Medical Properties Trust Inc (MPW) 2019 Q4 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Q4 2019 Medical Properties Trust Earnings Conference Call. (Operator Instructions) Please be advised that today's conference is being recorded. (Operator Instructions). I would now like to hand the conference over to your host today, Charles Lambert, Managing Director. Thank you. Please go ahead, sir.

女士們，先生們，感謝你們的支持，歡迎來到 2019 年第四季度醫療財產信託收益電話會議。（操作員說明）請注意，今天的會議正在錄製中。（操作員說明）。我現在想把會議交給今天的主持人，常務董事 Charles Lambert。謝謝。請繼續，先生。

Good morning. Welcome to the Medical Properties Trust conference call to discuss our fourth quarter and full year 2019 financial results. With me today are Edward K. Aldag Jr., Chairman, President and Chief Executive Officer of the company; and Steven Hamner, Executive Vice President and Chief Financial Officer.

早上好。歡迎參加 Medical Properties Trust 電話會議，討論我們 2019 年第四季度和全年的財務業績。今天和我在一起的有公司董事長、總裁兼首席執行官 Edward K. Aldag Jr.；執行副總裁兼首席財務官 Steven Hamner。

Our press release was distributed this morning and furnished on Form 8-K with the Securities and Exchange Commission. If you did not receive a copy, it is available on our website at www.medicalpropertiestrust.com in the Investor Relations section.

我們的新聞稿於今天上午發布，並以 8-K 表格形式提交給美國證券交易委員會。如果您沒有收到副本，可在我們網站 www.medicalpropertiestrust.com 的投資者關係部分獲取。

Additionally, we're hosting a live webcast of today's call, which you can access in that same section.

此外，我們還舉辦了今天電話會議的網絡直播，您可以在同一部分訪問。

During the course of this call, we will make projections and certain other statements that may be considered forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our financial results and future events to differ materially from those expressed and/or underlying such forward-looking statements. We refer you to the company's reports filed with the Securities and Exchange Commission for a discussion of the factors that could cause the company's actual results or future events to differ materially from those expressed in this call.

在本次電話會議期間，我們將做出預測和某些其他陳述，這些陳述可能被視為 1995 年《私人證券訴訟改革法案》含義內的前瞻性陳述。這些前瞻性陳述受已知和未知的風險、不確定性和其他因素的影響，這些因素可能導致我們的財務結果和未來事件與此類前瞻性陳述中表達的和/或潛在的存在重大差異。我們建議您參考公司向美國證券交易委員會提交的報告，以討論可能導致公司實際業績或未來事件與本次電話會議中表達的內容存在重大差異的因素。

The information being provided today is as of this date only, and except as required by federal securities laws, the company does not undertake a duty to update any such information.

今天提供的信息僅截至該日期，除聯邦證券法要求外，公司不承擔更新任何此類信息的義務。

In addition, during the course of the conference call, we will describe certain non-GAAP financial measures, which should be considered in addition to, and not in lieu of, comparable GAAP financial measures. Please note that in our press release, Medical Properties Trust has reconciled all non-GAAP financial measures to the most directly comparable GAAP measures in accordance with Reg G requirements. You can also refer to our website at www.medicalpropertiestrust.com for the most directly comparable financial measures and related reconciliations.

此外，在電話會議期間，我們將描述某些非 GAAP 財務指標，這些指標應被視為補充而非替代可比的 GAAP 財務指標。請注意，在我們的新聞稿中，Medical Properties Trust 已根據 Reg G 的要求將所有非 GAAP 財務指標與最直接可比的 GAAP 指標進行了核對。您還可以訪問我們的網站 www.medicalpropertiestrust.com，了解最直接的可比財務指標和相關調節。

I will now turn the call over to our Chief Executive Officer, Ed Aldag.

我現在將電話轉交給我們的首席執行官 Ed Aldag。

Thank you, Charles. Good morning, and thank you all for joining us on today's fourth quarter earnings call. 2019 was a record year for MPT. During 2019, we completed approximately $4.5 billion in international and domestic acquisitions with new as well as existing operators, investing in approximately $2.7 billion domestically and $1.8 billion in international acquisitions.

謝謝你，查爾斯。早上好，感謝大家參加今天的第四季度財報電話會議。2019 年是 MPT 創紀錄的一年。2019 年，我們與新運營商和現有運營商完成了約 45 億美元的國際和國內收購，國內投資約 27 億美元，國際收購投資約 18 億美元。

MPT now has hospitals located in the U.S., United Kingdom, Germany, Switzerland, Spain, Italy, Portugal and Australia. On 12/31/18, our enterprise value was approximately $10 billion. Today, it is approximately $19 billion. This represents a 90% increase.

MPT 現在在美國、英國、德國、瑞士、西班牙、意大利、葡萄牙和澳大利亞設有醫院。2018 年 12 月 31 日，我們的企業價值約為 100 億美元。今天，它約為 190 億美元。這代表了 90% 的增長。

At the end of 2018, our equity market cap was approximately $6 billion. Today, it's almost $12 billion. From our IPO in 2005 to-date, our total shareholder return was more than 554% compared to 336% for the SNL Healthcare REIT index, and 195% of the broader REIT index. Our 3-year total shareholder return was 113% compared to the 33% for the SNL Healthcare REIT index, and 29% for the broader REIT Index. Last year, our total shareholder return was 38.5% compared to 21.5% for the SNL REIT Index, and 26% for the broader REIT Index.

2018 年底，我們的股票市值約為 60 億美元。今天，它幾乎是 120 億美元。從 2005 年首次公開募股至今，我們的股東總回報率超過 554%，而 SNL Healthcare REIT 指數為 336%，更廣泛的 REIT 指數為 195%。我們 3 年的總股東回報率為 113%，而 SNL Healthcare REIT 指數為 33%，更廣泛的 REIT 指數為 29%。去年，我們的股東總回報率為 38.5%，而 SNL REIT 指數為 21.5%，更廣泛的 REIT 指數為 26%。

At the beginning of 2019, our largest tenant represented almost 40% of our total portfolio. Today, our largest tenant represents less than 25% of our next 2 largest -- and our next 2 largest tenants represent 13% and 9.5%, respectively. And most importantly, to us, no 1 property represents more than 2.3% of our total portfolio.

2019 年初，我們最大的租戶占我們總投資組合的近 40%。今天，我們最大的租戶占我們下兩個最大租戶的不到 25%，而我們接下來的兩個最大租戶分別佔 13% 和 9.5%。最重要的是，對我們來說，沒有一處房產占我們總投資組合的 2.3% 以上。

In early January, we acquired 30 BMI acute care facilities in the United Kingdom for an aggregate purchase price approximating $1.95 billion. In a related transaction, Circle Health, who has been a trusted MPT tenant for years, has assumed the operations of the entire BMI portfolio of acute care facilities. Circle has committed to a multi-million pound investment program for facility infrastructure, technology and people. We are confident in Circle's ability to operate this portfolio of hospitals. Circle brings significant depth of experienced U.K. private healthcare leadership, combined with the backing of a strong financial and experienced healthcare partner in Centene Corporation, along with deep knowledge of local markets from experienced existing BMI hospital level leadership. MPT is excited about the benefits of this transaction from a portfolio perspective, including the increase of our U.K. hospital footprint and the growing opportunities related to private hospital operators in the U.K.

