Executive Summary
Medical Properties Trust (0JZZ.L) reported QQ4 2024 revenue of $231.844 million, with an impressive gross margin of 95.78% and a positive operating margin of 33.08%. However, the quarter also featured a substantial net loss of $412.8 million driven by large non-operating charges, notably totalOtherIncomeExpensesNet of approximately $531.4 million, and an elevated interest expense of about $214.9 million. Despite the near-term bottom-line pressure, the company posted positive operating cash flow of $76.7 million and free cash flow of $76.7 million, underscoring ongoing cash generation that can support liquidity and capital deployment. The balance sheet shows a substantial asset base dominated by intangible assets, with total assets of about $14.29 billion and total debt of roughly $8.93 billion, yielding a debt-to-capitalization of ~0.65 and a net debt load of ~$8.60 billion. Cash balances remained robust around $332 million at period-end, providing liquidity to fund capex and selective acquisitions. The quarter’s earnings were helped by a YoY revenue surge (YoY ≈ 289%) and sizable gross profit, yet the bottom line remains pressured by non-cash and non-operating items. Looking ahead, management commentary is not included in the provided transcript, limiting directional guidance; however, the quasi-stable rent base and ongoing portfolio activity suggest potential for earnings leverage if non-operating headwinds abate. Investors should monitor portfolio development, balance-sheet risk, and the timing/miber of new acquisitions, as well as sensitivity to interest rates and cap-rate environments in hospital real estate.
Key Performance Indicators
QoQ: 722.34% | YoY:155.17%
Key Insights
Revenue and profitability overview: Revenue for QQ4 2024 was $231.844 million, up 289.4% YoY and up 2.66% QoQ. Gross profit was $222.064 million, yielding a gross margin of 95.78% (grossProfitMargin). Operating income was $128.619 million, with an operating margin of 33.08%. Net income was a loss of $412.848 million, with a net income margin of -178.07%. Earnings per share (diluted) stood at -$0.69, reflecting the same negative bottom-line trend despite strong gross profitability. EBITDA reporte...
Financial Highlights
Revenue and profitability overview: Revenue for QQ4 2024 was $231.844 million, up 289.4% YoY and up 2.66% QoQ. Gross profit was $222.064 million, yielding a gross margin of 95.78% (grossProfitMargin). Operating income was $128.619 million, with an operating margin of 33.08%. Net income was a loss of $412.848 million, with a net income margin of -178.07%. Earnings per share (diluted) stood at -$0.69, reflecting the same negative bottom-line trend despite strong gross profitability. EBITDA reported as $2.099 billion, with an EBITDAR ratio of ~9.05x, suggesting substantial non-cash or non-operating contributions to EBITDA, though the company also reported significant non-operating expense. The period also featured a heavy totalOtherIncomeExpensesNet of approximately -$531.378 million and interest expense of around -$214.9 million, driving the pre-tax result to about -$402.759 million and contributing to the net loss.
Cash flow and liquidity: Net cash provided by operating activities was $76.687 million. Capital expenditures were $195.488 million, resulting in free cash flow of $76.687 million for QQ4 2024. Net change in cash was $55.426 million, ending cash and cash equivalents at $332.335 million, with total cash at period end reported as $335.173 million. The balance sheet shows total assets of $14.2946 billion and total liabilities of $9.4608 billion, yielding total stockholders’ equity of $4.8327 billion. Net debt stood at $8.5963 billion, with a long-term debt load of $7.7857 billion and a total debt figure of $8.9286 billion, indicating meaningful leverage.
Balance sheet health and leverage: Intangible assets are substantial at $11.2598 billion, contributing to a large asset base with equity of $4.833 billion and a debt-to-capitalization ratio of approximately 0.649. The company’s current liquidity profile is supported by cash balances, but the heavy intangible asset base and high absolute debt levels remain key considerations for solvency and refinancing risk in a rising-rate environment. Valuation metrics show price-to-book around 0.485x and price-to-sales around 10.10x, with a negative trailing P/E due to the reported net loss. Dividend yield is indicated at ~2.06%, but payout appears inconsistent with earnings, reflected by a negative payout ratio in the indicator data.
Notes on sources and comparability: All figures are USD and based on QQ4 2024 results and the accompanying quarterly data set. The earnings transcript is listed as empty, limiting management-quote insights from the conference call. Four-quarters data show a mix of quarter-to-quarter variability, with Q4’24 revenue lower than Q2’24 and Q1’24, suggesting portfolio execution and seasonal effects across the year. || YoY and QoQ comparisons are drawn from the provided incomeMetrics, which report Revenue YoY 289.4%, Gross Profit YoY 276.7%, Operating Income YoY 155.2%, Net Income YoY 37.8%, and EPS YoY 37.8%.
Income Statement
| Metric |
Value |
YoY Change |
QoQ Change |
| Revenue |
231.84M |
289.44% |
2.66% |
| Gross Profit |
222.06M |
276.69% |
0.56% |
| Operating Income |
128.62M |
155.17% |
722.34% |
| Net Income |
-412.85M |
37.82% |
48.47% |
| EPS |
-0.69 |
37.84% |
48.51% |
Key Financial Ratios
operatingProfitMargin
33%
operatingCashFlowPerShare
$0.13
freeCashFlowPerShare
$0.13
dividendPayoutRatio
-11.7%
Management Commentary
Management call transcript not provided in the data set. As a result, no verbatim management quotes or quote-by-theme highlights are available. If a transcript is supplied, we will extract quotes by themes such as strategy, operations, and market conditions, with context and significance.
Forward Guidance
No formal forward guidance appears in the provided data set for QQ4 2024. Given the sector dynamics of real estate (hospitals) and the company’s leverage, investors should consider potential catalysts such as: (i) portfolio accretive acquisitions or divestitures that could shift earnings toward recurring rent income, (ii) stabilization or improvement in operating metrics of hospital tenants, (iii) refinancing activity and debt maturities in a rising-rate environment, and (iv) macro factors affecting healthcare earnings and capital markets. Risks include sustained high leverage, variability in non-operating items that depress net income, and sensitivity to cap rates and occupancy. Management commentary, when available, would be expected to discuss targeted cap rates, rent escalators, portfolio diversification, and capital allocation priorities. In the absence of guidance, a scenario-based approach suggests monitoring quarterly cash flow progression, deleveraging progress, and the pace of acquisitions versus debt maturities.