Medical Properties Trust Inc (MPW) 2024 Q3 法說會逐字稿

Good morning and welcome to the Q3 2024 Medical Properties Trust earnings conference call. (Operator Instructions) Please note this event is a 60-minute presentation and is being recorded.

早安，歡迎參加 2024 年第三季醫療財產信託收益電話會議。（操作員說明）請注意，本次活動為 60 分鐘的演示，並且正在錄製中。

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

我現在想把電話轉給高級副總裁查爾斯·蘭伯特 (Charles Lambert)。請繼續。

Good morning, and welcome to the Medical Properties Trust conference call to discuss our third-quarter 2024 financial results. With me today are Edward K. Aldag, Jr., Chairman, President and Chief Executive Officer of the company; Steven Hamner, Executive Vice President and Chief Financial Officer; Kevin Hanna, Senior Vice President, Controller and Chief Accounting Officer; Rosa Hooper, Senior Vice President of Operations and Secretary; and Jason Frey, Managing Director, Asset Management & Underwriting

早安，歡迎參加醫療財產信託電話會議，討論我們 2024 年第三季的財務表現。今天與我在一起的有公司董事長、總裁兼執行長 Edward K. Aldag, Jr.； Steven Hamner，執行副總裁兼財務長； Kevin Hanna，資深副總裁、財務長兼首席會計官； Rosa Hooper，營運資深副總裁兼秘書； Jason Frey，資產管理與承保部董事總經理

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 medicalpropertiestrust.com in the Investor Relations section.

我們的新聞稿已於今天上午發布，並以 8-K 表格提交給美國證券交易委員會。如果您沒有收到副本。您可以在我們的網站medicalpropertiestrust.com 的投資者關係部分找到這些資訊。

Additionally, we're hosting a live webcast of today's call which you can access in that same section. During the course of this call, we will make projections and certain other statements that may be considered forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to known and unknown risks, uncertainties, and other factors that may cause our financial results and future events to differ materially from those expressed in or underlying such forward-looking statements.

此外，我們還將舉辦今天電話會議的網路直播，您可以在同一部分中進行觀看。在本次電話會議期間，我們將做出預測和某些其他可能被視為 1995 年《私人證券訴訟改革法案》含義內的前瞻性陳述的陳述。這些前瞻性陳述受到已知和未知的風險、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表現和未來事件與此類前瞻性陳述中表達的或潛在的內容有重大差異。

We refer you to the company's reports filed with the Securities and Exchange Commission for a discussion of the factors that could cause the company's actual results or future events to differ materially from those expressed in this call. The information being provided today is as of this date only. And except as required by federal securities laws, the company does not undertake a duty to update any such information.

我們建議您參閱該公司向美國證券交易委員會提交的報告，以討論可能導致該公司的實際結果或未來事件與本次電話會議中表達的結果有重大差異的因素。今天提供的資訊僅截至該日期。除非聯邦證券法要求，否則公司不承擔更新任何此類資訊的義務。

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 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，這些指標應作為可比較 GAAP 財務指標的補充而非替代。請注意，在我們的新聞稿中，Medical Properties Trust 已根據 Reg G 要求將所有非 GAAP 財務指標與最直接可比較的 GAAP 指標進行了核對。您也可以造訪我們的網站medicalpropertiestrust.com，以了解最直接可比較的財務指標和相關調節表。

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

我現在將把電話轉給我們的執行長艾德·阿爾達格。

Thank you, Charles, and thanks to all of you for joining us this morning on our third-quarter 2024 earnings call. I'm pleased to be joined again today by Steve Hamner, Kevin Hanna, Rosa Hooper, and Jason Frey. Before you hear from the rest of the team, I'll spend a few minutes covering a few important recent strategic updates.

謝謝 Charles，也謝謝大家今天早上參加我們的 2024 年第三季財報電話會議。我很高興今天再次與史蒂夫哈姆納、凱文漢納、羅莎胡珀和傑森弗雷一起出席。在您聽取團隊其他成員的意見之前，我將花幾分鐘時間介紹一些最近的重要策略更新。

The big news during the quarter was our global settlement with Steward and its creditors that enabled us to take back control of our real estate and sever our relationship with Steward. While there has been widespread media attention on Steward's bankruptcy process over the past few months, we believe these stories failed to note the significant steps that MPT has taken throughout the process to avoid hospital closures, protect jobs and ensure continuity of patient care.

本季的重大新聞是我們與 Steward 及其債權人的全球和解，使我們能夠收回對房地產的控制權並切斷與 Steward 的關係。儘管過去幾個月媒體廣泛關注 Steward 的破產程序，但我們認為這些報告未能注意到 MPT 在整個過程中為避免醫院關閉、保護就業和確保患者護理連續性所採取的重大步驟。

When Steward was unable to complete transactions with buyers for its operations around the country, our team worked around the clock for weeks to identify a diverse set of qualified operators to take over facilities in five markets. We are confident these five operators are better positioned to serve their respective communities in Arizona, Florida, Louisiana, Ohio and Texas.

