8-K
MEDICAL PROPERTIES TRUST INC false 0001287865 0001287865 2021-10-28 2021-10-28

 

 

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): October 28, 2021

 

 

MEDICAL PROPERTIES TRUST, INC.

(Exact Name of Registrant as Specified in Charter)

 

 

Commission File Number 001-32559

 

Maryland   20-0191742
(State or other jurisdiction of
incorporation or organization)
 

(I.R.S. Employer

Identification No.)

 

1000 Urban Center Drive, Suite 501

Birmingham, AL

  35242
(Address of principal executive offices)   (Zip Code)

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:

 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class

 

Trading

Symbol

 

Name of each exchange

on which registered

Common Stock, par value $0.001 per share, of Medical Properties Trust, Inc.   MPW   The New York Stock Exchange

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.  ☐

 

 

 


Item 2.02. Results of Operations and Financial Condition.

On October 28, 2021, Medical Properties Trust, Inc. issued a press release announcing its financial results for the three and nine months ended September 30, 2021. 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.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits.

 

Exhibit
Number

  

Description

99.1    Press release dated October 28, 2021 reporting financial results for the three and nine months ended September 30, 2021
99.2    Medical Properties Trust, Inc. 3rd Quarter 2021 Supplemental Information
104    Cover Page Interactive Data File (embedded within the Inline XBRL document)

 

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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.

 

MEDICAL PROPERTIES TRUST, INC.
By:  

/s/ R. Steven Hamner

Name:   R. Steven Hamner
Title:   Executive Vice President and Chief Financial Officer

Date: October 28, 2021

 

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EX-99.1

Exhibit 99.1

 

LOGO

 

      Contact: Drew Babin, CFA
      Senior Managing Director of Corporate Communications
      Medical Properties Trust, Inc.
      (646) 884-9809
      dbabin@medicalpropertiestrust.com

MEDICAL PROPERTIES TRUST, INC. REPORTS THIRD QUARTER RESULTS

Per Share Net Income of $0.29 and Normalized FFO of $0.44 in Third Quarter

Double-Digit Per Share NFFO and AFFO Growth Year-to-Date in 2021 Versus Prior-Year Period

Announced Transactions Expected to Provide $1.5 Billion in Capital and Reduce Leverage

Birmingham, AL – October 28, 2021 – Medical Properties Trust, Inc. (the “Company” or “MPT”) (NYSE: MPW) today announced financial and operating results for the third quarter ended September 30, 2021, as well as certain events occurring subsequent to quarter end.

 

   

Net income of $0.29 and Normalized Funds from Operations (“NFFO”) of $0.44 for the 2021 third quarter on a per diluted share basis, in line with portfolio run-rate guidance;

 

   

Completed in early August the previously announced sale-leaseback transaction totaling $900 million for five general acute hospitals in South Florida leased to Steward Health Care System (“Steward”);

 

   

In late October:

 

 

Completed the previously announced $760 million sale-leaseback transaction for 18 inpatient behavioral health hospital facilities operated by Springstone, LLC (“Springstone”), as well as a $190 million investment in the operating company;

 

 

Acquired an €18 million cancer treatment and diagnostics center near Porto, Portugal operated by an affiliate of Atrys Health;

 

 

Completed the sales of the Company’s equity interest in the operations of German acute hospital operator ATOS Clinics International and separately of its equity interest in the operations of German post-acute operator MEDIAN Kliniken, both for strong double-digit internal rates of return, further validating MPT’s investing strategies;

 

 

Received full repayment of a short-term £250 million bridge loan extended to the buyer of Priory Group (“Priory”) in January;

 

   

Previously announced agreements and capital markets activity:

 

 

Announced in early September a partnership agreement with Macquarie Infrastructure Partners V (“MIP V”) to own a portfolio of eight Massachusetts-based general acute care hospitals currently owned by MPT and operated by Steward;

 

 

Announced in mid-September an agreement to lease five Utah general acute care hospitals to HCA Healthcare (“HCA”);

 

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Priced in late September €500 million 0.993% senior unsecured notes due 2026 and fully redeemed all outstanding 4.000% senior unsecured notes due 2022;

 

   

Hospital tenants uniformly reporting continued strong operating and financial performance.

“We are delighted to see value creation recognized in our strong portfolio through the recent transactions in Massachusetts and Utah, as well as in Steward as a preeminent operator,” said Edward K. Aldag, Jr., Chairman, President, and Chief Executive Officer. “As I always say, our hospitals are a part of the infrastructure in their communities, but the real importance is in the value of our demonstrated ability to identify and underwrite the full potential of both individual hospitals and regional portfolios.”

Mr. Aldag continued, “We manage our business for long-term shareholder returns, supported by both a dividend well-covered by lease payments from our tenants and consistent growth in per share AFFO, while staying within certain long-term balance sheet parameters. Our shareholders should expect nothing different from us going forward, and we have never felt better about our range of attractive capital options and investment opportunities than we do today.”

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 2020 results, and reconciliations of total assets to total pro forma gross assets and total revenues to total adjusted revenues.

PORTFOLIO UPDATE

During and subsequent to the third quarter, MPT continued to make accretive investments while taking advantage of private capital demand for hospital real estate to realize value creation from within its portfolio.

As described in more detail in the Company’s September 1, 2021 press release, MPT has entered into an agreement with MIP V, an Americas-focused $6.9 billion unlisted infrastructure fund managed by Macquarie Asset Management (“MAM”), pursuant to which a MIP V controlled subsidiary will acquire a 50% interest in a portfolio of eight Massachusetts-based general acute care hospitals currently owned by MPT and operated by Steward. The transaction values the real estate at $1.78 billion based on a 5.6% cash cap rate, a 48% increase versus MPT’s initial cost basis in 2016, and is expected to result in up to $1.3 billion in proceeds to MPT, including new secured debt on the currently unencumbered properties. This transaction, in addition to illustrating growing demand from sophisticated institutional investors for hospital real estate, will reduce MPT’s leverage, provide an attractive cost of equity capital to fund previously announced investments, and contribute to overall portfolio diversification.

In addition, as further depicted in the Company’s September 20, 2021 press release, MPT has entered into an agreement to lease five of its Utah hospitals to HCA with no change to the amount of cash rent currently being collected from current operator Steward. The new 15-year master lease will include five extension options of five years each, cash rental payments increasing at CPI within a collared range of 2.0% to 5.0%, and certain options allowing HCA to purchase the facilities beginning in 2028 or for MPT to sell the facilities to HCA. HCA will become one of MPT’s top-five tenants when the transaction closes in the first half of 2022. Proceeds from the sale will provide Steward with meaningful new liquidity to pursue strategic reinvestment initiatives.

