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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
 Washington, D.C. 20549
 
 FORM 10-K/A
 (Amendment No. 1)
 (Mark One)
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    ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
 For the fiscal year ended December 31, 2010
 or
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    TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
 Commission file number 001-32559
 
 Medical Properties Trust, Inc.
 (Exact Name of Registrant as Specified in Its Charter)
 Maryland
    
    20-0191742(State or Other Jurisdiction of Incorporation or Organization)
    
    (IRS Employer Identification No.)1000 Urban Center Drive, Suite 501Birmingham, AL
    
    35242(Address of Principal Executive Offices)
    
    (Zip Code)
 (205) 969-3755  (Registrants telephone number, including area code)
 Securities registered pursuant to Section 12(b) of the Act:
 Title of Each Class
    
    Name of Each Exchange on Which RegisteredCommon Stock, par value $0.001 per share
    
    New York Stock Exchange
 Securities registered pursuant to Section 12(g) of the Act:
None
 
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Non-accelerated filer o(Do not check if a smaller reporting company)Smaller reporting company o o þ
   DOCUMENTS INCORPORATED BY REFERENCE




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MEDICAL PROPERTIES TRUST, INC.
AMENDMENT NO. 1 TO ANNUAL REPORT ON FORM 10-K
FOR THE FISCAL YEAR ENDED DECEMBER 31, 2010
   Table of Contents
 PART IVItem 14. Exhibits and Financial Statement SchedulesSIGNATURESINDEX
TO EXHIBITSEX-23.1EX-23.2EX-31.1EX-31.2EX-99.1




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Item 14. Exhibits and Financial Statement Schedules.
   (b) Exhibits
 ExhibitNumber
    
    Exhibit Title3.1(1)
    
    Registrants Second Articles of Amendment and Restatement3.2(2)
    
    Registrants Second Amended and Restated Bylaws3.3(3)
    
    Articles of Amendment of Registrants Second Articles of Amendment and Restatement4.1(1)
    
    Form of Common Stock Certificate4.2(4)
    
    Indenture, dated July 14, 2006, among Registrant, MPT Operating Partnership, L.P. and the Wilmington Trust
Company, as trustee4.3(5)
    
    Indenture, dated November 6, 2006, among Registrant, MPT Operating Partnership, L.P. and the Wilmington
Trust Company, as trustee4.4(5)
    
    Registration Rights Agreement among Registrant, MPT Operating Partnership, L.P. and UBS Securities LLC and
J.P. Morgan Securities Inc., as representatives of the initial purchasers, dated as of November 6, 20064.5(13)
    
    Indenture, dated as of March 26, 2008, among MPT Operating Partnership, L.P., as Issuer, Medical Properties
Trust, Inc., as Guarantor, and Wilmington Trust Company, as Trustee.4.6(13)
    
    Registration Rights Agreement among MPT Operating Partnership, L.P., Medical Properties Trust, Inc. and UBS
Securities LLC, as representative of the initial purchases of the notes, dated as of March 26, 200810.1(11)
    
    Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P.10.2(6)
    
    Amended and Restated 2004 Equity Incentive Plan10.3(7)
    
    Form of Stock Option Award10.4(7)
    
    Form of Restricted Stock Award10.5(7)
    
    Form of Deferred Stock Unit Award10.6(1)
    
    Employment Agreement between Registrant and Edward K. Aldag, Jr., dated September 10, 200310.7(1)
    
    First Amendment to Employment Agreement between Registrant and Edward K. Aldag, Jr., dated March 8, 200410.8(1)
    
    Employment Agreement between Registrant and R. Steven Hamner, dated September 10, 200310.9
    
    Not used10.10(1)
    
    Employment Agreement between Registrant and Emmett E. McLean, dated September 10, 200310.11(1)
    
    Employment Agreement between Registrant and Michael G. Stewart, dated April 28, 200510.12(1)
    
    Form of Indemnification Agreement between Registrant and executive officers and directors10.13(11)
    
    Form of Medical Properties Trust, Inc. 2007 Multi-Year Incentive Plan Award Agreement (LTIP Units)10.14(11)
    
    Form of Medical Properties Trust, Inc. 2007 Multi-Year Incentive Plan Award Agreement (Restricted Shares)10.15(12)
    
    Term Loan Credit Agreement among Medical Properties Trust, Inc., MPT Operating Partnership, L.P., as
Borrower, the Several Lenders from Time to Time Parties Thereto, KeyBank National Association, as
Syndication Agent, and JP Morgan Chase Bank, N.A. as Administrative Agent, with J.P. Morgan Securities Inc.
and KeyBank National Association, as Joint Lead Arrangers and Bookrunners10.16(10)
    
    First Amendment to Term Loan Agreement10.17(16)
    
    Second Amendment to Employment Agreement between Registrant and Edward K. Aldag, Jr., dated September 29,
200610.18(16)
    
    First Amendment to Employment Agreement between Registrant and R. Steven Hamner, dated September 29, 200610.19(16)
    
    First Amendment to Employment Agreement between Registrant and Emmett E. McLean, dated September 29, 200610.20(16)
    
    First Amendment to Employment Agreement between Registrant and Michael G. Stewart, dated September 29, 200610.21(8)
    
    Second Amended and Restated 2004 Equity Incentive Plan10.22(17)
    
    Second Amendment to Employment Agreement between Registrant and William G. McKenzie, dated February 27, 200910.23(17)
    
