UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

FORM 8-K

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934

Date of report (Date of earliest event reported): February 7, 2019

MEDICAL PROPERTIES TRUST, INC.

(Exact Name of Registrant as Specified in Charter)

Commission File Number 001-32559

Registrant’s telephone number, including area code

(205) 969-3755

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the Registrant under any of the following provisions:

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company  ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

On February 7, 2019, Medical Properties Trust, Inc. issued a press release announcing its financial results for the quarter and year ended December 31, 2018. A copy of the press release is attached as Exhibit 99.1 to this Current Report on Form 8-K and is incorporated herein by reference. The information in this Current Report on Form 8-K, including the information set forth in Exhibit 99.1 and Exhibit 99.2 attached hereto, shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liability of that section or Sections 11 and 12(a)(2) of the Securities Act of 1933, as amended. In addition, this information shall not be deemed incorporated by reference in any filing of Medical Properties Trust, Inc. with the Securities and Exchange Commission, except as expressly set forth by specific reference in any such filing.

(d) Exhibits.

2

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunder duly authorized.

Date: February 7, 2019

3

Exhibit 99.1

MEDICAL PROPERTIES TRUST, INC. REPORTS FOURTH QUARTER RESULTS

Increases Company’s Acquisition Estimates for 2019

And Affirms Previous Earnings Guidance

Birmingham, AL – February 7, 2019 – Medical Properties Trust, Inc. (NYSE: MPW) (the “Company” or “MPT”) today announced financial and operating results for the fourth quarter and year ended December 31, 2018. Per diluted share net income was $0.21 and $2.76, respectively and Normalized Funds from Operations (“NFFO”) was $0.31 and $1.37, respectively.

“We have begun 2019 by immediately executing the growth plans we laid out late last year,” said Edward K. Aldag, Jr., MPT’s Chairman, President and Chief Executive Officer. “Our recently announced agreements to acquire 11 premier hospitals in Australia for approximately $859 million is the first of what we expect to be several major acquisitions in 2019. We have continued growing our acquisition pipeline and look forward to capitalizing on diverse and accretive opportunities through the coming year.”

FOURTH QUARTER AND RECENT HIGHLIGHTS

1

HEALTHSCOPE TRANSACTION

MPT’s pending investments of up to $1.2 billion in 11 Healthscope hospitals are expected to immediately generate rental revenues that strongly exceed the Company’s cost of capital on a per share basis. Such spread is substantially similar to that which the Company has recently achieved in U.S. and European hospital real estate investments.

The acquisition provides MPT and its shareholders with irreplaceable assets in the strongest Australian markets operated by the country’s second largest private hospital operator. Other immediate benefits of the transaction include diversification of both the geographies and tenants in MPT’s portfolio. Australia will be the Company’s third continent and sixth country while Healthscope will become one of MPT’s top five operators by size and rental revenue.

Included in the financial tables accompanying this press release is information about the Company’s assets and liabilities, net income and reconciliations of net income to NFFO, all on a basis comparable to 2017 results. In addition, a reconciliation of pro forma total gross assets to total assets is included in the financial tables accompanying this press release.

OPERATING RESULTS AND OUTLOOK

Net income for the fourth quarter and year ended December 31, 2018 was $78 million ($0.21 per share), and $1.02 billion ($2.76 per share), respectively compared to $72 million ($0.19 per share) and $290 million ($0.82 per share) in the year earlier periods.

NFFO for the fourth quarter and year ended December 31, 2018 was $112 million ($0.31 per share), and $501 million ($1.37 per share), respectively compared to $135 million ($0.37 per share) and $475 million ($1.35 per share) in the year earlier periods.

The Company increased its estimate of 2019 acquisitions from $2.0 billion to $2.5 billion and maintained its estimate of 2019 net income as a range from $1.01 to $1.05 per diluted share and 2019 NFFO as a range from $1.42 to $1.46 per diluted share. A reconciliation of NFFO guidance to net income is included with the financial tables accompanying this press release.

These estimates do not include the effects, if any, of unexpected real estate operating costs, changes in accounting pronouncements, litigation costs, debt refinancing costs, acquisition costs, currency exchange rate movements, interest rate hedging activities, write-offs of straight-line rent or other non-recurring or unplanned transactions. These estimates may change if the Company acquires or sells assets in amounts and at times different from estimates, market interest rates change, debt is refinanced, new shares are issued, additional debt is incurred, other operating expenses vary, income from investments in tenant operations vary from expectations, or existing leases do not perform in accordance with their terms.

