Document and Entity Information
Document and Entity Information - shares shares in Millions | 6 Months Ended | |
Jun. 30, 2022 | Aug. 05, 2022 | |
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2022 | |
Document Fiscal Year Focus | 2022 | |
Document Fiscal Period Focus | Q2 | |
Trading Symbol | MPW | |
Entity Registrant Name | MEDICAL PROPERTIES TRUST, INC. | |
Entity Central Index Key | 0001287865 | |
Current Fiscal Year End Date | --12-31 | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Common Stock, Shares Outstanding | 599 | |
Title of 12(b) Security | Common stock, par value $0.001 per share, of Medical Properties Trust, Inc. | |
Security Exchange Name | NYSE | |
Entity Shell Company | false | |
Entity File Number | 001-32559 | |
Entity Tax Identification Number | 20-0191742 | |
Entity Address, Address Line One | 1000 URBAN CENTER DRIVE | |
Entity Address, Address Line Two | SUITE 501 | |
Entity Address, City or Town | BIRMINGHAM | |
Entity Address, State or Province | AL | |
Entity Address, Postal Zip Code | 35242 | |
City Area Code | 205 | |
Local Phone Number | 969-3755 | |
Entity Incorporation, State or Country Code | MD | |
Document Quarterly Report | true | |
Document Transition Report | false | |
MPT Operating Partnership, L.P. [Member] | ||
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2022 | |
Document Fiscal Year Focus | 2022 | |
Document Fiscal Period Focus | Q2 | |
Entity Registrant Name | MPT OPERATING PARTNERSHIP, L.P. | |
Entity Central Index Key | 0001524607 | |
Current Fiscal Year End Date | --12-31 | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Non-accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity File Number | 333-177186 | |
Entity Tax Identification Number | 20-0242069 | |
Entity Address, Address Line One | 1000 URBAN CENTER DRIVE | |
Entity Address, Address Line Two | SUITE 501 | |
Entity Address, City or Town | BIRMINGHAM | |
Entity Address, State or Province | AL | |
Entity Address, Postal Zip Code | 35242 | |
City Area Code | 205 | |
Local Phone Number | 969-3755 | |
Entity Incorporation, State or Country Code | DE |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Real estate assets | ||
Land, buildings and improvements, intangible lease assets, and other | $ 13,696,681 | $ 14,062,722 |
Investment in financing leases | 2,076,813 | 2,053,327 |
Real estate held for sale | 0 | 1,096,505 |
Mortgage loans | 314,681 | 213,211 |
Gross investment in real estate assets | 16,088,175 | 17,425,765 |
Accumulated depreciation and amortization | (1,109,592) | (993,100) |
Net investment in real estate assets | 14,978,583 | 16,432,665 |
Cash and cash equivalents | 257,269 | 459,227 |
Interest and rent receivables | 94,206 | 56,229 |
Straight-line rent receivables | 702,683 | 728,522 |
Investments in unconsolidated real estate joint ventures | 1,460,373 | 1,152,927 |
Investments in unconsolidated operating entities | 1,439,910 | 1,289,434 |
Other loans | 213,897 | 67,317 |
Other assets | 596,163 | 333,480 |
Total Assets | 19,743,084 | 20,519,801 |
Liabilities | ||
Debt, net | 10,138,774 | 11,282,770 |
Accounts payable and accrued expenses | 562,255 | 607,792 |
Deferred revenue | 21,210 | 25,563 |
Obligations to tenants and other lease liabilities | 154,974 | 158,005 |
Total Liabilities | 10,877,213 | 12,074,130 |
Equity / Capital | ||
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding | ||
Common stock, $0.001 par value. Authorized 750,000 shares; issued and Outstanding - 598,839 shares at June 30, 2022 and 596,748 shares at December 31, 2021 | 599 | 597 |
Additional paid-in capital | 8,557,120 | 8,564,009 |
Retained earnings (deficit) | 385,545 | (87,691) |
Accumulated other comprehensive loss | (83,431) | (36,727) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 8,859,833 | 8,440,188 |
Non-controlling interests | 6,038 | 5,483 |
Total Equity / Capital | 8,865,871 | 8,445,671 |
Total Liabilities and Equity / Capital | 19,743,084 | 20,519,801 |
MPT Operating Partnership, L.P. [Member] | ||
Real estate assets | ||
Land, buildings and improvements, intangible lease assets, and other | 13,696,681 | 14,062,722 |
Investment in financing leases | 2,076,813 | 2,053,327 |
Real estate held for sale | 1,096,505 | |
Mortgage loans | 314,681 | 213,211 |
Gross investment in real estate assets | 16,088,175 | 17,425,765 |
Accumulated depreciation and amortization | (1,109,592) | (993,100) |
Net investment in real estate assets | 14,978,583 | 16,432,665 |
Cash and cash equivalents | 257,269 | 459,227 |
Interest and rent receivables | 94,206 | 56,229 |
Straight-line rent receivables | 702,683 | 728,522 |
Investments in unconsolidated real estate joint ventures | 1,460,373 | 1,152,927 |
Investments in unconsolidated operating entities | 1,439,910 | 1,289,434 |
Other loans | 213,897 | 67,317 |
Other assets | 596,163 | 333,480 |
Total Assets | 19,743,084 | 20,519,801 |
Liabilities | ||
Debt, net | 10,138,774 | 11,282,770 |
Accounts payable and accrued expenses | 387,848 | 430,908 |
Deferred revenue | 21,210 | 25,563 |
Obligations to tenants and other lease liabilities | 154,974 | 158,005 |
Payable due to Medical Properties Trust, Inc. | 174,017 | 176,494 |
Total Liabilities | 10,876,823 | 12,073,740 |
Equity / Capital | ||
General Partner -- issued and outstanding -- 5,988 units at June 30, 2022 and 5,968 units at December 31, 2021 | 89,511 | 84,847 |
Limited Partners -- issued and outstanding -- 592,851 units at June 30, 2022 and 590,780 units at December 31, 2021 | 8,854,143 | 8,392,458 |
Accumulated other comprehensive loss | (83,431) | (36,727) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 8,860,223 | 8,440,578 |
Non-controlling interests | 6,038 | 5,483 |
Total Equity / Capital | 8,866,261 | 8,446,061 |
Total Liabilities and Equity / Capital | $ 19,743,084 | $ 20,519,801 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares | Jun. 30, 2022 | Dec. 31, 2021 |
Preferred stock, par value | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized | 10,000,000 | 10,000,000 |
Preferred stock, shares outstanding | 0 | 0 |
Common stock, par value | $ 0.001 | $ 0.001 |
Common stock, shares authorized | 750,000,000 | 750,000,000 |
Common stock, shares issued | 598,839,000 | 596,748,000 |
Common stock, shares outstanding | 598,839,000 | 596,748,000 |
General Partner [Member] | MPT Operating Partnership, L.P. [Member] | ||
General partner, units issued | 5,988 | 5,968 |
General partner, units outstanding | 5,988 | 5,968 |
Common Units | MPT Operating Partnership, L.P. [Member] | ||
Limited Partners, units issued | 592,851 | 590,780 |
Limited Partners, units outstanding | 592,851 | 590,780 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Revenues | ||||
Rent billed | $ 241,209 | $ 216,870 | $ 504,611 | $ 430,214 |
Straight-line rent | 58,518 | 55,465 | 119,562 | 110,338 |
Income from financing leases | 51,873 | 50,337 | 103,649 | 101,231 |
Interest and other income | 48,626 | 59,120 | 82,204 | 102,774 |
Total revenues | 400,226 | 381,792 | 810,026 | 744,557 |
Expenses | ||||
Interest | 87,730 | 92,305 | 178,913 | 179,277 |
Real estate depreciation and amortization | 84,334 | 76,369 | 169,650 | 152,011 |
Property-related | 21,135 | 18,684 | 29,733 | 24,137 |
General and administrative | 38,858 | 34,545 | 80,282 | 70,618 |
Total expenses | 232,057 | 221,903 | 458,578 | 426,043 |
Other income (expense) | ||||
Gain (loss) on sale of real estate and other, net | 16,355 | (1,387) | 467,993 | (398) |
Earnings from equity interests | 14,785 | 7,339 | 22,123 | 14,440 |
Debt refinancing and unutilized financing costs | (619) | (70) | (9,435) | (2,339) |
Other (including fair value adjustments on securities) | 2,031 | (771) | 11,918 | 7,023 |
Total other income | 32,552 | 5,111 | 492,599 | 18,726 |
Income before income tax | 200,721 | 165,000 | 844,047 | 337,240 |
Income tax expense | (10,657) | (50,179) | (22,036) | (58,539) |
Net income | 190,064 | 114,821 | 822,011 | 278,701 |
Net income attributable to non-controlling interests | (467) | (256) | (733) | (353) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 189,597 | $ 114,565 | $ 821,278 | $ 278,348 |
Earnings per common share (units) basic | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners), basic | $ 0.32 | $ 0.19 | $ 1.37 | $ 0.48 |
Earnings per common share (units) diluted | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners), diluted | $ 0.32 | $ 0.19 | $ 1.37 | $ 0.48 |
Weighted average shares (units) outstanding basic | 598,827 | 587,514 | 598,751 | 581,877 |
Weighted average shares (units) outstanding diluted | 599,026 | 589,053 | 598,979 | 583,297 |
Dividends declared per common share (unit) | $ 0.29 | $ 0.28 | $ 0.58 | $ 0.56 |
MPT Operating Partnership, L.P. [Member] | ||||
Revenues | ||||
Rent billed | $ 241,209 | $ 216,870 | $ 504,611 | $ 430,214 |
Straight-line rent | 58,518 | 55,465 | 119,562 | 110,338 |
Income from financing leases | 51,873 | 50,337 | 103,649 | 101,231 |
Interest and other income | 48,626 | 59,120 | 82,204 | 102,774 |
Total revenues | 400,226 | 381,792 | 810,026 | 744,557 |
Expenses | ||||
Interest | 87,730 | 92,305 | 178,913 | 179,277 |
Real estate depreciation and amortization | 84,334 | 76,369 | 169,650 | 152,011 |
Property-related | 21,135 | 18,684 | 29,733 | 24,137 |
General and administrative | 38,858 | 34,545 | 80,282 | 70,618 |
Total expenses | 232,057 | 221,903 | 458,578 | 426,043 |
Other income (expense) | ||||
Gain (loss) on sale of real estate and other, net | 16,355 | (1,387) | 467,993 | (398) |
Earnings from equity interests | 14,785 | 7,339 | 22,123 | 14,440 |
Debt refinancing and unutilized financing costs | (619) | (70) | (9,435) | (2,339) |
Other (including fair value adjustments on securities) | 2,031 | (771) | 11,918 | 7,023 |
Total other income | 32,552 | 5,111 | 492,599 | 18,726 |
Income before income tax | 200,721 | 165,000 | 844,047 | 337,240 |
Income tax expense | (10,657) | (50,179) | (22,036) | (58,539) |
Net income | 190,064 | 114,821 | 822,011 | 278,701 |
Net income attributable to non-controlling interests | (467) | (256) | (733) | (353) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 189,597 | $ 114,565 | $ 821,278 | $ 278,348 |
Earnings per common share (units) basic | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners), basic | $ 0.32 | $ 0.19 | $ 1.37 | $ 0.48 |
Earnings per common share (units) diluted | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners), diluted | $ 0.32 | $ 0.19 | $ 1.37 | $ 0.48 |
Weighted average shares (units) outstanding basic | 598,827 | 587,514 | 598,751 | 581,877 |
Weighted average shares (units) outstanding diluted | 599,026 | 589,053 | 598,979 | 583,297 |
Dividends declared per common share (unit) | $ 0.29 | $ 0.28 | $ 0.58 | $ 0.56 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Net income | $ 190,064 | $ 114,821 | $ 822,011 | $ 278,701 |
Other comprehensive income: | ||||
Unrealized gain on interest rate swaps, net of tax | 25,920 | 4,207 | 70,852 | 19,711 |
Foreign currency translation (loss) gain | (104,341) | 9,014 | (117,556) | (21,886) |
Total comprehensive income | 111,643 | 128,042 | 775,307 | 276,526 |
Comprehensive income attributable to non-controlling interests | (467) | (256) | (733) | (353) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | 111,176 | 127,786 | 774,574 | 276,173 |
MPT Operating Partnership, L.P. [Member] | ||||
Net income | 190,064 | 114,821 | 822,011 | 278,701 |
Other comprehensive income: | ||||
Unrealized gain on interest rate swaps, net of tax | 25,920 | 4,207 | 70,852 | 19,711 |
Foreign currency translation (loss) gain | (104,341) | 9,014 | (117,556) | (21,886) |
Total comprehensive income | 111,643 | 128,042 | 775,307 | 276,526 |
Comprehensive income attributable to non-controlling interests | (467) | (256) | (733) | (353) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | $ 111,176 | $ 127,786 | $ 774,574 | $ 276,173 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands | Total | MPT Operating Partnership, L.P. [Member] | MPT Operating Partnership, L.P. [Member] General Partner [Member] | Common Par Value [Member] | Common Par Value [Member] MPT Operating Partnership, L.P. [Member] Limited Partner [Member] | Additional Paid-in Capital [Member] | Retained Earnings (Deficit) [Member] | Accumulated Other Comprehensive Loss [Member] | Accumulated Other Comprehensive Loss [Member] MPT Operating Partnership, L.P. [Member] | Non-Controlling Interests [Member] | Non-Controlling Interests [Member] MPT Operating Partnership, L.P. [Member] |
Beginning balance at Dec. 31, 2020 | $ 7,343,857 | $ 7,344,247 | $ 73,977 | $ 541 | $ 7,316,269 | $ 7,460,726 | $ (71,411) | $ (51,324) | $ (51,324) | $ 5,325 | $ 5,325 |
Beginning balance (in shares) at Dec. 31, 2020 | 5,414 | 541,353 | 535,939 | ||||||||
Net income | 163,880 | 163,880 | $ 1,638 | $ 162,145 | 163,783 | 97 | 97 | ||||
Unrealized gain (loss) on interest rate swap, net of tax | 15,504 | 15,504 | 15,504 | 15,504 | |||||||
Foreign currency translation (loss) gain | (30,900) | (30,900) | (30,900) | (30,900) | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 12,264 | 12,264 | $ 123 | $ 2 | $ 12,141 | 12,262 | |||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 17 | 1,741 | 1,724 | ||||||||
Distributions to non-controlling interests | (193) | (193) | (193) | (193) | |||||||
Proceeds from offering (net of offering costs) | 779,241 | 779,241 | $ 7,792 | $ 40 | $ 771,449 | 779,201 | |||||
Proceeds from offering (net of offering costs) (shares) | 399 | 39,949 | 39,550 | ||||||||
Dividends (Distributions) declared | (163,443) | (163,443) | $ (1,634) | $ (161,809) | (163,443) | ||||||
Ending balance at Mar. 31, 2021 | 8,120,210 | 8,120,600 | $ 81,896 | $ 583 | $ 8,100,195 | 8,252,189 | (71,071) | (66,720) | (66,720) | 5,229 | 5,229 |
Ending balance (in shares) at Mar. 31, 2021 | 5,830 | 583,043 | 577,213 | ||||||||
Beginning balance at Dec. 31, 2020 | 7,343,857 | 7,344,247 | $ 73,977 | $ 541 | $ 7,316,269 | 7,460,726 | (71,411) | (51,324) | (51,324) | 5,325 | 5,325 |
Beginning balance (in shares) at Dec. 31, 2020 | 5,414 | 541,353 | 535,939 | ||||||||
Net income | 278,701 | 278,701 | |||||||||
Unrealized gain (loss) on interest rate swap, net of tax | 19,711 | 19,711 | |||||||||
Foreign currency translation (loss) gain | (21,886) | (21,886) | |||||||||
Ending balance at Jun. 30, 2021 | 8,217,081 | 8,217,471 | $ 82,732 | $ 589 | $ 8,182,895 | 8,386,287 | (121,639) | (53,499) | (53,499) | 5,343 | 5,343 |
Ending balance (in shares) at Jun. 30, 2021 | 5,890 | 588,898 | 583,008 | ||||||||
Beginning balance at Mar. 31, 2021 | 8,120,210 | 8,120,600 | $ 81,896 | $ 583 | $ 8,100,195 | 8,252,189 | (71,071) | (66,720) | (66,720) | 5,229 | 5,229 |
