MEDICAL PROPERTIES TRUST INC
For the period ended Dec 31, 2025. Filed Feb 26, 2026.
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FY2025 · Filed Feb 26, 2026
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Item 8. Financial Statements and Supplementary Data
Report of Independent Registered Public Accounting Firm
To the Board of Directors and Stockholders of Medical Properties Trust, Inc.
Opinions on the Financial Statements and Internal Control over Financial Reporting
We have audited the accompanying consolidated balance sheets of Medical Properties Trust, Inc. and its subsidiaries (the "Company") as of December 31, 2025 and 2024, and the related consolidated statements of net income, of comprehensive loss, of equity and of cash flows for each of the three years in the period ended December 31, 2025, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the "consolidated financial statements"). We also have audited the Company's internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2025 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.
Basis for Opinions
The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in Management’s Report on Internal Control over Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.
Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.
Definition and Limitations of Internal Control over Financial Reporting
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
Critical Audit Matters
The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
Impairment Assessment of Real Estate Investments
As described in Notes 2 and 3 to the consolidated financial statements, the carrying value of the Company’s real estate investments was $10.5 billion as of December 31, 2025, including land, buildings and improvements net of accumulated depreciation and intangible assets net of accumulated amortization. Management reviews real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. Management analyzes recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Estimated future cash flows used in such analysis are based on the Company’s plans for the real estate asset and their view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates.
The principal considerations for our determination that performing procedures relating to the impairment assessment of real estate investments is a critical audit matter are (i) the significant judgment by management when developing the undiscounted cash flows to be generated by the assets, and developing the fair value estimate, and (ii) a high degree of auditor judgment, subjectivity and effort in performing procedures related to evaluating management’s undiscounted cash flows to be generated by the assets and significant assumptions related to market rental rates and the holding period used in developing the undiscounted cash flows, and the market rental rates and capitalization rates, used in the fair value estimate.
Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to the Company’s impairment assessment, including controls over the development of the undiscounted cash flows to be generated by the assets and fair value estimate. These procedures also included, among others, (i) testing management’s process for developing the estimated future undiscounted cash flows and for developing the fair value used in the impairment assessment of real estate investments, (ii) evaluating the appropriateness of the undiscounted cash flows and direct capitalization models, (iii) testing the completeness and accuracy of underlying data used in the models, and (iv) evaluating the reasonableness of the significant assumptions used by management related to the market rental rates and holding period used in the undiscounted cash flow model and the market rental rates and capitalization rates used in the direct capitalization model. Evaluating management's assumptions related to market rental rates, capitalization rates and holding period involved evaluating whether the assumptions used by management were reasonable considering the consistency with external market data and comparable transactions.
/s/ PricewaterhouseCoopers LLP
PricewaterhouseCoopers LLP
Birmingham, Alabama
February 26, 2026
We have served as the Company’s auditor since 2008.
Report of Independent Registered Public Accounting Firm
To the Partners of MPT Operating Partnership, L.P.:
Opinions on the Financial Statements and Internal Control over Financial Reporting
We have audited the accompanying consolidated balance sheets of MPT Operating Partnership, L.P. and its subsidiaries (the "Company") as of December 31, 2025 and 2024, and the related consolidated statements of net income, of comprehensive loss, of capital and of cash flows for each of the three years in the period ended December 31, 2025, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the "consolidated financial statements"). We also have audited the Company's internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2025 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control - Integrated Framework(2013) issued by the COSO.
Basis for Opinions
The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in Management’s Report on Internal Control over Financial Reporting appearing under Item 9A. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.
Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.
Definition and Limitations of Internal Control over Financial Reporting
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
Critical Audit Matters
The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
Impairment Assessment of Real Estate Investments
As described in Notes 2 and 3 to the consolidated financial statements, the carrying value of the Company’s real estate investments was $10.5 billion as of December 31, 2025, including land, buildings and improvements net of accumulated depreciation and intangible assets net of accumulated amortization. Management reviews real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. Management analyzes recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Estimated future cash flows used in such analysis are based on the Company’s plans for the real estate asset and their view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates.
