Business Wire | Feb 4, 2021 08:04AM EST

Medical Properties Trust, Inc. Reports Fourth Quarter and Full-Year Results

Feb. 04, 2021

BIRMINGHAM, Ala.--(BUSINESS WIRE)--Feb. 04, 2021--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, 2020 as well as certain events occurring subsequent to quarter end.

* Net income of $0.20 and Normalized Funds from Operations ("NFFO") of $0.41 for the 2020 fourth quarter and net income of $0.81 and NFFO of $1.57 for the full-year 2020, all on a per diluted share basis; * Closed in the fourth quarter on one inpatient rehabilitation ("IRF") development agreement and six general acute and IRF acquisitions in the U.S., the U.K., Switzerland, and Colombia totaling nearly $670 million; * Closed in mid-January on an 800 million real estate investment in behavioral health properties in the UK operated by Priory Group ("Priory"); * In the first quarter of 2021 completed the sale of Olympia Medical Center to the UCLA Health System for proceeds of $51 million, recovering a loan balance of $25 million and other past due amounts at an overall expected gain exceeding $10 million; * During and subsequent to the fourth quarter issued $1.3 billion in 3.5% senior unsecured notes due in 2031, redeemed $800 million of senior unsecured notes due in 2024 with a blended interest rate of 6%, raised $828 million in common equity, extended with improved pricing the existing $1.5 billion line of credit agreement, and arranged a $900 million interim credit facility.

"I am pleased that in spite of the pandemic, MPT grew NFFO per share by 21% in 2020 and is approaching $5 billion in investments closed since the end of 2019 in a manner both accretive to earnings and beneficial to operator and property diversity in an already strongly diverse portfolio," said Edward K. Aldag, Jr., MPT's Chairman, President, and Chief Executive Officer. "While not a surprise to MPT, the challenges of 2020 proved that hospitals are essential to global healthcare delivery and that our growth pipeline can sustain momentum under challenging circumstances."

Mr. Aldag continued, "2021 is obviously off to a strong start on the investment front, and growth-related conversations with our operators are picking up as they emerge from 2020 with strong operations and significant liquidity."

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 2019 results, and reconciliations of total assets to pro forma total gross assets and total revenues to total adjusted revenues.

PORTFOLIO UPDATE

During the fourth quarter and thus far in 2021, MPT and its operators continued to execute on several accretive acquisitions despite the COVID-19 pandemic.

Throughout the fourth quarter, the Company closed on various investments in IRFs across the U.S. In late-November, MPT agreed to a roughly $48 million development in Stockton, CA with Ernest Health ("Ernest") and also acquired an Ernest facility in Elgin, SC in late December for roughly $17 million. In addition, the Company acquired in December properties in El Paso, TX and the Louisville, KY market operated by Curahealth for a combined $58 million. These transactions were closed at a weighted average GAAP cap rate approximating 10%.

In addition to these U.S. rehabilitation facilities, MPT closed on the previously announced $130 million Colombian investment and three other transactions: (i) the Company purchased the 999-year ground lease at The Royal Marsden Private Care, a flagship facility located in London's Cavendish Square and MPT's first lease with the National Health Service ("NHS"), for 50 million; (ii) separately, MPT acquired Circle Reading Hospital, to be joined to MPT's master lease agreement with Circle, in December for 85 million; and (iii) MPT increased its equity ownership and related investment in Infracore, the landlord entity of Swiss hospital operator Swiss Medical Network, for a total investment of approximately 207 million Swiss Francs. Terms of these investment agreements provide for long-term absolute net lease arrangements and investment returns well in-line with recently disclosed yields in the U.K. and Switzerland.

As discussed in more detail in the Company's January 6, 2021 press release, MPT invested 800 million on January 19, 2021 in a sale-leaseback agreement of U.K. behavioral hospitals operated by Priory at an 8.6% GAAP cap rate. In addition, the Company extended a short-term 250 million loan to the purchaser of the operator, expected to be repaid by the end of the third quarter, and acquired a 9.9% equity interest in Priory. In relation to the deal, MPT utilized approximately 500 million of interim short-term financing at terms similar to those in its revolving line of credit agreement.