當 Steward 無法與買家完成其在全國各地運營的交易時，我們的團隊晝夜不停地工作了數週，以確定一組不同的合格運營商來接管五個市場的設施。我們相信，這五家業者能夠更好地為亞利桑那州、佛羅裡達州、路易斯安那州、俄亥俄州和德克薩斯州各自的社區提供服務。

The four operators that assume the management of 15 facilities in September, HSA, Honor Health, Insight Health, and Quorum Health have already done a tremendous job of stabilizing the hospitals in each market and laying the foundations to return them to profitability by providing high-quality patient care.

9 月負責管理15 家醫院的四家營運商，即HSA、Honor Health、Insight Health 和Quorum Health，已經在穩定各個市場的醫院方面做出了巨大的努力，並透過提供高額醫療服務為恢復盈利奠定了基礎。

They have dedicated significant time and energy to employee, physician, and community outreach, all of which have reportedly been well received. While it will take time for these facilities to return to pre-bankruptcy operational performance, we are very impressed with what we have seen so far. In most cases, October discharges are trending higher than the low point in September prior to these transitions.

他們為員工、醫生和社區外展投入了大量時間和精力，據報道，所有這些都受到了好評。雖然這些設施需要一段時間才能恢復到破產前的營運績效，但迄今為止所看到的情況給我們留下了深刻的印象。在大多數情況下，10 月的排放量趨勢高於這些轉變之前 9 月的低點。

Earlier this week, we reached an agreement with College Health to lease the Saint Luke's campus in Phoenix, Arizona. College Health has over 35 years of experience and specializes in inpatient behavioral health services. They expect to reopen the campus as a Behavioral Health hospital in the first quarter of 2025.

本週早些時候，我們與 College Health 達成協議，租賃亞利桑那州鳳凰城的聖路加校區。College Health 擁有超過 35 年的經驗，專門從事住院病患行為健康服務。他們預計在 2025 年第一季將校園作為行為健康醫院重新開放。

With the successful re-tenanting of these 17 properties which collectively carry a lease base of approximately $2.1 billion, we expect to gradually resume receipt of cash rents on this portfolio in the first quarter of 2025, ramping up to approximately $90 million in the aggregate annualized rent by the end of 2025, and fully stabilized aggregate annualized rent of approximately $160 million by the end of 2026. Assuming no further changes to our portfolio, when these 17 properties begin paying full rent, we expect MPT's total annualized cash rent to be in excess of $1 billion.

隨著這 17 處房產的成功重新出租，租賃基數總計約 21 億美元，我們預計該投資組合將在 2025 年第一季逐步恢復收取現金租金，年化總租金將增至約 9,000 萬美元到2025年底租金，到2026 年底年化租金總額完全穩定在約1.6 億美元。假設我們的投資組合不再進一步變化，當這 17 個物業開始支付全額租金時，我們預計 MPT 的年化現金租金總額將超過 10 億美元。

We are also actively engaged in discussions regarding the four other properties with an aggregate lease base of approximately $170 million as well as our development projects in Texarkana, Texas and Norwood, Massachusetts. With respect to Norwood, we remain in discussions with the state regarding critical licensing decisions.

我們也積極參與有關總租賃基數約為 1.7 億美元的其他四處房產以及我們在德克薩斯州特克薩卡納和馬薩諸塞州諾伍德的開發項目的討論。關於諾伍德，我們仍在與州政府就關鍵許可決定進行討論。

Before moving on from Steward, it's worth zooming out for a moment to evaluate our real estate portfolio. Beginning in 2016, MPT spent roughly $5.3 billion on real estate that was leased or mortgaged to Steward. We recovered approximately 45% of that through cash proceeds from asset sales and other transactions involving this portfolio. As just discussed, we also continue to hold a real estate portfolio with a lease base of approximately $2.3 billion excluding the development projects, more than 90% of which has already been re-tenanted. Over the years, we also collected approximately $1.9 billion in cash rent and mortgage interest.

在離開 Steward 之前，值得花點時間來評估我們的房地產投資組合。從 2016 年開始，MPT 在租賃或抵押給 Steward 的房地產上花費了約 53 億美元。我們透過資產出售和涉及該投資組合的其他交易的現金收益收回了大約 45%。正如剛才所討論的，我們也繼續持有租賃基數約為 23 億美元的房地產投資組合（不包括開發案），其中 90% 以上已重新出租。多年來，我們還收取了約 19 億美元的現金租金和抵押貸款利息。

During the third quarter, we continued to advance our strategy of generating additional liquidity to accelerate debt paydown and enhance financial flexibility. We sold 18 freestanding emergency departments as well as a general acute care hospital in Arizona and Colorado for approximately $246 million. In October, we sustained this momentum by closing the sale of two additional small freestanding EDs in Texas for approximately $5 million as well as the sale of Watsonville Community Hospital in California for approximately $40 million.