The principal considerations for our determination that performing procedures relating to the impairment assessment of real estate investments is a critical audit matter are (i) the significant judgment by management when developing the undiscounted cash flows to be generated by the assets, and developing the fair value estimate, and (ii) a high degree of auditor judgment, subjectivity and effort in performing procedures related to evaluating management’s undiscounted cash flows to be generated by the assets and significant assumptions related to market rental rates and the holding period used in developing the undiscounted cash flows, and the market rental rates and capitalization rates, used in the fair value estimate.
Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to the Company’s impairment assessment, including controls over the development of the undiscounted cash flows to be generated by the assets and fair value estimate. These procedures also included, among others, (i) testing management’s process for developing the estimated future undiscounted cash flows and for developing the fair value used in the impairment assessment of real estate investments, (ii) evaluating the appropriateness of the undiscounted cash flows and direct capitalization models, (iii) testing the completeness and accuracy of underlying data used in the models, and (iv) evaluating the reasonableness of the significant assumptions used by management related to the market rental rates and holding period used in the undiscounted cash flow model and the market rental rates and capitalization rates used in the direct capitalization model. Evaluating management's assumptions related to market rental rates, capitalization rates and holding period involved evaluating whether the assumptions used by management were reasonable considering the consistency with external market data and comparable transactions.
/s/ PricewaterhouseCoopers LLP
PricewaterhouseCoopers LLP
Birmingham, Alabama
February 26, 2026
We have served as the Company’s auditor since 2008.
Consolidated Balance Sheets
| December 31, | ||
|---|---|---|
| 2025 | 2024 | |
| (Amounts in thousands,except for per share data) | ||
| ASSETS | ||
| Real estate assets | ||
| Land | $1,790,154 | $1,607,869 |
| Buildings and improvements | 9,543,162 | 8,847,892 |
| Intangible lease assets | 872,371 | 804,081 |
| Investment in financing leases | 421,684 | 1,057,770 |
| Real estate held for sale | — | 34,019 |
| Mortgage loans | 123,651 | 119,912 |
| Gross investment in real estate assets | 12,751,022 | 12,471,543 |
| Accumulated depreciation | (1,438,594) | (1,221,644) |
| Accumulated amortization | (224,462) | (201,304) |
| Net investment in real estate assets | 11,087,966 | 11,048,595 |
| Cash and cash equivalents | 540,859 | 332,335 |
| Interest and rent receivables | 19,210 | 36,327 |
| Straight-line rent receivables | 881,452 | 700,783 |
| Investments in unconsolidated real estate joint ventures | 1,399,777 | 1,156,397 |
| Investments in unconsolidated operating entities | 322,179 | 439,578 |
| Other loans | 186,292 | 109,175 |
| Other assets | 564,040 | 471,404 |
| Total Assets | $15,001,775 | $14,294,594 |
| LIABILITIES AND EQUITY | ||
| Liabilities | ||
| Debt, net | $9,697,835 | $8,848,112 |
| Accounts payable and accrued expenses | 549,105 | 454,209 |
| Deferred revenue | 19,289 | 29,445 |
| Obligations to tenants and other lease liabilities | 128,297 | 129,045 |
| Total Liabilities | 10,394,526 | 9,460,811 |
| Commitments and Contingencies | ||
| Equity | ||
| Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding | — | — |
| Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding — 597,008 shares at December 31, 2025 and 600,403 shares at December 31, 2024 | 597 | 600 |
| Additional paid-in capital | 8,573,396 | 8,584,917 |
| Retained deficit | (4,136,011) | (3,658,516) |
| Accumulated other comprehensive income (loss) | 168,213 | (94,272) |
