8-K
MEDICAL PROPERTIES TRUST INC false 0001287865 0001287865 2022-08-03 2022-08-03

 

 

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): August 3, 2022

 

 

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 August 3, 2022, Medical Properties Trust, Inc. (the “Company”) issued a press release announcing its financial results for the three and six months ended June 30, 2022. 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.

 

Item 7.01

Regulation FD Disclosure

Beginning on August 3, 2022, the Company intends to use the presentation attached to this Current Report on Form 8-K as Exhibit 99.3 in discussions with investors. The presentation was also posted on the Company’s website, www.medicalpropertiestrust.com, on August 3, 2022.

The information in this Current Report on Form 8-K, including the information set forth in Exhibit 99.1, Exhibit 99.2, and Exhibit 99.3 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 the Company 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 August 3, 2022 reporting financial results for the three and six months ended June 30, 2022
99.2    Medical Properties Trust, Inc. 2nd Quarter 2022 Supplemental Information
99.3    Investor Presentation dated August 3, 2022
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: August 3, 2022

 

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EX-99.1

Exhibit 99.1

 

LOGO

 

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

MEDICAL PROPERTIES TRUST, INC. REPORTS SECOND QUARTER RESULTS

Per Share Net Income of $0.32 and Normalized FFO of $0.46 in Second Quarter

7% Growth in Per Share NFFO Versus Prior-Year Quarter

Expansion of Spain Footprint Includes New Relationship with a Global Leader in Cancer Care

Birmingham, AL – August 3, 2022 – Medical Properties Trust, Inc. (the “Company” or “MPT”) (NYSE: MPW) today announced financial and operating results for the second quarter ended June 30, 2022, as well as certain events occurring subsequent to quarter end. MPT plans to also publish an Investor Update presentation under “Webcasts & Presentations” in the Investor Relations section of the Company’s website, https://investor-relations.medicalpropertiestrust.com/.

 

   

Net income of $0.32 and Normalized Funds from Operations (“NFFO”) of $0.46 for the 2022 second quarter on a per diluted share basis;

 

   

Completed in April the acquisition from separate third parties of two general acute hospitals in Arizona and Florida leased to Steward Health Care System (“Steward”) for an aggregate $80 million;

 

   

Acquired in late April three radiotherapy facilities leased to GenesisCare in Spain for €27 million;

 

   

Agreed in May to develop three facilities in Spain leased to IMED with a total budget of €121 million;

 

   

Closed in May on the previously announced sale of a general acute hospital in Dodge City, KS for $63 million, resulting in a $8 million gain on sale of real estate;

 

   

Signed agreement in July to develop a behavioral health facility in McKinney, TX leased to Springstone with a total budget of approximately $35 million;

 

   

Acquired in late July a hospital in Colombia leased to Fundación Cardiovascular de Colombia for $26 million; and

 

   

Amended the credit facility in the second quarter, increasing the capacity to $2.0 billion and extending the maturity dates of the revolver and term loan to June 2026 and June 2027, respectively.

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 2021 results, and reconciliations of total assets to total pro forma gross assets and total revenues to total adjusted revenues.

 

1


PORTFOLIO UPDATE

In late April, MPT acquired three radiotherapy facilities in Spain leased to GenesisCare, a global leader in cancer care, for €27 million. In addition to its platform in Spain, GenesisCare has a meaningful and growing presence in several important MPT markets such as the U.S., UK and Australia. Further expanding its Spanish footprint, MPT also agreed in May to fund the development of three IMED general acute hospitals with nearly 300 beds in Barcelona, Valencia and Alicante over the next three years for a combined €121 million. These projects, in addition to MPT’s existing IMED facility in Valencia, are indicative of the growing presence of private hospitals in Spain and further demonstrate MPT’s ability to grow through existing relationships. Cap rates on these investments are expected to remain consistent with MPT’s historical investment spreads.

During the quarter, MPT acquired from separate third parties two facilities located in Arizona and Florida and leased to Steward for a combined $80 million. The Arizona facility, which will operate as a combined ambulatory surgery center, imaging center and free-standing emergency department, is expected to drive additional volume to Steward’s nearby Mountain Vista Medical Center in Mesa. The Florida general acute facility provides Steward an economical way to expand within the same service area as Coral Gables Hospital and is expected to commence operations in January 2023.

In July, MPT agreed to develop a 72-bed behavioral health facility in McKinney, TX for Springstone. The facility will be Springstone’s third inpatient facility in the Dallas-Fort Worth market. The budget is approximately $35 million, and the expected completion is the first quarter of 2024.

In late July, MPT established a new operator relationship in Colombia with the acquisition of a 197-bed hospital leased to non-profit operator Fundación Cardiovascular de Colombia (“FCV”) for $26 million. FCV was ranked sixth among hospital operators in Latin America in 2019 and the Instituto Cardiovascular de la FCV hospital in Bucaramanga that MPT acquired has received international accolades, including as the best cardiovascular hospital in Colombia.

The Company has total pro forma gross assets of approximately $22.3 billion, including $16.0 billion of general acute care hospitals, $2.5 billion of behavioral health facilities, $2.0 billion of inpatient rehabilitation facilities, $0.3 billion of long-term acute care hospitals, and $0.2 billion of freestanding emergency room and urgent care properties. MPT’s portfolio includes 447 properties and approximately 46,000 licensed beds across the United States as well as in the United Kingdom, Switzerland, Germany, Australia, Spain, Finland, Colombia, Italy and Portugal. The properties are leased to or mortgaged by 54 hospital operating companies.

OPERATING RESULTS AND OUTLOOK

Net income for the second quarter ended June 30, 2022 was $190 million ($0.32 per diluted share) compared to $115 million ($0.19 per diluted share) in the year earlier period.

NFFO for the second quarter was $275 million ($0.46 per diluted share) compared to $251 million ($0.43 per diluted share) in the year earlier period, a 7% increase on a per share basis.

The Company is maintaining its estimates of per share net income of $1.88 to $1.92 including gains on sales of $0.78 per share and NFFO of $1.78 to $1.82.

 

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These estimates do not include the effects, among others, 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 Wednesday, August 3, 2022 at 1:00 p.m. Eastern Time to present the Company’s financial and operating results for the quarter ended June 30, 2022. The dial-in numbers for the conference call are 800-715-9871 (U.S. and Canada) and 646-307-1963 (International); both numbers require passcode 6654773. 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 August 17, 2022 using dial-in numbers 800-770-2030 and 609-800-9909 for U.S. and International callers, respectively, and passcode 6654773. 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.

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 hospital real estate with 447 facilities and approximately 46,000 licensed beds in ten 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

 

3


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, potential impact from health crises (like COVID-19); (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 guidance for 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; (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 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; and (xvi) the risk that property sales, loan repayments, and other capital recycling transactions do 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, 2021 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.

# # #

 

4


MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES

Consolidated Balance Sheets

 

(Amounts in thousands, except for per share data)             
     June 30, 2022     December 31, 2021  
     (Unaudited)     (A)  

Assets

    

Real estate assets

    

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

   $ 13,696,681     $ 14,062,722  

Investment in financing leases

     2,076,813       2,053,327  

Real estate held for sale

     —         1,096,505  

Mortgage loans

     314,681       213,211  
  

 

 

   

 

 

 

Gross investment in real estate assets

     16,088,175       17,425,765  

Accumulated depreciation and amortization

     (1,109,592     (993,100
  

 

 

   

 

 

 

Net investment in real estate assets

     14,978,583       16,432,665  

Cash and cash equivalents

     257,269       459,227  

Interest and rent receivables

     94,206       56,229  

Straight-line rent receivables

     702,683       728,522  

Investments in unconsolidated real estate joint ventures

     1,460,373       1,152,927  

Investments in unconsolidated operating entities

     1,439,910       1,289,434  

Other loans

     213,897       67,317  

Other assets

     596,163       333,480  
  

 

 

   

 

 

 

Total Assets

   $ 19,743,084     $ 20,519,801  
  

 

 

   

 

 

 

Liabilities and Equity

    

Liabilities

    

Debt, net

   $ 10,138,774     $ 11,282,770  

Accounts payable and accrued expenses

     562,255       607,792  

Deferred revenue

     21,210       25,563  

Obligations to tenants and other lease liabilities

     154,974       158,005  
  

 

 

   

 

 

 

Total Liabilities

     10,877,213       12,074,130  

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 —598,839 shares at June 30, 2022 and 596,748 shares at December 31, 2021

     599       597  

Additional paid-in capital

     8,557,120       8,564,009  

Retained earnings (deficit)

     385,545       (87,691

Accumulated other comprehensive loss

     (83,431     (36,727
  

 

 

   

 

 

 

Total Medical Properties Trust, Inc. Stockholders’ Equity

     8,859,833       8,440,188  

Non-controlling interests

     6,038       5,483  
  

 

 

   

 

 

 

Total Equity

     8,865,871       8,445,671  
  

 

 

   

 

 

 

Total Liabilities and Equity

   $ 19,743,084     $ 20,519,801  
  

 

 

   

 

 

 

 

(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 Six Months Ended  
     June 30, 2022     June 30, 2021     June 30, 2022     June 30, 2021  

