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Welltower (WELL) Q4 2020 Earnings Call Transcript

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WELL earnings call for the period ending December 31, 2020.

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Welltower (WELL 1.80%)
Q4 2020 Earnings Call
Feb 10, 2021, 9:00 a.m. ET


  • Prepared Remarks
  • Questions and Answers
  • Call Participants

Prepared Remarks:


Ladies and gentlemen, thank you for standing by, and welcome to the Q4 2020 Welltower Inc. earnings conference call. [Operator instructions] Please be advised that today's conference is being recorded. [Operator instructions] I would now like to hand the conference over to your first speaker today, to Mr.

Matt Carrus.

Matt Carrus -- Vice President, Treasurer, Finance and Capital Markets

Thank you, Diletto, and good morning, everyone. As a reminder, certain statements made during this call may be deemed forward-looking statements in the meaning of the Private Securities Litigation Reform Act. Although Welltower believes any forward-looking statements are based on reasonable assumptions, the company can give no assurances that its projected results will be attained. Factors that could cause actual results to differ materially from those in the forward-looking statements are detailed in the company's filings with the SEC.

With that, I'll hand the call over to Shankh for his remarks. Shankh?

Shankh Mitra -- Chief Executive Officer

Thank you, Matt, and good morning, everyone. First and foremost, I hope that all of you and your families are safe and healthy during these extraordinary times. In the spirit of this year-end call, I would like to review year 2020, the most challenging in our history, and discuss different paths of growth, long-term value creation for our continuing shareholders on part-share basis. We came into 2020 prepared for perhaps a plain vanilla business cycle downturn.

We pushed out our maturities in Q4 of 2019, sold a lot of short duration assets, bought a lot of longer duration assets, and continue to upgrade our portfolio, operators, management contract, and talent. We were hopeful that with the continued decline in seniors housing deliveries and start, on one hand, and the aging of the population finally picking up, on the other hand, that 2020 would serve an inflection point for the fundamentals after decades of weak demographics, resulting from the aging of the Baby Boomers generation. Then the once-a-century pandemic happened, that would turn out to be particularly devastating for our business. The back half of first quarter, second, and third quarter were all about long-term value preservation.

We enhanced our liquidity profile dramatically by selling assets in record time at or near pre-COVID pricing, more importantly, avoided mistakes of raising long-term dilutive capital, a consistent theme for managing the company for continuing shareholder on a part-share basis. We started during the dark days of March and April by selling $1 billion of assets at great prices in record 43 days from signing a confidentiality agreement to receiving cash. We continued this journey during Q2 and Q3 and eventually executed on $3.7 billion of disposition at extraordinary prices to build an unprecedented war chest. Two things particularly surprised me during this time: the resilience of our team during our -- including our extended team of operating partners; and the liquidity of our assets.

Not that we didn't have doubts or failures, but we continue to move forward in spite of them with a steady hand on the wheel and an unwavering belief that we'll get to the other side. Our team's stoic resilient, reminded me every day of Winston Churchill's famous quote that, "Success is not final. Failure is not final. It is the courage to continue that counts." In those moments of reckoning, I realized how privileged I was to be part of this team that didn't miss a beat and blazed new trail.

For years, I have heard that healthcare-oriented real estate deserves a discount to the -- too, say, shiny tower in middle of a large gateway city due to the lack of liquidity and smaller ticket size, especially during down cycles. I hope that during the worst down cycle of our asset class, this debate has been finally settled as demonstrated by our execution and that of our colleagues that helped. In the fall, we pivoted again from defense to offense as we started underwriting and shaking hands on new acquisition. It is important for you to understand that we don't shake hands and find excuses to walk or chip away, which if we shake hands, we close.

Our handshake in this business is worth gold, and we only enhanced our long-term reputation during this pandemic. During last quarter's call, I discussed $1 billion of deep value opportunity. I'm delighted to report that we have closed roughly $700 million of acquisitions since the start of fourth quarter at a significant discount or replacement cost. Our acquisition pipeline has grown meaningfully.

And as I sit here today, I'm optimistic this year is shaping up to be a year of net acquisition, perhaps significantly so. At the same time, I will remind you that we're not driven and incentivized by volume up acquisition, but the value of it. Asset price is the ultimate determinant of how we'll behave. In this moment of confusion and ambiguity, I indulge you to focus on four distinct pillars of long-term value creation for Welltower.

One, operating fundamentals. Tim will get into the details of what happened last quarter and what might happen next quarter. While operating fundamentals is awful right now, with little near term visibility, we're optimistic about the vaccine rollout as 90% of our assisted living and memory care facilities have conducted their first vaccination clinic with virtually all residents taking the shot. While I would not expect this to be a source of value creation in the very near term, I'm hopeful about the second half of the year.

Normalization of operating performance remains the largest source of value creation for our shareholders. It is too early to comment on exact timing of the trough and the shape of the recovery, but we'll keep you posted frequently intra-quarter so that you can see what we see. Our focus remains on upholding the reputation of our communities and maintaining the safety of our operator staff and residents. We spared no expenses and have already spent in excess of $80 million on COVID-related expenses to date, doing everything we can within our control to support their well-being.

Due to the great reputation of our operators and the extraordinary value they provide, rates are holding out. In 2020, REVPOR was up 2% in AL memory care, 1% in independent living, and 4.4% in our seniors apartment business. This growth occurred despite the headwind resulting from lower community fees, driven by a decline in move-in activity. Number two, operator platform enhancement, management contracts, leadership and system enhancements, and building local scale are some of the examples of this.

Let me highlight two specifics here. A, Sunrise. We're delighted by the appointment of Jack Callison as the CEO of Sunrise Living, our largest operating partner. Jack will bring much-needed attention to operating excellence with an operations-first culture.

We are also negotiating a new management contract that will align the interest of Sunrise and Welltower as the owner of the assets. We're diligently working with the management of Revera, Sunrise's majority owner, to enhance Sunrise's position so that it can emerge from this pandemic as the leading operator poised for excellence and growth. B, building local scale. If I can quote Charlie Munger, the advantage of local scales are of ungodly important to this business.

We have and will continue to scale our most important strategic partner as we expand our senior housing footprint. To name a few in alphabetical order, Balfour, Brandywine, Clover, Cogir, Frontier, Kelsey-Seybold, Kisco, Oakmont, StoryPoint are just some of the examples of the partners we have grown significantly during this pandemic. What is common among them? They're excellent operators in their markets. Their great leadership.

They're disciplined yet courageous. And they have an aligned relationship with Welltower. We rise and fall together. This list is expanding with a significant opportunity set that I mentioned a few moments ago.

Number three, capital deployment opportunity. I have already commented on the acquisition opportunity on the deep value side. At the risk of sounding like a broken record, I would remind you that we're an IRR buyer with an incredible focus on basis, operators, and structure. Our opportunity set is rising rapidly, and I hope to provide you with more specific color in next 60 to 90 days.

This comment is obviously focused on the current opportunities. Let me provide you some color on a related topic but on future opportunities. We at Welltower have never been in a more advantageous position as a partner of choice. For years, we have focused on growth strategy driven by our relationship-based and alignment focused structure and data analytics platform rather than prioritize on cost and access to capital advantage.

After all, not all capital is equal. We never imagine that we've encountered today's extreme stress. But as you can see, we stood by our operators during this difficult time, not only to preserve their businesses but also to grow it significantly. Talk is cheap, but action is not.

For this reason, we are inundated with requests as a partner of choice from all asset classes we play in. As much as I like to do call, we have been on-road throughout this pandemic meeting with prospective partners. This is bearing meaningful fruits. We have executed more partnership and pipeline deals in last nine months than over five preceding years combined.

