##### Table of Contents



UNITED STATES SECURITIES AND EXCHANGE COMMISSION
 WASHINGTON, D.C. 20549
 FORM 10-Q
 þ
    
    QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 For the quarterly period ended September 30, 2010
 OR
 o
    
    TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 For
the transition period from __________ to __________
 Commission file number: 001-32559
 MEDICAL PROPERTIES TRUST, INC.
 (Exact Name of Registrant as Specified in Its Charter)
 MARYLAND
(State or other jurisdiction of 
incorporation or organization)
    
    20-0191742
(I. R. S. Employer
Identification No.)1000 URBAN CENTER DRIVE, SUITE 501
BIRMINGHAM, AL
(Address of principal executive offices)
    
    35242
(Zip Code)
 REGISTRANTS TELEPHONE NUMBER, INCLUDING AREA CODE: (205) 969-3755
 þ o
 o o
  Large accelerated filer o
Accelerated filer þ
Non-accelerated filer o(Do not check if a smaller reporting company)
Smaller reporting company o o þ




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##### 



MEDICAL PROPERTIES TRUST, INC.
QUARTERLY REPORT ON FORM 10-Q
FOR THE QUARTERLY PERIOD ENDED September 30, 2010
 Table of Contents
 PagePART I  FINANCIAL INFORMATION
    
    
    3Item 1 Financial Statements
    
    
    3Condensed Consolidated Balance Sheets at September 30, 2010 and December 31, 2009
    
    
    3Condensed Consolidated Statements of Income for the Three Months and Nine Months Ended September 30,
2010 and 2009
    
    
    4Condensed Consolidated Statements of Cash Flows for the Nine Months Ended September 30, 2010 and 2009
    
    
    5Notes to Condensed Consolidated Financial Statements
    
    
    6Item 2 Managements Discussion and Analysis of Financial Condition and Results of Operations
    
    
    13Item 3 Quantitative and Qualitative Disclosures about Market Risk
    
    
    21Item 4 Controls and Procedures
    
    
    21PART II  OTHER INFORMATION
    
    
    22Item 1 Legal Proceedings
    
    
    22Item 1A Risk Factors
    
    
    22Item 2 Unregistered Sales of Equity Securities and Use of Proceeds
    
    
    22Item 3 Defaults Upon Senior Securities
    
    
    22Item 4 (Removed and Reserved)
    
    
    22Item 5 Other Information
    
    
    22Item 6 Exhibits
    
    
    22SIGNATURE
    
    
    23INDEX TO EXHIBITS
    
    
    24EX-31.1EX-31.2EX-32EX-99.1
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##### Table of Contents



PART I  FINANCIAL INFORMATION
 
 Item 1. Financial Statements.
 MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
 
  (In thousands, except per share amounts)
    
    September 30, 2010
    
    
    December 31, 2009(Unaudited)
    
    
    (Note 2)AssetsReal estate assetsLand, buildings and improvements, and intangible lease assets
    
    $
    981,730
    
    
    $
    906,340Mortgage loans
    
    
    206,774
    
    
    
    200,164Real estate held for sale
    
    
    1,990
    
    
    
    71,668Gross investment in real estate assets
    
    
    1,190,494
    
    
    
    1,178,172Accumulated depreciation and amortization
    
    
    (71,830
    )
    
    
    (54,834
    )Net investment in real estate assets
    
    
    1,118,664
    
    
    
    1,123,338Cash and cash equivalents
    
    
    106,481
    
    
    
    15,307Interest and rent receivable
    
    
    28,656
    
    
    
    19,845Straight-line rent receivable
    
    
    28,233
    
    
    
    27,539Other loans
    
    
    51,154
    
    
    
    110,842Other assets
    
    
    28,821
    
    
    
    13,027Total Assets
    
    $
    1,362,009
    
    
    $
    1,309,898Liabilities and EquityLiabilitiesDebt, net
    
    $
    370,013
    
    
    $
    576,678Accounts payable and accrued expenses
    
    
    45,366
    
    
    
    29,247Deferred revenue
    
    
    21,266
    
    
    
