Medical Properties Trust, Inc.

Company Overview

Business Model: Medical Properties Trust, Inc. is a self-advised Real Estate Investment Trust (REIT) formed in 2003, primarily focused on acquiring and developing net-leased healthcare facilities. The company leases these facilities to healthcare operating companies under long-term net leases, which typically require the tenant to bear most property-related costs. Additionally, Medical Properties Trust, Inc. makes mortgage loans to healthcare operators collateralized by their real estate assets and may make noncontrolling investments in its tenants through taxable REIT subsidiaries (TRS) for working capital and other purposes. This model aims to facilitate acquisitions and recapitalizations, enabling operators to unlock real estate value for facility improvements and technology upgrades.

Market Position: As of December 31, 2025, Medical Properties Trust, Inc. held investments in 384 facilities, encompassing approximately 39,000 licensed beds across 31 states in the U.S., seven countries in Europe, and Colombia in South America. The portfolio is diversified by facility type, tenant relationships, and geography. The company primarily invests in facilities with high intensity of care, including 165 general acute care hospitals, 68 behavioral health facilities, 128 post acute care facilities, and 20 freestanding ER/urgent care facilities. The largest investment in any single property was less than 2% of total assets as of December 31, 2025.

Recent Strategic Developments:

• Debt Management & Refinancing: In 2025, Medical Properties Trust, Inc. repaid the remaining £493 million British pound sterling term loan due 2025. It completed a private offering of $1.5 billion in aggregate principal amount of senior secured notes due 2032 and €1.0 billion aggregate principal amount of senior secured notes due 2032. Proceeds were used to redeem 2025 and 2026 unsecured notes and reduce the revolving portion of its Credit Facility by approximately $800 million. The Credit Facility was amended to modify certain financial covenants, lower borrowing spreads, remove dividend payment limitations, and become secured ratably with the new notes. The company also provided notice of its plan to extend the revolving portion of its Credit Facility to June 30, 2027. The €655 million secured debt in the MEDIAN joint venture was replaced with a new €702.5 million nonrecourse, 10-year non-amortizing secured debt at a 5.1% fixed interest rate.
• Tenant & Property Restructurings: Following Prospect Medical Holdings, Inc.'s Chapter 11 bankruptcy filing in January 2025, a global settlement was approved in March 2025. This led to the re-leasing of six California properties to NOR Healthcare Systems Corporation in December 2025, with rents scheduled to ramp up to $45 million annually by December 2026. Five of the remaining seven properties previously operated by Prospect Medical Holdings, Inc. have been sold, with two more expected in 2026. Medical Properties Trust, Inc. expects to recover its remaining $61 million investment in Prospect Medical Holdings, Inc. The company also restructured its relationship with Vibra Healthcare, including a new 20-year master lease, the acquisition of one post-acute property for $32 million, and the cash receipt of approximately $18 million for past obligations. Cash rents on re-tenanted properties formerly operated by Steward Health Care System continued to ramp up, reaching 59% of contractual rents by December 31, 2025, with 100% expected by Q4 2026.
• Portfolio Adjustments: Medical Properties Trust, Inc. sold nine facilities (including two former Steward Health Care System-operated facilities) and ancillary land for aggregate cash proceeds of approximately $121 million, resulting in a gain on real estate of approximately $5.5 million. An investment in the Swiss Medical Network joint venture increased by approximately CHF 52 million (inclusive of a CHF 25 million short-term loan) to facilitate an acquisition and debt repayment.
• Shareholder Returns: The Board of Directors authorized a stock repurchase program for up to $150 million in October 2025, under which 4.5 million shares were acquired for $23.4 million in 2025. The quarterly cash dividend was increased by $0.01 to $0.09 per share in November 2025.
• Subsequent Events (post December 31, 2025): Acquired one property in Germany for approximately €23 million to be leased to MEDIAN. Sold one property previously leased to Vibra Healthcare for $12 million (proceeds received in 2025). Seven additional U.K. property holding entities were moved into the U.K. REIT effective February 1, 2026, expected to result in an approximate $40 million one-time tax benefit in Q1 2026. A regular quarterly cash dividend of $0.09 per share was declared in February 2026.

Geographic Footprint: Medical Properties Trust, Inc. has a significant international presence, with 50.3% of its total assets located outside the U.S. as of December 31, 2025.

