Medical Properties Trust Q1 2025 Earnings Call Transcript

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Provided by Quartr
May 1, 2025
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Operator

Thank you for standing by. My name is Bailey, and I will be your conference operator today. At this time, I would like to welcome everyone to the Medical Properties Trust First Quarter twenty twenty five Earnings Conference Call. All lines have been placed on mute to prevent any background noise during this sixty minute call. After the speakers' remarks, there will be a question and answer session.

Operator

Thank you. I would now like to turn the call over to Charles Lambert, Senior Vice President. Please go ahead.

Charles Lambert
Charles Lambert
Senior Vice President, Finance and Treasurer at Medical Properties Trust

Good morning, and welcome to the Medical Properties Trust conference call to discuss our first quarter twenty twenty five financial results. With me today are Edward K. Aldag, Jr, Chairman, President and Chief Executive Officer of the company Stephen Hamner, Executive Vice President and Chief Financial Officer Kevin Hannah, Senior Vice President, Controller and Chief Accounting Officer Rosa Hooper, Senior Vice President of Operations and Secretary and Jason Fry, Managing Director Asset Management and Underwriting. Our press release was distributed this morning and furnished on Form eight ks with the Securities and Exchange Commission. If you did not receive a copy, it is available on our website at medicalpropertiestrust.com in the Investor Relations section.

Charles Lambert
Charles Lambert
Senior Vice President, Finance and Treasurer at Medical Properties Trust

Additionally, we're hosting a live webcast of today's call, which you can access in that same During the course of this call, we will make projections and certain other statements that may be considered forward looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our financial results and future events to differ materially from those expressed in or underlying such forward looking statements. We refer you to the company's reports filed with the Securities and Exchange Commission for a discussion of the factors that could cause the company's actual results or future events to differ materially from those expressed in this call. The information being provided today is as of this date only, and except as required by the federal securities laws, the company does not undertake a duty to update any such information. In addition, during the course of the conference call, we will describe certain non GAAP financial measures, which should be considered in addition to and not in lieu of comparable GAAP financial measures.

Charles Lambert
Charles Lambert
Senior Vice President, Finance and Treasurer at Medical Properties Trust

Please note that in our press release Medical Properties Trust has reconciled all non GAAP financial measures to the most directly comparable GAAP measures in accordance with Reg G requirements. You can also refer to our website at medicalpropertiestrust.com for the most directly comparable financial measures and related reconciliations. I will now turn the call over to our Chief Executive Officer, Ed Aldag.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Thank you, Charles, and

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

thanks to all of you for joining us this morning on our first quarter twenty twenty five earnings call. I'm pleased to be joined again today by Steve, Kevin, Rosa and Jason. Before you hear from the rest of the team, I'll spend a few minutes discussing the state of the market and a few recent strategic updates. Beginning with the broader market environment, it's important to note that despite all of the noise surrounding the macro economy, health care has historically proven to be one of the most recession resistant industries. Across our portfolio, operators continue to report strong results with increasing volumes and steady coverage.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Further, any concerns surrounding the impacts of tariffs or proposed funding changes only serve to reinforce the importance of MPT's business model. When hospitals need access to affordable capital solutions that enhance their financial flexibility and operational agility, that's where we come in. We empower operators to replace the expensive debt solutions, immediately unlock 100% of the value of their real estate, and redirect those funds into patient care. And we are confident in our ability to continue playing that role in this critical economic environment. Turning to a few updates from quarter.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

In February, we issued more than $2,500,000,000 of seven year secured bonds at a blended coupon rate of approximately 7.8%, strengthening our balance sheet and providing sufficient liquidity to cover all debt maturities through 2026. As Rosa will discuss in more detail shortly, our new portfolio of tenants continues to ramp operations at facilities around the country. Broadly speaking, we remain highly encouraged by the volume improvements being reported across these locations as well as the steps these new operators are taking to upgrade facilities. And importantly, all new operators, except for Insight who owed less than $100,000 were current on rent through the first quarter. In Ohio, Insight Health had been making considerable progress turning around performance at two facilities in Trumbull County.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

