Medical Properties Trust : Quarterly Supplemental 1Q 2026

Published: 2026-04-30 08:29:30 ET MPT

Published on 04/30/2026 at 08:29 am EDT

QUARTERLY SUPPLEMENTAL

1Q 2026

COMPANY OVERVIEW

Company Information 3

FINANCIAL INFORMATION

Reconciliation of Funds from Operations 6

Debt Summary 7

Debt Maturities and Debt Metrics 8

PORTFOLIO INFORMATION

Lease and Loan Maturity Schedule 9

Total Assets and Revenues

by Asset Type, Operator, State and Country 10

Rent Coverage 13

Summary of Active Developments

and Capital Addition Projects 15

FINANCIAL STATEMENTS

Consolidated Statements of Income 16 Consolidated Balance Sheets 17 Investments in Unconsolidated Real Estate

Joint Ventures 18

Investments in Unconsolidated Operating Entities 19

Appendix - Non-GAAP Reconciliations 20

FORWARD-LOOKING STATEMENTS

This press release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements can generally be identified by the use of forward-looking words such as "may", "will", "would", "could", "expect", "intend", "plan", "estimate", "target", "anticipate", "believe", "objectives", "outlook", "guidance" or other similar words, and include statements regarding our strategies, objectives, prospects, industry, asset sales, tenant conditions and anticipated rent. 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 risk that projected rents may be lower than anticipated or realized later than expected;

(ii) the risk that the timing, outcome and terms of Prospect's causes of action, that is collateral for DIP and other fundings that remain outstanding, will

not be consistent with those anticipated by the Company; (iii) our success in implementing our business strategy and our ability to identify, underwrite, finance, consummate and integrate acquisitions and investments; (iv) the risk that previously announced or contemplated property sales, loan repayments, and other capital recycling transactions do not occur as anticipated or at all; (v) the risk that MPT is not able to attain its leverage, liquidity and cost of capital objectives within a reasonable time period or at all; (vi) MPT's ability to obtain or modify the terms of debt financing on attractive terms or at all, as a result

of changes in interest rates and other factors, which may adversely impact our ability to pay down, refinance, restructure or extend our indebtedness, including extending our 2026 credit facility, as it becomes due, or pursue acquisition and development opportunities; (vii) the ability of our tenants, operators and borrowers to satisfy their obligations under their respective

contractual arrangements with us; (viii) the ability of our tenants and operators to operate profitably and generate positive cash flow, remain solvent, comply with applicable laws, rules and regulations in the operation of our properties, to deliver high-quality services, to attract and retain qualified personnel and to attract patients; (ix) the risk that we are unable to monetize our investments in certain tenants at full value within a reasonable time period or at all; (x) the risk that the operations of our tenants will be negatively impacted by changes to

Medicaid funding introduced by the OBBBA; and (xi) the risks and uncertainties of litigation or other regulatory proceedings.

The risks described above are not exhaustive and additional factors could adversely affect our business and financial performance, including the risk factors discussed under the section captioned "Risk Factors" in our most recent Annual Report on Form 10-K and our Quarterly Reports on Form 10-Q, and as may be updated in our other filings with the SEC. Forward-looking statements are inherently uncertain and actual performance or outcomes may vary materially from any forward-looking statements and the assumptions on which those statements are based. Readers are cautioned not to 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.

Pictured above: Carrollton Springs - Operated by Lifepoint Behavioral Health - Carrollton Springs, Texas.

On the cover: IMED Alicante - Leased by IMED Hospitales - Alicante, Spain.

COMPANY OVERVIEW

edical Properties Trust, Inc. is a self-advised real estate investment trust formed in 2003

to acquire and develop net-leased hospital facilities. From its inception in Birmingham, Alabama, the Company has grown to become one of the world's largest owners of hospital real estate.

MPT's financing model facilitates acquisitions and recapitalizations and allows operators of hospitals to unlock the value of their real estate assets to fund facility improvements, technology upgrades and other investments in operations.

As of March 31, 2026.

378

properties

~38,000

operators

hospital beds

U.S. states

countries

MPT Officers

Edward K. Aldag, Jr.

R. Steven Hamner

J. Kevin Hanna Rosa H. Williams Larry H. Portal Charles R. Lambert

R. Lucas Savage

Chairman, President and Chief Executive Officer Executive Vice President and Chief Financial Officer

Senior Vice President, Controller and Chief Accounting Officer Senior Vice President of Operations and Secretary

Senior Vice President, Senior Advisor to the CEO Senior Vice President of Finance and Treasurer

Vice President, Head of Global Acquisitions

Board of Directors

Edward K. Aldag, Jr.

G. Steven Dawson

R. Steven Hamner Caterina A. Mozingo Emily W. Murphy Elizabeth N. Pitman

D. Paul Sparks, Jr. Michael G. Stewart

C. Reynolds Thompson, III

Corporate Headquarters

Medical Properties Trust, Inc.