We expect to deploy $10-plus billion of capital in these opportunities in the next few years. In other words, we are not only executing on deep value early cycle opportunities but also laying a strong foundation of growth to the entire cycle when inevitably the significant price discrepancies of today will be gone. To give you an example, we recently reupped our master development agreement for five years with Kelsey-Seybold, our largest MOB tenant. We're looking to start approximately 600,000 square feet of 100% pre-lease development in 2021 and 2022.

Number four, talents opportunity. I touched on this last call but let me elaborate for those of you who are focused on long term. We're seeing an incredible interest in our platform from seasoned professionals to early carrier applicants. We have taken advantage of recent disruption and brought in 41 new professionals in 2020.

We expect at least as many, if not more, to join our team in 2021. In addition to new talent, our existing talent pool is taking on more responsibilities and reaching new heights. As a result, we had 50 new promotions at Welltower. Though this puts early pressure on G&A, which is partially offset by lower executive comp, we think this incredible talent pool is the equivalent of a coiled spring, which will manifest itself in a meaningful growth for the firm.

Speaking of talent pool, how is the mood inside today, inside Welltower? What I described to you as the stoic resilience last year has transformed into an environment of optimism and unbridled passion this year. I want to make it abundantly clear. We have no crystal ball about the near-term operating fundamentals, but we are doing meaningful work that matters. We have meaningful relationship, and we're seeing a new level of positive energy of people who want to be part of this team internally and externally to create meaningful value and make a disproportionate impact.

With that, I'll pass it over -- the microphone to Tim. Tim?

Tim McHugh -- Executive Vice President and Chief Financial Officer

Thank you, Shankh. My comments today will focus on our fourth-quarter 2020 results. The performance of all of our investment segments in the quarter, our capital activity, and finally, a balance sheet and liquidity update and our first-quarter outlook. The fourth quarter was a tough end to a very challenging year.

And the ongoing impact of coronavirus accelerated meaningfully in the back half of the fourth quarter and into the beginning of 2021. The visibility for large parts of our business beyond the next 90 days remain very limited and very dependent on virus-related variables, such as unpredictable group path of growth, the rollout, and efficacy of the vaccine, the continuation of population lockdown mandates. As a result of this uncertainty, we decided to provide our first-quarter outlook this morning in place of the full-year outlook we would normally provide in our fourth-quarter call. As we have done over the last year, we'll continue to disclose and update information on frequent basis, with the intention of providing a more complete outlook as soon as the variance, the virus-related variables moderate to a level that allows for reliable forecasting.

Now, turning to the quarter. Welltower reported net income attributable to common shareholders of $0.39 per diluted share and normalized funds from operations of $0.84 per diluted share. Normalized FFO was sequentially flat in the third quarter and the decline in seniors housing operating earnings and dilution from dispositions to close over the last two quarters was offset by recognition of HHS funds, lower G&A, lower interest expense, and initial returns on reinvested capital. Now, turning to our individual portfolio components.

First, with our triple-net lease portfolios. As a reminder, our triple-net lease portfolio coverage and occupancy stats are reported a quarter in arrears. So these statistics reflect a trailing 12-month ending 9/30/2020 and, therefore, only reflects the partial impact from COVID-19. Importantly, our collection rate remained high in the fourth quarter, having collected 97% of triple-net contractual rent due in the period.

Starting with our senior housing triple-net portfolio, same-store NOI declined 2.7% year over year as leases that were removed to cash recognition in prior quarters continue to comp against prior full-year contractual rent received. Occupancy was down 260 basis points sequentially, consistent with the average occupancy drop from 2Q to 3Q in our RIDEA portfolio, and EBITDAR coverage decreased 0.01 times on a sequential basis in this portfolio from 1.01 times. During the quarter, we transitioned a U.K. development portfolio from triple-net to RIDEA, transitioned 14 former triple-net capital senior assets to new operators and RIDEA structures, and disposed of one asset, which has a net impact of increasing coverage by 0.03 times.

Consistent with my comments in the past, our senior housing triple-net lease operators experienced similar headwinds as our RIDEA operators over the past nine months, and we expect reported lease coverage stats to continue to reflect these challenges as more of the pandemic period is reflected in EBITDAR going forward. That being said, the resilience of this portfolio is reflected by the continued high cash collection rate is encouraging. As I described last quarter, we entered into an agreement with Capital Senior beginning of 2020, which allowed for an early termination of CSU leases on 24 Welltower-owned assets, in exchange for full rent being paid in 2020 in cooperation with transitioning the operations of these assets. We transitioned 14 properties operated by CSU to new operators in the fourth quarter, in addition to five that were transitioned during the third quarter.

We anticipate the remaining assets to be transitioned to new operators in the first half of 2021. As a result of the continued COVID backdrop, the initial expected dilution from these conversions are expected to be approximately $0.04 per share in 2021. Additionally, the conversion of a development portfolio in the U.K. from triple-net to RIDEA is also expected to be negatively impact normalized FFO by $0.04 per share in 2021.

The combination of these two transitions is expected to result in the sequential roll down of a little over $0.02 per share of normalized FFO from Q4 to Q1. Next, our long-term post-acute portfolio generate 2% year-over-year same-store growth. However, EBITDAR coverage declined by 0.012 times sequentially to 1.0 times, which was almost entirely due to deterioration in our largest long-term post-acute tenant, Genesis Healthcare. As we noted last quarter, Genesis Healthcare, which makes up approximately half of our long-term post-acute exposure, raised concerns around its ability to continue as a going concern in second-quarter financials filed on August 10.

As a result of this concern, Welltower began recording revenue and cash basis in the third quarter. Furthermore, we wrote down our unsecured loan exposure to them by $80 million in the fourth quarter. Similar to our Genesis lease income, we've been recognizing all interest on our unsecured loans on a cash basis. So this impairment does not change income recognition on these loans.

Genesis remains current on all financial obligations to Welltower through January. And lastly, health systems, which is comprised of our ProMedica senior care joint venture with the ProMedica Health System. We had same-store NOI growth of positive 2.7% year over year, and trailing 12-month EBITDAR coverage was 2.27 times. Turning to medical office.

Our outpatient medical office portfolio delivered positive 2.1% year-over-year same-store growth, modestly below long-term trends. Growth continues to be negatively impacted by reserves for uncollected rent. The large majority of which is resulting from lease enforcement moratoriums in several California jurisdictions, in which we have a sizable footprint, as I described last quarter. As these moratoriums expire, we expect rent collection to improve from 98.5% received in the fourth quarter.

Looking back to 2020, our outpatient medical platform displayed incredible resilience in a truly challenging year, which include periods of time which basic medical appointments and procedures were flat out not permitted. Yet, we still managed to grow same-store NOI an average of positive 1.7%. During the fourth quarter, we continued to observe improvements in several key operating trends as business continue to normalize. Notably a pickup in our leasing pipeline, which would start to reflect in positive occupancy pickup toward the back half of 2021.

Now, turning to our senior housing operating portfolio. Before getting into this quarter's results, I want to point out that we received approximately $9 million from the Department of Health and Human Services CARES Act provider release fund. And post quarter, we received another $34 million, delivering $8 million and $31 million of net expected proceeds at our share. We are recognizing these funds on a cash basis until they will flow through financials in the quarter in which they're received.

We are normalizing these HHS funds at a same-store metrics, however, along with any other government funds received that are not matched to expenses incurred in the period they were received. In the fourth quarter, there're approximately $11.8 million of reimbursement normalized out of our same-store senior housing operating results, mainly tied to the HHS program in the U.S. Now, turning to results of the quarter. Same-store NOI decreased 33.8% as compared to fourth-quarter 2019 and decreased 11.3% sequentially from the third quarter.

