Q3 2025 Medical Properties Trust Inc Earnings Call

Speaker #3: Thank you for standing by . My name is Kayla , and I will be your conference operator today . At this time , I'd like to welcome everyone to the medical third Quarter 2020 Earnings conference call .

Speaker #3: All lines have been placed on mute to prevent any background noise during this 60 minute call . After the speakers remarks , there will be a question and answer session .

Speaker #3: If you'd like to ask a question during this time , simply press star , followed by the number one on your telephone keypad .

Speaker #3: If you'd like to withdraw your question , press star one again . Thank you . I would now like to turn the call over to Charles Lambert , Senior Vice President .

Speaker #3: Please go ahead .

Speaker #4: Good morning . Welcome to the Medical conference call to discuss our third quarter 2020 financial results . With me today are Edward Clark Jr .

Charles Lambert: Good morning. Welcome to the Medical Properties Trust conference call to discuss our third quarter 2025 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, Comptroller and Chief Accounting Officer, Rosa Williams, Senior Vice President of Operations and Secretary, and Jason Fry, Managing Director, Asset Management and Underwriting. 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. Additionally, we're hosting a live webcast of today's call, which you can access in that same section.

Speaker #4: Chairman , president and Chief executive officer of the company . Steven Hamner , executive vice president and chief financial officer . Kevin Hannah , senior vice president , controller and chief accounting officer .

Speaker #4: Rozz Williams , senior vice president of operations and secretary . And Jason Fry , managing director , asset management and underwriting . Our press release was distributed morning and furnished on form 8-K with the Securities and Exchange Commission .

Speaker #4: If you did not receive a copy , it is available on our website at Medical Properties Trust . Com and in the Investor Relations section .

Speaker #4: 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 .

Charles Lambert: 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. We refer you to the Company's reports filed with the Securities and Exchange Commission for 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 the federal securities laws, the Company does not undertake a duty to update any such information.

Speaker #4: These forward looking statements are subject to known and unknown risks , uncertainties and other factors that may cause our financial results in future events to differ materially from those expressed in or underlying such forward looking statements .

Speaker #4: We refer you to the company's reports filed with the Securities and Exchange Commission for discussion of the factors that could cause the company's actual results or future events to differ materially from those expressed in this call .

Speaker #4: The information being provided today is as of this date only , and , except as required by the Federal securities laws , the company does not undertake a duty to update any such information .

Speaker #4: 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 .

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

Speaker #4: Please note that in our press release, Medical Properties Trust is reconciled. All non-GAAP financial measures are reconciled to the most directly comparable GAAP measures in accordance with Reg G requirements.

Speaker #4: You can also refer to our website at Medical Properties Trust . Com for the most directly comparable financial measures and related reconciliations . I will now turn the call over to our Chief Executive Officer , Edward Aldag .

Speaker #4: Thank you , Charles , and thanks to all of you for joining us this morning on our third quarter 2020 earnings call . Before you hear from the rest of the team , I'll spend a few minutes discussing recent strategic updates , including a few notable developments during the quarter in the prospect bankruptcy process .

Edward Aldag: Thank you, Charles, and thanks to all of you for joining us this morning on our third quarter 2025 earnings call. Before you hear from the rest of the team, I'll spend a few minutes discussing recent strategic updates, including a few notable developments during the quarter in the Prospect bankruptcy process. First, across all asset types, our tenants are delivering exceptional performance. General acute care operators reported a more than $200 million increase in EBITDARM year over year, with tenants such as LifePoint Health and ScionHealth delivering double-digit % revenue increases during the quarter. Post-acute operators reported a $50 million EBITDARM increase versus the same quarter last year. That includes Ernest Health up 17%, Vibra up 33%, and Median up 7%. Finally, in our Behavioral Health portfolio, EBITDARM increased $10 million year over year. Rosa will share more details on this performance trend across our portfolio shortly.

Speaker #4: First , across all asset types , our tenants are delivering exceptional performance . General acute care operators reported a more than $200 million increase in EBITDA year over year , with tenants such as Lifepoint Health and Zion Health delivering double digit percentage revenue increases during the quarter .

Speaker #4: Post-Acute operators reported a $50 million EBITDA increase versus the same quarter last year . That includes Ernest Health , up 17% . Vibra up 33% and median up 7% .

Speaker #4: Finally , in our behavioral health portfolio , EBITDA increased $10 million year over year . Rosa will share more details on this performance .

Speaker #4: Trends across our portfolio shortly . In August , nor health care systems in California was named the successful bidder for prospect . Six California facilities .

Edward Aldag: In August, Knorr Health Care Systems in California was named the successful bidder for Prospect's six California facilities. We promptly agreed to a new lease agreement with Knorr, the terms of which are broadly similar to those agreed to with the other operators in our transitional portfolio. All rent will be deferred for the first six months, ramping to 50% for an additional six months, and then reaching total stabilized annual rent of $45 million per year thereafter. More recently, we reached a settlement agreement with Yale New Haven and Prospect whereby Prospect will receive $45 million from Yale. This payment from Yale will be additive to the ultimate proceeds that Prospect receives for these properties. Prospect has already entered into an agreement to sell two of its Connecticut facilities to another operator and is actively engaged in negotiation with buyers around the third hospital.

Speaker #4: We promptly agreed to a new lease agreement with Nor , the terms of which are broadly similar to those agreed to with the other operators in our transitional portfolio .

