8-K
MEDICAL PROPERTIES TRUST INC false 0001287865 0001287865 2023-02-23 2023-02-23

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(d)

OF THE SECURITIES EXCHANGE ACT OF 1934

Date of report (Date of earliest event reported): February 23, 2023

 

 

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 February 23, 2023, Medical Properties Trust, Inc. issued a press release announcing its financial results for the three and twelve months ended December 31, 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. The information in this Current Report on Form 8-K, including the information set forth in Exhibit 99.1 and Exhibit 99.2 attached hereto, shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liability of that section or Sections 11 and 12(a)(2) of the Securities Act of 1933, as amended. In addition, this information shall not be deemed incorporated by reference in any filing of Medical Properties Trust, Inc. with the Securities and Exchange Commission, except as expressly set forth by specific reference in any such filing.

Item 9.01. Financial Statements and Exhibits.

(d) Exhibits.

 

Exhibit Number   

Description

99.1    Press release dated February 23, 2023 reporting financial results for the three and twelve months ended December 31, 2022
99.2    Medical Properties Trust, Inc. 4th Quarter 2022 Supplemental Information
104    Cover Page Interactive Data File (embedded within the Inline XBRL document)

 

2


SIGNATURES

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

 

MEDICAL PROPERTIES TRUST, INC.
By:  

/s/ R. Steven Hamner

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

Date: February 23, 2023

 

3

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 FOURTH QUARTER AND FULL-YEAR RESULTS

Per Share Net Loss of ($0.24) and Normalized FFO of $0.43 in Fourth Quarter

35% Growth in Net Income and 4% Growth in Both NFFO and AFFO, on a Per Share Basis, in Full-Year 2022

Birmingham, AL – February 23, 2023 – Medical Properties Trust, Inc. (the “Company” or “MPT”) (NYSE: MPW) today announced financial and operating results for the fourth quarter and full-year ended December 31, 2022, as well as certain events occurring subsequent to quarter end.

 

   

Net loss of ($0.24) and Normalized Funds from Operations (“NFFO”) of $0.43 for the 2022 fourth quarter and net income of $1.50 and NFFO of $1.82 for the full-year 2022, all on a per diluted share basis;

 

   

Fourth quarter 2022 net loss and full-year 2022 net income include a real estate impairment of approximately $171 million related to four properties leased to Prospect Medical Holdings (“Prospect”) in Pennsylvania as well as a write-off of roughly $112 million in unbilled Prospect rent also included in Funds from Operations (“FFO”) but excluded from normalized results;

 

   

In October, commenced a development project to be leased to Ernest in South Carolina upon completion for approximately $22 million;

 

   

In December, acquired six Priory behavioral health facilities previously leased from a third-party owner in the UK for £233 million; and

 

   

Additional cash rent from CPI-based and fixed rent escalators of approximately $50 million expected in 2023.

Previously announced activities:

 

   

January announcement that Pipeline Health will assume the existing terms of its Los Angeles hospital master lease and collect 100% of past due rent;

 

   

February repayment to MPT of $205 million loan investment in Springstone, upon Lifepoint Health’s acquisition of a majority interest in the operator;

 

   

Agreed in February to lease entire Utah hospital portfolio to a wholly owned subsidiary of CommonSpirit Health (“CommonSpirit”), upon CommonSpirit’s planned acquisition of Steward Health Care System’s (“Steward”) Utah operations; and

 

   

Declared in February a regular quarterly dividend of $0.29 per share, representing a fourth quarter payout of adjusted funds from operations (“AFFO”) per share of roughly 85%.

 

1


“The vast majority of our portfolio is positioned to support a significant inflation-based increase in cash rents for 2023,” said Edward K. Aldag, Jr., Chairman, President, and Chief Executive Officer. “On the other hand, our initial outlook for this year contemplates a conservative scenario due to the underperformance of Prospect’s Pennsylvania hospitals that we first communicated over a year ago, as well as the process by which we expect to recover our full investment in Prospect’s Pennsylvania and Connecticut hospitals.”

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 and AFFO, including per share amounts, all on a basis comparable to 2021 results, as well as a reconciliation of total assets to total adjusted gross assets.

PORTFOLIO UPDATE

In December, MPT acquired for £233 million six of the largest, highest acuity, most profitable and best-known Priory inpatient behavioral health facilities, comprising 374 beds in the vicinity of London, Manchester and Bristol in the United Kingdom. The third-party seller of the real estate provided MPT roughly £105 million in attractive seller financing, and MPT assumed the in-place lease at an attractive cash yield, with inflation-based rent escalators and more than 20 years of remaining lease term. The merged Priory and MEDIAN platforms are expected to continue to source select attractive real estate opportunities.

MPT plans to reallocate capital away from real estate leased to Prospect through the previously announced sale, predominantly for cash, of its Connecticut hospitals later this year, as well as by exercising lease provisions entitling it to the significant value embedded in Prospect’s managed care platform. In order for this to occur, 12 to 18 months is necessary to allow for Prospect to recapitalize and prepare its managed care business for sale or recapitalization.

The Company has total assets of approximately $19.7 billion, including $13.4 billion of general acute care hospitals, $2.7 billion of behavioral health facilities, $1.4 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 444 properties and approximately 44,000 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 55 hospital operating companies.

OPERATING RESULTS AND OUTLOOK

Operating results for the fourth quarter and year ended December 31, 2022 were a net loss of ($140) million (($0.24) per diluted share) and net income of $903 million ($1.50 per diluted share), respectively, compared to net income of $207 million ($0.34 per diluted share) and $656 million ($1.11 per diluted share) in the year earlier periods.

NFFO for the fourth quarter and year ended December 31, 2022 was $258 million ($0.43 per diluted share) and $1,088 million ($1.82 per diluted share), respectively, compared to $279 million ($0.47 per diluted share) and $1,036 million ($1.75 per diluted share) in the year earlier periods

The Company is introducing initial 2023 calendar estimates of per share net income and NFFO of $0.83 to $0.98 and $1.50 to $1.65, respectively. At their high-end, the ranges reflect management’s base case expectation that certain amounts are recovered from Prospect and recognized as revenue in the second half of 2023, while their low-end accounts for the remote possibility that the entirety of this revenue is recognized subsequent to 2023. The estimates are based on an existing portfolio which includes the impact of binding disposition transactions and changes to lease terms but excludes expected future contributions from development and other capital projects, the possible future impact of deleveraging and other capital markets strategies.

 

2


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, other impairments or other non-recurring/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 or repurchased, new shares are issued or repurchased, additional debt is incurred, other operating expenses vary, income from equity investments vary from expectations, or existing leases or loans do not perform in accordance with their terms.