10500 Liberty Parkway

Birmingham, AL 35242

(205) 969-3755 | (205) 969-3756 (fax)

MPT.com

INVESTOR RELATIONS

Contact

Charles Lambert, Senior Vice President of Finance and Treasurer

(205) 397-8897 [email protected]

Transfer

Agent

Equniti Trust Company, LLC 28 Liberty Street, Floor 53 New York, NY 10005

https://equiniti.com/us

Stock Exchange Listing and Trading Symbol

New York Stock Exchange (NYSE): MPT

Pictured above: Hackensack Meridian Mountainside Medical Center - Newark, New Jersey.

FINANCIAL INFORMATION

RECONCILIATION OF NET INCOME (LOSS) TO FUNDS FROM OPERATIONS

(Unaudited)

(Amounts in thousands, except per share data)

March 31, 2026

March 31, 2025

For the Three Months Ended

$ 32,827

(461)

$ (118,275)

(117)

$ 32,366

$ (118,392)

85,882

76,891

2,016

(8,059)

9,037

65,683

$ 129,301

$ 16,123

10,469

13,898

1,632

10,047

(8,462)

9,527

(5,568)

26,609

(45,155)

1,102

3,796

$ 82,217

$ 81,102

FFO INFORMATION:

Net income (loss) attributable to MPT common stockholders

Participating securities' share in earnings

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

Depreciation and amortization Loss (gain) on sale of real estate Real estate impairment charges Funds from operations

Other impairment charges, net Litigation, bankruptcy and other costs

Share-based compensation (fair value adjustments) (A)

Non-cash fair value adjustments Tax rate changes and other

Debt refinancing and unutilized financing costs

Normalized funds from operations

Certain non-cash and related recovery information:

Share-based compensation (A)

9,035

8,138

Debt costs amortization

7,547

6,006

Non-cash rent and interest revenue (B)

348

Cash recoveries of non-cash rent and interest revenue (C)

210

526

Straight-line rent revenue from operating and finance leases

(36,479)

(42,619)

$ 0.05

$ (0.20)

0.15

0.13

(0.01)

0.02

0.11

$ 0.22

$ 0.03

0.02

(0.01)

0.02

(0.01)

0.04

(0.08)

0.01

$ 0.14

PER DILUTED SHARE DATA:

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

Depreciation and amortization Loss (gain) on sale of real estate Real estate impairment charges Funds from operations

Other impairment charges, net Litigation, bankruptcy and other costs

Share-based compensation (fair value adjustments) (A)

Non-cash fair value adjustments Tax rate changes and other

Debt refinancing and unutilized financing costs

Normalized funds from operations

Certain non-cash and related recovery information:

Share-based compensation (A)

0.02

0.01

Debt costs amortization

0.01

Non-cash rent and interest revenue (B)

Cash recoveries of non-cash rent and interest revenue (C)

Straight-line rent revenue from operating and finance leases

(0.06)

(0.07)

Notes:

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

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

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

Total share-based compensation expense for GAAP purposes is $0.6 million and $17.7 million for the three months ended March 31, 2026 and 2025, respectively (including certain awards that are to be settled in cash). Cash-settled awards are typically recorded in accordance with GAAP at fair value and measured at each balance sheet date until settlement. The resulting fluctuations, which are primarily driven by changes in our stock price rather than operational performance, can introduce significant volatility in our earnings. To enhance comparability and provide a more stable view of performance over time, NFFO reflects an $(8.5) million and $9.5 million adjustment in the three months ended March 31, 2026 and 2025, respectively, to arrive at total share-based compensation expense using grant date fair value for all awards (including cash-settled awards) of $9.0 million and $8.1 million for the three months ended March 31, 2026 and 2025, respectively.

Includes revenue accrued during the period but not received in cash, such as deferred rent, payment-in-kind ("PIK") interest or other accruals.

Includes cash received to satisfy previously accrued non-cash revenue, such as the cash receipt of previously deferred rent or PIK interest.

DEBT SUMMARY

Debt Instrument

Rate Type

Rate

Balance

2026 Secured Credit Facility Revolver(A)(B)

Variable

5.026%

665,577

2027 Secured Term Loan

Variable

6.018%

200,000

0.993% Notes Due 2026 (€500M)(B)

Fixed

0.993%

577,650

5.000% Notes Due 2027

Fixed

5.000%

1,400,000

3.692% Notes Due 2028 (£600M)(B)

Fixed

3.692%

793,620

4.625% Notes Due 2029

Fixed

4.625%

900,000

3.375% Notes Due 2030 (£350M)(B)

Fixed

3.375%

462,945

3.500% Notes Due 2031

Fixed

3.500%

1,300,000

7.000% Secured Notes Due 2032 (€1B)(B)

Fixed

7.000%

1,155,300

8.500% Secured Notes Due 2032

Fixed

8.500%

1,500,000

2034 Secured GBP Term Loan (£631M)(B)

Fixed

6.877%

835,126

9,790,218

Debt issuance costs and discount

(127,559)

Weighted average rate 5.363%

9,662,659

Variable 9%

Fixed

91%

As part of our Credit Facility amendment on February 13, 2025, we provided notice to extend the maturity to June 30, 2027, subject to the satisfaction of certain other conditions. $200 million was repaid on April 1, 2026.

