Why this could be an isolated case

There's an alternate argument here: The hospitals were worth what MPT said they were, and the issue wasn't the size of the rent. The problem is that Steward's management ran it into the ground until it couldn't pay its bills.

By the numbers: The lease base for the eight Massachusetts hospitals, according to court documents, was $1.67 billion.

• The deal for six of them — remember, two closed — was for $343 million. One of the six is being acquired by the state through eminent domain.
• The total assessed 2024 value for those six hospitals was more than $400 million, meaning in this case the market valued them even less than the government did.
• "When acquiring hospital real estate assets, MPT focuses on identifying characteristics that will appeal to experienced and competent operators. That includes physical asset quality, location, competitive market dynamics, and facility-level operations to determine true community need and, in turn, cash flow potential," an MPT spokesperson told Axios in a statement when asked about the gap between valuations.

The intrigue: MPT argued on its earnings call last month that the eight properties "can be run profitably by other operators, and the recent bidding process validated this belief," and that there had been paths to keeping all eight hospitals open.

• Insight, a Michigan-based health system, made a bid for all eight properties, but it wasn't accepted, the Boston Herald reported last month.
• "The Commonwealth's focus seems to have been on transferring ownership of these hospitals only to in-state, not-for-profit operators and, ultimately, the regulators determine who receives the license to operate these facilities," MPT president and CEO Edward Aldag said. Given this, the company decided to exit the properties.
• The insinuation: Better deals had been available, which means the one that was approved last week may not actually reflect market value.
• For what it's worth, U.S. bankruptcy court Judge Christopher Lopez called the sales approved this week, "the best deal that's on the table," Reuters reports.

On the call, Aldag also defended the use of REITs: "We are deeply concerned that the recent criticism of privately owned healthcare businesses and real estate owned by REITs stems from a misunderstanding that will only damage access to care and employment opportunities for healthcare workers over the long term."

• In a memo posted to its website, MPT argues that Steward's financial problems were unrelated to its rent obligations and that Steward said so itself in its initial bankruptcy filing.

And Steward CEO Ralph de la Torre certainly isn't avoiding controversy.

• He said this week that he won't be testifying before a Senate health committee hearing next week, even after the committee voted to subpoena him.
• In response, committee chair Sen. Bernie Sanders called de la Torre the "poster child for the type of outrageous corporate greed that is permeating through our for-profit health care system," but had plenty of blame to spread around.
• "Working with private equity vultures, he became obscenely wealthy by loading up hospitals across the country with billions in debt and selling the land underneath these hospitals to real estate executives who charge unsustainably high rent," Sanders said.

What we're watching: In its Q2 filing, MPT disclosed how much money is still at stake:

• "We have approximately $2.3 billion in real estate that is expected to be re-leased or sold as part of the ongoing bankruptcy process. We believe these investments are fully recoverable at this time."
• My thought bubble: We'll see!