American Healthcare REIT Inc (AHR) 2024 Q4 法說會逐字稿

Good afternoon, and thank you for standing by. My name is John and I will be your conference operator today. At this time, I would like to welcome everyone to the American Healthcare REIT fourth quarter 2024 earnings conference call. (Operator Instructions)

下午好，感謝您的支持。我叫約翰，今天我將擔任您的會議主持人。現在，我歡迎大家參加美國醫療保健房地產投資信託基金 2024 年第四季財報電話會議。（操作員指令）

I would now like to turn the call over to Alan Peterson, Vice President of Investor Relations and Finance. You may begin your conference.

現在，我想將電話轉給投資者關係和財務副總裁艾倫彼得森 (Alan Peterson)。您可以開始您的會議了。

Good morning. Thank you for joining us for American Healthcare REIT's fourth quarter and full year 2024 earnings conference call. With me today are Danny Prosky, President and CEO; Gabe Willhite, Chief Operating Officer; Stefan Oh, Chief Investment Officer; and Brian Peay, Chief Financial Officer.

早安.感謝您參加 American Healthcare REIT 2024 年第四季和全年財報電話會議。今天與我在一起的有總裁兼執行長 Danny Prosky； Gabe Willhite，營運長； Stefan Oh，投資長；以及財務長 Brian Peay。

On today's call, Danny, Gabe, Stefan and Brian will provide high-level commentary discussing our operational results, financial position, guidance for 2025 and other recent news relating to American Healthcare REIT. Following these remarks, we will conduct a question-and-answer session.

在今天的電話會議上，Danny、Gabe、Stefan 和 Brian 將提供高層評論，討論我們的營運業績、財務狀況、2025 年指引以及與美國醫療保健房地產投資信託基金 (American Healthcare REIT) 相關的其他最新消息。在這些發言之後，我們將進行問答環節。

Please be advised that this call will include forward-looking statements. All statements made during this call other than statements of historical fact are forward-looking statements that are subject to numerous risks and uncertainties that could cause actual results to differ materially from those projected in these statements.

請注意，本次電話會議將包括前瞻性陳述。本次電話會議中除歷史事實陳述之外的所有陳述均為前瞻性陳述，受多種風險和不確定因素的影響，這些風險和不確定性可能導致實際結果與這些陳述中的預測存在重大差異。

Therefore, you should exercise caution in interpreting and relying on them. I refer you to our SEC filings for a more detailed discussion of the risks that could impact our future operating results, financial condition and prospects. All forward-looking statements speak only as of today, February 28, 2025 or such other dates as may otherwise be specified.

因此，您在解釋和依賴它們時應謹慎。請您參閱我們向美國證券交易委員會提交的文件，以便更詳細地討論可能影響我們未來經營業績、財務狀況和前景的風險。所有前瞻性陳述僅截至今天（2025 年 2 月 28 日）或另行指定的其他日期有效。

We assume no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law. During the call, we will discuss certain non-GAAP financial measures, which we believe can be useful in evaluating the company's operating performance.

除非法律要求，我們不承擔更新或修改任何前瞻性聲明的義務，無論是由於新資訊、未來事件或其他原因。在電話會議中，我們將討論某些非公認會計準則財務指標，我們認為這些指標有助於評估公司的營運表現。

These measures should not be considered in isolation or as a substitute for our financial results prepared in accordance with GAAP. Reconciliation of non-GAAP financial measures discussed on this call to the most directly comparable measures calculated in accordance with GAAP are included in our earnings release, supplemental information package and our filings with the SEC.

這些指標不應被孤立地考慮，也不應被當作我們按照 GAAP 編制的財務結果的替代。本次電話會議中討論的非 GAAP 財務指標與根據 GAAP 計算的最直接可比較指標的對帳包含在我們的收益報告、補充資訊包和我們向美國證券交易委員會提交的文件中。

You can find these documents as well as an audio webcast replay of this conference call on the investor relations section of our website at www.americanhealthcarereit.com.

您可以在我們網站 www.americanhealthcarereit.com 的投資者關係部分找到這些文件以及本次電話會議的音訊網路直播重播。

With that, I will turn the call over to our President and CEO, Danny Prosky.

說完這些，我將把電話轉給我們的總裁兼執行長丹尼·普羅斯基 (Danny Prosky)。

Thank you, Alan, and good day, everyone. We appreciate you joining us on today's call. We have much to celebrate and future successes to look forward to here at American Healthcare REIT. We recently commemorated the anniversary of our first full year as a listed healthcare REIT, a milestone achieved through the dedication of our AHR team who invested countless hours to get us here.

謝謝你，艾倫，大家好。感謝您參加今天的電話會議。在美國醫療保健房地產投資信託基金 (American Healthcare REIT)，我們有很多值得慶祝的事情，並且期待未來的成功。我們最近慶祝了作為上市醫療房地產投資信託基金 (REIT) 一周年，這一里程碑的實現離不開 AHR 團隊的奉獻，他們投入了無數的時間才使我們走到今天。

I'm grateful to work alongside such a committed group that shows up day in and day out to deliver on our mission, which I've shared on all our calls, of providing high-quality care, high-quality health outcomes and strong financial performance across our portfolio.

我很感激能夠與這樣一支忠誠的團隊一起工作，他們日復一日地完成我們的使命，我在所有電話會議上都分享了我們的使命，即在我們的整個投資組合中提供高質量的護理、高質量的健康結果和強勁的財務業績。

I am proud that we've delivered on this mission in 2024 and I look forward to the AHR team and its partners delivering on it once again in 2025. This continues to be one of the most favorable fundamental backdrops for long term care that I've observed during my 33 year career in the healthcare REIT industry.

我很自豪我們在 2024 年完成了這項使命，並期待 AHR 團隊及其合作夥伴在 2025 年再次完成這項使命。這是我在醫療房地產投資信託行業 33 年職業生涯中觀察到的長期照護最有利的基本背景之一。

Through 2030, the 80-plus year old population is expected to grow by over 700,000 individuals on average each year against the supply backdrop of the senior housing industry only having added less than 20,000 units on average each year since 2020. I am confident that across our portfolio, we will be able to capture this growing demand wave. Now let's dive into our results.

預計至2030年，80歲以上老人人口每年將平均增加70萬以上，而養老地產業的供給背景僅2020年以來每年平均新增不足2萬套。我相信，透過我們的產品組合，我們將能夠抓住這股不斷成長的需求浪潮。現在讓我們深入研究結果。

In the fourth quarter of 2024, our operational results reflected another exceptional period of same store NOI growth, meeting the rising long-term care needs of an aging population. Our hands-on asset management approach has continued to expand NOI margins, particularly within our managed segments that are comprised of our integrated senior health campuses, which we also refer to as Trilogy, and SHOP portfolios.

2024 年第四季度，我們的營運表現反映出同店淨營運收入又一個特殊的成長時期，滿足了老齡化人口日益增長的長期照護需求。我們務實的資產管理方法不斷擴大淨營運利潤率，特別是在我們管理的由綜合老年健康園區（我們也稱之為 Trilogy 和 SHOP 投資組合）組成的部門內。

As we enter 2025, we expect the rate of revenue growth to continue to exceed the rate of expense growth, positioning us to build on the impressive same store NOI growth that we achieved in 2024. NOI from Trilogy and SHOP segments has grown to 71% of our total NOI as of the end of the fourth quarter in 2024 and we expect this share to continue to grow by year-end, driven by both organic earnings growth and our investment strategy.

進入 2025 年，我們預計營收成長率將繼續超過費用成長率，這將使我們能夠在 2024 年實現的令人印象深刻的同店淨營業收入成長的基礎上再接再厲。截至 2024 年第四季末，Trilogy 和 SHOP 部門的淨營運收入已成長至我們總淨營運收入的 71%，我們預計這一份額到年底還將繼續成長，這得益於有機獲利成長和我們的投資策略。

Our Trilogy segment, which is the largest segment in our portfolio, contributed the largest share of our growth in 2024. This segment of our business meets the essential needs of an aging population. We believe that our Trilogy campuses are the gold standard asset class within the senior housing industry.

我們的三部曲部門是我們投資組合中最大的部門，為我們 2024 年的成長貢獻了最大份額。我們的這項業務部分滿足了老齡化人口的基本需求。我們相信，我們的 Trilogy 園區是老年住房產業的黃金標準資產類別。

Their purpose built design and the capabilities of Trilogy Management Services as our partner to treat all different levels of acuity have resulted in robust health outcomes for residents, which has helped to propel the strong financial results for the portfolio.

他們專門的設計以及 Trilogy Management Services 作為我們的合作夥伴治療不同程度疾病的能力，為居民帶來了健康的健康狀況，從而幫助推動了投資組合強勁的財務業績。

Trilogy's business and quality care outcomes were recently highlighted by Trilogy's overall CMS star rating exceeding over four stars on average portfolio-wide. I believe Trilogy's operating model, along with their service standards and their commitment to residents and employees, differentiate our Trilogy segment within the industry.

Trilogy 的業務和優質護理成果最近因其整體 CMS 星級評定而備受矚目，其整個投資組合的平均星級評定超過四星。我相信 Trilogy 的營運模式、服務標準以及對居民和員工的承諾使我們的 Trilogy 部門在業界脫穎而出。

On the capital allocation front, we remain focused on accretive external growth, primarily through RIDEA structured senior housing and care investments, leveraging our favorable cost of capital and balance sheet capacity to execute on new acquisitions and to fund our captive Trilogy development pipeline.

在資本配置方面，我們仍然專注於增值性外部成長，主要透過 RIDEA 結構化老年住房和護理投資，利用我們優惠的資本成本和資產負債表能力來執行新的收購並為我們的專屬 Trilogy 開發管道提供資金。

In 2024, we invested over $650 million in external growth in our managed long-term care segments and we're optimistic about unlocking further value through investment activity in 2025. Already in 2025, we announced that we are under contract to acquire two new SHOP assets.

2024 年，我們在管理長期照護部門的外部成長上投資了超過 6.5 億美元，我們對透過 2025 年的投資活動釋放更多價值充滿信心。早在 2025 年，我們就宣布已簽訂合同，將收購兩項新的 SHOP 資產。

We closed on a lease buyout in our Trilogy segment and announced plans to start several new Trilogy development projects this year. We believe that these investments will continue to grow our exposure to where we currently see the best risk-adjusted returns, which is in managed long-term care.

我們完成了 Trilogy 部門的租賃買斷，並宣布計劃今年啟動幾個新的 Trilogy 開發案。我們相信，這些投資將繼續增加我們在目前認為風險調整後回報最佳的領域，即管理長期照護領域的投資。

Our guidance, which Brian will break down in more detail later on the call, does not include investments beyond those announced last night, but our cost of capital and our strong balance sheet position us well to pursue accretive opportunities that may arise.

我們的指引（布萊恩將在稍後的電話會議上詳細闡述）不包括昨晚宣布的投資以外的投資，但我們的資本成本和強勁的資產負債表使我們能夠很好地追求可能出現的增值機會。

Our net debt-to-adjusted EBITDA has dramatically improved from both organic growth as well as our capital allocation activity, decreasing from 8.5 times at the end of 2023 to 4.3 times at the end of 2024. This provides flexibility to pursue accretive internal and external opportunities over a sustained period of time.

