Medical Properties Trust
A publicly traded healthcare real estate investment trust that owns and leases hospitals and other medical facilities.
Last updated August 22, 2026
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Overview
Medical Properties Trust, Inc. (MPT) is a healthcare-focused real estate investment trust headquartered in Birmingham, Alabama. Founded in 2003 and taken public in 2005, the company owns or holds interests in hospitals and other healthcare properties and generally leases them to healthcare operators under long-term arrangements. Its portfolio has included general acute-care hospitals, behavioral-health facilities, urgent-care centers, rehabilitation hospitals, long-term acute-care facilities and post-acute-care properties. MPT’s business model is based primarily on acquiring healthcare real estate, financing or participating in the development of facilities, and leasing the properties to hospital and healthcare-system tenants. The model can provide operators with capital for acquisitions, construction, modernization and refinancing while giving MPT rental income backed by specialized real estate. Unlike a conventional hospital operator, MPT generally does not provide clinical care itself; its exposure comes from the value of the properties, the financial condition of tenants and the enforceability of lease arrangements. The company initially developed and acquired properties in the United States. Its early expansion included the development of Town & Country Hospital in Houston, Texas, and a 2012 investment in Ernest Health’s rehabilitation and long-term acute-care platform. MPT began international expansion in 2013 by acquiring rehabilitation hospitals in Germany, followed by entry into the United Kingdom in 2014. It later expanded into Australia through a 2019 sale-and-leaseback transaction involving Healthscope facilities. MPT subsequently sold its Australian portfolio in 2023. A major phase of growth involved sale-and-leaseback and financing transactions with hospital operators, particularly Capella Healthcare and Steward Health Care. In 2015, MPT acquired Capella and later sold the operating business while retaining much of the underlying real estate. From 2016 onward, it completed several large transactions involving Steward properties and, at one point, Steward represented a substantial share of MPT’s real estate assets. These arrangements became the central focus of criticism from journalists, investors and other observers who argued that property valuations, lease terms and related financing increased reported income while placing financial pressure on hospitals and their operating businesses. Steward’s financial deterioration culminated in its 2024 bankruptcy filing. Steward terminated its master lease with MPT during the bankruptcy process, and MPT sought replacement operators and other remedies for hospitals formerly operated by Steward. MPT also faced tenant stress involving Prospect Medical Holdings, whose operating company filed for bankruptcy protection in 2025 according to the cited reference material. MPT has attempted to reduce concentration and reposition its portfolio through asset sales, joint ventures and new leasing arrangements. In 2022 it formed a 50/50 joint venture with Macquarie Group involving eight Massachusetts hospitals. In 2024 it sold most of its interests in five Utah hospitals. As of December 31, 2025, the cited company profile described interests in 384 facilities representing approximately 39,000 beds across nine countries. The portfolio was leased to 50 tenants and was concentrated in general hospitals, behavioral-health facilities, urgent-care facilities and post-acute-care properties. Its largest reported tenant exposures included Circle Health Group, Priory Group, Healthcare Systems of America, Swiss Medical Network and Lifepoint Behavioral. Because the company’s performance depends heavily on tenant credit quality, asset values, refinancing conditions and regulatory developments in healthcare, its investment profile differs materially from that of a diversified commercial-property REIT.
History
Medical Properties Trust traces its corporate origins to Medical Properties Trust, LLC, formed in Maryland in December 2002. The present company was established as its successor on August 27, 2003, with Edward K. Aldag Jr. among its founders. MPT was designed around a focused healthcare real estate model: acquire or finance medical facilities, lease them to healthcare operators and generate rental income from specialized properties. The company became public in July 2005. One of its early development projects was Town & Country Hospital in Houston, Texas. MPT completed the hospital in the mid-2000s and sold it in 2007 to Memorial Hermann Health System. In 2012, it announced a $400 million transaction involving a 49% interest in Ernest Health and the real estate of 16 rehabilitation and long-term acute-care facilities spread across nine states. MPT sold that interest in 2018. MPT began building an international platform in December 2013, when it acquired eleven rehabilitation hospitals in Germany operated by RHM Klinik- und Altenheimbetriebe. In August 2014, it entered the United Kingdom by acquiring Circle Bath. The company then pursued larger combinations of healthcare operations and property ownership. In July 2015, it purchased Capella Healthcare from GTCR in a transaction that included both operating assets and real estate. MPT sold its interest in the operating business to Apollo Global Management in 2016, after which the business was combined with RegionalCare, while MPT continued to own related real estate. Steward Health Care became one of MPT’s most important relationships. In 2016, MPT finalized a leaseback involving five Massachusetts properties and acquired a minority interest in Steward. It completed additional Steward property