Ventas Q1 2022 Earnings Report

Ventas EPS Results

• Actual EPS: $0.10
• Consensus EPS: $0.76
• Beat/Miss: Missed by -$0.66
• One Year Ago EPS: $0.72

Ventas Revenue Results

• Actual Revenue: $1.02 billion
• Expected Revenue: $1.02 billion
• Beat/Miss: Missed by -$6.67 million
• YoY Revenue Growth: +11.80%

Ventas Announcement Details

• Quarter: Q1 2022
• Date: 5/5/2022
• Time: After Market Closes
• Conference Call Date: Friday, May 6, 2022
• Conference Call Time: 8:02AM ET

Ventas (NYSE:VTR) (NYSE: VTR) is a real estate investment trust (REIT) that specializes in healthcare-related real estate. The company acquires, owns and manages a diversified portfolio of properties serving the healthcare continuum, including senior housing communities, skilled nursing facilities, medical office buildings, life science and research centers, and other properties leased to healthcare providers and operators. Ventas generates revenue through long-term leases, property management and selective development activities focused on meeting the real estate needs of the healthcare sector.

Ventas’ business model combines property ownership with active asset management and capital markets activity. The company leases space to a range of tenants that include senior living operators, healthcare systems, and research organizations, and it pursues a mix of ownership structures such as wholly owned properties and joint ventures. In addition to traditional real estate ownership, Ventas has historically provided structured financing and capital solutions to healthcare operators as part of its broader strategy to support operator stability and portfolio performance.

Founded in the late 1990s, Ventas has grown into a large, publicly traded REIT focused primarily on North American healthcare real estate, with additional selective investments in other developed markets. The company emphasizes portfolio diversification across property types, geographies and tenant relationships, and it pursues acquisitions, dispositions and strategic partnerships to reposition assets and create long-term value. Ventas is overseen by an experienced management team and board of directors that guide its capital allocation, risk management and operational strategies in the healthcare real estate sector.

Ventas Q1 2022 Earnings Call Transcript

Key Takeaways

• Ventas delivered year-over-year growth in normalized FFO and same-store SHOP NOI for the first time since the pandemic, driven by a 9.8% same-store revenue increase, 4.2% RevPOR growth and 83% average occupancy in Q1.
• Senior housing operations showed pricing power with 8% in-place rent hikes, 5% sequential street-rate gains and narrowing lease spreads to low single-digit declines, indicating further revenue upside as occupancies climb.
• The company has invested ~$4 billion since early 2021 in senior housing, life sciences and medical office assets, including the $107 million acquisition of Mangrove Bay (now yielding 6%) and a University City lab conversion project targeting a 7% yield.
• Ventas reset its partnership with Sunrise Senior Living to link management fees and incentives directly to NOI performance, aligning interests for profitable growth across 92 high-end assisted living communities.
• With 90% fixed-rate debt, 6.9× leverage and $2.2 billion of liquidity, Ventas guided Q2 normalized FFO of $0.69–$0.73/share and expects ~4% sequential SHOP NOI growth led by 400 basis points of occupancy gains.

Presentation

[Operator]

Ladies and gentlemen, good morning. My name is Abby, and I will be your conference operator today. At this time, I would like to welcome everyone to the Ventas first quarter 2022 earnings conference call. Today's conference is being recorded and all lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session. If you would like to ask a question during this time, simply press the star key followed by the number one on your telephone keypad. If you would like to withdraw your question, press star one once again. Thank you. At this time, I would like to turn the conference over to Sarah Whitford. Ms. Whitford, you may begin your conference.

[Sarah Whitford, Director of Investor Relations at Ventas, Inc.]

Thank you, Abby. Good morning and welcome to the Ventas first quarter financial results conference call. Yesterday, we issued our first quarter earnings release, supplemental, and investor presentation. These materials are available on the Ventas website at ir.ventasreit.com. As a reminder, remarks made today may include forward-looking statements, including certain expectations related to COVID-19 and other matters. Forward-looking statements are subject to risks and uncertainties, and a variety of factors may cause actual results to differ materially from those contemplated by 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.

[Sarah Whitford, Director of Investor Relations at Ventas, Inc.]

For a reconciliation of these measures to the most closely comparable GAAP measures, please refer to our supplemental posted on the investor relations section of our website. With that, I'll turn the call over to Debra A. Cafaro, Chairman and CEO.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Thank you, Sarah. Good morning to all of our shareholders and other participants. I want to welcome you to the Ventas first quarter earnings call. I'm delighted to be joined by my Ventas colleagues who have worked so hard for shareholders, each other, our partners, and our other stakeholders over the past 2+ years. We are off to a strong start in 2022. We are delighted to deliver on our commitment to grow normalized FFO and same-store SHOP NOI year-over-year for the first time since the pandemic began. It is certainly worth pausing to appreciate a quarter that returns us to growth and underscores our positive momentum and the senior housing recovery that is underway. In the quarter, we continued to benefit from stability and growth in our office and healthcare triple-net lease businesses.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

