Medical Properties Trust (NYSE: MPW) has been struggling because of tenant issues, which has made it more difficult for the real estate investment trust (REIT) to manage its large debt load. The hospital owner's largest tenant, Steward Health Care, filed for bankruptcy protection earlier this year. The REIT hopes this process will eventually enable it to completely exit its relationship with that troubled tenant.

Unfortunately, it recently encountered another setback as Steward struggles to sell assets. This latest setback could impact the healthcare REIT. It needs to reduce its exposure to Steward, or else it risks potentially needing to cut its dividend again. Its payout currently yields more than 12%, mainly because of the risks it continues to face.

Steward has been looking for buyers for the 31 hospitals it currently operates and its physicians' group, Stewardship Health. The company had reached a deal to sell Stewardship earlier this year to UnitedHealth affiliate Optum, but that company recently backed out of the acquisition, partly over regulatory concerns. That sale would have been enough to cover its debts to several of its creditors.

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Source Fool.com