CONFERENCE CALL AND WEBCAST

The Company has scheduled a conference call and webcast for Thursday, February 23, 2023 at 11:00 a.m. Eastern Time to present the Company’s financial and operating results for the quarter and year ended December 31, 2022. The dial-in numbers for the conference call are 833-630-1956 (U.S.) and 412-317-1837 (International); there is no passcode requirement. Call participants are to ask the operator to be joined to the Medical Properties Trust, Inc. conference call upon dialing in. 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 March 9, 2023 using dial-in numbers 877-344-7529 (U.S.), 855-669-9658 (Canada) and 412-317-0088 (International) along with passcode 7716069. 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 444 facilities and approximately 44,000 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.

 

3


This press release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements can generally be identified by the use of forward-looking words such as “may”, “will”, “would”, “could”, “expect”, “intend”, “plan”, “estimate”, “target”, “anticipate”, “believe”, “objectives”, “outlook”, “guidance” or other similar words, and include statements regarding our strategies, objectives, future expansion and development activities, and expected financial performance. Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual results or future events to differ materially from those expressed in or underlying such forward-looking statements, including, but not limited to: (i) the economic, political and social impact of, and uncertainty relating to, 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 operate profitably and generate positive cash flow, 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; (xvi) the risk that the expected sale of three Connecticut hospitals currently leased to Prospect does not occur; (xvii) the risk that Steward’s anticipated sale of its Utah operations and MPT’s expected lease with CommonSpirit are not executed as announced; and (xviii) the risk that other 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)             
     December 31, 2022     December 31, 2021  
     (Unaudited)     (A)  

Assets

    

Real estate assets

    

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

   $ 13,862,415     $ 14,062,722  

Investment in financing leases

     1,691,323       2,053,327  

Real estate held for sale

     —         1,096,505  

Mortgage loans

     364,101       213,211  
  

 

 

   

 

 

 

Gross investment in real estate assets

     15,917,839       17,425,765  

Accumulated depreciation and amortization

     (1,193,312     (993,100
  

 

 

   

 

 

 

Net investment in real estate assets

     14,724,527       16,432,665  

Cash and cash equivalents

     235,668       459,227  

Interest and rent receivables

     167,035       56,229  

Straight-line rent receivables

     787,166       728,522  

Investments in unconsolidated real estate joint ventures

     1,497,903       1,152,927  

Investments in unconsolidated operating entities

     1,444,872       1,289,434  

Other loans

     227,839       67,317  

Other assets

     572,990       333,480  
  

 

 

   

 

 

 

Total Assets

   $ 19,658,000     $ 20,519,801  
  

 

 

   

 

 

 

Liabilities and Equity

    

Liabilities

    

Debt, net

   $ 10,268,412     $ 11,282,770  

Accounts payable and accrued expenses

     621,324       607,792  

Deferred revenue

     27,727       25,563  

Obligations to tenants and other lease liabilities

     146,130       158,005  
  

 

 

   

 

 

 

Total Liabilities

     11,063,593       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 - 597,476 shares at December 31, 2022 and 596,748 shares at December 31, 2021

     597       597  

Additional paid-in capital

     8,535,140       8,564,009  

Retained earnings (deficit)

     116,285       (87,691

Accumulated other comprehensive loss

     (59,184     (36,727
  

 

 

   

 

 

 

Total Medical Properties Trust, Inc. Stockholders’ Equity

     8,592,838       8,440,188  

Non-controlling interests

     1,569       5,483  
  

 

 

   

 

 

 

Total Equity

     8,594,407       8,445,671  
  

 

 

   

 

 

 

Total Liabilities and Equity

   $ 19,658,000     $ 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 Twelve Months Ended  
     December 31, 2022     December 31, 2021     December 31, 2022     December 31, 2021  

Revenues

        

Rent billed

   $ 231,845     $ 259,517     $ 968,874     $ 931,942  

Straight-line rent

     58,045       66,458       204,159       241,433  

Income from financing leases

     48,920       50,701       203,580       202,599  

Interest and other income

     41,676       32,657       166,238       168,695  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total revenues

     380,486       409,333       1,542,851       1,544,669  

Expenses

        

Interest

     92,047       93,984       359,036       367,393  

Real estate depreciation and amortization

     81,454       84,199       332,977       321,249  

Property-related (A)

     7,699       7,833       45,697       39,098  

General and administrative

     42,893       38,326       160,494       145,638  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     224,093       224,342       898,204       873,378  

Other income (expense)

        

(Loss) gain on sale of real estate

     (33     43,575       536,755       52,471  

Real estate and other impairment charges, net

     (282,950     (39,411     (268,375     (39,411

Earnings from equity interests

     7,194       6,855       40,800       28,488  

Debt refinancing and unutilized financing costs

     —         (25,311     (9,452     (27,650

Other (including fair value adjustments on securities)

     (5,531     40,952       15,344       45,699  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total other (expense) income

     (281,320     26,660       315,072       59,597  
  

 

 

   

 

 

   

 

 

   

 

 

 

(Loss) income before income tax

     (124,927     211,651       959,719       730,888  

Income tax expense

     (15,285     (4,807     (55,900     (73,948
  

 

 

   

 

 

   

 

 

   

 

 

 

Net (loss) income

     (140,212     206,844       903,819       656,940  

Net income attributable to non-controlling interests

     (262     (308     (1,222     (919
  

 

 

   

 

 

   

 

 

   

 

 

 

Net (loss) income attributable to MPT common stockholders

   $ (140,474   $ 206,536     $ 902,597     $ 656,021  
  

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per common share—basic and diluted:

        

Net (loss) income attributable to MPT common stockholders

   $ (0.24   $ 0.34     $ 1.50     $ 1.11  
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average shares outstanding—basic

     598,053       596,395       598,634       588,817  

Weighted average shares outstanding—diluted

     598,053       596,665       598,837       590,139  

Dividends declared per common share

   $ 0.29     $ 0.28     $ 1.16     $ 1.12  

 

(A)

Includes $6.0 million and $4.8 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 December 31, 2022 and 2021, respectively, and $36.3 million and $27.9 million for the twelve months ended December 31, 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 Twelve Months Ended  
     December 31, 2022     December 31, 2021     December 31, 2022     December 31, 2021  

FFO information:

        

Net (loss) income attributable to MPT common stockholders

   $ (140,474   $ 206,536     $ 902,597     $ 656,021  

Participating securities’ share in earnings

     (567     (1,073     (1,602     (2,161
  

 

 

   

 

 

   

 

 

   

 

 

 

Net (loss) income, less participating securities’ share in earnings

   $ (141,041   $ 205,463     $ 900,995     $ 653,860  

Depreciation and amortization

     98,891       97,510       399,622       374,599  

Gain on sale of real estate

     (99     (43,575     (536,887     (52,471

Real estate impairment charges

     170,582       —         170,582       —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 128,333     $ 259,398     $ 934,312     $ 975,988  

