Healthcare REITs: A Boom Is Coming

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The story behind healthcare real estate investment trusts (REITs) has long been that they will benefit from the giant baby boomer generation as it crests into retirement. After all, healthcare needs materially increase for people age 65 and older and real estate that accommodates those needs will be in higher demand.

So far, however, the math hasn't worked out so well for senior housing, because construction has outstripped demand. But REIT industry giant Ventas (NYSE: VTR) thinks the trend is going to turn in a positive direction very soon.

A little background

At Ventas' investor day, the company spent some time discussing its market research approach. This was important because Ventas is making a bold call. After several years of performance decline due to portfolio repositioning, It believes that 2020 will be the year in which its funds from operations (FFO) start to "pivot" back to growth, with 2021 being the key year. That's when Ventas says demand for senior housing will outstrip supply following years of over-construction in anticipation of the baby boom retirement wave. That, in turn, will push the company's FFO higher.

The acronym REIT on a binder with the words real estate investment trust under it
The acronym REIT on a binder with the words real estate investment trust under it

Image source: Getty Images

This is a big deal for Ventas, which generates around 55% of its net operating income (NOI) from senior housing. Around 23% of its total NOI comes from net-lease senior housing properties. These assets are leased under long-term contracts to operators and generally include pre-set rent increases. This business has been doing OK, with a projected NOI growth rate of around 1% for 2019.

That growth rate isn't great, but it looks wonderful when you consider the REIT's senior housing operating portfolio (SHOP), which accounts for around 32% of NOI. These are assets that Ventas effectively owns and operates (though technically it hires others to run the facilities), allowing it to benefit from the upside of operating performance -- and weather the downside. Ventas' 2019 projections call for an NOI decline of as much as 3% in the SHOP group, largely because of weak pricing and demand driven by oversupply.

The SHOP portfolio has been a major headwind for Ventas, and a major concern for investors. It's one of the reasons why Ventas' shares have lagged the broader REIT group over the last three years. An upturn in this division would be a huge benefit to the REIT, but it isn't alone in the space. Peers Welltower (NYSE: WELL) and HCP (NYSE: HCP) also have notable SHOP portfolios, at roughly 40% and 36%, respectively.

The 2021 story

So how exactly did Ventas come to the conclusion that 2021 would be the transition year for supply and demand?