Revenues

        

Rent billed

   $ 241,209     $ 216,870     $ 504,611     $ 430,214  

Straight-line rent

     58,518       55,465       119,562       110,338  

Income from financing leases

     51,873       50,337       103,649       101,231  

Interest and other income

     48,626       59,120       82,204       102,774  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total revenues

     400,226       381,792       810,026       744,557  

Expenses

        

Interest

     87,730       92,305       178,913       179,277  

Real estate depreciation and amortization

     84,334       76,369       169,650       152,011  

Property-related (A)

     21,135       18,684       29,733       24,137  

General and administrative

     38,858       34,545       80,282       70,618  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     232,057       221,903       458,578       426,043  

Other income (expense)

        

Gain (loss) on sale of real estate and other, net

     16,355       (1,387     467,993       (398

Earnings from equity interests

     14,785       7,339       22,123       14,440  

Debt refinancing and unutilized financing costs

     (619     (70     (9,435     (2,339

Other (including fair value adjustments on securities)

     2,031       (771     11,918       7,023  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total other income

     32,552       5,111       492,599       18,726  
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income tax

     200,721       165,000       844,047       337,240  

Income tax expense

     (10,657     (50,179     (22,036     (58,539
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     190,064       114,821       822,011       278,701  

Net income attributable to non-controlling interests

     (467     (256     (733     (353
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to MPT common stockholders

   $ 189,597     $ 114,565     $ 821,278     $ 278,348  
  

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per common share - basic and diluted:

        

Net income attributable to MPT common stockholders

   $ 0.32     $ 0.19     $ 1.37     $ 0.48  
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average shares outstanding - basic

     598,827       587,514       598,751       581,877  

Weighted average shares outstanding - diluted

     599,026       589,053       598,979       583,297  

Dividends declared per common share

   $ 0.29     $ 0.28     $ 0.58     $ 0.56  

(A) Includes $18.3 million and $15.5 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 months ended June 30, 2022 and 2021, respectively, and $24.6 million and $19.0 million for the six months ended June 30, 2022 and 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 Six Months Ended  
     June 30, 2022     June 30, 2021     June 30, 2022     June 30, 2021  

FFO information:

        

Net income attributable to MPT common stockholders

   $ 189,597     $ 114,565     $ 821,278     $ 278,348  

Participating securities’ share in earnings

     (345     (390     (747     (760
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income, less participating securities’ share in earnings

   $ 189,252     $ 114,175     $ 820,531     $ 277,588  

Depreciation and amortization

     101,976       90,061       201,435       178,597  

(Gain) loss on sale of real estate and other, net

     (16,355     1,387       (467,993     398  
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 274,873     $ 205,623     $ 553,973     $ 456,583  

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

     977       (13     3,581       (5,251

Non-cash fair value adjustments

     (943     2,121       (8,966     (1,944

Tax rate changes

     (825     42,746       (825     42,746  

Debt refinancing and unutilized financing costs

     619       70       9,435       2,339  
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 274,701     $ 250,547     $ 557,198     $ 494,473  

Share-based compensation

     11,075       12,771       22,879       25,035  

Debt costs amortization

     4,560       4,100       10,173       8,109  

Rent deferral, net

     (3,327     836       (7,043     1,639  

Straight-line rent revenue and other

     (74,757     (67,921     (152,090     (135,196
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 212,252     $ 200,333     $ 431,117     $ 394,060  
  

 

 

   

 

 

   

 

 

   

 

 

 

Per diluted share data:

        

Net income, less participating securities’ share in earnings

   $ 0.32     $ 0.19     $ 1.37     $ 0.48  

Depreciation and amortization

     0.17       0.16       0.33       0.30  

(Gain) loss on sale of real estate and other, net

     (0.03     —         (0.78     —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 0.46     $ 0.35     $ 0.92     $ 0.78  

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

     —         —         —         —    

Non-cash fair value adjustments

     —         —         (0.01     —    

Tax rate changes

     —         0.08       —         0.07  

Debt refinancing and unutilized financing costs

     —         —         0.02       —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 0.46     $ 0.43     $ 0.93     $ 0.85  

Share-based compensation

     0.02       0.02       0.04       0.04  

Debt costs amortization

     0.01       0.01       0.02       0.01  

Rent deferral, net

     (0.01     —         (0.01     —    

Straight-line rent revenue and other

     (0.13     (0.12     (0.26     (0.22
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 0.35     $ 0.34     $ 0.72     $ 0.68  
  

 

 

   

 

 

   

 

 

   

 

 

 

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 all activity of our equity interests in the “Earnings from equity interests” line on the consolidated statements of income. The write-off of straight-line rent in 2022 is predominantly related to sold properties.

(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 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 such as straight-line rent, (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 more 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 infrastructure-type assets generally require longer term leases with annual contractual escalations of base rents, resulting in the recognition of a significant amount of rental income that is not collected until future periods. 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

2022 Guidance Reconciliation

(Unaudited)

 

     2022 Guidance - Per Share(1)  
     Low     High  

Net income attributable to MPT common stockholders

   $ 1.88     $ 1.92  

Participating securities’ share in earnings

     —         —    
  

 

 

   

 

 

 

Net income, less participating securities’ share in earnings

   $ 1.88     $ 1.92  

Depreciation and amortization

     0.68       0.68  

Gain on sale of real estate and other, net

     (0.78     (0.78
  

 

 

   

 

 

 

Funds from operations

   $ 1.78     $ 1.82  

Other adjustments

     —         —    
  

 

 

   

 

 

 
Normalized funds from operations    $ 1.78     $ 1.82  
  

 

 

   

 

 

 

 

(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)    June 30, 2022  

Total Assets

   $ 19,743,084  

Add:

  

Accumulated depreciation and amortization

     1,109,592  

Incremental gross assets of our joint ventures and other(1)

     1,689,012  

Less:

  

Cash on hand

     (257,269
  

 

 

 

Total Pro Forma Gross Assets(2)

   $ 22,284,419  
  

 

 

 

 

(1)

Adjustment to reflect our share of our joint ventures’ gross assets and certain lease intangible assets.

(2)

Total pro forma gross assets is total assets before accumulated depreciation/amortization (adjusted for our unconsolidated joint ventures) and assumes material real estate commitments on new investments are fully funded, and assumes cash on hand at period-end and cash generated from or to be generated from financing activities subsequent to period-end are either used in these transactions or used to reduce debt. We believe total pro forma 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.

Adjusted Revenues

(Unaudited)

 

     For the Three
Months Ended
 
(Amounts in thousands)    June 30, 2022  

Total Revenues

   $ 400,226  

Revenue from real estate properties owned through joint venture arrangements

     48,942  
  

 

 

 

Total Adjusted Revenues(1)

   $ 449,168  
  

 

 

 

 

(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 revenues 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 trustQ2 2022 Supplemental


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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 Pro Forma Net Debt / Annualized Adjusted EBITDAre    8 PORTFOLIO INFORMATION Pro Forma Lease and Loan Maturity Schedule    9 9    Total Pro Forma Gross Assets and Adjusted Revenue by Asset Type, Operator, State and Country    10 Rent Coverage    13 Summary of Investments and Development Projects    15 FINANCIAL STATEMENTS Consolidated Statements of Income    16 16 Consolidated Balance Sheets    17     Investments in Unconsolidated Real Estate Joint Ventures 18 Investments in Unconsolidated Operating Entities    19 FORWARD-LOOKING STATEMENTS COMPANY OVERVIEW Forward-looking statements involve known and 3 unknown risks, uncertainties and other factors that Company Information 3 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 FINANCIAL INFORMATION payout ratio; the amount of acquisitions of healthcare real estate, if any; Net Debt to EBITDAre; portfolio diver- Reconciliation of Net Income to Funds from Operations 6 sification; capital markets conditions; the repayment of debt arrangements; statements concerning the addi- 6 Debt Summary 7 tional income to the Company as a result of ownership interests in certain hospital operations and the timing Pro Forma Net Debt / Annualized Adjusted EBITDAre 8 of such income; the payment of future dividends, if any; completion of additional debt arrangements and additional investments; national and international economic, business, regulatory, real estate and other market PORTFOLIO INFORMATION conditions; the competitive environment in which the Company operates; the execution of the Company’s Pro Forma Lease and Loan Maturity Schedule 9 business plan; financing risks; the Company’s ability to maintain its status as a REIT for federal income tax Total Pro Forma Gross Assets and Adjusted Revenue purposes; acquisition and development risks; potential 9 environmental and other liabilities; potential impact by Asset Type, Operator, State and Country 10 from health crises (like COVID-19) and other events beyond the control of our tenants/borrowers and the Rent Coverage 13 related impact to us; and other factors affecting the real estate industry generally or healthcare real estate Summary of Investments and Development Projects 15 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, 2021, and as updated FINANCIAL STATEMENTS by the Company’s subsequently filed Quarterly Reports on Form 10-Q and other SEC filings. Except as otherwise Consolidated Statements of Income 16 required by the federal securities laws, the Company undertakes no obligation to update the information in Consolidated Balance Sheets 17 this report. 16 Investments in Unconsolidated Real Estate Certain information in the supplemental package may be shown pro forma for transactions completed subsequent Joint Ventures 18 to period end and the consummation of pending transactions. The pro forma adjustments are based Investments in Unconsolidated Operating Entities 19 upon available information and assumptions that we believe are reasonable. There is no assurance that any pending transactions will occur. On the Cover: Clinique de Genolier, Genolier, Switzerland Cottonwood Springs—Olathe, Kansas


