American Healthcare REIT (NYSE: AHR) reported another strong quarter, lifted by the best operating environment for long-term care in decades, executives said, highlighting Trilogy as one of its leading segments driven by a centralized revenue management approach that AHR is now leveraging across its portfolio.

AHR’s quarterly performance was generally a testament to the strength of its portfolio, effective platform integration, strong regional partners, and sustained demand in health care real estate, CEO Danny Prosky said during the company’s third quarter conference call.

“Trilogy and our SHOP segment continue to drive outsized growth, which is the result of our team’s proactive and hands-on asset management approach,” Prosky said.

Trilogy and senior housing operating portfolio [SHOP] occupancies currently sit above 90%, he said, and continue to trend in a positive direction.

Plans are underway to scale AHR’s operating portfolio with regional operating partners, with AHR closing upwards of $575 million – all in RIDEA – in acquisitions year to date, Prosky noted.

Among these new acquisitions, AHR was expanding a “highly curated stable of operators,” Prosky said, adding, “We introduced two new relationships to our group of operators this year, which will broaden our geographic diversification while reinforcing our focus on operators that share our values, including a strong employee culture, ability to deliver ongoing, outsized financial performance.”

Prosky projected ongoing occupancy gains driven by favorable supply-demand based on demographic shifts as well limited construction. And while short-term seasonality may cause temporary fluctuations, AHR expects sustained rate growth of roughly 200 basis points above inflation, supported by rising occupancy and pricing discipline.

Trilogy achieved 21.7% same-store net operating income (NOI) growth, with occupancy at 90.2%, up over 270 basis points year over year, and a 7% increase in average daily rates, which reflects not only continued pricing power, but also ongoing improvement and quality mix, according to Chief Operating Officer Gabe Willhite.

During the third quarter, AHR reported a normalized FFO of $0.44 per share, up 22% year-over-year, fueled by organic NOI growth and new acquisitions. Full-year 2025 FFO guidance was raised to $1.69 to $1.72 per share, implying more than 20% annual growth.

On Friday, AHR shares closed at $49.42, up $1.50, or 3.13%.

Medicare Advantage gains

Growth was also driven by Trilogy’s Medicare Advantage (MA) share, which accounted for 7.2% of resident days, up from 5.8% last year, Willhite said.

“Trilogy is continuously working to add to and also to optimize its Medicare Advantage partnerships with the plans most aligned on quality, which is in turn increasing access for residents to Trilogy and driving more Medicare Advantage census growth across the Trilogy portfolio,” he said.

In the future, MA will drive robust revenue growth for Trilogy, he said.

“Medicare Advantage reimbursement rates are significantly higher than other reimbursement sources and growing faster than other sources,” he said. “Increasing accessibility for Medicare Advantage Plans provides a tailwind for continued census growth.”

Following Trilogy’s way

Executives detailed how AHR is leveraging Trilogy’s revenue management system and best practices – including for staff management – across its broader portfolio.

AHR is extending Trilogy’s centralized revenue management system – a data-driven platform that integrates market rates, occupancy metrics, and discount controls – to other regional operators. This initiative has already optimized revenue at Trilogy’s highly occupied facilities and is in pilot phases across other partners, offering efficiency as regional operators grow.

The pilot program includes dashboard tools, marketing analytics, staff training, and development planning.

Willhite stated that adoption is gradual, as regional operators value autonomy, but that interest is growing, especially among those seeking scalable back-office and IT support.

“We’re leveraging the Trilogy centralized revenue management system across other operating partners,” Willhite said.

Trilogy flexes staffing through its internal travel nurse pool rather than adding permanent headcount, executives noted.

The full upside from Trilogy’s initiatives – particularly around technology, analytics, and Medicare Advantage alignment – have yet to be fully realized, suggesting continued earnings potential, executives noted.

“The numbers today are not fully reflective of the benefit of that Trilogy platform. We’re still in pilot phases with operators on that … What you’ll see over the next year and 24 months is probably an outsized input from Trilogy’s platform as we really start to lean into it and optimize for it,” Willhite said. “And it’s not going to be just limited to revenue management. It’s going to be sales marketing, search engine optimization. It’s going to be employee training, employee retention strategies. It’s going to be, potentially IT solutions.”

Investment plans

Chief Investment Officer Stefan Oh reported that AHR completed $211 million in acquisitions during Q3 and an additional $286 million post-quarter, bringing year-to-date investments to over $575 million, all within operating segments.

AHR’s pipeline of awarded deals exceeds $450 million, he said, noting that these are expected to close by early 2026. The company also maintains a $177 million development pipeline – of which $52 million has been spent so far – with projects ranging from new campuses to independent living expansions.

Even as the long-term care sector was a hotbed of transactional activity, AHR executives noted that health care real estate remains complicated, limiting the entry of new investors and preserving attractive acquisition opportunities for experienced operators like AHR.

Oh said about half of AHR’s deals are off-market, sourced through operators, reducing competition from other REITs. And, AHR prioritizes identifying operators first, then acquiring properties in their markets, Oh said.

The company also disposed of $13 million in non-core assets and further concentrated capital in high-performing, needs-based properties, Oh said.

Among these is the sale of roughly one-third of AHR’s medical operator building (MOB) portfolio, with mostly lower-growth assets, to divert funds to senior housing, where returns are more attractive, Oh said.

AHR, based in Irvine, California, acquires, owns and operates a diversified portfolio of clinical healthcare real estate, focusing primarily on senior housing communities, skilled nursing facilities, and outpatient medical buildings across the United States, and in the United Kingdom and the Isle of Man.