Exhibit 99.1 Reading Hospital near London, UK REITweek: 2021 Investor Conference JUNE 2021Exhibit 99.1 Reading Hospital near London, UK REITweek: 2021 Investor Conference JUNE 2021
® AT THE VERY HEART OF HEALTHCARE.® AT THE VERY HEART OF HEALTHCARE.
FORWARD-LOOKING STATEMENTS This presentation includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements can generally be identified by the use of forward-looking words such as “may”, “will”, “would”, “could”, “expect”, “intend”, “plan”, “estimate”, “target”, “anticipate”, “believe”, “objectives”, “outlook”, “guidance” or other similar words, and include statements regarding our strategies, objectives, future expansion and development activities, and expected financial performance. Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual results or future events to differ materially from those expressed in or underlying such forward-looking statements, including, but not limited to: (i) the economic, political and social impact of, and uncertainty relating to, 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; and (xvi) the closing of the Priory sale-leaseback transaction. 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.FORWARD-LOOKING STATEMENTS This presentation includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements can generally be identified by the use of forward-looking words such as “may”, “will”, “would”, “could”, “expect”, “intend”, “plan”, “estimate”, “target”, “anticipate”, “believe”, “objectives”, “outlook”, “guidance” or other similar words, and include statements regarding our strategies, objectives, future expansion and development activities, and expected financial performance. Forward-looking statements involve known and unknown risks and uncertainties that may cause our actual results or future events to differ materially from those expressed in or underlying such forward-looking statements, including, but not limited to: (i) the economic, political and social impact of, and uncertainty relating to, 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; and (xvi) the closing of the Priory sale-leaseback transaction. 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.
MPT AT THE VERY HEART OF HEALTHCARE EXCLUSIVE FOCUS ON HOSPITALS 2019 U.S. NATIONAL HEALTH EXPENDITURES SUCH AS: • General Acute Care • Inpatient Rehabilitation 31.4% 28.8% • Behavioral Health Hospital Care Other $3.8 Trillion 4.5% Nursing Care Facilities • 2019 National Health Expenditures and CCRCs (“NHE”) represented 17.7% of GDP. 5.3% 20.3% • Hospital Care expenditures of $1.2 Investment trillion represented 31% of NHE and (Research, Physician & Clinical Services 9.7% Structures and 5.6% of GDP. Equipment) Retail Prescription Drugs 4 Source: CMS.gov National Health Expenditure Data and American Hospital Association MPT AT THE VERY HEART OF HEALTHCARE EXCLUSIVE FOCUS ON HOSPITALS 2019 U.S. NATIONAL HEALTH EXPENDITURES SUCH AS: • General Acute Care • Inpatient Rehabilitation 31.4% 28.8% • Behavioral Health Hospital Care Other $3.8 Trillion 4.5% Nursing Care Facilities • 2019 National Health Expenditures and CCRCs (“NHE”) represented 17.7% of GDP. 5.3% 20.3% • Hospital Care expenditures of $1.2 Investment trillion represented 31% of NHE and (Research, Physician & Clinical Services 9.7% Structures and 5.6% of GDP. Equipment) Retail Prescription Drugs 4 Source: CMS.gov National Health Expenditure Data and American Hospital Association
MPT AT THE VERY HEART OF HEALTHCARE 2nd largest in the world Non-Government Owner of Hospitals 1 Total Pro Forma Gross Assets $20.9 Billion 5 1 As of March 31, 2021MPT AT THE VERY HEART OF HEALTHCARE 2nd largest in the world Non-Government Owner of Hospitals 1 Total Pro Forma Gross Assets $20.9 Billion 5 1 As of March 31, 2021
MPT AT THE VERY HEART OF HEALTHCARE 1 In Europe 191 Properties across the U.S. 220 In South America 3 In Australia 11 Total property count as of March 31, 2021 6 1 The Europe property count is adjusted for the Priory Group Transaction.MPT AT THE VERY HEART OF HEALTHCARE 1 In Europe 191 Properties across the U.S. 220 In South America 3 In Australia 11 Total property count as of March 31, 2021 6 1 The Europe property count is adjusted for the Priory Group Transaction.
EXPERIENCED MANAGEMENT TEAM OUR MANAGEMENT TEAM IS COMPRISED OF PEOPLE WITH EXTENSIVE EXPERIENCE IN: • Hospital Acquisitions and Finance / Capital Markets • Physician Practice Management • Hospital Development and Construction • Hospital Leases • Hospital Operations • Real Estate Management MPT’s Senior Management Years of Experience Areas of Expertise Edward K. Aldag, Jr. 35+ Hospital Ownership Chairman, President & CEO R. Steven Hamner 35+ Public Company Accounting & Finance Executive Vice President & CFO Emmett E. McLean 35+ Physician Practice Management & Ancillary Services Executive Vice President & COO Rosa H. Hooper 25+ Post-Acute Operations Vice President & Managing Director, Asset Management & Underwriting J. Kevin Hanna 25+ Public Company Accounting Vice President, Controller & Chief Accounting Officer Charles R. Lambert 20+ Capital Markets Vice President, Treasurer & Managing Director, Capital Markets R. Lucas Savage Corp. & Facility Acute Hospital Operations, 20+ Vice President, Head of Global Acquisitions Healthcare M&A Transactions Thomas W. Schultz 35+ Healthcare Operations Director of Healthcare 7EXPERIENCED MANAGEMENT TEAM OUR MANAGEMENT TEAM IS COMPRISED OF PEOPLE WITH EXTENSIVE EXPERIENCE IN: • Hospital Acquisitions and Finance / Capital Markets • Physician Practice Management • Hospital Development and Construction • Hospital Leases • Hospital Operations • Real Estate Management MPT’s Senior Management Years of Experience Areas of Expertise Edward K. Aldag, Jr. 35+ Hospital Ownership Chairman, President & CEO R. Steven Hamner 35+ Public Company Accounting & Finance Executive Vice President & CFO Emmett E. McLean 35+ Physician Practice Management & Ancillary Services Executive Vice President & COO Rosa H. Hooper 25+ Post-Acute Operations Vice President & Managing Director, Asset Management & Underwriting J. Kevin Hanna 25+ Public Company Accounting Vice President, Controller & Chief Accounting Officer Charles R. Lambert 20+ Capital Markets Vice President, Treasurer & Managing Director, Capital Markets R. Lucas Savage Corp. & Facility Acute Hospital Operations, 20+ Vice President, Head of Global Acquisitions Healthcare M&A Transactions Thomas W. Schultz 35+ Healthcare Operations Director of Healthcare 7
PREEMINENT GLOBAL HOSPITAL REAL ESTATE PLATFORM FOCUSED ON INVESTMENTS IN LICENSED HOSPITALS, UNLOCKING VALUE AROUND THE GLOBE TO DELIVER CONTINUED SHAREHOLDER GROWTH Best-in-class acute care Established source of capital portfolio driven by strong for leading hospital operator relationships operators around the globe • 425 properties in 9 countries and 33 U.S. • Nearly $21 billion gross investments states worldwide • 51 total operators, including leading not- • Roughly $5 billion new investments in for-profit and for-profit systems in the U.S. 2020 and early 2021 at a blended GAAP and abroad yield exceeding 8% Unlocking new global growth Strong track record of opportunities prudent balance sheet • New and compelling international markets management (Australia, Switzerland, Colombia) enhance • Successfully increased scale and existing global platform diversified portfolio, while maintaining • $8.8 billion international investment base conservative leverage and lowering accumulated since 2013 overall cost of capital • Leased to best-in-class international • Net debt to EBITDA target of ~5.5x hospital operators Sources: Company filings and SNL Financial. 8 Note: No assurances can be made that announced and pending transactions will close on the terms indicated or at all. Figures pro forma for newly announced acquisitions.PREEMINENT GLOBAL HOSPITAL REAL ESTATE PLATFORM FOCUSED ON INVESTMENTS IN LICENSED HOSPITALS, UNLOCKING VALUE AROUND THE GLOBE TO DELIVER CONTINUED SHAREHOLDER GROWTH Best-in-class acute care Established source of capital portfolio driven by strong for leading hospital operator relationships operators around the globe • 425 properties in 9 countries and 33 U.S. • Nearly $21 billion gross investments states worldwide • 51 total operators, including leading not- • Roughly $5 billion new investments in for-profit and for-profit systems in the U.S. 2020 and early 2021 at a blended GAAP and abroad yield exceeding 8% Unlocking new global growth Strong track record of opportunities prudent balance sheet • New and compelling international markets management (Australia, Switzerland, Colombia) enhance • Successfully increased scale and existing global platform diversified portfolio, while maintaining • $8.8 billion international investment base conservative leverage and lowering accumulated since 2013 overall cost of capital • Leased to best-in-class international • Net debt to EBITDA target of ~5.5x hospital operators Sources: Company filings and SNL Financial. 8 Note: No assurances can be made that announced and pending transactions will close on the terms indicated or at all. Figures pro forma for newly announced acquisitions.