    15,350Lease deposits and other obligations to tenants
    
    
    18,724
    
    
    
    17,048Total liabilities
    
    
    455,369
    
    
    
    638,323EquityPreferred stock, $0.001 par value. Authorized 10,000 shares; no
shares outstanding
    
    
    
    
    
    
    Common stock, $0.001 par value. Authorized 150,000 shares; issued
and outstanding  110,011 shares at September 30, 2010, and
78,725 shares at December 31, 2009
    
    
    110
    
    
    
    79Additional paid in capital
    
    
    1,050,429
    
    
    
    759,721Distributions in excess of net income
    
    
    (136,750
    )
    
    
    (88,093
    )Accumulated other comprehensive loss
    
    
    (7,005
    )
    
    
    Treasury shares, at cost
    
    
    (262
    )
    
    
    (262
    )Total Medical Properties Trust, Inc. stockholders equity
    
    
    906,522
    
    
    
    671,445Non-controlling interests
    
    
    118
    
    
    
    130Total equity
    
    
    906,640
    
    
    
    671,575Total Liabilities and Equity
    
    $
    1,362,009
    
    
    $
    1,309,898
  3




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##### Table of Contents



MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
 
 
 For the Three Months
    
    
    For the Nine MonthsEnded September 30,
    
    
    Ended September 30,(In thousands, except per share amounts)
    
    2010
    
    
    2009
    
    
    2010
    
    
    2009RevenuesRent billed
    
    $
    24,004
    
    
    $
    20,882
    
    
    $
    70,627
    
    
    $
    63,180Straight-line rent
    
    
    (1,084
    )
    
    
    3,244
    
    
    
    590
    
    
    
    5,856Interest and fee income
    
    
    6,296
    
    
    
    7,213
    
    
    
    20,771
    
    
    
    21,804Total revenues
    
    
    29,216
    
    
    
    31,339
    
    
    
    91,988
    
    
    
    90,840ExpensesReal estate depreciation and amortization
    
    
    6,336
    
    
    
    5,775
    
    
    
    18,482
    
    
    
    17,349Loan impairment charge
    
    
    
    
    
    
    
    
    
    
    12,000
    
    
    
    Property-related
    
    
    600
    
    
    
    1,213
    
    
    
    2,057
    
    
    
    2,867General and administrative
    
    
    6,213
    
    
    
    4,860
    
    
    
    21,846
    
    
    
    16,337Total operating expenses
    
    
    13,149
    
    
    
    11,848
    
    
    
    54,385
    
    
    
    36,553Operating income
    
    
    16,067
    
    
    
    19,491
    
    
    
    37,603
    
    
    
    54,287Other income (expense)Interest and other income (expense)
    
    
    1,475
    
    
    
    (6
    )
    
    
    1,488
    
    
    
    48Debt refinancing costs
    
    
    (342
    )
    
    
    
    
    
    
    (6,556
    )
    
    
    Interest expense
    
    
    (8,092
    )
    
    
    (9,390
    )
    
    
    (26,106
    )
    
    
    (28,284
    )Net other expense
    
    
    (6,959
    )
    
    
    (9,396
    )
    
    
    (31,174
    )
    
    
    (28,236
    )Income from continuing operations
    
    
    9,108
    
    
    
    10,095
    
    
    
    6,429
    
    
    
    26,051Income (loss) from discontinued
operations
    
    
    (144
    )
    
    
    289
    
    
    
    5,954
    
    
    
    2,909Net income
    
    
    8,964
    
    
    
    10,384
    
    
    
    12,383
    
    
    
    28,960Net income attributable to
non-controlling interests
    
    
    (45
    )
    
    
    (10
    )
    
    
    (63
    )
    
    
    (30
    )Net income attributable to MPT
common stockholders
    
    $
    8,919
    
    
    $
    10,374
    
    
    $
    12,320
    
    
    $
    28,930Earnings per common share  basic and
dilutedIncome from continuing operations
attributable to MPT common stockholders
    
    $
    0.08
    
    
    $
    0.12
    
    
    $
    0.06
    
    
    $
    0.32Income from discontinued operations
attributable to MPT common stockholders
    
