November 19, 2014

Jefferies 2014 Global Healthcare Conference

2

Safe Harbor

This presentation includes “forward-looking statements” within the meaning of securities laws of applicable jurisdictions. Forward-looking statements can generally be identified by the use of forward-looking words such as “may”, “will”, “would”, “could”, “expect”, “intend”, “plan”, “aim”, “estimate”, “target”, “anticipate”, “believe”, “continue”, “objectives”, “outlook”, “guidance” or other similar words, and include statements regarding MPT’s plans, strategies, objectives, targets, future expansion and development activities and expected financial performance. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause the actual results of the Company or future events to differ materially from those expressed in or underlying such forward-looking statements, including without limitation: the satisfaction of all conditions to, and the timely closing (if at all) of the MEDIAN acquisition and sale-leaseback transactions; the Company’s financing of the transactions described herein; MEDIAN’s expected rent coverage; the capacity of MEDIAN and the Company’s other tenants to meet the terms of their agreements; Normalized FFO per share; expected payout ratio, the amount of acquisitions of healthcare real estate, if any; capital markets conditions, the repayment of debt arrangements; statements concerning the additional income to the Company as a result of ownership interests in certain hospital operations and the timing of such income; the payment of future dividends, if any; completion of additional debt arrangement, and additional investments; national and international economic, business, real estate and other market conditions; the competitive environment in which the Company operates; the execution of the Company's business plan; financing risks; the Company's ability to maintain its status as a REIT for federal income tax purposes; acquisition and development risks; potential environmental and other liabilities; and other factors affecting the real estate industry generally or healthcare real estate in particular; and the value of our real estate assets, which may limit our ability to dispose of assets at attractive prices or obtain or maintain equity or debt financing secured by our properties or on an unsecured basis, and the factors referenced under the section captioned “Item 1.A Risk Factors” in our annual report on Form 10-K for the year ended December 31, 2013. Actual results, performance or achievements may vary materially from any projections and forward looking statements and the assumptions on which those statements are based. Readers are cautioned not to place undue reliance on forward-looking statements, and MPT disclaims any responsibility to update such information.

3

Table of Contents

MPT Overview

Highly Sustainable and Predictable Business Model 10

Growth Opportunities 18

Stable and Transparent Financing Structure 21

4

4

Company Overview

MPT By The Numbers

Only healthcare REIT providing significant hospital exposure Highest rental yield in healthcare real estate Provides long-term, inflation-protected cash returns

from critical community assets

33% CAGR in total assets over last 4 years

Normalized FFO per share growth of 16.8% compounded annually over last 4 years

$0.66 $0.71

$0.90 $0.96 $1.06

$1.23

$0.00

$0.20

$0.40

$0.60

$0.80

$1.00

$1.20

$1.40

2010 2011 2012 2013 2014E PF 2014ERun Rate

Normalized FFO per Share(1)

(1) Estimate of Normalized FFO per diluted share for 2014 is based on actual results for first three quarters and current run-rate estimate for Normalized FFO per diluted share of $1.10 - $1.14; Pro Forma 2014E Run Rate for Normalized FFO per diluted share is $1.19 -$1.26 after the announcement of MEDIAN acquisition and additional $155mm of acquisitions on October 20, 2014; $1.23 is the midpoint of Pro Forma 2014E Run Rate; Run Rate assumes development commitments are fully funded

(2) Total assets is defined as undepreciated book value and for pro forma 9/30/14, assumes development commitments are fully funded

$1,425$1,715

$2,306

$3,064$3,360

$4,452

$0

$1,000

$2,000

$3,000

$4,000

$5,000

2010 2011 2012 2013 9/30/14 PF9/30/14

Total Assets(2)

($ in millions)

5

Home Health

Care

General Acute Carehospitals

LTAC hospitals

InpatientRehab

hospitals

NursingHomes

AssistedLiving

MPT focuses on the heart of healthcare:

General Acute Care hospitals Long Term Acute Care hospitals Inpatient Rehabilitation hospitals

