# American Healthcare REIT, Inc.

> Clarifo company profile — qualitative business description generated from
> the company's filings. Financial statements, charts and ratios are
> available on Clarifo (https://www.clarifo.com/en/companies/American Healthcare REIT, Inc.).

## Overview

American Healthcare REIT, Inc. is a self-managed real estate investment trust that owns and operates clinical healthcare properties, with a portfolio centered on senior housing, skilled nursing facilities, outpatient medical buildings, and other healthcare-related assets. The company runs a fully integrated operating platform and uses RIDEA structures for certain senior housing and integrated senior health campus assets, which means it participates more directly in operating performance than a pure triple-net landlord. It also originates and acquires secured loans and may selectively develop healthcare properties when it sees attractive opportunities. The business is organized to qualify as a REIT for U.S. tax purposes and is listed on the New York Stock Exchange under the ticker AHR.

## Products & services

• Senior housing operating properties (SHOP)
• Integrated senior health campuses (ISHC)
• Skilled nursing facilities (SNFs)
• Outpatient medical (OM) buildings
• Triple-net leased healthcare properties
• Secured healthcare real estate loans
• Selective healthcare property development

- **Operating healthcare real estate** (55%) — Senior housing, ISHC, and SNF assets operated through RIDEA or similar structures where the company shares in property-level operating performance.
- **Medical office real estate** (20%) — Outpatient medical buildings leased to healthcare providers and related tenants for clinical and ambulatory care use.
- **Triple-net leased properties** (15%) — Healthcare properties leased on a triple-net basis, where tenants bear most operating costs and the company earns contractual rent.
- **Healthcare-related debt investments** (5%) — Secured loans and other real estate-related debt investments held opportunistically alongside owned properties.
- **Development and redevelopment** (5%) — Selective development or expansion of healthcare properties to add new assets or reposition existing ones.

- Senior housing operating properties (SHOP)
- Integrated senior health campuses (ISHC)
- Skilled nursing facilities (SNFs)
- Outpatient medical (OM) buildings
- Triple-net leased healthcare properties
- Secured healthcare real estate loans
- Selective healthcare property development

## Customers

The company’s customers are primarily healthcare operators rather than end consumers, because its revenue comes from tenants, managers, borrowers, and operating partners tied to its real estate assets. Senior housing and skilled nursing operators are especially important because they run facilities that depend on resident occupancy, reimbursement dynamics, and labor availability. Outpatient medical tenants include physician groups, health systems, and other clinical users that need well-located medical space close to patient demand. In its RIDEA-operated assets, the company is more directly exposed to the economics of senior housing operations, making operator quality and local market conditions central to performance.

- **Senior housing operators** (primary) — Operators of independent living, assisted living, and related senior housing assets that generate occupancy-driven revenue and are central to the SHOP and ISHC portfolio.
- **Skilled nursing operators** (primary) — Operators of SNF facilities that lease or manage specialized care properties and depend on reimbursement and staffing conditions.
- **Outpatient medical tenants** (secondary) — Medical practices, clinics, and health systems that lease OM space for patient access and clinical adjacency.
- **Healthcare borrowers** (secondary) — Borrowers on secured loans backed by healthcare real estate, used as an opportunistic capital deployment channel.
- **Joint venture operating partners** (secondary) — Partners involved in owned or co-owned assets where operating expertise and local market knowledge support performance.

- Senior housing operators that manage resident-facing communities and pay rent or share operating income
- Skilled nursing operators that need specialized facilities and stable reimbursement economics
- Outpatient medical tenants such as physicians, clinics, and health systems
- Healthcare borrowers seeking secured real estate-backed financing
- Joint venture and operating partners that help run RIDEA assets and campuses

## Geography

American Healthcare REIT operates primarily in the United States, which is the core market for its senior housing, SNF, OM, and triple-net portfolios. The company also has operations in the United Kingdom and the Isle of Man, giving it exposure to non-U.S. healthcare property markets and foreign currency movements. Because the business is asset-heavy and operator-dependent, geography matters not only for rent growth and occupancy but also for labor markets, reimbursement systems, and regulatory regimes. The international footprint is smaller than the U.S. base, but it adds diversification and introduces additional operational and FX complexity.

- **United States** (90%) — Primary operating market based on company disclosure.
- **United Kingdom** (9%) — Non-U.S. operating exposure disclosed in company filings.
- **Isle of Man** (1%) — Small additional operating presence disclosed in company filings.