2

CONFERENCE CALL AND WEBCAST

The Company has scheduled a conference call and webcast for Thursday, February 7, 2019 at 11:00 a.m. Eastern Time to present the Company’s financial and operating results for the quarter ended December 31, 2018. The dial-in numbers for the conference call are 844-535-3969 (U.S.) and 409-937-8903 (International); both numbers require passcode 2688239. The conference call will also be available via webcast in the Investor Relations’ section of the Company’s website, www.medicalpropertiestrust.com.

A telephone and webcast replay of the call will be available beginning shortly after the call’s completion through February 21, 2019. Dial-in numbers for the replay are 855-859-2056 and 404-537-3406 for U.S. and International callers, respectively. The replay passcode for both U.S. and International callers is 2688239.

The Company’s supplemental information package for the current period will also be available on the Company’s website under the “Investor Relations” section.

About Medical Properties Trust, Inc.

Medical Properties Trust, Inc. is a self-advised real estate investment trust formed to capitalize on the changing trends in healthcare delivery by acquiring and developing net-leased healthcare facilities. MPT’s financing model helps facilitate acquisitions and recapitalizations and allows operators of hospitals and other healthcare facilities to unlock the value of their real estate assets to fund facility improvements, technology upgrades and other investments in operations. Facilities include acute care hospitals, inpatient rehabilitation hospitals, long-term acute care hospitals, and other medical and surgical facilities. For more information, please visit the Company’s website at www.medicalpropertiestrust.com.

The statements in this press release that are forward looking are based on current expectations and actual results or future events may differ materially. Words such as “expects,” “believes,” “anticipates,” “intends,” “will,” “should” and variations of such words and similar expressions are intended to identify such forward-looking statements. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results of the Company or future events to differ materially from those expressed in or underlying such forward-looking statements, including without limitation: the satisfaction of all conditions to, and the timely closing (if at all) of pending transactions; net income per share for 2019; NFFO per share for 2019; resulting financial gains from pending transactions; the amount of acquisitions of healthcare real estate, if any; results from potential sales and joint venture arrangements, if any; capital markets conditions; estimated leverage metrics; the repayment of debt arrangements; statements concerning the additional income to the Company as a result of ownership interests in certain hospital operations and the timing of such income; the payment of future dividends, if any; completion of additional debt arrangements, and additional investments; national and international economic, business, real estate and other market conditions; the competitive environment in which the Company operates; the execution of the Company’s business plan; financing risks; the Company’s ability to maintain its status as a REIT for income tax purposes; acquisition and development risks; potential environmental and other liabilities; and other factors affecting the real estate industry generally or healthcare real estate in particular. For further discussion of the factors that could affect outcomes, please refer to the “Risk factors” section of the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 and as updated by the Company’s subsequently filed Quarterly Reports on Form 10-Q and other SEC filings. Except as otherwise required by the federal securities laws, the Company undertakes no obligation to update the information in this press release.

# # #

3

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Consolidated Balance Sheets

(A) Financials have been derived from the prior year audited financial statements.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Consolidated Statements of Income

(A) Financials have been derived from the prior year audited financial statements.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Reconciliation of Net Income to Funds From Operations

(Unaudited)

Notes:

(A) Certain line items above (such as real estate depreciation) include our share of such income/expense from unconsolidated joint ventures. These amounts are included with the activity of all of our equity interests in the “Other” line on the consolidated statements of income.

(B) Investors and analysts following the real estate industry utilize funds from operations, or FFO, as a supplemental performance measure. FFO, reflecting the assumption that real estate asset values rise or fall with market conditions, principally adjusts for the effects of GAAP depreciation and amortization of real estate assets, which assumes that the value of real estate diminishes predictably over time. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, or NAREIT, which represents net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization and after adjustments for unconsolidated partnerships and joint ventures.

In addition to presenting FFO in accordance with the NAREIT definition, we also disclose normalized FFO, which adjusts FFO for items that relate to unanticipated or non-core events or activities or accounting changes that, if not noted, would make comparison to prior period results and market expectations less meaningful to investors and analysts. We believe that the use of FFO, combined with the required GAAP presentations, improves the understanding of our operating results among investors and the use of normalized FFO makes comparisons of our operating results with prior periods and other companies more meaningful. While FFO and normalized FFO are relevant and widely used supplemental measures of operating and financial performance of REITs, they should not be viewed as a substitute measure of our operating performance since the measures do not reflect either depreciation and amortization costs or the level of capital expenditures and leasing costs necessary to maintain the operating performance of our properties, which can be significant economic costs that could materially impact our results of operations. FFO and normalized FFO should not be considered an alternative to net income (loss) (computed in accordance with GAAP) as indicators of our financial performance or to cash flow from operating activities (computed in accordance with GAAP) as an indicator of our liquidity.