However, those efforts were interrupted by disputes between Steward HealthCare's advisors and Insight regarding the distribution of cash collections from insight's revenue under the terms of the transition services agreement. We're working with insight and government officials to explore all viable solutions to restore full operations at these facilities as soon as possible. A word briefly on Prospect before turning it over to Rosa. In line with the terms of our global settlement agreement with Prospect and its other creditors that the bankruptcy court approved in March, Prospect and its advisors are in the process of marketing the Prospect assets. With the progress that our new operators are making across most markets, the steady contributions from our stabilized portfolio, we remain confident in our ability to reach total annualized cash rent of more than $1,000,000,000 once our new tenants are fully ramped.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

As we continue with this progress, we look forward to opportunities for accretive growth and increasing shareholders' return. Rosa?

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

Thank you, Ed. Turning now to some of the highlights across our portfolio. Overall, operator trends remain largely consistent with our observations over the past few quarters. As publicly traded operators have recently reported, in the first quarter of twenty twenty five, hospitals have produced strong revenues driven by reimbursement rate increases and admission trends. Within our portfolio, we continue to see strong growth in admissions and rate improvements.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

And on a trailing twelve month basis, we saw an uptick in year over year EBITDARM coverage across asset types, driven by improved volumes and strategic expense management. I'll begin with the new tenants in our transitional portfolio with cash rents ramping through the fourth quarter of twenty twenty six. HSA, which operates eight hospitals in South Florida, Texas, and Louisiana, commenced rent payments as scheduled in March. Performance has trended up, particularly in South Florida, driven by top line growth on higher volumes. In Louisiana and Texas, HSA remains focused on expanding inpatient capacity, reengaging key physicians, and improving operational efficiency.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

HonorHealth, which operates in the Phoenix Metro Area, remains engaged in enhancing physician alignment in the market and upgrading facilities ahead of anticipated volume recovery. Honor is executing a CapEx strategy for 2025 that includes $60,000,000 of self funded improvements spread across its new facilities. Forum Health, which operates two facilities in West Texas, has committed to recruiting physicians and staff to recapture volumes, ramping up new service lines, and upgrading facilities. In March, Quorum also finalized an agreement to assume ownership of Steward's remaining IT and revenue cycle transition service agreements. College Health is operating one MPT behavioral health facility in Phoenix.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

They have been ramping up capacity at the facility and now have a license for a 27 beds. With 30 beds open so far, they are actively adding beds on a regular basis and expect to be at full capacity within the next few months. Finally, Tenner Health took over operations at Sharon Regional in Pennsylvania and reopened the facility in March. Tenner is now expecting an eighteen executing an eighteen month plan to fully stabilize the facility and to facilitate this plan, recently secured new financing from a local community entity. Turning now to our more established portfolio of operators and beginning with Europe.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

In The UK, Three of the operators in MPT's portfolio have been nominated for Health Investors Private Hospital Group of the Circle Health, Priory, and Ramsay. Circle Health continues to benefit from increased private medical insurance utilization. To capitalize on these market tailwinds, Circle is investing in innovative technologies such as robotics and AI, And Circle continues to report strong performance driven by increasing surgical volumes and patient acuity as more complex cases are being addressed in the private sector. The need for mental health care services has never been greater within The UK, and Priory, the largest independent mental health care provider in The UK, has maintained steady performance based on strong reimbursement trends and increased patient acuity. Turning to Priory's parent company Median, these German assets have performed well through Q4 twenty twenty four.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

This solid performance is largely attributable to an improving reimbursement rate environment and increasing occupancy trends. Swiss Medical's performance has benefited from a combination of continued cost optimization efforts and top line growth, driving high single digit EBITDAR growth. With the planned integration of recent acquisitions, Swiss Medical's consolidated revenues are expected to increase by approximately CHF 100,000,000 in 2025. And in January 2025, Swiss Medical continued to grow its integrated care model with the addition of a second care region with 10 medical centers. In April, MPT invested approximately 50,000,000 Swiss francs in the InfraCore joint venture in Switzerland to facilitate the platform's acquisition of a strategically valuable general acute facility.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