Starting with revenue. Sequential same-store revenue was down 2.4% in Q4, driven primarily by 160 basis point drop in average occupancy. As a reminder, we started the fourth quarter with relative optimism on the occupancy front, with improving year-over-year move-in volumes and relatively low prevalence of COVID within our communities. However, these positive trends rapidly reversed as the exponential rise in global COVID cases in November and December, by the city and statewide lockdowns and missions bans across many of our key MSAs, particularly in the U.K.

and California, which together comprise 34% of our portfolio NOI. The result of this was 180 basis points of occupancy loss from November through year-end. As I stated on our third-quarter call, the path of COVID will dictate our business trends from the fourth quarter, not seasonality and not the seasonal flu, and that has proved quite true over the past three and a half months. Turning to REVPOR in the quarter.

Total show of REVPOR -- total show of portfolio REVPOR was down 1.2% year over year and flat sequentially. But as I described last quarter, mix shift is distorting the true picture of rent growth metrics. As stand-alone year-over-year REVPOR growth for our active adult, independent living and assisted living segments were positive 3.7%, 0.5%, and 1.1%, respectively. The combined total portfolio metric is being impacted by considerable changes in composition of occupied units in the year-over-year portfolio.

As lower acuity properties, independent living and senior departments have held up considerably better on the occupancy front since the start of COVID. We just had a mathematical impact of having a higher portion of our total portfolio occupied units being lower acuity and therefore, lower rent-paying units. The point being rental rates are proving more resilient across our portfolio than would appear in our aggregate reported statistics. And lastly, expenses.

Total same-store expenses declined 2.1% year over year and increased 50 basis points sequentially. I'll focus on the sequential since the changes are more relevant to trends in the current operating environment. The 50-basis point increase in operating costs was driven mainly by higher sequential COVID costs as a result of the surge in cases in the fourth quarter. The decline in top line, combined with these expense pressures, had a meaningful impact on our operating margins, which declined 220 basis points sequentially to 22.3%.

As I noted earlier in the call, we did not include government reimbursement that was not tied to period expenses -- in period expenses in our same-store results. And therefore, COVID expenses negatively impact same-store by $18.9 million in the quarter. We will stay consistent with this treatment in Q1, where we've already received a net $31 million in HHS fund. That will likely turn COVID expenses into a net benefit if included in our same-stores and offset.

Looking forward to the first quarter and starting with 2021 year-to-date data we have already reserved, we've experienced 180 basis point decline in occupancy through February 5. Given the still heightened presence of COVID, we expect average occupancy to be down 275 to 375 basis points from fourth quarter to first quarter. Note that we are providing the average occupancy as opposed to spot occupancy as the former better ties to our reported financials. And therefore, 260 basis points of our expected 275 to 375 basis point decline is already baked, given the swift drop for mid-November to date in occupancy.

We expect monthly REVPOR to be down 20 basis points sequentially, although it should be noted that actual rent per unit is up 2.1% sequentially. With mix shift, which I mentioned earlier and two fewer days in the quarter, skewing reported REVPOR versus actual rent growth. Lastly, we expect total expenses to be effectively flat as higher sequential COVID costs are offset by less labor utilization due to lower occupancy levels. Turning to capital markets activity.

Throughout 2020, we took a series of actions that were difficult, result in our ability to retain significant cash flow, and ultimately, gave us greater control to navigate through the pandemic. It's worth highlighting that despite the stress endured by our business, we've avoided the destabilization of the balance sheet by borrowing to pay the dividend or being forced in raising equity or selling assets at unattractive valuations. Given where we sit today, the $2.1 billion of cash, and over $5.1 billion of available liquidity, we are pleased with our course of actions being the most prudent way to maximize balance sheet stability and positioning us to take advantage of attractive capital deployment opportunities. In addition to showing up the balance sheet, we undertook a series of actions to optimize spend and maximize retained cash flow by reducing our corporate overhead through tighter cost controls and fine-tuning of capital expenditure plans.

We also made the decision in May to reduce our quarterly dividend by 30%, given the uncertainties around the pandemic's timeline and severity. Despite the pandemic, substantial negative impact on our business, our actions throughout 2020 removed any dependence on a quick recovery. And also afforded us the opportunity to be patient with respect to the transaction market and take advantage of attractive private market valuations relative to public markets, while also highlighting the institutional demand for our high-quality portfolio. Over the course of the year, we sold $3.7 billion of pro-rata assets at a blended 5.4% yield, including $1.3 billion of senior housing operating assets at a price per unit of $332,000 per bed.

Most recently, during the fourth quarter, we sold a portfolio of senior housing operating properties operated by Northbridge for $200 million, representing a 4.9% cap rate on March trailing 12-month NOI and $395,000 per unit. Also in the fourth quarter, we announced a new joint venture partnership with certain investment vehicles managed by Wafra. The joint venture comprised a portfolio of 24 outpatient medical properties previously majority-owned by Welltower. Many of these transactions were completed in the midst of significant disruption in real estate and capital markets from the long-term viability of our senior housing assets, in particular, were being called into question.

While we are pleased with execution on the disposition front, we're excited to now be executing on the acquisition side with financial flexibility and ample liquidity. On our third-quarter earnings call, Shankh described a $1 billion acquisition pipeline. And since the start of the fourth quarter, we've closed on $657 million at a blended initial yield of 4.5% With an expected stabilized yield over 7.5%. Lastly, moving to our first-quarter outlook.

Last night, we provided an outlook for the first quarter of net income attributable to common stockholders per diluted share of $0.24 to $0.29 and normalized cents per diluted share of $0.71 to $0.76 per share. The midpoint of our guidance, $0.735 per share, represents a sequential decline of approximately $0.105 per share from the fourth quarter. The $0.105 decline is composed of an $0.08 decline in senior housing operating results, driven by $0.06 of fundamental declines and $0.02 of increased COVID costs. A $0.03 per share sequential decline in triple-net senior housing NOI.

A little over $0.02 of which is related to the capital senior and signature U.K. transitions mentioned earlier, with the remainder due to fundamental declines on cash recognition leases. A $0.02 per share decline related to net investment activity in Q4 and Q1. And $0.03 related to a combination of other items, mainly made up of increased G&A, income tax, and a slight decline in interest income.

These declines are offset by a 5.5% increase in pro-rata HHS funds received to date in the first quarter. As a reminder, we're only guiding HHS funds that have already been received as of today's call. And with that, I will hand the call back over to Shankh.

Shankh Mitra -- Chief Executive Officer

Thank you, Tim. I want to end with two things before we open it up for questions. First, I'm excited about the collaboration that has emerged between our peers and us. We have worked diligently with Healthpeak, Ventas, and Omega to address operator and industry issues and toward mutually beneficial transactions.

For example, it was our absolute pleasure to work with Tom Herzog and his team on two separate transactions, totaling $170 million. I am positive we are embarking on a new era of collaboration among the public companies in our space. Second, in spite of our challenges being faced by our industry today, our confidence in our business has not changed, and I'm hopeful that my comments this morning have provided you with a framework for how we intend to create long-term value for all of our stakeholders. We're grateful to be part of your portfolio as our shareholders.

Personally, this management team has established a highly concentrated position in Welltower. In fact, neither Tim nor I, have sold a single share of the stock that we have received on a post-tax basis since we have come on board a few years ago, which should be an indication to you, our fellow shareholders, of our conviction and personal stake we have in this business. As Buffett taught us, diversification may preserve well, but concentration builds well. This does not mean the path forward will be without challenges, but it is clear that we're all in on this company and that our alignment with you, our shareholders, is strong and significant.

With that, we'll open the call up for questions.

Questions & Answers:


Thank you, sir. [Operator instructions] I show our first question comes from the line of Juan Sanabria from BMO Capital Markets. Please go ahead.

Juan Sanabria -- BMO Capital Markets -- Analyst

Hi. Good morning and thank you for the time. Just on the acquisition front, you guys talked about the $1 billion pipeline and being confident on more opportunities. I was hoping you could provide a little bit more color on what the focus is.