• U.S.: 49.7% of total assets ($7,452,365k) and 53.3% of total revenues in 2025. Key states include Texas (9.5% of total assets), California (6.5%), and Florida (5.6%).
• International: 50.3% of total assets ($7,549,410k) and 46.7% of total revenues in 2025.
  • United Kingdom: 27.9% of total assets and 38.4% of total revenues in 2025.
  • Switzerland: 5.8% of total assets.
  • Germany: 5.0% of total assets.
  • Spain: 2.0% of total assets.
  • Finland: 1.5% of total assets.
  • All other countries (Italy, Portugal, Colombia): 1.9% of total assets and 8.3% of total revenues in 2025.

Financial Performance

Revenue Analysis

Profitability Metrics:

• Net Margin: -28.39% (2025) vs. -241.91% (2024)

Investment in Growth:

• R&D Expenditure: Not disclosed in the filing.
• Capital Expenditures: $80,003k (2025) and $79,788k (2024) for construction in progress and other. The company has approximately $157 million in future expenditures related to committed capital improvement projects, including a $60 million commitment to NOR Healthcare Systems Corporation for seismic purposes.
• Strategic Investments: Cash paid for acquisitions and other related investments totaled $142,089k in 2025 and $105,618k in 2024. This includes the $32 million acquisition of a post-acute property for Vibra Healthcare, a CHF 52 million (~$63 million) investment in the Swiss Medical Network joint venture, and $47 million funded to the secured lender in the Steward Health Care System bankruptcy.

Business Segment Analysis

Medical Properties Trust, Inc. manages its business and reports financial results as a single business segment, encompassing its investments in healthcare real estate, other loans, and noncontrolling investments in tenants.

Overall Portfolio Composition (as of December 31, 2025):

• Total Properties: 384 facilities, with 373 properties leased or loaned to 52 different operators. Less than 1% of total assets are currently vacant.
• Property Types (by Total Assets):
  • General acute care hospitals: 58.5%
  • Behavioral health facilities: 16.3%
  • Post acute care facilities: 11.1%
  • Freestanding ER/urgent care facilities: 0.7%
  • Other assets: 13.4%
• Property Types (by Total Revenues in 2025):
  • General acute care hospitals: 60.3%
  • Behavioral health facilities: 22.1%
  • Post acute care facilities: 16.8%
  • Freestanding ER/urgent care facilities: 0.8%

Key Tenant Relationships

Circle:

• Financial Performance: 14.1% of total assets (Dec 31, 2025), 21.9% of total revenues (2025).
• Product Portfolio: Leases 36 facilities in the U.K.
• Market Dynamics: 34 cross-defaulted individual leases guaranteed by Circle Health Ltd. with initial fixed terms ending in 2050, plus two five-year extension options and annual inflation-based escalators. The remaining two facilities have a weighted-average remaining initial fixed term of 9.6 years with similar escalators and extension options.

Priory:

• Financial Performance: 8.7% of total assets (Dec 31, 2025), 10.9% of total revenues (2025).
• Product Portfolio: Leases 37 facilities in the U.K.
• Market Dynamics: 31 cross-defaulted individual leases guaranteed by Priory Group with initial fixed terms ending in 2046, with two ten-year extension options and annual inflation-based escalators. The remaining six facilities are cross-defaulted individual leases guaranteed by Priory Group with initial fixed terms ending in 2044 and annual inflation-based escalators. Medical Properties Trust, Inc. holds a minority interest in Priory Group approximating $44 million.

Healthcare Systems of America:

• Financial Performance: 8.0% of total assets (Dec 31, 2025).
• Product Portfolio: Leases eight facilities in the U.S. (three states) under one master lease agreement.
• Market Dynamics: Master lease has an initial fixed term ending in September 2044, with three five-year extension options and annual inflation-based escalators. Rents are currently at 50% of full contractual rates, scheduled to increase to 100% in Q4 2026. Revenue is accounted for on a cash basis.

Swiss Medical Network:

• Financial Performance: 5.8% of total assets (Dec 31, 2025).
• Product Portfolio: Leases 18 facilities in Switzerland under individual leases through the Infracore SA real estate joint venture (70% non-controlling interest held by Medical Properties Trust, Inc.), with one facility under development.
• Market Dynamics: Weighted-average remaining lease term of 25 years, subject to annual inflation-based escalators. Medical Properties Trust, Inc. also holds an 8.9% passive equity ownership interest in Swiss Medical Network and a loan as part of a syndicated loan facility, totaling approximately $197 million.