Speaker #4: All rent will be deferred for the first six months , ramping to 50% for an additional six months , and then reaching total stabilized annual rent of $45 million per year thereafter .

Speaker #4: More recently , we reached a settlement agreement with Yale , New Haven and Prospect whereby prospect will receive $45 million from Yale . This payment from Yale will be additive to the ultimate proceeds .

Speaker #4: That prospect receives for these properties . Prospect has already entered into an agreement to sell two of its Connecticut facilities to another operator , and is actively engaged in negotiation with buyers around the third hospital .

Speaker #4: Finally , our portfolio of new tenants continues to ramp . Monthly rent on schedule with a few exceptions , there are mentioned that are mentioned in our press release .

Edward Aldag: Finally, our portfolio of new tenants continues to ramp monthly rent on schedule, with a few exceptions that are mentioned in our press release. We have collected all rent due from these operators through October, including 100% of rent from HSA. In August, we sold two facilities from this portfolio in Phoenix, Arizona to a tenant for approximately $50 million pursuant to a purchase option in the lease. We continue to own approximately 15 acres of land in the area. We are increasingly confident in our ability to generate total annualized cash rent of more than $1 billion by year end 2026. Notably, this $1 billion target does not reflect any rent contributions from any of the California Prospect properties.

Speaker #4: We have collected all rent due from these operators through October , including a 100% of rent from HSA . In August , we sold two facilities from this portfolio in Phoenix , Arizona to the to a tenant for approximately $50 million pursuant to a purchase option in the lease .

Speaker #4: We continue to own approximately 15 acres of land in the area . We are increasingly confident in our ability to generate total annualized cash rent of more than $1 billion by year end 2026 .

Speaker #4: Notably , this $1 billion target does not reflect any rent contributions from any of the California Prospect properties . Reflecting this confidence , as well as our strong belief that our share price remains significantly undervalued , our Board of directors has authorized a new $150 million share repurchase program that we intend to deploy opportunistically .

Edward Aldag: Reflecting this confidence as well as our strong belief that our share price remains significantly undervalued, our Board of Directors has authorized a new $150 million share repurchase program that we intend to deploy opportunistically. Furthermore, I want to call your attention to a comprehensive reaffirmation of our business model presentation posted to our website earlier this week. In this presentation, we directly address a range of false narratives that critics have been spreading about our business model. We believe it is important that shareholders, operators, journalists, and lawmakers all have a complete understanding of the truth around MPT. There remains a dynamic macro policy environment, making the permanent and flexible capital solutions that Medical Properties Trust offers more important now than ever.

Speaker #4: Furthermore , I want to call your attention to a comprehensive reaffirmation of our business model presentation posted to our website earlier this week .

Speaker #4: In this presentation , we directly address a range of false narratives that critics have been spreading about our business model . We believe it is important that shareholders , operators , journalists and lawmakers all have a complete understanding of the truth around empty .

Speaker #4: There remains a dynamic macro policy environment , making the permanent and flexible capital solutions that empty offers more important now than ever . Rosa .

Rosa Williams: Rosa, thank you Ed. As always, I will cover some highlights from the quarter across our diverse global portfolio, beginning with Europe. As a reminder, international operators comprise approximately 50% of our total portfolio. We continue to be pleased with the consistency of coverages exceeding two times across this portfolio. This performance reflects these operators' strategic focus on high quality patient care as well as continuous expansion of access to care within their communities. In the UK, Circle repeatedly ranks among the highest of all healthcare operators in patient satisfaction, maintaining a reputation score well above its next closest competitor. Circle continues to make significant investments in advanced technologies including AI and robotics, strengthening its competitive advantages and reinforcing its position as one of the leading healthcare providers in the UK market.

Speaker #5: Thank you . As always , I will cover some highlights from the quarter across our diverse global portfolio . Beginning with Europe . As a reminder , international operators comprise approximately 50% of our total portfolio and we continue to be pleased with the consistency of coverages exceeding two times across this portfolio .

Speaker #5: This performance reflects these operators strategic focus on high quality patient care , as well as continuous expansion of access to care within their communities .

Speaker #5: In the UK , circle repeatedly ranks among the highest of all health care operators in patient satisfaction , maintaining a reputation score well above its next closest competitor , Circle continues to make significant investments in advanced technologies , including AI and robotics , strengthening its competitive advantages and reinforcing its position as one of the leading healthcare providers in the UK market .

Speaker #5: Our Bath Hospital in the UK is the first independent hospital to receive accreditation as an elective surgical hub deemed by the NHS and the Royal College of Surgeons of England .

Rosa Williams: Our Sulis Bath Hospital in the UK is the first independent hospital to receive accreditation as an elective surgical hub, deemed by the NHS and the Royal College of Surgeons of England. This recognition highlights the hospital's high standards in clinical performance, operational efficiency, and patient care. With coverages consistently above two times, Priory has demonstrated its ability to adapt its service lines to the needs of each market, allowing for flexibility as the NHS mental health model evolves. Priory continues to explore technological opportunities such as its partnership with Siomix and to launch an innovative digital pathway that aims to revolutionize access to personalized mental health care. In Germany, Median continues to report strong negotiated reimbursement rates and occupancy trends, enabling them to meaningfully outperform prior year revenue and earnings.

