Ventas, Inc. (NYSE:VTR) Q3 2023 Earnings Call Transcript

Ventas, Inc. (NYSE:VTR) Q3 2023 Earnings Call Transcript November 3, 2023

Operator: Thank you for standing by and welcome to the Ventas Reports Third Quarter Results Conference Call. I would now like to welcome BJ Grant, Senior Vice President of Investor Relations to begin the call. BJ, over to you.

BJ Grant: Thank you, Manny. Good morning everyone and welcome to the Ventas third quarter financial results conference call. Yesterday, we issued our third quarter earnings release, supplemental investor package, and presentation materials, which are available on the Ventas website at ir.ventasreit.com. As a reminder, remarks today may include forward-looking statements and other matters. Forward-looking statements are subject to risks and uncertainties and a variety of topics may cause actual results to differ materially from those contemplated in 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, and for a reconciliation of these measures to the most closely comparable GAAP measures, please refer to our supplemental investor package posted on the Investor Relations website. And with that, I’ll turn the call over to Debra A. Cafaro, Chairman and CEO of Ventas.

Debra Cafaro: Thank you, BJ. Good morning to all of our shareholders and other participants. I’m happy to welcome you to the Ventas third quarter 2023 earnings call. We’re pleased to deliver a strong quarter of normalized FFO of $0.75 per share, representing 6% year-over-year growth and total company same-store cash NOI growth of nearly 8%. Our results reflect both the actions we have taken to drive performance and the powerful demand across our diversified portfolio. that is unified in serving the needs of a large and growing aging population. We are also pleased to raise our full year 2023 normalized FFO guidance midpoint to $2.98 per share. Our senior housing operating portfolio fueled our performance, proving the significant benefits that our communities and operators provide to residents and their family.

Same-store year-over-year cash NOI growth exceeded 18%, driven by Ventas’ operational insights platform in collaboration with our operators. Our Canadian SHOP communities ended the quarter at nearly 96% occupancy and delivered 6% year-over-year NOI growth. Across the SHOP business, move-in significantly exceeded 2019 levels and the portfolio experienced broad-based occupancy gains in both assisted and independent living. Spot occupancy accelerated in the third, gaining 180 basis points from the beginning to the end of the quarter. The multiyear growth in recovery cycle in senior housing is in full swing. In addition, our outpatient medical and research portfolio continued to distinguish itself by delivering solid compounding consistent growth in the third quarter.

As we step back and look across commercial real estate, we continue to believe that Ventas occupies an advantaged physicians. Here are five key reasons why. First, because our portfolio is unified in serving the needs of the nation’s large and growing aging population, demand is strong and getting stronger. By 2030, 20% of the US population more than 70 million individuals will be 65 or older. The over 80 population alone is expected to grow 24% in the next five years. All of our asset classes benefit from these demographic demand trends and provide powerful tailwinds to our enterprise in a variety of economic scenarios. In senior housing, we’re facing the most favorable supply-demand fundamentals the industry has ever experienced. Senior housing starts are at cyclical lows and likely to go lower due to tightening credit conditions.

In our SHOP markets, we have virtually no new starts. This favorable supply-demand relationship creates a compelling backdrop for multiyear growth ahead in senior housing, occupancy and rate, particularly in light of the affordability of senior housing and the value proposition it provides. Second, investment opportunities continue to grow in the senior housing space, and we are well-positioned to capitalize on these opportunities. There is a huge pool of quality senior living communities with attractive return profiles that are coming to market as a result of debt maturities and higher debt service costs. These communities tend to have meaningful runway for occupancy and NOI growth in the hands of well-capitalized experienced and knowledgeable owners like Ventas.

This trend should accelerate in 2024 and 2025. We have the scale, team, relationships, capital access, analytical and operational insights and experience to expand our senior housing portfolio and create NOI growth. Third, we’ve continued to build out our Ventas Investment Management, or VIM platform. VIM provides Ventas another way to expand the opportunity set that benefits our institutional investors and public shareholders alike. This quarter, we invested over $200 million through our open-end fund. Fourth, Ventas has assembled the nation’s leading business at the intersection of medicine, research and universities. Our high-quality outpatient medical portfolio is well occupied and affiliated with leading health care systems across the country.