Lifepoint Behavioral:

• Financial Performance: 5.4% of total assets (Dec 31, 2025).
• Product Portfolio: Leases 19 facilities under one master lease agreement.
• Market Dynamics: Master lease's original initial fixed term was 20 years (ending October 2041), with two five-year extension options and inflation-based escalators.

Unconsolidated Real Estate Joint Ventures

Medical Properties Trust, Inc. has five unconsolidated real estate joint ventures totaling approximately $1.4 billion at December 31, 2025.

• Swiss Medical Network: 70% ownership, $611,347k investment.
• MEDIAN: 50% ownership, $486,695k investment.
• CommonSpirit (Utah partnership): 25% ownership, $162,278k investment. In 2025, this partnership's income included a favorable fair value adjustment of approximately $49 million.
• Policlinico di Monza: 50% ownership, $86,091k investment.
• HM Hospitales: 45% ownership, $53,366k investment.
• Dividends received from these joint ventures were $63 million in 2025 and $45 million in 2024.

Capital Allocation Strategy

Shareholder Returns:

• Share Repurchases: $23.4 million (4.5 million shares) in 2025 under a $150 million authorized stock repurchase program (expires December 31, 2026).
• Dividend Payments: $200,446k in 2025 and $276,436k in 2024.
• Dividend per share: $0.33 in 2025 and $0.46 in 2024.
• Future Capital Return Commitments: A quarterly cash dividend of $0.09 per share was declared in February 2026.

Balance Sheet Position (as of December 31, 2025):

• Cash and Equivalents: $540,859k
• Total Debt (net): $9,697,835k
• Credit Rating: S&P Global rates Medical Properties Trust, Inc. and its unsecured notes at CCC+ with a negative outlook. Moody's corporate family rating is B3, and its secured debt is rated B2 (as of February 23, 2026).
• Debt Maturity Profile (as of February 23, 2026, amounts in thousands):
  • 2026: $1,586,713
  • 2027: $2,118,113
  • 2028: $1,240,847
  • 2029: $1,302,276
  • 2030: $808,900
  • Thereafter: $5,478,750
  • Total: $12,535,599

Cash Flow Generation:

• Operating Cash Flow: $230,767k (2025) and $245,483k (2024).
• Cash Conversion Metrics: Not disclosed in the filing.

Operational Excellence

Production & Service Model: Medical Properties Trust, Inc.'s operational philosophy centers on acquiring and developing healthcare facilities and leasing them to experienced healthcare operators under long-term net leases. These leases typically obligate the tenant to cover all ongoing operating expenses, including property, casualty, general liability, and other insurance; utilities; real estate and certain other taxes; ground lease rent; and costs of repairs and maintenance. Tenants are also responsible for desired capital expenditures, though Medical Properties Trust, Inc. may fund these with a corresponding increase in lease revenue. Mortgage loan arrangements place ownership responsibilities, including maintenance and improvements, on the borrowers.

Supply Chain Architecture: The company's supply chain architecture is primarily managed by its tenants, who are responsible for the operational aspects and associated costs of the facilities.

Key Suppliers & Partners:

• Joint Venture Partners: Include an institutional asset manager (Utah partnership), Aevis Victoria SA (Swiss Medical Network joint venture), and Primotop Holdings S.à.r.l. (MEDIAN joint venture).
• Tenants/Operators: Key partners include Circle, Priory, Healthcare Systems of America, Swiss Medical Network, Lifepoint Behavioral, NOR Healthcare Systems Corporation, MEDIAN, CommonSpirit Health, Prime Healthcare Services, Inc., Dignity Health, UCHealth, Ernest Health, Inc., College Health, Tenor Health, Honor Health, Quorum Health, Insight Health, Vibra Healthcare, and Surgery Partners.

Facility Network:

• Manufacturing: Not applicable as Medical Properties Trust, Inc. is a REIT.
• Research & Development: Not applicable as Medical Properties Trust, Inc. is a REIT.
• Distribution: Not applicable as Medical Properties Trust, Inc. is a REIT.
• Operational Metrics: The portfolio consists of 384 properties, with a weighted-average remaining initial lease term of 16.7 years. 99% of leases include annual rent escalations based on CPI or fixed minimums. Vacant facilities represent less than 1% of total assets as of December 31, 2025.