我們的淨債務與調整後 EBITDA 比率因有機成長和資本配置活動而顯著改善，從 2023 年底的 8.5 倍下降到 2024 年底的 4.3 倍。這為在一段較長時間內尋求內部和外部增值機會提供了靈活性。

In aggregate, we finished 2024 within the increased normalized funds from operations, or NFFO, per share guidance range we set last quarter. We realized these earnings while further refining our portfolio with several opportunistic dispositions that closed in the fourth quarter and raised attractive equity capital via our ATM program.

總體而言，我們在 2024 年實現了上個季度設定的每股正常化營運資金 (NFFO) 成長指引範圍。我們實現了這些收益，同時透過在第四季度完成的幾項機會性處置進一步完善了我們的投資組合，並透過我們的 ATM 計劃籌集了有吸引力的股本。

Everything we achieved over the last year, I believe, strengthens the quality of our portfolio and earnings and provides us with more optionality to grow efficiently within our expanding industry. Before handing it over to the team to discuss our results and outlook for 2025 in more detail, I want to note that we've recently received questions from investors regarding potential policy changes in the healthcare sector, primarily related to Medicaid.

我相信，我們在過去一年所取得的成就增強了我們的投資組合和盈利質量，並為我們在不斷擴張的行業中有效發展提供了更多的選擇。在交給團隊更詳細地討論我們的業績和 2025 年展望之前，我想指出，我們最近收到了投資者關於醫療保健領域潛在政策變化的問題，主要與醫療補助有關。

Those of us that have been in this business for an extended period of time are used to seeing these types of potential policy shifts and have navigated changes over the years. We welcome any questions and are happy to address them during Q&A. However, as of now, it would be speculation as to what would occur with the ever changing regulatory discussion.

我們這些長期從事這一行業的人已經習慣了看到這些類型的潛在政策變化，並且多年來已經經歷了這些變化。我們歡迎任何問題，並很樂意在問答期間解答。然而，截至目前，隨著監管討論的不斷變化，未來將會發生什麼情況還只能是猜測。

With that, I'll turn it over to Gabe to discuss our operational results in more detail.

接下來，我將把話題交給 Gabe 來更詳細地討論我們的營運成果。

Thanks, Danny. Our exceptional operational performance in Q4 and full year 2024 really highlights the strength of our diversified portfolio and our hands-on asset management approach, which allowed us to capitalize on what are highly favorable supply and demand fundamentals.

謝謝，丹尼。我們在 2024 年第四季和全年出色的營運績效真正凸顯了我們多元化投資組合和親力親為的資產管理方法的優勢，這使我們能夠利用非常有利的供需基本面。

Total portfolio same-store NOI grew 21.6% year over year in the fourth quarter, bringing full year 2024 same-store NOI growth to 17.7% compared to 2023. Not surprisingly, our Trilogy and our SHOP segments continue to lead our quarterly and full year results. In our Trilogy segment, same store NOI grew by 28% year over year in Q4 2024. This brought full year same store NOI growth in Trilogy to 23.8%.

第四季度，總投資組合同店 NOI 年增 21.6%，使得 2024 年全年同店 NOI 成長率與 2023 年相比達到 17.7%。毫不奇怪，我們的三部曲和 SHOP 部門繼續引領我們的季度和全年業績。在我們的 Trilogy 部門中，2024 年第四季同店淨營業收入較去年同期成長 28%。這使得 Trilogy 全年同店淨營業利潤成長率達到 23.8%。

Now as I've discussed before, Trilogy has many levers to drive growth and optimize operations and multiple sources contributed to growth in this segment. Occupancy gains, particularly in lower acuity care settings such as assisted living and independent living, as well as Medicare reimbursements, private pay rate growth and disciplined expense control all contributed to sustained high performance.

正如我之前所討論過的，Trilogy 有許多槓桿來推動成長和優化運營，並且有多個來源促進了該領域的成長。入住率的提高，特別是在輔助生活和獨立生活等較低敏銳度的護理環境中，以及醫療保險報銷、私人支付率增長和嚴格的費用控制都有助於持續的高績效。

These factors also drove meaningful margin expansion throughout the year with same store margins in Q4 just shy of 19% and the margin achieved in Q4 2024 marks the return to Trilogy's pre-pandemic margin levels. We're also encouraged by our operating initiatives at Trilogy playing out in our performance in 2024.

這些因素也推動了全年利潤率的大幅擴張，第四季度同店利潤率略低於 19%，而 2024 年第四季實現的利潤率標誌著 Trilogy 的利潤率恢復到疫情前的水平。Trilogy 的營運措施將在 2024 年的業績中充分發揮作用，這也讓我們備受鼓舞。

For example, we noticed this in the fourth quarter as 40% of new admits in Trilogy's assisted living, memory care and independent living care settings came directly from its skilled nursing stays, which was a focal point and is ahead of conversion rates we achieved last year.

例如，我們在第四季度注意到了這一點，因為 Trilogy 的輔助生活、記憶護理和獨立生活護理環境中 40% 的新入院患者直接來自其專業護理，這是一個重點，並且超過了我們去年實現的轉化率。

Strong occupancy in assisted living and independent living villas bodes well for additional margin improvements, since those settings typically require less staff and are typically longer length of stay versus Trilogy's post-acute skilled nursing beds.

輔助生活和獨立生活別墅的強勁入住率預示著利潤率將進一步提高，因為與 Trilogy 的急性後熟練護理床位相比，這些環境通常需要更少的工作人員，並且住院時間通常更長。

Looking to 2025, I expect Trilogy to leverage increasing demand to increase occupancy, enhance pricing efficiency through private pay rate increases and importantly, street rate optimization, and continue refining its key mix, which, by the way, improved as a percentage of patient days by 130 basis points year over year to 73.8%.

展望 2025 年，我預計 Trilogy 將利用不斷增長的需求來提高入住率，透過提高私人費率以及更重要的是優化街道費率來提高定價效率，並繼續優化其關鍵組合，順便說一句，該組合的患者天數百分比同比提高了 130 個基點，達到 73.8%。

As we noted last quarter and consistent with Trilogy's business, we expect modest sequential headwinds to Trilogy NOI in the first quarter of 2025 versus the fourth quarter 2024, largely due to the start of the new year resetting certain compensation related expenses and there being just fewer days in Q1 versus Q4. As a reminder, reimbursement for Trilogy's skilled nursing beds are based on a daily rate. Despite sequential changes, Q1 2025 NOI at Trilogy is expected to be significantly higher versus Q1 2024.

正如我們上個季度所指出的，並且與 Trilogy 的業務一致，我們預計 2025 年第一季 Trilogy 的 NOI 將與 2024 年第四季度相比遭遇適度的連續阻力，這主要是由於新年伊始重置了某些薪酬相關費用，並且第一季度的天數僅少於第四季度。提醒一下，Trilogy 專業護理床位的報銷是按日費率計算的。儘管發生了連續變化，但 Trilogy 2025 年第一季的淨營業收入預計將較 2024 年第一季大幅增加。

In our SHOP segment, same store NOI grew over 65% year over year in Q4 2024, driven by accelerating RevPOR growth, occupancy gains and again, strong expense management. For full year 2024, SHOP achieved record same-store NOI growth of 52.8%.

在我們的 SHOP 部門，2024 年第四季同店 NOI 年成長超過 65%，這得益於 RevPOR 成長加速、入住率上升以及強勁的費用管理。2024年全年，SHOP同店淨營業利潤成長創紀錄，達52.8%。

Looking ahead to 2025, we expect further occupancy gains and now that we've achieved a critical mass occupancy level, pricing strategies will become an even more important driver of NOI growth. The operating leverage at these occupancy levels has led to significant margin expansion with same store NOI margins improving over 700 basis points in Q4 and 500 basis points for the full year compared to the same periods in 2023.

展望 2025 年，我們預計入住率將進一步上升，而且現在我們已達到臨界入住率，定價策略將成為 NOI 成長更重要的驅動力。這些入住率水準下的營業槓桿已導致利潤率大幅擴大，與 2023 年同期相比，第四季度同店 NOI 利潤率提高了 700 個基點以上，全年提高了 500 個基點。

Now as we've seen historically in the industry, the colder winter months and this year's particularly heavier flu season did result in some seasonality to start the year within our managed care segments. Which is resulting in some operating offsets between our Trilogy and our SHOP segments where we're seeing increased occupancy at Trilogy to start the year, especially in the skilled nursing setting and with occupancy in our SHOP segment seeing some modest headwinds.

正如我們在行業歷史中看到的那樣，寒冷的冬季和今年特別嚴重的流感季節確實導致了我們的管理醫療部門在年初出現一些季節性現象。這導致我們的 Trilogy 部門和 SHOP 部門之間出現了一些經營抵消，我們看到 Trilogy 在年初的入住率有所增加，特別是在專業護理環境中，而我們 SHOP 部門的入住率則遇到了一些適度的阻力。

Regardless, we remain confident growth will continue to ramp across our managed long-term care assets, particularly as we enter into the warmer spring and summer selling season. Overall, I'm proud of how our highly curated group of regional operators and our operations teams have delivered a really strong year of NOI growth in 2024 and even after robust growth in 2024, we expect double-digit growth again in 2025 in our SHOP segment.

無論如何，我們仍然相信，我們管理的長期照護資產將繼續成長，特別是當我們進入溫暖的春季和夏季銷售季節時。總的來說，我為我們精心挑選的區域運營商群體和營運團隊在 2024 年實現了真正強勁的 NOI 增長而感到自豪，即使在 2024 年實現強勁增長之後，我們預計 2025 年我們的 SHOP 部門仍將再次實現兩位數的增長。

Our outlook remains positive. We anticipate that RevPOR growth will continue to outpace ExPOR growth in our managed portfolio segments over at least the next 12 to 18 months, driving further NOI and margin expansion.

我們的前景依然樂觀。我們預計，至少在未來 12 到 18 個月內，我們所管理的投資組合部門中的 RevPOR 成長將繼續超過 ExPOR 成長，從而進一步推動 NOI 和利潤率擴大。

A big component of our confidence is driven by persistent barriers to new supply, since the onset of the pandemic, the cost of development has increased considerably as a result of not just construction costs rising, but also financing costs rising.

我們信心的很大一部分來自於新供應持續面臨的障礙，自疫情爆發以來，不僅建築成本上升，而且融資成本也上升，導致開發成本大幅增加。

At the very moment, the industry needs to increase the rate of construction to meet growing demand, the exact opposite is happening and construction starts are still decelerating. Consistently monitoring our own portfolio, we have yet to see any changes to the supply landscape in our markets, setting us up with strong fundamentals that could persist into the next decade.

目前，建築業需要提高建設速度來滿足日益增長的需求，但情況卻恰恰相反，建築開工速度仍在減速。透過持續監控我們自己的投資組合，我們尚未看到市場供應格局發生任何變化，這為我們奠定了強勁的基本面，並可能持續到下一個十年。

Looking ahead three to five years, we are confident that the aging population tailwind, combined with the limited new supply will continue to propel NOI growth across our portfolio.

展望未來三到五年，我們相信，人口老化的順風加上有限的新增供應將繼續推動我們整個投資組合的淨營運收入成長。

With that, I'll turn it over to Stefan to discuss recent transactions and his insights on today's transaction markets.

