Shankh Mitra
Chief Executive Officer at Welltower
Thank you, Matt, and good morning, everyone. I will review our fourth quarter and full year 2023 results and describe high-level business trends and our capital allocation priorities. John will provide an update on the operational performance of our senior housing and outpatient medical portfolios, and progress on our operating platform build-out. Nikhil will give you an update on the investment landscape and Tim will walk you through our Triple-Net businesses, balance sheet highlights and 2024 full year guidance.
First, as I reflect back on '23, it was a year of solid execution across the board with significant progress achieved in all aspects of the business. Operating performance far surpassed our initial expectations, we had a great year of record-setting year in terms of capital deployment, and we meaningfully strengthened our balance sheet and liquidity profile. Just as importantly, perhaps is the groundwork we laid to sustain this level of performance and continue to deliver outsized growth not only in 2024, but also well into the future.
This includes the considerable progress John and his team have made on the build-out of our operating platform, which we continue to believe will transform the industry. On top of that, as we have discussed in recent quarters, we have executed a number of operator transitions across all our geographies as well as converted a handful of properties from triple net to RIDEA all should bear fruit later this year and in 2025. We finished the year strong with significant momentum to set us up for another year of solid performance in 2024.
In terms of our senior housing operating portfolio, I was particularly encouraged by the occupancy growth in fourth quarter, which is seasonally not the strongest period. The portfolio saw 110 basis points of sequential occupancy gains, which translate into 330 basis points year-over-year occupancy growth and the 330 basis points year-over-year occupancy growth is by far the highest level we have ever achieved in the fourth quarter of any year in our recorded history. Just as compelling is that looking at the intra-quarter trends, year-over-year occupancy growth strengthened each month, which is unusual given the aforementioned seasonality of the business.
We're also pleased with the rate growth achieved by our managers. During our last call, I described to you that one of our largest operator Sunrise, pulled forward Jan 1, 2023 rate increases into 4Q 2022. This year, they have returned to their historical cadence of Jan 1 rate increases. While this distorts our show portfolios reported, Q4 2023 report or the unit revenue, the rest of the portfolio delivered REVPOR growth of 6.8%, reflecting the underlying fundamental strength of the business.
While our 2024 guidance assumes some domination of REVPOR growth from full year of 2023 levels of 6.6%, we still expect another year of near double-digit top line growth as occupancy continues to build at a solid pace. 4Q 2023 same-store explore our expense per occupied room grew 1.7% year-over-year the lowest level of growth in Welltower's recorded history, driven by 4Q 2023 same-store compensation for occupied room growth, which grew 1.9% year-over-year, also the lowest growth in Welltower's recorded history. While the normalization of agency labor usage is helping to dampen COMPOR growth we are also seeing some good trends in the salary and the wages line.
All of these trends are resulting in a favorable spread between RevPOR growth and ExpPOR growth. The powerful combination of this revenue backdrop with continued margin expansion that should be expected due to the high operating leverage inherent in the business lifts us feeling very strongly about our 2024 NOI growth setup. Tim will give you our detailed buildup of our NOI guidance based on our current assumptions, plus please understand that we have no false pretense about perfectly knowing what the business will look like as we move through the years, particularly the all-important summer months, but we are optimistic given the demand supply backdrop, which improves by the day and the rising system-wide occupancy as well as the early success we have seen in John's operating platform build-out.
While 24.4% NOI growth last year for our SHO portfolio alone was very encouraging. I'm extremely pleased with our capital allocation activities as well. 2023 was the most active year in our history in terms of raising and deploying capital. We completed almost $6 billion of investments in the year, nearly half of which closed in Q4 alone. While I won't get into the specific transactions, I will mention that they share some common characteristics. First, we generally grew with our existing operating partners in their respective markets. Second, we acquired assets at a significant discount to replacement cost from ore funds, PE funds, pension funds and financial institutions who are seeking liquidity.
We also added a couple of new operating partners along the way who I envision us growing with in the near term. More to come on this topic as we progress through the year. The torrid pace of investment activity in Q4 has continued with 2024 starting off with a bang. In fact, I do not recall having ever been this busy in first quarter on the deal front. While we have renegotiated documents and structure to leverage, it is great trust that we have built with our 2023 counterparties that will make follow-on transaction easier to execute.
These counterparties also experienced what our promise always is that we honor our handshake irrespective of circumstances as evidenced by the continued -- our continued execution through this historic capital market volatility in the fall and winter of 2023. They know that we remain the clean shirt in an industry where retreating counterparties is the norm. It is interesting and perhaps coincidental, that we're experiencing another bout of market volatility after a few weeks have come. Over the past few weeks, another regional banking crisis driven by U.S. CRE debt appears to be rearing its ugly head from New York to Tokyo to Germany.
We are currently staring at approximately $16 billion senior housing loans maturing in the next 24 months in the U.S. which dwarfs roughly about a couple of billion dollars of agency financing completed in 2023. This should generate significant equity as well as private credit opportunity for us. Suffice to say, our near-term capital deployment pipeline remains robust, highly visible and actionable and squarely within our circle of competence, which -- where we can bet with house odds rather than gambler's odds. Along with what we have already done in 2023, these acquisitions that carry an attractive basis, operational upside and significant value add from Welltower's operating platform we have -- we will have a meaningful impact on what remains a true North Star[phonetic], long-term compounding of part share value of our existing shareholders.
With that, I will hand the call over to John. John?