1 月初，我們在英國收購了 30 家 BMI 急症護理設施，總收購價約為 19.5 億美元。在一項相關交易中，多年來一直是值得信賴的 MPT 租戶的 Circle Health 承擔了整個 BMI 急救設施組合的運營。Circle 已承諾對設施基礎設施、技術和人員進行數百萬英鎊的投資計劃。我們對 Circle 運營這些醫院組合的能力充滿信心。Circle 帶來了經驗豐富的英國私人醫療保健領導層的豐富深度，加上 Centene Corporation 強大的財務和經驗豐富的醫療保健合作夥伴的支持，以及經驗豐富的現有 BMI 醫院級領導層對當地市場的深入了解。從投資組合的角度來看，MPT 對此次交易的好處感到興奮，包括我們在英國醫院足蹟的增加以及與英國私立醫院運營商相關的機會不斷增加。

Circle is confident that there's significant opportunity to expand private insurance and self-pay volumes, maximize certain service lines within local markets, optimize facility infrastructure and technology and to partner with the NHS to augment local market provisions of timely patient care in a comfortable setting. Additionally, in December, we closed on a $700 million transaction that expanded our already strong relationship with LifePoint Health and Apollo Global Management.

Circle 相信，有很大的機會擴大私人保險和自付額，最大限度地擴大當地市場內的某些服務線，優化設施基礎設施和技術，並與 NHS 合作，在舒適的環境中增加當地市場對患者及時護理的供應。此外，在 12 月，我們完成了一項價值 7 億美元的交易，進一步擴大了我們與 LifePoint Health 和 Apollo Global Management 之間業已牢固的關係。

This transaction included 10 acute care hospitals across 6 states, and increased our total investment with LifePoint to 17 acute care hospitals and $1.2 billion.

這筆交易包括 6 個州的 10 家急症醫院，並將我們對 LifePoint 的總投資增加到 17 家急症醫院和 12 億美元。

We continued our strong finish to the year with yet another acquisition in December. This transaction was an approximate $130 million equity investment for a 45% stake in 2 joint venture propco entities in Spain. These joint ventures own the real estate of 2 Madrid acute care hospitals that are leased to and operated by HM Hospitales, one of the largest private hospital operators in Spain.

我們在 12 月又進行了一次收購，延續了這一年的強勁勢頭。該交易是一項約 1.3 億美元的股權投資，用於收購西班牙 2 家合資 propco 實體 45% 的股份。這些合資企業擁有 2 家馬德里急救醫院的不動產，這些醫院出租給 HM Hospitales 並由其運營，HM Hospitales 是西班牙最大的私立醫院運營商之一。

We are also very excited about our first hospital investment in Portugal with José de Mello, Portugal's largest private operator. MPT acquired a newly-constructed, 37-bed hospital in the city of Viseu for approximately $31 million. This transaction represents MPT -- presents MPT with a unique opportunity to enter the attractive Portuguese healthcare market with a leading growth-oriented hospital operator that we've known for years.

我們也對我們與葡萄牙最大的私營運營商若澤德梅洛在葡萄牙的第一筆醫院投資感到非常興奮。MPT 以大約 3100 萬美元的價格收購了維塞烏市新建的擁有 37 個床位的醫院。這項交易代表 MPT——為 MPT 提供了一個獨特的機會，可以通過我們多年來熟知的領先的以增長為導向的醫院運營商進入有吸引力的葡萄牙醫療保健市場。

Similar to the U.K. healthcare market, the private hospitals in Portugal are filling the increasing gaps in coverage offered by the public system, and an increasingly consumer-driven health care marketplace is rewarding the providers with strong quality care metrics. This transaction provides a growth platform and market recognition for MPT to participate in future acquisitions with José de Mello and other operators in Portugal.

與英國醫療保健市場類似，葡萄牙的私立醫院正在填補公共系統提供的日益擴大的覆蓋範圍缺口，而越來越以消費者為導向的醫療保健市場正在以強大的質量醫療指標獎勵提供者。該交易為 MPT 提供了一個增長平台和市場認可度，以參與未來與 José de Mello 和葡萄牙其他運營商的收購。

With our continued strong international expansion highlighted above, MPT has undertaken the expansion of its international office space and people base to meet our day-to-day business needs. Accordingly, during 2019, we expanded our operations in Luxembourg, increasing our headcount to approximately 15 full-time employees, including the transfer of asset management and underwriting personnel from our Birmingham office.

隨著我們在上面強調的持續強勁的國際擴張，MPT 已著手擴大其國際辦公空間和人員基礎，以滿足我們的日常業務需求。因此，在 2019 年期間，我們擴大了在盧森堡的業務，將我們的員工人數增加到約 15 名全職員工，包括從伯明翰辦事處調動資產管理和承銷人員。

In addition, we are in the process of establishing our first Australian office to open in Sydney during the second quarter of this year. We also have continued to grow the depth and personnel and experience in our U.S. offices in Birmingham and New York.

此外，我們正在建立我們的第一個澳大利亞辦事處，將於今年第二季度在悉尼開業。我們還在伯明翰和紐約的美國辦事處繼續增加深度、人員和經驗。

With these acquisitions, our U.S. investment concentration is 67%, and International is 33%. As we've said, we expect our portfolio to generally be about 70% U.S. and 30% International. However, as we make significant investments, that will fluctuate from time to time.

通過這些收購，我們在美國的投資集中度是 67%，國際是 33%。正如我們所說，我們預計我們的投資組合通常約有 70% 美國和 30% 國際。但是，隨著我們進行大量投資，它會不時波動。

As reported last quarter, we closed on a $28 million behavioral health opportunity with NeuroPsychiatric Hospitals for the development of a 92-bed, freestanding hospital in the Houston, Texas market. NPH is a behavioral health company focused on providing best-in-class care for patients with acute complex medical and psychiatric conditions, and is known as the largest neuropsychiatric care organization in the country. They meet an underserved need in treating the severe comorbid cases that traditionally psych hospitals are not equipped to handle today. Construction began in the fourth quarter of 2019 and continues to progress as planned. We expect this hospital to open in the third quarter of this year.

正如上個季度報導的那樣，我們與 NeuroPsychiatric Hospitals 達成了價值 2800 萬美元的行為健康機會，用於在得克薩斯州休斯頓市場開發一家擁有 92 個床位的獨立醫院。NPH 是一家行為健康公司，專注於為患有急性複雜醫學和精神疾病的患者提供一流的護理，被稱為該國最大的神經精神護理組織。他們滿足了治療傳統精神病院今天無法處理的嚴重合併症病例的服務不足的需求。施工於 2019 年第四季度開始，並繼續按計劃進行。我們預計這家醫院將在今年第三季度開業。

There is such a tremendous unmet need for behavioral hospitals in the U.S. We expect to be at the forefront of -- we expect to be at the forefront to provide financing to help meet these needs.

美國的行為醫院存在巨大的未滿足需求。我們希望站在最前沿——我們希望站在最前沿，提供資金來幫助滿足這些需求。

For 2020, we are projecting that we will close on around $3 billion of property. To-date, we have already closed on $2 billion and are actively working an additional $3 billion. At this point, I'm not comfortable enough to project that we will do the full $5 million (sic)[billion]in 2020, but it is certainly possible. We will update you on this as we progress.

到 2020 年，我們預計將關閉約 30 億美元的房產。迄今為止，我們已經完成了 20 億美元的融資，並且正在積極籌備額外的 30 億美元。在這一點上，我不敢預測我們將在 2020 年完成全部 500 萬美元（原文如此）[十億美元]，但這當然是可能的。隨著我們的進展，我們會向您更新。

In healthcare-related legislation, we are seeing some increased talk regarding transparency and Medicaid fiscal accountability regulation. We do not expect any negative impact on our portfolio from either.

