UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM
CURRENT REPORT
PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
Date of report (Date of earliest event reported):
(Exact Name of Registrant as Specified in Charter)
Commission File Number
(State or other jurisdiction of incorporation or organization) |
(I.R.S. Employer Identification No.) |
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(Address of principal executive offices) | (Zip Code) |
Registrant’s telephone number, including area code
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 |
Name of each exchange | ||
of Medical Properties Trust, Inc. |
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 21, 2024, Medical Properties Trust, Inc. issued a press release announcing its financial results for the three and twelve months ended December 31, 2023. 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 21, 2024 reporting financial results for the three and twelve months ended December 31, 2023 | |
99.2 | Medical Properties Trust, Inc. 4th Quarter 2023 Supplemental Information | |
104 | Cover Page Interactive Data File (embedded within the Inline XBRL document) |
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunder duly authorized.
MEDICAL PROPERTIES TRUST, INC. | ||
By: | /s/ R. Steven Hamner | |
Name: | R. Steven Hamner | |
Title: | Executive Vice President and Chief Financial Officer |
Date: February 21, 2024
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Exhibit 99.1
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
Accelerated Asset Divestiture Strategy with More Than $480 million of Liquidity Transactions
Birmingham, AL February 21, 2024 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, 2023, as well as certain events occurring subsequent to quarter end.
| Net loss of ($1.11) and Normalized Funds from Operations (NFFO) of $0.36 for the 2023 fourth quarter and net loss of ($0.93) and NFFO of $1.59 for the full-year 2023, all on a per share basis. Included in NFFO is approximately $0.12 per share of revenue from Steward Health Care System (Steward) recognized prior to moving to cash basis accounting effective January 1, 2024; |
| Fourth quarter 2023 net loss includes approximately $772 million ($1.29 per share) in non-recurring write-offs and impairments, primarily related to Steward; |
| Entered into agreements in February to divest of five hospitals to Prime Healthcare (Prime) at a 7.4% economic cap rate for $350 million and the sale of MPTs remaining noncontrolling interest in a tenant and two under-leased hospitals in South Carolina for combined proceeds of approximately $17 million; and |
| Executed the sale of its syndicated term loan investment in MEDIAN, the parent of Priory Group (Priory), in January for approximately $115 million (£90 million). |
Edward K. Aldag, Jr., Chairman, President and Chief Executive Officer, said, Our primary focus is on accelerating our capital allocation strategy by pursuing transactions expected to generate at least $2 billion of incremental liquidity in 2024. We are making progress as evidenced by our recent agreement to sell hospital real estate to Prime at pricing well above our historical cost and substantially better than estimates of our implied market capitalization rate.
Mr. Aldag continued, With regard to Steward, we are encouraged by the amount of interest received to date from other hospital operators for these mission-critical facilities, and we expect this real estate portfolio will either resume its contributions to earnings or become additional sources of liquidity as the year progresses.
Included in the financial tables accompanying this press release is information about the Companys assets and liabilities, operating results, and reconciliations of net income (loss) to NFFO, including per share amounts, all on a basis comparable to 2022 results.
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PORTFOLIO UPDATE
Medical Properties Trust has total assets of approximately $18.3 billion, including $12.0 billion of general acute facilities, $2.6 billion of behavioral health facilities and $1.7 billion of post-acute facilities. As of December 31, 2023, MPTs portfolio included 439 properties and approximately 43,000 licensed beds leased to or mortgaged by 54 hospital operating companies across the United States as well as in the United Kingdom, Switzerland, Germany, Spain, Finland, Colombia, Italy and Portugal.
As of December 31, 2023, the Companys assets include approximately $5.0 billion of leased real estate and other investments which will be subject to cash basis accounting in 2024, with rent and interest only to be recognized as cash is received. More specifically, effective January 1, 2024, Steward and the International Joint Venture will become part of this portfolio, which already included Prospect and other smaller operators. For much of this portfolio, MPT has started a process to transition real estate to new tenants, sell, or otherwise monetize these assets in the near-term. To assist investors in more accurately assessing MPTs portfolio, the commentary and tables included below segregate the fourth quarter operating performance of these Cash Basis assets from the Companys Stabilized Portfolio with approximately $11.0 billion of total assets and for which accrual method accounting is appropriate. It is possible that the size and earnings contribution of these portfolios could be impacted by future asset sale and other transactions.
Stabilized / Accrual Method Portfolio (approximately $11.0 billion total assets)
Europe (approximately $6.0 billion)
Across MPTs European portfolio, operators continue to benefit from improving occupancy rates, growing reimbursement revenue, normalization of labor costs, and the rapid growth of behavioral health services.
Circle Health (Circle) ($2.1 billion) has maintained its performance, as the private healthcare market continues to attract patients in the United Kingdom who are seeking to minimize diagnostic and surgical waiting times. As previously announced, in January, Centene completed its sale of Circles operations to Pure Health for $1.2 billion. This transaction provides third-party validation of the inherent value of MPTs UK hospital real estate portfolio and demonstrates that the business of running private hospitals in the United Kingdom is attractive to a broad, global investor base.
MEDIAN maintained EBITDARM coverage in the 1.5-2.0x range and successfully achieved its 2023 financial targets given steadily improving occupancy, negotiated reimbursement rate increases, and stabilization of energy expenses. Priory ($1.4 billion) continues to operate profitably with improving EBITDARM coverage of 2.2x driven by increases to its already high utilization rate, reimbursement rate increases, and efficient cost management.
Americas (approximately $5.0 billion)
In MPTs Americas portfolio, operators have largely maintained hospital volumes while making significant progress in reducing contract labor. Behavioral health facilities continue to perform well driven primarily by revenues from increasing inpatient volume.
In February, the Company agreed to sell Saint Francis Medical Center in Lynwood, CA and four properties within the St. Clares system in New Jersey to Prime for $250 million in immediate cash and a $100 million interest-bearing mortgage note due to MPT in nine months, representing an approximate $50 million gain on sale of real estate. Completion of the transaction is subject to customary conditions and notice provisions.
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MPT and Prime have also agreed to combine three hospitals in Michigan and Missouri previously subject to a lease maturing in early 2025 with its only other remaining Prime facility (Newark, NJ) to form a new 20-year master lease with a double-digit prevailing cash rental yield and inflation-based escalators collared between 2% and 4%. Further, Prime has agreed to an approximately $5 million increase in annual escalating cash rents. Including this increase in rent for the remaining leased facilities, the St. Francis and St. Clares facilities were transacted at an economic cap rate of 7.4%.
The new lease also includes an option for Prime to repurchase the facilities at any time for a value of at least $260 million. Should Prime choose to exercise this purchase option, MPT would expect to record an additional gain on sale of real estate of approximately $95 million on the remaining four facilities leased to Prime.
Cash Basis Portfolio
Steward ($3.5 billion)
As announced in early January, MPT has worked with Steward to develop an action plan designed to strengthen Stewards liquidity and restore its balance sheet, optimize MPTs ability to recover unpaid rent and ultimately reduce MPTs exposure to Steward. MPT and certain of Stewards asset backed lenders are negotiating a new bridge facility whereby it is expected, but there is no assurance, that each party will fund an initial $37.5 million to Steward, based on its achievement of certain milestones previously established in January. MPT has already funded $20 million of such amount. Any subsequent loan fundings would be contingent on Steward achieving further significant milestones that optimize the amount and timing of recoveries for MPT and Stewards ABL lenders.
Prospect Medical (Prospect) ($1.1 billion)
In California, Prospect is current on all rent and interest due through the end of 2023, and EBITDARM improved year-over-year as a result of improved admissions, increased Medi-Cal reimbursement rates and lower supplies costs. Further, the $75 million delayed draw term loan MPT extended to Prospect in May 2023 was fully drawn as of December 31, 2023.
OPERATING RESULTS AND OUTLOOK
Net loss for the fourth quarter and year ended December 31, 2023 was ($664 million) (($1.11) per share) and ($556 million) (($0.93) per share), respectively, compared to ($140 million) (($0.24) per share) and net income of $903 million ($1.50 per share) in the year earlier periods. Net loss for the quarter ended December 31, 2023 included several non-recurring write-offs and impairments detailed in the tables below.