Write-off of unbilled rent and other

     3,390       8,814       37,682       7,213  

Gain on sale of equity investments

     —         (40,945     —         (40,945

Other impairment charges, net

     112,368       39,411       97,793       39,411  

Non-cash fair value adjustments

     10,230       (5,430     (2,333     (8,193

Tax rate changes and other

     3,795       (7,950     10,697       34,796  

Debt refinancing and unutilized financing costs

     —         25,311       9,452       27,650  
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 258,116     $ 278,609     $ 1,087,603     $ 1,035,920  

Share-based compensation

     12,377       13,520       46,345       52,110  

Debt costs amortization

     5,023       4,968       19,739       17,661  

Rent deferral, net

     514       557       (5,980     2,755  

Straight-line rent revenue and other

     (72,494     (81,909     (297,645     (297,078
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 203,536     $ 215,745     $ 850,062     $ 811,368  
  

 

 

   

 

 

   

 

 

   

 

 

 

Per diluted share data:

        

Net (loss) income, less participating securities’ share in earnings

   $ (0.24   $ 0.34     $ 1.50     $ 1.11  

Depreciation and amortization

     0.16       0.16       0.67       0.63  

Gain on sale of real estate

     —         (0.07     (0.90     (0.09

Real estate impairment charges

     0.29       —         0.29       —    
  

 

 

   

 

 

   

 

 

   

 

 

 

Funds from operations

   $ 0.21     $ 0.43     $ 1.56     $ 1.65  

Write-off of unbilled rent and other

     —         0.01       0.07       0.01  

Gain on sale of equity investments

     —         (0.07     —         (0.07

Other impairment charges, net

     0.19       0.07       0.16       0.07  

Non-cash fair value adjustments

     0.02       (0.01     —         (0.01

Tax rate changes and other

     0.01       (0.01     0.02       0.06  

Debt refinancing and unutilized financing costs

     —         0.05       0.01       0.04  
  

 

 

   

 

 

   

 

 

   

 

 

 

Normalized funds from operations

   $ 0.43     $ 0.47     $ 1.82     $ 1.75  

Share-based compensation

     0.02       0.02       0.08       0.09  

Debt costs amortization

     0.01       0.01       0.03       0.03  

Rent deferral, net

     —         —         (0.01     —    

Straight-line rent revenue and other

     (0.12     (0.14     (0.50     (0.50
  

 

 

   

 

 

   

 

 

   

 

 

 

Adjusted funds from operations

   $ 0.34     $ 0.36     $ 1.42     $ 1.37  
  

 

 

   

 

 

   

 

 

   

 

 

 

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.

 

(B)

Investors and analysts following the real estate industry utilize funds from operations (“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 (if any not paid by our tenants) 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) 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 billable/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

2023 Guidance Reconciliation

(Unaudited)

 

     2023 Guidance - Per Share(1)  
     Low      High  

Net income attributable to MPT common stockholders

   $ 0.83      $ 0.98  

Participating securities’ share in earnings

     —          —    
  

 

 

    

 

 

 

Net income, less participating securities’ share in earnings

   $ 0.83      $ 0.98  

Depreciation and amortization

     0.67        0.67  

Gain on sale of real estate and other, net

     —          —    
  

 

 

    

 

 

 

Funds from operations

   $ 1.50      $ 1.65  

Other adjustments

     —          —    
  

 

 

    

 

 

 

Normalized funds from operations

   $ 1.50      $ 1.65  
  

 

 

    

 

 

 

 

(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 Adjusted Gross Assets

(Unaudited)

 

(Amounts in thousands)    December 31, 2022  

Total Assets

   $ 19,658,000  

Add: Accumulated depreciation and amortization

     1,193,312  

Add: Incremental gross assets of our Investments in Unconsolidated Real Estate Joint Ventures(1)

     1,698,917  

Less: Gross book value of the transactions, net(2)

     (1,074,024

Net: Reclassification between operators(3)

     —    

Less: Decrease in cash from the transactions(4)

     (235,668
  

 

 

 

Total Adjusted Gross Assets(5)

   $ 21,240,537  
  

 

 

 

 

(1)

Reflects an addition to total assets to present our total share of each joint venture’s gross assets. See below for details of the calculation. While we do not control any of our unconsolidated real estate joint venture arrangements and do not have direct legal claim to the underlying assets of the unconsolidated real estate joint ventures, we believe this adjustment allows investors to view certain concentration information on a basis comparable to the remainder of our real estate portfolio. This presentation is also consistent with how our management team reviews our portfolio (dollar amounts in thousands):

 

Real estate joint venture total gross real estate and other assets

   $ 5,921,188  

Weighted-average equity ownership percentage

     55
  

 

 

 
     3,261,727  

Investments in Unconsolidated Real Estate Joint Ventures(A)

     (1,562,810
  

 

 

 

Incremental gross assets of our Investments in Unconsolidated Real Estate Joint Ventures

   $ 1,698,917  
  

 

 

 

(A) Includes amount shown on the “Investments in unconsolidated real estate joint ventures” line on our consolidated balance sheets, along with a CHF 60 million mortgage loan and included in the “Mortgage loans” line on our consolidated balance sheets.

 

(2)

Represents the gross book value of assets sold or written off due to the October 2022 commitment to sell three facilities leased to Prospect for approximately $457 million, the acquisition of the majority interest in Springstone by a subsidiary of Lifepoint in February 2023, and the February 2023 commitment to lease five facilities in Utah to CommonSpirit that are currently leased to Steward, partially offset by the addition of new gross assets from the committed transactions. See detail below (in thousands):

 

Gross book value of assets in transactions

   $ (655,354

Non-cash rent write-offs related to disposals

     (418,670
  

 

 

 

Gross book value of the transactions

   $ (1,074,024
  

 

 

 

 

(3)

Reclass of $0.8 billion of gross assets between Springstone and Lifepoint along with $0.9 billion reclass of gross assets between Steward and CommonSpirit as part of the committed transactions described in Note (2).