Speaker #5: This recognition highlights the hospital's high standards in clinical performance , operational efficiency and patient care , with coverages consistently above two times . Priory has demonstrated its ability to adapt its service lines to the needs of each market , allowing for flexibility as the NHS mental health model evolves .

Speaker #5: Priory continues to explore technological opportunities such as its partnership with Symyx to launch an innovative digital pathway that aims to revolutionize access to personalized mental health care in Germany .

Speaker #5: Median continues to report strong negotiated reimbursement rates and occupancy trends, enabling them to meaningfully outperform prior year revenue and earnings in Switzerland.

Rosa Williams: In Switzerland, Swiss Medical has launched integrated models in each of the French, German, and Italian speaking regions, with these new platforms successfully supplementing Swiss Medical's strong organic growth. EBITDAR grew more than 10% trailing 12 month year over year. In Spain, EMED continues to progress construction on new hospitals in Alicante and Barcelona with scheduled openings during 2026, with over 70% of construction completed. Turning to our U.S. portfolio, Ernest Health has continued increasing consolidated coverage every quarter over the past year, with legacy IRFs reporting strong results and new developments rapidly ramping. As such, consolidated EBITDARM coverage is now approaching 2.4 times. LifePoint Health continues to deliver high margin growth at a steady, stable rate versus the rapid acceleration observed in 2024. Kahnema Memorial continues to be the most significant growth driver within LifePoint Health's MPT portfolio, with trailing 12-month admissions increasing 15% year over year.

Speaker #5: Swiss Medical has launched integrated care models in each of the French , German and Italian speaking regions . With these new platforms , successfully supplementing Swiss medical strong organic growth , EBITDA grew more than 10% , trailing 12 month year over year .

Speaker #5: In Spain , IMD continues to progress construction on new hospitals in Alicante and Barcelona , with scheduled openings during 2026 , with over 70% of construction completed .

Speaker #5: Turning to our U.S. portfolio . Earnest health has continued increasing consolidated coverage every quarter over the past year , with legacy ERPs reporting strong results and new developments rapidly ramping .

Speaker #5: As such , consolidated EBITDA coverage is now approaching 2.4 times . Lifepoint health continues to deliver high margin growth at a steady , stable rate versus the rapid acceleration observed in 2024 .

Speaker #5: Conemaugh Memorial continues to be the most significant growth driver within Lifepoint inputs . Lifepoint portfolio with trailing 12 month admissions increasing 15% year over year .

Speaker #5: Surgery partners three facilities delivered another quarter of strong performance , with consolidated EBITDA coverage above six times our hospital in Wisconsin recently completed a much anticipated expansion to their operating suite to accommodate accommodate additional surgeons wanting to bring cases to this respected facility .

Rosa Williams: Surgery Partners' 3 facilities delivered another quarter of strong performance, with consolidated EBITDARM coverage above 6 times. Our hospital in Wisconsin recently completed a much-anticipated expansion to their operating suite to accommodate additional surgeons wanting to bring cases to this respected facility. HSA continues to improve operations and staffing across markets, with Q2 and Q3 EBITDARM coverage approaching 1 time on fully ramped rent, which, as a reminder, does not fully ramp until September of 2026. Summer seasonality drove softer volumes in the third quarter, but revenue remained strong due to a higher patient acuity mix. MPT has committed to funding approximately $40 million over the next two years for necessary infrastructure and other capital improvement projects, including HVAC and elevator replacements. The vast majority of this amount is for a newly constructed seven-story parking deck.

Speaker #5: HSA continues to improve operations and staffing across markets with Q2 and Q3 , EBITDA coverage approaching one times on fully ramped rent , which , as a reminder , does not fully ramp until September of 2026 .

Speaker #5: Summer seasonality drove softer volumes in the third quarter , but revenue remained strong due to a higher patient acuity mix empty has committed to funding approximately 40 million over the next two years for necessary infrastructure and other capital improvement projects , including HVAC and elevator replacements .

Speaker #5: The vast majority of this amount is for a newly constructed seven-story parking deck. These costs will be added to the lease base upon which the tenants will owe rent.

Rosa Williams: These costs will be added to the lease base upon which the tenants will owe rent. ONRRH Health launched its rebranding in Arizona by renaming Mountain Vista to Four Peaks Medical Center. In addition, ONRRH remains focused on physician recruitment, executing its self-funded CapEx strategy, and upgrading facilities ahead of anticipated volume recovery. Quorum Health's Odessa facility continues to improve performance with stronger than expected admissions and surgical volumes. In August, Odessa Regional announced that it achieved Silver certification as a Cribs for Kids National Safe Sleep Hospital, demonstrating adherence to rigorous guidelines established by the Cribs for Kids National Safe Sleep Hospital Certification Program. Insight Health reopened ER services at Trumbull, Ohio earlier this month, with plans to slowly open more services as volumes come back.

Speaker #5: Honor launched its rebranding and Arizona by renaming Mountain Vista to Four Peaks Medical Center . In addition , honor remains focused on physician recruitment , executing its self-funded CapEx strategy and upgrading facilities ahead of anticipated volume recovery .

Speaker #5: Quorum Health's Odessa facility continues to improve performance with stronger than expected admissions and surgical volumes . In August , Odessa Regional announced that it achieved silver certification as a cribs for kids National Safe Sleep Hospital , demonstrating adherence to rigorous guidelines established by The Cribs for kids , National Safe Sleep Hospital Certification Program , Insight health reopened air services at Trumbull , Ohio , earlier this month , with plans to slowly open more services as volumes come back , along with physicians and staff .