    
    
    
    
    
    0.01
    
    
    
    0.06
    
    
    
    0.04Net income attributable to MPT common
stockholders
    
    $
    0.08
    
    
    $
    0.13
    
    
    $
    0.12
    
    
    $
    0.36Weighted average shares outstanding:Basic:
    
    
    110,046
    
    
    
    78,665
    
    
    
    97,573
    
    
    
    77,904Diluted:
    
    
    110,046
    
    
    
    78,665
    
    
    
    97,575
    
    
    
    77,904Dividends declared per common share
    
    $
    0.20
    
    
    $
    0.20
    
    
    $
    0.60
    
    
    $
    0.60
  4




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MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
 
 
 For the Nine MonthsEnded September 30,2010
    
    
    2009Operating activitiesNet income
    
    $
    12,383
    
    
    $
    28,960Adjustments to reconcile net income to net cash provided by operating
activitiesDepreciation and amortization
    
    
    19,634
    
    
    
    19,726Straight-line rent revenue
    
    
    (3,282
    )
    
    
    (6,935
    )Share-based compensation
    
    
    5,250
    
    
    
    4,282Gain on sale of real estate/property swap transaction
    
    
    (7,693
    )
    
    
    Straight-line rent write off/reserve
    
    
    2,695
    
    
    
    1,079Loan impairment
    
    
    12,000
    
    
    
    Increase (decrease) in accounts payable and accrued liabilities
    
    
    2,899
    
    
    
    5,560Amortization and write-off of deferred financing costs and debt discount
    
    
    4,961
    
    
    
    4,225Premium paid on extinguishment of debt
    
    
    3,834
    
    
    
    Other adjustments
    
    
    (5,188
    )
    
    
    (6,454
    )Net cash provided by operating activities
    
    
    47,493
    
    
    
    50,443Investing activitiesReal estate acquired
    
    
    (73,851
    )
    
    
    (423
    )Principal received on loans receivable
    
    
    46,532
    
    
    
    3,273Proceeds from sale of real estate
    
    
    75,000
    
    
    
    Investment in loans receivable
    
    
    (9,626
    )
    
    
    (6,317
    )Construction in progress and other
    
    
    (15,578
    )
    
    
    (4,434
    )Net cash provided (used) for investing activities
    
    
    22,477
    
    
    
    (7,901
    )Financing activitiesRevolving credit facilities, net
    
    
    (137,200
    )
    
    
    (65,800
    )Additions to debt
    
    
    148,500
    
    
    
    Payments of debt
    
    
    (216,325
    )
    
    
    (907
    )Distributions paid
    
    
    (54,761
    )
    
    
    (45,602
    )Sale of common stock
    
    
    288,470
    
    
    
    67,843Other financing activities
    
    
    (7,480
    )
    
    
    3,270Net cash (used) provided by financing activities
    
    
    21,204
    
    
    
    (41,196
    )Increase in cash and cash equivalents for period
    
    
    91,174
    
    
    
    1,346Cash and cash equivalents at beginning of period
    
    
    15,307
    
    
    
    11,748Cash and cash equivalents at end of period
    
    $
    106,481
    
    
    $
    13,094Interest paid
    
    $
    20,846
    
    
    $
    21,068Supplemental schedule of non-cash financing activities:Distributions declared, unpaid
    
    
    22,326
    
    
    
    16,105
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##### Table of Contents



MEDICAL PROPERTIES TRUST, INC. AND SUBSIDIARIES
 
 
 1. Organization
    2. Summary of Significant Accounting Policies
 Unaudited Interim Condensed Consolidated Financial Statements
 Reclassifications:
 Recent accounting pronouncements:
   3. Real Estate and Lending Activities
 Acquisitions
  6




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##### Table of Contents



Land
    
    $
    6,264Building
    
    
    61,893Intangible lease assets  subject to amortization (weighted average useful life of 23.1 years)
    
    
    5,694Total
    
    $
    73,851
  Disposals
   Leasing Operations
        7




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Loans
  4. Debt
  As of September 30,
    