| Total Medical Properties Trust, Inc. stockholders’ equity | 4,606,195 | 4,832,729 |
| Non-controlling interests | 1,054 | 1,054 |
| Total Equity | 4,607,249 | 4,833,783 |
| Total Liabilities and Equity | $15,001,775 | $14,294,594 |
Consolidated Statem ents of Net Income
| For the Years Ended December 31, | |||
|---|---|---|---|
| 2025 | 2024 | 2023 | |
| (Amounts in thousands,except for per share data) | |||
| Revenues | |||
| Rent billed | $736,543 | $719,749 | $803,375 |
| Straight-line rent | 152,163 | 163,414 | (127,894) |
| Income from financing leases | 39,735 | 63,651 | 127,141 |
| Interest and other income | 43,581 | 48,733 | 69,177 |
| Total revenues | 972,022 | 995,547 | 871,799 |
| Expenses | |||
| Interest | 510,362 | 417,824 | 411,171 |
| Real estate depreciation and amortization | 265,405 | 447,657 | 603,360 |
| Property-related | 36,415 | 27,255 | 41,567 |
| General and administrative | 130,427 | 133,789 | 145,588 |
| Total expenses | 942,609 | 1,026,525 | 1,201,686 |
| Other (expense) income | |||
| Gain (loss) on sale of real estate | 5,545 | 478,693 | (1,815) |
| Real estate and other impairment charges, net | (193,947) | (1,825,402) | (376,907) |
| Earnings (loss) from equity interests | 97,851 | (366,642) | 13,967 |
| Debt refinancing and unutilized financing (costs) benefit | (3,629) | (4,292) | 285 |
| Other (including fair value adjustments on securities) | (172,552) | (615,565) | 7,586 |
| Total other expense | (266,732) | (2,333,208) | (356,884) |
| Loss before income tax | (237,319) | (2,364,186) | (686,771) |
| Income tax (expense) benefit | (38,618) | (44,101) | 130,679 |
| Net loss | (275,937) | (2,408,287) | (556,092) |
| Net income attributable to non-controlling interests | (1,112) | (1,984) | (384) |
| Net loss attributable to MPT common stockholders | $(277,049) | $(2,410,271) | $(556,476) |
| Earnings per common share — basic and diluted | |||
| Net loss attributable to MPT common stockholders | $(0.46) | $(4.02) | $(0.93) |
| Weighted average shares outstanding — basic | 600,892 | 600,248 | 598,518 |
| Weighted average shares outstanding — diluted | 600,892 | 600,248 | 598,518 |
Consolidated Statementsof Comprehensive Loss
| For the Years Ended December 31, | |||
|---|---|---|---|
| (In thousands) | 2025 | 2024 | 2023 |
| Net loss | $(275,937) | $(2,408,287) | $(556,092) |
| Other comprehensive (loss) income: | |||
| Unrealized loss on interest rate hedges, net of tax | (4,208) | (20,779) | (34,932) |
| Reclassification of interest rate hedges gain from AOCI to earnings, net of tax | — | (18,926) | (28,553) |
| Foreign currency translation gain (loss) | 266,693 | (97,068) | 162,680 |
| Reclassification of foreign currency translation loss from AOCI to earnings | — | — | 2,490 |
| Total comprehensive loss | (13,452) | (2,545,060) | (454,407) |
| Comprehensive income attributable to non-controlling interests | (1,112) | (1,984) | (384) |
| Comprehensive loss attributable to MPT common stockholders | $(14,564) | $(2,547,044) | $(454,791) |
Consolidated Stat ements of Equity
For the Years Ended December 31, 2025, 2024 and 2023
| Preferred · Common | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| (In thousands, except per share amounts) | Shares | ParValue | Shares | ParValue | AdditionalPaid-inCapital | RetainedEarnings (Deficit) | AccumulatedOtherComprehensive(Loss) Income | Non-ControllingInterests | TotalEquity |
| Balance at December 31, 2022 | — | $— | 597,476 | $597 | $8,535,140 | $116,285 | $(59,184) | $1,569 | $8,594,407 |
| Net (loss) income | — | — | — | — | — | (556,476) | — | 384 | (556,092) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | — | — | (34,932) | — | (34,932) |
| Reclassification of interest rate hedge gain to earnings, net of tax | — | — | — | — | — | — | (28,553) | — | (28,553) |
| Foreign currency translation gain | — | — | — | — | — | — | 162,680 | — | 162,680 |
