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TSX: DR INVESTOR PRESENTATION SEPTEMBER 2016 MEDICAL FACILITIES CORPORATION

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Page 1: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

TSX: DRINVESTOR PRESENTATION SEPTEMBER 2016

MEDICAL FACILITIES CORPORATION

Page 2: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Forward-Looking Statements

This presentation may contain forward-looking statements within the meaning of certain securities laws, including the

“safe harbour” provisions of the Securities Act (Ontario) and other provincial securities law in Canada. These forward-

looking statements include, among others, statements with respect to our objectives, goals and strategies to achieve

those objectives and goals, as well as statements with respect to our beliefs, plans, objectives, expectations,

anticipations, estimates and intentions. The words “may”, “will”, “could”, “should”, “would”, “suspect”, “outlook”,

“believe”, “plan”, “anticipate”, “estimate”, “expect”, “intend”, “forecast”, “objective” and “continue” (or the negative

thereof), and words and expressions of similar import, are intended to identify forward-looking statements. Any such

statements are subject to risks and uncertainties that could cause actual results to differ materially from those

projected in these forward-looking statements. For more information on the risk factors related to these forward-

looking statements, please refer to the management’s discussion and analysis, annual information form and ongoing

quarterly filings of Medical Facilities Corporation available on SEDAR at www.sedar.com.

Page 3: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Transforming U.S. Healthcare Landscape

Acute Care Hospital

Specialty Surgical Hospital

Ambulatory Surgery Center

Urgent Primary Care Center

MFC TODAY

Home Healthcare

Imaging Clinic

Other Specialty Clinic

(~5,600)

(~235)

(~5,300)

Page 4: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Multiple Payment Sources

Medicare20%

Medicaid16%

Other Public4%

Private Insurance33%

Out-of_Pocket11%

Public Health3%

Investment5%

Other Payors8%

2014:

$3TRILLION

40% Public Health Insurance

Source: “Payment Sources, 2014” Health Care Costs 101, California Health Care Foundation, 2016

Page 5: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Growing Demand for Healthcare

DRIVERS:

Overall population growth

Aging population

Healthcare reform expanding coverage

Source: U.S. Census Bureau, 2010 based on National Population Projections 2008; 2015 & 2020 based on National Population Projections 2012Centers for Medicare & Medicaid Services, National Health Expenditure Projections 2011-2021

(millions) (US$ billion)

Po

pula

tio

n

Natio

nal Health Expenditure

0

1,000

2,000

3,000

4,000

5,000

0

100

200

300

400

2010 2015E 2020E

Under 45 years 45 to 64 years 65 years and over National Health Expenditure(US$ billion)

Page 6: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Changing Healthcare Industry Driving Acquisition Opportunities

Affordable Care Act driving need for greater efficiency and scale in healthcare providers

Independent centers requiring scale to drive margin improvement

Portfolio rebalancing as a result of consolidation or service realignment makes attractive assets available

~940 healthcare transactions in 2015 ($175B)*

*Irving Levin Associates, cited in New York Times, April 8, 2016

Page 7: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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MFC: A Quality Healthcare Provider Well-Positioned for Growth

Majority ownership in four specialty surgical hospitals and one ambulatory surgery center • Specialty Surgical Hospitals: 42 operating rooms and 127 overnight rooms

• Ambulatory Surgery Center: 2 operating rooms and 1 procedure room

2015 Revenue: US$308.8 million

2015 Income from Operations: US$74.7 million

Page 8: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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MFC Specialty Surgical Hospitals

2

1 1Specialty surgical hospitals have

consistently demonstrated HIGHER PATIENT SATISFACTION

ratings resulting from HIGHER QUALITY OF CARE RECEIVED

Our physician owned hospitals benefit from direct physician involvement in

facility management resulting inSUPERIOR PROCESSES AND EFFICIENCIES

1

*Letter of intent in place to acquire hospital operations

FacilityOperating

SinceAcquired Operating Rooms Overnight Rooms Square Feet

Arkansas Surgical Hospital 2005 2012 11 41 126,000

Oklahoma Spine Hospital 1999 2005 7 25 61,000

Black Hills Surgical Hospital 1997 2004 11 26 75,000

Sioux Falls Specialty Hospital 1985 2004 13 35 76,000

Unity Medical and Surgical Hospital* 2009 2016 6 29 50,000

Page 9: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Unemployment Rate (%)1 U.S. South Dakota Oklahoma Arkansas

2015 5.0 2.9 4.1 4.7

2014 5.6 3.3 3.9 5.7

65 and Over (% of population)2

2014 14.5 15.3 14.5 15.7

Situated in geographic regions that have proven to be resilient against challenging economic environments

MFC physicians and staff are integral part of our success, they provide patients with innovative treatments and optimal service