接下來，我將讓 Stefan 討論最近的交易以及他對當今交易市場的見解。

Thanks, Gabe. As Danny mentioned, and as we discussed last quarter, our team continues to actively execute on our strategy of strengthening the quality and durability of our earnings. We are currently achieving this by sourcing capital through opportunistic dispositions from our lower growth assets and segments while targeting the best risk adjusted returns for capital deployment.

謝謝，加布。正如丹尼所提到的，以及我們上個季度討論的那樣，我們的團隊將繼續積極執行我們的策略，以加強我們的獲利品質和持久性。目前，我們正透過從成長較低的資產和部門中投機性地配置來獲取資本，同時瞄準最佳風險調整後的資本部署回報，從而實現這一目標。

In the fourth quarter, we sold approximately $140 million worth of properties across various segments by capitalizing on strong demand for assets that do not align with the long-term vision for our portfolio. This included the disposition of a triple-net leased portfolio of lower quality skilled nursing facilities that had inherently limited growth. It did not meet the profile of assets we want to support our future earnings.

第四季度，我們利用對不符合我們投資組合長期願景的資產的強勁需求，在各個領域出售了價值約 1.4 億美元的房產。其中包括處置三重淨租賃的低品質、本質上成長有限的專業護理機構組合。它不符合我們想要支持未來獲利的資產狀況。

As we enter 2025, market conditions remain dynamic, but transaction volumes have improved versus a year ago. This is highlighted by our investments team having already evaluated a meaningful number of potential SHOP deals since the beginning of this year compared to the same period in 2024.

進入 2025 年，市場狀況依然充滿活力，但交易量與一年前相比有所提高。值得一提的是，與 2024 年同期相比，我們的投資團隊自今年年初以來已經評估了大量潛在的 SHOP 交易。

As a well-capitalized buyer not reliant on secured financing, we are well-positioned to take advantage of these incremental opportunities while maintaining our disciplined approach in pursuing new investments that align with our portfolio strategy and return requirements. The increased deal volume that we have seen, combined with our strong operating relationships, has resulted in us identifying new opportunities that meet our investment criteria.

作為一個不依賴擔保融資的資本雄厚的買家，我們完全有能力利用這些增量機會，同時保持嚴謹的態度，尋求符合我們的投資組合策略和回報要求的新投資。我們看到交易量的增加，加上我們強大的營運關係，使我們能夠發現符合我們投資標準的新機會。

We announced yesterday that we are under contract to acquire two SHOP properties for a total expected cost of approximately $70.5 million. Upon closing in the first half of 2025, these properties will be operated by two of our trusted regional operators. We also completed a lease buyout this week within our Trilogy segment for approximately $15.9 million.

我們昨天宣布，我們已簽訂合同，將收購兩處 SHOP 房產，預計總成本約為 7,050 萬美元。2025 年上半年交易完成後，這些物業將由我們兩家值得信賴的區域營運商營運。本週，我們也在 Trilogy 部門內完成了約 1,590 萬美元的租賃收購。

In addition to these acquisitions, we plan to bolster our external growth by breaking ground on approximately $140 million in new Trilogy development projects in 2025, including new campuses, independent living villas, campus and wing expansions. Last quarter, I highlighted several avenues for external growth and we are actively pursuing all of them.

除了這些收購之外，我們還計劃在 2025 年破土動工，啟動價值約 1.4 億美元的新 Trilogy 開發項目，包括新校區、獨立生活別墅、校園和翼樓擴建，以促進我們的外部成長。上個季度，我強調了幾種外部成長的途徑，我們正在積極探索所有這些途徑。

Our recent activities in the fourth quarter and early 2025 demonstrate this commitment, including sourcing off market SHOP opportunities with our regional operators and other strategic relationships, focusing on single assets or smaller portfolios that meet our quality and return requirements and funding new accretive Trilogy captive developments.

我們在第四季度和 2025 年初的最新活動證明了這一承諾，包括與我們的區域運營商和其他戰略關係一起尋找場外 SHOP 機會，專注於符合我們的質量和回報要求的單一資產或較小的投資組合，並為新的增值 Trilogy 專屬開發項目提供資金。

I want to emphasize that as we deliver on our capital allocation strategy, all of the underwriting we are conducting is in close partnership with our operators to mitigate operational execution risk. While our relative size offers ample opportunities to drive significant value from our investments, we remain focused on ensuring strong performance from every dollar we invest.

我想強調的是，在我們實施資本配置策略時，我們進行的所有核保都是與營運商密切合作的，以降低營運執行風險。雖然我們的相對規模為我們從投資中獲得巨大價值提供了充足的機會，但我們仍然專注於確保我們投資的每一美元都能獲得強勁的表現。

Now I'll turn it over to Brian to discuss our fourth quarter and full year 2024 results, financial positioning and 2025 guidance.

現在，我將讓 Brian 討論我們的 2024 年第四季和全年業績、財務定位和 2025 年指引。

Thanks, Stefan. In the fourth quarter, we reported normalized funds from operations of $0.40 per diluted share. This resulted in full year 2024 NFFO per diluted share of $1.41, which was within our guidance range. These earnings reflect strong operating results and successful transaction activity while executing on the business plan we laid out at the beginning of the year as well as taking advantage of opportunities that were not originally contemplated.

謝謝，史蒂芬。第四季度，我們報告的正常化營運資金為每股攤薄收益 0.40 美元。這導致 2024 年全年每股攤薄 NFFO 為 1.41 美元，這在我們的指導範圍內。這些收益反映了強勁的經營業績和成功的交易活動，同時執行了我們年初制定的業務計劃並利用了最初未曾考慮過的機會。

As Gabe referenced earlier, our full year 2024 total portfolio same store net operating income growth was a sector leading 17.7%. Our initial guidance for 2024 was influenced by the fact that the industry was in the midst of the recovery from the impact of the pandemic.

正如 Gabe 先前所提到的，我們 2024 年全年總投資組合同店淨營業收入成長率達到業界領先水準的 17.7%。我們對 2024 年的初步指引受到業界正處於從疫情影響中復甦階段這一事實的影響。

Additionally, our initial 2024 earnings guidance did not contemplate the accretive acquisition opportunities that we were able to complete such as the purchase of the minority interest in Trilogy nor the sale of additional shares with proceeds used to reduce our leverage ratios.

此外，我們最初的 2024 年獲利指引並未考慮到我們能夠完成的增值收購機會，例如購買 Trilogy 的少數股權，或出售額外股份並用收益來降低我們的槓桿率。

Our approach to setting guidance for 2025 will in many ways be much easier within our managed segment and with anticipated occupancy growth still strong, but not necessarily at the pace that it was last year. Our total portfolio same store NOI growth guidance is between 7% and 10% for the full year of 2025.

在我們管理的細分市場中，我們制定 2025 年指導方針的方法在許多方面都會變得更加容易，預計入住率成長仍然強勁，但不一定能達到去年的速度。我們對 2025 年全年投資組合同店淨營業收入成長的預期為 7% 至 10%。

This guidance is comprised of the following segment same store NOI growth targets, 10% to 12% growth for Trilogy negative 1% to positive 1% for outpatient medical, 18% to 22% growth for our SHOP segment and declines of 1.5% to 0.5% for our triple-net leased properties.

該指引由以下分部同店 NOI 成長目標組成：Trilogy 成長 10% 至 12%、門診醫療成長 -1% 至 1%、SHOP 分部成長 18% 至 22%、三重淨租賃物業下降 1.5% 至 0.5%。

The guidance for outpatient medical reflects headwinds from expected tenant move outs, and with respect to the guidance for the triple-net leased segment, it reflects a lease extension and rent reset for 1 of our tenants that extends the lease term and provides for improved lease coverage.

門診醫療的指導反映了預期租戶搬離帶來的阻力，就三重淨租賃部門的指導而言，它反映了我們的一名租戶的租約延長和租金重置，從而延長了租賃期限並提供了更好的租賃覆蓋範圍。

Keep in mind that the triple-net leased assets are the smallest segment within our portfolio, so any impact will not be significant. In our managed segments comprised of Trilogy and SHOP, our expectations for 2025 are that supply and demand fundamentals, along with our operating capabilities, should support another year of double-digit same store NOI growth.

請記住，三重淨租賃資產是我們投資組合中最小的部分，因此任何影響都不會很大。在我們管理的由 Trilogy 和 SHOP 組成的部門中，我們對 2025 年的預期是，供需基本面以及我們的營運能力應能支持同店淨營業利潤再實現兩位數的增長。

We believe that the landscape for long-term care has never been better and we expect NOI growth in 2025 will contribute to strong earnings per share growth. Collectively, our outlook for same store NOI growth and the completed or announced investment activity translates to double-digit NFFO per share growth in 2025 as compared to 2024.

我們相信長期照護的前景從未如此好，我們預計 2025 年的淨營運收入成長將促進每股盈餘強勁成長。總的來說，我們對同店淨營業收入成長和已完成或宣布的投資活動的預測意味著，與 2024 年相比，2025 年每股 NFFO 將實現兩位數的成長。

We are issuing guidance of $1.56 to $1.60 of NFFO per fully diluted share for full year 2025. This NFFO guidance does not assume any additional capital markets or transaction activity beyond what we have already announced, although it does include the effects of the dispositions of lower growth assets we closed in the fourth quarter of 2024 and a significant improvement to our leverage ratios.

我們預計 2025 年全年每股 NFFO 為 1.56 美元至 1.60 美元。本 NFFO 指南不假設我們已經宣布的任何額外資本市場或交易活動，儘管它確實包括了我們在 2024 年第四季度關閉的增長較差資產的處置以及我們槓桿率的顯著改善的影響。

Our operations and investment teams are continuously evaluating assets across our portfolio, predominantly outpatient medical, as potential candidates for disposition. As always, our appetite for continued dispositions will be driven by pricing as well as the effect on the remaining portfolio from selling a particular asset or portfolio. During 2024, we recognized approximately $0.06 per fully diluted share of non-core earnings and I anticipate that number will be lower in 2025.

我們的營運和投資團隊正在不斷評估我們投資組合中的資產（主要是門診醫療資產），作為潛在的處置候選資產。與往常一樣，我們對持續處置的興趣將取決於定價以及出售特定資產或投資組合對剩餘投資組合的影響。2024 年，我們確認每股攤薄非核心收益約為 0.06 美元，我預計 2025 年這一數字將會更低。

Now turning to our capital markets activity, in the fourth quarter, we raised approximately $121 million through our recently initiated ATM program, at a weighted average price of $28.05 per share. Those funds were used to pay down outstanding debt, creating capacity for our announced 2025 investment and development funding.

現在談到我們的資本市場活動，在第四季度，我們透過最近啟動的 ATM 計畫籌集了約 1.21 億美元，加權平均價格為每股 28.05 美元。這些資金用於償還未償債務，為我們宣布的 2025 年投資和發展資金創造了能力。

As Danny mentioned, the significant organic growth in our portfolio and capital markets activity, which included raising nearly $1.4 billion of equity in 2024, reduced our net debt to adjusted EBITDA ratio by more than 4 turns, from 8.5 times at the end of 2023 to 4.3 times at the end of 2024.

