Delivering $0.73 of normalized FFO per share, which is in the upper half of our guidance range.
Demonstrating powerful demand, our U.S. same-store SHOP portfolio has increased occupancy 750 basis points since mid March 2021, lifting the entire same-store SHOP portfolio nearly 600 basis points during the same period.
Turning to capital allocation, we have been highly active with $3.7 billion of investments announced or closed year-to-date.
We've completed $2.5 billion in independent living investments, including our accretive acquisition of New Senior's hundred plus independent living communities at an attractive valuation well below replacement costs and a six community Canadian Senior Living portfolio with one of the New Senior operators, Hawthorne.
In medical office we've completed or announced $300 million of investments.
Second, by acquiring our partner PMB's interest in this Sutter Van Ness Trophy MOB in downtown San Francisco, we now own a 100% of this asset at a 6% yield.
With 92% of the MOB already leased, we intend to capture additional NOI growth and value.
Finally, we intend to expand our relationship with Ardent Healthcare by acquiring 18 of their 100% leased medical office buildings for $200 million by year-end.
On our third capital allocation priority, we are delighted to announce that we have commenced development of a 1 million square foot life science project anchored by Premier Research University, UC Davis with our exclusive partner Wexford.
Purpose-built for clinical research, this project will be 60% pre-leased to UC Davis, and total project cost are expected to be $0.5 billion.
In fact, we've now reviewed more deal volume this year than we saw in all of 2019, over $40 billion and we continue to pursue those that meet our multi-factor investment framework.
These strong capital flows are also supporting our intention to recycle $1 billion of capital this year to enhance both our balance sheet and our portfolio.
Moving on to third quarter performance; in SHOP, leading indicators continue to trend favorably during the quarter as leads and move-ins each surpassed a 100% of 2019 levels while move-outs remain steady.
In the third quarter, average occupancy grew by 230 basis points over the second quarter, led by the U.S. with growth of 290 basis points and a 110 basis points in Canada, which is over 93% occupied.
Turning to SHOP operating results, same-store revenue in the third quarter increased sequentially by $13.6 million or 3.1% driven by strong occupancy growth and slight rate growth.
Regarding rate growth, our operators have proposed rent increases to the residents of 8% in the U.S. and 4% in Canada, which on a blended basis is approximately 200 basis points higher than the historical levels.
Operating expenses increased sequentially by $16.7 million or 5.4% of which approximately half is due to overtime and agency costs.
For the sequential same-store pool SHOP generated $106.7 million of NOI in the third quarter, which represents a sequential decrease of $3.7 million or 3.4%.
The portfolio consists of 103 independent living communities located in attractive markets with favorable demand characteristics.
Its third quarter spot occupancy grew 110 basis points sequentially.
The same-store pool, which excludes the 33 communities that transitioned to new operators this year, grew 180 basis points in the third quarter and then another 10 basis points in October, marking occupancy growth in six out of the past seven months.
These acquisitions expand our independent living exposure to 59% of NOI on a stabilized basis.
This is in combination with our existing portfolio positions us well to capture demographic demand with the 80-plus population expected to grow over 17% over the next five years, while facing less new supply versus historical levels.
I'd also like to note our previously announced transition of 90 assisted living and Memory Care communities is off to a solid start as 65 communities have already transitioned and the rest are planned by year-end.
Ventas has 37 operator relationships including seven of the top 10 largest operators in the sector and 8 new relationships added this year.
These businesses taken together increased same-store NOI by 4.2% year-over-year and increased 1.2% sequentially on an adjusted basis.
MOB NOI grew 3.2% year-over-year and R&I increased 7.1%.
MOB occupancy is up 130 basis points year-to-date.
Same-store MOB occupancy of 91.3% is at its highest point since the first quarter of 2018.
MOB tenant retention was 91% in the third quarter and MOB new leasing increased 43% versus prior year.
R&I occupancy remains outstanding at 94.4% and improved 50 basis points sequentially due to exciting demand for lab space.
MOB expenses increased less than 1% year-on-year as a result of completed energy conservation projects and sourcing initiatives.
At the enterprise level, we delivered $0.73 of FFO per share in the third quarter.
This result is at the higher end of our $0.70 to $0.74 guidance range and benefited from the stable performance of our diversified portfolio as well as a $0.04 Ardent bond prepayment fee that was included in our guidance.
Consistent with our prior $1 billion disposition guidance, we now have $875 million of disposition proceeds in the bank with $170 million of senior housing and MOB portfolios under contract and expected to close in the fourth quarter.
These dispositions have enhanced and reshaped our portfolio and we view these proceeds to reduce $1.1 billion of near-term debt so far this year.
We also issued $1.4 billion of equity in the third quarter including $800 million for New Senior and $600 million in ATM issuance at $58 a share.
As a result, our net-debt-to-EBITDA ratio, excluding New Senior improved sequentially to 6.9 times, while including New Senior Q3 leverage was better than forecast at 7.2 times.
Turning to Q4 guidance, we expect fourth quarter net income will range from a $0.01 to $0.05 per fully diluted share.
Q4 normalized FFO is expected to range from $0.67 to $0.71 per share.
Starting with our SHOP same-store expectations, SHOP Q4 average occupancy is forecast to increase between 80 basis points and 120 basis points versus the Q3 average growing ahead of pre-pandemic levels while following seasonal trends.
At the guidance midpoint spot occupancy, September 30 to December the 31 is expected to be approximately flat.
No HHS grants are assumed to be received in the fourth quarter though our license assisted living communities have applied for qualified grants under Phase 4 of the Provider Relief Fund for COVID losses incurred at the communities.
We expect to receive an M&A fee in Q4 of $0.03 for the announced Kindred sale, which Kindred communicated is expected to be completed in the fourth quarter subject to customary closing conditions.
We continue to expect a $1 billion in asset sales and loan repayments for the full year 2021 at a blended yield in the high fives.
And our fully diluted share count is now 403 million shares reflecting the equity raised today.

Summary:
Delivering $0.73 of normalized FFO per share, which is in the upper half of our guidance range.
At the enterprise level, we delivered $0.73 of FFO per share in the third quarter.
Q4 normalized FFO is expected to range from $0.67 to $0.71 per share.