Medical Properties Trust (MPW) 10-K 3 Mar 25 2024 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2024	Feb. 28, 2025	Jun. 30, 2024
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Trading Symbol	MPW
Entity Registrant Name	Medical Properties Trust, Inc
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Common Stock, Shares Outstanding		600.6
Entity Public Float			$ 2.6
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
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 Annual Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Documents Incorporated by Reference	Portions of the definitive Proxy Statement of Medical Properties Trust, Inc. for the Annual Meeting of Stockholders to be held on May 29, 2025 are incorporated by reference into Items 10 through 14 of Part III, of this Annual Report on Form 10-K.
Auditor Opinion [Text Block]	Opinions on the Financial Statements and Internal Control over Financial Reporting We have audited the accompanying consolidated balance sheets of Medical Properties Trust, Inc. and its subsidiaries (the “Company”) as of December 31, 2024 and 2023, and the related consolidated statements of net income, of comprehensive (loss) income, of equity and of cash flows for each of the three years in the period ended December 31, 2024, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2024 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Entity Registrant Name	MPT Operating Partnership, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Non-accelerated Filer
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
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
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Auditor Opinion [Text Block]	Opinions on the Financial Statements and Internal Control over Financial Reporting We have audited the accompanying consolidated balance sheets of MPT Operating Partnership, L.P. and its subsidiaries (the “Company”) as of December 31, 2024 and 2023, and the related consolidated statements of net income, of comprehensive (loss) income, of capital and of cash flows for each of the three years in the period ended December 31, 2024, including the related notes and financial statement schedules listed in the index appearing under Item 15(a) (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2024 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Real estate assets
Land	$ 1,607,869	$ 1,806,765
Buildings and improvements	8,847,892	10,395,612
Intangible lease assets	804,081	1,034,810
Investment in financing leases	1,057,770	1,231,630
Real estate held for sale	34,019	0
Mortgage loans	119,912	309,315
Gross investment in real estate assets	12,471,543	14,778,132
Accumulated depreciation	(1,221,644)	(1,227,619)
Accumulated amortization	(201,304)	(180,352)
Net investment in real estate assets	11,048,595	13,370,161
Cash and cash equivalents	332,335	250,016
Interest and rent receivables	36,327	45,059
Straight-line rent receivables	700,783	635,987
Investments in unconsolidated real estate joint ventures	1,156,397	1,474,455
Investments in unconsolidated operating entities	439,578	1,778,640
Other loans	109,175	292,615
Other assets	471,404	457,911
Total Assets	14,294,594	18,304,844
Liabilities
Debt, net	8,848,112	10,064,236
Accounts payable and accrued expenses	454,209	412,178
Deferred revenue	29,445	37,962
Obligations to tenants and other lease liabilities	129,045	156,603
Total Liabilities	9,460,811	10,670,979
Commitments and Contingencies
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 - 600,403 shares at December 31, 2024 and 598,991 shares at December 31, 2023	600	599
Additional paid-in capital	8,584,917	8,560,309
Retained deficit	(3,658,516)	(971,809)
Accumulated other comprehensive (loss) income	(94,272)	42,501
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	4,832,729	7,631,600
Non-controlling interests	1,054	2,265
Total Equity / Capital	4,833,783	7,633,865
Total Liabilities and Equity / Capital	14,294,594	18,304,844
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,607,869	1,806,765
Buildings and improvements	8,847,892	10,395,612
Intangible lease assets	804,081	1,034,810
Investment in financing leases	1,057,770	1,231,630
Real estate held for sale	34,019	0
Mortgage loans	119,912	309,315
Gross investment in real estate assets	12,471,543	14,778,132
Accumulated depreciation	(1,221,644)	(1,227,619)
Accumulated amortization	(201,304)	(180,352)
Net investment in real estate assets	11,048,595	13,370,161
Cash and cash equivalents	332,335	250,016
Interest and rent receivables	36,327	45,059
Straight-line rent receivables	700,783	635,987
Investments in unconsolidated real estate joint ventures	1,156,397	1,474,455
Investments in unconsolidated operating entities	439,578	1,778,640
Other loans	109,175	292,615
Other assets	471,404	457,911
Total Assets	14,294,594	18,304,844
Liabilities
Debt, net	8,848,112	10,064,236
Accounts payable and accrued expenses	405,655	318,980
Deferred revenue	29,445	37,962
Obligations to tenants and other lease liabilities	129,045	156,603
Payable due to Medical Properties Trust, Inc.	48,164	92,808
Total Liabilities	9,460,421	10,670,589
Commitments and Contingencies
Equity / Capital
General partner - issued and outstanding - 6,006 units at December 31, 2024 and 5,991 units at December 31, 2023	49,348	75,969
Limited Partners - issued and outstanding - 594,397 units at December 31, 2024 and 593,000 units at December 31, 2023	4,878,043	7,513,520
Accumulated other comprehensive (loss) income	(94,272)	42,501
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	4,833,119	7,631,990
Non-controlling interests	1,054	2,265
Total Equity / Capital	4,834,173	7,634,255
Total Liabilities and Equity / Capital	$ 14,294,594	$ 18,304,844

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2024	Dec. 31, 2023
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	600,403,000	598,991,000
Common stock, shares outstanding	600,403,000	598,991,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	6,006,000	5,991,000
General partner, units outstanding	6,006,000	5,991,000
Common Units | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	594,397,000	593,000,000
Limited Partners, units outstanding	594,397,000	593,000,000

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenues
Rent billed	$ 719,749	$ 803,375	$ 968,874
Straight-line rent	163,414	(127,894)	204,159
Income from financing leases	63,651	127,141	203,580
Interest and other income	48,733	69,177	166,238
Total revenues	995,547	871,799	1,542,851
Expenses
Interest	417,824	411,171	359,036
Real estate depreciation and amortization	447,657	603,360	332,977
Property-related	27,255	41,567	45,697
General and administrative	133,789	145,588	160,494
Total expenses	1,026,525	1,201,686	898,204
Other (expense) income
Gain (loss) on sale of real estate	478,693	(1,815)	536,755
Real estate and other impairment charges, net	(1,825,402)	(376,907)	(268,375)
(Loss) earnings from equity interests	(366,642)	13,967	40,800
Debt refinancing and unutilized financing (costs) benefit	(4,292)	285	(9,452)
Other (including fair value adjustments on securities)	(615,565)	7,586	15,344
Total other (expense) income	(2,333,208)	(356,884)	315,072
(Loss) income before income tax	(2,364,186)	(686,771)	959,719
Income tax (expense) benefit	(44,101)	130,679	(55,900)
Net (loss) income	(2,408,287)	(556,092)	903,819
Net income attributable to non-controlling interests	(1,984)	(384)	(1,222)
Net (loss) income attributable to MPT common stockholders	$ (2,410,271)	$ (556,476)	$ 902,597
Earnings per common share (units) basic
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), basic	$ (4.02)	$ (0.93)	$ 1.5
Earnings per common share (units) diluted
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ (4.02)	$ (0.93)	$ 1.5
Weighted average shares (units) outstanding basic	600,248	598,518	598,634
Weighted average shares (units) outstanding diluted	600,248	598,518	598,837
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 719,749	$ 803,375	$ 968,874
Straight-line rent	163,414	(127,894)	204,159
Income from financing leases	63,651	127,141	203,580
Interest and other income	48,733	69,177	166,238
Total revenues	995,547	871,799	1,542,851
Expenses
Interest	417,824	411,171	359,036
Real estate depreciation and amortization	447,657	603,360	332,977
Property-related	27,255	41,567	45,697
General and administrative	133,789	145,588	160,494
Total expenses	1,026,525	1,201,686	898,204
Other (expense) income
Gain (loss) on sale of real estate	478,693	(1,815)	536,755
Real estate and other impairment charges, net	(1,825,402)	(376,907)	(268,375)
(Loss) earnings from equity interests	(366,642)	13,967	40,800
Debt refinancing and unutilized financing (costs) benefit	(4,292)	285	(9,452)
Other (including fair value adjustments on securities)	(615,565)	7,586	15,344
Total other (expense) income	(2,333,208)	(356,884)	315,072
(Loss) income before income tax	(2,364,186)	(686,771)	959,719
Income tax (expense) benefit	(44,101)	130,679	(55,900)
Net (loss) income	(2,408,287)	(556,092)	903,819
Net income attributable to non-controlling interests	(1,984)	(384)	(1,222)
Net (loss) income attributable to MPT common stockholders	$ (2,410,271)	$ (556,476)	$ 902,597
Earnings per common share (units) basic
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), basic	$ (4.02)	$ (0.93)	$ 1.5
Earnings per common share (units) diluted
Net (loss) income attributable to MPT common stockholders (Operating Partnership partners), diluted	$ (4.02)	$ (0.93)	$ 1.5
Weighted average shares (units) outstanding basic	600,248	598,518	598,634
Weighted average shares (units) outstanding diluted	600,248	598,518	598,837