We calculate adjusted funds from operations, or AFFO, by subtracting from or adding to normalized FFO (i) unbilled rent revenue, (ii) non-cash share-based compensation expense, and (iii) amortization of deferred financing costs. AFFO is an operating measurement that we use to analyze our results of operations based on the receipt, rather than the accrual, of our rental revenue and on certain other adjustments. We believe that this is an important measurement because our leases generally have significant contractual escalations of base rents and therefore result in recognition of rental income that is not collected until future periods, and costs that are deferred or are non-cash charges. Our calculation of AFFO may not be comparable to AFFO or similarly titled measures reported by other REITs. AFFO should not be considered as an alternative to net income (calculated pursuant to GAAP) as an indicator of our results of operations or to cash flow from operating activities (calculated pursuant to GAAP) as an indicator of our liquidity.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Fiscal Year 2019 Guidance Reconciliation

(Unaudited)

(Amounts in thousands, except for per share data)

Pro Forma Total Gross Assets

(Unaudited)

Exhibit 99.2

FOURTH QUARTER 2018 Supplemental Information

MEDICALPROPERTIESTRUST.COM TABLE OF CONTENTS COMPANY OVERVIEW Company Information 3 FINANCIAL INFORMATION Reconciliation of Net Income to Funds from Operations 5 Debt Summary 6 Debt Maturity Schedule 7 Pro Forma Net Debt /Annualized Adjusted EBITDA 8 PORTFOLIO INFORMATION Lease and Mortgage Loan Maturity Schedule 9 Total Pro Forma Gross Assets and Actual Revenue by Asset Type, Operator, State and Country 10 EBITDARM to Rent Coverage 13 Summary of Acquisitions and Development Projects 14 FINANCIAL STATEMENTS Consolidated Statements of Income 15 Consolidated Balance Sheets 16 FORWARD-LOOKING STATEMENT Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results of the Company or future events to differ materially from those expressed in or underlying such forward-looking statements, including without limitation: Normalized FFO per share; expected payout ratio, the amount of acquisitions of healthcare real estate, if any; estimated debt metrics, portfolio diversification, capital markets conditions, the repayment of debt arrangements; statements concerning the additional income to the Company as a result of ownership interests in certain hospital operations and the timing of such income; the payment of future dividends, if any; completion of additional debt arrangement, and additional investments; national and international economic, business, real estate and other market conditions; the competitive environment in which the Company operates; the execution of the Company’s business plan; financing risks; the Company’s ability to maintain its status as a REIT for federal income tax purposes; acquisition and development risks; potential environmental and other liabilities; and other factors affecting the real estate industry generally or healthcare real estate in particular. For further discussion of the factors that could affect outcomes, please refer to the “Risk Factors” section of the Company’s Annual Report on Form 10-K for the year ended December 31, 2017, and as updated by the Company’s subsequently filed Quarterly Reports on Form 10-Q and other SEC filings. Except as otherwise required by the federal securities laws, the Company undertakes no obligation to update the information in this report. Certain information in the supplemental package is shown pro forma for the consummation of pending transactions. The pro forma adjustments are based upon available information and assumptions that we believe are reasonable. There is no assurance that the pending transactions will occur. On the Cover: Mountain Vista Medical Center, which is an MPT-owned acute care hospital in Mesa, Arizona. Q4 2018 | SUPPLEMENTAL INFORMATION 2

MEDICALPROPERTIESTRUST.COM COMPANY OVERVIEW Medical Properties Trust, Inc. is a Birmingham, Alabama based self-advised real estate investment trust formed to capitalize on the changing trends in healthcare delivery by acquiring and developing net-leased healthcare facilities. MPT’s financing model allows hospitals and other healthcare facilities to unlock the value of their underlying real estate in order to fund facility improvements, technology upgrades, staff additions and new construction. Facilities include acute care hospitals, inpatient rehabilitation hospitals, long-term acute care hospitals, and other medical and surgical facilities. OFFICERS Edward K. Aldag, Jr. Chairman, President and Chief Executive Officer R. Steven Hamner Executive Vice President and Chief Financial Officer Emmett E. McLean Executive Vice President, Chief Operating Officer and Secretary J. Kevin Hanna Vice President, Controller and Chief Accounting Officer Rosa H. Hooper Vice President, Managing Director of Asset Management and Underwriting Charles R. Lambert Treasurer and Managing Director of Capital Markets BOARD OF DIRECTORS Edward K. Aldag, Jr. G. Steven Dawson R. Steven Hamner Elizabeth N. Pitman D. Paul Sparks, Jr. Michael G. Stewart C. Reynolds Thompson, III CORPORATE HEADQUARTERS Medical Properties Trust, Inc. 1000 Urban Center Drive, Suite 501 Birmingham, AL 35242 (205) 969-3755 MPT Officers: R. Steven Hamner, Emmett E. McLean, Edward K. Aldag, Jr., (205) 969-3756 (fax) Rosa H. Hooper, J. Kevin Hanna and Charles R. Lambert www.medicalpropertiestrust.com Q4 2018 | SUPPLEMENTAL INFORMATION 3

