Medical Properties Trust : MPT’s 2024 Corporate Responsibility Report

2024 CORPORATE RESPONSIBILITY REPORT

Table of Contents

Introduction

02 About this Report

03 Introduction / Message from the CEO

04 Business Overview

05 ESG Highlights

Environmental Sustainability

07 Risk Management

08 Sustainable Operations

1. Environmental Performance
2. Green Buildings

13 Tenant Engagement

Social Responsibility

1. Human Capital
2. Workforce Demographics
3. Workforce Training & Development
4. Benefits, Health, Wellness & Safety
5. Community Engagement

Corporate Governance

1. Board Composition
2. ESG Oversight
3. Cybersecurity
4. Stakeholder Engagement
5. Ethics

Appendix

1. Appendix A | Environmental Data
2. Appendix B | Our Goals
3. Appendix C | TCFD Disclosure

32 Appendix D | SASB Disclosure

35 Cautionary Statement

About

this Report

Reporting Boundary

Sustainability data and indicators presented in this report are derived from 2023 calendar year performance at Medical Properties Trust's ("MPT" or the "Company" or "we") corporate operations and real estate portfolio.

Triple-Net Lease Model

Within our real estate investment trust ("REIT") model, our leased properties are subject to long-termtriple-net leases, which generally provide that our tenants retain exclusive operational control of the properties and are solely responsible for management and operation of the property and all related expenses, including property taxes, insurance, operating expenses such as maintenance, repair, and improvement, and utilities. While the terms of our triple-net leases include conditions and requirements relating to, among other things, operating condition and maintenance, capital expenditures, and reporting, our tenants generally have autonomy in operating their businesses and managing the properties, including with respect to their implementation of any Environmental, Social, and Governance ("ESG") initiatives. As a result, our tenants make independent decisions regarding their business strategy and operations, including whether and how to pursue ESG initiatives at our leased properties.

On the cover: IMED Colón - Valencia, Spain

Enhanced Disclosure

MPT intends to present information related to sustainability performance indicators in a format that is understandable and accessible to our stakeholders. This report was prepared with respect to guidance provided by the following frameworks and disclosures.

SUSTAINABILITY ACCOUNTING

STANDARDS BOARD ("SASB")

See pages 32-34 for alignment.

TASK FORCE ON CLIMATE-RELATED

FINANCIAL DISCLOSURES ("TCFD")

See pages 30-31 for alignment.

CDP'S CLIMATE CHANGE

QUESTIONNAIRE

In 2023, we completed the CDP's Climate

Change questionnaire for the second time.

(NEW!)

UNITED NATIONS SUSTAINABLE

DEVELOPMENT GOALS ("UN SDGS")

See page 29 for alignment.

2024 Corporate Responsibility Report | Medical Properties Trust

INTRODUCTION | 2

INTRODUCTION

Welcome

This year marks the publishing of our third annual Corporate Responsibility Report. As an employer, corporate citizen, and integral part of our community, we strive to create enduring value for our stakeholders- including our shareholders, tenants, employees, business partners, the environment, and the communities in which we live and work. As such, we continue to develop and improve all facets of our business, to build and maintain sustainable value.

In 2023, we expanded our employee-led ESG Working Group. Since then, we have seen a direct and positive impact on commitment and progress towards our goals as a result of this group's ongoing discussions and actions. We believe collaboration across all elements of the Company drives more comprehensive solutions and raises the bar on our ability to develop and achieve sustainability goals.

Through this internal collaboration, we made great strides in our environmental sustainability journey. To position the Company for future success, a key focus for the year was to mature our sustainability programs, including asset- level utility data collection, physical climate risk assessments, and green leasing practices; we aim to continuously improve these programs, within the bounds of our triple-net lease business model. This dedication is exemplified through our significant increase in executed green lease

"This last year marked MPT's

20-year anniversary. As we embark upon the company's third decade, I am confident in the solid foundation we have built and the extremely talented and engaged employee base we have assembled. With this in mind, I know we will continue to drive our corporate responsibility initiatives towards

a more sustainable

future."

provisions in 2023 and our enhanced recognition as a GOLD Green Lease Leader through the Institute for Market Transformation and the U.S. Department of Energy's Better Building Alliance. Furthermore, we are grateful to be recognized amongst America's most responsible and greenest companies by Newsweek.