NFFO for the fourth quarter and year ended December 31, 2023 was $218 million ($0.36 per share) and $951 million ($1.59 per share), respectively, compared to $258 million ($0.43 per share) and $1,088 million ($1.82 per share) in the year earlier periods.
MPT has expanded its disclosure related to non-cash revenue, providing information allowing investors to adjust NFFO for non-cash components of accrued revenue not limited to deferred rent and payment-in-kind (PIK) interest, as well as cash recoveries of such items. These adjustments as they relate to fourth quarter and full-year 2023, as well as prior-year reporting, are included in this release and in the earnings supplemental.
Due to uncertainty regarding its hospitals leased to Steward and the timing of liquidity transactions, the Company is not providing an estimate of full-year 2024 net income or normalized funds from operations.
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Q4 2023 Non-Recurring Accounting Adjustment Summary ($ amounts in millions)
Income Statement: Line Item Impacted |
Amount | Description | ||||
Rent billed |
$ | (154 | ) | Write-off of Steward rent receivable, including deferred rent on Norwood Hospital, and lease incentive assets | ||
Straight-line rent |
(224 | ) | Write-off of Steward consolidated straight-line rent | |||
Interest and other income |
(81 | ) | Write-off of previously disclosed non-cash interest receivable on loans to Steward and International JV | |||
Real estate and other impairment charges, net |
(112 | ) | Steward and other real estate impairments | |||
Real estate and other impairment charges, net |
(171 | ) | Steward non-real estate impairments | |||
Loss from equity interests |
(30 | ) | Massachusetts partnership straight-line rent and other receivables |
Q4 2023 Consolidated Revenue Attribution ($ amounts in millions)
Stabilized/ Accrual Portfolio |
Steward1 | Prospect and Other Cash- Basis2 |
Non-Recurring Charges |
Total | ||||||||||||||||
Rent billed |
$ | 183 | $ | 48 | $ | 1 | $ | (154 | ) | $ | 78 | |||||||||
Straight-line rent |
44 | 13 | | (224 | ) | (167 | ) | |||||||||||||
Income from financing leases |
10 | | 10 | | 20 | |||||||||||||||
Interest and other income |
15 | 8 | 5 | (81 | ) | (53 | ) | |||||||||||||
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Total revenues |
$ | 252 | $ | 69 | $ | 16 | $ | (459 | ) | $ | (122 | ) | ||||||||
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Q4 2023 Unconsolidated FFO and NFFO Attribution ($ amounts in millions)
Stabilized/ Accrual Portfolio |
Steward1 | Non-Recurring Charges |
Total | |||||||||||||
Earnings from equity interests |
$ | 5 | $ | 4 | $ | (30 | ) | $ | (21 | ) | ||||||
Depreciation and amortization3 |
13 | 5 | | 18 | ||||||||||||
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MPT share of unconsolidated FFO |
18 | 9 | (30 | ) | (3 | ) | ||||||||||
Normalizing adjustments |
| | 30 | 30 | ||||||||||||
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MPT share of unconsolidated NFFO |
$ | 18 | $ | 9 | | $ | 27 | |||||||||
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1 | MPT will account for Steward revenue on a cash basis, effective January 1, 2024 |
2 | In addition to Prospect, includes revenue from other smaller tenants, as well as interest income from MPTs loan to the International Joint Venture for which interest will only be recognized as cash is received effective January 1, 2024 |
3 | MPT share of unconsolidated depreciation and amortization |
A reconciliation of net (loss) income to FFO and NFFO, including per share amounts, can be found in the financial tables accompanying this press release.
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ANNUAL MEETING OF STOCKHOLDERS
Medical Properties Trust also announced that its annual meeting of stockholders will be at 10:30 a.m. Central Time on May 30, 2024, in Birmingham, Alabama. Stockholders of record as of March 20, 2024, will be invited to attend.
CONFERENCE CALL AND WEBCAST
The Company has scheduled a conference call and webcast for February 21, 2024 at 12:00 p.m. Eastern Time to present the Companys financial and operating results for the quarter and year ended December 31, 2023. The dial-in numbers for the conference call are 877-883-0383 (U.S.) and 412-902-6506 (International) along with passcode 4099233. The conference call will also be available via webcast in the Investor Relations section of the Companys website, www.medicalpropertiestrust.com.
A telephone and webcast replay of the call will be available beginning shortly after the calls completion. The telephone replay will be available through March 6, 2024, using dial-in numbers 877-344-7529 (U.S.), 855-669-9658 (Canada) and 412-317-0088 (International) along with passcode 1685767. The webcast replay will be available for one year following the calls completion on the Investor Relations section of the Companys website.
The Companys supplemental information package for the current period will also be available on the Companys 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 worlds largest owners of hospital real estate with 439 facilities and approximately 43,000 licensed beds in nine countries and across three continents as of December 31, 2023. MPTs 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 Companys website at www.medicalpropertiestrust.com.
Forward-Looking Statements
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, asset sales and other liquidity transactions, expected returns on investments 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) macroeconomic
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conditions, including due to geopolitical conditions and instability, which may lead to a disruption of or lack of access to the capital markets, disruptions and instability in the banking and financial services industries, rising inflation and movements in currency exchange rates; (ii) the risk that MPT is not able to recover deferred rent or its other investments in Steward at full value, within a reasonable time period or at all; (iii) the risk that property sales, loan repayments, and other capital recycling transactions do not occur as anticipated or at all; (iv) the risk that MPT is not able to attain its leverage, liquidity and cost of capital objectives within a reasonable time period or at all; (v) MPTs ability to obtain debt financing on attractive terms or at all, as a result of changes in interest rates and other factors, which may adversely impact its ability to pay down, refinance, restructure or extend its indebtedness as it becomes due, or pursue acquisition and development opportunities; (vi) the ability of our tenants, operators and borrowers to satisfy their obligations under their respective contractual arrangements with us; (vii) the economic, political and social impact of, and uncertainty relating to, the potential impact from health crises (like COVID-19), which may adversely affect MPTs and its tenants business, financial condition, results of operations and liquidity; (viii) our success in implementing our business strategy and our ability to identify, underwrite, finance, consummate and integrate acquisitions and investments; (ix) the nature and extent of our current and future competition; (x) 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; (xi) factors affecting the real estate industry generally or the healthcare real estate industry in particular; (xii) our ability to maintain our status as a REIT for income tax purposes in the U.S. and U.K.; (xiii) federal and state healthcare and other regulatory requirements, as well as those in the foreign jurisdictions where we own properties; (xiv) 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; (xv) 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 our properties, to deliver high-quality services, to attract and retain qualified personnel and to attract patients; (xvi) potential environmental contingencies and other liabilities; (xvii) the risk that the expected sale of three Connecticut hospitals currently leased to Prospect does not occur; (xviii) the risk that MPT is unable to monetize its investment in PHP at full value within a reasonable time period or at all; and (xix) the risks and uncertainties of litigation or other regulatory proceedings.
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 most recent Annual Report on Form 10-K, as may be updated in our other filings with the SEC. Forward-looking statements are inherently uncertain and actual performance or outcomes may vary materially from any forward-looking statements and the assumptions on which those statements are based. Readers are cautioned to not place undue reliance on forward-looking statements as predictions of future events. We disclaim any responsibility to update such forward-looking statements, which speak only as of the date on which they were made.