Rosa Williams: Along with physicians and staff, Prime Healthcare's MPT facilities continue to show improved performance with EBITDARM coverage over 2 times as volumes and ER conversion rates have increased across the portfolio. Prime received credit rating upgrades from Fitch, Moody's, and S&P during the third quarter. Pipeline Health continues to demonstrate growth with EBITDARM coverage over 2 times. Additionally, they are opening new service lines for patients at all four hospitals. In summary, we are very encouraged by performance trends across our portfolio. Our portfolio of new tenants continues to ramp monthly rent payments, and we remain well positioned to generate significant cash flow from our 388 properties and approximately 39,000 licensed beds around the world, enabling us to create value for shareholders moving forward.

Speaker #5: Prime Healthcare's empty facilities continue to show improved performance with Ebitdar coverage over two times as volumes and air conversion rates have increased across the portfolio .

Speaker #5: Prime received credit rating upgrades from Fitch , Moody's and S&P during the third quarter . Pipeline health continues to demonstrate growth with EBITDA coverage over two times .

Speaker #5: Additionally , they are opening new service lines for patients at all four hospitals . In summary , we are very encouraged by performance trends across our portfolio .

Speaker #5: Our portfolio of new tenants continues to ramp monthly rent payments , and we remain well positioned to generate significant cash flow from our 388 properties and approximately 39,000 licensed beds around the world , enabling us to create value for shareholders , moving forward .

Speaker #5: Kevin .

Kevin Hanna: Kevin, thank you. Rosa, today we reported normalized FFO of $0.13 per share for the third quarter of 2025. The normalized FFO result would have been $0.01 higher if not for the payment of September rent by cash basis HSA on October 1. These results fully reflect the full quarter dilutive impact of not only our first quarter secured bonds, but the second quarter Median joint venture refinancing. Higher G&A expense versus the second quarter also impacted GAAP results, primarily driven by higher stock compensation expense resulting from the change in the fair market value of 2024 and 2025 performance-based equity compensation, of which no shares have been earned or vested.

Speaker #6: Thank you . Rosa . Today we reported normalized FFO of $0.13 per share for the third quarter of 2025 . The normalized FFO result would have been $0.01 higher if not for the payment of September rent by cash basis .

Speaker #6: HSA on October 1st . These results fully reflect the full quarter dilutive impact of not only our first quarter secure bonds . But the second quarter median joint venture refinancing , higher G&A expense versus the second quarter .

Speaker #6: Also impacted GAAP results , primarily driven by higher stock compensation expense resulting from the change in the fair market value of 2024 and 2025 .

Speaker #6: Performance based equity compensation , of which no shares have been earned or vested as of September 30th , 2025 . Our earnings from equity interests were higher in the quarter as changes in German tax policy resulted in a net deferred tax benefit to our German JV , and as the value of the underlying real estate in the common joint venture continues to adjust upwards , neither of these items are included in our normalized FFO results .

Kevin Hanna: As of September 30, 2025, our earnings from equity interest were higher in the quarter as changes in German tax policy resulted in a net deferred tax benefit to our German JV, and as the value of the underlying real estate in the CommonSpirit joint venture continues to adjust upwards. Neither of these items are included in our normalized FFO results. We recorded approximately $82 million in net impairments, the majority of which related to Prospect and the decline in expected proceeds of certain Pennsylvania and Rhode Island assets. We continue to expect the cash proceeds from both the settlement with Yale and Connecticut in the sale of the Connecticut.

Speaker #6: We recorded approximately $82 million in net impairments . The majority of which related to prospect and the decline in expected proceeds of certain Pennsylvania and Rhode Island assets .

Speaker #6: We continue to expect that cash proceeds from both the settlement with Yale and Connecticut and the sale of the Connecticut facilities will be more than sufficient , will be more than sufficient to repay Mpt's outstanding debt loan balances .

Rosa Williams: Facility.

Kevin Hanna: Will be more than sufficient to repay MPT's outstanding DIP loan balances. Despite this expectation, accounting rules require that we record impairments to our Prospect carrying values. There are other immaterial adjustments to carrying values during the quarter, including routine adjustments to marketable securities that were disclosed as non-cash fair value adjustments in our reporting. I will now hand the call over to Steve to discuss our liquidity and capital strategy moving forward.

Speaker #6: Despite this expectation , accounting rules require that we record impairments to our prospect carrying values . There are other immaterial adjustments to carrying values during the quarter , including routine adjustments to marketable securities that were disclosed as non-cash , fair value adjustments .

Speaker #6: In our reporting , I will now hand the call over to Steve to discuss our liquidity and capital strategy . Moving forward . Steve .

Steven Hamner: Steve, thank you. Kevin, I'll wrap up quickly with just a few points, none of which will be surprising, and then we can take any questions. First, a quick summary of the strategies we have been executing for repaying and otherwise addressing future maturities. We've sold at significant gains and financed at above book values many billions of dollars in highly attractive hospital assets. Almost without exception, these transactions have provided clear validation of our underwriting rigor and the resulting asset values. Access to these values has given us the assurance and flexibility to repay and refinance several billion dollars of debt in 2025 alone. The secured notes we issued in February are now trading at significant premiums, and our most recent transaction financed more than $2 billion of German revenue rehabilitation hospitals at a 5.1% coupon.

Speaker #4: Thank you . Kevin .