Is it still on the kind of the value opportunities in seniors housing buying it at a great basis? And if that's the case? Or more generally, if you can give color on the timeline to stabilization from the low cap rates going in, what we should expect in terms of we get those stabilized yields?

Shankh Mitra -- Chief Executive Officer

Thank you, Juan. Good morning. That is our focus is to buy near term, at least in the near-term basis value opportunities that are significant discount replacement cost where we can bring in the right operators or buy with the right operators if it is owned by some other capital partners of our operators. So we're focused on basis, we're focused on operator, we're focused on structure.

Interestingly, we are starting to see some opportunities where the initial yield is not as much of a drag. That's just a coincidence. We're not focused on that. We're focused very much on basis, structure, and operators, and I expect that our blended yield of the opportunities when we talk about next quarter will actually be dragged up overall by this set of opportunities.

But I can tell you that is not our focus. We're purely focused on basics, structure, and operator.

Juan Sanabria -- BMO Capital Markets -- Analyst

Any color on timelines to get to the stabilized yields? I mean, it just generally ties to the overall length of the recovery, I know. If you can just give some color, it would be appreciated.

Shankh Mitra -- Chief Executive Officer

Juan, it is purely dependent on the shape of the recovery. And when it drops, which I already said that I'm not going to comment on, right? It's a very uncertain environment. That is precisely why that we are buying these value opportunities so that we don't have to be dependent on that, right? So if we had a perfect sense of what the shape of the curve looks like and when it perfectly troughed, then we will be buying everything we possibly can, which we are not. We're very focused on is significant discount to replacement cost for that very reason.

But again, we need more time to give you a general sense of what that looks like, but it depends on assets to assets. We're buying assets that are 82% occupied. We're buying assets at a 22% occupied. So it's very hard to make a general comment on what we think that's sort of the shape of that acquisition looks like.


Thank you. I show our next question comes from the line of Steve Sakwa from Evercore ISI. Please go ahead.

Steve Sakwa -- Evercore ISI -- Analyst

Thanks. Good morning. Shankh and Tim, I know you can't really comment on sort of the exact bottoming and timing of the recovery, but maybe talk about sort of the move-ins and the conditions that you think you need to see within your facilities, kind of in the macro in order to ultimately start to drive move in volume, given what we've seen on the decline?

Tim McHugh -- Executive Vice President and Chief Financial Officer

Yes. Thanks, Steve. So I think the first and foremost, what we've seen and learned over the last 10 months is that one, cases naturally and cases in our buildings have very much married each other. The virus has presented itself is -- it's pretty challenging to kind of keep out of anywhere.

So I think when you talk about the macro and being cases, we're kind of speaking to both those at the same time. But we've seen both the negative and positive case counts rise and fall, start to impact our business, 30 to 45 days afterwards. And that makes sense given thinking about kind of the sales cycle and an average kind of 30 days of a kind of start of a lead to a close. So what we need to see is the direction we're seeing right now in case counts to continue.

We need to see likely the vaccinations that are going on at national level and in our buildings to then allow for that to be kind of held at a low level. And we're seeing those things take place now. But as of today's call, we're still very much at an elevated level of cases nationally in our building. So I think what we need to see is for this current level to drastically continue at the low level to sustain itself, and we'll start to see some early indicators of that if that direction continues over the next month or so.

And the fundamental impact on our business would come, as I said, kind of 30, 45 days after that. So I think it comes down to simply the path of COVID, and it's a big reason of kind of the outlook being one quarter here and not full year because I think any full-year outlook would essentially be just more of a guidance on where the path of the virus goes, which is something that we don't think we've got a better view on than those of you in the market. So it really comes down and just COVID.


Thank you. Our next question comes from the line of Connor Siversky from Berenberg. Please go ahead.

Connor Siversky -- Berenberg Bank -- Analyst

Good morning, everybody. Thanks for having me on the call. Appreciate the detail on the prepared remarks. I'm looking at lease maturities, specifically as it relates to the post-acute care portfolio in 2021.

I'm just wondering how those conversations are progressing and if there's any kind of expectation for renewal rates.

Tim McHugh -- Executive Vice President and Chief Financial Officer

I'm sorry. Say that again, Connor. You said which leases?

Connor Siversky -- Berenberg Bank -- Analyst

So the lease maturity is related to the post-acute care portfolio and then how those conversations are progressing.

Shankh Mitra -- Chief Executive Officer

So, Connor, the conversation with all tenants, it's the same, right? If a tenant wants to focus on what is the right near-term fundamentals right now and project that as the future, then I don't think that's our right tenant, right? I mean, you cannot think about this business as what is happening right now and lease to market on that basis on today's fundamentals. That's just not how we think about it. I laid out the whole framework of how we think about leases in a previous call. I'm not going to bore you with the details.

But the conversations are always the same. In a normalized cash flow of a business, what does that mean from a value, as well as the last dollar basis of that lease, the leverage, in fact, right? So that's how we think about leases. That's how we do leases, new leases, renewal leases, and that's how we're going to move forward. If we think that our tenants and us, we can't agree on what is the long-term value of our real estate is, then we have to move forward with a different operator.

Our value is in the real estate and we know how to preserve it.


Thank you. Our next question comes from the line of Michael Carroll from RBC Capital Markets. Please go ahead. Mr.

Carroll, if you have your phone on mute, please unmute your line.

Michael Carroll -- RBC Capital Markets -- Analyst

I do. Sorry. Tim, with regard to the seniors housing triple-net portfolio in your prepared remarks, can you kind of provide some color on what percent of the operators are being recognized on a cash basis? And I guess, what are they paying today versus their contractual rents? And just real quick off of that, in that came in coverage stratification, heat map that you have, is that coverage ratio reflected on their contractual rent? Or is that reflected on the rent that they're currently paying today?

Tim McHugh -- Executive Vice President and Chief Financial Officer

Yes. Thanks, Mike. So it's a little over 5% of our triple-net NOI is reflected as cash and not as contractual rent. And on the heat map, if things move to cash, they're removed from the heat map because they essentially at that point are one-for-one in relative to what's being reflected in our earnings and what's being received in cash.

And that kind of is not relevant to the actual contractual and also could end up kind of inflating of coverages. So if it moved to cash, essentially what it is we move it off because, at that point, earnings is reflecting exactly that cash. And I'd say, just as kind of relative to areas of where we've seen cash recognition, where EBITDAR has kind of fallen relative to rents, it's kind of probably been in the 0.5 to 0.75 times coverage areas.


Thank you. Our next question comes from the line of Derek Johnston from Deutsche Bank. Please go ahead.

Derek Johnston -- Deutsche Bank -- Analyst

Hi, everybody. Good morning. Spot occupancy stands at 74.4% for SHO. And with COVID cases declining and most of your residents likely vaccinated by the end of first quarter, is this 275 to 375 basis points of further decline in occupancy that you're guiding? Is this your estimate of Welltower's pandemic trough occupancy, given what we know today?

Shankh Mitra -- Chief Executive Officer

So what we're estimating in our actual first-quarter guidance with -- in my prepared remarks, I alluded this, but if we were to be -- if today's occupancy was to be held from here to quarter-end, we'd end up at an average occupancy decline from 4Q to 1Q of 260 basis points. And our guidance is for 325 basis points of decline from 4Q to 1Q. So our expectation is that given the heightened COVID cases on national basis, that declines in occupancy continue. And we're not making a call on the direction of COVID, which would therefore impact occupancy.

So in short, no, we are not calling today's occupancy trough.


Thank you. Our next question comes from the line of Jordan Sadler from KeyBanc Capital Markets. Please go ahead.