第三季度，我們繼續推進產生額外流動性的策略，以加快債務償還並增強財務靈活性。我們以約 2.46 億美元的價格出售了亞利桑那州和科羅拉多州的 18 個獨立急診科以及一家普通急診醫院。10 月份，我們以約500 萬美元的價格完成了德克薩斯州另外兩個小型獨立急診室的出售，並以約4000 萬美元的價格出售了加州的沃森維爾社區醫院，從而維持了這一勢頭。

Watsonville is a great story of community perseverance and our business model working as intended. Watsonville was forced into bankruptcy primarily because it was unable to access COVID funding similar to most of the other hospitals in 2020. At the time, MPT was virtually the only party willing to step in and provide the funds necessary to ensure the hospital could remain open.

沃森維爾是一個關於社區堅持不懈和我們的商業模式按預期運作的偉大故事。沃森維爾被迫破產，主要是因為它無法像 2020 年大多數其他醫院一樣獲得新冠病毒資金。當時，MPT 實際上是唯一願意介入並提供必要資金以確保醫院繼續開放的機構。

Our close engagement with community leaders helped facilitate the formation of a local non-profit to take over operations in 2022. And now for that same group to acquire the property outright by exhibiting patient and focusing on doing the right thing for the community, we were ultimately able to fully recover our real estate investment.

我們與社區領袖的密切接觸幫助促進了當地非營利組織的成立，並於 2022 年接手營運。現在，對於同一集團來說，透過表現出耐心並專注於為社區做正確的事情來徹底收購該房產，我們最終能夠完全收回我們的房地產投資。

In closing before I turn it over to Rosa, there is no doubt the health care sector is uniquely exposed to the impacts of global macroeconomic trends. At various intervals over the past few years, hospitals have been forced to navigate lagging reimbursement rates, declining patient volumes, heightened operating expenses, rising interest rates, revenue cycle management challenges, and cybersecurity incidents. While we are pleased that many of these trends appear to be reversing, it is important to remember that access to a broad array of potential capital solutions is critical to help ensure a flourishing health care sector over the long term.

最後，在我將其交給羅莎之前，毫無疑問，醫療保健產業特別容易受到全球宏觀經濟趨勢的影響。在過去幾年的不同時期，醫院被迫應對報銷率滯後、病患數量下降、營運費用增加、利率上升、收入週期管理挑戰和網路安全事件等問題。雖然我們很高興其中許多趨勢似乎正在逆轉，但重要的是要記住，獲得廣泛的潛在資本解決方案對於幫助確保醫療保健產業長期繁榮至關重要。

Simply put, sell leaseback transactions are a superior financing source for many operators compared to any other sources available. Land and buildings are often an operator's single largest asset, and that must be funded with some form of capital. So leasebacks provide a relatively inexpensive way for operators to access up to 100% of the value of their real estate to fund improvements that will more directly affect patient care. They enable operators to negotiate rents that typically represent only a small single-digit percentage of total sustainable reimbursement revenue and a plan for fixed annual amount over the long term without being subject to refinancing risk.

簡而言之，與任何其他可用來源相比，售後回租交易對於許多業者來說是一種優越的融資來源。土地和建築物通常是營運商最大的單一資產，必須以某種形式的資本提供資金。因此，回租為營運商提供了一種相對便宜的方式，可以獲得高達 100% 的房地產價值，為更直接影響患者護理的改進提供資金。它們使營運商能夠協商租金（通常僅佔可持續報銷總收入的一小部分）以及長期固定年度金額的計劃，而無需承受再融資風險。

For these reasons, we strongly believe MPTs business model is more important than ever. We continue to take meaningful action that better positions our business to create compelling shareholder value over the long term. And following our successful re-tenanting strategy, we look forward to demonstrating the strength and resilience of our business model. Rosa?

基於這些原因，我們堅信 MPT 的商業模式比以往任何時候都更重要。我們將繼續採取有意義的行動，更好地定位我們的業務，從而長期創造引人注目的股東價值。繼我們成功的重新租賃策略之後，我們期待展現我們業務模式的實力和彈性。羅莎？

Thank you, Ed. As usual, I will take you through some of the highlights across our portfolio of critical hospital real estate. We are encouraged by the positive utilization and revenue trends we continue to see across our portfolio. In line with what's recently been reported by several large public operators, hospital fundamentals continue to strengthen. Admissions are growing, surgical volumes are increasing, and operators are starting to realize the benefits from cost efficiency programs they've been implementing over the past few years.

