Hospitals trust Medical Properties to provide the leases under which their facilities operate. The self-advised real estate investment trust (REIT) invests in and owns more than 110 health care facilities, including acute care hospitals, inpatient rehabilitation hospitals, and wellness centers in 25 US states and Germany. California and Texas combined account for nearly 50% of the REIT's annual revenue. It leases the facilities to more than 25 hospital operating companies under long-term triple-net leases, where the tenant bears most of the operating costs. Prime Healthcare Services and Ernest Health are among the REIT's largest clients. Medical Properties Trust entered the European health care market in 2013.