Turning to The U. S, Ernest Health's consolidated EBITDARM coverage remains excellent at 2.1 times. Ernest legacy IRFs are performing very well and newer IRF developments are moving closer to fully ramped capacity. Given the success of its first inpatient rehab unit at the Provo LTAC, Ernest is pursuing plans to open two more inpatient rehab units at the Post Falls and Billings LTACs in 2025. LifePoint Health continues to report strong top line revenue growth driven by increased admissions, particularly at Conemaugh Memorial, where trailing twelve month admissions increased 17% year over year.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

LifePoint Behavioral reported another quarter of consistent operating performance with higher admissions growth year over year. In 2025, LifePoint Behavioral will remain focused on increasing outpatient volumes to drive increased revenues. Finally, MPT owns three hospitals operated by surgery partners. These facilities have performed exceptionally well with combined coverage greater than seven times. In closing, MPT is clearly well positioned to benefit from enhanced cash flows across a better diversified portfolio than ever before.

Rosa Hooper
Rosa Hooper
Senior VP of Operations & Secretary at Medical Properties Trust

With our stabilized portfolio producing steady or improving performance and our transitional portfolio ramping as expected, we are confident in our ability to create value for shareholders moving forward. Kevin?

Kevin Hanna
Kevin Hanna
SVP, Controller & CAO at Medical Properties Trust

Thank you, Rosa. This morning, we reported a GAAP net loss of $0.20 per share and normalized FFO of positive $0.14 per share for the first quarter of twenty twenty five. It is worth pointing out that first quarter net loss and normalized FFO when compared to the fourth quarter of twenty twenty four were affected by the partial quarter impact of our February debt refinancing transactions. The normalization of cash rent payments from a small tenant who made a one time catch up payment of $10,000,000 in the fourth quarter and higher stock compensation expense. We expect the second quarter normalized FFO will be reduced by an additional approximately $02 per share due to the full previously projected quarterly impact of higher interest expense resulting from our refinancing transactions.

Kevin Hanna
Kevin Hanna
SVP, Controller & CAO at Medical Properties Trust

The increased stock compensation expense results from a change in the fair market value of 2024 performance based equity compensation, of which no shares have invested. In fact, none of these shares will ever vest unless the market price of our stock exceeds $7 for twenty consecutive days. During the quarter, we recorded approximately $73,000,000 in impairments and fair market value adjustments to our investments in Prospect, real estate in Connecticut and in PHP. These adjustments were made according to third party appraisals and approved restructuring terms. Actual recoveries may ultimately differ from these book values.

Kevin Hanna
Kevin Hanna
SVP, Controller & CAO at Medical Properties Trust

Further, we impaired our mortgage investments in Colombia by approximately $11,000,000 as the government continues to limit reimbursement to hospitals. Normalized FFO was also adjusted for an approximate $12,000,000 negative fair value adjustment related to marketable securities such as our investment in EVIS. With that, I will now hand the call over to Steve.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Thank you, Kevin. I would just make a couple of brief comments that basically reiterate our near term perspective. I'll not go through the details of the February secured notes offerings except to point out again that it was a significant culmination of two years of carefully executed transactions designed to reduce debt, extend maturities, and provide liquidity, all at market valuations that demonstrate the resilience of well underwritten hospital real estate and the long term sustainability of our business model of net leased hospital real estate. But I will describe one detail of this refi. At quarter end, we thought it prudent to build some additional cushion for the covenant that measures our ratio of unencumbered assets to unsecured debt.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

At that time, we had not completed our evaluation of the need for impairments as of the quarter end and we wanted this cushion in an abundance of caution. Drawing cash on a secured revolver has the effect of increasing that cushion. The amounts we borrowed on March 31 were fully repaid on April 1. We remain and expect to remain within all covenants required by the secured and unsecured notes and the revolving credit facility. So our focus is on our existing portfolio of hospital real estate that continues to perform in accordance with lease terms, including annual inflationary escalations.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