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MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
Consolidated Balance Sheets
(Amounts in thousands, except for per share data)
December 31, 2023 | December 31, 2022 | |||||||
(Unaudited) | (A) | |||||||
Assets |
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Real estate assets |
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Land, buildings and improvements, intangible lease assets, and other |
$ | 13,237,187 | $ | 13,862,415 | ||||
Investment in financing leases |
1,231,630 | 1,691,323 | ||||||
Mortgage loans |
309,315 | 364,101 | ||||||
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Gross investment in real estate assets |
14,778,132 | 15,917,839 | ||||||
Accumulated depreciation and amortization |
(1,407,971 | ) | (1,193,312 | ) | ||||
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Net investment in real estate assets |
13,370,161 | 14,724,527 | ||||||
Cash and cash equivalents |
250,016 | 235,668 | ||||||
Interest and rent receivables |
45,059 | 167,035 | ||||||
Straight-line rent receivables |
635,987 | 787,166 | ||||||
Investments in unconsolidated real estate joint ventures |
1,474,455 | 1,497,903 | ||||||
Investments in unconsolidated operating entities |
1,778,640 | 1,444,872 | ||||||
Other loans |
292,615 | 227,839 | ||||||
Other assets |
457,911 | 572,990 | ||||||
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Total Assets |
$ | 18,304,844 | $ | 19,658,000 | ||||
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Liabilities and Equity |
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Liabilities |
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Debt, net |
$ | 10,064,236 | $ | 10,268,412 | ||||
Accounts payable and accrued expenses |
412,178 | 621,324 | ||||||
Deferred revenue |
37,962 | 27,727 | ||||||
Obligations to tenants and other lease liabilities |
156,603 | 146,130 | ||||||
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Total Liabilities |
10,670,979 | 11,063,593 | ||||||
Equity |
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Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding |
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Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 598,991 shares at December 31, 2023 and 597,476 shares at December 31, 2022 |
599 | 597 | ||||||
Additional paid-in capital |
8,560,309 | 8,535,140 | ||||||
Retained (deficit) earnings |
(971,809 | ) | 116,285 | |||||
Accumulated other comprehensive income (loss) |
42,501 | (59,184 | ) | |||||
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Total Medical Properties Trust, Inc. Stockholders Equity |
7,631,600 | 8,592,838 | ||||||
Non-controlling interests |
2,265 | 1,569 | ||||||
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Total Equity |
7,633,865 | 8,594,407 | ||||||
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Total Liabilities and Equity |
$ | 18,304,844 | $ | 19,658,000 | ||||
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(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, 2023 | December 31, 2022 | December 31, 2023 | December 31, 2022 | |||||||||||||
Revenues |
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Rent billed |
$ | 78,421 | $ | 231,845 | $ | 803,375 | $ | 968,874 | ||||||||
Straight-line rent |
(166,769 | ) | 58,045 | (127,894 | ) | 204,159 | ||||||||||
Income from financing leases |
19,412 | 48,920 | 127,141 | 203,580 | ||||||||||||
Interest and other income |
(53,447 | ) | 41,676 | 69,177 | 166,238 | |||||||||||
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Total revenues |
(122,383 | ) | 380,486 | 871,799 | 1,542,851 | |||||||||||
Expenses |
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Interest |
102,338 | 92,047 | 411,171 | 359,036 | ||||||||||||
Real estate depreciation and amortization |
77,295 | 81,454 | 603,360 | 332,977 | ||||||||||||
Property-related (A) |
3,298 | 7,699 | 41,567 | 45,697 | ||||||||||||
General and administrative |
30,150 | 42,893 | 145,588 | 160,494 | ||||||||||||
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Total expenses |
213,081 | 224,093 | 1,201,686 | 898,204 | ||||||||||||
Other (expense) income |
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(Loss) gain on sale of real estate |
(2,024 | ) | (33 | ) | (1,815 | ) | 536,755 | |||||||||
Real estate and other impairment charges, net |
(283,619 | ) | (282,950 | ) | (376,907 | ) | (268,375 | ) | ||||||||
(Losses) earnings from equity interests |
(20,873 | ) | 7,194 | 13,967 | 40,800 | |||||||||||
Debt refinancing and unutilized financing benefit (costs) |
239 | | 285 | (9,452 | ) | |||||||||||
Other (including fair value adjustments on securities) |
(17,861 | ) | (5,531 | ) | 7,586 | 15,344 | ||||||||||
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Total other (expense) income |
(324,138 | ) | (281,320 | ) | (356,884 | ) | 315,072 | |||||||||
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(Loss) income before income tax |
(659,602 | ) | (124,927 | ) | (686,771 | ) | 959,719 | |||||||||
Income tax (expense) benefit |
(3,982 | ) | (15,285 | ) | 130,679 | (55,900 | ) | |||||||||
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Net (loss) income |
(663,584 | ) | (140,212 | ) | (556,092 | ) | 903,819 | |||||||||
Net income attributable to non-controlling interests |
(359 | ) | (262 | ) | (384 | ) | (1,222 | ) | ||||||||
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Net (loss) income attributable to MPT common stockholders |
$ | (663,943 | ) | $ | (140,474 | ) | $ | (556,476 | ) | $ | 902,597 | |||||
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Earnings per common share - basic and diluted: |
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Net (loss) income attributable to MPT common stockholders |
$ | (1.11 | ) | $ | (0.24 | ) | $ | (0.93 | ) | $ | 1.50 | |||||
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Weighted average shares outstanding - basic |
598,984 | 598,053 | 598,518 | 598,634 | ||||||||||||
Weighted average shares outstanding - diluted |
598,984 | 598,053 | 598,518 | 598,837 | ||||||||||||
Dividends declared per common share |
$ | 0.15 | $ | 0.29 | $ | 0.88 | $ | 1.16 |
(A) | Includes $0.7 million and $6.0 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, 2023 and 2022, respectively, and $29.3 million and $36.3 million for the twelve months ended December 31, 2023 and 2022, respectively. |
MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
Reconciliation of Net (Loss) 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, 2023 | December 31, 2022 | December 31, 2023 | December 31, 2022 | |||||||||||||
FFO information: |
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Net (loss) income attributable to MPT common stockholders |
$ | (663,943 | ) | $ | (140,474 | ) | $ | (556,476 | ) | $ | 902,597 | |||||
Participating securities share in earnings |
(349 | ) | (567 | ) | (1,644 | ) | (1,602 | ) | ||||||||
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Net (loss) income, less participating securities share in earnings |
$ | (664,292 | ) | $ | (141,041 | ) | $ | (558,120 | ) | $ | 900,995 | |||||
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Depreciation and amortization |
95,648 | 98,891 | 676,132 | 399,622 | ||||||||||||
Loss (gain) on sale of real estate |
2,024 | (99 | ) | 1,815 | (536,887 | ) | ||||||||||
Real estate impairment charges |
112,112 | 170,582 | 167,966 | 170,582 | ||||||||||||
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Funds from operations |
$ | (454,508 | ) | $ | 128,333 | $ | 287,793 | $ | 934,312 | |||||||
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Write-off of billed and unbilled rent and other |
499,335 | 111 | 649,911 | 35,370 | ||||||||||||
Other impairment charges |
171,507 | 112,368 | 208,941 | 97,793 | ||||||||||||
Litigation and other |
2,899 | | 15,886 | | ||||||||||||
Share-based compensation adjustments |
(6,571 | ) | 4,042 | (9,691 | ) | 3,076 | ||||||||||
Non-cash fair value adjustments |
8,405 | 9,466 | (34,157 | ) | (3,097 | ) | ||||||||||
Tax rate changes and other |
(2,797 | ) | 3,796 | (167,332 | ) | 10,697 | ||||||||||
Debt refinancing and unutilized financing (benefit) costs |
(239 | ) | | (285 | ) | 9,452 | ||||||||||
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Normalized funds from operations |
$ | 218,031 | $ | 258,116 | $ | 951,066 | $ | 1,087,603 | ||||||||
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Certain non-cash and related recovery information: |
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Share-based compensation |
$ | 10,102 | $ | 12,377 | $ | 42,941 | $ | 46,345 | ||||||||
Debt costs amortization |
$ | 4,933 | $ | 5,023 | $ | 20,273 | $ | 19,739 | ||||||||
Non-cash rent and interest revenue (C) |
$ | (57,920 | ) | $ | (47,216 | ) | $ | (239,599 | ) | $ | (120,573 | ) | ||||
Cash recoveries of non-cash rent and interest revenue (D) |
$ | 2,364 | $ | 514 | $ | 38,451 | $ | 1,445 | ||||||||
Straight-line rent revenue from operating and finance leases |
$ | (63,282 | ) | $ | (72,494 | ) | $ | (247,699 | ) | $ | (297,645 | ) | ||||
Per diluted share data: |
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Net (loss) income, less participating securities share in earnings |
$ | (1.11 | ) | $ | (0.24 | ) | $ | (0.93 | ) | $ | 1.50 | |||||
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Depreciation and amortization |
0.16 | 0.16 | 1.13 | 0.67 | ||||||||||||
Loss (gain) on sale of real estate |
| | | (0.90 | ) | |||||||||||
Real estate impairment charges |
0.19 | 0.29 | 0.28 | 0.29 | ||||||||||||
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Funds from operations |
$ | (0.76 | ) | $ | 0.21 | $ | 0.48 | $ | 1.56 | |||||||
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Write-off of billed and unbilled rent and other |
0.83 | | 1.09 | 0.06 | ||||||||||||
Other impairment charges |
0.29 | 0.19 | 0.35 | 0.16 | ||||||||||||
Litigation and other |
| | 0.03 | | ||||||||||||
Share-based compensation adjustments |
(0.01 | ) | 0.01 | (0.02 | ) | 0.01 | ||||||||||
Non-cash fair value adjustments |
0.01 | 0.02 | (0.06 | ) | (0.01 | ) | ||||||||||
Tax rate changes and other |
| | (0.28 | ) | 0.02 | |||||||||||
Debt refinancing and unutilized financing (benefit) costs |
| | | 0.02 | ||||||||||||
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Normalized funds from operations |
$ | 0.36 | $ | 0.43 | $ | 1.59 | $ | 1.82 | ||||||||
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Certain non-cash and related recovery information: |
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Share-based compensation |
$ | 0.02 | $ | 0.02 | $ | 0.07 | $ | 0.08 | ||||||||
Debt costs amortization |
$ | 0.01 | $ | 0.01 | $ | 0.03 | $ | 0.03 | ||||||||
Non-cash rent and interest revenue (C) (E) |
$ | (0.10 | ) | $ | (0.08 | ) | $ | (0.40 | ) | $ | (0.20 | ) | ||||
Cash recoveries of non-cash rent and interest revenue (D) |
$ | | $ | | $ | 0.06 | $ | | ||||||||
Straight-line rent revenue from operating and finance leases (E) |
$ | (0.11 | ) | $ | (0.12 | ) | $ | (0.41 | ) | $ | (0.50 | ) |
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 (Losses) 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, including amortization related to in-place lease intangibles, 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.
