MPT 2026年第3四半期決算説明会：FFOは0.11ドル、債務リファイナンスと賃料の最新情報

要点

• メディカル・プロパティーズ・トラスト（MPT）が発表した2026年第3四半期のノーマライズドFFOは1株当たり0.11ドルとなり、HSAによる9月分の賃料未払いを除き、経営陣の予想通りの結果となった。
• 年初来の現金ベース収入は7億5,000万ドルを超え、年換算ベースで10億ドル超のペースとなった。不動産売却を実施しているものの、経営陣はポートフォリオ全体で10億ドルを超える現金ベースの賃料収入を維持できると引き続き見込んでいる。
• MPTは8月に24億ドルの担保付き債務のリファイナンスを完了し、約1億2,300万ドルの純ディスカウントを獲得した。このうち7,000万ドルを当四半期の利益として計上した。
• MPTとプライオリー（Priory）は年間賃料の支払い義務を約18％（当初金額で約1,100万ポンド）削減した。改定後の契約には、変動賃料による回収条項と、2055年までリース契約を延長できるMPT主導のオプションが含まれている。
• HSAの賃料支払いの再開時期は依然として不透明である。経営陣によると、8月以降の現金回収額は24％増加しており、オベーション・ヘルスケア（Ovation Healthcare）が病院ポートフォリオ全体の運営管理責任を引き継いでいる。
• MPTはリファイナンス計画の第2段階を進めており、経営陣はこれにより2027年に満期を迎える残りの債務に対応し、2028年6月まで債務の返済期限が存在しなくなる見込みであるとしている。

主要財務データ

事業および業績動向

MPTによると、急性期後ケア（ポスト・アキュート・ケア）がポートフォリオの主な成長推進力であり続け、一般急性期ケアの業績はおおむね安定していた。行動医療の事業者は、人員配置、サービスミックス、紹介体制の最適化に向けた取り組みを継続した。

欧州では、メディアン（Median）が整形外科、心身医学、依存症治療などを中心に高い稼働率を記録し、コスト管理も改善した。サークル・ヘルス（Circle Health）は増収を達成し、患者数は堅調に推移、高い利益率を維持した。

スイス・メディカル・ネットワーク（Swiss Medical Network）は7月のインフラコア（Infracore）IPO後、病院収入が前年同期比で増加し、賃料カバー率は2倍以上となった。スペインでは、アイメッド（IMED）の手術件数がバレンシア施設の約40％増に牽引され、前年同期比で11％以上増加した。アリカンテおよびバルセロナの新病院により、さらに受け入れ能力が拡大する見通しである。

米国では、アーネスト・ヘルス（Ernest Health）が2.5倍の賃料カバー率を維持した。NORは前年同期比で取扱量が増加し、全額契約賃料ベースで2.4倍のカバー率を報告した。同社は契約賃料の50％を延滞なく支払っており、12月には100％の支払いに戻る予定となっている。

HSAは引き続き運営上の重要な懸念事項となっている。経営陣によれば、9月以降の全体の取扱量は14％増加し、手術件数は33％増加した。現金回収額は8月から24％増加したものの、経営陣は賃料支払いの再開日を明言しなかった。米国の500以上の病院を管理するオベーション・ヘルスケア（Ovation Healthcare）が、収益サイクル管理、IT、人員配置、サプライチェーン、その他の業務機能を担うこととなった。

経営見通し

年中約6億ドルの現金収入を得て9物件を売却した後でも、経営陣はポートフォリオ全体の年間現金ベース賃料収入が10億ドルを超えると引き続き見込んでいる。

同社は今後数週間以内に新たな多年期リボルビング信用枠の設定を完了する見込みである。経営陣は、提示された融資枠により担保付きレバレッジ制限条項が廃止され、固定費カバー率および総レバレッジ制限条項の許容範囲（ヘッドルーム）が拡大するとしている。

MPTのリファイナンス計画の第2段階は、リボルビング信用枠の期間延長、2027年6月満期の2億ドルのタームローンの永久返済、および2027年満期の残り6億6,500万ドルの社債のリファイナンスを目的としている。想定通りに完了した場合、経営陣は、約6億ドルの英ポンド建て社債が満期を迎える2028年6月まで、MPTの債務返済期限が発生しないと見込んでいる。

リスクと注視すべき点

HSAは9月分の賃料を支払っておらず、経営陣は回収再開時期を特定できなかった。病院の患者数や現金回収額は改善しているものの、MPTは請求・回収業務を最重要の運営課題として認識している。

