MPT · Real estate(real estate investment trusts) · 10 years of annual accounts filed with the SEC · latest fiscal year ended 2025-12-31
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Medical Properties Trust Inc reported revenue of $972.0 million in fiscal 2025, after growing 6.7% a year over the previous 9 years. Its operating margin narrowed from 63.1% in 2016 to 28.1%, and it earned 2.2% on its invested capital in the latest year. Of the $4.7 billion its operations generated over 10 years, 92.4% went to dividends; the share count rose 130.2%. On the accounting screens, it passes 3 of 8 Piotroski tests; 2 of the six cross-checks between its statements fire.
Revenue, fiscal 2025972.0M+6.7% a year over 9 years
Operating margin28.1%gross margin 90.7%
Return on invested capital2.2%-0.5% on average over 5 years
Free cash flow—
Net debt ÷ EBITDA16.8×net debt 9.2B
Piotroski F-score3/8tests of improvement passed
Is it growing?
Revenue and the operating income it turns into. Growth that does not reach operating income is growth bought with margin.
RevenueOperating income
-2B-1B01B2B
2016Revenue 541.1MOperating income 341.6M
2017Revenue 704.7MOperating income 485.6M
2018Revenue 784.5MOperating income 1.2B
2019Revenue 854.2MOperating income 611.6M
2020Revenue 1.2BOperating income 792.1M
2021Revenue 1.5BOperating income 1.1B
2022Revenue 1.5BOperating income 1.3B
2023Revenue 871.8MOperating income -275.6M
2024Revenue 995.5MOperating income -1.9B
2025Revenue 972.0MOperating income 273.0M
2016201720182019202020212022202320242025
Compound growth a year
3 yrs
5 yrs
9 yrs
Revenue
-14.3%
-4.9%
+6.7%
Operating income
-40.8%
-19.2%
-2.5%
Dividend per share
-34.9%
-21.4%
-10.1%
Shares
+0.1%
+2.5%
+9.7%
Falling shares are buybacks: each remaining share owns more of the company.
Does it earn more than its capital costs?
Margins say how much of each sale is kept; return on invested capital says how much the business earns on the money it needs to operate. Growth only creates value when that return is above the cost of the capital.
GrossOperatingNetFree cash flow
-400%-200%0%200%
2016Operating 63.1%Net 41.6%
2017Operating 68.9%Net 41.1%
2018Gross 89.3%Operating 158.4%Net 129.6%
2019Gross 80.3%Operating 71.6%Net 43.9%
2020Gross 97.6%Operating 63.4%Net 34.5%
2021Gross 93.4%Operating 71.1%Net 42.5%
2022Gross 89.1%Operating 85.5%Net 58.5%
2023Gross 87.4%Operating -31.6%Net -63.8%
2024Gross 92.6%Operating -195.5%Net -242.1%
2025Gross 90.7%Operating 28.1%Net -28.5%
2016201720182019202020212022202320242025
Return on invested capital
Return on invested capital
-20%-10%0%10%20%
2016Return on invested capital 5.4%
2017Return on invested capital 5.5%
2018Return on invested capital 14.5%
2019Return on invested capital 4.3%
2020Return on invested capital 4.6%
2021Return on invested capital 5.0%
2022Return on invested capital 6.6%
2023Return on invested capital -1.9%
2024Return on invested capital -14.5%
2025Return on invested capital 2.2%
2016201720182019202020212022202320242025
Economic profit
Needs a cost of capital, which comes from the valuation below.
Return on equity
-6.0%
Return on assets
-1.8%
Asset turnover
0.06×
Overheads (SG&A)
13.4% of revenue
Is the profit cash, and where does the cash go?
Net income is an accounting opinion; free cash flow is what was left in the bank after investing. Stock-based pay does not leave the bank — shareholders pay it through dilution — so it is shown taken off as well.
Net incomeFree cash flowAfter stock-based pay
-3B-2B-1B01B2B
2016Net income 225.0M
2017Net income 289.8M
2018Net income 1.0B
2019Net income 374.7M
2020Net income 431.4M
2021Net income 656.0M
2022Net income 902.6M
2023Net income -556.5M
2024Net income -2.4B
2025Net income -277.0M
2016201720182019202020212022202320242025
Where 10 years of operating cash went, 2016–2025
4.7B generated by the business. Each band is its share of that total.
Reinvested in the business 0%0
Acquisitions 0%0
Dividends 92%4.4B
Share buybacks 1%41.4M
Kept, or used to pay down debt 7%317.8M
Over the same years it paid 307.2M in stock. The share count rose 130.2%. The buybacks did not even cover what was handed out in stock.