The Company has pro forma total gross assets of approximately $20.4 billion, including $15.1 billion in general acute care hospitals, $2.2 billion in inpatient rehabilitation hospitals, $1.7 billion in behavioral health facilities, $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 431 properties representing roughly 43,000 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 50 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 fourth quarter and year ended December 31, 2020 was $110 million (or $0.20 per diluted share) and $431 million ($0.81 per diluted share), respectively, compared to $130 million (or $0.26 per diluted share) and $375 million ($0.87 per diluted share) in the year earlier periods.

NFFO for the fourth quarter and year ended December 31, 2020 was $220 million ($0.41 per diluted share) and $831 million ($1.57 per diluted share), respectively, compared to $171 million ($0.35 per diluted share) and $557 million ($1.30 per diluted share) in the year earlier periods.

Based on 2020 and 2021 year-to-date transactions, including the Priory sale-leaseback transaction, 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.

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, 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, February 4, 2021 at 11:00 a.m. Eastern Time to present the Company's financial and operating results for the quarter ended December 31, 2020. 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 6688297. 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 through February 18, 2021. Dial-in numbers for the replay are 855-859-2056 and 404-537-3406 for U.S./Canada and International callers, respectively. The replay passcode for all callers is 6688297.

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 atwww.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 431 facilities and roughly 43,000 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; 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, 2019 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.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Consolidated Balance Sheets(Amounts in thousands, except for per share December 31, December 31,data) 2020 2019Assets (Unaudited) (A) Real estate assets Land, buildings and improvements, intangible $ 12,078,927 $ 8,102,754 lease assets, and other Investment in financing leases 2,010,922 2,060,302

Mortgage loans 248,080 1,275,022

Gross investment in real estate assets 14,337,929 11,438,078

Accumulated depreciation and amortization (833,529 ) (570,042 )

Net investment in real estate assets 13,504,400 10,868,036

Cash and cash equivalents 549,884 1,462,286

Interest and rent receivables 46,208 31,357

Straight-line rent receivables 490,462 334,231

Equity investments 1,123,623 926,990

Other loans 858,368 544,832

Other assets 256,069 299,599

Total Assets $ 16,829,014 $ 14,467,331

Liabilities and Equity Liabilities Debt, net $ 8,865,458 $ 7,023,679

Accounts payable and accrued expenses 438,750 291,489

Deferred revenue 36,177 16,098

Obligations to tenants and other lease 144,772 107,911 liabilities Total Liabilities 9,485,157 7,439,177

Equity Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding - -

Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 541,419 shares at 541 518 December 31, 2020 and 517,522 shares at December 31, 2019 Additional paid-in capital 7,461,503 7,008,199

Retained (deficit) earnings (71,411 ) 83,012

Accumulated other comprehensive loss (51,324 ) (62,905 )

Treasury shares, at cost (777 ) (777 )

Total Medical Properties Trust, Inc. 7,338,532 7,028,047 Stockholders' Equity Non-controlling interests 5,325 107

Total Equity 7,343,857 7,028,154

Total Liabilities and Equity $ 16,829,014 $ 14,467,331

(A) Financials have been derived from the prior year audited financial statements. MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIESConsolidated Statements of Income(Unaudited)(Amounts in thousands, except for per share data)For the Three Months EndedFor the Twelve Months EndedDecember 31, 2020December 31, 2019December 31, 2020December 31, 2019RevenuesRent billed$

203,034

$

130,310

$

741,311

$

474,151

Straight-line rent55,184

33,643

158,881

110,456

Income from financing leases49,081

52,364

206,550

119,617

Interest and other income26,507

40,121

142,496

149,973

Total revenues333,806

256,438

1,249,238

854,197

ExpensesInterest85,190

70,434

328,728

237,830

Real estate depreciation and amortization72,196

44,152

264,245

152,313

Property-related5,712

8,598

24,890

23,992

General and administrative34,542

27,402

131,663

96,411

Total expenses197,640

150,586

749,526

510,546

Other income (expense)(Loss) gain on sale of real estate(130

)