WELL-DIVERSIFIED PORTFOLIO GLOBAL PORTFOLIO MIX – COUNTRIES GLOBAL PORTFOLIO MIX - OPERATOR 8% Prospect 8% 425 22% 12% Priory Circle United Kingdom Germany 6% properties 7% Steward (MA) Switzerland 58% 6% 39% United States 6% 46 Operators Australia 5% Steward (UT) 51 Spain 1% 6% operators Other Countries Swiss Medical 1% Network Other Assets 1% 5% 3% Steward 6% Steward (AR/TX/LA) Other Other ~44,000 beds GLOBAL PORTFOLIO MIX – PROPERTY TYPE U.S. PORTFOLIO MIX - STATES ($ IN MILLIONS) 5.1% 33 General Acute Care Other 9.2% $15,164 Inpatient Rehabilitation (IRF) Texas U.S. states Behavioral Health Long-Term Acute Care 7.2% Freestanding ER/Urgent Care 19.1% MA 28 Other States 6.7% 9 CA $2,129 $1,730 6.2% 4.1% $336 $300 countries UT PA 9 9 Pro forma portfolio as of March 31, 2021WELL-DIVERSIFIED PORTFOLIO GLOBAL PORTFOLIO MIX – COUNTRIES GLOBAL PORTFOLIO MIX - OPERATOR 8% Prospect 8% 425 22% 12% Priory Circle United Kingdom Germany 6% properties 7% Steward (MA) Switzerland 58% 6% 39% United States 6% 46 Operators Australia 5% Steward (UT) 51 Spain 1% 6% operators Other Countries Swiss Medical 1% Network Other Assets 1% 5% 3% Steward 6% Steward (AR/TX/LA) Other Other ~44,000 beds GLOBAL PORTFOLIO MIX – PROPERTY TYPE U.S. PORTFOLIO MIX - STATES ($ IN MILLIONS) 5.1% 33 General Acute Care Other 9.2% $15,164 Inpatient Rehabilitation (IRF) Texas U.S. states Behavioral Health Long-Term Acute Care 7.2% Freestanding ER/Urgent Care 19.1% MA 28 Other States 6.7% 9 CA $2,129 $1,730 6.2% 4.1% $336 $300 countries UT PA 9 9 Pro forma portfolio as of March 31, 2021
WELL-DIVERSIFIED PORTFOLIO MPT’S LARGEST 5 OPERATORS’ INDIVIDUAL FACILITIES AS A PERCENTAGE OF TOTAL PRO FORMA GROSS ASSETS STEWARD LARGEST PROPERTY HEALTH CARE AS A PERCENTAGE OF 36 PROPERTIES TOTAL PRO FORMA NON-RE OPERATORS GROSS ASSETS INVESTMENTS Steward Health Care 2.8% (United States) Circle Health 1.2% (United Kingdom) CIRCLE Prospect HEALTH Medical Holdings 1.2% (United States) 36 PROPERTIES 46 OPERATORS 285 PROPERTIES Priory Group 0.6% (United Kingdom) Swiss Medical PROSPECT Network MEDICAL 0.8% (Switzerland) HOLDINGS 16 PROPERTIES 46 OTHER OPERATORS PRIORY (U.S., Germany, Spain, 1.4% SWISS MEDICAL GROUP Italy, Colombia, Australia, 35 PROPERTIES Portugal) NETWORK 17 PROPERTIES 10WELL-DIVERSIFIED PORTFOLIO MPT’S LARGEST 5 OPERATORS’ INDIVIDUAL FACILITIES AS A PERCENTAGE OF TOTAL PRO FORMA GROSS ASSETS STEWARD LARGEST PROPERTY HEALTH CARE AS A PERCENTAGE OF 36 PROPERTIES TOTAL PRO FORMA NON-RE OPERATORS GROSS ASSETS INVESTMENTS Steward Health Care 2.8% (United States) Circle Health 1.2% (United Kingdom) CIRCLE Prospect HEALTH Medical Holdings 1.2% (United States) 36 PROPERTIES 46 OPERATORS 285 PROPERTIES Priory Group 0.6% (United Kingdom) Swiss Medical PROSPECT Network MEDICAL 0.8% (Switzerland) HOLDINGS 16 PROPERTIES 46 OTHER OPERATORS PRIORY (U.S., Germany, Spain, 1.4% SWISS MEDICAL GROUP Italy, Colombia, Australia, 35 PROPERTIES Portugal) NETWORK 17 PROPERTIES 10
OPERATOR UPDATE STEWARD HEALTH • Strong liquidity position, $600 million as of March 2021 • Admissions have remained between 93-108% of prior-year levels since June of 2020 (thru March ’21) • Largest physician-owned private, tax-paying health care system in the U.S. • Diversified across six distinct markets • No individual market represents more than 33% of Steward’s total revenue • No individual hospital represents more than 8% of Steward’s total revenue 2020 EBITDAR Reconciliation ($ in millions) MPT Total Investment $4.5 billion (3/31/2021) 6,300+ (5,978 at MPT Net loss $ (407.6) # of Beds facilities) Income tax benefit (58.2) Non-operating Income/(loss), net 14.7 # of Facilities 39 (36 MPT-owned) Gain on sale (3.8) Depreciation and amortization 206.3 Percentage of MPT Total Gross 2.8% Interest 72.6 Assets – Largest Facility Operating leases 385.2 EBITDAR $ 209.2 Staffing optimization 63.7 Electronic health record conversion impact 92.1 Integration/Rationalization cost 78.7 COVID-19 inflationary and response costs 199.8 Other non-recurring 79.5 Adjusted EBITDAR $ 723.0 MPT Coverage Rent/Interest $ 300.1 Consolidated Adjusted EBITDAR Coverage 2.41x 11 11 Note: Steward Health Care System information provided by Steward Health Care System. MPT did not participate in the preparation of this information.OPERATOR UPDATE STEWARD HEALTH • Strong liquidity position, $600 million as of March 2021 • Admissions have remained between 93-108% of prior-year levels since June of 2020 (thru March ’21) • Largest physician-owned private, tax-paying health care system in the U.S. • Diversified across six distinct markets • No individual market represents more than 33% of Steward’s total revenue • No individual hospital represents more than 8% of Steward’s total revenue 2020 EBITDAR Reconciliation ($ in millions) MPT Total Investment $4.5 billion (3/31/2021) 6,300+ (5,978 at MPT Net loss $ (407.6) # of Beds facilities) Income tax benefit (58.2) Non-operating Income/(loss), net 14.7 # of Facilities 39 (36 MPT-owned) Gain on sale (3.8) Depreciation and amortization 206.3 Percentage of MPT Total Gross 2.8% Interest 72.6 Assets – Largest Facility Operating leases 385.2 EBITDAR $ 209.2 Staffing optimization 63.7 Electronic health record conversion impact 92.1 Integration/Rationalization cost 78.7 COVID-19 inflationary and response costs 199.8 Other non-recurring 79.5 Adjusted EBITDAR $ 723.0 MPT Coverage Rent/Interest $ 300.1 Consolidated Adjusted EBITDAR Coverage 2.41x 11 11 Note: Steward Health Care System information provided by Steward Health Care System. MPT did not participate in the preparation of this information.