 

(4)

Represents cash expected from the proceeds generated by the transactions, along with cash on hand to reduce debt as detailed below (in thousands):

 

Expected cash proceeds generated by the transactions

   $ 659,000  

Reduction of revolver balance

     (894,668
  

 

 

 

Net decrease in cash from the transactions

   $ (235,668
  

 

 

 

 

(5)

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

EX-99.2

Exhibit 99.2

 

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Q4 2022SUPPLEMENTAL


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COMPANY OVERVIEWCompany Information 3FINANCIAL INFORMATIONReconciliation of Net Income to Funds from Operations 6Debt Summary 7Adjusted Net Debt / Annualized EBITDAre 8PORTFOLIO INFORMATIONAdjusted Lease and Loan Maturity Schedule 9Total Assets and Revenuesby Asset Type, Operator, State and Country 10Rent Coverage 13Summary of Investments and Development Projects 15FINANCIAL STATEMENTSConsolidated Statements of Income 16Consolidated Balance Sheets 17Investments in Unconsolidated Real EstateJoint Ventures 18Investments in Unconsolidated Operating Entities 1939616FORWARD-LOOKING STATEMENTSForward-looking statements involve known and unknownrisks, uncertainties and other factors that may cause theactual results of the Company or future events to differmaterially from those expressed in or underlying suchforward-looking statements, including without limitation:Normalized FFO per share; expected payout ratio; theamount of acquisitions of healthcare real estate, if any; NetDebt to EBITDAre; portfolio diversification; capital marketsconditions; the repayment of debt arrangements; statementsconcerning the additional income to the Company asa result of ownership interests in certain hospital operationsand the timing of such income; the payment of future dividends,if any; completion of additional debt arrangementsand additional investments; national and internationaleconomic, business, regulatory, real estate and other marketconditions; the competitive environment in which the Companyoperates; the execution of the Company’s businessplan; financing risks; the Company’s ability to maintain itsstatus as a REIT for federal income tax purposes; acquisitionand development risks; potential environmental and otherliabilities; potential impact from health crises (like COVID-19)and other events beyond the control of our tenants/borrowersand the related impact to us; and other factors affectingthe real estate industry generally or healthcare real estatein particular. For further discussion of the factors that couldaffect outcomes, please refer to the “Risk Factors” sectionof the Company’s Annual Report on Form 10-K for the yearended December 31, 2021, and as updated by the Company’ssubsequently filed Quarterly Reports on Form 10-Q andother SEC filings. Except as otherwise required by the federalsecurities laws, the Company undertakes no obligation toupdate the information in this report.Certain information in the supplemental package may beshown adjusted for transactions completed subsequent toperiod end, including the acquisition of a majority interestin Springstone by Lifepoint in February 2023, and theconsummation of pending transactions, including theexpected sale of three Connecticut hospitals currentlyleased to Prospect and the expected purchase of Steward’sUtah operations by CommonSpirit Health. The adjustmentsare based upon available information and assumptions thatwe believe are reasonable. There is no assurance that anypending transactions will occur.On the Cover: Idaho Falls Community Hospital—Idaho Falls, Idaho; Below: Priory—Kneesworth House


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3 COMPANY OVERVIEWM edical 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. 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. As of December 31, 2022. 444 55 ~44,000 31 10 U. S. states countries beds operators properties


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4 COMPANY OVERVIEWMPT 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 Headquarters Edward K. Aldag, Jr. G. Steven Dawson R. Steven Hamner Caterina A. Mozingo Emily W. Murphy Elizabeth N. Pitman D. Paul Sparks, Jr. Michael G. Stewart C. Reynolds Thompson, III Medical Properties Trust, Inc. 1000 Urban Center Drive, Suite 501 Birmingham, AL 35242 (205) 969-3755 (205) 969-3756 (fax) www.medicalpropertiestrust.com


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MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2022 5INVESTOR RELATIONSTransferAgentStock ExchangeListing andTrading SymbolSeniorUnsecuredDebt RatingsDrew Babin Tim BerrymanAmerican Stock Transferand Trust Company6201 15th AvenueBrooklyn, NY 11219New York Stock Exchange(NYSE): MPWMoody’s – Ba1Standard & Poor’s – BBBIdahoFalls Community Hospital—Idaho Falls, Idaho.Senior Managing Director of Corporate Communications(646) 884-9809 dbabin@medicalpropertiestrust.comManaging Director of Investor Relations(205) 397-8589 tberryman@medicalpropertiestrust.comCOMPANY OVERVIEW


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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 Twelve Months EndedDecember 31, 2022 December 31, 2021 December 31, 2022 December 31, 2021FFO INFORMATION:Net (loss) income attributable to MPT common stockholders $ (140,474) $ 206,536 $ 902,597 $ 656,021Participating securities’ share in earnings (567) (1,073) (1,602) (2,161)Net (loss) income, less participating securities’ share in earnings $ (141,041) $ 205,463 $ 900,995 $ 653,860Depreciation and amortization 98,891 97,510 399,622 374,599 Gain on sale of real estate (99) (43,575) (536,887) (52,471) Real estate impairment charges 170,582—170,582 -Funds from operations $ 128,333 $ 259,398 $ 934,312 $ 975,988Write-off of unbilled rent and other 3,390 8,814 37,682 7,213 Gain on sale of equity investments—(40,945)—(40,945) Other impairment charges, net 112,368 39,411 97,793 39,411 Non-cash fair value adjustments 10,230 (5,430) (2,333) (8,193) Tax rate changes and other 3,795 (7,950) 10,697 34,796 Debt refinancing and unutilized financing costs—25,311 9,452 27,650Normalized funds from operations $ 258,116 $ 278,609 $ 1,087,603 $ 1,035,920Share-based compensation 12,377 13,520 46,345 52,110 Debt costs amortization 5,023 4,968 19,739 17,661 Rent deferral, net 514 557 (5,980) 2,755 Straight-line rent revenue and other (72,494) (81,909) (297,645) (297,078)Adjusted funds from operations $ 203,536 $ 215,745 $ 850,062 $ 811,368PER DILUTED SHARE DATA:Net (loss) income, less participating securities’ share in earnings $ (0.24) $ 0.34 $ 1 .50 $ 1 .11Depreciation and amortization 0.16 0.16 0.67 0.63 Gain on sale of real estate—(0.07) (0.90) (0.09) Real estate impairment charges 0.29—0.29 -Funds from operations $ 0.21 $ 0.43 $ 1 .56 $ 1 .65Write-off of unbilled rent and other—0.01 0.07 0.01 Gain on sale of equity investments—(0.07)—(0.07) Other impairment charges, net 0.19 0.07 0.16 0.07 Non-cash fair value adjustments 0.02 (0.01)—(0.01) Tax rate changes and other 0.01 (0.01) 0.02 0.06 Debt refinancing and unutilized financing costs—0.05 0.01 0.04Normalized funds from operations $ 0.43 $ 0.47 $ 1 .82 $ 1 .75Share-based compensation 0.02 0.02 0.08 0.09 Debt costs amortization 0.01 0.01 0.03 0.03 Rent deferral, net — (0.01) -Straight-line rent revenue and other (0.12) (0.14) (0.50) (0.50)Adjusted funds from operations $ 0.34 $ 0.36 $ 1 .42 $ 1 .37Notes:(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.(B) Investors and analysts following the real estate industry utilize funds from operations (“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 (if any not paid by our tenants) 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) 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 billable/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.