Market Access & Customer Relationships

Go-to-Market Strategy: Medical Properties Trust, Inc. employs a direct approach to market access, primarily through direct leasing and mortgage financing arrangements with healthcare operating companies.

• Distribution Channels: Direct sales to enterprise healthcare operators.
• Channel Partners: Strategic joint ventures with other investors are utilized for certain leased assets, such as the Utah partnership with an institutional asset manager and the Infracore SA joint venture with Aevis Victoria SA.
• Digital Platforms: Not explicitly detailed in the filing.

Customer Portfolio:

• Enterprise Customers: The company's portfolio includes 52 different operators. As of December 31, 2025, the top five tenants by total assets were Circle (14.1%), Priory (8.7%), Healthcare Systems of America (8.0%), Swiss Medical Network (5.8%), and Lifepoint Behavioral (5.4%). No other tenant accounted for more than 5% of total assets.
• Customer Concentration: The top five tenants collectively represent 42% of total assets. On a revenue basis for 2025, Circle accounted for 21.9% and Priory for 10.9% of total revenues.
• Geographic Revenue Distribution (2025):
  • U.S.: 53.3%
  • United Kingdom: 38.4%
  • All other countries: 8.3%

Competitive Intelligence

Market Structure & Dynamics

Industry Characteristics: The healthcare real estate market is extensive, driven by compelling demographics and the specialized nature of healthcare real estate investing. The sector is experiencing consolidation. The global outbreak of COVID-19 underscored the invaluable role of hospitals. Competitive Positioning Matrix:

Direct Competitors

Primary Competitors: Medical Properties Trust, Inc. competes with financial institutions, other lenders, real estate developers, healthcare operators, other REITs, other public and private real estate companies, infrastructure and other funds, and private real estate investors for acquisition and development opportunities. Emerging Competitive Threats: Not explicitly detailed in the filing, but the competitive landscape is dynamic. Competitive Response Strategy: The company's business model, which includes long-term net leases and mortgage financing, is designed to facilitate acquisitions and recapitalizations for healthcare operators, providing a competitive advantage.

Risk Assessment Framework

Strategic & Market Risks

• Market Dynamics: Adverse U.S. and global market, economic, and political conditions (including geopolitical instability, inflation, elevated interest rates, and credit market volatility) could materially impact business, results of operations, and financial condition. This may lead to reduced property values, limited access to debt financing, and tenant payment defaults.
• Customer Concentration: Revenues are highly dependent on the financial performance of tenants, particularly the largest ones (Circle, Priory, Healthcare Systems of America, Swiss Medical Network, and Lifepoint Behavioral). Operational challenges faced by tenants, including those arising from acquisitions, uncollectible accounts receivable, increased expenses, or insolvency, pose a significant risk. Impairment charges related to Steward Health Care System and Prospect Medical Holdings, Inc. in 2024 and 2025 highlight this risk.

Operational & Execution Risks

• Supply Chain Vulnerabilities: While tenants are responsible for operating costs, their operations can be impacted by supply chain disruptions and inflation-related challenges.
• Geographic Concentration: With 50.3% of total assets outside the U.S., the company faces risks associated with foreign laws, enforceability of contracts, political and economic instability, adverse or confiscatory taxes, currency transfer restrictions, and compliance with diverse foreign regulations (e.g., Foreign Corrupt Practices Act). Fluctuations in foreign currency exchange rates (Euro, British pound, Swiss franc, Colombian peso) can impact financial results.
• Management Capacity: The company's 121 employees manage a portfolio of over 380 properties across nine countries. Failure to effectively manage this extensive portfolio and any future growth could adversely impact financial condition and cash flows.
• IT/Cybersecurity: Reliance on information technology systems for operations, financial transactions, and data management exposes the company to cybersecurity risks. Security breaches could disrupt operations, lead to financial misstatements, covenant violations, unauthorized data access, liability claims, and reputational damage.
• Seismic Standards: 17 licensed hospitals in California (approximately $1.0 billion investment) require compliance with seismic standards; one hospital needs an extension to 2027 for compliance. Two facilities in Bogotá, Colombia, require approximately $15 million in seismic upgrades. While tenants are responsible for capital expenditures, Medical Properties Trust, Inc. may fund these with corresponding rent increases.

