Medical Properties Trust

(Dollars in thousands)

United States:

Alabama · 2 · 791 · 6,162

Arizona · 8 · 37,519 · 328,873

Arkansas · 1 · 10,582 · 65,030

California · 17 · 69,157 · 977,890

Colorado · 3 · 10,746 · 102,549

Connecticut · 3 · 60 · 41,414

Florida · 6 · 21,696 · 834,940 · (B)

Idaho · 6 · 42,180 · 299,826

Indiana · 4 · 7,148 · 58,522

Iowa · 1 · 5,396 · 44,374

Kansas · 9 · 15,982 · 208,893 · (B)

Kentucky · 1 · 10,288 · 53,080

Louisiana · 5 · 6,060 · 106,713

Massachusetts · 2 · 436 · 244,824 · (D)

Michigan · 1 · 3,521 · 13,038

Missouri · 4 · 23,986 · 117,424

Montana · 1 · 2,049 · 19,134

New Jersey · 2 · 21,520 · 142,121

New Mexico · 2 · 5,271 · 50,519

North Carolina · 1 · 3,163 · 30,027

Ohio · 9 · 25,910 · 330,189 · (B)

Oklahoma · 1 · 7,082 · 6,855

Oregon · 1 · 12,588 · 80,539

Pennsylvania · 7 · 31,450 · 304,372

South Carolina · 5 · 17,174 · 123,512

Texas · 44 · 100,839 · 1,427,391 · (C)

Utah · 7 · 4,288 · 193,752 · (E)

Virginia · 2 · 2,940 · 15,728

Washington · 2 · 4,319 · 35,334

Wisconsin · 1 · 3,703 · 27,266

Wyoming · 3 · 10,034 · 89,174

Other assets · — · — · 1,072,900

Total United States · 161 · 517,878 · 7,452,365

International:

Colombia · 4 · 6,216 · 147,620

Germany · 85 · 42,686 · 751,806 · (E)

Italy · 8 · — · 86,091 · (E)

Portugal · 2 · 3,748 · 50,205

Spain · 9 · 12,599 · 302,323 · (D)(E)

Switzerland · 19 · 2,877 · 873,703 · (E)

United Kingdom · 92 · 373,279 · 4,184,188

Finland · 4 · 12,739 · 220,813

Other assets · — · — · 932,661

Total International · 223 · 454,144 · 7,549,410

Total · 384 · 972,022 · 15,001,775

Represents total assets at December 31, 2025.

Includes a facility that was vacant at December 31, 2025.

Includes a development project still under construction and facilities that were vacant at December 31, 2025.

Includes development project(s) still under construction at December 31, 2025.

For Germany, the U.S., Switzerland, Spain, and Italy, we own properties through five real estate joint venture arrangements and our share of revenues from these joint ventures is reflected in the "Earnings (loss) from equity investments" line of our consolidated statements of net income. However, the table below shows revenues earned from these joint venture arrangements:

TotalProperties · Total 2025 Revenues

(Dollars in thousands)

Germany · 71 · 70,614

U.S. · 5 · 24,733

Switzerland · 19 · 61,077

Spain · 2 · 7,463

Italy · 8 · 7,111

Total · 105 · 170,998

A breakout of our facilities at December 31, 2025 based on property type is as follows:

Number ofProperties · TotalSquareFootage · TotalLicensedBeds(A)

General acute care hospitals · 168 · 27,501,398 · 17,184

Behavioral health facilities · 68 · 3,067,544 · 4,238

Post acute care facilities · 128 · 13,788,289 · 17,109

FSERs · 20 · 170,642 · —

384 · 44,527,873 · 38,531

Reflects all properties, including those that are part of real estate joint ventures, except for our facilities that are under development.

The following table shows lease and loan expirations, assuming that none of the tenants/borrowers exercise any of their renewal options (dollars in thousands):

Total Lease and Loan Portfolio(1) · TotalLeases/Loans(2) · AnnualizedBaseRent/Interest(3) · % of TotalAnnualizedBaseRent/Interest · TotalSquareFootage · TotalLicensedBeds

2026 · 1 · 228 · — · 7,040 · —

2027 · 1 · 3,681 · 0.3 · 107,849 · 13

2028 · 7 · 17,746 · 1.5 · 1,946,588 · 559

2029 · 4 · 16,112 · 1.4 · 775,575 · 527

2030 · 10 · 7,128 · 0.6 · 309,615 · 84

2031 · 4 · 3,852 · 0.3 · 133,505 · 123

2032 · 21 · 60,495 · 5.2 · 1,067,663 · 743

2033 · 5 · 6,201 · 0.6 · 85,477 · 24

2034 · 8 · 62,889 · 5.5 · 1,968,674 · 1,345

2035 · 7 · 25,516 · 2.2 · 750,199 · 983

Thereafter · 301 · 950,848 · 82.4 · 34,793,831 · 33,402

Total · 369 · 1,154,696 · 100.0 · 41,946,016 · 37,803

Schedule includes leases and mortgage loans and related terms as of December 31, 2025.

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

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.

