0001524607--12-31假的Q3假的Q3--12-310001287865http://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#OtherAssetshttp://fasb.org/us-gaap/2024#MortgagesMemberhttp://fasb.org/us-gaap/2024#OtherComprehensiveIncomeLossCashFlowHedgeGainLossReclassificationAfterTax0001287865美國 GAAP: 額外付費無法成員2024-03-310001287865美國會計師範圍:外國會員2024-04-012024-06-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:圓環健康會員2024-01-012024-09-300001287865美國 GAAP: 資產總成員國家:CH美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:預計醫療控股公司成員美國 GAAP: 按揭成員2023-05-232023-05-230001287865強積金:零點九十九人三百分之一元安全筆記數二萬二十六成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-03-310001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:管理醫療系統 LLC會員2023-01-012023-12-310001287865美國 GAAP: 額外付費無法成員2023-06-300001287865強積金:五分五點工作人數一級安全筆記二千二十六名2024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 其他資產成員美國 GAAP: 客戶集中風險成員2023-01-012023-12-310001287865強積公司:無形資產成員2024-09-300001287865強積公司:首要醫療服務設施會員2024-01-012024-09-3000012878652022-12-310001287865美國 GAAP: 資產總成員MPW: 自由行動緊急照顧設施會員美國 GAAP: 客戶集中風險成員2024-09-300001287865美國 GAAP: 資產備份證券成員強積公司:管理醫療系統 LLC會員2023-08-172023-08-170001287865強積公司:MPTOP 合作夥伴關係 PPP 會員MPW: 共同單位成員2023-12-310001287865美國 GAAP: 資產總成員產品標準:TX美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-09-300001287865MPW: 管線健康系統成員2023-02-070001287865MPW: 電子支持會員2024-09-300001287865美國 GAAP: 資產總成員MPW: 行為健康設施會員美國 GAAP: 客戶集中風險成員2023-01-012023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-06-300001287865強積公司:澳大利亞行動會員2023-05-182023-05-180001287865強積分公司:貸款女子美國 GAAP: 可變利益單位不是主要受益成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-07-012023-09-300001287865強積公司:預計醫療控股公司成員強積公司:急行社會成員2019-08-012019-08-310001287865美國 GAAP: 資產總成員MPW: 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PPP 會員美國 GAAP: 累積其他全面收入會員2023-01-012023-03-310001287865強積金:保證期貸款兩萬三十四人國家:GB2024-05-242024-05-240001287865美國 GAAP: 建築成員2023-09-300001287865美國 GAAP: 公共股成員2023-06-300001287865美國 GAAP: 公共股成員2024-06-300001287865MPW: 自由行動緊急部門成員強積公司:安全委員會2024-08-142024-08-140001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 其他操作員成員2023-01-012023-12-310001287865強積公司:預計醫療控股公司成員STPR: CT2022-10-052022-10-050001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2022-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:圓環健康會員2023-01-012023-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:運營商成員的其他資產2024-09-300001287865MPW: 管理人利益會員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-06-300001287865強積金:信貸便利修訂委員2024-04-122024-04-120001287865強積金:定期貸款成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-07-012023-09-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:預計醫療控股公司成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員MPW: 行為健康設施會員美國 GAAP: 客戶集中風險成員2024-01-012024-09-300001287865強積公司:管理人貸款成員2023-12-310001287865美國 GAAP: 公共股成員2023-12-310001287865美國 GAAP: 累積其他全面收入會員2023-09-300001287865美國 GAAP: 保留權益成員2024-04-012024-06-300001287865美國 GAAP: 資產總成員產品代碼:AZ美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:管理醫療系統 LLC會員2024-07-012024-09-300001287865美國 GAAP: 非控制權益成員2024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:圓環健康會員2024-09-300001287865美國 GAAP: 資產總成員國家:美國美國 GAAP: 地理集中風險成員2024-09-300001287865強積金:歐元借貸成員2024-09-300001287865強積公司:共同精神成員2024-04-120001287865強積公司:一般急診醫院成員2023-02-072023-02-070001287865強積公司:預計醫療控股公司成員標準證書:PA2022-12-310001287865美國 GAAP: 累積其他全面收入會員2023-12-310001287865MPW: 麻薩諸塞州基督管會員2024-01-012024-09-300001287865美國 GAAP: 資產總成員標準證書:PA美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積分公司:尊貴健康會員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2024-06-3000012878652023-07-012023-09-300001287865美國 GAAP: 公共股成員2024-03-310001287865美國 GAAP: 資產總成員MPW: 全國成員美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:CareMax 聯合會員2024-09-300001287865強積公司:斯普林斯通健康會員2023-02-070001287865MPW: 艾維斯維多利亞議會2024-09-300001287865強積公司:伊美德醫院衛生設施會員國家:ES2024-01-012024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 美國醫療保健系統2023-01-012023-12-310001287865強積公司:行為健康醫院會員2024-01-012024-03-310001287865強積金:期貸款二千二十五年國家:GB2024-09-300001287865強積公司:共同精神成員2024-01-012024-09-300001287865MPW: 機構資產管理員成員2024-04-122024-04-120001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-04-012024-06-300001287865強積公司:管理員順序會員SRT: 最低成員2024-01-012024-03-310001287865美國 GAAP: 資產總成員產品代碼:加美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:共同精神成員2022-04-012022-06-300001287865強積金:股東貸款成員2024-09-300001287865強積公司:安全委員會MPW: 綜合醫院及自由護理緊急部門成員2024-08-142024-08-140001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-04-012024-06-300001287865美國 GAAP: 資產總成員強積分公司:後急工廠會員美國 GAAP: 客戶集中風險成員2024-09-300001287865強積公司:斯普林斯通健康會員美國 GAAP: 按揭成員2023-09-300001287865MPW: 管線健康系統成員2024-09-300001287865MPW: 電子支持會員強積分公司:招募委員2024-09-300001287865強積公司:房地產投資或合併房地產及其他聯合投資公司成員2023-09-300001287865MPW: 太空海岸屬性成員美國 GAAP: 後續事件成員2024-10-012024-10-010001287865強積公司:五點零羅澤羅澤工作人員工人數一級安全筆記二千二十七名成員2024-09-300001287865強積分公司:媒體醫學院會員2023-12-310001287865美國 GAAP: 資產總成員MPW: 行為健康設施會員美國 GAAP: 客戶集中風險成員2024-09-300001287865美國 GAAP: 公共股成員2024-04-012024-06-300001287865強積金:零點九十九人三百分之一元安全筆記數二萬二十六成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-03-3100012878652024-03-310001287865美國 GAAP: 資產總成員國家:CH美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員強積分公司:後急工廠會員美國 GAAP: 客戶集中風險成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-01-012023-03-310001287865國家:GB強積金:保證期貸款兩萬二十四成員2023-12-310001287865強積金:投資於未合併營運單位成員2023-09-300001287865美國 GAAP: 額外付費無法成員2023-03-310001287865強積金:五分五點工作人數一級安全筆記二千二十六名2023-12-310001287865美國 GAAP: 非控制權益成員2024-03-310001287865SRT: 南美洲孟加拉2024-09-300001287865MPW: 艾維斯維多利亞議會2023-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員2024-09-300001287865強積金:信貸便利修訂委員SRT: 最低成員2024-08-060001287865MPW: 亞斯普里斯兒童服務會員2024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:預計醫療控股公司成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:優先組成員2023-12-310001287865美國 GAAP: 公共股成員2024-07-012024-09-300001287865美國 GAAP: 建築成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2022-12-310001287865強積公司:預計醫療控股公司成員標準證書:PA2024-09-300001287865MPW: 瑞士醫療網絡會員2024-09-300001287865MPW: 電子支持會員強積分:積極百基點成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員STPR: 佛羅里達州美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 非控制權益成員2023-06-300001287865美國 GAAP: 資產總成員產品標準:TX美國 GAAP: 地理集中風險成員2024-09-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:管理醫療系統 LLC會員2024-09-300001287865美國 GAAP: 資產總成員產品代碼:AZ美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積公司:管理員順序會員強積分公司:國際聯合企業會員美國 GAAP: 股票證券成員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-09-3000012878652023-01-012023-09-300001287865美國 GAAP: 保留權益成員2024-07-012024-09-300001287865美國 GAAP: 公共股成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-01-012024-03-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-09-3000012878652023-04-012023-06-300001287865美國 GAAP: 資產總成員國家:ES美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 資產總成員MPW: 其他國際資產成員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積公司:全國成員美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2024-09-300001287865美國 GAAP: 資產總成員產品代碼:AZ美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:一般急診醫院成員2023-12-310001287865強積公司:春石英國國際聯合會員2024-01-012024-09-300001287865MPW: 保留活動會員2024-09-180001287865MPW: 新型冠狀病毒 19 疫情成員美國 GAAP: 其他非營運收入成本一月2023-01-012023-09-300001287865MPW: 生命點行為成員2023-12-310001287865美國 GAAP: 資產總成員產品代碼:加美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積公司:首要醫療服務會員2023-03-082023-03-080001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-06-300001287865美國 GAAP: 保留權益成員2023-04-012023-06-300001287865強積公司:優先組成員2024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員2024-09-300001287865強積分:三點六十九人二百元一級安全筆記二千二十八歲2024-09-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:優先組成員2023-01-012023-12-310001287865美國 GAAP: 保留權益成員2024-09-300001287865強積金:歐元借貸成員2023-12-310001287865MPW: 電子支持會員強積公司:預計醫療控股公司成員美國 GAAP: 按揭成員2023-05-232023-05-230001287865美國 GAAP: 資產總成員強積金:其他國內資產成員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-01-012024-09-300001287865美國 GAAP: 資產總成員產品標準:TX美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 非控制權益成員2024-04-012024-06-300001287865強積分:四分六二五百分之二零一五百分之一百分之一2024-09-300001287865美國高級協會:租賃在位置成員獲得2024-01-012024-09-300001287865強積金:貸款及資產投資成員美國 GAAP: 可變利益單位不是主要受益成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2022-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 美國醫療保健系統2023-12-310001287865強積金:股東貸款成員2023-12-310001287865強積公司:管理員2024-09-300001287865美國 GAAP: 額外付費無法成員2023-12-310001287865美國 GAAP: 其他非營運收入成本一月2024-01-012024-03-310001287865美國 GAAP: 額外付費無法成員2023-01-012023-03-310001287865美國 GAAP: 其他非營運收入成本一月2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-03-310001287865美國 GAAP: 累積其他全面收入會員2023-06-300001287865國家:GB強積金:保證期貸款兩萬二十四成員2024-05-240001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-03-310001287865強積金:信貸便利修訂委員SRT: 最大會員數2024-08-060001287865強積公司:預計醫療控股公司成員SRT: 最大會員數2023-05-232023-05-230001287865強積金:定期貸款成員2023-12-310001287865MPW: 機構資產管理員成員2024-04-120001287865強積金:期貸款二千二十五年國家:GB強積金:成員期內修改的契約2024-08-062024-08-060001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-04-012023-06-300001287865美國 GAAP: 保留權益成員2023-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:一般急診醫院成員2024-01-012024-09-300001287865美國 GAAP: 保留權益成員2024-03-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 其他操作員成員2024-01-012024-09-3000012878652023-01-012023-03-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-12-310001287865美國 GAAP: 資產總成員國家:ES美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:全國成員美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-04-012024-06-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員國家:美國2024-01-012024-09-300001287865強積金:投資於未合併營運單位成員2024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 美國醫療保健系統2024-01-012024-09-300001287865強積金:保證期貸款兩萬三十四人國家:GB2024-05-240001287865MPW: 二點五點五個零人數一級安全筆記二千二十三歲2023-09-300001287865強積公司:管理醫療系統 LLC會員2023-11-032023-11-030001287865MPW: 屈臣氏維爾設施會員強積公司:帕賈羅瓦利醫療保健分公司會員2024-07-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-01-012024-03-310001287865美國 GAAP: 保留權益成員2023-12-310001287865國家:CO美國 GAAP: 公平價值評估重複成員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-09-300001287865強積公司:共同精神成員2023-12-310001287865美國 GAAP: 公共股成員2024-01-012024-03-310001287865強積公司:管理醫療系統 LLC會員2024-01-012024-09-300001287865強積公司:預計醫療控股公司成員2022-06-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:圓環健康會員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-09-300001287865美國 GAAP: 資產總成員MPW: 全國成員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 銷售收入會員強積公司:圓環健康會員美國 GAAP: 客戶集中風險成員2024-01-012024-09-300001287865美國 GAAP: 公共股成員2023-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:一般急診醫院成員2023-01-012023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-06-300001287865美國 GAAP: 資產總成員產品標準:TX美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-03-310001287865美國 GAAP: 出售集團不中止營運成員2024-01-012024-09-300001287865美國 GAAP: 額外付費無法成員2024-09-300001287865美國 GAAP: 資產總成員國家:ES美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865SRT: 歐洲成員2024-09-300001287865強積分公司:招募委員2024-01-012024-09-300001287865美國 GAAP: 循環信貸便利會員2023-12-310001287865國家:ES強積公司:伊美德醫院一廠會員2024-01-012024-09-300001287865美國 GAAP: 累積其他全面收入會員2023-07-012023-09-300001287865強積公司:一般急性工作會員國家:AU2023-03-292023-03-290001287865美國 GAAP: 非控制權益成員2023-01-012023-03-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-07-012024-09-300001287865美國 GAAP: 額外付費無法成員2022-12-310001287865強積分公司:媒體醫學院會員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-03-310001287865強積公司:共同精神成員MPW: 天主教健康計劃科羅拉議員2023-05-010001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-04-012023-06-300001287865強積金:三點三至五個百分之六百分之六千名成員2024-09-300001287865美國 GAAP: 資產總成員STPR: 佛羅里達州美國 GAAP: 地理集中風險成員2023-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 生命點行為成員2024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員國家:美國2023-12-310001287865強積公司:首要醫療服務設施會員2024-04-092024-04-090001287865國家:GB強積金:保證期貸款兩萬二十四成員2024-07-012024-09-300001287865強積金:股權激勵計劃成員2024-09-300001287865美國 GAAP: 銷售收入會員強積公司:圓環健康會員美國 GAAP: 客戶集中風險成員2024-07-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員國家:DE美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強權委員:安妮斯醫療會員2024-01-012024-09-300001287865美國 GAAP: 貸款成員2023-12-310001287865美國 GAAP: 非控制權益成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-06-300001287865強積公司:修改後的合約會員2024-08-062024-08-060001287865強積金:期貸款二千二十五年國家:GB2023-12-310001287865強積公司:行為健康醫院會員2023-04-012023-06-300001287865強積公司:澳大利亞事業會員2024-04-182024-04-180001287865美國 GAAP: 資產總成員MPW: 其他國際資產成員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積金:三點三至五個百分之六百分之六千名成員2023-12-310001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:預計醫療控股公司成員2023-12-310001287865美國 GAAP: 資產備份證券成員強積公司:管理醫療系統 LLC會員2023-09-300001287865MPW: 五個首要屬性成員2024-01-012024-09-300001287865MPW: 電子支持會員強積公司:預計醫療控股公司成員2023-03-310001287865強積公司:首要醫療服務設施會員SRT: 最低成員2024-04-092024-04-090001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-01-012023-09-300001287865美國 GAAP: 資產總成員MPW: 自由行動緊急照顧設施會員美國 GAAP: 客戶集中風險成員2024-01-012024-09-300001287865美國高級協會:租賃在位置成員獲得2024-07-012024-09-300001287865美國 GAAP: 公平價值評估重複成員強積金:股票方法投資及其他貸款成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-07-012024-09-300001287865強積分公司:聯合條款貸款成員2024-01-012024-03-310001287865MPW: 電子支持會員強積金:負數百基點成員2024-01-012024-09-300001287865美國 GAAP: 後續事件成員MPW: 保留活動會員2024-10-012024-10-010001287865MPW: 電子支持會員2023-12-310001287865強積公司:CareMax 聯合會員2023-12-310001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員2023-01-012023-12-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:管理醫療系統 LLC會員2023-12-310001287865強積公司:房地產投資或合併房地產及其他聯合投資公司成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-12-310001287865強積公司:管理員順序會員2024-01-012024-09-300001287865美國 GAAP: 資產總成員國家:CH美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員MPW: 全國成員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員強積分公司:後急工廠會員美國 GAAP: 客戶集中風險成員2023-01-012023-12-310001287865強積金:信貸便利修訂委員SRT: 最大會員數2024-04-120001287865美國 GAAP: 資產總成員產品代碼:加美國 GAAP: 地理集中風險成員2024-09-3000012878652024-01-012024-09-300001287865SRT: 最低成員2024-01-012024-09-300001287865MPW: 電子支持會員強積公司:運營商成員的其他資產2024-09-300001287865強積金:信貸便利修訂委員2024-08-060001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-04-012024-06-300001287865國家:ES強積公司:伊美德醫院一廠會員2024-09-300001287865強積公司:無形資產成員2023-09-300001287865MPW: 三點三個五百分之五百分之二十五百分之一年2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-03-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2023-12-310001287865強積公司:一般急性工作會員2024-01-012024-03-310001287865美國 GAAP: 資產總成員MPW: 其他國際資產成員美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:預計醫療控股公司成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-03-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2024-09-300001287865強積公司:伊美德醫院衛生設施會員國家:ES2024-09-300001287865美國高級協會:國家地域管理委員2023-09-300001287865美國 GAAP: 公平價值評估重複成員美國 GAAP: 按揭成員2023-12-310001287865強積公司:預計醫療控股公司成員標準證書:PASRT: 最大會員數2022-12-310001287865強積公司:預計醫療控股公司成員2019-08-012019-08-310001287865美國 GAAP: 資產總成員MPW: 全國成員美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 額外付費無法成員2024-01-012024-03-310001287865MPW: 其他租戶更新會員2024-07-012024-09-300001287865STPR: 佛羅里達州MPW: 太空海岸屬性成員強積公司:奧蘭多健康會員2024-09-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:優先組成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-09-300001287865美國 GAAP: 資產總成員國家:DE美國 GAAP: 地理集中風險成員2024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:運營商成員的其他資產2023-12-310001287865強積公司:管理醫療系統 LLC會員2024-09-300001287865美國 GAAP: 額外付費無法成員2023-04-012023-06-300001287865MPW: 亞斯普里斯兒童服務會員2023-12-310001287865強積公司:管理人貸款成員2024-09-300001287865強積公司:全國成員美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員2023-12-310001287865美國 GAAP: 循環信貸便利會員2024-09-300001287865美國 GAAP: 資產總成員美國會計師範圍:非美國會員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積金:保證期貸款兩萬三十四人國家:GB2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-07-012023-09-300001287865MPW: 綜合醫院及自由護理緊急部門成員2024-08-142024-08-140001287865強積公司:安全委員會2024-01-012024-09-300001287865強積金:定期貸款成員國家:AU2023-12-310001287865強積公司:管理醫療系統 LLC會員2024-09-180001287865國家:GB強積金:保證期貸款兩萬二十四成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2024-04-012024-06-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-04-012023-06-3000012878652024-06-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2024-01-012024-03-310001287865強積分公司:尊貴健康會員MPW: 亞利桑那一般醫院成員2024-07-232024-07-230001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2022-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-03-310001287865強積分公司:管理員團美國 GAAP: 銷售收入會員美國 GAAP: 客戶集中風險成員2023-01-012023-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員2023-01-012023-12-310001287865MPW: 政治醫學院議員2023-12-310001287865美國 GAAP: 累積其他全面收入會員2024-07-012024-09-3000012878652024-07-012024-09-300001287865STPR: 佛羅里達州MPW: 太空海岸屬性成員強積公司:奧蘭多健康會員2024-09-182024-09-180001287865MPW: 生命點行為成員2024-09-300001287865強積分公司:國際聯合企業會員2023-12-310001287865美國 GAAP: 資產總成員國家:GB美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:設施成員其他資產2023-12-310001287865強積公司:HM醫院會員2023-12-310001287865MPW: 綜合醫院及自由護理緊急部門成員2024-07-232024-07-230001287865美國 GAAP: 出售集團不中止營運成員2024-07-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-01-012023-03-310001287865MPW: 電子支持會員強積公司:預計醫療控股公司成員2023-05-232023-05-230001287865強積分:三點六十九人二百元一級安全筆記二千二十八歲2023-12-310001287865MPW: 電子支持會員2024-01-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:設施成員其他資產2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-09-300001287865強積金:信貸便利修訂委員SRT: 最低成員2024-04-120001287865美國 GAAP: 累積其他全面收入會員2024-01-012024-03-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 其他操作員成員2023-12-310001287865強積公司:HM醫院會員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-01-012023-03-310001287865美國 GAAP: 公共股成員2023-07-012023-09-300001287865強積公司:管理醫療系統 LLC會員2023-04-012023-06-300001287865美國 GAAP: 資產總成員美國會計師範圍:非美國會員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865美國 GAAP: 資產總成員國家:DE美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員STPR: 佛羅里達州美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865MPW: 電子支持會員2024-09-300001287865強積公司:管理醫療系統 LLC會員強積金:因資金利息而損失成員2024-01-012024-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 生命點行為成員2024-01-012024-09-300001287865強積分公司:國際聯合企業會員2024-09-300001287865MPW: 二點五點五個零人數一級安全筆記二千二十三歲2023-07-012023-09-300001287865美國 GAAP: 累積其他全面收入會員2023-03-310001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員2023-12-310001287865美國 GAAP: 資產總成員產品代碼:加美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積分:二點五個零點工作人數一級安全筆記二千二十六名成員2023-12-310001287865美國 GAAP: 額外付費無法成員2024-06-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2023-04-012023-06-300001287865強積金:以英鎊計價貸款成員2023-12-310001287865MPW: 管理人利益會員2024-09-300001287865MPW: 新型冠狀病毒 19 疫情成員美國 GAAP: 其他非營運收入成本一月2024-01-012024-09-300001287865美國 GAAP: 資產總成員標準證書:PA美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-07-012023-09-300001287865美國 GAAP: 資產總成員MPW: 自由行動緊急照顧設施會員美國 GAAP: 客戶集中風險成員2023-01-012023-12-310001287865強積公司:全球資產管理員會員2023-08-172023-08-170001287865強積公司:管理員順序會員2024-07-012024-09-300001287865美國 GAAP: 公共股成員2023-04-012023-06-300001287865MPW: 德克薩斯州馬薩諸塞州成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 累積其他全面收入會員2024-07-012024-09-300001287865美國 GAAP: 額外付費無法成員2023-09-300001287865美國 GAAP: 資產總成員產品代碼:AZ美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:全國成員美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2023-01-012023-12-310001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員強積公司:一般急診醫院成員2024-09-300001287865美國 GAAP: 貸款成員2024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員國家:美國2023-01-012023-12-310001287865美國 GAAP: 累積其他全面收入會員2023-01-012023-03-310001287865美國 GAAP: 累積其他全面收入會員2023-04-012023-06-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 其他操作員成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-07-012024-09-300001287865產品標準:TX美國 GAAP: 後續事件成員2024-10-182024-10-180001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員MPW: 生命點行為成員2023-01-012023-12-310001287865MPW: 瑞士醫療網絡會員2023-12-310001287865美國 GAAP: 額外付費無法成員2023-07-012023-09-300001287865美國 GAAP: 累積其他全面收入會員2024-03-310001287865美國 GAAP: 累積其他全面收入會員2024-04-012024-06-300001287865美國 GAAP: 資產總成員標準證書:PA美國 GAAP: 地理集中風險成員2024-09-300001287865國家:GB強積金:保證期貸款兩萬二十四成員2024-05-242024-05-2400012878652023-06-300001287865MPW: 管線健康系統成員2023-02-072023-02-070001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2022-12-310001287865美國 GAAP: 保留權益成員2023-01-012023-03-310001287865強積分公司:管理員團美國 GAAP: 銷售收入會員美國 GAAP: 客戶集中風險成員2023-07-012023-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員MPW: 共同單位成員2024-09-300001287865美國 GAAP: 非控制權益成員2023-09-300001287865強積公司:管理員2023-12-310001287865美國 GAAP: 資產總成員國家:CH美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:預計醫療控股公司成員2019-08-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-06-300001287865美國 GAAP: 非控制權益成員2023-07-012023-09-300001287865美國 GAAP: 保留權益成員2023-06-3000012878652024-11-080001287865美國 GAAP: 資產總成員美國 GAAP: 其他資產成員美國 GAAP: 客戶集中風險成員2024-01-012024-09-300001287865美國 GAAP: 出售集團不中止營運成員2023-07-012023-09-300001287865MPW: 電子支持會員強積分公司:招募委員2024-07-012024-09-300001287865SRT: 最大會員數2024-01-012024-09-300001287865強積公司:澳大利亞行動會員2023-01-012023-03-310001287865美國 GAAP: 保留權益成員2024-06-300001287865MPW: 自由行動緊急部門成員強積分公司:尊貴健康會員2024-07-232024-07-230001287865美國 GAAP: 資產總成員強積金:其他國內資產成員美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積公司:優先組成員2023-12-310001287865美國 GAAP: 資產總成員美國會計師範圍:非美國會員美國 GAAP: 地理集中風險成員2023-12-310001287865強積金:其他貸款成員2023-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-06-300001287865強積公司:預計醫療控股公司成員STPR: CT2022-10-050001287865美國 GAAP: 非控制權益成員2024-07-012024-09-300001287865MPW: 電子支持會員強積分公司:招募委員2024-01-012024-09-300001287865強積公司:行為健康醫院會員2023-04-142023-04-1400012878652024-09-300001287865MPW: 電子支持會員強積公司:預計醫療控股公司成員2023-01-012023-12-310001287865強積公司:預計醫療控股公司成員2023-05-232023-05-230001287865美國 GAAP: 公平價值投注 3 成員SRT: 加重平均成員美國 GAAP: 測量輸入折扣代表2024-09-300001287865MPW: 太空運輸設施會員2024-07-012024-09-300001287865美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2024-09-300001287865美國 GAAP: 保留權益成員2023-03-310001287865SRT: 最低成員2024-09-300001287865美國 GAAP: 後續事件成員強積公司:管理醫療系統 LLC會員2024-10-010001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-12-310001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:優先組成員2024-01-012024-09-300001287865強積金:信貸便利修訂委員2024-04-120001287865美國 GAAP: 資產總成員國家:GB美國 GAAP: 地理集中風險成員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2024-01-012024-03-310001287865強積金:期貸款二千二十五年國家:GB2024-05-242024-05-240001287865美國 GAAP: 累積其他全面收入會員2022-12-310001287865強積分公司:尊貴健康會員MPW: 綜合醫院及自由護理緊急部門成員2024-07-232024-07-230001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-01-012023-03-310001287865強積公司:斯普林斯通健康會員2023-02-072023-02-070001287865強積公司:共同精神成員2024-04-122024-04-120001287865美國 GAAP: 公平價值投注 3 成員強積公司:管理員順序會員美國 GAAP: 測量輸入折扣代表SRT: 最大會員數2024-09-3000012878652023-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2023-06-300001287865MPW: 政治醫學院議員2024-09-300001287865國家:CO強積金:收購貸款成員美國 GAAP: 公平價值評估重複成員2024-01-012024-09-300001287865美國 GAAP: 公共股成員2022-12-310001287865強積公司:管理醫療系統 LLC會員2023-09-300001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員MPW: 生命點行為成員2023-12-310001287865強積公司:共同精神成員2023-05-012023-05-010001287865強積公司:無形資產成員2023-01-012023-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-06-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員MPW: 美國醫療保健系統2024-09-300001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員強積公司:管理醫療系統 LLC會員2024-01-012024-09-300001287865強積金:信貸便利修訂委員2022-06-2900012878652024-04-012024-06-300001287865強積公司:預計醫療控股公司成員2024-01-012024-09-3000012878652023-03-310001287865美國 GAAP: 保留權益成員2022-12-310001287865MPW: 其他租戶更新會員2023-07-012023-09-300001287865強積公司:房地產投資或合併房地產及其他聯合投資公司成員2024-09-300001287865美國 GAAP: 資產總成員國家:GB美國 GAAP: 地理集中風險成員2024-01-012024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員2024-09-300001287865強積公司:管理醫療系統 LLC會員2024-09-182024-09-180001287865MPW: 機構資產管理員成員2024-01-012024-09-300001287865強積金:定期貸款成員國家:AU2024-09-300001287865美國 GAAP: 累積其他全面收入會員2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 有限合作夥伴會員2023-12-310001287865美國 GAAP: 公平價值評估重複成員強積金:股票方法投資及其他貸款成員2023-12-310001287865強積公司:斯普林斯通健康會員2024-01-012024-03-310001287865強積分:四分六二五百分之二零一五百分之一百分之一2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2024-01-012024-03-310001287865強積公司:共同精神成員2024-09-300001287865強積公司:首要醫療服務會員2023-01-012023-03-310001287865美國 GAAP: 資產總成員標準證書:PA美國 GAAP: 地理集中風險成員2023-12-310001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國高級協會:一般合作夥伴會員2023-04-012023-06-300001287865美國 GAAP: 資產總成員國家:DE美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 非控制權益成員2023-03-310001287865強積金:貸款網及資產投資成員美國 GAAP: 可變利益單位不是主要受益成員2024-09-300001287865美國 GAAP: 非控制權益成員2022-12-310001287865強積公司:預計醫療控股公司成員2022-10-012022-12-310001287865美國高級協會:國家地域管理委員2024-09-300001287865美國 GAAP: 非控制權益成員2023-04-012023-06-300001287865美國 GAAP: 保留權益成員2023-07-012023-09-300001287865強積公司:澳大利亞行動會員2023-10-102023-10-100001287865強積金:期貸款二千二十五年國家:GB2024-07-012024-09-300001287865美國高級協會:租賃在位置成員獲得強積公司:共同精神成員2023-05-012023-05-010001287865MPW: 操作員集中風險成員美國 GAAP: 資產總成員強積公司:預計醫療控股公司成員2024-01-012024-09-300001287865強積公司:房地產投資或合併房地產及其他聯合投資公司成員2024-07-012024-09-300001287865MPW: 三點五個零點工作人員工年輕人安全筆記二重六千三十一元2024-09-300001287865強積金:成員期內修改的契約2024-08-062024-08-060001287865MPW: 電子支持會員2023-12-310001287865美國 GAAP: 保留權益成員2024-01-012024-03-310001287865美國 GAAP: 資產總成員MPW: 自由行動緊急照顧設施會員美國 GAAP: 客戶集中風險成員2023-12-3100012878652024-01-012024-03-310001287865美國 GAAP: 資產總成員美國會計師範圍:非美國會員美國 GAAP: 地理集中風險成員2024-09-300001287865MPW: 電子支持會員美國 GAAP: 後續事件成員2024-11-082024-11-080001287865美國 GAAP: 資產總成員MPW: 操作員集中風險成員美國 GAAP: 其他資產成員2023-01-012023-12-310001287865強積金:保證期貸款兩萬三十四人國家:GB2024-09-300001287865強積公司:房地產投資或合併房地產及其他聯合投資公司成員SRT: 最大會員數2024-09-300001287865美國 GAAP: 資產總成員MPW: 行為健康設施會員美國 GAAP: 客戶集中風險成員2023-12-310001287865美國 GAAP: 非控制權益成員2024-01-012024-03-310001287865美國 GAAP: 資產總成員美國 GAAP: 客戶集中風險成員2024-01-012024-09-300001287865美國 GAAP: 公平價值投注 3 成員SRT: 最低成員美國 GAAP: 測量輸入折扣代表2024-09-300001287865強積公司:MPTOP 合作夥伴關係 PPP 會員美國 GAAP: 非控制權益成員2024-03-310001287865美國 GAAP: 後續事件成員2024-11-082024-11-080001287865強積分:二點五個零點工作人數一級安全筆記二千二十六名成員2024-09-300001287865美國 GAAP: 公平價值評估重複成員美國 GAAP: 按揭成員2024-09-300001287865美國會計師範圍:外國會員2023-04-012023-06-300001287865強積公司:管理醫療系統 LLC會員2024-09-300001287865美國 GAAP: 出售集團不中止營運成員2023-01-012023-09-300001287865美國 GAAP: 公共股成員2023-01-012023-03-310001287865美國 GAAP: 額外付費無法成員2024-04-012024-06-300001287865強積公司:首要醫療服務設施會員SRT: 最大會員數2024-04-092024-04-090001287865美國 GAAP: 公共股成員2023-03-310001287865強積公司:五點零羅澤羅澤工作人員工人數一級安全筆記二千二十七名成員2023-12-310001287865強積金:其他國內資產成員美國 GAAP: 資產總成員美國 GAAP: 地理集中風險成員2023-12-310001287865美國 GAAP: 資產總成員強積金:其他國內資產成員美國 GAAP: 地理集中風險成員2024-09-300001287865STPR: MA2024-09-300001287865美國 GAAP: 非控制權益成員2024-06-30MPW: 獨立式ISO417: 澳元ISO422: 歐元強積公司:健康中心xbrli: 純MPW: 設施MPW: 國家MPW: 項目MPW: 床MPW: 國家MPW: 醫院ISO417: 美元xbrli: 股份MPW: 屬性xbrli: 股份強積公司:租賃ISO417: 瑞士法郎ISO422: 英鎊ISO417: 美元