Non-USD denominated debt converted to U.S. dollars at March 31, 2026.

DEBT MATURITIES

Year

Senior Notes

Term Loans/Revolver

Total Debt

% of Total

2026

$ 577,650

$ 665,577

(A)

$ 1,243,227

12.7%

2027

1,400,000

200,000

1,600,000

16.4%

2028

793,620

8.1%

2029

900,000

9.2%

2030

462,945

4.7%

2031

1,300,000

13.3%

2032

2,655,300

27.1%

2033

2034

835,126

8.5%

Totals

$ 8,089,515

$ 1,700,703

$ 9,790,218

100.0%

DEBT BY LOCAL CURRENCY

Senior Notes

Term Loans/Revolver

Total Debt

% of Total

United States dollars

5,100,000

685,000

5,785,000

59.1%

British pound sterling

1,256,565

835,126

2,091,691

21.4%

Euros

1,732,950

115,530

1,848,480

18.9%

Swiss francs

65,047

0.6%

Totals

$ 8,089,515

$ 1,700,703

$ 9,790,218

100.0%

DEBT METRICS (B)

Adjusted Net Debt to Annualized EBITDAre Ratios:

Adjusted Net Debt

Adjusted Annualized EBITDAre

For the Three Months Ended March 31, 2026

8,693,633

934,688

Adjusted Net Debt to Adjusted Annualized EBITDAre Ratio 9.3x

8,693,633

932,660

Adjusted Net Debt

Transaction Adjusted Annualized EBITDAre

Unsecured Debt Secured Debt

Total Debt

Total Gross Assets(C)

$ 5,434,215

4,356,003

$ 9,790,218

$ 16,475,959

Financial Leverage

59.4%

Interest Coverage Ratio:

Interest Expense

Capitalized Interest

$ 133,330

2,179

Debt Costs Amortization

(6,983)

Total Interest

Adjusted EBITDAre

$ 128,526

$ 233,672

Adjusted Interest Coverage Ratio

1.8x

Adjusted Net Debt to Transaction Adjusted Annualized EBITDAre Ratio 9.3x Leverage Ratio:

As part of our Credit Facility amendment on February 13, 2025, we provided notice to extend the maturity to June 30, 2027, subject to the satisfaction of certain other conditions.

Not intended to reflect covenants per debt agreements.

Total Gross Assets equals total assets plus real estate accumulated depreciation and amortization. See appendix for reconciliation of Non-GAAP financial measures.

(As of March 31, 2026)

($ amounts in thousands)

Years of Maturities(B)

Total Properties(C)

Base Rent/Interest(D)

Percentage of Total Base Rent/Interest

2026

$ 234

0.0%

2027

3,782

0.3%

2028

7,981

0.7%

2029

16,422

1.5%

2030

7,301

0.7%

2031

4,925

0.4%

2032

62,251

5.6%

2033

6,201

0.6%

2034

21,343

1.9%

2035

27,002

2.4%

Thereafter

302

962,740

85.9%

364

$ 1,120,182

100.0%

Percentage of total base rent/interest

85.9%

5.6%

0.0%

0.3%

0.7%

1.5%

0.7%

0.4%

0.6%

1.9%

2.4%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

(A) Schedule includes leases and mortgage loans and related terms as of March 31, 2026.

(B) Lease/Loan expiration is based on the fixed term of the lease/loan and does not factor in potential renewal or other options provided for in our agreements.

(C) Reflects all properties, including those that are part of joint ventures, except vacant properties (less than 1% of total assets), facilities that are under development, and transitioning properties.

(D) Represents base rent/interest income contractually owed per the lease/loan agreements on an annualized basis as of period end (including foreign currency exchange rates) but does not include tenant recoveries, additional rents and other lease-related adjustments to revenue (i.e., straight-line rents and deferred revenues), or any reserves or write-offs.