Beginning balance (in shares) at Mar. 31, 2021 | 5,830 | 583,043 | 577,213 | ||||||||
Net income | 114,821 | 114,821 | $ 1,146 | $ 113,419 | 114,565 | 256 | 256 | ||||
Unrealized gain (loss) on interest rate swap, net of tax | 4,207 | 4,207 | 4,207 | 4,207 | |||||||
Foreign currency translation (loss) gain | 9,014 | 9,014 | 9,014 | 9,014 | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 12,771 | 12,771 | $ 128 | $ 12,643 | 12,771 | ||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 2 | 176 | 174 | ||||||||
Distributions to non-controlling interests | (142) | (142) | (142) | (142) | |||||||
Proceeds from offering (net of offering costs) | 121,333 | 121,333 | $ 1,213 | $ 6 | $ 120,120 | 121,327 | |||||
Proceeds from offering (net of offering costs) (shares) | 58 | 5,679 | 5,621 | ||||||||
Dividends (Distributions) declared | (165,133) | (165,133) | $ (1,651) | $ (163,482) | (165,133) | ||||||
Ending balance at Jun. 30, 2021 | 8,217,081 | 8,217,471 | $ 82,732 | $ 589 | $ 8,182,895 | 8,386,287 | (121,639) | (53,499) | (53,499) | 5,343 | 5,343 |
Ending balance (in shares) at Jun. 30, 2021 | 5,890 | 588,898 | 583,008 | ||||||||
Beginning balance at Dec. 31, 2021 | 8,445,671 | 8,446,061 | $ 84,847 | $ 597 | $ 8,392,458 | 8,564,009 | (87,691) | (36,727) | (36,727) | 5,483 | 5,483 |
Beginning balance (in shares) at Dec. 31, 2021 | 5,968 | 596,748 | 590,780 | ||||||||
Net income | 631,947 | 631,947 | $ 6,317 | $ 625,364 | 631,681 | 266 | 266 | ||||
Unrealized gain (loss) on interest rate swap, net of tax | 44,932 | 44,932 | 44,932 | 44,932 | |||||||
Foreign currency translation (loss) gain | (13,215) | (13,215) | (13,215) | (13,215) | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 11,804 | 11,804 | $ 118 | $ 3 | $ 11,686 | 11,801 | |||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 31 | 3,107 | 3,076 | ||||||||
Acquisition of non-controlling interest | 929 | 929 | 929 | 929 | |||||||
Stock vesting - satisfaction of tax withholding | (27,919) | (27,919) | $ (279) | $ (1) | $ (27,640) | (27,918) | |||||
Stock vesting - satisfaction of tax withholding (Shares) | (12) | (1,179) | (1,167) | ||||||||
Distributions to non-controlling interests | (772) | (772) | (772) | (772) | |||||||
Dividends (Distributions) declared | (174,018) | (174,018) | $ (1,740) | $ (172,278) | (174,018) | ||||||
Ending balance at Mar. 31, 2022 | 8,919,359 | 8,919,749 | $ 89,263 | $ 599 | $ 8,829,590 | 8,547,892 | 369,972 | (5,010) | (5,010) | 5,906 | 5,906 |
Ending balance (in shares) at Mar. 31, 2022 | 5,987 | 598,676 | 592,689 | ||||||||
Beginning balance at Dec. 31, 2021 | 8,445,671 | 8,446,061 | $ 84,847 | $ 597 | $ 8,392,458 | 8,564,009 | (87,691) | (36,727) | (36,727) | 5,483 | 5,483 |
Beginning balance (in shares) at Dec. 31, 2021 | 5,968 | 596,748 | 590,780 | ||||||||
Net income | 822,011 | 822,011 | |||||||||
Unrealized gain (loss) on interest rate swap, net of tax | 70,852 | 70,852 | |||||||||
Foreign currency translation (loss) gain | (117,556) | (117,556) | |||||||||
Ending balance at Jun. 30, 2022 | 8,865,871 | 8,866,261 | $ 89,511 | $ 599 | $ 8,854,143 | 8,557,120 | 385,545 | (83,431) | (83,431) | 6,038 | 6,038 |
Ending balance (in shares) at Jun. 30, 2022 | 5,988 | 598,839 | 592,851 | ||||||||
Beginning balance at Mar. 31, 2022 | 8,919,359 | 8,919,749 | $ 89,263 | $ 599 | $ 8,829,590 | 8,547,892 | 369,972 | (5,010) | (5,010) | 5,906 | 5,906 |
Beginning balance (in shares) at Mar. 31, 2022 | 5,987 | 598,676 | 592,689 | ||||||||
Net income | 190,064 | 190,064 | $ 1,896 | $ 187,701 | 189,597 | 467 | 467 | ||||
Unrealized gain (loss) on interest rate swap, net of tax | 25,920 | 25,920 | 25,920 | 25,920 | |||||||
Foreign currency translation (loss) gain | (104,341) | (104,341) | (104,341) | (104,341) | |||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation | 10,108 | 10,108 | $ 101 | $ 10,007 | 10,108 | ||||||
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares) | 2 | 204 | 202 | ||||||||
Stock vesting - satisfaction of tax withholding | (880) | (880) | $ (9) | $ (871) | (880) | ||||||
Stock vesting - satisfaction of tax withholding (Shares) | (1) | (41) | (40) | ||||||||
Distributions to non-controlling interests | (335) | (335) | (335) | (335) | |||||||
Dividends (Distributions) declared | (174,024) | (174,024) | $ (1,740) | $ (172,284) | (174,024) | ||||||
Ending balance at Jun. 30, 2022 | $ 8,865,871 | $ 8,866,261 | $ 89,511 | $ 599 | $ 8,854,143 | $ 8,557,120 | $ 385,545 | $ (83,431) | $ (83,431) | $ 6,038 | $ 6,038 |
Ending balance (in shares) at Jun. 30, 2022 | 5,988 | 598,839 | 592,851 |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2022 | Mar. 31, 2022 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Dividends (Distributions) declared per common share / unit | $ 0.29 | $ 0.29 | $ 0.28 | $ 0.28 | $ 0.58 | $ 0.56 |
MPT Operating Partnership, L.P. [Member] | ||||||
Dividends (Distributions) declared per common share / unit | 0.29 | 0.28 | $ 0.58 | $ 0.56 | ||
MPT Operating Partnership, L.P. [Member] | General Partner [Member] | ||||||
Dividends (Distributions) declared per common share / unit | $ 0.29 | $ 0.29 | $ 0.28 | $ 0.28 |
Condensed Consolidated Statem_5
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Operating activities | ||
Net income | $ 822,011 | $ 278,701 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 176,077 | 157,675 |
Amortization of deferred financing costs and debt discount | 9,219 | 7,692 |
Straight-line rent revenue and other | (145,725) | (131,291) |
Share / (Unit)-based compensation expense | 21,912 | 25,035 |
Gain (loss) on sale of real estate and other, net | (467,993) | 398 |
Straight-line rent and other write-off (recovery) | 4,548 | (5,251) |
Debt refinancing and unutilized financing costs | 9,435 | 2,339 |
Tax rate changes | (825) | 42,746 |
Other adjustments | (13,171) | 12,909 |
Changes in: | ||
Interest and rent receivables | (44,224) | (24,999) |
Other assets | (6,343) | (2,633) |
Accounts payable and accrued expenses | (15,558) | 19,320 |
Deferred revenue | (5,347) | (17,383) |
Net cash provided by operating activities | 344,016 | 365,258 |
Investing activities | ||
Cash paid for acquisitions and other related investments | (946,243) | (3,062,029) |
Net proceeds from sale of real estate | 1,817,642 | 25,186 |
Principal received on loans receivable | 19,478 | 1,206,699 |
Investment in loans receivable | (175,734) | (24,487) |
Construction in progress and other | (91,167) | (21,436) |
Proceeds from return of equity investment | 775 | 11,000 |
Capital additions and other investments, net | (90,623) | (97,758) |
Net cash provided by (used for) investing activities | 534,128 | (1,962,825) |
Financing activities | ||
Proceeds from term debt, net of discount | 0 | 1,839,735 |
Payments of term debt | (869,606) | (689,450) |
Revolving credit facilities, net | 200,945 | 42,323 |
Dividends / Distribution paid | (350,519) | (311,109) |
Lease deposits and other obligations to tenants | 3,174 | 322 |
Proceeds from sale of common shares, net of offering costs | 0 | 900,574 |
Unit vesting - satisfaction of tax withholdings | (28,799) | |
Payment of debt refinancing, deferred financing costs, and other financing activities | (17,917) | (23,489) |
Net cash provided by financing activities | (1,062,722) | 1,758,906 |
(Decrease) increase in cash, cash equivalents, and restricted cash for period | (184,578) | 161,339 |
Effect of exchange rate changes | (14,786) | 6,173 |
Cash, cash equivalents, and restricted cash at beginning of period | 461,882 | 556,369 |
Cash, cash equivalents, and restricted cash at end of period | 262,518 | 723,881 |
Interest paid | 209,445 | 160,985 |
Supplemental schedule of non-cash financing activities: | ||
Dividend / Distributions declared, unpaid | 174,017 | 165,133 |
Cash, cash equivalents, and restricted cash are comprised of the following: | ||
Cash and cash equivalents at beginning of period | 459,227 | 549,884 |
Restricted cash, included in Other assets at beginning of period | $ 2,655 | $ 6,485 |
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] | Other Assets | Other Assets |
Cash, cash equivalents, and restricted cash at beginning of period | $ 461,882 | $ 556,369 |
Cash and cash equivalents at end of period | 257,269 | 721,321 |
Restricted cash, included in Other assets at end of period | $ 5,249 | $ 2,560 |
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] | Other Assets | Other Assets |
Cash, cash equivalents, and restricted cash at end of period | $ 262,518 | $ 723,881 |
MPT Operating Partnership, L.P. [Member] | ||
Operating activities | ||
Net income | 822,011 | 278,701 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 176,077 | 157,675 |
Amortization of deferred financing costs and debt discount | 9,219 | 7,692 |
Straight-line rent revenue and other | (145,725) | (131,291) |
Share / (Unit)-based compensation expense | 21,912 | 25,035 |
Gain (loss) on sale of real estate and other, net | (467,993) | 398 |
Straight-line rent and other write-off (recovery) | 4,548 | (5,251) |
Debt refinancing and unutilized financing costs | 9,435 | 2,339 |
Tax rate changes | (825) | 42,746 |
Other adjustments | (13,171) | 12,909 |
Changes in: | ||
Interest and rent receivables | (44,224) | (24,999) |
Other assets | (6,343) | (2,633) |
Accounts payable and accrued expenses | (15,558) | 19,320 |
Deferred revenue | (5,347) | (17,383) |
Net cash provided by operating activities | 344,016 | 365,258 |
Investing activities | ||
Cash paid for acquisitions and other related investments | (946,243) | (3,062,029) |
Net proceeds from sale of real estate | 1,817,642 | 25,186 |
Principal received on loans receivable | 19,478 | 1,206,699 |
Investment in loans receivable | (175,734) | (24,487) |
Construction in progress and other | (91,167) | (21,436) |
Proceeds from return of equity investment | 775 | 11,000 |
Capital additions and other investments, net | (90,623) | (97,758) |
Net cash provided by (used for) investing activities | 534,128 | (1,962,825) |
Financing activities | ||
Proceeds from term debt, net of discount | 0 | 1,839,735 |
Payments of term debt | (869,606) | (689,450) |
Revolving credit facilities, net | 200,945 | 42,323 |
Dividends / Distribution paid | (350,519) | (311,109) |
Lease deposits and other obligations to tenants | 3,174 | 322 |
Proceeds from sale of units, net of offering costs | 0 | 900,574 |
Unit vesting - satisfaction of tax withholdings | (28,799) | |
Payment of debt refinancing, deferred financing costs, and other financing activities | (17,917) | (23,489) |
Net cash provided by financing activities | (1,062,722) | 1,758,906 |
(Decrease) increase in cash, cash equivalents, and restricted cash for period | (184,578) | 161,339 |
Effect of exchange rate changes | (14,786) | 6,173 |
Cash, cash equivalents, and restricted cash at beginning of period | 461,882 | 556,369 |
Cash, cash equivalents, and restricted cash at end of period | 262,518 | 723,881 |
Interest paid | 209,445 | 160,985 |
Supplemental schedule of non-cash financing activities: | ||
Dividend / Distributions declared, unpaid | 174,017 | 165,133 |
Cash, cash equivalents, and restricted cash are comprised of the following: | ||
Cash and cash equivalents at beginning of period | 459,227 | 549,884 |
Restricted cash, included in Other assets at beginning of period | $ 2,655 | $ 6,485 |
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] | Other Assets | Other Assets |
Cash, cash equivalents, and restricted cash at beginning of period | $ 461,882 | $ 556,369 |
Cash and cash equivalents at end of period | 257,269 | 721,321 |
Restricted cash, included in Other assets at end of period | $ 5,249 | $ 2,560 |
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List] | Other Assets | Other Assets |
Cash, cash equivalents, and restricted cash at end of period | $ 262,518 | $ 723,881 |
Organization
Organization | 6 Months Ended |
Jun. 30, 2022 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization | 1. Organ ization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P. (the “Operating Partnership”), through which we conduct all of our operations, was formed in September 2003. At present, we own all of the partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist. We operate as a real estate investment trust (“REIT”). Accordingly, we will generally not be subject to United States (“U.S.”) federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain non-real estate activities we undertake are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S., we are subject to the local taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur additional taxes, of a significant nature, in the U.S. from foreign-based income as the majority of such income flows through our REIT. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services, such as operators of general acute care hospitals, behavioral health facilities, inpatient physical rehabilitation facilities, long-term acute care hospitals, and freestanding ER/urgent care facilities. We also make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants, from time-to-time, in order to enhance our overall return and provide for certain minority rights and protections. Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At June 30, 2022 , we have investments in 447 facilities in 32 states in the U.S., in seven countries in Europe, one country in South America, and across Australia. We manage our business as a single business segment. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 6 Months Ended |
Jun. 30, 2022 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary o f Significant Accounting Policies Unaudited Interim Condensed Consolidated Financial Statements : The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair statement have been included. Operating results for the three and six months ended June 30, 2022, are not necessarily indicative of the results that may be expected for the year ending December 31, 2022. The condensed consolidated balance sheet at December 31, 2021 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of June 30, 2022 (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Actual results could differ from these estimates for various reasons including the impact from COVID-19 and other risk factors as outlined in Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2021. For information about significant accounting policies (including any recent accounting developments), refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2021 . Except for changes disclosed in our Quarterly Report on Form 10-Q for the period ended March 31, 2022, there have been no material changes to these significant accounting policies. Reclassifications Certain amounts in the condensed consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. Variable Interest Entities At June 30, 2022 , we had loans and/or equity investments in certain variable interest entities approximating $ 620 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities. |