MEDICALPROPERTIESTRUST.COM COMPANY OVERVIEW (continued) INVESTOR RELATIONS CAPITAL MARKETS Tim Berryman Charles Lambert Director—Investor Relations Treasurer and Managing Director—Capital Markets (205) 397-8589 tberryman@medicalpropertiestrust.com (205) 397-8897 clambert@medicalpropertiestrust.com TRANSFER AGENT STOCK EXCHANGE SENIOR UNSECURED American Stock Transfer LISTING AND DEBT RATINGS and Trust Company TRADING SYMBOL Moody’s – Ba1 6201 15th Avenue New York Stock Exchange Standard & Poor’s – BBB-Brooklyn, NY 11219 (NYSE): MPW CONTINUUM OF CARE R E Medical Properties Trust focuses on the most H I G H critical components of healthcare delivery. ACUTE CARE HOSPITALS ACUTE CARE HOSPITALS & FREE STANDING EMERGENCY ROOMS INPATIENT REHABILITATION FACILITIES LONG-TERM ACUTE CARE HOSPITALS NURSING HOMES INPATIENT ASSISTED LIVING REHABILITATION FACILITIES HOME HEALTH CARE MPT facility types shown in green. HOME LONG-TERM HEALTH ACUTE CARE CARE I HOSPITALS N T E ASSISTED N S NURSING LIVING I T HOMES YO FC AR E LOWER Q4 2018 | SUPPLEMENTAL INFORMATION 4

FINANCIAL INFORMATION RECONCILIATION OF NET INCOME TO FUNDS FROM OPERATIONS (Amounts in thousands, except per share data) December 31, 2018 December 31, 2017 December 31, 2018 December 31, 2017FFO INFORMATION: Net income attributable to MPT common stockholders $ 78,483 $ 71,944 $ 10,16,685 $ 2,89,793 Participating securities’ share in earnings (2,877) (1,102) (3,685) (1,409) Net income, less participating securities’ share in earnings $ 75,606 $ 70,842 $ 10,13,000 $ 2,88,384 Depreciation and amortization 39,406 36,815 1,43,720 1,27,559 Loss (gain) on sale of real estate and other, net 1,437 - (6,71,385) (7,431) Funds from operations $ 1,16,449 $ 1,07,657 $ 4,85,335 $ 4,08,512 Write-off of straight-line rent and other 387 4,223 18,002 5,340 Debt refinancing costs - 13,780 - 32,574 Release of income tax valuation allowance (4,405) - (4,405) -Acquisition and other transaction costs, net of tax benefit - 9,103 2,072 28,453 Normalized funds from operations Share-based compensation 4,810 2,801 16,505 9,949 Debt costs amortization 1,991 1,773 7,534 6,521 Straight-line rent revenue and other (30,528) (26,844) (1,05,072) (83,476) Adjusted funds from operations $ 88,704 $ 1,12,493 $ 4,19,971 $ 4,07,873 PER DILUTED SHARE DATA: Net income, less participating securities’ share in earnings $ 0.21 $ 0.19 $ 2.76 $ 0.82 Depreciation and amortization 0.11 0.10 0.39 0.37 Loss (gain) on sale of real estate and other, net - - (1.83) (0.02) Funds from operations $ 0.32 $ 0.29 $ 1.32 $ 1.17 Write-off of straight-line rent and other - 0.01 0.05 0.01 Debt refinancing costs - 0.04 - 0.09 Release of income tax valuation allowance (0.01) - (0.01) - Acquisition and other transaction costs, net of tax benefit - 0.03 0.01 0.08 Normalized funds from operations Share-based compensation 0.01 0.01 0.05 0.03 Debt costs amortization 0.01 0.01 0.02 0.02 Straight-line rent revenue and other (0.09) (0.08) (0.29) (0.24) Adjusted funds from operations $ 0.24 $ 0.31 $ 1.15 $ 1.16 Notes: (A) Certain line items above (such as real estate depreciation) include our share of such income/expense from unconsolidated joint ventures. These amounts are included with the activity of all of our equity interests in the “Other” line on the consolidated statements of income. (B) Investors and analysts following the real estate industry utilize funds from operations, or FFO, as a supplemental performance measure. FFO, reflecting the assumption that real estate asset values rise or fall with market conditions, principally adjusts for the effects of GAAP depreciation and amortization of real estate assets, which assumes that the value of real estate diminishes predictably over time. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, or NAREIT, which represents net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization and after adjustments for unconsolidated partnerships and joint ventures. In addition to presenting FFO in accordance with the NAREIT definition, we also disclose normalized FFO, which adjusts FFO for items that relate to unanticipated or non-core events or activities or accounting changes that, if not noted, would make comparison to prior period results and market expectations less meaningful to investors and analysts. We believe that the use of FFO, combined with the required GAAP presentations, improves the understanding of our operating results among investors and the use of normalized FFO makes comparisons of our operating results with prior periods and other companies more meaningful. While FFO and normalized FFO are relevant and widely used supplemental measures of operating and financial performance of REITs, they should not be viewed as a substitute measure of our operating performance since the measures do not reflect either depreciation and amortization costs or the level of capital expenditures and leasing costs necessary to maintain the operating performance of our properties, which can be significant economic costs that could materially impact our results of operations. FFO and normalized FFO should not be considered an alternative to net income (loss) (computed in accordance with GAAP) as indicators of our financial performance or to cash flow from operating activities (computed in accordance with GAAP) as an indicator of our liquidity. We calculate adjusted funds from operations, or AFFO, by subtracting from or adding to normalized FFO (i) unbilled rent revenue, (ii) non-cash share-based compensation expense, and (iii) amortization of deferred financing costs. AFFO is an operating measurement that we use to analyze our results of operations based on the receipt, rather than the accrual, of our rental revenue and on certain other adjustments. We believe that this is an important measurement because our leases generally have significant contractual escalations of base rents and therefore result in recognition of rental income that is not collected until future periods, and costs that are deferred or are non-cash charges. Our calculation of AFFO may not be comparable to AFFO or similarly titled measures reported by other REITs. AFFO should not be considered as an alternative to net income (calculated pursuant to GAAP) as an indicator of our results of operations or to cash flow from operating activities (calculated pursuant to GAAP) as an indicator of our liquidity.