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FINANCIAL INFORMATION (As of December 31, 2022) ($ amounts in thousands)DEBT MATURITIESSenior Unsecured Term Year Total Debt % of Total Notes Loans/Revolver2023 $ 483,320 $—$ 483,320 4.7% 2024—944,250 944,250 9.1% 2025 535,250 845,810 1,381,060 13.4% 2026 1,639,400 929,584 2,568,984 24.9% 2027 1,400,000 200,000 1,600,000 15.5% 2028 724,980—724,980 7.0% 2029 900,000—900,000 8.7% 2030 422,905—422,905 4.1% 2031 1,300,000—1,300,000 12.6%Totals $ 7,405,855 $ 2,919,644 $ 10,325,499 100.0%DEBT BY LOCAL CURRENCYSenior Unsecured Term Total Debt % of Total Notes Loans/RevolverUnited States $ 4,100,000 $ 750,000 $ 4,850,000 47.0% United Kingdom 2,235,355 1,081,247 3,316,602 32.1% Australia—817,560 817,560 7.9% Europe 1,070,500 270,837 1,341,337 13.0%Totals $ 7,405,855 $ 2,919,644 $ 10,325,499 100.0%DEBT SUMMARYDebt Instrument Rate Type Rate Balance2026 Credit Facility Revolver (A) Variable 2.747%—5.561% $ 929,584 2027 Term Loan Variable 5.698% 200,000 RATE TYPE AS PERCENTAGE OF TOTAL DEBT2.550% Notes Due 2023 (£400M) (A) Fixed 2.550% 483,320Variable2024 AUD Term Loan (A$1.2B) (A) Fixed (B) 2.450% 817,560 11%3.325% Notes Due 2025 (€500M) (A) Fixed 3.325% 2024 GBP Term Loan (£105M) (A) Fixed 5.250% (A) Fixed (C) 1.949% 2025 GBP Term Loan (£700M)0.993% Notes Due 2026 (€500M) (A) Fixed 0.993% Fixed 89%5.250% Notes Due 2026 Fixed 5.250% 2.500% Notes Due 2026 (£500M) (A) Fixed 2.500% 5.000% Notes Due 2027 Fixed 5.000% 3.692% Notes Due 2028 (£600M) (A) Fixed 3.692% 4.625% Notes Due 2029 Fixed 4.625% 900,0003.375% Notes Due 2030 (£350M) (A) Fixed 3.375% 422,9053.500% Notes Due 2031 Fixed 3.500% 1,300,000 $ 10,325,499Debt issuance costs and discount (57,087) Weighted average rate 3.608% $ 10,268,412(A) Non-USD denominated debt converted to U.S. dollars at December 31, 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 | Q4 2022 7


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FINANCIAL INFORMATION ADJUSTED NET DEBT / ANNUALIZED EBITDAre(Unaudited)(Amounts in thousands)For the Three Months Ended December 31, 2022Net loss $ (140,212)Add back:Interest 92,047 Income tax 15,285 Depreciation and amortization 84,859 Gain on sale of real estate (99) Real estate impairment charge 170,582 Adjustment to reflect MPT’s share of unlevered EBITDAre from unconsolidated real estate joint ventures (A) 12,4544Q 2022 EBITDAre $ 234,916 Share-based compensation 12,377 Write-off of unbilled rent and other 3,390 Other impairment charges 112,368 Non-cash fair value adjustments 10,2304Q 2022 Adjusted EBITDAre $ 373,281 Adjustments for investment activity (B) (22,919)4Q 2022 Further Adjusted EBITDAre $ 350,362 Annualization $ 1,401,448Total debt at December 31, 2022 $ 10,268,412 Adjustments after December 31, 2022 (B) (1,253,596) Adjusted net debt $ 9,014,816Adjusted net debt / annualized EBITDAre (C) 6.4xInvestors and analysts following the real estate industry utilize net debt (debt less cash) to EBITDA as a measurement of leverage that shows how many years it would take for us to pay back our debt, assuming net debt and EBITDA are held constant. In our calculation, we start with EBITDAre, as defined by Nareit, which is net 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 prior periods and other companies more meaningful, to derive Adjusted EBITDAre. We further adjust net debt and Adjusted EBITDAre for the 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 as of the beginning of the period to derive Adjusted Net Debt and Further Adjusted EBITDAre. Although non-GAAP measures, we believe Adjusted Net Debt and 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 Adjusted Net Debt line. We believe this adjustment is needed to appropriately reflect the relationship between EBITDAre and net debt.(B) Adjustments to reflect the acquisition of a majority interest in Springstone by Lifepoint, the expected sale of three Connecticut hospitals currently leased to Prospect, the expected purchase of Steward’s Utah operations by CommonSpirit Health, and a full quarter impact from our mid-quarter investments and property sales.C) Adjusted net debt / annualized EBITDAre of 6.4x reflects the expected EBITDA at the high end of our calendar year 2023 guidance range. Adjusted net debt / annualized EBITDAre would be 6.7x at the low end of our calendar year 2023 guidance range.


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PORTFOLIO INFORMATION ADJUSTED 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/Interest2023 4 14,903 1.2% 2024 1 2,731 0.2% 2025 7 18,785 1.5% 2026 4 2,333 0.2% 2027 1 3,346 0.3% 2028 4 5,832 0.5% 2029 6 15,788 1.2% 2030 11 6,053 0.5% 2031 4 4,236 0.3% 2032 41 64,384 5.1% Thereafter 346 1,117,664 89.0% 429 $ 1,256,055 100.0%Percentage of total base rent/interest100%89.0% 90% 80% 70% 60% 50% 40% 30% 20% 10% 5.1%1.2% 0.2% 1.5% 0.2% 0.3% 0.5% 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 or other options provided for in our agreements. (C) Reflects all properties, including those that are part of joint ventures, except three Connecticut properties under previously disclosed commitment to be sold, vacant properties representing less than 0.2% of total assets, and seven facilities that are under development. This schedule also reflects extended lease terms as part of Lifepoint’s acquisition of a majority interest in Springstone.(D) Represents contractual base rent/interest income on an annualized basis as of period end (including foreign currency exchange rates) but does not include tenant recoveries, additional rents and other lease-related adjustments to revenue (i.e., straight-line rents and deferred revenues)


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PORTFOLIO INFORMATION TOTAL ASSETS AND REVENUES BY ASSET TYPE(December 31, 2022) ($ amounts in thousands)Total Percentage of Q4 2022 Percentage of Asset Types Properties (A) (B) Assets Total Assets Revenues Q4 2022 RevenuesGeneral Acute Care Hospitals 202 $ 13,386,376 68.1% $ 286,376 75.2% Behavioral Health Facilities 67 2,727,326 13.9% 51,624 13.6% Inpatient Rehabilitation Facilities 112 1,418,603 7.2% 28,489 7.5% Long-Term Acute Care Hospitals 20 277,772 1.4% 7,955 2.1% Freestanding ER/Urgent Care Facilities 43 236,764 1.2% 6,042 1.6% Other—1,611,159 8.2% —Total 444 $ 19,658,000 100.0% $ 380,486 100.0%TOTAL ASSETS BY ASSET TYPE TOTAL REVENUES BY ASSET TYPE8% 1%1% 2% 2%7% General Acute Care Hospitals8%Behavioral Health Facilities14%Inpatient Rehabilitation Facilities14% 68%Long-Term Acute Care Hospitals 75% Freestanding ER/Urgent Care Facilitie OtherDOMESTIC ASSETS BY ASSET TYPE DOMESTIC REVENUES BY ASSET TYPE 2%2% 9% 8% 2% 2%General Acute Care Hospitals6% 9%Behavioral Health Facilities9% Inpatient Rehabilitation Facilities72% 79%Long-Term Acute Care Hospitals Freestanding ER/Urgent Care Facilities Other(A) Agrees to total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statement of income.