在與醫療保健相關的立法中，我們看到一些關於透明度和醫療補助財政責任監管的討論越來越多。我們預計兩者都不會對我們的投資組合產生任何負面影響。

Now I'll provide a quick update on our existing portfolio. We added 13 properties, 11 general acute care and 2 IRFs, to our same-store reporting; and subtracted 3, 2 acute care and 1 LTAC. With these changes, we saw our EBITDARM essentially flat across all categories. Just to remind you, we will report one quarter in arrears. So this is referring to the third quarter of the year, which is historically the softest quarter. Some of our operators have reported a slight uptick in fourth quarter admissions with the flu. However, none of our operators have reported cases of the coronavirus at this time. I would like to provide a quick update on Steward. Steward continues to see good progress, both operationally and financially.

現在我將快速更新我們現有的投資組合。我們在同店報告中添加了 13 個屬性、11 個普通急症護理和 2 個 IRF；並減去 3、2 個急症護理和 1 個 LTAC。通過這些變化，我們發現我們的 EBITDARM 在所有類別中基本持平。只是提醒您，我們將報告欠款四分之一。所以這是指今年第三季度，這是歷史上最疲軟的季度。我們的一些運營商報告稱，第四季度因流感而入院的人數略有上升。但是，目前我們的運營商都沒有報告冠狀病毒病例。我想提供有關 Steward 的快速更新。Steward 在運營和財務方面繼續取得良好進展。

As Steward continues to implement its fully integrated model in the various markets in which it operates, opportunities remain for both growth and potential divestitures. In December, Steward successfully completed the sale of its health choice managed care plan in Arizona. Prime Healthcare continues to be consistently the high performer that it has been since our initial investment in 2005. Overall, EBITDARM coverage for our 22 Prime hospitals remain strong. Nearly half of their hospitals covered greater than 4x.

隨著 Steward 繼續在其運營的各個市場實施其完全整合的模式，增長和潛在資產剝離的機會仍然存在。12 月，Steward 成功完成了其在亞利桑那州的健康選擇管理式醫療計劃的銷售。自我們 2005 年首次投資以來，Prime Healthcare 一直保持著高績效。總體而言，我們 22 家主要醫院的 EBITDARM 覆蓋率仍然很高。近一半的醫院覆蓋率超過 4 倍。

At Healthgrades 2020 Report to the Nation event, Prime hospitals were identified among the best in the nation, receiving over 300 recognitions for exceptional performance and quality. Currently, Prime's concentration is 6.9%. Prospect continues to perform in line with our underwriting expectations, and their concentration is currently at 9.5%.

在 Healthgrades 2020 Report to the Nation 活動中，Prime 醫院被評為全美最佳醫院，因其卓越的績效和質量獲得了 300 多項認可。目前，Prime的集中度為6.9%。Prospect 的表現繼續符合我們的承保預期，其集中度目前為 9.5%。

I know that all of you are well aware of the wildfires in Australia. At this time, none of our facilities have been affected and none have been seriously threatened. We continue to stay in consistent contact with Healthscope and monitor the evolving situation. At this time, I'll ask Steve to go over our financial performance. Steve?

我知道你們都很清楚澳大利亞的山火。目前，我們的設施都沒有受到影響，也沒有受到嚴重威脅。我們繼續與 Healthscope 保持一致聯繫並監控不斷變化的情況。這時候，我會請史蒂夫回顧一下我們的財務業績。史蒂夫？

Thank you, Ed. This morning, we reported normalized FFO of $0.35 per diluted share for the fourth quarter of 2019, and $1.30 for the full year. I will highlight a few items in just a minute, but most important -- the most important point to make is that even though 2019 was a truly monumental year regardless of how success is defined, MPT has already demonstrated that 2020 should continue to provide unmatched per share growth, diversification and financial performance.

謝謝你，埃德。今天早上，我們報告了 2019 年第四季度的標準化 FFO 為攤薄後每股 0.35 美元，全年為 1.30 美元。我將在一分鐘內強調幾個項目，但最重要的是——最重要的一點是，儘管 2019 年是真正具有里程碑意義的一年，無論成功的定義如何，MPT 已經證明 2020 年應該繼續提供無與倫比的每股增長、多元化和財務業績。

In 2019, we acquired immediately and strongly accretive hospital real estate, totaling $4.5 billion, resulting in a 64% year-over-year increase in total assets. This, along with the tremendous start for 2020, demonstrates that MPT's hospital real estate solutions are gaining acceptance at an accelerated pace from hospital operators, sponsors, investors and other market participants, both in the U.S. and internationally. Our acquisition activity in 2019 was supported by similarly unmatched execution in the capital markets.

2019 年，我們收購了立即強勁增長的醫院房地產，總計 45 億美元，導致總資產同比增長 64%。這一點，連同 2020 年的巨大開端，表明 MPT 的醫院房地產解決方案正在加速獲得美國和國際醫院運營商、贊助商、投資者和其他市場參與者的認可。我們在 2019 年的收購活動得到了資本市場同樣無與倫比的執行力的支持。

During the year, we issued almost $4 billion of unsecured notes and term loans with strategically staggered maturities in multiple currencies at a blended interest rate of approximately 3%. That's a full 500 basis point spread compared to the 8% blended investment yield on the $4.5 billion of hospital real estate we acquired.

在這一年中，我們以大約 3% 的混合利率以多種貨幣發行了近 40 億美元的無擔保票據和定期貸款，這些票據和定期貸款具有戰略性的交錯期限。與我們收購的 45 億美元醫院房地產的 8% 混合投資收益率相比，這是整整 500 個基點的利差。

We also issued 145 million shares of common stock for more than $2.6 billion in proceeds, accounting for a full 10% of all REIT equity raised during the year.

我們還發行了 1.45 億股普通股，募集資金超過 26 億美元，佔當年籌集的所有房地產投資信託基金股權的 10%。

Even with this substantial amount of new common equity, we delivered total return to shareholders of almost 39%, and our dividend yield is now below the health care REIT average for the first time. And we have an outstanding AFFO pro forma payout ratio of 75%, reflecting all-time highs in our share price.

即使擁有如此大量的新普通股，我們也為股東帶來了近 39% 的總回報率，而且我們的股息收益率現在首次低於醫療保健 REIT 的平均水平。我們的 AFFO 備考派息率為 75%，反映了我們股價的歷史新高。

With respect to the fourth quarter financial results that we released this morning, there are just a couple of items to highlight. These are primarily the results of the very busy quarter that included large acquisitions, dispositions, closings and capital markets activities. Number one, there are a handful of transactions, primarily, the gain on sale of 2 hospitals in New Jersey, then in accordance with NAREIT guidance, an aggregating about $20.5 million are adjusted from FFO. Below the FFO line to arrive at normalized FFO, we make adjustments that are similar to what we have done in recent years, including for unused financing fees related to pre-funding expected acquisitions, straight-line rent write-offs related to disposed properties and other less material items that are not expected to recur.

關於我們今天上午發布的第四季度財務業績，只有幾個項目需要強調。這些主要是非常繁忙的季度的結果，其中包括大型收購、處置、關閉和資本市場活動。第一，有幾筆交易，主要是出售新澤西州 2 家醫院的收益，然後根據 NAREIT 的指導，從 FFO 調整了總計約 2050 萬美元。在 FFO 線以下以達到正常化的 FFO，我們進行了與我們近年來所做的類似的調整，包括與預籌資金預期收購相關的未使用融資費用、與處置物業相關的直線租金註銷以及預計不會重複發生的其他不太重要的項目。

G&A expenses were nominally higher in the fourth quarter relative to recent prior quarters, due primarily to the tremendous growth in assets and revenue and the achievement of certain share-based compensation performance metrics. We expect 2020 G&A will normalize to a range of between 9% and 9.5% of total adjusted revenue.