MPT’S ABSOLUTE NET LEASE MODEL LEASE STRUCTURE Absolute Net Long-Term Inflation-Protected Master Lease Tenant bears all costs, 10-year to 20-year initial 99% of leases have inflation- Over 95% of properties including maintenance terms with multiple 5-year based or fixed annual rent are master leased, cross- and repairs, utilities and extensions in U.S.; longer escalators; CPI floors in defaulted and/or with a taxes terms internationally materially all inflation-based parent guaranty leases SALE-LEASEBACK APPEAL TO HOSPITAL OPERATORS • Hospital operators can turn their real estate assets into long-term growth capital • Allows operators to execute on long-term strategies • Operators maintain control of their facilities • Provides up to 100% financing • Often lowers operator’s overall cost of capital • Rent payments are fully tax deductible (not subject to interest deduction limitations) 12 12MPT’S ABSOLUTE NET LEASE MODEL LEASE STRUCTURE Absolute Net Long-Term Inflation-Protected Master Lease Tenant bears all costs, 10-year to 20-year initial 99% of leases have inflation- Over 95% of properties including maintenance terms with multiple 5-year based or fixed annual rent are master leased, cross- and repairs, utilities and extensions in U.S.; longer escalators; CPI floors in defaulted and/or with a taxes terms internationally materially all inflation-based parent guaranty leases SALE-LEASEBACK APPEAL TO HOSPITAL OPERATORS • Hospital operators can turn their real estate assets into long-term growth capital • Allows operators to execute on long-term strategies • Operators maintain control of their facilities • Provides up to 100% financing • Often lowers operator’s overall cost of capital • Rent payments are fully tax deductible (not subject to interest deduction limitations) 12 12
INFLATION-PROTECTED LEASES ~90% OF AGREEMENTS PROVIDE FOR CPI-BASED ESCALATORS o Materially all such contracts include minimum escalators averaging nearly 2% annually o ~75% of CPI-based arrangements include inflation ceilings averaging approximately 4.5% annually Absolute Net Long-Term Master Lease ~9% CONTAIN FIXED ESCALATORS AVERAGING 2.3% ANNUALLY CONSUMER PRICE INDEX SENSITIVITY CPI Growth 1.0% 2.0% 3.0% 4.0% 5.0% Scenario: Rent Growth: Total 1.9% 2.0% 2.8% 3.7% 4.3% MPT Portfolio HOSPITAL REIMBURSEMENT RATES HAVE CONSISTENTLY OUTPACED COST INFLATION o Rates negotiated between hospitals and commercial payors are informed by inflationary conditions o CMS inpatient PPS rate CAGR has exceeded inflation by 40bps from FY05-FY21 o Medicare spending on hospitals has declined only once in last 35+ years 13 Source: Bureau of Labor Statistics, CMSINFLATION-PROTECTED LEASES ~90% OF AGREEMENTS PROVIDE FOR CPI-BASED ESCALATORS o Materially all such contracts include minimum escalators averaging nearly 2% annually o ~75% of CPI-based arrangements include inflation ceilings averaging approximately 4.5% annually Absolute Net Long-Term Master Lease ~9% CONTAIN FIXED ESCALATORS AVERAGING 2.3% ANNUALLY CONSUMER PRICE INDEX SENSITIVITY CPI Growth 1.0% 2.0% 3.0% 4.0% 5.0% Scenario: Rent Growth: Total 1.9% 2.0% 2.8% 3.7% 4.3% MPT Portfolio HOSPITAL REIMBURSEMENT RATES HAVE CONSISTENTLY OUTPACED COST INFLATION o Rates negotiated between hospitals and commercial payors are informed by inflationary conditions o CMS inpatient PPS rate CAGR has exceeded inflation by 40bps from FY05-FY21 o Medicare spending on hospitals has declined only once in last 35+ years 13 Source: Bureau of Labor Statistics, CMS
A PROVEN GROWTH STRATEGY ACUTE CARE REAL ESTATE OPPORTUNITY IS RAPIDLY EXPANDING Growing Acceptance Further Accretive Large Domestic & of Sale-Leaseback Consolidation of Opportunities in International Model Among Hospital Systems 1H 2021 and Beyond Opportunity Set Not-for-Profit Operators • Substantial domestic and • Consolidation of hospital • ~75% of all community • ~$9.7 billion invested since international potential systems continues, hospitals in the U.S. are the end of 2018 while acquisition targets searching for cost owned by not-for-profit supporting growth of best- in-class operators efficiencies, competitive ( NFP ) operators • Estimated $500-$750 advantages, and billion of operater-owned • Leading NFP operators • MPT’s platform is economies of scale hospital real estate in U.S. continue building positioned to continue • Increasing ownership of relationships with private growing in the acute care • Additional opportunities in hospitals by for-profit real estate owners and space in the remainder of attractive markets 2021 and beyond systems established in REITs to leverage their scale throughout the world the past decade (e.g., and cost of capital Steward, Prospect) and increasing investment from global private equity (e.g., Apollo, Waterland, Brookfield) Sources: Company filings, American Hospital Association, World Health Organization and Wall Street research. 14A PROVEN GROWTH STRATEGY ACUTE CARE REAL ESTATE OPPORTUNITY IS RAPIDLY EXPANDING Growing Acceptance Further Accretive Large Domestic & of Sale-Leaseback Consolidation of Opportunities in International Model Among Hospital Systems 1H 2021 and Beyond Opportunity Set Not-for-Profit Operators • Substantial domestic and • Consolidation of hospital • ~75% of all community • ~$9.7 billion invested since international potential systems continues, hospitals in the U.S. are the end of 2018 while acquisition targets searching for cost owned by not-for-profit supporting growth of best- in-class operators efficiencies, competitive ( NFP ) operators • Estimated $500-$750 advantages, and billion of operater-owned • Leading NFP operators • MPT’s platform is economies of scale hospital real estate in U.S. continue building positioned to continue • Increasing ownership of relationships with private growing in the acute care • Additional opportunities in hospitals by for-profit real estate owners and space in the remainder of attractive markets 2021 and beyond systems established in REITs to leverage their scale throughout the world the past decade (e.g., and cost of capital Steward, Prospect) and increasing investment from global private equity (e.g., Apollo, Waterland, Brookfield) Sources: Company filings, American Hospital Association, World Health Organization and Wall Street research. 14
HOSPITAL EXPERTISE ESSENTIAL TO UNDERWRITING Market Operator • MPT’s underwriting process involves a • MPT seeks to be aligned with proven operators comprehensive study and evaluation of each having a successful track record and individual hospital and the market it serves, even if demonstrating market leadership. part of a large portfolio acquisition. • Skilled operators are able to successfully deploy MPT’s capital to improve patient outcomes, • Fundamental questions such as “is this hospital truly increase EBITDA and expand margins. needed in this market?” and “would this community suffer were this hospital not here?” are addressed. • In the uncommon event an operator needs to be replaced, MPT would turn to its Plan B, C or D recognizing that a good market will attract high- quality replacement operators, often on more favorable financial terms. Physicians • Only physicians can admit patients to hospitals, and the next step in MPT’s underwriting involves a thorough review of physician relationships to the hospital. • MPT studies hospital admissions to determine if they are coming from a broad spectrum of referring physicians or possibly a highly concentrated grouping. 15HOSPITAL EXPERTISE ESSENTIAL TO UNDERWRITING Market Operator • MPT’s underwriting process involves a • MPT seeks to be aligned with proven operators comprehensive study and evaluation of each having a successful track record and individual hospital and the market it serves, even if demonstrating market leadership. part of a large portfolio acquisition. • Skilled operators are able to successfully deploy MPT’s capital to improve patient outcomes, • Fundamental questions such as “is this hospital truly increase EBITDA and expand margins. needed in this market?” and “would this community suffer were this hospital not here?” are addressed. • In the uncommon event an operator needs to be replaced, MPT would turn to its Plan B, C or D recognizing that a good market will attract high- quality replacement operators, often on more favorable financial terms. Physicians • Only physicians can admit patients to hospitals, and the next step in MPT’s underwriting involves a thorough review of physician relationships to the hospital. • MPT studies hospital admissions to determine if they are coming from a broad spectrum of referring physicians or possibly a highly concentrated grouping. 15