Financial & Regulatory Risks

• Market & Financial Risks: The company's approximately $9.6 billion in debt (as of February 23, 2026) could adversely affect its financial condition, reduce cash available for distributions, and potentially force asset disposals. Variable interest rate debt (approximately $0.6 billion as of February 23, 2026) exposes the company to interest rate volatility. The market price and trading volume of common stock may be volatile. Downgrades in credit ratings (S&P Global: CCC+ with negative outlook; Moody's: B3 corporate family, B2 secured debt) could increase capital costs and limit availability. Elevated interest rates may adversely affect security prices and increase interest expense. Limited access to capital could restrict growth.
• Regulatory & Compliance Risks: Tenants are subject to extensive federal, state, local, and international healthcare laws and regulations (e.g., Anti-Kickback Statute, Stark Law, False Claims Act, Civil Monetary Penalties Law, licensure, data privacy like HIPAA and GDPR, EMTALA, antitrust laws). Non-compliance by tenants could jeopardize their ability to make payments. Regulatory restrictions on healthcare transactions involving REITs (e.g., prohibitions on certain sale-leaseback transactions, enhanced transaction review) could limit acquisition capabilities, delay transactions, and increase compliance costs.
• REIT Status: Failure to maintain U.S. or U.K. REIT status would result in significant adverse tax consequences. Compliance with REIT requirements may necessitate foregoing otherwise attractive investment opportunities.
• Tax Risks: Sale-leaseback transactions may be re-characterized by tax authorities, leading to adverse tax consequences. Transactions with Taxable REIT Subsidiaries (TRSs) not at market terms may incur a 100% excise tax. Loans to tenants characterized as equity could jeopardize REIT status. Certain property transfers may generate prohibited transaction income subject to a 100% penalty tax. Changes in U.S. or foreign tax laws could adversely affect results of operations.

Geopolitical & External Risks

• Geographic Dependencies: Investments in foreign countries expose the company to risks from unexpected changes in regulatory requirements, political and economic instability, potential imposition of adverse or confiscatory taxes, currency transfer restrictions, and difficulties in enforcing obligations in foreign jurisdictions.
• Public Health Crises: Epidemics and pandemics (e.g., COVID-19) can adversely impact the company and its tenants by disrupting supply chains, creating labor shortages, increasing operating expenses, and negatively affecting local, national, or global economies and capital availability.

Innovation & Technology Leadership

Research & Development Focus: As a REIT, Medical Properties Trust, Inc. does not have a primary focus on research and development in the traditional sense. Its business model is centered on real estate acquisition, development, and leasing.

Core Technology Areas: Not applicable.

Innovation Pipeline: Not applicable.

Intellectual Property Portfolio: Not applicable.

Technology Partnerships: Not applicable.

Leadership & Governance

Executive Leadership Team

Leadership Continuity: The company depends on its executives and other officers to execute its business and investment strategy. The loss of key personnel or inability to recruit and retain qualified staff could materially adversely affect the business. Board Composition: The Board of Directors, including its Risk Committee and Ethics, Nominating and Governance Committee, oversees enterprise risk management, corporate responsibility, and governance policies.

Human Capital Strategy

Workforce Composition: As of February 23, 2026, Medical Properties Trust, Inc. has 121 employees located in the U.S., Luxembourg, and the U.K. None of its employees are subject to a collective bargaining agreement. Talent Management:

• Acquisition & Retention: The company offers a competitive benefits package, including annual discretionary performance-based bonuses, stock compensation, a 401(k) plan, healthcare and insurance benefits, paid time off, and health and wellness reimbursement programs. Recruitment involves a robust search, vetting, and assessment by an independent industrial psychologist.
• Retention Metrics: Medical Properties Trust, Inc. was recognized among Modern Healthcare's Best Places to Work for 2025, based on an employee satisfaction survey.
• Employee Value Proposition: The company is committed to providing a dynamic and supportive workplace that encourages personal and professional growth through training, continuing education, and leadership development. Diversity & Development:
• Diversity Metrics: The company is committed to equal opportunity in all employment aspects, prohibiting discrimination, harassment, or hostility.
• Development Programs: Regular training is provided on topics such as personal safety, cybersecurity, and data security awareness.
• Culture & Engagement: The company fosters a positive culture, evidenced by high employee satisfaction, and encourages community involvement through financial support for non-profit programs and paid time off for volunteering.