The Company has total pro forma gross assets of approximately $22.1 billion, including $15.9 billion in general acute care hospitals, $2.4 billion in behavioral health facilities, $2.1 billion in inpatient rehabilitation hospitals, $0.3 billion in long-term acute care hospitals, and $0.3 billion in freestanding emergency room and urgent care properties. MPT’s portfolio, pro forma for the transactions described herein, includes roughly 440 properties

 

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and 46,000 licensed beds across the United States and in Germany, the United Kingdom, Switzerland, Italy, Spain, Portugal, Australia, and Colombia. The properties are leased to or mortgaged by 52 hospital operating companies. MPT continues to work with existing and new operators in the U.S. and abroad on numerous opportunities.

OPERATING RESULTS AND OUTLOOK

Net income for the third quarter ended September 30, 2021 was $171 million (or $0.29 per diluted share) compared to $131 million (or $0.25 per diluted share) in the year earlier period.

NFFO for the third quarter ended September 30, 2021 was $263 million ($0.44 per diluted share) compared to $221 million ($0.41 per diluted share) in the year earlier period.

Based on year-to-date transactions, along with an assumed capital structure pro forma for the completion of the partnership with Macquarie and no additional debt or equity transactions (resulting in a net debt to EBITDA ratio of approximately 6.0 times), MPT expects an annual run-rate of $1.16 to $1.20 per diluted share for net income and $1.81 to $1.85 per diluted share for NFFO. Included in the annual run-rate estimate, but not fully included in the actual results for the third quarter, are timing adjustments related to investment and capital markets transactions closed during and subsequent to the quarter, the impact of MPT’s binding agreement to execute the partnership, and the aggregate future earnings contribution from two hospitals under development and various expansion projects where rent has not yet commenced.

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, changes in income tax rates, interest rate hedging activities, write-offs of straight-line rent or other non-recurring or unplanned transactions. Moreover, these estimates do not provide for the impact on MPT or its tenants and borrowers from the global COVID-19 pandemic. These estimates may change if the Company acquires or sells assets in amounts that are different from estimates, market interest rates change, debt is refinanced, new shares are issued, additional debt is incurred, other operating expenses vary, income from equity investments vary from expectations, or existing leases or loans do not perform in accordance with their terms.

CONFERENCE CALL AND WEBCAST

The Company has scheduled a conference call and webcast for Thursday, October 28, 2021 at 11:00 a.m. Eastern Time to present the Company’s financial and operating results for the quarter ended September 30, 2021. The dial-in numbers for the conference call are 844-535-3969 (U.S. and Canada) and 409-937-8903 (International); both numbers require passcode 8966934. 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. The telephone replay will be available through November 11, 2021 using dial-in numbers 855-859-2056 and 404-537-3406 for U.S. and International callers, respectively, and passcode 8966934. The webcast replay will be available for one year following the call’s completion on the Investor Relations section of the company’s website.

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

 

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The Company uses, and intends to continue to use, the Investor Relations page of its website, which can be found at www.medicalpropertiestrust.com, as a means of disclosing material nonpublic information and of complying with its disclosure obligations under Regulation FD, including, without limitation, through the posting of investor presentations that may include material nonpublic information. Accordingly, investors should monitor the Investor Relations page, in addition to following our press releases, SEC filings, public conference calls, presentations and webcasts. The information contained on, or that may be accessed through, our website is not incorporated by reference into, and is not a part of, this document.

About Medical Properties Trust, Inc.

Medical Properties Trust, Inc. is a self-advised real estate investment trust formed in 2003 to acquire and develop net-leased hospital facilities. From its inception in Birmingham, Alabama, the Company has grown to become one of the world’s largest owners of hospitals with roughly 440 facilities and 46,000 licensed beds (on a pro forma basis) in nine countries and across four continents. MPT’s financing model facilitates acquisitions and recapitalizations and allows operators of hospitals to unlock the value of their real estate assets to fund facility improvements, technology upgrades and other investments in operations. For more information, please visit the Company’s website at www.medicalpropertiestrust.com.

This press release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements can generally be identified by the use of forward-looking words such as “may”, “will”, “would”, “could”, “expect”, “intend”, “plan”, “estimate”, “target”, “anticipate”, “believe”, “objectives”, “outlook”, “guidance” or other similar words, and include statements regarding our strategies, objectives, future expansion and development activities, and expected financial performance. Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual results or future events to differ materially from those expressed in or underlying such forward-looking statements, including, but not limited to: (i) the economic, political and social impact of, and uncertainty relating to, the COVID-19 pandemic, including governmental assistance to hospitals and healthcare providers, including certain of our tenants; (ii) the ability of our tenants, operators and borrowers to satisfy their obligations under their respective contractual arrangements with us, especially as a result of the adverse economic impact of the COVID-19 pandemic, and government regulation of hospitals and healthcare providers in connection with same (as further detailed in our Current Report on Form 8-K filed with the SEC on April 8, 2020); (iii) our expectations regarding annual run-rate net income and NFFO per share; (iv) our success in implementing our business strategy and our ability to identify, underwrite, finance, consummate and integrate acquisitions and investments; (v) the nature and extent of our current and future competition; (vi) macroeconomic conditions, such as a disruption of or lack of access to the capital markets or movements in currency exchange rates; (vii) our ability to obtain debt financing on attractive terms or at all, which may adversely impact our ability to pursue acquisition and development opportunities and pay down, refinance, restructure or extend our indebtedness as it becomes due; (viii) increases in our borrowing costs as a result of changes in interest rates and other factors, including the potential phasing out of LIBOR after 2021; (ix) international, national and local economic, real estate and other market conditions, which may negatively impact, among other things, the financial condition of our tenants, lenders and institutions that hold our cash balances, and may expose us to increased risks of default by these parties; (x) factors affecting the real estate industry generally or the healthcare real estate industry in particular; (xi) our ability to maintain our status as a REIT for federal and state income tax purposes; (xii) federal and state healthcare and other regulatory requirements, as well as those in the foreign jurisdictions where we own properties; (xiii) the value of our real estate assets, which may limit our ability to dispose of assets at attractive prices or obtain or maintain equity or debt financing secured by our properties or on an unsecured basis; (xiv) the ability of our tenants and operators to comply with applicable laws, rules and

 

4


regulations in the operation of the our properties, to deliver high-quality services, to attract and retain qualified personnel and to attract patients; (xv) potential environmental contingencies and other liabilities; (xvi) the risk that the Steward Massachusetts partnership transaction and unrelated property sales, loan repayments, and other capital recycling transactions do not occur; and (xvii) the risk that the sale by Steward of its Utah operations to HCA does not occur.