In SHOP, we saw outstanding year-over-year NOI revenue and occupancy growth that overcame meaningful impacts of COVID-19 and inflationary pressures during the quarter. Looking forward, the power of our well-positioned communities, strong demand evidenced by leads that consistently exceed pre-pandemic levels into April, pricing power, and advantaged markets should translate into sustained NOI growth through the balance of the year. These trends should be further enhanced by favorable supply-demand fundamentals supporting net absorption in our markets. Specifically, Q1 2022 starts are down two-thirds from the peak, just as the over eighty population is set to grow over 20% during the next several years. We are not just relying on demographics to win the recovery. Justin and his senior housing team continue to take decisive actions following the right asset, right market, right operator approach to best position our senior housing portfolio to capture the upside ahead.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

We've already started to see the benefit of these actions with a strong first quarter, and our SHOP portfolio has outperformed industry benchmarks for comparable senior housing communities over the last year. Today, we've announced another important step in this progress. We have revised our agreement with Sunrise to align our interests toward profitable growth and value creation. We've been working together with Sunrise since 2007 and are delighted to reset the relationship with the current management team at this point in the cycle. In addition to organic growth, we also benefited from the investments we've made under our consistent long-term capital allocation philosophy and priorities.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

On the investment front, we've posted about $4 billion of investment activity since the beginning of 2021, with our first quarter 2022 capital allocation priorities continuing to be the acquisition and development of senior housing, life science, and select medical office buildings. I want to highlight two of our first quarter investments and show how they demonstrate our investment approach. The two investments have reliable going-in cash yields, limited downside, and room for growth. Both came from trusted relationships built over long periods of time through repeated and mutual success. Mangrove Bay is an irreplaceable senior housing community located on the waterfront in the high wealth sub-market of Jupiter, Florida. Acquired for $107 million, Mangrove has large units, high RevPOR, and a strong, consistent operating history. Since the acquisition, performance has been strong, and our investment yield has grown to 6%.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Our recent value add investment in the University City Philadelphia submarket represents an opportunity to add another component to our incredibly well-performing research and innovation portfolio located between Penn and Drexel. We intend to convert a portion of the building to high demand lab space and achieve a 7% stabilized yield on our aggregate investment costs. The Penn Drexel market has been very successful for us with our two ongoing developments now 90% leased or committed and rents up 40% since we put a shovel in the ground. I'd like to touch on three more points before closing. Our continued focus on driving total shareholder return, ESG leadership, and the macro environment. First, as a continuation of our commitment to driving TSR performance, I welcome BJ Grant to the VTR Team.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

He is a highly regarded longtime REIT investor who has a distinct appreciation for healthcare and senior housing real estate. BJ is going to work with the Ventas team and externally with the investment community to reinforce the Ventas value proposition. Second, I'd like to highlight our sustainability leadership, which continues with our announced commitment to achieve net zero carbon emissions over the next two decades and our recent recognition as the number one medical office building owner operator for ENERGY STAR certifications. Finally, let's discuss the all-important macro economy, particularly current inflationary pressures and the tightest labor market we've seen in 50 years. It is encouraging that today's jobs report evidenced some emerging indications of stability.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Emanating from a confluence of factors, annual inflation is expected to continue to run high, perhaps exceeding 8% through the second quarter, and then moderate by a couple of percentage points in the back half of the year and moderate again by another couple of percentage points by mid-2023. While significant uncertainty remains, this improvement in expectations is the result of various policy actions, including Fed tightening, tempering demand, greater balance in workforce supply and demand from expansion of the labor force participation rate and a slower pace of job creation, and some supply chain normalization. Whether these forces result in a soft landing or trigger a recession, Ventas is relatively well-positioned. Our demand is robust, it is need-based, and it is growing. Pricing power is strong and has the potential to strengthen further as occupancies continue to recover.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Softening the rate of growth in labor and other expenses should improve our margin, particularly as revenue and occupancy increase. Regardless of the macro environment and uncertainty, at Ventas, we will remain agile, execution-focused, and performance-driven. With an attractive valuation and high-quality portfolio, growth potential, a well-covered advantage dividend, 90% fixed-rate debt, and the opportunity to drive external growth, we are very well positioned. In closing, I want you to know that all of us at Ventas are committed to using every tool at our disposal to excel and create sustained value for our shareholders and other stakeholders. Thank you. Justin.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Thank you, Debbie. I'll start by noting that we are very pleased with the NOI growth in the quarter and the start of what should be sustained improvement in our SHOP portfolio throughout the year. The revenue performance is very strong, driven by volume and pricing in spite of the COVID activity in the first quarter, leading to our best year-over-year and sequential revenue performance we have ever seen in our portfolio. Now, I will speak to the first quarter SHOP performance, excluding HHS Grants, second quarter guidance, comments, and update on our key initiatives. In the first quarter, same-store revenue increased by nearly 10% versus the prior year due to the positive trends in occupancy and rates. Same-store average occupancy grew year-over-year by 420 basis points to 83%, which was ahead of the guidance midpoint of 410 basis points.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Although the first quarter was slowed by impacts of COVID, demand remained resilient. Year-to-date through April, lead and move-in activity continues to outperform pre-pandemic levels, led principally by our USAL business. RevPOR increased by 4.2% versus the prior year, benefiting from strong in-place resident rate increases approximating 8% and improving re-leasing spreads. Not only did we execute very strong in-house rent increases during the quarter, we have also witnessed strong sequential growth in street rates over the past several months as move-in rates have improved 5% sequentially. The result of these favorable pricing trends has helped to translate into narrowing re-leasing spreads, which is now a low single-digit reduction and more favorable than pre-pandemic levels. This demonstrated pricing power is occurring at 83% occupancy. Therefore, we believe we have significant occupancy rate and ultimately revenue growth potential in front of us. Turning to expenses.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Same-store operating expenses grew 8% year-over-year, excluding HHS, driven by higher occupancy and macro inflationary impacts throughout the quarter on labor utilities and other operating expenses. Labor expenses remain elevated as we navigate the macro staff shortages with enhanced hiring practices and target wage increases. Net hiring has improved 7 months in a row, and although we are pleased to see the progress on hiring, we have yet to see it impact the P&L. Although inflation is elevated and labor expenses remain high, the incremental margin growth is strong. One of the best aspects of the senior housing operating business at this point in the cycle is the high operating leverage. We are starting to see benefit from this operating leverage as the incremental margin was 56%, which helped the overall margin improve to 24%.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