And over the remaining three quarters of twenty twenty five, cash rents solely from the former Steward facilities are scheduled to increase from the $4,000,000 received in this first quarter to more than $23,000,000 in the fourth. That's more than $90,000,000 annualized. And investors can make their own estimates of an appropriate equity capitalization rate for that incremental revenue. And that incremental revenue is scheduled to continue growing to total contractual annual cash rents of $160,000,000 from these hospitals by October 2026. The first quarter results, of course, include no revenue or other proceeds from any prospect assets or from certain of our Colombian real estate assets, which have a book value of about $112,000,000 Any such revenue or proceeds will of course be available to further add to our operating and balance sheet strength.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

We're not in a position to predict these outcomes today, but it is important that with the balance sheet repositioning we have completed over the last couple of years, we have multiple options to continue to use the demonstrated value of our performing assets for further delevering and repositioning as we may decide. As we previously described, those options still include resolution of the prospect assets through sales and retenanting, possible other asset sales, joint ventures and other transactions to reposition rationalize our equity value. And with our current level of near term maturities and liquidity, we have the freedom to be patient, while even if we assume no external growth, our expected cash earnings escalate annually and we can hope macroeconomic conditions stabilize. Lastly, as Ed emphasized, we are pleased with the operational performance that our new operators are achieving. This performance, along with the very public and widespread support of local, state, and federal government officials and healthcare advocates, yet again demonstrates the importance of and the demand for these infrastructure like hospital assets.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Because our underwriting is designed to identify hospitals that we believe are critically necessary to their communities, this performance and public support is what we expected. And from a financial perspective, MPT as landlord has gone above and beyond to demonstrate our long term commitment to keeping these hospitals open. We have invested in the facilities, we have made working capital loans to facilitate the steward transition, and we have agreed to lengthy periods where rent payments are not required. Along with our own efforts, the new operators are devoting time, effort, resources and their own finances to serve patients across many spectrums of care. And we can point to government officials and representatives in Ohio and Pennsylvania who we see working out a public view on behalf of patients and employees in their own and even other jurisdictions.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

All of that is why we remain firm in our belief that these hospitals need to and will stay operating in their communities. And this is what we expected. What we did not expect and what is virtually inexplicable to us are the apparent roadblocks in front of these efforts to keep the hospitals open and operating. The managers of the Steward bankruptcy process, for example, have paid professional fees now approaching $400,000,000 They are collecting from Medicare, Medicaid, state reimbursement programs, and commercial insurers amounts for medical, surgical, and other treatment services that the new operators are providing to patients. Our tenant in two Ohio hospitals believes it is owed more than $20,000,000 that has been collected by the bankrupt estate but not remitted to the operator.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Most recently, another of the replacement operators was notified that the bankrupt estate is seeking to retain $55,000,000 in Florida Medicaid supplemental funds that would not have been paid had not the new operator contributed approximately $30,000,000 to the program in late December. These disputes are all apparently subject to defense by the professionals managing the Steward bankruptcy and they are being addressed in bankruptcy court. Our point is that these new operators are diligently treating patients even though substantial payments for these services are being withheld from them. Thankfully, we believe these operators will soon be able to bill and collect for themselves. Meanwhile, MPT has continued to cooperate with and support these local communities, including financially, while the Steward transition process finally unwinds.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

For example, during the first quarter, in order to accelerate this unwinding process, we agreed to repurchase certain real estate interest we had previously exchanged for value with a secured creditor. Along with funding another small operator obligation, this aggregates about $40,000,000 We're actually happy to have these assets back because we believe we will get much more value out of them than the secured lender could have. And with that, I will turn the call back to Bailey to queue any questions.

Operator

Your first question comes from the line of Michael Carroll with RBC Capital Markets. Please go ahead.