謝謝你，艾德。像往常一樣，我將帶您了解我們重要醫院房地產投資組合中的一些亮點。我們對整個投資組合中持續看到的積極利用率和收入趨勢感到鼓舞。根據幾家大型公共運營商最近的報告，醫院的基本面繼續加強。入院人數不斷增加，手術量不斷增加，業者開始意識到過去幾年實施的成本效益計畫的好處。

Within our portfolio of hospitals, general acute care properties reported the largest increase in year-over-year revenues followed by our behavioral health properties which have delivered steady performance over the past several quarters. In the UK, utilization of private medical insurance and self-pay has hit a new all-time high as patient demand for quality and timely access to care continues. Circle Health is a clear beneficiary of this trend, recording consistent growth in both private medical insurance and self-pay volumes.

在我們的醫院組合中，普通急診護理資產的收入年增幅最大，其次是我們的行為健康資產，在過去幾季中表現穩定。在英國，隨著患者對高品質和及時獲得護理的需求持續不斷，私人醫療保險和自費的利用率創下了歷史新高。Circle Health 是這一趨勢的明顯受益者，私人醫療保險和自費金額均持續成長。

Circle's performance has also benefited from improved patient acuity mix as more complex cases are now being addressed in the private sector. In addition, the UK Health Secretary has called for the NHS to grow its partnership with the private sector to reduce their backlog.

Circle 的表現也得益於患者敏銳度組合的改善，因為私營部門現在正在處理更複雜的病例。此外，英國衛生部長呼籲 NHS 加強與私營部門的合作，以減少積壓。

Priory, the largest independent mental health care provider in the UK, continued to produce positive cash flow from operations in 2023 and its cash flow generation has accelerated year-to-date in 2024. In fact, revenue and EBITDAR are meaningfully outperforming prior year.

英國最大的獨立精神衛生保健提供者 Priory 在 2023 年繼續從營運中產生正現金流，其現金流產生在 2024 年年初至今有所加速。事實上，收入和 EBITDAR 的表現明顯優於去年。

Last quarter, we mentioned their focus on a comprehensive strategy for improving quality and optimizing our occupancy mix. Continued focus on this strategy has increased acuity, driving reimbursement rates higher while promoting a more efficient utilization of external labor, resulting in bolstered financial performance, including improved coverages for the portfolio. Notably, the change in government in the UK has created some uncertainties around referrals into the behavioral health market and Priory is anticipating lower occupancy levels. Their increased focus on higher acuity patients and collaborative work with commissioners should help to offset any potential disruption.

上季度，我們提到他們專注於提高品質和優化入住組合的綜合策略。繼續關注這項策略提高了敏銳度，提高了報銷率，同時促進了外部勞動力的更有效利用，從而提高了財務業績，包括改善了投資組合的覆蓋範圍。值得注意的是，英國政府的更迭為行為健康市場的推薦帶來了一些不確定性，Priory 預計入住率將會下降。他們對高風險患者的更多關注以及與委員的合作應該有助於抵消任何潛在的干擾。

Turning to Priory's parent company MEDIAN, these assets have delivered strong year-to-date performance in 2024, driven by an improving reimbursement rate environment in Germany as well as improving occupancy trends. Swiss Medical network's solid top-line growth and ongoing cost optimization efforts have resulted in 10% year-over-year earnings growth for the first half of 2024.

至於 Priory 的母公司 MEDIAN，在德國報銷率環境改善以及入住率趨勢改善的推動下，這些資產在 2024 年迄今表現強勁。Swiss Medical Network 穩健的營收成長和持續的成本優化工作使得 2024 年上半年的獲利年增 10%。

In September, Swiss Medical Network officially opened its Genolier Innovation Hub which will also help to drive additional cash flows to MPT over time. They anticipate significant activity in the center, working toward the continuous improvement of health care for patients now as well as for future generations. During the quarter, MPT and our JV partner increased the equity investment in Infracore by retiring approximately CHF50 million in maturing third-party debt.

9 月，瑞士醫療網絡正式開設 Genolier 創新中心，隨著時間的推移，這也將有助於為 MPT 帶來額外的現金流。他們預計該中心將開展重大活動，致力於不斷改善現在和子孫後代的醫療保健水平。本季度，MPT 和我們的合資夥伴透過償還約 5,000 萬瑞士法郎的到期第三方債務，增加了對 Infracore 的股權投資。

Turning to our US portfolio where my comments do not include the recently re-tenanted Steward properties, overall, general acute care revenue trends continue to benefit from increasing admissions, surgeries, and higher reimbursement rates. And in our behavioral portfolio, we continue to see steadily increasing volumes as well as reduced reliance on contract labor.