It is important to note that even though we were pleased with the quarter's performance, the impacts from COVID drove uneven geographic results, with the U.S. significantly outperforming Canada on the bottom line. NOI in the U.S. grew 26% year-over-year versus Canada, which was down 2%. We expect conditions to improve over the balance of the year as Canada's move-in restrictions were the primary driver of its performance compared to the U.S. Our independent living business was also impacted by COVID in the quarter, but I am encouraged to see re-acceleration of move-ins in that portfolio in both March and April. We continue to believe in the independent living thesis over time. We should benefit from our independent living through the overall higher stability with higher margin, lower labor, higher occupancy, and a longer length of stay.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Our independent living communities in the U.S. and Canada are located in markets that support strong net absorption over time. Moving on to significant updates in the senior housing portfolio. Our Transition 90 portfolio of mid-market assisted living communities located in markets with favorable demand characteristics, which was fully transitioned as of January 1st of this year to new regional operators, is showing early signs of improvement as occupancy and NOI are both starting to improve. Our leading senior living portfolio services over 75,000 residents across 46 U.S. states, 7 Canadian provinces, and the U.K., and it's comprised of 38 operators. We remain fully engaged in developing deeper and mutually beneficial relationships, especially with our SHOP operating partners through Ventas OI.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Our goal with this platform is to use our operating experience and deep analytical capabilities to improve all aspects of operations, from digital marketing strategy to CapEx optimization to recruitment and retention. We have developed a differentiated support structure to help our operators succeed. We continue to identify opportunities to improve our portfolio through selective pruning as we are targeting roughly $200 million of senior housing dispositions this year. We are also pleased, as announced today, that we refreshed our relationship with Sunrise Senior Living, who operates 92 of our high-end assisted living communities. This relationship has been reframed with better alignment, which adds flexibility and rewards NOI performance, which now contributes to the management fee and incentives based on outsized NOI growth. Given the emphasis on NOI at this point in the cycle, we think this alignment is perfectly timed.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

I'll close by reiterating our expectation for sustained improved SHOP performance throughout the year, driven by revenue through occupancy growth and improved pricing. I would also like to acknowledge our operating partners who have been successfully navigating an evolving macro environment and ultimately creating a valuable living experience for our residents and value creation for our shareholders. Now I'll hand the call to Bob.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

Thanks, Justin. I'm going to share a few thoughts on our first quarter office and enterprise results and finish up with our second quarter outlook before turning the call to Q&A. Our office segment, which includes our medical office and research and innovation businesses, performed well in Q1, delivering 4.6% year-on-year same-store growth. Medical office year-on-year quarterly same-store growth was 3.5%, led by strong retention, contractual escalators, and parking recovery. R&I increased 7.9%, which also benefited from escalators and leasing, as well as from $1 million in holdover rent from an exiting tenant. Adjusting for this holdover rent, R&I growth was 4.6% in the quarter, and office same-store NOI growth was 3.8%.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

In terms of overall enterprise performance, we were very pleased to have posted growth in the first quarter for the first time since the onset of the pandemic. We delivered FFO of $0.79 per share and organic SHOP revenue and NOI same-store growth of 10% and 14% respectively. Meanwhile, total property same-store NOI increased 5.8%, excluding HHS grants. This growth was achieved while Omicron raged for the majority of the quarter. These results speak to the quality of the Ventas portfolio and the commitment and skill of the Ventas operators and team. Leverage improved sequentially by 30 basis points to 6.9x in Q1 as a result of senior housing NOI growth and HHS proceeds, partially offset by acquisitions closed in the first quarter that had been pre-funded in 2021.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

In this rising interest rate environment, 90% of our debt is fixed rate with a duration exceeding 6 years and an average cost of debt of 3.4%. We are pleased that we extended debt maturities in 2021, having paid down over $1 billion of near-term debt while raising over $1 billion of new debt with a weighted coupon of 2.65%. Our liquidity remains robust, with $2.2 billion available at the close of the first quarter. In terms of Q2 guidance, we expect net income to range from -$0.03 to +$0.01 per fully diluted share. Q2 normalized FFO is expected to range from $0.69-$0.73 per share. When excluding HHS grants, our Q2 guidance midpoint of $0.71 compares to Q1 FFO of $0.71.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