(C) | Includes revenue accrued during the period but not received in cash, such as deferred rent, payment-in-kind (PIK) interest or other accruals. |
(D) | Includes cash received to satisfy previously accrued non-cash revenue, such as the cash receipt of previously deferred rent or PIK interest. |
(E) | Each line includes a portion of non-cash revenue from Steward in Q4 2023 totaling $0.12 per share. |
Exhibit 99.2
QUARTERLY SUPPLEMENTAL FOURTH QUARTER 2023
3 COMPANY OVERVIEW Company Information 3 FINANCIAL INFORMATION 6 Reconciliation of Funds from Operations 6 Debt Summary 7 Debt Maturities and Debt Metrics 8 PORTFOLIO INFORMATION Lease and Loan Maturity Schedule 9 9 Total Assets and Revenues 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 AppendixNon-GAAP Reconciliations 20 FORWARD-LOOKING STATEMENTS Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results of the Company or future events to differ materially from those expressed in or underlying such forward-looking statements, including without limitation: (i) macroeconomic conditions, including due to geopolitical conditions and instability, which may lead to a disruption of or lack of access to the capital markets, disruptions and instability in the banking and financial services industries, rising inflation and movements in currency exchange rates; (ii) the risk that MPT is not able to recover deferred rent or its other investments in Steward at full value, within a reasonable time period or at all; (iii) the risk that property sales, loan repayments, and other capital recycling transactions do not occur as anticipated or at all; (iv) the risk that MPT is not able to attain its leverage, liquidity and cost of capital objectives within a reasonable time period or at all; (v) MPTs ability to obtain debt financing on attractive terms or at all, as a result of changes in interest rates and other factors, which may adversely impact its ability to pay down, refinance, restructure or extend its indebtedness as it becomes due, or pursue acquisition and development opportunities; (vi) the ability of our tenants, operators and borrowers to satisfy their obligations under their respective contractual arrangements with us; (vii) the economic, political and social impact of, and uncertainty relating to, the potential impact from health crises (like COVID-19), which may adversely affect MPTs and its tenants business, financial condition, results of operations and liquidity; (viii) our success in implementing our business strategy and our ability to identify, underwrite, finance, consummate and integrate acquisitions and investments; (ix) the nature and extent of our current and future competition; (x) 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; (xi) factors affecting the real estate industry generally or the healthcare real estate industry in particular; (xii) our ability to maintain our status as a REIT for income tax purposes in the U.S. and U.K.; (xiii) federal and state healthcare and other regulatory requirements, as well as those in the foreign jurisdictions where we own properties; (xiv) 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; (xv) 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 our properties, to deliver high-quality services, to attract and retain qualified personnel and to attract patients; (xvi) potential environmental contingencies and other liabilities; (xvii) the risk that the expected sale of three Connecticut hospitals currently leased to Prospect does not occur; (xviii) the risk that MPT is unable to monetize its investment in PHP at full value within a reasonable time period or at all; and (xix) the risks and uncertainties of litigation or other regulatory proceedings. For further discussion of the factors that could affect outcomes, please refer to the Risk Factors section of the Companys Annual Report on Form 10-K for the year ended December 31, 2022, and as updated by the Companys subsequently filed Quarterly Reports on Form 10-Q and other SEC filings. Except as otherwise required by the federal securities laws, the Company undertakes no obligation to update the information in this report. On the cover: Bakersfield Rehabilitation HospitalBakersfield, California. Below: Davis Hospital and Medical CenterLayton, Utah.
COMPANY OVERVIEW edical Properties Trust, Inc. is a self-advised MPTs financing model facilitates acquisitions M 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 worlds technology upgrades and other investments largest owners of hospital real estate. in operations. As of December 31, 2023. 439 54 ~43,000 31 9 properties operators beds U.S. states countries
MPT Officers Edward K. Aldag, Jr. Chairman, President and Chief Executive Officer R. Steven Hamner Executive Vice President and Chief Financial Officer J. Kevin Hanna Senior Vice President, Controller and Chief Accounting Officer Rosa H. Hooper Senior Vice President of Operations & Secretary Larry H. Portal Senior Vice President, Senior Advisor to the CEO Charles R. Lambert Vice President, Treasurer and Managing Director of Capital Markets R. Lucas Savage Vice President, Head of Global Acquisitions Board of Directors Corporate Headquarters Edward 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 Elizabeth N. Pitman (205) 969-3755 D. Paul Sparks, Jr. (205) 969-3756 (fax) Michael G. Stewart www.medicalpropertiestrust.com C. Reynolds Thompson, III MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023
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 Transfer Stock Exchange Senior Agent Listing and Unsecured Trading Symbol Debt Ratings Equiniti Trust Company, LLC New York Stock Exchange Moodys: Ba2 6201 15th Avenue (NYSE): MPW Standard & Poors: BB-Brooklyn, NY 11219 https://equiniti.com/us Cavendish Square HospitalLondon, U.K., operated by NHS. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023
FINANCIAL INFORMATION RECONCILIATION OF NET (LOSS) INCOME TO FUNDS FROM OPERATIONS (Unaudited) (Amounts in thousands, except per share data) For the Three Months Ended For the Twelve Months Ended December 31, 2023 December 31, 2022 December 31, 2023 December 31, 2022 FFO INFORMATION: Net (loss) income attributable to MPT common stockholders $ (663,943) $ (140,474) $ (556,476) $ 902,597 Participating securities share in earnings (349) (567) (1,644) (1,602) Net (loss) income, less participating securities share in earnings $ (664,292) $ (141,041) $ (558,120) $ 900,995 Depreciation and amortization 95,648 98,891 676,132 399,622 Loss (gain) on sale of real estate 2,024 (99) 1,815 (536,887) Real estate impairment charges 112,112 170,582 167,966 170,582 Funds from operations $ (454,508) $ 128,333 $ 287,793 $ 934,312 Write-off of billed and unbilled rent and other 499,335 111 649,911 35,370 Other impairment charges 171,507 112,368 208,941 97,793 Litigation and other 2,89915,886 -Share-based compensation adjustments (6,571) 4,042 (9,691) 3,076 Non-cash fair value adjustments 8,405 9,466 (34,157) (3,097) Tax rate changes and other (2,797) 3,796 (167,332) 10,697 Debt refinancing and unutilized financing (benefit) costs (239)(285) 9,452 Normalized funds from operations $ 218,031 $ 258,116 $ 951,066 $ 1,087,603 Certain non-cash and related recovery information: Share-based compensation $ 10,102 $ 12,377 $ 42,941 $ 46,345 Debt costs amortization $ 4,933 $ 5,023 $ 20,273 $ 19,739 Non-cash rent and interest revenue (C) $ (57,920) $ (47,216) $ (239,599) $ (120,573) Cash