Shankh Mitra
Chief Executive Officer at Welltower
Thank you, Matt, and good morning, everyone. I'll review the quarter, reflect back on 2021 on this year-end call, walk you through high-level business trends and our capital allocation priorities. John will provide an update on the operational environment for SHO and MOB portfolios, and Tim will walk you through our triple-net businesses, balance sheet highlights and first quarter guidance. 2021 was a year marked by high conviction capital deployment, partner and talent acquisition and a powerful inflection in our senior housing business. Our belief in the long-term demand thesis for the senior housing proved out as we witnessed significant occupancy growth starting in the spring of last year, which continued through the historically seasonally weak winter season. Just as importantly, in the second half of 2021, we began to see a significant shift in the pricing power. Interestingly, we found these pricing power during a period of relatively low occupancy levels. After all, what industry or asset class do you know of that is able to achieve pricing power with occupancy levels in the low 70% range. Low behold that pricing power continued to strengthen in Q4, and in the first quarter of this year despite the impact of Delta and Omicron. Same-store REVPOR grew 3.4% in Q4, following a year-over-year same-store revenue growth of 4.8%, one of the strongest quarter in the company's history. And even more encouraging is the revenue growth in U.S., exceeded 6% with the momentum accelerating through fourth quarter. John will walk you through the details in a moment. Though I am not happy with our subpar bottom line results due to increased expenses mainly from the Omicron induced labor crisis, I continue to believe we will see significant improvement throughout the year given the continued net hiring trends we're seeing from our operating partners. This assumes we don't experience a highly infectious variant.
We can offset the higher cost of full-time employees just as we have done during the years prior to COVID, it is a significant presence of contract labor at surge pricing level that is a source of the issue. From a demand standpoint, we saw record interest in our product in Q4 that continued through January with inquiries up significantly from December. However, a meaningful number of tours got canceled or postponed as either the prospective resident or their family got COVID or a community that did not have enough employees to conduct the tour as there was a COVID crisis in the communities. However, the tours have picked up meaningfully in recent weeks, and we are starting to see strong sales activity, which should translate into higher net move-ins in next three to four weeks. If we are right about this, you may see occupancy growth exceed seasonal trends while occurring in an environment of strong rate growth. We project this will put us into the double-digit NOI growth range in Q1, only to accelerate further throughout the year. As disappointed as I am about the diminished bottom line flow-through in Q4 due to $30 million of agency costs compared to only $5 million in Q1 of last year I continue to believe that our 2022 exit run rate and 2023 earnings power of this platform is unchanged. Moving to capital allocation. In 2021, we deployed $5.7 billion across great real estate with fantastic operator and at even a better price. The most incredible aspect of this story was the granular nature of execution with a median transaction size of $26 million. We're not believers in elephant hunting as larger transactions usually result in value accruing to the seller. As you know, we manage this company for our long-term shareholders to increase our share value. Q4 was no exception to this consistent trend. We have deployed $1.4 billion of capital in Q4 across 20 separate transactions with a median size of $24 million.
I won't bore you with the details of every transaction, but I would be remiss not to mention a couple of them, which I'm particularly proud of, including a handful of trophy buildings in Boston and Florida at a very attractive basis. But perhaps the most exciting investment of the quarter was the formation of our partnership with Andy and Glenn at Quality Senior Living or QSL. It is hard to overstate how strong of a team Andy and Glenn have built from conceptualization of the product to development execution and ultimately, their operational excellence. For example, despite all the labor challenges that I've highlighted, QSL have used virtually no agency labor and their buildings are well occupied. Andy, who is one of the biggest users of our data analytics platform is embarking on a multiyear effort to expand the Blake brand with the full support of our platform behind him. I hope you are seeing a pattern here with how our data and predictive analytics platform attracts some of the best people in the business as we offer so much more than capital. This network effect of platform execution across multiyear partnership that were formed over the last few years will fuel our growth for years to come. As Delta and Omicron induce challenges, we had that ugly hit in Q4, capital deployment opportunity set only expanded, and that continued in Q1, which is seasonally the weakest quarter from a deal activity. With -- after a strong close of 2021, we have already closed an approximately $600 million of the investment over the last six weeks. And I'm pleased to report that our pipeline remains robust, highly visible and actionable. While the capital market backdrops remain volatile of late, driven primarily by the Fed headlines, we're well positioned to fund our pipeline with well over $1 billion of equity and availability of liquidity in excess of $4 billion.
We're proud of our capital allocation track record both deployment and sourcing. But if capital markets volatility continues, we will access different tools from our toolbox as we have done before. Lastly, I'm very proud to announce our new partnership with Reuben Brothers, which is buying Avery Healthcare, one of our largest operating partner. Reuben Brothers, founded by David and Simon Reuben is one of the largest family offices in the world, and is the owner of prime real estate and infrastructure, both in U.K. and globally. They are also a pioneer of investing in alternative real estate and infrastructure as an early investor and owner of Global Switch. Reuben Brothers share our optimism for the exceptional growth trajectory for health care and wellness infrastructure as society ages. We're particularly excited about the prospect of expanding the platform together as Reuben Brothers owns some of the most prime land and real estate in the U.K. Tim and I have said on this call many times that temporary degradation of cash flow doesn't necessarily mean the extraction of value. Avery which constitutes 16% of our same-store triple net NOI will be significantly delevered through this equity infusion from Reuben Brothers. Partnering with highly sophisticated global investors like Reuben Brothers, validates our view of the long-term value of this business despite Wall Street's obsession with point-to-time coverage. In conclusion, I'm very proud to of our execution in 2021 across operations, capital allocation and partnership. That stage is set for multiyear earnings growth as we find ourselves at the bottom of both secular and cyclical cycles with unparalleled platform built with advanced data analytics, 20 or so growth vehicles with different partners and talent to execute on it. The pandemic has been devastating for our entire ecosystem, but we have doubled down during this massive disruption given our high conviction investment thesis, you as our shareholders can rest assured that we'll not be resting on our laurels and that will continue to dig deeper and wider moat.
With that, I'll pass it over to John. John?