 

 

美國

證券交易委員會

華盛頓特區20549

 

表格 10-Q

 

根據1934年證券交易所法第13或15(d)條款的季度報告

截至2024年6月30日季度結束 九月三十日, 2024

根據1934年證券交易法第13或15(d)條進行的過渡報告

委員會文件編號 001-32559

委員會文件編號 333-177186

醫療資產信託公司

MPt 營運合夥企業, 有限合夥

(根據其組織憲章規定的正式名稱)

 

 

 

 

 

馬里蘭

特拉華州

20-0191742

20-0242069

(依據所在地或其他管轄區)

的註冊地或組織地點)

(美國稅務局僱主

識別號碼)

 

 

 

 

1000 URBAN CENTER DRIVE, 501套房

伯明翰, AL

35242

(總部辦公地址)

(郵遞區號)

登記人的電話號碼,包括區號:(205) 969-3755

根據法案第12(b)條規定註冊的證券:

 

每種類別的名稱

交易標的(s)

每個註冊交易所的名稱

醫療房地產信託公司普通股,每股面值$0.001。

MPW

紐約證券交易所

 

請勾選以下選項以表示申報人(1)已提交證券交易法1934年第13條或15(d)條所要求提交的所有報告,且在過去12個月中(或申報人需要提交此類報告的較短期間)已提交;(2)已受到過去90天內此類提交要求的限制。 Yes ☒ 否 ☐

請勾選是否在過去12個月(或較短時期)內根據Regulation S-t第405條規定提交所有需要提交的互動數據文件。 Yes ☒ 否 ☐

請打勾表示,申請人是否為大快速歸檔者、快速歸檔者、非快速歸檔者、較小的報告公司或新興成長公司。請參閱《交易所法》第120億2條對“大快速歸檔者”、“快速歸檔者”、“較小的報告公司”和“新興成長公司”的定義。

 

大型加速歸檔人

☒(僅限Medical Properties Trust, Inc.)

加速歸檔人

非加速歸檔人

☒(僅限MPt Operating Partnership, L.P.)

小型報告公司

 

 

新興成長型企業

如果一家新興成長公司,請打勾表示申請人已選擇不使用根據交易所法第13(a)條提供的任何新的或修訂的財務會計準則的擴展過渡期遵守。 ☐

 

 

請在核取方框內表明公司是否為空殼公司(根據交易所法規120億2號所定義)。 是 ☐ 否

截至2024年11月8日醫療物業信託公司截至當日擁有 600.4 百萬股普通股,面值$0.001,流通中。

 

 


 

解說說明

本報告結合了醫療物業信託公司和MPt Operating Partnership,L.P.到2024年9月30日結束的三個月和九個月的第10-Q表格的季度報告,醫療物業信託公司是一家馬里蘭州公司,MPt Operating Partnership,L.P.是一家特拉華州有限合夥公司,醫療物業信託公司通過其執行基本所有業務的MPt Operating Partnership,L.P.,除非另有說明或上下文另有要求,本報告中所有提到的“我們”,“我們”,“我們的”,“醫療物業”,“MPt”,或“公司”均指醫療物業信託公司及其合併子公司,包括MPt Operating Partnership,L.P. 除非另有說明或上下文另有要求,所有提到的“經營合夥”都指MPt Operating Partnership,L.P.及其合併子公司。

 


 

MEDICAL PROPERTIES TRUSt, INC.與MPt營運合夥企業,L.P。

及其附屬公司

第10-Q表格季報告

截至2024年9月30日的季度結束

目錄 內容

 

頁面

第一部分 — 財務資訊

3

項目 1 基本報表

3

Medical Properties Trust, Inc.及其附屬公司

 

2024年9月30日和2023年12月31日的精簡合併資產負債表

3

2024年9月30日以及2023年結束的三個月和九個月的凈利潤簡明合併基本報表

4

2024年9月30日以及2023年結束的三個月和九個月的綜合損益簡明合併基本報表

5

2023年及2024年截至9月30日的簡明綜合權益陳述

6

截至2024年和2023年9月30日九個月的綜合現金流量簡明合併財務報表

8

MPt營運合夥企業及附屬公司

 

2024年9月30日和2023年12月31日的精簡合併資產負債表

9

2023年及2024年截至9月30日的簡明損益表

10

2023年及2024年截至9月30日的簡明綜合(虧損)收入表

11

2023年及2024年截至9月30日的簡明資本陳述

12

截至2024年和2023年9月30日九個月的綜合現金流量簡明合併財務報表

14

Medical Properties Trust, Inc.和MPt Operating Partnership, L.P.及其附屬公司

 

附註至簡明綜合財務報表

15

項目 2 管理層對財務狀況和業績的討論和分析

36

項目 3 有關市場風險之定量和定性披露

49

項目 4 控制和程序

50

第二部分 — 其他資訊

51

Item 1 法律訴訟

51

Item 1風險因素

51

項目 2 股票權益的未註冊銷售和資金用途

51

項目 3 優先證券違約

51

項目 4 礦業安全披露

51

項目 5 其他資訊

51

項目 6 展品

52

簽名

53

 

 

2


 

 

第一部分 — 財務撥號信息

項目 1. 財務報表財務報表。

醫療屬性真St, INC.及其子公司

精簡合併資產負債表簡明合併資產負債表

 

 

 

九月三十日,
2024

 

 

12月31日,
2023

 

(以千爲單位,除每股金額外)

 

(未經審計)

 

 

(附註2)

 

資產

 

 

 

 

 

 

房地產業資產

 

 

 

 

 

 

土地、建築、改良、無形租賃資產和其他

 

$

11,653,954

 

 

$

13,237,187

 

融資租賃投資

 

 

1,184,992

 

 

 

1,231,630

 

持有待售房地產

 

 

85,000

 

 

 

 

抵押貸款

 

 

298,221

 

 

 

309,315

 

房地產資產的總投資

 

 

13,222,167

 

 

 

14,778,132

 

累計折舊及攤銷費用

 

 

(1,423,702

)

 

 

(1,407,971

)

房地產資產的淨投資

 

 

11,798,465

 

 

 

13,370,161

 

現金及現金等價物

 

 

275,616

 

 

 

250,016

 

利息和租金應收款

 

 

35,142

 

 

 

45,059

 

平折租賃應收款

 

 

685,742

 

 

 

635,987

 

未納入合併範圍的房地產合資企業投資

 

 

1,242,772

 

 

 

1,474,455

 

未納入合併範圍的經營實體投資

 

 

508,227

 

 

 

1,778,640

 

其他貸款

 

 

155,889

 

 

 

292,615

 

其他

 

 

534,303

 

 

 

457,911

 

總資產

 

$

15,236,156

 

 

$

18,304,844

 

負債和股東權益

 

 

 

 

 

 

負債

 

 

 

 

 

 

淨債務

 

$

9,215,751

 

 

$

10,064,236

 

應付賬款和應計費用

 

 

418,339

 

 

 

412,178

 

遞延營業收入

 

 

24,332

 

 

 

37,962

 

對租戶的債務和其他租賃責任

 

 

136,635

 

 

 

156,603

 

總負債

 

 

9,795,057

 

 

 

10,670,979

 

股權

 

 

 

 

 

 

優先股,$0.00010.001 面值。已授權 10,000股份;
   
任何 股份已發行

 

 

 

 

 

 

普通股,每股面值爲 $0.0001;0.001面值。已授權 750,000股;
已發行並流通股份爲
600,229截至2024年9月30日的股份數爲
   
598,991  股,截至2023年12月31日

 

 

600

 

 

 

599

 

額外實收資本

 

 

8,578,355

 

 

 

8,560,309

 

赤字

 

 

(3,197,505

)

 

 

(971,809

)

累計其他綜合收益

 

 

57,114

 

 

 

42,501

 

Total Medical Properties Trust, Inc.股東權益

 

 

5,438,564

 

 

 

7,631,600

 

非控股權益

 

 

2,535

 

 

 

2,265

 

總股本

 

 

5,441,099

 

 

 

7,633,865

 

總負債和股權

 

$

15,236,156

 

 

$

18,304,844

 

 

請參閱附註事項的簡明合併財務報表。

3


 

醫療產業信託公司及其子公司

彙總的合併財務報表淨利潤報表

(未經審計)

 

 

三個月期間
截至9月30日結束,

 

 

九個月期間
截至9月30日結束,

 

(以千爲單位,除每股金額外)

2024

 

 

2023

 

 

2024

 

 

2023

 

營業收入

 

 

 

 

 

 

 

 

 

 

 

出租費用計入賬單

$

169,721

 

 

$

229,306

 

 

$

552,784

 

 

$

724,954

 

直線租金

 

36,602

 

 

 

21,511

 

 

 

119,719

 

 

 

38,875

 

融資租賃收入

 

9,798

 

 

 

26,066

 

 

 

53,832

 

 

 

107,729

 

利息和其他收入

 

9,706

 

 

 

29,693

 

 

 

37,368

 

 

 

122,624

 

總收入

 

225,827

 

 

 

306,576

 

 

 

763,703

 

 

 

994,182

 

費用

 

 

 

 

 

 

 

 

 

 

 

利息

 

106,243

 

 

 

106,709

 

 

 

316,358

 

 

 

308,833

 

房地產折舊及攤銷

 

204,875

 

 

 

77,802

 

 

 

382,701

 

 

 

526,065

 

房地產相關

 

4,994

 

 

 

6,483

 

 

 

17,475

 

 

 

38,269

 

總務和行政

 

36,625

 

 

 

38,110

 

 

 

105,300

 

 

 

115,438

 

總支出

 

352,737

 

 

 

229,104

 

 

 

821,834

 

 

 

988,605

 

其他(費用)收入

 

 

 

 

 

 

 

 

 

 

 

房地產業銷售利潤 (損失)

 

91,795

 

 

 

(20

)

 

 

475,196

 

 

 

209

 

房地產和其他減值損失,淨額

 

(607,922

)

 

 

(3,750

)

 

 

(1,438,429

)

 

 

(93,288

)

股權投資收益(損失)

 

21,643

 

 

 

11,264

 

 

 

(369,565

)

 

 

34,840

 

債務再融資和未使用融資(成本)益處

 

(713

)

 

 

862

 

 

 

(3,677

)

 

 

46

 

其他(包括證券的公允價值調整)

 

(169,790

)

 

 

41,125

 

 

 

(566,821

)

 

 

25,447

 

其他收支總額

 

(664,987

)

 

 

49,481

 

 

 

(1,903,296

)

 

 

(32,746

)

 

 

 

 

 

 

 

 

 

 

 

 

稅前(虧損)收益

 

(791,897

)

 

 

126,953

 

 

 

(1,961,427

)

 

 

(27,169

)

所得稅費用(收益)

 

(9,032

)

 

 

(10,058

)

 

 

(34,538

)

 

 

134,661

 

 

 

 

 

 

 

 

 

 

 

 

 

淨(損失)收入

 

(800,929

)

 

 

116,895

 

 

 

(1,995,965

)

 

 

107,492

 

歸屬於非控股股權的淨利潤

 

(234

)

 

 

(185

)

 

 

(1,458

)

 

 

(25

)

淨利潤(損失)歸屬於普通股東

$

(801,163

)

 

$

116,710

 

 

$

(1,997,423

)

 

$

107,467

 

 

 

 

 

 

 

 

 

 

 

 

 

每普通股收益 - 基本和稀釋

 

 

 

 

 

 

 

 

 

 

 

淨利潤(損失)歸屬於普通股東

$

(1.34

)

 

$

0.19

 

 

$

(3.33

)

 

$

0.18

 

 

 

 

 

 

 

 

 

 

 

 

 

基本加權平均股本

 

600,229

 

 

 

598,444

 

 

 

600,197

 

 

 

598,363

 

攤薄加權平均股本

 

600,229

 

 

 

598,553

 

 

 

600,197

 

 

 

598,406

 

 

 

 

 

 

 

 

 

 

 

 

 

每股普通股宣佈的分紅派息

$

0.08

 

 

$

0.15

 

 

$

0.38

 

 

$

0.73

 

 

參見簡明合併財務報表的附註。

4


 

醫療產業信託公司及其子公司

壓縮合並財務報表綜合損益表項目

(未經審計)

 

 

 

三個月期間
截至9月30日結束,

 

 

九個月期間
截至9月30日結束,

 

(以千爲單位)

 

2024

 

 

2023

 

 

2024

 

 

2023

 

淨(損失)收入

 

$

(800,929

)

 

$

116,895

 

 

$

(1,995,965

)

 

$

107,492

 

其他綜合收益(損失):

 

 

 

 

 

 

 

 

 

 

 

 

利率對沖的未實現損失,稅後淨額

 

 

(9,823

)

 

 

(12,440

)

 

 

(16,099

)

 

 

(9,845

)

將來自AOCI的利率對沖收益重新分類爲
稅後利潤,稅後

 

 

(13,349

)

 

 

 

 

 

(17,354

)

 

 

(28,553

)

外匯翻譯收益(損失)

 

 

114,196

 

 

 

(54,018

)

 

 

48,066

 

 

 

34,570

 

將未實現的外匯轉換損失重新分類爲
AOCI到收益

 

 

 

 

 

 

 

 

 

 

 

3,234

 

綜合(損失)收益合計

 

 

(709,905

)

 

 

50,437

 

 

 

(1,981,352

)

 

 

106,898

 

歸屬於非控制權益的綜合收益

 

 

(234

)

 

 

(185

)

 

 

(1,458

)

 

 

(25

)

歸屬於MPt普通股股東的全面(虧損)收入

 

$

(710,139

)

 

$

50,252

 

 

$

(1,982,810

)

 

$

106,873

 

 

請參閱附註事項的簡明合併財務報表。

5


 

醫療產業信託公司及其子公司

 

簡明綜合報表 權益報表

(未經審計)

 

 

 

優先的

 

 

Common

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(以千爲單位,除每股金額外)

 

股份

 

 

面值
價值

 

 

股份

 

 

面值
價值

 

 

其他
實收
資本

 

 

留存收益
赤字

 

 

累計
其他
綜合
(損失)收益

 

 

非-
控制
利益

 

 

合計
股東權益合計

 

2023年12月31日的餘額

 

 

 

 

$

 

 

 

598,991

 

 

$

599

 

 

$

8,560,309

 

 

$

(971,809

)

 

$

42,501

 

 

$

2,265

 

 

$

7,633,865

 

淨(損失)收入

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(875,625

)

 

 

 

 

 

248

 

 

 

(875,377

)

利率對沖的未實現損失,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2,797

)

 

 

 

 

 

(2,797

)

外幣匯兌損失

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(58,542

)

 

 

 

 

 

(58,542

)

股票分配和攤銷的
股票補償

 

 

 

 

 

 

 

 

1,370

 

 

 

1

 

 

 

7,173

 

 

 

 

 

 

 

 

 

 

 

 

7,174

 

股票分配 - 納稅滿足
稅務預扣款

 

 

 

 

 

 

 

 

(57

)

 

 

 

 

 

(283

)

 

 

 

 

 

 

 

 

 

 

 

(283

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(245

)

 

 

(245

)

分紅派息已宣佈調整

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

572

 

 

 

 

 

 

 

 

 

572

 

2024年3月31日結存餘額

 

 

 

 

$

 

 

 

600,304

 

 

$

600

 

 

$

8,567,199

 

 

$

(1,846,862

)

 

$

(18,838

)

 

$

2,268

 

 

$

6,704,367

 

淨(損失)收入

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(320,635

)

 

 

 

 

 

976

 

 

 

(319,659

)

利率對沖未實現損失,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3,479

)

 

 

 

 

 

(3,479

)

利率對沖收益重新分類
到稅後收益中

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(4,005

)

 

 

 

 

 

(4,005

)

外幣匯兌損失

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(7,588

)

 

 

 

 

 

(7,588

)

股票解禁和攤銷
以股票爲基礎的薪酬

 

 

 

 

 

 

 

 

270

 

 

 

 

 

 

7,013

 

 

 

 

 

 

 

 

 

 

 

 

7,013

 

股票解禁 - 納稅額滿足
扣減

 

 

 

 

 

 

 

 

(517

)

 

 

 

 

 

(2,550

)

 

 

 

 

 

 

 

 

 

 

 

(2,550

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(349

)

 

 

(349

)

已宣佈的分紅派息($0.30/s
(普通股份)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(180,673

)

 

 

 

 

 

 

 

 

(180,673

)

2024年6月30日餘額

 

 

 

 

$

 

 

 

600,057

 

 

$

600

 

 

$

8,571,662

 

 

$

(2,348,170

)

 

$

(33,910

)

 

$

2,895

 

 

$

6,193,077

 

淨(損失)收入

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(801,163

)

 

 

 

 

 

234

 

 

 

(800,929

)

利率套期保值未實現損失,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(9,823

)

 

 

 

 

 

(9,823

)

利率套期保值收益重新分類
(稅後)轉回收入

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(13,349

)

 

 

 

 

 

(13,349

)

外幣兌換收益

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

114,196

 

 

 

 

 

 

114,196

 

股票解禁和攤銷
股份補償代

 

 

 

 

 

 

 

 

266

 

 

 

 

 

 

7,112

 

 

 

 

 

 

 

 

 

 

 

 

7,112

 

股票解禁 - 納稅滿足
代扣

 

 

 

 

 

 

 

 

(94

)

 

 

 

 

 

(419

)

 

 

 

 

 

 

 

 

 

 

 

(419

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(594

)

 

 

(594

)

已宣佈的分紅派息($0.08
普通股份)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(48,172

)

 

 

 

 

 

 

 

 

(48,172

)

2024年9月30日的餘額

 

 

 

 

$

 

 

 

600,229

 

 

$

600

 

 

$

8,578,355

 

 

$

(3,197,505

)

 

$

57,114

 

 

$

2,535

 

 

$

5,441,099

 

 

6


 

醫療產業信託公司及其子公司

 

簡明合併股東權益表

(未經審計)

 

 

 

優先的

 

 

Common

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(以千爲單位,除每股金額外)

 

股份

 

 

面值
價值

 

 

股份

 

 

面值
價值

 

 

其他
實收
資本

 

 

留存收益
赤字

 

 

累計
其他
綜合
(損失)收益

 

 

非-
控制
利益

 

 

合計
股東權益合計

 

2022年12月31日的餘額

 

 

 

 

$

 

 

 

597,476

 

 

$

597

 

 

$

8,535,140

 

 

$

116,285

 

 

$

(59,184

)

 

$

1,569

 

 

$

8,594,407

 

淨利潤

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

32,794

 

 

 

 

 

 

236

 

 

 

33,030

 

利率對沖的未實現損失分紅派息,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(15,325

)

 

 