    
    As of December 31,2010
    
    
    2009Balance
    
    
    Interest Rate
    
    
    Balance
    
    
    Interest RateRevolving credit facilities
    
    $
    
    
    
    Variable
    
    $
    137,200
    
    
    VariableSenior unsecured notes  fixed
rate through July and October
2011 due July and October 2016
    
    
    125,000
    
    
    
    7.333% - 7.871
    %
    
    
    125,000
    
    
    
    7.333% - 7.871
    %Exchangeable senior notesPrincipal amount
    
    
    91,175
    
    
    
    6.125% - 9.250
    %
    
    
    220,000
    
    
    
    6.125% - 9.250
    %Unamortized discount
    
    
    (2,866
    )
    
    
    
    
    
    
    (8,265
    )88,309
    
    
    
    
    
    
    
    211,735Term loansPrincipal amount
    
    
    158,123
    
    
    Various
    
    
    102,743
    
    
    VariousUnamortized discount
    
    
    (1,419
    )
    
    
    
    
    
    
    156,704
    
    
    
    
    
    
    
    102,743$
    370,013
    
    
    
    
    
    
    $
    576,678
 8




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##### Table of Contents



2010
    
    $
    4432011
    
    
    19,1052012
    
    
    1,5002013
    
    
    83,5002014
    
    
    1,500Thereafter
    
    
    268,250Total
    
    $
    374,298
         9




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##### Table of Contents



5. Common Stock
   6. Stock Awards
  7. Fair Value of Financial Instruments
  10




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September 30, 2010
    
    December 31, 2009Book
    
    Fair
    
    Book
    
    FairAsset (Liability)
    
    Value
    
    Value
    
    Value
    
    ValueInterest and Rent Receivables
    
    $
    28,656
    
    
    $
    20,692
    
    
    $
    19,845
    
    
    $
    16,712Loans
    
    
    257,928
    
    
    
    244,473
    
    
    
    311,006
    
    
    
    299,133Debt
    
    
    (370,013
    )
    
    
    (358,829
    )
    
    
    (576,678
    )
    
    
    (547,242
    )
 8. Discontinued Operations
      For the Three Months
    
    For the Nine MonthsEnded September 30,
    
    Ended September 30,2010
    
    2009
    
    2010
    
    2009Revenues
    
    $
    
    
    
    $
    2,161
    
    
    $
    2,371
    
    
    $
    6,482Gain on sale
    
    
    
    
    
    
    
    
    
    
    6,178
    
    
    
    Net income (loss)
    
    
    (144
    )
    
    
    289
    
    
    
    5,954
    
    
    
    2,909Earnings per share  diluted
    
    $
    
    
    
    $
    0.01
    
    
    $
    0.06
    
    
    $
    0.04
 9. Earnings Per Share
  For the Three MonthsEnded September 30,2010
    
    
    2009Numerator:Income from continuing operations
    
    $
    9,108
    
    
    $
    10,095Non-controlling interests share in continuing operations
    
    
    (45
    )
    
    
    (8
    )Participating securities share in earnings
    
    
    (315
    )
    
    
    (372
    )Income from continuing operations, less participating securities share in earnings
    
    
    8,748
    
    
    
    9,715Income (loss) from discontinued operations
    
    
    (144
    )
    
    
    289Non-controlling interests share in discontinued operations
    
    
    
    
    
    
    (2
    )Income (loss) from discontinued operations attributable to MPT common stockholders
    
    
    (144
    )
    
    
    287Net income, less participating securities share in earnings
    
    $
    8,604
    
    
    $
    10,002
 11




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##### Table of Contents



For the Nine MonthsEnded September 30,2010
    
    
    2009Numerator:Income from continuing operations
    
    $
    6,429
    
    
    $
    26,051Non-controlling interests share in continuing operations
    
    
    (63
    )
    
    
    (27
    )Participating securities share in earnings
    
    
    (994
    )
    
    
    (1,142
    )Income from continuing operations, less participating securities share in earnings
    
    
    5,372
    
    
    