recoveries of non-cash rent and interest revenue (D) $ 2,364 $ 514 $ 38,451 $ 1,445 Straight-line rent revenue from operating and finance leases $ (63,282) $ (72,494) $ (247,699) $ (297,645) PER DILUTED SHARE DATA: Net (loss) income, less participating securities share in earnings $ (1.11) $ (0.24) $ (0.93) $ 1.50 Depreciation and amortization 0.16 0.16 1.13 0.67 Loss (gain) on sale of real estate (0.90) Real estate impairment charges 0.19 0.29 0.28 0.29 Funds from operations $ (0.76) $ 0.21 $ 0.48 $ 1.56 Write-off of billed and unbilled rent and other 0.831.09 0.06 Other impairment charges 0.29 0.19 0.35 0.16 Litigation and other 0.03 -Share-based compensation adjustments (0.01) 0.01 (0.02) 0.01 Non-cash fair value adjustments 0.01 0.02 (0.06) (0.01) Tax rate changes and other (0.28) 0.02 Debt refinancing and unutilized financing (benefit) costs 0.02 Normalized funds from operations $ 0.36 $ 0.43 $ 1.59 $ 1.82 Certain non-cash and related recovery information: Share-based compensation $ 0.02 $ 0.02 $ 0.07 $ 0.08 Debt costs amortization $ 0.01 $ 0.01 $ 0.03 $ 0.03 Non-cash rent and interest revenue (C) (E) $ (0.10) $ (0.08) $ (0.40) $ (0.20) Cash recoveries of non-cash rent and interest revenue (D) $$$ 0.06 $ -Straight-line rent revenue from operating and finance leases (E) $ (0.11) $ (0.12) $ (0.41) $ (0.50) 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 (Losses) 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, including amortization related to in-place lease intangibles, 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. (C) Includes revenue accrued during the period but not received in cash, such as deferred rent, payment-in-kind (PIK) interest or other accruals. (D) Includes cash received to satisfy previously accrued non-cash revenue, such as the cash receipt of previously deferred rent or PIK interest. (E) Each line includes a portion of non-cash revenue from Steward in Q4 2023 totaling $0.12 per share. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 6
FINANCIAL INFORMATION (As of December 31, 2023) ($ amounts in thousands) DEBT SUMMARY Debt Instrument Rate Type Rate Balance 2026 Credit Facility Revolver(A) Variable 5.343%6.960% $ 1,514,420 2027 Term Loan Variable 7.156% 200,000 2024 AUD Term Loan (A$470M)(A) Fixed(B) 2.850% 320,164 2024 GBP Term Loan (Ł105M)(A) Fixed 5.250% 133,484 3.325% Notes Due 2025 (€500M)(A) Fixed 3.325% 551,950 2025 GBP Term Loan (Ł700M)(A) Fixed(C) 2.349% 891,170 0.993% Notes Due 2026 (€500M)(A) Fixed 0.993% 551,950 5.250% Notes Due 2026 Fixed 5.250% 500,000 2.500% Notes Due 2026 (Ł500M)(A) Fixed 2.500% 636,550 5.000% Notes Due 2027 Fixed 5.000% 1,400,000 3.692% Notes Due 2028 (Ł600M)(A) Fixed 3.692% 763,860 4.625% Notes Due 2029 Fixed 4.625% 900,000 3.375% Notes Due 2030 (Ł350M)(A) Fixed 3.375% 445,585 3.500% Notes Due 2031 Fixed 3.500% 1,300,000 $ 10,109,133 Debt issuance costs and discount (44,897) Weighted average rate 4.123% $ 10,064,236 Variable 17% Fixed 83% (A) Non-USD denominated debt converted to U.S. dollars at December 31, 2023. (B) We entered into an interest rate swap transaction, effective July 3, 2019, to fix the benchmark variable interest rate of the loan. On March 10, 2023, the rate increased to 2.850%. (C) We entered into an interest rate swap transaction, effective March 6, 2020, to fix the benchmark variable interest rate of the loan. On March 10, 2023, the rate increased to 2.349%. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 7
FINANCIAL INFORMATION (As of December 31, 2023) ($ amounts in thousands) DEBT MATURITIES Senior Unsecured Year Term Loans/Revolver Total Debt % of Total Notes 2024 $$ 453,648 $ 453,648 4.5% 2025 551,950 891,170 1,443,120 14.3% 2026 1,688,500 1,514,420 3,202,920 31.7% 2027 1,400,000 200,000 1,600,000 15.8% 2028 763,860763,860 7.5% 2029 900,000900,000 8.9% 2030 445,585445,585 4.4% 2031 1,300,0001,300,000 12.9% Totals $ 7,049,895 $ 3,059,238 $ 10,109,133 100.0% DEBT BY LOCAL CURRENCY Senior Unsecured Term Loans/Revolver Total Debt % of Total Notes United States $ 4,100,000 $ 970,000 $ 5,070,000 50.1% United Kingdom 1,845,995 1,434,592 3,280,587 32.5% Australia320,164 320,164 3.2% Europe 1,103,900 334,482 1,438,382 14.2% Totals $ 7,049,895 $ 3,059,238 $ 10,109,133 100.0% DEBT METRICS For the Three Months Ended December 31, 2023 Adjusted Net Debt to Annualized EBITDAre Ratios: Adjusted Net Debt $ 9,234,044 Adjusted Annualized EBITDAre 1,339,160 Adjusted Net Debt to Adjusted Annualized EBITDAre Ratio 6.9x Adjusted Net Debt $ 9,234,044 Transaction Adjusted Annualized EBITDAre 1,337,260 Adjusted Net Debt to Transaction Adjusted Annualized EBITDAre Ratio(A) 6.9x Leverage Ratio: Unsecured Debt $ 9,975,649 Secured Debt 133,484 Total Debt $ 10,109,133 Total Gross Assets(B) 19,712,815 Financial Leverage 51.3% Interest Coverage Ratios: Interest Expense $ 102,338 Capitalized Interest 5,250 Debt Costs Amortization (3,797) Total Interest $ 103,791 Adjusted EBITDAre $ 334,790 Adjusted Interest Coverage Ratio 3.2x (A) Adjusting for billed rent, straight-line rent and interest income reserves related to Steward and the International Joint Venture, Adjusted Net Debt to Transaction Adjusted Annualized EBITDAre Ratio would be 8.7x. (B) Total Gross Assets equals total assets plus accumulated depreciation and amortization. See appendix for reconciliation of Non-GAAP financial measures. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023
PORTFOLIO INFORMATION 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 2024$0.0% 2025 7 19,961 1.5% 2026 4 2,274 0.2% 2027 1 3,476 0.3% 2028 8 19,968 1.5% 2029 6 15,163 1.2% 2030 11 6,454 0.5% 2031 4 4,789 0.4% 2032 41 68,677 5.3% 2033 8 11,991 0.9% Thereafter 336 1,147,291 88.2% 426 # $ 1,300,044 100.0% Percentage of total base rent/interest 100% 88.2% 90% 80% 70% 60% 50% 40% 30% 20% 10% 5.3% 0.0% 1.5% 0.2% 0.3% 1.5% 1.2% 0.5% 0.4% 0.9% 0% (A) Schedule includes leases and mortgage loans and related terms as of December 31, 2023. (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 vacant properties (approximately 0.2% of total assets), and facilities that are under development. (D) Represents base rent/interest income per the lease/loan agreements 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), or any reserves or write-offs. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 9
PORTFOLIO INFORMATION TOTAL ASSETS AND REVENUES BY ASSET TYPE (December 31, 2023) ($ amounts in thousands) Total Percentage of Q4 2023 Percentage of Asset Types Properties (A) (B) Assets Total Assets Revenues Q4 2023 Revenues General Acute Care Hospitals 192 $ 11,764,151 64.3% $ 244,791 72.8% Behavioral Health Facilities 70 2,576,983 14.1% 53,957 16.0% Inpatient Rehabilitation Facilities 114 1,445,399 7.9% 25,448 7.5% Long-Term Acute Care Hospitals 20 270,849 1.5% 6,266 1.9% Freestanding ER/Urgent Care Facilities 43 230,065 1.2% 6,018 1.8% Other2,017,397 (C) 11.0% Total 439 $ 18,304,844 100.0% $ 336,480 100.0% TOTAL ASSETS BY ASSET TYPE TOTAL REVENUES BY ASSET TYPE 2% 2% 1% 2% 11% General Acute Care Hospitals 7% 8% Behavioral Health Facilities 16% Inpatient Rehabilitation Facilities 64% 73% 14% Long-Term Acute Care Hospitals Freestanding ER/Urgent Care Facilities Other DOMESTIC ASSETS BY ASSET TYPE DOMESTIC REVENUES BY ASSET TYPE 3% 3% 2% 2% General Acute Care Hospitals 13% Behavioral Health Facilities 8% 9% 7% 68% Inpatient Rehabilitation Facilities 8% 77% Long-Term Acute Care Hospitals Freestanding ER/Urgent Care Facilities Other Note: Investments in operating entities are allocated pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period. (A) Reflects total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statements of income, except for $458.9M of reserves for billed rent, straight-line rent, and interest income, primarily related to Steward. (C) Includes our PHP Holdings investment of $700 million. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 10