 

 

 

(15,325

)

外幣兌換收益

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28,143

 

 

 

 

 

 

28,143

 

利率對沖再分類
稅後的盈利,淨的

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(28,553

)

 

 

 

 

 

(28,553

)

股票分紅及分攤
股票補償的待配股份及攤銷

 

 

 

 

 

 

 

 

1,325

 

 

 

1

 

 

 

11,828

 

 

 

 

 

 

 

 

 

 

 

 

11,829

 

股票歸還-滿足稅款
扣減

 

 

 

 

 

 

 

 

(499

)

 

 

 

 

 

(5,554

)

 

 

 

 

 

 

 

 

 

 

 

(5,554

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(231

)

 

 

(231

)

已宣佈的分紅派息($0.29/s
普通股份)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(174,492

)

 

 

 

 

 

 

 

 

(174,492

)

2023年3月31日的餘額

 

 

 

 

$

 

 

 

598,302

 

 

$

598

 

 

$

8,541,414

 

 

$

(25,413

)

 

$

(74,919

)

 

$

1,574

 

 

$

8,443,254

 

淨虧損

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(42,037

)

 

 

 

 

 

(396

)

 

 

(42,433

)

利率對沖的未實現收益,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17,920

 

 

 

 

 

 

17,920

 

外幣兌換收益

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

60,445

 

 

 

 

 

 

60,445

 

外幣重分類
報告主體收益的外匯翻譯損失

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3,234

 

 

 

 

 

 

3,234

 

股票授予及攤銷
基於股票的薪酬

 

 

 

 

 

 

 

 

59

 

 

 

 

 

 

6,437

 

 

 

 

 

 

 

 

 

 

 

 

6,437

 

股票授予-滿足稅收
代扣稅款

 

 

 

 

 

 

 

 

(17

)

 

 

 

 

 

(16

)

 

 

 

 

 

 

 

 

 

 

 

(16

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(276

)

 

 

(276

)

已宣佈的分紅派息($0.29
每普通股份)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(173,851

)

 

 

 

 

 

 

 

 

(173,851

)

2023年6月30日的餘額

 

 

 

 

$

 

 

 

598,344

 

 

$

598

 

 

$

8,547,835

 

 

$

(241,301

)

 

$

6,680

 

 

$

902

 

 

$

8,314,714

 

淨利潤

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

116,710

 

 

 

 

 

 

185

 

 

 

116,895

 

利率對沖未實現損失,
稅後淨額

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(12,440

)

 

 

 

 

 

(12,440

)

外幣匯兌損失

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(54,018

)

 

 

 

 

 

(54,018

)

股票分紅和攤銷
股票補償

 

 

 

 

 

 

 

 

156

 

 

 

 

 

 

11,453

 

 

 

 

 

 

 

 

 

 

 

 

11,453

 

股票分紅 - 納稅滿足
代扣稅款

 

 

 

 

 

 

 

 

(56

)

 

 

 

 

 

(520

)

 

 

 

 

 

 

 

 

 

 

 

(520

)

分配給非控股股權的股東

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(200

)

 

 

(200

)

已宣佈的分紅派息($0.15
(每普通股份)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(90,467

)

 

 

 

 

 

 

 

 

(90,467

)

2023年9月30日財務狀況表

 

 

 

 

$

 

 

 

598,444

 

 

$

598

 

 

$

8,558,768

 

 

$

(215,058

)

 

$

(59,778

)

 

$

887

 

 

$

8,285,417

 

 

 

請參閱附註事項的簡明合併財務報表。

7


 

醫療地產信託有限公司和子公司

壓縮的合併現金流量表現金流量表

(未經審計)

 

 

 

九個月期間
截至9月30日結束,

 

 

 

2024

 

 

2023

 

 

 

(以千爲單位)

 

經營活動

 

 

 

 

 

 

淨(損失)收入

 

$

(1,995,965

)

 

$

107,492

 

調整爲將淨(虧損)收益調節爲經營活動提供的現金流量:

 

 

 

 

 

 

折舊與攤銷

 

 

387,545

 

 

 

536,200

 

延期融資成本和貼現債務攤銷

 

 

12,266

 

 

 

11,978

 

按直線法計算的租金收入和其他

 

 

(127,326

)

 

 

(174,202

)

基於股票的薪酬

 

 

30,581

 

 

 

29,719

 

房地產出售盈利

 

 

(475,196

)

 

 

(209

)

房地產和其他減值損失,淨額

 

 

1,438,429

 

 

 

93,288

 

股權利益房地產減值

 

 

410,790

 

 

 

 

按直線法計算的租金和其他沖銷

 

 

2,846

 

 

 

150,576

 

債務再融資和未使用融資成本(利益)

 

 

3,677

 

 

 

(46

)

稅率變更和其他

 

 

4,596

 

 

 

(164,535

)

非現金公允價值調整

 

 

511,472

 

 

 

(42,562

)

從債務和股權證券收到的非現金收入

 

 

 

 

 

(81,706

)

其他調整

 

 

12,406

 

 

 

15,062

 

變動內容:

 

 

 

 

 

 

利息和租金應收款

 

 

4,147

 

 

 

(100,384

)

其他

 

 

(18,884

)

 

 

(6,701

)

應付賬款和應計費用

 

 

(20,869

)

 

 

(6,279

)

遞延營收

 

 

(11,719

)

 

 

2,677

 

營業活動產生的淨現金

 

 

168,796

 

 

 

370,368

 

投資活動

 

 

 

 

 

 

收購和其他相關投資

 

 

(105,618

)

 

 

(235,187

)

房地產銷售淨收益

 

 

1,761,661

 

 

 

589,420

 

銷售及應收貸款回收款項

 

 

214,416

 

 

 

499,549

 

投資應收款項

 

 

(392,241

)

 

 

(220,223

)

在建工程和其他資產

 

 

(63,535

)

 

 

(80,708

)

股權投資銷售和回報的收益

 

 

11,656

 

 

 

12,430

 

資本增值和其他投資淨額

 

 

(199,735

)

 

 

(217,940

)

投資活動提供的淨現金流量

 

 

1,226,604

 

 

 

347,341

 

籌資活動

 

 

 

 

 

 

來自有期限債務的收入

 

 

804,188

 

 

 

 

償還有期限的債務

 

 

(662,968

)

 

 

(533,864

)

循環信貸額度淨額

 

 

(1,119,312

)

 

 

426,515

 

分紅派息

 

 

(272,909

)

 

 

(524,155

)

租金按金和對租戶的其他義務

 

 

(726

)

 

 

7,752

 

股票解禁-滿足稅款代扣要求

 

 

(3,252

)

 

 

(6,090

)

其他融資活動,償付債務再融資和延期融資成本

 

 

(124,595

)

 

 

12,243

 

籌集淨現金流量

 

 

(1,379,574

)

 

 

(617,599

)

現金及現金等價物的增加,期間受限制現金的增加

 

 

15,826

 

 

 

100,110

 

匯率變動的影響

 

 

7,969

 

 

 

4,238

 

期初現金、現金等價物和受限制的現金餘額

 

 

255,952

 

 

 

241,538

 

期末現金、現金等價物和受限制的現金餘額

 

$

279,747

 

 

$

345,886

 

支付利息

 

$

349,608

 

 

$

322,006

 

非現金投資活動表:

 

 

 

 

 

 

收到用於特定義務、房地產和營業收入的債務和股權證券

 

$

 

 

$

804,520

 

滿足特定義務和應收款項,並出售房地產

 

 

 

 

 

722,814

 

非現金融資活動表:

 

 

 

 

 

 

宣佈未支付的分紅

 

$

48,172

 

 

$

90,467

 

現金、現金等價物和受限現金包括以下內容:

 

 

 

 

 

 

期初:

 

 

 

 

 

 

現金及現金等價物

 

$

250,016

 

 

$

235,668

 

包括在受限制現金中 其他

 

 

5,936

 

 

 

5,870

 

 

 

$

255,952

 

 

$

241,538

 

期末:

 

 

 

 

 

 

現金及現金等價物

 

$

275,616

 

 

$

340,058

 

包括在受限制現金中 其他

 

 

4,131

 

 

 

5,828

 

 

 

$

279,747

 

 

$

345,886

 

 

參見簡明合併財務報表的附註。

8


 

MPt運營合作伙伴P,L.P.及其子公司

精簡合併資產負債表簡明合併資產負債表

 

 

 

九月三十日,
2024

 

 

12月31日,
2023

 

(以千爲單位)

 

(未經審計)

 

 

(附註2)

 

資產

 

 

 

 

 

 

房地產業資產

 

 

 

 

 

 

土地、建築、改良、無形租賃資產和其他

 

$

11,653,954

 

 

$

13,237,187

 

融資租賃投資

 

 

1,184,992

 

 

 

1,231,630

 

持有待售房地產

 

 

85,000

 

 

 

 

抵押貸款

 

 

298,221

 

 

 

309,315

 

房地產資產的總投資

 

 

13,222,167

 

 

 

14,778,132

 

累計折舊及攤銷費用

 

 

(1,423,702

)

 

 

(1,407,971

)

房地產資產的淨投資

 

 

11,798,465

 

 

 

13,370,161

 

現金及現金等價物

 

 

275,616

 

 

 

250,016

 

利息和租金應收款

 

 

35,142

 

 

 

45,059

 

平折租賃應收款

 

 

685,742

 

 

 

635,987

 

未納入合併範圍的房地產合資企業投資

 

 

1,242,772

 

 

 

1,474,455

 

未納入合併範圍的經營實體投資

 

 

508,227

 

 

 

1,778,640

 

其他貸款

 

 

155,889

 

 

 

292,615

 

其他

 

 

534,303

 

 

 

457,911

 

總資產

 

$

15,236,156

 

 

$

18,304,844

 

負債和資本

 

 

 

 

 

 

負債

 

 

 

 

 

 

淨債務

 

$

9,215,751

 

 

$

10,064,236

 

應付賬款和應計費用

 

 

369,777

 

 

 

318,980

 

遞延營收

 

 

24,332

 

 

 

37,962

 

對租戶的債務和其他租賃責任

 

 

136,635

 

 

 

156,603

 

應付醫療房地產信託公司

 

 

48,172

 

 

 

92,808

 

總負債

 

 

9,794,667

 

 

 

10,670,589

 

資本

 

 

 

 

 

 

普通合夥人 - 已發行和未流通 - 6,004 units at
  September 30, 2024 and
5,991 units at December 31, 2023

 

 

53,893

 

 

 

75,969

 

Limited Partners — issued and outstanding — 594,225 units at
於2024年9月30日
593,000 units at December 31, 2023

 

 

5,327,947

 

 

 

7,513,520

 

累計其他綜合收益

 

 

57,114

 

 

 

42,501

 

Total MPt Operating Partnership, L.P.資產

 

 

5,438,954

 

 

 

7,631,990

 

非控股權益

 

 

2,535

 

 

 

2,265

 

總資本

 

 

5,441,489

 

 

 

7,634,255

 

負債和資本合計

 

$

15,236,156

 

 

$

18,304,844

 

 

請參閱附註事項的簡明合併財務報表。

9


 

MPt操作合夥企業,有限合夥及其附屬公司

壓縮的合併現金流量表淨利潤報表

(未經審計)

 

 

 

三個月期間
截至9月30日結束,

 

 

九個月期間
截至9月30日結束,

 

(以千爲單位,除每單位金額外)

 

2024

 

 

2023

 

 

2024

 

 

2023

 

營業收入

 

 

 

 

 

 

 

 

 

 

 

 

出租費用計入賬單

 

$

169,721

 

 

$

229,306

 

 

$

552,784

 

 

$

724,954

 

直線租金

 

 

36,602

 

 

 

21,511

 

 

 

119,719

 

 

 

38,875

 

融資租賃收入

 

 

9,798

 

 

 

26,066

 

 

 

53,832

 

 

 

107,729

 

利息和其他收入

 

 

9,706

 

 

 

29,693

 

 

 

37,368

 

 

 

122,624

 

總收入

 

 

225,827

 

 

 

306,576

 

 

 

763,703

 

 

 

994,182

 

費用

 

 

 

 

 

 

 

 

 

 

 

 

利息

 

 

106,243

 

 

 

106,709

 

 

 

316,358

 

 

 

308,833

 

房地產折舊及攤銷

 

 

204,875

 

 

 

77,802

 

 

 

382,701

 

 

 

526,065

 

房地產相關

 

 

4,994

 

 

 

6,483

 

 

 

17,475

 

 

 

38,269

 

總務和行政

 

 

36,625

 

 

 

38,110

 

 

 

105,300

 

 

 

115,438

 

總支出

 

 

352,737

 

 

 

229,104

 

 

 

821,834

 

 

 

988,605

 

其他(費用)收入

 

 

 

 

 

 

 

 

 

 

 

 

房地產業銷售利潤 (損失)

 

 

91,795

 

 

 

(20

)

 

 

475,196

 

 

 

209

 

房地產和其他減值損失,淨額

 

 

(607,922

)

 

 

(3,750

)

 

 

(1,438,429

)

 

 

(93,288

)

股權投資收益(損失)

 

 

21,643

 

 

 

11,264

 

 

 

(369,565

)

 

 

34,840

 

債務再融資和未使用融資(成本)益處

 

 

(713

)

 

 

862

 

 

 

(3,677

)

 

 

46

 

其他(包括證券的公允價值調整)

 

 

(169,790

)

 

 

41,125

 

 

 

(566,821

)

 

 

25,447

 

其他收支總額

 

 

(664,987

)

 

 

49,481

 

 

 

(1,903,296

)

 

 

(32,746

)

 

 

 

 

 

 

 

 

 

 

 

 

 

稅前(虧損)收益

 

 

(791,897

)

 

 

126,953

 

 

 

(1,961,427

)

 

 

(27,169

)

所得稅費用(收益)

 

 

(9,032

)

 

 

(10,058

)

 

 

(34,538

)

 

 

134,661

 

 

 

 

 

 

 

 

 

 

 

 

 

 

淨(損失)收入

 

 

(800,929

)

 

 

116,895

 

 

 

(1,995,965

)

 

 

107,492

 

歸屬於非控股股權的淨利潤

 

 

(234

)

 

 

(185

)

 

 

(1,458

)

 

 

(25

)

淨利潤(虧損)歸屬於MPt經營合夥企業合夥人

 

$

(801,163

)

 

$

116,710

 

 

$

(1,997,423

)

 

$

107,467

 

 

 

 

 

 

 

 

 

 

 

 

 

 

基本和稀釋每單位盈利

 

 

 

 

 

 

 

 

 

 

 

 

淨利潤(虧損)歸屬於MPt經營合夥企業合夥人

 

$

(1.34

)

 

$

0.19

 

 

$

(3.33

)

 

$

0.18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

加權平均每單位股數(基本)

 

 

600,229

 

 

 

598,444

 

 

 

600,197

 

 

 

598,363

 

稀釋後加權平均單位數

 

 

600,229

 

 

 

598,553

 

 

 

600,197

 

 

 

598,406

 

 

 

 

 

 

 

 

 

 

 

 

 

 

每單位宣佈的分紅

 

$

0.08

 

 

$

0.15

 

 

$

0.38

 

 

$

0.73

 

 

See accompanying notes to condensed consolidated financial statements.

10


 

MPT OPERATING PARTNERSHIP, L.P. AND SUBSIDIARIES

Condensed Consolidated Statements of Comprehensive (Loss) Income

(Unaudited)

 

 

 

For the Three Months
Ended September 30,

 

 

For the Nine Months
Ended September 30,

 

(In thousands)

 

2024

 

 

2023

 

 

2024

 

 

2023

 

Net (loss) income

 

$

(800,929

)

 

$

116,895

 

 

$

(1,995,965

)

 

$

107,492

 

Other comprehensive (loss) income:

 

 

 

 

 

 

 

 

 

 

 

 

Unrealized loss on interest rate hedges, net of tax

 

 

(9,823

)

 

 

(12,440

)

 

 

(16,099

)

 

 

(9,845

)

Reclassification of interest rate hedges gain from AOCI to
   earnings, net of tax

 

 

(13,349

)

 

 

 

 

 

(17,354

)

 

 

(28,553

)

Foreign currency translation gain (loss)

 

 

114,196

 

 

 

(54,018

)

 

 

48,066

 

 

 

34,570

 

Reclassification of foreign currency translation loss from
   AOCI to earnings

 

 

 

 

 

 

 

 

 

 

 

3,234

 

Total comprehensive (loss) income

 

 

(709,905

)

 

 

50,437

 

 

 

(1,981,352

)

 

 

106,898

 

Comprehensive income attributable to non-controlling interests

 

 

(234

)

 

 

(185

)

 

 

(1,458

)

 

 

(25

)

Comprehensive (loss) income attributable to MPT Operating
   Partnership partners

 

$

(710,139

)

 

$

50,252

 

 

$

(1,982,810

)

 

$

106,873

 

 

See accompanying notes to condensed consolidated financial statements.

11


 

MPT OPERATING PARTNERSHIP, L.P. AND SUBSIDIARIES

Condensed Consolidated Statements of Capital

(Unaudited)

 

 

 

General

 

 

 

 

 

 

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Partner

 

 

Limited Partners

 

 

Other

 

 

Non-

 

 

 

 

(In thousands, except per unit amounts)

 

Units

 

 

Unit
Value

 

 

Units

 

 

Unit
Value

 

 

Comprehensive
(Loss) Income

 

 

Controlling
Interests

 

 

Total
Capital

 

Balance at December 31, 2023

 

 

5,991

 

 

$

75,969

 

 

 

593,000

 

 

$

7,513,520

 

 

$

42,501

 

 

$

2,265

 

 

$

7,634,255

 

Net (loss) income

 

 

 

 

 

(8,756

)

 

 

 

 

 

(866,869

)

 

 

 

 

 

248

 

 

 

(875,377

)

Unrealized loss on interest rate hedges, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(2,797

)

 

 

 

 

 

(2,797

)

Foreign currency translation loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(58,542

)

 

 

 

 

 

(58,542

)

Unit vesting and amortization of unit-based
   compensation

 

 

14

 

 

 

72

 

 

 

1,356

 

 

 

7,102

 

 

 

 

 

 

 

 

 

7,174

 

Unit vesting - satisfaction of tax
   withholdings

 

 

(1

)

 

 

(3

)

 

 

(56

)

 

 

(280

)

 

 

 

 

 

 

 

 

(283

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(245

)

 

 

(245

)

Distributions declared adjustment

 

 

 

 

 

6

 

 

 

 

 

 

566

 

 

 

 

 

 

 

 

 

572

 

Balance at March 31, 2024

 

 

6,004

 

 

$

67,288

 

 

 

594,300

 

 

$

6,654,039

 

 

$

(18,838

)

 

$

2,268

 

 

$

6,704,757

 

Net (loss) income

 

 

 

 

 

(3,206

)

 

 

 

 

 

(317,429

)

 

 

 

 

 

976

 

 

 

(319,659

)

Unrealized loss on interest rate hedges, net
   of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3,479

)

 

 

 

 

 

(3,479

)

Reclassification of interest rate hedge gain to earnings,
   net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(4,005

)

 

 

 

 

 

(4,005

)

Foreign currency translation loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(7,588

)

 

 

 

 

 

(7,588

)

Unit vesting and amortization of unit-based
   compensation

 

 

3

 

 

 

70

 

 

 

267

 

 

 

6,943

 

 

 

 

 

 

 

 

 

7,013

 

Unit vesting - satisfaction of tax
   withholdings

 

 

(5

)

 

 

(25

)

 

 

(512

)

 

 

(2,525

)

 

 

 

 

 

 

 

 

(2,550

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(349

)

 

 

(349

)

Distributions declared ($0.30 per unit)

 

 

 

 

 

(1,807

)

 

 

 

 

 

(178,866

)

 

 

 

 

 

 

 

 

(180,673

)

Balance at June 30, 2024

 

 

6,002

 

 

$

62,320

 

 

 

594,055

 

 

$

6,162,162

 

 

$

(33,910

)

 

$

2,895

 

 

$

6,193,467

 

Net (loss) income

 

 

 

 

 

(8,012

)

 

 

 

 

 

(793,151

)

 

 

 

 

 

234

 

 

 

(800,929

)

Unrealized loss on interest rate hedges, net
   of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(9,823

)

 

 

 

 

 

(9,823

)

Reclassification of interest rate hedge gain to earnings,
   net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(13,349

)

 

 

 

 

 

(13,349

)

Foreign currency translation gain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

114,196

 

 

 

 

 

 

114,196

 

Unit vesting and amortization of unit-based
   compensation

 

 

3

 

 

 

71

 

 

 

263

 

 

 

7,041

 

 

 

 

 

 

 

 

 

7,112

 

Unit vesting - satisfaction of tax
   withholdings

 

 

(1

)

 

 

(4

)

 

 

(93

)

 

 

(415

)

 

 

 

 

 

 

 

 

(419

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(594

)

 

 

(594

)

Distributions declared ($0.08 per unit)

 

 

 

 

 

(482

)

 

 

 

 

 

(47,690

)

 

 

 

 

 

 

 

 

(48,172

)

Balance at September 30, 2024

 

 

6,004

 

 

$

53,893

 

 

 

594,225

 

 

$

5,327,947

 

 

$

57,114

 

 

$

2,535

 

 

$

5,441,489

 

 

 

12


 

MPT OPERATING PARTNERSHIP, L.P. AND SUBSIDIARIES

Condensed Consolidated Statements of Capital

(Unaudited)

 

 

 

General

 

 

 

 

 

 

 

 

Accumulated

 

 

 

 

 

 

 

 

 

Partner

 

 

Limited Partners

 

 

Other

 

 

Non-

 

 

 

 

(In thousands, except per unit amounts)

 

Units

 

 

Unit
Value

 

 

Units

 

 

Unit
Value

 

 

Comprehensive
(Loss) Income

 

 

Controlling
Interests

 

 

Total
Capital

 

Balance at December 31, 2022

 

 

5,976

 

 

$

86,599

 

 

 

591,500

 

 

$

8,565,813

 

 

$

(59,184

)

 

$

1,569

 

 

$

8,594,797

 

Net income

 

 

 

 

 

328

 

 

 

 

 

 

32,466

 

 

 

 

 

 

236

 

 

 

33,030

 

Unrealized loss on interest rate hedges, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(15,325

)

 

 

 

 

 

(15,325

)

Foreign currency translation gain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28,143

 

 

 

 

 

 

28,143

 

Reclassification of interest rate hedge gain to
   earnings, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(28,553

)

 

 

 

 

 

(28,553

)

Unit vesting and amortization of unit-based
   compensation

 

 

13

 

 

 

118

 

 

 

1,312

 

 

 

11,711

 

 

 

 

 

 

 

 

 

11,829

 

Unit vesting - satisfaction of tax
   withholdings

 

 

(5

)

 

 

(56

)

 

 

(494

)

 

 

(5,498

)

 

 

 

 

 

 

 

 

(5,554

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(231

)

 

 

(231

)

Distributions declared ($0.29 per unit)

 

 

 

 

 

(1,745

)

 

 

 

 

 

(172,747

)

 

 

 

 

 

 

 

 

(174,492

)

Balance at March 31, 2023

 

 

5,984

 

 

$

85,244

 

 

 

592,318

 

 

$

8,431,745

 

 

$

(74,919

)

 

$

1,574

 

 

$

8,443,644

 

Net loss

 

 

 

 

 

(420

)

 

 

 

 

 

(41,617

)

 

 

 

 

 

(396

)

 

 

(42,433

)

Unrealized gain on interest rate hedges, net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17,920

 

 

 

 

 

 

17,920

 

Foreign currency translation gain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

60,445

 

 

 

 

 

 

60,445

 

Reclassification of foreign currency translation loss to earnings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3,234

 

 

 

 

 

 

3,234

 

Unit vesting and amortization of unit-based
   compensation

 

 

1

 

 

 

64

 

 

 

58

 

 

 

6,373

 

 

 

 

 

 

 

 

 

6,437

 

Unit vesting - satisfaction of tax
   withholdings

 

 

 

 

 

 

 

 

(17

)

 

 

(16

)

 

 

 

 

 

 

 

 

(16

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(276

)

 

 

(276

)

Distributions declared ($0.29 per unit)

 

 

 

 

 

(1,739

)

 

 

 

 

 

(172,112

)

 

 

 

 

 

 

 

 

(173,851

)

Balance at June 30, 2023

 

 

5,985

 

 

$

83,149

 

 

 

592,359

 

 

$

8,224,373

 

 

$

6,680

 

 

$

902

 

 

$

8,315,104

 

Net income

 

 

 

 

 

1,167

 

 

 

 

 

 

115,543

 

 

 

 

 

 

185

 

 

 

116,895

 

Unrealized loss on interest rate hedges,
   net of tax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(12,440

)

 

 

 

 

 

(12,440

)

Foreign currency translation loss

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(54,018

)

 

 

 

 

 

(54,018

)

Unit vesting and amortization of unit-based
   compensation

 

 

2

 

 

 

115

 

 

 

154

 

 

 

11,338

 

 

 

 

 

 

 

 

 

11,453

 

Unit vesting - satisfaction of tax
   withholdings

 

 

(1

)

 

 

(5

)

 

 

(55

)

 

 

(515

)

 

 

 

 

 

 

 

 

(520

)

Distributions to non-controlling interests

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(200

)

 

 

(200

)

Distributions declared ($0.15 per unit)

 

 

 

 

 

(905

)

 

 

 

 

 

(89,562

)

 

 

 

 

 

 

 

 

(90,467

)

Balance at September 30, 2023

 

 

5,986

 

 

$

83,521

 

 

 

592,458

 

 

$

8,261,177

 

 

$

(59,778

)

 

$

887

 

 

$

8,285,807

 

 

See accompanying notes to condensed consolidated financial statements.