41,498

(2,833

)

41,560

Real estate impairment charges-

(21,031

)

(19,006

)

(21,031

)

Earnings from equity interests5,154

4,416

20,417

16,051

Debt refinancing and unutilized financing costs(27,569

)

(1,233

)

(28,180

)

(6,106

)

Other (including mark-to-market adjustments on equity securities)2,717

1,152

(6,782

)

(345

)

Total other income (expense)(19,828

)

24,802

(36,384

)

30,129

Income before income tax116,338

130,654

463,328

373,780

Income tax (expense) benefit(6,232

)

(731

)

(31,056

)

2,621

Net income110,106

129,923

432,272

376,401

Net income attributable to non-controlling interests(222

)

(285

)

(822

)

(1,717

)

Net income attributable to MPT common stockholders$

109,884

$

129,638

$

431,450

$

374,684

Earnings per common share - basic and diluted:Net income attributable to MPT common stockholders$

0.20

$

0.26

$

0.81

$

0.87

Weighted average shares outstanding - basic537,003

493,593

529,239

427,075

Weighted average shares outstanding - diluted538,351

494,893

530,461

428,299

Dividends declared per common share$

0.27

$

0.26

$

1.08

$

1.02

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Consolidated Statements of Income (Unaudited) (Amounts in thousands, For the Three Months For the Twelve Monthsexcept for per share data) Ended Ended December December December 31, December 31, 2020 31, 2019 2020 31, 2019 Revenues Rent billed $ 203,034 $ 130,310 $ 741,311 $ 474,151

Straight-line rent 55,184 33,643 158,881 110,456

Income from financing 49,081 52,364 206,550 119,617 leases Interest and other income 26,507 40,121 142,496 149,973

Total revenues 333,806 256,438 1,249,238 854,197

Expenses Interest 85,190 70,434 328,728 237,830

Real estate depreciation 72,196 44,152 264,245 152,313 and amortization Property-related 5,712 8,598 24,890 23,992

General and 34,542 27,402 131,663 96,411 administrative Total expenses 197,640 150,586 749,526 510,546

Other income (expense) (Loss) gain on sale of (130 ) 41,498 (2,833 ) 41,560 real estate Real estate impairment - (21,031 ) (19,006 ) (21,031 ) charges Earnings from equity 5,154 4,416 20,417 16,051 interests Debt refinancing and (27,569 ) (1,233 ) (28,180 ) (6,106 ) unutilized financing costs Other (including mark-to-market 2,717 1,152 (6,782 ) (345 ) adjustments on equity securities) Total other income (19,828 ) 24,802 (36,384 ) 30,129 (expense) Income before income tax 116,338 130,654 463,328 373,780

Income tax (expense) (6,232 ) (731 ) (31,056 ) 2,621 benefit Net income 110,106 129,923 432,272 376,401

Net income attributable (222 ) (285 ) (822 ) (1,717 ) to non-controlling interests Net income attributable $ 109,884 $ 129,638 $ 431,450 $ 374,684 to MPT common stockholders Earnings per common share - basic and diluted: Net income attributable $ 0.20 $ 0.26 $ 0.81 $ 0.87 to MPT common stockholders Weighted average shares 537,003 493,593 529,239 427,075 outstanding - basic Weighted average shares 538,351 494,893 530,461 428,299 outstanding - diluted Dividends declared per $ 0.27 $ 0.26 $ 1.08 $ 1.02 common share MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIESReconciliation of Net Income to Funds From Operations(Unaudited)(Amounts in thousands, except for per share data)For the Three Months EndedFor the Twelve Months EndedDecember 31, 2020December 31, 2019December 31, 2020December 31, 2019FFO information:Net income attributable to MPT common stockholders$