Our research business represents a differentiated credit-driven model centered on serving the nation’s top universities and our excellent internal property management and leasing function enables us to deliver an outstanding experience to our tenants and drive leasing activity. We continue to see meaningful institutional demand in our university-based research portfolio. And I’d like to give you just a few recent examples. Atrium Health Wake Forest Baptist recently announced its intention to create a new 160,000 square-foot Eye Institute at our redevelopment site in the innovation quarter at Wake Forest. At Arizona State University, the National Institutes of Health or NIH, recently leased space for medical research, demonstrating the desirability of our site and creating a magnet for other researchers.

In addition, Siemens Medical Solutions recently leased space at our $0.5 billion Charlotte, North Carolina project, which is already 80% pre-leased. And last, we are pleased to welcome Dr. Drew Weisman, recent Nobel Laureate to our Penn site at One U [ph] City later this year. We are proud to serve these world-class medical and scientific leaders as they pursue life-changing discoveries. Fifth and finally, we continue to demonstrate access to multiple capital markets at attractive pricing to maintain financial strength and flexibility. We have raised nearly $3 billion year-to-date in various capital markets ahead of the recent rise in interest rates. These actions enhance our liquidity and underscore the competitive advantages Ventas has because of our size, scale and diversified enterprise.

Across Ventas, we are laser-focused on maximizing fundamental performance and generating superior total return for shareholders by enabling exceptional environments that meet the needs of individuals, families and communities. In closing, we are pleased to improve our 2023 outlook and to see that while we certainly have more work to do. Our total returns to shareholders over the last one and three-year periods and since the beginning of 2022, have outperformed both the health care REIT and the REIT indices. The whole Ventas team remains intent on delivering outsized value to its shareholders and other stakeholders. Now, I’m happy to turn the call over to Justin.

Justin Hutchens: Thank you, Debbie. I will start by reporting our third quarter SHOP results, which were very good. Broad-based demand combined with the implementation of the Ventas OI active asset management playbook in collaboration with our operators delivered healthy top and bottom line growth in SHOP during the quarter. Our SHOP portfolio continues to deliver double-digit same-store cash NOI growth for the fifth quarter in a row. The NOI growth of 18.2% was led by the US with 24% growth and our 95% occupied Canadian portfolio contributed 6%. Occupancy accelerated throughout the quarter. with 180 basis points of spot occupancy from June to September, led by the US with 210 basis points. US SHOP occupancy growth was supported primarily by strong demand with move-ins that were 120% at 2019 levels.

Furthermore, we saw 130 basis points of average sequential occupancy growth from the second quarter to the third. Revenue growth was 7.6% year-over-year, driven by the occupancy growth as well as RevPOR growth of 6.2%, which was led by the US with 6.4% as we continue to focus on optimizing price and volume to maximize NOI. RevPOR would have been 20 basis points higher if adjusted for the Sunrise Special Assessment that occurred in the quarter last year. OpEx performed well with 4% growth and margin expanded 230 basis points year-over-year. Now, I’ll give an update on the holiday independent-living communities. We are pleased with the performance across this portfolio. The 75 holiday by Atria US IL communities are benefiting from the broad-based demand and saw spot occupancy increase by 190 basis points from July to September.

We continue to see good performance in this more streamlined portfolio which allows for enhanced focus and with a renewed sense of urgency to execute. We will continue to closely monitor the performance. The 26 IL communities that moved to proven operators grew spot occupancy by 140 basis points from July to September. These three operators are making early improvements to service delivery and performance. Our expert approach of move-in communities to new operators ensures that lead banks are transferred immediately, websites are integrated and management, including the CEOs, have access to the communities well ahead of the transition date to enable quick execution and results. We continue to advance the OI platform and its impact on the portfolio.

I’m pleased to see outsized performance in our Sunrise portfolio, where our move-in volume is exceptionally high, our transition communities are experiencing remarkable occupancy and RevPOR growth and our NOI generating CapEx program, which is delivering initial returns of about 20%. As we look to finish the year, we are expecting attractive top and bottom line SHOP same-store cash NOI growth of 17% to 19% for the full year. The key assumptions that drive the midpoint of our range are average occupancy growth of about 110 basis points and RevPOR growth of about 6%, which was total revenue growth to at least 7.5%. We expect operating expenses at around 4.5% growth due to increased occupancy. This, of course, implies continued margin expansion.