We expect SHOP to grow approximately $0.02 sequentially. This is largely offset by two items previously communicated. A $0.01 sequential reduction from the move out of two life science tenants, which will enable redevelopment into high demand lab space, and $0.01 from lease resolutions with a handful of smaller operators in the senior housing triple net business, with future upside participation in the cash flows at the assets. Further unpacking the SHOP Q2 year-over-year same store guidance, we expect revenue to grow approximately 10% at the midpoint, led by occupancy increasing by 400 basis points as well as improved rates. We expect to grow SHOP NOI in the range of 2%-10%. At the guidance midpoint, Ventas expects operating expenses per day in Q2 to remain consistent with Q1.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

Flat operating expenses per day sequentially in Q2 is higher than normal seasonal trends as a result of incorporated continued inflationary pressures, notably on labor, utilities, and resident services. Looking sequentially, overall SHOP segment NOI is expected to grow approximately 4% from Q1-Q2. Looking beyond Q2 for SHOP, based on the favorable supply-demand backdrop, the strength of the revenue engine, and the expectation of some moderation in inflationary pressure in the back half, we continue to expect sustained improvement in SHOP same-store cash NOI through 2022. Final Q2 guidance assumptions include no new unannounced material acquisitions or capital markets activities and 403 million fully diluted shares. For more information on our guidance assumptions, I would direct you to the business update deck posted to our website.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

I would also point you to pages 29 and 31 of our supplemental, which provide insights and disclosure, including segment NOI guidance and an NOI to FFO trending schedule to allow for easier insight into unique items in our results. To echo Debbie's comments, I'm excited to have BJ Grant join Ventas as our leader of IR. BJ is an accomplished REIT investor, has deep knowledge of healthcare and Ventas, and will be a great fit with our team. To close, we believe the senior housing recovery that is now underway, the actions we have taken, and our continued focus on execution position us for sustained value creation. That concludes our prepared remarks. Before we start with Q&A, we ask each caller to limit to one question to be respectful to everyone on the line. With that, I will turn the call back to the operator.

[Operator]

Thank you. At this time, I would like to remind everyone in order to ask a question, press star, then the number one on your telephone keypad, and we will pause for just a moment to compile the Q&A roster. We will take our first question from Steve Sakwa with Evercore ISI. Your line is open.

[Steve Sakwa, Senior Managing Director and Senior Equity Research Analyst at Evercore ISI]

Thanks. Bob, I just wanted to maybe drill in a little bit on what you were talking about on expenses and just make sure I understand. You know, contract labor, I know was kind of a big headwind in the first quarter. I'm just trying to understand what are your expectations for that in Q2, and just maybe labor overall in Q2 versus kinda labor in Q1.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

Sure. Thanks, Steve. There's a really helpful page in the business update on page 12, which speaks to expenses. Just to frame this, I know you're asking about labor, but again, I wanna put labor in the context of the overall expense base because we are seeing inflationary pressure not only in labor, but in other areas such as food and, utilities and so on, and that's embedded in the forecast. Specific to labor, contract labor within that, which is, call it 5% of labor, with 95% being in-house labor. We did see some modest improvement in contract labor towards the end of the first, and we expect that to continue modestly improving into the second, as we continue to get some success in hiring, as Justin articulated.

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

Importantly, though, overall labor, we are assuming continued inflationary impacts in targeted ways in order to enable that recruiting. If you step back from it all, we are holding our cost per day flat sequentially Q2-Q1 in a quarter which is seasonally lower typically to reflect that inflation. Hopefully that helps frame the answer.

[Operator]

We will take our next question from Nick Joseph with Citi. Your line is open.

[Michael Griffin, Director at Evercore]

Hey. You've got Michael Griffin here on for Nick. Just curious, on future senior housing investments, is there more of a preference for the U.S. or Canada?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

I'll take that and then turn it over to Justin, but we've been very successful in both markets over time. Canada has really outperformed during the pandemic. Occupancies remain very high and the market has been favorable over long periods of time. Of course, the U.S. is the engine of growth in this quarter with 26% year-over-year. We like the growth potential there as well. Justin, do you wanna-

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah. I'll just say that, you know, as we're underwriting deals.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

We always drill into the local market, and we're following the philosophy of, you know, right asset, right market, right operator. Certainly the broader Canadian market tends to have a better supply-demand dynamic over time. They've been 90% occupied for the last 10 years, so that's. It's been supportive of a very stable and growing investment in Canada. Then the U.S., you know, looking ahead, you know, with supply being so low, and starts being so low over the next few years, you know, we like our opportunity to grow organically, but also to make investments in the U.S. as well.

[Operator]

We will take our next question from Vikram Malhotra with Mizuho. Your line is open.