Environmental & Social Impact

Environmental Commitments:

• Climate Strategy: Medical Properties Trust, Inc.'s approach to sustainability is overseen by its Board of Directors, executive management, and Environmental and Social Committee. Initiatives focus on improvements to corporate operations and hospital facilities. In 2025, the company measured and reported greenhouse gas emissions from controlled and part of noncontrolled operations and increased the number of green provisions in its lease agreements.
• Supply Chain Sustainability: The company engages with suppliers on ESG requirements and supplier diversity programs. Social Impact Initiatives:
• Community Investment: Provides financial support to non-profit programs aimed at improving community public health and supports diverse employee interests. Employees are encouraged to engage in community service with provided paid time off. Corporate Responsibility Achievements: In 2025, the company was honored among Modern Healthcare's Best Places to Work for the fifth consecutive year and named to Newsweek's America's Most Responsible Companies list for the third consecutive year. It also strengthened its GRESB Real Estate Assessment score and completed construction of a new environmentally-friendly corporate headquarters.

Business Cyclicality & Seasonality

Demand Patterns: The healthcare industry, in which Medical Properties Trust, Inc.'s tenants operate, is generally positive for efficient operators but is impacted by economic, regulatory, healthcare, and market conditions. Planning & Forecasting: Not explicitly detailed in the filing.

Regulatory Environment & Compliance

Regulatory Framework:

• Industry-Specific Regulations: Medical Properties Trust, Inc.'s tenants are subject to extensive U.S. federal, state, and local healthcare laws and regulations, as well as comparable laws in Europe and South America. These include the Anti-Kickback Statute, Stark Law, False Claims Act, Civil Monetary Penalties Law, licensure, data privacy and security laws (e.g., HIPAA, GDPR), EMTALA, and antitrust laws. Non-compliance by tenants could adversely affect their financial condition and ability to meet obligations.
• International Compliance: Foreign jurisdictions impose laws governing patient care, safety, reimbursement, licensure, and data protection. Government approval may be required for transfers or establishment of new facilities. Legal Proceedings:
• Securities and Derivative Litigation: A federal securities class action lawsuit in Alabama was dismissed with prejudice in September 2024, and related shareholder derivative lawsuits were subsequently dismissed. A federal securities class action lawsuit in New York, alleging misstatements regarding Prospect Medical Holdings, Inc. transactions, is pending a motion to dismiss. Related shareholder derivative lawsuits in New York and Maryland are stayed. Medical Properties Trust, Inc. believes these claims are without merit and intends to defend them vigorously.
• General: The company is subject to various other legal proceedings, claims, and regulatory inquiries. While management believes the ultimate liability will not materially affect its financial position, outcomes are inherently uncertain.

Tax Strategy & Considerations

Tax Profile: Medical Properties Trust, Inc. operates as a U.S. REIT and generally avoids federal corporate income tax by distributing at least 90% of its REIT taxable income. Its TRS entities are subject to U.S. federal and state income taxes. The majority of its U.K. real estate operations have operated as a U.K. REIT since July 1, 2023, generally subject only to a withholding tax on distributions.

• Effective Tax Rate: -16.3% in 2025, -1.9% in 2024, and -19.0% in 2023.
• Geographic Tax Planning: The company's international structure aims to minimize additional U.S. taxes on foreign-based income. Germany enacted legislation in 2025 to reduce future income tax rates by 5%, resulting in a $13 million deferred tax benefit for the MEDIAN joint venture.
• NOLs: As of December 31, 2025, the company had gross U.S. net operating loss (NOL) carryforwards of $929,887k and gross foreign NOL carryforwards of $569,760k. A valuation allowance of approximately $489,604k was recorded against certain deferred tax assets. Tax Status: Medical Properties Trust, Inc. has maintained its U.S. REIT status since 2004 and its U.K. REIT status since July 1, 2023, and intends to continue to do so.

Insurance & Risk Transfer

Risk Management Framework: Medical Properties Trust, Inc. obtains various types of insurance, including property, business interruption, liability, flood, earthquake, fire, wind, and environmental coverage. Tenants and borrowers are generally required to maintain applicable insurance on facilities and operations. The company also maintains a comprehensive insurance program. Certain catastrophic losses may be uninsurable or not economically insurable. Lease and loan documents typically require tenants to indemnify Medical Properties Trust, Inc. for environmental liabilities.