109,884

$

129,638

$

431,450

$

374,684

Participating securities' share in earnings(719

)

(954

)

(2,105

)

(2,308

)

Net income, less participating securities' share in earnings$

109,165

$

128,684

$

429,345

$

372,376

Depreciation and amortization83,327

53,497

306,493

183,921

Loss (gain) on sale of real estate130

(41,498

)

2,833

(41,560

)

Real estate impairment charges-

21,031

19,006

21,031

Funds from operations$

192,622

$

161,714

$

757,677

$

535,768

Write-off of straight-line rent and other(683

)

12,943

26,415

22,447

Non-cash fair value adjustments612

(4,636

)

9,642

(6,908

)

Tax rate change(366

)

-

9,295

-

Debt refinancing and unutilized financing costs27,569

1,233

28,180

6,106

Normalized funds from operations$

219,754

$

171,254

$

831,209

$

557,413

Share-based compensation12,554

10,069

47,154

32,188

Debt costs amortization3,548

2,761

13,937

9,675

Rent deferral, net1,267

-

(11,393

)

-

Straight-line rent revenue and other(71,659

)

(48,836

)

(238,687

)

(145,598

)

Adjusted funds from operations$

165,464

$

135,248

$

642,220

$

453,678

Per diluted share data:Net income, less participating securities' share in earnings$

0.20

$

0.26

$

0.81

$

0.87

Depreciation and amortization0.16

0.11

0.57

0.43

Loss (gain) on sale of real estate-

(0.08

)

0.01

(0.10

)

Real estate impairment charges-

0.04

0.04

0.05

Funds from operations$

0.36

$

0.33

$

1.43

$

1.25

Write-off of straight-line rent and other-

0.03

0.05

0.05

Non-cash fair value adjustments-

(0.01

)

0.02

(0.01

)

Tax rate change-

-

0.02

-

Debt refinancing and unutilized financing costs0.05

-

0.05

0.01

Normalized funds from operations$

0.41

$

0.35

$

1.57

$

1.30

Share-based compensation0.02

0.02

0.09

0.08

Debt costs amortization0.01

0.01

0.02

0.02

Rent deferral, net-

-

(0.02

)

-

Straight-line rent revenue and other(0.13

)

(0.11

)

(0.45

)

(0.34

)

Adjusted funds from operations$

0.31

$

0.27

$

1.21

$

1.06

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 the activity of all of our equity interests in the "Earnings from equity interests" line on the consolidated statements of income.

(B) Investors and analysts following the real estate industry utilize funds from operations, or FFO, as a supplemental performance measure. FFO, reflecting the assumption that real estate asset values rise or fall with market conditions, principally adjusts for the effects of GAAP depreciation and amortization of real estate assets, which assumes that the value of real estate diminishes predictably over time. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, or NAREIT, which represents net income (loss) (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization and after adjustments for unconsolidated partnerships and joint ventures.

In addition to presenting FFO in accordance with the NAREIT definition, we also disclose normalized FFO, which adjusts FFO for items that relate to unanticipated or non-core events or activities or accounting changes that, if not noted, would make comparison to prior period results and market expectations less meaningful to investors and analysts. We believe that the use of FFO, combined with the required GAAP presentations, improves the understanding of our operating results among investors and the use of normalized FFO makes comparisons of our operating results with prior periods and other companies more meaningful. While FFO and normalized FFO are relevant and widely used supplemental measures of operating and financial performance of REITs, they should not be viewed as a substitute measure of our operating performance since the measures do not reflect either depreciation and amortization costs or the level of capital expenditures and leasing costs necessary to maintain the operating performance of our properties, which can be significant economic costs that could materially impact our results of operations. FFO and normalized FFO should not be considered an alternative to net income (loss) (computed in accordance with GAAP) as indicators of our results of operations or to cash flow from operating activities (computed in accordance with GAAP) as an indicator of our liquidity.