As always, this work is only possible with our most important asset, our people. In today's competitive environment, retaining qualified, skilled talent

is one of our highest priorities. This can only be achieved by creating a culture that respects their values and embraces their needs. MPT promotes diversity, equity, and inclusion principles and supports innovation and career development. We remain committed to advancing our social priorities; we empower our employees through development and training programs, exceptional health and wellness benefits, and fostering a culture of inclusivity and belonging. We are honored to be selected by Modern Healthcare again as one of the best places to work in the healthcare industry.

With a global footprint in an evolving regulatory environment, we recognize the need to remain compliant with various rules and regulations. We continue to monitor the evolution of policy and regulatory changes that will impact our industry.

This last year marked MPT's 20-year anniversary. As we embark upon the company's third decade, I am confident in the solid foundation we have built and

the extremely talented and engaged employee base we have assembled. With this in mind, I know we will continue to drive our corporate responsibility initiatives towards a more sustainable future.

Within this report, we have highlighted our recent progress and continuing efforts over the past year. This report is in alignment with SASB guidelines and TCFD framework. We hope you will find this report useful and encourage you to reach out to us at [e-mail] with any questions or thoughts you may have.

Edward K. Aldag, Jr.

Chairman, President and CEO

2024 Corporate Responsibility Report | Medical Properties Trust

INTRODUCTION | 3

Business Overview

MPT is a self-advised real estate investment trust formed in 2003 to acquire and develop net-leased hospital facilities. From our inception in Birmingham, Alabama, we have grown to become one of the world's largest owners of hospital real estate.

Our 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.

Global Portfolio Mix

BY PERCENTAGE OF

SQUARE FEET

" MPT owns facilities that comprise approximately

43,000 hospital beds worldwide."

121		52+		439
EMPLOYEES		MILLION		PROPERTIES
	SQUARE FEET

General Acute Care	Behavioral Health	Inpatient Rehabilitation
66%	6%	25%

Long-Term Acute Care	Freestanding E.R. / Urgent Care
2%
1%

Statistics as of 12/31/2023.

2024 Corporate Responsibility Report | Medical Properties Trust

INTRODUCTION | 4

ESG Highlights

This 2024 Corporate Responsibility Report offers a comprehensive and consolidated view of our environmental sustainability, social responsibility, and corporate governance. Summary highlights concerning each area are included below, although we encourage you to review the full report for more information. In addition to our annual reporting, please visit our website's "Responsibility" section for updates throughout the year.

ACCELERATING ESG PROGRESS

3Years of Corporate

Sustainability

Reporting

fIncreased our coverage of green lease		fConducted a physical climate risk analysis
provisions in existing leases.		for our entire real estate portfolio.
fIncreased our collection and reporting		fIncreased disclosure on human capital metrics.
of tenant emissions.
fCompleted CDP's Climate Change Questionnaire
	fMaintained an impactful charitable giving
for the second year in a row.		focus for 2023.

fEstablished sustainability goals in line with the UN's Sustainable Development Goals.

fStrengthened our SASB and TCFD alignment and disclosure.

fRecognized for our sustainability achievements through multiple third-party publications and certifications.

2024	2024	2024	2024
"BEST PLACES TO WORK"	"AMERICA'S MOST	"AMERICA'S GREENEST	"GOLD" CERTIFICATION
BY MODERN HEALTHCARE	RESPONSIBLE COMPANIES"	COMPANIES" LIST BY	BY GREEN LEASE
	LIST BY NEWSWEEK	NEWSWEEK	LEADERS

2024 Corporate Responsibility Report | Medical Properties Trust

INTRODUCTION | 5

ENVIRONMENTAL

SUSTAINABILITY

As part of an ongoing commitment to environmental sustainability across our business operations, we worked over the past year to strengthen ESG integration within our internal processes.