Real Estate and Other Activitie
Real Estate and Other Activities | 6 Months Ended |
Jun. 30, 2022 | |
Real Estate [Abstract] | |
Real Estate and Other Activities | 3. Real Estate a nd Other Activities New Investments We acquired or invested in the following net assets (in thousands): For the Six Months 2022 2021 Land and land improvements $ 34,204 $ 345,039 Buildings 290,256 825,322 Intangible lease assets — subject to amortization (weighted-average useful 20.1 years for 2022 and 45.0 years for 2021) 16,949 96,455 Mortgage loans(1)(2) 100,000 1,090,400 Investments in unconsolidated real estate joint ventures 399,456 — Investments in unconsolidated operating entities 131,105 845,646 Liabilities assumed ( 25,727 ) ( 65,411 ) 946,243 3,137,451 Loans repaid(1) — ( 1,090,400 ) Total net assets acquired $ 946,243 $ 2,047,051 (1) The 2021 column includes an £ 800 million mortgage loan advanced to the Priory Group ("Priory") in the first quarter of 2021 and converted to fee simple ownership of 35 properties in the second quarter of 2021 as described below. (2) In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment, which is anticipated during the fourth quarter. 2022 Activity Macquarie Transaction On March 14, 2022, we completed a transaction with Macquarie Asset Management (“MAM”) to form a partnership (the “Macquarie Transaction”), pursuant to which we contributed eight Massachusetts-based general acute care hospitals that are leased to Steward Health Care System LLC ("Steward"), and a fund managed by MAM has acquired, for cash consideration, a 50 % interest in the partnership. The transaction valued the portfolio at approximately $ 1.7 billion, and we recognized a gain on real estate of approximately $ 600 million from this transaction, partially offset by the write-off of unbilled straight-line rent receivables. The partnership raised nonrecourse secured debt of 55 % of asset value, and we received proceeds, including from the secured debt, of approximately $ 1.3 billion, virtually all of which was used to repay debt. We obtained a 50 % interest in the real estate partnership valued at approximately $ 400 million (included in the "Investments in unconsolidated real estate joint ventures" line of the condensed consolidated balance sheets), which is being accounted for under the equity method of accounting. Other Transactions On March 11, 2022, we acquired four general acute care hospitals in Finland for € 178 million ($ 194 million). These hospitals are leased to Pihlajalinna pursuant to a long-term lease with annual inflation-based escalators. We acquired these facilities by the share purchase of real estate holding entities that included deferred income tax and other liabilities of approximately $ 26 million. On February 16, 2022, we agreed to participate in an existing syndicated term loan with a term of six years originated on behalf of Priory. We funded £ 96.5 million towards a £ 100 million participation level in the variable rate loan, reflecting a 3.5 % discount. Other acquisitions in the first half of 2022 included five general acute care facilities. Three general acute care facilities, located throughout Spain, were acquired on April 29, 2022 for € 27 million and are leased to GenesisCare pursuant to a long-term lease with annual inflation-based escalators. The other two general acute care facilities, one in Arizona and the other in Florida, were acquired on April 18 and 25, 2022, respectively, for approximately $ 80 million and are leased to Steward pursuant to an already existing master lease agreement with annual inflation-based escalators. 2021 Activity Priory Group Transaction On January 19, 2021, we completed the first of two phases in the Priory transaction in which we funded an £ 800 million interim mortgage loan on an identified portfolio of Priory real estate assets in the United Kingdom. On June 25, 2021, we completed the second phase of the transaction in which we converted this interim mortgage loan to fee simple ownership in a portfolio of 35 select real estate assets from Priory (which is currently majority-owned by Waterland Private Equity Fund VII C.V. (“Waterland VII”)) in individual sale-and-leaseback transactions. Therefore, the net aggregate purchase price for the real estate assets we acquired from Priory was approximately £ 800 million, plus customary stamp duty, tax, and other transaction costs. In addition to the real estate investment, on January 19, 2021, we made a £ 250 million interim acquisition loan to Waterland VII, in connection with the closing of Waterland VII’s acquisition of Priory, which was repaid in full plus interest on October 22, 2021. In addition, we acquired a 9.9 % equity interest in the Waterland VII affiliate that indirectly owns Priory. Other Transactions On April 16, 2021, we made a CHF 145 million investment in Swiss Medical Network, our tenant via our Infracore SA ("Infracore") equity investment. On January 8, 2021, we made a $ 335 million loan to affiliates of Steward, all of the proceeds of which were used to pay to and redeem a similarly sized convertible loan from Steward’s former private equity sponsor. This loan now carries a four percent interest rate with possible additional returns based on the increase in the value of Steward. The initial term of the loan is seven years . Development Activities During the 2022 second quarter, we agreed to finance the development of four new projects. One of these development projects is a behavioral health facility in McKinney, Texas with a total budget of approximately $ 35 million. This facility will be leased to Springstone, LLC ("Springstone") pursuant to the existing long-term master lease. In addition, we agreed to finance the development of and lease three general acute care facilities located throughout Spain for a total commitment of approximately € 120 million. These facilities will be leased to our existing tenant, IMED Hospitales ("IMED"), under a long-term master lease agreement. During the 2022 first quarter, we completed construction and began recording rental income on an inpatient rehabilitation facility located in Bakersfield, California. This facility commenced rent on March 1, 2022 and is being leased to Ernest Health, Inc. ("Ernest") pursuant to an existing long-term master lease. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Estimated Rent Steward (Texas) $ 169,408 $ 57,405 2Q 2024 IMED (Spain) 49,371 12,542 2Q 2023 Ernest (California) 47,700 42,073 3Q 2022 IMED (Spain) 44,470 29,538 3Q 2023 IMED (Spain) 35,975 8,000 3Q 2024 Springstone (Texas) 34,600 — 1Q 2024 $ 381,524 $ 149,558 Disposals 2022 Activity On March 14, 2022, we completed the previously described partnership with MAM, in which we sold the real estate of eight Massachusetts-based general acute care hospitals, with a fair value of approximately $ 1.7 billion. See "New Investments" in this Note 3 for further details on this transaction. During the first half of 2022, we also completed the sale of four other facilities and two ancillary properties for approximately $ 154 million, resulting in a gain on real estate of approximately $ 31 million. Summary of Operations for Disposed Assets in 2022 The properties sold during 2022 do not meet the definition of discontinued operations. However, the following represents the operating results from these properties for the periods presented (in thousands): For the Three Months For the Six Months 2022 2021 2022 2021 Revenues(1) $ ( 400 ) $ 35,215 $ 20,948 $ 67,484 Real estate depreciation and amortization(2) ( 215 ) ( 8,205 ) ( 961 ) ( 16,254 ) Property-related expenses ( 1,310 ) ( 2,823 ) ( 1,854 ) ( 3,518 ) Other income(3) 16,348 63 467,957 135 Income from real estate dispositions, net $ 14,423 $ 24,250 $ 486,090 $ 47,847 (1) Includes $ 1.8 million and $ 6.3 million of straight-line rent write-offs associated with the non-Macquarie disposal transactions for the three and six months ended June 30, 2022, respectively. (2) Lower in 2022 as we stopped depreciating the properties making up the Macquarie Transaction once deemed held for sale in September 2021. (3) Includes $ 16.4 million and $ 468.0 million of gains (net of $ 125 million write-off of straight-line rent receivables related to the Macquarie Transaction) for the three and six months ended June 30, 2022, respectively. 2021 Activity During the first half of 2021, we completed the sale of five facilities and an ancillary property for approximately $ 25 million, resulting in a net loss on real estate of approximately $ 0.4 million. Leasing Operations (Lessor) We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. These infrastructure-type assets generally require a longer term (typical initial fixed terms of at least 15 years), and most include renewal options at the election of our tenants, generally in five year increments. Over 99 % of our leases provide annual rent escalations based on increases in the Consumer Price Index (or similar indices outside the U.S.) and/or fixed minimum annual rent escalations. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total initial investment. For five properties with a carrying value of approximately $ 230 million, our leases require a residual value guarantee from the tenant. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance. We routinely inspect our properties to ensure the residual value of each of our assets is being maintained. Except for leases classified as financing leases as noted below, all of our leases are classified as operating leases. At June 30, 2022 , leases on 13 Ernest facilities and five Prime Healthcare Services, Inc. ("Prime") facilities are accounted for as direct financing leases and leases on 13 of our Prospect facilities and five of our Ernest facilities are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands): As of June 30, As of December 31, Minimum lease payments receivable $ 1,160,820 $ 1,183,855 Estimated residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 893,158 ) ( 918,584 ) Net investment in direct financing leases 471,480 469,089 Other financing leases (net of allowance for credit loss) 1,605,333 1,584,238 Total investment in financing leases $ 2,076,813 $ 2,053,327 COVID-19 Rent Deferrals Due to the COVID-19 pandemic and its impact on our tenants' business, we agreed to defer collection of a certain amount of rent for a few tenants. Pursuant to our agreements with these tenants, we expect repayments of previously deferred rent to continue, with the remaining outstanding deferred rent balance of approximately $ 15.7 million as of June 30, 2022, to be paid over specified periods in the future with interest. Halsen Healthcare On September 30, 2019, we acquired the real estate of Watsonville Community Hospital in Watsonville, California for $ 40 million, which was then leased to Halsen Healthcare. In addition, we made a working capital loan to Halsen Healthcare. The hospital operator faced significant financial challenges over a two-year period that were worsened by revenue losses during the COVID-19 pandemic. During this time, we increased the loan in an effort to support the operator of this facility, allowing it to continue serving the community's needs. On December 5, 2021, Halsen Healthcare filed Chapter 11 bankruptcy in order to reorganize, while keeping the hospital open. As such, we have a credit loss reserve against the estimated uncollectible portion of the loan and have written off approximately $ 2.5 million of billed and straight-line rent receivables. On February 23, 2022, the bankruptcy court approved the Pajaro Valley Healthcare District's bid to purchase the operations of the Watsonville Community Hospital and lease the real estate from us. Although there are certain hurdles still to be met, this transaction is progressing and expected to close during the third quarter of 2022. At June 30, 2022, we believe our current investment in the Watsonville property, representing less than 0.3 % of total assets, is fully recoverable, but no assurances can be given that we will not have any further write-offs or impairments in future periods. Other Leasing Activities Prime has certain rights to repurchase from us during the third quarter the real estate associated with two master leases representing approximately $ 300 million of net book value at June 30, 2022. If this repurchase closes, we expect to receive cash proceeds approximating $ 370 million and recognize a gain, net of any straight-line rent write-offs. At June 30, 2022, 99 % of our properties are occupied by tenants, leaving five properties as vacant, representing less than 0.3 % of total assets. We are in various stages of either releasing or selling these vacant properties, for one of which we received and recorded a significant termination fee in 2019. Investments in Unconsolidated Entities Investments in Unconsolidated Real Estate Joint Ventures Our primary business strategy is to acquire real estate and lease to providers of healthcare services. Typically, we directly own 100 % of such fee simple real estate. However, from time-to-time, we will co-invest with other investors that share a similar view that hospital real estate is a necessary infrastructure-type asset in communities. In these types of investments, we will own undivided interests of less than 100 % of the real estate and share control over the assets through unconsolidated real estate joint ventures. The underlying real estate and leases in these unconsolidated real estate joint ventures are structured similarly and carry a similar risk profile to the rest of our real estate portfolio. The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands): Operator As of June 30, As of December 31, Median Kliniken S.