Per share
Earnings per shareFree cash flow per shareDividend per share
-$6-$4-$2$0$2$4
2016Earnings per share $0.86Dividend per share $0.84
2017Earnings per share $0.83Dividend per share $0.93
2018Earnings per share $2.78Dividend per share $0.99
2019Earnings per share $0.87Dividend per share $0.96
2020Earnings per share $0.81Dividend per share $1.07
2021Earnings per share $1.11Dividend per share $1.09
2022Earnings per share $1.51Dividend per share $1.17
2023Earnings per share $-0.93Dividend per share $1.03
2024Earnings per share $-4.02Dividend per share $0.53
2025Earnings per share $-0.46Dividend per share $0.32
2016201720182019202020212022202320242025
Shares outstanding
Diluted shares
200M300M400M500M600M700M
2016Diluted shares 261.1M
2017Diluted shares 350.4M
2018Diluted shares 366.3M
2019Diluted shares 428.3M
2020Diluted shares 530.5M
2021Diluted shares 590.1M
2022Diluted shares 598.8M
2023Diluted shares 598.5M
2024Diluted shares 600.2M
2025Diluted shares 600.9M
2016201720182019202020212022202320242025
Debt and liquidity
Debt is not bad in itself; debt the business cannot service in a bad year is. Net debt is debt minus cash, and below zero the company holds more cash than it owes.
Net debt
05B10B15B
2016Net debt 2.8B
2017Net debt 4.7B
2018Net debt 3.2B
2019Net debt 5.6B
2020Net debt 8.3B
2021Net debt 10.8B
2022Net debt 10.0B
2023Net debt 9.8B
2024Net debt 8.5B
2025Net debt 9.2B
2016201720182019202020212022202320242025
Net debt ÷ EBITDA
16.8×
Interest coverage
1× operating income ÷ interest
Current ratio
— current assets ÷ current liabilities
Cash conversion cycle
—
Three classic screens of the accounts
Each asks a different question of the same statements — is it improving, does it look like a company heading for distress, do the accounts resemble ones that were manipulated. None is a verdict; each shows what moves it.
Piotroski F-score
Is the business improving? Nine yes-or-no tests, this year against last.
3of 8 tests passed
✕ProfitableReturn on assets above zerofailed
✓Cash from operationsOperating cash flow above zeropassed
✓Profitability improvedReturn on assets higher than a year beforepassed
✓Profit backed by cashOperating cash flow above net income (low accruals)passed
✕Less long-term debtLong-term debt as a share of assets fellfailed
–More liquidCurrent ratio higher than a year before — not reportedno data
✕No new sharesShare count did not growfailed
✕Better gross marginGross margin higher than a year beforefailed
✕Sells more per assetAsset turnover higher than a year beforefailed
Where it misleads: it measures change, not level. An excellent business that stood still for a year scores low; a poor one recovering from a disaster scores high.
Altman Z''-score
Does the balance sheet look like those of companies that went bankrupt?
The accounts lack a line it needs (retained earnings, current assets or liabilities).
Beneish M-score
Do the accounts resemble those of companies that manipulated their earnings?
The accounts lack too many of the lines it needs.
Where the statements disagree
Cross-checks between the income statement, the balance sheet and the cash flow for the latest year, each with the benign reading and the worrying one.
The effective tax rate is -16.3%.
Benign
A favourable geographic mix, or legitimate tax credits.
Worrying
Not sustainable; projecting it forward inflates the valuation.
Net debt is 16.8 times EBITDA.
Benign
A stable sector with predictable cash flows and comfortable maturities.
Worrying
Little room if earnings fall; the maturity schedule is what to check.
What is it worth, under which assumptions?
A company is worth the cash it will generate, brought back to today. This model projects revenue with growth that fades over the years, applies a free cash flow margin, and discounts the result at the cost of capital. Every assumption says where it came from, and all of them can be changed.
The SEC accounts lack the lines needed for revenue, free cash flow or the share count, so there is no DCF for this company.
What it has filed lately
The last twelve months at the SEC, most important first: annual and quarterly reports, events, large holders and insiders.
Every Form 4 filed in the last twelve months, read line by line: 6 filings by 5 people. Open-market purchases and sales are counted apart from awards, option exercises and shares withheld for taxes.
Bought on the open market$9,5451 purchase(s) by 1 insider(s)
Sold on the open market—none in the period
Under pre-arranged plans—of the sales followed a 10b5-1 plan set months earlier
A Form 4 says what happened, when, how many shares and at what price. It does not say why: a sale can be diversification, a tax bill or a plan fixed months earlier, and an award is pay, not a purchase. Nothing here is a reason to buy or sell anything.
Which large funds report holding it
From the Form 13F of the 28 institutions followed on this site, as of the end of their last reported quarter. A 13F is filed up to 45 days later and shows only long positions in US-listed shares.
Accounts from the company's own SEC filings; lines some companies do not report are shown as a dash rather than estimated. The risk-free rate is the 10-year US Treasury yield. A DCF is a way of making assumptions explicit, not a forecast: it states what the company would be worth if the assumptions held. The scores are screens that point where to look, not verdicts. Nothing here is a recommendation to buy or sell.