與前幾個季度相比，第四季度的 G&A 費用名義上高於前幾個季度，這主要是由於資產和收入的巨大增長以及某些基於股份的薪酬績效指標的實現。我們預計 2020 年 G&A 將正常化至調整後總收入的 9% 至 9.5% 之間。

The real story about 2019 is how our efforts and their results have positioned us for continued growth into 2020. In late December, upon announcing our $1.95 billion agreement to acquire 30 hospitals in the U.K., We also announced our estimate that the resulting portfolio, after expected delevering from our current 6.0x debt-to-EBITDA to around 5.5x, will generate a run-rate annualized FFO per share of between $1.65 and $1.68. This morning, we reaffirmed that estimate. And while that is not meant to be a prediction of actual calendar year FFO, the 25% plus increase over 2019's actual FFO per share is virtually unmatched in almost any meaningfully-sized REIT.

關於 2019 年的真實故事是我們的努力和他們的成果如何使我們能夠在 2020 年繼續增長。12 月下旬，在宣布我們以 19.5 億美元收購英國 30 家醫院的協議後，我們還宣布了我們的估計，即在預期從我們目前的 6.0 倍債務與 EBITDA 比率降低到 5.5 倍左右之後，由此產生的投資組合將產生擠兌- 每股年化 FFO 在 1.65 美元至 1.68 美元之間。今天早上，我們重申了這一估計。雖然這並不意味著對實際日曆年 FFO 的預測，但與 2019 年實際 FFO 相比，每股增長 25% 以上幾乎是任何規模較大的 REIT 所無法比擬的。

I'll point out also that other than the January completion of the $1.95 billion U.K. transaction, that run-rate doesn't include any estimates for further acquisitions. As Ed mentioned just a few minutes ago, we are actively working a pipeline of about $3 billion, so we certainly expect to add accretive FFO during 2020.

我還要指出，除了 1 月份完成的 19.5 億美元英國交易外，該運行率不包括對進一步收購的任何估計。正如 Ed 幾分鐘前提到的那樣，我們正在積極處理約 30 億美元的管道，因此我們當然希望在 2020 年增加增值 FFO。

And with that, we'll be happy to take any questions, and I'll turn this back to the operator.

有了這個，我們很樂意回答任何問題，我會把它轉回給接線員。

(Operator Instructions) And our first question comes from the line of Chad Vanacore from Stifel.

（操作員說明）我們的第一個問題來自 Stifel 的 Chad Vanacore。

So with the new Circle Health transaction, they're a large part of your portfolio, what can you tell us about the coverage there? And then you also have 2 development projects with them as well. So do you actually have plans on the board to expand that relationship further?

因此，對於新的 Circle Health 交易，它們是您投資組合的很大一部分，您能告訴我們那裡的覆蓋範圍嗎？然後你也有 2 個開發項目。那麼，董事會中您是否真的有進一步擴大這種關係的計劃？

Chad, I think that, from an expansion standpoint, I think they'll have their hands full for the upcoming year. We certainly think that they'll be able to grow the company, but not in the near future. The coverage for these facilities are approximately 2x, and the 2 development facilities are really -- 2 development facilities at one location, or 2 developments in one location, they're expected to be completed in May of this year.

查德，我認為，從擴張的角度來看，我認為他們會在來年忙得不可開交。我們當然認為他們將能夠發展公司，但不是在不久的將來。這些設施的覆蓋範圍約為 2 倍，而這 2 個開發設施實際上是 - 一個地點有 2 個開發設施，或一個地點有 2 個開發項目，預計將於今年 5 月完成。

All right. Then, Ed, just think about any potential Brexit impact there? How do you think about that in your underwriting coverage?

好的。那麼，埃德，想想英國脫歐對那裡有什麼潛在影響嗎？您在承保範圍內如何看待這一點？

Yes, we really haven't seen any impact whatsoever, Chad. The only real impact that we had any concern over would be the loss of physicians or the inability to recruit physicians, but we haven't seen that affected at any of our facilities and neither have any of the operators that we're working in.

是的，乍得，我們真的沒有看到任何影響。我們擔心的唯一真正影響是醫生的流失或無法招募醫生，但我們沒有看到我們的任何設施受到影響，我們正在工作的任何操作員也沒有受到影響。

All right. Then sticking in the European local. You increased your Luxembourg personnel. You promoted Luke Savage to senior management. Is that an indication of more opportunities that you're seeing abroad? And then how should we think about any kind of shift from today's distribution in U.S. and international?

好的。然後堅持在歐洲當地。你增加了你在盧森堡的人員。你將 Luke Savage 提拔為高級管理人員。這是否表明您在國外看到了更多機會？那麼我們應該如何考慮今天在美國和國際上的分佈發生的任何變化？

Well, that's a good question. We see a tremendous amount of opportunities internationally, not just in Europe, but with our expansions in Australia, and potentially expansions into Central and South America. But Luke is responsible for all of our international properties. He's been with us for 12 years and has done an outstanding job. I don't think that our overall mix will change much. It will, obviously, fluctuate because all acquisitions don't happen on the same day, but we're still generally comfortable with the 30% to 35% international number.

嗯，這是個好問題。我們在國際上看到了大量的機會，不僅在歐洲，而且隨著我們在澳大利亞的擴張，並可能向中美洲和南美洲擴張。但盧克負責我們所有的國際資產。他已經和我們一起工作了 12 年，並且做得非常出色。我認為我們的整體組合不會有太大變化。顯然，它會波動，因為所有收購都不會在同一天發生，但我們仍然對 30% 到 35% 的國際數字感到滿意。

All right. And then you're developing a psychiatric hospital. How should we think about the opportunities there?

好的。然後你正在開發一家精神病院。我們應該如何看待那裡的機會？

Well, it's a great need in this country. There's a great opportunity for it out there, but there just aren't that many big operators out there. So I don't think it will be a very big part of our portfolio, but I certainly hope that we can grow it from where it is today.

好吧，這在這個國家是非常需要的。那裡有一個很好的機會，但那裡沒有那麼多大運營商。所以我不認為它會成為我們投資組合的很大一部分，但我當然希望我們能從今天的地方發展它。

All right. One last one for me, which is straight-line rent bumped up pretty significantly in the quarter. How should we think about a normalized run-rate?

好的。最後一個對我來說，這是直線租金在本季度大幅上漲。我們應該如何考慮標準化運行率？

I think what you see, the adjustment in the FFO reconciliation is probably indicative of what you'd expect going forward on a quarterly basis.

我想你所看到的，FFO 對賬的調整可能表明你對每季度的預期。

Our next question comes from the line of Drew Babin from Baird.

我們的下一個問題來自 Baird 的 Drew Babin。

A question related to one of Chad's on the Portugal and Spain investments. I think it was mentioned in the release that there's some opportunity for consolidation here, and obviously, you believe in the partners that you've chosen in those markets. I guess, can you reconcile what you did with those investments with acquisitions that may be occurring this year? And also add anything about the Portugal and Spain healthcare models nationally that potentially create an opportunity or things that are -- if you could give some color on the dynamics and why those markets are attractive, that would also be helpful.

一個與乍得關於葡萄牙和西班牙投資的問題有關的問題。我認為發布中提到這裡有一些整合的機會，顯然，你相信你在這些市場中選擇的合作夥伴。我想，您能否將您所做的這些投資與今年可能發生的收購相協調？並且還要在全國范圍內添加有關葡萄牙和西班牙醫療保健模式的任何內容，這些模式可能會創造機會或事情 - 如果您可以對動態以及為什麼這些市場具有吸引力給出一些顏色，那也會有所幫助。

Sure. Let me start with Portugal. We've been working in Portugal for a very long time. We've built very strong relationships with 3 different private operators there, the largest one is José de Mello. It's a relationship that we've been cultivating very, very well for 3 to 4 years. We think they do an outstanding job of running hospitals. We're excited about this first opportunity that we've done with them. We think it gives us a great platform to grow that relationship with them. There are also 2 other operators that we've known for a long time, that we're working with as well, that we think, in the near future, we'll be able to actually consummate some of those transactions.