PORTFOLIO INFORMATION TOTAL ASSETSLARGEST INDIVIDUAL FACILITY (December 31, 2023) COMPREHENSIVE PROPERTY-LEVEL UNDERWRITING FRAMEWORK Largest Individual MPT invests in real estate, not the consolidated financial performance of its Operators Facility as a Percentage tenants. Each facility is underwritten for characteristics that make the of Total Assets(A) infrastructure attractive to any experienced, competent operatornot just the current tenant. If we have underwritten these correctly, then coupled Steward Health Care 2.1% with our absolute net master lease structure, our real estate will be Circle Health 1.1% attractive to a replacement operator, in the rare event we must transition. Such underwriting characteristics include: Priory Group 0.7% Prospect Medical Holdings 1.1% Lifepoint Behavioral Health 0.4% Physical Quality Competition 49 operators 2.0% Largest Individual Facility Investment is Approximately 2% of MPT Investment Portfolio Demographics Financial and Market TOTAL ASSETS AND REVENUES BY OPERATOR (December 31, 2023) ($ amounts in thousands) Total Percentage of Q4 2023 Percentage of Operators Properties (A) (B) Assets Total Assets Revenues Q4 2023 Revenues Steward Health Care 36 Florida market $ 1,348,210 7.4% $ 26,984 8.0% Texas/Arkansas/Louisiana market 1,026,315 5.6% 23,444 7.0% Massachusetts market 727,832 4.0% 5,417 1.6% Arizona market 288,089 1.6% 8,867 2.6% Ohio/Pennsylvania market 122,108 0.6% 3,744 1.1% Utah market 5,983 0.0%0.0% Circle Health 36 2,119,392 11.6% 49,123 14.6% Priory Group 37 1,391,005 7.6% 27,551 8.2% Prospect Medical Holdings 13 1,092,974 6.0% 11,328 3.4% Lifepoint Behavioral Health(C) 19 813,527 4.4% 18,054 5.4% CommonSpirit Health 5 786,186 4.3% 29,352 8.7% Swiss Medical Network 19 735,891 4.0% 281 0.1% MEDIAN 81 660,003 3.6% 7,871 2.3% Ernest Health 29 619,388 3.4% 18,418 5.5% Lifepoint Health 8 497,521 2.7% 15,061 4.5% 44 operators 156 4,053,023 22.2% 90,985 27.0% Other2,017,397 11.0% Total 439 $ 18,304,844 100.0% $ 336,480 100.0% Note: Investments in operating entities are allocated pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period. (A) Reflects total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statements of income, except for $458.9M of reserves for billed rent, straight-line rent, and interest income, primarily related to Steward. (C) Formerly Springstone. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 11
PORTFOLIO INFORMATION TOTAL ASSETS AND REVENUES BY U.S. STATE AND COUNTRY (December 31, 2023) ($ amounts in thousands) Total Percentage of Q4 2023 Percentage of U.S. States and Other Countries Properties (A) (B) Assets Total Assets Revenues Q4 2023 Revenues Texas 51 $ 1,891,482 10.3% $ 42,706 12.7% Florida 9 1,348,210 7.4% 26,984 8.0% California 19 1,252,674 6.8% 24,810 7.4% Utah 7 824,048 4.5% 30,368 9.0% Massachusetts 10 732,550 4.0% 5,453 1.6% 26 Other States 120 3,726,145 20.4% 95,038 28.3% Other1,397,170 7.6% United States 216 $ 11,172,279 61.0% $ 225,359 67.0% United Kingdom 92 $ 4,261,944 23.3% $ 89,459 26.6% Switzerland 19 735,891 4.0% 281 0.1% Germany 85 734,630 4.0% 9,887 2.9% Spain 9 252,529 1.4% 2,039 0.6% Other Countries 18 527,344 2.9% 9,455 2.8% Other620,227 3.4% International 223 $ 7,132,565 39.0% $ 111,121 33.0% Total 439 $ 18,304,844 100.0% $ 336,480 100.0% Note: Investments in operating entities are allocated pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period. (A) Reflects total assets on our consolidated balance sheets. (B) Reflects actual revenues on our consolidated statements of income, except for $458.9M of reserves for billed rent, straight-line rent, and interest income, primarily related to Steward. TOTAL ASSETS BY COUNTRY TOTAL REVENUES BY COUNTRY 4% 1% 3% 3% 1% 3% 4% 4% United States United Kingdom Switzerland 26% 23% 61% Germany Spain 67% Other Countries Other ASSETS BY U.S. STATE REVENUES BY U.S. STATE 8% Texas 10% Florida 13% California 28% 7% Utah 8% 20% Massachusetts 7% 26 Other States 5% 2% 7% 4% Other 9% MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 12
PORTFOLIO INFORMATION as TOTAL PORTFOLIO TTM EBITDARM(A)(B) RENT COVERAGE EXCLUSIVE OF ALL CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE EBITDARM Rent Coverage 3.00x 2.50x 2.4x 2.4x 2.4x 2.1x 2.1x 2.1x 2.00x 1.9x 1.9x 1.8x 1.9x 1.8x 1.8x 1.7x 1.50x 1.4x 1.1x 1.00x 0.50x 0.00x General Acute Care Hospitals Inpatient Rehabilitation Behavioral Health Long-Term Acute Care Total Portfolio Facilities Facilities Hospitals Q3 2022 TTM Q2 2023 TTM Q3 2023 TTM % of Total Assets(C) 64.3% 7.9% 14.1% 1.5% 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, 2023. (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. MPTs 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 MPTs 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.All CARES Act Grants received by tenants have been removed from the tenants reported financial results in the above time periods.EBITDARM figures for California hospitals include amounts expected to be received under the Hospital Quality Assurance Fee (HQAF) Program 8. The HQAF amounts are based on the current payment model from the California Hospital Association which was approved by CMS on December 19, 2023. (B) General Acute Care coverages and Total Portfolio coverages do not include Pipeline Health facilities as Pipeline Health filed Chapter 11 bankruptcy in October 2022 and emerged in February 2023, one Prime Healthcare facility due to pending sale, Prospect Medical Holdings Connecticut facilities due to pending sale, $150M mortgage investment in Prospect Medical Holdings Pennsylvania facilities, and Steward Health Care due to restructuring. (C) Reflects total assets on our consolidated balance sheets. Total Portfolio includes Freestanding ER/Urgent Care Facilities and Other, representing 12.2% of Total Assets. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 13
PORTFOLIO INFORMATION TOTAL PORTFOLIO TTM EBITDARM RENT COVERAGE EXCLUSIVE OF ALL CARES ACT GRANTS EBITDARM RENT COVERAGE: OPERATORS WITH PROPERTY-LEVEL REPORTING Net Investment Tenant Primary Property Type TTM EBITDARM Rent Coverage (in thousands)(A) Steward Health Care(B) $ 2,342,414 General Acute N/A Priory Group 1,227,168 Behavioral 2.2x MEDIAN 660,003 IRF 1.6x Ernest Health 619,388 IRF/LTACH 2.2x Prospect Medical Holdings(C) 510,916 General Acute 0.9x Prime Healthcare 276,270 General Acute 1.9x Aspris Childrens Services 244,105 Behavioral 2.1x Vibra Healthcare 219,260 IRF/LTACH 1.1x Surgery Partners 178,373 General Acute 7.6x Cordiant Healthcare Services 124,728 General Acute 1.6x Ardent Health Services 85,668 General Acute 7.8x Other Reporting Tenants 549,735 Various 2.8x Total $ 7,038,028 2.3x Net Investment Tenant Primary Property Type TTM EBITDARM Rent Coverage (in thousands)(A) International Operator 1 $ 2,068,016 General Acute 2.4x Domestic Operator 1 497,521 General Acute 0.3x Domestic Operator 2 380,372 General Acute/LTACH 1.7x Domestic Operator 3 774,945 Behavioral 1.6x Total $ 3,720,854 1.7x