13


 

MPT OPERATING PARTNERSHIP, L.P. AND SUBSIDIARIES

Condensed Consolidated Statements of Cash Flows

(Unaudited)

 

 

 

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

 

 

(In thousands)

 

Operating activities

 

 

 

 

 

 

Net (loss) income

 

$

(1,995,965

)

 

$

107,492

 

Adjustments to reconcile net (loss) income to net cash provided by operating activities:

 

 

 

 

 

 

Depreciation and amortization

 

 

387,545

 

 

 

536,200

 

Amortization of deferred financing costs and debt discount

 

 

12,266

 

 

 

11,978

 

Straight-line rent revenue and other

 

 

(127,326

)

 

 

(174,202

)

Unit-based compensation

 

 

30,581

 

 

 

29,719

 

Gain on sale of real estate

 

 

(475,196

)

 

 

(209

)

Real estate and other impairment charges, net

 

 

1,438,429

 

 

 

93,288

 

Equity interest real estate impairment

 

 

410,790

 

 

 

 

Straight-line rent and other write-off

 

 

2,846

 

 

 

150,576

 

Debt refinancing and unutilized financing costs (benefit)

 

 

3,677

 

 

 

(46

)

Tax rate changes and other

 

 

4,596

 

 

 

(164,535

)

Non-cash fair value adjustments

 

 

511,472

 

 

 

(42,562

)

Non-cash revenue from debt and equity securities received

 

 

 

 

 

(81,706

)

Other adjustments

 

 

12,406

 

 

 

15,062

 

Changes in:

 

 

 

 

 

 

Interest and rent receivables

 

 

4,147

 

 

 

(100,384

)

Other assets

 

 

(18,884

)

 

 

(6,701

)

Accounts payable and accrued expenses

 

 

(20,869

)

 

 

(6,279

)

Deferred revenue

 

 

(11,719

)

 

 

2,677

 

Net cash provided by operating activities

 

 

168,796

 

 

 

370,368

 

Investing activities

 

 

 

 

 

 

Acquisitions and other related investments

 

 

(105,618

)

 

 

(235,187

)

Net proceeds from sale of real estate

 

 

1,761,661

 

 

 

589,420

 

Proceeds received from sale and repayment of loans receivable

 

 

214,416

 

 

 

499,549

 

Investment in loans receivable

 

 

(392,241

)

 

 

(220,223

)

Construction in progress and other

 

 

(63,535

)

 

 

(80,708

)

Proceeds from sale and return of equity investments

 

 

11,656

 

 

 

12,430

 

Capital additions and other investments, net

 

 

(199,735

)

 

 

(217,940

)

Net cash provided by investing activities

 

 

1,226,604

 

 

 

347,341

 

Financing activities

 

 

 

 

 

 

Proceeds from term debt

 

 

804,188

 

 

 

 

Payments of term debt

 

 

(662,968

)

 

 

(533,864

)

Revolving credit facility, net

 

 

(1,119,312

)

 

 

426,515

 

Distributions paid

 

 

(272,909

)

 

 

(524,155

)

Lease deposits and other obligations to tenants

 

 

(726

)

 

 

7,752

 

Unit vesting - satisfaction of tax withholdings

 

 

(3,252

)

 

 

(6,090

)

Other financing activities, payment of debt refinancing, and deferred financing costs

 

 

(124,595

)

 

 

12,243

 

Net cash used for financing activities

 

 

(1,379,574

)

 

 

(617,599

)

Increase in cash, cash equivalents, and restricted cash for period

 

 

15,826

 

 

 

100,110

 

Effect of exchange rate changes

 

 

7,969

 

 

 

4,238

 

Cash, cash equivalents, and restricted cash at beginning of period

 

 

255,952

 

 

 

241,538

 

Cash, cash equivalents, and restricted cash at end of period

 

$

279,747

 

 

$

345,886

 

Interest paid

 

$

349,608

 

 

$

322,006

 

Supplemental schedule of non-cash investing activities:

 

 

 

 

 

 

Debt and equity securities received for certain obligations, real estate, and revenue

 

$

 

 

$

804,520

 

Certain obligations and receivables satisfied and real estate sold

 

 

 

 

 

722,814

 

Supplemental schedule of non-cash financing activities:

 

 

 

 

 

 

Distributions declared, unpaid

 

$

48,172

 

 

$

90,467

 

Cash, cash equivalents, and restricted cash are comprised of the following:

 

 

 

 

 

 

Beginning of period:

 

 

 

 

 

 

Cash and cash equivalents

 

$

250,016

 

 

$

235,668

 

Restricted cash, included in Other assets

 

 

5,936

 

 

 

5,870

 

 

 

$

255,952

 

 

$

241,538

 

End of period:

 

 

 

 

 

 

Cash and cash equivalents

 

$

275,616

 

 

$

340,058

 

Restricted cash, included in Other assets

 

 

4,131

 

 

 

5,828

 

 

 

$

279,747

 

 

$

345,886

 

 

See accompanying notes to condensed consolidated financial statements.

14


 

MEDICAL PROPERTIES TRUST, INC. AND MPT OPERATING PARTNERSHIP, L.P.

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements

(Unaudited)

1. Organization

Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P. (the “Operating Partnership”), through which we conduct substantially all of our operations, was formed in September 2003. At present, we own, directly and indirectly, all of the partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist.

We operate as a real estate investment trust (“REIT”). Accordingly, we are generally not subject to United States (“U.S.”) federal income tax on our REIT taxable income, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed such taxable income. Similarly, the majority of our real estate operations in the United Kingdom ("U.K.") operate as a REIT and generally are subject only to a withholding tax on earnings upon distribution out of the U.K. REIT. Certain non-real estate activities we undertake in the U.S. are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S. (excluding those assets that are in the U.K. REIT), we are subject to the local income taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur additional taxes, of a significant nature, in the U.S. from foreign-based income as the majority of such income flows through our REIT.

Our primary business strategy is to acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100%; however, we do own some leased assets through joint ventures with other partners that share our view that healthcare facilities are part of the infrastructure of any community, which we refer to as investments in unconsolidated real estate joint ventures. We also may make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants (which we refer to as investments in unconsolidated operating entities), from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections.

Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At September 30, 2024, we have investments in 402 facilities in 31 states in the U.S., in seven countries in Europe, and one country in South America. Our properties consist of general acute care hospitals, behavioral health facilities, post acute care facilities (including inpatient physical rehabilitation facilities and long-term acute care hospitals), and freestanding ER/urgent care facilities. We manage our business as a single business segment.

2. Summary of Significant Accounting Policies

Unaudited Interim Condensed Consolidated Financial Statements: The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair statement have been included. Operating results for the three and nine months ended September 30, 2024, are not necessarily indicative of the results that may be expected for the year ending December 31, 2024. The condensed consolidated balance sheet at December 31, 2023 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements.

The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of September 30, 2024, (particularly as it relates to our assessments of the recoverability of our real estate, the ability of our tenants/borrowers to make lease/loan payments in accordance with their respective

15


 

agreements, the fair value of our equity and loan investments, and the adequacy of our credit loss reserves on loans and financing receivables).

For information about significant accounting policies, and how actual results could differ from estimates, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2023. There have been no material changes to these significant accounting policies.

Reclassifications

Certain amounts in the condensed consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Variable Interest Entities

At September 30, 2024, we had loans and/or equity investments in certain variable interest entities ("VIEs"), which may also be tenants of our facilities. We have determined that we were not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at September 30, 2024 are presented below (in thousands):

 

VIE Type

 

Carrying
    Amount(1)

 

 

Asset Type
Classification

 

Maximum Loss
Exposure(2)

 

Loans, net and equity investments

 

$

201,526

 

 

Investments in Unconsolidated
Operating Entities

 

$

201,526

 

Loans, net

 

 

141,464

 

 

Mortgage and other loans

 

 

141,544

 

(1)
Carrying amount only reflects the net book value of our loan or equity investment in the VIE.
(2)
Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.

For the VIE types above, we do not consolidate the VIEs because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of September 30, 2024, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g. cash short falls).

Recent Accounting Developments

Segment Reporting

In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" ("ASU 2023-07") to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. We are finalizing our assessment of the impact of adopting this standard and expect to have additional disclosures in our Form 10-K for the year ended December 31, 2024.

Income Taxes

In December 2023, the FASB issued ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" ("ASU 2023-09") which focuses on income tax disclosures regarding effective tax rates and cash income taxes paid. This standard requires public entities to disclose (1) specific categories in the rate reconciliation, (2) the income or loss from continuing operations before income tax expense or benefit disaggregated by domestic and foreign, and (3) provide additional information for certain reconciling items at or above a quantitative threshold of 5% of the statutory tax. Additionally, this standard requires disclosure of income taxes paid (net of refunds), separated by international, federal, state, and local jurisdictions. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. We plan to adopt and include the necessary additional required disclosures in our filings in 2025.

16


 

Disaggregation of Income Statement Expenses

In November 2024, the FASB issued ASU 2024-03, "Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses" ("ASU 2024-03") to improve the disclosures about a public company's expenses and address requests from investors for more detailed information about the types of expenses in commonly presented expense captions. ASU 2024-03 is effective for annual periods beginning after December 15, 2026. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.

3. Real Estate and Other Activities

New Investments

We acquired or invested in the following net assets (in thousands):

 

 

 

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

 

 

 

 

 

 

 

Land and land improvements

 

$

 

 

$

28,916

 

Buildings

 

 

 

 

 

114,966

 

Intangible lease assets — subject to amortization (weighted-average useful
   life of
24.8 years for 2023)

 

 

 

 

 

16,305

 

Investments in unconsolidated real estate joint ventures

 

 

107,908

 

 

 

 

Investments in unconsolidated operating entities

 

 

 

 

 

50,000

 

Other loans

 

 

 

 

 

25,000

 

Liabilities assumed

 

 

(2,290

)

 

 

 

 

 

$

105,618

 

 

$

235,187

 

Loans repaid(1)

 

 

 

 

 

(22,900

)

Total net assets acquired

 

$

105,618

 

 

$

212,287

 

(1)
The 2023 column includes a $23 million mortgage loan that was converted to fee simple ownership of one property as described under Lifepoint Transaction below.

2024 Activity

Utah Transaction

On April 12, 2024, we sold our interests in five Utah hospitals for an aggregate agreed valuation of approximately $1.2 billion to a newly formed joint venture (the "Utah partnership") with an institutional asset manager (the "Fund"), which we call the Utah Transaction, and we recognized a gain on real estate of approximately $380 million, partially offset by a $20 million write-off of unbilled straight-line rent receivables. We retained an approximately 25% interest in the Utah partnership valued initially at approximately $108 million, which is being accounted for on the equity method on a quarterly lag basis and included in the "Investments in unconsolidated real estate joint ventures" line of the condensed consolidated balance sheets. The Fund purchased an approximate 75% interest for $886 million. In conjunction with this transaction closing, the Utah partnership placed new non-recourse secured financing, providing $190 million of additional cash to us. In total, the Utah Transaction generated $1.1 billion of cash to us.

The Utah lessee (an affiliate of CommonSpirit Health ("CommonSpirit")) may acquire the leased real estate at a price equal to the greater of fair market value and the approximate $1.2 billion lease base at the fifth or tenth anniversary of the 2023 master lease commencement. We granted the Fund certain limited and conditional preferences based on the possible execution of the purchase option, which we accounted for as a derivative liability with an initial value of approximately $2.3 million.

2023 Activity

Prospect Transaction

In August 2019, we invested in a portfolio of 14 acute care hospitals in three states (California, Pennsylvania, and Connecticut) operated by and master leased to or mortgaged by Prospect Medical Holdings, Inc. ("Prospect") for a combined investment of approximately $1.5 billion. In addition, we originated a $112.9 million term loan cross-defaulted to the master lease and mortgage loan agreements and further secured by a parent guaranty. In the 2022 second quarter, we funded an additional $100 million towards the existing mortgage loan that was secured by a first lien on a California hospital. Prospect's operations were negatively impacted by the coronavirus global pandemic commencing in early 2020, but Prospect remained current with respect to contractual rent and interest payments until the fourth quarter of 2022. Accordingly, and due further to the termination of certain refinancing negotiations

17


 

between Prospect and certain third parties in early 2023 that would have recapitalized Prospect and provided for payment of unpaid rent and interest, we recorded an approximate $280 million impairment charge in the 2022 fourth quarter. As part of this charge, we reduced the carrying value of the underperforming Pennsylvania properties by approximately $170 million (to approximately $250 million) and reserved all unbilled rent accruals for a total of $112 million.

However, Prospect continued to pursue a recapitalization plan, and, in late March 2023, Prospect received a binding commitment from several lenders to provide liquidity to pay down certain debt instruments. Along with these commitments from third-party lenders, we agreed to pursue certain transactions with Prospect as part of their recapitalization plan, including originating a $50 million convertible loan to PHP Holdings, the managed care business of Prospect, in the first quarter of 2023.

On May 23, 2023, Prospect completed its recapitalization plan, which included receiving $375 million in new financing from several lenders. Along with this new debt capital from third-party lenders, we agreed to the following restructuring of our then $1.7 billion investment in Prospect including: a) maintaining the master lease covering six California hospitals without any changes in rental rates or escalator provisions, but with cash payments starting in September 2023 for a substantial portion of the contractual monthly rent due on these California properties, b) transitioning the Pennsylvania properties back to Prospect in return for a $150 million first lien mortgage on the facilities, c) providing up to $75 million in a loan secured by a first lien on Prospect's accounts receivable and certain other assets, of which we funded in full during 2023, d) continuing to pursue the sale of the three Connecticut properties to Yale New Haven ("Yale"), as more fully described in Note 9 to the condensed consolidated financial statements, and e) obtaining a non-controlling ownership interest in PHP Holdings of approximately $654 million consisting of an approximate $68 million equity investment and $586 million loan convertible into equity of PHP Holdings (collectively, the "Prospect Transaction"). This non-controlling ownership interest was received in exchange for unpaid rent and interest through December 2022, previously unrecorded rent and interest revenue in 2023 totaling approximately $82 million, our $151 million mortgage loan on a California property, our $112.9 million term loan, and other obligations at the time of such investment.

Lifepoint Transaction

On February 7, 2023, a subsidiary of Lifepoint Health, Inc. ("Lifepoint") acquired a majority interest in Springstone (now Lifepoint Behavioral Health, "Lifepoint Behavioral") (the "Lifepoint Transaction") based on an enterprise value of $250 million. As part of the transaction, we received approximately $205 million in full satisfaction of our initial acquisition loan, including accrued interest, and we retained our minority equity investment in the operations of Lifepoint Behavioral. Separately, we converted a mortgage loan (as part of our initial acquisition in 2021) into the fee simple ownership of a property in Washington, which is leased, along with other behavioral health hospitals, to Lifepoint Behavioral, under a master lease agreement. In connection with the Lifepoint Transaction, Lifepoint extended its lease on eight existing general acute care hospitals by five years to 2041.

In the first quarter of 2024, we sold our minority equity investment in Lifepoint Behavioral for approximately $12 million.

Other Transactions

In the second quarter of 2023, we acquired three inpatient rehabilitation facilities for a total of approximately €70 million (approximately $77 million). These hospitals are leased to Median Kliniken S.á.r.l ("MEDIAN") pursuant to a long-term master lease with annual inflation-based escalators.

On April 14, 2023, we acquired five behavioral health hospitals located in the U.K. for approximately £44 million (approximately $58 million). These hospitals are leased to Priory Group ("Priory") pursuant to five separate lease agreements with annual inflation-based escalators.

Development Activities

 

See table below for a status summary of our current development projects (in thousands):

 

Property

 

Commitment

 

 

Costs
Incurred as of
September 30, 2024

 

 

Estimated Rent
Commencement
Date

IMED Hospitales ("IMED") (Spain)

 

$

38,974

 

 

$

31,445

 

 

3Q 2025

IMED (Spain)

 

 

53,427

 

 

 

21,594

 

 

3Q 2026

 

 

$

92,401

 

 

$

53,039

 

 

 

We have two other development projects ongoing in Texas (Texarkana development) and Massachusetts (Norwood redevelopment). These are not highlighted above; however, on a combined basis, we have spent approximately $400 million through September 30, 2024.

18


 

Separately, on the Norwood redevelopment, we recovered cash in November 2024 that was in excess of our recovery receivable (included in "Other assets" in the condensed consolidated balance sheets), resulting in a $24 million additional recovery in the 2024 third quarter.

2024 Activity

During the first quarter of 2024, we completed construction and began recording rental income on a $35.4 million behavioral health facility located in McKinney, Texas, that is leased to Lifepoint Behavioral. We also completed construction and began recording rental income on a €46 million (approximately $49.0 million) general acute care facility located in Spain that is leased to IMED.

2023 Activity

During the first nine months of 2023, we completed construction and began recording rental income on one inpatient rehabilitation facility located in Lexington, South Carolina, which commenced rent on July 1, 2023, and another inpatient rehabilitation facility located in Stockton, California, which commenced rent on May 1, 2023. Both of these facilities are leased to Ernest Health, Inc. ("Ernest") pursuant to an existing long-term master lease.

Disposals

2024 Activity

During the first nine months of 2024, we had the following disposal activities:

See Utah Transaction above for a discussion of the five Utah hospitals sold on April 12, 2024.
On April 9, 2024, we sold five properties to Prime Healthcare Services, Inc. ("Prime") for total proceeds of approximately $250 million along with a $100 million interest-bearing mortgage loan (which was fully repaid on August 29, 2024). This transaction resulted in a gain on real estate of approximately $53 million, partially offset by a non-cash straight-line rent write-off of approximately $30 million. As part of this sale transaction, we extended the lease maturity of four other facilities with Prime to 2044. This amended lease has inflation-based escalators, collared between 2% and 4%, and a purchase option on or prior to August 26, 2028 for a value of $238 million, which is greater than our net book value for these properties at September 30, 2024. After August 26, 2028, this option price reverts to $260 million (subject to annual escalations).
On July 23, 2024, we sold the 50-bed Arizona General Hospital in Mesa, Arizona and seven freestanding emergency departments to Dignity Health ("Dignity") for $160 million. This sale resulted in a gain on real estate of approximately $85 million, partially offset by a non-cash straight-line rent write-off of approximately $20 million.
On August 14, 2024, we sold 11 freestanding emergency departments to UCHealth for $86 million. This sale resulted in a gain on real estate of approximately $40 million, partially offset by a non-cash straight-line rent write-off of approximately $16 million.
As a result of the Company’s global settlement with Steward Health Care System ("Steward") approved by the bankruptcy court on September 18, 2024 (as discussed further under "Leasing Operations (Lessor)" under this same Note 3), we agreed to sell three facilities located in Florida ("Space Coast" properties) to Orlando Health. As such, we designated these properties as held for sale at September 30, 2024 and adjusted the value of our investment, after considering the provisions of the settlement agreement, to $45 million, equal to fair value less cost to sell.
In the third quarter of 2024, Pajaro Valley Healthcare District Corporation notified us of their intent to exercise their purchase option on the Watsonville facility. As such, we designated this property as held for sale at September 30, 2024 under a sales-type lease. This transaction, which closed on October 31, 2024, resulted in an approximate $4 million gain in the third quarter of 2024.
During the first nine months of 2024, we also completed the sale of four other facilities and two ancillary facilities for approximately $9 million, resulting in a loss on real estate of approximately $2 million.

19


 

Summary of Operations for Disposed (or to be Disposed) Assets in 2024

The following represents the operating results from the five properties sold as part of the Utah Transaction, the five Prime properties sold in April 2024, the eight properties sold to Dignity Health, the 11 properties sold to UCHealth, and the properties designated as held for sale at September 30, 2024 (in thousands):

 

 

 

For the Three Months
Ended September 30,

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

 

2024

 

 

2023

 

Revenues(1)

 

$

5,305

 

 

$

64,318

 

 

$

67,672

 

 

$

106,435

 

Real estate depreciation and amortization(2)

 

 

(10,429

)

 

 

(12,101

)

 

 

(24,213

)

 

 

(324,720

)

Property-related expenses

 

 

134

 

 

 

(600

)

 

 

(4,017

)

 

 

(6,252

)

Real estate impairment charges(3)

 

 

(129,159

)

 

 

 

 

 

(129,159

)

 

 

 

Other income (expense)(4)

 

 

91,728

 

 

 

(29

)

 

 

476,999

 

 

 

(77

)

(Expense) income from real estate dispositions, net

 

$

(42,421

)

 

$

51,588

 

 

$

387,282

 

 

$

(224,614

)

(1)
The nine month 2023 column includes an approximate $95 million write-off of straight-line rent receivables related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023.
(2)
The nine month 2023 column includes approximately $286 million of lease intangible amortization acceleration related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023.
(3)
Includes the charge associated with the three Space Coast facilities in the third quarter of 2024 due to the global settlement reached with Steward and its lenders.
(4)
The 2024 columns include approximately $24 million of gains (net of approximately $16 million write-off of straight line receivables) related to the UCHealth disposal and $65 million of gains (net of approximately $20 million write-off of straight-line rent receivables) related to the Dignity disposal. In addition, the nine month 2024 column includes $360 million of gains (net of approximately $20 million write-off of straight-line rent receivables) related to the Utah Transaction and $23 million of gains (net of $30 million write-off of straight-line rent receivables) related to the sale of five Prime properties.

2023 Activity

On March 30, 2023, we entered into a definitive agreement to sell our 11 general acute care facilities located in Australia and operated by Healthscope Ltd. ("Healthscope") (the "Australia Transaction") to affiliates of HMC Capital for cash proceeds of approximately A$1.2 billion. As a result, we designated the Australian portfolio as held for sale in the first quarter of 2023 and recorded approximately $79 million of net impairment charges at that time, which included $37.4 million of straight-line rent receivable write-offs and approximately $8 million in fees to sell the hospitals, partially offset by approximately $16 million of gains from our interest rate swap and foreign currency translation amounts in accumulated other comprehensive income that were reclassified to earnings in 2023 as part of the transaction. This transaction closed in two phases. The first phase closed on May 18, 2023, in which we sold seven of the 11 facilities for A$730 million, and the final phase closed on October 10, 2023, in which we sold the remaining four facilities for approximately A$470 million.

On March 8, 2023, we received notice that Prime planned to exercise its right to repurchase from us the real estate associated with one master lease for approximately $100 million. As such, we recorded an approximate $11 million impairment charge in the first quarter of 2023 related to non-cash rent receivables on the three facilities that were sold on July 11, 2023.

Leasing Operations (Lessor)

We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. The initial fixed lease terms of these infrastructure-type assets are typically at least 15 years, and most include renewal options at the election of our tenants, generally in five year increments. Over 99% of our leases provide annual rent escalations based on increases in the Consumer Price Index ("CPI") (or similar indices outside the U.S.) and/or fixed minimum annual rent escalations. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total initial investment. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance.

For all of our properties subject to lease, we are the legal owner of the property and the tenant's right to use and possess such property is guided by the terms of a lease. At September 30, 2024, we account for all of these leases as operating leases, except where GAAP requires alternative classification, including leases on 13 Ernest facilities that are accounted for as direct financing leases and

20


 

leases on nine of our Prospect facilities and five of our Ernest facilities that are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands):

 

 

 

As of September 30,
   2024

 

 

As of December 31,
   2023

 

Minimum lease payments receivable

 

$

596,274

 

 

$

611,669

 

Estimated unguaranteed residual values

 

 

203,818

 

 

 

203,818

 

Less: Unearned income and allowance for credit loss

 

 

(553,772

)

 

 

(571,059

)

Net investment in direct financing leases

 

 

246,320

 

 

 

244,428

 

Other financing leases (net of allowance for credit loss)

 

 

938,672

 

 

 

987,202

 

Total investment in financing leases

 

$

1,184,992

 

 

$

1,231,630

 

 

Other Leasing Activities

At September 30, 2024, our vacant properties represent less than 1% of total assets. We are in various stages of either re-leasing or selling these vacant properties.

Our tenants’ financial performance and resulting ability to satisfy their lease and loan obligations to us are material to our financial results and our ability to service our debt and make distributions to our stockholders. Our tenants operate in the healthcare industry, which is highly regulated, and changes in regulation (or delays in enacting regulation) may temporarily impact our tenants’ operations until they are able to make the appropriate adjustments to their business. In addition, our tenants may experience operational challenges from time-to-time as a result of many factors, including those external to them, such as cybersecurity attacks or public health crises (like the COVID-19 pandemic), economic issues resulting in high inflation and spikes in labor costs, extreme or severe weather and climate-related events, and adverse market and political conditions. We monitor our tenants' operating results and the potential impact from these challenges. We may elect to provide support to our tenants from time-to-time in the form of short-term rent deferrals to be paid back in full (like as described below under Pipeline Health System), or in the form of temporary loans (like as described previously in the Prospect Transaction). See below for an update on some of our tenants:

Steward Health Care System

As discussed in previous filings, Steward has experienced significant operational and liquidity challenges and filed for Chapter 11 bankruptcy on May 6, 2024 with the United States Bankruptcy Court for the Southern District of Texas. On September 11, 2024, the bankruptcy court entered an interim order approving a global settlement between Steward, its lenders, the unsecured creditors committee, and the Company. The interim order was made final by the bankruptcy court on September 18, 2024. The order provided for the following: a) termination of our master lease with Steward; b) the release of claims against 23 of our properties, allowing us to begin the process of re-tenanting or selling these properties; and c) a full release of claims against us from all parties. In return, we agreed to provide $395 million to the Steward estate from the proceeds of the sale of the Space Coast properties along with a full release of our claims in Steward including claims to past due rent and interest, outstanding loans, and our equity investment.

With this global settlement, our relationship with Steward effectively ends with no remaining Steward exposure on our condensed consolidated balance sheets at September 30, 2024, other than from the re-tenanting or selling of formerly leased Steward properties that are currently not under lease.

In regard to our real estate partnership with Macquarie Asset Management (“Macquarie”), the bankruptcy court approved the termination of the partnership’s master lease with Steward during the 2024 third quarter. In addition, we and Macquarie entered into an agreement with the mortgage lender of the partnership to transition the eight Massachusetts properties to them along with cash proceeds of approximately $40 million (representing our share), in return for full payment of the underlying mortgage debt and a release of claims against each party.