(March 31, 2026)

($ amounts in thousands)

Asset Types

Properties

Total Assets(A)

Percentage of Total Assets

Q1 2026

Revenues

Percentage of Q1 2026 Revenues

General Acute Care Hospitals

162

$ 8,673,783

58.8%

$ 156,194

62.0%

Behavioral Health Facilities

2,407,964

16.3%

55,575

22.0%

Post Acute Care Facilities

128

1,668,629

11.3%

38,370

15.2%

Freestanding ER/Urgent Care Facilities

101,423

0.7%

1,926

0.8%

Other

1,910,878

12.9%

Total

378

$ 14,762,677

100.0%

$ 252,065

100.0%

TOTAL ASSETS BY ASSET TYPE TOTAL REVENUES BY ASSET TYPE

11%

59%

16%

15%

22%

62%

13% 1%

General Acute Care Hospitals Behavioral Health Facilities Post Acute Care Facilities

Freestanding ER/Urgent Care Facilities Other

13%

60%

12%

DOMESTIC ASSETS BY ASSET TYPE 14%

General Acute Care Hospitals Behavioral Health Facilities Post Acute Care Facilities

Freestanding ER/Urgent Care Facilities

DOMESTIC REVENUES BY ASSET TYPE 1%

Other

22%

17%

60%

Note: Investments in operating entities are allocated pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

(A) Reflects total assets on our consolidated balance sheets.

Largest Individual

Operators Facility as a Percentage of Total Assets(A)

Circle Health

1.3%

Priory Group

0.9%

Healthcare Systems of America

1.8%

Swiss Medical Network

1.8%

Lifepoint Behavioral Health

0.5%

46 operators

1.6%

Largest Individual Facility Investment is Less Than 2% of MPT Investment Portfolio

(March 31, 2026)

COMPREHENSIVE PROPERTY-LEVEL UNDERWRITING FRAMEWORK

MPT invests in real estate, not the consolidated financial performance of its tenants. Each facility is underwritten for characteristics that make the infrastructure attractive to any experienced, competent operator - not just the current tenant. If we have underwritten these correctly, then coupled with our absolute net master lease structure, our real estate will be attractive to a replacement operator, should we find it necesssary to transition. Such underwriting characteristics include:

(March 31, 2026)

Operators

Properties

Total Assets(A)

Percentage of Total Assets

Q1 2026

Revenues

Circle Health

$ 2,069,009

14.0%

$ 54,961

Priory Group

1,273,725

8.6%

27,496

Healthcare Systems of America

1,209,459

8.2%

17,406

Swiss Medical Network

868,978

5.9%

991

Lifepoint Behavioral Health

806,344

5.5%

21,346

MEDIAN

687,771

4.6%

9,022

Ernest Health

615,836

4.2%

19,231

NOR Healthcare Systems

528,525

3.6%

Lifepoint Health

453,236

3.1%

15,434

Ramsay Health Care

395,899

2.7%

6,797

41 operators

127

3,943,017

26.7%

79,381

Other

1,910,878

12.9%

Total

378

$ 14,762,677

100.0%

$ 252,065

($ amounts in thousands)

Demographics and Market

Competition

Percentage of Q1 2026 Revenues

(A) Reflects total assets on our consolidated balance sheets.

21.8%

10.9%

6.9%

0.4%

8.5%

3.6%

7.6%

-6.1%

2.7%

31.5%

100.0%

(March 31, 2026)

($ amounts in thousands)

U.S. States and Other Countries

Properties

Total Assets(A)

Percentage of Total Assets

Q1 2026

Revenues

Percentage of Q1 2026 Revenues

Texas

$ 1,403,311

9.5%

$ 27,015

10.7%

California

1,024,998

7.0%

15,324

6.1%

Florida

832,712

5.6%

11,308

4.5%

Arizona

329,471

2.2%

9,496

3.8%

Ohio

317,842

2.2%

6,507

2.6%

25 Other States

2,422,158

16.4%

65,211

25.8%

Other

1,046,367

7.1%

United States

154

$ 7,376,859

50.0%

$ 134,861

53.5%

United Kingdom

$ 4,084,982

27.7%

$ 96,396

38.2%

Switzerland

868,978

5.9%

991

0.4%

Germany

761,421

5.1%

11,265

4.5%

Spain

306,718

2.1%

3,291

1.3%

Other Countries

499,208

3.4%

5,261

2.1%

Other

864,511

5.8%

International

224

$ 7,385,818

50.0%

$ 117,204

46.5%

Total

378

$ 14,762,677

100.0%

$ 252,065

100.0%

Note: Investments in operating entities are allocated pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

(A) Reflects total assets on our consolidated balance sheets.

TOTAL ASSETS BY COUNTRY TOTAL REVENUES BY COUNTRY

38%

54%

50%

28%

1% 2%

ASSETS BY U.S. STATE REVENUES BY U.S. STATE

10%

Texas

California

11%

16%

Florida Arizona

Ohio

26%

25 Other States

2% 2%

Other

PORTFOLIO INFORMATION

YoY and SEQUENTIAL QUARTER COMPARISONS BY PROPERTY TYPE

3.50x

EBITDARM Rent Coverage

3.0x

2.9x

2.5x

2.6x

2.5x

2.4x

2.2x

2.0x

1.9x

1.7x

1.5x

3.00x

2.50x

2.00x

1.50x

1.00x

0.50x

0.00x

General Acute Care Hospitals Post Acute Care Facilities (C)

Behavioral Health Facilities (D)

Total Portfolio

58.8%

11.3%

% of Total Assets(E)

16.3%

86.4%

Notes: All data presented is on a trailing twelve month ("TTM") basis. For properties acquired in the preceding twelve months, data is for the period between MPT acquisition and December 31, 2025.