Embedded in this guidance is the impact of the Sunrise Special Assessment that occurred in the third and fourth quarters of last year. Had Sunrise repeated the special assessment in 2023, our SHOP full year NOI guidance midpoint would have been 200 basis points higher, this impact reverses out in Q1 2024 as Sunrise intends to return to the normal first quarter cadence during this rate increase cycle. We expect the fourth quarter to exhibit normal seasonal patterns and are projecting sequential and year-over-year average occupancy growth. The strong demand supporting our portfolio growth is indicative of the macro backdrop that Debbie described and most importantly, a testament to the high-quality care and services that we are offering our residents and their families.

Our operating partners are focused on delivering a valuable living experience for our residents, a meaningful work experience for our employees and a value proposition that is attractive to our residents and their families as they choose to live in our communities. Moving onto investments. We made two investments in the quarter through our VIM platform’s open-ended fund. We acquired a trophy portfolio consisting of two outpatient medical facilities, totaling 281,000 square feet located in Tucson, Arizona, fully leased to AA- rated Banner Health. The purchase price was $134 million. These buildings are crucial and Banner’s delivery of care and services, providing multi-specialty clinical care. We also acquired two Class A private-pay senior housing assets with 181 units in Connecticut, Massachusetts.

The purchase price was $79.5 million, the assets were developed and sold by Benchmark senior living and two private equity firms. Benchmark is a strong regional operator with a long-standing reputation as a market leader in the Northeast. Our top investment priorities continue to be NOI generating CapEx in our existing real estate and senior housing acquisitions. Now, I’ll hand over to Bob.

Bob Probst: Thank you, Justin. I’ll share some highlights of the Q3 performance in our outpatient medical and research and equitized loan portfolios, turn to the enterprise results for the quarter, discuss our balance sheet, and close with our updated and improved 2023 guidance. Starting with some highlights from our outpatient medical business. Outpatient Medical continued its string of 3% or greater same-store cash NOI growth in the quarter. Benefiting from operational excellence as evidenced by tenant satisfaction scores, which outperformed 97% of our peers as surveyed by Kingsley. Meanwhile, our university-based R&I same-store cash NOI increased 3.3%, with occupancy growing year-over-year on the back of strong demand for space from our university tenants.

This demand is evidenced by our recently completed developments at Penn and Pitt, which combined are already nearly 90% leased or committed. Ventas has experienced asset management teams continue to drive performance and value across all asset classes in the recently equitized loan portfolio or ELP. Underlying NOI performance in the ELP outpatient medical, triple-net and SHOP portfolios is trending well and our timing of taking the portfolio over is proving to be prescient. Our 2023 ELP NOI expectation remains in line with last quarter. We also pruned the ELP portfolio through the sale of 6 skilled nursing assets for a gain in the quarter at an attractive price of $60 million or $135,000 per bed. Our overall enterprise reported strong third quarter normalized FFO per share of $0.75.

And representing an increase of nearly 6% year-over-year, adjusting for lapping $0.05 in prior year HHS proceeds. Total company same-store cash NOI increased 7.9% year-over-year, powered by our SHOP portfolio growth of over 18% in the quarter. In terms of the balance sheet, our liquidity is significant. We have $3.1 billion of available liquidity and which covers our 2024 maturities by over three times with our revolver undrawn and $400 million of available cash on hand. And I’m really pleased with how we realize that liquidity, namely through proactive capital raising well ahead of our 2024 maturing debt and prior to the run up in base rates. We first took action in Canada in April, then raised over $1.8 billion in attractive convertible, secured and bank debt in the summer and early fall.

As a result, we’ve now raised $2.8 billion of capital year-to-date at an average cash interest rate below 5%. We’ve used these proceeds to reduce our 2024 maturities, less available cash to just $800 million. We extended our debt duration. We entered pay fixed hedges at low points in base rates, and we reduced Ventas’ floating rate to just 8% from 18% earlier this year. These are strong proof points of our advantaged access to attractive capital and our skill in using that access to the benefit of our shareholders. I’ll conclude with our updated and improved outlook for fiscal 2023. After another solid quarter, we are improving our full year normalized FFO guidance to now range from $2.96 per share to $2.99 per share. This guidance midpoint represents a $0.01 increase versus prior guidance and 5% growth year-over-year ex-HHS, led by broad-based property strength.