    Second Amendment to Employment Agreement between Registrant and Michael G. Stewart, dated January 1, 200810.24(17)
    
    Third Amendment to Employment Agreement between Registrant and Michael G. Stewart, dated January 1, 200910.25(17)
    
    Second Amendment to Employment Agreement between Registrant and Emmett E. McLean, dated January 1, 200810.26(17)
    
    Third Amendment to Employment Agreement between Registrant and Emmett E. McLean, dated January 1, 200910.27(17)
    
    Second Amendment to Employment Agreement between Registrant and Richard S. Hamner, dated January 1, 200810.28(17)
    
    Third Amendment to Employment Agreement between Registrant and R. Steven Hamner, dated January 1, 200910.29(17)
    
    Third Amendment to Employment Agreement between Registrant and Edward K. Aldag, Jr., dated January 1, 200810.30(17)
    
    Fourth Amendment to Employment Agreement between Registrant and Edward K. Aldag, Jr., dated January 1, 200910.31(17)
    
    Third Amendment to Employment Agreement between Registrant and William G. McKenzie, dated January 1, 200810.32(17)
    
    Fourth Amendment to Employment Agreement between Registrant and William G. McKenzie, dated January 1, 200910.33(18)
    
    Separation Agreement and General Release, dated June 11, 2010, between Medical Properties Trust, Inc. and
Michael G. Stewart10.34(9)
    
    Revolving Credit and Term Loan Agreement, dated as of May 17, 2010, among Medical Properties Trust, Inc.,
MPT Operating Partnership, L.P., KeyBank National Association and Royal Bank of Canada, as syndication
agents, and JPMorgan Chase Bank, N.A., as administrative agent12.1(19)
    
    Statement re Computation of Ratios21.1(19)
    
    Subsidiaries of Registrant




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ExhibitNumber
    
    Exhibit Title23.1(21)
    
    Consent of PricewaterhouseCoopers LLP23.2(21)
    
    Consent of Moss Adams LLP31.1(21)
    
    Certification of Chief Executive Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 193431.2(21)
    
    Certification of Chief Financial Officer pursuant to Rule 13a-14(a) under the Securities Exchange Act of 193432(19)
    
    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 135099.1(20)(21)
    
    Consolidated Financial Statements of Prime Healthcare Services, Inc. as of December 31, 2010 and 2009
 
 (1)
    
    Incorporated by reference to Registrants Registration Statement on
Form S-11 filed with the Commission on October 26, 2004, as amended
(File No. 333-119957).(2)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on November 24, 2009.(3)
    
    Incorporated by reference to Registrants quarterly report on Form
10-Q for the quarter ended September 30, 2005, filed with the
Commission on November 10, 2005.(4)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on July 20, 2006.(5)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on November 13, 2006.(6)
    
    Incorporated by reference to Registrants definitive proxy statement
on Schedule 14A, filed with the Commission on September 13, 2005.(7)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on October 18, 2005.(8)
    
    Incorporated by reference to Registrants definitive proxy statement
on Schedule 14A, filed with the Commission on April 14, 2007.(9)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on May 20, 2010.(10)
    
    Incorporated by reference to Registrants quarterly report on Form
10-Q for the quarter ended September 30, 2007, filed with the
Commission on November 9, 2007.(11)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on August 6, 2007.(12)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on August 15, 2007.(13)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on March 26, 2008.(14)
    
    Incorporated by reference to Registrants quarterly report on Form
10-Q for the quarter ended March 31, 2008, filed with the Commission
on May 9, 2008.(15)
    
    Incorporated by reference to Registrants quarterly report on Form
10-Q for the quarter ended June 30, 2008, filed with the Commission
on August 8, 2008.(16)
    
    Incorporated by reference to Registrants annual report on Form
10-K/A for the period ended December 31, 2007, filed with the
Commission on July 11, 2008.(17)
    
    Incorporated by reference to Registrants annual report on Form 10-K
for the period ended December 31,




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2008, filed with the Commission on
March 13, 2009.(18)
    
    Incorporated by reference to Registrants current report on Form 8-K,
filed with the Commission on June 11, 2010.(19)
    
    Previously filed as an exhibit to Registrants Annual Report on form
10-K, filed with the Commission on February 28, 2011.(20)
    
    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 audited consolidated financial statements (as of
and for the years ended December 31, 2010 and 2009) are attached as
Exhibit 99.1 to this Amendment No. 1 to the Annual Report on Form
10-K. Refer to our 2009 Form 10-K/A filed on April 9, 2010 for the
audited financial statements of Prime for the years ended December
31, 2009 and 2008. 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.(21)
    
    Included in this Form 10-K/A.




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SIGNATURES
  MEDICAL PROPERTIES TRUST, INC.By:
    /s/ R. Steven HamnerR. Steven HamnerExecutive Vice President and
Chief Financial Officer
(Principal Financial and
Accounting Officer)  
  ExhibitNumber
    
    Description23.1
    
    Consent of PricewaterhouseCoopers LLP23.2
    
    Consent of Moss Adams LLP31.1
    
    Certification of Chief Executive Officer pursuant to Rule
13a-14(a) under the Securities Exchange Act of 193431.2
    
    Certification of Chief Financial Officer pursuant to Rule
13a-14(a) under the Securities Exchange Act of 193499.1
    
    Consolidated Financial Statements of Prime Healthcare
Services, Inc. as of December 31, 2010 and 2009