| Reclassification of foreign currency translation loss to earnings | — | — | — | — | — | — | 2,490 | — | 2,490 |
| Stock vesting and amortization of stock-based compensation | — | — | 2,457 | 2 | 33,248 | — | — | — | 33,250 |
| Stock vesting - satisfaction of tax withholdings | — | — | (942) | — | (8,079) | — | — | — | (8,079) |
| Issuance of non-controlling interests | — | — | — | — | — | — | — | 1,375 | 1,375 |
| Distributions to non-controlling interests | — | — | — | — | — | — | — | (1,063) | (1,063) |
| Dividends declared ($0.88 per common share) | — | — | — | — | — | (531,618) | — | — | (531,618) |
| Balance at December 31, 2023 | — | $— | 598,991 | $599 | $8,560,309 | $(971,809) | $42,501 | $2,265 | $7,633,865 |
| Net (loss) income | — | — | — | — | — | (2,410,271) | — | 1,984 | (2,408,287) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | — | — | (20,779) | — | (20,779) |
| Reclassification of interest rate hedge gain to earnings, net of tax | — | — | — | — | — | — | (18,926) | — | (18,926) |
| Foreign currency translation loss | — | — | — | — | — | — | (97,068) | — | (97,068) |
| Stock vesting and amortization of stock-based compensation | — | — | 2,173 | 2 | 28,412 | — | — | — | 28,414 |
| Stock vesting - satisfaction of tax withholdings | — | — | (761) | (1) | (3,804) | — | — | — | (3,805) |
| Acquisitions of non-controlling interests | — | — | — | — | — | — | — | (1,500) | (1,500) |
| Distributions to non-controlling interests | — | — | — | — | — | — | — | (1,695) | (1,695) |
| Dividends declared ($0.46 per common share) | — | — | — | — | — | (276,436) | — | — | (276,436) |
| Balance at December 31, 2024 | — | $— | 600,403 | $600 | $8,584,917 | $(3,658,516) | $(94,272) | $1,054 | $4,833,783 |
| Net (loss) income | — | — | — | — | — | (277,049) | — | 1,112 | (275,937) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | — | — | (4,208) | — | (4,208) |
| Foreign currency translation gain | — | — | — | — | — | — | 266,693 | — | 266,693 |
| Stock vesting and amortization of stock-based compensation | — | — | 1,639 | 2 | 15,116 | — | — | — | 15,118 |
| Stock vesting - satisfaction of tax withholdings | — | — | (529) | — | (2,474) | — | — | — | (2,474) |
| Repurchase of common stock | — | — | (4,505) | (5) | (23,436) | — | — | — | (23,441) |
| Distributions to non-controlling interests | — | — | — | — | — | — | — | (1,112) | (1,112) |
| Offering costs | — | — | — | — | (727) | — | — | — | (727) |
| Dividends declared ($0.33 per common share) | — | — | — | — | — | (200,446) | — | — | (200,446) |
| Balance at December 31, 2025 | — | $— | 597,008 | $597 | $8,573,396 | $(4,136,011) | $168,213 | $1,054 | $4,607,249 |
Consolidated Statem ents of Cash Flows
| For the Years Ended December 31, | |||
|---|---|---|---|
| 2025 | 2024 | 2023 | |
| (Amounts in thousands) | |||
| Operating activities | |||
| Net loss | $(275,937) | $(2,408,287) | $(556,092) |
| Adjustments to reconcile net loss to net cash provided by operating activities: | |||
| Depreciation and amortization | 272,817 | 453,749 | 616,127 |
| Amortization of deferred financing costs and debt discount | 26,283 | 17,348 | 15,775 |
| Straight-line rent revenue and other | (158,172) | (172,765) | (233,703) |
| Stock-based compensation | 25,746 | 32,976 | 33,250 |
| (Gain) loss on sale of real estate | (5,545) | (478,693) | 1,815 |
| Real estate and other impairment charges, net | 193,947 | 1,825,402 | 376,907 |
| Equity interest real estate impairment | — | 410,790 | — |
| Straight-line rent and other write-off | 11,054 | 2,514 | 649,911 |
| Debt refinancing and unutilized financing costs (benefit) | 3,629 | 4,292 | (285) |
| Tax rate changes and other | (11,231) | 5,119 | (167,332) |
| Non-cash fair value adjustments | 106,442 | 563,666 | (34,157) |
| Non-cash revenue from debt and equity securities received | — | — | (81,706) |
| Other adjustments | 7,580 | 4,975 | 10,287 |
| Changes in: | |||
| Interest and rent receivables | 7,111 | 2,778 | (141,729) |
