Birmingham's Medical Properties Trust (NYSE: MPW) has signed to make $1.2 billion in hospital real estate investments, the company announced Monday.

All nine hospitals are owned by Steward Health Care System, an affiliate of Cerberus Capital Management.

The company also announced plans to invest $50 million in equity investment in Steward, which is the largest for-profit hospital system in the Massachusetts market. The agreement includes right of first refusal for Medical Properties Trust to buy more Steward hospitals in the future.

"As a result of our strategic asset sales earlier this year, along with the opportunistic utilization of our ATM program and refinancing of long term debt, MPT has reduced our leverage to among the best in the industry at 5.0 times EBITDA," Edward K. Aldag, Jr., MPT's Chairman, President and CEO, said in a statement. "The successful execution of our strategy has made possible this new relationship with Steward, which represents tremendous opportunity for MPT, as Steward similarly positions itself for rapid growth."

With the purchase, Medical Properties Trust has more than 30 hospital operators. The nine hospitals add about 1,800 bed and brings total hospitals to 248.