PROFILE OF AN MPT INFRASTRUCTURE HOSPITAL Community Need Contributes to Stable and Naturally Diverse Revenue Base ✓ Positive population growth, density and/or aging trends✓ Diversified referral base, by both practice and specialization ✓ Accommodating economic/political conditions✓ Physicians communicate favorable bias toward facility ✓ High barriers to entry for new development and no local ✓ Documented history of profitability, regardless of payor mix substitute hospital ✓ Attractive to multiple local, regional, or national operators MPT SAME-STORE GENERAL ACUTE CARE Attractive Setup for Operator Profitability FY2020 HOSPITAL AVERAGES • If MPT facility underwriting is correct, a path to mid-to-high teens EBITDARM margin exists Net Revenue $113 million • Leases allow for operator change in event of default and for entire master lease or other cross-defaulted agreement with operator, if applicable EBITDARM $22 million EBITDARM Margin 19.5% Payment to MPT $6.4 million Payment to MPT – Percentage of Net Payments to MPT Are Not “Controllable” Expenses Under 6% Revenue • Rent/interest is a small, fixed expense within hospital cost structures Master Lease and/or Cross-Defaulted dominated by highly variable and proactively managed wage, salary, and Agreements – Percentage of 86% benefit costs equal to ~50% of operating expenses Payments • Rent/interest is functionally senior to parent creditor obligations Subject to Parent Guaranty – 91% Percentage of Payments o In event of default, all stakeholders, including the community itself, depend on continuous hospital operations 16 * Representative of same-store MPT general acute hospitals based on TTM 12/31/2020 operating data including CARES Act grant funds distributed to offset expenses and revenue disruption related to mandatory deferral of elective procedures due to the COVID-19 pandemic. For reference, 2019 EBITDARM coverage was similar at 2.8x, and rents due to MPT as a percentage of operator net revenues were in mid-5% range.PROFILE OF AN MPT INFRASTRUCTURE HOSPITAL Community Need Contributes to Stable and Naturally Diverse Revenue Base ✓ Positive population growth, density and/or aging trends✓ Diversified referral base, by both practice and specialization ✓ Accommodating economic/political conditions✓ Physicians communicate favorable bias toward facility ✓ High barriers to entry for new development and no local ✓ Documented history of profitability, regardless of payor mix substitute hospital ✓ Attractive to multiple local, regional, or national operators MPT SAME-STORE GENERAL ACUTE CARE Attractive Setup for Operator Profitability FY2020 HOSPITAL AVERAGES • If MPT facility underwriting is correct, a path to mid-to-high teens EBITDARM margin exists Net Revenue $113 million • Leases allow for operator change in event of default and for entire master lease or other cross-defaulted agreement with operator, if applicable EBITDARM $22 million EBITDARM Margin 19.5% Payment to MPT $6.4 million Payment to MPT – Percentage of Net Payments to MPT Are Not “Controllable” Expenses Under 6% Revenue • Rent/interest is a small, fixed expense within hospital cost structures Master Lease and/or Cross-Defaulted dominated by highly variable and proactively managed wage, salary, and Agreements – Percentage of 86% benefit costs equal to ~50% of operating expenses Payments • Rent/interest is functionally senior to parent creditor obligations Subject to Parent Guaranty – 91% Percentage of Payments o In event of default, all stakeholders, including the community itself, depend on continuous hospital operations 16 * Representative of same-store MPT general acute hospitals based on TTM 12/31/2020 operating data including CARES Act grant funds distributed to offset expenses and revenue disruption related to mandatory deferral of elective procedures due to the COVID-19 pandemic. For reference, 2019 EBITDARM coverage was similar at 2.8x, and rents due to MPT as a percentage of operator net revenues were in mid-5% range.
INTERNATIONAL INVESTMENT ATLAS: UNITED STATES 57.6% % of MPT Total Pro Forma Gross Assets 17.7% Healthcare Spending As % of GDP UNITED 328M Population STATES 38.5 Median Age $65,298/+1.8% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Global standard for quality of hospital care and • US hospital real estate market, with 6,000+ immediacy of access to advanced medical procedures facilities, estimated to exceed $1 trillion • Private insurance, often employer-sponsored and both • Consolidation of market into large, expanding employer- and employee-funded, covers most citizens health systems creates appetite for capital • Health of seniors and at-risk populations stabilized by • Monetization of health care facilities is a tax-funded Medicare and Medicaid growing trend Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 17 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.INTERNATIONAL INVESTMENT ATLAS: UNITED STATES 57.6% % of MPT Total Pro Forma Gross Assets 17.7% Healthcare Spending As % of GDP UNITED 328M Population STATES 38.5 Median Age $65,298/+1.8% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Global standard for quality of hospital care and • US hospital real estate market, with 6,000+ immediacy of access to advanced medical procedures facilities, estimated to exceed $1 trillion • Private insurance, often employer-sponsored and both • Consolidation of market into large, expanding employer- and employee-funded, covers most citizens health systems creates appetite for capital • Health of seniors and at-risk populations stabilized by • Monetization of health care facilities is a tax-funded Medicare and Medicaid growing trend Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 17 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.
INTERNATIONAL INVESTMENT ATLAS: U.K. 22.4% % of MPT Total Pro Forma Gross Assets U.K. 10.0% Healthcare Spending As % of GDP 67M Population 40.6 Median Age $42,329/+0.9% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Robust investment spreads considering 6th • Overall quality of care very well-regarded in terms of key largest GDP in world & sociopolitical stability indicators • Dominant acute care operators seeking • Private insurance supplemental to tax-funded National funding to further consolidate market Health Service (NHS) care for which wait times are increasingly problematic • Sophisticated operators aware of advantages of sale-leaseback concept, as well as cost of • Private hospitals provide expedited access to quality capital MPT offers health care and are dominant in specialized medicine Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 18 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.INTERNATIONAL INVESTMENT ATLAS: U.K. 22.4% % of MPT Total Pro Forma Gross Assets U.K. 10.0% Healthcare Spending As % of GDP 67M Population 40.6 Median Age $42,329/+0.9% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Robust investment spreads considering 6th • Overall quality of care very well-regarded in terms of key largest GDP in world & sociopolitical stability indicators • Dominant acute care operators seeking • Private insurance supplemental to tax-funded National funding to further consolidate market Health Service (NHS) care for which wait times are increasingly problematic • Sophisticated operators aware of advantages of sale-leaseback concept, as well as cost of • Private hospitals provide expedited access to quality capital MPT offers health care and are dominant in specialized medicine Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 18 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.