PORTFOLIO INFORMATION TOTAL ASSETS—LARGEST INDIVIDUAL FACILITY(December 31, 2022)COMPREHENSIVE PROPERTY-LEVEL UNDERWRITING FRAMEWORKLargest Individual MPT invests in real estate, not the consolidated financial performance of its tenants. Operators Facility as a Percentage Each facility is underwritten for characteristics that make the infrastructure of Total Assets (A) attractive to any experienced, competent operator—not just the current tenant. If we have underwritten these correctly, then coupled with our absolute net master Steward Health Care 2.7% lease structure, our real estate will be attractive to a replacement operator, in the rare event we must transition. Such underwriting characteristics include:Prospect Medical Holdings 1.2% Circle Health 1.0% Priory Group 0.6%Springstone 0.4% Physical Quality Competition50 operators 1.3%Largest Individual Facility Investment is Less Than 3% of MPT Investment Portfolio Demographics Financial and MarketTOTAL ASSETS AND REVENUES BY OPERATOR(December 31, 2022) ($ amounts in thousands)Total Percentage of Q4 2022 Percentage of Operators (C) Properties (A) (B) Assets Total Assets Revenues Q4 2022 RevenuesSteward Health Care 41 Florida market $ 1,324,555 6.7% $ 25,466 6.7% Utah market 1,192,384 6.1% 33,724 8.9% Massachusetts market 756,818 3.8% 6,490 1.7% Texas/Arkansas/Louisiana market 1,073,425 5.5% 21,503 5.6% Arizona market 298,486 1.5% 8,698 2.3% Ohio/Pennsylvania market 117,005 0.6% 3,518 0.9% Circle Health 36 2,062,474 10.5% 45,282 11.9% Prospect Medical Holdings 14 1,483,599 7.5% 43,781 11.5% Priory Group 32 1,290,213 6.6% 20,151 5.3% Springstone 19 985,959 5.0% 21,930 5.8% 50 operators 302 7,461,923 38.0% 149,943 39.4% Other—1,611,159 8.2% — Total 444 $ 19,658,000 100.0% $ 380,486 100.0%(A) Agrees to total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statement of income. (C) On an adjusted gross asset basis comparable to our presentation for the third quarter of 2022, and after adjusting for the acquisition of a majority interest in Springstone by Lifepoint, the expected sale of three Connecticut hospitals currently leased to Prospect, and the expected purchase of Steward’s Utah operations by CommonSpirit Health, the concentration for Steward, Circle, Lifepoint, Swiss Medical Network, and Priory would be 19.8%, 10.4%, 6.6%, 6.4%, and 6.2%, respectively, at December 31, 2022.

 

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PORTFOLIO INFORMATION TOTAL ASSETS AND REVENUES BY U.S. STATE AND COUNTRY(December 31, 2022) ($ amounts in thousands)Total Percentage of Q4 2022 Percentage of U.S. States and Other Countries Properties (A) (B) Assets Total Assets Revenues Q4 2022 RevenuesTexas 52 $ 1,967,948 10.0% $ 41,625 10.9% California 20 1,450,112 7.4% 41,313 10.9% Florida 9 1,324,555 6.8% 25,466 6.7% Utah 7 1,224,484 6.2% 34,714 9.1% Massachusetts 10 761,694 3.9% 6,662 1.8%26 Other States 122 4,245,306 21.6% 120,418 31.6% Other—1,028,946 5.2% —United States 220 $ 12,003,045 61.1% $ 270,198 71.0%United Kingdom 87 $ 4,083,244 20.8% $ 77,502 20.4% Australia 11 854,582 4.3% 14,157 3.7% Switzerland 17 748,947 3.8% 868 0.2% Germany 82 664,900 3.4% 8,040 2.1% Spain 9 222,316 1.1% 1,919 0.5% Other Countries 18 498,753 2.5% 7,802 2.1% Other—582,213 3.0% —International 224 $ 7,654,955 38.9% $ 110,288 29.0% Total 444 $ 19,658,000 100.0% $ 380,486 100.0%(A) Agrees to total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statement of income. TOTAL ASSETS BY COUNTRY TOTAL REVENUES BY COUNTRY3% 2%3% 2%1%1% 4%United States3%4% 4% United KingdomAustralia 20% Switzerland61% 21%Germany 71% Spain Other Countries OtherASSETS BY U.S. STATE REVENUES BY U.S. STATE5% Texas10% 11%California Florida7% 31%Utah 11% 22%Massachusetts7% 26 Other States7%4% 6% 2%Other 9%

 

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PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM(A)(B)(C) RENT COVERAGE INCLUSIVE OF ALL CARES ACT GRANTSYOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPENotes: 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 September 30, 2022.(A) EBITDARM is facility-level earnings before interest, taxes, depreciation, amortization, rent and management fees. EBITDARM includes normal GAAP expensed maintenance and repair costs. EBITDARM does 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 does not represent property net income or cash flows from operations and should not be considered an alternative to those indicators. EBITDARM 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 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.- Prospect and Prime EBITDARM for California facilities has been adjusted for amounts expected to be received under the Hospital Quality Assurance Fee (“HQAF”) Program 7. Amounts included are derived from the current model from the California Hospital Association which was approved by CMS on September 30, 2022.(B) General Acute Care coverages and Total Portfolio coverages include Prospect Medical Holdings’s Connecticut facilities. Prospect Medical Holdings has entered into a binding letter of intent for its Connecticut operations.(C) General Acute Care coverages and Total Portfolio coverages do not include Pipeline Health facilities as Pipeline Health filed Chapter 11 bankruptcy in October 2022.