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COMPANY OVERVIEW M edical Properties Trust, Inc. is a self-advised MPT’s financing model facilitates acquisitions real estate investment trust formed in 2003 and recapitalizations and allows operators to acquire and develop net-leased hospital facilities. of hospitals to unlock the value of their real From its inception in Birmingham, Alabama, the estate assets to fund facility improvements, Company has grown to become one of the world’s technology upgrades and other investments largest owners of hospital real estate. in operations. Pro forma as of June 30, 2022. 447 54 ~46,000 32 10 properties operators beds U. S. states countries MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 3


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COMPANY OVERVIEW MPT OFFICERS: From the Left: Charles R. Lambert, Emmett E. McLean, R. Lucas Savage, Edward K. Aldag, Jr., R. Steven Hamner, Rosa H. Hooper 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 Corporate HeEdward K. Aldag, Jr. G. Steven Dawson Medical Properties Trust, Inc. R. Steven Hamner 1000 Urban Center Drive, Suite 501 Caterina A. Mozingo Birmingham, AL 35242 Emily W. Murphy (205) 969-3755 Elizabeth N. Pitman D. Paul Sparks, Jr. (205) 969-3756 (fax) Michael G. Stewart www.medicalpropertiestrust.com C. Reynolds Thompson, III MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 4


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COMPANY OVERVIEW INVESTOR RELATIONS Drew Babin Tim Berryman Senior Managing Director of Corporate Communications Managing Director of Investor Relations (646) 884-9809 dbabin@medicalpropertiestrust.com (205) 397-8589 tberryman@medicalpropertiestrust.com Stock Exchange Senior Transfer Listing and Unsecured Agent Trading Symbol Debt Ratings American Stock Transfer New York Stock Exchange Moody’s – Ba1 and Trust Company (NYSE): MPW Standard & Poor’s – BBB- 6201 15th Avenue Brooklyn, NY 11219 Idaho Falls Community Hospital—Idaho Falls, Idaho MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 5


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FINANCIAL INFORMATION RECONCILIATION OF NET INCOME TO FUNDS FROM OPERATIONS (Unaudited) (Amounts in thousands, except per share data) For the Three Months Ended For the Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 FFO INFORMATION: Net income attributable to MPT common stockholders $ 189,597 $ 114,565 $ 821,278 $ 278,348 Participating securities’ share in earnings (345) (390) (747) (760) Net income, less participating securities’ share in earnings $ 189,252 $ 114,175 $ 820,531 $ 277,588 Depreciation and amortization 101,976 90,061 201,435 178,597 (Gain) loss on sale of real estate and other, net (16,355) 1,387 (467,993) 398 Funds from operations $ 274,873 $ 205,623 $ 553,973 $ 456,583 Write-off (recovery) of straight-line rent and other 977 (13) 3,581 (5,251) Non-cash fair value adjustments (943) 2,121 (8,966) (1,944) Tax rate changes (825) 42,746 (825) 42,746 Debt refinancing and unutilized financing costs 619 70 9,435 2,339 Normalized funds from operations $ 274,701 $ 250,547 $ 557,198 $ 494,473 Share-based compensation 11,075 12,771 22,879 25,035 Debt costs amortization 4,560 4,100 10,173 8,109 Rent deferral, net (3,327) 836 (7,043) 1,639 Straight-line rent revenue and other (74,757) (67,921) (152,090) (135,196) Adjusted funds from operations $ 212,252 $ 200,333 $ 431,117 $ 394,060 PER DILUTED SHARE DATA: Net income, less participating securities’ share in earnings $ 0.32 $ 0.19 $ 1.37 $ 0.48 Depreciation and amortization 0.17 0.16 0.33 0.30 (Gain) loss on sale of real estate and other, net (0.03) — (0.78) - Funds from operations $ 0 .46 $ 0 .35 $ 0.92 $ 0.78 Write-off (recovery) of straight-line rent and other — — — -Non-cash fair value adjustments — — (0.01) -Tax rate changes — 0.08 — 0.07 Debt refinancing and unutilized financing costs — — 0.02 - Normalized funds from operations $ 0 .46 $ 0 .43 $ 0.93 $ 0.85 Share-based compensation 0.02 0.02 0.04 0.04 Debt costs amortization 0.01 0.01 0.02 0.01 Rent deferral, net (0.01) — (0.01) -Straight-line rent revenue and other (0.13) (0.12) (0.26) (0.22) Adjusted funds from operations $ 0 .35 $ 0 .34 $ 0.72 $ 0.68 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 all activity of our equity interests in the “Earnings from equity interests” line on the consolidated statements of income. The write-off of straight line rent in 2022 is predominantly related to sold properties. (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 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 such as straight-line rent, (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 more 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 infrastructure-type assets generally require longer term leases with annual contractual escalations of base rents, resulting in the recognition of a significant amount of rental income that is not collected until future periods. 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 | Q2 2022 6


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FINANCIAL INFORMATION (As of June 30, 2022) ($ amounts in thousands) DEBT MATURITIES Senior Unsecured Year Term Loans/Revolver Total Debt % of Total Notes 2022 $—$—$—0.0% 2023 487,120—487,120 4.8% 2024—828,360 828,360 8.1% 2025 524,200 852,460 1,376,660 13.5% 2026 1,633,100 920,245 2,553,345 25.0% 2027 1,400,000 200,000 1,600,000 15.7% 2028 730,680—730,680 7.2% 2029 900,000—900,000 8.8% 2030 426,230—426,230 4.2% 2031 1,300,000—1,300,000 12.7% Totals $ 7,401,330 $ 2,801,065 $ 10,202,395 100.0% DEBT BY LOCAL CURRENCY Senior Unsecured Term Loans/Revolver Total Debt % of Total Notes United States $ 4,100,000 $ 855,000 $ 4,955,000 48.6% United Kingdom 2,252,930 852,460 3,105,390 30.4% Australia—828,360 828,360 8.1% Europe 1,048,400 265,245 1,313,645 12.9% Totals $ 7,401,330 $ 2,801,065 $ 10,202,395 100.0% DEBT SUMMARY Debt Instrument Rate Type Rate Balance 2026 Credit Facility Revolver (A) Variable 1.125%—2.518% $ 920,245 RATE TYPE AS PERCENTAGEOF TOTAL DEBT 2027 Term Loan Variable 2.899% 200,000 2.550% Notes Due 2023 (Ł400M) (A) Fixed 2.550% 487,120 (A) (B) Variable 2024 AUD Term Loan (A$1.2B) Fixed 2.450% 828,360 11% 3.325% Notes Due 2025 (€500M) (A) Fixed 3.325% (A) Fixed(C) 1.949% 2025 GBP Term Loan (Ł700M) 0.993% Notes Due 2026 (€500M) (A) Fixed 0.993% 5.250% Notes Due 2026 Fixed 5.250% 2.500% Notes Due 2026 (Ł500M) (A) Fixed 2.500% Fixed 89% 5.000% Notes Due 2027 Fixed 5.000% 3.692% Notes Due 2028 (Ł600M) (A) Fixed 3.692% 4.625% Notes Due 2029 Fixed 4.625% 3.375% Notes Due 2030 (Ł350M) (A) Fixed 3.375% 3.500% Notes Due 2031 Fixed 3.500% 1,300,000 $ 10,202,395 Debt issuance costs and discount (63,621) Weighted average rate 3.296% $ 10,138,774 (A) Non-USD denominated debt converted to U.S. dollars at June 30, 2022. (B) 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. (C) 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 | Q2 2022 7