INTERNATIONAL INVESTMENT ATLAS: GERMANY 6.3% % of MPT Total Pro Forma Gross Assets 11.4% Healthcare Spending As % of GDP GERMANY 83M Population 47.8 Median Age $46,468/+1.2% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Returns attractive considering sociopolitical stability • Excellent quality and outcomes provided in state-of-the- and 4th largest GDP in world art facilities • Fragmented general acute and rehab hospital operators • Federally-mandated universal health care coverage consolidating and evaluating funding options funded by employer and employee contributions to national insurance and pension plans • Mature and well-established private equity owners monetizing hospitals and aware of MPT leading sale- • Private health insurance available for those who opt out leaseback capabilities of public system Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 19 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.INTERNATIONAL INVESTMENT ATLAS: GERMANY 6.3% % of MPT Total Pro Forma Gross Assets 11.4% Healthcare Spending As % of GDP GERMANY 83M Population 47.8 Median Age $46,468/+1.2% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Returns attractive considering sociopolitical stability • Excellent quality and outcomes provided in state-of-the- and 4th largest GDP in world art facilities • Fragmented general acute and rehab hospital operators • Federally-mandated universal health care coverage consolidating and evaluating funding options funded by employer and employee contributions to national insurance and pension plans • Mature and well-established private equity owners monetizing hospitals and aware of MPT leading sale- • Private health insurance available for those who opt out leaseback capabilities of public system Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 19 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.
INTERNATIONAL INVESTMENT ATLAS: SWITZERLAND 6.0% % of MPT Total Pro Forma Gross Assets 11.9% Healthcare Spending As % of GDP SWITZERLAND 9M Population 42.7 Median Age $81,989/+1.0% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Aging of population increases demand for • High quality system with virtually no wait times, ample acute and post-acute facilities consumer choice, and low avoidable admissions • ~300 public and private hospitals with • Universal, mandatory, and tax-funded system significant underlying real estate value administered by individual cantons (states) • Fragmented operator landscape conducive to • Swiss government subsidizes premiums for 30% of future consolidation for which new capital population to ensure broad access will be required Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 20 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.INTERNATIONAL INVESTMENT ATLAS: SWITZERLAND 6.0% % of MPT Total Pro Forma Gross Assets 11.9% Healthcare Spending As % of GDP SWITZERLAND 9M Population 42.7 Median Age $81,989/+1.0% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Aging of population increases demand for • High quality system with virtually no wait times, ample acute and post-acute facilities consumer choice, and low avoidable admissions • ~300 public and private hospitals with • Universal, mandatory, and tax-funded system significant underlying real estate value administered by individual cantons (states) • Fragmented operator landscape conducive to • Swiss government subsidizes premiums for 30% of future consolidation for which new capital population to ensure broad access will be required Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 20 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.
INTERNATIONAL INVESTMENT ATLAS: AUSTRALIA 4.7% % of MPT Total Pro Forma Gross Assets 9.3% Healthcare Spending As % of GDP AUSTRALIA 25M Population 37.5 Median Age $55,057/+0.9% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Growing and aging population drive need for more • Ranks among global leaders in health care quality hospitals and/or facility expansion projects • Federally-funded Medicare available to all citizens, but • Private hospitals gaining market share due to private insurance is gaining appeal referrals from capacity-constrained public hospitals • Complementary relationship between public and private hospitals • Consolidating market resulting in sale of not-for- profit systems Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 21 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.INTERNATIONAL INVESTMENT ATLAS: AUSTRALIA 4.7% % of MPT Total Pro Forma Gross Assets 9.3% Healthcare Spending As % of GDP AUSTRALIA 25M Population 37.5 Median Age $55,057/+0.9% GDP Per Capita (USD) & 3-Year CAGR NATIONAL HEALTH LANDSCAPE INVESTMENT OPPORTUNITY • Growing and aging population drive need for more • Ranks among global leaders in health care quality hospitals and/or facility expansion projects • Federally-funded Medicare available to all citizens, but • Private hospitals gaining market share due to private insurance is gaining appeal referrals from capacity-constrained public hospitals • Complementary relationship between public and private hospitals • Consolidating market resulting in sale of not-for- profit systems Source: MPT Q1 2021 supplemental report, World Bank, CMS.gov, American Hospital Association, US Census, CIA World Factbook 21 Note: Reconciliation of MPT total pro forma gross assets at March 31, 2021 provided on slide 35.
2020 INVESTMENTS – INCREASING DIVERSIFICATION & SCALE $3.6 BILLION of Investments in 2020 Circle U.S. Acute Care Swiss Medical U.K. Acute Care Mortgage International Development Health/BMI and IRF Network Conversions Joint Venture Projects 30 1 15 3 2 2 3 Acute care hospitals Acute care hospital Acute Care Acute care hospitals Acute care hospitals IRFs Campuses Acute care hospitals (increased ownership) 3 4 IRFs Post Acute U.K. U.S. U.K. U.S. Colombia U.S. Switzerland $2.0B $375M $233M $224M $200M $135M $96M Completed Completed Completed Completed Completed Completed Underway ✔ ✔ ✔✔✔✔✔ ~8.5% Weighted Average GAAP Rate 22 $3.6 billion total includes non-disclosed tenant capital expenditure projects as well as loan investments not directly related to real estate2020 INVESTMENTS – INCREASING DIVERSIFICATION & SCALE $3.6 BILLION of Investments in 2020 Circle U.S. Acute Care Swiss Medical U.K. Acute Care Mortgage International Development Health/BMI and IRF Network Conversions Joint Venture Projects 30 1 15 3 2 2 3 Acute care hospitals Acute care hospital Acute Care Acute care hospitals Acute care hospitals IRFs Campuses Acute care hospitals (increased ownership) 3 4 IRFs Post Acute U.K. U.S. U.K. U.S. Colombia U.S. Switzerland $2.0B $375M $233M $224M $200M $135M $96M Completed Completed Completed Completed Completed Completed Underway ✔ ✔ ✔✔✔✔✔ ~8.5% Weighted Average GAAP Rate 22 $3.6 billion total includes non-disclosed tenant capital expenditure projects as well as loan investments not directly related to real estate
ACQUISITION OF PRIORY BEHAVIORAL HEALTH PORTFOLIO TRANSACTION UPDATE REPRESENTATIVE ASSETS — On January 6, 2021, MPT announced the acquisition of a portfolio of behavioral health facilities owned and operated by the Priory Group (“Priory”), a leading U.K.-based private behavioral health service provider for £800 million. — Two phases of the transaction: 1. On January 19, 2021, Waterland Private Equity acquired Priory from Acadia Healthcare Company, with proceeds from MPT’s £800 million Sale / Leaseback Loan and £250 million short-term Acquisition Loan 2. The Sale / Leaseback Loan will be satisfied with freehold property interest in 35 facilities, and the Acquisition Loan will be fully repaid in cash — Key terms of the Priory lease include: — Master sale-leaseback structure with an initial term of 25 years and two 10-year extension options — Annual rent escalator linked to U.K. inflation, subject to a 2.0% floor — Expected GAAP Yield: 8.6% — Expected Closing: Phase two real estate sale-leaseback transactions during Q2 of 2021 TRANSACTION BENEFITS TO MPT ✓ Immediately accretive transaction ✓ Expanded international presence ✓ Strengthens U.K. market footprint ✓ Greater operator diversification 23ACQUISITION OF PRIORY BEHAVIORAL HEALTH PORTFOLIO TRANSACTION UPDATE REPRESENTATIVE ASSETS — On January 6, 2021, MPT announced the acquisition of a portfolio of behavioral health facilities owned and operated by the Priory Group (“Priory”), a leading U.K.-based private behavioral health service provider for £800 million. — Two phases of the transaction: 1. On January 19, 2021, Waterland Private Equity acquired Priory from Acadia Healthcare Company, with proceeds from MPT’s £800 million Sale / Leaseback Loan and £250 million short-term Acquisition Loan 2. The Sale / Leaseback Loan will be satisfied with freehold property interest in 35 facilities, and the Acquisition Loan will be fully repaid in cash — Key terms of the Priory lease include: — Master sale-leaseback structure with an initial term of 25 years and two 10-year extension options — Annual rent escalator linked to U.K. inflation, subject to a 2.0% floor — Expected GAAP Yield: 8.6% — Expected Closing: Phase two real estate sale-leaseback transactions during Q2 of 2021 TRANSACTION BENEFITS TO MPT ✓ Immediately accretive transaction ✓ Expanded international presence ✓ Strengthens U.K. market footprint ✓ Greater operator diversification 23