Skilled Nursing Facilities

Focusing Exclusively on the Most Critical Components of Healthcare Delivery

6

Diversification Generates Reliable Cash Flow

72%

27%

1%

International Geographic Mix

United States

Germany

United Kingdom

49%

36%

10%4% 1%

Investments by Property Type

General Acute Care

Inpatient Rehabilitation

Long-Term Acute

Non RE Assets

Other

29%

17%7%

6%

4%

3%

3%

3%

20%

U.S. Geographic Mix

Texas

California

New Jersey

Arizona

Louisiana

Utah

Idaho

Kansas

19 Other States

(1)

Note: Mix based on investment amounts. Property type diversification by investment based on both U.S. and European investments;all measures are pro forma for uncompleted acquisitions announced through November 14, 2014(1) Includes freestanding emergency rooms

20%

16%

11%8%7%

6%

4%

3%3%2%2%

18%

Investments by Operator

MEDIAN

Prime

Ernest

IASIS

RHM

Adeptus/First Choice

Non RE Assets

IJKG/HUMC

Legacy

CHS

Kindred

18 Other Operators

7

Top 5 Inpatient Rehabilitation and Long-Term Acute Care operator

Sixth largest for-profit system; Texas Pacific Group is largest IASIS shareholder

Largest Rehabilitation hospital provider

MPT Operators Are Innovative Industry Leaders

U.S.

Leading freestanding emergency room system that is revolutionizing the delivery of emergency medical services

Private equity backed (CCMP) company formed by the experienced management team from former Triad Health that

joint ventures with local not-for-profit entities to operate acute care facilities

International

UK operator that uses clinician partnership model and closely collaborates with government funded National Health

Service

Largest private German rehabilitation operator

Top 5 German rehabilitation operator

Largest Long-Term Acute Care operator

Top 15 Hospital System based on quality of care, efficiency and patient satisfaction; only for-profit system so

honored(1)

(1) Prime Healthcare recognized as a Top 15 Health System by Truven Health Analytics and is the only for-profit system named in the Top 15 in the nation in 2013 Note: U.S. ranking source Modern Healthcare

8

Lease Coverage by Property Type2

10%

8% 8%

4%

0%

2%

4%

6%

8%

10%

12%

MPW HCN VTR HCP

Superior Returns and Coverage from Acute Care Facilities

(3) Source: Company filings, press releases, Q3 earnings call transcripts, FactSet 2015E data represents consensus research estimatesfrom FactSet as of 11/13/14

2014E FFO per share growth

2015E FFO per share growth3

(2) Lease coverage are MPT’s same-stores TTM coverages ended 8/31/14; SNF and ALFcoverages are from peer companies filings and supplemental information.

2013 Returns from Healthcare Real Estate1

(1) Returns from Healthcare Real Estate are actual returns for MPT through12/31/13; SNF, ALF and MOB returns are from BofA Merrill Lynch research.

16%

5% 5%

3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

MPW HCN VTR HCP

4.8x

2.7x

1.8x1.5x

1.2x

NA0.0x

1.0x

2.0x

3.0x

4.0x

5.0x

6.0x

Acute Care IRF LTACH SNF Sr.Housing

MOB

12%

10% 10%9%

7% 7%

0%

2%

4%

6%

8%

10%

12%

14%

IRF AcuteCare

LTACH SNF Sr.Housing

MOB

9

Table of Contents

MPT Overview

Highly Sustainable and Predictable Business Model 10

Growth Opportunities 18

Stable and Transparent Financing Structure 21

4

10

Favorable Demographic and Market Trends in the U.S.

43

56

73

8084

92

14%

17%

20%21% 21%

22%

10%

15%

20%

25%

30%

0

20

40

60

80

100

2012 2020 2030 2040 2050 2060

Po

pu

lati

on

in m

illio

ns

Aging Population in the U.S.

65+ population

65+ as % of total population

1,480

3,147

6,058

19,226

0

5,000

10,000

15,000

20,000

25,000

Under 18 years 18-44 years 45-64 years 65 years andover

Da

ys p

er 1

0,0

00

po

pu

lati

on

Hospital Days of Care per Yearper 10,000 Population

Source: U.S. Census Bureau Source: CDC/NCHS, National Hospital Discharge Survey. “Health,

United States, 2013.”