Speaker #5: I'll wrap up quickly with just a few points . None of which will none of which will be surprising . And then we can take any .

Speaker #4: Questions .

Speaker #5: First , a quick summary of strategies . We have been executing for . repaying and otherwise addressing future maturities we've sold at significant gains and financed at above book values .

Speaker #5: Many billions of dollars in highly attractive hospital .

Speaker #4: Assets .

Speaker #5: Almost without exception , these transactions have provided clear validation of our underwriting rigor and the resulting asset values . Access to these values has given us has .

Speaker #4: Given us .

Speaker #5: The assurance and flexibility to repay and refinance several billion dollars of debt in 2025 alone. The secured notes we issued in February are now trading at significant premiums, and our most recent transaction financed more than $2 billion of German rehabilitation hospitals at a 5.1% coupon.

Speaker #5: This access to capital has also given us the ability to retenant and begin collecting what is now scheduled to be in an incremental $200 million plus in annual cash rent from new operators .

Steven Hamner: This access to capital has also given us the ability to re-tenant and begin collecting what is now scheduled to be an incremental $200 million plus in annual cash rent from new operators, resolve the issues around Prospect Medical Group bankruptcies, and address debt maturing in 2027 and beyond, all of which we are doing successfully. Along with our clear visibility into rent ramping to a scheduled incremental $200 million plus, the upcoming 2026 annual escalations, cash payment of our roughly $100 million DIP loan, and periodic asset sales similar to what we have reported in the last few quarters, we also have reason to expect even more liquidity. Specifically, and while there is no certainty, Prospect Medical Group is expected to generate proceeds in excess of the $100 million balance of our DIP loan. A substantial majority of any such proceeds will flow to Medical Properties Trust.

Speaker #5: Resolve the issues around prospective bankruptcies and address debt maturing in 2027 and beyond. All of which we are doing successfully, along with our clear visibility into rent ramping to a scheduled incremental $200 million plus.

Speaker #5: The upcoming 2026 annual Escalations Cash payment of our roughly $100 million Dip loan and periodic asset sales , similar to what we have reported in the last few quarters , we also have reason to expect even more liquidity specifically .

Speaker #5: And while there is no certainty prospect is expected to generate proceeds in excess of the $100 million balance of our loan , a substantial majority of any such proceeds will flow to empty .

Speaker #5: We are evaluating the sale or lease of several assets which are not currently yielding meaningful returns , and we also continue to evaluate sales of earning assets and portfolios for attractive gains .

Steven Hamner: We are evaluating the sale or lease of several assets which are not currently yielding meaningful returns, and we also continue to evaluate sales of earning assets and portfolios for attractive gains. For example, Evis Victoria, our co-owner of Infracor and the parent of Infracor's Swiss Medical Network lessee, is currently exploring various strategic options for its affiliates, including Infracor, to support their long-term development. Infracor is considering various opportunities to open up its capital or even list on a stock market in order to meet the growing demand for sale and leaseback solutions in the public and private hospital market in Switzerland. As this and other market indicators demonstrate, demand for hospital real estate is strong across virtually all geographies. Our cost of capital is still higher than we expect it will be, but as we have previously said, we may make modest acquisitions when strategically important.

Speaker #5: For example . Eva's Victoria , our co-owner of Infracore and the parent of Infracore Suisse Medical Network lessee , is currently exploring various strategic options for its affiliates , including Infracore , to support their long term development .

Speaker #5: Infracore is considering various opportunities to open up its capital , or even list on a stock market in order to meet the growing demand for sale and leaseback solutions in the public and private hospital market .

Speaker #5: In Switzerland . As this and other market indicators demonstrate , demand for hospital real estate is strong across virtually all geographies , our cost of capital is still higher than we expect it will be .

Speaker #5: But as we have previously said , we may make modest acquisitions when strategically important . But as Ed pointed out , repurchasing our own common stock is among our very best and most accretive uses of capital .

Steven Hamner: As Ed pointed out, repurchasing our own common stock is among our very best and most accretive uses of capital, and for that reason we announced this morning that we have implemented a $150 million strategic stock repurchase plan that will make available some of this expected growing liquidity to capture that permanent value. This announcement demonstrates our conviction that recent prices of our common stock do not reflect our assets' underlying value, and we have therefore not issued any shares under our recently implemented At the Market Offering program. We reestablished that program and the long-term opportunistic flexibility it provides us in August, shortly after the effectiveness of our new three-year shelf registration statement. Importantly, some of our unsecured notes outstanding still trade at discounts in today's markets.

Speaker #5: And for that reason, we announced this morning that we have implemented a $150 million strategic stock repurchase plan that will make available some of this expected growing liquidity to capture that permanent value.

Speaker #5: This announcement demonstrates our conviction that recent prices of our common stock do not reflect our assets underlying value , and we have therefore not issued any shares under our recently implemented at the market offering program .

Speaker #5: We re-established that program and the long term opportunistic flexibility it provides us . In August , shortly after the effectiveness of our new three year shelf registration statement .

Speaker #5: Importantly , some of our unsecured notes outstanding still trade at discounts in today's markets and nothing we may consider with respect to share repurchase or ATM programs .

