NOTICE: THIS AGREEMENT IS SUBJECT TO ARBITRATION PURSUANT TO THE SOUTH CAROLINA UNIFORM
ARBITRATION ACT, SECTION 15-48-10 ET SEQ. OF THE CODE OF LAWS OF SOUTH CAROLINA

FUTURE DEVELOPMENT AGREEMENT

THIS FUTURE DEVELOPMENT AGREEMENT (this “ Agreement ”) is made as of September 9, 2009 by and between HTA — GREENVILLE, LLC, a Delaware limited liability company (“ REIT ”), and GREENVILLE HOSPITAL SYSTEM, a political subdivision organized under the laws of South Carolina (“ GHS ”). REIT and GHS are sometimes collectively referred to herein as the “ Parties ” and individually as a “ Party ”.

RECITALS

A. REIT, as buyer, and GHS (along with certain of its affiliates), as seller, entered into that certain Agreement of Sale and Purchase, dated as of July 15, 2009 as amended by that certain First Amendment to Agreement of Sale and Purchase dated as of August 14, 2009, that certain Second Amendment to Agreement of Sale and Purchase dated as of August 21, 2009 and that certain Third Amendment to Agreement of Sale and Purchase dated as of August 26, 2009 and that certain Fourth Amendment to Agreement of Sale and Purchase dated as of September 4, 2009 (as so amended, the “ Purchase Agreement ”), pursuant to which, on the date hereof, REIT has purchased from GHS a portfolio of medical office building properties located in Greenville, South Carolina, as more particularly described therein (the “ Existing Portfolio ”). All capitalized terms used herein which are not defined herein shall have the meanings given to such terms in the Purchase Agreement.

B. GHS is contemplating the development of certain additional medical office buildings and/or childcare facilities in Greenville, South Carolina, all of which are listed on Exhibit A hereto, a portion of which may be developed on property currently owned by GHS (but not included in the Existing Portfolio) and a portion of which may be developed on property to be subsequently acquired by GHS (each, a “ Development Property ” and collectively, the “ Development Properties ”).

C. As partial and mutual consideration for the purchase and sale of the Existing Portfolio, the Parties agree that, should GHS elect to develop or sell any of the Development Properties with “Outside Funding” (as hereinafter defined), REIT and GHS mutually agree to an arrangement under which REIT will be provided with the opportunity (subject to its approval) to either (i) own and fund the development of such Development Property or (ii) purchase the developed Development Properties at completion, in each case subject to a lease back to GHS as set forth herein.

NOW THEREFORE, in consideration of the foregoing recitals, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows:

AGREEMENT

1.  General Provisions .

(a)  Notice of Intent to Develop . If at any time during the Term, GHS desires to develop or sell (or ground lease) any Development Property with Outside Funding, GHS shall notify REIT in writing (a “ Development Notice ”) (i) of the specific Development Property which GHS intends to develop and/or transfer; (ii) of the desired location of such Development Property (and whether such Development Property is located within a medical campus owned by GHS as of the date hereof (an “ On-Campus Development Property ”) or offsite of any existing campus owned by GHS as of the date hereof (each, an “ Off-Campus Development Property ”); (iii) whether GHS desires for REIT to fund the development and/or acquisition of the Development Property upon completion; and (iv) if GHS has indicated that they would structure the transaction as a transfer, whether GHS prefers to sell or ground lease such Development Property to REIT. For purposes of this Agreement, “ Outside Funding ” shall mean funding for the applicable development or transfer of a Development Property which comes from sources other than (A) GHS itself, (B) joint venture relationships with other healthcare providers or (C) physicians or other tenants of space occupied by GHS.

(b)  Conditions for Approval of Funding or Purchase . Should GHS elect for the REIT to provide funding for development costs (whether as development funds, a construction loan or the purchase price for the completed Development Property), all of the following provisions must have been satisfied on or before       , 2011 (the “Term”):

(i) The maximum commitment amounts (whether as development funds, a construction loan or the purchase price for the completed Development Property) do not exceed, for each Development Property, the amounts reflected for such Development Property on Exhibit A hereto;

(ii) The total amount to be funded by REIT pursuant to this Agreement (whether as development funds, a construction loan or the purchase price for the completed Development Property) does not exceed $5,500,000 in the aggregate;

(iii) At GHS’ election, the applicable Development Property will either be sold or ground leased to REIT (a) prior to the commencement of construction or (b) upon completion of development; provided, however, that notwithstanding the foregoing, (A) each Off-Campus Development Property shall be conveyed to REIT (whether by fee or a “ Development Property Ground Lease ” (as hereinafter defined)) only upon completion of development thereof and (B) with respect to any On-Campus Development Property, if GHS desires to convey such property to REIT prior to commencement of construction, then such property shall be conveyed by a Development Property Ground Lease;

(iv) REIT shall have received evidence satisfactory to REIT that all Development Properties (once constructed) shall be first class medical office buildings and/or childcare facilities of a quality consistent with the other buildings located on or near the applicable campus, and shall be at locations acceptable to REIT;

(v) GHS (or the applicable affiliate thereof) shall have executed and delivered mutually acceptable (a) “ Development Agreement ” (as hereinafter defined), (b) “ Construction Loan Documents ” or “ Construction Disbursement Documents ” (each, as hereinafter defined), as applicable, (c) “ Purchase Agreement ” (as hereinafter defined) or Development Property Ground Lease, as applicable, and (d) a “ Master Lease ” (as hereinafter defined). The documents executed pursuant to this clause (v) shall hereinafter, with respect to any given Development Property, be referred to herein as the “ Development Property Documents ”.

(vi) REIT shall have approved the applicable plans and specifications and project budget. The approved budget shall be the basis for the amount (as applicable) (a) to be funded by the REIT pursuant to Construction Loan Documents or Construction Disbursement Documents (as applicable), (b) the purchase price for such Development Property to be sold under an applicable Purchase Agreement, or (c) the ground lease rent under the Ground Lease in the event the REIT acquires the Development Property after completion;

(vii) REIT shall have approved the selection of the general contractor, architect and engineering teams;

(viii) All conditions precedent to