正如 Danny 所提到的，我們的投資組合和資本市場活動實現了顯著的有機成長，其中包括在 2024 年籌集近 14 億美元的股權，使我們的淨債務與調整後 EBITDA 比率降低了 4 倍以上，從 2023 年底的 8.5 倍降至 2024 年底的 4.3 倍。

Our strong balance sheet affords us the ability to take advantage of any new opportunities that we uncover. We remain disciplined in our capital planning, building on the success we had this past year and positioning ourselves to continue to capture growth in the attractive long-term care environment within healthcare real estate. That concludes our prepared remarks.

我們強勁的資產負債表使我們能夠利用所發現的任何新機會。我們繼續嚴格執行資本規劃，在過去一年取得的成功的基礎上再接再厲，繼續在醫療房地產領域具有吸引力的長期照護環境中實現成長。我們的準備好的演講到此結束。

Operator, we are now ready to open the line for questions.

接線員，我們現在可以開始回答您的提問了。

(Operator Instructions)

（操作員指令）

Ronald Kamdem, Morgan Stanley.

摩根士丹利的羅納德‧坎登 (Ronald Kamdem)。

Hey, just two quick ones. I guess. I'd love to hear what you're seeing in terms of the trends in January and February so far. And the reason I asked that is because when I think about sort of the deceleration baked into the same store NOI guidance, I guess I'm just wondering, is something sort of that you're seeing leading to that? Is it conservatism? Just what was the thought process in that number given you guys exceeded last year by quite a bit. Thanks.

嘿，只需兩個問題。我想是的。我很想聽聽您對一月和二月迄今為止的趨勢有何看法。我之所以問這個問題，是因為當我想到同一家商店淨營業收入指引中所包含的減速時，我只是想知道，您是否看到某種東西導致了這種情況？這是保守主義嗎？考慮到你們比去年多了不少，那麼這個數字是怎麼想的呢？謝謝。

All right. So I'll start with that one. This is Danny speaking. So a lot of things, I think -- there's a lot of moving parts there that I think answer your question. I would say looking at Trilogy, for example, I think we're expecting necessarily not to see growth in NOI between Q4 and Q1.

好的。因此我就從這個開始。我是丹尼。所以我認為，很多事情——有很多活動部件可以回答你的問題。以 Trilogy 為例，我認為我們預期第四季和第一季之間的淨營運收入必然不會成長。

Although Q1 2025 will obviously be much higher than Q1 2024. There are several things affecting that. I think number one, just the fact that you've got 14,000 employees and you see a reset on employer of FICA, for example, has a significant effect the first couple of months of the year.

儘管 2025 年第一季顯然會比 2024 年第一季高得多。有幾件事影響了這一點。我認為，首先，你有 14,000 名員工，你看到 FICA 的雇主重新設定，這將對今年頭幾個月產生重大影響。

We've got higher utilities in the winter, which is always to be expected. And not -- this is a trend that we've seen for years, where Q1 tends to be kind of flat over Q4 and then growth throughout the year, year in, year out.

冬季我們的水電費會更高，這是可以預料到的。而這並不是我們多年來一直看到的趨勢，第一季與第四季相比趨於持平，然後全年都呈現成長態勢，年復一年。

I think we -- the last few years, we had COVID recovery, so it wasn't as pronounced. But we're kind of going back to where we were beforehand. I think you're seeing the same issue that we saw before COVID as far as occupancy. We've seen really strong occupancy growth on the skilled side during January and February. I think a lot of it has to do with the flu season, where SHOP has been, dropped slightly as we've seen in years past.

我認為，過去幾年，我們已經從新冠疫情中恢復過來，所以影響並不那麼明顯。但我們又回到了之前的狀況。就入住率而言，我認為您看到的問題與我們在 COVID 之前看到的問題相同。一月和二月，我們看到技術人才的入住率成長非常強勁。我認為這在很大程度上與流感季節有關，正如我們在過去幾年看到的那樣，SHOP 的銷量略有下降。

So I think that's as far as Trilogy specifically. As far as kind of where we see operations so far this year, we're pleased. I mean I think we -- it's only been a couple of months, and of course, February hasn't even ended, so we don't have February numbers. But so far, so good. We're happy with what we've seen so far this year as far as our budget and our forecast. Anything you want to add, Brian?

所以我認為這與三部曲的具體內容有關。就今年迄今的營運情況而言，我們感到滿意。我的意思是，我認為我們——這才過了幾個月，當然二月還沒結束，所以我們沒有二月的數據。但到目前為止，一切都很好。就今年目前的預算和預測而言，我們感到滿意。布萊恩，您還有什麼要補充嗎？

Yeah. Listen, just to put it into context, a couple of things. We grew our SHOP occupancy by 600 basis points in 2024. I don't think anybody here thinks we're going to grow SHOP occupancy by another 600 basis points. So that's definitely going to be part of it.

是的。聽著，為了將其放在上下文中，有幾件事。到 2024 年，我們的 SHOP 入住率將增加 600 個基點。我認為這裡沒有人會認為我們會將 SHOP 入住率再提高 600 個基點。所以這肯定會是其中的一部分。

The other thing to keep in mind is that our RIDEA occupancy is ahead of our peers RIDEA occupancies. So all those things sort of contribute to 2025 being by all measures, a great year of same store expectations for our growth, but at the same time, lower than it was in '24.

要記住的另一件事是，我們的 RIDEA 入住率領先於同行的 RIDEA 入住率。因此，從各方面來看，所有這些因素都導致 2025 年成為我們同店銷售額預期成長極佳的一年，但同時，也低於 24 年的水準。

Great. And then my second question was just on the acquisition pipeline. I know you talked about the $71 million that you're looking at, which is great. But just can you give us a sense of what that pipeline actually sort of looks like, the amount of deals that you're looking at? Just to get a sense of how much product is possible in this environment for you guys. Thanks

偉大的。我的第二個問題是關於收購管道。我知道您談到了您正在考慮的 7100 萬美元，這很棒。但您能否向我們介紹一下該管道的實際情況以及您正在考慮的交易數量？只是想了解在這種環境下你們可以生產多少產品。謝謝

Yeah. I would say that the pipeline right now is very robust. I mean we have been very active over the past few months in looking at potential new opportunities. And we have been working very closely with our operators and identifying the opportunities that will be a best fit for the portfolio.

是的。我想說的是，目前的管道非常強勁。我的意思是，過去幾個月我們一直非常積極地尋找潛在的新機會。我們一直與營運商密切合作，尋找最適合投資組合的機會。

In terms of the pipeline size, I mean I think we're seeing that grow. And it's definitely more significant than it was at this time last year. So I think there are plenty of opportunities out there for us to underwrite and to participate in.

就管道規模而言，我認為我們看到了它的成長。它絕對比去年此時更重要。所以我認為我們有很多機會可以承保和參與。

Right. That's it for me. Thank you.

正確的。對我來說就是這樣了。謝謝。

Farrell Granath, Bank of America.

法雷爾·格拉納特，美國銀行。

Hey, Farrell.

嘿，法雷爾。

Hi, good afternoon. Thanks for taking my questions. I wanted to ask about specifically when you're thinking about the tipping point of occupancy, and I know you kind of alluded to it in the previous answers, specifically in Trilogy, when you're thinking about the tipping point of occupancy and when you can really start pushing rate and really start seeing that margin expansion, I think I'm looking at the numbers now, seeing that you're already seeing it kind of in 4Q. What would you be thinking about going forward?

嗨，下午好。感謝您回答我的問題。我想具體問一下，您何時考慮入住率的臨界點，我知道您在之前的回答中提到過這個問題，特別是在《三部曲》中，您何時考慮入住率的臨界點，當您真正開始提高入住率並真正開始看到利潤率擴大時，我想我現在正在看這些數字，看到您已經在第四季度看到了它。您對未來有什麼想法？

Yeah. So look, if you look at where occupancy is today, it's well above where it was pre-COVID levels. And I think we're already at the point now where we're able to increase rates at a pretty good clip. We're looking at pretty strong increases this year. We're very comfortable where we are, but we think it's going to keep going up.

是的。所以，如果你看看今天的入住率，你會發現它遠高於 COVID 之前的水平。我認為我們現在已經達到了能夠以相當快的速度提高利率的階段。我們預計今年的成長將會非常強勁。我們對目前的狀況非常滿意，但我們認為還會繼續上漲。

Keep in mind that you've got to split it up. With Trilogy, you've got the AL component -- the AOL component, which I think is very similar to what you see across the industry. And that right now is in the high 80s. It's gone up a lot and we expect it to keep going up over time, going back to everything we said as far as the demand drivers, lots of new demand, very little new supply.

請記住，你必須將其分開。有了 Trilogy，您就擁有了 AL 組件——AOL 組件，我認為這與您在整個行業中看到的非常相似。現在溫度已接近華氏 80 度。它已經上漲了很多，我們預計它會隨著時間的推移繼續上漲，回到我們所說的需求驅動因素，大量的新需求，很少的新供應。

On the post-acute care, on the skilled side, they're right around 90% today, which is higher than anyone else I've seen. There's room to continue growing that. But just keep in mind, their model is really a short-term stay, much more Medicare, private pay, private insurance, much less Medicaid.

在急性後期護理方面，從技術層面來說，他們目前的比例已經達到 90% 左右，比我見過的任何人都要高。還有繼續成長的空間。但請記住，他們的模式實際上是短期住宿，更多的是醫療保險、私人支付、私人保險，而不是醫療補助。

So they're always going to want to have beds available to bring in new residents who are coming out of a hospital setting. So we don't want them at 98%. We always want to have -- we want to be able to accept those higher paying Medicare patients.

所以他們總是希望有剩餘的床位來接收剛從醫院出院的新病人。所以我們不希望達到 98%。我們一直希望——我們希望能夠接受那些支付更高的醫療保險患者。

We want to make sure we have beds available. So I really think that can we continue to raise the skilled nursing occupancy within Trilogy? Yes. But we don't -- I don't necessarily think that we want to do so. We're very comfortable in the low 90s.

我們希望確保有空床位。所以我真的認為我們能否繼續提高 Trilogy 內熟練護理師的佔有率？是的。但我們不會——我不認為我們想這樣做。我們在 90 年代初期感覺非常舒適。

Great. And I guess also a follow-up on that, and you made the -- in your opening remarks about Medicaid exposure. Can you give a little bit more color on how you're thinking about it? And again, specifically in the Trilogy, more in the operating exposure that you have, how you think about what potential impact could be on the worst case scenario if major cuts across Medicaid or even more limited, how you could see that impacting and if you're hearing anything from your operators?

偉大的。我想這也是對此的後續關注，您在開場白中提到了關於醫療補助的風險。您能否更詳細地說明一下您對此的看法？再次，特別是在三部曲中，您在營運方面面臨更多挑戰，您如何看待如果大幅削減醫療補助甚至更加有限，在最壞的情況下可能產生什麼影響，您如何看待這種影響，以及您是否從您的運營商那裡聽到了什麼消息？

Yeah. So you're right to focus on Trilogy because looking at our portfolio, really, the portfolio that had the most Medicaid exposure, I believe it's about 97%, is the one we sold back in December. That was the skilled nursing portfolio in Missouri.

是的。因此，您關注 Trilogy 是正確的，因為從我們的投資組合來看，實際上，醫療補助敞口最大的投資組合（我認為約為 97%）是我們在 12 月出售的投資組合。這是密蘇裡州的專業護理組合。

And one of the reasons we decided to sell it is, of course, we started that process way before the election and before any of this became an issue. But just from a quality perspective, they were older assets, they were smaller, more rural, less growth, just assets that we didn't feel met the overall criteria of where our portfolio is and where we want it to continue to be.