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FINANCIAL INFORMATION PRO FORMA NET DEBT / ANNUALIZED ADJUSTED EBITDAre (Unaudited) (Amounts in thousands) For the Three Months Ended June 30, 2022 Net income $ 190,064 Add back: Interest 87,730 Income tax 10,657 Depreciation and amortization 87,316 Gain on sale of real estate and other, net (16,355) Adjustment to reflect MPT’s share of unlevered EBITDAre from unconsolidated real estate joint ventures (A) 7,282 2Q 2022 EBITDAre $ 366,694 Share-based compensation 11,075 Write-off of straight-line rent and other 977 Debt refinancing and unutilized financing costs 619 Non-cash fair value adjustments (943) 2Q 2022 Adjusted EBITDAre $ 378,422 Pro forma adjustments for investment activity (B) 2,236 2Q 2022 Pro Forma Adjusted EBITDAre $ 380,658 Annualization $ 1,522,632 Total debt at June 30, 2022 $ 10,138,774 Pro forma changes after June 30, 2022 (564,041) Pro forma net debt $ 9,574,733 Pro forma net debt / annualized adjusted EBITDAre 6.3x Investorsandanalystsfollowingtherealestateindustryutilizenetdebt(debtlesscash)toEBITDAasameasurementofleverag ethatshowshowmanyyearsitwouldtakeforustopay back our debt,assuming net debt andEBITDA areheld constant.Inour calculation, westart with EBITDAre, asdefinedbyNareit, which isnet income before interest expense,income tax expense, depreciation and amortization, losses/gains on disposition of depreciated property, impairment losses, and adjustments to reflect our share of EBITDA from unconsolidated real estate joint ventures. We then adjust EBITDAre for non-cash share-based compensation, non-cash fair value adjustments and other items that would make comparison of our operating results with priorperiodsandother companiesmoremeaningful, toderive Adjusted EBITDAre. We further adjust net debt and Adjusted EBITDAre forthe pro forma effects from investments and capital transactions that were either completed during the period or disclosed as firm commitments, assuming such transactions were consummated/fully funded asof the beginning of the periodtoderiveProformaNet DebtandProformaAdjusted EBITDAre. Although non-GAAP measures, we believe Pro formaNet Debt and Pro forma Adjusted EBITDAre 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. (A) Includes only the unlevered portion of our share of EBITDAre from unconsolidated real estate joint ventures, as we have excluded any net debt from our unconsolidated real estate joint ventures in the Pro forma Net Debt line. We believe this adjustment is needed to appropriately reflect the relationship between EBITDAre and net debt. (B) Pro forma adjustments to reflect a full quarter impact from our mid-quarter investments and property sales. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 8


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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 2022 11 $ 47,372 3.6% 2023 4 14,904 1.1% 2024 1 2,731 0.2% 2025 7 18,785 1.4% 2026 4 2,333 0.2% 2027 1 3,346 0.3% 2028 4 5,836 0.4% 2029 6 15,927 1.2% 2030 11 6,054 0.5% 2031 4 4,211 0.3% Thereafter 383 1,206,096 90.8% 436 $ 1,327,595 100.0% Percentage of total base rent/interest 100% 90.8% 90% 80% 70% 60% 50% 40% 30% 20% 10% 3.6% 1.1% 0.2% 1.4% 0.2% 0.3% 0.4% 1.2% 0.5% 0.3% 0% (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 0.2% of total pro forma gross assets, and six facilities that are under development. (D) Represents base rent/interest income on an annualized basis as of period end 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 | Q2 2022 9


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUES BY ASSET TYPE (June 30, 2022) ($ amounts in thousands) Pro Forma Total Adjusted Total Percentage of Q2 2022 Percentage of Asset Types Properties (A) (B) Gross Assets Total Gross Assets Revenues Q2 2022 Revenues General Acute Care Hospitals 214 $ 15,995,775 71.8% $ 339,106 75.5% Behavioral Health Facilities 61 2,508,938 11.2% 51,763 11.5% Inpatient Rehabilitation Facilities 111 1,963,046 8.8% 44,201 9.8% Long-Term Acute Care Hospitals 20 327,335 1.5% 8,270 1.9% Freestanding ER/Urgent Care Facilities 41 247,974 1.1% 5,828 1.3% Other—1,241,351 5.6% — Total 447 $ 22,284,419 100.0% $ 449,168 100.0% TOTAL PRO FORMA GROSS ASSETS BY ASSET TYPE TOTAL ADJUSTED REVENUES BY ASSET TYPE 1% 6% 1% 1% 2% 9% General Acute Care Hospitals 10% Behavioral Health Facilities 11% 11% Inpatient Rehabilitation Facilities 72% Long-Term Acute Care Hospitals 76% Freestanding ER/Urgent Care Facilities Other DOMESTIC PRO FORMA GROSS ASSETS BY ASSET TYPE DOMESTIC ADJUSTED REVENUES BY ASSET TYPE 2% 6% 3% 2% 7% 2% 6% General Acute Care Hospitals 8% Behavioral Health Facilities 9% Inpatient Rehabilitation Facilities 75% Long-Term Acute Care Hospitals 80% 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 material real estate commitments on new investments are fully funded. See press release dated August 3, 2022 for reconciliation of total assets to total pro forma gross assets at June 30, 2022. (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 August 3, 2022 for a reconciliation of actual revenues to total adjusted revenues. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 10


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS—LARGEST INDIVIDUAL FACILITY (June 30, 2022) COMPREHENSIVE PROPERTY-LEVELUNDERWRITING FRAMEWORK Percentage of Operators Total Pro Forma Gross MPT invests in real estate, not the consolidated financial performance of its tenants. Assets—Largest Each facility is underwritten for characteristics that make the infrastructure (A) attractive to any experienced, competent operator -not just the current tenant. If we Individual Facility 2.5% have underwritten these correctly, then coupled with our absolute net master lease Steward Health Care structure, our real estate will be attractive to a replacement operator, in the rare Prospect Medical Holdings 1.1% event we must transition. Such underwriting characteristics include: Circle Health 1.0% Swiss Medical Network 0.8% MEDIAN 0.3% Physical Quality Competition 49 operators 1.3% Largest Individual Facility Investment is Less Than 3% of MPT Investment Portfolio Demographics Financial and Market TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUES BY OPERATOR (June 30, 2022) ($ amounts in thousands) Pro Forma Total Adjusted Total Percentage of Q2 2022 Percentage of Operators (B) Properties (A) (C) Gross Assets Total Gross Assets Revenues Q2 2022 Revenues Steward Health Care 41 Florida market $ 1,377,996 6.2% $ 28,263 6.3% Utah market 1,310,776 5.9% 35,808 8.0% Massachusetts market 1,152,118 5.1% 27,012 6.0% Texas/Arkansas/Louisiana market 1,115,557 5.0% 21,103 4.7% Arizona market 352,325 1.6% 9,185 2.0% Ohio/Pennsylvania market 138,345 0.6% 3,698 0.8% Circle Health 36 2,228,804 10.0% 47,539 10.6% Prospect Medical Holdings 14 1,751,440 7.9% 42,364 9.4% Swiss Medical Network 17 1,272,123 5.7% 11,284 2.5% MEDIAN 78 1,079,940 4.8% 21,728 4.8% 49 operators 261 9,263,644 41.6% 201,184 44.9% Other—1,241,351 5.6% — Total 447 $ 22,284,419 100.0% $ 449,168 100.0% (A) Includes gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming material real estate commitments on new investments are fully funded. See press release dated August 3, 2022 for reconciliation of total assets to total pro forma gross assets at June 30, 2022. (B) Section 2340 of the SEC Staff’s Financial Reporting Manual states that audited financial statements of lessees should generally be provided, if properties triple-net leased to a single lessee exceed 20% of the registrant’s assets. At June 30, 2022, we did not have a single lessee (including Steward Health Care) in which the value of the leased properties (subject to a triple-net lease) represented more than 20% of our total assets. (C) 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 August 3, 2022 for a reconciliation of actual revenues to total adjusted revenues. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 11


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PORTFOLIO INFORMATION TOTAL PRO FORMA GROSS ASSETS AND ADJUSTED REVENUES BY U.S. STATE AND COUNTRY (June 30, 2022) ($ amounts in thousands) Pro Forma Total Adjusted Total Percentage of Q2 2022 Percentage of U.S. States and Other Countries Properties (A) (B) Gross Assets Total Gross Assets Revenues Q2 2022 Revenues Texas 52 $ 2,090,829 9.4% $ 41,310 9.2% California 28 1,753,744 7.9% 48,109 10.7% Florida 9 1,377,996 6.2% 28,263 6.3% Utah 7 1,346,356 6.0% 36,795 8.2% Massachusetts 10 1,157,518 5.2% 27,175 6.0% 27 Other States 124 5,088,441 22.8% 125,128 27.9% Other—875,487 3.9% — United States 230 $ 13,690,371 61.4% $ 306,780 68.3% United Kingdom 81 $ 4,041,683 18.1% $ 79,415 17.7% Switzerland 17 1,272,123 5.7% 11,284 2.5% Germany 82 1,164,361 5.2% 23,642 5.3% Australia 11 916,603 4.1% 15,846 3.5% Spain 9 323,935 1.5% 3,498 0.8% Other Countries 17 509,479 2.3% 8,703 1.9% Other—365,864 1.7% — International 217 $ 8,594,048 38.6% $ 142,388 31.7% Total 447 $ 22,284,419 100.0% $ 449,168 100.0% (A) Includes gross real estate assets, other loans, equity investments, and pro rata portion of gross assets in joint venture arrangements, assuming material real estate commitments on new investments are fully funded. See press release dated August 3, 2022 for reconciliation of total assets to total pro forma gross assets at June 30, 2022. (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 August 3, 2022 for a reconciliation of actual revenues to total adjusted revenues. TOTAL PRO FORMA GROSS ASSETS BY COUNTRY TOTAL ADJUSTED REVENUES BY COUNTRY 2% 2% 2% 4% 1% 2% 5% United States 2% 4% United Kingdom 5% 6% Switzerland Germany 18% 61% 18% Australia 68% Spain Other Countries Other PRO FORMA GROSS ASSETS BY U.S. STATE ADJUSTED REVENUES BY U.S. STATE Texas 4% 9% 9% California Florida 28% 11% 8% Utah 23% 6% Massachusetts 6% 6% 27 Other States 8% 5% 6% Other MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 12