21


 

Impairment Charges

Due to the events discussed above, we recorded real estate and other impairment charges, net of approximately $600 million and $1.6 billion for the three and nine months ended September 30, 2024, which included the following (in millions):

 

Description

 

For the Three Months Ended September 30, 2024

 

 

For the Nine Months Ended September 30, 2024

 

Working capital and other loans

 

$

425

 

 

$

787

 

Real estate, primarily Space Coast facilities

 

 

180

 

 

 

277

 

Investment in Massachusetts partnership(1)

 

 

 

 

 

445

 

9.9% equity investment in Steward

 

 

 

 

 

36

 

Property taxes, insurance and other, net

 

 

(2

)

 

 

18

 

Total real estate and other impairment charges, net

 

$

603

 

 

$

1,563

 

(1)
$410 million of this charge was recorded in the "Earnings (loss) from equity interests" line of our condensed consolidated statements of net income.

In addition with the lease termination discussed above, we accelerated the amortization on the related in-place lease intangibles resulting in $115 million and $149 million of amortization expense in the three and nine months ended September 30, 2024 as reflected in the real estate depreciation and amortization line of our condensed consolidated statements of net income.

Re-tenanting Activity

Subsequent to the release of claims on the 23 properties as part of the global settlement, we reached definitive agreements with five operators (Healthcare Systems of America, Honor Health, Insight Health, Quorum Health, and College Health) to lease 17 of these facilities during and shortly after the quarter ending September 30, 2024. Excluding the two developments, the remaining four properties (with a net book value of less than 1% of our total assets) are in various stages of being re-tenanted or sold.

Other Activity

During 2024, we received and recorded rent and interest revenue from Steward of $10 million and $40 million for the three and nine months ended September 30, 2024, respectively. In addition, we were benefited from rent paid by Steward to the Massachusetts partnership of $76 million ($38 million representing our share) for the nine months ended September 30, 2024.

Subsequent to September 30, 2024, the sale of the Space Coast properties to Orlando Health was completed, and the Steward bankruptcy estate retained $395 million of the approximately $440 million total proceeds as discussed above.

Prospect

We lease real estate assets to Prospect in California and Connecticut and have a mortgage loan secured by four properties in Pennsylvania. Our total real estate investment is approximately $1 billion at September 30, 2024. Starting January 1, 2023, we began accounting for our leases and loans to Prospect on a cash basis versus our normal accrual method. In the first nine months of 2024, we recognized approximately $25 million of revenue representing cash received for rents on our California properties. In addition, we received and recorded approximately $3.8 million of interest on the asset-backed loan in 2024. However, Prospect did not make any scheduled rent or interest payments in the 2024 third quarter, resulting in no revenue recorded in the period. Although we believe our remaining real estate and asset-backed loan investments are recoverable at September 30, 2024, no assurances can be given that a future impairment will not be needed, particularly if Prospect's east coast operations do not improve or are not sold timely and they continue to miss scheduled rent and interest payments.

In regard to PHP Holdings, we account for our investment (both the equity investment and convertible loan) using the fair value option method. Prospect and its investment bankers continued to work through the sale process during and subsequent to the end of the period, resulting in a binding agreement with Astrana Health on November 8, 2024, as further described in Note 10 to the condensed consolidated financial statements. Based on our consideration of information in the purchase agreement, along with consultations with our third party appraisers, we recorded an additional approximate $134 million unfavorable fair value adjustment in the third quarter of 2024 (total unfavorable fair value adjustment in 2024 of $498 million), resulting in a total investment in PHP Holdings of approximately $200 million at September 30, 2024. Each quarter, we mark such investment to fair value as more fully described in Note 7 to the condensed consolidated financial statements.

22


 

Pipeline Health System

On October 2, 2022, Pipeline Health System ("Pipeline") filed for reorganization relief under Chapter 11 protection of the United States Bankruptcy Code in the Southern District of Texas, while keeping its hospitals open to continue providing care to the communities served. On February 6, 2023, Pipeline emerged from bankruptcy. Per the bankruptcy settlement, Pipeline's lease of our California assets remained in place, and we were repaid on February 7, 2023, for all rent that was outstanding at December 31, 2022, along with what was due for the first quarter of 2023. As part of the settlement, we deferred approximately $6 million, or approximately 30%, of rent in 2023 to be paid in 2024 with interest. As of September 30, 2024, Pipeline is current on their monthly base rent obligations per the terms of the lease, and we hold a rent deposit that more than covers the remaining $5 million of unpaid deferred rent.

International Joint Venture

As discussed in our Annual Report on Form 10-K for the year ending December 31, 2023, we placed our loan to the international joint venture on the cash basis of accounting, as we determined that it was no longer probable that the borrower would pay its future interest in full. This loan, accounted for under the fair value option method, was collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. Consistent with the discussion above on non-real estate investments in Steward, we recorded a $225 million unfavorable fair value adjustment in the 2024 first quarter to fully reserve for the loan and related equity investment. These investments, which are included in “Investments in unconsolidated operating entities” on our condensed consolidated balance sheets, were adjusted for after comparing our carrying value to an updated fair value analysis of the underlying collateral, with assistance from a third-party, independent valuation firm.

CommonSpirit

On May 1, 2023, Catholic Health Initiatives Colorado ("CHIC"), a wholly owned subsidiary of CommonSpirit, acquired the Utah hospital operations of five general acute care facilities previously operated by Steward. As a result of this transaction, we received $100 million on May 1, 2023, of the $150 million loan made in the 2022 second quarter. The new lease, at the time, for these Utah assets had an initial fixed term of 15 years with annual escalation provisions. As part of this transaction, we severed these facilities from the master lease with Steward, and accordingly accelerated the amortization of the associated in-place lease intangibles (approximately $286 million) and wrote-off approximately $95 million of straight-line rent receivables. As described earlier, these five properties make up the Utah Transaction.

Other Tenant Matters

In the 2023 third quarter, we moved to the cash basis of accounting for a tenant that comprised approximately 1% of our total assets due to declines in operating results. As a result, we recorded a $49 million charge to reserve billed and straight-line rent receivables. During the 2024 third quarter, we terminated the lease with this tenant, resulting in the acceleration of lease intangible amortization of $22 million. The former tenant is currently working on raising external capital, independent of us. In addition, we are currently working with the former tenant on an agreement that could result in either the sale and/or re-leasing of these real estate assets in early 2025. At September 2024, we believe the net book value of the related assets are recoverable. However, no assurances can be given that a future impairment will not be needed.

Investments in Unconsolidated Entities

Investments in Unconsolidated Real Estate Joint Ventures

Our primary business strategy is to acquire real estate and lease to providers of healthcare services. Typically, we directly own 100% of such investments. However, from time-to-time, we will co-invest with other investors that share a similar view that hospital real estate is a necessary infrastructure-type asset in communities. In these types of investments, we will own undivided interests of less than 100% of the real estate through unconsolidated real estate joint ventures. The underlying real estate and leases in these

23


 

unconsolidated real estate joint ventures are generally structured similarly and carry a similar risk profile to the rest of our real estate portfolio.

 

The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands):

 

Operator

 

Ownership Percentage

As of September 30,
   2024

 

 

As of December 31,
   2023

 

Swiss Medical Network

 

70%

$

515,878

 

 

$

472,434

 

MEDIAN

 

50%

 

472,179

 

 

 

471,336

 

CommonSpirit (Utah partnership)

 

25%

 

119,708

 

 

 

 

Policlinico di Monza

 

50%

 

81,785

 

 

 

80,562

 

HM Hospitales

 

45%

 

53,222

 

 

 

56,071

 

Steward (Macquarie partnership)

 

50%

 

 

 

 

394,052

 

Total

 

 

$

1,242,772

 

 

$

1,474,455

 

 

The decrease in our total investment in unconsolidated real estate joint ventures since December 31, 2023, is primarily due to the impairment recorded to our Massachusetts-based partnership with Macquarie in the second quarter of 2024 as more fully described above in this same Note 3. In the third quarter of 2024, we and the other equity owners funded capital contributions (our share being approximately $40 million) to the Swiss Medical Network investment, proceeds of which were used to pay off debt inside the joint venture.

As discussed previously, we hold a 25% interest in the Utah partnership accounted for under the equity method. The Utah partnership elected to apply specialized accounting and reporting for investment companies under Topic 946, which measures the underlying investments at fair value. For the quarter ending September 30, 2024, our share of the Utah partnership's favorable fair value adjustment was approximately $13.5 million, primarily related to the underlying real estate.

Investments in Unconsolidated Operating Entities

Our investments in unconsolidated operating entities are noncontrolling investments that are typically made in conjunction with larger real estate transactions in which the operators are vetted as part of our overall underwriting process. In many cases, we would not be able to acquire the larger real estate portfolio without such investments in operators. These investments also offer the opportunity to enhance our overall return and provide for certain minority rights and protections.

 

The following is a summary of our investments in unconsolidated operating entities (amounts in thousands):

 

 

Operator

 

As of September 30,
   2024

 

 

As of December 31,
   2023

 

PHP Holdings

 

$

201,526

 

 

$

699,535

 

Swiss Medical Network

 

 

185,185

 

 

 

186,113

 

Aevis Victoria SA ("Aevis")

 

 

63,758

 

 

 

77,345

 

Priory

 

 

41,670

 

 

 

163,837

 

Aspris Children's Services ("Aspris")

 

 

15,958

 

 

 

15,986

 

Caremax

 

 

130

 

 

 

1,148

 

Steward (loan investment)

 

 

 

 

 

361,591

 

International joint venture

 

 

 

 

 

225,960

 

Steward (equity investment)

 

 

 

 

 

35,696

 

Lifepoint Behavioral

 

 

 

 

 

11,429

 

Total

 

$

508,227

 

 

$

1,778,640

 

 

See "Leasing Operations (Lessor)" under this same Note 3 for details on the change in the first nine months of 2024 related to Steward.

For our investments marked to fair value (including our investments in PHP Holdings, Aevis, Caremax, and the international joint venture), we recorded approximately $739 million in unfavorable non-cash fair value adjustments during the first nine months of 2024; whereas, this was a $48.7 million favorable non-cash fair value adjustment for the same period of 2023. The amount recorded in 2024 includes an approximate $498 million unfavorable fair market value adjustment to our investment in PHP Holdings, as further described in the "Prospect" subheading of this Note 3 (included in the "Other (including fair value adjustments on securities)" line of the condensed consolidated statements of net income) and $225 million unfavorable fair value adjustment in the 2024 first quarter

24


 

related to our international joint venture investments as described in Note 3 and included in the "Real estate and other impairment charges, net" line of the condensed consolidated statements of net income.

In the first quarter of 2024, we sold our interest in the Priory syndicated term loan for £90 million (approximately $115 million), resulting in an approximate £6 million ($7.8 million) economic loss. In addition, we sold our remaining minority equity investment in Lifepoint Behavioral in the 2024 first quarter.

Other Investment Activities

In the third quarter of 2023, we invested approximately $105 million for a participation in Steward's syndicated asset-backed credit facility, and we loaned an additional $40 million. On August 17, 2023, we sold the $105 million interest to a global asset manager for approximately $100 million, and Steward paid approximately $2 million on November 3, 2023. The remainder was written off as part of the $425 million loan impairment charge in the 2024 third quarter as discussed in the "Leasing Operations (Lessor)" section of this same Note 3.

In the second quarter of 2023, we received repayment of the CHF 60 million mortgage loan from Infracore SA ("Infracore") that was originally made in the fourth quarter of 2022.

Credit Loss Reserves

We apply a forward-looking "expected loss" model to all of our financing receivables, including financing leases and loans, based on historical credit losses of similar instruments.

The following table summarizes the activity in our credit loss reserves (in thousands):

 

 

 

For the Three Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Balance at beginning of the period

 

$

538,534

 

 

$

87,105

 

Provision for credit loss, net

 

 

438,154

 

(1)

 

165

 

Expected credit loss reserve written off or related to financial
     instruments sold, repaid, or satisfied

 

 

(825,548

)

(3)

 

(63

)

Balance at end of the period

 

$

151,140

 

 

$

87,207

 

 

 

 

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Balance at beginning of the year

 

$

96,001

 

 

$

121,146

 

Provision for credit loss, net

 

 

880,687

 

(1)(2)

 

1,513

 

Expected credit loss reserve written off or related to financial
     instruments sold, repaid, or satisfied

 

 

(825,548

)

(3)

 

(35,452

)

Balance at end of the period

 

$

151,140

 

 

$

87,207

 

(1)
Includes charges and reserves related to our investments in cash basis tenants.
(2)
Includes the charge related to the $362 million loan to Steward, as further described under "Steward Health Care System" subheading of this Note 3.
(3)
Includes write-offs in the third quarter of 2024 of previously reserved loans to Steward as further described under "Steward Health Care System" subheading of this Note 3.

25


 

Concentrations of Credit Risk

We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our ability to replace inefficient operators of our facilities, if needed, with more effective operators. See below for our concentration details (dollars in thousands):

Total Assets by Operator

 

 

 

As of September 30, 2024

 

 

As of December 31, 2023

 

Operators

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

 

Total Assets (1)

 

 

Percentage of
Total Assets

 

Circle Health Ltd ("Circle")

 

$

2,179,805

 

 

 

14.3

%

 

$

2,119,392

 

 

 

11.6

%

Priory

 

 

1,325,408

 

 

 

8.7

%

 

 

1,391,005

 

 

 

7.6

%

Healthcare Systems of America

 

 

1,176,533

 

 

 

7.7

%

 

 

 

 

 

0.0

%

Prospect

 

 

1,042,343

 

 

 

6.8

%

 

 

1,092,974

 

 

 

6.0

%

Lifepoint Behavioral

 

 

815,439

 

 

 

5.4

%

 

 

813,527

 

 

 

4.4

%

Steward

 

 

 

 

 

0.0

%

 

 

3,518,537

 

 

 

19.2

%

Other operators

 

 

7,059,205

 

 

 

46.3

%

 

 

7,352,012

 

 

 

40.2

%

Other assets

 

 

1,637,423

 

(2)

 

10.8

%

 

 

2,017,397

 

 

 

11.0

%

Total

 

$

15,236,156

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%

(1)
Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans.
(2)
Includes our investment in PHP Holdings of approximately $200 million as part of the Prospect Transaction and tenant update described previously in this same Note 3.

 

Total Assets by U.S. State and Country (1)

 

 

As of September 30, 2024

 

 

As of December 31, 2023

 

U.S. States and Other Countries

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

Texas

 

$

1,367,932

 

 

 

9.0

%

 

$

1,891,482

 

 

 

10.3

%

California

 

 

1,051,443

 

 

 

6.9

%

 

 

1,252,674

 

 

 

6.8

%

Florida

 

 

890,879

 

 

 

5.8

%

 

 

1,348,210

 

 

 

7.4

%

Pennsylvania

 

 

455,757

 

 

 

3.0

%

 

 

470,562

 

 

 

2.6

%

Arizona

 

 

380,756

 

 

 

2.5

%

 

 

547,789

 

 

 

3.0

%

All other states

 

 

2,890,763

 

 

 

19.0

%

 

 

4,264,392

 

 

 

23.3

%

Other domestic assets

 

 

858,750

 

 

 

5.7

%

 

 

1,397,170

 

 

 

7.6

%

Total U.S.

 

$

7,896,280

 

 

 

51.9

%

 

$

11,172,279

 

 

 

61.0

%

United Kingdom

 

$

4,283,890

 

 

 

28.1

%

 

$

4,261,944

 

 

 

23.3

%

Switzerland

 

 

764,821

 

 

 

5.0

%

 

 

735,891

 

 

 

4.0

%

Germany

 

 

732,489

 

 

 

4.8

%

 

 

734,630

 

 

 

4.0

%

Spain

 

 

265,574

 

 

 

1.7

%

 

 

252,529

 

 

 

1.4

%

All other countries

 

 

514,429

 

 

 

3.4

%

 

 

527,344

 

 

 

2.9

%

Other international assets

 

 

778,673

 

 

 

5.1

%

 

 

620,227

 

 

 

3.4

%

Total international

 

$

7,339,876

 

 

 

48.1

%

 

$

7,132,565

 

 

 

39.0

%

Grand total

 

$

15,236,156

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%

 

26


 

Total Assets by Facility Type (1)

 

 

As of September 30, 2024

 

 

As of December 31, 2023

 

Facility Types

 

Total Assets

 

 

Percentage of
Total Assets

 

 

Total Assets

 

 

Percentage of
Total Assets

 

General acute care hospitals

 

$

9,308,236

 

 

 

61.1

%

 

$

11,764,151

 

 

 

64.3

%

Behavioral health facilities

 

 

2,487,861

 

 

 

16.3

%

 

 

2,576,983

 

 

 

14.1

%

Post acute care facilities

 

 

1,676,426

 

 

 

11.0

%

 

 

1,716,248

 

 

 

9.4

%

Freestanding ER/urgent care facilities

 

 

126,210

 

 

 

0.8

%

 

 

230,065

 

 

 

1.2

%

Other assets

 

 

1,637,423

 

 

 

10.8

%

 

 

2,017,397

 

 

 

11.0

%

Total

 

$

15,236,156

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%

(1)
For geographic and facility type concentration metrics in the tables above, we allocate our investments in unconsolidated operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

On an individual property basis, our largest investment in any single property was less than 2% of our total assets as of September 30, 2024.

From a revenue concentration perspective, Circle and Priory individually represented more than 10% of our total revenues for the three and nine months ended September 30, 2024. Steward and Circle each represented more than 10% of our total revenues for the three and nine months ended September 30, 2023.

27


 

4. Debt

The following is a summary of debt (dollar amounts in thousands):

 

 

 

As of September 30,
2024

 

 

As of December 31,
2023

 

Revolving credit facility(A)

 

$

397,391

 

 

$

1,514,420

 

Term loan

 

 

200,000

 

 

 

200,000

 

British pound sterling secured term loan due 2024(B)

 

 

 

 

 

133,484

 

British pound sterling term loan due 2025(B)

 

 

699,512

 

 

 

891,170

 

British pound sterling secured term loan due 2034(B)

 

 

844,470

 

 

 

 

Australian term loan facility(B)

 

 

 

 

 

320,164

 

3.325% Senior Unsecured Notes due 2025(B)

 

 

556,750

 

 

 

551,950

 

0.993% Senior Unsecured Notes due 2026(B)

 

 

556,750

 

 

 

551,950

 

2.500% Senior Unsecured Notes due 2026(B)

 

 

668,750

 

 

 

636,550

 

5.250% Senior Unsecured Notes due 2026

 

 

500,000

 

 

 

500,000

 

5.000% Senior Unsecured Notes due 2027

 

 

1,400,000

 

 

 

1,400,000

 

3.692% Senior Unsecured Notes due 2028(B)

 

 

802,500

 

 

 

763,860

 

4.625% Senior Unsecured Notes due 2029

 

 

900,000

 

 

 

900,000

 

3.375% Senior Unsecured Notes due 2030(B)

 

 

468,125

 

 

 

445,585

 

3.500% Senior Unsecured Notes due 2031

 

 

1,300,000

 

 

 

1,300,000

 

 

 

$

9,294,248

 

 

$

10,109,133

 

Debt issue costs and discount, net

 

 

(78,497

)

 

 

(44,897

)

 

 

$

9,215,751

 

 

$

10,064,236

 

 

(A)
Includes £- million and £322 million of GBP-denominated borrowings and €303 million and €303 million of Euro-denominated borrowings that reflect the applicable exchange rates at September 30, 2024 and December 31, 2023, respectively.
(B)
Non-U.S. dollar denominated debt reflects the exchange rates at September 30, 2024 and December 31, 2023.

As of September 30, 2024, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands):

2024

 

$

 

2025

 

 

1,256,262

 

2026

 

 

2,122,891

 

2027

 

 

1,600,000

 

2028

 

 

802,500

 

Thereafter

 

 

3,512,595

 

Total

 

$

9,294,248

 

 

Credit Facilities

On April 12, 2024, we amended our unsecured credit facility (the "Credit Facility") and certain other agreements to (i) reduce revolving commitments from $1.8 billion to $1.4 billion, (ii) apply certain proceeds from the Utah Transaction and other asset sales and debt transactions to repay the Australian term loan facility and certain other outstanding obligations, including revolving loans under the Credit Facility to the extent necessary to reduce the outstanding borrowings to no more than the amended $1.4 billion commitment, (iii) amend or waive certain covenants as described under "Covenants" in this same Note 4, and (iv) waive the 10% cap on unencumbered asset value attributable to tenants subject to a bankruptcy event for purposes of determining compliance with the unsecured leverage ratio for the trailing four fiscal quarter periods ended June 30, 2024, and for purposes of determining pro forma compliance with the unsecured leverage ratio for certain asset sale and debt transactions.

On August 6, 2024, we amended the Credit Facility and the British pound sterling term loan due 2025 to (i) further reduce revolving commitments in the Credit Facility from $1.4 billion to $1.28 billion, (ii) increase borrowing spreads to 300 basis points during the Modified Covenant Period (defined in "Covenants" section in this same Note 4) and then to 225 basis points after the Modified Covenant Period, (iii) require that proceeds of certain future asset sales and debt transactions (during the Modified Covenant Period) be applied to repay certain outstanding obligations, including our revolving loans (by 15% of such proceeds but for which the revolving loans can be reborrowed) and our British pound sterling term loan due 2025 (by 50% of such proceeds), and (iv) amend or waive certain covenants as described under "Covenants" in this same Note 4.

 

28


 

Australian Term Loan Facility

On May 18, 2023, we completed the first phase of the Australia Transaction in which we sold seven of the 11 Australia facilities for A$730 million. We used the proceeds from the first phase of this sale to prepay A$730 million (approximately $475 million) of the A$1.2 billion Australian term loan. On April 18, 2024, we paid off and terminated the remainder of the A$470 million (approximately $306 million) Australian term loan facility with proceeds from the Utah Transaction described in Note 3.

British Pound Sterling Secured Term Loan due 2034

On May 24, 2024, we closed on a secured loan facility with a consortium of institutional investors that provides for a term loan in aggregate principal amount of approximately £631 million (approximately $800 million) secured by a portfolio of 27 properties located in the U.K. currently leased to affiliates of Circle. The facility carries a fixed rate of 6.877% over its 10-year term, excluding fees and expenses, and is interest-only (payable quarterly in advance) through the maturity date. The facility is secured by first priority mortgages or similar security instruments on the relevant properties, including assignments of rents and security over accounts, and is non-recourse to us. We used the majority of the net proceeds of the facility to pay down portions of our revolving credit facility and British pound sterling term loan due 2025, and to pay off our British pound sterling secured term loan due 2024 (approximately £105 million).

British Pound Sterling Term Loan due 2025

In addition to the £105 million pay down from proceeds of the secured term loan discussed above, we paid down another £72 million of our British pound sterling term loan due 2025 in the 2024 third quarter.

Debt Refinancing and Unutilized Financing Costs

2024 Activity

In the first nine months of 2024, we incurred $3.7 million of debt refinancing and unutilized financing costs. These costs were incurred primarily as a result of the reduction in revolving commitments under our Credit Facility and partial paydown of our British pound sterling term loan due 2025.

2023 Activity

As a result of the prepayment of a portion of the Australian term loan, we incurred approximately $0.8 million to accelerate the amortization of related debt issue costs in the first nine months of 2023. This charge was more than offset by the $0.9 million gain realized on the purchase of approximately £40 million of our 2.550% Senior Unsecured Notes due 2023 at a discount in the 2023 third quarter.

Covenants

Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem, or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreement governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreement, on a rolling four quarter basis to 95% of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances, and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness.

In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio (which was amended on April 12, 2024 to lower the maximum permitted ratio from 40% to 25%), consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. The Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations, and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable.

On August 6, 2024, we entered into an amendment to the Credit Facility and the British pound sterling term loan due 2025 (the “Amendments”) to increase the maximum total leverage ratio covenant from 60% to 65% and the maximum unsecured leverage ratio covenant from 65% to 70% and to decrease the minimum unsecured interest coverage ratio from 1.75:1.00 to 1.45:1.00. These Amendments were effective as of June 30, 2024 and will continue in effect through and including September 30, 2025, unless earlier terminated by us (the “Modified Covenant Period”) at which point the credit agreement provides that covenants will automatically reset to their prior levels. In addition, the Amendments permanently reduced the minimum consolidated adjusted net worth covenant from approximately $6.7 billion to $5 billion, in each case plus the sum of certain equity proceeds. The Amendments also limit the

29


 

payment of dividends in cash during the Modified Covenant Period to $0.08 per share in any fiscal quarter, but the Amendments do not provide any additional restrictions on the payment of dividends outside of the Modified Covenant Period.

As of September 30, 2024, we are in compliance with all such financial and operating covenants. However, as of September 30, 2024, we would not have been in compliance with certain covenants without the Amendments discussed above. Our ability to maintain compliance with our debt covenants, including the reset leverage and interest coverage requirements, after the end of the Modified Covenant Period depends primarily on reducing debt through asset sales, retention of cash generated from our monthly rent and interest receipts, extending maturities of certain debt instruments, and other access to capital. We expect to continue to comply with these covenants, but if we are not in compliance, including following the expiration of the Modified Covenant Period, we would have to seek additional amendments to our covenants. However, no assurances can be made that such amendments will be approved by our lenders. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable which could have a material adverse impact to the Company.

5. Income Taxes

2024 Activity

In connection with closing the secured term loan facility in the U.K. on May 24, 2024, we realized a gain, for U.K. tax purposes, on the interest rate swap associated with the internal restructuring of the British pound sterling term loan due 2025. This gain resulted in a tax expense of approximately $5 million in the 2024 second quarter.