 

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PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM RENT COVERAGE INCLUSIVE OF ALL CARES ACT GRANTSEBITDARM RENT COVERAGE: OPERATORS WITH PROPERTY-LEVEL REPORTINGNet Investment Tenant Primary Property Type TTM EBITDARM Rent Coverage (in thousands) (A)Steward Health Care $ 3,544,088 General Acute 2.5x Prospect Medical Holdings(B) 912,996 General Acute -0.5x Priory Group 837,461 Behavioral 2.1x Springstone 779,833 Behavioral 1.3x MEDIAN 590,679 IRF 1.7x Prime Healthcare 583,949 General Acute 3.4x Ernest Health 544,483 IRF/LTACH 2.4x Vibra Healthcare 247,070 IRF/LTACH 2.3x Aspris Children’s Services 236,227 Behavioral 2.2x Surgery Partners 164,037 General Acute 7.2x Ardent Health Services 88,656 General Acute 6.6x Other Reporting Tenants 590,598 Various 2.6xTotal $ 9,120,077 2.3xNet Investment Tenant Primary Property Type TTM EBITDARM Rent Coverage (in thousands) (A)International Operator 1 $ 2,012,534 General Acute 2.2x International Operator 2 854,582 General Acute 1.8x Domestic Operator 1 517,268 General Acute 1.8x Domestic Operator 2 394,320 General Acute/LTACH 1.0xTotal $ 3,778,704 1.9xPROPERTY-LEVEL REPORTING NOT REQUIRED AND/OR NOT AVAILABLENet Investment Tenant Primary Property Type Comments (in thousands) (A)Swiss Medical Network $ 519,197 General Acute Second largest group of private hospitals in SwitzerlandOne of largest health care operators in the world; Parent guaranty; Investment Ramsay Health Care UK 391,992 General Acute grade-ratedPihlajalinna 219,309 General Acute Finland’s leading provider of social and health servicesSaint Luke’s—Kansas City 131,135 General Acute Investment grade-ratedNHS 86,314 General Acute Single-payor government entity in UKDignity Health 44,586 General Acute Part of CommonSpirit; Parent guaranty; Investment grade-rated Largest private hospital system in Portugal with 20 facilities and 75+ year CUF 29,980 General Acute operating historyNeuroPsychiatric Hospitals 27,386 Behavioral Parent guarantyCommunity Health Systems 27,137 General Acute U.S. hospital operator with substantial operating historyOther Tenants 63,758 General Acute N/ATotal $ 1,540,794 Above data represents approximately 88% 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 September 30, 2022. (A) Investment figures exclude equity investments, non-real estate loans, freestanding ER/urgent care facilities, and facilities under development. (B) Prospect Medical Holdings’s coverage excludes Connecticut as Prospect Medical Holdings has entered into a binding letter of intent for its Connecticut operations.

 

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PORTFOLIO INFORMATION SUMMARY OF INVESTMENTS(For the twelve months ended December 31, 2022)(Amounts in thousands)Operator Location Investment (A) Commencement DatePriory Group U.K. $ 131,105 Q1 2022 Pihlajalinna Finland 194,234 Q1 2022 Steward Health Care Arizona 20,000 Q2 2022 Steward Health Care Florida 60,000 Q2 2022 GenesisCare Spain 28,472 Q2 2022 Fundación Cardiovascular Colombia 26,000 Q3 2022 Priory Group U.K. 285,635 Q4 2022 Capital Additions, Development and Other Funding for Existing Various 348,675 Various Tenants(B) $ 1,094,121SUMMARY OF CURRENT DEVELOPMENT PROJECTS AS OF DECEMBER 31, 2022(Amounts in thousands)Costs Incurred as of Estimated Commencement Operator Location Commitment December 31, 2022 DateErnest Health California $ 47,700 $ 45,739 Q1 2023 IMED Hospitales Spain 50,411 13,037 Q2 2023 Ernest Health South Carolina 22,400 7,541 Q2 2023 IMED Hospitales Spain 45,408 33,801 Q3 2023 Springstone Texas 34,600 1,962 Q1 2024 IMED Hospitales Spain 36,734 8,320 Q3 2024 Steward Health Care Texas 169,408 57,020 Q1 2026$ 406,661 $ 167,420 (A) Excludes transaction costs, such as real estate transfer and other taxes. Amount assumes exchange rate as of the investment date. (B) Reflects normal capital additions that extend the life or improve existing facilities in which we receive a return equal to the lease rate for the respective facility. This includes more than 20 facilities and 11 different operators.

 

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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 Twelve Months EndedDecember 31, 2022 December 31, 2021 December 31, 2022 December 31, 2021 REVENUESRent billed $ 231,845 $ 259,517 $ 968,874 $ 931,942 Straight-line rent 58,045 66,458 204,159 241,433 Income from financing leases 48,920 50,701 203,580 202,599 Interest and other income 41,676 32,657 166,238 168,695 Total revenues 380,486 409,333 1,542,851 1,544,669 EXPENSESInterest 92,047 93,984 359,036 367,393 Real estate depreciation and amortization 81,454 84,199 332,977 321,249 Property-related (A) 7,699 7,833 45,697 39,098 General and administrative 42,893 38,326 160,494 145,638 Total expenses 224,093 224,342 898,204 873,378OTHER INCOME (EXPENSE)(Loss) gain on sale of real estate (33) 43,575 536,755 52,471 Real estate and other impairment charges, net (282,950) (39,411) (268,375) (39,411) Earnings from equity interests 7,194 6,855 40,800 28,488 Debt refinancing and unutilized financing costs—(25,311) (9,452) (27,650) Other (including fair value adjustments on securities) (5,531) 40,952 15,344 45,699 Total other (expense) income (281,320) 26,660 315,072 59,597(Loss) income before income tax (124,927) 211,651 959,719 730,888 Income tax expense (15,285) (4,807) (55,900) (73,948)Net (loss) income (140,212) 206,844 903,819 656,940Net income attributable to non-controlling interests (262) (308) (1,222) (919)Net (loss) income attributable to MPT common stockholders (140,474) $ 206,536 902,597 $ 656,021EARNINGS PER COMMON SHARE—BASIC AND DILUTEDNet (loss) income attributable to MPT common stockholders $ (0.24) $ 0.34 $ 1.50 $ 1.11WEIGHTED AVERAGE SHARES OUTSTANDING—BASIC 598,053 596,395 598,634 588,817 WEIGHTED AVERAGE SHARES OUTSTANDING—DILUTED 598,053 596,665 598,837 590,139$—$ -DIVIDENDS DECLARED PER COMMON SHARE $ 0.29 $ 0.28 $ 1.16 $ 1.12(A) Includes $6.0 million and $4.8 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 December 31, 2022 and 2021, respectively, and $36.3 million and $27.9 million for the twelve months ended December 31, 2022 and 2021, respectively.