á.r.l ("MEDIAN") $ 477,509 $ 517,648 Swiss Medical Network 434,323 476,193 Steward (Macquarie Transaction) 408,681 — Policlinico di Monza 82,548 95,468 HM Hospitales 57,312 63,618 Total $ 1,460,373 $ 1,152,927 See "New Investments" section in this same Note 3 for a discussion of the Macquarie Transaction. Through the first half of 2022, we earned approximately $ 50 million of dividends from these real estate joint ventures, including approximately $ 27 million of annual dividends from our joint venture in Switzerland. Investments in Unconsolidated Operating Entities Our investments in unconsolidated operating entities are noncontrolling investments that are typically made in conjunction with larger real estate transactions in which the operators are vetted as part of our overall underwriting process. In many cases, we would not be able to acquire the larger real estate portfolio without such investments in operators. These investments also offer the opportunity to enhance our overall return and provide for certain minority rights and protections. The following is a summary of our investments in unconsolidated operating entities (amounts in thousands): Operator As of June 30, As of December 31, Steward (loan investment) $ 362,821 $ 360,164 International joint venture 231,402 219,387 Springstone 196,768 187,450 Priory 156,389 42,315 Swiss Medical Network 152,128 159,208 Steward (equity investment) 139,000 139,000 Prospect 112,772 112,283 Aevis Victoria SA ("Aevis") 72,590 61,271 Aspris Children's Services ("Aspris") 16,040 8,356 Total $ 1,439,910 $ 1,289,434 The increase during the 2022 first half is primarily due to our investment in the Priory syndicated term loan as described under "New Investments" in this Note 3 . Pursuant to our approximate 5 % stake in Aevis and other investments marked to fair value, we recorded a $ 9.0 million favorable non-cash fair value adjustment during the first half of 2022; whereas, this was a $ 1.9 million favorable non-cash fair value adjustment for the same period of 2021. We also earned $ 2.0 million of dividend income during the first half of 2022. Pursuant to our existing 9.9 % equity interest in Steward, we received an $ 11 million cash distribution during the first half of 2021, which was accounted for as a return of capital. Credit Loss Reserves Upon the adoption of Accounting Standards Update ("ASU") No. 2016-13 "Measurement of Credit Losses on Financial Instruments" ("ASU 2016-13") on January 1, 2020, we began applying a forward-looking "expected loss" model to all of our financing receivables, including financing leases and loans. We are using ASU 2016-13 to establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. The following table summarizes the activity in our credit loss reserves (in thousands): For the Three Months 2022 2021 Balance at beginning of the period $ 53,933 $ 8,722 Provision (recovery) for credit loss 1,345 ( 939 ) Expected credit losses related to financial instruments sold ( 28 ) — Balance at end of the period $ 55,250 $ 7,783 For the Six Months 2022 2021 Balance at beginning of the year $ 48,527 $ 8,726 Provision (recovery) for credit loss 6,757 ( 939 ) Expected credit losses related to financial instruments sold ( 34 ) ( 4 ) Balance at end of the period $ 55,250 $ 7,783 Other Investment Activities In the 2022 second quarter, we loaned $ 150 million to Steward pursuant to a five-year secured loan. The loan bears interest at a current market rate (comparable to recent lease rates) plus a component of additional interest upon repayment. The loan is prepayable without penalty and is mandatorily prepayable upon certain sales of Steward assets and operations. Concentrations of Credit Risk We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities, if needed, with more effective operators: 1) Facility concentration – At June 30, 2022 , our largest single property represented approximately 2.8 % of our total assets, similar to December 31, 2021. 2) Operator concentration – For the three and six months ended June 30 , 2022 and 20 21, revenue from Steward, Circle Health Ltd. ("Circle"), and Prospect individually represented more than 10 % of our total revenues. At June 30, 2022, the assets leased under triple-net leases to Steward (our largest tenant), including our share of assets leased through the MAM partnership discussed above, represented less than 20 % of our total assets. 3) Geographic concentration – At June 30, 2022 , investments in the U.S., Europe, Australia, and South America represented approximately 63 %, 31 %, 5 %, and 1 %, respectively, of our total assets compared to 64 %, 30 %, 5 %, and 1 %, respectively, of our total assets at December 31, 2021. 4) Facility type concentration – For the three and six months ended June 30, 2022 , approximately 77 % of our revenues were generated from our general acute care facilities, while revenues from our behavioral and rehabilitation facilities made up 13 % and 7 %, respectively. Freestanding ER/urgent care facilities and long-term acute care facilities combined to make up the remaining 3 %. In comparison, general acute care and rehabilitation facilities made up 80 % and 10 %, respectively, of our total revenues for the three and six months ended June 30, 2021. Revenues from our behavioral health, freestanding ER/urgent care, and long-term acute care facilities combined to make up less than 10 % of our revenues for the three and six months ended June 30, 2021. |
Debt
Debt | 6 Months Ended |
Jun. 30, 2022 | |
Debt Disclosure [Abstract] | |
Debt | 4. D ebt The following is a summary of debt (dollar amounts in thousands): As of June 30, As of December 31, Revolving credit facility(A) $ 920,245 $ 730,000 Interim credit facility — 869,606 Term loan 200,000 200,000 British pound sterling term loan(B) 852,460 947,240 Australian term loan facility(B) 828,360 871,560 2.550 % Senior Unsecured Notes due 2023(B) 487,120 541,280 3.325 % Senior Unsecured Notes due 2025(B) 524,200 568,500 0.993 % Senior Unsecured Notes due 2026(B) 524,200 568,500 2.500 % Senior Unsecured Notes due 2026(B) 608,900 676,600 5.250 % Senior Unsecured Notes due 2026 500,000 500,000 5.000 % Senior Unsecured Notes due 2027 1,400,000 1,400,000 3.692 % Senior Unsecured Notes due 2028(B) 730,680 811,920 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 426,230 473,620 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 10,202,395 $ 11,358,826 Debt issue costs and discount, net ( 63,621 ) ( 76,056 ) $ 10,138,774 $ 11,282,770 (A) Includes € 253 million of Euro-denominated borrowings that reflect the exchange rate at June 30, 2022. (B) Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . As of June 30, 2022, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands): 2022 $ — 2023 487,120 2024 828,360 2025 1,376,660 2026 2,553,345 Thereafter 4,956,910 Total $ 10,202,395 2022 Activity On May 6, 2022, we received commitments from certain of our credit facility syndicate members to increase the amount of our revolving credit facility by $ 500 million by exercising the accordion feature of our unsecured credit facility ("Credit Facility"). Additionally, our revolver and U.S. dollar term loan were modified with SOFR as a replacement reference rate to U.S. dollar LIBOR. With the closing of the accordion, our Credit Facility includes a $ 1.8 billion unsecured revolving loan facility and a $ 200 million unsecured term loan facility. On June 29, 2022, we amended our Credit Facility. The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months. The maturity date of our $ 200 million unsecured term loan facility was extended to June 30, 2027 . Additionally, we may request incremental term loan and/or revolving loan commitments in an aggregate amount not to exceed $ 1 billion, such that the aggregate amount of revolving commitments and term loans does not exceed $ 3 billion. In addition to extending the maturity date and increasing the incremental borrowing capacity, the amendment improved interest rate spreads for both facilities. Under the amended Credit Facility and at our election, loans may be made as either ABR Loans or Term Benchmark Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00 % to 0.70 % based on current credit rating. The applicable margin for term loans that are Term Benchmark Loans is adjustable on a sliding scale from 0.875 % to 1.70 % based on current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00 % to 0.50 % based on current credit rating. The applicable margin for revolving loans that are Term Benchmark Loans or RFR Loans is adjustable on a sliding scale from 0.80 % to 1.50 % based on current credit rating. The facility fee is adjustable on a sliding scale from 0.125 % to 0.30 % (currently 0.25 %) based on current credit rating and is payable on the revolving loan facility. On March 15, 2022, we paid off and terminated our $ 1 billion interim credit facility that was entered into on July 27, 2021 ("July 2021 Interim Credit Facility") and paid down our revolving credit facility with proceeds from the Macquarie Transaction as more fully described in Note 3 to the condensed consolidated financial statements. 2021 Activity Interim Credit Facility On January 15, 2021, we entered into a $ 900 million interim credit facility (“January 2021 Interim Credit Facility”), of which we borrowed £ 500 million to partially fund the Priory Group Transaction. We paid off and terminated this facility on March 26, 2021 with proceeds from the issuance of the 2.500 % Senior Unsecured Notes due 2026 and the 3.375 % Senior Unsecured Notes due 2030 . Senior Unsecured Notes On March 24, 2021, we completed an £ 850 million senior unsecured notes offering in two tranches. See below for details of each tranche: 2.500% Senior Unsecured Notes due 2026 On March 24, 2021, we completed a £ 500 million senior unsecured notes offering. The notes were issued at 99.937 % of par value, and interest on the notes is payable annually on March 24 of each year, commencing on March 24, 2022. The notes pay interest in cash at a rate of 2.500 % and mature on March 24, 2026 . 3.375% Senior Unsecured Notes due 2030 On March 24, 2021, we completed a £ 350 million senior unsecured notes offering. The notes were issued at 99.448 % of par value, and interest on the notes is payable annually on April 24 of each year, commencing on April 24, 2022. The notes pay interest in cash at a rate of 3.375 % and mature on April 24, 2030 . We used proceeds from the £ 850 million senior unsecured notes offering to pay off the January 2021 Interim Credit Facility and reduce our revolving facility by approximately £ 340 million on March 26, 2021. Debt Refinancing and Unutilized Financing Costs 2022 Activity With proceeds from the Macquarie Transaction on March 14, 2022, we fully paid off our July 2021 Interim Credit Facility. As a result, we incurred $ 8.8 million of debt refinancing costs. We also incurred approximately $ 0.6 million of debt refinancing costs in the 2022 second quarter due to the amendment of our Credit Facility on June 29, 2022 . 2021 Activity With the termination of our January 2021 Interim Credit Facility and other debt activity, we incurred approximately $ 2.3 million of debt refinancing costs in the first half of 2021. Covenants Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem, or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations (“NAFFO”), as defined in the agreements, on a rolling four quarter basis. At June 30, 2022 , the dividend restriction was 95 % of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95 % of NAFFO, proceeds of equity issuances, and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150 % of our unsecured indebtedness. In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. The Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations, and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At June 30, 2022 , we were in compliance with all such financial and operating covenants. |
Income Taxes
Income Taxes | 6 Months Ended |
Jun. 30, 2022 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 5. Income Taxes During the 2021 second quarter, the United Kingdom enacted an increase in its corporate income tax rates from 19 % to 25 % effective April 1, 2023, which resulted in higher tax expense, from adjusting our net deferred tax liabilities, of approximately $ 43 million. |
Common Stock_Partner's Capital
Common Stock/Partner's Capital | 6 Months Ended |
Jun. 30, 2022 | |
Equity [Abstract] | |
Common Stock/Partner's Capital | 6. Common Stock/ Partners’ Capital Medical Properties Trust, Inc. On January 11, 2021, we completed an underwritten public offering of 36.8 million shares of our common stock, resulting in net proceeds of approximately $ 711 million, after deducting underwriting discounts and commissions and offering expenses. In addition, we sold 8.8 million shares of common stock under our at-the-market equity offering program during the first half of 2021, resulting in net proceeds of approximately $ 189 million. MPT Operating Partnership, L.P. At June 30, 2022 , the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100 % of the General Partner) and MPT TRS, Inc. (which is 100 % owned by the General Partner). By virtue of its ownership of the General Partner, the Company has a 100 % ownership interest in the Operating Partnership. During the six months ended June 30, 2021, the Operating Partnership issued approximately 45.6 million units in direct response to the common stock offerings by Medical Properties Trust, Inc. during the same period. |
Stock Awards
Stock Awards | 6 Months Ended |
Jun. 30, 2022 | |
Share-Based Payment Arrangement [Abstract] | |
Stock Awards | 7 . Stock Awards During the second quarter of 2022, we amended the 2019 Equity Incentive Plan (the “Equity Incentive Plan”), which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and other stock-based awards. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. Among other things, the recent amendment increased the number of shares of common stock registered and reserved for stock awards by 16 million to 28.9 million. As of June 30, 2022 (and adjusted for the August 8, 2022 registration), 19.2 million shares remain available for future stock awards. Share-based compensation expense totaled $ 21.9 million and $ 25.0 million for the six months ended June 30, 2022 and 2021 , respectively. |
Fair Value of Financial Instrum
Fair Value of Financial Instruments | 6 Months Ended |
Jun. 30, 2022 | |
Fair Value Disclosures [Abstract] | |