我們決定出售它的一個原因當然是，我們在選舉之前、在這一切成為問題之前就開始了這個過程。但從品質角度來看，這些資產比較老，規模較小，更加鄉村化，成長速度較慢，我們認為這些資產不符合我們投資組合的整體標準，也不符合我們希望其繼續維持的標準。

So looking at what we have left, really from a Medicaid perspective, it's really just at Trilogy. And Trilogy's exposure is pretty low. It's about 21% of the portfolio and it's been shrinking by design over time as we continue to expand the AL, IL and Medicare portion of Trilogy. But the way I'd answer the question is really in three parts.

因此，從醫療補助的角度來看，我們所剩下的就只剩下三部曲了。而且Trilogy的曝光率相當低。它約佔投資組合的 21%，隨著我們繼續擴大 Trilogy 的 AL、IL 和 Medicare 部分，它的份額也逐漸縮小。但我回答這個問題其實分為三個部分。

So number one, we don't know what's going to happen. I don't -- anybody who says they can predict what's going to happen with Medicaid, I don't think is telling the truth. Who knows, you can listen to the same politicians at the same day and they'll say two different things. So is there a chance there'll be some changes? Yes, I think there is, but we don't know what those will be.

首先，我們不知道會發生什麼事。我不認為任何聲稱能夠預測醫療補助計劃未來發展的人是在說實話。誰知道呢，也許同一天聽同一些政客講話，他們會說出兩件不同的事情。那麼有可能會有一些變化嗎？是的，我認為有，但我們不知道它們是什麼。

Number two, I believe that if there are adjustments to Medicaid, it is much more likely to be affecting those who benefited from the Medicaid expansion, for example, maybe reduced eligibility work requirements, et cetera.

第二，我認為，如果對醫療補助進行調整，則更有可能影響那些從醫療補助擴展中受益的人，例如，可能降低資格工作要求等。

I think that's much less likely to see any effect on Medicaid reimbursements for long-term care. I've been around 33 years in this business. We've seen what happens when they try to cut skilled nursing reimbursements, it never ends up well. And typically, those cuts need to be reversed.

我認為這不太可能對長期照護的醫療補助報銷產生任何影響。我從事這個行業已經 33 年了。我們已經看到，當他們試圖削減專業護理報銷金額時，會發生什麼情況，結果通常都不會好。通常情況下，這些削減措施需要撤銷。

And number three, really going back to Trilogy, they're down to 21% of their revenue being Medicaid and as Gabe mentioned in his prepared remarks, they have a lot of levers at Trilogy that they can pull. There is -- they can -- if they determine that Medicaid reimbursements don't make sense, it's very easy for them to pivot and convert those rooms to AL, memory care, more Medicare beds.

第三，回到 Trilogy，他們的收入中只有 21% 來自醫療補助，正如 Gabe 在準備好的發言中提到的那樣，他們在 Trilogy 可以利用很多槓桿。他們可以——如果他們確定醫療補助報銷不合理，他們可以輕鬆地將這些房間轉變為 AL、記憶護理和更多的醫療保險床位。

Trilogy, that's just not one of their focus, Medicaid. It's really more of an accommodation to existing residents, to where they if time out of Medicare or if they run out of money, we can move them into a Medicaid bed. Usually, there's a wing that's Medicaid that has double occupancy rooms.

三部曲，這不是他們的重點之一，醫療補助。這實際上更多的是為了給現有居民提供便利，如果他們的醫療保險時間已到或錢用完了，我們可以讓他們轉到醫療補助病床。通常，有一個醫療補助病房，裡面有雙人房間。

It's not really a line of business that they focus on specifically. It's really more of an accommodation to existing residents. And if they need to shrink that business because the reimbursement isn't there, it's very easy for them to do so. But I honestly don't think it's going to come to that.

這實際上並不是他們特別關注的業務。這實際上更像是為現有居民提供便利。如果他們因為沒有報銷而需要縮減業務，那麼他們很容易這樣做。但我真的不認為事情會發展到這一步。

Great. Thank you.

偉大的。謝謝。

Nick Joseph, Citi.

花旗銀行的尼克約瑟夫 (Nick Joseph)。

Hey, Nick, looking forward to seeing you next week.

嘿，尼克，期待下週見到你。

Well, thank you, Danny, but it's actually Griff on for Nick, but we're looking forward to seeing you as well.

好吧，謝謝你，丹尼，但實際上是格里夫代替尼克，但我們也期待著見到你。

Hey, Griff.

嘿，格里夫。

Maybe just -- hello, maybe just getting back to kind of the opportunity set within Trilogy and the margin expansions. And Gabe, I know you kind of touched on this during your prepared remarks, but as you kind of think about maybe the SNF portion of Trilogy is getting closer to that terminal occupancy, you've probably got some more room to run on the AL component.

也許只是——你好，也許只是回到三部曲中設定的機會和利潤擴張。加布，我知道您在準備好的發言中提到了這一點，但是當您想到 Trilogy 的 SNF 部分可能越來越接近終端佔用率時，您可能在 AL 組件上還有更多的運行空間。

Where could we see margins get to? I realize that you're not giving guidance, but I would expect if you added on additional capacity within AL, you add on some of these IL villas, it stands to reason you should see decent margin expansion in the future. Do I have that right?

我們能看到利潤達到什麼程度？我知道您沒有給出指導，但我希望如果您在 AL 中增加了額外的容量，增加了一些 IL 別墅，那麼您應該會看到未來利潤率的大幅擴大。我說得對嗎？

This is Danny. I'll start off and let Gabe chime in if I miss anything. But yeah, I think you're right as far as we've been increasing the AL and IL component of Trilogy's business, every year in the nine years since we acquired Trilogy. So I would expect that to continue to grow and that's going to have a positive impact on the margin. We're back up to, I think, around 19% in Q4, which is, I think about where we were pre-COVID.

這是丹尼。我先開始，如果我遺漏了什麼，讓 Gabe 補充。但是的，我認為你是對的，自從我們收購 Trilogy 以來的九年裡，我們每年都在增加 Trilogy 業務的 AL 和 IL 部分。因此我預計該數字將繼續增長，並對利潤率產生積極影響。我認為，我們在第四季度的成長率已經回升至 19% 左右，這與新冠​​疫情之前的水平相當。

But I expect it to continue to go up and that's going to be a function of, number one, as you mentioned, having more AL and IL. Number two, we expect RevPOR growth to continue to exceed ExPOR growth across the entire portfolio, which I think is going to drive up margins everywhere, not just at Trilogy.

但我預計它會繼續上升，而這將取決於，第一，正如你所提到的，有更多的 AL 和 IL。第二，我們預計整個投資組合的 RevPOR 增幅將繼續超過 ExPOR 增幅，我認為這將推高所有地方的利潤率，而不僅僅是 Trilogy 的利潤率。

As far as opportunities at Trilogy, I think beyond just the same store, you've got a bunch of campuses that have opened up recently that have not yet stabilized. Now those margins don't show up in same store margins. But the overall margin, I think you're going to continue to see improvement as assets are given time to stabilize.

就 Trilogy 的機會而言，我認為除了同一家商店之外，還有很多最近新開設但尚未穩定的校區。現在這些利潤並沒有反映在同店利潤中。但我認為，隨著資產逐漸穩定，整體利潤率將持續改善。

Other opportunities at Trilogy that aren't necessarily margin related is we've got about -- we talked about the leased asset that we bought out. That was about a 9% cap rate on our lease payment on an asset that we already operate and own.

Trilogy 的其他機會不一定與利潤相關，我們已經討論過我們買下的租賃資產。這相當於我們已經經營並擁有的資產的租賃付款的 9% 資本化率。

So there really is no underwriting risk there. There's a few more of those. There's also some assets that Trilogy manages but does not own, where -- there's about a dozen in total, including the leased portfolio, so there's opportunity there to buy those out.

因此實際上不存在承保風險。還有其他一些。Trilogy 也管理一些不屬於自己的資產，總共有十幾項，包括租賃資產組合，因此有機會將其買斷。

While we don't have any kind of below market purchase option on those like we've had on a lot of our assets in the past, I still think we have a pretty good path to ownership on those. And we have a good track record of buying those out, just like the one we closed this week. So I think you're going to continue to see us go after those.

儘管我們對這些資產沒有任何低於市場的購買選擇，就像我們過去的許多資產一樣，但我仍然認為，我們擁有一條很好的途徑來獲得這些資產的所有權。我們在收購這些產品方面有著良好的記錄，就像我們本週完成的那筆收購一樣。所以我想你會繼續看到我們追求這些。

We're the logical buyer. We already operate them. We know them better than anyone else. And we think we can acquire those at cap rates that are more attractive than anything else we'd acquire in the open market. Gabe, anything else you want to add about margin expansion there?

我們是合理的買家。我們已經在運作它們了。我們比任何人都更了解他們。我們認為，我們可以以比在公開市場上收購的任何其他資產都更有吸引力的資本化利率收購這些資產。加布，關於利潤擴大，您還有什麼要補充的嗎？

Yeah. Just a couple of things. One, I think the demand is still coming everywhere. And certainly, at Trilogy, some of their buildings are operating at 99% or 100% occupied in AL, and not all of them are, so I still think there's room to grow occupancy on the AL side, certainly at Trilogy. Once you get to kind of that mid-90s range of occupancy, you've got tremendous pricing power as well.

是的。僅舉幾例。首先，我認為需求仍然無所不在。當然，在 Trilogy，他們的一些建築在 AL 的入住率達到 99% 或 100%，但並不是所有建築都是如此，所以我仍然認為 AL 方面的入住率還有增長空間，在 Trilogy 肯定如此。一旦入住率達到 90% 左右，您就會擁有巨大的定價權。

One of the things that we really like about Trilogy is their focus on care has driven outsized demand for their products, which is why their occupancies are consistently running ahead of what the national average is. And that same focus on care is appreciated by the residents and the families that are considering their properties.

我們真正喜歡 Trilogy 的一點是，他們對護理的重視推動了其產品的巨大需求，這也是為什麼他們的入住率一直高於全國平均水平。同樣的，對護理的關注也受到了居民和正在考慮購買房產的家庭的讚賞。

So that strategy has been a winning one. I think that strategy will allow them to drive rate further on the private pay side, both private pay AL, IL and also on the skilled nursing private pay. A couple of other things that are more nuanced in the industry, value-based care still exists and is expanding in the skilled nursing setting, meaning the states are appreciating more and more every year that the good operators should be rewarded for good quality outcomes and Trilogy still hasn't unlocked all of those value-based care add-ons.

所以這個策略是成功的。我認為這項策略將使他們能夠進一步提高私人支付方面的費率，包括私人支付 AL、IL 以及專業護理私人支付。該行業中還有一些其他更微妙的事情，基於價值的護理仍然存在，並在熟練的護理環境中不斷擴大，這意味著各州每年都越來越認識到，優秀的操作員應該因高質量的結果而獲得獎勵，而 Trilogy 仍然沒有解鎖所有這些基於價值的護理附加功能。

I think you could see them continue to manage to that, to make sure that not just that the care is there, that it's reported correctly, that you're capturing all the necessary reporting and that you've seasoned into it long enough to unlock what those reimbursements are, which by the way, are incredibly complex and is one of the reasons why Trilogy's scale in regional markets is important and valuable, so they can manage through that.