當然。讓我從葡萄牙開始。我們在葡萄牙工作了很長時間。我們在那裡與 3 家不同的私人運營商建立了非常牢固的關係，其中最大的一家是 José de Mello。這種關係我們已經培養了 3 到 4 年，非常非常好。我們認為他們在經營醫院方面做得非常出色。我們對與他們一起完成的第一次機會感到興奮。我們認為這為我們提供了一個很好的平台來發展與他們的關係。還有另外 2 家我們認識很久的運營商，我們也在與之合作，我們認為在不久的將來，我們將能夠真正完成其中的一些交易。

Portugal is much like the U.K. from a standpoint that they have the public healthcare, but they also have a very vibrant private health care, which supplements the public healthcare. It's a model that the country knows very well and is very comfortable with. And so we think that being a part of the private health care sector in Portugal is a much sought after model. It's a model where there are other big U.S. operators United owns some Portuguese hospitals. So it's one that we feel very strongly about.

從公共醫療保健的角度來看，葡萄牙很像英國，但他們也有非常活躍的私人醫療保健，可以補充公共醫療保健。這是一個國家非常了解並且非常滿意的模式。因此，我們認為成為葡萄牙私營醫療保健部門的一部分是一種備受追捧的模式。在這種模式下，美國其他大型運營商聯合擁有一些葡萄牙醫院。所以這是我們非常強烈的感受。

In Spain, we actually started work in Spain probably 8-plus years ago, more than that now, back during the credit crisis. Spain is a great example of a country that's committed to healthcare for its people. We all know the suffering that Spain had during the great credit crisis. But even during that time period, the EBITDA for their hospitals continued to increase. As we all know, people generally get sicker in bad times than they do in good times. That was certainly the case in Spain and the country continued to support the healthcare for their people. It's a model that's very much like Portugal and the U.K. as well. It's got a very vibrant private healthcare system as well as their very well-respected public health care system. We think we'll be able to grow in Spain. We've been able to do this particular investment with the largest private hospital operator in Spain. We've spent a lot of time in their hospitals. We are very pleased with the way they operate hospitals and are tickled to death to be able to have that under our belt.

在西班牙，我們實際上可能在 8 年多以前就開始在西班牙工作，比現在更多，回到信貸危機期間。西班牙是一個致力於為其人民提供醫療保健的國家的典範。我們都知道西班牙在嚴重的信貸危機期間所遭受的苦難。但即使在那段時間裡，他們醫院的 EBITDA 仍在繼續增長。眾所周知，人們在經濟不景氣時通常比在景氣時更容易生病。西班牙的情況確實如此，該國繼續支持其人民的醫療保健。這是一個非常像葡萄牙和英國的模式。它有一個非常活躍的私人醫療保健系統以及他們非常受人尊敬的公共醫療保健系統。我們認為我們將能夠在西班牙成長。我們已經能夠與西班牙最大的私立醫院運營商進行這項特殊投資。我們在他們的醫院呆了很多時間。我們對他們經營醫院的方式感到非常滿意，並且很高興能夠將其置於我們的腰帶之下。

As you know, the U.K. took a very long time for us to get the footprint that we thought we would have as long ago as 8-plus years ago. We're glad that we finally have it now. We've got a big investment in Ramsay hospitals and this BMI Circle transaction. And we think that with those 2 operators, we'll be able to grow as well.

如您所知，英國花了很長時間才獲得我們認為早在 8 多年前就擁有的足跡。我們很高興我們現在終於擁有了它。我們對 Ramsay 醫院和 BMI Circle 交易進行了大量投資。我們認為，有了這兩個運營商，我們也將能夠成長。

And then the fourth quarter hospital sales, I think you mentioned they were in New Jersey. Can you talk about kind of the pricing you paid for those assets relative to where they were sold? And maybe the type of buyer that was -- that took those down?

然後是第四季度的醫院銷售，我想你提到過他們在新澤西州。你能談談你為這些資產支付的相對於它們出售地點的定價嗎？也許是那種類型的買家——讓那些人失望了？

Yes, these facilities were not for sale. We weren't looking to sell them. We had one of those situations where we had an opportunistic situation, where a purchaser came to us and offered to purchase them from us for significantly -- a significant gain. The total gain was about...

是的，這些設施是非賣品。我們不打算出售它們。我們遇到過一種機會主義的情況，一位買家來找我們，並提出要從我們這裡購買它們，以獲得顯著的收益。總收益約為...

Well, it was included in a primary part of the adjustment you saw in the FFO reconciliation of $20.5 million. It was actually more than that. The operator of both of those facilities is in the midst of exiting the business itself. And so when this opportunistic buyer came along and was willing to pay us at least full value, we were excited to take it, frankly.

好吧，它包含在您在 FFO 對賬中看到的 2050 萬美元調整的主要部分中。實際上不止於此。這兩個設施的運營商都在退出業務本身。因此，當這個投機取巧的買家出現並願意至少全額支付給我們時，坦率地說，我們很高興接受它。

And just one related follow-on. Obviously, with the share price is right now, issuing on the ATM from a cost of equity standpoint probably begins to make some sense to bring down leverage, but you did mention the property sales could be part of the capital strategy for this year. I guess, what are the odds that we see something larger on the property sale or JV sale side? And how does that relate to pricing for hospital assets as it stands right now?

並且只是一個相關的後續行動。顯然，鑑於目前的股價，從股權成本的角度來看，在自動櫃員機上發行股票可能開始對降低杠桿率有一定意義，但你確實提到房地產銷售可能是今年資本戰略的一部分。我想，我們在房地產銷售或合資銷售方面看到更大的可能性有多大？這與目前醫院資產的定價有何關係？

Yes, Drew. I would not look for any big, large sales of properties. We don't expect to have any additional that you'll see will be purely opportunistic like this one. So don't look for that.

是的，德魯。我不會尋找任何大的、大的房產銷售。我們不希望有任何額外的東西，你會看到像這個一樣純粹是機會主義的。所以不要尋找那個。

From a joint venture standpoint, while we certainly like the concept, it's a very time-consuming process. The people that are -- we get calls all the time for people that are interested in doing a joint venture with us, but they generally move at a very slow pace, and it's not something that we're actively pursuing right now.

從合資企業的角度來看，雖然我們當然喜歡這個概念，但這是一個非常耗時的過程。這些人 - 我們一直接到有興趣與我們合資的人的電話，但他們的行動通常非常緩慢，這不是我們現在積極追求的事情。

Our next question comes from the line of Omotayo Okusanya from Mizuho.

我們的下一個問題來自 Mizuho 的 Omotayo Okusanya。

Great quarter. Two quick ones for me. In the AFFO reconciliation for the quarter, there's a $0.02 adjustment, the write-off of straight-line rent and other net of tax benefit, could you tell me what that relates to?

偉大的季度。兩個快速的給我。在本季度的 AFFO 對賬中，有 0.02 美元的調整，直線租金和其他稅後收益的註銷，你能告訴我這與什麼有關嗎？

Well, it's mostly the write-off of straight-line rent. And my prepared remarks referenced that just other aggregation of activities that happen in the busy quarter that we have. I don't have my hands right on exactly what makes that up, I'd be happy to follow-up with you.

