Per Share Net Income of $0.19 and Normalized FFO of $0.43 in Second Quarter

Per Share NFFO and AFFO Growth Exceeding 13% Compared to Prior-Year Quarter

Year-to-Date Investments of More than $3.6 Billion

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

• Net income of $0.19 and Normalized Funds from Operations (“NFFO”) of $0.43 for the 2021 second quarter on a per diluted share basis, in line with portfolio run-rate guidance;
• Closed in late June on previously announced sale-leaseback transactions totaling £800 million on 35 Priory Group (“Priory”) behavioral health facilities in the United Kingdom, with proceeds used to fully retire the initial January real estate loan investment of the same amount;
• Completed in early July the $215 million acquisition of four general acute care hospitals operated by Pipeline Health System (“Pipeline Health”) in Los Angeles;
• Closed in early July the £15.6 million acquisition of Kings Park Hospital in Stirling, Scotland;
• Agreed to sell Capital Medical Center in Olympia, Washington for $135 million, contingent on regulatory approval;
• Since the end of the first quarter issued 12.2 million shares through the Company’s “at-the-market” program for net proceeds of approximately $253 million and $320 million year-to-date;
• As previously announced, in June agreed to invest $950 million in behavioral health assets of Springstone, LLC (“Springstone”), including full ownership of 18 inpatient behavioral hospital facilities and an interest in the operations, and to acquire five general acute care hospitals in South Florida to be operated by Steward Health Care System (“Steward”) for $900 million;
• Hospital tenants uniformly reporting continued strong operating and financial performance.

“Following two-plus years of strong growth in key European and Australian markets, our acquisitions since early 2021 have been heavily weighted to the U.S.,” said Edward K. Aldag, Jr., Chairman, President, and Chief Executive Officer. Aldag also pointed out that the Company enjoys investment spreads over funding costs that are similar regardless of the location. “Although lease rates vary across different countries, so does our cost of capital, and we have very successfully positioned our balance sheet with the lowest cost long-term, currency-weighted capital for our non-U.S. investments.”

Mr. Aldag continued, “Consistent with our long-term funding strategy, our high-cap rate U.S. acquisitions will be primarily funded with equity capital. Significant proceeds from one-off dispositions, loan repayments, and a vibrant and growing private market for hospital real estate are expected to normalize our leverage to the 6.0x range without the need for follow-on common equity, while also providing cost of capital and operator diversification benefits that we look forward to detailing in the near future.”

Included in the financial tables accompanying this press release is information about the Company’s assets and liabilities, net income, and reconciliations of net income to NFFO, all on a basis comparable to 2020 results, and reconciliations of total assets to total pro forma gross assets and total revenues to total adjusted revenues.

PORTFOLIO UPDATE

During and subsequent to the second quarter, MPT continued to execute accretive acquisitions.

As described in more detail in the Company’s June 15, 2021 press release, MPT announced its entry into a binding agreement to acquire 18 inpatient behavioral hospitals and an interest in the operations of Springstone from Welsh, Carson, Anderson & Stowe for total consideration of $950 million. In addition, as detailed in MPT’s June 23, 2021 press release, the Company agreed to acquire for $900 million five general acute care hospitals in South Florida to be operated by Steward. Both transactions are expected to close in the second half of 2021.

In early July, MPT acquired a network of four hospitals with nearly 500 beds in Los Angeles from Pipeline Health for $215 million. The facilities are located in densely populated areas with high barriers to entry and are essential to the communities they serve. The properties are subject to a 20-year master lease with multiple extension options.

Terms of the three U.S. acquisitions reflect a weighted average GAAP cap rate of approximately 8.7%, further demonstrating the Company’s success at delivering very attractive returns while continuing to increase the size of its portfolio at growth rates unique in the REIT environment.

Also in early July, MPT acquired Kings Park Hospital, a private acute care hospital to be operated by Circle Health in Stirling, Scotland, for £15.6 million. The property will be joined to the Circle Health master lease, which has 29 years remaining on its initial term.

The Company has total pro forma gross assets of approximately $22.3 billion, including $16.1 billion in general acute care hospitals, $2.4 billion in behavioral health facilities, $2.1 billion in inpatient rehabilitation hospitals, $0.3 billion in long-term acute care hospitals, and $0.3 billion in freestanding emergency room and urgent care properties. MPT’s portfolio, pro forma for the transactions described herein, includes 446 properties representing roughly 47,000 licensed beds across the United States and in Germany, the United Kingdom, Switzerland, Italy, Spain, Portugal, Australia, and Colombia. The properties are leased to or mortgaged by 51 hospital operating companies. MPT continues to work with existing and new operators in the U.S. and abroad on numerous opportunities.

OPERATING RESULTS AND OUTLOOK

Net income for the second quarter ended June 30, 2021 was $115 million (or $0.19 per diluted share) compared to $109 million (or $0.21 per diluted share) in the year earlier period.

NFFO for the second quarter ended June 30, 2021 was $251 million ($0.43 per diluted share) compared to $200 million ($0.38 per diluted share) in the year earlier period.

Based on the completed and funded year-to-date transactions, along with an assumed capital structure resulting in a net debt to EBITDA ratio between 5.0 and 6.0 times, MPT expects an annual run-rate of $1.14 to $1.18 per diluted share for net income and $1.72 to $1.76 per diluted share for NFFO. Included in the annual run-rate estimate, but not included in annualized actual results for the second quarter, are timing adjustments related to investment and capital markets transactions closed during the quarter, the annualized difference between the 8.6% Priory GAAP lease rate and the loan interest rate effective for most of the second quarter, and the aggregate future earnings contribution from two hospitals under development and various expansion projects where rent has not yet commenced. Not included in the annual run-rate estimate is the impact of announced but unclosed transactions as of June 30. While interest income from the £250 million non-real estate acquisition loan related to the Priory transaction was included in second quarter actual results, it is not included in annual run-rate guidance due to its temporary nature.

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

CONFERENCE CALL AND WEBCAST

The Company has scheduled a conference call and webcast for Thursday, July 29, 2021 at 11:00 a.m. Eastern Time to present the Company’s financial and operating results for the quarter ended June 30, 2021. The dial-in numbers for the conference call are 844-535-3969 (U.S. and Canada) and 409-937-8903 (International); both numbers require passcode 2367177. The conference call will also be available via webcast in the Investor Relations section of the Company’s website, www.medicalpropertiestrust.com.

A telephone and webcast replay of the call will be available beginning shortly after the call’s completion. The telephone replay will be available through August 12, 2021 using dial-in numbers 855-859-2056 and 404-537-3406 for U.S. and International callers, respectively, and passcode 2367177. 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 hospitals with 446 facilities and roughly 47,000 licensed beds in nine countries and across four continents on a pro forma basis. MPT’s financing model facilitates acquisitions and recapitalizations and allows operators of hospitals to unlock the value of their real estate assets to fund facility improvements, technology upgrades and other investments in operations. For more information, please visit the Company’s website at www.medicalpropertiestrust.com.

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

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

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