2023 Activity

During the 2023 second quarter, we elected to move a majority of our U.K. assets into a U.K. REIT regime with an effective date of July 1, 2023. With this election, we adjusted the deferred tax liabilities associated with these properties, resulting in a $158 million income tax benefit in the second quarter of 2023.

As a result of the Australia Transaction described in Note 3 to the condensed consolidated financial statements, we recorded a $5 million tax benefit in the first quarter of 2023.

6. Stock Awards

During the second quarter of 2022, we amended the 2019 Equity Incentive Plan (the “Equity Incentive Plan”), which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors, and we have reserved 28.9 million shares of common stock for awards, of which 8.8 million shares remain available for future stock awards as of September 30, 2024. Share-based compensation expense totaled $30.6 million (including $9.3 million related to certain grants in 2024 with cash-settlement features) and $29.7 million for the nine months ended September 30, 2024 and 2023, respectively.

7. Fair Value of Financial Instruments

We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and other loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt.

Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be a prudent management decision.

 

 

 

30


 

The following table summarizes fair value estimates for our financial instruments (in thousands):

 

 

 

As of September 30, 2024

 

 

As of December 31, 2023

 

Asset (Liability)

 

Book
Value

 

 

Fair
Value

 

 

Book
Value

 

 

Fair
Value

 

Interest and rent receivables

 

$

35,142

 

 

$

35,130

 

 

$

45,059

 

 

$

45,476

 

Loans(1)

 

 

694,809

 

(2)

 

675,683

 

 

 

1,302,727

 

(2)

 

1,202,383

 

Debt, net

 

 

(9,215,751

)

 

 

(8,035,236

)

 

 

(10,064,236

)

 

 

(8,256,465

)

 

(1)
Excludes the convertible loan made in May 2023 to PHP Holdings and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below.
(2)
Includes $162.0 million and $162.4 million of mortgage loans, a $339.6 million and $323.8 million shareholder loan included in investments in unconsolidated real estate joint ventures, $42.6 million and $526.9 million of loans that are part of our investments in unconsolidated operating entities, and $150.6 million and $289.6 million of other loans at September 30, 2024 and December 31, 2023, respectively.

Items Measured at Fair Value on a Recurring Basis

Our equity investment and related loan to the international joint venture, our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia, our equity investment in Lifepoint Behavioral (which was sold in March 2024), and our investment in PHP Holdings are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option at the point of initial investment. We elected to account for these investments at fair value due to the size of the investments and because we believed this method was more reflective of current values.

At September 30, 2024 and December 31, 2023, the amounts recorded under the fair value option method were as follows (in thousands):

 

 

 

As of September 30, 2024

 

 

As of December 31, 2023

 

 

 

Asset (Liability)

 

Fair Value

 

 

Original
Cost

 

 

Fair Value

 

 

Original
Cost

 

 

Asset Type Classification

Mortgage loans

 

$

136,192

 

 

$

136,192

 

 

$

146,892

 

 

$

146,892

 

 

Mortgage loans

Equity investment and other loans

 

 

206,798

 

 

 

909,726

 

 

 

939,903

 

 

 

912,999

 

 

Investments in unconsolidated operating entities/Other loans

Our loans to the international joint venture and its subsidiaries are recorded at fair value based on Level 2 and Level 3 inputs by discounting the estimated future contractual cash flows using a credit-adjusted rate of return, which is derived from market rates of return on similar loans with similar credit quality and remaining maturity. Our equity investment in Lifepoint Behavioral (which was sold in March 2024) was recorded at fair value as of December 31, 2023, based on Level 2 inputs by discounting the estimated cash flows expected to be realized as part of the Lifepoint Transaction described in Note 3 to the condensed consolidated financial statements. Our equity investment in the international joint venture and our investment in PHP Holdings are recorded at fair value based on Level 3 inputs, by using a market approach (for our equity investment in the international joint venture) and a discounted cash flow model and guideline public company model, a form of market approach, (for our investment in PHP Holdings), which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of these investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuations require management judgment due to the absence of quoted market prices. For the cash flow and market approach models used for our investment in PHP Holdings, our unobservable inputs include use of a discount rate (which is based on a weighted-average cost of capital), selected revenue and EBITDA multiples in reference to guideline public companies, and an adjustment for a marketability discount ("DLOM"). In regard to the underlying projections used in the discounted cash flow model, such projections are provided by the investees. However, we may modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry.

In the first nine months of 2024, we recorded a net unfavorable adjustment to the investments accounted for under the fair value option method of approximately $720 million, primarily related to the loan to the international joint venture and our investment in PHP Holdings as further discussed in Note 3 to the condensed consolidated financial statements. In the first nine months of 2023, we had a net favorable adjustment of approximately $25 million for our investments accounted for under the fair value option method.

The discount rate and DLOM on our investment in PHP Holdings was approximately 25% and 14%, respectively, at September 30, 2024, compared to 11% and 8% at December 31, 2023. The selected revenue multiples ranged from 0.60x to 0.70x at September

31


 

30, 2024 compared to 1.1x to 1.3x at December 31, 2023. The selected EBITDA multiples ranged from 5.5x to 6.5x at September 30, 2024, compared to 10x to 14x at December 31, 2023. The decrease in multiples used in the fair value analysis of our investment in PHP Holdings compared to December 31, 2023 aligned with the expected value from the Astrana Health deal more fully described in Note 10 to the condensed consolidated financial statements.

In arriving at the DLOM, we considered many qualitative factors, including the percent of control, the nature of the underlying investee's business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using full basis point variations (in thousands):

 

Basis Point Change in Marketability Discount

 

Estimated
Increase
(Decrease)
In Fair Value

 

+100 basis points

 

$

(2,315

)

- 100 basis points

 

 

2,315

 

Items Measured at Fair Value on a Nonrecurring Basis

In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured, from time-to-time, at fair value on a nonrecurring basis, such as for impairment purposes of our real estate, financial instruments, and for certain equity investments without a readily determinable fair value.

Impairment and Fair Value Adjustments of Non-Real Estate Investments

Prior to the global settlement in September 2024 (as described in Note 3 to the condensed consolidated financial statements) in which our claims were released, our non-real estate investments in Steward and related affiliates included our 9.9% equity investment, working capital and other secured loans, and a loan made to a Steward affiliate in 2021, proceeds of which were used to redeem a similarly sized convertible loan held by Steward’s former private equity sponsor. In addition, the loan to the international joint venture is collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. To assess recovery of these investments, we performed a valuation of Steward’s business at March 31, 2024, with assistance from a third-party, independent valuation firm. The valuation approaches utilized included the cost, market, and income approaches. The fair value analysis was performed under a non-going concern, orderly liquidation premise of value and assuming normal exposure to market participants. We utilized this premise of value due to Steward’s ongoing financial distress and subsequent filing of bankruptcy. Accordingly, the valuation approaches used, including the Level 3 inputs, were based on the financial performance of the Steward assets. For profitable hospitals, Level 3 inputs included a weighted average EBITDA multiple of 6.48x from a selected range of 5x to 7x in reference to comparable transactions. We also used a weighted average discount rate of 15.03% from a selected range of 15% to 16%. For unprofitable hospitals, Level 3 inputs included a weighted average net revenue multiple range of 0.275x from a selected range of 0.25x to 0.30x in reference to comparable transactions. We also considered the reported book values inclusive of various adjustments for unprofitable hospitals. After reducing the derived fair value of Steward's business for Steward's secured debt (including our working capital and other secured loans) and their working capital deficit, we arrived at only a nominal remaining value that could not support the carrying value of the loan to a Steward affiliate from 2021 or our remaining 9.9% equity investment. In addition, the value of the investor's share of the remaining 90.1% of Steward's equity that collateralized the loan to the international joint venture was deemed insufficient to support recovery of this investment. As a result, we recorded impairment charges and negative fair value adjustments in the 2024 first quarter of more than $600 million, as discussed further in Note 3 to the condensed consolidated financial statements.

We updated our fair value analysis of Steward's business at June 30, 2024, using a similar approach as done in the 2024 first quarter resulting in no further impairments or fair value adjustments to non-real estate investments in the 2024 second quarter. In the third quarter of 2024, as a result of the Company’s global settlement with Steward (as discussed further in Note 3 to the condensed consolidated financial statements), the Company recorded impairment charges of approximately $425 million for the working capital loans and other secured loans previously advanced to Steward.

Impairment of Real Estate Investments

In the 2024 third quarter, we recognized a real estate impairment charge of approximately $180 million related to the Space Coast facilities and certain excess properties previously leased to Steward that were deemed held for sale at September 30, 2024. The charge was needed to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. In the 2024 second quarter, we recognized approximately $500 million of real

32


 

estate impairment charges, primarily involving the eight Massachusetts properties in the Macquarie partnership. In our assessment, we first made a comparison of the carrying value of our real estate to projected undiscounted cash flows. For those properties for which the carrying value was not deemed recoverable, we recorded an impairment charge to the extent our carrying value was greater than its estimated fair value. In estimating fair value for these properties, we, along with assistance from a third-party, independent valuation firm, used a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (i.e. revenue less expenses, if any) from the property by a market capitalization rate (range from 7% to 10%). Our share of the real estate impairment charge in the Macquarie partnership exceeded the remaining equity amount in the joint venture, which resulted in a write down of our equity interest to zero and such charge is reflected in the "Earnings (loss) from equity interests" line on the condensed consolidated statements of net income.

8. Earnings Per Share/Unit

Medical Properties Trust, Inc.

Our earnings per share were calculated based on the following (in thousands):

 

 

 

For the Three Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

Net (loss) income

 

$

(800,929

)

 

$

116,895

 

Non-controlling interests’ share in net income

 

 

(234

)

 

 

(185

)

Participating securities’ share in earnings

 

 

(153

)

 

 

(311

)

Net (loss) income, less participating securities’ share in earnings

 

$

(801,316

)

 

$

116,399

 

Denominator:

 

 

 

 

 

 

Basic weighted-average common shares

 

 

600,229

 

 

 

598,444

 

Dilutive potential common shares(1)

 

 

 

 

 

109

 

Diluted weighted-average common shares

 

 

600,229

 

 

 

598,553

 

 

 

 

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

Net (loss) income

 

$

(1,995,965

)

 

$

107,492

 

Non-controlling interests’ share in net income

 

 

(1,458

)

 

 

(25

)

Participating securities’ share in earnings

 

 

(807

)

 

 

(1,295

)

Net (loss) income, less participating securities’ share in earnings

 

$

(1,998,230

)

 

$

106,172

 

Denominator:

 

 

 

 

 

 

Basic weighted-average common shares

 

 

600,197

 

 

 

598,363

 

Dilutive potential common shares(1)

 

 

 

 

 

43

 

Diluted weighted-average common shares

 

 

600,197

 

 

 

598,406

 

MPT Operating Partnership, L.P.

Our earnings per unit were calculated based on the following (in thousands):

 

 

 

For the Three Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

Net (loss) income

 

$

(800,929

)

 

$

116,895

 

Non-controlling interests’ share in net income

 

 

(234

)

 

 

(185

)

Participating securities’ share in earnings

 

 

(153

)

 

 

(311

)

Net (loss) income, less participating securities’ share in earnings

 

$

(801,316

)

 

$

116,399

 

Denominator:

 

 

 

 

 

 

Basic weighted-average units

 

 

600,229

 

 

 

598,444

 

Dilutive potential units(1)

 

 

 

 

 

109

 

Diluted weighted-average units

 

 

600,229

 

 

 

598,553

 

 

33


 

 

 

 

 

For the Nine Months
Ended September 30,

 

 

 

2024

 

 

2023

 

Numerator:

 

 

 

 

 

 

Net (loss) income

 

$

(1,995,965

)

 

$

107,492

 

Non-controlling interests’ share in net income

 

 

(1,458

)

 

 

(25

)

Participating securities’ share in earnings

 

 

(807

)

 

 

(1,295

)

Net (loss) income, less participating securities’ share in earnings

 

$

(1,998,230

)

 

$

106,172

 

Denominator:

 

 

 

 

 

 

Basic weighted-average units

 

 

600,197

 

 

 

598,363

 

Dilutive potential units(1)

 

 

 

 

 

43

 

Diluted weighted-average units

 

 

600,197

 

 

 

598,406

 

 

(1)
The above computation of diluted earnings per share/units does not include 37,967 and 18,422 potential common shares/units for the three and nine months ended September 30, 2024, respectively.

 

9. Commitments and Contingencies

Commitments

On October 5, 2022, we entered into definitive agreements to sell three Prospect facilities located in Connecticut to Yale for approximately $457 million, of which we are still contractually owed $355 million in cash and have previously received the remainder in additional investments in PHP Holdings - part of the Prospect Transaction discussed in Note 3. This transaction was approved by the state of Connecticut's Office of Health Strategy on March 27, 2024 and is now subject to the completion of Yale's acquisition of the hospital operations from Prospect. However, given the length of time since the definitive agreements were signed, no assurances can be given that this transaction will be consummated as described or at all. Our net book value for these three facilities is slightly less than 2% of our total assets at September 30, 2024.

Contingencies

As part of the global settlement with Steward discussed in Note 3, upon completion of the transfers to the new operators and satisfaction of certain other conditions, in addition to approval by relevant state and local regulators, each of the Company and Steward have agreed, subject to specified exceptions, to the mutual release of claims against each other, including payment by Steward of any accrued or future rent under its master leases with the Company and accrued or future payments of principal and interest on outstanding loans from the Company. Steward’s asset backed lenders also forfeited their right to cause the Company to purchase up to $60 million of bridge loans made to Steward during the first quarter of 2024. In connection with the global settlement with Steward and reciprocal release of claims, the Company has an approximate $35 million liability at September 30, 2024, for property taxes, other property related expenses, and other obligations due to third parties.

 

 

We are party to various lawsuits as described below:

Securities and Derivative Litigation

On April 13, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit alleging false and/or misleading statements and/or omissions resulted in artificially inflated prices for our common stock, filed by a purported stockholder in the United States District Court for the Northern District of Alabama (Case No. 2:23-cv-00486). The complaint seeks class certification on behalf of purchasers of our common stock between July 15, 2019 and February 22, 2023 and unspecified damages including interest and an award of reasonable costs and expenses. This class action complaint was amended on September 22, 2023 and alleges that we made material misstatements or omissions relating to the financial health of certain of our tenants. On September 26, 2024, the Court dismissed the amended complaint with prejudice. On October 24, 2024, the plaintiff moved to alter the Court’s judgment and for leave to further amend the complaint. On November 11, 2024, the Company filed an opposition to plaintiff's motion.

34


 

Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Northern District of Alabama on October 19, 2023 (Case No. 2:23- cv-01415) and December 7, 2023 (Case No. 2:23-cv-01667). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the Alabama securities lawsuit described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. Members of our Board of Directors were also named as defendants in three related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the District of Maryland on February 16, 2024 (Case No. 1:24-cv-00471), June 28, 2024 (Case No. 1:24-cv-01899), and July 26, 2024 (Case No. 1 24-cv-02173). The Company was named as a nominal defendant. These shareholder derivative complaints make allegations similar to those made in the Alabama securities and derivative lawsuits described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants.

On September 29, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit filed by a purported stockholder in the United States District Court for the Southern District of New York (Case No. 1:23-cv- 08597). The complaint seeks class certification on behalf of purchasers of our common stock between May 23, 2023 and August 17, 2023 and alleges false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. This class action complaint was amended on October 30, 2024 and alleges that we made material misstatements or omissions in connection with certain transactions involving Prospect.

Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Southern District of New York on December 18, 2023 (Case No. 1:23-cv- 10934) and March 1, 2024 (Case No. 1:24-cv-01589). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the New York securities lawsuit described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. On February 21, 2024, members of our Board of Directors were named as defendants in a shareholder derivative lawsuit filed by a purported stockholder in the United States District Court for the District of Maryland (Case No. 1:24-cv-00527). The Company was named as a nominal defendant. This shareholder derivative complaint makes allegations similar to those made in the New York securities and derivative lawsuits described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect.

We believe these claims are without merit and intend to defend the cases vigorously. We have not recorded a liability related to the lawsuits above because, at this time, we are unable to determine whether an unfavorable outcome is probable or to estimate reasonably possible losses.

Defamation Litigation

On March 30, 2023, we commenced an action in the United States District Court for the Northern District of Alabama (Case No. 2:23-cv-00408), against short-seller Viceroy Research LLC (“Viceroy”) and its members. We are seeking injunctive relief and damages for defamation, civil conspiracy, tortious interference, private nuisance, and unjust enrichment based on defamatory statements expressed against us. On June 29, 2023, we won a preliminary ruling in this lawsuit after Viceroy's motion to dismiss the case was denied by a judge in the United States District Court for the Northern District of Alabama.

From time-to-time, we are a party to other legal proceedings, claims, or regulatory inquiries and investigations arising out of, or incidental to, our business. While we are unable to predict with certainty the outcome of any particular matter, in the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows.

 

 

10. Subsequent Events

On October 18, 2024, we sold two facilities located in Texas and previously leased for total proceeds of approximately $5 million.

On November 8, 2024, Astrana Health entered into a binding agreement to purchase the majority of PHP Holdings for approximately $745 million and the assumption of certain liabilities. After satisfaction of certain obligations, we expect to receive approximately $200 million in total proceeds. We expect to receive the majority of these proceeds in the first half of 2025, while a $50 million payment is expected by 2027.

35


 

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations.

The following discussion and analysis of the consolidated financial condition and consolidated results of operations are presented on a combined basis for Medical Properties Trust, Inc. and MPT Operating Partnership, L.P. as there are no material differences between these two entities. Such discussion and analysis should be read together with the condensed consolidated financial statements and notes thereto contained in this Form 10-Q and the consolidated financial statements and notes thereto contained in our Annual Report on Form 10-K for the year ended December 31, 2023.

Forward-Looking Statements.

This Quarterly Report on Form 10-Q contains certain “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Forward-looking statements can generally be identified by the use of forward-looking words such as "may", "will", "would", "could", "expect", "intend", "plan", "estimate", "target", "anticipate", "believe", "objectives", "outlook", "guidance", or other similar words, and include statements regarding our strategies, objectives, asset sales and other liquidity transactions (including the use of proceeds thereof), expected returns on investments and financial performance, expected trends and performance across our various markets, and expected outcomes from Steward's restructuring process. Such forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause our actual results or future performance, achievements or transactions or events to be materially different from those expressed or implied by such forward-looking statements, including, but not limited to, the risks described in our Annual Report on Form 10-K and as updated in our quarterly reports on Form 10-Q for future periods, and current reports on Form 8-K as we file them with the SEC under the Exchange Act. Such factors include, among others, the following:

the risk that property sales, loan repayments, and other capital recycling transactions do not occur as anticipated or at all, including the transactions described in Note 9 and Note 10 to the condensed consolidated financial statements;
the risk that we are not able to attain our leverage, liquidity, and cost of capital objectives within a reasonable time period or at all;
our ability to obtain debt financing on attractive terms or at all, as a result of changes in interest rates and other factors, which may adversely impact our ability to pay down, refinance, restructure, or extend our indebtedness as it becomes due, or pursue acquisition and development opportunities;
our ability to remain in compliance with our financial covenants under our debt facilities and obtain additional debt covenant relief under our Credit Facility;
macroeconomic conditions, including due to geopolitical conditions and instability, which may lead to a disruption of or lack of access to the capital markets, disruptions and instability in the banking and financial services industries, rising inflation and movements in currency exchange rates, and may negatively impact the financial condition of our tenants;
the risk that the expected sale of three Connecticut hospitals currently leased to Prospect does not occur on the agreed upon terms or at all, and that we are otherwise unable to monetize our investment in PHP at current value within a reasonable time period or at all;
any downgrades in our credit ratings;
the ability of our tenants, operators, and borrowers (including those of our joint ventures) to satisfy their obligations under their respective contractual arrangements with us;
the ability of our tenants and operators to operate profitably and generate positive cash flow, comply with applicable laws, rules and regulations in the operation of our properties, to deliver high-quality services, to attract and retain qualified personnel, and to attract patients;
the cooperation of our joint venture partners, including adverse developments affecting the financial health of such joint venture partners or the joint venture itself;
the economic, political and social impact of, and uncertainty relating to, the potential impact from health crises (like COVID-19), which may adversely affect our and our tenants’ business, financial condition, results of operations, and liquidity;
our success in implementing our business strategy and our ability to identify, underwrite, finance, consummate, and integrate acquisitions and investments;
the nature and extent of our current and future competition;
factors affecting the real estate industry generally or the healthcare real estate industry in particular;

36


 

our ability to maintain our status as a REIT for income tax purposes in the U.S. and U.K.;
changes in federal, state, or local tax laws in the U.S., Europe, South America, or other jurisdictions in which we may own healthcare facilities or transact business;
federal and state healthcare and other regulatory requirements, as well as those in the foreign jurisdictions where we own properties;
the value of our real estate assets, which may limit our ability to dispose of assets at attractive prices or obtain or maintain equity or debt financing secured by our properties or on an unsecured basis;
loss of property owned through ground leases upon breach or termination of the ground leases;
potential environmental contingencies and other liabilities;
our ability to attract and retain qualified personnel;
the risks and uncertainties of litigation or other regulatory proceedings and investigations; and
the accuracy of our methodologies and estimates regarding environmental, social, and governance (“ESG”) metrics and targets, tenant willingness and ability to collaborate towards reporting ESG metrics and meeting ESG goals and targets, and the impact of governmental regulation on our and our tenants’ ESG efforts.

Key Factors that May Affect Our Operations

Our revenue is derived from rents we earn pursuant to the lease agreements with our tenants, from interest income from loans to our tenants and other facility owners, and from profits or equity interests in certain of our tenants’ operations. Our tenants operate in the healthcare industry, generally providing medical, surgical, rehabilitative, and behavioral health care to patients. The capacity of our tenants to pay our rents and interest is dependent upon their ability to conduct their operations at profitable levels. We believe that the business environment of the industry segments in which our tenants operate is generally positive for efficient operators. However, our tenants’ operations are subject to economic, regulatory, market, and other conditions (such as the impact of the COVID-19 pandemic) that may affect their profitability, which could impact our results. Accordingly, we monitor certain key performance indicators that we believe provide us with early indications of conditions that could affect the level of risk in our portfolio.

Key factors that we may consider in underwriting prospective deals and in our ongoing monitoring of our tenants’ (and guarantors’) performance, as well as the condition of our properties, include, but are not limited to, the following:

the scope and breadth of clinical services and programs, including utilization trends (both inpatient and outpatient) by service type;
the size and composition of medical staff and physician leadership at our facilities, including specialty, tenure, and number of procedures performed and/or referrals;
an evaluation of our operators’ administrative team, as applicable, including background and tenure within the healthcare industry;
staffing trends, including ratios, turnover metrics, recruitment and retention strategies at corporate and individual facility levels;
facility operating performance measured by current, historical, and prospective operating margins (measured by a tenant's earnings before interest, taxes, depreciation, amortization, management fees, and facility rent) of each tenant and at each facility;
the ratio of our tenants' operating earnings to facility rent and to other fixed costs, including debt costs;
changes in revenue sources of our tenants, including the relative mix of public payors (including Medicare, Medicaid/MediCal, and managed care in the U.S., as well as equivalent payors in Europe, and South America) and private payors (including commercial insurance and private pay patients);
historical support (financial or otherwise) from governments and/or other public payor systems during major economic downturns/depressions;
trends in tenants' cash collections, including comparison to recorded net patient service revenues, knowing and assessing current revenue cycle management systems and potential future planned upgrades or replacements;
tenants' free cash flow;
the potential impact of healthcare pandemics/epidemics, legislation, and other regulations (including changes in reimbursement) on our tenants', borrowers', and guarantors' profitability and liquidity;

37


 

the potential impact of any legal, regulatory, or compliance proceedings with our tenants (including at the facility level);
the potential impact of supply chain and inflation-related challenges as they relate to new developments or capital addition projects;
an ongoing assessment of the operating environment of our tenants, including demographics, competition, market position, status of compliance, accreditation, quality performance, and health outcomes as measured by The Centers for Medicare and Medicaid Services ("CMS"), The Joint Commission, and other governmental bodies in which our tenants operate;
the level of investment in the hospital infrastructure and health IT systems; and
physical real estate due diligence, typically including property condition and Phase 1 environmental assessments, along with routine property inspections thereafter.

Certain business factors, in addition to those described above that may directly affect our tenants and borrowers, will likely materially influence our future results of operations. These factors include:

trends in interest rates and other costs due to general inflation and availability and increased costs from labor shortages could adversely impact the operations of our tenants and their ability to meet their lease obligations;
changes in healthcare regulations that may limit the opportunities for physicians to participate in the ownership of healthcare providers and healthcare real estate;
reductions (or non-timely increases) in reimbursements from Medicare, state healthcare programs, and commercial insurance providers that may reduce our tenants’ or borrowers’ profitability and our revenues;
competition from other financing sources; and
the ability of our tenants and borrowers to access funds in the credit markets.

CRITICAL ACCOUNTING POLICIES

Refer to our 2023 Annual Report on Form 10-K for a discussion of our critical accounting policies, which include investments in real estate, purchase price allocation, loans, credit losses, losses from rent and interest receivables, investments accounted for under the fair value option election, and our accounting policy on consolidation. During the nine months ended September 30, 2024, there were no material changes to these policies.

Overview

We are a self-advised REIT focused on investing in and owning net-leased healthcare facilities across the U.S. and selectively in foreign jurisdictions. Medical Properties Trust, Inc. was incorporated under Maryland law on August 27, 2003, and MPT Operating Partnership, L.P. was formed under Delaware law on September 10, 2003. We conduct substantially all of our business through MPT Operating Partnership, L.P. We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100%; however, we do own some leased assets through joint ventures with other partners that share our view that healthcare facilities are part of the infrastructure of any community, which we refer to as investments in unconsolidated real estate joint ventures. We also make mortgage loans to healthcare operators collateralized by their real estate assets. In addition, we may make loans to certain of our operators through our TRS, the proceeds of which are typically used for working capital and other purposes. From time-to-time, we may make noncontrolling investments in our tenants, which we refer to as investments in unconsolidated operating entities. These investments are typically made in conjunction with larger real estate transactions with the tenant that give us a right to share in such tenant’s profits and losses, and provide for certain minority rights and protections. Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to serve their communities by unlocking the value of their real estate assets to fund facility improvements, technology upgrades, and other investments in operations.