transactions in 2017, including one involving ten facilities. MPT also participated in arrangements in which it financed or supported Steward acquisitions and received leases on the underlying properties. By 2018, Steward accounted for a large portion of MPT’s real estate assets. The Steward relationship later became the subject of sustained criticism. Critics argued that MPT paid inflated prices for properties, accepted inflated rents and used financing structures that increased reported earnings and executive compensation while extracting funds from hospital budgets. MPT disputed or defended aspects of these criticisms, but Steward’s subsequent financial distress made the relationship a significant source of investor and public scrutiny. MPT entered Australia in 2019 through a sale-and-leaseback transaction with Healthscope involving eleven hospitals, including acute-care and behavioral-health facilities. That same year it acquired the real estate supporting fourteen facilities operated by Prospect Medical Holdings. Both relationships later became associated with tenant-credit concerns. MPT formed another significant structure in 2022, creating a 50/50 joint venture with Macquarie Group for eight Massachusetts hospitals. The company sold its Australian portfolio to HMC Capital in 2023. Steward’s financial condition deteriorated during the same period, with reporting describing reliance on funding arrangements connected to MPT to meet rent obligations. Steward filed for bankruptcy protection in May 2024. Its bankruptcy proceedings included allegations against former Steward leaders concerning more than $245 million in alleged fraud, and Steward terminated its master lease with MPT. MPT subsequently worked to place hospitals formerly operated by Steward with replacement operators and to limit the effects of the tenant failure. In April 2024, MPT sold most of its interests in five Utah hospitals. The transaction formed part of a broader effort to manage liquidity, reduce concentration and reposition the portfolio. The cited company profile reports that, by December 31, 2025, MPT held interests in 384 facilities with roughly 39,000 beds across the United States, United Kingdom, Germany, Switzerland, Spain, Italy, Finland, Colombia and Portugal. Its properties were leased to 50 tenants, with general hospitals forming the largest category, followed by behavioral-health, urgent-care and post-acute-care facilities. This scale coexists with material concentration risk: the company’s results remain sensitive to tenant solvency, hospital reimbursement, regulatory policy, interest rates, property valuations and access to capital.
- 2024
Steward bankruptcy and lease termination
[1]Steward filed for bankruptcy protection and terminated its master lease with MPT.
- 2024
Utah hospital interests sold
[1]MPT sold most of its interests in five Utah hospitals.
- 2023
Australian portfolio divestiture
[1]MPT sold its Australian portfolio to HMC Capital.
- 2022
Macquarie hospital joint venture
[1]MPT established a 50/50 joint venture with Macquarie Group involving eight Massachusetts hospitals.
- 2019
Australian and Prospect expansion
[1]MPT acquired eleven Australian hospital properties from Healthscope and the real estate supporting fourteen Prospect-operated facilities.
- 2016
Major Steward leaseback completed
[1]MPT completed a leaseback involving five Steward properties in Massachusetts and acquired a minority interest in Steward.
- 2015
Capella Healthcare acquired
[1]MPT purchased Capella Healthcare and its associated real estate in a transaction reported at approximately $900 million.
- 2014
United Kingdom entry
[1]The company acquired Circle Bath, its first reported hospital in the United Kingdom.
- 2013
First international expansion
[1]MPT acquired eleven rehabilitation hospitals in Germany.
- 2012
Ernest Health investment announced
[1]MPT announced a transaction involving a 49% interest in Ernest Health and the real estate of 16 facilities.
Products and positioning
A specialized healthcare real estate investment trust providing property capital and long-term real estate solutions to hospital and healthcare operators.
Healthcare property · 2003
Hospital real estate
MPT owns or holds interests in general hospitals and other acute-care properties. These assets are typically leased to healthcare operators rather than operated directly by MPT. Hospital real estate is the core of the portfolio and is exposed to tenant credit quality, reimbursement conditions, local healthcare demand and the specialized nature of medical buildings.
Healthcare property
Behavioral-health facilities
Behavioral-health properties form a significant part of MPT’s healthcare real estate platform. These facilities may serve psychiatric, addiction-treatment or related behavioral-health needs and are leased to specialist operators. The category gives MPT exposure beyond general hospitals but remains dependent on operator performance, payer mix and healthcare regulation.
Healthcare property
Rehabilitation and post-acute facilities
MPT has acquired and financed rehabilitation, long-term acute-care and post-acute properties in the United States and Europe. These facilities support recovery and continuing care and are often operated through specialized healthcare platforms. Their value depends on occupancy, reimbursement, referral networks and the financial strength of the operating tenant.
Real estate finance · 2003
Healthcare sale-and-leaseback financing
Through sale-and-leaseback transactions, MPT acquires hospital or healthcare property from an operator and leases it back, allowing the operator to unlock real estate capital while continuing to use the facility. MPT’s return is primarily rent and potential property value appreciation. These structures can create concentration and tenant-credit risks when an operator becomes financially distressed.