Fair Value of Financial Instruments | 8 . Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and other loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt. Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): As of June 30, 2022 As of December 31, 2021 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 94,206 $ 94,296 $ 56,229 $ 56,564 Loans(2) 1,319,002 (1) 1,312,882 991,609 (1) 991,954 Debt, net ( 10,138,774 ) ( 9,201,093 ) ( 11,282,770 ) ( 11,526,388 ) (1) Includes $ 159.0 million and $ 70.1 million of mortgage loans, a $ 309.4 million and $ 335.6 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 639.5 million and $ 521.4 million of loans that are part of our investments in unconsolidated operating entities, and $ 211.1 million and $ 64.5 million of other loans at June 30, 2022 and December 31, 2021, respectively. (2) Excludes the acquisition loan and mortgage loan made in October 2021 for our Springstone investment and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below. Items Measured at Fair Value on a Recurring Basis Our equity investment and related loan to the international joint venture, our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia, and our equity investment and related loans in Springstone are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option at the point of initial investment. We elected to account for these investments at fair value due to the size of the investments and because we believe this method was more reflective of current values. At June 30, 2022 and December 31, 2021, the amounts recorded under the fair value option method were as follows (in thousands): As of June 30, 2022 As of December 31, 2021 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 155,661 $ 155,661 $ 143,068 $ 143,068 Mortgage loans Equity investment and other loans 430,944 438,278 409,638 409,638 Investments in unconsolidated operating entities/Other loans Our loans to Springstone and the international joint venture and its subsidiaries are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates at which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities, while also considering the value of the underlying collateral of each loan. Our equity investment in Springstone and the international joint venture is recorded at fair value based on Level 3 inputs, by using a discounted cash flow model, which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of equity investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuations require management judgment due to absence of quoted market prices. For the cash flow models, our observable inputs include use of a capitalization rate and discount rate (which is based on a weighted-average cost of capital) and our unobservable input includes an adjustment for a marketability discount (“DLOM”). In regards to the underlying projections used in the discounted cash flow model, such projections are provided by the investees. However, we will modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry. In the first half of 2022, we recorded an unfavorable fair value adjustment to our investments. No fair value adjustment was recorded in the first half of 2021. The DLOM on our Springstone equity investment was 40 % at June 30, 2022 . In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors, including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated +100 basis points $ ( 41 ) - 100 basis points 41 Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured, from time-to-time, at fair value on a nonrecurring basis, such as for long-lived asset impairment purposes. In these cases, fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest by using Level 2 inputs. |
Earnings Per Share_Unit
Earnings Per Share/Unit | 6 Months Ended |
Jun. 30, 2022 | |
Earnings Per Share [Abstract] | |
Earnings Per Share/Unit | 9 . Earnings Per Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months 2022 2021 Numerator: Net income $ 190,064 $ 114,821 Non-controlling interests’ share in net income ( 467 ) ( 256 ) Participating securities’ share in earnings ( 345 ) ( 390 ) Net income, less participating securities’ share in earnings $ 189,252 $ 114,175 Denominator: Basic weighted-average common shares 598,827 587,514 Dilutive potential common shares 199 1,539 Diluted weighted-average common shares 599,026 589,053 For the Six Months 2022 2021 Numerator: Net income $ 822,011 $ 278,701 Non-controlling interests’ share in net income ( 733 ) ( 353 ) Participating securities’ share in earnings ( 747 ) ( 760 ) Net income, less participating securities’ share in earnings $ 820,531 $ 277,588 Denominator: Basic weighted-average common shares 598,751 581,877 Dilutive potential common shares 228 1,420 Diluted weighted-average common shares 598,979 583,297 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Three Months 2022 2021 Numerator: Net income $ 190,064 $ 114,821 Non-controlling interests’ share in net income ( 467 ) ( 256 ) Participating securities’ share in earnings ( 345 ) ( 390 ) Net income, less participating securities’ share in earnings $ 189,252 $ 114,175 Denominator: Basic weighted-average units 598,827 587,514 Dilutive potential units 199 1,539 Diluted weighted-average units 599,026 589,053 For the Six Months 2022 2021 Numerator: Net income $ 822,011 $ 278,701 Non-controlling interests’ share in net income ( 733 ) ( 353 ) Participating securities’ share in earnings ( 747 ) ( 760 ) Net income, less participating securities’ share in earnings $ 820,531 $ 277,588 Denominator: Basic weighted-average units 598,751 581,877 Dilutive potential units 228 1,420 Diluted weighted-average units 598,979 583,297 |
Commitments and Contingencies
Commitments and Contingencies | 6 Months Ended |
Jun. 30, 2022 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 10. Commitments and Contingencies Commitments As disclosed in previous filings, we entered into a definitive agreement that would result in the leasing of five general acute care hospitals located in Utah to HCA Healthcare ("HCA") if the agreement by HCA to purchase the operations of these five facilities from Steward occurred. This agreement was terminated in June 2022 following a regulatory ruling, and these five hospitals will continue to be leased to Steward. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows. |
Subsequent Events
Subsequent Events | 6 Months Ended |
Jun. 30, 2022 | |
Subsequent Events [Abstract] | |
Subsequent Events | 11. Subsequent Events On July 29, 2022, we acquired a general acute care facility in Colombia for $ 26 million. This hospital is leased to Fundación Cardiovascular de Colombia pursuant to a long-term lease with inflation-based escalators. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 6 Months Ended |
Jun. 30, 2022 | |
Accounting Policies [Abstract] | |
Unaudited Interim Condensed Consolidated Financial Statements | Unaudited Interim Condensed Consolidated Financial Statements : The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair statement have been included. Operating results for the three and six months ended June 30, 2022, are not necessarily indicative of the results that may be expected for the year ending December 31, 2022. The condensed consolidated balance sheet at December 31, 2021 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our condensed consolidated financial statements are reasonable and supportable based on the information available as of June 30, 2022 (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Actual results could differ from these estimates for various reasons including the impact from COVID-19 and other risk factors as outlined in Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2021. For information about significant accounting policies (including any recent accounting developments), refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2021 . Except for changes disclosed in our Quarterly Report on Form 10-Q for the period ended March 31, 2022, there have been no material changes to these significant accounting policies. |
Reclassifications | Reclassifications Certain amounts in the condensed consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. |
Variable Interest Entities | Variable Interest Entities At June 30, 2022 , we had loans and/or equity investments in certain variable interest entities approximating $ 620 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities. |
Real Estate and Other Activit_2
Real Estate and Other Activities (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Real Estate [Abstract] | |
Net Assets Acquired | We acquired or invested in the following net assets (in thousands): For the Six Months 2022 2021 Land and land improvements $ 34,204 $ 345,039 Buildings 290,256 825,322 Intangible lease assets — subject to amortization (weighted-average useful 20.1 years for 2022 and 45.0 years for 2021) 16,949 96,455 Mortgage loans(1)(2) 100,000 1,090,400 Investments in unconsolidated real estate joint ventures 399,456 — Investments in unconsolidated operating entities 131,105 845,646 Liabilities assumed ( 25,727 ) ( 65,411 ) 946,243 3,137,451 Loans repaid(1) — ( 1,090,400 ) Total net assets acquired $ 946,243 $ 2,047,051 (1) The 2021 column includes an £ 800 million mortgage loan advanced to the Priory Group ("Priory") in the first quarter of 2021 and converted to fee simple ownership of 35 properties in the second quarter of 2021 as described below. (2) In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment, which is anticipated during the fourth quarter. |
Summary of Status on Current Development Projects | See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Estimated Rent Steward (Texas) $ 169,408 $ 57,405 2Q 2024 IMED (Spain) 49,371 12,542 2Q 2023 Ernest (California) 47,700 42,073 3Q 2022 IMED (Spain) 44,470 29,538 3Q 2023 IMED (Spain) 35,975 8,000 3Q 2024 Springstone (Texas) 34,600 — 1Q 2024 $ 381,524 $ 149,558 |
Summary of Operating Results from Properties | The properties sold during 2022 do not meet the definition of discontinued operations. However, the following represents the operating results from these properties for the periods presented (in thousands): For the Three Months For the Six Months 2022 2021 2022 2021 Revenues(1) $ ( 400 ) $ 35,215 $ 20,948 $ 67,484 Real estate depreciation and amortization(2) ( 215 ) ( 8,205 ) ( 961 ) ( 16,254 ) Property-related expenses ( 1,310 ) ( 2,823 ) ( 1,854 ) ( 3,518 ) Other income(3) 16,348 63 467,957 135 Income from real estate dispositions, net $ 14,423 $ 24,250 $ 486,090 $ 47,847 (1) Includes $ 1.8 million and $ 6.3 million of straight-line rent write-offs associated with the non-Macquarie disposal transactions for the three and six months ended June 30, 2022, respectively. (2) Lower in 2022 as we stopped depreciating the properties making up the Macquarie Transaction once deemed held for sale in September 2021. (3) Includes $ 16.4 million and $ 468.0 million of gains (net of $ 125 million write-off of straight-line rent receivables related to the Macquarie Transaction) for the three and six months ended June 30, 2022, respectively. |
Components of Total Investment in Financing Leases | The components of our total investment in financing leases consisted of the following (in thousands): As of June 30, As of December 31, Minimum lease payments receivable $ 1,160,820 $ 1,183,855 Estimated residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 893,158 ) ( 918,584 ) Net investment in direct financing leases 471,480 469,089 Other financing leases (net of allowance for credit loss) 1,605,333 1,584,238 Total investment in financing leases $ 2,076,813 $ 2,053,327 |
Summary of Investments in Unconsolidated Operating Entities. | The following is a summary of our investments in unconsolidated real estate joint ventures by operator (amounts in thousands): Operator As of June 30, As of December 31, Median Kliniken S.á.r.l ("MEDIAN") $ 477,509 $ 517,648 Swiss Medical Network 434,323 476,193 Steward (Macquarie Transaction) 408,681 — Policlinico di Monza 82,548 95,468 HM Hospitales 57,312 63,618 Total $ 1,460,373 $ 1,152,927 The following is a summary of our investments in unconsolidated operating entities (amounts in thousands): Operator As of June 30, As of December 31, Steward (loan investment) $ 362,821 $ 360,164 International joint venture 231,402 219,387 Springstone 196,768 187,450 Priory 156,389 42,315 Swiss Medical Network 152,128 159,208 Steward (equity investment) 139,000 139,000 Prospect 112,772 112,283 Aevis Victoria SA ("Aevis") 72,590 61,271 Aspris Children's Services ("Aspris") 16,040 8,356 Total $ 1,439,910 $ 1,289,434 |
Summary of Activity in Credit Loss reserves | The following table summarizes the activity in our credit loss reserves (in thousands): For the Three Months 2022 2021 Balance at beginning of the period $ 53,933 $ 8,722 Provision (recovery) for credit loss 1,345 ( 939 ) Expected credit losses related to financial instruments sold ( 28 ) — Balance at end of the period $ 55,250 $ 7,783 For the Six Months 2022 2021 Balance at beginning of the year $ 48,527 $ 8,726 Provision (recovery) for credit loss 6,757 ( 939 ) Expected credit losses related to financial instruments sold ( 34 ) ( 4 ) Balance at end of the period $ 55,250 $ 7,783 |
Debt (Tables)
Debt (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Debt Disclosure [Abstract] | |
Summary of Debt | The following is a summary of debt (dollar amounts in thousands): As of June 30, As of December 31, Revolving credit facility(A) $ 920,245 $ 730,000 Interim credit facility — 869,606 Term loan 200,000 200,000 British pound sterling term loan(B) 852,460 947,240 Australian term loan facility(B) 828,360 871,560 2.550 % Senior Unsecured Notes due 2023(B) 487,120 541,280 3.325 % Senior Unsecured Notes due 2025(B) 524,200 568,500 0.993 % Senior Unsecured Notes due 2026(B) 524,200 568,500 2.500 % Senior Unsecured Notes due 2026(B) 608,900 676,600 5.250 % Senior Unsecured Notes due 2026 500,000 500,000 5.000 % Senior Unsecured Notes due 2027 1,400,000 1,400,000 3.692 % Senior Unsecured Notes due 2028(B) 730,680 811,920 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 426,230 473,620 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 10,202,395 $ 11,358,826 Debt issue costs and discount, net ( 63,621 ) ( 76,056 ) $ 10,138,774 $ 11,282,770 (A) Includes € 253 million of Euro-denominated borrowings that reflect the exchange rate at June 30, 2022. (B) Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Principal Payments Due on Debt | As of June 30, 2022, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (amounts in thousands): 2022 $ — 2023 487,120 2024 828,360 2025 1,376,660 2026 2,553,345 Thereafter 4,956,910 Total $ 10,202,395 |
Fair Value of Financial Instr_2
Fair Value of Financial Instruments (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Fair Value Disclosures [Abstract] | |