1 Source: The Bureau of Labor Statistics of the US Department of Labor.

2 Source: U.S. Census Bureau, Population Estimates as of July 1, 2014. Release Date: June 2015.

Well-Situated in Current Markets

Page 10: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Unity Medical and Surgical HospitalMishawaka, Indiana

Healthgrades: 5 Star rating in Patient Safety and Outstanding Patient Experience

Indiana Hospital Association Coalition of Care: 6 awards

The only hospital in Northern Indiana and Southern Michigan (Michiana) to

receive a 5 Star ranking from CMS

Becker’s: 150 Great Places to Work in Healthcare

Women’s Choice Award 2015: America’s 100 Best Hospitals for Patient

Experience

Top 1% nationally in overall patient satisfaction and #1 in the state of Indiana

#4 nationally in Value Based Purchasing score 2014

HCAHPS score in top 5%

Letter of intent in place to

purchase (72% ownership in PAM), 62%

Can be purchased over 3 years (all but 4% of the remaining ownership in PAM),

21%

Remaining PAM ownership, 3%

Remaining ownership held by practicing physicians directly in Unity,

14%PAM*ownership, 86%

* Physicians ASC Management, current majority owners of Unity

Page 11: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Strict Acquisition Criteria

Accretive metrics

Strong operating performance

Balanced composition of physicians

Attractive markets (demographics, location)

Change pic to something less similar

Page 12: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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FINANCIALREVIEW

Page 13: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Factors Driving Our Results

Revenues

Case Mix

Case Counts

Payor Mix

Ancillary Services

Levelof

Revenue

Operating Margins

Salaries & Benefits

Drugs & Supplies (incl. implants)

General & Administrative

Page 14: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Blue Cross/Blue Shield

Medicare/Medicaid

WorkersCompensation

Other Private Insurance

Other

MFC Payor Mix – 2015

33%

36%

9%

14%

8%

GROSS BILLING NET REVENUE

33%

27%

10%

19%

11%

Page 15: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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(US$ millions, except where noted otherwise)

Q2 2016 Q2 2015 Change %

REVENUE 76.7 73.6 4.2%

INCOME FROM OPERATIONS* 13.8 16.0 (13.9%)

OPERATING MARGIN 17.9% 21.7% (17.1%)

CASH AVAILABLE FOR DISTRIBUTION (C$ MILLIONS)

10.5 12.1 (13.2%)

PAYOUT RATIO 82.8% 72.8% 13.7%

Operating Results – Q2 2016

* Based on income from operations, which is income before interest expense, gains or losses on foreign currency translation and other non-operating income and expenses.

Page 16: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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$257.0

$187.4

$50.5

$116.0

$69.4$34.2

$39.3

Strong Financial Position – Q2 2016

Current Assets Total

Liabilities

Total EquityNon-Current Assets

Cash & Cash Equivalents, Short-Term Investments

Subsidiary Debt (including current portion)

Corporate Level Debt

Other Current AssetsOther Liabilities

Consolidated Balance Sheet(US$ millions)

3.4xCurrent Ratio

52.4%Net Debt/Equity

2.6xSubsidiary Debt Coverage

(LTM)

Page 17: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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31.2 31.534.4 35.3 35.233.8

37.840.8 41.4

45.9

33.335.7

40.843.3

51.9

2011 2012 2013 2014 2015

76.72015

PAYOUT RATIO*

%

83.3%92.3%

(C$ millions)

Distributions Cash Available for Distribution (including realized gains/losses on FX forward contracts)

84.3%Payout Ratio*

*Including realized gains/losses of FX forward contracts

Strong Cash Flow

Cash Available for Distribution (Excluding realized gains/losses on FX forward contracts)

85.2% 76.7%

Page 18: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Key Strengths

• Well-located facilities providing stable cash flows

• Favorable industry growth drivers

• Experienced, entrepreneurial management team

• Resources in place to execute on growth strategy

Page 19: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Board of Directors

Marilynne Day-Linton, CPA, CA Chair of the Board of Directors

Irving Gerstein, C.M., O.OntCorporate Director

David Bellaire Senior Advisor, Bain & Company

Dale Lawr, CPA, CA (Ontario) & CPA (Illinois)Corporate Director

John PerriPartner, Dorchester Capital, LLC

Stephen Dineley, FCPA, FCA Corporate Director

Jeffrey LozonCorporate Director

Page 20: Medical Facilities Corporation TSX: DR€¦ · Transforming U.S. Healthcare Landscape Acute Care Hospital Specialty Surgical Hospital Ambulatory Surgery Center Urgent Primary Care

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Capital Markets Profile* (as at August 9, 2016)

Stock Symbol: TSX: DR

Shares Outstanding: 31 million

Price: $21.50

52-Week Low / High: $12.75/$22.66

Market Capitalization: $667.5 million

Annualized Distribution (per share): $1.125

Current Yield: 5.2%

Payout Ratio (TTM): 82.8%

*All figures in $Canadian