[Vikram Malhotra, Managing Director at Mizuho Americas]

Thanks so much for taking the question. Maybe just a bigger, broader one, Debbie and Justin. You know, you've created now at between 4 and call it 7 turns multiple, spread to your largest peer. I'm just wondering, like, you know, I know you're gonna be executing over the next few quarters, but are there other changes or strategies? Are there other things you can do that you think investors will allow that gap to close?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Well, thank you for the question. As I mentioned, we are and have been taking a lot of decisive action on the portfolio, with the team, and just in general to execute to make sure people understand the Ventas story and the opportunities. Really, we have a consistent strategy that over time has delivered superior performance, and we look forward to the opportunities ahead and, again, look forward to driving TSR, as I mentioned.

[Operator]

We will take our next question from Austin Wurschmidt with KeyBanc Capital Markets. Your line is open.

[Austin Wurschmidt, Senior Equity Research Analyst at KeyBanc Capital Markets]

Great, thank you. I was curious, based on the positive trends you're seeing in street rate growth for senior housing, and the improvement in re-leasing spreads to the low single digit decreases, do you expect re-leasing spreads to turn positive, into the stronger leasing season, and what that could imply for future pricing? Thanks.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Hi, it's Justin. Yes. We are very encouraged by the trends, and we certainly have demonstrated pricing power, as we mentioned. To do so at 83% occupancy is just a real good indicator of the demand for senior housing, which has been strong and growing and, you know, performing above pre-pandemic levels. We would expect pricing power to persist. We demonstrated first with rent in-house rent increases at around 8%, which was solid. You know, the next lever we can pull is street rates and narrowing the re-leasing spread, which is happening already. We would expect it to continue. There are parts of our portfolio that are already positive in terms of re-leasing spread, so we certainly think that can be achieved and should be.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

You know, I'd just say that we're encouraged by the trends and expect, you know, the environment to support more improvement in that area.

[Operator]

We will take our next question from Juan Sanabria with BMO Capital Markets. Your line is open.

[Juan Sanabria, Managing Director at BMO Capital Markets]

Hi, good morning.

[Operator]

Good morning.

[Juan Sanabria, Managing Director at BMO Capital Markets]

Good morning. Just a two-parter. I guess one would be any April occupancy update you can provide, and part two would be a follow-up to Austin's question. Typically, we see RevPAR year-over-year growth peak in the first quarter and then kind of moderate as you see some churn in the portfolio. Wondering if you can give any commentary on expectations beyond the second quarter in the context of your comment in the investor or the quarterly deck about the percentage of the portfolio having the one-year anniversary between the second and fourth quarter, as well as the re-leasing spreads on how we should think about year-over-year RevPAR growth for the balance of the year.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

I'll take the second one first and let Justin talk about April 1. You're right. RevPAR traditionally, at least over the last five years or so, if you look sequentially at the growth rate year-over-year, would tend to drift down over the quarters with the first quarter being supported by the in-house rate increase and then the re-leasing spread dragging that down over the balance of the year. That was in the supply backdrop, really. That was typically the case. What's really encouraging here is the firming street rate or new resident pricing would suggest that that drift should improve, i.e., ultimately, a positive re-leasing spread over time as discussed. We should have a better profile over time, notwithstanding the fact that the re-leasing spread is still lower.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Over as a trend, I would expect that would be better than the supply era, particularly given the backdrop of the fundamentals. You wanna talk about.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Page 11, of course, has April leads and move-ins, which are, as Justin mentioned, ahead of pre-pandemic levels. Leads were very strong. We're entering the key selling season, obviously.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah. One thing about the key selling season, which is really May through September, we would expect that literally 99% of our net move-ins occur during this period. You know, so this is, you know, the red-hot part of the selling season for this sector. We're around 83.3% occupied in April. You know, off to a good start in the quarter. As Debbie mentioned, the underlying demand's been just really solid.

[Operator]

We will take our next question from Rich Anderson with SMBC. Your line is open.

[Rich Anderson, Managing Director at Cantor Fitzgerald]

Hey, thanks. Good morning. You know, drafting off that occupancy, monthly occupancy number, you mentioned in your deck, 500 basis points to return you to pre-pandemic occupancy. I think, the market is probably, it has an appetite for what you know, the sequential, occupancy numbers look like.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Mm-hmm

[Rich Anderson, Managing Director at Cantor Fitzgerald]

In your guidance for the second quarter. Maybe you could give some cadence to the April, May, June expectation.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah.

[Rich Anderson, Managing Director at Cantor Fitzgerald]

Also what the timeline is in your mind to, you know, to capture that 500 basis points and get us back to square one pre-pandemic occupancy. Thanks.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Hey, Rich. Sequentially, we would expect 80 basis points of sequential average occupancy growth. The start of the quarter in April is 20 basis points, suggesting it to go, if you like, in the 50 on average per month, for the balance of the quarter. Remember back to the key selling season that begins to accelerate here in the coming months. If you looked at last year how we trended, that looks like a reasonable forecast. The leads, as you look this year versus last year, are also favorable. That would suggest a good setup for the guidance number.

[Operator]

We will take our next question from Michael Carroll with RBC Capital Markets. Your line is open.