As we raise our normalized FFO per share midpoint for the year, we note that 2023 is unfolding directionally as we stated at the beginning of the year, marked by significant year-over-year property NOI growth partially offset by the macro impact of higher interest rates and FX. At the full year guidance midpoint, the implied fourth quarter normalized FFO of $0.75 per share is consistent with the third quarter, with sequential property growth led by SHOP, offset by higher interest rates, FX and back-half dispositions. Total company full year same-store cash NOI year-over-year growth is maintained at 8% at the midpoint. Please see our investor presentation and supplemental disclosure posted to our website for further guidance assumptions. To close, we are pleased with the strong quarter, improved full year guidance and the commitment and skill of the Ventas team.

For Q&A, we ask each caller to state one question to be respectful to everyone on the line. And with that, I’ll turn the call back to the operator.

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Q&A Session

Operator: [Operator Instructions] Our first question comes from the line of Austin Wurschmidt with KeyBanc Capital Markets. Please go ahead.

Austin Wurschmidt: Yes, thanks. Good morning everybody. Justin, you highlighted the impact that the later timing on the renewal increases or the special assessments that you send Alpha Sunrise last year is having in the portfolio. I’m curious, is there anywhere else that you dialed back either the timing or magnitude of rate increases in order to drive occupancy here recently.

Justin Hutchens: So, first of all, price volume optimization is an ongoing focus for us. You can see in our numbers the RevPOR growth year-over-year has been solid. Obviously, there was an impact from Sunrise. So, the $6.2 million would have been $6.4 million, had not been for that bad year-over-year comp. So, strong pricing power, really strong volume in the third quarter. So, we’re really putting together, I think, the right balance of price and volume to drive growth.

Debra Cafaro: I think it’s important to know Austin, also that last year was an extraordinary measure that had never been taken and so we — this is just returning to normalcy with the January 1 increases.

Operator: Our next question comes from the line of Steve Sakwa with Evercore ISI. Please go ahead.

Steve Sakwa: Yes. Thanks. Good morning. Debbie or maybe Justin, you talked about kind of growing acquisition opportunities. I’m just wondering if you could kind of frame what kind of returns you might be seeing either with going in yields or unlevered IRRs. I guess to marry that, how do you sort of think about the funding of those? Is that going to be part of them? Or is that going to be done on balance sheet with a combination of equity and debt? Thank you.

Debra Cafaro: Great. Question. We’ll tag team that. First of all, we do see our cost of capital and the yield of senior housing investments, which were most attracted to coming into line. You noted a number of advantages that we have in terms of funding. We have liquidity. We have the VIM platform and of course, we do see these — the volume of senior housing coming to market and yields increasing so that we feel optimistic about the cost of capital and the yields coming into an attractive focus. And I’ll just turn it over to Justin to talk about what kinds of opportunities are building in the pipeline.

Justin Hutchens: So, we’re seeing a number of opportunities that are really building and particularly in recent months and weeks, include the number of seller institutional — sellers that are dealing with debt maturities or fund maturities. And we’re starting to see the returns become more interesting to us. We’re seeing call it, 6% to 8% in place, and it really depends on the type of asset you’re buying. If it’s something that has more growth, it might be low to mid-6s that can grow to an 8% or better, and then a stabilized senior housing asset in the mid-7s, and we target low double digit and in some cases, even mid-double-digit unlevered IRRs.

Operator: Our next question comes from the line of Nick Joseph with Citi. Please go ahead.

Nick Joseph: Thanks. Maybe just following up on the acquisitions. We obviously saw a medical office M&A deal announced this week. So, curious your interest in growing on the medical office side and how you’re thinking about current pricing within that space relative to the IRRs you can get in other asset types?

Debra Cafaro: We really intend to lean into senior housing, where we have significant expertise and really ought to be a great owner of senior housing with our platform and our relationships. And as Justin said, double-digit low to mid double-digit IRR. So, we’re very interested in that area. First and foremost, you saw that we did close in the VIM platform a medical office building, which has advantages for the VIM stakeholders, in particular, in terms of being reliable, compounding cash flow.