We calculate adjusted funds from operations, or AFFO, by subtracting from or adding to normalized FFO (i) non-cash revenue, (ii) non-cash share-based compensation expense, and (iii) amortization of deferred financing costs. AFFO is an operating measurement that we use to analyze our results of operations based on the receipt, rather than the accrual, of our rental revenue and on certain other adjustments. We believe that this is an important measurement because our leases generally have significant contractual escalations of base rents and therefore result in recognition of rental income that is not collected until future periods, and costs that are deferred or are non-cash charges. Our calculation of AFFO may not be comparable to AFFO or similarly titled measures reported by other REITs. AFFO should not be considered as an alternative to net income (calculated pursuant to GAAP) as an indicator of our results of operations or to cash flow from operating activities (calculated pursuant to GAAP) as an indicator of our liquidity.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Reconciliation of Net Income to Funds From Operations (Unaudited) (Amounts in thousands, For the Twelve Monthsexcept for per share For the Three Months Ended Endeddata) December 31, December 31, December 31, December 31, 2020 2019 2020 2019 FFO information: Net income $ 109,884 $ 129,638 $ 431,450 $ 374,684 attributable to MPT common stockholders Participating (719 ) (954 ) (2,105 ) (2,308 ) securities' share in earnings Net income, less participating $ 109,165 $ 128,684 $ 429,345 $ 372,376 securities' share in earnings Depreciation and 83,327 53,497 306,493 183,921 amortization Loss (gain) on sale of 130 (41,498 ) 2,833 (41,560 ) real estate Real estate impairment - 21,031 19,006 21,031 charges Funds from operations $ 192,622 $ 161,714 $ 757,677 $ 535,768

Write-off of (683 ) 12,943 26,415 22,447 straight-line rent and other Non-cash fair value 612 (4,636 ) 9,642 (6,908 ) adjustments Tax rate change (366 ) - 9,295 -

Debt refinancing and 27,569 1,233 28,180 6,106 unutilized financing costs Normalized funds from $ 219,754 $ 171,254 $ 831,209 $ 557,413 operations Share-based 12,554 10,069 47,154 32,188 compensation Debt costs 3,548 2,761 13,937 9,675 amortization Rent deferral, net 1,267 - (11,393 ) -

Straight-line rent (71,659 ) (48,836 ) (238,687 ) (145,598 ) revenue and other Adjusted funds from $ 165,464 $ 135,248 $ 642,220 $ 453,678 operations Per diluted share data: Net income, less participating $ 0.20 $ 0.26 $ 0.81 $ 0.87 securities' share in earnings Depreciation and 0.16 0.11 0.57 0.43 amortization Loss (gain) on sale of - (0.08 ) 0.01 (0.10 ) real estate Real estate impairment - 0.04 0.04 0.05 charges Funds from operations $ 0.36 $ 0.33 $ 1.43 $ 1.25

Write-off of - 0.03 0.05 0.05 straight-line rent and other Non-cash fair value - (0.01 ) 0.02 (0.01 ) adjustments Tax rate change - - 0.02 -

Debt refinancing and 0.05 - 0.05 0.01 unutilized financing costs Normalized funds from $ 0.41 $ 0.35 $ 1.57 $ 1.30 operations Share-based 0.02 0.02 0.09 0.08 compensation Debt costs 0.01 0.01 0.02 0.02 amortization Rent deferral, net - - (0.02 ) -

Straight-line rent (0.13 ) (0.11 ) (0.45 ) (0.34 ) revenue and other Adjusted funds from $ 0.31 $ 0.27 $ 1.21 $ 1.06 operations Notes:

(A) Certain line items above (such as depreciation and amortization) includeour share of such income/expense from unconsolidated joint ventures. Theseamounts are included with the activity of all of our equity interests in the"Earnings from equity interests" line on the consolidated statements of income.