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

Steve, I wanted to follow-up on your, I guess, prepared remarks, your last two comments. Do you think that there is risk to the Steward transitioned assets, those new operators and being able to have the ramp up versus what you expect, given your comments regarding the issues within the Steward bankruptcy process and then not being able to collect the payments that are potentially owed to them?

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

No. I don't think so for a couple of reasons. Number one, I pointed out the Ohio situation and I think we'd already described that that's very limited in any case. It's a $100,000 that went uncollected. That's all that went uncollected in the quarter.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

And and my point really was what was that these operators are doing as well as they are in the face of, you know, the the the disruption and not being able to collect what what they're actually billing. We we are hopeful that the transition will be fully moved away from Steward, and and it already is for some of the operators. But we think that will be complete in the very near future and this issue will resolve going forward.

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

Okay. And then can you talk about the $40,000,000 investment? Was that made during the quarter? What type of asset did you get back from that? And are you getting rent on that asset now?

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

And or do you plan on selling that asset in the near term?

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

We did do it during the quarter. Those assets represent assets that were originally part of Steward campuses. For example, just as an example, big piece of it is a parking lot. And the parking lot was not necessary for the hospital operations other than than to have contractual access to parking, which the hospital did. The secured creditor to which we transferred rights to it well over a year ago was unable to market it and and monetize it really because it was still connected to and part of the hospital.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

And so we were very happy to be able to get that back, and frankly, we got it back at at a significant discount to what the original transaction was. And it will remain part of and could be monetized as part of the hospital. That's a typical example.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

The vast majority of those, Mike, we will collect rent on.

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

Okay. And then just last for me, were there any other investments that occurred in the quarter? I didn't see the supplemental section that highlighted your investments in the sup this time around. And your debt seemed a little bit higher than what I would have expected. So is there any other cash outflows that we should be aware of that kind of explain some of that?

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

We made a relatively modest investment in an additional hospital in Switzerland with, InfraCore.

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

Okay. So just those just that 40,000,000 deal on the Infracore deal?

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Yeah. And and and as part of the transition very early in the quarter, I think very early in January, we did add to the Florida operator working capital loan to the extent of $10,000,000

Michael Carroll
Michael Carroll
Managing Director & Head of US Real Estate Research at RBC Capital Markets

Okay. Thank you.

Operator

Your next question comes from the line of Georgie Dinkov with Mizuho Securities. Please go ahead.

Georgi Dinkov
Senior Equity Research Associate at Mizuho Securities

Hi. This is Georgie on for Vikram. Can you just talk sort of what are you monitoring on the regulatory side and any potential Medicaid cuts? Like, what are your expectations in scenario where you see some severe budget cuts?

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Georgie, if you listened to our last earnings call, we welcomed some of those Medicare cuts. As you know, Medicare doesn't just cover reimbursement to hospitals. It's a very broad basket of items that we believe would be better served if it went to hospitals. So we, at this point, don't have any of our tenants that are nervous about any potential changes to Medicare or Medicaid.

Georgi Dinkov
Senior Equity Research Associate at Mizuho Securities

Okay. And if I may squeeze a second question, have you do you expect to provide any loans, to any of the operators? And do you currently have any tenants on your watch list that you're closely monitoring?

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

So we don't expect to make any loans. We we don't have any situation where we think that that would come up, and we currently don't have any operators on our watch list.

Georgi Dinkov
Senior Equity Research Associate at Mizuho Securities

Great. Thank you for taking my question.

Operator

Your next question comes from the line of John Kielakowski with Wells Fargo. Your line is open.

John Kilichowski
John Kilichowski
Vice President - Equity Research Analyst at Wells Fargo

Good morning. Thank you. My question is just on two operators. You mentioned no operators on the watch list, but I know that there were there were a couple situations we were watching. There was an operator in Colombia dealing with some government holding back of reimbursement, and then there was another one that was 1% of assets that you had gotten 10,000,000 for last quarter, but I think that was a onetime chunk.

John Kilichowski
John Kilichowski
Vice President - Equity Research Analyst at Wells Fargo

Could you give some color on how those processes are going?