| Other assets | 14,971 | (36,109) | 13,750 |
| Accounts payable and accrued expenses | 21,680 | 23,481 | (4,599) |
| Deferred revenue | (9,608) | (5,753) | 7,567 |
| Net cash provided by operating activities | 230,767 | 245,483 | 505,786 |
| Investing activities | |||
| Cash paid for acquisitions and other related investments | (142,089) | (105,618) | (235,187) |
| Net proceeds from sale of real estate | 120,550 | 1,854,077 | 897,500 |
| Principal received from sale and repayment of loans receivable | 116,309 | 214,416 | 501,630 |
| Investment in loans receivable | (205,752) | (420,324) | (250,223) |
| Construction in progress and other | (80,003) | (79,788) | (114,425) |
| Proceeds from sale and return of equity investments | — | 11,656 | 12,430 |
| Capital additions and other investments, net | (73,753) | (156,078) | (294,167) |
| Net cash (used for) provided by investing activities | (264,738) | 1,318,341 | 517,558 |
| Financing activities | |||
| Proceeds from term debt | 2,512,970 | 804,188 | — |
| Payments of term debt | (2,252,731) | (701,809) | (988,162) |
| Revolving credit facilities, net | 241,530 | (1,131,312) | 567,910 |
| Dividends paid | (193,259) | (321,080) | (615,390) |
| Lease deposits and other obligations to tenants | (3,202) | 2,237 | 10,139 |
| Offering costs | (727) | — | — |
| Repurchase of common stock | (23,441) | — | — |
| Stock vesting - satisfaction of tax withholdings | (2,474) | (3,805) | (8,079) |
| Payment of debt refinancing and deferred financing costs and other financing activities | (50,585) | (127,798) | 13,255 |
| Net cash provided by (used for) financing activities | 228,081 | (1,479,379) | (1,020,327) |
| Increase in cash, cash equivalents, and restricted cash for the year | 194,110 | 84,445 | 3,017 |
| Effect of exchange rate changes | 14,712 | (5,224) | 11,397 |
| Cash, cash equivalents, and restricted cash at beginning of year | 335,173 | 255,952 | 241,538 |
| Cash, cash equivalents, and restricted cash at end of year | $543,995 | $335,173 | $255,952 |
| Interest paid, including capitalized interest of $12,920 in 2025, $7,642 in 2024, and $14,178 in 2023 | $458,225 | $420,315 | $406,141 |
| 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 | 50,000 | — | 722,814 |
| Lease incentive provided | 50,000 | — | — |
| Supplemental schedule of non-cash financing activities: | |||
| Dividends declared, unpaid | $55,351 | $48,164 | $92,808 |
| Cash, cash equivalents, and restricted cash are comprised of the following: | |||
| Beginning of period: | |||
| Cash and cash equivalents | $332,335 | $250,016 | $235,668 |
| Restricted cash, included in Other assets | 2,838 | 5,936 | 5,870 |
| $335,173 | $255,952 | $241,538 | |
| End of period: | |||
| Cash and cash equivalents | $540,859 | $332,335 | $250,016 |
| Restricted cash, included in Other assets | 3,136 | 2,838 | 5,936 |
| $543,995 | $335,173 | $255,952 | |
Consoli dated Balance Sheets
| December 31, | ||
|---|---|---|
| 2025 | 2024 | |
| (Amounts in thousands,except for per unit data) | ||
| ASSETS | ||
| Real estate assets | ||
| Land | $1,790,154 | $1,607,869 |
| Buildings and improvements | 9,543,162 | 8,847,892 |
| Intangible lease assets | 872,371 | 804,081 |
| Investment in financing leases | 421,684 | 1,057,770 |
| Real estate held for sale | — | 34,019 |
| Mortgage loans | 123,651 | 119,912 |
| Gross investment in real estate assets | 12,751,022 | 12,471,543 |
| Accumulated depreciation | (1,438,594) | (1,221,644) |
| Accumulated amortization | (224,462) | (201,304) |
| Net investment in real estate assets | 11,087,966 | 11,048,595 |
| Cash and cash equivalents | 540,859 | 332,335 |
| Interest and rent receivables | 19,210 | 36,327 |
| Straight-line rent receivables | 881,452 | 700,783 |
| Investments in unconsolidated real estate joint ventures | 1,399,777 | 1,156,397 |
| Investments in unconsolidated operating entities | 322,179 | 439,578 |