 

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FINANCIAL STATEMENTS CONSOLIDATED BALANCE SHEETS(Amounts in thousands, except per share data)December 31, 2022 December 31, 2021(Unaudited) (A) ASSETSReal estate assetsLand, buildings and improvements, intangible lease assets, and other $ 13,862,415 $ 14,062,722 Investment in financing leases 1,691,323 2,053,327 Real estate held for sale—1,096,505 Mortgage loans 364,101 213,211Gross investment in real estate assets 15,917,839 17,425,765Accumulated depreciation and amortization (1,193,312) (993,100)Net investment in real estate assets 14,724,527 16,432,665Cash and cash equivalents 235,668 459,227 Interest and rent receivables 167,035 56,229 Straight-line rent receivables 787,166 728,522 Investments in unconsolidated real estate joint ventures 1,497,903 1,152,927 Investments in unconsolidated operating entities 1,444,872 1,289,434 Other loans 227,839 67,317 Other assets 572,990 333,480Total Assets $ 19,658,000 $ 20,519,801LIABILITIES AND EQUITY LiabilitiesDebt, net $ 10,268,412 $ 11,282,770 Accounts payable and accrued expenses 621,324 607,792 Deferred revenue 27,727 25,563 Obligations to tenants and other lease liabilities 146,130 158,005 Total Liabilities 11,063,593 12,074,130Equity 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—597,476 shares at December 31, 2022 and 596,748 shares at December 31, 2021 597 597 Additional paid-in capital 8,535,140 8,564,009 Retained earnings (deficit) 116,285 (87,691) Accumulated other comprehensive loss (59,184) (36,727) Total Medical Properties Trust, Inc. Stockholders’ Equity 8,592,838 8,440,188 Non-controlling interests 1,569 5,483Total Equity 8,594,407 8,445,671Total Liabilities and Equity $ 19,658,000 $ 20,519,801(A) Financials have been derived from the prior year audited financial statements.

 

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FINANCIAL STATEMENTSINVESTMENTS IN UNCONSOLIDATED REAL ESTATE JOINT VENTURES(As of and for the three months ended December 31, 2022) (Unaudited) ($ amounts in thousands)Swiss Medical Steward Health Policlinico di HM MPT Pro Rata MEDIAN (C) (D) (E) (F) (G) TotalNetwork Care Monza Hospitales ShareGross real estate $ 1,883,989 $ 1,441,191 $ 1,677,587 $ 179,434 $ 362,437 $ 5,544,638 $ 3,042,435 Cash 28,933 3,178 7,279 11,025 4,036 54,451 27,659 Accumulated depreciation and amortization (191,535) (108,259) (32,850) (28,164) (23,016) (383,824) (212,413) Other assets 72,165 154,151 80,753 10,092 4,938 322,099 191,633Total Assets $ 1,793,552 $ 1,490,261 $ 1,732,769 $ 172,387 $ 348,395 $ 5,537,364 $ 3,049,314Debt (third party) $ 697,010 $ 663,695 $ 892,845 $—$ 138,041 $ 2,391,591 $ 1,321,058 Other liabilities 131,072 112,968 4,523 (103) 83,379 331,839 184,918 Mortgage loans—64,908 ——64,908 45,435(A)Equity and shareholder loans 965,470 648,690 835,401 172,490 126,975 2,749,026 1,497,903Total Liabilities and Equity $ 1,793,552 $ 1,490,261 $ 1,732,769 $ 172,387 $ 348,395 $ 5,537,364 $ 3,049,314MPT share of real estate joint venture 50% 70% 50% 50% 45%Total $ 482,735 $ 454,083 $ 417,701 $ 86,245 $ 57,139 $ 1,497,903 Swiss Medical Steward Health Policlinico di HM MPT Pro Rata MEDIAN (C) (D) (E) (F) (G) TotalNetwork Care Monza Hospitales ShareTotal revenues (B) $ 29,414 $ 15,641 $ 33,782 $ 3,777 $ 3,531 $ 86,145 $ 46,024Expenses:Property-related $ 705 $ 461 $ (134) $ 843 $ 81 $ 1,956 $ 1,067 Interest 12,223 2,600 17,489—498 32,810 16,900 Real estate depreciation and amortization 10,612 7,840 10,307 982 1,937 31,678 17,310 General and administrative 789 259 162 48 11 1,269 686 Gain on sale of real estate (262) — — (262) (131) Income taxes 4,741 705 — 257 5,703 2,979Total expenses $ 28,808 $ 11,865 $ 27,824 $ 1,873 $ 2,784 $ 73,154 $ 38,811Net Income $ 606 $ 3,776 $ 5,958 $ 1,904 $ 747 $ 12,991 $ 7,213 MPT share of real estate joint venture 50% 70% 50% 50% 45%(H)Earnings from equity interests $ 303 $ 2,643 $ 2,979 $ 952 $ 336 $ 7,213 (A) Includes approximately €297 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. Includes a one-time tax charge incurred in the quarter. (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 amortization of equity investment costs.

 

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FINANCIAL STATEMENTS INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES(Amounts in thousands)OPERATING ENTITY INVESTMENT FRAMEWORKMPT’s hospital expertise and comprehensive underwriting process allows for opportunistic investments in hospital operations.• Passive investments typically needed in order to acquire the larger real • Certain of these investments entitle us to customary minority rights and estate transactions. protections.• Cash payments go to previous owner and not to the tenant, with limited • No additional operating loss exposure beyond our investment. exceptions.• Proven track record of successful investments, including Ernest Health and • Operators are vetted as part of our overall underwriting process. Capella Healthcare. • Potential for outsized returns and organic growth.Investment Ownership Operator as of Structure Interest December 31, 2022Loan, for which proceeds were paid to Steward’s former private equity sponsor, is secured by the equity Steward Health Care $ 362,831 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 200,827 49.0% a loan, proceeds of which were paid to the former owners of the Springstone operating entity. The loan was paid off in full in February 2023.In order to close the 2021 acquisition of 35 facilities, we made a 9.9% passive equity investment and a Priory 156,575 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 157,145 10.0% loan facility. Earned approximately $2.1 million in dividends in Q3 2022.Includes our passive equity ownership interest. Proceeds from our investment were paid directly to Steward Health Care 125,862 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 112,777 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 72,904 4.6% original investment of CHF 47 million is marked-to-market quarterly.Includes our passive equity ownership interest in Aspris, a recent spin-off of Priory’s education and Aspris 16,023 9.9% children’s services line of business. Includes our passive equity ownership interest in Caremax, a public care delivery system. Our original Caremax 8,526 9.9% investment is marked-to-market quarterly. Total $ 1,444,872INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES AS A PERCENTAGE OF TOTAL ASSETS7%93%

 

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1000 Urban Center Drive, Suite 501 Birmingham, AL 35242 (205) 969-3755 NYSE: MPW www.medicalpropertiestrust.comContact: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

 

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