The risks described above are not exhaustive and additional factors could adversely affect our business and financial performance, including the risk factors discussed under the section captioned “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2020 and as updated in our quarterly reports on Form 10-Q. Forward-looking statements are inherently uncertain and actual performance or outcomes may vary materially from any forward-looking statements and the assumptions on which those statements are based. Readers are cautioned to not place undue reliance on forward-looking statements as predictions of future events. We disclaim any responsibility to update such forward-looking statements, which speak only as of the date on which they were made.

# # #

 

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MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES    

Consolidated Balance Sheets    

 

(Amounts in thousands, except for per share data)    September 30, 2021     December 31, 2020  
     (Unaudited)     (A)  

Assets

    

Real estate assets

    

Land, buildings and improvements, intangible lease assets, and other

   $ 13,244,403     $ 12,078,927  

Investment in financing leases

     2,042,585       2,010,922  

Real estate held for sale

     1,096,475       —    

Mortgage loans

     200,285       248,080  
  

 

 

   

 

 

 

Gross investment in real estate assets

     16,583,748       14,337,929  

Accumulated depreciation and amortization

     (936,289     (833,529
  

 

 

   

 

 

 

Net investment in real estate assets

     15,647,459       13,504,400  

Cash and cash equivalents

     349,652       549,884  

Interest and rent receivables

     64,622       46,208  

Straight-line rent receivables

     661,429       490,462  

Equity investments

     1,170,171       1,123,623  

Other loans

     1,502,677       858,368  

Other assets

     315,977       256,069  
  

 

 

   

 

 

 

Total Assets

   $ 19,711,987     $ 16,829,014  
  

 

 

   

 

 

 

Liabilities and Equity

    

Liabilities

    

Debt, net

   $ 10,581,023     $ 8,865,458  

Accounts payable and accrued expenses

     595,003       438,750  

Deferred revenue

     19,739       36,177  

Obligations to tenants and other lease liabilities

     157,488       144,772  
  

 

 

   

 

 

 

Total Liabilities

     11,353,253       9,485,157  

Equity

    

Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding

     —         —    

Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 596,145 shares at September 30, 2021 and 541,419 shares at December 31, 2020

     596       541  

Additional paid-in capital

     8,541,092       7,461,503  

Distributions in excess of net income

     (117,733     (71,411

Accumulated other comprehensive loss

     (69,843     (51,324

Treasury shares, at cost

     (777     (777
  

 

 

   

 

 

 

Total Medical Properties Trust, Inc. Stockholders’ Equity

     8,353,335       7,338,532  

Non-controlling interests

     5,399       5,325  
  

 

 

   

 

 

 

Total Equity

     8,358,734       7,343,857  
  

 

 

   

 

 

 

Total Liabilities and Equity

   $ 19,711,987     $ 16,829,014  
  

 

 

   

 

 

 

 

(A)

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


MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Consolidated Statements of Income

(Unaudited)

 

(Amounts in thousands, except for per share data)    For the Three Months Ended     For the Nine Months Ended  
     September 30, 2021     September 30, 2020     September 30, 2021     September 30, 2020  

Revenues

        

Rent billed

   $ 242,211     $ 192,953     $ 672,425     $ 538,277  

Straight-line rent

     64,637       51,125       174,975       103,697  

Income from financing leases

     50,667       52,544       151,898       157,469  

Interest and other income

     33,264       32,836       136,038       115,989  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total revenues

     390,779       329,458       1,135,336       915,432  

Expenses

        

Interest

     94,132       82,263       273,409       243,538  

Real estate depreciation and amortization

     85,039       69,665       237,050       192,049  

Property-related (A)

     7,128       5,897       31,265       19,178  

General and administrative

     36,694       31,718       107,312       97,121  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     222,993       189,543       649,036       551,886  

Other income (expense)

        

Gain (loss) on sale of real estate

     9,294       (927     8,896       (2,703

Real estate impairment charges

     —         —         —         (19,006

Earnings from equity interests

     7,193       5,893       21,633       15,263  

Debt refinancing and unutilized financing costs

     —         —         (2,339     (611

Other (including mark-to-market adjustments on equity securities)

     (2,276     2,461       4,747       (9,499
  

 

 

   

 

 

   

 

 

   

 

 

 

Total other income (expense)

     14,211       7,427       32,937       (16,556
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax

     181,997       147,342       519,237       346,990  

Income tax expense

     (10,602     (15,985     (69,141     (24,824
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     171,395       131,357       450,096       322,166  

Net income attributable to non-controlling interests

     (258     (251     (611     (600
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to MPT common stockholders

   $ 171,137     $ 131,106     $ 449,485     $ 321,566  
  

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per common share - basic and diluted:

        

Net income attributable to MPT common stockholders

   $ 0.29     $ 0.25     $ 0.76     $ 0.61  
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average shares outstanding - basic

     595,119       531,095       586,291       526,651  

Weighted average shares outstanding - diluted

     597,320       532,436       587,971       527,832  

Dividends declared per common share

   $ 0.28     $ 0.27     $ 0.84     $ 0.81  

 

(A)

Includes $4.0 million and $23.1 million of ground lease and other expenses (such as property taxes and insurance) paid directly by us and reimbursed by our tenants for the three and nine months ended September 30, 2021, respectively.


MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Reconciliation of Net Income to Funds From Operations

(Unaudited)

 

(Amounts in thousands, except for per share data)    For the Three Months Ended     For the Nine Months Ended  
     September 30, 2021     September 30, 2020     September 30, 2021     September 30, 2020  

FFO information:

        

Net income attributable to MPT common stockholders

   $ 171,137     $ 131,106     $ 449,485     $ 321,566  

Participating securities’ share in earnings

     (328     (435     (1,088     (1,386
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income, less participating securities’ share in earnings

   $ 170,809     $ 130,671     $ 448,397     $ 320,180  

Depreciation and amortization

     98,492       80,841       277,089       223,166  

(Gain) loss on sale of real estate

     (9,294     927       (8,896     2,703  

Real estate impairment charges

     —         —         —         19,006  
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 260,007     $ 212,439     $ 716,590     $ 565,055  

Write-off (recovery) of straight-line rent and other

     3,650       1,266       (1,601     27,098  

Non-cash fair value adjustments

     (819     (1,575     (2,763     9,030  

Tax rate and other changes

     —         8,535       42,746       9,661  

Debt refinancing and unutilized financing costs

     —         —         2,339       611  
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 262,838     $ 220,665     $ 757,311     $ 611,455  