我想你可以看到他們繼續努力做到這一點，以確保不僅有護理，而且報告正確，捕獲所有必要的報告，並且你已經有足夠的經驗來解鎖這些報銷，順便說一句，這非常複雜，也是 Trilogy 在區域市場的規模很重要且有價值的原因之一，這樣他們才能做到這一點。

The final thing that I think could be good is on the Medicare advantage side. So what we saw in Medicare advantage more recently is Trilogy having high occupancies, having deep conviction in the value of the product that they're delivering and saying we're not going to take a reimbursement rate that's below a certain threshold rate.

我認為最後一個好的事情是醫療保險優勢方面。因此，我們最近在醫療保險優勢方面看到的是，Trilogy 擁有很高的佔用率，對其所提供的產品的價值堅信不疑，並表示我們不會接受低於某個門檻值的報銷率。

So we will sit out of your program, if necessary, until you decide to pay us a proper value for a daily rate for the value that we're delivering. More recently, the Medicare advantage plans that Trilogy deals with have realized that value and have stepped up to show a little bit of a willingness to pay a higher rate.

因此，如果有必要，我們將不參與您的項目，直到您決定按照我們提供的價值的每日費率支付適當的費用。最近，Trilogy 處理的醫療保險優勢計劃已經意識到了這一價值，並已加緊努力，表現出願意支付更高費率的意願。

I think we could see rate growth there that's a little bit higher than what we're predicting currently as well. So look, going back to my initial comments, there are a lot of different ways that Trilogy Management Services, our operator there, can optimize the business. If all of them go right, I think there's a chance for us to outperform where the guidance can be. But I don't think it would be prudent to predict every single thing works out exactly right at this time.

我認為，我們可能會看到那裡的利率成長比我們目前的預測略高一些。所以，回到我最初的評論，我們的營運商 Trilogy Management Services 可以透過很多不同的方式優化業務。如果一切順利，我認為我們就有機會超越期望。但我認為，現在就預測每件事都會完全順利，這並不明智。

Great, guys. That's certainly helpful context. And maybe switching back over to kind of the acquisition pipeline. Stefan, I'd be curious to get your insights in terms of the properties you're targeting. It seems that they're more in the stabilized category. Fair to say that maybe going-in yields are in the low to mid-7s, with some kicker on top of that, given the SHOP component?

太棒了，夥計們。這無疑是很有幫助的背景。或許可以切換回某種收購管道。史蒂芬，我很想知道您對您所針對的房產有何見解。看起來他們更屬於穩定類別。公平地說，考慮到 SHOP 成分，初始收益率可能在 7% 左右的低位到中位，再加上一些附加收益，對嗎？

I mean I think just generally speaking, I think what we're seeing right now are yields that are somewhere between the mid [6% to the 8%] range. We are definitely targeting SHOP assets. We think that's where the best risk adjusted return is today.

我的意思是，我認為一般來說，我們現在看到的收益率介於中間 [6% 到 8%] 範圍之間。我們的目標肯定是 SHOP 資產。我們認為這就是目前最佳的風險調整報酬率。

And we are very active with our partners, our operating partners, in trying to identify those assets. In terms of stabilized, yeah, I mean certainly, we're looking at stabilized assets, but we're also looking at some potentially moderate value-add type of assets.

我們正積極地與我們的合作夥伴和營運夥伴一起嘗試識別這些資產。就穩定而言，是的，我的意思是，我們當然在關注穩定的資產，但我們也在關註一些潛在的中等增值類型的資產。

We'll also consider assets that maybe have some room to improve, but we can acquire those at a below market -- or I'm sorry, below replacement cost price. So I mean we're looking at a wide range of property types, I mean properties.

我們也會考慮那些可能有提升空間的資產，但我們可以以低於市價——或者對不起，低於重置成本的價格——收購這些資產。所以我的意思是我們正在考慮各種各樣的財產類型，我指的是財產。

And it's really all a matter of does it fit within the portfolio? Does it fit within the geographic footprint of our existing operators? And are they going to be assets that we think can be long-term holds that are going to perform well?

這實際上只是一個它是否適合投資組合的問題嗎？它是否適合我們現有業者的地理覆蓋範圍？我們是否認為這些資產可以長期持有且表現良好？

I'd also mention that we are probably more focused on the assisted living and memory care side of the SHOP portfolio than maybe the IL side. And not to say that we wouldn't look to acquire IL, but I think we have a good group of operators that do very well on the higher acuity level of senior housing and are a good fit for our portfolio going forward. And everything we're looking at is really things that we can do to continue to build on the quality of our portfolio today.

我還想說一下，我們可能更關注 SHOP 產品組合中的輔助生活和記憶護理方面，而不是 IL 方面。並不是說我們不會考慮收購 IL，但我認為我們擁有一群優秀的營運商，他們在更高級別的老年住房方面表現非常出色，非常適合我們未來的投資組合。我們正在考慮的一切實際上都是我們可以做的事情，以繼續提高我們今天的投資組合的品質。

Great. That's it for me. Thanks for the time.

偉大的。對我來說就是這樣了。感謝您的時間。

Thanks, Griff.

謝謝，格里夫。

Michael Carroll, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Michael Carroll。

Hi, Mike.

你好，麥克。

Hey, thanks guys. Can you provide some details on how many Trilogy developments and expansions that you completed in 2024, I guess maybe what's in process right now? And the guidance that you quoted in the call about how many you plan on starting in '25, is that an uptick of what you did in '24? I guess how should we think about that whole dynamic? And how does that roll into earnings over time?

嘿，謝謝大家。您能否提供一些有關 2024 年完成了多少個三部曲開發和擴展的詳細信息，我猜也許正在進行中？您在電話會議中提到的關於 25 年開始計劃招聘多少人的指導，是否比 24 年有所增加？我想我們該如何看待這整個動態？那麼隨著時間的推移，這會如何影響收益呢？

Yeah. So we had quite a few. We had more than the typical number open up in late '23 and '24. I think we had three to five in probably the 18 month period between summer of '23 and the end of '24 and then we only launched one new project in 2024, which I'm not sure we'll even open until early 2026. And of course, we announced two new ones that we approved that will start construction this year.

是的。所以我們有不少。在 23 年末和 24 年，我們開設的門市數量超過了正常水平。我認為，從 2023 年夏季到 2024 年底的 18 個月內，我們大概推出了 3 到 5 個新項目，然後在 2024 年我們只推出了一個新項目，而且我不確定我們是否會在 2026 年初之前開業。當然，我們也宣布了兩個已批准的新項目，它們將於今年開工。

So we had a lot open last year. We will have quite a few villa projects that will open this year and expansions. But as far as new campuses, I don't think we have another one opening up until the first part of next year. So there's about $50 million of starts that were in 2024. As I mentioned, it was -- we only had the one new campus and then a bunch of expansions.

因此，去年我們有許多開放機會。我們今年會有不少別墅項目開幕和擴建。但就新校區而言，我認為我們要到明年年初才會再開設一個校區。因此，2024 年的啟動資金約為 5,000 萬美元。正如我提到的那樣，我們只有一個新校區，然後還有一堆擴建。

We've announced $136 million for 2025 so far. That includes two new campuses, quite a few villa projects and some expansions as well. I really think just on an annual go-forward basis, two to three campuses is probably the number of starts you're going to see going on year in, year out. I think '24 was light because '23 was so heavy as far as new campuses.

到目前為止，我們已經宣布2025年的資金為1.36億美元。其中包括兩個新校區、相當多的別墅項目以及一些擴建項目。我真的認為，僅從年度來看，兩到三所校園可能是你每年都會看到的開辦數量。我認為 24 年比較輕鬆，因為 23 年對新校區來說太沉重了。

All in, I think it's going to vary, but $150 million a year is probably a good number to use. It's kind of an estimated annual number of new construction each year, including new campuses, villas and expansions.

總的來說，我認為這會有所不同，但每年 1.5 億美元可能是一個不錯的數字。這是對每年新建築數量的估計，包括新校園、別墅和擴建建築。

And just a small point of clarification, Mike, when we put in our guidance development spend, that's just what we anticipate spending on everything that Danny just mentioned in 2025 and that guidance was $80 million to $100 million.

麥克，需要澄清的一點是，當我們投入指導開發支出時，這只是我們預計在 2025 年對丹尼剛才提到的所有事項的支出，而該指導金額為 8000 萬至 1 億美元。

Right.

正確的。

Yeah. Okay. Got it. And then can you remind us, once those assets are completed, I guess is there initial cash drag once those buildings are completed? And how long are you assuming it takes for them to stabilize? And then are they going to be stabilizing at those double-digit type yields?

是的。好的。知道了。然後您能否提醒我們，一旦這些資產完成，我猜一旦這些建築物完成，是否會出現最初的現金拖累？您認為它們需要多長時間才能穩定下來？那麼，收益率會穩定在兩位數水準嗎？

Well, it depends on the project. So an expansion is usually only done on a campus that's full and has a waiting list. Those usually fill up very quickly. An expansion could be adding 8, 10 or 12 new rooms onto an existing wing. And you only usually do that if there's demand for it.

嗯，這取決於項目。因此，擴建通常只在已滿且有等候名單的校園進行。這些通常很快就會填滿。擴建可能是在現有翼樓上增加 8、10 或 12 個新房間。而且通常只有在有需求時才會這樣做。

So those fill up fast. Same with the villas, those are typically pre-leased. So they usually fill up almost as soon as they're done. Now the new campuses take longer, obviously. In the past, we've looked at 2.5, 3 years to fill up a new campus.

因此這些很快就填滿了。別墅也是一樣，通常都是預先出租的。因此，他們通常一完成就吃飽了。現在，新校區的建設顯然需要更長的時間。過去，我們預計需要 2.5 到 3 年的時間才能填滿一個新校區。

And what's typically happened is the skilled nursing side fills up faster and then as Gabe mentioned in his comments, one of Trilogy's strategies is to use the skilled residents to help fill up the AL and IL. What we've seen the last few that have opened is that seems to be actually kind of switching a little bit.

通常發生的情況是，熟練的護理人員職位填滿得更快，然後正如 Gabe 在評論中提到的，Trilogy 的策略之一就是利用熟練的住院醫師來幫助填補 AL 和 IL。我們看到，最近開業的幾家店似乎確實發生了一些轉變。

The AL and IL outside, because of the demand, because of the lack of new supply, that actually seems to be filling up even faster than the skilled side. So I really think that the 2.5 to 3 year time period that it used to take Trilogy, I think that's getting compressed. And I think you'll see that be more kind of 12 to 18 months to fill up a new campus.

而外面的 AL 和 IL，由於需求大，由於缺乏新的供應，實際上似乎比技術型球隊的填補速度更快。所以我真的認為，《三部曲》過去所花的 2.5 到 3 年的時間段正在被壓縮。我認為，可能需要 12 到 18 個月的時間才能填滿一個新校區。

Yields on those are typically on a stabilized basis on a new campus is probably low double digit, whereas villas are probably high single digit, and a campus expansion, which is like an addition or something like that, a new addition to an existing wing, those are mid-teens, but they're very small, right? One of those projects could be $1 million, $1.5 million. They're not big projects.