    24,882Income from discontinued operations
    
    
    5,954
    
    
    
    2,909Non-controlling interests share in discontinued operations
    
    
    
    
    
    
    (3
    )Income from discontinued operations attributable to MPT common stockholders
    
    
    5,954
    
    
    
    2,906Net income, less participating securities share in earnings
    
    $
    11,326
    
    
    $
    27,788
   10. Contingencies
  11. Comprehensive Income
  For the Three MonthsEnded September 30,2010
    
    
    2009Net income
    
    $
    8,964
    
    
    $
    10,384Other comprehensive income:Unrealized gain (loss) on interest rate swaps
    
    
    (3,845
    )
    
    
    Total comprehensive income
    
    
    5,119
    
    
    
    10,384Comprehensive income attributable to
non-controlling interests
    
    
    (45
    )
    
    
    (10
    )Comprehensive income attributable to MPT
common stockholders
    
    $
    5,074
    
    
    $
    10,374
 For the Nine MonthsEnded September 30,2010
    
    
    2009Net income
    
    $
    12,383
    
    
    $
    28,960Other comprehensive income:Unrealized gain (loss) on interest rate swaps
    
    
    (7, 005
    )
    
    
    Total comprehensive income
    
    
    5,378
    
    
    
    28,960Comprehensive income attributable to non-controlling interests
    
    
    (63
    )
    
    
    (30
    )Comprehensive income attributable to MPT common stockholders
    
    $
    5,315
    
    
    $
    28,930
 12




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##### Table of Contents



12. Income Taxes
  13. Executive Severance
  14. Subsequent Events
  
 Item 2. Managements Discussion and Analysis of Financial Condition and Results of Operations.
  13




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Forward-Looking Statements.
  
    
    national and local economic, business, real estate and other market conditions;
    
    the competitive environment in which we operate;
    
    the execution of our business plan;
    
    financing risks;
    
    acquisition and development risks;
    
    potential environmental, contingencies, and other liabilities;
    
    other factors affecting the real estate industry generally or the healthcare real estate
industry in particular;
    
    our ability to maintain our status as a REIT for federal and state income tax purposes;
    
    our ability to attract and retain qualified personnel;
    
    federal and state healthcare regulatory requirements; and
    
    the impact of a downturn in the credit markets and a global economic slowdown, which has had
and may continue to have a negative effect on the following, among other things:
 
    
    the financial condition of our tenants, our lenders, counterparties to our capped call
transactions and institutions that hold our cash balances, which may expose us to increased
risks of default by these parties;
    
    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 refinance
existing debt and our future interest expense; and
    
    the value of our real estate assets, which may limit our ability to dispose of assets at
attractive prices or obtain or maintain debt financing secured by our properties or on an
unsecured basis.
 Key Factors that May Affect Our Operations
   
    
    the historical and prospective operating margins (measured by a tenants earnings before
interest, taxes, depreciation, amortization and facility rent) of each tenant or borrower and
at each facility;
 14




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##### Table of Contents




    
    the ratio of our tenants and borrowers operating earnings both to facility rent and to
facility rent plus other fixed costs, including debt costs;
    
    trends in the source of our tenants or borrowers revenue, including the relative mix of
Medicare, Medicaid/MediCal, managed care, commercial insurance, and private pay patients; and
    
    the effect of evolving healthcare regulations on our tenants and borrowers profitability.
  
    
    trends in the cost and availability of capital, including market interest rates, that our
prospective tenants may use for their real estate assets instead of financing their real
estate assets through lease structures;
    
    changes in healthcare regulations that may limit the opportunities for physicians to
participate in the ownership of healthcare providers and healthcare real estate;
    
    reductions in reimbursements from Medicare, state healthcare programs, and commercial
insurance providers that may reduce our tenants profitability and our lease rates;
    
    competition from other financing sources; and
    
    the ability of our tenants and borrowers to access funds in the credit markets.
 15




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##### Table of Contents



CRITICAL ACCOUNTING POLICIES
  Overview
     Revenue by property type:
 For the Three
    
    
    
    
    
    
    For the ThreeMonths Ended
    
    
    