Summary of Fair Value Information of Financial Instruments | The following table summarizes fair value estimates for our financial instruments (in thousands): As of June 30, 2022 As of December 31, 2021 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 94,206 $ 94,296 $ 56,229 $ 56,564 Loans(2) 1,319,002 (1) 1,312,882 991,609 (1) 991,954 Debt, net ( 10,138,774 ) ( 9,201,093 ) ( 11,282,770 ) ( 11,526,388 ) (1) Includes $ 159.0 million and $ 70.1 million of mortgage loans, a $ 309.4 million and $ 335.6 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 639.5 million and $ 521.4 million of loans that are part of our investments in unconsolidated operating entities, and $ 211.1 million and $ 64.5 million of other loans at June 30, 2022 and December 31, 2021, respectively. (2) Excludes the acquisition loan and mortgage loan made in October 2021 for our Springstone investment and the acquisition loan made in May 2020 related to our investment in the international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia, as these assets are accounted for under the fair value option method, as noted below. |
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis | At June 30, 2022 and December 31, 2021, the amounts recorded under the fair value option method were as follows (in thousands): As of June 30, 2022 As of December 31, 2021 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 155,661 $ 155,661 $ 143,068 $ 143,068 Mortgage loans Equity investment and other loans 430,944 438,278 409,638 409,638 Investments in unconsolidated operating entities/Other loans |
Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations | The DLOM on our Springstone equity investment was 40 % at June 30, 2022 . In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors, including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated +100 basis points $ ( 41 ) - 100 basis points 41 |
Earnings Per Share_Unit (Tables
Earnings Per Share/Unit (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Earnings Per Share [Abstract] | |
Calculation of Earnings Per Share | Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months 2022 2021 Numerator: Net income $ 190,064 $ 114,821 Non-controlling interests’ share in net income ( 467 ) ( 256 ) Participating securities’ share in earnings ( 345 ) ( 390 ) Net income, less participating securities’ share in earnings $ 189,252 $ 114,175 Denominator: Basic weighted-average common shares 598,827 587,514 Dilutive potential common shares 199 1,539 Diluted weighted-average common shares 599,026 589,053 For the Six Months 2022 2021 Numerator: Net income $ 822,011 $ 278,701 Non-controlling interests’ share in net income ( 733 ) ( 353 ) Participating securities’ share in earnings ( 747 ) ( 760 ) Net income, less participating securities’ share in earnings $ 820,531 $ 277,588 Denominator: Basic weighted-average common shares 598,751 581,877 Dilutive potential common shares 228 1,420 Diluted weighted-average common shares 598,979 583,297 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Three Months 2022 2021 Numerator: Net income $ 190,064 $ 114,821 Non-controlling interests’ share in net income ( 467 ) ( 256 ) Participating securities’ share in earnings ( 345 ) ( 390 ) Net income, less participating securities’ share in earnings $ 189,252 $ 114,175 Denominator: Basic weighted-average units 598,827 587,514 Dilutive potential units 199 1,539 Diluted weighted-average units 599,026 589,053 For the Six Months 2022 2021 Numerator: Net income $ 822,011 $ 278,701 Non-controlling interests’ share in net income ( 733 ) ( 353 ) Participating securities’ share in earnings ( 747 ) ( 760 ) Net income, less participating securities’ share in earnings $ 820,531 $ 277,588 Denominator: Basic weighted-average units 598,751 581,877 Dilutive potential units 228 1,420 Diluted weighted-average units 598,979 583,297 |
Organization - Additional Infor
Organization - Additional Information (Detail) | Jun. 30, 2022 Country Facility State |
Business Acquisition [Line Items] | |
Number of facilities | Facility | 447 |
Number of states | State | 32 |
Europe [Member] | |
Business Acquisition [Line Items] | |
Number of countries | 7 |
South America [Member] | |
Business Acquisition [Line Items] | |
Number of countries | 1 |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies - Additional Information (Detail) $ in Millions | Jun. 30, 2022 USD ($) |
Accounting Policies [Abstract] | |
Loans and/or equity investments in variable interest entities | $ 620 |
Real Estate and Other Activit_3
Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands | Jun. 30, 2022 | Jun. 30, 2021 | |
Business Acquisition [Line Items] | |||
Total assets acquired | $ 946,243 | $ 3,137,451 | |
Liabilities assumed | (25,727) | (65,411) | |
Loans repaid | (1,090,400) | ||
Total net assets acquired | 946,243 | 2,047,051 | |
Land and Land Improvements [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | 34,204 | 345,039 | |
Building [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | 290,256 | 825,322 | |
Intangible Lease Assets [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | 16,949 | 96,455 | |
Mortgage Loans [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | [1],[2] | 100,000 | 1,090,400 |
Investments in Unconsolidated Real Estate Joint Ventures [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | 399,456 | ||
Investments In Unconsolidated Operating Entities [Member] | |||
Business Acquisition [Line Items] | |||
Total assets acquired | $ 131,105 | $ 845,646 | |
[1] In the 2022 second quarter, we increased our mortgage loan to Prospect Medical Holdings, Inc. ("Prospect") that was originated in 2019 and that is secured by a first lien on a California hospital. The loan bears interest at a current market rate plus a component of additional interest upon repayment, which is anticipated during the fourth quarter. The 2021 column includes an £ 800 million mortgage loan advanced to the Priory Group ("Priory") in the first quarter of 2021 and converted to fee simple ownership of 35 properties in the second quarter of 2021 as described below. |
Real Estate and Other Activit_4
Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail) $ in Thousands, £ in Millions | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 USD ($) Property | Jun. 30, 2021 GBP (£) Property | |
Business Acquisition [Line Items] | |||
Advanced to the mortgage loan | $ | $ 1,090,400 | ||
Priory Group [Member] | |||
Business Acquisition [Line Items] | |||
Number of real estate assets acquired | Property | 35 | 35 | |
Mortgage Loans [Member] | Priory Group [Member] | |||
Business Acquisition [Line Items] | |||
Advanced to the mortgage loan | £ | £ 800 | ||
Intangible Lease Assets [Member] | |||
Business Acquisition [Line Items] | |||
Weighted-average useful life of acquired intangible lease assets (in years) | 20 years 1 month 6 days | 45 years |
Real Estate and Other Activit_5
Real Estate and Other Activities - 2022 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions | 3 Months Ended | 6 Months Ended | |||||||||
Apr. 29, 2022 EUR (€) Facility | Apr. 25, 2022 USD ($) Facility | Apr. 18, 2022 Facility | Mar. 14, 2022 USD ($) Facility | Mar. 11, 2022 USD ($) Facility | Mar. 11, 2022 EUR (€) Facility | Feb. 16, 2022 GBP (£) | Jun. 30, 2022 USD ($) Facility | Jun. 30, 2022 USD ($) Facility | Jun. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) | |
Business Acquisition [Line Items] | |||||||||||
Percentage of equity investment | 50% | ||||||||||
Gain (loss) on real estate dispositions | $ 31,000 | $ 400 | |||||||||
Investments in unconsolidated real estate joint ventures | $ 1,460,373 | 1,460,373 | $ 1,152,927 | ||||||||
Acquisition loan | $ 946,243 | $ 946,243 | $ 3,137,451 | ||||||||
Deferred income tax liabilities and other liabilities, incurred | $ 26,000 | ||||||||||
Syndicated Term Loan [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Purchase price of acquisition | £ | £ 96.5 | ||||||||||
Acquisition loan | £ | £ 100 | ||||||||||
Loan term | 6 years | ||||||||||
Percentage of discount on investment | 3.50% | ||||||||||
Joint Venture [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Investments in unconsolidated real estate joint ventures | $ 400,000 | ||||||||||
General Acute Care Hospitals [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Facility | 2 | 5 | |||||||||
Purchase price of acquisition | $ 80,000 | ||||||||||
General Acute Care Hospitals [Member] | Spain [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Facility | 3 | 3 | |||||||||
Purchase price of acquisition | € | € 27 | ||||||||||
General Acute Care Hospitals [Member] | Arizona [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Facility | 1 | ||||||||||
General Acute Care Hospitals [Member] | Finland [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Number of facilities acquired | Facility | 4 | 4 | |||||||||
Purchase price of acquisition | $ 194,000 | € 178 | |||||||||
Massachusetts-based General Acute Care Hospitals [Member] | |||||||||||
Business Acquisition [Line Items] | |||||||||||
Percentage of equity investment | 50% | ||||||||||
Number of facilities acquired | Facility | 8 | ||||||||||
Purchase price of acquisition | $ 1,700,000 | ||||||||||
Gain (loss) on real estate dispositions | $ 600,000 | ||||||||||
Nonrecourse secured debt percentage of asset value | 55% | ||||||||||
Proceeds from expected secured debt | $ 1,300,000 |
Real Estate and Other Activit_6
Real Estate and Other Activities - 2021 Activity - Additional Information (Detail) £ in Millions, SFr in Millions, $ in Millions | Jun. 25, 2021 GBP (£) Property | Jan. 19, 2021 GBP (£) | Jan. 08, 2021 USD ($) | Mar. 14, 2022 | Apr. 16, 2021 CHF (SFr) |
Business Acquisition [Line Items] | |||||
Ownership interest | 50% | ||||
Swiss Medical Network [Member] | |||||
Business Acquisition [Line Items] | |||||
Equity investment | SFr | SFr 145 | ||||
Waterland Private Equity Fund VII C.V. [Member] | |||||
Business Acquisition [Line Items] | |||||
Number of real estate assets acquired | Property | 35 | ||||
Payment for acquisition | £ 800 | ||||
Purchase price of acquisition loan | £ 250 | ||||
Ownership interest | 9.90% | ||||
Waterland Private Equity Fund VII C.V. [Member] | United Kingdom [Member] | |||||
Business Acquisition [Line Items] | |||||
Purchase price of acquisition | £ 800 | ||||
Steward Health Care System LLC [Member] | |||||
Business Acquisition [Line Items] | |||||
Ownership interest | 9.90% | ||||
Percentage of interest rate with possible outside returns | 4% | ||||
Other loan to affiliates | $ | $ 335 | ||||
Initial term of loan | 7 years |
Real Estate and Other Activit_7
Real Estate and Other Activities - Development Activities - Additional Information (Detail) $ in Thousands, € in Millions | 3 Months Ended | 6 Months Ended | |||
Apr. 29, 2022 Facility | Apr. 25, 2022 Facility | Jun. 30, 2022 USD ($) Facility NewProject | Jun. 30, 2022 USD ($) Facility | Jun. 30, 2022 EUR (€) | |
Business Acquisition [Line Items] | |||||
Number of development of new projects | NewProject | 4 | ||||
Total commitment | $ | $ 381,524 | $ 381,524 | |||
General Acute Care Hospitals [Member] | |||||
Business Acquisition [Line Items] | |||||
Number of facilities acquired | Facility | 2 | 5 | |||
Spain [Member] | General Acute Care Hospitals [Member] | |||||
Business Acquisition [Line Items] | |||||
Number of facilities acquired | Facility | 3 | 3 | |||
Total commitment | € | € 120 | ||||
Springstone [Member] | McKinney, Texas [Member] | |||||
Business Acquisition [Line Items] | |||||
Total commitment | $ | $ 35,000 | $ 35,000 |
Real Estate and Other Activit_8
Real Estate and Other Activities - Development Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands | 6 Months Ended |
Jun. 30, 2022 USD ($) | |
Business Acquisition [Line Items] | |
Commitment | $ 381,524 |
Costs Incurred as of June 30, 2022 | 149,558 |
Steward [Member] | Texas [Member] | |
Business Acquisition [Line Items] | |
Commitment | 169,408 |
Costs Incurred as of June 30, 2022 | $ 57,405 |
Estimated Rent Commencement Date | 2Q 2024 |
IMED [Member] | Spain [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 49,371 |
Costs Incurred as of June 30, 2022 | $ 12,542 |
Estimated Rent Commencement Date | 2Q 2023 |
Ernest [Member] | California [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 47,700 |
Costs Incurred as of June 30, 2022 | $ 42,073 |
Estimated Rent Commencement Date | 3Q 2022 |
IMED [Member] | Spain [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 44,470 |
Costs Incurred as of June 30, 2022 | $ 29,538 |
Estimated Rent Commencement Date | 3Q 2023 |
IMED [Member] | Spain [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 35,975 |
Costs Incurred as of June 30, 2022 | $ 8,000 |
Estimated Rent Commencement Date | 3Q 2024 |
Springstone [Member] | Texas [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 34,600 |
Estimated Rent Commencement Date | 1Q 2024 |
Real Estate and Other Activit_9
Real Estate and Other Activities - Disposals - Additional Information (Detail) $ in Millions | 6 Months Ended | ||
Mar. 14, 2022 USD ($) Facility | Jun. 30, 2022 USD ($) Facility Property | Jun. 30, 2021 USD ($) Facility | |
Debt Instrument [Line Items] | |||
Gain (loss) on real estate dispositions | $ 31 | $ 0.4 | |
Number of facilities sold | Facility | 4 | 5 | |
Number of ancillary properties sold | Property | 2 | ||
Proceeds from sale of facilities | $ 154 | $ 25 | |
Massachusetts-based General Acute Care Hospitals [Member] | |||
Debt Instrument [Line Items] | |||
Number of facilities acquired | Facility | 8 | ||
Purchase price of acquisition | $ 1,700 | ||
Gain (loss) on real estate dispositions | $ 600 |
Real Estate and Other Activi_10
Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Revenues | $ 400,226 | $ 381,792 | $ 810,026 | $ 744,557 |
Real estate depreciation and amortization | (84,334) | (76,369) | (169,650) | (152,011) |
Other income | 2,031 | (771) | 11,918 | 7,023 |
Disposal Group, Not Discontinued Operations [Member] | ||||
Revenues | (400) | 35,215 | 20,948 | 67,484 |
Real estate depreciation and amortization | (215) | (8,205) | (961) | (16,254) |
Property-related expenses | (1,310) | (2,823) | (1,854) | (3,518) |
Other income | 16,348 | 63 | 467,957 | 135 |
Income from real estate dispositions, net | $ 14,423 | $ 24,250 | $ 486,090 | $ 47,847 |
Real Estate and Other Activi_11
Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Parenthetical) (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended |
Jun. 30, 2022 | Jun. 30, 2022 | |
Disposal Group, Not Discontinued Operations [Member] | ||
Straight-line rent write-offs | $ 1.8 | $ 6.3 |
Massachusetts-based General Acute Care Hospitals [Member] | ||
Straight-line rent write-offs | 125 | 125 |
Massachusetts-based General Acute Care Hospitals [Member] | Disposal Group, Not Discontinued Operations [Member] | ||