Share-based compensation

     13,555       12,372       38,590       34,600  

Debt costs amortization

     4,584       3,552       12,693       10,389  

Rent deferral, net

     559       (5,420     2,198       (12,660

Straight-line rent revenue and other

     (79,973     (66,554     (215,169     (167,028
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 201,563     $ 164,615     $ 595,623     $ 476,756  
  

 

 

   

 

 

   

 

 

   

 

 

 

Per diluted share data:

        

Net income, less participating securities’ share in earnings

   $ 0.29     $ 0.25     $ 0.76     $ 0.61  

Depreciation and amortization

     0.17       0.15       0.48       0.42  

(Gain) loss on sale of real estate

     (0.02     —         (0.02     0.01  

Real estate impairment charges

     —         —         —         0.03  
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 0.44     $ 0.40     $ 1.22     $ 1.07  

Write-off (recovery) of straight-line rent and other

     —         —         —         0.05  

Non-cash fair value adjustments

     —         —         —         0.02  

Tax rate and other changes

     —         0.01       0.07       0.02  

Debt refinancing and unutilized financing costs

     —         —         —         —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 0.44     $ 0.41     $ 1.29     $ 1.16  

Share-based compensation

     0.02       0.02       0.07       0.06  

Debt costs amortization

     0.01       0.01       0.02       0.02  

Rent deferral, net

     —         (0.01     —         (0.02

Straight-line rent revenue and other

     (0.13     (0.12     (0.37     (0.32
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 0.34     $ 0.31     $ 1.01     $ 0.90  
  

 

 

   

 

 

   

 

 

   

 

 

 

Notes:

 

(A)

Certain line items above (such as depreciation and amortization) 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 “Earnings from equity interests” 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 results of operations 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) non-cash 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

Annual Run-Rate Guidance Reconciliation

(Unaudited)

 

     Annual Run-Rate Guidance - Per Share(1)  
     Low      High  

Net income attributable to MPT common stockholders

   $ 1.16      $ 1.20  

Participating securities’ share in earnings

     —          —    
  

 

 

    

 

 

 

Net income, less participating securities’ share in earnings

   $ 1.16      $ 1.20  

Depreciation and amortization

     0.65        0.65  
  

 

 

    

 

 

 

Funds from operations

   $ 1.81      $ 1.85  

Other adjustments

     —          —    
  

 

 

    

 

 

 

Normalized funds from operations

   $ 1.81      $ 1.85  
  

 

 

    

 

 

 

 

(1)

The guidance is based on current expectations and actual results or future events may differ materially from those expressed in this table, which is a forward-looking statement within the meaning of the federal securities laws. Please refer to the forward-looking statement included in this press release and our filings with the Securities and Exchange Commission for a discussion of risk factors that affect our performance.

Total Pro Forma Gross Assets

(Unaudited)

 

(Amounts in thousands)    September 30, 2021     December 31, 2020  

Total Assets

   $ 19,711,987     $ 16,829,014  

Add:

    

Real estate commitments on new investments(1)

     990,002       1,901,087  

Unfunded amounts on development deals and commenced

    

capital improvement projects(2)

     180,529       166,258  

Accumulated depreciation and amortization

     936,289       833,529  

Incremental gross assets of our joint ventures and other(3)

     1,752,842       1,287,077  

Less:

    

Cash used for funding the transactions above(4)

     (1,445,329     (587,384
  

 

 

   

 

 

 

Total Pro Forma Gross Assets(5)

   $ 22,126,320     $ 20,429,581  
  

 

 

   

 

 

 

 

(1)

The 2021 column reflects investments made or committed to subsequent to September 30, 2021, including the commitment to invest $950 million in a behavioral health platform across nine states and the commitment to acquire one facility in Portugal for €18 million. The 2020 column reflects investments made in 2021, including the acquisition of 35 facilities in the United Kingdom on January 19, 2021.

(2)

Includes $31.1 million and $65.5 million of unfunded amounts on ongoing development projects and $149.4 million and $100.8 million of unfunded amounts on capital improvement projects, as of September 30, 2021 and December 31, 2020, respectively.

(3)

Adjustment to reflect our share of our joint ventures’ gross assets.

(4)

Includes cash available on-hand plus cash generated from activities subsequent to period-end including loan repayments or dispositions, if any.

(5)

Total pro forma gross assets is total assets before accumulated depreciation/amortization and assumes all real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded using cash on hand (if available). We believe pro forma total gross assets is useful to investors as it provides a more current view of our portfolio and allows for a better understanding of our concentration levels as our commitments close and our other commitments are fully funded.

Adjusted Revenues

(Unaudited)

 

(Amounts in thousands)    For the Three Months Ended
September 30, 2021
 

Total Revenues

   $ 390,779  

Revenue from real estate properties owned through joint venture arrangements

     33,129  
  

 

 

 

Total Adjusted Revenues(1)

   $ 423,908  
  

 

 

 

 

(1)

Adjusted revenues are total revenues adjusted for our pro rata portion of similar revenues in our real estate joint venture arrangements. We believe adjusted revenue is useful to investors as it provides a more complete view of revenue across all of our investments and allows for better understanding of our revenue concentration.

EX-99.2

Exhibit 99.2

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Medical Properties Trust SUPPLEMENTAL Q3


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3 COMPANY OVERVIEW Company Information 3 FINANCIAL INFORMATION Reconciliation of Net Income to Funds from Operations 6 6 Debt Summary 7 Debt Maturity Schedule 8 Pro Forma Net Debt /Annualized Adjusted

EBITDA 9 PORTFOLIO INFORMATION Pro Forma Lease and Loan Maturity Schedule 10 10 Total Pro Forma Gross Assets and Adjusted Revenue by Asset Type, Operator, State and Country 11 EBITDARM to Rent Coverage 14 Summary of Investments and Development Projects 15 FINANCIAL STATEMENTS Consolidated Statements of Income 16 16 Consolidated Balance Sheets 17 Unconsolidated Joint Venture Investments 18 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: 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 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 federal income tax purposes; acquisition and development risks; potential environmental and other liabilities; potential impact from COVID-19 on our tenants/borrowers and the related impact to us; and other factors affecting the real estate industry generally or health-care 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, 2020, 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 transactions completed subsequent to period end and the consummation of pending transactions, including the Steward Massachusetts partnership and leasing five facilities in Utah to a new tenant. 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. Mountain Point Medical Center is an acute care facility located in Ogden, Utah