PROPERTY-LEVEL REPORTING NOT REQUIRED AND/OR NOT AVAILABLE Net Investment Tenant Primary Property Type Comments (in thousands)(A) One of the largest nonprofit health care operators in the U.S.; CommonSpirit Health $ 786,186 General Acute Investment grade-rated Swiss Medical Network 472,433 General Acute Second largest group of private hospitals in Switzerland One of largest health care operators in the world; Parent Ramsay Health Care UK 403,180 General Acute guaranty; Investment grade-rated Pihlajalinna 218,322 General Acute One of Finlands leading providers of social and health services Saint LukesKansas City 127,085 General Acute Investment grade-rated NHS 88,276 General Acute Single-payor government entity in UK Dignity Health 43,441 General Acute Part of CommonSpirit; Parent guaranty; Investment grade-rated One of the largest private hospital systems in Portugal with 24 CUF 29,958 General Acute facilities and 75+ year operating history NeuroPsychiatric Hospitals 26,825 Behavioral Parent guaranty Community Health Systems 26,168 General Acute U.S. hospital operator with substantial operating history Other Tenants 17,015 General Acute N/A Total $ 2,238,889 Above data represents approximately 85% 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, 2023. (A) Investment figures exclude equity investments, non-real estate loans, freestanding ER/urgent care facilities, and facilities under development. (B) Coverage not available due to restructuring. (C) Prospect Medical Holdings coverage includes California facilities only. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 14
PORTFOLIO INFORMATION SUMMARY OF INVESTMENTS (For the twelve months ended December 31, 2023) (Amounts in thousands) Operator Location Investment(A) Commencement Date PHP Holdings California $ 50,000 Q1 2023 MEDIAN Germany 77,230 Q2 2023 Priory Group U.K. 57,606 Q2 2023 Prospect Medical Holdings California 75,000 Q2 2023 Capital Additions, Development and (B) Various 292,460 Various Other Funding for Existing Tenants $ 552,296 SUMMARY OF CURRENT DEVELOPMENT PROJECTS AS OF DECEMBER 31, 2023 (Amounts in thousands) Costs Incurred as of Estimated Commencement Operator Location Commitment December 31, 2023 Date IMED Hospitales Spain $ 50,099 $ 49,534 Q1 2024 Lifepoint Behavioral Health Texas 31,600 24,023 Q1 2024 IMED Hospitales Spain 37,879 17,876 Q3 2024 IMED Hospitales Spain 51,984 18,640 Q1 2025 $ 171,562 $ 110,073 (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 on which we receive a return equal to the lease rate for the respective facility. This includes over 10 facilities and six different operators. Note: Due to Steward restructuring, the Texas development is omitted from this schedule. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 15
FINANCIAL STATEMENTS CONSOLIDATED STATEMENTS OF INCOME (Unaudited) (Amounts in thousands, except per share data) For the Three Months Ended For the Twelve Months Ended December 31, 2023 December 31, 2022 December 31, 2023 December 31, 2022 REVENUES Rent billed $ 78,421 $ 231,845 $ 803,375 $ 968,874 Straight-line rent (166,769) 58,045 (127,894) 204,159 Income from financing leases 19,412 48,920 127,141 203,580 Interest and other income (53,447) 41,676 69,177 166,238 Total revenues (122,383) 380,486 871,799 1,542,851 EXPENSES Interest 102,338 92,047 411,171 359,036 Real estate depreciation and amortization 77,295 81,454 603,360 332,977 Property-related(A) 3,298 7,699 41,567 45,697 General and administrative 30,150 42,893 145,588 160,494 Total expenses 213,081 224,093 1,201,686 898,204 OTHER (EXPENSE) INCOME (Loss) gain on sale of real estate (2,024) (33) (1,815) 536,755 Real estate and other impairment charges, net (283,619) (282,950) (376,907) (268,375) (Losses) earnings from equity interests (20,873) 7,194 13,967 40,800 Debt refinancing and unutilized financing benefit (costs) 239285 (9,452) Other (including fair value adjustments on securities) (17,861) (5,531) 7,586 15,344 Total other (expense) income (324,138) (281,320) (356,884) 315,072 (Loss) income before income tax (659,602) (124,927) (686,771) 959,719 Income tax (expense) benefit (3,982) (15,285) 130,679 (55,900) Net (loss) income (663,584) (140,212) (556,092) 903,819 Net income attributable to non-controlling interests (359) (262) (384) (1,222) Net (loss) income attributable to MPT common stockholders $ (663,943) $ (140,474) $ (556,476) $ 902,597 EARNINGS PER COMMON SHAREBASIC AND DILUTED Net (loss) income attributable to MPT common stockholders $ (1.11) $ (0.24) $ (0.93) $ 1.50 WEIGHTED AVERAGE SHARES OUTSTANDINGBASIC 598,984 598,053 598,518 598,634 WEIGHTED AVERAGE SHARES OUTSTANDINGDILUTED 598,984 598,053 598,518 598,837 $$DIVIDENDS DECLARED PER COMMON SHARE $ 0.15 $ 0.29 $ 0.88 $ 1.16 (A) Includes $0.7 million and $6.0 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, 2023 and 2022, respectively, and $29.3 million and $36.3 million for the twelve months ended December 31, 2023 and 2022, respectively. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 16
FINANCIAL STATEMENTS CONSOLIDATED BALANCE SHEETS (Amounts in thousands, except per share data) December 31, 2023 December 31, 2022 (Unaudited) (A) ASSETS Real estate assets Land, buildings and improvements, intangible lease assets, and other $ 13,237,187 $ 13,862,415 Investment in financing leases 1,231,630 1,691,323 Mortgage loans 309,315 364,101 Gross investment in real estate assets 14,778,132 15,917,839 Accumulated depreciation and amortization (1,407,971) (1,193,312) Net investment in real estate assets 13,370,161 14,724,527 Cash and cash equivalents 250,016 235,668 Interest and rent receivables 45,059 167,035 Straight-line rent receivables 635,987 787,166 Investments in unconsolidated real estate joint ventures 1,474,455 1,497,903 Investments in unconsolidated operating entities 1,778,640 1,444,872 Other loans 292,615 227,839 Other assets 457,911 572,990 Total Assets $ 18,304,844 $ 19,658,000 LIABILITIES AND EQUITY Liabilities Debt, net $ 10,064,236 $ 10,268,412 Accounts payable and accrued expenses 412,178 621,324 Deferred revenue 37,962 27,727 Obligations to tenants and other lease liabilities 156,603 146,130 Total Liabilities 10,670,979 11,063,593 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 outstanding598,991 shares at December 31, 2023 and 597,476 shares at December 31, 2022 599 597 Additional paid-in capital 8,560,309 8,535,140 Retained (deficit) earnings (971,809) 116,285 Accumulated other comprehensive income (loss) 42,501 (59,184) Total Medical Properties Trust, Inc. Stockholders Equity 7,631,600 8,592,838 Non-controlling interests 2,265 1,569 Total Equity 7,633,865 8,594,407 Total Liabilities and Equity $ 18,304,844 $ 19,658,000 (A) Financials have been derived from the prior year audited financial statements. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 17