[Michael Carroll, Managing Director and Head of US Real Estate Research at RBC Capital Markets]

Yeah. I just wanted to stick on the seniors housing demand trends. Obviously, the leads and move-ins are strong and have been strong. How could a potential economic slowdown or even a downdraft in the housing market impact those trends? Obviously, the leads as a % of 2019 kind of started to dip in the first quarter into April. I mean, I'm not sure if there's anything to read into that, or is that just something unique with the 2019 versus the 2022 trends?

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Hi, it's Justin. You know, the first part of your question really refers to the macro backdrop, and we've obviously been through other cycles, including one that had a housing demand and price decline. You know, there can be, you know, if it's dramatic like it was during the Great Recession, there can be an initial, you know, shock, you know, to the system. But what we saw, you know, during, you know, post kind of the initial period of the Great Recession is that senior housing performed really well.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Yes.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

It performed well and had a backdrop for a few years of limited new competition, you know, more so than what we're seeing now. We have a real opportunity with the starts being so low and the deliveries being so low, relative to that period. The other thing too is that, you know, house wealth and, you know, income demographics in our markets are very supportive. The affordability for our product is very, very strong. We think we're well positioned.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Right

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

in that regard.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

I would say even potentially within real estate relatively advantaged because that would result in some more slack in the labor market as well. It would change the expense equation here while the demand and supply are favorable. That's, I think, an important point to understand. Then in terms of April, I think we're, you know, actually doing well compared to prior Aprils.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah. We're way ahead of April of last year in terms of, you know, absolute leads. We're still well ahead of 2019. We're not, you know, we're more encouraged than anything.

[Rich Anderson, Managing Director at Cantor Fitzgerald]

Because those quarters, you know, embed this key selling season of May and June, the prior period presentation.

[Operator]

We will take our next question from Joshua Dennerlein with Bank of America. Your line is open.

[Joshua Dennerlein, Raycliff Capital at CFO]

Yeah. Good morning, everyone.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Good morning.

[Joshua Dennerlein, Raycliff Capital at CFO]

Just curious what spurred the initial conversation with Sunrise on switching the management contract over to more NOI-based. Kinda just how did that come about? Is there any ability to do this with other operators?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Well, this was all part of, you know, Justin's mandate. We keep talking about these decisive actions, operationally focused, positioning the portfolio to capture the upside. Obviously, when he first came in March of 2020, there was a lot of focus on sort of the COVID reaction and stabilization. Now we've been taking these steps, and the Sunrise is another good example of what we're trying to do to position the portfolio. Justin, you can comment in particular about how you've done this.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Sure. I mean, one thing I'll just mention is that, you know, Jack Callison and the team at Sunrise have just been, you know, performing really well, and we couldn't be happier about having a partnership with them. You know, what we like about this new arrangement is it's pretty simple. You know, if they deliver higher NOI to us, then they'll get a higher management fee. If it's lower, it's lower. You know, we love the alignment. They're fired up about creating value over time, and we'll both benefit from this. We definitely, you know, anticipate more of our portfolio to have this type of contract. We have several already, but it will continue to put this type of arrangement in place.

[Operator]

We will take our next question from Steven Valiquette with Barclays. Your line is open.

[Steven Valiquette, Managing Director and Healthcare Technology and Distribution Anlayst at Mizuho]

Great. Thanks. Good morning.

[Austin Wurschmidt, Senior Equity Research Analyst at KeyBanc Capital Markets]

Good morning.

[Steven Valiquette, Managing Director and Healthcare Technology and Distribution Anlayst at Mizuho]

Good morning. You guys touched on, obviously, the pricing RevPOR environment. There is a bit of a growing vibe among some investors and conjecture from a few other senior housing companies about the potential for a multiyear cycle of annual resident rate increases trending well above historical averages in the current inflationary environment. I know it's hard to predict any sort of multi-year trend, but I'm wondering, at least for 2023, do you have any preliminary view on whether your rate growth in 2023 can mimic your 8% average trend in 2022? Or is there already a bias that maybe 2022 is a unique year and 2023 increases go back to historical averages?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Look, we've taken a view generally that this is really sustainable demand. Again, the fundamental backdrop in our markets is favorable because of the incredible drop in starts. Supply is low, and it's gonna stay low. We have this window of opportunity where the senior population is starting to grow, and then we have an attractive kind of compelling portfolio. That is a backdrop. Justin always says it's the table is set. That certainly is a good backdrop for a window of opportunity over time.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Our view is, and I think Justin mentioned it too, is if you can drive rate, in place rate in the U.S. went up 8% in January at this low occupancy level in the low 80s, as those occupancies increase and these demographic supply-demand fundamentals improve, that should further support that kind of pricing power. A lot has to go right. There's a lot of uncertainty. It may not be a straight line. I need to, you know, caution all those things. Certainly, there is a case to be made.

[Operator]

We will take our next question from Rich Hill with Morgan Stanley. Your line is open.