EBITDARM is facility-level earnings before interest, taxes, depreciation, amortization, rent and management fees. EBITDARM includes normal GAAP expensed maintenance and repair costs. EBITDARM does not give effect for capitalized expenditures that extend the life or improve the facility and equipment to increase revenues at the facility. The majority of these types of capital expenditures are financed and do not have an immediate cash impact. MPT's rent has priority and is not subordinate to capitalized expenses. In addition, EBITDARM does not represent property net income or cash flows from operations and should not be considered an alternative to those indicators. EBITDARM figures utilized in calculating coverages presented are based on financial information provided by MPT's tenants. Where MPT owns assets through unconsolidated joint ventures, MPT's proportionate share of EBITDARM and Rent is included. MPT has not independently verified this information, but has no reason to believe this information is inaccurate in any material respect. TTM Coverages are calculated based on actual, unadjusted EBITDARM results as presented in tenant financial reporting and cash rent paid to MPT, except as noted below.

- EBITDARM figures for California hospitals include amounts expected to be received under the Hospital Quality Assurance Fee ("HQAF") Program 8. The HQAF amounts are based on the current payment model from the California Hospital Association which was approved by CMS on December 19, 2023.

General Acute Care coverages, Behavioral Health coverages and Total Portfolio coverages do not include operators whose data is not required, available, or re-tenanted during 2024-2025.

Pos-t Acute Care Facilities property type includes both Inpatient Rehabilitation Hospitals and Long Term Acute Care Hospitals.

We have revised our allocated central costs for Priory Group to better reflect retrospective, recent, and future facility-level actual performance. On a retrospective basis, these changes reduce trailing

twelve month coverage by 40 bps for Priory Group and 20 bps for the Behavioral Health property type, with no impact on the consolidated portfolio.

Reflects percentage of total assets on March 31, 2026 balance sheet.

TOTAL PORTFOLIO TTM EBITDARM RENT COVERAGE

EBITDARM RENT COVERAGE: OPERATORS WITH PROPERTY-LEVEL REPORTING

Tenant Net Investment Primary Property Type TTM EBITDARM Rent Coverage(B)

(in thousands)(A)

Priory Group

1,227,881

Behavioral

1.6x

MEDIAN

659,360

Post Acute

2.3x

Ernest Health

615,836

Post Acute

2.5x

Swiss Medical Network

595,630

General Acute

1.9x

Aspris Children's Services

242,414

Behavioral

2.1x

Surgery Partners

223,470

General Acute

5.8x

Pipeline Health System

194,900

General Acute

2.8x

Vibra Healthcare

152,198

Post Acute

3.0x

Prime Healthcare

155,807

General Acute

2.4x

IMED Hospitales

131,279

General Acute

1.9x

Other Reporting Tenants

573,928

Various

2.9x

Total

4,772,703

2.5x

Tenant Net Investment Primary Property Type TTM EBITDARM Rent Coverage (in thousands)(A)

International Operator 1

2,023,378

General Acute

2.6x

Domestic Operator 1

453,236

General Acute

2.0x

Domestic Operator 2

259,010

General Acute

2.6x

Domestic Operator 3

806,344

Behavioral

1.2x

Domestic Operator 4

78,944

General Acute

9.4x

Total

3,620,912

2.5x

PROPERTY-LEVEL REPORTING NOT REQUIRED AND/OR NOT AVAILABLE

Tenant

Net Investment

(in thousands)(A)

Primary Property Type

Comments

Healthcare Systems of America $ 1,115,328 General Acute

Ramsay Health Care 395,899 General Acute

U.S. hospital operator with eight community hospitals across

NOR Healthcare Systems

505,181

General Acute

U.S. hospital operator with six general acute hospitals in California

three states

One of the largest healthcare operators in the world; Parent guaranty; Investment grade-rated

Pihlajalinna 215,630 General Acute One of Finland's leading providers of social and health services

CommonSpirit Health 169,269 General Acute

One of the largest nonprofit healthcare operators in the U.S.; Investment grade-rated

Quorum Health

117,660

General Acute

U.S. hospital operator with eleven community hospitals across nine states

HonorHealth 131,129 General Acute

One of Arizona's largest nonprofit healthcare systems;

Investment grade-rated

Saint Luke's - Kansas City

117,973

General Acute

U.S. hospital operator with investment grade-rating and largest nonprofit healthcare organization in Missouri

NHS 85,482 General Acute Single-payor government entity in UK

Select Medical

52,664

Post Acute

Publicly-traded and one of the largest post acute operators in the U.S.

