a higher share price. The all-important senior housing key selling season begins in the second quarter and runs through September. We have updated our guidance for full-year 2025 investments focused on senior housing from 1 billion to 1.5 billion, as a result of a growing pipeline. We expect the increase in the investment guidance to close later in the year, so we anticipate the FFO contribution to be minimal for 2025. We’ve largely funded the increased investment guidance with 1.3 billion in aggregate equity raised, alongside 200 million of disposition activity previously factored into the guidance and expected to close in the second quarter. Our balance sheet continues to strengthen due to SHOP organic growth and equity funded senior housing investments. Our Q1 net debt to EBITDA of 5.7 times represents a 30 basis point improvement from year-end 2024 and a full turn reduction compared to the previous year’s first quarter. We expect further leverage improvement throughout the year, driven by our senior housing growth. We also repaid nearly 1 billion of senior notes in the first quarter at an approximate rate of 3%, utilizing proactive senior notes issued in September at about 5%. Our liquidity position is robust, with available liquidity of $3.6 billion as of April 2025, bolstered by a 750 million increase in our revolving credit facility to 3.5 billion, supporting our growing enterprise. We had strong subscription from our bank group, demonstrating their support of our platform. For additional guidance assumptions in 2025, please refer to our Q1 supplemental and earnings presentation on our website. In closing, we’re pleased with our start to 2025. The entire Ventas team is enthusiastic about the future and committed to delivering superior performance for our shareholders. I’ll turn the call back to the operator.

Good morning. Thank you. Justin, you always provide great statistics on the SHOP update. I’m curious, what color can you provide about the dynamics when you reach 85%, 87%, or 88% occupancy? How does that translate to margin expansion?

Yes, one of my favorite topics. In this period of growing occupancy, especially with significant growth expected, this question becomes more relevant. What we focus on are some simple rules of thumb. When you reach 90% occupancy and look backward, you should have achieved around 50% incremental margin from 80% to 90% occupancy. When you get to 100%, you'll see about a 70% incremental margin. The operating leverage in the business allows this to happen. At a certain point, you’re fully staffed. Most expenses are fixed. Some variability remains, contributing to margin. This aspect of the business model offers powerful advantages, and as we grow occupancy, both margin expansion and occupancy growth are significant opportunities.

Thanks. I was looking at the Canadian portfolio, which you provided helpful information about, and I’m curious if it is a decent proxy. You are still extracting double-digit NOI growth at 95% occupancy. Is it achievable to get double-digit NOI growth at that point?

Yes, we are very pleased with our strong-performing Canadian portfolio, which has been an excellent contributor to NOI growth even at high occupancies. While it is possible that at some point, double-digit growth may not be feasible, it's encouraging to see good performance even at high occupancies.

And Justin, thanks for noticing page 12. That is a good new page for investors. Could you touch on the two-thirds of the portfolio where we have significant occupancy upside and explain the margin and NOI growth potential because that’s where much of your efforts are focused?

Yes, page 12 shows that we've made significant efforts over the past five years to position ourselves for increased demand. We looked at our portfolio and took deliberate actions to ensure we're in the right markets that could generate strong net absorption and affordability. We have a lot of projects in progress aimed at improving not only occupancy but also overall performance. Our efforts have positioned the portfolio well for significant growth.

Thank you for the information.

Thanks, Jim.

Good morning. I’d like to discuss the investments you made this quarter and the change this quarter versus last quarter. I wanted to ask about the basis; it seems your cost per bed took a meaningful step up. Is that due to the competitive landscape or due to where you’re buying?

So when you look at the profile of what we’ve bought, you mentioned the per unit numbers. It was around $2.70 last year, now $3.50 for this recent tranche. A couple of drivers include newer communities we acquired, around seven years on average. The markets we entered are actually stronger than last year. The fundamental affordability and the demand characteristics reflect that as well as the quality of the portfolio we are acquiring.

Yes, the rising replacement costs due to hard cost inflation and labor scarcity continue to be crucial factors. In most cases, we expect the replacement costs to start at 4, and we’re still buying at a significant discount, offering unlevered return expectations in the low to mid-teens, essential when analyzing the risk-reward balance for our investments.

Thank you. Just to confirm, you said a 7.02% is the number you’re looking for?

No, it’s for the $900 million that we closed.

Can you give insights on the performance of the Brookdale assets being transitioned? I recall EBITDAR around $50 million, but previously it was in the mid-fifties. Has that changed or should we expect that to change during the transition?

I’ll hesitate to provide an exact number until we transition. What’s encouraging is that the 45 communities in transition are outperforming those that remain in the lease. We've observed strong engagement from the new operators, and we believe they will perform as expected when transitioning.

With most transitions, there is a period of disruption where EBITDAR might dip. Should we expect that with these assets, or will the transition be more seamless than historical examples?

It’s always a waiting game, but we have transitioned nearly 200 communities with good growth following transitions. Our experience indicates that even where disruption occurs, growth typically follows. We will do our best to mitigate risks and hope to see similar results with Brookdale.

I’d like to delve deeper into the March comments regarding move-outs. Were these caused by flu or specific properties? Has that trend continued into April?

Interestingly, there’s no correlation between the clinical move-outs and flu season; it's quite random. Our move-in activity is very strong, in line with last year. This was purely a move-out issue driven by mortality, which is unpredictable. It’s important for investors to understand that while move-ins are solid, the clinical nature of these move-outs impacts our starting point.

Debbie, in your initial comments, you mentioned high macro uncertainty. Given strong demand and tour activity, could you walk us through leasing season's importance?

Yes, while macro uncertainty exists, we believe senior housing is among the top asset classes within real estate for numerous reasons. The powerful demographic demand paired with muted supply is a great fit for our growth aims. We are optimistic about our multiyear NOI growth potential, supported by strong demand and favorable market conditions.

Justin, regarding the Brookdale transition to RIDEA, can you provide insight on any potential revenue left on the table?

The entire Brookdale portfolio is generally improving, and the assets we are moving are underperforming relative to what we can generate in that space. The ones remaining also perform well; significant rent increases are driving improvements there. We are focused on maximizing investments.

There are concerns regarding same-store NOI growth slowing this quarter compared to previous performance. Can you address potential idiosyncrasies within this quarter?

We were pleased with the first quarter's 14% growth, which was ahead of our expectations. We've underscored that we expect stronger performance in the second half based on historical context. The key selling season is key in determining this outcome for the year.

Expecting higher occupancy growth, we have a strong conviction in our portfolio's growth potential. The key selling season is crucial, and we believe we are well-positioned as market conditions improve. We have numerous projects under way that will ultimately enhance performance.

Yes, our outpatient medical segment continues to perform strongly, contributing positively. We remain focused on maximizing NOI opportunities while navigating challenges in the research sector and appreciate the continued robust interest in our locations from credit tenants.

Given the incremental $500 million added to guidance, should we expect a temporary pause until reloads, or is there other interim activity planned?

We’ve seen an acceleration in investment activity over the past year. We have a growing pipeline and continue to pursue opportunities while being flexible across various asset types and markets as we identify those that will meet our strategic criteria.

Do you expect independent living occupancy growth to continue outpacing assisted living throughout 2025, and will the gap be consistent with the first quarter?

Independent living generally has a higher absolute occupancy, and we've seen strong contributions from both segments of our portfolio. Both categories are anticipated to see continued growth as we move into the key selling season.

Our strategy is centered on driving organic growth in senior housing, enhancing performance, and maximizing NOI opportunity while ensuring stability through our credit business in more challenging times.