WARREN — Steward Health Care System, which operates hospitals in eight states — including Ohio in Trumbull County and Pennsylvania in Mercer County — owed about $50 million in back rent at the end of 2023 to its landlord, according to a press release.

Medical Properties Trust Inc., one of the largest owners of hospital real estate in the world, also states in the release that its management team and advisers have worked closely with the Texas-based health care provider to develop an action plan that includes the “potential sale or re-tenanting of certain hospital operations” and “divestiture of non-core operations.”

Steward Health Care, most notably, locally operates Trumbull Regional Medical Center in Warren and Hillside Rehabilitation Hospital in Howland. In western Pennsylvania, it operates Sharon Regional Medical Center in Sharon.

It’s unclear, however, if any of the local facilities will be impacted by the plan to move forward that, according to the release, will strengthen Steward Health Care’s liquidity and restore its balance sheet, optimize Medical Properties Trust’s ability to recover the unpaid rent and reduce the Birmingham, Alabama-based company’s exposure to Steward Health Care.

An email seeking comment was sent Monday to a spokeswoman at Trumbull Regional Medical Center.

According to the Trumbull County Auditor’s Office, Birmingham, Alabama-based MPT of Warren Steward LLC acquired 25 properties in May 2017 from Warren Ohio Hospital Company LLC for $61.6 million. Among them were Trumbull Regional Medical Center and Steward Health Center on Elm Road.

Records also show MPT of Hillside Steward LLC, also of Birmingham, Alabama, acquired Hillside Rehabilitation Center on Squires Lane in May 2017 for $20.6 million from Warren Ohio Rehab Hospital Company LLC.

The release also states Steward Health Care is seeking a third-party capital partner for its managed care business, net proceeds from which would be used to help repay outstanding obligations to Medical Properties Trust.

The health care company also has “intensified measures to improve collections and overall governance,” the release states.

Medical Properties Trust, “to protect the value” of its assets and hospital operations while Steward moves on its plan, agreed to fund a new $60 million bridge loan and agreed to the deferral of unpaid rent under a master lease agreement as of Dec. 31 “as well as a limited and tapering deferral” of about $55 million in 2024 rents until June 30 or the completion of the anticipated asset sales, whichever comes first, the release states.

Partial cash rent payments are expected to recommence in February, including about $9 million in the first quarter and approximately $44 million in the second quarter, the release states.