- United States is the main operating market and revenue base
- United Kingdom adds exposure to a separate healthcare property market
- Isle of Man is part of the company’s non-U.S. operating footprint
- Geographic mix affects labor costs, occupancy, and operator performance
- Foreign operations add currency and regulatory exposure

## Strategy

The company’s strategy is to own and operate healthcare real estate that produces current income while maintaining flexibility to selectively develop, acquire, or finance assets when opportunities are attractive. A key priority is managing a diversified mix of operating and leased healthcare properties so it can balance contractual rent streams with higher-upside operating exposure. The company also emphasizes disciplined capital allocation through secured loans and opportunistic real estate-related investments, which broadens deployment options beyond direct property ownership. Maintaining REIT qualification, access to capital, and strong operator relationships is central to preserving its ability to grow and distribute cash.

- **Expand and optimize the healthcare property portfolio** (medium-term) — Scale and mix management are important because the company’s cash flow depends on occupancy, operator quality, and asset type diversification.
- **Strengthen operating performance in RIDEA assets** (short-term) — SHOP and ISHC assets expose the company to property-level operating results, so operator execution directly affects revenue and margins.
- **Maintain liquidity and capital flexibility** (short-term) — Healthcare real estate is capital intensive and the company needs financing capacity to refinance debt, fund acquisitions, and manage dispositions.
- **Preserve REIT compliance and tax efficiency** (long-term) — REIT status is essential to the company’s tax structure and distribution model.

- Acquire and operate healthcare properties that generate current income
- Use RIDEA structures to participate in operating upside at senior housing assets
- Maintain a diversified mix across SHOP, ISHC, OM, SNF, and triple-net assets
- Pursue selective development and redevelopment when returns justify the risk
- Originate or acquire secured loans as an opportunistic capital deployment tool
- Preserve REIT status and access to capital to support acquisitions and distributions

## Risks

The company is exposed to tenant and operator credit risk because a meaningful part of its revenue depends on healthcare operators, borrowers, and managers making timely payments and running facilities successfully. Its RIDEA-based senior housing and ISHC assets increase operating risk relative to a pure lease model, since occupancy, labor costs, and resident demand can move results materially. The company also faces regulatory and reimbursement risk in senior housing and skilled nursing, where Medicare, Medicaid, and other government reviews can affect operators’ economics and therefore the company’s cash flow. In addition, interest rates, refinancing conditions, foreign currency movements, and REIT qualification risk can all affect liquidity, distributions, and valuation.

- **Major tenant, operator, or borrower financial distress** [high] — Revenue depends on counterparties paying rent, fees, or debt service; insolvency can directly impair cash flow.
- **Operating risk in RIDEA structures** [high] — ISHC and SHOP assets are tied to operating performance, so occupancy and labor inflation can quickly affect results.
- **Government reimbursement and regulatory scrutiny** [high] — SNF and senior care economics depend on Medicare/Medicaid and healthcare regulation, which can change operator profitability.
- **Interest rate and refinancing risk** [medium] — Higher rates can increase interest expense, reduce asset values, and make debt refinancing more difficult.
- **REIT qualification risk** [high] — Loss of REIT status would subject the company to corporate-level tax and reduce distributable cash.
- **Foreign currency and cross-border operating risk** [medium] — UK and Isle of Man operations introduce FX translation and local regulatory exposure.

- Tenant or operator distress can reduce rent collections and operating income
- RIDEA assets expose the company to occupancy, staffing, and operating margin volatility
- Medicare and Medicaid changes can pressure SNF and senior housing economics
- Interest rate increases can raise borrowing costs and reduce property values
- Refinancing risk matters because debt maturities may require capital market access
- Failure to maintain REIT status would materially increase tax expense
- Foreign operations add currency and regulatory complexity

## Accounting

The most important accounting judgments for this company relate to real estate acquisition accounting, impairment testing, goodwill, and revenue recognition. When it acquires properties or entities, management must decide whether the transaction is a business combination or an asset acquisition, which changes whether transaction costs are expensed immediately or capitalized and how purchase price is allocated. Real estate and goodwill impairment are critical because property values and reporting-unit fair values can move with interest rates, cap rates, occupancy, and operator performance, creating potentially material non-cash charges. The company also uses interest rate swaps and caps and has not always elected hedge accounting, so derivative fair value changes can flow through interest expense and create quarter-to-quarter volatility.

- **Real estate investments purchase price allocation** — Can materially change reported asset values and earnings timing
- **Impairment of long-lived assets** — May create non-cash write-downs
- **Goodwill impairment** — Could result in a material impairment charge
- **Derivative accounting** — Can increase earnings volatility
- **Revenue recognition in operating properties** — Affects quarterly comparability and operating income

- Purchase price allocation affects how acquisition costs and asset values are recorded
- Business combination vs asset acquisition treatment changes reported earnings timing
- Impairment testing for long-lived assets can create non-cash charges when values weaken
- Goodwill is tested annually and depends on subjective cash flow and valuation assumptions
- Derivative fair value changes can run through interest expense if hedge accounting is not elected
- Revenue recognition matters for operating properties and lease-related income timing
- Property dispositions can change comparability across periods

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*Last updated: 2026-08-11T04:46:20.746094+00:00*