Consolidated Statements of Comp

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Net (loss) income	$ (2,408,287)	$ (556,092)	$ 903,819
Other comprehensive (loss) income:
Unrealized (loss) gain on interest rate hedges, net of tax	(20,779)	(34,932)	100,550
Reclassification of interest rate hedges gain from AOCI to earnings, net of tax	(18,926)	(28,553)
Foreign currency translation (loss) gain	(97,068)	162,680	(123,007)
Reclassification of foreign currency translation loss from AOCI to earnings		2,490
Total comprehensive (loss) income	(2,545,060)	(454,407)	881,362
Comprehensive income attributable to non-controlling interests	(1,984)	(384)	(1,222)
Comprehensive (loss) income attributable to MPT common stockholders (Operating Partnership Partners)	(2,547,044)	(454,791)	880,140
MPT Operating Partnership, L.P. [Member]
Net (loss) income	(2,408,287)	(556,092)	903,819
Other comprehensive (loss) income:
Unrealized (loss) gain on interest rate hedges, net of tax	(20,779)	(34,932)	100,550
Reclassification of interest rate hedges gain from AOCI to earnings, net of tax	(18,926)	(28,553)
Foreign currency translation (loss) gain	(97,068)	162,680	(123,007)
Reclassification of foreign currency translation loss from AOCI to earnings		2,490
Total comprehensive (loss) income	(2,545,060)	(454,407)	881,362
Comprehensive income attributable to non-controlling interests	(1,984)	(384)	(1,222)
Comprehensive (loss) income attributable to MPT common stockholders (Operating Partnership Partners)	$ (2,547,044)	$ (454,791)	$ 880,140

Consolidated Statements of Equi

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]	MPT Operating Partnership, L.P. [Member] Limited Partner [Member]	Common Par Value [Member]	Additional Paid-in Capital [Member]	Retained (Deficit) Earnings [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Accumulated Other Comprehensive (Loss) Income [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, 2021	$ 8,445,671	$ 8,446,061	$ 84,847	$ 8,392,458	$ 597	$ 8,564,009	$ (87,691)	$ (36,727)	$ (36,727)	$ 5,483	$ 5,483
Beginning balance (in shares) at Dec. 31, 2021			5,968	590,780	596,748
Net (loss) income	903,819	903,819	$ 9,026	$ 893,571			902,597			1,222	1,222
Unrealized gain (loss) on interest rate hedges, net of tax	100,550	100,550						100,550	100,550
Foreign currency translation gain (loss)	(123,007)	(123,007)						(123,007)	(123,007)
Stock (Unit) vesting and amortization of stock-based compensation	49,421	49,421	$ 494	$ 48,927	$ 3	49,418
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			37	3,638	3,675
Stock (Unit) vesting - satisfaction of tax withholding	(29,922)	(29,922)	$ (299)	$ (29,623)	$ (1)	(29,921)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(13)	(1,289)	(1,302)
Repurchase of units	(17,940)	(17,940)	$ (179)	$ (17,761)	$ (2)	(17,938)
Repurchase of units (shares)			(16)	(1,629)	(1,645)
Acquisitions of non-controlling interest	(35,022)	(35,022)	$ (304)	$ (30,124)		(30,428)				(4,594)	(4,594)
Issuance of non-controlling interest	1,054	1,054								1,054	1,054
Distributions to non-controlling interests, net	(1,596)	(1,596)								(1,596)	(1,596)
Dividends (Distributions) declared	(698,621)	(698,621)	(6,986)	(691,635)			(698,621)
Ending balance at Dec. 31, 2022	8,594,407	8,594,797	$ 86,599	$ 8,565,813	$ 597	8,535,140	116,285	(59,184)	(59,184)	1,569	1,569
Ending balance (in shares) at Dec. 31, 2022			5,976	591,500	597,476
Net (loss) income	(556,092)	(556,092)	$ (5,564)	$ (550,912)			(556,476)			384	384
Unrealized gain (loss) on interest rate hedges, net of tax	(34,932)	(34,932)						(34,932)	(34,932)
Reclassification of interest rate hedge gain to earnings, net of tax	(28,553)	(28,553)						(28,553)	(28,553)
Foreign currency translation gain (loss)	162,680	162,680						162,680	162,680
Reclassification of foreign currency translation loss from AOCI to earnings	2,490	2,490						2,490	2,490
Stock (Unit) vesting and amortization of stock-based compensation	33,250	33,250	$ 332	$ 32,918	$ 2	33,248
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			25	2,432	2,457
Stock (Unit) vesting - satisfaction of tax withholding	(8,079)	(8,079)	$ (81)	$ (7,998)		(8,079)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(10)	(932)	(942)
Issuance of non-controlling interest	1,375	1,375								1,375	1,375
Distributions to non-controlling interests, net	(1,063)	(1,063)								(1,063)	(1,063)
Dividends (Distributions) declared	(531,618)	(531,618)	$ (5,317)	$ (526,301)			(531,618)
Ending balance at Dec. 31, 2023	7,633,865	7,634,255	$ 75,969	$ 7,513,520	$ 599	8,560,309	(971,809)	42,501	42,501	2,265	2,265
Ending balance (in shares) at Dec. 31, 2023			5,991	593,000	598,991
Net (loss) income	(2,408,287)	(2,408,287)	$ (24,102)	$ (2,386,169)			(2,410,271)			1,984	1,984
Unrealized gain (loss) on interest rate hedges, net of tax	(20,779)	(20,779)						(20,779)	(20,779)
Reclassification of interest rate hedge gain to earnings, net of tax	(18,926)	(18,926)						(18,926)	(18,926)
Foreign currency translation gain (loss)	(97,068)	(97,068)						(97,068)	(97,068)
Stock (Unit) vesting and amortization of stock-based compensation	28,414	28,414	$ 285	$ 28,129	$ 2	28,412
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			23	2,150	2,173
Stock (Unit) vesting - satisfaction of tax withholding	(3,805)	(3,805)	$ (39)	$ (3,766)	$ (1)	(3,804)
Stock (Unit) vesting - satisfaction of tax withholding (shares)			(8)	(753)	(761)
Acquisitions of non-controlling interest	(1,500)	(1,500)								(1,500)	(1,500)
Distributions to non-controlling interests, net	(1,695)	(1,695)								(1,695)	(1,695)
Dividends (Distributions) declared	(276,436)	(276,436)	$ (2,765)	$ (273,671)			(276,436)
Ending balance at Dec. 31, 2024	$ 4,833,783	$ 4,834,173	$ 49,348	$ 4,878,043	$ 600	$ 8,584,917	$ (3,658,516)	$ (94,272)	$ (94,272)	$ 1,054	$ 1,054
Ending balance (in shares) at Dec. 31, 2024			6,006	594,397	600,403