38


 

At September 30, 2024, our portfolio consisted of 402 properties leased or loaned to 55 operators, of which four are under development. We manage our business as a single business segment.

At September 30, 2024, all of our investments are located in the U.S., Europe, and South America. Our total assets are made up of the following (dollars in thousands):

 

 

 

As of
September 30,
2024

 

 

% of
Total

 

 

As of
December 31,
2023

 

 

% of
Total

 

Real estate assets - at cost

 

$

13,222,167

 

 

 

86.7

%

 

$

14,778,132

 

 

 

80.8

%

Accumulated real estate depreciation and amortization

 

 

(1,423,702

)

 

 

(9.3

)%

 

 

(1,407,971

)

 

 

(7.7

)%

Net investment in real estate assets

 

 

11,798,465

 

 

 

77.4

%

 

 

13,370,161

 

 

 

73.1

%

Cash and cash equivalents

 

 

275,616

 

 

 

1.8

%

 

 

250,016

 

 

 

1.4

%

Investments in unconsolidated real estate joint ventures

 

 

1,242,772

 

 

 

8.2

%

 

 

1,474,455

 

 

 

8.0

%

Investments in unconsolidated operating entities

 

 

508,227

 

 

 

3.3

%

 

 

1,778,640

 

 

 

9.7

%

Other

 

 

1,411,076

 

 

 

9.3

%

 

 

1,431,572

 

 

 

7.8

%

Total assets

 

$

15,236,156

 

 

 

100.0

%

 

$

18,304,844

 

 

 

100.0

%

Results of Operations

Three Months Ended September 30, 2024 Compared to September 30, 2023

Net loss for the three months ended September 30, 2024, was ($801.2) million, or ($1.34) per share compared to net income of $116.7 million, or $0.19 per diluted share, for the three months ended September 30, 2023. This decrease in net income is primarily driven by the approximate $608 million of impairment charges primarily related to the global settlement reached with Steward and its lenders as described in Note 3 to the condensed consolidated financial statements, the approximate $134 million unfavorable fair value adjustment to our investment in PHP Holdings, $137 million of accelerated amortization of in-place lease intangibles, and lower revenues from Steward and Prospect along with property sales, partially offset by approximately $90 million of gains as a result of the Dignity Health and UCHealth sales, both discussed further in Note 3 to the condensed consolidated financial statements. Normalized funds from operations (“FFO”), after adjusting for certain items (as more fully described in the section titled “Reconciliation of Non-GAAP Financial Measures” in Item 2 of this Quarterly Report on Form 10-Q), was $93.9 million for the 2024 third quarter, or $0.16 per diluted share, as compared to $225.5 million, or $0.38 per diluted share, for the 2023 third quarter. This 58% decrease in Normalized FFO is primarily due to lower revenues from Steward moving to the cash basis of accounting on December 31, 2023, and lower revenues as a result of various disposals in 2023 and 2024.

Revenues

A comparison of revenues for the three months ended September 30, 2024 and 2023 is as follows (dollar amounts in thousands):

 

 

 

2024

 

 

% of
Total

 

 

2023

 

 

% of
Total

 

 

Year over
Year
Change

 

Rent billed

 

$

169,721

 

 

 

75.2

%

 

$

229,306

 

 

 

74.8

%

 

 

(26.0

)%

Straight-line rent

 

 

36,602

 

 

 

16.2

%

 

 

21,511

 

 

 

7.0

%

 

 

70.2

%

Income from financing leases

 

 

9,798

 

 

 

4.3

%

 

 

26,066

 

 

 

8.5

%

 

 

(62.4

)%

Interest and other income

 

 

9,706

 

 

 

4.3

%

 

 

29,693

 

 

 

9.7

%

 

 

(67.3

)%

Total revenues

 

$

225,827

 

 

 

100.0

%

 

$

306,576

 

 

 

100.0

%

 

 

(26.3

)%

 

Our total revenues for the 2024 third quarter are down $80.7 million, or 26%, over the same period in the prior year. This decrease is made up of the following:

Operating lease revenue (includes rent billed and straight-line rent) – down $44.5 million from the prior year due to approximately $59 million of less revenue from our operators on a cash basis in the third quarter of 2024 as compared to the prior year. The majority of this decline is due to Steward (who moved to cash basis starting December 31, 2023, and executed the global settlement in the third quarter of 2024 described in Note 3 to the condensed consolidated financial statements) as we recognized $60 million of rent revenue in the 2023 third quarter, while receiving and recording approximately $10 million of rent revenue in the third quarter of 2024. Operating lease revenues in the 2024 third quarter further declined by approximately $47 million due to disposals and other leasing transactions in 2023 and 2024 (including $29 million from the Utah Transaction described in Note 3 to the condensed consolidated financial statements).

 

39


 

The decreases in operating lease revenue discussed above were partially offset by approximately $50 million more straight-line rent write-offs in the 2023 third quarter compared to the same period of 2024; approximately $2 million from incremental revenue from acquisitions in 2023, capital additions, and the commencement of rent on two development properties in 2024; $2.4 million of favorable foreign currency fluctuations; and approximately $6 million from increases in CPI above the contractual minimum escalations in our leases.

Income from financing leases – down $16.3 million primarily due to not receiving any cash for rent revenue from Prospect (cash basis tenant) in the third quarter of 2024, whereas we recorded $16.5 million of rent for this tenant in the 2023 third quarter as part of the Prospect Transaction as described in Note 3 to the condensed consolidated financial statements. These decreases were partially offset by $0.2 million from the increase in CPI above the lease contractual minimum escalations.
Interest and other income – down approximately $20.0 million from the prior year due to the following:
o
Interest from loans – down $19.2 million, primarily due to a $17 million decrease in interest income related to Steward and the international joint venture with moving to cash basis on December 31, 2023, and an approximate $4 million decrease from loan payoffs. These decreases are partially offset by $1.6 million of interest income from the Prime mortgage loan we received in the second quarter of 2024 as a result of the Prime disposal (further described in Note 3 to the condensed consolidated financial statements including the repayment of this loan on August 29, 2024) and $0.4 million of favorable foreign currency fluctuations.
o
Other income – down $0.8 million from the prior year as we had less direct reimbursements from our cash basis tenants for ground leases, property taxes, and insurance.

Interest Expense

Interest expense for the quarters ended September 30, 2024 and 2023 totaled $106.2 million and $106.7 million, respectively. This decrease is primarily related to debt principal repayments including paying off the Australian term loan facility in the second quarter of 2024 (A$470 million), the 2.550% Senior Unsecured Notes in December 2023, and the British pound sterling secured term loan due 2024 in the 2024 second quarter and paying down a portion of our revolver and British pound sterling term loan due 2025 in 2024. The decrease was offset by additional interest from our British pound sterling secured term loan due 2034 that closed in May 2024 and higher overall interest rates. Overall, our weighted-average interest rate was 4.3% for the quarter ended September 30, 2024, compared to 4.0% for the same period in 2023, as our specific rates have increased due to a credit rating adjustment in March 2023 and our Credit Facility amendment on August 6, 2024.

Real Estate Depreciation and Amortization

Real estate depreciation and amortization during the third quarter of 2024 increased to $204.9 million from $77.8 million in 2023 due to approximately $137 million of additional amortization expense recorded in the 2024 third quarter to fully amortize the intangibles associated with two terminated master leases, including the Steward master lease that was terminated effective September 11, 2024 as part of the global settlement discussed in Note 3 to the condensed consolidated financial statements.

Property-related

Property-related expenses totaled $5.0 million and $6.5 million for the quarters ended September 30, 2024 and 2023, respectively. Of the property expenses in the third quarter of 2024 and 2023, approximately $2.6 million and $3.3 million, respectively, represents costs that were reimbursed by our tenants and included in the “Interest and other income” line on our condensed consolidated statements of net income.

General and Administrative

General and administrative expenses decreased to $36.6 million for the 2024 third quarter, compared to $38.1 million for the 2023 third quarter. For the 2024 period, general and administrative expenses included $14.4 million of stock compensation expenses, of which $7 million related to certain 2024 stock grants with cash-settled features that are marked to fair value quarterly.

Gain on Sale of Real Estate

During the three months ended September 30, 2024, the gain on sale of real estate of $91.8 million primarily relates to the sale of eight Dignity Health facilities and 11 UCHealth facilities as more fully described in Note 3 to the condensed consolidated financial statements.

40


 

Real Estate and Other Impairment Charges, Net

In the 2024 third quarter, we recognized $607.9 million of real estate and other impairment charges. Of these charges, approximately $425 million consisted of the impairment of working capital loans and other secured loans advanced to Steward, and $180 million was related to real estate, including the Space Coast facilities and certain excess properties previously leased to Steward (as more fully described in Note 3 to the condensed consolidated financial statements).

Earnings (Loss) from Equity Interests

Earnings from equity interests was $21.6 million for the quarter ended September 30, 2024 compared to the $11.3 million of earnings for the same period in 2023. This increase is primarily from our share of income in the Utah partnership that was formed in the 2024 second quarter, which included a $13.5 million positive fair value adjustment primarily related to the underlying real estate, (as further described in Note 3 to the condensed consolidated financial statements), partially offset by not recording any income in the third quarter of 2024 related to our Massachusetts-based partnership with Macquarie.

Debt Refinancing and Unutilized Financing (Costs) Benefit

Debt refinancing and unutilized financing costs were $0.7 million for the third quarter of 2024. These costs were incurred as a result of the reduction in revolving commitments under our Credit Facility and partial paydown of our British pound sterling term loan due 2025. We recognized a benefit for the same period of 2023, as a result of the purchase of £40 million of our 2.550% Senior Unsecured Notes due 2023 at a discounted price.

Other (Including Fair Value Adjustments on Securities)

Other expense for the third quarter of 2024 was $169.8 million, compared to income of $41.1 million in the prior year. For the third quarter of 2024, we recognized unfavorable non-cash fair value adjustments to our investment in PHP Holdings and Aevis of approximately $140 million. The 2024 third quarter also included approximately $29 million of legal and other professional expenses associated with the Steward bankruptcy, responding to certain defamatory statements published by certain parties, including those who are defendants to a lawsuit we filed on March 30, 2023, among other things. For the third quarter of 2023, we recognized an approximate $30 million favorable non-cash fair value adjustment on our investment in PHP Holdings and a CHF 20 million (approximately $22 million) unrealized gain on our equity investment in Swiss Medical Network, partially offset by $2.8 million of expenses associated with responding to defamatory statements previously mentioned.

With certain investments accounted for at fair value, such as our investment in PHP Holdings, we may have positive or negative fair value adjustments from quarter-to-quarter.

Income Tax Expense

Income tax expense includes U.S. federal and state income taxes on our TRS entities, as well as non-U.S. income based or withholding taxes on certain investments located in jurisdictions outside the U.S. The $9.0 million income tax expense for the three months ended September 30, 2024 is primarily based on the income generated by our investments in the U.K. and Germany and slightly less than the $10.1 million income tax expense in the third quarter of 2023.

We utilize the asset and liability method of accounting for income taxes. Deferred tax assets are recorded to the extent we believe these assets will more likely than not be realized. In making such determination, all available positive and negative evidence is considered, including scheduled reversals of deferred tax liabilities, projected future taxable income, tax planning strategies, and recent financial performance. Based upon our review of all positive and negative evidence, including our three-year cumulative pre-tax book loss position in certain entities, we concluded that a valuation allowance of approximately $386 million should be reflected against certain of our international and domestic net deferred tax assets at September 30, 2024. In the future, if we determine that it is more likely than not that we will realize our net deferred tax assets, we will reverse the applicable portion of the valuation allowance, recognize an income tax benefit in the period in which such determination is made, and potentially incur higher income tax expense in future periods as income is earned.

41


 

Nine Months Ended September 30, 2024 Compared to September 30, 2023

Net loss for the nine months ended September 30, 2024, was ($2.0) billion, or ($3.33) per share compared to net income of $107.5 million, or $0.18 per diluted share, for the nine months ended September 30, 2023. This decrease in net income is primarily driven by the approximate $1.8 billion of impairment charges and negative fair value adjustments related to Steward and the international joint venture as further described in Note 3 to the condensed consolidated financial statements. In addition, we had an approximate $498 million unfavorable fair value adjustment to our investment in PHP Holdings in the first nine months of 2024 along with lower revenues from Steward and property sales. These decreases were partially offset by approximately $475 million of gains on real estate sales in the first nine months of 2024. Normalized funds from operations (“FFO”), after adjusting for certain items (as more fully described in the section titled “Reconciliation of Non-GAAP Financial Measures” in Item 2 of this Quarterly Report on Form 10-Q), was $375.0 million for the first nine months of 2024, or $0.62 per diluted share, as compared to $733.0 million, or $1.22 per diluted share, for the same period of 2023. This 49% decrease in Normalized FFO is primarily due to lower revenues from Steward moving to the cash basis of accounting on December 31, 2023, and as a result of various disposals in 2023 and 2024.

Revenues

A comparison of revenues for the nine months ended September 30, 2024 and 2023 is as follows (dollar amounts in thousands):

 

 

 

2024

 

 

% of
Total

 

 

2023

 

 

% of
Total

 

 

Year over
Year
Change

 

Rent billed

 

$

552,784

 

 

 

72.4

%

 

$

724,954

 

 

 

72.9

%

 

 

(23.7

)%

Straight-line rent

 

 

119,719

 

 

 

15.7

%

 

 

38,875

 

 

 

3.9

%

 

 

208.0

%

Income from financing leases

 

 

53,832

 

 

 

7.0

%

 

 

107,729

 

 

 

10.8

%

 

 

(50.0

)%

Interest and other income

 

 

37,368

 

 

 

4.9

%

 

 

122,624

 

 

 

12.4

%

 

 

(69.5

)%

Total revenues

 

$

763,703

 

 

 

100.0

%

 

$

994,182

 

 

 

100.0

%

 

 

(23.2

)%

 

Our total revenues for the first nine months of 2024 are down $230.5 million, or 23%, over the same period in the prior year. This decrease is made up of the following:

Operating lease revenue (includes rent billed and straight-line rent) – down $91.3 million from the prior year, primarily due to approximately $164 million of less revenue from our operators on a cash basis in the first nine months of 2024 as compared to the prior year. The majority of this decline is due to Steward as we recognized $181 million of rent revenue in the first nine months of 2023, while receiving and recording approximately $40 million of rent revenue in the first nine months of 2024.

Operating lease revenues in the first nine months of 2024 further declined by approximately $107 million due to disposals and other leasing transactions in 2023 and 2024 (including approximately $60 million from the Utah Transaction described in Note 3 to the condensed consolidated financial statements). These decreases are partially offset by approximately $145 million more straight-line rent write-offs in the first nine months of 2023 compared to the same period of 2024 (related to the Steward and CommonSpirit transaction in 2023 described in Note 3 to the condensed consolidated financial statements); approximately $11 million in incremental revenue from acquisitions in 2023, capital additions, and the commencement of rent on two development properties in 2024; approximately $7 million of favorable foreign currency fluctuations; and approximately $16 million from increases in CPI above the contractual minimum escalations in our leases.

Income from financing leases – down $53.9 million primarily due to receiving cash of approximately $25 million for rent revenue from Prospect (cash basis tenant) in the first nine months of 2024, whereas we recorded $72 million of rent for this tenant in the first nine months of 2023. In addition, financing lease income was lower due to an approximate $8 million decrease from the disposal of three Prime financing leases in the third quarter of 2023. These decreases were partially offset by approximately $1 million from the increase in CPI above the lease contractual minimum escalations.
Interest and other income – down $85.3 million from the prior year due to the following:
o
Interest from loans – down $66.5 million, primarily due to an approximate $49 million decrease in interest income related to Steward and the international joint venture with the move to cash basis on December 31, 2023 and the Steward global settlement in the third quarter of 2024, and an approximate $14 million decrease from loan payoffs and reserves (including $9.1 million from the sale of our interest in the Priory syndicated term loan in the first quarter of 2024). We also recorded approximately $9.5 million more interest revenue in the first nine months of 2023 compared to the same period of 2024 as a result of the Prospect Transaction as described in Note 3 to the condensed consolidated financial statements. These decreases are partially offset by approximately $4 million of interest income from the Prime mortgage loan we received as a result of the

42


 

Prime disposal (further described in Note 3 to the condensed consolidated financial statements including the repayment on August 29, 2024), $1 million of higher income from annual escalations due to increases in CPI, and approximately $1.5 million of favorable foreign currency fluctuations.
o
Other income – down $18.8 million from the prior year as we had less direct reimbursements from our cash basis tenants for ground leases, property taxes, and insurance.

Interest Expense

Interest expense for the nine months ended September 30, 2024 and 2023 totaled $316.4 million and $308.8 million, respectively. This increase is primarily related to an increase in borrowings on our revolving credit facility on average during the comparable periods that carried higher interest rates (as variable rate debt) compared to the lower fixed interest rates of debt that was repaid in 2023, including the A$730 million Australian term loan facility paid off in the 2023 second quarter and the 2.550% Senior Unsecured Notes paid off in December 2023. We closed on a new British pound sterling secured term loan in May 2024 that also partially contributed to higher interest expense period over period. Overall, our weighted-average interest rate was 4.3% for the nine months ended September 30, 2024, compared to 3.9% for the same period in 2023, as our specific rates have increased due to a credit rating adjustment in March 2023 and our Credit Facility amendment on August 6, 2024.

Real Estate Depreciation and Amortization

Real estate depreciation and amortization during the first nine months of 2024 decreased to $382.7 million from $526.1 million in 2023 due to accelerating the amortization of lease intangibles as part of the sale of hospital operations by Steward and re-leasing of five Steward Utah facilities to CommonSpirit in May 2023 (approximately $286 million) and the sale of various properties in 2024 and 2023. This decrease is partially offset by approximately $170 million of additional amortization expense recorded in 2024 primarily to fully amortize the intangibles associated with two master leases, including the Steward master lease that was terminated effective September 11, 2024.

Property-related

Property-related expenses totaled $17.5 million and $38.3 million for the nine months ended September 30, 2024 and 2023, respectively. Of the property expenses in the first nine months of 2024 and 2023, approximately $9.8 million and $28.6 million, respectively, represents costs that were reimbursed by our tenants and included in the “Interest and other income” line on our condensed consolidated statements of net income.

General and Administrative

General and administrative expenses decreased to $105.3 million for the first nine months of 2024, compared to $115.4 million for the same period of 2023. For the 2024 period, general and administrative expenses included $30.6 million of stock compensation expense, of which $9 million related to certain 2024 stock grants with cash-settled features that are marked to fair value quarterly.

Gain on Sale of Real Estate

During the nine months ended September 30, 2024, the gain on sale of real estate of $475.2 million primarily related to the disposal of five Prime facilities, a 75% interest in five Utah facilities as part of the Utah Transaction, and the sale of eight Dignity Health facilities and 11 UCHealth facilities as more fully described in Note 3 to the condensed consolidated financial statements.

Real Estate and Other Impairment Charges, Net

In the first nine months of 2024, we recognized $1.4 billion of real estate and other impairment charges and fair value adjustments, primarily associated with our investments in Steward and the international joint venture as further described in Note 3 to the condensed consolidated financial statements. In the first nine months of 2023, we recorded a $93.3 million net impairment charge, of which $82 million related to the Australia Transaction and $11 million was a non-cash impairment charge on the three Prime properties as more fully described in Note 3 to the condensed consolidated financial statements.

Earnings (Loss) from Equity Interests

Loss from equity interests was ($369.6) million for the nine months ended September 30, 2024, compared to $34.8 million of earnings for the same period in 2023, primarily due to the $410 million charge in the second quarter of 2024 associated with the real estate impairment in our Massachusetts-based partnership with Macquarie as further described in Note 3 to the condensed

43


 

consolidated financial statements. This was partially offset by our share of income on our new Utah partnership as a result of the Utah Transaction in the second quarter of 2024.

Debt Refinancing and Unutilized Financing (Costs) Benefit

Debt refinancing and unutilized financing costs were $3.7 million for the first nine months of 2024. These costs were incurred as a result of the reduction in revolving commitments under our Credit Facility and partial paydown of our British pound sterling term loan due 2025, both of which are described in more detail in Note 4 to the condensed consolidated financial statements. Our debt refinancing and unutilized financing net benefit for the first nine months of 2023 was a result of a $0.9 million benefit related to the purchase of £40 million of our 2.550% Senior Unsecured Notes due 2023 in the third quarter of 2023 at a discounted price, partially offset by $0.8 million of costs associated with the partial prepayment of our A$1.2 billion Australian term loan in the second quarter of 2023.

Other (Including Fair Value Adjustments on Securities)

Other expense for the first nine months of 2024 was $566.8 million, compared to $25.4 million of income in the prior year. For 2024, we recognized an approximate $498 million unfavorable fair value adjustment to our investment in PHP Holdings. In addition, we incurred a $7.8 million economic loss from the sale of our interest in the Priory syndicated term loan and approximately $46.5 million of legal and other professional expenses associated with the Steward bankruptcy, responding to certain defamatory statements published by certain parties, including those who are defendants to a lawsuit we filed on March 30, 2023, among other things. For 2023, we had an approximate $30 million favorable non-cash fair value adjustment on our investment in PHP Holdings and a CHF 20 million (approximately $22 million) unrealized gain on our equity investment in Swiss Medical Network, partially offset by $13 million of expenses associated with responding to defamatory statements previously mentioned.

Income Tax Expense

Income tax expense includes U.S. federal and state income taxes on our TRS entities, as well as non-U.S. income based or withholding taxes on certain investments located in jurisdictions outside the U.S. The $34.5 million income tax expense for the nine months ended September 30, 2024 is primarily based on the income generated by our investments in the U.K. and Germany, and included $5 million of additional tax expense in the second quarter of 2024 as a result of the gain on the interest rate swap associated with the internal restructuring of the British pound sterling term loan due 2025. In comparison, we had a $134.7 million income tax benefit in the first nine months of 2023, which included a $158 million benefit by entering the U.K. REIT regime and a $5.0 million tax benefit recognized in the first quarter of 2023 related to the expected sale of our Australia facilities.

We utilize the asset and liability method of accounting for income taxes. Deferred tax assets are recorded to the extent we believe these assets will more likely than not be realized. In making such determination, all available positive and negative evidence is considered, including scheduled reversals of deferred tax liabilities, projected future taxable income, tax planning strategies, and recent financial performance. Based upon our review of all positive and negative evidence, including our three-year cumulative pre-tax book loss position in certain entities, we concluded that a valuation allowance of approximately $386 million should be reflected against certain of our international and domestic net deferred tax assets at September 30, 2024. In the future, if we determine that it is more likely than not that we will realize our net deferred tax assets, we will reverse the applicable portion of the valuation allowance, recognize an income tax benefit in the period in which such determination is made, and potentially incur higher income tax expense in future periods as income is earned.

Reconciliation of Non-GAAP Financial Measures

Investors and analysts following the real estate industry utilize funds from operations, or FFO, as a supplemental performance measure. FFO, reflecting the assumption that real estate asset values rise or fall with market conditions, principally adjusts for the effects of GAAP depreciation and amortization of real estate assets, which assumes that the value of real estate diminishes predictably over time. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, or Nareit, which represents net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization, including amortization related to in-place lease intangibles, and after adjustments for unconsolidated partnerships and joint ventures.

In addition to presenting FFO in accordance with the Nareit definition, we disclose normalized FFO, which adjusts FFO for items that relate to unanticipated or non-core events or activities or accounting changes that, if not noted, would make comparison to prior period results and market expectations less meaningful to investors and analysts.

44


 

We believe that the use of FFO, combined with the required GAAP presentations, improves the understanding of our operating results among investors and the use of normalized FFO makes comparisons of our operating results with prior periods and other companies more meaningful. While FFO and normalized FFO are relevant and widely used supplemental measures of operating and financial performance of REITs, they should not be viewed as a substitute measure of our operating performance since the measures do not reflect either depreciation and amortization costs or the level of capital expenditures and leasing costs (if any are not paid by our tenants) to maintain the operating performance of our properties, which can be significant economic costs that could materially impact our results of operations. FFO and normalized FFO should not be considered an alternative to net income (loss) (computed in accordance with GAAP) as indicators of our financial performance or to cash flow from operating activities (computed in accordance with GAAP) as an indicator of our liquidity.