    
    
    
    Months EndedSeptember 30,
    
    
    % of
    
    
    September 30,
    
    
    % of2010
    
    
    Total
    
    
    2009
    
    
    TotalGeneral Acute Care Hospitals
    
    $
    17,402
    
    
    
    59.5
    %
    
    $
    21,812
    
    
    
    69.6
    %Long-term Acute Care Hospitals
    
    
    6,648
    
    
    
    22.7
    %
    
    
    6,454
    
    
    
    20.6
    %Rehabilitation Hospitals
    
    
    4,402
    
    
    
    15.1
    %
    
    
    2,476
    
    
    
    7.9
    %Medical Office Buildings
    
    
    426
    
    
    
    1.5
    %
    
    
    612
    
    
    
    2.0
    %Wellness Centers
    
    
    338
    
    
    
    1.2
    %
    
    
    (15
    )
    
    
    (0.1
    )%Total revenues
    
    $
    29,216
    
    
    
    100.0
    %
    
    $
    31,339
    
    
    
    100.0
    %For the Nine
    
    
    
    
    
    
    For the NineMonths Ended
    
    
    
    
    
    
    Months EndedSeptember 30,
    
    
    % of
    
    
    September 30,
    
    
    % of2010
    
    
    Total
    
    
    2009
    
    
    TotalGeneral Acute Care Hospitals
    
    $
    59,935
    
    
    
    65.2
    %
    
    $
    61,783
    
    
    
    68.0
    %Long-term Acute Care Hospitals
    
    
    19,777
    
    
    
    21.5
    %
    
    
    18,536
    
    
    
    20.4
    %Rehabilitation Hospitals
    
    
    9,984
    
    
    
    10.8
    %
    
    
    7,556
    
    
    
    8.3
    %Medical Office Buildings
    
    
    1,279
    
    
    
    1.4
    %
    
    
    1,838
    
    
    
    2.0
    %Wellness Centers
    
    
    1,013
    
    
    
    1.1
    %
    
    
    1,127
    
    
    
    1.3
    %Total revenues
    
    $
    91,988
    
    
    
    100.0
    %
    
    $
    90,840
    
    
    
    100.0
    %
 16




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17




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##### Table of Contents



Results of Operations
 Three months Ended September 30, 2010 Compared to September 30, 2009
   Year over% of
    
    
    
    
    
    
    % of
    
    
    Year2010
    
    
    Total
    
    
    2009
    
    
    Total
    
    
    ChangeBase rents
    
    $
    23,575
    
    
    
    80.7
    %
    
    $
    20,083
    
    
    
    64.1
    %
    
    
    17.4
    %Straight-line rents
    
    
    (1,084
    )
    
    
    -3.7
    %
    
    
    3,244
    
    
    
    10.4
    %
    
    
    -133.4
    %Percentage rents
    
    
    429
    
    
    
    1.5
    %
    
    
    799
    
    
    
    2.5
    %
    
    
    -46.3
    %Fee income
    
    
    158
    
    
    
    0.5
    %
    
    
    37
    
    
    
    0.1
    %
    
    
    327.0
    %Interest from loans
    
    
    6,138
    
    
    
    21.0
    %
    
    
    7,176
    
    
    
    22.9
    %
    
    
    -14.5
    %Total revenue
    
    $
    29,216
    
    
    
    100.0
    %
    
    $
    31,339
    
    
    
    100.0
    %
    
    
    -6.8
    %
         Nine Months Ended September 30, 2010 Compared to September 30, 2009
  18




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##### Table of Contents



Year over% of
    
    
    
    
    
    
    % of
    
    
    Year2010
    
    
    Total
    
    
    2009
    
    
    Total
    
    
    ChangeBase rents
    
    $
    68,585
    
    
    
    74.6
    %
    
    $
    61,550
    
    
    
    67.8
    %
    
    
    11.4
    %Straight-line rents
    
    
    590
    
    
    
    0.6
    %
    
    
    5,856
    
    
    
    6.4
    %
    
    
    -89.9
    %Percentage rents
    
    
    2,042
    
    
    