好吧，這主要是沖銷直線租金。我準備好的發言提到了在我們繁忙的季度發生的其他活動集合。我不知道究竟是什麼構成了它，我很樂意跟進你。

Okay, great. That's helpful. Then the second thing, Luxembourg and as well as Australia and your offices there, could you talk, kind of, ultimately, how big are those offices going to be? What's the skill set of people you're looking to hire there? Is it more of people from Birmingham going over there? Is it more of you kind of hiring local talent? we'd love to do just a little bit more about Luke Savage's background as well?

好的，太好了。這很有幫助。然後第二件事，盧森堡以及澳大利亞和你在那裡的辦公室，你能談談，最終，這些辦公室有多大？您希望在那裡僱用具備哪些技能的人員？去那邊的伯明翰人多嗎？你們更傾向於僱傭本地人才嗎？我們也想多了解一下 Luke Savage 的背景嗎？

Sure, absolutely. So let me start with Luke. Luke's background is that he's been in healthcare, all of his life outside of public accounting. He worked for one of the very large hospital operators, CHS, originally as a finance person and -- in one of their regional offices. He's been with us for 12 years, and the entire time he's been with us, he's been involved in acquisitions. Luke opened to the Luxembourg office for us about 5 years ago and has done an outstanding job.

當然，絕對。所以讓我從盧克開始。盧克的背景是，他一直從事醫療保健工作，一生都在公共會計之外。他曾在一家非常大的醫院運營商 CHS 工作，最初是一名財務人員，後來在他們的一個地區辦事處工作。他已經和我們在一起 12 年了，在他和我們在一起的整個時間裡，他都參與了收購。Luke 大約 5 年前為我們開設了盧森堡辦事處，並且做得非常出色。

Our asset management, underwriting people in Luxembourg, the people that we moved over from Birmingham, we have probably close to the right number there right now. Any additions that we make in that particular department would probably continue to be transfers from Birmingham. We are in the process of hiring some additional asset management and accounting -- I'm sorry, acquisition analysts and accounting personnel at the lower level. We certainly will have some people that will swap in and out between our New York, Birmingham offices and Luxembourg as time goes through and people come back to the U.S.

我們的資產管理，盧森堡的承銷人員，我們從伯明翰搬來的人員，我們現在可能已經接近正確的人數。我們在那個特定部門所做的任何補充可能會繼續從伯明翰轉移。我們正在招聘一些額外的資產管理和會計人員——對不起，是較低級別的收購分析師和會計人員。隨著時間的流逝和人們返回美國，我們肯定會有一些人在我們的紐約、伯明翰辦事處和盧森堡之間進進出出。

And in Australia, where we're starting from scratch, the person that we have opening the office of somebody that we've known for '18 years. He's been involved in commercial real estate and is -- knows us very, very well and his primary responsibility is relationship building and relationship maintaining with our customers that we have there now.

在澳大利亞，我們從頭開始，我們已經認識了 18 年的人開設了辦公室。他一直參與商業房地產，並且非常非常了解我們，他的主要職責是與我們現在在那裡的客戶建立和維持關係。

Ultimately, I think the Australian office will probably match out somewhere at 4 or 5 additional people in that office, and they'll all be in the acquisitions area, whether it's relationships or analysts.

最終，我認為澳大利亞辦事處可能會在該辦公室的某個地方匹配 4 或 5 個額外的人，他們都將在收購領域，無論是關係還是分析師。

Your next question comes from the line of Steven Valiquette from Barclays.

你的下一個問題來自巴克萊銀行的 Steven Valiquette。

I think this is your first public appearance since announcing the LifePoint 10 hospital deal, which was just after your last quarterly earnings call. I guess, I'm just curious if you're able to provide a little more general color around which specific LifePoint hospitals were chosen for sale leaseback in this particular transaction versus which ones we're not chosen? Whether it's financial variables or geographic/census-related, et cetera? And also, is there a chance to do more deals with LifePoint/Apollo in the future given that they still own, I think, more than half of their hospitals?

我認為這是您宣布 LifePoint 10 醫院交易以來的首次公開露面，那是在您上次季度財報電話會議之後。我想，我只是想知道您是否能夠提供一些更一般的顏色，說明在這個特定交易中哪些特定的 LifePoint 醫院被選擇用於售後回租，哪些我們沒有被選擇？是金融變量還是地理/人口普查相關的，等等？而且，考慮到 LifePoint/Apollo 仍然擁有他們一半以上的醫院，未來是否有機會與他們進行更多交易？

Sure. Let me start with the original portfolio that we acquired here. We had -- we literally have been working on this transaction with Apollo probably since the middle of last summer. They had a number that they knew that they wanted to get so that they could make some different changes to their balance sheet. And so they pretty much gave us their entire portfolio and said, "Here, pick what you'd like to have for this particular price." And so we took our time in analyzing the entire portfolio. We went to all of the different locations, and we were able to come back with them and say, "Here are the ones that we want to put together." I don't have the exact list here in front of me, but they were our choice, and Apollo worked very well with us in putting that portfolio together.

當然。讓我從我們在這裡獲得的原始投資組合開始。我們已經 - 我們可能從去年夏天中期開始就一直在與 Apollo 進行這項交易。他們有一個他們知道他們想要得到的數字，這樣他們就可以對他們的資產負債表做出一些不同的改變。所以他們幾乎把他們的整個投資組合都給了我們，然後說，“在這裡，以這個特定的價格選擇你想要的東西。”因此，我們花時間分析了整個投資組合。我們去了所有不同的地點，我們能夠和他們一起回來，然後說，“這是我們想要放在一起的。”我面前沒有確切的清單，但它們是我們的選擇，Apollo 與我們合作得很好，將這些產品組合在一起。

We've got a long relationship with Apollo and the LifePoint management team. I certainly hope that we will continue to do additional business with them. But we are very excited about this particular portfolio because of the way we were able to put it together.

我們與 Apollo 和 LifePoint 管理團隊建立了長期合作關係。我當然希望我們能繼續與他們開展更多業務。但我們對這個特定的投資組合感到非常興奮，因為我們能夠將它組合在一起。

Our next question comes from the line of Derek Johnston from Deutsche Bank.

我們的下一個問題來自德意志銀行的 Derek Johnston。

Based on your attractive cost of capital and track record. Has the deal pipeline increased to where you can even be more selective and engage with even higher quality operators. And one way could be to potentially offer better deal terms due to the lower cost of capital that you guys are enjoying?

基於您有吸引力的資本成本和業績記錄。交易管道是否增加到您可以更有選擇性並與更高質量的運營商互動的地方。由於你們正在享受的較低的資本成本，一種方法可能是提供更好的交易條件？

Well, Derek, let me point out that we think we have a very strong group of operators in our portfolio now. We are very happy with all, but maybe one of our operators. But yes, the overall answer is absolutely. As we continue to grow in the market, people know who we are, our cost of capital, obviously, has changed dramatically over the last 18 months, we -- our pipeline continues to grow dramatically and is really only limited, at this point, by our ability to actively give the attention that each potential deal needs.

好吧，德里克，讓我指出，我們認為我們現在的投資組合中有一群非常強大的運營商。我們對所有人都非常滿意，但也許是我們的運營商之一。但是，是的，總體答案是絕對的。隨著我們在市場上的不斷發展，人們知道我們是誰，我們的資本成本顯然在過去 18 個月發生了巨大變化，我們 - 我們的管道繼續急劇增長，而且實際上只是有限的，在這一點上，通過我們積極關注每筆潛在交易所需的能力。

I would just add, Derek, the ideal target for that is the not-for-profit world. And if you look back over the last couple of years, although it's probably, in total, less than $500 million, it's a tremendous increase relative to what we've had invested with not-for-profits in the past. And we, today, are negotiating potential transactions, some fairly sized with not-for-profit systems. So we expect that will continue to grow. And -- but just to reiterate what Ed said, we've got great operators on for-profit side already.