(B) Investors and analysts following the real estate industry utilize fundsfrom operations, or FFO, as a supplemental performance measure. FFO, reflectingthe assumption that real estate asset values rise or fall with marketconditions, principally adjusts for the effects of GAAP depreciation andamortization of real estate assets, which assumes that the value of real estatediminishes predictably over time. We compute FFO in accordance with thedefinition provided by the National Association of Real Estate InvestmentTrusts, or NAREIT, which represents net income (loss) (computed in accordancewith GAAP), excluding gains (losses) on sales of real estate and impairmentcharges on real estate assets, plus real estate depreciation and amortizationand after adjustments for unconsolidated partnerships and joint ventures.



In addition to presenting FFO in accordance with the NAREIT definition, we alsodisclose normalized FFO, which adjusts FFO for items that relate tounanticipated or non-core events or activities or accounting changes that, ifnot noted, would make comparison to prior period results and marketexpectations less meaningful to investors and analysts. We believe that the useof FFO, combined with the required GAAP presentations, improves theunderstanding of our operating results among investors and the use ofnormalized FFO makes comparisons of our operating results with prior periodsand other companies more meaningful. While FFO and normalized FFO are relevantand widely used supplemental measures of operating and financial performance ofREITs, they should not be viewed as a substitute measure of our operatingperformance since the measures do not reflect either depreciation andamortization costs or the level of capital expenditures and leasing costsnecessary to maintain the operating performance of our properties, which can besignificant economic costs that could materially impact our results ofoperations. FFO and normalized FFO should not be considered an alternative tonet income (loss) (computed in accordance with GAAP) as indicators of ourresults of operations or to cash flow from operating activities (computed inaccordance with GAAP) as an indicator of our liquidity.



We calculate adjusted funds from operations, or AFFO, by subtracting from oradding to normalized FFO (i) non-cash revenue, (ii) non-cash share-basedcompensation expense, and (iii) amortization of deferred financing costs. AFFOis an operating measurement that we use to analyze our results of operationsbased on the receipt, rather than the accrual, of our rental revenue and oncertain other adjustments. We believe that this is an important measurementbecause our leases generally have significant contractual escalations of baserents and therefore result in recognition of rental income that is notcollected until future periods, and costs that are deferred or are non-cashcharges. Our calculation of AFFO may not be comparable to AFFO or similarlytitled measures reported by other REITs. AFFO should not be considered as analternative to net income (calculated pursuant to GAAP) as an indicator of ourresults of operations or to cash flow from operating activities (calculatedpursuant to GAAP) as an indicator of our liquidity.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIESAnnual Run?Rate Guidance Reconciliation(Unaudited)Annual Run-Rate Guidance - Per Share(1)LowHighNet income attributable to MPT common stockholders$

1.14

$

1.18

Participating securities' share in earnings-

-

Net income, less participating securities' share in earnings$

1.14

$

1.18

Depreciation and amortization0.58

0.58

Funds from operations$

1.72

$

1.76

Other adjustments-

-

Normalized funds from operations$

1.72

$

1.76

(1)The guidance is based on current expectations and actual results or future events may differ materially from those expressed in this table, which is a forward-looking statement within the meaning of the federal securities laws. Please refer to the forward-looking statement included in this press release and our filings with the Securities and Exchange Commission for a discussion of risk factors that affect our performance.

MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES Annual Run?Rate Guidance Reconciliation(Unaudited) Annual Run-Rate Guidance - Per Share ^(1) Low High Net income attributable to MPT common stockholders $ 1.14 $ 1.18

Participating securities' share in earnings - -

Net income, less participating securities' share in $ 1.14 $ 1.18 earnings Depreciation and amortization 0.58 0.58

Funds from operations $ 1.72 $ 1.76

Other adjustments - -

Normalized funds from operations $ 1.72 $ 1.76

(1) The guidance is based on current expectations and actual results or futureevents may differ materially from those expressed in this table, which is aforward-looking statement within the meaning of the federal securities laws.Please refer to the forward-looking statement included in this press releaseand our filings with the Securities and Exchange Commission for a discussionof risk factors that affect our performance.