FINANCIAL INFORMATION DEBT SUMMARY (as of December 31, 2018) ($ amounts in thousands) 2021 Credit Facility Revolver (£22M) (A) Variable 1.980% $ 28,059 2022 Term Loan Variable3.890% 2,00,000 4.000% Notes Due 2022 (€500M) (B) Fixed 4.000% 5,73,350 6.375% Notes Due 2024 Fixed6.375% 5,00,000 5.500% Notes Due 2024 Fixed5.500% 3,00,000 3.325% Notes Due 2025 (€500M) (B) Fixed3.325% 5,73,350 5.250% Notes Due 2026 Fixed5.250% 5,00,000 5.000% Notes Due 2027 Fixed5.000% 14,00,000 $ 40,74,759 Debt issuance costs (37,370) Weighted average rate (A) Represents credit facility borrowings in pound sterling and converted to U.S. dollars at December 31, 2018. (B) Represents bonds issued in euros and converted to U.S. dollars at December 31, 2018.

FINANCIAL INFORMATION DEBT MATURITY SCHEDULE ($ amounts in thousands) 2021 Credit Facility Revolver (£22M) $ — $ — $ 28,059 $ — $ — $ — $ — $ — $ — $ —2021 Credit Facility Revolver (£22M) $ — $ — $ 28,059 $ — $ — $ — $ — $ — $ — - 2022 Term Loan — — — 2,00,000 — — — — — —2022 Term Loan $ — $ — $ — $ 2,00,000 $ — $ — $ — $ — $ — - 4.000% Notes Due 2022 (€500M) — — — 5,73,350 — — — — — —4.000% Notes Due 2022 (€500M) $ — $ — $ — $ 5,73,350 $ — $ — $ — $ — $ — - 6.375% Notes Due 2024 — — — — — 5,00,000 — — — —6.375% Notes Due 2024 $ — $ — $ — $ — $ — $ 5,00,000 $ — $ — $ — - 5.500% Notes Due 2024 — — — — — 3,00,000 — — — —5.500% Notes Due 2024 $ — $ — $ — $ — $ — $ 3,00,000 $ — $ — $ — - 3.325% Notes Due 2025 (€500M) — — — — — — 5,73,350 — — —3.325% Notes Due 2025 (€500M) $ — $ — $ — $ — $ — $ — $ 5,73,350 $ — $ — - 5.250% Notes Due 2026 — — — — — — — 5,00,000 — —5.250% Notes Due 2026 $ — $ — $ — $ — $ — $ — $ — $ 5,00,000 - 5.000% Notes Due 2027 — — — — — — — — 14,00,000 —5.000% Notes Due 2027 $ — $ — $ — $ — $ — $ — $ — $ — 14,00,000 -