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

So the 1% tenant, the $10,000,000 was a catch up in rent. They remain current on the rent schedule now. I actually spoke to the CEO of that operator yesterday, and they had their best quarter in a long time. So they believe they're very much on track. We believe their operations are back where they should be.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

From Columbia's standpoint, the hospitals in all of Columbia continue to perform well. There is a political fight trying to get some health care reforms by the current president. And he's using the reimbursement to their system as a way to help pressure the politicians there to go along with his reforms. We are not concerned about the long term viability. We obviously are concerned about when they'll start getting full reimbursement from the government, but we think it's just a matter of time, not a matter of if.

John Kilichowski
John Kilichowski
Vice President - Equity Research Analyst at Wells Fargo

Okay. Thank you. And then maybe just on Prospect following the court approval. How do you expect that process to go, I guess, as far as timing is concerned?

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

So it's a little bit different or a lot different, I should say, than the Steward process went. We and Prospect and the other creditors reached an agreement early in this process. We expect that we'll have the potential new tenants in the hospitals late identified late May, early June, and then closing as soon as regulatory can happen after that.

John Kilichowski
John Kilichowski
Vice President - Equity Research Analyst at Wells Fargo

Alright. Thank you.

Operator

Your next question comes from the line of Omotayo Okusana with Deutsche Bank. Your line is open.

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

Hi. Yes. Good morning, everyone. First of all, just a shout out to Rosa. I'm always impressed with all the details she gives in the operational overview.

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

I I always find that very helpful.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Thanks,

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

In terms of the cash ramp up for the transitional tenant, could you just give us an an overview of how exactly that works in terms of the is the arrangement that they they transfer kind of all the excess cash flow to kind of ramp up to that 40,000,000 a quarter? Is there some type of set math of, you know, based on how much they earned that quarter, how much they have to kind of pay you? Just trying to understand how that works.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Yeah, Tayo, it's actually a percentage of the rent not based on revenue or on their income. For example, at beginning. And each lease is slightly different. They go from 25 to 50 to 75 into 100. And by the time that we get to 100% is In the quarter of twenty quarter twenty six.

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

Gotcha. Okay. So that's helpful. And then in terms of, again, at March 31, the drawdown on the line to kind of make sure you guys were okay with the covenant, Just curious now that you've kind of, you know, you've kind of settled in with the with the write downs, you know, associated with prospects. Is that something you would expect to occur again on a on a you know, at the end of a quarter?

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

Or now that you kind of solidified what your write down numbers are, you you kind of have much more sense of what your coverage is and and you may not have to do that going forward?

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Well, in retrospect, Talia, we didn't have to do it even at the end of the quarter. Had had we not made that drawdown, we still had sufficient comfortable cushion even had we not done it. The reason we did it, as I said in my remarks, was because we were still working on the impairment calculations. And as it turned out, as I say, we plenty of room even had we not done that. Kind of to answer your question going forward, it's available to us.

Steven Hamner
Steven Hamner
EVP and CFO at Medical Properties Trust

Banks are perfectly satisfied with it. It was the plan all along that this would give us, you know, that type of cushion should should we need it. But there's there's there's no expectation as we sit here today that we will or or will not need it. You know, it depends on on a number of things, frankly.

Omotayo Okusanya
Omotayo Okusanya
Managing Director at Deutsche Bank

That's helpful. Thank you.

Operator

Thank you. And I will now turn the call back over to Ed Aldag for closing remarks.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Hey, Lee. Thank you very much. I I do have an unplanned comment I'd like to make. Over the last year of walking through the Stewart bankruptcy, I've reflected on the different reactions and actions of the many different people involved. The bankruptcy process itself was obviously very painful.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Those controlling the process didn't always have as their number one priority the patients or the communities. Some politicians used this as an opportunity to further their own political agendas as opposed to finding ways that we could all work together for the best outcome of each community affected. Steve has commented on the more than 100,000,000 that MPT has put in voluntarily to help keep these hospitals open, but we haven't been alone in our fight to save these hospitals. And at the risk of inadvertently leaving someone out, let me do my best to call out some of the real heroes by name and some of those that I don't know their names. Let me start with Judge Marvin Isker and Judge Lopez the bankruptcy court in Houston.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