我只想補充一點，Derek，理想的目標是非營利性世界。如果你回顧過去幾年，雖然總計可能不到 5 億美元，但相對於我們過去對非營利組織的投資，這是一個巨大的增長。今天，我們正在就潛在交易進行談判，其中一些交易規模相當大，屬於非營利系統。所以我們預計它將繼續增長。而且 - 但只是重申埃德所說的話，我們已經在營利方面擁有出色的運營商。

Okay, great. Understood. And then secondly, you raised the dividend by $0.01. As I look at our model, we see further room as we approach 2021, especially given the pro forma FAD payout, I think you said around the mid-70s. It's certainly noting the accretive that Circle will bring to the table throughout 2020. I mean, how does the Board assess when to raise the dividend, especially when you have very healthy 20% plus FFO growth? Do you anticipate raising it more than once a year as you approach the pro forma FFO guidance range?

好的，太好了。明白了。其次，您將股息提高了 0.01 美元。當我審視我們的模型時，我們看到在 2021 年臨近時還有更多空間，特別是考慮到形式上的 FAD 支出，我想你在 70 年代中期左右說過。它肯定會注意到 Circle 將在整個 2020 年帶來的收益。我的意思是，董事會如何評估何時提高股息，尤其是當您的 FFO 增長超過 20% 時？當您接近備考 FFO 指導範圍時，您預計每年會提高一次以上嗎？

So Derek, I think the Board has done a great job over the years of setting the dividend after properties have -- and deal transactions have actually closed, not just when we announce them. We obviously have gotten everything closed at this point. We have an upcoming Board meeting, and the Board will certainly look at where everything is and make those decisions, but we understand the importance of raising dividends.

所以 Derek，我認為董事會多年來在財產擁有後設定股息方面做得很好 - 交易交易實際上已經結束，而不僅僅是我們宣布它們時。顯然，此時我們已經關閉了所有內容。我們即將召開董事會會議，董事會肯定會查看一切情況並做出這些決定，但我們了解提高股息的重要性。

Our next question comes from the line of Jordan Sadler from KeyBanc Capital.

我們的下一個問題來自 KeyBanc Capital 的 Jordan Sadler。

So, Ed, I was interested in your mention of the backing of Circle by Centene. Can you elaborate at all on their stake in Circle and their interest in the U.K. portfolio?

所以，埃德，我對你提到的 Centene 對 Circle 的支持很感興趣。您能否詳細說明他們在 Circle 的股份以及他們對英國投資組合的興趣？

Yes. Centene has a passive minority interest in Circle, as they do in other areas of Europe with other operators. For the sake of everybody on this call, who may not know, Centene is a very large, very successful managed care provider based out of St. Louis. And in their underwriting and diligence on different markets, in particular, the U.K., they felt like Circle gave them the greatest opportunity to expand. There are relatively little, if any, antitrust issues given Circle's size. So Circle's management continues to be Circle's management. We see no anticipated changes there and the investment is passive.

是的。Centene 在 Circle 中擁有被動的少數股權，就像他們在歐洲其他地區與其他運營商一樣。為了參加此次電話會議的每個人（可能不知道），Centene 是一家非常大、非常成功的管理式醫療服務提供商，總部位於聖路易斯。路易斯。在他們對不同市場（尤其是英國）的承銷和盡職調查中，他們覺得 Circle 給了他們最大的擴張機會。鑑於 Circle 的規模，反壟斷問題相對較少（如果有的話）。所以 Circle 的管理層繼續是 Circle 的管理層。我們在那裡沒有看到預期的變化，投資是被動的。

Do you expect to see them do more? And is there an opportunity for you guys to do more with some managed care enterprises of the world?

您希望看到他們做得更多嗎？你們有沒有機會與世界上的一些管理式醫療企業做更多的事情？

Well, I certainly think that we have the opportunity to grow with them. It is their intention to grow throughout Europe. Steve and I spent a good amount of time with the Centene management team before we did the Circle transaction and are very comfortable that our relationship with them allows us to participate in some of their future growth.

好吧，我當然認為我們有機會與他們一起成長。他們打算在整個歐洲發展。在我們進行 Circle 交易之前，史蒂夫和我在 Centene 管理團隊度過了很長一段時間，並且很高興我們與他們的關係使我們能夠參與他們未來的一些發展。

But Jordan, you're absolutely right. I mean, Circle's not -- sorry, Centene is not the only managed care company that's looking to get into operations, the biggest, obviously, being United. And we haven't done anything with United or others, but we absolutely think it offers opportunity for us.

但是喬丹，你是完全正確的。我的意思是，Circle 不是——抱歉，Centene 並不是唯一一家希望投入運營的管理式醫療公司，最大的顯然是 United。我們還沒有與曼聯或其他人做過任何事情，但我們絕對認為它為我們提供了機會。

And as it relates to the $3 billion pipeline, Ed, it sounds like you're confident in $1 billion of it getting done this year, although that's not necessarily in the run-rate. Can you talk about maybe the pipeline a little bit? Can you characterize domestic versus Europe or Australia and then how much of it is under active negotiation or contract versus maybe not being as far along?

關於 30 億美元的管道，Ed，聽起來你對今年完成其中的 10 億美元很有信心，儘管這不一定在運行率中。你能談談管道嗎？你能描述一下國內與歐洲或澳大利亞的特徵，然後有多少正在積極談判或簽訂合同，而不是可能沒有那麼遠？

So there's $3 billion that we are actively working, $1 billion of that, we are much further along, and that's why I broke it out the way it did in today's -- earlier part of the call.

因此，我們正在積極處理 30 億美元，其中 10 億美元，我們走得更遠，這就是為什麼我在今天的電話會議的早期部分以它的方式打破它。

It still continues to be about 50-50, 50% international and 50% here in the U.S. Right now, that is all broken out between Western Europe and in South America. And it's all general acute care hospitals.

它仍然是大約 50-50，50% 國際和 50% 在美國這裡。現在，這一切都在西歐和南美之間發生了變化。而且都是普通的急救醫院。

Okay. And then I guess, Steve, just last one for you. If the $1 billion -- if that $1 billion gets done this year at some point in the reasonable near-term -- or how should we be expecting the timing of that to sort of hit?

好的。然後我想，史蒂夫，最後一個給你。如果這 10 億美元——如果這 10 億美元在今年的某個時間點在合理的短期內完成——或者我們應該如何預期它會在某種程度上受到打擊？

We've learned long ago not to try to predict. I mean, you can look at last year, and we got into June, and I think we had closed one little hospital over in the U.K. and yet we ended up with almost $5 billion. It's just totally not predictable. I hate to leave you hanging with not being able to model.

我們很久以前就學會了不要試圖預測。我的意思是，你可以看看去年，我們進入了 6 月，我想我們已經關閉了英國的一家小醫院，但我們最終獲得了近 50 億美元。這完全是不可預測的。我不想讓你因無法建模而懸而未決。

No, I know.

不，我知道。

But yes, you're...

但是，是的，你是...

We always struggle with this run-rate, just to sort of bridge our own estimates for the full year to the run-rate. So is there anything -- it seems like you're in pretty good shape having closed on BMI early in the year to sort of be on course toward this run-rate. Am I thinking about that correctly?