這些的收益率通常是穩定的，新校區的收益率可能是低兩位數，而別墅的收益率可能是高個位數，而校園擴建，就像是增加或類似的東西，在現有翼樓上增加新的建築，這些收益率是十幾歲的中段，但它們非常小，對吧？其中一個項目的價值可能為100萬美元、150萬美元。它們並不是大項目。

Okay. And those ground ups, they initially are losing money once they're completed? Is that fair?

好的。這些新建案一旦完工，最初就會虧損嗎？這樣公平嗎？

Yeah. Day one, when they open up, there's no residents. And there's -- it's always going to take time. Even on the skilled side, which tends to fill up faster, there's always a licensing period, especially some states it's longer, like Michigan takes longer than some of the other states.

是的。開業第一天，沒有居民。而且——這總是需要時間的。即使對於技術含量較高的職位來說，這個職位往往填滿得更快，也總是有一個執照期限，特別是在一些州，這個期限會更長，例如密西根州的執照期限就比其他一些州要長。

So there's always going to be a period of time, it could be three months, where you need to get your Medicare, Medicaid license and then it will start filling up. So it's always going to start -- it's never going to -- it's always going to open up with zero residents.

因此，總是會有一段時間，可能是三個月，你需要獲得醫療保險、醫療補助許可證，然後它就會開始填滿。所以它總是會開始——它永遠不會——它總是在零居民的情況下開放。

Okay, great. Thank you.

好的，太好了。謝謝。

Austin Wurschmidt, KeyBanc Capital Markets.

Austin Wurschmidt，KeyBanc 資本市場。

Hey, good morning, everybody. I think Danny referenced sort of flattish NOI from 4Q to 1Q within Trilogy for some of the seasonal factors that you all highlighted. Are there any other seasonal considerations included in guidance that could impact the sequential growth through the year and sort of cadence of NOI after you get through the first quarter?

嘿，大家早安。我認為丹尼提到了 Trilogy 中第四季至第一季的平穩淨營業收入，這是因為你們都強調了一些季節性因素。指導中是否包含任何其他季節性考慮因素，可能會影響全年的連續成長以及第一季後的 NOI 節奏？

Anything that I missed, or --

我錯過的任何內容，或者--

No, I think Gabe kind of delineated a little bit of the headwinds in Q1. It's obviously -- there's fewer days -- there's increased utility costs because of weather. And then the final one is a reset on some of the taxes. There's such a heavy labor component in the skilled nursing business that ultimately, if your employer tax is reset, that it can show up in numbers in a headwind in the first quarter. I can't think of anything necessarily beyond that. I mean yeah, that's about it.

不，我認為 Gabe 已經描述了第一季的一些不利因素。顯然，由於天氣原因，可用天數減少，水電費也增加了。最後一個是重新設定一些稅。專業護理業務中的勞動成分非常重，因此，如果雇主稅被重置，那麼第一季的數字就會出現逆風。除此之外我想不出還有什麼別的事。我是說，是的，就是這樣。

Yeah. Just having 90 days in Q1 versus 92 in Q4, that alone is material.

是的。第一季為 90 天，而第四季為 92 天，光是這一點就很重要。

No, that makes sense. Just trying to understand if flattish NOI seems about right or even a slight dip. It seems like then the -- there's little sequential improvement necessary to hit the midpoint of guidance within the same store growth assumed for Trilogy.

不，這很有道理。只是想了解平穩的淨營運收入是否正確，或者是否略有下降。看起來——在 Trilogy 假設的同一門市成長範圍內，幾乎不需要進行連續改進就能達到指導的中點。

Secondarily, wondering when you look out over the next 12 to 24 months, with some of the staging of the expansion opportunities and any other kind of activity within development that's happening, how you would expect the senior housing versus SNF bed component to -- how that ratio to change over the next one to two years?

其次，想一想，在未來 12 到 24 個月內，隨著一些擴張機會的陸續推出以及正在進行的任何其他類型的開發活動，您認為老年住房與 SNF 床位部分的比例將如何變化——這一比例在未來一到兩年內將如何變化？

It's -- in the last nine years, it's been a slow and steady progression. When we bought Trilogy, I'm going to tell you, this is the best of my recollection, I believe it was about 58% skilled beds and close to 60%, and maybe 40% to 42% AL and IL.

在過去的九年裡，這是一個緩慢而穩定的進步。當我們購買 Trilogy 時，我要告訴你，這是我記憶中最清楚的情況，我相信大約有 58% 的技術床位和接近 60%，也許有 40% 到 42% 的 AL 和 IL。

And I believe they're getting close to 50% now, and it's a slow progression because if you look at it -- if you go back to the Trilogy campuses of old, I mean when they started out, 25 years ago, they were 100% skilled nursing.

我相信現在這個比例已經接近 50% 了，這是一個緩慢的過程，因為如果你看一下——如果你回到以前的 Trilogy 校區，我的意思是，當他們 25 年前剛開始的時候，他們 100% 都是專業護理人員。

So a lot of those campuses have been expanded or sold off. But over time, and what happened was is that the CEO at the time, Randy Bufford, realized, hey, we're basically taking these patients on a short-term basis and then moving them into AL or IL after the fact with some other operator, why don't we just do that ourselves?

因此許多校園都被擴建或出售。但隨著時間的推移，當時的執行長 Randy Bufford 意識到，嘿，我們基本上是短期接收這些患者，然後透過其他業者將他們轉移到 AL 或 IL，為什麼我們不自己這樣做呢？

That's kind of how the whole thing started. Whereas the typical model, once they started doing that, was 100 units, call it, [58% to 60% might be skilled and the other 40% to 42% would be AL. This is before they even did IL. A typical new campus today is going to be larger. Usually, there are about 125 units and there are, call it, 50%, maybe 55%, skilled, and then another 70%] or so, AL, IL.

整件事情就是這樣開始的。而一旦他們開始這樣做，典型的模型就是 100 個單位，其中 58% 到 60% 可能是熟練的，另外 40% 到 42% 是 AL。這甚至是在他們進行 IL 之前。如今，典型的新校園將會更大。通常，大約有 125 個單位，其中 50%、也許 55% 是熟練的，然後是另外 70%] 左右，AL、IL。

So just that alone has continued to reduce that exposure, to increase the AL, IL component and reduce the skilled nursing component. And then you add on the villas and it does even more. So it's a slow and steady movement every time a new campus opens.

因此，僅此一點就可以繼續減少這種暴露，增加 AL、IL 成分並減少技術護理成分。然後再增加別墅，它的功能就更多了。因此，每次開設新校區都是一個緩慢而穩定的過程。

Yeah. That's helpful context and suspect the NOI differential is even greater given the margin difference between the two. Last one for me was you guys had the opportunity to decrease leverage with some ATM issuance in the fourth quarter and kind of expand that available dry powder.

是的。這是一個很有幫助的背景信息，考慮到兩者之間的利潤率差異，我懷疑 NOI 差異甚至會更大。對我來說最後一個是，你們有機會在第四季度透過發行一些 ATM 來降低槓桿率，並擴大可用的乾火藥量。

I think you may still have some expensive Trilogy debt and so just wondering if there's additional opportunities to deleverage and build additional capacity given the runway for new investments, but at the same time, even just drive some interest expense savings over time. Thanks.

我認為您可能仍有一些昂貴的 Trilogy 債務，因此只是想知道是否還有其他機會去槓桿並建立額外的產能，考慮到新投資的空間，但與此同時，甚至只是隨著時間的推移節省一些利息支出。謝謝。

So the majority of the expensive debt at Trilogy has already been paid off. At this point, Trilogy is a pretty big user of HUD debt, which is quite attractive. We've got -- they have about $700 million of [HUD debt at a coupon of 3.66%]. That stuff is going to be there for a while. It's got long duration on it as well.

因此，Trilogy 的大部分昂貴債務已經償還。目前，Trilogy 是 HUD 債務的一個相當大的用戶，這非常有吸引力。我們知道 — — 他們有大約 7 億美元的 [HUD 債務，票面利率為 3.66%]。那些東西將會在那裡停留一段時間。它的持續時間也很長。

So really, the low hanging fruit on debt paydowns is kind of behind us. We do have a revolver, which might be in the high 5% range. So it's definitely a lot less attractive than it was when we had a lot of those expensive HUD debt -- or excuse me, expensive fixed secured debt at Trilogy. I mean listen, we're going to be very judicious. We fought really hard to get our debt to EBITDA down to 4.3 times.

因此，事實上，償還債務的輕鬆成果已經是我們過去的事了。我們確實有一把左輪手槍，其機率可能在 5% 左右。因此，它肯定比我們擁有大量昂貴的 HUD 債務（或者對不起，Trilogy 昂貴的固定擔保債務）時的吸引力小得多。我的意思是聽著，我們會非常明智。我們竭盡全力將債務與 EBITDA 比率降低至 4.3 倍。

And I think we're quite pleased with it there and we're going to -- we're going to maintain it around that level ideally. Ultimately, we will have external growth this year. We've announced guidance for $86 million. That's things that weren't under contract that will close -- either have closed already or will close in the first quarter. Beyond that, we're, as I say, going to be very judicious about additional leverage and any additional ATM issuance.

我認為我們對此非常滿意，並且我們將 — — 理想情況下我們將保持在這個水平上。最終，我們今年將實現外部成長。我們已經宣布了8600萬美元的指導金額。這些都是未簽訂合約但即將結束的事情——要么已經結束，要么將在第一季結束。除此之外，正如我所說，我們將非常謹慎地對待額外的槓桿和任何額外的 ATM 發行。

Very helpful. Thanks everybody.

非常有幫助。謝謝大家。

Michael Stroyeck, Green Street.

邁克爾·斯特羅耶克，綠街。

(inaudible) Thanks and good morning. Hey guys. Maybe going back to your comments on the levers that Trilogy can pull in the event that they want to move away from Medicaid a bit. What's a reasonable floor in terms of percentage of revenue coming from Medicaid that Trilogy could actually get to?

（聽不清楚）謝謝，早安。嘿，大家好。也許可以回到你對 Trilogy 如果想稍微擺脫醫療補助計劃 (Medicaid) 可以採取的措施的評論。就來自醫療補助的收入百分比而言，Trilogy 實際上可以達到的合理最低限度是多少？

That's a tough question. I mean it -- definitely bring it down. I mean I don't -- look, Trilogy could say, hey, we're getting out of the Medicaid business. And if you are in one of our facilities and you need to move to Medicaid, you got to move out and you got to go somewhere else. I don't necessarily think that is maybe the best way for them to run their business, because that may not be very popular.

這是一個很難回答的問題。我是認真的——絕對會把它降低。我的意思是，我不這麼認為——看，Trilogy 可以說，嘿，我們要退出醫療補助業務。如果您現在在我們的某個機構，但需要轉到醫療補助計劃，您必須搬出去，去其他地方。我並不認為這也許是他們經營業務的最佳方式，因為這可能不太受歡迎。

So they can definitely reduce it. It would have to -- there would have to be some massive cuts to Medicaid to where I think we make the decision just to get out of it completely. Never say never, but I think it's a good accommodation to have. And in some of the states, it's actually a pretty good line of business. So could they get down to zero? Maybe, but I don't know if they'd necessarily want to. I mean Gabe, anything? It's really hard to predict.