談到我們的美國投資組合，我的評論不包括最近重新租用的 Steward 房產，總體而言，一般急診收入趨勢繼續受益於入院率、手術率的增加和報銷率的提高。在我們的行為投資組合中，我們繼續看到數量穩定成長以及對合約工的依賴減少。

Ernest Health's consolidated EBITDARM coverage remains stable at approximately two times while Ernest's legacy IRF continue to perform exceptionally well with coverages above 2.5 times. Their newer IRF are continuing to ramp up with improved volumes quarter over quarter. In order to counteract the declines in LTACH reimbursement nationally, Ernest recently converted a portion of their Provo LTACH beds to an inpatient rehabilitation unit. Given the success of this unit, Ernest is actively exploring options to implement this model in other markets.

Ernest Health 的綜合 EBITDARM 覆蓋率保持穩定在約兩倍，而 Ernest 的傳統 IRF 繼續表現出色，覆蓋率超過 2.5 倍。他們的新 IRF 繼續成長，銷售逐季提高。為了應對全國 LTACH 報銷下降的影響，Ernest 最近將普羅沃 LTACH 床位的一部分改造成住院復健病房。鑑於該部門的成功，歐內斯特正在積極探索在其他市場實施該模式的選擇。

Lifepoint Health has produced strong top-line revenue growth and accelerating profitability driven by the highest quarterly admissions seen in over three years. Lifepoint's self-funded expansion of Conemaugh Memorial Medical Center in Johnstown, Pennsylvania has driven significantly higher volumes while labor costs have continued to moderate. We believe this will continue to drive EBITDARM improvements looking ahead.

在三年多來最高的季度入院人數的推動下，Lifepoint Health 實現了強勁的營收成長和獲利能力的加速成長。Lifepoint 自籌資金擴大賓州約翰斯敦康內莫紀念醫療中心，大幅提高了治療量，同時勞動成本持續下降。我們相信這將繼續推動未來 EBITDARM 的改進。

At Lifepoint behavioral, consistent year-over-year admissions growth coupled with disciplined labor cost management led to another quarter of improved operating performance. And ScionHealth's trailing 12-month EBITDARM coverage is up slightly year over year as improved performance at its acute facilities is offsetting LTACH declines.

在 Lifepoint 行為學，持續的同比招生成長加上嚴格的勞動力成本管理導致營運績效又一個季度得到改善。ScionHealth 過去 12 個月的 EBITDARM 覆蓋率同比略有上升，因為其急診設施的業績改善抵消了 LTACH 的下降。

Finally, Prospect's California facilities continue to report growth driven by admissions and surgeries which have each increased 3% year over year. Despite improved coverage trends across the six California properties, Prospect's overall liquidity continues to be impacted by ongoing sales processes in various East Coast markets.

最後，Prospect 的加州設施繼續報告在入院率和手術率的推動下實現成長，年比分別成長 3%。儘管加州六處房產的覆蓋率趨勢有所改善，但 Prospect 的整體流動性繼續受到東海岸各市場正在進行的銷售流程的影響。

While it's our understanding that Prospect continues to work with regulators and potential buyers in each of these markets, they have been unable to pay rent in a timely fashion over the past few months. Prospect expects liquidity to improve in the coming months as they are scheduled to receive approximately $100 million of quality assurance fee program, or QAF, payments during the first-quarter of 2025.

據我們了解，Prospect 繼續與各市場的監管機構和潛在買家合作，但他們在過去幾個月一直無法及時支付租金。Prospect 預計未來幾個月的流動性將有所改善，因為他們計劃在 2025 年第一季收到約 1 億美元的品質保證費計劃 (QAF) 付款。

In closing, we are very encouraged by the volume, revenue, and cost trends being reported across care types and geographies. Today, we are more diversified than ever before with tenants like Lifepoint, Ernest, HSA, and surgery partners in the US; and Circle, Priory, MEDIAN, and Swiss Medical Network internationally. The growth of these operators over the past five years has helped to largely offset the dilutive revenue impact of Steward's financial distress and asset sales.

最後，我們對跨護理類型和地區報告的數量、收入和成本趨勢感到非常鼓舞。如今，我們比以往任何時候都更加多元化，擁有 Lifepoint、Ernest、HSA 等租戶以及美國的手術合作夥伴；國際上還有 Circle、Priory、MEDIAN 和 Swiss Medical Network。這些營運商過去五年的成長在很大程度上抵消了 Steward 的財務困境和資產出售帶來的稀釋收入影響。

Moving forward, we are confident that our portfolio is well positioned to generate robust cash flows for MPT and our shareholders over both the near and long term. Kevin?

展望未來，我們相信我們的投資組合能夠在近期和長期為 MPT 和我們的股東產生強勁的現金流。凱文？

Thank you, Rosa. This morning, we reported GAAP net loss of a $1.34 per share and normalized FFO of $0.16 per share for the third quarter of 2024. As disclosed in our Form 8-K filed on September 17, our global settlement with Steward and its creditors resulted in multiple onetime accounting items that impacted our GAAP results and resulted in adjustments to normalized FFO.