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COMPANY OVERVIEW Medical Properties Trust, Inc. is a self-advised real estate investment trust formed in 2003 to acquire and develop net-leased hospital facilities. From its inception in Birmingham, Alabama, the Company has grown to become one of the world’s largest owners of hospitals. MPT’s financing model facilitates acquisitions and recapitalizations and allows operators of hospitals to unlock the value of their real estate assets to fund facility improvements, technology upgrades and other investments in operations. Pro Forma as of September 30, 2021. 444 52 ~46,000 32 9 properties operators beds U. S. states countries MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 3


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COMPANY OVERVIEW MPT OFFICERS: From the Left: Charles R. Lambert, Rosa H. Hooper, R. Lucas Savage, Edward K. Aldag, Jr., R. Steven Hamner, Emmett E. McLean and J. Kevin Hanna. 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 R. Lucas Savage Vice President, Head of Global Acquisitions Charles R. Lambert Vice President, Treasurer and Managing Director of Capital Markets Board of Directors Edward K. Aldag, Jr. G. Steven Dawson R. Steven Hamner Caterina A. Mozingo 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 (205) 969-3756 (fax) www.medicalpropertiestrust.com MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 4


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COMPANY OVERVIEW INVESTOR RELATIONS Drew Babin Senior Managing Director of Corporate Communications (646) 884-9809 dbabin@medicalpropertiestrust.com Tim Berryman Managing Director of Investor Relations (205) 397-8589 tberryman@medicalpropertiestrust.com Transfer Agent American Stock Transfer and Trust Company 6201 15th Avenue Brooklyn, NY 11219 Stock Exchange Listing and Trading Symbol New York Stock Exchange (NYSE): MPW MPW LISTED NYSE Senior Unsecured Debt Ratings Moody’s – Ba1 Standard & Poor’s – BBB- Above: Crozer-Chester Medical Center in Upland, Pennsylvania. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 5


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FINANCIAL INFORMATION RECONCILIATION OF NET INCOME TO FUNDS FROM OPERATIONS (Unaudited) (Amounts in thousands, except per share data) FFO INFORMATION: Net income attributable to MPT common stockholders Participating securities’ share in earnings Net income, less participating securities’ share in earnings Depreciation and amortization (Gain) loss on sale of real estate Real estate impairment charges Funds from operations Write-off (recovery) of straight-line rent and other Non-cash fair value adjustments Tax rate and other changes Debt refinancing and unutilized financing costs Normalized funds from operations Share-based compensation Debt costs amortization Rent deferral, net Straight-line rent revenue and other Adjusted funds from operations PER DILUTED SHARE DATA: Net income, less participating securities’ share in earnings Depreciation and amortization (Gain) loss on sale of real estate Real estate impairment charges Funds from operations Write-off (recovery) of straight-line rent and other Non-cash fair value adjustments Tax rate and other changes Debt refinancing and unutilized financing costs Normalized funds from operations Share-based compensation Debt costs amortization Rent deferral, net Straight-line rent revenue and other Adjusted funds from operations For the Three Months Ended For the Nine Months Ended September 30, 2021 September 30, 2020 September 30, 2021 September 30, 2020 $ 171,137 $ 131,106 $ 449,485 $ 321,566 (328) (435) (1,088) (1,386) $ 170,809 $ 130,671 $ 448,397 $ 320,180 98,492 80,841 277,089 223,166 (9,294) 927 (8,896) 2,703 — — — 19,006 $ 260,007 $ 212,439 $ 716,590 $ 565,055 3,650 1,266 (1,601) 27,098 (819) (1,575) (2,763) 9,030 — 8,535 42,746 9,661 — — 2,339 611 $ 262,838 $ 220,665 $ 757,311 $ 611,455 13,555 12,372 38,590 34,600 4,584 3,552 12,693 10,389 559 (5,420) 2,198 (12,660) (79,973) (66,554) (215,169) (167,028) $ 201,563 $ 164,615 $ 595,623 $ 476,756 $ 0.29 $ 0.25 $ 0.76 $ 0.61 0.17 0.15 0.48 0.42 (0.02) — (0.02) 0.01 — — — 0.03 $ 0.44 $ 0.40 $ 1.22 $ 1.07 — — — 0.05 — — — 0.02 — 0.01 0.07 0.02 — — — -$ 0.44 $ 0.41 $ 1.29 $ 1.16 0.02 0.02 0.07 0.06 0.01 0.01 0.02 0.02 — (0.01) — (0.02) (0.13) (0.12) (0.37) (0.32) $ 0.34 $ 0.31 $ 1.01 $ 0.90 Notes: (A) Certain line items above (such as depreciation and amortization) 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 “Earnings from equity interests” 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 results of operations 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) non-cash 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 | SUPPLEMENTAL INFORMATION | Q3 2021 6


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FINANCIAL INFORMATION DEBT SUMMARY (As of September 30, 2021) ($ amounts in thousands) Debt Instrument Rate Type Rate Balance 2024 Credit Facility Revolver (A) Variable 1.257% $ 245,227 2022 Interim Loan Variable 1.340% 650,000 2026 Term Loan Variable 1.540% 200,000 4.000% Notes Due 2022 (€500M) (A) (B) Fixed 4.000% 579,000 2.550% Notes Due 2023 (£400M) (A) Fixed 2.550% 538,960 2024 AUD Term Loan (A$1.2B) (A) Fixed (C) 2.450% 867,240 3.325% Notes Due 2025 (€500M) (A) Fixed 3.325% 579,000 2025 GBP Term Loan (£700M) (A) Fixed (D) 1.949% 943,180 5.250% Notes Due 2026 Fixed 5.250% 500,000 2.500% Notes Due 2026 (£500M) (A) Fixed 2.500% 673,700 5.000% Notes Due 2027 Fixed 5.000% 1,400,000 3.692% Notes Due 2028 (£600M) (A) Fixed 3.692% 808,440 4.625% Notes Due 2029 Fixed 4.625% 900,000 3.375% Notes Due 2030 (£350M) (A) Fixed 3.375% 471,590 3.500% Notes Due 2031 Fixed 3.500% 1,300,000 $ 10,656,337 Debt issuance costs and discount (75,314) Weighted average rate 3.347% $ 10,581,023 RATE TYPE AS PERCENTAGE OF TOTAL DEBT Variable 10.3% Fixed 89.7% (A) Non-USD denominated debt converted to U.S. dollars at September 30, 2021. (B) The 4.000% Euro Notes Due 2022 were redeemed on October 22, 2021. On October 6, 2021, the Company issued €500M of 0.993% Notes Due 2026. (C) We entered into an interest rate swap transaction, effective July 3, 2019, to fix the interest rate to 2.450% for the duration of the loan. (D) We entered into an interest rate swap transaction, effective March 6, 2020, to fix the interest rate to 1.949% for the duration of the loan. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 7