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PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM AND EBITDAR (A)(B) RENT COVERAGE INCLUSIVE OF ALL CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE Notes: All data presented is on a trailing twelve month basis. For properties acquired in the preceding twelve months, data is for the period between MPT acquisition and March 31, 2022. (A) EBITDARM is facility-level earnings before interest, taxes, depreciation, amortization, rent and management fees. EBITDAR is EBITDARM less management fees (corporate overhead) that reflects a 5% normalized fee applied across all facilities. EBITDARM and EBITDAR include normal GAAP expensed maintenance and repair costs. EBITDARM and EBITDAR do not give effect for capitalized expenditures that extend the life or improve the facility and equipment in a way to drive more future revenues. The majority of these types of capital expenditures are financed and do not have an immediate cash impact. MPT’s rent is not subordinate to capitalized expenses. In addition, EBITDARM and EBITDAR do not represent property net income or cash flows from operations and should not be considered an alternative to those indicators. EBITDARM and EBITDAR figures utilized in calculating coverages presented are based on financial information provided by MPT’s tenants. MPT has not independently verified this information, but has no reason to believe this information is inaccurate in any material respect. TTM Coverages are calculated based on actual, unadjusted EBITDARM and EBITDAR results as presented in tenant financial reporting and cash rent paid to MPT, except as noted below.—Total CARES Act Grants received by tenants during the period between March 2020 and June 2021 have been spread evenly by quarter from Q2 2020 through Q2 2021. Any additional grants received after June 2021 are included in the quarter that they were recorded by the tenant.—Steward Health Care EBITDARM and EBITDAR have been adjusted for a one-time out-of-period legal settlement in July 2020.—LifePoint Health EBITDARM and EBITDAR have been adjusted for a one-time out-of-period legal settlement in June 2020. (B) General Acute Care coverages and Total Portfolio coverages include Prospect Medical Holdings’s Pennsylvania and Connecticut facilities. Prospect Medical Holdings has entered into non-binding letters of intent for its Pennsylvania and Connecticut operations. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 13


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PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM AND EBITDAR RENT COVERAGE INCLUSIVE OF ALL CARES ACT GRANTS EBITDARM AND EBITDAR RENT COVERAGE: OPERATORS WITH PROPERTY-LEVEL REPORTING Investment Tenant (A) Primary Property Type TTM EBITDARM Rent Coverage TTM EBITDAR Rent Coverage (in thousands) Steward Health Care $ 4,281,622 General Acute 2.6x 1.8x MEDIAN 1,079,940 IRF 1.9x 1.5x Prime Healthcare 1,007,076 General Acute 4.2x 3.0x Priory Group 870,652 Behavioral 1.9x 1.5x Springstone 804,676 Behavioral 1.4x 1.0x Prospect Medical Holdings(B) 699,040 General Acute 1.3x 0.6x LifePoint Health 599,254 General Acute 2.0x 0.9x Ernest Health 521,764 IRF/LTACH 2.6x 2.1x ScionHealth 454,742 General Acute /LTACH 1.7x 0.9x Vibra Healthcare 272,845 IRF/LTACH 2.2x 1.6x Aspris Children’s Services 244,960 Behavioral 2.1x 1.8x Pipeline Health System 218,318 General Acute 1.6x 0.7x Surgery Partners 196,253 General Acute 7.1x 5.7x HM Hospitales 163,318 General Acute 3.4x 2.7x Other Reporting Tenants 702,555 Various 2.2x 1.7x Total $ 12,117,015 2.6x 1.9x Investment Tenant (A) Primary Property Type TTM EBITDARM Rent Coverage TTM EBITDAR Rent Coverage (in thousands) International Operator 1 $ 2,175,844 General Acute 2.3x 1.9x International Operator 2 916,602 General Acute 1.9x 1.4x Total $ 3,092,446 2.2x 1.7x PROPERTY-LEVEL REPORTING NOT REQUIRED AND/OR NOT AVAILABLE Investment Tenant (A) Primary Property Type Comments (in thousands) Swiss Medical Network $ 1,047,690 General Acute 2021 AEVIS Hospital Segment 1.9x EBITDARM lease coverage One of the largest health care operators in the world; Parent Guaranty; Investment Ramsay Health Care UK 426,432 General Acute grade-rated Pihlajalinna 219,000 General Acute Finland’s leading producer of social and health services Saint Luke’s—Kansas City 145,648 General Acute Investment grade-rated NHS 98,407 General Acute Single-payor government entity in UK Dignity Health 51,357 General Acute Part of CommonSpirit; Parent guaranty; Investment grade-rated Community Health Systems 41,443 General Acute U.S. hospital operator with substantial operating history McLeod Health 37,824 General Acute Parent guaranty Largest private hospital system in Portugal with 18 facilities and 75+ year operating Jose de Mello—CUF 32,165 General Acute history NeuroPsychiatric Hospitals 28,509 Behavioral Parent guaranty Other Tenants 70,102 General Acute N/A Total $ 2,198,577 Above data represents approximately 90% of MPT Total Real Estate Investment Notes: All data presented is on a trailing twelve month basis. For properties acquired in the preceding twelve months, data is for the period between MPT acquisition and March 31, 2022. (A) Investment figures exclude non-real estate equity investments, non-real estate loans, freestanding ER/urgent care facilities, and facilities under development. (B) Prospect Medical Holdings’s coverage excludes Pennsylvania and Connecticut as Prospect Medical Holdings has entered into non-binding letters of intent for its Pennsylvania and Connecticut operations. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 14


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PORTFOLIO INFORMATION SUMMARY OF COMPLETED INVESTMENTS (For the six months ended June 30, 2022) (Amounts in thousands) Operator Location Investment (A) Commencement Date Investment/ Development Priory Group U.K. $ 131,105 Q1 2022 Investment Ernest Health California 47,929 Q1 2022 Development Pihlajalinna Finland 194,234 Q1 2022 Investment Steward Health Care Arizona 20,000 Q2 2022 Investment Steward Health Care Florida 60,000 Q2 2022 Investment GenesisCare Spain 28,472 Q2 2022 Investment $ 481,740 SUMMARY OF CURRENT DEVELOPMENT PROJECTS AS OF JUNE 30, 2022 (Amounts in thousands) Costs Incurred as of Estimated Commencement Operator Location Commitment June 30, 2022 Date Steward Health Care Texas $ 169,408 $ 57,405 Q2 2024 IMED Hospitales Spain 49,371 12,542 Q2 2023 Ernest Health California 47,700 42,073 Q3 2022 IMED Hospitales Spain 44,470 29,538 Q3 2023 IMED Hospitales Spain 35,975 8,000 Q3 2024 Springstone Texas 34,600—Q1 2024 $ 381,524 $ 149,558 (A) Excludes transaction costs, such as real estate transfer and other taxes. Amount assumes exchange rate as of the investment date. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 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 Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 REVENUES Rent billed $ 241,209 $ 216,870 $ 504,611 $ 430,214 Straight-line rent 58,518 55,465 119,562 110,338 Income from financing leases 51,873 50,337 103,649 101,231 Interest and other income 48,626 59,120 82,204 102,774 Total revenues 400,226 381,792 810,026 744,557 EXPENSES Interest 87,730 92,305 178,913 179,277 Real estate depreciation and amortization 84,334 76,369 169,650 152,011 Property-related (A) 21,135 18,684 29,733 24,137 General and administrative 38,858 34,545 80,282 70,618 Total expenses 232,057 221,903 458,578 426,043 OTHER INCOME (EXPENSE) Gain (loss) on sale of real estate and other, net 16,355 (1,387) 467,993 (398) Earnings from equity interests 14,785 7,339 22,123 14,440 Debt refinancing and unutilized financing costs (619) (70) (9,435) (2,339) Other (including fair value adjustments on securities) 2,031 (771) 11,918 7,023 Total other income 32,552 5,111 492,599 18,726 Income before income tax 200,721 165,000 844,047 337,240 Income tax expense (10,657) (50,179) (22,036) (58,539) Net income 190,064 114,821 822,011 278,701 Net income attributable to non-controlling interests (467) (256) (733) (353) Net income attributable to MPT common stockholders $ 189,597 $ 114,565 $ 821,278 $ 278,348 EARNINGS PER COMMON SHARE—BASIC AND DILUTED Net income attributable to MPT common stockholders $ 0.32 $ 0.19 $ 1.37 $ 0.48 WEIGHTED AVERAGE SHARES OUTSTANDING—BASIC 598,827 587,514 598,751 581,877 WEIGHTED AVERAGE SHARES OUTSTANDING—DILUTED 599,026 589,053 598,979 583,297 $—$—DIVIDENDS DECLARED PER COMMON SHARE $ 0.29 $ 0.28 $ 0.58 $ 0.56 (A) Includes $18.3 million and $15.5 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 months ended June 30, 2022 and 2021, respectively, and $24.6 million and $19.0 million for the six months ended June 30, 2022 and 2021, respectively. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 16