11

80

90

100

110

120

130

140

92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12

(in

mill

ion

s)

Source: American Hospital Association

U.S. Emergency Department Visits

$609 $652 $693 $729 $777 $813 $841 $882 $919 $960 $1,009 $1,068 $1,128 $1,199

$1,276 $1,361

$1,449 $1,542

$1,638

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

U.S. Hospital Care Expenditures

Source: CMS.gov National Health Expenditure Data - Projections 2013-2023

Actual5.4% CAGR ↗

Projected6.0% CAGR ↗

46% Growth

U.S. Hospital Expenditures Projected to Increase

($ in billions)

12

$26

$224

$271

$431

$301

$187

$107

$530

$20

$124

$0

$100

$200

$300

$400

$500

$600

2010 2011 2012 2013 2014E

U.S. Investments Existing and New Relationships

Existing New

Unique Portfolio in the U.S.

($ in

mill

ion

s)

Acute care focus uniquely positions MPT at the very heart of healthcare

64%

15%

14%

6% 1%

U.S. Investments By Property Type

General Acute Care

Inpatient Rehabilitation

Long-Term Acute

Non RE Assets

Other

(1)

(1) Includes freestanding emergency rooms

13

High Quality and Diversified Payor Mix

38%

13%

37%

11%1%

Payor Mix - United States

Medicare

Medicaid

Managed Care

Self Pay

Other

62%

39%

Payor Mix - United Kingdom

NHS

Private

1) Includes private insurance, employers insurance for civil servants, accident insurance, self pay and others

40%

30%

30%

Payor Mix - GermanyPensionFunds

SHI

Other (1)

Note: Data as of 8/31/14. Based on net revenue

14

German Rehabilitation Environment is Favorable

Economy Germany has a strong economic position in term of GDP per capita

Germany’s healthcare spending compares favorably to other European countries

Demographics

Aging population

Decline in average length of stay in acute care hospitals results in increasing

conversions and revenue for rehab hospitals

Increase in number of single households

Funding

Rehab spending increasing at more than 2.7% annually

Public payors continue to operate with surplus funds

Rehabilitation is a small share of total healthcare expenditures, it plays a central

role in ensuring that employees get back to work quickly, and that retirees and

other non-working Germans avoid long hospital stays or long-term care

Market

Decrease in number of rehabilitation facilities

Market consolidation

Positive supply / demand adjustment

Increasing quality and outcomes demanded by payors is driving smaller,

less capitalized operators to sell to consolidators such as MEDIAN

15

MEDIAN: Key Elements of the Deal

Bad Sülze

MEDIAN Deal Summary € $

Purchase Price (mm) €705 $900

Lease Rate(1) 9.3% 9.3%

Incremental EBITDA (mm) €65.6 $83.7Berggießhübel

Adelsberg

Note: Throughout the presentation, the Company is using the EUR/USD exchange rate as of October 17 of 1.276

(1) Based on Purchase Price plus up to €30mm in costs that are required to be capitalized under GAAP convention and 1.0% minimum annual escalation of rent

27 year Master Lease covering 40 properties provides strongest credit protection

Cash lease payments increase every year by 70% of German CPI –no ceiling; 1% floor

Strong going-in coverage exceeds 1.7x with expectations of 2.0x in near term

Highly marketed, sophisticated process with strong competition including U.S. REITs

MEDIAN Kliniken is the largest private provider of post-acute and acute rehabilitation in Germany

Focus on neurology, orthopedics, and traditional post-acute rehabilitation –fastest growing and most profitable sectors of German rehab

16

MPT’s Expanding German Footprint

Hamburg

Berlin

Dresden

Frankfurt

Stuttgart

Munich

Cologne

11 Rehabilitation Hospitals across five German states

1,834 Hospital Beds added to MPT’s portfolio

Hamburg

Berlin

Dresden

Frankfurt

Stuttgart

Munich

Cologne

52 Rehabilitation Hospitals and 2 Acute Hospitals across 12 German states

11,279 German hospital beds in MPT’s portfolio (by 1Q 2015)