FINANCIAL INFORMATION PRO FORMA NET DEBT / ANNUALIZED ADJUSTED EBITDA (Unaudited) (Amounts in thousands) December 31, 2018 Net income attributable to MPT common stockholders $ 78,483 Pro forma adjustments for acquisitions and other â½á´¬â¾ 1,684 Pro forma net income $ 80,167 Add back: Interest (B) 50,712 Depreciation and amortization (B) 39,181 Share-based compensation 4,810 Loss on sale of real estate and other, net 1,437 Impairment and other charges Write-off of straight-line rent and other 387 Income tax benefit (B) (3,433) 4Q 2018 Pro forma adjusted EBITDA $ 1,73,261 Annualization $ 6,93,044 Total debt $ 40,37,389 Pro forma changes to cash and debt balance after December 31, 2018 (A) (10,01,621) Pro forma net debt $ 30,35,768 Pro forma net debt / annualized adjusted EBITDA (A) Reflects our commitment to acquire one facility in Germany along with transactions completed mid-quarter. (B) Includes our share of interest, real estate depreciation and income tax expense from unconsolidated joint ventures. Investors and analysts following the real estate industry utilize net debt (debt less cash) to EBITDA (net income before interest expense, income taxes, depreciation and amortization) as a measurement of leverage that shows how many years it would take for us to pay back our debt, assuming net debt and EBITDA are held constant. The table above considers the pro forma effects on net debt and EBITDA from investments and capital transactions that were either completed during the period or disclosed as firm commitments, assuming such transactions were consummated/fully funded as of the beginning of the period. In addition, we show EBITDA adjusted to exclude stock compensation expense, gains or losses on real estate and other dispositions, debt refinancing charges, and impairment charges to derive Pro forma Annualized Adjusted EBITDA, which is a non-GAAP measure. We believe Pro forma Net Debt and Pro forma Annualized Adjusted EBITDA are useful to investors and analysts as they allow for a more current view of our credit quality and allow for the comparison of our credit strength between periods and to other real estate companies without the effect of items that by their nature are not comparable from period to period.

PORTFOLIO INFORMATION LEASE AND MORTGAGE LOAN MATURITY SCHEDULE (as of December 31, 2018) ($ amounts in thousands) 2019 3 $ 6,481 0.9% 2020 1 2,073 0.3% 2021 1 2,250 0.3% 2022 15 75,138 10.7% 2023 4 13,147 1.9% 2024 2 5,401 0.8% 2025 6 19,933 2.8% 2026 5 25,789 3.7% 2027 1 3,051 0.4% 2028 5 7,155 1.0% 2029 19 48,902 6.9% Thereafter 214 4,96,224 70.3% (A) Lease/Loan expiration is based on the fixed term of the lease/loan and does not factor in potential renewal options provided for in our agreements. (B) Includes all properties, including those that are part of joint ventures, except eight vacant properties representing less than 1.0% of total pro forma gross assets, and three facilities that are under development. The schedule also includes previously disclosed commitments to acquire one facility in Germany and 11 facilities in Australia. (C) Represents base rent/interest income on an annualized basis but does not include tenant recoveries, additional rents and other lease-related adjustments to revenue (i.e., straight-line rents and deferred revenues).

PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ACTUAL REVENUE BY ASSET TYPE (December 31, 2018) ($ amounts in thousands) General Acute Care Hospitals $ 76,34,178 75.9% $ 6,07,506 74.4% Inpatient Rehabilitation Hospitals 16,12,849 16.0% 1,79,456 22.0% Long-Term Acute Care Hospitals 2,82,751 2.8% 29,903 3.6% Other assets 5,28,669 5.3% — - Total Domestic Pro Forma Gross Assets by Asset Type Domestic Actual Revenue by Asset Type Total Pro Forma Gross Assets by Asset Type Total Actual Revenue by Asset Type (A) Represents investment concentration as a percentage of gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all binding real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated February 7, 2019 for reconciliation of total assets to pro forma total gross assets at December 31, 2018. (B) Includes revenue from properties owned through joint venture arrangements.

PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ACTUAL REVENUE BY OPERATOR (December 31, 2018) ($ amounts in thousands) Steward Massachusetts market $ 14,69,423 14.6% $ 1,18,155 14.5% Utah market 10,19,874 10.1% 78,642 9.6% Texas/Arkansas/Louisiana market 6,35,496 6.3% 54,059 6.6% Arizona market 3,12,872 3.1% 27,463 3.4% Florida market 1,96,096 2.0% 13,394 1.6% Ohio/Pennsylvania market 1,89,864 1.9% 17,683 2.2% Prime Healthcare 11,24,711 11.2% 1,27,151 15.6% MEDIAN 10,75,504 10.7% 1,22,197 15.0% Healthscope 8,58,569 8.5% — - LifePoint 5,02,072 5.0% 42,828 5.2% Ernest 5,00,397 5.0% 65,462 8.0% 24 operators 16,44,900 16.3% 1,49,831 18.3% Other assets 5,28,669 5.3% — - Total (A) Represents investment concentration as a percentage of gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all binding real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated February 7, 2019 for reconciliation of total assets to pro forma total gross assets at December 31, 2018. (B) No single facility accounts for more than 3.7% of total pro forma gross assets. (C) Includes revenue from properties owned through joint venture arrangements. Total Pro Forma Gross Assets by Operator Total Actual Revenue by Operator

PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ACTUAL REVENUE BY U.S. STATE AND COUNTRY (December 31, 2018) ($ amounts in thousands) Massachusetts $ 14,69,423 14.6% $ 1,18,155 14.5% Texas 11,26,217 11.2% 1,15,748 14.2% Utah 10,54,539 10.5% 83,335 10.2% California 5,22,753 5.2% 61,059 7.5% Arizona 4,83,778 4.8% 46,724 5.7% 24 Other States 26,30,231 26.1% 2,45,960 30.0% Other assets 4,82,992 4.8% - - United States $ 77,69,933 77.2% $ 6,70,981 82.1% Germany $ 11,64,973 11.6% $ 1,30,465 16.0% Australia 8,58,569 8.5% - - United Kingdom 1,00,823 1.0% 3,813 0.5% Italy 92,683 0.9% 8,060 1.0% Spain 25,789 0.3% 3,546 0.4% Other assets 45,677 0.5% - - International $ 22,88,514 22.8% $ 1,45,884 17.9% Total (A) Represents investment concentration as a percentage of gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all binding real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated February 7, 2019 for reconciliation of total assets to pro forma total gross assets at December 31, 2018. (B) Includes revenue from properties owned through joint venture arrangements.

PORTFOLIO INFORMATION Same Store EBITDARM(1) Rent Coverage YOY and Sequential Quarter Comparisons by Property Type Greater than or equal to 4.50x $ 1,32,869 42.5% 3.00x—4.49x $ 1,18,932 22.3% 1.50x—2.99x $ 78,656 51.5% Less than 1.50x $ 3,197 10.1% Total Master Leased, Cross-Defaulted and/or with Parent Guaranty: 2.9x $ 48,97,185 12993.6% General Acute Master Leased, Cross-Defaulted and/or with Parent Guaranty: 3.4x $ 35,09,458 5167.1% Inpatient Rehabilitation Facilities Master Leased, Cross-Defaulted and/or with Parent Guaranty: 1.9x $ 11,40,405 6521.8% Long-Term Acute Care Hospitals Master Leased, Cross-Defaulted and/or with Parent Guaranty: 1.5x $ 2,47,322 134.7% (1) EBITDARM adjusted for non-recurring items.

PORTFOLIO INFORMATION SUMMARY OF COMPLETED ACQUISITIONS / DEVELOPMENT PROJECTS FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2018 ($ amounts in thousands) Ernest Health Flagstaff, Arizona $ 25,513 01-03-2018 Development MEDIAN Germany 18,797 28-08-2018 Acquisition RCCH Pasco, Washington 17,500 31-08-2018 Acquisition SUMMARY OF CURRENT INVESTMENT COMMITMENTS ($ amounts in thousands) MEDIAN Germany $ 6,596 Acquisition Healthscope Australia 8,58,569 Acquisition SUMMARY OF CURRENT DEVELOPMENT PROJECTS AS OF DECEMBER 31, 2018 ($ amounts in thousands) Circle Health United Kingdom $ 43,288 $ 28,881 Q2 2019 Circle Health Rehabilitation United Kingdom 21,505 9,081 Q3 2019 Surgery Partners Idaho Falls, Idaho 1,13,468 46,210 Q1 2020 (A) Represents £33,940 commitment converted to USD at December 31, 2018. (B) Represents £16,862 commitment converted to USD at December 31, 2018.