プライオリーは、英国国民保健サービス（NHS）の予算制約による圧力を受け続けており、これにより行動医療施設におけるNHS公費負担患者数が制限されている。MPTによる賃料減額は短期的な負担軽減となるが、今後の回復はプライオリーが特定の売上高基準を達成できるかにかかっている。

MPTのリファイナンスの第2段階はまだ完了していない。経営陣は早期の完了を希望する意向を示しているものの、実施時期と構成については引き続き検討中である。

MPTは約2,400万ドルの減損損失を計上した。これは主に8月に発生した同国の地震に伴うコロンビアでの投資案件に関連するものである。

アナリスト質疑応答の要点

HSAに関して、経営陣は病院事業の好転が明確な賃料再開日の決定にはまだ結びついていないと述べた。病院の運営状況が低下するか悪化し続ける場合は、より抜本的なオペレーター変更が検討されることになる。

プライオリーに関して、経営陣はプライオリーとその親会社を含む与信枠組み（クレジット・ペリメーター）が改善したことを強調した。また、MPTは2055年までリース契約を延長する独自の決定権を獲得し、売上が改善した場合には減額した賃料の一部または全部を回収できる権利を得た。

債務削減に関して、経営陣は第2段階のファイナンスによって2027年満期の残存債務に対応する予定であると語った。資産売却で得た現金は、より長期の債務の返済に充てられる可能性があるが、具体的な割り当ては決定していない。

経営陣は、進行中の重要な資産売却はなく、MPTが特定のポートフォリオを積極的に売り出しているわけではないと述べた。ただし、同社が債務の満期延長と削減を継続する中で、単発的な取引が行われる可能性は残されている。

決算説明会 文字起こし全文

決算説明会の完全なトランスクリプト

経営陣による説明

Operator

Hello, everyone. Welcome to the Medical Properties Third Quarter 2026 Earnings Conference Call. [Operator Instructions] After todays' prepared remarks, we will host a question-and-answer session. If you would like to ask a question, please press star one to raise your hand. [Operator Instructions] I will now hand the conference call over to Charles Lambert, Senior Vice President. Charles, please go ahead.

Charles Lambert

Good morning. Welcome to the MPT conference call to discuss our third quarter 2026 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; Rose Williams, Senior Vice President of Operations and Secretary; and Jason Fray, 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 mpt.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.

During the course of this call, we will make projections and certain other statements that may be considered forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our financial results and future events to differ materially from those expressed and/or underlying such forward-looking statements.

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

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, MPT 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 mpt.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.

Edward Aldag

Thank you, Charles, and thank all of you for joining us this morning. Earlier this year, we projected MPT would reach annualized cash rental revenue of at least $1 billion by the end of this year. Year-to-date, we have already collected more than $750 million of cash revenue, which annualizes to more than the $1 billion we projected earlier. .

This reflects the strength of our diverse portfolio of operators around the world. During the year, we've sold 9 properties for cash proceeds of approximately $600 million, and we still hit our target for 2027. Despite these cells, we continue to expect portfolio cash rent above $1 billion.

Now I'd like to address some recent changes at HSA. Many of you are aware that the 2 principles leading HSA have been engaged in a legal dispute that has served as an unfortunate distraction from core hospital operations. With the resolution of this matter and the exit of one of those principles, we now have a new tenant in place that goes by the name of our [indiscernible].

At this time, the hospitals will continue to operate under the HSA game. As we have discussed in the past few quarters, HSA's core challenges remain revenue cycle management. Simply put, these hospitals have not done a good enough job of billing and collecting.

To address these continued challenges, HSA has engaged Ovation Healthcare based in Nashville, Tennessee, to provide management services Ovation manages over 500 hospitals across the U.S. and will immediately take over all aspects of operations across the portfolio, including revenue cycle, IT staffing, supply chain and other areas.

Ovation's immediate focus will be on improving RCM. We are optimistic that Ovation can help HSA to unlock the significant potential of these hospitals. Turning to the U.K., where we have been discussing budget constraints that have adversely impacted the NHS for several quarters now. As a result of these challenges, the NHS has not been able to fully fund the robust demand the country continues to see for vehicle health services.