Steven Hamner: Nothing we may consider with respect to share repurchase or ATM programs rules out continued consideration of possible debt refinancing or redemption strategies. We've conclusively demonstrated that we have the asset values to accomplish these strategies. Moreover, as you would expect, we carefully monitor and plan for the maintenance of all debt covenants as we look into possible future capital transactions. We consciously designed and negotiated these covenants to provide us the opportunistic flexibility to execute these strategies, and we are confident that we will do so. With that, I will turn the call back to the operator to queue any questions. Kayla.

Speaker #5: Rules out continued consideration of possible debt refinancing or redemption strategies . We've conclusively demonstrated that we have the asset values to accomplish these strategies .

Speaker #5: Moreover , as you would expect , we carefully monitor and plan for the maintenance of all debt covenants as we look into possible future capital transactions , we consciously designed and negotiated these covenants to provide us the opportunistic flexibility to execute these strategies , and we are confident that we will do so .

Speaker #5: And with that , I will turn the call back to the operator to queue . Any questions ? Kayla .

Speaker #3: At this time , I'd like to remind everyone , in order to ask a question , press star . Then the number one on your telephone keypad , please limit to one question and one follow up .

Operator: At this time I'd like to remind everyone, in order to ask a question, press Star, then the number one on your telephone keypad. Please limit to one question and one follow-up. Your first question comes from the line of Mike Mueller with J.P. Morgan. Your line is open.

Speaker #3: Your first question comes from the line of Mike Mueller with J.P. Morgan . Your line is open .

Speaker #7: Yeah . Hi . I guess on the . Buyback , the questions here , I mean , how do you weigh looking at a buyback versus using the capital to either pay down debt , buyback , other debt , just given where the leverage level is today and , you know , even on a pro forma basis where it'll be .

[Analyst]: Yeah, hi. I guess on the buyback, the question's here. How do you weigh looking at a buyback versus using the capital to either pay down debt, buy back other debt, just given where the leverage level is today and, you know, even on a pro forma basis where it'll be? I guess the follow up to that is, in terms of funding a buyback, would you only use asset sales or would you use cash on hand or cap the credit line? Can you just put that whole buyback into perspective for us?

Speaker #7: And I guess the follow up to that is in terms of funding a buyback , would you only , you know , use asset sales or would you use cash on hand or tap the credit line .

Speaker #7: Just can you just put that whole buyback into perspective for us ?

Speaker #5: Sure , Mike . We we we first of all have a number of opportunities . And we've been talking about these for several quarters .

Steven Hamner: Sure, Mike. We first of all have a number of opportunities and we've been talking about these for several quarters and that's reinvesting the business with, as I mentioned and as we've done on a very limited basis, strategically buying new assets. We certainly recognize the trading volumes and levels of some of the unsecured bonds that could provide attractive opportunities for tendering or repurchasing on either small or large scale. We recognize, as we've just conceded, that we think our shares are significantly undervalued. We have all of those options. We have resources available. We will continue to evaluate the opportunities and the timing of those opportunities and the sources of that capital. I can't say I doubt we're going to borrow money, incremental money in order to fund a buyback.

Speaker #5: And that's reinvesting in the business with , as I mentioned , and as we've done on a very limited basis , strategically buying new assets , we certainly recognize the the trading volumes and levels of some of the unsecured bonds that could could provide attractive opportunities for , for tendering or repurchasing on on either small or large scale and , and we , we , we , we recognize as we've just , just conceded that we think our , our shares are significantly undervalued .

Speaker #5: So we have all of those options . We have resources available . We we will continue to evaluate the opportunities and the timing of those opportunities .

Speaker #5: And the sources of that capital . I can say I doubt we're going to borrow money , incremental money , in order to fund the buyback .

Speaker #5: And we've mentioned a few of the increasing , possibly increasing cash resources that we'll have , including some assets that are currently not earning much .

Steven Hamner: We mentioned a few of the increasing, possibly increasing cash resources that we'll have, including some assets that are currently not earning much, if anything, and possibly some of the well received earning assets that we've demonstrated. Just as in the last several billion dollars of asset sales, we expect any additional asset sale earning asset sales would also be very attractive profitable gains. All of that is available and as we've been doing for a couple of years now, we evaluate periodically, constantly, in fact, what's the best use of the available capital that we have.

Speaker #5: If anything . And possibly some of the the well received earning assets that we've demonstrated , just as in the last several billion dollars of asset sales , we expect any additional asset sale earning asset sales would also be at very attractive , profitable gains .

Speaker #5: So all all of that is available . And as we've been doing for a couple of years now , we evaluate periodically , constantly .

Speaker #5: In fact , what's the best use of the available capital that we have ?

Speaker #7: Got it. Okay, I appreciate it. Thank you.

[Analyst]: Got it. Okay, appreciate it. Thank you.

Speaker #3: And your next question comes from the line of Michael Carroll with RBC Capital Markets . Please go ahead .

Operator: Your next question comes from the line of Michael Carroll with RBC Capital Markets. Please go ahead.

Speaker #8: Yeah . Thanks . I just want to follow up with Mike's questions related to to the buyback . I mean , is this can you kind of highlight the timing of this of when some of these purchases could occur ?

[Analyst]: I just want to follow up with Mike's questions related to the buyback. Is this, can you kind of highlight the timing of this, of when some of these purchases could occur? I know you have a big debt maturity in 2027. You still are pooling money on the line of credit to meet some of the debt covenants. You're still kind of cash flow negative, at least in terms of some of the investments you made. I guess post that. Do we need to have all that kind of resolved before you start to buy back stock? Are you willing to do that in the near term?