[Rich Hill, Senior Managing Director at Principal Asset Management]

Hey, guys. Thanks for taking the question. I wanted to come back to maybe some comments in the prepared remarks. I think specifically you said, you know, first quarter 2022 capital allocation priorities continued to be acquisition and development of senior housing, life sciences, and select medical office buildings. At the risk of reading into it too much, cluing in on the select, does that mean you're maybe deprioritizing MOBs a little bit more in favor of senior housing and life sciences? Or have I read into that too much?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Mm-hmm. Well, when we looked at, you know, 2021, the $3.7 billion that we had, it was really, I think, 70% senior housing, 20% life science, and 10% MOBs. I mean, we've been fortunate to have had an early thesis on MOBs and grown that business, and Pete's done a great job running it. We've done these bolt-on type of acquisitions like the one we did this quarter with our hospital partner, Ardent, which was a relationship-driven opportunity. That's what I would say about our capital allocation priorities, and we've been very consistent in that regard.

[Operator]

We will take our next question from Omotayo Okusanya with Credit Suisse. Your line is open.

[Omotayo Okusanya, Managing Director at Deutsche Bank]

Hi. Yes. Good morning, everyone. Debbie, congrats on the Order of Lincoln in Illinois. BJ, welcome aboard. Question is on senior housing, on the triple net portfolio in particular. Again, realizing you guys have made a bunch of adjustments already to some of the struggling tenants, but you still have kind of a low rent coverage that's still probably somewhat weak relative to historical levels. About 10% of your NOI is still tied to triple net senior housing tenants where rent coverage is below one. How comfortable do you kind of feel that you've made all the adjustments and restructurings you need to do for those tenants? Or is there kind of a risk that you may have to expand that scope going forward?

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

I think at this point, Tayo, because of the pandemic, we have probably touched on the vast majority of these triple net tenants. You know, that's a lot of what we were doing, you know, during the pandemic and working with them. As Bob said, you know, what we've tried to do is really get to a sustainable rent level and then participate in the upside as the industry recovers. That's what we've done generally. Justin, do you wanna-

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah. I would just say that, you know, there has been a lot of action taken, and, you know, we certainly believe that the vast majority of that's way behind us. You know, we'll look to see the operations improve as the rest of the sector recovers.

[Operator]

We will take our next question from John Pawlowski with Green Street. Your line is open.

[John Pawlowski, Managing Director at Green Street]

Thanks. Justin, could you spend a minute just talking about specifically in Canada, what's really holding back that market from the shop fundamental perspective. You know, occupancy remains high, but NOI, cash NOI down 2% year-over-year. Feels like, Canada's been lagging for a while. Just a bit more specifics of what's happening on the ground there.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah, sure. You know, the main thing that really happened was the Omicron variant. In Canada, our communities had restrictions. They've always been much quicker to kind of shut down when there's a little bit of an outbreak or a threat of an outbreak. That slowed the move-ins down. You know, Canada is 93% occupied. It's gonna have kind of structurally higher move-outs because it doesn't have the benefit of this U.S. portfolio that dropped so much because it's just been such a strong, stable performer. January, February had soft move-ins. March and April, off to a good start. We do think there's potential to recover. We're looking forward to Canada getting back on track.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

I'd just really point to COVID, really.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Yeah

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

being the driving force.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Some of those restrictions really are continuing. They have been from a healthcare standpoint a much more rigorous kind of government controls on activities. It'll take a little while for this to kind of run off, but it is a great portfolio and a really high performer, and we're very confident in the future performance.

[Operator]

We will take our next question from Mike Mueller with J.P. Morgan. Your line is open.

[Mike Mueller, Executive Director at JPMorgan Securities]

Yeah, hi. Curious, what are your in-place escalators today for the MOB and life science portfolio? As you're looking at signing new leases today, are the new escalators something considerably higher?

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah. Thanks. Thanks, Mike. This is Pete. Thanks for the question. Yeah. Our escalators are about 2.5% right now, in-place escalators for MOB, and they're about the same for R&I. We are certainly pushing limits on that. We're starting pushing to 3% and in some cases higher. A related comment would be we are trying to push more CPI-related escalators as we deal with this inflationary environment. In some places, we're finding success. In others, you know, we're just settling for higher escalators in the 3% and 3%+ ranges.

[Operator]

We will take our next question from Nick Yulico with Scotiabank. Your line is open.

[Nick Yulico, Managing Director of U.S. REIT Research at Scotiabank]

Thanks. Good morning, everyone. I know you haven't given third quarter guidance, but just trying to put together various numbers here to try and think about, you know, what a third quarter sequential occupancy, you know, growth could look like for the shop portfolio. I mean, last year, third quarter grew sequentially 230 basis points. I think you said, Bob, in the guidance for the second quarter that May and June, we're assuming about 50 a month. You know, should we use that 50 a month, kind of assume that pace could continue, you know, in the third quarter, so you get to around 150 basis points for the quarter, or you're closer to, you know, 200 if you look at the numbers from last year?

[Nick Yulico, Managing Director of U.S. REIT Research at Scotiabank]

Just trying to kind of frame out a possible occupancy, growth scenario for the third quarter. Thanks.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Great try. Great try.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

We're very focused on executing and delivering in the second. You're right about the expectations for the second. We have said we expect sustained NOI improvement through the year.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

I would just add, you know, sequentially, which to your point, 3 versus 2, this key selling season and occupancy manifests itself.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Will be crucial to.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Yeah

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Determining the answer to your question.