Insight Health 48,925 General Acute

U.S. hospital operator with eight medical centers across four

states

NeuroPsychiatric Hospitals

25,563

Behavioral

U.S. hospital operator with nine behavioral health hospitals; Parent guaranty

Community Health Systems 23,987 General Acute Publicly-traded U.S. hospital operator

Tenor Health 19,215 General Acute U.S. hospital operator focused on turnaround opportunities

AHRK Holdings 7,537 General Acute U.S. hospital operator with two community hospitals in Texas

Total $ 3,031,442

Above data represents approximately 91% of MPT Total Real Estate Investment

Notes: All data presented is on a trailing twelve month ("TTM") basis. For properties acquired in the preceding twelve months, data is for the period between MPT acquisition and December 31, 2025.

Investment figures exclude equity investments, non-real estate loans, freestanding ER/urgent care facilities, and facilities under development.

General Acute Care coverages, Behavioral Health coverages and Total Portfolio coverages do not include operators whose data is not required, available, or re-tenanted during 2024-2025.

SUMMARY OF ACTIVE DEVELOPMENTS AND CAPITAL ADDITION PROJECTS AS OF March 31, 2026(A)

(Amounts in thousands)

Operator

Location

Commitment

Costs Incurred as of March 31, 2026

Cost Remaining

Estimated Construction Completion Date

IMED

Spain

$ 42,780

$ 42,594

$ 186

2Q26

IMED

Spain

65,952

49,820

16,132

4Q26

Healthcare Systems of America

Florida

43,500

4,421

39,079

2Q27

NOR Healthcare Systems

California

24,333

289

24,044

3Q27

Other Various

554

210

344

2Q26

$ 177,119

$ 97,334

$ 79,785

(A) In addition to the above projects, the costs of which will be included in lease bases upon which the lessees will pay rent, we are constructing two hospitals for which there is no presently-identified lessee; these projects were both originally planned to be operated by a former tenant. We have completed construction to the stage where the building is "weathered in" and environmentally secure so as to physically protect our investment while we actively market the hospitals for sale or lease. As of March 31, 2026, we estimate that the cost of additional construction that we believe will be more efficient if completed in the near term (such as electing to accelerate completion of a parking structure at one hospital), approximates between $5 million and $10 million. If we agree to lease terms for any prospective tenant, we expect such terms will include construction specifications of such prospective lessee, and we may elect to fund such completion for addition to the final lease base upon which we would be paid rent. Alternatively, we may elect to sell one or both of the facilities, in which case we would not expect to incur material additional costs.

(Unaudited)

(Amounts in thousands, except per share data)

March 31, 2026

March 31, 2025

For the Three Months Ended

REVENUES

Rent billed

197,520

165,190

Straight-line rent

34,196

40,127

Income from financing leases

10,064

9,905

Interest and other income

10,285

8,577

Total revenues

252,065

223,799

EXPENSES

Interest

133,330

115,801

Real estate depreciation and amortization

69,717

64,572

Property-related(A)

9,940

7,035

General and administrative

32,205

41,911

Total expenses

245,192

229,319

OTHER (EXPENSE) INCOME

(Loss) gain on sale of real estate

(790)

8,059

Real estate and other impairment charges, net

(19,032)

(76,102)

Earnings from equity interests

15,739

13,986

Debt refinancing and unutilized financing costs

(3,796)

Other (including fair value adjustments on securities)

(2,505)

(45,206)

Total other expense

(6,588)

(103,059)

Income (loss) before income tax

(108,579)

Income tax benefit (expense)

(9,437)

Net income (loss)

(118,016)

Net income attributable to non-controlling interests

(259)

Net income (loss) attributable to MPT common stockholders

$ (118,275)

EARNINGS PER COMMON SHARE - BASIC AND DILUTED

Net income (loss) attributable to MPT common stockholders

0.05

(0.20)

WEIGHTED AVERAGE SHARES OUTSTANDING - BASIC

597,715

600,594

WEIGHTED AVERAGE SHARES OUTSTANDING - DILUTED

597,715

600,594

DIVIDENDS DECLARED PER COMMON SHARE

0.09

0.08

285

32,822

33,107

(280)

$ 32,827

(A) Includes $1.9 million and $1.9 million of ground lease and other expenses (such as property taxes and insurance) paid directly by us and reimbursed by our tenants for the three months ended March 31, 2026 and 2025, respectively.