Speaker #8: I mean , I know you have a big debt maturity in 2027 . You still are pulling money on the line of credit for to to meet some of the debt covenants .

Speaker #8: You're still kind of cash flow negative , at least in terms of some of the investments you made . I guess post that .

Speaker #8: I mean , do we need to have all that kind of resolved before you start to buy back stock , or are you willing to do that in the near term ?

Speaker #4: Yeah , Mike , I think you should assume it'll start immediately .

Edward Aldag: Yeah, Mike, I think you should assume it will start immediately.

Speaker #8: Okay . And then , Ed , can you give us an update on HSA ? I know you were you had some positive commentaries on their progress and the ramp up that they've been doing .

[Analyst]: Okay. Ed, can you give us an update on HSA? I know you had some positive commentaries on their progress and the ramp up that they've been doing. Maybe provide some details on what drove the late September rent payment. Is that a concern that, like, does that cause you any concerns of their ability to pay the ramped up rent over time? Can you provide some color on that?

Speaker #8: Maybe provide some details on what drove the late September rent payment . And is that a concern that like , does that cause you any concerns of their ability to , to pay the ramped up rent over time ?

Speaker #8: Can you provide some color on that ?

Speaker #4: Sure . They continue to perform very well . The biggest improvements in Florida come from recruiting the doctors back to the facilities that left during the steward debacle .

Edward Aldag: Sure. They continue to perform very well. The biggest improvements in Florida come from recruiting the doctors back to the facilities that left during the Steward debacle. They also have been extremely successful, probably exceeding even our expectations in Texas from the standpoint of their cash delay in October and September. It was the, we believe the final steps of getting the TSA in order, getting the money repaid to the lender that they had for the DIP money in Florida. We do not expect any additional issues.

Speaker #4: They also have been extremely successful , probably exceeding even our expectations in Texas from the standpoint of their cash . The delay in October , in September , excuse me , it was the we believe the final steps of getting the TSA in order , getting the money repaid to the lender that they had for the dip money in Florida .

Speaker #4: And we do not expect any additional issues.

Speaker #5: And I'll just point out one last thing and remember , September , the rent actually doubled . And so they paid twice in September , actually , on October 1st .

Steven Hamner: I'll just point out one last thing. Remember September, the rent actually doubled. They paid twice in September, actually on October 1st, what they had been paying. I think we made clear in the press release they've already paid October rent.

Speaker #5: And what they had been paying and again , I think we made clear in the press release they've already paid October rent .

Speaker #8: Okay . Great . Thanks .

[Analyst]: Okay, great, thanks.

Speaker #3: And your next question comes from the line of Farrell Granoff with Bank of America. Please go ahead.

Operator: Your next question comes from the line of Faro Grinoth with Bank of America. Please go ahead. Thank you and good morning. I was just wondering if you could add a little commentary around the Yale New Haven Health hospitals. I saw the update with having at least two with greater line of sight of a potential close. Is there anything else that you can share? Also, the potential third if there's been further interest.

Speaker #9: Thank you . And good morning . I was wondering if you could add a little commentary around the Yale New Haven hospitals . I saw the update with having at least two with greater line of sight of a potential close .

Speaker #9: Is there anything else that you can share ? And also the potential third , if there's been further interest . ?

Speaker #4: So I , I think you're going to need to repeat that . No one around the table heard the first part of your question .

Edward Aldag: Farrell, I think you're going to need to repeat that. No one around the table heard the first part of your question.

Speaker #9: Oh , so sorry about that . I was just asking about the Yale New Haven hospitals and the progress on having those either released or sold under the the binding agreements , or is that involved as well as the third property ?

Operator: Sorry about that. I was just asking about the Yale New Haven hospitals and the progress on having those either released or sold under the binding agreements. Is that involved as well as the third property?

Speaker #4: Yeah , sure . So the two facilities are under binding agreement . We expect those to close , hopefully before year end . If not shortly thereafter .

Edward Aldag: The two facilities are under binding agreement. We expect those to close hopefully before year end, if not shortly thereafter. The other one, we hope to have a binding agreement imminently with another buyer.

Speaker #4: The other one , we hope to have a binding agreement imminently with , with a with another buyer .

Speaker #9: Okay . Thank you . And and also I saw a little bit of commentary on the NIH restructuring and impacting of the referral on the behavioral providers .

Operator: Okay, thank you. I saw a little bit of commentary on the NHS restructuring and impacting of the referral on the behavioral providers. Does that grant you any concern on the future health of that sector for Priory Group for their EBITDARM coverage? Or does that maybe add a little target if that could be something to dispose of and use for capital funding?

Speaker #9: Does that grant you any concern on the future health of that sector for Priory , for their ebitdar coverage , or does that maybe add a little target if that could be something to dispose of and use for capital funding .

Speaker #5: So we've talked about this in the last quarter . I know perhaps the one before too . So NHS , as they have did with acute care a few years back , they want to try to keep as much of their mix of patients in their own hospitals .

Rosa Williams: We talked about this in the last quarter, and perhaps the one before too. NHS, as they did with acute care a few years back, want to try to keep as much of their mix of patients in their own hospitals. Now they're doing the same thing with behavioral. It's our belief that they ultimately will realize the benefit of having independent hospitals to treat some of those patients because the resources are needed in the independent sector to assist with getting the volume of patients treated. We think it's short term and will come back around. In the meantime, Priory has, as evidenced by their two times coverage, been able to put operational items in place to continue to perform very well.

