# Medical Properties Trust The Birmingham, Alabama hospital REIT (NYSE: MPW; founder/CEO Ed Aldag) that industrialized the sale-leaseback: buy a hospital's real estate, hand the operator cash, and charge rent forever. MPT is the financial mechanism that made the [[Steward Health Care]] catastrophe possible — the load-bearing middle of the extraction machine mapped in [[Private Equity Sector]] and [[Healthcare Industry Ecosystem]]. ## The Steward machine In 2016 MPT put ~$1.25B into Steward: about $600M as a sale-leaseback of hospital real estate, about $600M in mortgage loans, and a $50M equity stake (MPT's release; corrected 2026-10-06 from "up to $1B more committed"). The cash didn't rebuild hospitals: reporting traces a nearly $500M dividend to a [[Cerberus Capital Management]] fund and ~$800M total extracted by Cerberus and CEO Ralph de la Torre in connection with the sales, while the rent obligation hollowed out the operator. Steward filed Chapter 11 in May 2024 (~$9B debt, 31 hospitals); MPT took a $736M loss, settled with the estate in September 2024, and re-leased 15 former Steward hospitals to new operators. The Steward litigation trust's ~$3.4B asset-stripping suit targets de la Torre and Cerberus (MPT's settlement reportedly shields it); the Senate HELP Committee under Bernie Sanders voted 20–0 to recommend contempt after he defied a subpoena, and the full Senate referred him for criminal contempt by unanimous consent on Sept 25, 2024. See [[Steward Health Care]]. ## The pattern beyond Steward Tenant Prospect Medical Holdings followed Steward into Chapter 11 (January 2025). The stock fell from $13+ in 2022 to roughly $4–5 by mid-2026. Short-seller Viceroy Research alleged inflated asset values (the defamation suit MPT filed was dismissed/settled in December 2024). [[Elizabeth Warren]] has pressed DOJ/SEC to investigate, though no formal SEC probe is confirmed. The core question MPT poses for the vault: when hospitals fail, the REIT keeps the land — heads I win, tails the community loses. ## See Also - [[Steward Health Care]] · [[Cerberus Capital Management]] - [[Private Equity Sector]] · [[Healthcare Industry Ecosystem]]