Recognizing these ongoing dynamics, MPT and Priory have reached an agreement to reduce the annual rental obligations by approximately 18% with the ability for rents to increase as patient volumes recover. As part of this agreement, we added an extension option at MPT's election that effectively extends priority lease by 10 years.

Following our recent asset sales at attractive valuations and the comprehensive steps we have taken to refinance our debt, as Steve will discuss in more detail shortly, we have meaningfully strengthened our balance sheet this year. Additionally, as ROSA will cover, our portfolio consists of more than 50 operators around the world that are well positioned to continue servicing increased global demand for health care services.

As such, we remain confident that our business model is as important today as it has ever been, and we are well positioned to achieve our financial objectives and to create enduring value for our shareholders. Rosa?

Rosa Hooper

Thank you, Ed. Across the portfolio, Coast acute care remains a notable source of momentum general acute performance is broadly stable and operators in behavioral health are taking targeted steps to improve staffing, service mix and referral alignment.

Across Europe, operators are benefiting from strong performance trends. Median delivered another quarter of solid performance, driven by strong occupancy, particularly in orthopedics and psychosomatic and addiction treatment, combined with proved cost management. Circle help continues its strong performance, delivering increased revenue, consistent volumes and robust margins.

Following the successful Infracore IPO in July, Swiss Medical Network reported increasing hospital revenue year-over-year and coverage surpassing 2x, driven by its growing integrated care networks and cost containment initiatives.

Finally, in Spain, AMED is generating notable volume growth with surgeries increasing more than 11% year-over-year led by a nearly 40% increase at IMED alone in Valencia, which is reaching stabilization in its third year of operations. The opening of the new hospitals in Alicante and Barcelona in the coming months will further expand IMD's capacity in attractive Spanish markets.

In the U.S. Ernest Health remains a standout post-acute operator, maintaining a consistent coverage of 2.5x. NOR continues to produce strong earnings with volumes up year-over-year and coverage of 2.4x on full contractual rent. Nor is currently paying 50% of contractual rent as scheduled and with all payments current, and we'll begin paying 100% contractual rent in December.

In summary, we see meaningful momentum across several of our largest investments along with practical operating plans where improvement is needed. The strength of our portfolio's diversity is as evident as it has ever been. Post-acute care remains a clear portfolio differentiator supported by improving coverage and favorable demand. We are also encouraged by early signs of stabilization in behavioral health, while our general acute portfolio generates solid coverage. Together, these trends demonstrate the value of our diversified portfolio. Kevin?

James Hanna

Thank you, Rosa. Today, we reported normalized FFO of $0.11 per share for the third quarter of 2026. The which was in line with our expectations, excel for the nonpayment of September rent from HSA. The $2.4 billion secured debt refinancing transaction that was completed in August included extinguishments of existing unsecured notes at par and other extinguishments of debt below par, capturing an approximate $123 million of net discount.

We recognized $70 million of this discount as a gain in the quarter with the remainder to be recognized through interest expense over the term of the notes. Also in the quarter, we agreed to a rent modification of approximately 11 million pounds annually to Priority. We have incorporated a variable rent component to recapture some or all of that rent and priority were to reach certain revenue hurdles.

We've also effectively extended the lease term by an additional 10 years. The lease will continue to be classified as an operating lease and no material changes expected from a GAAP revenue perspective. As Ed mentioned, we monetized certain assets during the quarter. an aggregate, we recorded $158 million of gains on those transactions.

G&A expense for the quarter was lower year-over-year, primarily driven by stock compensation expense due to the change in fair market value of certain cash settled stock awards. Finally, during the quarter, we incurred approximately $24 million in impairment charges primarily related to our investments in Colombia due to the major earthquake the country suffered in August, with that said, our team has had recent discussions with representatives of the Colombian government, and we are encouraged about the direction and future of our facilities there. Steve?

R. Hamner

Thank you, Kevin. Last quarter, we described a 2-step process for addressing our 2026 and 2027 maturities and reducing our debt. I'll give a brief recap of Step 1, which was completed in early August, and a status report on step 2. In August, we issued $2.4 billion of secured notes to first fully redeem the EUR 500 million of notes due earlier this month, second, redeem about $735 million of the $1.4 billion of notes due next October. And third, exchange about $1 billion of longer-dated notes.

Through this exchange, we captured about $123 million in net discount and Kevin has just described the accounting for that. Step 2 will involve, one, the extension of our multiyear bank revolver two, the permanent repayment of our $200 million term loan due in June 2027 and three, the refinancing of the remaining $665 million in the 2027 notes.