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Thanks. Good morning. I know that you guys have some optimism because you've sort of transitioned from defense to offense and have begun buying assets again. So I just wanted to get a little bit of a sense of what your thinking is as you're underwriting these assets in terms -- and I mean seniors housing specifically, in terms of the pace of potential lease-up.

So on the other side, of sort of this spike in COVID. How do you think about what -- and maybe you can give us some brackets for what lease-up occupancy might look like during the peak leasing season like April to September?

Tim McHugh -- Executive Vice President and Chief Financial Officer

Hey, Jordan. So I can put some brackets around it, just thinking through kind of pre-COVID occupancy levels. We've talked a bit this year of looking at move-ins as a percentage of pre-COVID levels and to give an idea of not only how much they decline since the start of COVID, but kind of where they sit relative to levels in 2019. If you were to look at kind of move in levels from April to September 2019 and compare that to move-out levels we saw in the fourth quarter of this year.

So just the most recent experience, which is a bit heightened relative to historical. But as you can see in our stats, it certainly is not spiking. You would see at a 100% to back to pre-COVID with demand levels, 90 to 110 basis points of occupancy increases on a monthly basis. And that's really a product of, again, demand coming back quite a bit.

You look at January of 2021, and we're at 50% of prior-year move-ins, so thinking about that 50% to back to pre-COVID levels, that's quite a climb from here. But another way to look at it is we likely have to get back to kind of 65% of pre-COVID demand levels to get to breakeven on occupancy and then, from there, build to start to gain. And just putting that in context, when COVID did come down in late summer, early fall 2020, we did see demand as measured by move-ins move back to kind of 70% prior year. So we've seen demand move back in that range during COVID and pre-vaccine, but certainly, we're well below that now.

So current trends on the move-in side have gotten worse. But hopefully, that gives you an idea of where that could move to if demand really comes back to pre-COVID levels in the short term and also where we kind of need them to get to just see some stabilization of the portfolio.

Shankh Mitra -- Chief Executive Officer

Jordan, that does not mean that we're underwriting that in this April to sort of the ale summer to late fall leasing season, we're going to see that kind of occupancy increase. If we did that, we would buy every product that we can possibly buy in the market. So I want to remind you that what we are not -- we're focused on basis so that our value creation is not dependent on our ability to pinpoint the shape of the recovery. It is purely dependent on what it takes to build a building.

And if you can buy at a significant discount, the two things will happen, right? You can wait for that demand to come back. And if you can't make money, obviously, at a 50% to 60% discount replacement cost, then no one will build a new building at the replacement cost because they have to charge a lot more than you. So ultimately, in any capital-heavy asset class like real estate, assuming your overall demand is increasing, ultimately, that demand-supply will balance. If I can't make money at discount replacement cost, you will not be able to make money by building a new one at replacement cost.

This is a particularly interesting phenomena in this cycle, in most cycles, what you see is replacement -- I mean, the cost to build goes down when a recession hits because housing is white hard, replacement cost is actually spiking through this particular cycle. That keeps you even a bigger gap as we think through a cycle.


Thank you. I show our next question comes from the line of Nick Joseph from Citi. Please go ahead.

Michael Bilerman -- Citi -- Analyst

Hey, it's Michael Bilerman here with Nick. Just a two-part question, Shankh, just in relation to partners in relationships that you talked about during your opening comments. You talked about a $10 billion pipeline of opportunities. As you've executed more partnerships over the last nine months than you did in the five years prior.

And you mentioned the 600,000 pre-leased MOB. Can you just step back and sort of break down that $10 billion, and a little bit more detail about what comprises it, what sectors, and the timeline? And then the second part of sort of the relationships, you talked about this new collaboration with your fellow Health Care REITs. What drove the change in those relationships? And I think it's definitely a positive. It's nice to see.

But what was the drivers? Because I think you've been a little bit more critical over time. And I just want to know what sort of led to these newfound positive relationships?

Shankh Mitra -- Chief Executive Officer

OK. Let me take the second one first because that's the easy one. I don't believe that I've ever been critical of our peer companies. What led to the collaboration is that I reached out to my fellow CEOs, and we absolutely agree that we need to work on these industry issues and operator issues together, and I got a very warm reception.

So that's just very simple, right? I mean, it is true that we have to work on this. And there is a power in bigger numbers, and we have very smart companies in our space run by very competent and smart management team. It is only in our interest to work together to solve these bigger issues than work alone. So that's a simple one.

I'm not going to get into the first question. I will tell you that we are creating, as I said, we're very much focused on from an acquisition side on two things, right? Early cycle opportunities that, obviously, we're executing, and we'll be very pleased as the year progress where that will shake out. But we're very much cognizant of the fact that early cycle opportunities, eventually, that will be gone. So if we start working on then what will eventually become is the normal cycle opportunity is too late.

So we have never stopped, and it is also pretty much to be a very advantageous position. To be a large company in our space, the largest company in our space, which we're expanding pretty rapidly, and we didn't bat an eyelid and stopped. And because we believe in the business, as I laid out. You have to think about it.

This is a very interesting business where you have to work with other people, and you have to work with operators, you have to work with developers. In many cases, they are one and the same. And to grow, create value together, not at the expense of each other, that alignment is extremely important. And this last nine, 10 months has given us the opportunity to work with more of our operators.

And frankly speaking, as you can see, being aligned with Welltower has created significant and has continued to create significant value for our operators whose -- if you think about if you're not aligned with a capital source that has the capability and the fierce resolve to deploy capital through this kind of disruption then ultimately, as I said, you'll come to the other end of the cycle, and it's too late. So I'm not going to get into what that looks like. I'll just give you one example. 600,000 square feet of 100% pre-leased MOBs.

Michael, you can do the math and think about how much value creation. And that is not a pipeline that is just the start that we're sitting here today between 2021 and 2022.


Thank you. I show our next question comes from the line of Jonathan Hughes from Raymond James. Please go ahead.

Jonathan Hughes -- Raymond James -- Analyst

Hey. Good morning. Could you talk about your underwriting assumptions on the recent shop acquisitions at a mid-3 yield? And the reason I ask is because using some of the assumptions laid out in the December 2018 investor day, like exit price and 7% IRR requirement, it implies a high single-digit NOI growth CAGR for the next decade. I know you won't comment on the growth and the recovery trajectory, but maybe some of those other assumptions like exit price have changed versus two-plus years ago.

So any details or talk about how you underwrite shop and compare it to perhaps now higher-yielding but more stable and slower-growing medical office buildings would be helpful. Thanks.

Shankh Mitra -- Chief Executive Officer

Thank you, Jonathan. It depends. Obviously, every asset is different, where you buy the asset, what basis you buy the assets is completely different. When we made that presentation, we never thought we'll be able to buy assets at a meaningful discount to replacement cost.

If we look at pre-pandemic, healthcare real estate, particularly on the senior housing, usually traded at a mild to modest premium to replacement cost because the healthcare income has a multiple, not a real estate multiple, but it's still a multiple, right? So in asset class where you're starting above some level of replacement costs, you're going to keep your pricing power really strong through the whole cycle and the next buyer analysis, you have to think about your next buyer analysis, and the next buyer has to also believe that will continue. That by implication, you are buying above replacement cost, and you're selling above replacement cost, or you're making a bet that the NOI growth -- if you're not -- NOI growth will meaningfully outstrip the cost of construction increase, right? So in both sides, you are at some form of above replacement costs. That equation changes completely when you can buy at a significant discount replacement cost. So if you buy $0.50 on the dollar, and at some period of normalization, you sell it at $0.100 on the dollar, you are still at a significant discount to the previous case when you make buyer analysis, it's much, much easier.

Nothing has changed, except the price. And that price tells you why we're so excited about it today.


Thank you. Our next question comes from the line of Amanda Sweitzer from Baird. Please go ahead.