2013 PF 1Q 2015

RHM Facilities

MEDIAN Facilities

17

Table of Contents

MPT Overview

Highly Sustainable and Predictable Business Model

Growth Opportunities 18

Stable and Transparent Financing Structure 21

4

10

18

Proven acceptance of sale/leaseback funding

Private equity

Not-for-profits

IPO candidates

Growing awareness of low risks of hospital reimbursements

New investors coming into the market

Non-traded REITs

Large and smaller public REITs

Sovereign wealth

Fund managers

Highest returns of any real estate class

New trends in healthcare delivery

Affordable Care Act

Validation of post-acute care efficiency and

reimbursement stability

Rapid development of free-standing Emergency Rooms

Aggressive conversion of not-for-profit facilities

to for-profit ownershipFirst Choice ER

Bayonne Medical Center

Baptist Emergency Hospital

Key Market Events Since 2010

19

An Exemplary Investment Track Record

Total Investments since inception: Deep industry knowledge

(MPT knows hospitals)

Investing in critical community infrastructure (“Hospitals needed by the community don’t fail”)

Underwriting conservatively(We always have a “Plan B”)

Lease Defaults Provide Opportunity to Reset Rates

<1% Credit Losses over 10 Years

$4.1 Billion

MPT’s Underwriting Experience and Lease Provisions Protect Against Losses

20

Table of Contents

MPT Overview

Highly Sustainable and Predictable Business Model

Growth Opportunities 18

Stable and Transparent Financing Structure 21

4

10

21

Target Balance Sheet Metrics

Net Leverage %(1)

44%

40%-45%

0% 10% 20% 30% 40% 50%

Net Debt/EBITDA

5.5x

5.5x

0x 2x 4x 6x

(1) Based on total assets + accumulated depreciation(2) Net Debt / EBITDA is calculated for the period ended September 30, 2014 and then annualized.

Target

9/30/14

Target

LQA 9/30/142

Expectations regarding MEDIAN financing: Maintain 45% company leverage Considering 60% LTV financing on the MEDIAN portfolio

Investigating local mortgage debt Unsecured Euro bonds are also an option

as MPT is a seasoned issuer

22

Prudent Capital Structure

Debt Maturities ($ in million)¹

$1.025bn of revolver capacity available for investments

Well-staggered debt maturities

93% of debt is fixed rate with an average rate of 6.17%

$125

$274$450

$350$300

$125

$0

$100

$200

$300

$400

$500

$600

$700

$800

$900

$1,000

$1,100

2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Senior unsecured notes Secured loans Credit Facility Term Loans

(1) Senior unsecured notes due 2020 are €200 million. Debt due in 2022 excludes debt premium.

23

Well Structured and Covered Leases

0% 0% 1% 1% 0% 1% 2%0%

4%

15%

3%1% 2%

69%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Lease Maturity Schedule

Low near-term lease maturity level provides MPT with stable and predictable cash flow

Most often: Elect to extend

Typically 5 years at contractual escalations

Occasionally: Elect to repurchase

Typically at the greater of fair value or MPT’s investment

Rarely: Elect to vacate

Typically obligated to transition business to a new operator

Operator Options at Maturity:

97% of 2022 Maturities

under Master Lease

Master Lease elections

are all or none

Average annual lease maturities through 2021 < 1.5% per annum

24

0% to 5% increase in CPI, MPT Rents increase

$4.1 Billion 1.4% - 4.0%

Note: Rents would increase based on 2014 rent; Investment value includes 2014 property sales and construction in progress and assumes fully funded development projects

Hospital Investments Create Long-Term Predictable Cash Flow

Total Leases and Mortgage Loans

Pro Forma Escalated Rate

Investment Value Percent of

Investments Escalation Provisions

$ 2,290,000,000 55% Full CPI (91% have a floor of 1% to 2.65%)

$ 1,206,000,000 28% CPI-based, most with collars ranging from 1% floor to 5% ceiling

$ 544,000,000 13% Fixed increases, averaging 2.4%

$ 92,000,000 2% Flat

$4,132,000,000

25

7.1%

10.9%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

Total return REITIndex

CAGR Since IPO

3

121%113%

89%83%

79%

68%

0%

20%

40%

60%

80%

100%

120%

140%

2010 2011 2012 2013 2014E PF 2014ERun Rate

MPT Payout Ratio

Target FFO payout ratio of 75-80%

4.2%4.5%

5.0%

6.2%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

Current Dividend Yield1

(1) As of 11/14/2014(2) Since 7/11/2005(3) Represents RMZ gross indexSource: FactSet