| Other loans | 186,292 | 109,175 |
| Other assets | 564,040 | 471,404 |
| Total Assets | $15,001,775 | $14,294,594 |
| LIABILITIES AND CAPITAL | ||
| Liabilities | ||
| Debt, net | $9,697,835 | $8,848,112 |
| Accounts payable and accrued expenses | 493,364 | 405,655 |
| Deferred revenue | 19,289 | 29,445 |
| Obligations to tenants and other lease liabilities | 128,297 | 129,045 |
| Payable due to Medical Properties Trust, Inc. | 55,351 | 48,164 |
| Total Liabilities | 10,394,136 | 9,460,421 |
| Commitments and Contingencies | ||
| Capital | ||
| General Partner — issued and outstanding — 5,972 units at December 31, 2025 and 6,006 units at December 31, 2024 | 44,457 | 49,348 |
| Limited Partners — issued and outstanding — 591,036 units at December 31, 2025 and 594,397 units at December 31, 2024 | 4,393,915 | 4,878,043 |
| Accumulated other comprehensive income (loss) | 168,213 | (94,272) |
| Total MPT Operating Partnership, L.P. capital | 4,606,585 | 4,833,119 |
| Non-controlling interests | 1,054 | 1,054 |
| Total Capital | 4,607,639 | 4,834,173 |
| Total Liabilities and Capital | $15,001,775 | $14,294,594 |
Conso lidated Statements of Net Income
| For the Years Ended December 31, | |||
|---|---|---|---|
| 2025 | 2024 | 2023 | |
| (Amounts in thousands,except for per unit data) | |||
| Revenues | |||
| Rent billed | $736,543 | $719,749 | $803,375 |
| Straight-line rent | 152,163 | 163,414 | (127,894) |
| Income from financing leases | 39,735 | 63,651 | 127,141 |
| Interest and other income | 43,581 | 48,733 | 69,177 |
| Total revenues | 972,022 | 995,547 | 871,799 |
| Expenses | |||
| Interest | 510,362 | 417,824 | 411,171 |
| Real estate depreciation and amortization | 265,405 | 447,657 | 603,360 |
| Property-related | 36,415 | 27,255 | 41,567 |
| General and administrative | 130,427 | 133,789 | 145,588 |
| Total expenses | 942,609 | 1,026,525 | 1,201,686 |
| Other (expense) income | |||
| Gain (loss) on sale of real estate | 5,545 | 478,693 | (1,815) |
| Real estate and other impairment charges, net | (193,947) | (1,825,402) | (376,907) |
| Earnings (loss) from equity interests | 97,851 | (366,642) | 13,967 |
| Debt refinancing and unutilized financing (costs) benefit | (3,629) | (4,292) | 285 |
| Other (including fair value adjustments on securities) | (172,552) | (615,565) | 7,586 |
| Total other expense | (266,732) | (2,333,208) | (356,884) |
| Loss before income tax | (237,319) | (2,364,186) | (686,771) |
| Income tax (expense) benefit | (38,618) | (44,101) | 130,679 |
| Net loss | (275,937) | (2,408,287) | (556,092) |
| Net income attributable to non-controlling interests | (1,112) | (1,984) | (384) |
| Net loss attributable to MPT Operating Partnership partners | $(277,049) | $(2,410,271) | $(556,476) |
| Earnings per unit — basic and diluted | |||
| Net loss attributable to MPT Operating Partnership partners | $(0.46) | $(4.02) | $(0.93) |
| Weighted average units outstanding — basic | 600,892 | 600,248 | 598,518 |
| Weighted average units outstanding — diluted | 600,892 | 600,248 | 598,518 |
Consolidated Statementsof Comprehensive Loss
| For the Years Ended December 31, | |||
|---|---|---|---|
| (In thousands) | 2025 | 2024 | 2023 |
| Net loss | $(275,937) | $(2,408,287) | $(556,092) |
| Other comprehensive (loss) income: | |||
| Unrealized loss on interest rate hedges, net of tax | (4,208) | (20,779) | (34,932) |
| Reclassification of interest rate hedges gain from AOCI to earnings, net of tax | — | (18,926) | (28,553) |
| Foreign currency translation gain (loss) | 266,693 | (97,068) | 162,680 |
| Reclassification of foreign currency translation loss from AOCI to earnings | — | — | 2,490 |
| Total comprehensive loss | (13,452) | (2,545,060) | (454,407) |
| Comprehensive income attributable to non-controlling interests | (1,112) | (1,984) | (384) |
| Comprehensive loss attributable to MPT Operating Partnership partners | $(14,564) | $(2,547,044) | $(454,791) |