PRIORY GROUP IS AN ESTABLISHED BEHAVIORAL HEALTH SERVICES PROVIDER 2 GEOGRAPHIC FOOTPRINT QUALITY U.K. BEHAVIORAL HEALTH PLATFORM Comprehensive service offering leading positions in all areas of behavioral health, in both adults and children, and across the entire ✓ 1 care pathway Attractive geographic footprint: nationwide coverage offering 1 specialist centers of excellence in local markets ✓ 1 Excellent clinical outcomes reinforcing premium brand reputation ✓ Healthcare Rehab & Recovery Forensic Acute Adult Care Learning Supported Living Adult Autism Mental Health Disabilities Education & Children’s Services SEMH Schools Autism Schools Adult Colleges Residential Care Elderly Care Healthcare Adult Care MPT assets will be heavily weighted (~80%) toward healthcare ✓ Education & Children Source: Acadia Healthcare 1 According to Acadia Healthcare 24 2 Includes approximately 35 Priory facilities that MPT expects to acquire. Comprehensive Continuum of CarePRIORY GROUP IS AN ESTABLISHED BEHAVIORAL HEALTH SERVICES PROVIDER 2 GEOGRAPHIC FOOTPRINT QUALITY U.K. BEHAVIORAL HEALTH PLATFORM Comprehensive service offering leading positions in all areas of behavioral health, in both adults and children, and across the entire ✓ 1 care pathway Attractive geographic footprint: nationwide coverage offering 1 specialist centers of excellence in local markets ✓ 1 Excellent clinical outcomes reinforcing premium brand reputation ✓ Healthcare Rehab & Recovery Forensic Acute Adult Care Learning Supported Living Adult Autism Mental Health Disabilities Education & Children’s Services SEMH Schools Autism Schools Adult Colleges Residential Care Elderly Care Healthcare Adult Care MPT assets will be heavily weighted (~80%) toward healthcare ✓ Education & Children Source: Acadia Healthcare 1 According to Acadia Healthcare 24 2 Includes approximately 35 Priory facilities that MPT expects to acquire. Comprehensive Continuum of Care
PRIORY HAS A LEADING MARKET POSITION IN THE U.K. 1 BEHAVIORAL HEALTH MARKET SHARE 26% 26 % 17% 17 % 11% 10% 11 % 10 % 4% 4 % 2% 2% 2 % 2 % 1% 1 % Priory Group Cygnet Health Care St Andrew's Elysium Healthcare Four Seasons Royal Hospital Barchester Ludlow Street Healthcare Health Care Healthcare Healthcare Source: LaingBuisson U.K. Market Review (32nd Edition) published September 2020 1 Represents 2018 market share based on revenue of the top 8 operators in the U.K. mental health hospital market. 25PRIORY HAS A LEADING MARKET POSITION IN THE U.K. 1 BEHAVIORAL HEALTH MARKET SHARE 26% 26 % 17% 17 % 11% 10% 11 % 10 % 4% 4 % 2% 2% 2 % 2 % 1% 1 % Priory Group Cygnet Health Care St Andrew's Elysium Healthcare Four Seasons Royal Hospital Barchester Ludlow Street Healthcare Health Care Healthcare Healthcare Source: LaingBuisson U.K. Market Review (32nd Edition) published September 2020 1 Represents 2018 market share based on revenue of the top 8 operators in the U.K. mental health hospital market. 25
SUSTAINED TSR OUTPERFORMANCE TOTAL SHAREHOLDER RETURNS COMPARED TO BENCHMARK INDICES S&P 500, MSCI U.S. REIT and SNL U.S. REIT Healthcare 555% 387% 328% 283% 233% 215% 131% 121% 105% 97% 85% 64% 41% 38% 36% 33% MSCI SNL SNL MSCI S&P 500 SNL S&P 500 MPW SNL MSCI S&P 500 MPW MSCI S&P 500 MPW MPW 3-YEAR PERIOD 5-YEAR PERIOD 10-YEAR PERIOD SINCE IPO JULY 7, 2005 Sources: FactSet and S&P Global Market Intelligence; as of 5/31/2021 26SUSTAINED TSR OUTPERFORMANCE TOTAL SHAREHOLDER RETURNS COMPARED TO BENCHMARK INDICES S&P 500, MSCI U.S. REIT and SNL U.S. REIT Healthcare 555% 387% 328% 283% 233% 215% 131% 121% 105% 97% 85% 64% 41% 38% 36% 33% MSCI SNL SNL MSCI S&P 500 SNL S&P 500 MPW SNL MSCI S&P 500 MPW MSCI S&P 500 MPW MPW 3-YEAR PERIOD 5-YEAR PERIOD 10-YEAR PERIOD SINCE IPO JULY 7, 2005 Sources: FactSet and S&P Global Market Intelligence; as of 5/31/2021 26
TRANSFORMATIVE INVESTMENTS DRIVING MPT’S EXTRAORDINARY GROWTH GROSS ASSETS ($ in millions) Completes the acquisition of 30 acute care hospitals in the U.K. from BMI Healthcare for approximately $2.0 billion. $20,861 $20,430 Completes joint venture with Primonial Acquires real Group for 71 German estate of Priory post-acute hospitals Group in U.K. for $16,529 valued at €1.63 billion. Announces agreement to acquire 40 £800 million. hospitals operated by MEDIAN Kliniken, Acquires nine acute care Sells common equity one of Germany’s top rehab hospital hospitals operated by interest in Ernest operators, for approximately $900 million. Steward Health Care in Health at 13% Acquires 11 Australian Massachusetts in $1.25 unlevered IRR. hospitals from affiliates of billion transaction. Acquires 11 properties in Germany from Healthscope Ltd. for $859 RHM Klinik for $245 million, representing million. $10,058 the first hospital transaction outside the $9,476 United States by any U.S. REIT. Acquires 16 acute care hospitals operated by Prospect $7,143 Medical Holdings in California, Announces acquisition of a 16-property Acquires real estate Pennsylvania and Connecticut portfolio operated by Ernest Health, Inc., interest in 10 acute care $5,867 for $1.55 billion. for $300 million and a $100 million hospitals and one investment in the operator. behavioral health facility $3,923 Announces the acquisition of leased to Steward Health $3,040 Announces the 10 LifePoint acute care Care in Arizona, Utah, $2,285 acquisition of Capella hospitals across six U.S. states Texas, and Arkansas for $1,699 $1,410 Healthcare and the real for $700 million, bringing MPT’s $1.4 billion. estate of seven acute care total investment in LifePoint hospitals for $900 million. facilities to $1.2 billion. 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Source: Company filings; Gross Assets derived from Company’s Balance Sheet for period 2010-2015 and represents total assets before accumulated depreciation and amortization; 27 Pro Forma Total Gross Assets for period 2016-2020 is further explained on page 35.TRANSFORMATIVE INVESTMENTS DRIVING MPT’S EXTRAORDINARY GROWTH GROSS ASSETS ($ in millions) Completes the acquisition of 30 acute care hospitals in the U.K. from BMI Healthcare for approximately $2.0 billion. $20,861 $20,430 Completes joint venture with Primonial Acquires real Group for 71 German estate of Priory post-acute hospitals Group in U.K. for $16,529 valued at €1.63 billion. Announces agreement to acquire 40 £800 million. hospitals operated by MEDIAN Kliniken, Acquires nine acute care Sells common equity one of Germany’s top rehab hospital hospitals operated by interest in Ernest operators, for approximately $900 million. Steward Health Care in Health at 13% Acquires 11 Australian Massachusetts in $1.25 unlevered IRR. hospitals from affiliates of billion transaction. Acquires 11 properties in Germany from Healthscope Ltd. for $859 RHM Klinik for $245 million, representing million. $10,058 the first hospital transaction outside the $9,476 United States by any U.S. REIT. Acquires 16 acute care hospitals operated by Prospect $7,143 Medical Holdings in California, Announces acquisition of a 16-property Acquires real estate Pennsylvania and Connecticut portfolio operated by Ernest Health, Inc., interest in 10 acute care $5,867 for $1.55 billion. for $300 million and a $100 million hospitals and one investment in the operator. behavioral health facility $3,923 Announces the acquisition of leased to Steward Health $3,040 Announces the 10 LifePoint acute care Care in Arizona, Utah, $2,285 acquisition of Capella hospitals across six U.S. states Texas, and Arkansas for $1,699 $1,410 Healthcare and the real for $700 million, bringing MPT’s $1.4 billion. estate of seven acute care total investment in LifePoint hospitals for $900 million. facilities to $1.2 billion. 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Source: Company filings; Gross Assets derived from Company’s Balance Sheet for period 2010-2015 and represents total assets before accumulated depreciation and amortization; 27 Pro Forma Total Gross Assets for period 2016-2020 is further explained on page 35.