謝謝你，羅莎。今天早上，我們報告 2024 年第三季 GAAP 淨虧損為每股 1.34 美元，正常化 FFO 為每股 0.16 美元。正如我們在9 月17 日提交的8-K 表格中所披露的，我們與Steward 及其債權人的全球和解導致了多個一次性會計項目影響了我們的GAAP 業績，並導致對標準化FFO 進行了調整。

First, we impaired approximately $425 million of working capital loans previously made to Steward. Second, we recorded impairments of approximately $183 million, of which $180 million related to the real estate of the Space Coast facilities and certain excess properties, charges for property taxes and other obligations, net of recovery, and the donation of our former Steward operated hospital in Hope, Arkansas, to the local community rounded out the balance. Lastly, the termination of our master lease agreement with Steward resulted in an accelerated amortization of about $115 million of lease and tangible assets during the quarter.

首先，我們對先前向 Steward 發放的約 4.25 億美元的營運資金貸款進行了減損。其次，我們記錄了約1.83 億美元的減值，其中1.8 億美元與太空海岸設施的房地產和某些超額財產、財產稅費用和其他義務（扣除回收後的費用）以及我們前Steward 經營的醫院的捐贈有關在阿肯色州霍普市，當地社區實現了平衡。最後，我們與 Steward 的主租賃協議的終止導致本季約 1.15 億美元的租賃和有形資產加速攤銷。

Before wrapping up on Steward, as noted in our press release this morning, we have received substantially all of the $45 million of proceeds expected from the sale of the Space Coast hospitals to Orlando Health. Normalized FFO was also adjusted during the quarter for the reduction in fair value or investment in PHP holdings by approximately $130 million to roughly $200 million based on the most recent independent third-party appraisal.

正如我們今天早上的新聞稿中所指出的，在結束 Steward 之前，我們已經收到了將太空海岸醫院出售給奧蘭多健康中心預計獲得的 4500 萬美元收益的大部分。根據最新的獨立第三方評估，標準化 FFO 也在本季度進行了調整，因為 PHP 持有的公允價值或投資減少了約 1.3 億美元至約 2 億美元。

With that, I will hand the call over to Steve to discuss liquidity and capital allocation. Steve.

這樣，我將把電話轉交給史蒂夫，討論流動性和資本配置。史蒂夫.

Thank you, Kevin. At the end of the third quarter, we had cash balances of approximately $275 million and revolver capacity of about $880 million. Year-to-date, we have executed more than $2.9 billion in profitable asset sales and other monetization transactions, including the approximately $350 million during the third quarter that we had previously described. These are primarily the sales for $246 million of 18 freestanding emergency rooms plus a general acute hospital that Ed mentioned along with repayment by Prime of a $100 million mortgage loan.

謝謝你，凱文。截至第三季末，我們的現金餘額約為 2.75 億美元，左輪手槍容量約為 8.8 億美元。今年迄今，我們已經執行了超過 29 億美元的獲利資產銷售和其他貨幣化交易，其中包括我們先前描述的第三季的約 3.5 億美元。這些主要是 Ed 提到的 18 間獨立急診室和一家普通急診醫院的 2.46 億美元銷售，以及 Prime 償還的 1 億美元抵押貸款。

These transactions have effectively demonstrated, especially over the recent years since COVID, the strength of our business model in general and our real estate underwriting in particular. Not only have our real estate investments held their values in a volatile macroeconomic environment, but they have actually increased in value. This has provided us significant flexibility and optionality as we execute our delevering strategy.

這些交易有效地證明了我們業務模式的整體實力，特別是我們的房地產承銷的實力，尤其是自新冠疫情以來的最近幾年。我們的房地產投資不僅在動盪的宏觀經濟環境中保值，而且實際上還增加了價值。這為我們執行去槓桿策略提供了極大的靈活性和選擇性。

Since the beginning of 2023, we have repaid $2.2 billion in debt. We have aggregate 2025 maturities of approximately $1.2 billion, which we believe we are well positioned to address with our current liquidity and other options, including additional possible monetization transactions. For example, since the end of the quarter, we have settled certain insurance litigation that will result in incremental cash to us during the fourth quarter. We closed the Space Coast sale, resulting in about $45 million to us. The Watsonville and small FSED sales mentioned earlier resulted in another $45 million and we have signed non-binding LOIs and offer sheets for profitable sales that would generate additional cash proceeds. The aggregate of these transactions approximates another $400 million.