Speaker #5: And now they're doing the same thing with behavioral . It's our belief that they ultimately will realize the benefit of having independent hospitals to treat some of those patients because they're just they're the resources are needed in the independent sector to assist with getting the volume of patients treated .

Speaker #5: So no , we think it's short term and we'll come back around . And in the meantime , Priory has , you know , as evidenced by their two times coverage , been able to put up operational items in place to to continue to perform very well .

Speaker #4: The the operator there does not expect to see a significant decrease in their coverage .

Edward Aldag: The operator there does not expect to see a significant decrease in their coverage.

Speaker #9: Okay . Thank you so much .

Operator: Okay, thank you so much. Your next question comes from the line of Omotayo Okusanya with Georgia Bank. Your line is open.

Speaker #3: And your next question comes from the line of Amol Akisanya with Deutsche Bank . Your line is open .

Speaker #10: Yes . Good morning everyone . In terms of the rent collections in the quarter , I think in the press release . You did mention that , you know , there was maybe not as much as collection as you expected in Pennsylvania and Ohio that curious if that relates to insight in particular , and if you could just kind of give us an update on that , on that asset transition .

[Analyst]: Yes. Good morning everyone. In terms of the rent collections in the quarter, I think in the press release you did mention that there was maybe not as much of a collection as you expected in Pennsylvania and Ohio. Curious if that relates to Insight Health in particular. If you could just kind of give us an update on that, on that asset transition.

Speaker #4: Yeah . So it's almost exclusively to Ohio facility , as you probably know , probably read , they were delayed in reopening the facility that's up in has gotten open .

Edward Aldag: Yes, Omotayo. It's almost exclusively the Ohio facility, as you probably know. You probably read they were delayed in reopening the facility that's up and has gotten open. Senator Moreno has been very helpful in that. We expect that to change. We have delayed when we expect their actual full rent to begin. I believe that's in move to January. In Pennsylvania, that's a very, very small amount of money. The facility continues to improve and not exactly sure when that one will start paying rent.

Speaker #4: Senator Marino has been very helpful in that. So we expect that to change. We have delayed when we expect their actual full rent to begin.

Speaker #4: I believe that's in move to January . And then the in in Pennsylvania . That's a very , very small amount of money .

Speaker #4: The facility continues to improve, and I'm not exactly sure when that one will start paying rent.

Speaker #5: That's a $30,000 a month rent payment . You .

Steven Hamner: That's a $30,000 per month rent payment.

Speaker #10: Gotcha . Okay . That's helpful . And then just kind of looking through this up , it looks like there were some additional , you know , about $20 million of new loans in the quarter .

[Analyst]: Gotcha. Okay, that's helpful. Just kind of looking through the sup, it looks like there were some additional, about $20 million of new loans in the quarter. Just kind of curious if you could kind of talk us through who that was to, if it's to any of the kind of operators of the assets in transition.

Speaker #10: Just kind of curious if you could kind of talk us through what, you know, who that was to, if it's to any of the kind of operators of the assets in transition.

Speaker #4: There were two loans to operators , one being Insight , and that was for CapEx . And for reopening cost . And then there was a loan to the facility in Pennsylvania .

Edward Aldag: There were two loans to operators, one being Insight Health, and that was for CapEx and for reopening cost. There was a loan to the facility in Pennsylvania, Tenor, and that too was for CapEx.

Speaker #4: Tenor . And that too was for CapEx .

Speaker #10: Gotcha . That's helpful . And then another one from me , eight assets , Stuart , you took back 23 assets , 15 were leased , eight were kind of out there and you kind of , you know , were kind of looking at what ultimately do with those eight assets , including some of the developments .

[Analyst]: Gotcha. That's helpful. Another one for me. The eight assets, Steward, you took back 23 assets. Fifteen were leased, eight were kind of out there. You were kind of looking at what to ultimately do with those eight assets, including some of the developments. Could you just walk us through the status of those eight and what's happening?

Speaker #10: Could you just walk us through kind of the status of those eight and kind of what's happening ?

Edward Aldag: I'm not sure exactly the eight, I guess the two big ones would be the one in Massachusetts, in Norwood, and then the other one in Texas, Texas and Texarkana. Both of those facilities remain under construction. Other than that, about all I can say at this particular point, because of various NDAs, we are in negotiations with people about those facilities.

Speaker #4: I'm not sure exactly the eight . I guess the two big ones would be the one in Massachusetts and Norwood , and then the other one in Texas .

Speaker #4: And Texarkana . Both of those facilities remain under construction . And other than about say at this particular point , because of various NDAs , we we are in negotiations with people about those facilities .

Speaker #11: Gotcha .

[Analyst]: Gotcha. Thank you.

Speaker #10: Thank you .

Speaker #3: I will now turn the call back over to Edward Aldag for closing remarks .

Operator: I will now turn the call back over to Edward K. Aldag Jr. for closing remarks.

Speaker #4: Thank you very much . And thank you all for joining us . As always , if you have any questions , please don't hesitate to reach out to drew and we'll get back with you all I can .

Edward Aldag: Thank you very much, and thank you all for joining us. As always, if you have any questions, please don't hesitate to reach out to Drew, and we'll get back with you.

Operator: Ladies and gentlemen, that concludes today's call. Thank you all for joining. You may now disconnect.