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FINANCIAL INFORMATION DEBT MATURITY SCHEDULE ($ amounts in thousands) Debt Instrument 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2024 Credit Facility Revolver (A) $ —$ —$ —$ 245,227 $ —$ —$ —$ —$ —$ —$ -2022 Interim Loan — 650,000 — — — — — — — — -2026 Term Loan — — — — — 200,000 — — — — - 4.000% Notes Due 2022 (€500M) (A) (B) — 579,000 — — — — — — — — - 2.550% Notes Due 2023 (£400M) (A) — — 538,960 — — — — — — — -2024 AUD Term Loan (A$1.2B) (A) — — — 867,240 — — — — — — - 3.325% Notes Due 2025 (€500M) (A) — — — — 579,000 — — — — — -2025 GBP Term Loan (£700M) (A) — — — — 943,180 — — — — — - 5.250% Notes Due 2026 — — — — — 500,000 — — — — - 2.500% Notes Due 2026 (£500M) (A) — — — — — 673,700 — — — — - 5.000% Notes Due 2027 — — — — — — 1,400,000 — — — - 3.692% Notes Due 2028 (£600M) (A) — — — — — — — 808,440 — — - 4.625% Notes Due 2029 — — — — — — — — 900,000 — - 3.375% Notes Due 2030 (£350M) (A) — — — — — — — — — 471,590 - 3.500% Notes Due 2031 — — — — — — — — — — 1,300,000 $ —$1,229,000 $ 538,960 $1,112,467 $1,522,180 $1,373,700 $1,400,000 $ 808,440 $ 900,000 $ 471,590 $1,300,000 (A) Non-USD denominated debt converte to U.S. dollars at September 30, 2021. (B) The 4.000% Euro Notes Due 2022 wer edeemed on October 22, 2021. On October 6, 2021, the Company issued €500M of 0.993% Notes Due 2026. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 8


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FINANCIAL INFORMATION PRO FORMA NET DEBT / ANNUALIZED ADJUSTED EBITDA (Unaudited) (Amounts in thousands) For the Three Months Ended September 30, 2021 Net income attributable to MPT common stockholders $ 171,137 Pro forma adjustments for investment activity (A) 774 Pro forma net income $ 171,911 Add back: Interest (B) 92,062 Depreciation and amortization (B) 96,394 Share-based compensation 13,555 Gain on sale of real estate (9,294) Write-off (recovery) of straight-line rent and other 3,650 Non-cash fair value adjustments (819) Income tax (B) 11,516 3Q 2021 Pro forma adjusted EBITDA $ 378,975 Annualization $ 1,515,900 Total debt at September 30, 2021 $ 10,581,023 Pro forma changes after September 30, 2021 (1,018,742) Pro forma net debt $ 9,562,281 Pro forma net debt / annualized adjusted EBITDA 6.3x (A) Reflects our binding commitments on the Steward Massachusetts partnership, leasing five facilities in Utah to a new tenant, and sale of one facility in Washington, as well as our October 2021 acquisitions of 18 behavioral health facilities in the United States, one acute care facility in Portugal and our other mid quarter investments. (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 share-based compensation, gains or losses on real estate and other dispositions, debt refinancing or similar charges, and impairment or other non-cash 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. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 9


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PORTFOLIO INFORMATION PRO FORMA LEASE AND LOAN MATURITY SCHEDULE (A) ($ amounts in thousands) (B) (C) (D) Percentage of Total Years of Maturities Total Properties Base Rent/Interest Base Rent/Interest 2021 1 $ 2,250 0.2% 2022 12 46,646 3.6% 2023 5 14,399 1.1% 2024 1 2,731 0.2% 2025 6 17,448 1.3% 2026 2 9,027 0.7% 2027 1 3,221 0.2% 2028 4 5,678 0.4% 2029 11 43,346 3.3% 2030 11 5,737 0.4% Thereafter 374 1,150,435 88.6% 428 $ 1,300,918 100.0% Percentage of total base rent/interest (A) Schedule includes leases and mortgage loans. (B) 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. (C) Reflects all properties, including those that are part of joint ventures except vacant properties representing less than 1% of total pro forma gross assets and two facilities that are under development. (D) 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). MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 10


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUE BY ASSET TYPE (September 30, 2021) ($ amounts in thousands) Pro Forma Adjusted Total Percentage of Q3 2021 Percentage of Asset Types Properties (A) (B) Gross Assets Total Gross Assets Revenue Q3 2021 Revenue General Acute Care Hospitals 207 $ 15,893,336 71.9% $ 334,239 78.8% Behavioral Health Facilities 58 2,406,907 10.9% 32,843 7.8% Inpatient Rehabilitation Hospitals 112 2,104,417 9.5% 44,825 10.6% Long-Term Acute Care Hospitals 20 337,205 1.5% 8,120 1.9% Freestanding ER/Urgent Care Facilities 47 274,118 1.2% 3,881 0.9% Other — 1,110,337 5.0% — - Total 444 $ 22,126,320 100.0% $ 423,908 100.0% TOTAL PRO FORMA GROSS ASSETS BY ASSET TYPE TOTAL ADJUSTED REVENUE BY ASSET TYPE General Acute Care Hospitals Behavioral Health Facilities Inpatient Rehabilitation Hospitals Long-Term Acute Care Hospitals Freestanding ER/Urgent Care Facilities Other DOMESTIC PRO FORMA GROSS ASSETS BY ASSET TYPE DOMESTIC ADJUSTED REVENUE BY ASSET TYPE General Acute Care Hospitals Behavioral Health Facilities Inpatient Rehabilitation Hospitals Long-Term Acute Care Hospitals Freestanding ER/Urgent Care Facilities Other (A) Includes gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated October 28, 2021 for reconciliation of total assets to total pro forma gross assets at September 30, 2021. (B) Reflects actual revenues on our consolidated statement of income along with revenue from properties owned through our unconsolidated joint venture arrangements. See press release dated October 28, 2021 for a reconciliation of actual revenues to adjusted revenues. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 11