Consolidated Statements of Eq_2

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Dividends (Distributions) declared per common share / unit	$ 0.46	$ 0.88	$ 1.16
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.46	$ 0.88	$ 1.16

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating activities
Net (loss) income	$ (2,408,287)	$ (556,092)	$ 903,819
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	453,749	616,127	345,577
Amortization of deferred financing costs and debt discount	17,348	15,775	17,045
Straight-line rent revenue and other	(172,765)	(233,703)	(282,504)
Stock / (Unit)-based compensation expense	32,976	33,250	49,421
(Gain) loss on sale of real estate	(478,693)	1,815	(536,755)
Real estate and other impairment charges, net	1,825,402	376,907	268,375
Equity interest real estate impairment	410,790
Straight-line rent and other write-off	2,514	649,911	34,605
Debt refinancing and unutilized financing (benefit) costs	4,292	(285)	9,452
Tax rate changes and other	5,119	(167,332)	10,697
Non-cash fair value adjustments	563,666	(34,157)	(3,097)
Non-cash revenue from debt and equity securities received		(81,706)
Other adjustments	4,975	10,287	9,205
Changes in:
Interest and rent receivables	2,778	(141,729)	(116,420)
Other assets	(36,109)	13,750	(4,029)
Accounts payable and accrued expenses	23,481	(4,599)	33,576
Deferred revenue	(5,753)	7,567	43
Net cash provided by operating activities	245,483	505,786	739,010
Investing activities
Cash paid for acquisitions and other related investments	(105,618)	(235,187)	(1,332,962)
Net proceeds from sale of real estate	1,854,077	897,500	2,185,574
Principal received from sale and repayment of loans receivable	214,416	501,630	53,322
Investment in loans receivable	(420,324)	(250,223)	(207,542)
Construction in progress and other	(79,788)	(114,425)	(109,237)
Proceeds from sale and return of equity investments	11,656	12,430	14,295
Capital additions and other investments, net	(156,078)	(294,167)	(207,394)
Net cash provided by investing activities	1,318,341	517,558	396,056
Financing activities
Proceeds from term debt	804,188		128,536
Payments of term debt	(701,809)	(988,162)	(869,606)
Revolving credit facilities, net	(1,131,312)	567,910	203,576
Dividends / Distribution paid	(321,080)	(615,390)	(698,535)
Lease deposits and other obligations to tenants	2,237	10,139	(5,020)
Repurchase of common stock / unit			(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(3,805)	(8,079)	(29,922)
Other financing activities, Payment of debt refinancing and deferred financing costs	(127,798)	13,255	(53,612)
Net cash used for financing activities	(1,479,379)	(1,020,327)	(1,342,523)
Increase (decrease) in cash, cash equivalents, and restricted cash for the year	84,445	3,017	(207,457)
Effect of exchange rate changes	(5,224)	11,397	(12,887)
Cash, cash equivalents, and restricted cash at beginning of year	255,952	241,538	461,882
Cash, cash equivalents, and restricted cash at end of year	335,173	255,952	241,538
Interest paid, including capitalized interest of $7,642 in 2024, $14,178 in 2023, and $6,454 in 2022	420,315	406,141	353,838
Supplemental schedule of non-cash investing activities:
Debt and equity securities received for certain obligations, real estate, and revenue		804,520
Certain obligations and receivable satisfied and real estate sold		722,814
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	48,164	92,808	176,580
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	250,016	235,668	459,227
Restricted cash, included in Other assets at beginning of period	$ 5,936	$ 5,870	$ 2,655
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 335,173	$ 255,952	$ 241,538
Cash and cash equivalents at end of period	332,335	250,016	235,668
Restricted cash, included in Other assets at end of period	$ 2,838	$ 5,936	$ 5,870
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 335,173	$ 255,952	$ 241,538
MPT Operating Partnership, L.P. [Member]
Operating activities
Net (loss) income	(2,408,287)	(556,092)	903,819
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	453,749	616,127	345,577
Amortization of deferred financing costs and debt discount	17,348	15,775	17,045
Straight-line rent revenue and other	(172,765)	(233,703)	(282,504)
Stock / (Unit)-based compensation expense	32,976	33,250	49,421
(Gain) loss on sale of real estate	(478,693)	1,815	(536,755)
Real estate and other impairment charges, net	1,825,402	376,907	268,375
Equity interest real estate impairment	410,790
Straight-line rent and other write-off	2,514	649,911	34,605
Debt refinancing and unutilized financing (benefit) costs	4,292	(285)	9,452
Tax rate changes and other	5,119	(167,332)	10,697
Non-cash fair value adjustments	563,666	(34,157)	(3,097)
Non-cash revenue from debt and equity securities received		(81,706)
Other adjustments	4,975	10,287	9,205
Changes in:
Interest and rent receivables	2,778	(141,729)	(116,420)
Other assets	(36,109)	13,750	(4,029)
Accounts payable and accrued expenses	23,481	(4,599)	33,576
Deferred revenue	(5,753)	7,567	43
Net cash provided by operating activities	245,483	505,786	739,010
Investing activities
Cash paid for acquisitions and other related investments	(105,618)	(235,187)	(1,332,962)
Net proceeds from sale of real estate	1,854,077	897,500	2,185,574
Principal received from sale and repayment of loans receivable	214,416	501,630	53,322
Investment in loans receivable	(420,324)	(250,223)	(207,542)
Construction in progress and other	(79,788)	(114,425)	(109,237)
Proceeds from sale and return of equity investments	11,656	12,430	14,295
Capital additions and other investments, net	(156,078)	(294,167)	(207,394)
Net cash provided by investing activities	1,318,341	517,558	396,056
Financing activities
Proceeds from term debt	804,188		128,536
Payments of term debt	(701,809)	(988,162)	(869,606)
Revolving credit facilities, net	(1,131,312)	567,910	203,576
Dividends / Distribution paid	(321,080)	(615,390)	(698,535)
Lease deposits and other obligations to tenants	2,237	10,139	(5,020)
Repurchase of common stock / unit			(17,940)
Stock / Unit vesting - satisfaction of tax withholdings	(3,805)	(8,079)	(29,922)
Other financing activities, Payment of debt refinancing and deferred financing costs	(127,798)	13,255	(53,612)
Net cash used for financing activities	(1,479,379)	(1,020,327)	(1,342,523)
Increase (decrease) in cash, cash equivalents, and restricted cash for the year	84,445	3,017	(207,457)
Effect of exchange rate changes	(5,224)	11,397	(12,887)
Cash, cash equivalents, and restricted cash at beginning of year	255,952	241,538	461,882
Cash, cash equivalents, and restricted cash at end of year	335,173	255,952	241,538
Interest paid, including capitalized interest of $7,642 in 2024, $14,178 in 2023, and $6,454 in 2022	420,315	406,141	353,838
Supplemental schedule of non-cash investing activities:
Debt and equity securities received for certain obligations, real estate, and revenue		804,520
Certain obligations and receivable satisfied and real estate sold		722,814
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	48,164	92,808	176,580
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	250,016	235,668	459,227
Restricted cash, included in Other assets at beginning of period	$ 5,936	$ 5,870	$ 2,655
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 335,173	$ 255,952	$ 241,538
Cash and cash equivalents at end of period	332,335	250,016	235,668
Restricted cash, included in Other assets at end of period	$ 2,838	$ 5,936	$ 5,870
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 335,173	$ 255,952	$ 241,538

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Interest paid, capitalized	$ 7,642	$ 14,178	$ 6,454
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 7,642	$ 14,178	$ 6,454

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (2,410,271)	$ (556,476)	$ 902,597

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule 10b51 Arr Mofified Flag	false
Non Rule 10b51 Arr Modified Flag	false

Insider Trading Policies and Pr

Insider Trading Policies and Procedures	12 Months Ended
	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Cybersecurity Risk Management S