Although Step 2 is not yet completed, I will describe our current progress as of today. We are in the bank market for a new multiyear revolver that we expect to complete in coming weeks. Importantly, we expect that the terms of the new revolver will eliminate the secured leverage financial covenant and provide additional headroom under both the fixed charge coverage covenant and the total leverage financial covenant.

We expect that this new covenant package will provide us with significant flexibility to address longer-dated maturities beyond 2027. We are still considering the appropriate size of the new revolver. But in any case, we will purposefully downsize the current revolver commitment of about $1.3 billion to a level more aligned with our current needs.

By doing so, and freeing up the collateral that currently secures our total roughly $1.5 billion credit facility, along with repaying the $200 million term loan, we will create substantial additional secured financing capacity to further refinance our existing debt, including the 2027 notes that I just mentioned.

We continue to evaluate the timing and structure of that refinancing, but we are eager to get it done sooner than later. However, we decide to allocate this $1.5 billion collateral capacity between a revolver and other secured financing alternatives. We expect the result will be that we have no maturities until June 2028 when about $600 million of sterling bonds are due and that expected position does not contemplate use of the cash we have as of September 30.

That cash gives us flexibility to decide which additional longer-term debt to retire and win. To recap what we have previously reported, we received $600 million in sale proceeds in the second quarter. Third quarter, approximately $140 million from Infracore $170 million from the sale of our minority interest in a U.S. joint venture and $370 million from the sale of 2 Idaho facilities.

Both of the U.S. portfolios transacted at sub-7% cap rate. And as a reminder, since 2022, we have sold hospital real estate for which we paid about $5.6 billion for an aggregate sale price of more than $6.8 billion. And we have collateralized another roughly $3.9 billion in assets at underwritten valuations, similarly in excess of our original investments.

Combined, those transactions reflect about a 23% increase in value over our original undepreciated book values. Our bond indentures provide us with flexibility as well. As of September '30, our unencumbered assets to unsecured debt ratio is more than 180%, reflecting substantial headroom in excess of the 150% covenant.

Headroom created by our August financing. We anticipate that further headroom will be created with the completion of step 2, up to 225%. And and it could increase even further with additional transactions that we are considering. That headroom, together with the additional financial covenant headroom and secured financing capacity we expect to create through our revolver extension. As well as further financing optionality provided under our bond indentures will provide us with additional flexibility to continue deleveraging our balance sheet. With that, we'll open up the call for questions. Jesse?

Operator

[Operator Instructions] Your first question comes from the line of Mike Mueller with JPMorgan. Please go ahead.

質疑応答

Michael Mueller

I'll ask just 2 HSA questions. I'm sure you're going to get a bunch of priority questions. But -- but when do you expect to now resume rent collections for that portfolio? And at what level compared to the last time you were collecting rent? And then the second question would be -- like what would it take to trigger a real plan B here where you're looking at bringing in completely different operators or just something along those.

Edward Aldag

Mike, I think it's important to note that the operations at these hospitals is very strong. and continues to be strong. Let me just give you some points here. The surgeries, the overall volume is up 14% since September. The surgeries themselves are up 33%. They've recently entered to agreement with Miami's largest HMO that has made these hospitals, the preferred hospital network for their members. That should start increasing the patient volumes even further. I know we always focus on the Miami hospitals, but also in Houston. Sam Houston State University has entered into an agreement to begin their residency program at the St. Joseph Hospital Lea Hospital's residency program has now been accepted and will be started in '27.

Both of those 2 items will increase the CMS reimbursement for HSA, so from an operational standpoint, we feel good about the hospitals. Ovation has been in there for about a month, reviewing the situation at the hospitals reviewing the different procedures.

Since since August, the cash collections at HSA has increased 24%. Those are all significant items. So exactly when they'll start paying rent in, I'm not exactly sure. We certainly haven't projected it at this point. But it's not as if there's an issue with the operations at the hospital it literally has been an issue with the billing and the collections. We have a lot of confidence in Ovation's ability to come in and fix that. And was there a second part of the question?

R. Hamner

When might we do something more drastic.

Edward Aldag

Well, if HSAs operations were declining or continuing to decline. That's certainly an item that we would look at doing. .

Operator

Your next question comes from the line of Varel Granite with Bank of America.