Consolidated Stat ements of Capital
For the Years Ended December 31, 2025, 2024 and 2023
| General · Limited · Accumulated | |||||||
|---|---|---|---|---|---|---|---|
| Partner · Partners · Other · Non- | |||||||
| (In thousands, except per unit amounts) | Units | UnitValue | Units | UnitValue | Comprehensive(Loss) Income | ControllingInterests | TotalCapital |
| Balance at December 31, 2022 | 5,976 | $86,599 | 591,500 | $8,565,813 | $(59,184) | $1,569 | $8,594,797 |
| Net (loss) income | — | (5,564) | — | (550,912) | — | 384 | (556,092) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | (34,932) | — | (34,932) |
| Reclassification of interest rate hedge gain to earnings, net of tax | — | — | — | — | (28,553) | — | (28,553) |
| Foreign currency translation gain | — | — | — | — | 162,680 | — | 162,680 |
| Reclassification of foreign currency translation loss to earnings | — | — | — | — | 2,490 | — | 2,490 |
| Unit vesting and amortization of unit-based compensation | 25 | 332 | 2,432 | 32,918 | — | — | 33,250 |
| Unit vesting - satisfaction of tax withholdings | (10) | (81) | (932) | (7,998) | — | — | (8,079) |
| Issuance of non-controlling interests | — | — | — | — | — | 1,375 | 1,375 |
| Distributions to non-controlling interests | — | — | — | — | — | (1,063) | (1,063) |
| Distributions declared ($0.88 per unit) | — | (5,317) | — | (526,301) | — | — | (531,618) |
| Balance at December 31, 2023 | 5,991 | $75,969 | 593,000 | $7,513,520 | $42,501 | $2,265 | $7,634,255 |
| Net (loss) income | — | (24,102) | — | (2,386,169) | — | 1,984 | (2,408,287) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | (20,779) | — | (20,779) |
| Reclassification of interest rate hedge gain to earnings, net of tax | — | — | — | — | (18,926) | — | (18,926) |
| Foreign currency translation loss | — | — | — | — | (97,068) | — | (97,068) |
| Unit vesting and amortization of unit-based compensation | 23 | 285 | 2,150 | 28,129 | — | — | 28,414 |
| Unit vesting - satisfaction of tax withholdings | (8) | (39) | (753) | (3,766) | — | — | (3,805) |
| Acquisitions of non-controlling interests | — | — | — | — | — | (1,500) | (1,500) |
| Distributions to non-controlling interests | — | — | — | — | — | (1,695) | (1,695) |
| Distributions declared ($0.46 per unit) | — | (2,765) | — | (273,671) | — | — | (276,436) |
| Balance at December 31, 2024 | 6,006 | $49,348 | 594,397 | $4,878,043 | $(94,272) | $1,054 | $4,834,173 |
| Net (loss) income | — | (2,771) | — | (274,278) | — | 1,112 | (275,937) |
| Unrealized loss on interest rate hedges, net of tax | — | — | — | — | (4,208) | — | (4,208) |
| Foreign currency translation gain | — | — | — | — | 266,693 | — | 266,693 |
| Unit vesting and amortization of unit-based compensation | 17 | 151 | 1,622 | 14,967 | — | — | 15,118 |
| Unit vesting - satisfaction of tax withholdings | (6) | (25) | (523) | (2,449) | — | — | (2,474) |
| Repurchase of units | (45) | (234) | (4,460) | (23,207) | — | — | (23,441) |
| Distributions to non-controlling interests | — | — | — | — | — | (1,112) | (1,112) |
| Offering costs | — | (7) | — | (720) | — | — | (727) |
| Distributions declared ($0.33 per unit) | — | (2,005) | — | (198,441) | — | — | (200,446) |
| Balance at December 31, 2025 | 5,972 | $44,457 | 591,036 | $4,393,915 | $168,213 | $1,054 | $4,607,639 |
Consolidated Statem ents of Cash Flows
| For the Years Ended December 31, | |||
|---|---|---|---|
| 2025 | 2024 | 2023 | |
| (Amounts in thousands) | |||
| Operating activities | |||
| Net loss | $(275,937) | $(2,408,287) | $(556,092) |
| Adjustments to reconcile net loss to net cash provided by operating activities: | |||
| Depreciation and amortization | 272,817 | 453,749 | 616,127 |
| Amortization of deferred financing costs and debt discount | 26,283 | 17,348 | 15,775 |
| Straight-line rent revenue and other | (158,172) | (172,765) | (233,703) |
| Unit-based compensation | 25,746 | 32,976 | 33,250 |