Cybersecurity Risk Management Strategy and Governance	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	ITEM 1C. Cybersecurity Cyber Risk Management and Strategy We have developed, implemented, and continue to maintain processes and procedures to identify and mitigate cybersecurity risks across our company (including our offices in Europe). Because we rely on various information technology systems and software programs to operate our business, we have an extensive cybersecurity program designed to protect our properties and confidential data. Our cybersecurity risk management and strategy program includes the following: • implementing the latest software releases and tools (including multi-factor authentication) in a timely manner; • seek to minimize the amount of personal information collected and stored about our employees and seek to avoid any collection and storage of non-financial or contact information from our tenants/borrowers; • constant security monitoring of computers, networks, and cloud-based information assets to detect and respond to cybersecurity risks and threats; • third party internal and external vulnerability assessments and penetration testing; • annual review and audit of cyber controls and procedures; • periodic review of cybersecurity procedures and implementation of new procedures as necessary to adhere to cybersecurity standards set forth by the National Institute of Standards and Technology; • periodic evaluation and review of cybersecurity risks associated with our use of key third-party business partners, vendors, and service providers. Because we do not control the systems or cybersecurity plans put in place by such third parties, and we may have limited contractual protections with such parties, we may be negatively impacted as a result of threats or incidents experienced by such third parties; • security awareness training provided during employee onboarding process and successful completion required at least annually for all employees with passing requirements; • employee anti-phishing campaigns performed at least quarterly; • a cybersecurity incident response plan, which is reviewed annually, but generally consists of a coordinated approach to investigating, containing, documenting, and reporting findings and keeping management and others informed and involved as appropriate; and • a cybersecurity risk insurance policy. We have not identified any known cybersecurity threats or incidents within the prior year that have materially affected or are reasonably likely to materially affect us , including our overall business strategy, results of operations, or financial condition. Although we have taken steps to protect the security of our information systems and the data maintained in those systems, there is no guarantee the measures and security we have implemented will be successful in detecting and preventing a cybersecurity incident. Please refer to Item 1A of this Annual Report on Form 10-K for more information regarding additional risks related to cybersecurity and information technology. Cyber Governance Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats. The Board receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes. Led by our Director of Information Technology and Security (“Director of IT”) with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	the Board, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	The Board receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.
Cybersecurity Risk Role of Management [Text Block]	Cybersecurity holds a pivotal role in our comprehensive risk management processes and is a key focus for both our Board and management. Our management has primary responsibility for identifying, assessing, and managing our exposure to cybersecurity threats and incidents. However, the Board, led by members of the Risk Committee, oversees the enterprise risk management process, specifically addressing material risks stemming from cybersecurity threats. The Board receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	The Board receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes. Led by our Director of Information Technology and Security (“Director of IT”) with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Director of Information Technology and Security (“Director of IT”) with years of experience in Information Technology, our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	The Board receives regular updates from the Computer Security Incident Response Team (“CSIRT”) to provide insight into significant cybersecurity risks, potential impacts on business operations, and management's strategies for identifying, monitoring, and mitigating these risks. This includes sharing results from assessments or audits of relevant processes. our CSIRT, comprising cross-functional professionals, collaborates to execute our cybersecurity risk assessment and management processes by reviewing and assessing cybersecurity initiatives, including the incident response plan, cybersecurity compliance, training, and overall risk management efforts. The collaborative efforts of the Board and our skilled CSIRT team underscore our commitment to effectively addressing and mitigating cybersecurity risks within the organization.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Organization

Organization	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	1. Orga nization 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 substantially all of our operations, was formed in September 2003. At present, we own, directly and indirectly, 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 are generally not subject to United States (“U.S.”) federal income tax on our REIT taxable income, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed such taxable income. Similarly, the majority of our real estate operations in the United Kingdom ("U.K.") operate as a REIT and generally are subject only to a withholding tax on earnings upon distribution out of the U.K. REIT. Certain non-real estate activities we undertake in the U.S. 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. (excluding those assets that are in the U.K. REIT), we are subject to the local income 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 healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100 %; however, we do own some leased assets through joint ventures with other partners that share our view that healthcare facilities are part of the infrastructure of any community, which we refer to as investments in unconsolidated real estate joint ventures. We also may make mortgage loans to healthcare operators collateralized by their real estate. In addition, we may make noncontrolling investments in our tenants (which we refer to as investments in unconsolidated operating entities), from time-to-time, typically in conjunction with larger real estate transactions with the tenant, which may 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 December 31, 2024 , we have investments in 396 facilities in 31 states in the U.S., in seven countries in Europe, and one country in South America. Our properties consist of general acute care hospitals, behavioral health facilities, post acute care facilities (including inpatient physical rehabilitation facilities and long-term acute care hospitals), and freestanding ER/urgent care facilities.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Signific ant Accounting Policies Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. 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 financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements at December 31, 2024 are reasonable and supportable based on the information available (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 those estimates. Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100 % of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity ("VIE"). If we determine that we have a variable interest in a VIE, we then evaluate if we are the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. We consolidate each VIE in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2024, we had loans and/or equity investments in certain VIEs, which may also be tenants of our facilities. We have determined that we were not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at December 31, 2024 are presented below (in thousands): VIE Type Carrying Asset Type Maximum Loss Loans, net and equity investments $ 149,027 Investments in Unconsolidated $ 149,027 Loans, net 117,187 Mortgage and other loans 117,268 (1) Carrying amount only reflects the net book value of our loan or equity investment in the VIE. (2) Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities. For the VIE types above, we do not consolidate the VIEs because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of December 31, 2024, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g. cash short falls). Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2024. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “(Loss) earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop Holdings S.à.r.l. ("Primotop") (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income. Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets. Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards Codification (“ASC”) 842, “Leases”, (“ASC 842”). ASC 842 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). For lessors, we apply this standard as follows: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the cash basis method, when collectability of the lease payments is not deemed probable. Rent revenue from base rents is recorded on the straight-line method, when collectability of the lease payments is deemed probable, over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under ASC 842, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method. Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received on operating lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease on the straight-line method. Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method. Acquired Real Estate Purchase Price Allocation: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months , but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time. Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, is maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements, which improve and/or extend the useful life of the asset, are capitalized and depreciated over their estimated useful lives. We review real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. We analyze recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Future cash flows are discounted when determining fair value of an asset. Estimated future cash flows used in such analysis are based on our plans for the real estate asset and our view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates. When a real estate investment is designated as held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is typically based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2024 are as follows: Buildings and improvements 38.6 years Lease intangibles 28.3 years Leasehold improvements 14.3 years Furniture, equipment, and other 5.2 years Credit Losses: Losses from Rent Receivables: For our leases, we review tenant provided financial data and monitor the performance of our tenants in areas generally consisting of: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as rising inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity. Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding billed rent and/or straight-line rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces lease income to the lesser of a) lease payments that have been collected (cash basis) or b) income under the straight-line method. Losses on Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we group our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further group our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determine a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjust as needed for current trends or unusual circumstances. We apply these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral. We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash. Loans : Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible. Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, we assess their collectability similar to how we assess collectability for interest receivables on financing leases described above. The following table summarizes our credit loss reserves (in thousands): December 31, 2024 December 31, 2023 Balance at beginning of the year $ 96,001 $ 121,146 Provision for credit loss, net 1,241,020 10,194 Expected credit loss reserve written off or related to financial ( 825,548 ) ( 35,339 ) Balance at end of year $ 511,473 $ 96,001 Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income by the weighted-average number of shares/units outstanding during the period. Diluted earnings per common share/unit is calculated by including the effect of dilutive securities. Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit. Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90 % of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of TRS entities. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities. With the property acquisitions and investments in Europe and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes, of a significant nature, in the U.S. as the majority of such income from our international properties flows through our REIT income tax returns. For our TRS entities and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which was amended during the second quarter of 2022. Equity awards of restricted stock with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years ), using the straight-line method. Equity awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years , using the straight-line method. Equity awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. In 2024, certain market-based restricted stock units ("RSUs") were issued with cash-settlement features. These liability-type awards are adjusted to fair value (using a Monte Carlo valuation model) on a quarterly basis and amortized over the derived service period, which is also adjusted on a quarterly basis. Forfeitures of stock-based awards are recognized as they occur. Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other third-party leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan. Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other assets” on our consolidated balance sheets. Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity/partnership capital on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income (expense) in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets. Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose

Real Estate and Other Activitie

Real Estate and Other Activities	12 Months Ended
	Dec. 31, 2024
Real Estate [Abstract]
Real Estate and Other Activities	3. Real Esta te and Other Activities New Investments For the years ended December 31, 2024, 2023, and 2022, we acquired or invested in the following net assets (in thousands): 2024 2023 2022 Land and land improvements $ — $ 28,916 $ 135,301 Buildings — 114,966 487,698 Intangible lease assets — subject to amortization 24.8 years in 2023 21.3 years in 2022) — 16,305 45,394 Mortgage loans — — 159,735 Investments in unconsolidated real estate joint ventures 107,908 — 399,456 Investments in unconsolidated operating entities — 50,000 131,105 Other loans — 25,000 — Liabilities assumed ( 2,290 ) — ( 25,727 ) $ 105,618 $ 235,187 $ 1,332,962 Loans repaid(1) — ( 22,900 ) — Total net assets acquired $ 105,618 $ 212,287 $ 1,332,962 (1) The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below. 2024 Activity Utah Transaction On April 12, 2024, we sold our interests in five Utah hospitals for an aggregate agreed valuation of approximately $ 1.2 billion to a newly formed joint venture (the "Utah partnership") with an institutional asset manager (the "Fund"), which we call the Utah Transaction, and we recognized a gain on real estate of approximately $ 380 million, partially offset by a $ 20 million write-off of unbilled straight-line rent receivables. We retained an approximately 25 % interest in the Utah partnership valued initially at approximately $ 108 million, which is being accounted for on the equity method on a quarterly lag basis and included in the "Investments in unconsolidated real estate joint ventures" line of the consolidated balance sheets. The Fund purchased an approximate 75 % interest for $ 886 million. In conjunction with this transaction closing, the Utah partnership placed new non-recourse secured financing, providing $ 190 million of additional cash to us. In total, the Utah Transaction generated $ 1.1 billion of cash to us. The Utah lessee (an affiliate of CommonSpirit Health ("CommonSpirit")) may acquire the leased real estate at a price equal to the greater of fair market value and the approximate $ 1.2 billion lease base at the fifth or tenth anniversary of the 2023 master lease commencement. We granted the Fund certain limited and conditional preferences based on the possible execution of the purchase option, which we accounted for as a derivative liability with an initial value of approximately $ 2.3 million. 2023 Activity Prospect Transaction In August 2019, we invested in a portfolio of 14 acute care hospitals in three states (California, Pennsylvania, and Connecticut) operated by and master leased to or mortgaged by Prospect Medical Holdings, Inc. ("Prospect") for a combined investment of approximately $ 1.5 billion. In addition, we originated a $ 112.9 million term loan cross-defaulted to the master lease and mortgage loan agreements and further secured by a parent guaranty. In the 2022 second quarter, we funded an additional $ 100 million towards the existing mortgage loan that was secured by a first lien on a California hospital. Prospect's operations were negatively impacted by the coronavirus global pandemic commencing in early 2020, but Prospect remained current with respect to contractual rent and interest payments until the fourth quarter of 2022. Accordingly, and due further to the termination of certain refinancing negotiations between Prospect and certain third parties in early 2023 that would have recapitalized Prospect and provided for payment of unpaid rent and interest, we recorded an approximate $ 280 million impairment charge in the 2022 fourth quarter. As part of this charge, we reduced the carrying value of the underperforming Pennsylvania properties by approximately $ 170 million (to approximately $ 250 million) and reserved all unbilled rent accruals for a total of $ 112 million. However, Prospect continued to pursue a recapitalization plan, and, in late March 2023, Prospect received a binding commitment from several lenders to provide liquidity to pay down certain debt instruments. Along with these commitments from third-party lenders, we agreed to pursue certain transactions with Prospect as part of their recapitalization plan, including originating a $ 50 million convertible loan to PHP Holdings, the managed care business of Prospect, in the first quarter of 2023. On May 23, 2023, Prospect completed its recapitalization plan, which included receiving $ 375 million in new financing from several lenders. Along with this new debt capital from third-party lenders, we agreed to the following restructuring of our then $ 1.7 billion investment in Prospect including: a) maintaining the master lease covering six California hospitals without any changes in rental rates or escalator provisions, but with cash payments to start in September 2023 for a substantial portion of the contractual monthly rent due on these California properties, b) transitioning the Pennsylvania properties back to Prospect in return for a $ 150 million first lien mortgage on the facilities, c) providing up to $ 75 million in a loan secured by a first lien on Prospect's accounts receivable and certain other assets, of which we funded in full during 2023, d) continuing to pursue the sale of the three Connecticut properties to Yale New Haven ("Yale"), and e) obtaining a non-controlling ownership interest in PHP Holdings of approximately $ 654 million consisting of an approximate $ 68 million equity investment and $ 586 million loan convertible into equity of PHP Holdings (collectively, the "Prospect Transaction"). This non-controlling ownership interest was received in exchange for unpaid rent and interest through December 2022, previously unrecorded rent and interest revenue in 2023 totaling approximately $ 82 million, our $ 151 million mortgage loan on a California property, our $ 112.9 million term loan, and other obligations at the time of such investment. See subheading "Leasing Operations (Lessor)" in this Note 3 for further updates on Prospect. Lifepoint Transaction On February 7, 2023, a subsidiary of Lifepoint Health, Inc. ("Lifepoint") acquired a majority interest in Springstone (now Lifepoint Behavioral Health, "Lifepoint Behavioral") (the "Lifepoint Transaction") based on an enterprise value of $ 250 million. As part of the transaction, we received approximately $ 205 million in full satisfaction of our initial acquisition loan, including accrued interest, and we retained our minority equity investment in the operations of Lifepoint Behavioral. Separately, we converted a mortgage loan (as part of our initial acquisition in 2021) into the fee simple ownership of a property in Washington, which is leased, along with other behavioral health hospitals, to Lifepoint Behavioral, under a master lease agreement. In connection with the Lifepoint Transaction, Lifepoint extended its lease on eight existing general acute care hospitals by five years to 2041 . In the first quarter of 2024, we sold our minority equity investment in Lifepoint Behavioral for approximately $ 12 million. Other Transactions In the second quarter of 2023, we acquired three inpatient rehabilitation facilities for a total of approximately € 70 million (approximately $ 77 million). These hospitals are leased to Median Kliniken S.á.r.l ("MEDIAN") pursuant to a long-term master lease with annual inflation-based escalators. On April 14, 2023, we acquired five behavioral health hospitals located in the U.K. for approximately £ 44 million (approximately $ 58 million). These hospitals are leased to Priory pursuant to five separate lease agreements with annual inflation-based escalators. 2022 Activity Macquarie Transaction On March 14, 2022, we completed a transaction with Macquarie Asset Management ("Macquarie"), an unrelated party, to form a partnership (the “Macquarie Transaction”), pursuant to which we contributed eight Massachusetts-based general acute care hospitals that were leased to Steward, and a fund managed by Macquarie 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 sale of 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. 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 our consolidated balance sheets), which was accounted for under the equity method of accounting. See subheading "Leasing Operations (Lessor)" in this Note 3 for an update on this partnership. Other Transactions On December 9, 2022, we acquired six behavioral health facilities in the U.K. for £ 233 million ($ 286 million), plus customary tax and other transaction costs. These hospitals are leased to Priory pursuant to separate long-term leases with inflation-based escalators. As part of this transaction, the third-party seller of the real estate provided £ 105 million of seller financing - see Note 4 for further details on this debt. 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 purchasing the shares of the real estate holding entities, which 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, of which we funded £ 96.5 million towards a £ 100 million participation level in the variable rate loan. Other investments in 2022 included six 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. 