American Healthcare REIT Senior Living Revenue Set to Jump 44% in 2026

American Healthcare REIT’s senior housing operating business is expected to generate $476 million of resident-fee revenue in 2026, up 44% from 2025, as acquisitions, higher occupancy and stronger revenue per occupied room accelerate the healthcare landlord’s shift toward directly operated senior living assets.

Visible Alpha consensus estimates published by S&P Global Market Intelligence put American Healthcare REIT’s total 2026 revenue at $2.8 billion, up 22% year over year. Its Integrated Senior Health Campuses business remains the largest segment, with revenue projected to rise 18% to $2.1 billion, but Senior Housing Operating Properties, or SHOP, is emerging as the faster-growing source of incremental earnings. S&P Global’s American Healthcare REIT senior living analysis shows the shift is being driven by both portfolio expansion and improving property-level economics.

The growth adds another dimension to institutional investment in healthcare assets, where capital is increasingly targeting operating platforms as well as underlying real estate. PE NEWSWIRE recently examined the same convergence of healthcare operations and property value in the Ares-backed $1.4 billion takeover of Spire Healthcare, where the buyers are considering sale-and-leaseback transactions involving parts of the hospital portfolio.

Senior housing NOI is growing faster than revenue

American Healthcare REIT’s senior living cash net operating income is expected to more than double to $130 million in 2026, according to the Visible Alpha estimates. SHOP units are projected to increase 12% to 8,025, while same-store occupancy is expected to rise to 90% from 87% in 2025. Revenue per occupied room is forecast to increase 3% to $5,334.

Those operating assumptions translate into an estimated 21% increase in same-store SHOP NOI to $64 million. The combination of occupancy gains and pricing growth is particularly important for an operating REIT because incremental revenue can produce disproportionately stronger property-level earnings once fixed costs are covered.

American Healthcare REIT’s reported results already show that operating leverage taking effect. In the second quarter, SHOP same-store NOI increased 20.5% year over year, while Integrated Senior Health Campuses posted 16.1% growth. Total portfolio same-store NOI increased 13.2%. The company subsequently raised its full-year total portfolio same-store NOI growth guidance to 11% to 13% and normalized funds from operations guidance to $2.15 to $2.19 per diluted share. The American Healthcare REIT second-quarter results also show the company completed $1.4 billion of new investments during the first half.

Acquisitions accelerate the SHOP strategy

Organic growth represents only part of the expansion. American Healthcare REIT invested approximately $127 million in SHOP assets during the second quarter and subsequently added about $1 billion of senior housing operating assets after June 30, according to S&P Global. The September acquisitions of Kensington Senior Living and LCB Senior Living expanded the REIT’s exposure to higher-acuity communities in affluent markets where new supply can be difficult to develop.

Kensington’s portfolio includes eight communities totaling 745 units, about 93% of which are dedicated to assisted living and memory care. That concentration gives American Healthcare REIT greater exposure to needs-based senior care rather than purely discretionary independent living.

The strategy also changes the REIT’s operating exposure. American Healthcare REIT uses a RIDEA structure for its SHOP and Integrated Senior Health Campuses businesses, allowing it to participate directly in property operating results rather than collecting only contractual rent from tenants. Its triple-net portfolio, by contrast, places most property operating costs on tenants. As of June 30, the company owned or operated 347 buildings and integrated senior health campuses, representing about 23.34 million square feet and an aggregate contract purchase price of approximately $5.73 billion.

Healthcare capital shifts toward operating performance

The expansion illustrates why operating performance has become increasingly important in healthcare real estate. A traditional triple-net structure provides relatively predictable contractual rent, while SHOP assets expose owners more directly to occupancy, resident pricing, labor expenses and other operating variables.

That exposure can increase earnings sensitivity in both directions. For American Healthcare REIT, current occupancy and revenue trends are producing stronger NOI growth, while acquisitions add another layer of expansion.

The broader healthcare investment market is also showing how capital structures can change when operating performance deteriorates. PE NEWSWIRE recently reported on the private credit lender takeover of Affordable Care after a $1 billion debt restructuring, demonstrating the other side of institutional exposure to healthcare operating businesses.

American Healthcare REIT enters the second half of 2026 with a different set of dynamics: accelerating senior housing earnings, significant acquisition activity and lower leverage. The REIT reported net debt to annualized adjusted EBITDA of 2.5 times at June 30, down from 3.0 times three months earlier, while equity offerings provided additional capital for investment.

For investors, the key metric is therefore not simply the projected 44% increase in SHOP revenue. The larger change is the growing contribution of directly operated senior housing to American Healthcare REIT’s earnings mix. If occupancy and revenue-per-room gains persist alongside the expanded portfolio, SHOP could account for an increasingly significant share of the REIT’s incremental NOI even while Integrated Senior Health Campuses remains its largest business.