所以他們肯定可以減少它。我們必須——必須對醫療補助進行大幅削減，我認為我們必須決定徹底退出它。永遠不要說永遠，但我認為這是一個很好的安排。在某些州，這實際上是一個相當不錯的業務。那麼它們能降到零嗎？也許吧，但我不知道他們是否一定願意這麼做。我是說 Gabe，什麼事嗎？這確實很難預測。

Yeah, from a -- let's talk -- let's break it down a little bit. From a physical plant perspective, they could go to zero. The physical plant is built to AL quality by design so that they've got total optionality in every wing in the building to pivot from skilled nursing to assisted living to memory care, so they've got maximum flexibility on which line of business they want to be in. And by the way, they do pivot, even outside of these kind of macro conditions and reimbursement issues. The kind of micro conditions, market specific issues dictate demand sometimes.

是的，從 — — 讓我們來談談 — — 讓我們稍微分析一下。從物理工廠的角度來看，它們可能會降至零。該實體工廠在設計上是按照 AL 品質建造的，因此，他們可以完全自由地選擇大樓的每個側樓，從專業護理到輔助生活再到記憶護理，這樣，他們可以最大限度地靈活地選擇自己想要從事的業務線。順便說一句，即使不受這些宏觀條件和報銷問題的影響，他們確實也會做出調整。有時，微觀條件和特定市場問題會決定需求。

And it's one of the reasons why we like developing through Trilogy, because you can switch the bed mix and add Medi -- excuse me, memory care beds where needed. So from a physical plant perspective, the answer is they could go full AL if they wanted to.

這也是我們喜歡透過 Trilogy 進行開發的原因之一，因為你可以切換床組合併在需要的地方添加 Medi（對不起，是記憶護理床）。因此，從物理工廠的角度來看，答案是，如果他們願意，他們可以全面實現 AL。

And it's a high enough quality to get people into those beds as well, where they want it and the care is at the right level. I think what Danny said is spot on, you'd have to start balancing where the value of this is as even a loss leader for Trilogy, where people know that they've got a place to stay forever and they're not going to get kicked out on the street.

而且其品質足夠高，可以讓人們住進他們想要的病床，並獲得適當水平的護理。我認為丹尼說的很對，你必須開始權衡它的價值，即使是作為 Trilogy 的虧本銷售，人們也知道他們有地方可以永遠住，而且不會被趕到街上。

That being said, I think one more comment on Medicare cuts and the skilled business industry. That industry operates at pretty thin margins already. And if you're a primarily Medicaid skilled operator right now, I don't think that there's a lot of profit to cut out and I don't think -- I think certainly, the number of beds in the skilled -- in the skilled nursing industry would decrease with significant Medicaid cuts in that industry.

話雖如此，我想對醫療保險削減和科技商業產業再發表一點評論。該行業的利潤已經相當微薄了。如果你現在是一名主要的醫療補助技術操作員，我不認為會有太多的利潤被削減，而且我認為——我認為當然，技術護理行業的床位數量不會因為該行業的醫療補助大幅削減而減少。

Over the long term, that would obviously dramatically decrease access to care for people in all of these states, which I think would cause quite an uproar. But also, if you're looking at it from our business perspective, probably Trilogy is not going out of business. We're not going to have the same issues. So there is opportunity to capture market share. I think we're pretty insulated from these cuts.

從長遠來看，這顯然會大大減少這些州的人們獲得醫療服務的機會，我認為這會引起不小的轟動。但同樣，如果從我們的商業角度來看，Trilogy 可能不會破產。我們不會遇到同樣的問題。因此有機會奪取市場份額。我認為我們基本上不會受到這些削減的影響。

Just to rephrase that, if Medicaid reimbursement gets to the point where Trilogy says we need to get out of this business completely, we're going to be talking about a bunch of other stuff in the space, because that means that you're going to have a bunch of facilities shutting down head mass because -- if -- I mean you've been around long enough to see what happens, right? It's a lot -- most of the skilled business is very low margin, relies heavily on Medicaid and you cut the rates even slightly and that margin goes from -- goes to negative very, very quickly.

換句話說，如果醫療補助報銷達到了 Trilogy 所說的我們需要完全退出這個業務的程度，我們將討論該領域的許多其他事情，因為這意味著你將擁有一堆關閉頭部質量的設施，因為 - 如果 - 我的意思是你已經存在了足夠長的時間來觀察會發生什麼，對嗎？大多數科技企業的利潤率都很低，嚴重依賴醫療補助，如果你稍微降低費率，利潤率就會很快變成負數。

So that's why I believe that there's just a limit to any potential Medicaid cuts because you just can't do it, because the business will just won't survive. So -- and as Gabe mentioned, Trilogy is going to survive just fine. Trilogy is going to be okay. It's the rest of the skilled business that's really going to suffer. The ones that rely on longer-term Medicaid residents that I don't know how they make it.

所以我相信任何潛在的醫療補助削減都是有限制的，因為你無法這樣做，否則企業將無法生存。所以 — — 正如 Gabe 所提到的，Trilogy 將會很好地生存下來。三部曲還不錯。其餘的技術型企業真正會遭受損失。那些依賴長期醫療補助居民的人，我不知道他們是如何做到的。

Got it. Yeah. That's helpful. And maybe one question on the outpatient business. Where do you expect occupancy to trough at within your portfolio? And are there any additional known move-outs happening maybe later this year that could weigh on NOI growth in 2026 as well?

知道了。是的。這很有幫助。也許還有一個關於門診業務的問題。您預計您的投資組合中的入住率會在何處達到最低點？今年稍後是否還會發生其他已知的遷出事件，從而對 2026 年的 NOI 成長產生影響？

Yeah. I expect occupancy to remain kind of where it is in the high 80s. What we've seen with outpatient medical for the last few years, it did great during COVID, when the health systems were expanding. But what we're basically seeing is kind of one step forward, one step back. There's a lot of activity, lots of tours.

是的。我預計入住率將維持在 80% 左右。從過去幾年的門診醫療來看，在衛生系統不斷擴張的新冠疫情期間，門診醫療表現十分優異。但我們基本上看到的是前進一步，退後一步。有很多活動，有很多旅遊。

We're signing new leases. But for every big new lease that you sign, you have a health system lease which is really the dominant tenancy in the outpatient medical space today, where the lease is up and the hospital looks at their options and says, hey, I've got a 40,000 foot lease that's expiring, but I only want to renew 20,000 feet because I can move some of these doctors to other spaces.

我們正在簽署新的租約。但是，對於您簽署的每一份新的大型租約，您都有一個醫療系統租約，這實際上是當今門診醫療領域的主要租賃，租約到期後，醫院會考慮他們的選擇並說，嘿，我有一個即將到期的 40,000 平方英尺的租約，但我只想續簽 20,000 平方英尺，因為我可以將其中一些醫生轉移到其他地方。

And that's kind of been the name of the game for the last couple of years, which is why our occupancy has kind of held pretty steady. Our same store NOI growth has been pretty flat and I think we're going to see more of the same in 2025.

這就是過去幾年的遊戲規則，這也是為什麼我們的入住率一直保持相當穩定。我們的同店淨營業收入成長一直比較平穩，我認為到 2025 年我們將看到更多類似的成長。

We do have a couple of leases that we know of, I think later in the year, where the hospital system has already indicated they're not likely to renew all their space. And then you offset that with new leasing that we know about and it kind of keeps us where we are today.

據我們所知，確實有幾份租約，我想在今年晚些時候，醫院系統已經表示他們不太可能續簽所有空間。然後，您透過我們所知道的新租賃來抵消這一損失，從而使我們保持現在的水平。

Yeah. I mean from a pragmatic standpoint, I think that we've got some expirations. We're typically out talking to these tenants at least two years before their lease expires. And they'll -- typically, if they are moving out, they'll have a pretty good sense that that's going to happen.

是的。我的意思是，從務實的角度來看，我認為我們已經有一些到期日了。我們通常會在租約到期前至少兩年與這些租戶進行交談。而且通常，如果他們要搬出去，他們就會很清楚地知道這會發生。

So we've got some expirations that are happening starting in April and ending in November, that are chunky and that we already know that they are likely not going to renew. And we've known that and we've worked that space and we're continuing to try and backfill.

因此，我們有一些合約將於 4 月開始、11 月結束到期，這些合約金額較大，而且我們已經知道它們很可能不會續約。我們已經了解這一點，並且已經努力填補這一空白，並將繼續努力。

If you speak to an actual trough-trough, I mean I would say it's probably late Q2, maybe in Q3 at some point. But we -- keeping in mind, we have had time to lease and we have additional time to lease before those things are truly given back. So the team continues to work those and endeavor to backfill.

如果說到真正的低谷，我的意思是說可能是在第二季末，或者在第三季的某個時候。但是我們—請記住，我們有時間租賃，而且在真正歸還這些東西之前，我們還有更多的時間租賃。因此，該團隊將繼續努力並盡力填補。

Yeah. What we've seen more than once is you'll be out in front of the tenant, talking to them a couple of years before their expiration. And it will be someone at the local hospital who handles the real estate saying, yeah, of course, we love -- we need the space. We love the space.

是的。我們不只一次看到這樣的情況：你會在租約到期前幾年就去找房客談話。當地醫院負責房地產的人會說，是的，當然，我們喜歡——我們需要這個空間。我們熱愛這個空間。

And then when you're nine months out, there's a mandate from corporate, from the system that, hey, you need to cut your G&A. And that's -- oftentimes, they are the ones that are driving the decision as opposed to the local hospital, who would really like to keep it.

然後，當你離開九個月時，公司和系統會給你下達命令，說你需要削減一般行政費用 (G&A)。而且 — — 很多時候，是他們而不是真正想保留它的當地醫院來做出決定。

That's helpful. Thanks for the time.

這很有幫助。感謝您的時間。

As there are no further questions at this time, I would like to turn the call back over to Danny Prosky for closing remarks.

由於目前沒有其他問題，我想將電話轉回給丹尼·普羅斯基 (Danny Prosky) 做結束語。

All right. Thank you very much, operator. Thank you for everybody joining us on the call. I want to thank the entire AHR team and a lot of our operating partners who are on the call today. I mean if you look at our guidance for next year, we're guiding towards 12% per share NOI growth -- I'm sorry, NFFO growth next year, which if you look at our earnings growth that we're guiding to, look at the NOI growth that we're guiding to and you compare us to our peer set, we are at or near the top on all those metrics.

好的。非常感謝，接線生。感謝各位參加我們的電話會議。我要感謝整個 AHR 團隊以及今天參加電話會議的許多營運合作夥伴。我的意思是，如果你看看我們明年的指引，我們指引的每股 NOI 增長為 12%——抱歉，是明年的 NFFO 增長，如果你看看我們指引的盈利增長，看看我們指引的 NOI 增長，並將我們與同行進行比較，我們在所有這些指標上都處於或接近領先地位。

So that's really due to all the hard work for everybody here at corporate as well as around the country. We couldn't do it without everybody's help, so I want to just thank everybody for that. And thank all of you for taking the time to spend with us on a Friday morning. Thank you.

這確實歸功於公司和全國各地所有人的辛勤工作。如果沒有大家的幫助我們就無法做到這一點，所以我想對此表示感謝。感謝大家在周五早上抽出時間與我們共度時光。謝謝。

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

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。