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FINANCIAL STATEMENTS CONSOLIDATED BALANCE SHEETS (Amounts in thousands, except per share data) June 30, 2022 December 31, 2021 (Unaudited) (A) ASSETS Real estate assets Land, buildings and improvements, intangible lease assets, and other $ 13,696,681 $ 14,062,722 Investment in financing leases 2,076,813 2,053,327 Real estate held for sale—1,096,505 Mortgage loans 314,681 213,211 Gross investment in real estate assets 16,088,175 17,425,765 Accumulated depreciation and amortization (1,109,592) (993,100) Net investment in real estate assets 14,978,583 16,432,665 Cash and cash equivalents 257,269 459,227 Interest and rent receivables 94,206 56,229 Straight-line rent receivables 702,683 728,522 Investments in unconsolidated real estate joint ventures 1,460,373 1,152,927 Investments in unconsolidated operating entities 1,439,910 1,289,434 Other loans 213,897 67,317 Other assets 596,163 333,480 Total Assets $ 19,743,084 $ 20,519,801 LIABILITIES AND EQUITY Liabilities Debt, net $ 10,138,774 $ 11,282,770 Accounts payable and accrued expenses 562,255 607,792 Deferred revenue 21,210 25,563 Obligations to tenants and other lease liabilities 154,974 158,005 Total Liabilities 10,877,213 12,074,130 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—598,839 shares at June 30, 2022 and 596,748 shares at December 31, 2021 599 597 Additional paid-in capital 8,557,120 8,564,009 Retained earnings (deficit) 385,545 (87,691) Accumulated other comprehensive loss (83,431) (36,727) Total Medical Properties Trust, Inc. Stockholders’ Equity 8,859,833 8,440,188 Non-controlling interests 6,038 5,483 Total Equity 8,865,871 8,445,671 Total Liabilities and Equity $ 19,743,084 $ 20,519,801 (A) Financials have been derived from the prior year audited financial statements. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 17


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FINANCIAL STATEMENTS INVESTMENTS IN UNCONSOLIDATED REAL ESTATE JOINT VENTURES (As of and for the three months ended June 30, 2022) (Unaudited) ($ amounts in thousands) Swiss Medical Steward Health Policlinico di HM MPT Pro Rata MEDIAN (C) (D) (E) (F) (G) Total Network Care Monza Hospitales Share Gross real estate $ 1,841,933 $ 1,373,021 $ 1,671,000 $ 175,730 $ 354,955 $ 5,416,639 $ 2,965,176 Cash 29,556 3,283 18,025 19,300 4,098 74,262 37,583 Accumulated depreciation and amortization (165,588) (88,988) (12,251) (25,564) (18,563) (310,954) (172,346) Other assets 57,706 134,063 48,306 11,890 3,700 255,665 154,460 Total Assets $ 1,763,607 $ 1,421,379 $ 1,725,080 $ 181,356 $ 344,190 $ 5,435,612 $ 2,984,873 Debt (third party) $ 681,835 $ 647,339 $ 900,394 $—$ 137,193 $ 2,366,761 $ 1,305,989 Other liabilities 126,754 153,579 7,324 16,260 79,637 383,554 218,511 Equity and shareholder loans 955,018(A) 620,461 817,362 165,096 127,360 2,685,297 1,460,373 Total Liabilities and Equity $ 1,763,607 $ 1,421,379 $ 1,725,080 $ 181,356 $ 344,190 $ 5,435,612 $ 2,984,873 MPT share of real estate joint venture 50% 70% 50% 50% 45% Total $ 477,509 $ 434,323 $ 408,681 $ 82,548 $ 57,312 $ 1,460,373 Swiss Medical Steward Health Policlinico di HM MPT Pro Rata MEDIAN (C) (D) (E) (F) (G) Total Network Care Monza Hospitales Share Total revenues (B) $ 30,608 $ 15,705 $ 38,123 $ 3,893 $ 3,637 $ 91,966 $ 48,942 Expenses: Property-related $ 458 $ 756 $ 6,034 $ 806 $ 31 $ 8,085 $ 4,192 Interest 12,576 1,983 11,232—533 26,324 13,532 Real estate depreciation and amortization 10,984 7,826 10,264 1,018 2,007 32,099 17,514 General and administrative 444 274 64 58 13 853 481 Income taxes 1,174 (463) — 269 980 384 Total expenses $ 25,636 $ 10,376 $ 27,594 $ 1,882 $ 2,853 $ 68,341 $ 36,103 Net Income $ 4,972 $ 5,329 $ 10,529 $ 2,011 $ 784 $ 23,625 $ 12,839 MPT share of real estate joint venture 50% 70% 50% 50% 45% (H) Earnings from equity interests $ 2,486 $ 3,729 $ 5,265 $ 1,006 $ 353 $ 12,839 (A) Includes approximately $310 million shareholder loan. (B) Includes $5.0 million of straight-line rent revenue. (C) MPT managed joint venture of 71-owned German facilities that are fully leased. (D) Represents ownership in Infracore, which owns and leases all 17 Switzerland facilities. (E) MPT managed joint venture of eight-owned Massachusetts hospital facilities that are fully leased pursuant to a master lease. (F) Represents ownership in eight Italian facilities that are fully leased. (G) Represents ownership in two Spanish facilities that are fully leased. (H) Excludes $1.9 million of dividend income earned on our Aevis investment that is included in “Earnings from equity interests” on our consolidated statement of income. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 18


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FINANCIAL STATEMENTS INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES (Amounts in thousands) OPERATING ENTITY INVESTMENT FRAMEWORK MPT’s hospital expertise and comprehensive underwriting process allows for opportunistic investments in hospital operations. • Passive investments typically needed in order to acquire the larger • Certain of these investments entitle us to customary minority rights and real estate transactions. protections. • Cash payments go to previous owner and not to the tenant, with • No additional operating loss exposure beyond our investment. limited exceptions. • Proven track record of successful investments, including Ernest Health • Operators are vetted as part of our overall underwriting process. and Capella Healthcare. • Potential for outsized returns and organic growth. Investment Ownership Operator as of Structure Interest June 30, 2022 Loan, for which proceeds were paid to Steward’s former private equity sponsor, is secured by the equity Steward Health Care $ 362,821 N/A of Steward and provides for an initial 4% cash return plus 37% of the increase in the value of Steward over seven years. Includes our 49% equity ownership interest and a loan made for the purpose of investing in select International Joint Venture 231,402 49.0% international hospital operations. The loan carries a 7.5% interest rate and is secured by the remaining equity of the international joint venture and guaranteed by the other equity owner. In order to close the 2021 acquisition of 18 behavioral facilities, we made a 49% equity investment and Springstone 196,768 49.0% a loan, proceeds of which were paid to the former owners of the Springstone operating entity. The loan carries an 8% interest rate and is secured by the remaining equity of the other equity owner. In order to close the 2021 acquisition of 35 facilities, we made a 9.9% passive equity investment and a Priory 156,389 9.9% loan, proceeds of which were paid to the former owner. The loan carries a variable interest rate. Includes our passive equity ownership interest, along with a CHF 45 million loan as part of a syndicated Swiss Medical Network 152,128 10.0% loan facility. Earned approximately $1.3 million in dividends in Q2 2022. Includes our passive equity ownership interest. Proceeds from our investment were paid directly to Steward Health Care 139,000 9.9% Steward’s former private equity sponsor and other shareholders. Loan originated in connection with the overall $1.55 billion acquisition of 14 facilities, proceeds of Prospect Medical Holdings 112,772 N/A which were paid to the prior owner. The loan carries an interest rate of 8% and matures in 2026. The loan is secured and cross-defaulted with real estate and guaranteed by Parent. Includes our passive equity ownership interest in Aevis, a public healthcare investment company. Our Aevis 72,590 4.6% original investment of CHF 47 million is marked-to-market quarterly. Earned approximately $4.0 million in dividends in Q2 2022. Includes our passive equity ownership interest in Aspris, a recent spin-off of Priory’s education and Aspris 16,040 9.9% children’s services line of business. Total $ 1,439,910 INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES AS A PERCENTAGE OF TOTAL ASSETS 7% 93% MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q2 2022 19


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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

EX-99.3

Exhibit 99.3

 

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Pictured: Morton Hospital Investor Update AUGUST 2022


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AT THE VERY HEART OF HEALTH CARE.®


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FORWARD-LOOKING STATEMENTS This presentation 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, health crises like COVID-19, 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; (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 regulations in the operation of our properties, to deliver high-quality services, to attract and retain qualified personnel and to attract patients; (xv) potential environmental contingencies and other liabilities, and (xvi) the risk that property sales, loan repayments, and other capital recycling transactions do 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, 2021 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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MPT INVESTS IN REAL ESTATE NOT THE CONSOLIDATED FINANCIAL PERFORMANCE OF ITS TENANTS MPT’S UNDERWRITING PROCESS IDENTIFIES CERTAIN CHARACTERISTICS IN EACH PHYSICAL FACILITY THAT MAKE IT ATTRACTIVE TO ANY EXPERIENCED AND COMPETENT OPERATOR –INCLUDING THE CURRENT TENANT • History of maintenance and improvements in critical care-delivery spaces such as operating Physical Quality theatres, emergency departments, imaging facilities, patient rooms, etc. • High quality and modern technology for imaging, lab and surgical equipment • Cost to fully replace facility significantly in excess of acquisition cost Demographics • Measurable patient demand growth • Sustainable reimbursement sources and Market • Desirable work/live environment • Replacement cost advantage • Growth constraints on existing competitors Competition • Licensing and other regulations • Scarcity of developable real estate • High start-up costs for new entrants • Facility-level operations generate strong EBITDARM coverage of contractual lease payments Financial • Patient and case mix result in high-quality and diverse reimbursement sources • Diverse and unconcentrated physician and other (i.e. ED) referral sources If a facility meets the criteria above, its very existence is the natural result of true community need, and the proper conditions are in place for profitability. Nonetheless, if an operator becomes distressed and cannot meet its obligations, MPT’s absolute net, master leased structures facilitate a rapid transition to a competent replacement operator. 4