March 31, 2026

December 31, 2025

(Unaudited)

(A)

$ 12,109,743

$ 12,205,687

381,589

421,684

124,479

123,651

12,615,811

12,751,022

(1,713,282)

(1,663,056)

10,902,529

11,087,966

425,001

540,859

17,981

19,210

904,075

881,452

1,390,385

1,399,777

320,928

322,179

237,957

186,292

563,821

564,040

$ 14,762,677

$ 15,001,775

$ 9,662,659

$ 9,697,835

433,165

549,105

18,580

19,289

102,514

128,297

10,216,918

10,394,526

598

597

8,577,846

8,573,396

(4,157,439)

(4,136,011)

123,700

168,213

4,544,705

4,606,195

1,054

4,545,759

4,607,249

$ 14,762,677

$ 15,001,775

(Amounts in thousands, except per share data)

ASSETS

Real estate assets

Land, buildings and improvements, intangible lease assets, and other Investment in financing leases

Mortgage loans

Gross investment in real estate assets Accumulated depreciation and amortization Net investment in real estate assets

Cash and cash equivalents Interest and rent receivables Straight-line rent receivables

Investments in unconsolidated real estate joint ventures Investments in unconsolidated operating entities

Other loans Other assets

Total Assets

LIABILITIES AND EQUITY

Liabilities

Debt, net

Accounts payable and accrued expenses Deferred revenue

Obligations to tenants and other lease liabilities

Total Liabilities

Equity

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

Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding - 597,715 shares at March 31, 2026 and 597,008 shares at December 31, 2025

Additional paid-in capital Retained deficit

Accumulated other comprehensive income

Total Medical Properties Trust, Inc. stockholders' equity Non-controlling interests

Total Equity

Total Liabilities and Equity

(A) Financials have been derived from the prior year audited financial statements.

INVESTMENTS IN UNCONSOLIDATED REAL ESTATE JOINT VENTURES

(As of and for the three months ended March 31, 2026) (Unaudited)

($ amounts in thousands)

Gross real estate Cash

Accumulated depreciation and amortization

Other assets

MEDIAN(B)

2,060,746 $

25,792

(363,739)

123,213

Swiss Medical Network(C)

1,874,016

1,170

(248,067)

93,000

CommonSpirit(D)

1,479,521

3,667

-8,567

Policlinico di Monza(E)

193,649

17,733

(44,851)

4,268

Hospitales(F)

391,148

1,664

(53,331)

11,284

Total

5,999,080 $

50,026

(709,988)

240,332

MPT Pro Rata Share

2,988,643

24,251

(402,337)

136,213

Total Assets

$ 1,846,012 $ 1,720,119 $ 1,491,755 $

170,799 $

350,765 $ 5,579,450 $ 2,746,770

$ 778,705 $

119,067

948,240 (A)

706,175 $

144,795

869,149

770,000 $

46,029

675,726

- $

(207)

171,006

150,066 $ 2,404,946 $ 1,145,220

85,815 395,499 211,165

114,884 2,779,005 1,390,385

$ 1,846,012 $ 1,720,119 $ 1,491,755 $

170,799 $

350,765 $ 5,579,450 $ 2,746,770

Debt (third party) Other liabilities

Equity and shareholder loans

Total Liabilities and Equity

MPT share of real estate joint venture

50% 70%

25%

50%

45%

Total

474,120 $

609,795 $

169,269 $

85,503 $

51,698

MEDIAN(B)

36,697

Swiss Medical

Network(C)

CommonSpirit(D)

Policlinico di Monza(E)

3,904

Hospitales(F)

4,912

Total

Total revenues

Other expenses (income): Property-related

Interest

Real estate depreciation and amortization General and administrative

Fair value adjustments Loss on sale of real estate Income and other taxes

Non-controlling interest expense

24,341

24,865

94,719

MPT Pro Rata Share

$ 45,818

Total other expenses (income)

947

20,988

12,304

722

-1,668

36,629

1,570

3,623

10,616

508

-1,747

126

18,190

13,056

-(28,587)

-69

(15,457)

1,117

-1,138

(23)

2,232

649

583

2,243

-361

3,856

4,288

38,250

26,301

1,227

(28,587)

1,747

2,155

45,450

2,427

16,569

15,178

715

(7,161)

1,226

1,085

30,056

Net income

68 $

6,151 $

40,322 $

1,672 $

1,056 $

49,269 $

15,762

MPT share of real estate joint venture

50%

70%

25%

50%

45%

Earnings from equity interests

34 $

4,316 $

10,101 $

836 $

475

$ 15,762

$ 1,390,385

(G)

Includes a €309 million loan from both shareholders.

MPT managed joint venture of 71-owned German facilities that are fully leased.

Represents ownership in Infracore, which owns and leases 18 Switzerland facilities. We also have one Infracore facility currently under development.

Represents ownership in five Utah facilities that are fully leased. The joint venture elected to apply specialized accounting and reporting for investment companies under Topic 946, which measures the underlying investments at fair value. For this quarter, our share of the joint venture's favorable fair value adjustment was $7.2 million, primarily related to real estate.

