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Medical Properties Trust 2015 Annual Report

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Medical Properties Trust 2015 Annual Report A POSITION OF STRENGTH $ 307 +61% 495 +50% 742 +41% TOT 1,045 +25% (2004 -2015) AL ASSETS AL 1,305 +0% 1,306 +3% 1,344 MPW CELEBRATES TEN YEARS ON THE NYSE THE ON YEARS TEN CELEBRATES MPW +20% 1,609 +34% 2,162 +33% 2,880 +29% 3,720 +51% $ 5,609 $ 2.3 +331% 9.8 +161% 26 +155% TOT 65 +41% (2004 -2015) (IN MILLIONS) AL REVENUE AL 92 +11% 102 +3% 104 +26% 132 +50% 198 +22% 243 +29% 313 +41% $ 442 $ 6.1 +290% 24 +57% NORMALIZED FUNDS 37 +42% FROM OPERATIONS 52 +34% (2004 -2015) 70 -13% 62 +8% 67 +17% 78 +53% 119 +23% 147 +23% 182 +51% $ 275 BELLS SHOULD BE RINGING… Medical Properties Trust (NYSE: MPW) The event proved to be even more exciting In retrospect, the experience seems to reflect celebrated a special milestone in 2015 as we than anticipated, as a major computer one of the values that define a very strong completed our 10th year as a New York Stock malfunction caused the Exchange to company – that no matter what external Exchange listed company. suspend trading that afternoon. For several challenges may arise – we do our best to To mark the occasion, a group of our long hours, we weren’t sure there was even going exceed objectives and trust the rest to our tenured team members traveled to New to be a closing bell. great good fortune. York to ring the closing bell on July 8th, in And yet, with computer problems resolved, recognition of the contributions each has made trading resumed. And at the end of the day – to establish MPT as the leading source of with what felt like all of America applauding – capital for hospitals around the world. we rang an unusually historic closing bell. ANNUAL REPORT 2015 per share increased by almost 19 percent. This enabled us to Building on Strength increase our dividend while still 205 improving the payout ratio to rank PROPERTIES among the sector’s best. MPT now stands out as the fourth Medical Properties Trust (NYSE: MPW) took largest U.S.-based owner of advantage of exceptional opportunities during for-profit hospital beds, with 2015 to enhance its already strong position as more than 21,300, including 1,169 the leading provider of real estate capital to Capella beds. Over the past 13 hospital operators across the United States and years, our portfolio has grown Western Europe. from zero assets to more than 200 In a single transaction, the company grew its properties across 29 states and five portfolio of high quality hospital real estate by countries. Throughout that time, almost 20 percent, adding seven acute care and under our original founders, hospitals across five states operated by Franklin, we have upheld the values and Tennessee based Capella Healthcare, one of the goals that we established in 10 largest for-profit U.S. hospital operators – and founding the company in 2003. one of the best. GROWING WITH We also established an innovative new HEALTHCARE LEADERS estate assets of eight acute care hospitals in relationship with AXA Real Estate Investment With every acquisition, we strive Northern Italy operated by Policlinico di Monza, Managers, a global leader in real estate to affilliate with premier, industry- plus another hospital under development in investment and portfolio management. In leading hospital operators, Valencia, Spain, to be operated by IMED. Both partnership with AXA REIM, we acquired the real TH carefully evaluating each are distinguished operators and we expect to opportunity for immediate positive continue to grow with AXA in Europe. We are 4 financial impact and long-term pleased that AXA, one of the world’s largest LARGEST U.S. value creation for our shareholders. financial service firms, chose MPT as its partner, BASED OWNER recognizing our in-depth hospital knowledge. OF FOR-PROFIT We acquired our first acute care HOSPITAL BEDS hospital in 2005, beginning a During the year, MPT invested a record $1.7 relationship with Prime Healthcare, billion in new acquisitions, growing our total which now ranks as the fifth assets to nearly $6 billion. Total revenue for largest for-profit acute care 2015 increased 41 percent, from $313 million hospital system in the U.S. (in to almost $442 million, and normalized FFO number of hospitals). Since then, 2 MEDICALPROPERTIESTRUST.COM we have grown with Prime, completing more BUILDING ON THE STRENGTHS than 20 additional transactions representing OF OUR OPERATORS more than $1 billion in hospital real estate. In this Annual Report, you will find stories about From that first investment, Prime has grown to six of MPT’s largest tenants (including Prime and include 42 facilities across 14 states, employing Ernest), which collectively represent nearly 75 more than 42,000 people. percent of our portfolio – and all are