Amanda Sweitzer -- Baird -- Analyst

Great. Thanks for taking the question. As you kind of think about building occupancy post-pandemic, how are you thinking either about changing service levels or where and how you invest capex, if at all, in order to attract new residents?

Shankh Mitra -- Chief Executive Officer

OK. So this is a question that has a -- I don't want to be too long-winded and give you an answer. It depends on the pricing, really, the service level of the assets inside those buildings today. And we don't increase the occupancy, our operating partners, too.

And we work with our operating partners and service levels, capex needed, and everything, but this is a collaborative process, and I don't want to sort of sit here and tell you that this is -- we have the operating expertise to do that. I'm assuming you're asking a sharp question. We have the best operators in the business that are very, very good of what they do and their local dominance in the marketplace, obviously, as well as their particular service area is very much of a -- very much of what we are depending on. Having said that, we have worked diligently with our operators on payers and provider integration.

And as I said, this is a very long answer to a question. We are happy to take this offline. And have you talked to Mark Shaver, who leads this, obviously, these process in our SHOP, but the pricing question, the service question, is more of an operator question than a Welltower question. capex question is definitely something that we work together having said that the payer and provider integration is something that we are leading, and our operators are collaborating with us.

But that's a long discussion, and we'll take this up offline if this is of interest to you.


Thank you. I show our next question comes from the line of Rich Anderson from SMBC. Please go ahead.

Rich Anderson -- SMBC Nikko Securities America Inc. -- Analyst

Thanks and good morning. And just a comment, the olive branch, you're extending your peers and they to you is like red meat to me. So happy to hear about that type of collaboration in this space. And speaking of collaboration, one of the things the gaming sector has noticed -- gaming REIT sector has noticed the ability to expand margins post-pandemic and some lessons learned about what was kind of wasteful in their four walls and perhaps a better product at the other side of this.

Question is on SHOP. I know there's a lot of talk about margins going down. Of course, these days. But do you envision that there will be some positive lessons learned from all this and that, ultimately, part of your interest in senior housing and SHOP specifically is that there is a margin expansion sort of thesis down the road here, maybe two, three years down the road, perhaps that will come out of this? Or should we not be thinking along those lines?

Tim McHugh -- Executive Vice President and Chief Financial Officer

So, Rich, that's a very good question. It's one we've talked about a lot actually with our operators through the last period -- kind of the last six months. I think I'll answer in two ways. The first is on the lessons learned.

Absolutely, this has made our operators look at their cost constructs in a more critical way than they probably ever could imagine, just given the pressure on occupancy and getting back to levels that for a lot of them look like they haven't been in since they leased up some of these assets years ago. We've had feedback from operators and large platforms saying they've found ways to do things on the labor front, just a lot more efficiently. And given the feedback ahead of time to what you're speaking to, that when you start to see the business come back, they think there is significant cost savings is in the -- particularly the labor model as far as getting a bit more leverage off it. I think on the margin side, I would hesitate to kind of speak to that from a margin expansion story just driven purely by that as of yet.

As you know, there's cost in the structure right now that are being added because of COVID. We feel pretty confident a lot of these things are temporary. But given that there's two things to speak now, kind of a margin expansion story. We're having those costs in the current business and having an unclear picture of when and how the kind of the virus moves away from our business, I think would be a bit aggressive.

But I do think the margin expansion story, I'm thinking about it relative to even where we were pre-pandemic. We think there's an occupancy lift story in this space just given the demand story and the thing that makes us -- still keeps us very positive in the space that long-term demand story hasn't changed in the pandemic. And it certainly has been a very impactful last nine months, 12 months to continue to be in the near future, but in the long term, demand story stands. And that's going to lift occupancy, and there's a lot of operating leverage in this business even without changes to the structure.

So you're going to see as kind of industry occupancies lift up over the next three to five years. I think you are going to see margins move above where they were pre-pandemic even without those operating efficiencies being put into the model.

Shankh Mitra -- Chief Executive Officer

Rich, I will just add two things. One is that we obviously -- I would encourage you and our team would be happy to set it up to talk to Mark Shaver and our team with what we're doing on the payer-provider side, which should help margin as well. The second lessons learned, I would say, not a margin point, but a separate point is one of the lessons learned, SHOP through, not just this pandemic, but through the last few years, is that you should not lend money to an entity or any type of entity where you are not willing to take the keys, right? As a REIT, we're not allowed to obviously own an operating company more than 35%. so we should not lend money to operating companies where we're not able to take over the asset.

Today, we're only focused, obviously, in last few years and through this cycle, through the pandemic. We're only focused on, if we write a credit check, we only write. If we are completely able to take over the asset, and we're very happy owner of the asset on the last dollar exposure that we have. That is a big lesson learned inside our SHOP and a good one for the long-term valuation of our shareholders.


Thank you. I show our next question comes from the line of Nick Yulico from Scotiabank. Please go ahead.

Nick Yulico -- Scotiabank -- Analyst

Thanks. Good morning, everyone. So a couple of questions just here on the vaccine rollout. Clearly, that's important in terms of getting move-in activity back.

And so I was hoping to get some stats on what the adoption rate has been of the vaccine by residents and staff members so far? And then I'm also wondering, we saw an announcement from Atria which is very vocal saying that they were requiring staff members to get vaccinated by May. And we haven't seen anything from Sunrise. And so I guess I'm wondering as a part owner there in Sunrise, are you guys pushing for that policy? And maybe just give us an update on kind of what that policy is in regards to staff members across your operators in assisted living? Thanks.

Shankh Mitra -- Chief Executive Officer

Nick, I'll answer the second question. Mark will answer the first question. We have tremendous amount of respect for John Moore and his team at Atria. We do not comment on the vaccine policy of different operators.

We work with our operators and supportive of their different policies. I can tell you everybody's focus is to get to the right place. How they get there is the decision that the management teams and the CEOs of specific operators to take that. We do not push for one or the other, but I can tell you that everybody is focused on the same outcome.


Mark Shaver -- Assistant Vice President Performance Management

Yes. So just to give some stats, the relationships the operators have with CVS and Walgreens has worked quite positively. We've seen over 120,000 vaccination across the platform as of earlier this week. About 90% of our communities have completed their first clinic and very actively working through the second clinic.

We feel by the end of February, first week of March, most, if not all, of the second clinics will have taken place. With regards to adoption and consent, 90-plus percent of residents have consent or received the vaccination. 55% of staff across the portfolio that varies from operator to operator have consented to receive the vaccination. We're not going to get into specifics on number of vaccines by individuals.

Some of this is SKUs. You may be aware that if there was active COVID or an active COVID diagnosis in the prior 28 days, an individual has to wait to delay that. So we're focusing really on consent and the percentage of vaccinations that have occurred across the communities. But we're happy to provide additional color, but those are the highlights.


Thank you. I show our next question comes from the line of Mike Mueller from J.P. Morgan. Please go ahead.

Mike Mueller -- J.P. Morgan -- Analyst

Yes. Curious, how are the yields on the various new developments you're looking at compared to what underwriting would have been in pre-pandemic?

Shankh Mitra -- Chief Executive Officer

Our target yields might have not changed. Market conditions have changed. So obviously, we're even more critically thinking about the cost, as well as the land price. And ultimately, how much it takes to, obviously, how long it takes to get to that stabilization and the working capital loss in between, right? So our focus, again, as I said, you have to imagine these things, they are long time, we think about at least the developments that we're interested in.

You're talking about a five-, six-year cycle. So you have to really, really think hard about when do you start, when it actually finishes, when you get your approval. And just for an example, as you know, that for the last few months of last year or so, we have worked on a new development project in Brooklyn. It is one of the hardest place to build in the country, right? You can't change your view depending on how you're feeling about your occupancy today.