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ESSENTIAL HOSPITAL REAL ESTATE STAYS LEASED TO COMPETENT OPERATORS, AS PROVEN BY MPT’S HISTORY SPECIALIZED EXPERTISE DEMONSTRATED MPT CASH FLOWS PROTECTED BY THE NATURE FOR NEARLY TWO DECADES OF HOSPITALS, AS WELL AS LEASE STRUCTURE MPT has replaced only 11 operators of 20 facilities, in addition to the The right to access the hospital building is an operator’s most Adeptus portfolio, over the course of cumulatively investing more important asset than $24 billion in nearly 530 hospitals. • Hospital license is attached to facility itself (no building, no business) Real Estate Recovered/ Gross Retained (Loss) Landlords cannot be “crammed down” in bankruptcy Operator Facilities Investment Valuation Recovery • Lessees may only accept or reject a lease, and landlords cannot be Adeptus1 59 $415 MM $482 MM $67 MM compelled to negotiate • Lessees must stay current on all lease requirements All others since 2 20 $605 MM $585 MM ($20 MM) inception Bumps in the road Total 79 $1.02 BN $1.07 BN $47 MM • Truly temporary or correctible challenges, not uncommon over a multi-decade lease, rarely justify lease termination WELL-UNDERWRITTEN HOSPITALS RAPIDLY ATTRACT COMPETENT OPERATORS HOUSTON TOWN & COUNTRY SHASTA REGIONAL MEDICAL CENTER COVINGTON LTACH GENERAL ACUTE CARE HOSPITAL (Houston, TX) GENERAL ACUTE CARE HOSPITAL (Redding, CA) LONG-TERM ACUTE CARE (Covington, LA) RE Investment $57 MM RE Investment $57 MM RE Investment $12 MM Recovered $72 MM • Original operator Hospital Partners of Sold for $15 MM America files for bankruptcy • Original operator failed due to the • Original operator files for bankruptcy due • In October 2008, the replacement absence of key managed care contracts to parent-level liquidity issues in 2011 operator paid MPT $12 MM in cash for the • Lease terminated in October 2006 • Promptly re-leased to the replacement right to immediately assume the lease at • No interruption of services operator with no missed rent and a 20% an increased lease base • No missed rent payments profits interest in the operator for no • No missed rent or service interruption, • Sold promptly to Memorial Hermann additional MPT investment and the facility remains leased • Property sold at a gain in 2016 1. See page 7 of April 2022 Investor Update 2. Aggregate of all lease/mortgaged facilities transitioned from the original lessee since MPT’s 2005 IPO; represents real estate investments and does not include any costs 5 incurred by MPT for operations or costs of transition. Primarily comprised of lease transitions and sales to third parties.


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FOR MPT PURPOSES, AN OPERATOR IS AS HEALTHY AS ITS HOSPITALS MPT IS COMMITTED TO TRANSPARENT COVERAGE REPORTING THAT ALIGNS WITH ITS OWN FACILITY-CENTRIC UNDERWRITING APPROACH Tenants operate and invest in business segments not directly MPT rarely owns 100% of an operator’s real estate and, in relevant to the profitable operations of MPT facilities many cases, does not own a majority 1 Hospitals account for a majority of operator total revenue (often > 90%) and are central to enterprise value, largely due to high barriers to entry related to the business such as: CERTIFICATE OF NEED SIGNIFICANT REAL ESTATE HIGH START-UP TIME INVESTMENT TO OBTAIN PATIENT LAWS AND LICENSURE REQUIREMENT AND AND OPERATING VOLUME AND REFERRALS FROM REQUIREMENTS CAPITAL INTENSITY COSTS A LIMITED NUMBER OF PHYSICIANS 2 Hospitals can and do exist without Corporate Offices yet, “Corporate” would not exist without the hospitals they support. 3Hospitals own/operate entities focused throughout the full spectrum of care, coordinate referral patterns and control valuable health information/data MD Managed Offices Outpatient â–ª Ancillary healthcare functions remain reliant on hospitals Care clinics o Physicians need venue to perform surgeries, refer patients for Networks diagnostics and to transfer high-acuity patients o Ambulatory surgery centers limited in scope and generally Medical require transfer agreements with hospitals STRATEGICALLY FSEDs Groups o Most long-term care facilities (LTACH, SNF, etc.) have similar LOCATED CLOSE agreements with hospitals TO HOSPITALS Labs ASCs 4 Hospitals and health systems are often one of a community’s largest employers Rehab Imaging – in urban, suburban and rural areas Centers Centers 6


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CONSERVATIVE EBITDAR COVERAGE REPORTING REINTRODUCED TO FURTHER ENHANCE TRANSPARENCY FACILITY-LEVEL EBITDARM = NET FACILITY REVENUE, LESS DIRECT OPERATING EXPENSES SUCH AS: PEOPLE SUPPLIES DRUGS MAINTENANCE PROPERTY TAX UTILITIES INSURANCE (Wages, Benefits, AND REPAIRS Contract Labor, (expensed here and typically Purchased Services 3-4% of net revenue) and Professional Fees) FACILITY-LEVEL EBITDAR ALSO SUBTRACTS ALLOCATED “MANAGEMENT FEE” OF ~5% OF NET REVENUE: â–ª While many facility-level management functions are already expensed in the calculation of EBITDARM, EBITDAR also compensates for a conservative estimate of tenant corporate entity-level expenses that would remain relevant to the operations of MPT facilities in the rare event of a tenant transition REVENUE CYCLE LEGAL ACCOUNTING INFORMATION HUMAN MANAGEMENT TECHNOLOGY RESOURCES â–ª EBITDAR-based coverages were reported through Q2 2018, after which time MPT determined in conversations with stakeholders that the market was not awarding “credit” for conservative reporting methodology â–ª MPT has reintroduced facility-level EBITDAR coverage disclosure with Q2 2022 earnings 7


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INVESTMENT IN OPERATORS INSTRUMENTAL IN ASSEMBLING REAL ESTATE BUT REMAINS A SECONDARY FOCUS MPT HAS LONG INVESTED A RELATIVELY SMALL PERCENTAGE OF ITS OVERALL PORTFOLIO IN ITS OPERATORS â–ª Importantly, more than half of MPT’s investments in 10% unconsolidated entities in the second quarter of 2022 was 9% comprised of real estate joint ventures – much of which was formerly consolidated 8% 7% 7% â–ª At 6/30/2022, MPT’s investments in unconsolidated operating entities represented roughly 7% of total pro forma gross assets, 6% modestly above MPT’s 6% average since IPO (see chart) 5% â–ª While underwritten to be individually profitable, the broader 4% purpose of non-real estate investments is to source current and 3% future real estate opportunities 2% â–ª With very few exceptions, cash consideration from MPT for all 1% investments is paid immediately to the seller of the assets and is 0% never made available to the operator 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Q2 â–ª Investments in operators can take the following forms: MPT Non-Real Estate Investments (percentage of Passive Equity Total Pro Forma Gross Assets) Short- and RIDEA interest Average Long-term Loans Ownership in Operator As well as other loan Interest Often the result of the seller of derivative instruments a platform requiring same buyer to purchase “WholeCo” 8 Total Pro Forma Gross Assets for period 2016—Q1 2022 is further explained on slide 14


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COMPETENCE AND CONFIDENCE TO INVEST IN OPCOS: A HIGHLY PROFITABLE COMPETITIVE ADVANTAGE MPT’S SCALE AND EXPERTISE ARE OF GREAT BENEFIT WHEN A SELLER MANDATES A “WHOLECO” EXIT OpCo Exit OpCo 2004 2012 Holding period: (Ernest, Capella, Springstone) Holding period: Seven IRF/LTACH + $400 MM “WholeCo” 6 years Repaid within 5 years properties acquired purchase of Ernest, 13% unlevered IRR for $212 MM includes 16 hospitals for o OpCo investments become prior to MPT’s IPO. ~$300 MM. on 2018 sale of OpCo independently marketable for $43 MM secured $96 MM convertible loan profitable exit, often quickly loan investment. investment. Cash consideration was paid from MPT to seller and not retained by operator in MPT now owns ~$900 MM in combined materially all cases listed Ernest and Vibra real estate OpCo Exit OpCo Exit 2014 2015 Holding period: Holding period: < 1 year MPT acquires 32 German post-acute $600 MM investment 7 years facilities for $880 MM, concurrent with in seven Capella hospitals. 8% unlevered IRR Waterland’s purchase of their operations. 13% unlevered IRR $300 MM debt and equity on sale of OpCo €11 MM passive investment in operator on 2021 sale of OpCo investment in operator to facilitate to Apollo for the purpose of sourcing future real seller’s desired sale of entire estate opportunities. platform to single buyer. 50% interest in 71 properties Several hospitals from original sold in 2018 for €500 MM gain. Capella transaction included in today’s $1.1 BN $1.1 BN current MPT pro rata ownership Apollo-sponsored LifePoint and ScionHealth of 78 MEDIAN facilities. portfolios or since sold at a profit. 9 Note: IRRs represent unlevered internal rate of return