Controversies
2025
Prospect Medical Holdings bankruptcy concerns
Prospect Medical Holdings filed for bankruptcy protection, creating additional scrutiny of MPT’s exposure to financially troubled healthcare operators and allegations that its real estate arrangements contributed to operator distress.
2024
Steward bankruptcy and MPT exposure
Steward’s bankruptcy and termination of its master lease exposed MPT to tenant default, operator replacement and property-restructuring risks. The episode became the principal public controversy associated with MPT’s portfolio and business model.
2023
Criticism of Steward Health Care transactions
MPT’s long-running relationship with Steward Health Care drew criticism that property purchases, valuations, leaseback rents and related financing were structured at levels that increased MPT’s reported earnings and executive compensation while placing financial pressure on hospitals. The controversy intensified as Steward’s finances deteriorated.
Brand decisions
2024
Sell Utah hospital interestsStrategyBackground
MPT pursued asset sales and portfolio changes during a period of tenant and liquidity stress.
Action taken
The company sold most of its interests in five Utah hospitals.
Aftermath
The transaction supported portfolio repositioning and reduced exposure to the relevant assets.
Reported sale value. $886 million (April 2024)
2023
Divest the Australian portfolioStrategyBackground
MPT was repositioning its portfolio amid tenant, valuation and capital-market pressures.
Action taken
It sold the Australian portfolio to HMC Capital.
Aftermath
The sale reduced MPT’s geographic exposure to Australia but was reported below the original purchase price.
Reported sale value. $802 million (2023)
2022
Create Macquarie hospital joint ventureM&ABackground
MPT sought to monetize part of its Massachusetts hospital exposure while maintaining an investment position.
Action taken
It formed a 50/50 joint venture with Macquarie Group involving eight Massachusetts hospitals.
Aftermath
The structure provided a partial ownership and capital-recycling mechanism for the portfolio.
2019
Enter Australia through Healthscope sale-and-leasebackStrategyBackground
MPT continued international diversification and sought hospital assets with established operators.
Action taken
It acquired the real estate of eleven Healthscope hospitals in Australia.
Aftermath
MPT later exited the Australian portfolio in 2023.
Reported acquisition value. $860 million (2019)
2015
Acquire Capella Healthcare and retain its real estateM&ABackground
MPT pursued a larger platform combining healthcare operations with ownership of the underlying properties.
Action taken
MPT acquired Capella Healthcare, later sold the operating interest and retained ownership of much of the related real estate.
Aftermath
The transaction reinforced MPT’s property-focused strategy and sale-and-leaseback model.
Reported transaction value. $900 million (2015)
2013
Expand into European healthcare real estateStrategyBackground
MPT sought to broaden its healthcare property base beyond the United States.
Action taken
It acquired eleven German rehabilitation hospitals and subsequently entered the United Kingdom.
Aftermath
The transactions established an international platform that later included multiple European markets.
Recent events
- 2024
MPT sells most interests in five Utah hospitals[1]
M&A
MPT sold the majority of its interests in five Utah hospitals, continuing efforts to manage exposure to stressed tenants and recycle capital.
- 2023
MPT sells Australian portfolio[1]
M&A
The company sold its Australian hospital portfolio to HMC Capital as part of a portfolio-repositioning effort.
- 2022
MPT forms Massachusetts hospital joint venture with Macquarie[1]
M&A
MPT created a 50/50 joint venture with Macquarie Group for a portfolio of eight Massachusetts hospitals.
- 2019
MPT enters Australia through Healthscope transaction[1]
M&A
MPT acquired the real estate of eleven Australian hospitals in a sale-and-leaseback arrangement with Healthscope.
- 2015
MPT acquires Capella Healthcare[1]
M&A
MPT acquired Capella Healthcare in a transaction combining healthcare operations and their underlying real estate, later selling the operating interest while retaining property ownership.
- 2014
MPT enters the United Kingdom hospital market[1]
M&A
The company acquired Circle Bath, marking its first reported hospital acquisition in the United Kingdom.
- 2013
MPT begins international expansion in Germany[1]
M&A
MPT acquired eleven German rehabilitation hospitals, its first reported expansion outside the United States.
- 2012
MPT announces Ernest Health investment[1]
M&A
The company announced a transaction involving a minority interest in Ernest Health and the real estate supporting its rehabilitation and long-term acute-care facilities.
- 2005
Medical Properties Trust completes its initial public offering[1]
Other
MPT became a publicly traded company through an initial public offering, establishing the capital-market structure used to expand its healthcare property portfolio.
Sources3 sources
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