Unknown Analyst

This is Andrew Real on for Farrell. I guess, first, just with asset sale proceeds now in hand, could you just speak in a little more detail to how much room they're creating under the secured debt limit? And then should we expect those proceeds to go towards the remaining 27 maturities?

R. Hamner

Well, in the spirit of everything is fungible, we expect the step 2 financings that I just described will address the remaining [ 2027 ] And that leaves cash from asset sales, as I mentioned, for addressing longer-dated maturities beyond the 27 whether it's sequentially just to bring down the 28 sort to spread it across the maturities, we have those -- we have that optionality. But we haven't made any specific determination at this point. .

Unknown Analyst

Okay. And then where does the working capital balance to HSA stand today .

R. Hamner

Our loan to HSA. You said.

Unknown Analyst

Correct .

R. Hamner

About $150 million. .

Operator

Your next question comes from the line of Michael Carroll with RBC Capital Markets.

Unknown Analyst

I guess, Ed or Steve, can you provide some additional color on the priority lease restructuring? Like what did MPT receive in return for the rent cut? I know you mentioned something that MPT can share on the upside when the recovery happens. Is that like some form of percentage rent. And then you said there was an ability to extend the lease termeture option. When does the lease expire now and you can extend it out 10 years from that point?

Edward Aldag

Yes. So Mike, let me -- I'll answer your questions, but let me point out that we have a great deal of confidence in Priority's ability to operate. This truly is in a situation where there's a lack of demand or inability to operate. We believe that priority is absolutely the best operator for these facilities. This is entirely a situation where the U.K. government and obviously, where we're concerned, particularly the NHS as budget constraints and has limited the number of NHS patients in April health facilities. Probably the most important thing that we received out of this is greatly enhancing our financial credit with the parent company priority.

R. Hamner

That's the main thing, Mike, is, as I just mentioned, we have a much improved credit perimeter with Priory and actually its ownership parent. Our ability now is to extend the lease to 2055. That's totally within our discretion. And yes as revenue recovers, whether from NHS or elsewhere, we have the opportunity to recover the foregone rent I think Kevin mentioned starting at 11 million pounds that escalates.

But as revenue recovers, the rent would also recover. And I would point out that in recent weeks, if not months, -- we think we did this at the bottom because revenue is already increasing. We're already seeing improving operations in revenue at Priory.

Unknown Analyst

And then switching over to NOR and HSA. It looks like in the supplemental on the development tab that the budget for the NOR development and some of the HSA developments increased pretty noticeably. specifically at NOR. Can you kind of talk about what drove those increases? I mean did new projects get added to that? Or did the scope of the existing projects just get bigger?

Edward Aldag

Remember that on or the vast majority of that is for a new ET at the largest hospital in that portfolio. And that actually started under the previous owners prospect. Obviously, there's also the continued seismic work that's going on there, but the vast majority of it is the -- that's an important project. It was an important project on a prospect. It got sidelined during the bankruptcy, and it's back in full speed.

Unknown Executive

The -- all that to with that HSA is primarily elevators, boil, chillers, roofs, basic type of situation. The biggest project is the project that we announced a while back, which is the replacement of a parking garage at Haile.

Unknown Analyst

And then just if I can sneak 1 last 1 in there. I guess, Steve, can you talk about I guess, how MPT plans on raising additional capital? I know you talked a little bit about some -- the Phase 2 of the debt refinancing. I mean are there more asset sales on TAP? And at what point do you start thinking about the dividend just given where earnings have been trending with the priority in the HSA situations.

R. Hamner

So as we've discussed below these many quarters now, we continue to have a lot of flexibility, Mike. You mentioned asset sales. There's nothing meaningful pending. We're not in the market for any particular portfolios or assets. I mean there may be a one-off here and there like we've done recently. My point in kind of going through the recent history where we've sold or monetized upwards of $9 billion in assets at significant premiums over our original investment -- what was, in fact, to point out that, that is available.

We continue with the balance sheet restructuring, the extension of maturities and modest reduction of debt to give us longer runway to continue improving operations, including with the HSA situation. So we have options, and we have the luxury of some time before we have to or would consider more drastic alternatives.

Operator

This concludes today's Q&A. I will now turn the call back over to Ed Aldag, CEO, for closing remarks.

Edward Aldag

Thank you, Jesse. And if anybody has any follow-up questions, please don't hesitate to reach out to Charles, and we'll get back with you. So thank you very much. .

Operator

This concludes today's call. Thank you for attending. You may now disconnect.