HealthPeak (DOC) Q4 2025: Senior Housing NOI Jumps 17% as Janus Living IPO Reshapes Portfolio
HealthPeak’s Q4 marked a pivotal transition, with senior housing NOI surging and the Janus Living IPO unlocking value from a previously underutilized segment. Outpatient medical continues to anchor stability, while lab headwinds weigh on near-term earnings, but management’s capital recycling and opportunistic acquisitions signal a portfolio positioned for recovery. Execution on operator transitions, capital allocation, and segment-level discipline remain central as the company navigates sector inflections and prepares for a new era of growth.
Summary
- Senior Housing Monetization: Janus Living IPO unlocks value and shifts HealthPeak’s portfolio focus.
- Lab Segment Drag: Life science headwinds drive near-term earnings compression despite early signs of recovery.
- Outpatient Medical Stability: Core portfolio and capital recycling underpin resilience and future upside.
Performance Analysis
HealthPeak delivered mixed results across its three core segments, with senior housing and outpatient medical offsetting pronounced weakness in the lab business. Senior housing posted a standout quarter, with same-store NOI growth of 16.7% in Q4 and 12.6% for the year, driven by highly amenitized campuses, robust asset management, and favorable supply-demand fundamentals. Outpatient medical, now over half of portfolio income, delivered 3.9% same-store growth, record new leasing, and strong tenant retention, reflecting sector-leading execution and tailwinds from policy and demographic shifts.
Conversely, the lab segment continued to face a challenging environment, ending the year at 77% occupancy and posting just 1.5% same-store growth. The Gateway acquisition in South San Francisco added significant vacancy but is positioned as a long-term value play. The company’s balance sheet remains sound, with net debt to EBITDA at 5.2x and $2.4 billion in liquidity, supporting ongoing capital recycling and opportunistic investment even as refinancing costs rise.
- Senior Housing Outperformance: Record entrance fee sales and 50%+ NOI growth potential from operator transitions.
- Lab Segment Headwinds: Occupancy declines and lagging NOI impact will be more pronounced in early 2026.
- Outpatient Medical Execution: 4.9 million square feet leased, 79% tenant retention, and low cap rate asset sales fueling capital redeployment.
Aggregate results reveal a portfolio in transition, with management’s discipline in segment allocation and capital recycling critical to future earnings stability and growth.
Executive Commentary
"The outpatient sector is benefiting from the ongoing shift in care delivery to lower cost, more convenient outpatient settings. Policy changes from Washington also support demand, including CMS allowing more and more surgeries to be done in outpatient settings. And new supply continues to be very low given the cost of new construction."
Scott Brink, President and Chief Executive Officer
"We continue to make investments in technology, team, and process to deliver our investment management capabilities to a broader asset base even more efficiently than we have in the past. A component of the strategy is the acceleration of corporate automation, which will streamline our internal workflows and deliver a best-in-class experience to our clients."
Kelvin Moses, Chief Financial Officer
Strategic Positioning
1. Senior Housing Unlock and Janus Living Spin-Out
HealthPeak is executing a significant portfolio transformation by contributing its entire senior housing portfolio to Janus Living, a new pure-play REIT, via IPO. This move monetizes a high-performing but underappreciated segment, allowing HealthPeak to capture value through a higher multiple and future upside as a major Janus shareholder. The company retains management, ensuring alignment and ongoing participation in operational results and share price appreciation.
2. Outpatient Medical as Defensive Anchor
The outpatient medical segment, now over 50% of portfolio income, anchors HealthPeak’s stability and growth. The merger with Physicians Realty Trust and internalization of property management have delivered $70 million in synergies, while the sector benefits from policy-driven demand and minimal new supply. Strategic asset sales at low cap rates are funding acquisitions with higher growth potential, reinforcing the portfolio’s defensive characteristics.
3. Life Science: Tactical Patience and Opportunistic Expansion
Despite ongoing headwinds, HealthPeak is positioning for a life science recovery by acquiring prime assets at attractive bases. The Gateway campus acquisition in South San Francisco expands the company’s market leadership, with management forecasting occupancy and earnings improvement as capital markets and tenant demand recover. The team’s prior decision to halt capital deployment at the cycle’s peak has preserved balance sheet flexibility for this phase.
4. Capital Recycling and Balance Sheet Discipline
Management is aggressively recycling capital, targeting over $1 billion in asset sales, recaps, and loan repayments in 2026. Proceeds are being redeployed into higher-growth opportunities, while refinancing activity is managed opportunistically to mitigate rising borrowing costs. Liquidity and prudent leverage remain central to the company’s risk management framework.
Key Considerations
This quarter’s results highlight a company actively repositioning its portfolio while navigating cyclical and structural shifts across healthcare real estate. Management’s ability to execute on operator transitions, capital recycling, and opportunistic investments will define the next phase of value creation.
Key Considerations:
- Janus Living IPO Timing and Execution: The value realization and operational transition depend on a successful IPO and seamless management handoff.
- Lab Segment Recovery Pace: Earnings lag and occupancy headwinds will persist until leasing momentum and capital markets fully rebound.
- Outpatient Medical Asset Sales: Continued strong pricing in private markets enables capital redeployment, but future supply-demand dynamics must be monitored.
- Balance Sheet and Refinancing Risk: $1.1 billion of 2026 maturities and higher interest rates create near-term pressure, requiring disciplined execution.
Risks
HealthPeak faces material near-term earnings risk from lab segment occupancy losses and refinancing at higher rates. The timing and success of the Janus Living IPO, as well as integration of new operators in senior housing, present execution risk. Broader capital markets volatility and policy changes could further impact leasing, asset sales, and acquisition pipelines. Management’s guidance assumes continued improvement in capital markets and stable outpatient demand, both of which remain subject to external shocks.
Forward Outlook
For Q1 2026, HealthPeak guided to:
- FFO as adjusted of $1.70 to $1.74 per share for the full year
- Total same-store NOI growth between down 1% and up 1%
Segment guidance for 2026:
- Outpatient medical: 2% to 3% growth
- Lab: down 5% to down 10%
- Senior housing: 8% to 12% growth
Management noted that 2026 will reflect the full impact of lab occupancy losses, with earnings expected to bottom before a gradual recovery as leasing builds and senior housing transitions drive additional upside.
Takeaways
HealthPeak’s Q4 marks a strategic inflection, with the Janus Living IPO, outpatient medical stability, and tactical life science expansion setting the stage for a new portfolio mix and future growth.
- Senior Housing Value Unlock: Monetization through Janus Living IPO crystallizes value and positions HealthPeak for capital-efficient growth.
- Lab Segment Headwinds: Near-term earnings drag from occupancy losses will weigh on 2026, but pipeline and market signals suggest a turn in 2027.
- Capital Allocation Discipline: Asset sales and redeployment into higher-growth opportunities underpin balance sheet resilience and strategic flexibility.
Conclusion
HealthPeak’s disciplined execution, segment reshuffling, and capital recycling position it to weather near-term headwinds and capitalize on sector recovery. The next twelve months will be defined by the integration of Janus Living, lab segment stabilization, and continued outpatient medical leadership.
Industry Read-Through
HealthPeak’s experience signals a broader re-rating of healthcare real estate, with outpatient medical assets attracting robust private demand and senior housing entering a new value realization phase through public markets. The lab segment’s cyclical reset and cautious capital deployment highlight the importance of timing and discipline in life science real estate. Other REITs and healthcare landlords should watch for similar asset recycling, operator transitions, and the growing role of capital markets in shaping portfolio strategy. The interplay between policy, capital flows, and operational execution remains the defining theme for the sector in 2026.