--- title: "Steward Health Care — Medical Properties Trust and Steward: property, preferred equity and settlement" language: en canonical: https://dossiertwist.com/dossiers/steward-health-care/medical-properties-trust/ as_of: 2026-10-14 keywords: ["Steward Health Care","Cerberus","Medical Properties Trust","Ralph de la Torre","hospital bankruptcy","hospital transactions","CareMax","TRACO","Malta"] --- # Steward Health Care — Medical Properties Trust and Steward: property, preferred equity and settlement **Question.** How did MPT’s property, financing and equity roles differ? **Answer.** MPT was a property and financing counterparty as well as a preferred investor. The September 2024 settlement changed specific leases and claims; it does not erase the historical transactions or resolve every ownership dispute. ## The original property and financing arrangements - Analysis: The 2016 MPT arrangement combined roughly $600 million for real estate sold and leased back at five hospitals, $600 million of mortgage refinancing at four others, and a $50 million equity investment. The retained lease names separate hospital tenants and MPT property companies, with System guaranteeing obligations. Its initial term was fifteen years with three five-year extension options. The rate schedule reached 8% in 2020 and thereafter used annual CPI adjustments bounded by 2% and 5%. [s-d6] [s-d8] [s-d23] [s-d76] [s-d77] [s-d86] [s-d88] [s-d89] - Qualification: The nine facilities were not all sold outright in the same way. Lease base, rent, mortgage principal, equity and accounting yield describe different things. Contractual exclusions from an “Affiliate” definition do not erase an economic connection; an EBITDAR clause allowing certain fees does not prove the fees were actually paid. Citibank is identified as administrative agent, not automatically the sole lender. - Response: MPT described its shareholding as passive, with protective rights rather than management authority. - Outcome: The master leases were subsequently terminated and the parties exchanged releases of the defined claims in the 2024 settlement. These historical documents do not establish current obligations. ## Expansion, hospitals and separate financing measures - Analysis: MPT financing accompanied the 2017 IASIS expansion and later property transactions. The acquisition agreement separated real-estate purchases from a $700 million acquisition loan and subsequent $350 million mortgage loans for each of Davis and Jordan Valley. In July 2020 the two Utah properties were sold to a joint venture and leased back. MPT later described a 50/50 Macquarie partnership for eight Massachusetts properties in March 2022. [s-d8] [s-d14] [s-d23] [s-d77] [s-d90] [s-d148] [s-d228] - Qualification: The real estate investor, operating company, acquisition lender and ultimate parent are distinct capacities. Transaction announcements and conditional letters of intent are not evidence that every contemplated step closed. Historical accounting treatment as financing does not by itself decide whether a transaction was unlawful. - Response: MPT disputed claims of “round-tripping”, saying its IASIS and Tenet purchase payments went directly to those sellers. It announced a 2023 defamation action against its critic; the retained material does not establish that action’s final outcome. ## Preferred units and the disputed percentage - Analysis: A retained investigation contrasted references to about 11% preferred ownership in internal correspondence with MPT’s public 9.9% figure. The same passage explains that the operating agreement capped the preferred interests’ equivalent equity at 9.9%, while the financial statements described 10.98779 preferred units. [s-d8] [s-d90] [s-d148] - Qualification: The record does not justify treating preferred-unit count, common-equivalent economic percentage and voting percentage as the same denominator, or concluding that a REIT threshold was violated from these numbers alone. - Response: MPT’s account was that it remained a passive minority investor with no operating control. A representative of the former chief executive said MPT never owned more than 9.9%. ## What the September 2024 settlement changed - Analysis: The September 2024 global settlement resolved a dispute over hospital-operating value and MPT real estate. The restructuring declaration described potential MPT claims of up to $7.5 billion, including future rent and funded obligations, and expected approximately $395 million for the estates from the Space Coast transaction. MPT’s later filing says the court approved the settlement, the master leases ended, reciprocal claims were released, and no Steward exposure remained on its consolidated balance sheet at 30 September 2024. [s-d75] [s-d86] [s-d171] [s-d278] - Qualification: The $7.5 billion was a description of potential claims at that time, not a new cash payment. MPT’s subsequent filing reports a roughly $440 million Space Coast sale, of which it received about $47 million. These figures measure different allocations and dates. - Response: The parties presented settlement and hospital transitions as preferable to costly, uncertain litigation and continued operating losses. - Outcome: MPT reported $1.6 billion of Steward-related impairment charges for the first nine months of 2024. A later description of MPT as still owed $6.6 billion must be read against the earlier release, rather than repeated as a current balance. ## Sources - [s-d6] Regulatory record concerning Steward or the identified proceeding, U.S. Senator Elizabeth Warren - [s-d8] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d23] Company statement source · s-d23 - [s-d76] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d77] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d86] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d88] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d89] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d14] Company statement source · s-d14 - [s-d90] Company statement concerning Steward or the identified proceeding, U.S. Securities and Exchange Commission - [s-d148] Media source · s-d148 - [s-d228] Company statement source · s-d228 - [s-d75] Company statement source · s-d75 - [s-d171] Company statement source · s-d171 - [s-d278] Company statement source · s-d278