Financial Data and Key Metrics Changes - The company reported a GAAP net loss of $413 million for Q4 2024 and a normalized FFO of $0.18 per share, with a full-year GAAP net loss of $2.4 billion and normalized FFO of $0.80 per share [38][39] - Impairments and adjustments related to Prospect's Chapter 11 bankruptcy impacted GAAP results, leading to a $415 million adjustment to normalized FFO in the quarter [39] Business Line Data and Key Metrics Changes - The company has seen improvements in hospital fundamentals, with admissions and surgical volumes growing, leading to better coverage across all asset types in the portfolio [21] - New operators added to the portfolio are expected to ramp up cash rent payments to an aggregate quarterly run rate of about $40 million by October 2026 [22][54] Market Data and Key Metrics Changes - In the U.K., private medical insurance utilization has reached an all-time high, benefiting Circle Health and Priory, which reported strong revenue and EBITDARM performance [31][32] - LifePoint Health has shown strong top-line growth driven by increased admissions, with Conemaugh Memorial reporting a 23% year-over-year increase in admissions [34] Company Strategy and Development Direction - The company executed approximately $3 billion in liquidity transactions in 2024, exceeding its $2 billion target, and issued over $2.5 billion in secured bonds to strengthen liquidity [10][11] - The company aims to continue executing its strategy with a focus on generating predictable rent payments and enhancing recoveries from the Prospect bankruptcy [19][14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the business model, emphasizing the need for hospitals to access affordable capital to innovate and serve patients [16] - The company anticipates total annualized cash rent of more than $1 billion once new tenants are fully ramped, with debt maturities covered through 2026 [19] Other Important Information - The company has agreed to provide $25 million in funding to support Prospect during its bankruptcy proceedings, pending court approval [14] - The company has a diverse global portfolio of hospital real estate, which remains attractive to investors and operators [11] Q&A Session Summary Question: Can you provide additional color on Prospect? - The settlement agreement is subject to court approval, and MPT is treated as a secured creditor, with various resolutions being sought for the best financial results [63][64] Question: Are there any other asset sales currently being evaluated? - No other pending sales have been announced, but there are a couple of small sales still pending, totaling well under $100 million [68][70] Question: Are the new tenants cash flow positive before rent? - Most operators are cash flow positive at this point, with cash collections ramping up [74][75] Question: What led to the decline in Accordion Health Services coverage? - The decline is attributed to ongoing healthcare reform in Colombia, not operational issues [86][87] Question: What is the percentage of encumbered versus unencumbered assets? - Approximately $6 billion is encumbered, with the remainder being unencumbered [109] Question: Any expectations about collecting rent from co-off payments? - Significant exposure to co-off is expected to come in March and April [102]

Financial Data and Key Metrics Changes - GAAP net income for the year ended 2024 was $42.7 million or $0.75 per diluted share, compared to $24 million or $0.42 per diluted share for the year ended 2023, indicating significant growth [22] - Cash NOI for the fourth quarter was $41 million, a decrease of 4.3% from $42.8 million in the same period in 2023 [22][23] - AFFO for the fourth quarter was $30.2 million or $0.54 per diluted share, compared to $32.7 million or $0.57 per diluted share during the same period in 2023 [24] Business Line Data and Key Metrics Changes - The company executed renewal leases and lease modifications for over 1.1 million rentable square feet, representing approximately 20% of the total real estate portfolio [15] - The weighted average lease rate increased by 50 basis points to 96% compared to 95.5% at the end of the third quarter [17] - The overall portfolio EBITDARM coverage ratio improved to 5.3 times, with only 1.8% of ABR coming from reporting obligors with EBITDARM coverage ratios below one time [10][18] Market Data and Key Metrics Changes - The company increased exposure to investment grade and rated tenants to 66.9% since the fourth quarter of 2023 [11] - The company noted a lack of new healthcare real estate development, creating a stickier leasing environment [7] - The company is particularly focused on opportunities within the Sunbelt region, also referred to as the "Smile States" [20] Company Strategy and Development Direction - The company aims to enhance the diversity, quality, and size of its healthcare real estate portfolio through strategic acquisitions and capital allocation [7][9] - The company plans to continue executing on its growth strategy in 2025, with a target to grow enterprise value by approximately 7.5% to 15% per annum [33][35] - The company is focused on long-term net lease investments in strategic locations with reliable tenancy sponsorship [35] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the improving credit metrics of tenants and the overall health of the healthcare industry [44] - The company anticipates attractive opportunities in the transaction market, despite a higher interest rate environment [20][21] - Management highlighted the importance of maintaining a strong and low to moderately leveraged balance sheet for future growth [27] Other Important Information - The company successfully resolved all exposure related to Genesis Care by re-leasing or selling all 17 assets owned [12] - The company announced a change in the frequency of distributions to stockholders from monthly to quarterly, effective in 2025 [28] - The company has seen a material change in its shareholder base, becoming more institutionally diversified [13] Q&A Session Summary Question: What is the 2025 guidance? - The company indicated a target to grow the enterprise roughly between 7.5% and 15% per annum, with a focus on disciplined growth and accretive assets [33][35] Question: What is the expected mix between loans and acquisitions in 2025? - The majority of transaction volume is expected to be acquisition fee ownership, with some opportunities in loans to fill gaps in development budgets [36][39] Question: Are there any known credit issues or tenant move-outs? - The company reported only one small tenant left, maintaining a high renewal rate and improving credit metrics across the portfolio [42][44] Question: What drove the timing of the Post Acute Medical lease extension? - The extension was driven by a proactive approach and a strong relationship with the tenant, providing them with more certainty as they grow their business [51][52] Question: What is the outlook for the Stoughton facility? - The company is actively marketing the Stoughton property for sale or lease, with interest in both residential and healthcare uses [60][61] Question: Where are the best acquisition opportunities currently? - The company sees attractive opportunities in inpatient rehab and outpatient medical facilities, as well as potential in micro hospitals and urgent care facilities [62]