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 a master lease agreement with annual inflation-based escalators. The other general acute care facility, located in Colombia, was acquired on July 29, 2022 for $ 26 million and is leased to Fundación Cardiovascular de Colombia pursuant to a long-term lease with inflation-based escalators. Development and Capital Addition Activities See table below for a status summary of our current development and capital addition projects (in thousands): Property Commitment Costs Cost Remaining Lifepoint Behavioral (Arizona) $ 10,504 $ 5,411 $ 5,093 Lifepoint Behavioral (Kansas) 20,183 11,584 8,599 Surgery Partners (Idaho) 15,993 5,590 10,403 Lifepoint Behavioral (Arizona) 10,659 470 10,189 IMED Hospitales (Spain) 49,749 21,355 28,394 IMED Hospitales (Spain) 36,294 29,261 7,033 Other (Various) 799 494 305 $ 144,181 $ 74,165 $ 70,016 We have two other development projects ongoing in Texas (Texarkana development) and Massachusetts (Norwood redevelopment). These are not highlighted above; however, we are presently completing construction to the stage where the building is "weathered in" and environmentally secure so as to physically protect our investment while we actively market the hospitals for sale or lease. As of December 31, 2024, we estimate that the cost to complete construction to this stage approximates $ 30 million. Separately, on the Norwood redevelopment, we recovered from our casualty insurers cash in November 2024 that was in excess of our recovery receivable related to the 2020 storm losses (included in "Other assets" in the consolidated balance sheets), resulting in a $ 24 million additional recovery in the 2024 third quarter. 2024 Activity During the fourth quarter of 2024, we completed construction and began recording rental income on an existing general acute care facility located in Idaho Falls, Idaho for a total amount of approximately $ 50 million. During the first quarter of 2024, we completed construction and began recording rental income on a $ 35.4 million behavioral health facility located in McKinney, Texas, that is leased to Lifepoint Behavioral. We also completed construction and began recording rental income on a € 46 million (approximately $ 49.0 million) general acute care facility located in Spain that is leased to IMED. 2023 Activity During 2023, we completed construction and began recording rental income on one inpatient rehabilitation facility located in Lexington, South Carolina, which commenced rent on July 1, 2023, and another inpatient rehabilitation facility located in Stockton, California, which commenced rent on May 1, 2023. Both of these facilities are leased to Ernest Health, Inc. ("Ernest") pursuant to an existing long-term master lease. 2022 Activity During 2022, 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 leased to Ernest pursuant to an existing long-term master lease. Disposals 2024 Activity During 2024, we had the following disposal activities: • See Utah Transaction above for a discussion of the five Utah hospitals sold on April 12, 2024. • On April 9, 2024, we sold five properties to Prime Healthcare Services, Inc. ("Prime") for total proceeds of approximately $ 250 million along with a $ 100 million interest-bearing mortgage loan (which was fully repaid on August 29, 2024). This transaction resulted in a gain on real estate of approximately $ 53 million, partially offset by a non-cash straight-line rent write-off of approximately $ 30 million. As part of this sale transaction, we extended the lease maturity of four other facilities with Prime to 2044. This amended lease has inflation-based escalators, collared between 2 % and 4 %, and a purchase option on or prior to August 26, 2028 for a value of $ 238 million, which is greater than our net book value for these properties at December 31, 2024. After August 26, 2028, this option price reverts to $ 260 million (subject to annual escalations). • On July 23, 2024, we sold the 50 -bed Arizona General Hospital in Mesa, Arizona and seven freestanding emergency departments to Dignity Health ("Dignity") for $ 160 million. This sale resulted in a gain on real estate of approximately $ 85 million, partially offset by a non-cash straight-line rent write-off of approximately $ 20 million. • On August 14, 2024, we sold 11 freestanding emergency departments to UCHealth for $ 86 million. This sale resulted in a gain on real estate of approximately $ 40 million, partially offset by a non-cash straight-line rent write-off of approximately $ 16 million. • As a result of the Company’s global settlement with Steward Health Care System ("Steward") approved by the bankruptcy court on September 18, 2024 (as discussed further under "Leasing Operations (Lessor)" under this same Note 3 ), we consented to the sale of three facilities located in Florida ("Space Coast" properties) to Orlando Health, which closed on October 23, 2024. In accordance with the terms of the global settlement, the Steward bankruptcy estate retained $ 395 million of the approximately $ 440 million total proceeds, and we recognized an approximate $ 2 million gain in the fourth quarter of 2024. • In the third quarter of 2024, Pajaro Valley Healthcare District Corporation notified us of their intent to exercise their purchase option on the Watsonville facility. This transaction, which closed on October 31, 2024, resulted in cash proceeds of approximately $ 40 million and an approximate $ 4 million gain. • During 2024, we also completed the sale of six other facilities and two ancillary facilities for approximately $ 14 million. Summary of Operations for Disposed (or to be Disposed) Assets in 2024 The following represents the operating results from properties sold for 2024 and properties designated as held for sale at December 31, 2024 (in thousands): For the Year Ended December 31, 2024 2023 2022 Revenues(1) $ 72,362 $ 88,938 $ 220,183 Real estate depreciation and amortization(2) ( 26,476 ) ( 331,099 ) ( 53,350 ) Property-related expenses ( 8,277 ) ( 4,697 ) ( 1,759 ) Real estate impairment charges(3) ( 129,159 ) — — Other (expense) income(4) 480,416 ( 90 ) ( 19 ) (Loss) income from real estate dispositions, net $ 388,866 $ ( 246,948 ) $ 165,055 (1) The 2023 column includes an approximate $ 95 million write-off of straight-line rent receivables related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023. (2) The 2023 column includes approximately $ 286 million of lease intangible amortization acceleration related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023. (3) Includes the charge associated with the three Space Coast facilities in the third quarter of 2024 due to the global settlement reached with Steward and its lenders. (4) The 2024 column includes approximately $ 24 million of gains (net of approximately $ 16 million write-off of straight line receivables) related to the UCHealth disposal and $ 65 million of gains (net of approximately $ 20 million write-off of straight-line rent receivables) related to the Dignity disposal. In addition, the 2024 column includes $ 360 million of gains (net of approximately $ 20 million write-off of straight-line rent receivables) related to the Utah Transaction and $ 23 million of gains (net of $ 30 million write-off of straight-line rent receivables) related to the sale of five Prime properties. 2023 Activity On March 30, 2023, we entered into a definitive agreement to sell our 11 general acute care facilities located in Australia and operated by Healthscope Ltd. ("Healthscope") (the "Australia Transaction") to affiliates of HMC Capital for cash proceeds of approximately A$ 1.2 billion. As a result, we designated the Australian portfolio as held for sale in the first quarter of 2023 and recorded approximately $ 79 million of net impairment charges at that time, which included $ 37.4 million of straight-line rent receivable write-offs and approximately $ 8 million in fees to sell the hospitals, partially offset by approximately $ 16 million of gains from our interest rate swap and foreign currency translation amounts in accumulated other comprehensive income that were reclassified to earnings in 2023 as part of the transaction. This transaction closed in two phases. The first phase closed on May 18, 2023, in which we sold seven of the 11 facilities for A$ 730 million, and the final phase closed on October 10, 2023, in which we sold the remaining four facilities for approximately A$ 470 million. On March 8, 2023, we received notice that Prime planned to exercise its right to repurchase from us the real estate associated with one master lease for approximately $ 100 million. As such, we recorded an approximate $ 11 million impairment charge in the first quarter of 2023 related to non-cash rent receivables on the three facilities that were sold on July 11, 2023. 2022 Activity On March 14, 2022, we completed the previously described partnership with Macquarie, 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 same Note 3 for further details on this transaction. During 2022, we also completed the sale of 15 other facilities (including 11 properties sold on September 1, 2022 to Prime for proceeds of $ 366 million) and five ancillary properties for total proceeds of approximately $ 522 million and recognized a gain on the sale of real estate of approximately $ 100 million, along with a $ 42 million write-off of straight-line rent receivables due to the early termination of certain properties' expected lease terms. Intangible Assets At December 31, 2024 and 2023 , our intangible lease assets were $ 0.8 billion ($ 0.6 billion, net of accumulated amortization) and $ 1.0 billion ($ 0.9 billion, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $ 205.6 million (including $ 170 million for accelerating the amortization of the in-place lease intangibles associated with two master leases, including the Steward master lease that was terminated effective September 11, 2024), $ 332.5 million (including $ 286 million for accelerating the amortization of the in-place lease intangibles related to re-leasing the Utah properties to CommonSpirit as described in this same Note 3 ), and $ 55.9 million in 2024, 2023, and 2022, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2025 $ 29,201 2026 29,052 2027 28,730 2028 28,566 2029 26,726 As of December 31, 2024 , capitalized lease intangibles have a weighted-average remaining life of 23.5 years. Leasing Operations (Lessor) We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies. The initial fixed lease terms of these infrastructure-type assets are typically 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 CPI (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. 