我們總是與這個運行率作鬥爭，只是為了將我們自己對全年的估計與運行率聯繫起來。那麼有沒有什麼 - 看起來你在年初關閉 BMI 時狀態非常好，可以朝著這個運行率邁進。我的想法是否正確？

No, you absolutely are. Kind of the run-rate is what we have today and only what we have today. So the only difference, and this would be virtually miniscule would be included in that run-rate or in our developments. I think Ed, mentioned a little earlier, we've got a project in Birmingham, England with Circle. We've still got the one in Idaho and a few others, but those are the only projects in the run-rate that we're not earning as of right now.

不，你絕對是。這種運行率是我們今天所擁有的，而且只是我們今天所擁有的。所以唯一的區別，這幾乎是微不足道的，將包含在運行率或我們的開發中。我想 Ed，之前提到過，我們在英國伯明翰與 Circle 有一個項目。我們在愛達荷州和其他一些地方還有一個，但這些是我們目前沒有賺到的唯一項目。

Our next question comes from the line of Michael Mueller from JP Morgan.

我們的下一個問題來自摩根大通的 Michael Mueller。

A couple of questions. I guess, just a follow-up to that. Steve, are you permanently moving away from calendar year guidance at this point?

幾個問題。我想，只是後續行動。史蒂夫，您此時是否永久性地偏離日曆年指導？

Yes, we really haven't provided calendar year guidance since about this time last year for the very reasons that Jordan and I were just discussing. It's just, especially when you're growing as at 30% to 60% per year as we have, it is just impossible with the gestation periods that we have. You heard Ed mentioned a minute ago that we've been talking to José de Mello in Portugal for 3-plus years about projects. So it's just not predictable. And we haven't tried to give calendar guidance in well over a year.

是的，由於喬丹和我剛才討論的原因，自去年大約這個時候以來，我們確實沒有提供日曆年指導。只是，尤其是當你像我們一樣每年以 30% 到 60% 的速度增長時，這對於我們的妊娠期來說是不可能的。你剛才聽到 Ed 提到我們已經與葡萄牙的 José de Mello 討論了 3 年多的項目。所以這只是不可預測的。我們已經有一年多沒有嘗試提供日曆指導了。

Got it. Okay. And then, Ed, you mentioned, I think, about half of the Prime assets were covering more than 4x. Can you talk a little bit about when leases expire? And is there an opportunity to really roll some of those rents up?

知道了。好的。然後，Ed，你提到過，我認為大約一半的 Prime 資產覆蓋了 4 倍以上。你能談談租約何時到期嗎？是否有機會真正提高其中一些租金？

So the question about when they expire? The first set of Prime hospitals expire in '22. They're under a master lease, so it's an all or nothing situation. I don't know what their intentions are right now, but from a standpoint, if they want to roll it over again, then the rental rates will just continue what they were under the lease -- under the increases in the existing lease.

那麼關於它們何時到期的問題？第一組 Prime 醫院將於 22 年到期。他們在主租約下，所以這是一個全有或全無的情況。我不知道他們現在的意圖是什麼，但從一個角度來看，如果他們想再次滾動，那麼租金將繼續按照租約支付——在現有租約增加的情況下。

Got it. So there's not a bring-to-market?

知道了。所以沒有上市？

Well, we think that, that is going to be very close to market. The way we structure our leases, they all have the inflation protection in them. So theoretically, whatever the market rents are in '22, the lease should be at that.

好吧，我們認為那將非常接近市場。我們構建租約的方式，它們都有通貨膨脹保護。所以從理論上講，無論 22 年的市場租金是多少，租約都應該是這樣。

Okay. But if you're doing new hospital deals today, the coverages are more in the 2s, right?

好的。但是，如果您今天要進行新的醫院交易，那麼 2s 的承保範圍會更多，對嗎？

Well, that's right. If we're buying an existing hospital, we expect to see it in the 2% to 2.5% range from a going-in standpoint. But the Prime and some of the other hospitals have been in our portfolio for so long and performed so well, that's how you get them well over 3x covered.

嗯，沒錯。如果我們要購買一家現有醫院，我們預計從進入的角度來看，它會在 2% 到 2.5% 的範圍內。但是 Prime 和其他一些醫院在我們的投資組合中已經存在了很長時間並且表現非常好，這就是您如何讓他們獲得超過 3 倍的保障。

Our next question comes from the line of Todd Stender from Wells Fargo.

我們的下一個問題來自富國銀行的 Todd Stender。

Just going back to the dispositions in the quarter, were those the Median assets?

回到本季度的配置，那些是中值資產嗎？

No, no. Those were 2 general acute care hospitals in New Jersey.

不，不。那是新澤西州的 2 家普通急症醫院。

Okay. And so Median is no longer on your top tenant list. Is that just a reflection of they've been diluted down, I guess?

好的。因此 Median 不再在您的頂級租戶名單上。我猜這是否只是他們被稀釋的反映？

Well, it's 2 things. It's last year's joint venture, where we sold half of Median and then, of course, the upwards of $6-plus billion of non-Median acquisitions in the last year.

好吧，這是兩件事。這是去年的合資企業，我們出售了 Median 的一半，當然，去年還有超過 6 億美元的非 Median 收購。

Okay. And then, Ed, you provided the rent coverage for Circle. We saw that in the release at 2x. Do you have the rent coverages for the other acquisitions? I guess, just to give us context for Spain, maybe those markets like Portugal and certainly LifePoint.

好的。然後，Ed，你為 Circle 提供了租金保險。我們在 2x 的發布中看到了這一點。您有其他收購的租金保障嗎？我想，只是為了給我們介紹西班牙的背景，也許是像葡萄牙這樣的市場，當然還有 LifePoint。

Yes, they're all in that same range in the 1.75x to 2.5x for all of the new acquisitions.

是的，對於所有新收購，它們都在 1.75 倍到 2.5 倍的相同範圍內。

Okay. And then we see your equity investments on the balance sheet creeping up. Anything in the fourth quarter and then so far in Q1, are you investing alongside the operators in any cases?

好的。然後我們看到您在資產負債表上的股權投資逐漸增加。第四季度的任何事情，然後是第一季度到目前為止，在任何情況下，您是否都在與運營商一起投資？

No. The equity investments, for example, the 2 hospitals in Madrid are accounted for in equity because it's structurally a joint venture.

不。股權投資，例如馬德里的兩家醫院，因為在結構上是一家合資企業，所以計入股權。

Okay. But no equity investments to...

好的。但沒有股權投資...

That's not what we're trying to mean there when we say equity, that does not mean we're investing in the equity of the operator necessarily it is the structure of our investment is in the equity of a joint venture rather than the fee interest of the hospital. That's all that means.

當我們說股權時，這不是我們要表達的意思，這並不意味著我們必然投資於運營商的股權，我們的投資結構是合資企業的股權，而不是費用利息醫院的。這就是全部的意思。

Todd, the last investment we've made in a hospital operator was the Switzerland transaction, where we bought a 5% interest in the operator.

托德，我們對醫院運營商的最後一次投資是在瑞士的交易，我們在那裡購買了運營商 5% 的股份。

Right. I remember that.

正確的。我記得那個。

At this time, I'm showing no further questions. I would like to turn the call back over to Ed Aldag for closing remarks.

目前，我沒有進一步提問。我想將電話轉回給 Ed Aldag 以作結束語。

Thank you, operator. And again, thank all of you for listening in today. If you have any additional follow-up questions, please do not hesitate to reach out to one of us. Thank you very much.

謝謝你，運營商。再次感謝大家今天的收聽。如果您有任何其他後續問題，請隨時與我們聯繫。非常感謝。

Ladies and gentlemen, this concludes today's conference call. Thank you for standing -- thank you for participating. You may now disconnect.

女士們，先生們，今天的電話會議到此結束。感謝您的站立——感謝您的參與。您現在可以斷開連接。