Gains | $ 16.4 | $ 468 |
Real Estate and Other Activi_12
Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions | 6 Months Ended |
Jun. 30, 2022 USD ($) Lease Property | |
Lessor Lease Description [Line Items] | |
Lease renewal term | 5 years |
Annual rent escalations | 99% |
Number of properties | Property | 5 |
Carrying value of lease requiring residual value guarantee | $ | $ 230 |
Ernest [Member] | |
Lessor Lease Description [Line Items] | |
Number of direct financing leases | 13 |
Number of financing leases | 5 |
Prime Healthcare Services, Inc. Facilities [Member] | |
Lessor Lease Description [Line Items] | |
Number of direct financing leases | 5 |
Prospect [Member] | |
Lessor Lease Description [Line Items] | |
Number of financing leases | 13 |
Minimum [Member] | |
Lessor Lease Description [Line Items] | |
Term of lease | 15 years |
Real Estate and Other Activi_13
Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Direct Financing Lease Net Investment In Leases [Abstract] | ||
Minimum lease payments receivable | $ 1,160,820 | $ 1,183,855 |
Estimated residual values | 203,818 | 203,818 |
Less: Unearned income and allowance for credit loss | (893,158) | (918,584) |
Net investment in direct financing leases | 471,480 | 469,089 |
Other financing leases (net of allowance for credit loss) | 1,605,333 | 1,584,238 |
Total investment in financing leases | $ 2,076,813 | $ 2,053,327 |
Real Estate and Other Activi_14
Real Estate and Other Activities - Coronavirus (COVID-19) Rent Deferrals - Additional Information (Detail) $ in Millions | Jun. 30, 2022 USD ($) |
Business Acquisition [Line Items] | |
Remaining outstanding deferred rent to be received | $ 15.7 |
Real Estate and Other Activi_15
Real Estate and Other Activities - Halsen Healthcare - Additional Information (Details) - USD ($) $ in Millions | 6 Months Ended | |
Sep. 30, 2019 | Jun. 30, 2022 | |
Halsen Healthcare [Member] | Maximum [Member] | ||
Business Acquisition [Line Items] | ||
Write off of billed and straight-line rent receivables | $ 2.5 | |
Watsonville, California [Member] | Halsen Healthcare [Member] | Maximum [Member] | ||
Business Acquisition [Line Items] | ||
Percentage of assets fully recoverable | 0.30% | |
Acute Care Hospital [Member] | Watsonville, California [Member] | ||
Business Acquisition [Line Items] | ||
Funded for interim mortgage loan | $ 40 |
Real Estate and Other Activi_16
Real Estate and Other Activities - Other Leasing Activities - Additional Information (Details) $ in Millions | 6 Months Ended | |
Jun. 30, 2022 USD ($) Property Lease | Jun. 30, 2021 USD ($) | |
Lessor, Lease, Description [Line Items] | ||
Percentage of properties occupied by tenants | 99% | |
Expected cash proceeds on repurchase closes | $ 154 | $ 25 |
Number of properties vacant | Property | 5 | |
Prime [Member] | ||
Lessor, Lease, Description [Line Items] | ||
Number of master leases | Lease | 2 | |
Net book value | $ 300 | |
Expected cash proceeds on repurchase closes | $ 370 | |
Minimum [Member] | ||
Lessor, Lease, Description [Line Items] | ||
Percentage of vacant on leased property | 0.30% |
Real Estate and Other Activi_17
Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Details) - USD ($) $ in Millions | 6 Months Ended | |
Jun. 30, 2022 | Mar. 14, 2022 | |
Business Acquisition [Line Items] | ||
Percentage of equity investment | 50% | |
Investments in Unconsolidated Real Estate Joint Ventures [Member] | ||
Business Acquisition [Line Items] | ||
Percentage of equity investment | 100% | |
Dividend income | $ 50 | |
Investments in Unconsolidated Real Estate Joint Ventures [Member] | Switzerland [Member] | ||
Business Acquisition [Line Items] | ||
Dividend income | $ 27 | |
Investments in Unconsolidated Real Estate Joint Ventures [Member] | Maximum [Member] | ||
Business Acquisition [Line Items] | ||
Percentage of equity investment | 100% |
Real Estate and Other Activi_18
Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | $ 1,460,373 | $ 1,152,927 |
MEDIAN [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | 477,509 | 517,648 |
Swiss Medical Network [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | 434,323 | 476,193 |
Steward (Macquarie Transaction) [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | 408,681 | |
Policlinico di Monza [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | 82,548 | 95,468 |
HM Hospital [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated real estate joint ventures | $ 57,312 | $ 63,618 |
Real Estate and Other Activi_19
Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | $ 1,439,910 | $ 1,289,434 |
Steward Loan Investment [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 362,821 | 360,164 |
International Joint Venture [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 231,402 | 219,387 |
Springstone [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 196,768 | 187,450 |
Priory [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 156,389 | 42,315 |
Swiss Medical Network [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 152,128 | 159,208 |
Steward Equity Investment [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 139,000 | 139,000 |
Prospect [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 112,772 | 112,283 |
Aevis Victoria SA [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | 72,590 | 61,271 |
Aspris Children's Services [Member] | ||
Schedule of Equity Method Investments [Line Items] | ||
Investments in unconsolidated operating entities | $ 16,040 | $ 8,356 |
Real Estate and Other Activi_20
Real Estate and Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Detail) - USD ($) $ in Millions | 6 Months Ended | |||
Jun. 30, 2022 | Jun. 30, 2021 | Mar. 14, 2022 | Jan. 08, 2021 | |
Business Acquisition [Line Items] | ||||
Passive equity interest | 50% | |||
Steward Health Care System LLC [Member] | ||||
Business Acquisition [Line Items] | ||||
Passive equity interest | 9.90% | |||
Distribution on equity investment | $ 11 | |||
Aevis Victoria SA [Member] | ||||
Business Acquisition [Line Items] | ||||
Ownership interest in joint venture under the cost method | 5% | |||
COVID-19 Pandemic [Member] | ||||
Business Acquisition [Line Items] | ||||
Favorable non-cash fair value adjustment on investment | $ 9 | $ 1.9 | ||
Dividend income | $ 2 |
Real Estate and Other Activi_21
Real Estate and Other Activities - Summary of Activity in Credit Loss Reserves (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Receivables [Abstract] | ||||
Balance at beginning of the period | $ 53,933 | $ 8,722 | $ 48,527 | $ 8,726 |
Provision (recovery) for credit loss | 1,345 | (939) | 6,757 | (939) |
Expected credit losses related to financial instruments sold or repaid | (28) | (34) | (4) | |
Balance at end of the period | $ 55,250 | $ 7,783 | $ 55,250 | $ 7,783 |
Real Estate and Other Activi_22
Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2022 | Jun. 30, 2022 | Jun. 30, 2021 | Mar. 14, 2022 | Jan. 08, 2021 | |
Business Acquisition [Line Items] | |||||
Passive equity interest | 50% | ||||
COVID-19 Pandemic [Member] | |||||
Business Acquisition [Line Items] | |||||
Favorable non-cash fair value adjustment on investment | $ 9 | $ 1.9 | |||
Aevis Victoria SA [Member] | |||||
Business Acquisition [Line Items] | |||||
Ownership interest in joint venture under the cost method | 5% | 5% | |||
Steward Health Care System LLC [Member] | |||||
Business Acquisition [Line Items] | |||||
Passive equity interest | 9.90% | ||||
Distribution on equity investment | $ 11 | ||||
Secured loan amount | $ 150 | $ 150 | |||
Secured loan period | 5 years |
Real Estate and Other Activi_23
Real Estate and Other Activities - Concentrations of Credit Risk - Additional Information (Detail) | 3 Months Ended | 6 Months Ended | 12 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Total Gross Assets [Member] | Operator Concentration Risk [Member] | Steward Health Care System LLC [Member] | Maximum [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 20% | ||||
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 63% | 64% | |||
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 31% | 30% | |||
Total Gross Assets [Member] | Geographic Concentration [Member] | Australia [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 5% | 5% | |||
Total Gross Assets [Member] | Geographic Concentration [Member] | South America [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 1% | 1% | |||
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Facilities [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 77% | 77% | |||
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital and Healthcare System [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 80% | 80% | |||
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Facilities [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 13% | 10% | 13% | 10% | |
Revenue [Member] | Customer Concentration Risk [Member] | Long Term Acute Care Hospital [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 7% | 7% | |||
Revenue [Member] | Customer Concentration Risk [Member] | Freestanding ER/Urgent Care and Long-Term Acute Care Facilities [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 3% | ||||
Revenue [Member] | Customer Concentration Risk [Member] | Maximum [Member] | Freestanding ER/Urgent Care and Long-Term Acute Care Facilities [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 10% | 10% | |||
Revenue [Member] | Operator Concentration Risk [Member] | Steward Health Care System LLC [Member] | Minimum [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 10% | 10% | 10% | 10% | |
Revenue [Member] | Operator Concentration Risk [Member] | Prospect [Member] | Minimum [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 10% | ||||
Revenue [Member] | Operator Concentration Risk [Member] | Circle [Member] | Minimum [Member] | |||||
Business Acquisition [Line Items] | |||||
Percentage of concentration risk | 10% | 10% | 10% | 10% | |
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk [Member] | |||||
Business Acquisition [Line Items] | |||||
Maximum percentage of entity's assets invested on single property | 2.80% | 2.80% |
Debt - Summary of Debt (Detail)
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 | |
Debt Instrument [Line Items] | |||
Debt | $ 10,202,395 | $ 11,358,826 | |
Debt issue costs and discount, net | (63,621) | (76,056) | |
Debt, net | 10,138,774 | 11,282,770 | |
Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [1] | 920,245 | 730,000 |
Interim Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 869,606 | ||
Term Loan [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 200,000 | 200,000 | |
Term Loan [Member] | United Kingdom [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 852,460 | 947,240 |
Term Loan [Member] | Australia [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 828,360 | 871,560 |
2.550% Senior Unsecured Notes due 2023 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 487,120 | 541,280 |
3.325% Senior Unsecured Notes Due 2025 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 524,200 | 568,500 |
0.993% Senior Unsecured Notes due 2026 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 524,200 | 568,500 |
2.500% Senior Unsecured Notes due 2026 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 608,900 | 676,600 |
5.250% Senior Unsecured Notes Due 2026 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 500,000 | 500,000 | |
5.000% Senior Unsecured Notes Due 2027 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 1,400,000 | 1,400,000 | |
3.692% Senior Unsecured Notes due 2028 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 730,680 | 811,920 |
4.625% Senior Unsecured Notes Due 2029 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 900,000 | 900,000 | |
3.375% Senior Unsecured Notes due 2030 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 426,230 | 473,620 |
3.500% Senior Unsecured Notes due 2031 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | $ 1,300,000 | $ 1,300,000 | |
[1] Includes € 253 million of Euro-denominated borrowings that reflect the exchange rate at June 30, 2022. Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Debt - Summary of Debt (Parenth
Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, € in Millions | Jun. 30, 2022 USD ($) | Jun. 30, 2022 EUR (€) | Dec. 31, 2021 USD ($) | Mar. 26, 2021 | Mar. 24, 2021 | ||||
Debt Instrument [Line Items] | |||||||||
Debt | $ 10,202,395 | $ 11,358,826 | |||||||
EURO-denominated Borrowings [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt | € | € 253 | ||||||||
2.550% Senior Unsecured Notes due 2023 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | [1] | 2.55% | 2.55% | 2.55% | |||||
Debt | [1] | $ 487,120 | $ 541,280 | ||||||
3.325% Senior Unsecured Notes Due 2025 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | [1] | 3.325% | 3.325% | 3.325% | |||||
Debt | [1] | $ 524,200 | $ 568,500 | ||||||
0.993% Senior Unsecured Notes due 2026 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | [1] | 0.993% | 0.993% | 0.993% | |||||
Debt | [1] | $ 524,200 | $ 568,500 | ||||||
2.500% Senior Unsecured Notes due 2026 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 2.50% | [1] | 2.50% | [1] | 2.50% | [1] | 2.50% | 2.50% | |
Debt | [1] | $ 608,900 | $ 676,600 | ||||||
5.250% Senior Unsecured Notes Due 2026 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 5.25% | 5.25% | 5.25% | ||||||
Debt | $ 500,000 | $ 500,000 | |||||||
5.000% Senior Unsecured Notes Due 2027 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 5% | 5% | 5% | ||||||
Debt | $ 1,400,000 | $ 1,400,000 | |||||||
3.692% Senior Unsecured Notes due 2028 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | [1] | 3.692% | 3.692% | 3.692% | |||||
Debt | [1] | $ 730,680 | $ 811,920 | ||||||
4.625% Senior Unsecured Notes Due 2029 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 4.625% | 4.625% | 4.625% | ||||||
Debt | $ 900,000 | $ 900,000 | |||||||
3.375% Senior Unsecured Notes due 2030 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 3.375% | [1] | 3.375% | [1] | 3.375% | [1] | 3.375% | 3.375% | |
Debt | [1] | $ 426,230 | $ 473,620 | ||||||
3.500% Senior Unsecured Notes due 2031 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 3.50% | 3.50% | 3.50% | ||||||
Debt | $ 1,300,000 | $ 1,300,000 | |||||||
[1] Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Debt - Principal Payments Due f
Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Debt Disclosure [Abstract] | ||
2022 | $ 0 | |
2023 | 487,120 | |
2024 | 828,360 | |
2025 | 1,376,660 | |
2026 | 2,553,345 | |
Thereafter | 4,956,910 | |