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CURRENT OPCO ROSTER SIMILAR TO PRIOR TRANSACTIONS IN ORIGIN, STRUCTURE AND POTENTIAL Materially all cash investment consideration paid to sellers of real estate and/or operations, not to the current operator International JV Est. 2021 Est. 2020 Est. 2016 Real Estate ~$870 MM Real Estate ~$4.6BN Real Estate ~$130 MM of UK behavioral facilities under master lease Colombian real estate under master lease of facilities under master lease and future and future real estate opportunities and future international real estate real estate opportunities OpCo $156 MM opportunities OpCo $363 MM Passive 9.9% equity interest in operations OpCo $231 MM loan investment in operator with and variable rate syndicated loan investment RIDEA investment in operator embedded upside participation features $139 MM Loan earning 7.5% interest 49% ownership of operator equity passive equity investment in operator Est. 2021 Real Estate ~$245 MM of UK childhood special education facilities Est. 2021 Note: “WholeCo” sale desired by and future real estate opportunities seller of platform OpCo $16 MM Est. 2019 Real Estate ~$800 MM Real Estate ~$1.0 BN passive equity ownership Swiss real estate held in 70% Infracore JV in 19 facilities under master lease, as well and future real estate opportunities as future opportunities OpCo $197 MM OpCo $152 MM passive investment marketable RIDEA investment in operator Est. 2019 in Swiss Medical Network Loan component earning 8% interest Real Estate ~$1.6 BN + 49% ownership of operator equity $73 MM passive equity ownership of of U.S. facilities and future real estate opportunities Swiss Medical majority owner Aevis Victoria OpCo $113 MM loan earning 8% interest 10


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STEWARD RELATIONSHIP IS CREATING ENDURING PROPERTY-BASED VALUE FOR MPT—WITH OPCO “OPTION VALUE” â–ª Approximately $1.6 billion in cash rent and interest â–ª Secondarily, equity and structured debt investments collected on real estate leased to Steward since Q4 2016 position MPT to benefit from growth in the value of Steward, with limited downside â–ª Approximate $600 million real estate gain on sale of eight Massachusetts hospitals in Q1 2022 o Steward’s Utah operations are highly profitable and generating â–ª ~$105 million EBITDA run-rate Utah real estate valued at $1.6 to $1.9 billion o Sale of non-core seniors managed care business to CareMax puts based on estimated 5.5% to 6.5% cap rate range Steward in position to capture substantial value in the form of ($1.2 billion MPT cost basis) CareMax stock (41% ownership) in full earnout scenario MPT TOTAL PRO FORMA GROSS ASSETS: STEWARD ($ MILLIONS) $6,000 $5,447 • Acquisition of 10 IASIS Health Care hospitals • MPT converts two mortgages in Utah into $5,381 • Initial MPT $5,156 in AR, AZ, TX, UT for $1.4 billion $950 MM in much preferred sale-leaseback investment in investments by providing Steward $200 nine Steward • MPT adds $100 MM to establish 9.9% equity $5,000 MM of incremental funds hospitals in interest in Steward $4,490 Massachusetts for • All cash consideration paid directly to seller • Acquisition of two $1.2 BN MPT passive Steward facilities in • 5% $3,879 AZ and FL for $80 MM interest in • Cash paid to seller $4,000 Steward initiated $4,205 for $50 MM $3,411 • All cash proceeds • MPT invests $335 MM in paid by Steward Steward to fund the exit of • MPT announces to former sponsor former sponsor Cerberus $3,000 Macquarie partnership Cerberus (cash paid directly to • MPT acquires transaction on eight Cerberus) Scenic Valley Medical Center in West MPT Mass. hospitals with Texas for $26 MM • receives $11 MM approx. $600 MM gain on distribution on its sale of real estate • Cash proceeds to Steward to fund their 9.9% equity interest $2,000 acquisition of the operations and • $1.3 BN in cash received $1,551 substantial investment in facility by MPT • MPT acquires 5 properties in South • Acquisition of eight hospitals Florida from Tenet Health for $900 MM in FL, OH and PA from $1,000 $1,250 Community Health Systems • Steward acquires the operating for ~$300 MM entity without MPT funding • All cash consideration • Cash from MPT paid directly to seller paid directly to seller $- Q3 2016 Q4 2016 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 Q1 2021 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Source: Company filings 11


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STEWARD OPERATIONS HAVE IMPROVED SUBSTANTIALLY, AHEAD OF FOURTH QUARTER CASH FLOW RESET WINNING CORPORATE STRATEGY Steward is focused on applying its physician-led and technologically advanced care delivery model to improve outcomes, lower costs and create lasting partnerships with communities. The level of success Steward continues to demonstrate in Massachusetts and Utah is being replicated in new strategic markets. OPERATIONS RAMPED-UP TO STRONG RUN-RATE DURING Q2 20221 Results improving substantially versus Q1 2022, as restrictions on elective surgeries in Massachusetts have expired and as staffing and other cost pressures have eased. â–ª Volume metrics up across all key categories â–ª May and June significantly outperformed â–ª Higher-quality volume improving profitability original expectations â–ª EBITDAR increased in majority of regions â–ª Q2 2022 +11% versus pre-COVID Q2 2019 â–ª Contract labor expense decreased 21%, with (excluding South Florida) labor costs now < 50% of revenue LIQUIDITY UPDATE1 Recent improvements to hospital operations noted above are expected to continue through the remainder of the year and to coincide with positive developments related to Steward’s liquidity position: â–ª $350 million annual labor and non-labor cost savings initiative is fully-implemented as of August â–ª $70 million in Medicaid reimbursement previously delayed due to dispute between Texas and CMS is now being collected â–ª $70 million collection in Q3 2022 of accounts receivable related to Tenet transition in Florida â–ª $125 million in cash expected from CareMax transaction, expected to close in Q4 2022 â–ª $45-50 million current monthly pace of Medicare advance and Tenet management contract repayments ends in September Steward expects a substantial and sustainable positive free cash flow run-rate beginning in Q4 2022 12 1 The information was provided by Steward Health Care. We have not independently verified this information.


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HOSPITAL REAL ESTATE THAT STAYS LEASED SUPPORTS DECADES OF COMPOUNDING, INFLATION-PROTECTED CASH FLOW ESCALATORS CREATE IMMEDIATE VALUE WITHOUT A CORRESPONDING CAPITAL COST Pro forma 2022 cash rent1 ~$1,295 MM Estimated escalation for 20232 ~$57 MM Total estimated 2023 cash rent ~$1,352 MM Estimated escalation rate 4.4% Valuation of escalation in rental revenue if the blended ~$875 MM capitalization rate is assumed to be 6.5% The cash lease rate is permanently increased in any year in which the inflationary escalator exceeds the minimum contractual escalator 1 Adjusted for March 16, 2022 sale of 50% of Steward assets to Macquarie partnership as if completed on January 1, 2022 13 2 Based on July 2022 U.S., UK and EuroZone inflation


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TOTAL PRO FORMA GROSS ASSETS RECONCILIATION Total Pro Forma Gross Assets (Unaudited) (Amounts in millions) December 31, 2016 December 31, 2017 December 31, 2018 December 31, 2019 December 31, 2020 December 31, 2021 June 30, 2022 Total Assets $ 6,419 $ 9,020 $ 8,844 $ 14,467 $ 16,829 $ 20,520 $ 19,743 Add: Real estate commitments on new investments 288 18 865 1,989 1,901 —Accumulated depreciation and amortization 325 456 465 570 834 993 1,109 Incremental gross assets of our joint ventures and other1 — 376 564 1,287 1,713 1,689 Less: Cash used for funding the transactions above and debt repayment2 (83) (18) (722) (1,061) (421) (897) (257) Total Pro Forma Gross Assets $ 6,949 $ 9,476 $ 9,828 $ 16,529 $ 20,430 $ 22,329 $ 22,284 1 Adjustment to reflect our share of our joint ventures’ gross assets and certain lease intangible assets. 2 Includes cash available on hand plus cash generated from activities subsequent to period-end including loan repayments or dispositions, if any Gross assets derived from our consolidated balance sheet for period 2012—2015 and represents total assets before accumulated depreciation and amortization. We initiated reporting of total pro forma gross assets in 2017 (with disclosure provided for 2016). Total pro forma gross assets is total assets before accumulated depreciation/amortization (adjusted for our unconsolidated joint ventures) and assumes material real estate commitments on new investments are fully funded, and assumes cash on hand at period-end and cash generated from or to be generated from financing activities subsequent to period-end are either used in these transactions or used to reduce debt. We believe total pro forma 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. 14