recognized leaders in the healthcare field. In 2012, we partnered with Ernest Health, a premier U.S. developer and operator of The collective hospital knowledge that these post-acute facilities, acquiring 16 hospitals. tenants bring to our relationships only adds to Ernest's rehab facilities consistently rank in MPT’s own strength of knowledge. And that the top 10 percent of nearly 800 rehabilitation nuanced understanding not only grows every hospitals in the U.S., as measured by the day as we deal with our tenants, but also stands Uniform Data System for Medical Rehabilitation. out as the defining characteristic of our company as we talk with other potential tenants about the MPT has continued to invest in Ernest, which benefits of long-term relationships with MPT. now operates 25 facilities in 11 states. ENDURING RELATIONSHIPS: These six tenants represent 75 percent of MPT’s portfolio, demonstrating that MPT TOTAL INVESTMENTS (in millions) builds relationships to grow. $1B $1B(1) $989 $1B(2) Initial Investment Current Investment/ Commitment $579 $500 $396 $348 $200 $100 $66 $28 ERNEST PRIME IASIS ADEPTUS MEDIAN CAPELLA (1) Based on EUR-USD exchange rate of 12/31/2015. (2) Includes $79 million of cash on hand. 3 ANNUAL REPORT 2015 to hold the investment grade rating that we first On behalf of the Board of Directors, as achieved in 2014. well as our senior management team and the dedicated employees of MPT, I want In February 2016, we completed an upsized $500 million to thank you for your continued support. bond offering that was used to repay a significant portion We are proud of what your company has of the borrowings under our revolving credit facility. accomplished in 2015 and we look And, in March 2016, we announced a transaction that is expected to generate an additional $550 million in proceeds that will further reduce our debt, resulting in leverage metrics among the best of large healthcare REITs. This transaction, which is expected to close in the second quarter of 2016, will merge Capella Healthcare and RegionalCare into one of the largest for-profit hospital companies in the United States, with benefits of the merger accruing to MPT over both the short and long term. We have always carefully managed our investments, our capital and our overall balance sheet for the long-term and we will continue to do so. Since our initial public offering in 2005, MPT has demonstrated operational success year after year while delivering exceptional shareholder value. Total shareholder returns for that period have totaled 170 percent (including dividends and stock price appreciation) – compared to only 88 percent for the REIT index and 97 percent for the S&P 500. And we expect additional success in 2016 as we continue to grow our footprint and expand our global leadership. MAINTAINING BALANCE SHEET STRENGTH While achieving significant growth and delivering superior shareholder returns, MPT has maintained a very stable balance sheet. Our senior notes continue 4 MEDICALPROPERTIESTRUST.COM EXPANDING GLOBALLY In 2015, MPT invested approximately $120 million in joint ventures with AXA Real Estate Investment Managers to acquire eight acute care hospitals in Northern Italy and one under development in Valencia, Spain. TOTAL RETURN TO forward to creating more value for all of our (1) SHAREHOLDERS shareholders in 2016 and beyond, as we move 10 YEARS 170% (As of 3/31/16) forward from a position of strength. Sincerely, 97% 88% Edward K. Aldag, Jr. Chairman, President and Chief Executive Officer MSCI S&P 500 MPW U.S REIT Index Index Source: (1) FactSet as of March 31, 2016. 5 ANNUAL REPORT 2015 A Compelling Focus on the Patient There are no ‘insignificant’ jobs in a community hospital, as Capella Healthcare’s CEO learned early in a stellar career. Michael Wiechart didn’t make it is one of the fastest-growing for-profit Experiences there still shape his thinking today. to medical school. hospital operators in the U.S., employing “I learned that even my ‘insignificant’ job in the more than 6,500 people and providing career Like many other pre-med stock room was important because the nurses opportunities for more than 1,500 doctors – students before him, he found were depending on me to deliver supplies to all of whom once managed to make it his career path diverted by their floors, so they could take care of patients,” through organic. Chem 205 – otherwise known Wiechart said. as organic chemistry – at the Healthcare has always been in Wiechart’s “I also saw how hard everybody worked to meet University of Kentucky. blood, and in his heart. patient needs. That’s where it was drilled into me Now, he spearheads Franklin, His mother is a nurse, now retired after nearly that the closer you are to the patient, the more Tennessee based Capella 40 years of caring for others.
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