Pro Forma Total Gross Assets(Unaudited)(Amounts in thousands)December 31, 2020December 31, 2019Total Assets$

16,829,014

$

14,467,331

Add:Real estate commitments on new investments(1)1,901,087

1,988,550

Unfunded amounts on development deals and commencedcapital improvement projects(2)166,258

163,370

Accumulated depreciation and amortization833,529

570,042

Incremental gross assets of our joint ventures(3)1,287,077

563,911

Proceeds from new debt and equity subsequent to period-end1,479,961

927,990

Less:Cash used for funding the transactions above(4)(2,067,345

)

(2,151,920

)

Pro Forma Total Gross Assets(5)$

20,429,581

$

16,529,274

(1) The 2020 column reflects investments made in 2021, including the acquisition of 40 facilities in the United Kingdom on January 19, 2021. The 2019 column reflects the acquisition of 30 facilities in the United Kingdom on January 8, 2020.

(2) Includes $65.5 million and $41.7 million of unfunded amounts on ongoing development projects and $100.8 million and $121.7 million of unfunded amounts on capital improvement projects and development projects that have commenced rent, as of December 31, 2020 and December 31, 2019, respectively.

(3) Adjustment to reflect our share of our joint ventures' gross assets.

(4) Includes cash available on-hand plus cash generated from activities subsequent to period-end including proceeds from new debt, equity or loan repayments.

(5) Proforma total gross assets is total assets before accumulated depreciation/amortization and assumes all real estate commitments on new investments and unfunded amounts on development deals and commenced capital improvement projects are fully funded using cash on hand (if available). 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 commitments close and our other commitments are fully funded.

Pro Forma Total Gross Assets(Unaudited) (Amounts in thousands) December 31, December 31, 2020 2019 Total Assets $ 16,829,014 $ 14,467,331

Add: Real estate commitments on new 1,901,087 1,988,550 investments^(1) Unfunded amounts on development deals and commenced capital improvement projects^(2) 166,258 163,370

Accumulated depreciation and 833,529 570,042 amortization Incremental gross assets of our joint 1,287,077 563,911 ventures^(3) Proceeds from new debt and equity 1,479,961 927,990 subsequent to period-end Less: Cash used for funding the transactions (2,067,345 ) (2,151,920 ) above^(4) Pro Forma Total Gross Assets^(5) $ 20,429,581 $ 16,529,274

(1) The 2020 column reflects investments made in 2021, including theacquisition of 40 facilities in the United Kingdom on January 19, 2021. The2019 column reflects the acquisition of 30 facilities in the United Kingdomon January 8, 2020.

(2) Includes $65.5 million and $41.7 million of unfunded amounts on ongoingdevelopment projects and $100.8 million and $121.7 million of unfundedamounts on capital improvement projects and development projects that havecommenced rent, as of December 31, 2020 and December 31, 2019, respectively.

(3) Adjustment to reflect our share of our joint ventures' gross assets.

(4) Includes cash available on-hand plus cash generated from activitiessubsequent to period-end including proceeds from new debt, equity or loanrepayments.

(5) Pro forma total gross assets is total assets before accumulateddepreciation/amortization and assumes all real estate commitments on newinvestments and unfunded amounts on development deals and commenced capitalimprovement projects are fully funded using cash on hand (if available). Webelieve pro forma total gross assets is useful to investors as it provides amore current view of our portfolio and allows for a better understanding ofour concentration levels as our commitments close and our other commitmentsare fully funded.

Adjusted Revenues(Unaudited)(Amounts in thousands)For the Year EndedDecember 31, 2020Total revenues$

1,249,238

Revenue from real estate properties owned throughjoint venture arrangements105,758

Total adjusted revenues(1)$

1,354,996

(1) Adjusted revenues are total revenues adjusted for our pro rata portion of similar revenues in our real estate joint venture arrangements. We believe adjusted revenue is useful to investors as it provides a more complete view of revenue across all of our investments and allows for better understanding of our revenue concentration.

View source version on businesswire.com: https://www.businesswire.com/news/home/20210204005625/en/

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