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS—LARGEST INDIVIDUAL FACILITY (September 30, 2021) Percentage of Total Gross Assets— Operators Largest Individual Facility HCA Healthcare 2.5% Steward Health Care 1.9% Circle Health 1.1% Prospect Medical Holdings 1.1% Swiss Medical Network 0.8% 47 operators 1.3% Largest Individual Facility Investment is Less Than 3% of MPT Investment Portfolio COMPREHENSIVE PROPERTY-LEVEL UNDERWRITING FRAMEWORK While MPT seeks to align with proven operators with successful track records and demonstrated market leadership, individual facilities are discrete transactions regardless of portfolio size or related master lease and/or cross-default provisions Is this hospital truly needed in this local • Is referral network sufficiently diversified by market? both practice and specialty? Would the community suffer were this • Would the facility be attractive to multiple hospital not here? identified high-quality replacement operators in the rare event a tenant must be replaced? Are hospital relationships with admitting local physicians deep, time-tested, and • Could the operator potentially be replaced at sustainable? equal or more favorable (to MPT) terms? TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUE BY OPERATOR (September 30, 2021) ($ amounts in thousands) Pro Forma Adjusted Total Percentage of Q3 2021 Percentage of Operators Properties (A) (B) Gross Assets Total Gross Assets Revenue Q3 2021 Revenue Steward Health Care 34 Florida market $ 1,260,206 5.7% $ 16,929 4.0% Massachusetts market 1,162,101 5.3% 35,965 8.5% Texas/Arkansas/Louisiana market 1,060,506 4.8% 21,740 5.1% Arizona market 319,760 1.4% 8,126 1.9% Ohio/Pennsylvania market 133,751 0.6% 3,236 0.8% Utah market — — 31,879 7.5% Circle Health 36 2,470,658 11.2% 52,612 12.4% Prospect Medical Holdings 14 1,623,254 7.3% 37,864 8.9% Swiss Medical Network 17 1,242,022 5.6% 12,182 2.9% HCA Healthcare 8 1,235,498 5.6% 290 0.1% 47 operators 335 10,508,227 47.5% 203,085 47.9% Other — 1,110,337 5.0% — - Total 444 $ 22,126,320 100.0% $ 423,908 100.0% (A) Includes gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated October 28, 2021 for reconciliation of total assets to total pro forma gross assets at September 30, 2021. (B) Reflects actual revenues on our consolidated statement of income along with revenue from properties owned through our unconsolidated joint venture arrangements. See press release dated October 28, 2021 for a reconciliation of actual revenues to adjusted revenues. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 12


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUE BY U.S. STATE AND COUNTRY (September 30, 2021) ($ amounts in thousands) Pro Forma Adjusted Total Percentage of Q3 2021 Percentage of U.S. States and Other Countries Properties (A) (B) Gross Assets Total Gross Assets Revenue Q3 2021 Revenue Texas 59 $ 2,178,399 9.8% $ 38,007 9.0% California 28 1,656,353 7.5% 40,850 9.6% Florida 9 1,286,016 5.8% 17,479 4.1% Utah 7 1,255,468 5.7% 32,837 7.7% Massachusetts 10 1,167,501 5.3% 36,123 8.5% 27 Other States 124 5,024,965 22.7% 107,160 25.4% Other — 725,314 3.3% — - United States 237 $ 13,294,016 60.1% $ 272,456 64.3% United Kingdom 81 $ 4,352,007 19.7% $ 90,141 21.3% Germany 82 1,279,598 5.8% 25,755 6.1% Switzerland 17 1,242,022 5.6% 12,182 2.9% Australia 11 1,038,165 4.6% 15,248 3.6% Spain 3 214,566 1.0% 2,709 0.6% Other Countries 13 320,923 1.5% 5,417 1.2% Other— 385,023 1.7%— - International 207 $ 8,832,304 39.9% $ 151,452 35.7% Total 444 $ 22,126,320 100.0% $ 423,908 100.0% (A) Includes gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming all real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded. See press release dated October 28, 2021 for reconciliation of total assets to total pro forma gross assets at September 30, 2021. (B) Reflects actual revenues on our consolidated statement of income along with revenue from properties owned through our unconsolidated joint venture arrangements. See press release dated October 28, 2021 for a reconciliation of actual revenues to adjusted revenues. TOTAL PRO FORMA GROSS ASSETS BY COUNTRY TOTAL ADJUSTED REVENUE BY COUNTRY United States United Kingdom Germany Switzerland Australia Spain Other Countries Other PRO FORMA GROSS ASSETS BY U.S. STATE ADJUSTED REVENUE BY U.S. STATE Texas California Florida Utah Massachusetts 27 Other States Other MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 13


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PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM(A) RENT COVERAGE INCLUSIVE OF CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE STRATIFICATION OF PORTFOLIO EBITDARM RENT COVERAGE Investment Percentage of EBITDARM Rent Coverage TTM No. of Facilities (in thousands) Investment Greater than or equal to 4.50x $ 144,062 2 1.1% 3.00x—4.49x $ 10,295 2 0.1% 1.50x—2.99x $ 87,617 5 0.6% Less than 1.50x $ 70,065 4 0.5% Total Master Leased, Cross-Defaulted and/or with Parent $ 13,192,816 262 97.7% Guaranty: 2.8x General Acute Care Hospitals Master Leased, Cross- $ 10,935,919 136 81.0% Defaulted and/or with Parent Guaranty: 3.0x Inpatient Rehabilitation Facilities Master Leased, Cross- $ 1,969,196 107 14.6% Defaulted and/or with Parent Guaranty: 2.1x Long-Term Acute Care Hospitals Master Leased, Cross- $ 287,701 19 2.1% Defaulted and/or with Parent Guaranty: 3.3x Greater than or equal to 4.50x 3.00x—4.49x 1.50x—2.99x Less than 1.50x General Acute Master Lease, Cross-Default or Parent Guaranty Rehab Master Lease, Cross-Default or Parent Guaranty LTACH Master Lease, Cross-Default or Parent Guaranty Notes: Properties that do not provide financial reporting and disposed assets are not included. All data presented is on a trailing twelve month basis. (A) EBITDARM adjusted for non-recurring items. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 14


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PORTFOLIO INFORMATION SUMMARY OF COMPLETED INVESTMENTS (For the nine months ended September 30, 2021) (Amounts in thousands) Operator Location Investment (A) Commencement Date Investment/ Development Steward Health Care U.S.—Various $ 335,000 1/8/2021 Investment Priory Group United Kingdom 1,090,400 1/19/2021 Investment Swiss Medical Network Switzerland 157,630 4/16/2021 Investment Pipeline Health Systems California 215,000 7/6/2021 Investment Circle Health United Kingdom 21,528 7/6/2021 Investment Steward Health Care Florida 900,000 8/1/2021 Investment $ 2,719,558 SUMMARY OF CURRENT INVESTMENT COMMITMENTS (Amounts in thousands) Operator Location Commitment Investment/ Development Springstone U.S.—Various $ 950,000 Investment Atrys Health Portugal 20,589 Investment $ 970,589 SUMMARY OF CURRENT DEVELOPMENT PROJECTS AS OF SEPTEMBER 30, 2021 (Amounts in thousands) Costs Incurred as of Estimated Commencement Operator Location Commitment 9/30/2021 Date Ernest Health California $ 47,929 $ 39,544 Q4 2021 Ernest Health California 47,700 24,990 Q2 2022 $ 95,629 $ 64,534 (A) Excludes transaction costs, including real estate transfer and other taxes. Amount assumes exchange rate as of the investment date. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 15