自2023年初以來，我們已償還了22億美元的債務。我們的 2025 年到期期限總計約為 12 億美元，我們相信我們有能力利用當前的流動性和其他選擇（包括額外的可能的貨幣化交易）來解決這個問題。例如，自本季結束以來，我們已經解決了某些保險訴訟，這將導致我們在第四季度獲得增量現金。我們完成了 Space Coast 的出售，為我們帶來了約 4500 萬美元的收益。前面提到的 Watsonville 和小型 FSED 銷售又帶來了 4500 萬美元的收入，我們已經簽署了不具約束力的意向書和要約表，以實現盈利銷售，從而產生額外的現金收益。這些交易總額約為另外 4 億美元。

With respect to these non-binding LOIs and offer sheets, I will point out that there are buyer diligence rights and other conditions and there is no certainty that these proposed transactions will actually be completed. We now believe that our cost of debt has likely peaked and is in fact coming down albeit at different paces depending on the geography. At the same time, MPT continues to resolve difficult tenant situations and simplify its business strategies for the future which we expect will make us more attractive to capital markets in the future.

關於這些不具約束力的意向書和要約表，我要指出的是，存在買方盡職權和其他條件，並且不能確定這些擬議交易是否會實際完成。我們現在認為，我們的債務成本可能已經見頂，而且實際上正在下降，儘管根據地理位置的不同，下降速度有所不同。同時，MPT 繼續解決困難的租戶情況並簡化未來的業務策略，我們預計這將使我們未來對資本市場更具吸引力。

As a reminder, the normalized FFO of $0.16 we reported for the quarter does not recognize income from tenants we have moved to cash-based accounting. That includes investments related to about $1.6 billion of real estate formerly leased to Steward, now leased to new operators and accounted for under the cash basis. And an additional $400 million of real estate previously leased to Steward is accounted for under the GAAP basis straight-line method.

提醒一下，我們報告的本季正常化 FFO 為 0.16 美元，並未確認我們已轉向現金會計的租戶的收入。其中包括與先前租給 Steward 的約 16 億美元房地產相關的投資，現在租給新營運商並按現金制計算。先前租給 Steward 的另外 4 億美元房地產按照 GAAP 直線法進行核算。

We have plans to resolve these in the coming few quarters, even further simplifying our business or returning them to collection status. When considering these portfolio simplification efforts, our success in re-tenanting more than $2 billion of real estate formerly leased to Steward as well as anticipated interest rate and capital market improvements, we expect an expanded set of levers to be able to address debt maturing in 2026 and beyond.

我們計劃在未來幾季解決這些問題，甚至進一步簡化我們的業務或將它們恢復到收集狀態。考慮到這些投資組合簡化工作、我們成功重新租用了先前租給 Steward 的超過 20 億美元的房地產以及預期的利率和資本市場改善，我們預計擴大的槓桿組合能夠解決 2017 年到期的債務問題。年及以後。

As such, we are not limited only to continue reducing the size of our portfolio in order to meet our capital allocation objectives, especially given that we believe that even with the level of normalized FFO that we reported this morning, we are confident there is significant unrecognized value in MPT's current share price.

因此，我們不僅限於繼續減少投資組合規模來實現我們的資本配置目標，特別是考慮到我們相信，即使我們今天早上報告的正常化 FFO 水平，我們仍然有信心MPT 當前股價的價值尚未得到認可。

With that, I'll conclude and we'll be happy to take questions and I'll turn the call back to the operator.

至此，我就結束了，我們很樂意回答問題，然後我會將電話轉回給接線生。

(Operator Instructions) Michael Carroll, RBC Capital Markets.

（操作員說明）Michael Carroll，RBC 資本市場。

Yeah, thanks. Can you talk about why the working capital loans to, I guess, the former -- on the operators taking over the former Steward assets increased to $90 million? And kind of highlight the timing of the expected repayments. I mean, how long does it take for these operators to get the necessary ABL that could pay back those working capital loans?

是的，謝謝。您能否談談為什麼向前者提供的營運資金貸款（我猜是接管前 Steward 資產的運營商）增加到了 9000 萬美元？並強調預期還款的時間。我的意思是，這些業者需要多長時間才能獲得必要的 ABL 來償還這些營運資金貸款？

So Mike, it's a simple answer on the $90 million, and that was additional primary professional fee cost not related to MPT or the new operators for the transitions. On the ABL, some of them already have replacement ABL that they're in works with. Others believe that they'll have them completed either by the end of this quarter or the early part of 2025. These are short-term loans and we expect them to be all repaid in 2025.

麥克，這是對 9000 萬美元的簡單回答，這是與 MPT 或新的過渡運營商無關的額外主要專業費用成本。在 ABL 上，他們中的一些人已經有了他們正在使用的替代 ABL。其他人則認為他們將在本季末或 2025 年初完成。這些是短期貸款，我們預計將於 2025 年全部償還。

Okay, great. And then can you provide an update on the PHP sale? And I believe last call, you kind of highlighted that the final bids for this asset was due in August. I guess, did that sale process? Is that starting to get completed? And then maybe when you're answering that, can you highlight why the write down in the PHP, why did that specifically occur again this quarter?