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. The following table summarizes total future contractual minimum lease payments, excluding operating expense reimbursements, tenant recoveries, and other lease/loan-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2024 (amounts in thousands): Total Under Total Under Total 2025 $ 721,305 $ 118,855 $ 840,160 2026 810,002 121,289 931,291 2027 856,426 123,772 980,198 2028 868,390 126,304 994,694 2029 869,681 128,887 998,568 Thereafter 20,744,147 3,075,567 23,819,714 $ 24,869,951 $ 3,694,674 $ 28,564,625 For all of our properties subject to lease, we are the legal owner of the property and the tenant's right to use and possess such property is guided by the terms of a lease. At December 31, 2024 , we account for all of these leases as operating leases, except where generally accepted accounting principles (“GAAP”) requires alternative classification, including leases on 13 Ernest facilities that are accounted for as DFLs and leases on nine of our Prospect facilities and five of our Ernest facilities that are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands): As of December 31, 2024 As of December 31, 2023 Minimum lease payments receivable $ 591,142 $ 611,669 Estimated unguaranteed residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 547,770 ) ( 571,059 ) Net investment in direct financing leases 247,190 244,428 Other financing leases (net of allowance for credit loss) 810,580 987,202 Total investment in financing leases $ 1,057,770 $ 1,231,630 Other Leasing Activities At December 31, 2024, our vacant properties represent less than 1 % of total assets. We are in various stages of either re-leasing or selling these vacant properties. Our tenants’ financial performance and resulting ability to satisfy their lease and loan obligations to us are material to our financial results and our ability to service our debt and make distributions to our stockholders. Our tenants operate in the healthcare industry, which is highly regulated, and changes in regulation (or delays in enacting regulation) may temporarily impact our tenants’ operations until they are able to make the appropriate adjustments to their business. In addition, our tenants may experience operational challenges from time-to-time as a result of many factors, including those external to them, such as cybersecurity attacks, public health crises, economic issues resulting in high inflation and spikes in labor costs, extreme or severe weather and climate-related events, and adverse market and political conditions. We monitor our tenants' operating results and the potential impact from these challenges. We may elect to provide support to our tenants from time-to-time in the form of short-term rent deferrals to be paid back in full, or in the form of temporary loans. See below for an update on some of our tenants. Steward Health Care System As discussed in previous filings, Steward experienced significant operational and liquidity challenges that led to rent payment shortfalls in the 2023 fourth quarter and our decision to move to the cash basis of accounting effective December 31, 2023. Steward's business worsened in 2024, and they ultimately filed for Chapter 11 bankruptcy on May 6, 2024 with the United States Bankruptcy Court for the Southern District of Texas. On September 11, 2024, the bankruptcy court entered an interim order, subsequently made final on September 18, 2024, approving a global settlement between Steward, its lenders, the unsecured creditors committee, and the Company. The order provided for the following: a) termination of our master lease with Steward; b) the release of claims against 23 of our properties (including the release of claims by the secured lender over its liens on equipment, inventory, and licenses), allowing us to begin the process of re-tenanting or selling these properties; and c) a full release of claims against us from all parties. In return, we consented to the sale of the operations and our real estate in three facilities in the Space Coast region of Florida, along with a full release of our claims in Steward including claims to past due rent and interest, outstanding loans, and our equity investment. The three Space Coast facilities were sold in October 2024, and we received $ 47 million, with the remaining proceeds going to Steward in accordance with the global settlement. In regard to our real estate partnership with Macquarie that owned and leased eight properties in Massachusetts to Steward, the bankruptcy court approved the termination of the master lease with Steward during the 2024 third quarter. We and Macquarie entered into an agreement with the mortgage lender of the joint venture to transition the eight properties to them along with cash proceeds of approximately $ 40 million (representing our share), in return for full payment of the underlying mortgage debt and a release of claims against each party. With this global settlement and termination of the joint venture master lease, our relationship with Steward effectively ended. Impairment Charges Due to the events discussed above, we recorded various impairment charges during 2024 and 2023, which included the following (in millions): For the Years Ended December 31, Description 2024 2023 Income Statement Reserve for unpaid rent and interest and straight-line $ — $ 413 Total revenues Working capital and other loans(1) 787 — Real estate and other Investment in Massachusetts partnership(2) 445 30 (Loss) earnings from Real estate(2) 277 100 Real estate and other Equity investment and other(1) 54 171 Real estate and other Total $ 1,563 $ 714 (1) For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which was no value after the global settlement and our release of claims against Steward as discussed above. (2) The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $ 180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8 % to 10 %). In addition with the lease termination discussed above, we fully amortized the related in-place lease intangibles resulting in $ 149 million of amortization expense in 2024 as reflected in the real estate depreciation and amortization line of our consolidated statements of net income. Re-tenanting Activity Subsequent to the release of claims on the 23 properties as part of the global settlement, we reached definitive agreements with six operators (Healthcare Systems of America, Honor Health, Insight Health, Quorum Health, College Health, and Tenor Health) to lease 18 of these facilities in 2024 and early 2025. As of December 31, 2024, we have provided less than $ 100 million in short-term working capital loans to these operators. As of January 2025, we have started receiving partial cash rental payments from the re-tenanted portfolio, and based on our lease contracts, rent payments are ramped up to approximately 57 % of contractual rent by the fourth quarter of 2025, 78 % of contractual rent by second quarter 2026, and 100 % of contractual rent by year end 2026. Excluding the two developments, the remaining three former Steward properties (with a net book value of less than 1 % of our total assets) are in various stages of being re-tenanted or sold. Other Activity During 2024, we received and recorded rent and interest revenue from Steward of $ 40 million for the year ended December 31, 2024. In addition, we were benefited from rent paid by Steward to the Massachusetts joint venture of $ 76 million ($ 38 million representing our share) for the year ended December 31, 2024. Prospect We lease real estate assets to Prospect in California and Connecticut (for which we account for as financing leases), have a mortgage loan secured by four properties operated by Prospect in Pennsylvania, and have a $ 75 million asset-backed loan outstanding. In addition, in connection with the Prospect Transaction in May 2023, we acquired a non-controlling investment in PHP Holdings. In recent periods, Prospect’s operating losses in multiple East Coast markets, including Pennsylvania and Rhode Island (a state in which we have no investment), have adversely impacted Prospect’s overall liquidity. Starting January 1, 2023, we began accounting for our leases and loans to Prospect on a cash basis. In 2024, we recognized approximately $ 25 million of revenue representing cash received for rents on our California properties. In addition, we received and recorded approximately $ 3.8 million of interest on the $ 75 million asset-backed loan. However, Prospect has not made any scheduled rent or interest payments since the second quarter of 2024. In comparison, we recognized approximately $ 96 million of revenue in 2023, including $ 14 million received in cash and $ 82 million was recorded as part of the Prospect Transaction, in which we received additional monetizable investments in PHP Holdings, in lieu of cash for rent and in