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Fundamental, but seasonal patterns would suggest Q3 occ is sequentially, you know, favorable.

[Operator]

We'll take our next question from Vikram Malhotra with Mizuho. Your line is open.

[Vikram Malhotra, Managing Director at Mizuho Americas]

I'm taking the follow-up. Just sort of in this market, with all the volatility, I'm just wondering your views on two things. One, just using the fund more actively that you've created. Two, maybe given the medical office environment, using that as a source of capital for other growth, just all tying that into the balance sheet and where you see leverage, or how you see leverage trending, over the next 12 months.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Well, thanks. Yes, the fund is a great competitive advantage that we have. We started in March 2020, and our overall third-party investment management business is up to about $5 billion of assets under management. It generally is focused on kind of lower cap rate core type assets. To the extent there was an opportunity there that made sense, that is an attractive asset that we have. Bob, do you want to talk about the balance sheet?

[Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer at Ventas, Inc.]

Sure. In terms of leverage, it's a little bit of a broken record, but the recovery of the $300 million of NOI we lost in SHOP in the pandemic is really the key to unlock the leverage ratio back into 5-6 times. You know, we're trending that direction, which is encouraging. In the meantime, you know, we've been doing other things such as upgrading the portfolio through asset sales, for example, last year, reducing near-term debt, extending duration, things like that, to make sure that we're in a good spot, which we are.

[Operator]

We will take our next question from Joshua Dennerlein with Bank of America. Your line is open.

[Joshua Dennerlein, Raycliff Capital at CFO]

Yeah. Hey, guys. I wanted to ask about the 110 drag from the life science redevelopment. It seems like two tenants moved out. Did you disclose who those tenants were?

[Bob Probst, EVP, CFO, and Interim Chief Accounting Officer at Ventas, Inc.]

No, we disclosed the locations, which maybe Pete can give a little color.

[Peter Bulgarelli, EVP and Outpatient Medical and Research at Ventas, Inc.]

Sure, yeah. This is Pete. Yeah, you know, just as a reminder, you know, life sciences is one of our high capital priorities. Over the last couple of years the research innovation portfolio has performed very well. What we found consistently is when we have ready lab space that the space leases up very quickly and at very good rates. It's unique space in the marketplace, and there's a shortage of it across the country. One of our upcoming vacancies is in Raleigh, very near Research Triangle Park. It's a straight office tenant that is departing. This building is associated with Wake Forest University. It's in the innovation center. It's adjacent to the medical school that they have.

[Peter Bulgarelli, EVP and Outpatient Medical and Research at Ventas, Inc.]

We think that there's a good probability that we would redevelop that space into lab space and be very successful in releasing it. The other is associated with our Keystone Properties. Sorry, I mixed-

[Peter Bulgarelli, EVP and Outpatient Medical and Research at Ventas, Inc.]

It's. Yeah.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

I mixed two of them up. I'm sorry.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Uh, there-

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

There's one in Raleigh.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

There's 2. One's in RTP, and one's in the Wake Innovation Center.

[Peter Bulgarelli, EVP and Outpatient Medical and Research at Ventas, Inc.]

That's right.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

They both could be very in demand for kind of lab space.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

That's right.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

That's what we're undertaking.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

That's right.

[Operator]

There are no further questions at this time. I will now turn the call back to Ms. Debra A. Cafaro for closing remarks.

[Debra Cafaro, CEO and Chairman at Ventas, Inc.]

Yep. Okay. Well, thank you, Abby, and thank you to everyone who joined us today. We really appreciate your support and participation and are excited about the quarter, excited about the senior housing recovery that's underway, and look forward to seeing you soon.

[Operator]

This concludes today's conference call. We thank you for your participation. You may now disconnect.

Participants

Executives

• Bob Probst, EVP, CFO, and Interim Chief Accounting Officer
• Debra Cafaro, CEO and Chairman
• Justin Hutchens, EVP, Senior Housing, and Chief Investment Officer
• Peter Bulgarelli, EVP and Outpatient Medical and Research
• Sarah Whitford, Director of Investor Relations

Analysts

• Austin Wurschmidt, Senior Equity Research Analyst at KeyBanc Capital Markets
• John Pawlowski, Managing Director at Green Street
• Joshua Dennerlein, Raycliff Capital at CFO
• Juan Sanabria, Managing Director at BMO Capital Markets
• Michael Carroll, Managing Director and Head of US Real Estate Research at RBC Capital Markets
• Michael Griffin, Director at Evercore
• Mike Mueller, Executive Director at JPMorgan Securities
• Nick Yulico, Managing Director of U.S. REIT Research at Scotiabank
• Omotayo Okusanya, Managing Director at Deutsche Bank
• Rich Anderson, Managing Director at Cantor Fitzgerald
• Rich Hill, Senior Managing Director at Principal Asset Management
• Steve Sakwa, Senior Managing Director and Senior Equity Research Analyst at Evercore ISI
• Steven Valiquette, Managing Director and Healthcare Technology and Distribution Anlayst at Mizuho
• Vikram Malhotra, Managing Director at Mizuho Americas