History of Strong Shareholder Returns

2

26

27

U.S. Western Europe1

GovernmentVery stable

Democratic process to elect political leaders

Very stable

Democratic process to elect political leaders

Demographics

Laws Affordable Care Act – movement towards universal care Universal healthcare and reimbursement mandated by law

Opportunities

for Growth

Continued opportunities for growth primarily through acquisition and

development of private and for-profit hospitals

Increasing opportunities for growth as private for-profit hospital operators

recognize the benefits of sale/leaseback financing model to fund facility

improvements, technology upgrades, staff additions and new construction

Germany UK

Payors

Medicare – Federal government sponsored

Medicaid – State and Federal government sponsored

Commercial insurance - Private

Statutory Health Insurance (SHI) Pension Funds (DRV)– National and

Regional funds that pay for rehabilitation services

Private Health Insurance – limited to higher earners

National Health Service (NHS)- Singlepayor government system

Private Health Insurance

Coverage

Coverage depends on individual’s ability to pay and/or plan benefits

Insurance primarily offered through employers and government

German law mandates universal access

and coverage; SHI and DRV covers 90%

of German population

In the UK, defined healthcare benefits

are free to all residents of the UK

through the NHS

Physicians Combination of private practice and employment model

Rate determined by government and negotiated health plans

German physicians are employed

doctors

While most physicians are employed by

NHS, they are free to admit patients to

private healthcare facilities.

Hospital

Ownership

(1) Countries constituting Western Europe from UCLA Center for European and Eurasian Studies - web.international.ucla.edu/euro/countries/westeurope(2) 2012 population estimates from The World Bank - data.worldbank.org/indicator/SP.POP.TOTL

21%

58%

21%

Public Not-for-profit

Private Not-for-profit

Private For-profit

314M Total2Under 65

65+

413M Total2

87% 13% 19%81%

50%

33%

17%

92%

0%

8%

International Diversification in Attractive Healthcare Markets

28

Normalized FFO Reconciliation

Note: Normalized FFO is a non-GAAP measure that is reconciled to net income at www.medicalpropertiestrust.com

($ in millions) 2011 2012 2013 YTD 2014

Net Income attributable to MPT Operating Partnership, L.P. 26.5$ 89.9$ 97.0$ 35.6$

Participating securities' share in earnings (1.1) (0.9) (0.7) (0.6)

Net Income 25.4$ 89.0$ 96.3$ 35.0$

Depreciation and amortization

Continuing operations 30.9 32.8 37.0 39.5

Discontinued operations 3.8 2.0 0.7 -

Loss (gain) on sale of real estate (5.4) (16.3) (7.7) -

Real estate impairment charge 0.6 - - 6.0

Funds from operations 55.3$ 107.5$ 126.3$ 80.5$

Write-off of straight line rent 2.5 6.5 1.5 1.0

Acquisition costs 4.2 5.4 19.4 7.9

Debt refinancing costs 14.2 - - 0.3

Loan and other impairment charges - - - 44.1

Write-off of other receivables 1.8 - - -

Normalized funds from operations 78.0$ 119.4$ 147.2$ 133.8$

For the Twelve Months Ended

Normalized FFO Reconciliation

29

Adjusted EBITDA Reconciliation

($ in millions) 2011 2012 2013 YTD 2014 3Q 2014

Net income 26.7$ 90.1$ 97.2$ 35.7$ 28.7$

Interest expense 57.9 58.3 66.8 71.7 25.5

Taxes 0.1 0.0 0.7 0.2 0.2

Depreciation and amortization 35.5 35.6 38.8 40.4 13.7

EBITDA 120.2$ 184.0$ 203.5$ 148.0$ 68.1$

Gains on asset sales (5.4) (16.3) (7.7) - -

Impairment charges 0.6 - - 50.1 -

Write-off of straight-line rent 2.5 6.5 1.5 1.0 -

Write-off of other receivables 1.8 - - - -

Acquisition costs 4.2 5.4 19.4 7.9 4.9

Adjusted EBITDA 123.8$ 179.6$ 216.7$ 207.0$ 73.0$

Plus: EBITDA from announced acquisitions 24.3$

Total Pro Forma Adjusted EBITDA 97.3$

For the Twelve Months Ended

Adjusted EBITDA Reconciliation