好的，太好了。那麼您能否提供有關 PHP 銷售的最新情況？我相信上次電話會議中，您強調了該資產的最終投標將於八月到期。我想，銷售過程有嗎？是不是開始完成了？然後，也許當您回答這個問題時，您能否強調為什麼要在 PHP 中寫下這一內容，為什麼本季會再次出現這種情況？

So Mike, the write down is based on the most recent, what we believe, reliable information that's available to us and we can't comment further on the status of what are continued confidential negotiations amongst the buyers and seller, which is PHP.

所以，麥克，減記是基於我們所掌握的最新的、我們認為可靠的信息，我們無法進一步評論買家和賣家之間持續進行的保密談判的狀態，即 PHP。

Omotayo Okusanya, Deutsche Bank.

Omotayo Okusanya，德意志銀行。

Hi. Yes, good morning everyone. Could you please -- for the Steward assets that have not yet been transitioned that you guys are now operating, could you just give us a sense of the earnings impact of those assets in third quarter? And how would you kind of think about that going forward until you can also transition those assets?

你好。是的，大家早安。對於你們目前正在經營的尚未過渡的 Steward 資產，您能否讓我們了解一下這些資產對第三季獲利的影響？在您也可以轉移這些資產之前，您會如何考慮這一點？

Well, Tayo, these aren't operational facilities. These include the Youngstown, Ohio, facility which has been closed for years. The San Antonio facility, which was closed, I believe, last year. It also includes, Sharon Pennsylvania, which is operational but it's not operational by us. It's still being operated by Steward. And then it also includes a facility in Miami which is in -- when Steward still owned it, it had been rehabbed and was getting ready to open and it's still closed at this particular time. So it shouldn't have any additional impact, negative, on MPT.

好吧，Tayo，這些不是營運設施。其中包括俄亥俄州揚斯敦的工廠，該工廠已關閉多年。聖安東尼奧工廠，我相信是去年關閉的。它還包括賓夕法尼亞州沙龍，它正在運營，但不是由我們運營的。它仍然由 Steward 運營。然後它還包括邁阿密的一個設施，當斯圖爾特仍然擁有它時，它已經被修復並準備開放，但在這個特定時間它仍然關閉。因此，它不會對 MPT 產生任何額外的負面影響。

Nikita Bely, J.P. Morgan.

尼基塔貝利，摩根大通。

Well, couple of modelling questions. Where do you think you could issue a new secured and unsecured debt today, at what cost?

嗯，有幾個建模問題。您認為今天可以在哪裡發行新的有擔保和無擔保債務，成本是多少？

Yeah, so we're not contemplating that right now. As I mentioned a few minutes ago, we think we're hopeful. I think with good reason that the yields on the outstanding notes are coming in. I think that's a result of two things: one, improving macroeconomic conditions in capital markets; and then obviously, as we resolve Steward, our hope and anticipation is that Prospect follows shortly on that with resolution that the market spreads will also come in. But again, right now, we're not even out testing that market.

是的，所以我們現在不考慮這個。正如我幾分鐘前提到的，我們認為我們充滿希望。我認為未償票據的收益率正在上升是有充分理由的。我認為這是兩件事的結果：一是資本市場宏觀經濟狀況改善；二是資本市場宏觀經濟狀況改善。然後顯然，當我們解決 Steward 問題時，我們的希望和預期是 Prospect 很快就會跟進，解決市場價差也會出現。但現在，我們還沒有測試這個市場。

What about the early thoughts on '25 term loan maturity? You think you'll extend it or pay it off with sales?

關於「25 年定期貸款到期日」的早期想法怎麼樣？你認為你會延長它或透過銷售來償還嗎？

We think we have options on that. That's a good question. As we laid out, our liquidity allows us a lot of optionality whether that gets extended, partially extended, paid. We have liquidity now, and with anticipated transactions that I walked through a few minutes ago, we think that gives us the optionality that I mentioned.

我們認為我們對此有選擇。這是個好問題。正如我們所闡述的，我們的流動性讓我們有很多選擇權，無論是延期、部分延期還是付款。我們現在擁有流動性，根據我幾分鐘前經歷的預期交易，我們認為這為我們提供了我提到的選擇性。

This concludes our question-and-answer session. I would like to turn the call back over to Ed Aldag for any closing remarks.

我們的問答環節到此結束。我想將電話轉回給艾德·阿爾達格，讓其發表結束語。

Thank you, Anthony, and thank you all for listening in today. And as always, if you have any questions later on, please give Drew or Tim a call.

謝謝安東尼，也謝謝大家今天的收聽。一如既往，如果您稍後有任何疑問，請給德魯或蒂姆打電話。

The conference is now concluded. Thank you for attending today's presentation. You may not disconnect.

會議現已結束。感謝您參加今天的演講。您可能無法斷開連線。