(AHR) American Healthcare REIT, Inc. Porters Five Forces Research

Labor is a key indirect supplier force for American Healthcare REIT, Inc. because tenant operators need nurses, caregivers, and facility staff to keep occupancy and care levels high. In tight labor markets, wage inflation and staffing gaps can squeeze tenant margins, which can slow rent coverage and raise collection risk, especially in senior housing and skilled nursing. That makes labor availability a real credit risk for American Healthcare REIT, Inc.

• Staff shortages weaken tenant cash flow.
• Wage pressure hits senior housing first.
• Skilled nursing faces the highest labor strain.

Licensing, reimbursement rules, and compliance support can push operator costs up fast, especially when Medicare and Medicaid rates shift. U.S. CMS says Medicare covered about 66 million people in 2025, and Medicaid about 80 million, so rule changes hit a huge cost base. American Healthcare REIT, Inc. is less exposed than its tenants, but supplier power rises when regulatory services get scarce or pricier.

• Medicare and Medicaid rules drive operator costs.
• Compliance vendors can become scarce.
• American Healthcare REIT, Inc. feels the impact indirectly.

Switching costs are high in healthcare, because moving patients, licenses, staff, and heavy equipment is slow, costly, and disruptive. That lowers customer power for American Healthcare REIT, Inc. when its assets are well located and purpose built, since operators usually cannot move a facility without risking care delivery and occupancy. In practice, these sites act like mission critical infrastructure, which helps keep leases stickier and tenant churn lower.

• Relocation is costly and disruptive.
• Licenses and staffing add friction.
• Mission-critical assets reduce customer power.

Tenant sophistication is high because large healthcare operators know real estate pricing, lease terms, and fit-out costs, so they can push American Healthcare REIT, Inc. hard on rent and concessions.

They can compare American Healthcare REIT, Inc. against other REITs, private buyers, or build-to-suit deals, and in healthcare real estate, 10 to 20 year lease talks often turn on small pricing gaps.

American Healthcare REIT, Inc.'s broad portfolio and long operator ties help protect occupancy and pricing, especially when switching costs and care disruption are high.

• Aggressive, informed tenants दबain pricing.
• Scale and relationships help defend renewals.

Medical office buildings, senior housing, and skilled nursing facilities each face their own active rival sets, so American Healthcare REIT, Inc. competes in several arenas at once. That broad asset overlap raises rivalry because pricing, lease terms, and occupancy are all tested by different operators, not one market. It also lowers risk, since weak demand in one subsector can be offset by stronger leasing or census trends in another.

• Multiple asset classes mean multiple rival pools
• Competition hits rent, occupancy, and census
• Diversification softens single-subsector shocks

American Healthcare REIT, Inc.'s long operating history and detailed asset knowledge can improve underwriting and day-to-day asset management, which helps in a market where mistakes are costly. Its integrated management platform can also reduce execution risk versus newer buyers that must outsource more work. Still, rivals with cheaper capital can bid harder and pressure returns.

• History can improve underwriting quality.
• Integrated control can cut execution risk.
• Low-cost capital can still win deals.

Integrated health systems and virtual care platforms can cut dependence on leased sites, so the threat of substitutes is real for American Healthcare REIT, Inc. If care shifts to fewer physical footprints, demand weakens for standard outpatient and admin space. AHR is better protected when it owns mission-critical assets like seniors housing and specialized medical facilities that are hard to replace.

• Virtual care lowers space needs.
• Integrated systems internalize more services.
• Specialized assets are harder to substitute.

Repurposed space is a real substitute risk for American Healthcare REIT, Inc. because some office, retail, or light-industrial sites can be converted into medical or senior-use space, which can cap rent growth in easy-to-redevelop markets. Still, purpose-built facilities with higher code, accessibility, and MEP demands are much harder to copy, which helps protect American Healthcare REIT, Inc.’s asset quality.

• Conversion risk is highest in flexible markets.
• Compliance-heavy sites are harder to replace.
• That supports pricing power for American Healthcare REIT, Inc.

Healthcare real estate is hard to underwrite because leases, operator credit, and care-model fit can shift fast, so sector know-how matters. A firm like American Healthcare REIT, Inc. that has managed healthcare assets across cycles can spot tenant stress and property-type risk earlier than a new entrant. That makes mispricing and wrong-asset picks much less likely.

In practice, new rivals need deep underwriting, tenant monitoring, and asset management skills before they can compete.

• Specialized underwriting cuts pricing errors.
• Tenant monitoring flags weak operators early.
• Cross-cycle experience raises the entry bar.

American Healthcare REIT, Inc.’s scale lowers its cost of capital, supports bigger acquisitions, and signals tenant stability, which smaller entrants often cannot match. Public-market access also helps American Healthcare REIT, Inc. raise funds faster than private buyers, tightening the gap for new competitors.

As American Healthcare REIT, Inc. expands its listed platform, brand trust and institutional reach can make tenant and seller relationships harder to win for smaller REITs.

• Lower funding costs
• Better deal access
• Stronger tenant trust
• Harder for small entrants