Represents ownership in eight Italian facilities that are fully leased.

Represents ownership in two Spanish facilities that are fully leased.

Excludes $23,000 of amortization of equity investment costs.

INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES

(Amounts in thousands)

OPERATING ENTITY INVESTMENT FRAMEWORK

MPT's hospital expertise and comprehensive underwriting process allows for opportunistic investments in hospital operations.

Passive investments typically needed in order to acquire the larger real estate transactions.

Cash payments go to previous owner and not to the tenant, with limited exceptions.

Operators are vetted as part of our overall underwriting process.

Potential for outsized returns and organic growth.

Certain of these investments entitle us to customary minority rights and protections.

Typically, no additional operating loss exposure beyond our investment.

Proven track record of successful investments, including Ernest Health, Capella Healthcare and Springstone.

Investment as of

March 31, 2026

Operator

Ownership Interest

Structure

Swiss Medical Network

$ 195,838

8.9% Includes our passive equity ownership interest, along with a CHF 37 million loan as part of a syndicated loan facility.

Aevis

63,346

4.6% Includes our passive equity ownership interest in Aevis, a public healthcare investment company. Our original investment of CHF 47 million is marked-to-market quarterly.

Priory Group

45,844

9.2% In order to close the 2021 acquisition of 35 facilities, we made an investment in Priory, proceeds of which

were paid to the former owner.

Aspris

15,900

9.2%

Includes our passive equity ownership interest in Aspris, a spin-off of Priory's education and children's services line of business.

Total

$ 320,928

INVESTMENTS IN UNCONSOLIDATED OPERATING ENTITIES AS A PERCENTAGE OF TOTAL ASSETS

98%

APPENDIX - NON-GAAP RECONCILIATIONS

(Unaudited)

(Amounts in thousands)

For the Three Months Ended

March 31, 2026

ADJUSTED EBITDAre RECONCILIATION

Net income

$ 33,107

Interest

133,330

Income tax

(32,822)

Depreciation and amortization

73,348

Loss on sale of real estate

790

Real estate impairment charges

9,037

from unconsolidated real estate joint ventures(A)

9,776

1Q 2026 EBITDAre

$ 226,566

Share-based compensation

573

Other impairment charges, net

10,469

Litigation, bankruptcy and other costs

1,632

Non-cash fair value adjustments

(5,568)

Annualized

1Q 2026 Adjusted EBITDAre

$ 233,672 $ 934,688

Adjustments for mid-quarter investment activity(B)

(507)

1Q 2026 Transaction Adjusted EBITDAre

$ 233,165 $ 932,660

ADJUSTED NET DEBT RECONCILIATION

Total debt at March 31, 2026

9,662,659

Less: Cash at March 31, 2026

(425,001)

Less: Cash funded for development and capital

addition projects at March 31, 2026(C)

(544,025)

Adjusted Net Debt

$ 8,693,633

Add back:

Adjustment to reflect MPT's share of unlevered EBITDAre

Investors and analysts following the real estate industry utilize net debt (debt less cash) to EBITDAre as a measurement of leverage that shows how many years it would take for us to pay back our debt, assuming net debt and EBITDAre are held constant. In our calculation, we start with EBITDAre, as defined by Nareit, which is net income before interest expense, income tax expense, depreciation and amortization, losses/gains on disposition of depreciated property, impairment losses, and adjustments to reflect our share of EBITDAre from unconsolidated real estate joint ventures. We then adjust EBITDAre for non-cash share-based compensation, non-cash fair value adjustments and other items that would make comparison of our operating results with prior periods and other companies more meaningful, to derive Adjusted EBITDAre. We adjust net debt for cash funded for building improvements in progress and construction in progress for which we are not yet receiving rent (but will generate a return once completed) to derive Adjusted Net Debt. We adjust Adjusted EBITDAre for the effects from investments and capital transactions that were completed during the period, assuming such transactions were consummated/fully funded as of the beginning of the period to derive Transaction Adjusted EBITDAre. Although non-GAAP measures, we believe Adjusted Net Debt, Adjusted EBITDAre, and Transaction Adjusted EBITDAre are useful to investors and analysts as they allow for a more current view of our credit quality and allow for the comparison of our credit strength between periods and to other real estate companies without the effect of items that by their nature are not comparable from period to period.

Includes only the unlevered portion of our share of EBITDAre from unconsolidated real estate joint ventures, as we have excluded any net debt from our unconsolidated real estate joint ventures in the Adjusted Net Debt line. We believe this adjustment is needed to appropriately reflect the relationship between EBITDAre and net debt.

Reflects a full quarter impact from our mid-quarter investments, disposals, and loan payoffs.

Reflects development and capital improvement projects that are in process and not yet generating a cash return.

Disclaimer

Medical Properties Trust Inc. published this content on April 30, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on April 30, 2026 at 12:28 UTC.