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FINANCIAL STATEMENTS CONSOLIDATED STATEMENTS OF INCOME (Unaudited) (Amounts in thousands, except per share data) For the Three Months Ended For the Nine Months Ended September 30, 2021 September 30, 2020 September 30, 2021 September 30, 2020 REVENUES Rent billed $ 242,211 $ 192,953 $ 672,425 $ 538,277 Straight-line rent 64,637 51,125 174,975 103,697 Income from financing leases 50,667 52,544 151,898 157,469 Interest and other income 33,264 32,836 136,038 115,989 Total revenues 390,779 329,458 1,135,336 915,432 EXPENSES Interest 94,132 82,263 273,409 243,538 Real estate depreciation and amortization 85,039 69,665 237,050 192,049 Property-related (A) 7,128 5,897 31,265 19,178 General and administrative 36,694 31,718 107,312 97,121 Total expenses 222,993 189,543 649,036 551,886 OTHER INCOME (EXPENSE) Gain (loss) on sale of real estate 9,294 (927) 8,896 (2,703) Real estate impairment charges — — — (19,006) Earnings from equity interests 7,193 5,893 21,633 15,263 Debt refinancing and unutilized financing costs — — (2,339) (611) Other (including mark-to-market adjustments on equity securities) (2,276) 2,461 4,747 (9,499) Total other income (expense) 14,211 7,427 32,937 (16,556) Income before income tax 181,997 147,342 519,237 346,990 Income tax expense (10,602) (15,985) (69,141) (24,824) Net income 171,395 131,357 450,096 322,166 Net income attributable to non-controlling interests (258) (251) (611) (600) Net income attributable to MPT common stockholders $ 171,137 $ 131,106 $ 449,485 $ 321,566 EARNINGS PER COMMON SHARE—BASIC AND DILUTED Net income attributable to MPT common stockholders $ 0.29 $ 0 .25 $ 0.76 $ 0.61 WEIGHTED AVERAGE SHARES OUTSTANDING—BASIC 595,119 531,095 586,291 526,651 WEIGHTED AVERAGE SHARES OUTSTANDING—DILUTED 597,320 532,436 587,971 527,832 $ —$ - DIVIDENDS DECLARED PER COMMON SHARE $ 0.28 $ 0 .27 $ 0.84 $ 0.81 (A) Includes $4.0 million and $23.1 million of ground lease and other expenses (such as property taxes and insurance) paid directly by us and reimbursed by our tenants for the three and nine months ended September 30, 2021, respectively. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 16


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FINANCIAL STATEMENTS CONSOLIDATED BALANCE SHEETS (Amounts in thousands, except per share data) September 30, 2021 December 31, 2020 (Unaudited) (A) ASSETS Real estate assets Land, buildings and improvements, intangible lease assets, and other $ 13,244,403 $ 12,078,927 Investment in financing leases 2,042,585 2,010,922 Real estate held for sale 1,096,475 - Mortgage loans 200,285 248,080 Gross investment in real estate assets 16,583,748 14,337,929 Accumulated depreciation and amortization (936,289) (833,529) Net investment in real estate assets 15,647,459 13,504,400 Cash and cash equivalents 349,652 549,884 Interest and rent receivables 64,622 46,208 Straight-line rent receivables 661,429 490,462 Equity investments 1,170,171 1,123,623 Other loans 1,502,677 858,368 Other assets 315,977 256,069 Total Assets $ 19,711,987 $ 16,829,014 LIABILITIES AND EQUITY Liabilities Debt, net $ 10,581,023 $ 8,865,458 Accounts payable and accrued expenses 595,003 438,750 Deferred revenue 19,739 36,177 Obligations to tenants and other lease liabilities 157,488 144,772 Total Liabilities 11,353,253 9,485,157 Equity Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding — - Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding —596,145 shares at September 30, 2021 and 541,419 shares at December 31, 2020 596 541 Additional paid-in capital 8,541,092 7,461,503 Distributions in excess of net income (117,733) (71,411) Accumulated other comprehensive loss (69,843) (51,324) Treasury shares, at cost (777) (777) Total Medical Properties Trust, Inc. Stockholders’ Equity 8,353,335 7,338,532 Non-controlling interests 5,399 5,325 Total Equity 8,358,734 7,343,857 Total Liabilities and Equity $ 19,711,987 $ 16,829,014 (A) Financials have been derived from the prior year audited financial statements. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 17


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FINANCIAL STATEMENTS UNCONSOLIDATED JOINT VENTURE INVESTMENTS (As of and for the three months ended September 30, 2021) (Unaudited) ($ amounts in thousands) REAL ESTATE JOINT VENTURE DETAILS MPT Pro Rata Interest Property- MPT Weighted Total Gross Third-Party Shareholder Total Operators Related Average Interest Assets Net Debt Loans Revenues Expenses HM Hospitales, IMED Hospitales, MEDIAN, 56% $ 2,405,917 $ 869,672 $ 357,257 $ 33,129 $ 1,866 Policlinico di Monza, Swiss Medical Network PRO RATA TOTAL GROSS ASSETS BY COUNTRY PRO RATA TOTAL GROSS ASSETS BY PROPERTY TYPE JOINT VENTURE IMPACT Income Statement Impact to MPT Amounts Financial Statement Location Real estate joint venture income (1) $ 7,193 Earnings from equity interests Management fee revenue $ 151 Interest and other income Shareholder loan interest revenue $ 4,657 Interest and other income Balance Sheet Impact to MPT Amounts Financial Statement Location Real estate joint venture investments $ 827,813 Equity Investments Other joint venture investments 342,358 Equity Investments Total joint venture investments $ 1,170,171 Shareholder loans $ 357,257 Other Loans (1) Includes $2.1 million of straight-line revenue, $13.3 million of depreciation and amortization expense, and $8.6 million of interest expense on third-party debt and shareholder loans. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q3 2021 18


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Medical Properties Trust 1000 Urban Center Drive, Suite 501 Birmingham, AL 35242 (205) 969-3755 NYSE: MPW www.medicalpropertiestrust.com Contact: Drew Babin, Senior Managing Director of Corporate Communications (646) 884-9809 or dbabin@medicalpropertiestrust.com or Tim Berryman, Managing Director of Investor Relations (205) 397-8589 or tberryman@medicalpropertiestrust.com