The following table presents a reconciliation of net (loss) income attributable to MPT common stockholders to FFO and Normalized FFO for the three and nine months ended September 30, 2024 and 2023 (in thousands except per share data):

 

 

 

For the Three Months Ended

 

 

For the Nine Months Ended

 

 

 

September 30, 2024

 

 

September 30, 2023

 

 

September 30, 2024

 

 

September 30, 2023

 

FFO information:

 

 

 

 

 

 

 

 

 

 

 

 

Net (loss) income attributable to MPT common stockholders

 

$

(801,163

)

 

$

116,710

 

 

$

(1,997,423

)

 

$

107,467

 

Participating securities’ share in earnings

 

 

(153

)

 

 

(311

)

 

 

(807

)

 

 

(1,295

)

Net (loss) income, less participating securities’ share in
   earnings

 

$

(801,316

)

 

$

116,399

 

 

$

(1,998,230

)

 

$

106,172

 

Depreciation and amortization

 

 

218,646

 

 

 

96,280

 

 

 

430,128

 

 

 

580,484

 

(Gain) loss on sale of real estate

 

 

(91,795

)

 

 

20

 

 

 

(475,196

)

 

 

(209

)

Real estate impairment charges

 

 

179,952

 

 

 

3,750

 

 

 

679,276

 

 

 

55,854

 

Funds from operations

 

$

(494,513

)

 

$

216,449

 

 

$

(1,364,022

)

 

$

742,301

 

Write-off of billed and unbilled rent and other

 

 

(159

)

 

 

52,742

 

 

 

2,846

 

 

 

150,576

 

Other impairment charges, net

 

 

427,970

 

 

 

 

 

 

1,169,943

 

 

 

37,434

 

Litigation and other

 

 

28,899

 

 

 

2,759

 

 

 

46,507

 

 

 

12,987

 

Share-based compensation adjustments

 

 

 

 

 

1,243

 

 

 

 

 

 

(3,120

)

Non-cash fair value adjustments

 

 

130,949

 

 

 

(46,815

)

 

 

511,472

 

 

 

(42,562

)

Tax rate changes and other

 

 

8

 

 

 

 

 

 

4,596

 

 

 

(164,535

)

Debt refinancing and unutilized financing costs (benefit)

 

 

713

 

 

 

(862

)

 

 

3,677

 

 

 

(46

)

Normalized funds from operations

 

$

93,867

 

 

$

225,516

 

 

$

375,019

 

 

$

733,035

 

Per diluted share data:

 

 

 

 

 

 

 

 

 

 

 

 

Net (loss) income, less participating securities’ share in
   earnings

 

$

(1.34

)

 

$

0.19

 

 

$

(3.33

)

 

$

0.18

 

Depreciation and amortization

 

 

0.37

 

 

 

0.16

 

 

 

0.72

 

 

 

0.97

 

(Gain) loss on sale of real estate

 

 

(0.15

)

 

 

 

 

 

(0.79

)

 

 

 

Real estate impairment charges

 

 

0.30

 

 

 

0.01

 

 

 

1.13

 

 

 

0.09

 

Funds from operations

 

$

(0.82

)

 

$

0.36

 

 

$

(2.27

)

 

$

1.24

 

Write-off of billed and unbilled rent and other

 

 

 

 

 

0.09

 

 

 

 

 

 

0.25

 

Other impairment charges, net

 

 

0.71

 

 

 

 

 

 

1.94

 

 

 

0.06

 

Litigation and other

 

 

0.05

 

 

 

0.01

 

 

 

0.08

 

 

 

0.02

 

Share-based compensation adjustments

 

 

 

 

 

 

 

 

 

 

 

(0.01

)

Non-cash fair value adjustments

 

 

0.22

 

 

 

(0.08

)

 

 

0.85

 

 

 

(0.07

)

Tax rate changes and other

 

 

 

 

 

 

 

 

0.01

 

 

 

(0.27

)

Debt refinancing and unutilized financing costs (benefit)

 

 

 

 

 

 

 

 

0.01

 

 

 

 

Normalized funds from operations

 

$

0.16

 

 

$

0.38

 

 

$

0.62

 

 

$

1.22

 

 

LIQUIDITY AND CAPITAL RESOURCES

2024 Cash Flow Activity

During the first nine months of 2024, we generated approximately $169 million of cash flows from operating activities, primarily consisting of rent and interest from mortgage and other loans. In addition to operating cash flows, we received approximately $1.8 billion during the first nine months of 2024 from the Utah Transaction and the sale of 25 properties (as further discussed in Note 3 to the condensed consolidated financial statements), along with approximately $130 million from the sale of our interest in the syndicated Priory term loan and remaining minority interest in Lifepoint Behavioral. In May 2024, we closed on a new secured term loan, generating proceeds of approximately $800 million. We used our operating cash flows, asset sale proceeds, and

45


 

term loan proceeds to fund our dividends of $273 million, pay down over $1 billion of our revolving credit facility and British pound sterling term loan due 2025, and to pay off our British pound sterling secured term loan due 2024.

See below for further details of these transactions along with additional liquidity activity in the first nine months of 2024:

we completed the sales of 11 properties to UCHealth for approximately $86 million of proceeds and eight properties to Dignity Health for approximately $160 million of proceeds;
we completed the sale of five properties to Prime for cash proceeds of $250 million along with a $100 million interest-bearing mortgage loan that was fully repaid on August 29, 2024;
we completed the Utah Transaction (as discussed in Note 3 to the condensed consolidated financial statements) that generated cash proceeds of approximately $1.1 billion. With the proceeds from these asset sales, we paid off and terminated our $306 million Australian term loan facility that was due in May 2024 and paid down a portion of our revolving credit facility;
on May 24, 2024, we closed on a secured loan facility with a consortium of institutional investors that provides for a term loan in aggregate principal amount of approximately £631 million (approximately $800 million) secured by a portfolio of 27 properties located in the U.K. currently leased to affiliates of Circle. The facility carries a fixed rate of 6.877% over its 10-year term, excluding fees and expenses, and is interest-only (payable quarterly in advance) through the maturity date. The facility is secured by first priority mortgages or similar security instruments on the relevant properties, including assignments of rents and security over accounts, and is non-recourse to us. We used the majority of the net proceeds of the facility to pay down portions of our revolving credit facility and British pound sterling term loan due 2025, and to pay off our British pound sterling secured term loan due 2024 (approximately £105 million);
in May 2024, both S&P Global Ratings and Moody's downgraded our corporate ratings. These ratings declining could have a negative impact on us in the form of higher interest rates on any new or amended debt instruments we may enter into in the future; and
primarily as a result of our Quarterly Report on Form 10-Q for the period ended March 31, 2024, not being filed timely, we are currently ineligible to file a new short-form registration statement on Form S-3 or access our existing registration statement on Form S-3 for sales of securities, including under our at-the-market ("ATM") program, until June 1, 2025, which may impair our ability to raise capital in the public markets. While we are able to use other registration avenues for public offerings, such avenues are less expeditious and efficient than a shelf registration statement on Form S-3. See "Risk Factors" in our Quarterly Report on Form 10-Q for the period ended March 31, 2024, for additional information.

 

Subsequent to September 30, 2024, we recovered cash related to our Norwood property that exceeded our recovery receivables (as discussed in Note 3 to the condensed consolidated financial statements) and sold three facilities for approximately $45 million. In addition, we funded a quarterly cash dividend of $48 million on October 10, 2024, which was declared by our Board of Directors on August 22, 2024. Finally, on November 8, 2024, Astrana Health entered into a binding agreement to purchase the majority of PHP Holdings for approximately $745 million and the assumption of certain liabilities. After satisfaction of certain obligations, we expect to receive approximately $200 million in total proceeds. We expect to receive the majority of these proceeds in the first half of 2025, while a $50 million payment is expected by 2027.

Debt Amendments and Covenant Compliance

On April 12, 2024, we amended the Credit Facility and certain other agreements to (i) reduce revolving commitments from $1.8 billion to $1.4 billion, (ii) apply certain proceeds from the Utah Transaction and other asset sales and debt transactions to repay the Australian term loan facility and certain other outstanding obligations, including revolving loans under the Credit Facility to the extent necessary to reduce the outstanding borrowings to no more than the amended $1.4 billion commitment, (iii) lower the maximum permitted secured leverage ratio from 40% to 25%, and (iv) waive the 10% cap on unencumbered asset value attributable to tenants subject to a bankruptcy event for purposes of determining compliance with the unsecured leverage ratio for the trailing four fiscal quarter period ended June 30, 2024, and for purposes of determining pro forma compliance with the unsecured leverage ratio for certain asset sale and debt transactions.

On August 6, 2024, we entered into an amendment to the Credit Facility and the British pound sterling term loan due 2025 (the “Amendments”) to (i) further reduce our maximum borrowing in the Credit Facility from $1.4 billion to $1.28 billion, (ii) increase borrowing spreads to 300 basis points during the Modified Covenant Period (defined below) and then to 225 basis points after the Modified Covenant Period, and (iii) require that proceeds of certain future asset sales and debt transactions (during the Modified Covenant Period) be applied to repay certain outstanding obligations, including our revolving loans (by 15% of such proceeds but for which the revolving loans can be reborrowed) and our British pound sterling term loan due 2025 (by 50% of such proceeds).

The Amendments also amended certain covenants including increasing the maximum total leverage ratio covenant from 60% to 65% and the maximum unsecured leverage ratio covenant from 65% to 70% and decreasing the minimum unsecured interest coverage

46


 

ratio from 1.75:1.00 to 1.45:1.00. The Amendments were effective as of June 30, 2024 and will continue in effect through and including September 30, 2025, unless earlier terminated by us (the “Modified Covenant Period”) at which point the credit agreement provides that covenants will automatically reset to their prior levels. In addition, the Amendments permanently reduced the minimum consolidated adjusted net worth covenant from approximately $6.7 billion to $5 billion, in each case plus the sum of certain equity proceeds. The Amendments also limit the payment of dividends in cash during the Modified Covenant Period to $0.08 per share in any fiscal quarter, but the Amendments do not provide any additional restrictions on the payment of dividends outside of the Modified Covenant Period.

As of September 30, 2024, we are in compliance with all such financial and operating covenants. However, as of September 30, 2024, we would not have been in compliance with certain covenants without the Amendments discussed above. Our ability to maintain compliance with our debt covenants, including the reset leverage and interest coverage requirements after the end of the Modified Covenant Period, depends primarily on reducing debt through asset sales, retention of cash generated from our monthly rent and interest receipts, extending maturities of certain debt instruments, and other access to capital. We expect to continue to comply with these covenants, but if we are not in compliance, including following the expiration of the Modified Covenant Period, we would have to seek additional amendments to our covenants. However, no assurances can be made that such amendments will be approved by our lenders. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable which could have a material adverse impact to the Company.

2023 Cash Flow Activity

During the first nine months of 2023, we generated approximately $370.4 million of cash flows from operating activities, primarily consisting of rent and interest from mortgage and other loans. We used these operating cash flows (along with cash on-hand and borrowings on our revolving credit facility) to fund our dividends of $524.2 million.

In regard to other investing and financing activities in the first nine months of 2023, we did the following:

a)
sold seven Australian properties as part of the Australia Transaction resulting in proceeds of A$730 million and used such proceeds to pay down our Australian term loan;
b)
sold three properties to Prime resulting in proceeds of $100 million;
c)
received approximately $500 million of loan principal proceeds, including approximately $200 million from the Lifepoint Transaction, $100 million from Steward after the completion of their sale of Utah properties to CHIC, CHF 60 million from the payoff of a loan by Infracore, and approximately $100 million from the sale of our temporary interest in Steward's asset-backed credit facility;
d)
funded approximately $250 million of new investments, including $95 million to Prospect as part of its recapitalization plan that was implemented on May 23, 2023;
e)
funded approximately $195 million to Steward, including its temporary participation in its syndicated four-year asset-backed credit facility and loans for general working capital purposes; and
f)
retired approximately £40 million of our 2.550% Senior Unsecured Notes due 2023.

 

See Note 3 to the condensed consolidated financial statements for further details on the transactions above.

Short-term Liquidity Requirements:

Our short-term liquidity requirements typically consist of general and administrative expenses, dividends in order to comply with REIT requirements, interest payments on our debt, and planned funding commitments on development and capital improvement projects for the next twelve months. Our monthly rent and interest receipts and distributions from our joint venture arrangements are typically enough to cover our short-term liquidity requirements.

However, with higher interest rates, loss of revenue from asset sales, ramping up of cash rents from new operators of 17 properties formerly leased to Steward, not as predictable revenue from Prospect, and $1.2 billion of debt coming due within the next twelve months, we have looked to other initiatives to improve cash flows including:

through November 8, 2024, we have raised approximately $2.9 billion of liquidity (as previously discussed above under "2024 Cash Flow Activity") comfortably exceeding our initial full year liquidity target of $2.0 billion;
completing the binding sale of PHP Holdings to Astrana Health, from which we expect to receive approximately $150 million in the first half of 2025 with the remaining $50 million to be received by 2027;
completing the binding sale of three Connecticut facilities to Yale New Haven with a contract price of $355 million, which such sale has been approved by the state of Connecticut's Office of Health Strategy;

47


 

extending the maturity of existing term loans; and
managing the form (cash or stock) and amount of our dividend requirements in line with the credit facility amendment dated August 6, 2024 and REIT requirements.

We believe these initiatives, along with liquidity of approximately $1.2 billion (including cash on-hand, availability under our $1.28 billion revolving credit facility, and recovery proceeds received on our Norwood property as discussed in Note 3 to the condensed consolidated financial statements) at November 8, 2024, and routine cash receipts of rent and interest can fund our short-term liquidity requirements.

In addition to the cash flow improvement initiatives discussed above, we could see further cash flow upside from the transition of our remaining vacant facilities to new healthcare operators (whether it be from a sale of our real estate or in the form of rent paid by the new lessee).

Long-term Liquidity Requirements:

Our long-term liquidity requirements generally consist of the same requirements described above under “Short-term Liquidity Requirements” along with the acquisition of real estate and the funding of debt maturities coming due after the next twelve months. At this time, we do not expect any material acquisitions of real estate in the foreseeable future.

As described previously, our monthly rent and interest receipts and distributions from our joint venture arrangements along with our current liquidity of approximately $1.2 billion at November 8, 2024, are typically enough to cover our short-term liquidity requirements. However, to address upcoming debt maturities (as outlined below), we may need to look to other sources, which may include one or a combination of the following:

reducing our dividend (or moving to a stock dividend), while still complying with REIT requirements and credit facility covenants, as amended on August 6, 2024;
further property sales or joint ventures, including the completion of the binding sale of three Connecticut facilities to Yale with a contract price of $355 million;
monetizing our investment in operators, including our investment in PHP Holdings that is expected to close in the first half of 2025;
entering into new secured loans on real estate;
extending the maturity of existing term loans;
identifying and implementing cost reduction opportunities;
entering into new bank term loans or issuing new USD, EUR, or GBP denominated debt securities; and
sale of equity securities.

However, there is no assurance that conditions will be favorable for such possible transactions or that our plans will be successful. As a result of our Quarterly Report on Form 10-Q for the period ended March 31, 2024, not being filed timely, we are currently ineligible to file a new shelf registration statement on Form S-3 or access our existing registration statement on Form S-3 for sales of securities, including under our ATM program, until June 1, 2025, which may impair our ability to raise capital in the public markets. While we are able to use other registration avenues for public offerings, such avenues are less expeditious and efficient than a shelf registration statement on Form S-3. See "Risk Factors" in our Quarterly Report on Form 10-Q for the period ended March 31, 2024.

Principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) as of November 8, 2024 are as follows (in thousands):

 

2024

 

$

 

2025

 

 

1,172,905

 

2026

 

 

2,054,706

 

2027

 

 

1,600,000

 

2028

 

 

775,260

 

Thereafter

 

 

3,468,040

 

Total

 

$

9,070,911

 

 

48


 

Contractual Commitments

We presented our contractual commitments in our 2023 Annual Report on Form 10-K and provided updates in our Quarterly Reports on Form 10-Q for the periods ended March 31, 2024 and June 30, 2024. Except for the changes noted below, there have been no significant changes through November 8, 2024.

The following table updates our contractual commitments schedule as of November 8, 2024 (in thousands):

 

Contractual Commitments

 

2024(1)

 

 

2025

 

 

2026

 

 

2027

 

 

2028

 

 

Thereafter

 

 

Total

 

British pound sterling term loan

 

$

1,912

 

 

$

637,974

 

 

$

 

 

$

 

 

$

 

 

$

 

 

$

639,886

 

Revolving credit facility

 

 

4,062

 

 

 

26,894

 

 

 

385,085

 

 

 

 

 

 

 

 

 

 

 

 

416,041

 

Term loan

 

 

2,611

 

 

 

15,403

 

 

 

14,266

 

 

 

207,074

 

 

 

 

 

 

 

 

 

239,354

 

(1)
This column represents obligations post November 8, 2024.

Distribution Policy

The table below is a summary of our distributions declared during the two year period ended September 30, 2024:

 

Declaration Date

 

Record Date

 

Date of Distribution

 

Distribution
per Share

 

August 22, 2024

 

September 9, 2024

 

October 10, 2024

 

$

0.08

 

May 30, 2024

 

June 10, 2024

 

July 9, 2024

 

$

0.15

 

April 12, 2024

 

April 22, 2024

 

May 1, 2024

 

$

0.15

 

November 9, 2023

 

December 7, 2023

 

January 11, 2024

 

$

0.15

 

August 21, 2023

 

September 14, 2023

 

October 12, 2023

 

$

0.15

 

April 27, 2023

 

June 15, 2023

 

July 13, 2023

 

$

0.29

 

February 16, 2023

 

March 16, 2023

 

April 13, 2023

 

$

0.29

 

November 10, 2022

 

December 8, 2022

 

January 12, 2023

 

$

0.29

 

It is our policy to make sufficient distributions to stockholders in order for us to maintain our status as a REIT under the Internal Revenue Code of 1986, as amended, and to efficiently manage corporate income and excise taxes on undistributed income. However, our Credit Facility limits the amount of dividends we can make- see Note 4 to the condensed consolidated financial statements for further information.

Item 3. Quantitative and Qualitative Disclosures About Market Risk.

Market risk includes risks that arise from changes in interest rates, foreign currency exchange rates, commodity prices, equity prices, and other market changes that affect market sensitive instruments. We seek to mitigate the effects of fluctuations in interest rates by matching the terms of new investments with new long-term fixed rate borrowings to the extent possible. We may or may not elect to use financial derivative instruments to hedge interest rate or foreign currency exposure. For interest rate hedging, these decisions are principally based on our policy to match investments with comparable borrowings, but are also based on the general trend in interest rates at the applicable dates and our perception of the future volatility of interest rates. For foreign currency hedging, these decisions are principally based on how our investments are financed, the long-term nature of our investments, the need to repatriate earnings back to the U.S., and the general trend in foreign currency exchange rates.

In addition, the value of our facilities will be subject to fluctuations based on changes in local and regional economic conditions and changes in the ability of our tenants to generate profits.

Our primary exposure to market risks relates to fluctuations in interest rates and foreign currency. The following analyses present the sensitivity of the market value, earnings, and cash flows of our significant financial instruments to hypothetical changes in interest rates and exchange rates as if these changes had occurred. The hypothetical changes chosen for these analyses reflect our view of changes that are reasonably possible over a one-year period. These forward looking disclosures are selective in nature and only address the potential impact from these hypothetical changes. They do not include other potential effects which could impact our business as a result of changes in market conditions. In addition, they do not include measures we may take to minimize our exposure such as entering into future interest rate swaps to hedge against interest rate increases on our variable rate debt.

Interest Rate Sensitivity

For fixed rate debt, interest rate changes affect the fair market value but do not impact net income to common stockholders or cash flows. Conversely, for floating rate debt, interest rate changes generally do not affect the fair market value but do impact net

49


 

income to common stockholders and cash flows, assuming other factors are held constant. At September 30, 2024, our outstanding debt totaled $9.3 billion, which consisted of fixed-rate debt of approximately $8.7 billion (after considering interest rate swaps in-place) and variable rate debt of $0.6 billion. If market interest rates increase by 10% on our fixed rate debt, the fair value of our debt at September 30, 2024 would decrease by approximately $212.0 million. Changes in the fair value of our fixed rate debt will not have any impact on us unless we decided to repurchase the debt in the open market.

If market rates of interest on our variable rate debt increase by 10%, the increase in annual interest expense on our variable rate debt would decrease future earnings and cash flows by $4.2 million per year. If market rates of interest on our variable rate debt decrease by 10%, the decrease in interest expense on our variable rate debt would increase future earnings and cash flows by $4.2 million per year. This assumes that the average amount outstanding under our variable rate debt for a year is $0.6 billion, the balance of such variable rate debt at September 30, 2024.

Foreign Currency Sensitivity

With our investments in the U.K., Germany, Spain, Italy, Portugal, Switzerland, Finland, and Colombia, we are subject to fluctuations in the British pound, euro, Swiss franc, and Colombian peso to U.S. dollar currency exchange rates. Although we generally deem investments in these countries to be of a long-term nature, are typically able to match any non-U.S. dollar borrowings with investments in such currencies, and historically have not needed to repatriate a material amount of earnings back to the U.S., increases or decreases in the value of the respective non-U.S. dollar currencies to U.S. dollar exchange rates may impact our financial condition and/or our results of operations. Based solely on our 2024 operating results to-date and on an annualized basis, a 10% change to the following exchange rates would have impacted our net income, FFO, and Normalized FFO by the amounts below (in thousands):

 

 

 

Net Income Impact

 

 

FFO Impact

 

 

NFFO Impact

 

British pound (£)

 

$

10,591

 

 

$

20,476

 

 

$

21,411

 

Euro (€)

 

 

1,317

 

 

 

5,981

 

 

 

6,230

 

Swiss franc (CHF)

 

 

1,247

 

 

 

1,263

 

 

 

2,956

 

Colombian peso (COP)

 

 

187

 

 

 

264

 

 

 

2,018

 

Item 4. Controls and Procedures.

Medical Properties Trust, Inc. and MPT Operating Partnership, L.P.

We have adopted and maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in our reports under the Securities Exchange Act of 1934, as amended, is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow for timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives, and management is required to apply its judgment in evaluating the cost-benefit relationship of possible controls and procedures.

As required by Rule 13a-15(b), under the Securities Exchange Act of 1934, as amended, we have carried out an evaluation, under the supervision and with the participation of management, including our Chief Executive Officer and Chief Financial Officer, of the effectiveness of the design and operation of our disclosure controls and procedures as of the end of the quarter covered by this report. Based on the foregoing, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures are effective in providing reasonable assurance that information required to be disclosed by us in the reports that we file under the Securities Exchange Act of 1934 is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms.

There has been no change in our internal control over financial reporting during our most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

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PART II — OTHER INFORMATION

We are party to various lawsuits as further described in Note 9 “Commitments and Contingencies” to the condensed consolidated financial statements. We have not recorded a liability related to any particular lawsuit because, at this time, we are unable to determine whether an unfavorable outcome is probable or to estimate reasonably possible losses.

In addition to the foregoing, we are currently and have in the past been subject to various legal proceedings and regulatory actions in connection with our business. We believe that the resolution of any current pending legal or regulatory matters will not have a material adverse effect on our business, financial condition, results of operations, or cash flows. Nonetheless, we cannot predict the outcome of these proceedings, as legal and regulatory matters are subject to inherent uncertainties, and there exists the possibility that the ultimate resolution of such matters could have a material adverse effect on our financial condition, cash flows, results of operations, and the trading price of our common stock.

Item 1A. Risk Factors.

Other than the risk factors disclosed on pages 41 and 42 in our Quarterly Report on Form 10-Q for the period ended March 31, 2024, there have been no material changes to the Risk Factors as presented in our Annual Report on Form 10-K for the year ended December 31, 2023.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.

(a)
None.
(b)
Not applicable.
(c)
Stock repurchases:

 

The table below summarizes repurchases of our common stock made during the quarter ended September 30, 2024:

 

Period

 

Total number of
shares purchased(1)
(in thousands)

 

 

Average price
per share

 

 

Total number of shares
purchased as part of
publicly announced
programs

 

 

Approximate dollar
value of shares that
may yet be
purchased under the
plans or programs
(in thousands)

 

July 1-July 31, 2024

 

 

94

 

 

$

4.46

 

 

 

 

 

$

 

(1)
The number of shares purchased consists of shares of common stock tendered by employees to satisfy the employees' tax withholding obligations arising as a result of vesting of restricted stock awards under the Equity Incentive Plan, which shares were purchased based on their fair market value on the vesting date.

Item 3. Defaults Upon Senior Securities.

None.

Item 4. Mine Safety Disclosures.

None.

Item 5. Other Information.

(a)
None.
(b)
None.
(c)
Director and Officer Trading Arrangements

During the three months ended September 30, 2024, none of the Company's directors or officers (as defined in Rule 16a-1(f) of the Securities and Exchange Act) adopted, terminated or modified a Rule 10b5-1 trading arrangement or non-Rule 10b5-1 trading arrangement (as such terms are defined in Item 408 of Regulation S-K).

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Item 6. Exhibits

Exhibit Number

 

Description

 

 

 

10.1*

 

Amendment No. 2 to Second Amended and Restated Revolving Credit and Term Loan Agreement, dated as of August 6, 2024, by and among Medical Properties Trust, Inc., MPT Operating Partnership, L.P., the Guarantors party hereto, the several lenders from time to time party thereto, and JPMorgan Chase Bank, N.A., as administrative agent

 

 

 

31.1*

 

Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934. (Medical Properties Trust, Inc.)

 

 

31.2*

 

Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934. (Medical Properties Trust, Inc.)

 

 

31.3*

 

Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934. (MPT Operating Partnership, L.P.)

 

 

31.4*

 

Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934. (MPT Operating Partnership, L.P.)

 

 

32.1**

 

Certification of Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. (Medical Properties Trust, Inc.)

 

 

32.2**

 

Certification of Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. (MPT Operating Partnership, L.P.)

 

 

Exhibit 101.INS*

 

XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.

 

 

Exhibit 101.SCH*

 

Inline XBRL Taxonomy Extension Schema With Embedded Linkbase Documents

 

 

Exhibit 104*

 

Cover Page Interactive Data File (formatted as Inline XBRL with applicable taxonomy extension information contained in Exhibits 101.*)

 

* Filed herewith.

** Furnished herewith.

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SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the registrants have duly caused this report to be signed on their behalf by the undersigned thereunto duly authorized.

 

MEDICAL PROPERTIES TRUST, INC.

 

 

 

By:

 

/s/ J. Kevin Hanna

 

 

J. Kevin Hanna

 

 

Senior Vice President, Controller, Assistant Treasurer, and Chief Accounting Officer

(Principal Accounting Officer)

 

MPT OPERATING PARTNERSHIP, L.P.

 

 

 

By:

 

/s/ J. Kevin Hanna

 

 

J. Kevin Hanna

 

 

Senior Vice President, Controller, Assistant Treasurer, and Chief Accounting Officer

of the sole member of the general partner

of MPT Operating Partnership, L.P.

(Principal Accounting Officer)

 

Date: November 12, 2024

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