LEASES STRUCTURED FOR PREDICTABLE CASH FLOW (A) SAME STORE TTM EBITDARM RENT COVERAGE INCLUSIVE OF CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE 5.00x 4.00x 3.00x 2.00x 1.00x 0.00x General Acute Care Hospitals Inpatient Rehabilitation Facilities Long-Term Acute Care Hospitals Total Portfolio Q4 2019 (YoY) Q4 2020 (YoY) Q3 2020 (QoQ) Q4 2020 (QoQ) Percentage of total LEASE & MORTGAGE LOAN MATURITY SCHEDULE base rent/interest 100% 86.9% 90% 80% 70% 60% 2018 2017 2018 50% 40% 30% 20% 4.6% 10% 3.7% 1.4% 1.1% 0.7% 0.2% 0.2% 0.3% 0.5% 0.4% 0% Source: Company’s 1Q 2021 Supplemental. 28 A) EBITDARM adjusted for non-recurring items. 2.8x 3.4x 3.0x 3.4x 2.2x 2.2x 2.2x 2.2x 1.8x 2.6x 2.3x 2.6x 2.6x 3.1x 2.8x 3.1xLEASES STRUCTURED FOR PREDICTABLE CASH FLOW (A) SAME STORE TTM EBITDARM RENT COVERAGE INCLUSIVE OF CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE 5.00x 4.00x 3.00x 2.00x 1.00x 0.00x General Acute Care Hospitals Inpatient Rehabilitation Facilities Long-Term Acute Care Hospitals Total Portfolio Q4 2019 (YoY) Q4 2020 (YoY) Q3 2020 (QoQ) Q4 2020 (QoQ) Percentage of total LEASE & MORTGAGE LOAN MATURITY SCHEDULE base rent/interest 100% 86.9% 90% 80% 70% 60% 2018 2017 2018 50% 40% 30% 20% 4.6% 10% 3.7% 1.4% 1.1% 0.7% 0.2% 0.2% 0.3% 0.5% 0.4% 0% Source: Company’s 1Q 2021 Supplemental. 28 A) EBITDARM adjusted for non-recurring items. 2.8x 3.4x 3.0x 3.4x 2.2x 2.2x 2.2x 2.2x 1.8x 2.6x 2.3x 2.6x 2.6x 3.1x 2.8x 3.1x
LEASES STRUCTURED FOR PREDICTABLE CASH FLOW (A) SAME STORE EBITDARM RENT COVERAGE EXCLUDING ALL CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE 5.00x 4.00x 3.00x 2.00x 1.00x 0.00x General Acute Care Hospitals Inpatient Rehabilitation Facilities Long-Term Acute Care Hospitals Total Portfolio Q4 2019 (YoY) Q4 2020 (YoY) Q3 2020 (QoQ) Q4 2020 (QoQ) Percentage of total LEASE & MORTGAGE LOAN MATURITY SCHEDULE base rent/interest 100% 86.9% 90% 80% 70% 60% 2018 2017 2018 2017 50% 40% 30% 20% 4.6% 10% 3.7% 1.4% 1.1% 0.7% 0.2% 0.2% 0.3% 0.5% 0.4% 0% Source: Company’s 1Q 2021 Supplemental. 29 A) EBITDARM adjusted for non-recurring items. 2.8x 1.9x 2.0x 1.9x 2.2x 2.1x 2.1x 2.1x 1.8x 2.2x 2.1x 2.2x 2.6x 2.0x 2.0x 2.0xLEASES STRUCTURED FOR PREDICTABLE CASH FLOW (A) SAME STORE EBITDARM RENT COVERAGE EXCLUDING ALL CARES ACT GRANTS YOY AND SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE 5.00x 4.00x 3.00x 2.00x 1.00x 0.00x General Acute Care Hospitals Inpatient Rehabilitation Facilities Long-Term Acute Care Hospitals Total Portfolio Q4 2019 (YoY) Q4 2020 (YoY) Q3 2020 (QoQ) Q4 2020 (QoQ) Percentage of total LEASE & MORTGAGE LOAN MATURITY SCHEDULE base rent/interest 100% 86.9% 90% 80% 70% 60% 2018 2017 2018 2017 50% 40% 30% 20% 4.6% 10% 3.7% 1.4% 1.1% 0.7% 0.2% 0.2% 0.3% 0.5% 0.4% 0% Source: Company’s 1Q 2021 Supplemental. 29 A) EBITDARM adjusted for non-recurring items. 2.8x 1.9x 2.0x 1.9x 2.2x 2.1x 2.1x 2.1x 1.8x 2.2x 2.1x 2.2x 2.6x 2.0x 2.0x 2.0x
LADDERED DEBT MATURITIES DEBT MATURITY SCHEDULE $1,551,310 $1,389,150 $1,400,000 $1,300,000 $1,090,939 $900,000 $826,980 $586,500 $551,320 $482,405 $- 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2024 Credit Facility Revolver 2026 Term Loan 4.000% Notes Due 2022 2.550% Notes Due 2023 2024 AUD Term Loan 3.325% Notes Due 2025 2025 GBP Term Loan 5.250% Notes Due 2026 2.500% Notes Due 2026 5.000% Notes Due 2027 3.692% Notes Due 2028 4.625% Notes Due 2029 3.375% Notes Due 2030 3.500% Notes Due 2031 PERCENTAGE OF TOTAL DEBT Variable 3.8% Fixed 96.2% 30 Source: Company’s 1Q 2021 Supplemental; percentage of total debt as of March 31, 2021.LADDERED DEBT MATURITIES DEBT MATURITY SCHEDULE $1,551,310 $1,389,150 $1,400,000 $1,300,000 $1,090,939 $900,000 $826,980 $586,500 $551,320 $482,405 $- 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2024 Credit Facility Revolver 2026 Term Loan 4.000% Notes Due 2022 2.550% Notes Due 2023 2024 AUD Term Loan 3.325% Notes Due 2025 2025 GBP Term Loan 5.250% Notes Due 2026 2.500% Notes Due 2026 5.000% Notes Due 2027 3.692% Notes Due 2028 4.625% Notes Due 2029 3.375% Notes Due 2030 3.500% Notes Due 2031 PERCENTAGE OF TOTAL DEBT Variable 3.8% Fixed 96.2% 30 Source: Company’s 1Q 2021 Supplemental; percentage of total debt as of March 31, 2021.