FINANCIAL STATEMENTS INVESTMENTS IN UNCONSOLIDATED REAL ESTATE JOINT VENTURES (As of and for the three months ended December 31, 2023) (Unaudited) ($ amounts in thousands) Swiss Medical Steward Policlinico di HM MPT Pro Rata MEDIAN(C) (D) (E) (F) (G) Total Network Health Care Monza Hospitales Share Gross real estate $ 1,947,056 $ 1,654,138 $ 1,677,587 $ 185,033 $ 373,746 $ 5,837,560 $ 3,230,920 Cash 27,291 3,729 1,616 18,422 2,103 53,161 27,221 Accumulated depreciation and amortization (243,403) (155,397) (74,076) (33,293) (32,111) (538,280) (298,614) Other assets 69,745 109,978 39,777 3,818 8,436 231,754 137,451 Total Assets $ 1,800,689 $ 1,612,448 $ 1,644,904 $ 173,980 $ 352,174 $ 5,584,195 $ 3,096,978 Debt (third party) $ 720,444 $ 797,724 $ 847,433 $$ 142,565 $ 2,508,166 $ 1,406,499 Other liabilities 137,571 139,819 9,367 12,856 85,008 384,621 216,024 Equity and shareholder loans 942,674 (A) 674,905 788,104 161,124 124,601 2,691,408 1,474,455 Total Liabilities and Equity $ 1,800,689 $ 1,612,448 $ 1,644,904 $ 173,980 $ 352,174 $ 5,584,195 $ 3,096,978 MPT share of real estate joint venture 50% 70% 50% 50% 45% Total $ 471,336 $ 472,434 $ 394,052 $ 80,562 $ 56,071 $ 1,474,455 Swiss Medical Steward Policlinico di HM MPT Pro Rata MEDIAN(C) (D) (E) (F) (G) Total Network Health Care Monza Hospitales Share Total revenues(B) $ 32,116 $ 17,626 $ (25,516) $ 4,482 $ 3,797 $ 32,505 $ 19,588 Expenses: Property-related $ 628 $ 824 $ 194 $ 1,093 $ 43 $ 2,782 $ 1,553 Interest 12,891 5,208 17,099533 35,731 18,881 Real estate depreciation and amortization 11,199 8,611 10,307 1,041 2,052 33,210 18,225 General and administrative 1,573 291 105 (63) 14 1,920 1,018 Income taxes 1,166 563 295 2,024 1,109 Total expenses $ 27,457 $ 15,497 $ 27,705 $ 2,071 $ 2,937 $ 75,667 $ 40,786 Net Income $ 4,659 $ 2,129 $ (53,221) $ 2,411 $ 860 $ (43,162) $ (21,198) MPT share of real estate joint venture 50% 70% 50% 50% 45% Earnings from equity interests (H) $ 2,330 $ 1,490 $ (26,611) $ 1,206 $ 387 $ (21,198) (A) Includes a €297 million loan from both shareholders. (B) Includes $60 million of reserves for billed and straight-line rent receivables on our Steward joint venture (of which our share is $30 million). (C) MPT managed joint venture of 71-owned German facilities that are fully leased. (D) Represents ownership in Infracore, which owns and leases 17 Switzerland facilities. We also have two Infracore facilities currently under development. (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 $0.3 million from returns on our Lifepoint Behavioral Health equity investment, less amortization of equity investment costs. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 18
FINANCIAL STATEMENTS INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES (Amounts in thousands) OPERATING ENTITY INVESTMENT FRAMEWORK MPTs 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. Operators are vetted as part of our overall underwriting process. Proven track record of successful investments, including Ernest Health and Capella Healthcare. Potential for outsized returns and organic growth. Investment Ownership Operator as of Structure Interest December 31, 2023 Includes a 49% equity ownership interest in, along with a loan convertible into PHP Holdings, the PHP Holdings $ 699,535 49.0% managed care business of Prospect. Both instruments are accounted for under the fair value option method, which resulted in a combined $45 million gain in Q3 and Q4 2023. Loan, for which proceeds were paid to Stewards former private equity sponsor, is secured by the equity Steward Health Care 361,591 N/A of Steward and provides for an initial 4% 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 225,960 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. Includes our passive equity ownership interest, along with a CHF 37 million loan as part of a syndicated Swiss Medical Network 186,113 8.9% loan facility. In order to close the 2021 acquisition of 35 facilities, we made a 9.9% passive equity investment and a Priory Group 163,837 9.9% loan to Priory (a subsidiary of MEDIAN) proceeds of which were paid to the former owner. The loan, which pays a variable rate, was sold in the first quarter of 2024. Includes our passive equity ownership interest in Aevis, a public healthcare investment company. Our Aevis 77,345 4.6% original investment of CHF 47 million is marked-to-market quarterly. Includes our passive equity ownership interest. Proceeds from our original investment of $150 million Steward Health Care 35,696 9.9% were paid directly to Stewards former private equity sponsor and other shareholders. In the fourth quarter of 2023, we recorded a $90 million impairment charge on this investment. Includes our passive equity ownership interest in Aspris, a spin-off of Priorys education and childrens Aspris 15,986 9.2% services line of business. In order to close the 2021 acquisition of 18 behavioral facilities, we made an equity investment and a loan, proceeds of which were paid to the former owners. As a result of Lifepoints acquisition of a Lifepoint Behavioral Health 11,429 20.9% majority interest in Springstone (now Lifepoint Behavioral Health) in February 2023, the loan and related interest (of approximately $205 million) was paid in full. Includes our passive equity ownership interest in Caremax, a public care delivery system. Our original Caremax 1,148 9.9% investment is marked-to-market quarterly. Total $ 1,778,640 INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES AS A PERCENTAGE OF TOTAL ASSETS 10% 90% MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 19
APPENDIXNON-GAAP RECONCILIATIONS ADJUSTED NET DEBT/ANNUALIZED EBITDAre (Unaudited) (Amounts in thousands) For the Three Months Ended December 31, 2023 ADJUSTED EBITDAre RECONCILIATION Net loss $ (663,584) Add back: Interest 102,338 Income tax 3,982 Depreciation and amortization 79,927 Loss on sale of real estate 2,024 Real estate impairment charges 112,112 Adjustment to reflect MPTs share of unlevered EBITDAre from unconsolidated real estate joint ventures(A) 12,553 4Q 2023 EBITDAre $ (350,648) Share-based compensation 3,531 Write-off of unbilled rent and other 499,335 Other impairment charges 171,507 Litigation and other 2,899 Debt refinancing and unutilized financing benefit (239) Non-cash fair value adjustments 8,405 Annualized 4Q 2023 Adjusted EBITDAre $ 334,790 $ 1,339,160 Adjustments for mid-quarter investment activity(B) (475) 4Q 2023 Transaction Adjusted EBITDAre $ 334,315 $ 1,337,260 ADJUSTED NET DEBT RECONCILIATION Total debt at December 31, 2023 $ 10,064,236 Less: Cash at December 31, 2023 (250,016) Less: Cash funded for building improvements in progress and construction in progress at December 31, 2023(C) (580,176) Adjusted Net Debt $ 9,234,044 Investors and analysts following the real estate industry utilize net debt (debt less cash) to EBITDAre as a measurement of leverage that shows how many years it would take for us to pay back our debt, assuming net debt and EBITDAre 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 EBITDAre 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 adjust net debt for cash funded for building improvements in progress and construction in progress for which we are not yet receiving rent to derive Adjusted Net Debt. We adjust Adjusted EBITDAre for the effects from investments and capital transactions that were completed during the period, assuming such transactions were consummated/fully funded as of the beginning of the period to derive Transaction Adjusted EBITDAre . Although non-GAAP measures, we believe Adjusted Net Debt, Adjusted EBITDAre , and Transaction 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) Reflects a full quarter impact from our mid-quarter investments, disposals, and loan payoffs. (C) Excluded development and capital improvement projects that are in process and not yet generating a cash return but will generate a return once completed. MEDICAL PROPERTIES TRUST | SUPPLEMENTAL INFORMATION | Q4 2023 20
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