RISK MANAGEMENT	07
SUSTAINABLE OPERATIONS	08
ENVIRONMENTAL PERFORMANCE	09
GREEN BUILDINGS	10
TENANT ENGAGEMENT	13

2024 Corporate Responsibility Report | Medical Properties Trust

ENVIRONMENTAL SUSTAINABILITY | 6

Risk Management

As a global real estate owner and investor, we recognize that climate-change related risks have the potential to impact our business. While under our triple-net lease model, the operations, maintenance, repair, and improvements of our leased properties are generally our tenants' responsibility, the efforts described below allow us to further our understanding of climate risks,

Physical Risk

Extreme weather and changes in precipitation and temperatures due to climate change could cause physical damage to, or a shift in demand for, our properties. We recognize that our assets may be vulnerable to acute and chronic climate- related risks, including rising sea levels, drought, flooding, and more frequent and intense storms. To mitigate these potential risks, we endeavor to do the following:

Transition Risk

Our evaluation of potential transition risks includes routinely monitoring existing and emerging requirements that apply to our corporate operations as well as to our tenants. We review current and proposed energy-related legislation and work with external counsel and consultants to identify and mitigate any potential legal risks to our

take cost-effective steps to mitigate physical and transitional risks to our portfolio, and leverage associated opportunities to drive long-term value.

MPT's senior management is responsible for risk assessments and risk management with oversight from the Board of Directors ("the Board"). At the Board level, the Environmental and Social Committee and the Risk Committee oversee physical risks and transition risks, respectively.

TCFD recommendations guide our risk management reporting. Further details on our TCFD alignment can be found in the Appendix.

Collaborate with our tenants and other relevant stakeholders to ensure we are sustainably managing our business and minimizing our impact on the environment.

Provide return-generating capital to our tenants that are interested

in upgrading their HVAC systems, lighting, water fixtures, and backup generators with effective, efficient, and environmentally-sound systems.

Ensure appropriate levels of insurance are placed on our properties based on modeling and projections of hazards and risk levels.

Integrate robust enterprise risk management and strategic planning.

Observe local risks and hazards, including identifying zones likely to experience drought, flooding, and coastal storms, and diversify the footprint of our portfolio across multiple risk factors.

Engage third-parties to perform Phase 1 Environmental Site Assessments and, to the extent necessary, Phase II Assessments (or equivalent studies outside the U.S.) and other risk mitigating remediation measures.

Ensure that our governance structure allows the Board and executive leadership to exercise their oversight responsibilities with respect to strategy and risk.

Organize risk management between our risk management team, which is responsible for managing operational risk for our business, and our executives who are responsible for enterprise risk management.

business.

While our tenants are responsible for complying with local regulatory requirements under our triple- net-lease model, we understand the importance of identifying the potential impact on our business of these regulations over short-, medium- and long- term periods. Accordingly, we engaged a third-party energy and sustainability consultant to regularly perform and update regulatory compliance risk assessments to gain a better understanding of

the regulatory requirements currently facing our properties. Through these assessments, which also include rebate market analyses, we identified an abundance of incentive programs for low- and no- cost efficiency measures that we may use to further support our tenant engagement initiatives.

2024 Corporate Responsibility Report | Medical Properties Trust

ENVIRONMENTAL SUSTAINABILITY | 7

Sustainable Operations

At MPT, we understand the effects that our operations have on the environment, and we are focused on reducing our energy, water, and waste consumption. While our direct environmental impact is limited due to the triple-net structure of our leases, which places direct operating responsibility on our tenants, we are committed to reducing the impact of our corporate operations and supporting the efforts of our tenants to enhance the sustainability of their operations.

Our environmental sustainability initiatives focus on efficiency improvements in our corporate operations and engaging with our tenants

to deliver efficient improvements across our healthcare portfolio.

Over 75% of our corporate workforce is housed in our Birmingham, AL, headquarters; therefore, the building is a large contributor to our corporate environmental footprint. However, the sustainable operations of even our smallest office are essential. We annually assess all of our corporate offices and operations to identify opportunities to continue to improve our sustainability practices. This includes monitoring

consumption, identifying potential for additional efficiency measures, and reviewing waste streams.

We are committed to working with our tenants to reduce our portfolio's carbon footprint and energy consumption. In doing so, we are targeting collection of monthly energy consumption data on an annual basis across our portfolio. To increase our data collection coverage, our team works with our tenants to record data in ENERGY STAR® Portfolio Manager® and other data management tools. We leverage these tools for data collection, benchmarking, and for the assessments of property performance and reduction strategies.