| Gain (loss) on sale of real estate | (5,545) | (478,693) | 1,815 |
| Real estate and other impairment charges, net | 193,947 | 1,825,402 | 376,907 |
| Equity interest real estate impairment | — | 410,790 | — |
| Straight-line rent and other write-off | 11,054 | 2,514 | 649,911 |
| Debt refinancing and unutilized financing costs (benefit) | 3,629 | 4,292 | (285) |
| Tax rate changes and other | (11,231) | 5,119 | (167,332) |
| Non-cash fair value adjustments | 106,442 | 563,666 | (34,157) |
| Non-cash revenue from debt and equity securities received | — | — | (81,706) |
| Other adjustments | 7,580 | 4,975 | 10,287 |
| Changes in: | |||
| Interest and rent receivables | 7,111 | 2,778 | (141,729) |
| Other assets | 14,971 | (36,109) | 13,750 |
| Accounts payable and accrued expenses | 21,680 | 23,481 | (4,599) |
| Deferred revenue | (9,608) | (5,753) | 7,567 |
| Net cash provided by operating activities | 230,767 | 245,483 | 505,786 |
| Investing activities | |||
| Cash paid for acquisitions and other related investments | (142,089) | (105,618) | (235,187) |
| Net proceeds from sale of real estate | 120,550 | 1,854,077 | 897,500 |
| Principal received from sale and repayment of loans receivable | 116,309 | 214,416 | 501,630 |
| Investment in loans receivable | (205,752) | (420,324) | (250,223) |
| Construction in progress and other | (80,003) | (79,788) | (114,425) |
| Proceeds from sale and return of equity investments | — | 11,656 | 12,430 |
| Capital additions and other investments, net | (73,753) | (156,078) | (294,167) |
| Net cash (used for) provided by investing activities | (264,738) | 1,318,341 | 517,558 |
| Financing activities | |||
| Proceeds from term debt | 2,512,970 | 804,188 | — |
| Payments of term debt | (2,252,731) | (701,809) | (988,162) |
| Revolving credit facilities, net | 241,530 | (1,131,312) | 567,910 |
| Distributions paid | (193,259) | (321,080) | (615,390) |
| Lease deposits and other obligations to tenants | (3,202) | 2,237 | 10,139 |
| Offering costs | (727) | — | — |
| Repurchase of units | (23,441) | — | — |
| Unit vesting - satisfaction of tax withholdings | (2,474) | (3,805) | (8,079) |
| Payment of debt refinancing and deferred financing costs and other financing activities | (50,585) | (127,798) | 13,255 |
| Net cash provided by (used for) financing activities | 228,081 | (1,479,379) | (1,020,327) |
| Increase in cash, cash equivalents, and restricted cash for the year | 194,110 | 84,445 | 3,017 |
| Effect of exchange rate changes | 14,712 | (5,224) | 11,397 |
| Cash, cash equivalents, and restricted cash at beginning of year | 335,173 | 255,952 | 241,538 |
| Cash, cash equivalents and restricted cash at end of year | $543,995 | $335,173 | $255,952 |
| Interest paid, including capitalized interest of $12,920 in 2025, $7,642 in 2024, and $14,178 in 2023 | $458,225 | $420,315 | $406,141 |
| 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 | 50,000 | — | 722,814 |
| Lease incentive provided | 50,000 | — | — |
| Supplemental schedule of non-cash financing activities: | |||
| Distributions declared, unpaid | $55,351 | $48,164 | $92,808 |
| Cash, cash equivalents, and restricted cash are comprised of the following: | |||
| Beginning of period: | |||
| Cash and cash equivalents | $332,335 | $250,016 | $235,668 |
| Restricted cash, included in Other assets | 2,838 | 5,936 | 5,870 |
| $335,173 | $255,952 | $241,538 | |
| End of period: | |||
| Cash and cash equivalents | $540,859 | $332,335 | $250,016 |
| Restricted cash, included in Other assets | 3,136 | 2,838 | 5,936 |
| $543,995 | $335,173 | $255,952 | |
Notes To Consolidated Financial Statements
- Orga nization
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 December 31, 2025, we have investments in 384 facilities in 31 states in the U.S., inseven countries in Europe, andone 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.
- Summary of Signific
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.