That's a five- to seven-year process. And so our return thresholds have not changed. Clearly, what we think, sort of the trended yields, the trending has changed, given what is going on in the business today, and we still need to make money on an un-trended basis to start these developments. So that's how we're thinking about it.

Mike Mueller -- J.P. Morgan -- Analyst

Got it. OK.


Thank you. I show our next question comes from the line of Todd Stender from Wells Fargo. Please go ahead.

Todd Stender -- Wells Fargo Securities -- Analyst

Thanks. Your data analytics team has been instrumental in having you guys drill down on MSAs, just for senior housing, of course. But can you share the recommendations that they're providing now just in light of lingering new supply, out-migration from more urban cities due to COVID, maybe any specifics you can share?

Shankh Mitra -- Chief Executive Officer

So, Todd, we have the ability to tell you today. Firstly is they're not just focused on senior housing. The team has built -- the platform has been enhanced pretty meaningfully in last few quarters. So we have the ability -- we're beyond what you have seen in senior housing into metal office and our other housing businesses, such as active adult where you play pretty heavily.

One of the questions that you raised, which is the migration pattern, you can do -- we have a team an entire team, which has been working on this data scientists today. I'm glad to tell you that we have the ability to do pinpoint that out-migration or in migration on a weekly basis. Not just focused on the longer-term data, such as ACS and IRS data but also cellphone data and other more near-term or more instantaneous sort of data. I don't mean instantaneous.

I didn't write at this point. But we can tell you almost on a weekly basis -- not almost on a weekly basis. We can tell you on a weekly basis where people have moved out and moved in. That is very much we're flowing through our models as we're making investments.

As you know that we're very, very focused on making new investments on all the asset classes we deal in. And it's definitely a big part of why we're seeing today, the attractiveness of us as the capital has enhanced in the last few months or three quarters because we're still standing here and taking advantage of the disruption in the marketplace. But also that huge predictive analytics platform that we have built over many years that our partners are attracted to.


Thank you. I show our next question comes from the line of Steven Valiquette from Barclays. Please go ahead.

Steven Valiquette -- Barclays -- Analyst

Thanks. Good morning, everybody. So a couple of questions here. I guess first regarding REVPOR, it was encouraging to see the positive year-over-year trends in 4Q '20 in AL, IL and senior apartments in that 1% to 4% range.

In your walk-through of the FFO sequentially into 1Q '21, you mentioned that $0.06 hit from a fundamental decline in senior housing. I guess I'm curious what's the REVPOR assumption within that? Does that stay positive year over year, or does that start to decline? Thanks.

Tim McHugh -- Executive Vice President and Chief Financial Officer

Yes. That's a good question, Steve. So when you think about on a sequential basis, that $0.06 that moves from 4Q to 1Q, effectively, if you think about like REVPOR and occupancy decline combined, you get to your revenue change sequentially. Our REVPOR is down 20 basis points.

But that's driven by two things. 40% of our senior housing revenue in the fourth quarter is actually from operators that receive rent on a daily basis, which is pretty common in the higher acuity side of senior living. And so just moving from the fourth quarter to the first quarter, you lose two days, you go from 92 days to 90 days. So with REVPOR being an approximation of monthly rent, your rent would go down 2.2% just from that.

So there's a headwind from that on a sequential REVPOR basis. And then you've got this continued mix shift where the occupancy, the mix shift, the makeup of revenue in the fourth quarter versus first quarter, again, you're seeing a higher occupancy fall off in the higher acuity segments of our portfolio, which pay higher rent. So in combination of those two things is the REVPOR from how that impacts kind of total revenue is down 20 basis points. But if you look at on a per day, per unit rent, we're up 2.1% in the fourth quarter relative to the first quarter, and it's actually pretty strong sequential growth.

And it's driven mainly by roughly half of our operators also have Gen 1 increasers. So there was increases pushed through on Gen 1, and that's helped kind of run growth.


Thank you. I show our next question comes from the line of Lukas Hartwich from Green Street. Please go ahead.

Lukas Hartwich -- Green Street Advisors -- Analyst

Thanks. Hey, Shankh, in the past, you've talked about Welltower's indifference between the SH-NNN and SHOP formats is structured correctly. I'm curious how the teams of evaluating that question for the existing portfolio, as well as acquisitions in this environment because clearly, there's a lot more uncertainty in not only near-term fundamentals but the recovery, the trajectory, potential long-term impacts from the senior housing business. There are a lot of moving pieces relative to the history there.

Shankh Mitra -- Chief Executive Officer

Well, I think you just coined a new term. I'm assuming you're asking about the difference between senior housing triple-net versus senior housing operating. So look, given where the cycle is, I want to be a majority being the equity position or in the RIDEA side. But there are opportunities to strip white capital in the senior housing -- in a triple-net side.

If you have assets that are stabilized and you can buy it cheap enough that the last dollar of the lease is still in a place where the operators can make money and we can make money, there, obviously, you can create a lot of bells and whistles and for the operators have a second bit of the apple. So there's ways you can create that alignment. But remember, if you simplistically think about RIDEA as an equity exposure and a lease is more of a credit exposure, you can't create value, if, a, from our side, if the buildings have stabilized or near stabilization. And you buy it cheap enough that your last dollar is still a pretty low rent relative to what the cash flow of the buildings look like, then you can create value.

But that's how we think about it. That's how our operators think about it. And so we have found two opportunities to do leases. If we do find more opportunities, we'll do it.

But I can tell you that the industry is moving away, at least we are moving away from very tightly covered leases. Today, we're thinking about there should be even more marginal safety. And when we find opportunities where we're buying so cheap that we can, that's when we're going for it.


Thank you. I show our next question comes from the line of Joshua Dennerlein from Bank of America. Please go ahead.

Joshua Dennerlein -- Bank of America Merrill Lynch -- Analyst

Hey, good morning, guys. Shankh, I just wanted to follow-up on your comment in your opening remarks about hiring, and it sounds like you added -- I think you said 41 employees last year. Curious just what area of the business are you guys hiring and added to.

Shankh Mitra -- Chief Executive Officer

Pretty much across the board. I mean, if you think about it, we have added a lot of people on our investment teams, and we have hired a lot of people on our data analytics team. We had a lot of hiring people on our infrastructure teams, our accounting, tax. I don't have the background.

I can tell you that we have seen an incredible resurgence of interest in our company today, from both sort of externally and internally. And what I mean externally as an operator developers and internally as prospective employees, both experienced employees that we're hiring, there's a lot of talent in the market for obvious disruption. Also, a lot of early carrier employees that we are seeing. I'll just tell you, just one small step, an interesting one, doesn't change really for anything we do.

We hire East Coast, West Coast, and Midwest, we hired the top seven schools for MBA candidates. This year, we got more than 1,400 applications for really four, five positions we hire. So that sort of tells you the interest in our business. And the amount of incredible talent we're seeing, both on the early career side, as well as super experience side, and we'll see some really good hires this year as well.

This year, I expect that we'll add 40 to 50 professionals across the board in the company. Acquisition is not just, as I said, I want you to think about Josh acquisition in this kind of market, which is so disruptive in three ways: one, obvious one, right, we're doing value opportunities that we can add at a discount to replacement cost; b, acquisition of partnership, an operator relationship and developer relationship, that's b; c is employees, we're in a business of talent. And given the amount of disruption that's in the marketplace that we see, and what we think this business will become as we think about three years, five years, 10 years from now, we're very much adding an incredible level of talent that we have sort of never seen in the marketplace.

Joshua Dennerlein -- Bank of America Merrill Lynch -- Analyst

Great. Appreciate the color.


I show our next question comes from the line of Omotayo Okusanya from Mizuho. Please go ahead.

Omotayo Okusanya -- Mizuho Securities -- Analyst

Yes. Good morning, everyone. First of all, Shankh and Tim, I just wanted to give your entire team credit for such strong transparent disclosure on your business update, I wish more of your peers were doing that. And also regards to Tom, I hope he's doing well.