CORPORATE RESPONSIBILITY Solar panels above employees’ parking lot at Desert Valley Hospital, Prime’s 148-bed general acute hospital in Victorville, CA Pictured: IMED Valencia Hospital (Spain) Environmental • ESG Committee formed in 2019 to drive environmental • Saved over 200,000 kWh in energy usage in performance improvements across all business functions 2020 compared to 2019 at corporate headquarters • ESG performance metrics incorporated into executive compensation program • 2021 proxy statement reports environmental initiatives and accomplishments of MPT • Engaged with more than 80% of tenants regarding operators, including elimination of CO 2 environmental sustainability of their properties and operations emissions, reduction in electricity demand and • Environmentally responsible design features for development water consumption, and improvements in projects waste management 31 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/ CORPORATE RESPONSIBILITY Solar panels above employees’ parking lot at Desert Valley Hospital, Prime’s 148-bed general acute hospital in Victorville, CA Pictured: IMED Valencia Hospital (Spain) Environmental • ESG Committee formed in 2019 to drive environmental • Saved over 200,000 kWh in energy usage in performance improvements across all business functions 2020 compared to 2019 at corporate headquarters • ESG performance metrics incorporated into executive compensation program • 2021 proxy statement reports environmental initiatives and accomplishments of MPT • Engaged with more than 80% of tenants regarding operators, including elimination of CO 2 environmental sustainability of their properties and operations emissions, reduction in electricity demand and • Environmentally responsible design features for development water consumption, and improvements in projects waste management 31 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/
CORPORATE RESPONSIBILITY 40% 41% Report to female Female manager employees MPT has served as a presenting sponsor of Mitchell’s Place “A Night at the Oscars.” Mitchell’s Place is a nonprofit organization that provides preschool and other services to children with autism and other developmental disabilities 27% 21% Over 50 Under 30 Social • Given long-term focus and ownership in our properties, MPT places importance on supporting the communities in which it operates by providing financial and volunteer support for private and public non-profit programs aimed at improving communities and public health • MPT Charity and Community Support Committee supports health, social, educational, and community organizations with contributions to 180+ different groups in 2020 • 41% of all MPT employee are female, and 40% of employees report to a female manager or director • Regular training for employees including anti-harassment, cybersecurity, data security awareness • Independent, third-party administered, anonymous employee engagement survey covering 100% of U.S. employees introduced in 2021 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports 32 For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/ CORPORATE RESPONSIBILITY 40% 41% Report to female Female manager employees MPT has served as a presenting sponsor of Mitchell’s Place “A Night at the Oscars.” Mitchell’s Place is a nonprofit organization that provides preschool and other services to children with autism and other developmental disabilities 27% 21% Over 50 Under 30 Social • Given long-term focus and ownership in our properties, MPT places importance on supporting the communities in which it operates by providing financial and volunteer support for private and public non-profit programs aimed at improving communities and public health • MPT Charity and Community Support Committee supports health, social, educational, and community organizations with contributions to 180+ different groups in 2020 • 41% of all MPT employee are female, and 40% of employees report to a female manager or director • Regular training for employees including anti-harassment, cybersecurity, data security awareness • Independent, third-party administered, anonymous employee engagement survey covering 100% of U.S. employees introduced in 2021 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports 32 For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/
CORPORATE RESPONSIBILITY MPW BOARD COMPOSITION Gender Tenure Age Minority 59.4 50% 13% 25% 6 years 1 Average Age Minority Women or less Key Director Skills Executive Leadership Experience Industry Experience Financial & Accounting Experience Investment Experience 5 directors out of 8 6 directors out of 8 5 directors out of 8 5 directors out of 8 Governance • Robust governance practices including, but not limited to: o Opted out of the Maryland Unsolicited Takeover Act (“MUTA”) o History of and commitment to Board diversity and refreshment o Proxy access o No stockholder rights plan (“poison pill”) o Majority voting for uncontested director elections o Regular executive sessions of independent Board members o Lead independent director o Mandatory director retirement age o Active and responsive stockholder engagement o Executives require prior authorization to purchase or sell our shares o Stockholders’ ability to amend Bylaws o Claw-back policy o Anti-hedging and anti-pledging policies o Over 92% support of executive compensation program in each of o Unclassified Board of Directors past four years 1. One MPT Director is Latina 33 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/ CORPORATE RESPONSIBILITY MPW BOARD COMPOSITION Gender Tenure Age Minority 59.4 50% 13% 25% 6 years 1 Average Age Minority Women or less Key Director Skills Executive Leadership Experience Industry Experience Financial & Accounting Experience Investment Experience 5 directors out of 8 6 directors out of 8 5 directors out of 8 5 directors out of 8 Governance • Robust governance practices including, but not limited to: o Opted out of the Maryland Unsolicited Takeover Act (“MUTA”) o History of and commitment to Board diversity and refreshment o Proxy access o No stockholder rights plan (“poison pill”) o Majority voting for uncontested director elections o Regular executive sessions of independent Board members o Lead independent director o Mandatory director retirement age o Active and responsive stockholder engagement o Executives require prior authorization to purchase or sell our shares o Stockholders’ ability to amend Bylaws o Claw-back policy o Anti-hedging and anti-pledging policies o Over 92% support of executive compensation program in each of o Unclassified Board of Directors past four years 1. One MPT Director is Latina 33 Source: April 26, 2021 proxy filing, MPW Website and Annual Reports For more information regarding our sustainability commitments, please visit our Website: https://medicalpropertiestrust.com/corporate-responsibility/
APPENDIX 34APPENDIX 34
TOTAL PRO FORMA GROSS ASSETS RECONCILIATION Total Pro Forma Gross Assets (Unaudited) (Amounts in millions) December 31, 2016 December 31, 2017 December 31, 2018 December 31, 2019 December 31, 2020 March 31, 2021 Total Assets $6,419 $9,020 $8,844 $14,467 $16,829 $18,746 Add: Real estate commitments on new investments 288 18 865 1,989 1,901 158 Unfunded amounts on development deals and commenced capital improvement projects 194 154 230 163 166 114 Accumulated depreciation and amortization 325 456 465 570 834 904 1 Incremental gross assets of our joint ventures - - 376 564 1,287 1,211 Proceeds from new debt and equity subsequent to period-end - - - 928 1 ,480 - Less: Cash used for funding the transactions above (83) (172) (722) (2,152) ( 2,067) (272) Total Pro Forma Gross Assets $7,143 $9,476 $10,058 $16,529 $20,430 $20,861 Pro forma total gross assets is total assets before accumulated depreciation/amortization, assumes all real estate binding commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded, and assumes cash on hand is fully used in these transactions. We believe pro forma total gross assets is useful to investors as it provides a more current view of our portfolio and allows for a better understanding of our concentration levels as our binding commitments close and our other commitments are fully funded. 1 Adjusted to reflect our share of our joint ventures’ gross assets. 35 Note: MPT initiated reporting of pro forma total gross assets in 2017 (with disclosure provided for 2016).TOTAL PRO FORMA GROSS ASSETS RECONCILIATION Total Pro Forma Gross Assets (Unaudited) (Amounts in millions) December 31, 2016 December 31, 2017 December 31, 2018 December 31, 2019 December 31, 2020 March 31, 2021 Total Assets $6,419 $9,020 $8,844 $14,467 $16,829 $18,746 Add: Real estate commitments on new investments 288 18 865 1,989 1,901 158 Unfunded amounts on development deals and commenced capital improvement projects 194 154 230 163 166 114 Accumulated depreciation and amortization 325 456 465 570 834 904 1 Incremental gross assets of our joint ventures - - 376 564 1,287 1,211 Proceeds from new debt and equity subsequent to period-end - - - 928 1 ,480 - Less: Cash used for funding the transactions above (83) (172) (722) (2,152) ( 2,067) (272) Total Pro Forma Gross Assets $7,143 $9,476 $10,058 $16,529 $20,430 $20,861 Pro forma total gross assets is total assets before accumulated depreciation/amortization, assumes all real estate binding commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded, and assumes cash on hand is fully used in these transactions. We believe pro forma total gross assets is useful to investors as it provides a more current view of our portfolio and allows for a better understanding of our concentration levels as our binding commitments close and our other commitments are fully funded. 1 Adjusted to reflect our share of our joint ventures’ gross assets. 35 Note: MPT initiated reporting of pro forma total gross assets in 2017 (with disclosure provided for 2016).
® AT THE VERY HEART OF HEALTHCARE.® AT THE VERY HEART OF HEALTHCARE.