They recognized that the process that was in place to find replacement operators for Stewart Hospitals wasn't working. And in August of last year, Judge Isger invited me to Houston to look for solution. He worked tirelessly to give MPT the opportunity to retenant these hospitals. He and we obviously didn't have much time starting in early September. He literally worked twenty four hours a day to find a solution that Judge Lopez could approve.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

And then he worked with the parties for months to implement those solutions. But without Judge Iskur and Judge Lopez, none of this would have been possible. I got to know Judge Iskur well over a five month period of time. He's an outstanding person and a terrific mediator and we appreciate all that he did for the people in all of the communities to ensure that these hospitals stayed open. In Pennsylvania, I worked night and day with Judge Iskur and Deputy Attorney General Jim Donahue to find solutions in Sharon, Pennsylvania.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Jim and Judge Iskard and I spent many hours late into the night in the holidays working to do what we could for Sharon. State Senator Michelle Brooks reached out to me to find ways that we could work together to find funding for the hospital there in Sharon. I can tell you her commitment to that community is truly second to none, and her willingness to work with MPT was very much appreciated. In Ohio, I've gotten to know US Senator Bernie Marino. Senator Marino reached out to me to work with MPT to find solutions for the two facilities there.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

Senator Marino has been a breath of fresh air and a real pleasure to work with, and we both are working very hard to keep these two hospitals in Ohio open. In Florida, Texas, Arizona, and Arkansas, while I don't know the names of the state officials there, but without exception, the attorney general offices, the departments of health, and others have truly been can do people. People who jump through hoops to work with us and judge Iskur to ensure their community hospitals stayed open. They offered help at every turn, not roadblocks. And I'm truly sorry I don't know their names to give them the credit they deserve.

Edward Aldag
Edward Aldag
Chairman, President & Chief Executive Officer at Medical Properties Trust

While there have been people with personal agendas in other states, people who haven't wanted to let a crisis pass without using it for their benefit, truly the vast majority of the people that I came in contact with during this whole process are the true unsung heroes, and it's been my honor to work with each and every one of them. We look forward to moving forward from this point. And again, we thank you all for being with us today. And if you have any additional questions, please don't hesitate to reach out to Tim and Drew. Thank you.

Operator

Ladies and gentlemen, that concludes today's call. Thank you for joining. You may now disconnect.

Executives
    • Charles Lambert
      Charles Lambert
      Senior Vice President, Finance and Treasurer
    • Edward Aldag
      Edward Aldag
      Chairman, President & Chief Executive Officer
    • Rosa Hooper
      Rosa Hooper
      Senior VP of Operations & Secretary
    • Kevin Hanna
      Kevin Hanna
      SVP, Controller & CAO
    • Steven Hamner
      Steven Hamner
      EVP and CFO
Analysts
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Key Takeaways

  • In February MPT issued $2.5 billion of seven-year secured bonds at a blended 7.8% coupon, bolstering liquidity to cover all debt maturities through 2026.
  • New transitional tenants are ramping operations on schedule, with annualized cash rent expected to exceed $1 billion once fully stabilized by late 2026.
  • The stabilized portfolio delivered improved volumes, rate increases, and year-over-year EBITDARM coverage growth across U.S. and European assets, driven by top-line revenue growth and strategic expense management.
  • First-quarter results included a GAAP net loss of $0.20 per share and normalized FFO of $0.14 per share. These were affected by higher interest expense, stock-based compensation and impairments/fair-value adjustments of nearly $100 million, with an additional ~$0.02/share FFO headwind expected in Q2.
  • Despite minor rent disputes under the Steward bankruptcy transition, MPT secured judicial and government backing to support new operators and keep all community hospitals open.
AI Generated. May Contain Errors.
Earnings Conference Call
Medical Properties Trust Q1 2025
00:00 / 00:00

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