• MPT SWINDON LTD³²
• MPT WINCHESTER LTD³³
• MPT WORTHING LTD³⁴

• Our employees are responsible for all aspects of managing our portfolio of over 380 properties across nine countries, and our failure to effectively manage our properties along with any growth may adversely impact our financial condition and cash flows, which could negatively affect our ability to service our debt and make distributions.
• We have less experience with healthcare facilities located outside the U.S.
• We and our tenants have exposure to contingent rent escalators, which could impact profitability.
• Our business is highly competitive, and we may be unable to compete successfully.
• Many of our tenants have an option to purchase the facilities we lease to them, which could disrupt our operations.
• Merger and acquisition activity or consolidation in the healthcare industry may result in a change of control of, or a competitor’s investment in, one or more of our tenants or operators, which could have a material adverse effect on us.
• Our investments in joint ventures could be adversely affected by our lack of control, our partners’ failure to meet their obligations, and disputes with our partners.
• Increased scrutiny, politicization, and changing expectations from investors, employees, tenants, and other stakeholders regarding corporate responsibility and sustainability matters could adversely impact our reputation, tenant and employee acquisition and retention, and access to capital.
• FINANCING RISKS
• Our indebtedness could adversely affect our financial condition, and may otherwise adversely impact our business operations and our ability to make distributions to stockholders.
• Covenants in our debt instruments limit our operational flexibility, and a breach of these covenants could materially affect our financial condition and results of operations.
• Failure to hedge effectively against interest rate changes may adversely affect our results of operations and our ability to make distributions to our stockholders.
• The market price and trading volume of our common stock may be volatile and may decline regardless of our operating performance, and you may lose all or part of your investment.
• Future sales of common stock may adversely affect our stock price.
• Downgrades in our credit ratings could have a material adverse effect on our cost and availability of capital.
• Elevated interest rates may adversely affect the market price of our securities.
• Limited access to capital may restrict our growth.
• RISKS RELATING TO REAL ESTATE INVESTMENTS
• Our investments are, and are expected to continue to be, concentrated in a single industry, making us more vulnerable economically than if our investments were more diversified.
• The illiquidity of real estate investments could significantly impede our ability to respond to adverse changes in the performance of our facilities and harm our financial condition.
• Development and construction risks could adversely affect our ability to service our debt and make distributions to our stockholders.
• We may be subject to risks arising from future acquisitions of real estate.
• Our facilities may not achieve expected results, which may harm our results of operations and financial condition, as well as our ability to service our debt and make the distributions to our stockholders required to maintain our REIT status.
• We may suffer losses that are not covered by insurance or that are in excess of our insurance coverage limits.
• Capital expenditures for facility renovation may be greater than anticipated and may adversely impact rent payments by our tenants and our ability to service our debt and make distributions to our stockholders.
• Certain of our healthcare facilities are subject to property taxes that may increase in the future and adversely affect our business.
• As an owner and lessor of real estate, we are subject to risks under applicable environmental laws, the cost of compliance with which and any violation of which could materially adversely affect us.
• Our interests in facilities through ground leases expose us to the risk of loss of the facility upon breach or termination of the underlying ground lease, may limit our use of the facility, and may result in additional expenses to us if our tenants vacate the facility.
• RISKS RELATING TO THE HEALTHCARE INDUSTRY
• The continued pressure on healthcare reimbursement in the U.S. and other countries in which we do business, including shifts from fee-for-service reimbursement towards alternative payment models, other healthcare policy reforms, and government cost cutting measures, could adversely affect the profitability of our tenants and their ability to make payments to us.
• Significant regulation and loss of licensure or certification or failure to obtain licensure or certification could negatively impact our tenants' financial condition and results of operations and affect their ability to make payments to us.
• Our tenants are subject to fraud and abuse laws, the violation of which may jeopardize their ability to make payments to us and adversely affect their profitability.
• Certain of our lease arrangements may be subject to laws related to fraud and abuse or physician self-referrals.
• We may incur substantial capital expenditures to make our healthcare facilities suitable for tenants or compliant with applicable regulatory requirements.
• State certificate of need laws may adversely affect our development of facilities and the operations of our tenants.
• Regulatory restrictions on healthcare transactions involving REITs could adversely affect our business, results of operations, and financial condition.
• RISKS RELATING TO OUR ORGANIZATION AND STRUCTURE
• We depend on key personnel, the loss of any one of whom may threaten our ability to operate our business successfully.
• Pursuant to Maryland law, our charter and bylaws contain provisions that may have the effect of deterring changes in management and third-party acquisition proposals, which in turn could depress the price of our common stock or cause dilution.
• We rely on information technology in our operations, and any material failure, inadequacy, interruption, or security failure of our technology (or that of our third-party vendors) could harm our business.
• Unfavorable resolution of pending and future litigation, regulatory proceedings, or governmental inquiries could have a material adverse effect on our and our tenants' business, results of operations, financial condition, and reputation.
• Changes in accounting pronouncements could adversely affect us and the reported financial performance of our tenants.
• TAX RISKS
• Loss of our tax status as a REIT would have significant adverse consequences to us and the value of our common stock.
• Failure to make required distributions as a REIT would increase our tax burden.
• Complying with REIT requirements may cause us to forego otherwise attractive opportunities.
• If certain sale-leaseback transactions are not characterized by the Internal Revenue Service (“IRS”) or similar tax authorities internationally as “true leases,” we may be subject to adverse tax consequences.
• Transactions with TRSs may be subject to excise tax.
• Loans to our tenants could be characterized as equity, in which case our income from that tenant might not be qualifying income under the REIT rules and we could lose our REIT status.
• Certain transfers may generate prohibited transaction income, resulting in a penalty tax on gain attributable to the transaction.
• Changes in U.S. or foreign tax laws, regulations, including changes to tax rates, may adversely affect our results of operations.