    2.2
    %
    
    
    1,630
    
    
    
    1.8
    %
    
    
    25.3
    %Fee income
    
    
    395
    
    
    
    0.4
    %
    
    
    212
    
    
    
    0.2
    %
    
    
    86.3
    %Interest from loans
    
    
    20,376
    
    
    
    22.2
    %
    
    
    21,592
    
    
    
    23.8
    %
    
    
    -5.6
    %Total revenue
    
    $
    91,988
    
    
    
    100.0
    %
    
    $
    90,840
    
    
    
    100.0
    %
    
    
    1.3
    %
           LIQUIDITY AND CAPITAL RESOURCES
   19




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##### Table of Contents



Short-term Liquidity Requirements:
 Long-term Liquidity Requirements:
 Distribution Policy
  20




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##### Table of Contents



Declaration Date
    
    Record Date
    
    Date of Distribution
    
    Distribution per ShareAugust 19, 2010
    
    September 14, 2010
    
    October 14, 2010
    
    $
    0.20May 20, 2010
    
    June 17, 2010
    
    July 15, 2010
    
    $
    0.20February 18, 2010
    
    March 18, 2010
    
    April 14, 2010
    
    $
    0.20November 19, 2009
    
    December 17, 2009
    
    January 14, 2010
    
    $
    0.20August 20, 2009
    
    September 17, 2009
    
    October 15, 2009
    
    $
    0.20May 21, 2009
    
    June 11, 2009
    
    July 14, 2009
    
    $
    0.20February 24, 2009
    
    March 19, 2009
    
    April 9, 2009
    
    $
    0.20December 4, 2008
    
    December 23, 2008
    
    January 22, 2009
    
    $
    0.20
  
 Item 3. Quantitative and Qualitative Disclosures About Market Risk.
    
 Item 4. Controls and Procedures.
    21




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##### Table of Contents



PART II  OTHER INFORMATION
 
 Item 1. Legal Proceedings.
  
 Item 1A. Risk Factors.
  
 Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.
    
 Item 3. Defaults Upon Senior Securities.
  
 Item 4. (Removed and Reserved).
 
 Item 5. Other Information.
   
 Item 6. Exhibits.
  ExhibitNumber
    
    Description31.1
    
    Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934.31.2
    
    Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934.32
    
    Certification of Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) under the
Securities Exchange Act of 1934 and 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the
Sarbanes-Oxley Act of 2002.99.1
    
    Consolidated Financial Statements of Prime Healthcare Services, Inc. as of June 30, 2010. Since affiliates of
Prime Healthcare Services, Inc. lease more than 20% of our total assets under triple net leases, the
financial status of Prime may be considered relevant to investors. Primes most recently available financial
statements (unaudited, as of and for the period ended June 30, 2010) are attached as Exhibit 99.1 to this
Quarterly Report on Form 10-Q. We have not participated in the preparation of Primes financial statements
nor do we have the right to dictate the form of any financial statements provided to us by Prime.
 22




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##### Table of Contents



SIGNATURE
  MEDICAL PROPERTIES TRUST, INC.By:
    /s/ R. Steven HamnerR. Steven HamnerExecutive Vice President and Chief Financial Officer
(On behalf of the Registrant and as the Registrants Principal
Financial and Accounting Officer)  23




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##### Table of Contents



ExhibitNumber
    
    Description31.1
    
    Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934.31.2
    
    Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 1934.32
    
    Certification of Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) under the
Securities Exchange Act of 1934 and 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the
Sarbanes-Oxley Act of 2002.99.1
    
    Consolidated Financial Statements of Prime Healthcare Services, Inc. as of June 30, 2010. Since affiliates of
Prime Healthcare Services, Inc. lease more than 20% of our total assets under triple net leases, the
financial status of Prime may be considered relevant to investors. Primes most recently available financial
statements (unaudited, as of and for the period ended June 30, 2010) are attached as Exhibit 99.1 to this
Quarterly Report on Form 10-Q. We have not participated in the preparation of Primes financial statements
nor do we have the right to dictate the form of any financial statements provided to us by Prime.
 24