FINANCIAL STATEMENTS MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Consolidated Statements of Income (Amounts in thousands, except per share data) December 31, 2018 December 31, 2017December 31, 2018December 31, 2017 (Unaudited) (Unaudited)(Unaudited)(A) REVENUES Rent billed $ 1,04,267 $ 1,24,642 $ 4,73,343 $ 4,35,782 Straight-line rent 25,584 18,907 74,741 65,468 Income from direct financing leases 18,370 19,188 73,983 74,495 Interest and fee income 32,357 42,224 1,62,455 1,29,000 Total revenues 1,80,578 2,04,961 7,84,522 7,04,745 EXPENSES Interest 50,910 56,456 2,23,274 1,76,954 Real estate depreciation and amortization 32,866 36,112 1,33,083 1,25,106 Property-related 2,414 1,811 9,237 5,811 General and administrative 21,734 15,312 80,086 58,599 Acquisition costs — 8,649 917 29,645 Total expenses 1,07,924 1,18,340 4,46,597 3,96,115 OTHER INCOME (EXPENSE) (Loss) gain on sale of real estate and other, net (1,437) — 6,71,385 7,431 Debt refinancing costs — (13,780) — (32,574) Other 3,849 1,433 10,094 10,432 Total other income (expense) 2,412 (12,347) 6,81,479 (14,711) Income before income tax 75,066 74,274 10,19,404 2,93,919 Income tax benefit (expense) 3,875 (1,898) (927) (2,681) Net income 78,941 72,376 10,18,477 2,91,238 Net income attributable to non-controlling interests (458) (432) (1,792) (1,445) Net income attributable to MPT common stockholders EARNINGS PER COMMON SHARE—BASIC Net income attributable to MPT common stockholders EARNINGS PER COMMON SHARE—DILUTED Net income attributable to MPT common stockholders WEIGHTED AVERAGE SHARES OUTSTANDING—BASIC 3,66,655 3,64,382 3,65,364 3,49,902 WEIGHTED AVERAGE SHARES OUTSTANDING—DILUTED 3,67,732 3,64,977 3,66,271 3,50,441 DIVIDENDS DECLARED PER COMMON SHARE $ 0.25 $ 0.24 $ 1.00 $ 0.96 (A) Financials have been derived from the prior year audited financial statements.

FINANCIAL STATEMENTS MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Consolidated Balance Sheets (Amounts in thousands, except per share data) (Unaudited) (A) ASSETS Real estate assets Land, buildings and improvements, intangible lease assets, and other $ 52,68,459 $ 59,44,220 Mortgage loans 12,13,322 17,78,316 Net investment in direct financing leases 6,84,053 6,98,727 Gross investment in real estate assets 71,65,834 84,21,263 Accumulated depreciation and amortization (4,64,984) (4,55,712) Net investment in real estate assets 67,00,850 79,65,551 Cash and cash equivalents 8,20,868 1,71,472 Interest and rent receivables 25,855 78,970 Straight-line rent receivables 2,20,848 1,85,592 Other assets 10,75,222 6,18,703 Total Assets LIABILITIES AND EQUITY Liabilities Debt, net $ 40,37,389 $ 48,98,667 Accounts payable and accrued expenses 2,04,325 2,11,188 Deferred revenue 13,467 18,178 Lease deposits and other obligations to tenants 27,524 57,050 Total Liabilities 42,82,705 51,85,083 Equity Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding — - Common stock, $0.001 par value. Authorized 500,000 shares; issued and outstanding - 370,637 shares at December 31, 2018 and 364,424 shares at December 31, 2017 371 364 Additional paid-in capital 44,42,948 43,33,027 Retained earnings (deficit) 1,62,768 (4,85,932) Accumulated other comprehensive loss (58,202) (26,049) Treasury shares, at cost (777) (777) Total Medical Properties Trust, Inc. Stockholders’ Equity 45,47,108 38,20,633 Non-controlling interests 13,830 14,572 Total Equity 45,60,938 38,35,205 Total Liabilities and Equity (A) Financials have been derived from the prior year audited financial statements.

1000 Urban Center Drive, Suite 501 Birmingham, AL 35242 (205) 969-3755 NYSE: MPW www.medicalpropertiestrust.com Contact: Tim Berryman, Director—Investor Relations (205) 397-8589 or tberryman@medicalpropertiestrust.com or Charles Lambert, Treasurer and Managing Director—Capital Markets (205) 397-8897 or clambert@medicalpropertiestrust.com At the Very heArt of heAlthcAre® .