Total | $ 10,202,395 | $ 11,358,826 |
Debt - 2022 Activity - Addition
Debt - 2022 Activity - Additional Information (Detail) - USD ($) | 6 Months Ended | |||
Jun. 29, 2022 | May 06, 2022 | Jun. 30, 2022 | Mar. 15, 2022 | |
Debt Instrument [Line Items] | ||||
Line of credit , entered date | Jul. 27, 2021 | |||
Debt instrument amendment extended maturity date description | The amendment extended the maturity date of our revolving facility to June 30, 2026 with our option to extend for an additional 12 months. | |||
Commitment fee | 0.25% | |||
Line of credit facility, Borrowing capacity | $ 1,000,000,000 | |||
Alternate Base Rate [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0% | |||
Unsecured Revolving Credit Facility [Member] | ||||
Debt Instrument [Line Items] | ||||
Increase in amount of credit facility | $ 500,000,000 | |||
Amount of senior unsecured debt | 1,800,000,000 | |||
Debt instrument maturity date | Jun. 30, 2026 | |||
Line of credit facility, Borrowing capacity | $ 1,000,000,000 | |||
Unsecured Revolving Credit Facility [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Commitment fee | 0.125% | |||
Unsecured Revolving Credit Facility [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Commitment fee | 0.30% | |||
Unsecured Revolving Credit Facility [Member] | Alternate Base Rate [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0% | |||
Unsecured Revolving Credit Facility [Member] | Alternate Base Rate [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0.50% | |||
Unsecured Revolving Credit Facility [Member] | Term Benchmark Loans or RFR Loans [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0.80% | |||
Unsecured Revolving Credit Facility [Member] | Term Benchmark Loans or RFR Loans [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 1.50% | |||
Term Loan [Member] | ||||
Debt Instrument [Line Items] | ||||
Amount of senior unsecured debt | $ 200,000,000 | $ 200,000,000 | ||
Debt instrument maturity date | Jun. 30, 2027 | |||
Line of credit facility, Borrowing capacity | $ 3 | |||
Term Loan [Member] | Alternate Base Rate [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0.70% | |||
Term Loan [Member] | Term Benchmark Loans [Member] | Minimum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 0.875% | |||
Term Loan [Member] | Term Benchmark Loans [Member] | Maximum [Member] | ||||
Debt Instrument [Line Items] | ||||
Applicable margin for term loan | 1.70% |
Debt - Interim Credit Facility
Debt - Interim Credit Facility - Additional Information (Detail) £ in Millions | 6 Months Ended | ||||||||
Mar. 26, 2021 | Mar. 24, 2021 | Jan. 15, 2021 USD ($) | Jun. 30, 2022 | Mar. 15, 2022 USD ($) | Dec. 31, 2021 | [1] | Jan. 15, 2021 GBP (£) | ||
Debt Instrument [Line Items] | |||||||||
Line of credit facility, Borrowing capacity | $ 1,000,000,000 | ||||||||
2.500% Senior Unsecured Notes due 2026 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 2.50% | 2.50% | 2.50% | [1] | 2.50% | ||||
Debt instrument maturity date | Mar. 24, 2026 | Mar. 24, 2026 | |||||||
3.375% Senior Unsecured Notes due 2030 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 3.375% | 3.375% | 3.375% | [1] | 3.375% | ||||
Debt instrument maturity date | Apr. 24, 2030 | Apr. 24, 2030 | |||||||
Waterland Private Equity Fund VII C.V. [Member] | Interim Credit Facility [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Line of credit facility, Borrowing capacity | $ 900,000,000 | ||||||||
Line of credit | £ | £ 500 | ||||||||
Line of credit, terminated date | Mar. 26, 2021 | ||||||||
Debt instrument maturity date | Jun. 29, 2022 | ||||||||
[1] Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Debt - Senior Unsecured Notes -
Debt - Senior Unsecured Notes - Additional Information (Detail) - Unsecured Debt - GBP (£) | Mar. 26, 2021 | Mar. 24, 2021 |
Debt Instrument [Line Items] | ||
Senior unsecured notes face amount | £ 850,000,000 | |
Interim Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Payoff of credit facility | £ 850,000,000 | |
Revolving Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Line of credit | £ 340,000,000 |
Debt - 2.500% Senior Unsecured
Debt - 2.500% Senior Unsecured Notes Due 2028 - Additional Information (Detail) - 2.500% Senior Unsecured Notes due 2026 [Member] - GBP (£) | 6 Months Ended | |||||
Mar. 26, 2021 | Mar. 24, 2021 | Jun. 30, 2022 | Dec. 31, 2021 | [1] | ||
Debt Instrument [Line Items] | ||||||
Senior unsecured notes face amount | £ 500,000,000 | |||||
Percentage of par value on senior notes | 99.937% | |||||
Senior unsecured notes, payable term | interest on the notes is payable annually on March 24 of each year, commencing on March 24, 2022. | |||||
Debt instrument maturity date | Mar. 24, 2026 | Mar. 24, 2026 | ||||
Senior unsecured notes, interest rate | 2.50% | 2.50% | 2.50% | [1] | 2.50% | |
[1] Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Debt - 3.375% Senior Unsecured
Debt - 3.375% Senior Unsecured Notes Due 2028 - Additional Information (Detail) - 3.375% Senior Unsecured Notes due 2030 [Member] - GBP (£) | 6 Months Ended | |||||
Mar. 26, 2021 | Mar. 24, 2021 | Jun. 30, 2022 | Dec. 31, 2021 | [1] | ||
Debt Instrument [Line Items] | ||||||
Senior unsecured notes face amount | £ 350,000,000 | |||||
Percentage of par value on senior notes | 99.448% | |||||
Senior unsecured notes, payable term | interest on the notes is payable annually on April 24 of each year, commencing on April 24, 2022. | |||||
Debt instrument maturity date | Apr. 24, 2030 | Apr. 24, 2030 | ||||
Senior unsecured notes, interest rate | 3.375% | 3.375% | 3.375% | [1] | 3.375% | |
[1] Non-U.S. dollar denominated debt reflects the exchange rate at June 30, 2022 and December 31, 2021 . |
Debt - British Pound Sterling T
Debt - British Pound Sterling Term Loan - Additional Information (Detail) $ in Billions | Mar. 15, 2022 USD ($) |
Debt Instrument [Line Items] | |
Maximum borrowing capacity | $ 1 |
Debt - Additional Information (
Debt - Additional Information (Detail) - Waterland Private Equity Fund VII C.V. [Member] - Interim Credit Facility [Member] - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Mar. 14, 2022 | Jun. 30, 2022 | Jun. 30, 2022 | Jun. 30, 2021 | |
Debt Instrument [Line Items] | ||||
Debt refinancing costs | $ 8.8 | $ 2.3 | ||
Debt instrument maturity date | Jun. 29, 2022 | |||
Amendment of Our Credit Facility [Member] | ||||
Debt Instrument [Line Items] | ||||
Debt refinancing costs | $ 0.6 |
Debt - Covenants - Additional I
Debt - Covenants - Additional Information (Detail) | 6 Months Ended |
Jun. 30, 2022 | |
Debt Disclosure [Abstract] | |
Percentage of dividends which could be paid from adjusted operating funds | 95% |
Percentage of dividends which could be paid from operation funds | 95% |
Maximum percentage of total unencumbered assets | 150% |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Detail) - United Kingdom [Member] - USD ($) $ in Millions | 3 Months Ended | |
Apr. 01, 2023 | Jun. 30, 2021 | |
Income Tax Disclosure [Line Items] | ||
Income tax at the US statutory federal rate | 19% | |
Net deferred tax liabilities, adjustment | $ 43 | |
Forecast [Member] | ||
Income Tax Disclosure [Line Items] | ||
Income tax at the US statutory federal rate | 25% |
Common Stock_Partners' Capital
Common Stock/Partners' Capital - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jan. 11, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Class Of Stock [Line Items] | ||||||
Common stock, shares issued | 598,839,000 | 596,748,000 | ||||
Proceeds from sale of common shares / units, net of offering costs | $ 0 | $ 900,574 | ||||
MPT Operating Partnership, L.P. [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Number of units sold | 45,600,000 | |||||
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, LLC. [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Percentage of ownership of general partner | 100% | |||||
MPT Operating Partnership, L.P. [Member] | MPT TRS, Inc [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Percentage of ownership of general partner | 100% | |||||
MPT Operating Partnership, L.P. [Member] | Operating Partnership [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Percentage of ownership limited partner | 100% | |||||
Public Offering [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Common stock, shares issued | 36,800,000 | |||||
Proceeds from sale of common shares / units, net of offering costs | $ 711,000 | |||||
At-the-Market Equity Offering Program [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Proceeds from sale of common shares / units, net of offering costs | $ 189,000 | |||||
Common Units [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Number of share sold | 5,679,000 | 39,949,000 | ||||
Common Units [Member] | At-the-Market Equity Offering Program [Member] | ||||||
Class Of Stock [Line Items] | ||||||
Number of share sold | 8,800,000 |
Stock Awards - Additional Infor
Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Share / (Unit)-based compensation expense | $ 21,912 | $ 25,035 |
Equity Incentive Plan [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Reserved shares of common stock for awards under the Equity Incentive Plan | 28,900,000 | |
Reserved an additional shares of common stock for awards under the Equity Incentive Plan | 16,000,000 | |
Common stock remaining for future stock awards transferred to the equity incentive plan | 19,200,000 |
Fair Value of Financial Instr_3
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Fair Value Disclosures [Abstract] | ||
Interest and rent receivables, Book value | $ 94,206 | $ 56,229 |
Loans, Book value | 1,319,002 | 991,609 |
Debt, net Book value | (10,138,774) | (11,282,770) |
Interest and rent receivables, Fair value | 94,296 | 56,564 |
Loans, Fair value | 1,312,882 | 991,954 |
Debt, net Fair value | $ (9,201,093) | $ (11,526,388) |
Fair Value of Financial Instr_4
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 USD ($) Health_Center | Dec. 31, 2021 USD ($) | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Mortgage loans | $ 314,681 | $ 213,211 |
Investments in unconsolidated real estate joint ventures | 1,460,373 | 1,152,927 |
Investments in unconsolidated operating entities | 1,439,910 | 1,289,434 |
Loans [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Investments in unconsolidated operating entities | 639,500 | 521,400 |
Other loans | 211,100 | 64,500 |
Shareholder Loan [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Mortgage loans | 159,000 | 70,100 |
Investments in unconsolidated real estate joint ventures | $ 309,400 | $ 335,600 |
Fair Value, Recurring [Member] | Colombia [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Number of facilities acquired | Health_Center | 3 | |
Fair Value, Recurring [Member] | Acquisition Loans [Member] | Colombia [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Number of facilities acquired | Health_Center | 3 |
Fair Value of Financial Instr_5
Fair Value of Financial Instruments - Additional Information (Detail) - USD ($) | 6 Months Ended | ||
Jun. 30, 2021 | Jun. 30, 2022 | Mar. 14, 2022 | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |||
Percentage of equity investment | 50% | ||
Springstone Inc. and International Joint Venture [Member] | |||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |||
Percentage of equity investment | 40% | ||
Equity investments unrealized gain/loss | $ 0 |
Fair Value of Financial Instr_6
Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring [Member] - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Mortgage Loans [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Fair Value | $ 155,661 | $ 143,068 |
Original Cost | 155,661 | 143,068 |
Equity Method Investment and Other Loans [Member] | ||
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | ||
Fair Value | 430,944 | 409,638 |
Original Cost | $ 438,278 | $ 409,638 |
Fair Value of Financial Instr_7
Fair Value of Financial Instruments - Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations (Details) - Springstone Inc. and International Joint Venture [Member] | 6 Months Ended |
Jun. 30, 2022 USD ($) | |
+ 100 Basis Points [Member] | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |
Estimated Increase (Decrease) in Fair Value | $ (41) |
- 100 Basis Points [Member] | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |
Estimated Increase (Decrease) in Fair Value | $ 41 |
Earnings Per Share_Unit - Calcu
Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||||
Jun. 30, 2022 | Mar. 31, 2022 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | ||||||
Net income | $ 190,064 | $ 631,947 | $ 114,821 | $ 163,880 | $ 822,011 | $ 278,701 |
Non-controlling interests’ share in net income | (467) | (256) | (733) | (353) | ||
Participating securities’ share in earnings | (345) | (390) | (747) | (760) | ||
Net income, less participating securities’ share in earnings | $ 189,252 | $ 114,175 | $ 820,531 | $ 277,588 | ||
Basic weighted-average common shares | 598,827 | 587,514 | 598,751 | 581,877 | ||
Dilutive potential common shares | 199 | 1,539 | 228 | 1,420 | ||
Diluted weighted-average common shares | 599,026 | 589,053 | 598,979 | 583,297 | ||
MPT Operating Partnership, L.P. [Member] | ||||||
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | ||||||
Net income | $ 190,064 | $ 631,947 | $ 114,821 | $ 163,880 | $ 822,011 | $ 278,701 |
Non-controlling interests’ share in net income | (467) | (256) | (733) | (353) | ||
Participating securities’ share in earnings | (345) | (390) | (747) | (760) | ||
Net income, less participating securities’ share in earnings | $ 189,252 | $ 114,175 | $ 820,531 | $ 277,588 | ||
Basic weighted-average common shares | 598,827 | 587,514 | 598,751 | 581,877 | ||
Dilutive potential common shares | 199 | 1,539 | 228 | 1,420 | ||
Diluted weighted-average common shares | 599,026 | 589,053 | 598,979 | 583,297 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) - HCA Healthcare [Member] | 6 Months Ended |
Jun. 30, 2022 Hospital | |
Commitment And Contingencies [Line Items] | |
Number of facilities acquired | 5 |
Steward Health Care System LLC [Member] | |
Commitment And Contingencies [Line Items] | |
Number of facilities acquired | 5 |
Acute Care Hospital [Member] | |
Commitment And Contingencies [Line Items] | |
Number of facilities acquired | 5 |
Subsequent Events - Additional
Subsequent Events - Additional Information (Detail) $ in Millions | Jul. 29, 2022 USD ($) |
Subsequent Event [Member] | Colombia [Member] | General Acute Care Facility [Member] | |
Subsequent Event [Line Items] | |
Purchase price of acquisition | $ 26 |