• Waste Management

The following are examples of waste management practices we work to integrate into our corporate operations:

• Reduce landfill waste and increase recycling capabilities and rates
• Responsibly recycle or dispose of old/broken technology
• Responsibly dispose of all ink cartridges through the manufacturer's recycling program
• Provide employees with reusable cups and provide filtered water machines throughout the office

2024 Corporate Responsibility Report | Medical Properties Trust

ENVIRONMENTAL SUSTAINABILITY | 8

Environmental Performance

• GHG Emissions

We monitor and benchmark our greenhouse gas emissions ("GHGs") from our corporate operations and work to identify reduction opportunities. As a triple-net landlord, the majority of our emissions are from our tenants and fall under Scope 3: Downstream Leased Assets. Therefore, we continually work with our tenants to collect emissions and energy data to better understand our total portfolio carbon footprint. As we continue to monitor and benchmark our portfolio's emissions, we look forward to increased collaboration with our tenants to reduce our environmental impact.

CORPORATE OPERATIONS1 (SCOPE 1+2)

Emissions

(MT CO2e)

5,532
-11%	4,904
CHANGE
2022	2023

REAL ESTATE PORTFOLIO2 (SCOPE 3)

Emissions Intensity

(MT CO2e/SQ FT)

0.0106	-1%	0.0104
	CHANGE
2022		2023

• Energy Efficiency

The following are examples of energy efficiency practices we work to integrate into our corporate operations and/or actions our triple-net lease tenants have taken:

• Monitoring trends and benchmarking usage
• Installing energy-efficient,motion-activated lighting
• Using smart thermostats and smart energy management systems
• Evaluating opportunities to increase both on and off-site renewable energy

CORPORATE OPERATIONS

Energy Use (MWh)

21,275	18,753
-12%
CHANGE
2022	2023

REAL ESTATE PORTFOLIO

Energy Intensity

(MWh/SQ FT)

0.0442	-3%	0.0430
	CHANGE
2022		2023

• Water Conservation

The following are examples of water efficiency practices we work to integrate into our corporate operations and/ or actions our triple-net lease tenants have taken:

• Monitoring trends and benchmarking usage
• Utilizing low-flow and high-efficiency fixtures and equipment
• Choosing drought-tolerant landscaping
• Installing leak detection systems

CORPORATE OPERATIONS

Water Consumption (m3)

15,395 -7% 14,264

CHANGE

2022 2023

REAL ESTATE PORTFOLIO

Water Intensity

(m3/SQ FT)

0.2059

+34%

0.1534

CHANGE

2022 2023

1. Corporate operation emissions excludes Scope 3 Business Travel. See Appendix A for more information.
2. Real estate portfolio emissions represent our Scope 3 Downstream Leased Assets.

2024 Corporate Responsibility Report | Medical Properties Trust

ENVIRONMENTAL SUSTAINABILITY | 9

Green Buildings

Corporate

Operations

MPT's corporate office spaces are all leased, meaning we have limited control over the buildings' environmental practices and performance. However, we continually strive to improve the resiliency and sustainability of our corporate offices. Since 2021, all our newly executed corporate office leases have been recognized as sustainable buildings through various green

NYC

WELL Gold LEED Gold

Real Estate

Portfolio

We understand that as a company that primarily focuses on purchasing pre-existing real estate, the efficiency of how our portfolio operates is crucial. While we do not control the day- to-day operations, we continue to look for ways to increase the number of green-certified buildings in our portfolio. We work to achieve this through:

4 LEED Certified

Properties

2 BREEAM Certified Properties with 3 Additional in Progress

50 U.K. Buildings with Energy Performance Certificate (EPC) Grades B or Above

building frameworks. As part of the growing commitment to green buildings, MPT is a member of the U.S. Green Building Council.

Goal

London

BREEAM excellent

Cert. BREEAM-0089-0418

• Green Leasing - Our standard green provisions encourage energy-efficient upgrades and cooperation with any green building certification processes. As of December 31,
  2023, 18% of our portfolio (by square feet) includes green lease provisions.
• Tenant Engagement - We encourage our tenants to pursue green building certifications for existing assets. For U.S. assets, we assist with benchmarking energy data on ENERGY STAR Portfolio Manager. Information on certifications within our real estate portfolio is based on publicly available sources. We continue to work with our tenants to update our tracking of existing certifications and ensure all qualifying properties pursue ENERGY STAR certification.

Lease corporate offices with no less than a LEED Gold (or comparable certification), when available in the selected market

LEED, BREEAM and EPC stats as of 05/31/2024.

2024 Corporate Responsibility Report | Medical Properties Trust

ENVIRONMENTAL SUSTAINABILITY | 10