My first question really is around government support. Could you just talk a little bit about kind of post the phase III announcements, kind of what you're seeing in the pipeline at this point, or what the lobby group is seeing and what the potential is for further government release for your operators?

Shankh Mitra -- Chief Executive Officer

So let me take your question and see what I can get there. I'm not going to comment on sort of what might happen. There's too much uncertainty. We have a new administration.

If I sit here and try to comment on what might happen, I'll be so much outside my zone of confidence, which I think, you know, that I focus very much on talking about confidence. Being a lifelong Buffett and Munger sort of is -- I'm not going to venture that. But I will tell you that Tom is doing well. I talked to him pretty frequently.

He's been an incredible mentor and a friend. He continues to help me, think through a lot of issues, and he's definitely doing well. If you reach out to him, he will reply to you, but he's definitely doing well. And he's been a great supporter of the company and he is helping any way he can.


Thank you. I show our next question comes from the line of Daniel Bernstein from Capital One. Please go ahead.

Daniel Bernstein -- Capital One Securities -- Analyst

Hey, good morning. I appreciate you staying on and taking the calls here. It seems to me that the initial acquisitions you've done here, I mean, clearly, there's destruction, you're buying a below replacement cost, but they're not really truly distressed sales. So just trying to understand what you're seeing in the marketplace in terms of lenders, bankers kind of exercising covenants and forcing more distressed sales in the remainder of this year, especially given your comments on a strong pipeline.

And I don't know if you can talk difference between that distress in seniors housing and skilled nursing? Thanks.

Shankh Mitra -- Chief Executive Officer

Like beauty, distress is also something that lies in the eyes of the beholder. I can tell you, Dan, we're buying assets in core markets of New Jersey, Seattle, California for less than $200,000 unit, where replacement cost is $400,000, $500,000, above $500,000 a unit. If you don't think that's a devalue opportunity, I really don't know how to answer to that. So I guess we just have to obviously think about it different way.

If you just always remember, price relative to what it takes to build, that gap is what creates distress. If you just want to look at purely on a price per pound and does it look cheap. Just wait for a few -- as I said, 60 to 90 days, I can tell you more about some of those opportunities that we are seeing. But I think we're executing on some very significant sort of discount to replacement cost opportunities.

Some we have reported. And if you look at what those assets are and dig into what it takes to build it, you'll understand that. So going back to the banks, look, I have no idea when the banks will obviously push more toward sort of pushing this -- sort of this whole pipeline of new construction that happened between '15 and '19 from their books. But I can tell you that we have been working diligently with many of our banking partners.

Just yesterday, we executed on one such loan. Look, we're here, open for business. We have a sense of what the value is. We have a sense of how we can create value, not just at the buy but also with our operating partners, and we're executing.

But I can't sit here and tell you when the banks will keep their books. There's just no way to say that.


Thank you. I show our next question comes from the line of Vikram Malhotra from Morgan Stanley. Please go ahead.

Vikram Malhotra -- Morgan Stanley -- Analyst

Thanks again for sticking on. Just to go back to sort of the potential inflection. I know you can't give a near-term prognosis on when that's going to happen. But just in terms of early indicators, both on move-ins and move-outs.

Tim, I found your comment that 65% needed for stabilization. Interesting. I'm just wondering, in the different geographies, given the COVID cases have trended somewhat differently, and that has a correlation to the move-ins. Any early signs you're seeing on monitoring that would suggest move in and move-outs kind of can turn the other way?

Tim McHugh -- Executive Vice President and Chief Financial Officer

So there is not -- I think as far as early indicators, we haven't seen enough to note it as a trend, I'd say. You certainly have seen operators where you've seen deposits or tours or initial inquiries move up. You've also seen, as your question goes, you've seen it move down in geographies in which you've had essentially the last six to eight weeks has been shut off in a lot of ways. So not enough of a trend on the initial indicators or first movers to say that there's something there.

I do think part of what I was getting at earlier is what we've seen in the past, you follow some of the first indicators being inquiries and request for tours, etc. You've seen that kind of lag cases in that kind of 30- or 45-day range. So what we've seen in cases, the fact that they're still very high, it may make this time a bit different as far as how much time it takes to post it. But just thinking about it a mid-January kind of peak in cases, you would likely -- if things continue on this trend, the positive trend we're seeing.

I think you start to see toward the middle to the end of the month, maybe some of those first indicators move in a more portfoliowide basis. And so we can provide some more color on that as we update the market over the next month or two. But right now, it's a little too early to speak to it.

Vikram Malhotra -- Morgan Stanley -- Analyst



Thank you. I show our next question comes from the line of Omotayo Okusanya from Mizuho. Please go ahead.

Omotayo Okusanya -- Mizuho Securities -- Analyst

Hi, good morning. Thanks for continuing to go on. My question actually ties into what Vikram was just discussing. If the inspection which rents have been getting better over the past few weeks, you guys kind of talk about a 45-day lag.

I guess, it does seem to indicate to me that things should get better in the back half of the quarter, but yet you have 260 basis points of average occupancy decline baked in today, but the guidance range for 1Q is 275 to 375. So it seems a few things actually get worse in the back half of the quarter versus better. So could you just help me clarify that?

Tim McHugh -- Executive Vice President and Chief Financial Officer

Yes. No, I appreciate the question. To clarify that a bit, we're saying if the trends were to continue, and I think you're saying the same, you would start to see some improvement in the latter part of the quarter. But trends getting better from here or staying the same is the part that we're not taking a position on, right? So certainly, if that continues that way, that's when we start to see some improvement.

Our guidance doesn't take a position on COVID and the path of it. Even today, despite where we've come off of, case counts in every way, shape, or form or higher than any point we've given a forward look in the past nine months. So today, still is a lot of uncertainty. It certainly feels better than it did three or four weeks ago.

But what's baked into guidance in our view, is not an attempt to call for a better or a continued improvement, and it's more of a current state holding where it is.

Shankh Mitra -- Chief Executive Officer

Also, Omotayo, as Tim sort of pointed out before, majority of that decline is, on an average basis, we already baked in, right? So if you see the improvement that you are hoping for, which we're not hoping for, we're not guiding for it. Then that will more impact the second quarter than the first quarter.


[Operator signoff]

Duration: 85 minutes

Call participants:

Matt Carrus -- Vice President, Treasurer, Finance and Capital Markets

Shankh Mitra -- Chief Executive Officer

Tim McHugh -- Executive Vice President and Chief Financial Officer

Juan Sanabria -- BMO Capital Markets -- Analyst

Steve Sakwa -- Evercore ISI -- Analyst

Connor Siversky -- Berenberg Bank -- Analyst

Michael Carroll -- RBC Capital Markets -- Analyst

Derek Johnston -- Deutsche Bank -- Analyst

Jordan Sadler -- KeyBanc Capital Markets -- Analyst

Michael Bilerman -- Citi -- Analyst

Jonathan Hughes -- Raymond James -- Analyst

Amanda Sweitzer -- Baird -- Analyst

Rich Anderson -- SMBC Nikko Securities America Inc. -- Analyst

Nick Yulico -- Scotiabank -- Analyst

Mark Shaver -- Assistant Vice President Performance Management

Mike Mueller -- J.P. Morgan -- Analyst

Todd Stender -- Wells Fargo Securities -- Analyst

Steven Valiquette -- Barclays -- Analyst

Lukas Hartwich -- Green Street Advisors -- Analyst

Joshua Dennerlein -- Bank of America Merrill Lynch -- Analyst

Omotayo Okusanya -- Mizuho Securities -- Analyst

Daniel Bernstein -- Capital One Securities -- Analyst

Vikram Malhotra -- Morgan Stanley -- Analyst

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