Debt

Debt	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt (dollar amounts in thousands): As of December 31, As of December 31, Revolving credit facility(A) $ 361,726 $ 1,514,420 Term loan 200,000 200,000 British pound sterling secured term loan due 2024(B) — 133,484 Australian term loan facility(B) — 320,164 British pound sterling term loan due 2025(B) 617,039 891,170 British pound sterling secured term loan due 2034(B) 790,234 — 3.325 % Senior Unsecured Notes due 2025(B) 517,700 551,950 0.993 % Senior Unsecured Notes due 2026(B) 517,700 551,950 2.500 % Senior Unsecured Notes due 2026(B) 625,800 636,550 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) 750,960 763,860 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 438,060 445,585 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 8,919,219 $ 10,109,133 Debt issue costs and discount, net ( 71,107 ) ( 44,897 ) $ 8,848,112 $ 10,064,236 (A) Includes £- million and £ 322 million of GBP-denominated borrowings and € 303 million and € 303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2024 and December 31, 2023, respectively. (B) Non-U.S. dollar denominated debt that reflects the exchange rates at period-end. As of December 31, 2024, 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): 2025 $ 1,134,739 2026 2,005,226 2027 1,600,000 2028 750,960 2029 900,000 Thereafter 2,528,294 Total $ 8,919,219 2024 Activity During 2024, we closed on a term loan with an aggregate principal amount of approximately £ 631 million (approximately $ 800 million) secured by a portfolio of properties in the U.K. We used the majority of the net proceeds of the facility to pay down our revolving credit facility by $ 375 million and British pound sterling term loan due 2025 by £ 105 million, and to pay off our British pound sterling secured term loan due 2024 (approximately £ 105 million). During the year, we also paid down an additional $ 756 million on our revolving credit facility and £ 102 million on our British pound sterling term loan due 2025 with cash proceeds from asset sales. In addition, on April 18, 2024, we paid off and terminated the remainder of the A$ 470 million (approximately $ 306 million) Australian term loan facility with proceeds from the Utah Transaction described in Note 3 . 2023 Activity During 2023, we paid down, prior to maturity, A$ 730 million (approximately $ 475 million) of the A$ 1.2 billion Australian term loan with proceeds from the Australia Transaction as discussed in Note 3 . In addition, we purchased approximately £ 50 million of our 2.550 % Senior Unsecured Notes due 2023 at a discounted price and yield averaging approximately 13 %. As a result of this prepayment, we realized an approximate $ 1.1 million gain. On December 5, 2023, we fully paid off the remaining £ 350 million balance of our 2.550 % Senior Unsecured Notes due 2023 with cash on-hand and proceeds from the revolving portion of our credit facility ("Credit Facility"). Credit Facility We have a multi-currency denominated revolver and a $ 200 million term loan that make up our Credit Facility. Prior to a series of amendments in 2024 (discussed below), maximum borrowings under the revolving portion of the Credit Facility was $ 1.8 billion. Prior to the 2024 amendments and at our election, loans were made as either alternate base rate loans ("ABR Loans") or loans for an interest period of either one, three, or six months ("Term Benchmark Loans"). The applicable margin for term loans that were ABR Loans was adjustable on a sliding scale from 0.00 % to 0.70 % based on current credit rating. The applicable margin for term loans that were Term Benchmark Loans was adjustable on a sliding scale from 0.875 % to 1.70 % based on current credit rating. The applicable margin for revolving loans that were ABR Loans was adjustable on a sliding scale from 0.00 % to 0.50 % based on current credit rating. The applicable margin for revolving loans that were Term Benchmark Loans or risk-free rate loans ("RFR Loans"), as defined in the Credit Facility agreement, was adjustable on a sliding scale from 0.80 % to 1.50 % based on current credit rating. The facility fee was adjustable on a sliding scale from 0.125 % to 0.30 % based on current credit rating and was payable on the revolving loan facility. During 2023, our credit rating negatively changed, resulting in adjustments to the applicable margin by 0.375 % and an increase to the facility fee from 0.25 % to 0.30 %. On April 12, 2024, we amended our Credit Facility and certain other agreements to (i) reduce revolving commitments from $ 1.8 billion to $ 1.4 billion, (ii) apply certain proceeds from asset sales and debt transactions to repay the Australian term loan facility and certain other outstanding obligations, including revolving loans under the Credit Facility to the extent necessary to reduce the outstanding borrowings to no more than the amended $ 1.4 billion commitment, and (iii) amend or waive certain covenants to our Credit Facility and British pound sterling term loan due 2025 as described under "Covenants" in this same Note 4 . On August 6, 2024, we amended the Credit Facility and the British pound sterling term loan due 2025 to (i) further reduce revolving commitments in the Credit Facility from $ 1.4 billion to $ 1.28 billion, (ii) increase borrowing spreads to 300 basis points during the Modified Covenant Period (defined in "Covenants" section in this same Note 4 ) and then to 225 basis points after the Modified Covenant Period, (iii) require that proceeds of certain future asset sales and debt transactions (during the Modified Covenant Period) be applied to repay certain outstanding obligations, including our revolving loans (by 15 % of such proceeds but for which the revolving loans can be reborrowed) and our British pound sterling term loan due 2025 (by 50 % of such proceeds), and (iv) amend or waive certain covenants as described under "Covenants" in this same Note 4 . At December 31, 2024 , we had $ 0.4 billion outstanding on the revolver, whereas, we had $ 1.5 billion outstanding on our revolver at December 31, 2023. At December 31, 2024 and 2023, our availability under our revolver was $ 0.9 billion and $ 0.3 billion, respectively. The weighted-average interest rate on the revolver was 6.6 % and 5.9 % during 2024 and 2023, respectively. At December 31, 2024 and 2023 , the interest rate in effect on our term loan was 7.5 % and 7.2 %, respectively. Non-U.S. Term Loans British Pound Sterling Secured Term Loan due 2034 On May 24, 2024, we completed a secured loan facility with a consortium of institutional investors that provides for a term loan in aggregate principal amount of approximately £ 631 million (approximately $ 800 million) secured by a portfolio of 27 properties located in the U.K. currently leased to affiliates of Circle. The facility carries a fixed rate of 6.877 % over its 10-year term, excluding fees and expenses, and is interest-only (payable quarterly in advance) through the maturity date. The facility is secured by first priority mortgages or similar security instruments on the relevant properties, including assignments of rents and security over accounts, and is non-recourse to us. British Pound Sterling Term Loan due 2025 On January 6, 2020, we entered into a £ 700 million unsecured sterling-denominated term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The applicable margin under the term loan was adjustable based on a pricing grid from 0.85 % to 1.65 % dependent on our current credit rating. On March 4, 2020, we entered into an interest rate swap transaction (effective March 6, 2020 ) to fix the interest rate to approximately 0.70 % for the duration of the loan. The applicable margin for the pricing grid (which can vary based on our credit rating) increased from 1.25 % to 1.65 % on March 10, 2023 with the change in credit rating, for an all-in fixed rate at December 31, 2023 of 2.349 %. With the August 6, 2024 amendment discussed above, our all-in fixed rate increased to 3.70 %. As noted earlier, we paid down the British pound sterling secured term loan due 2025 by £ 207 million in 2024 with proceeds from the British pound sterling secured term due 2034 and asset sales. The balance of this loan of £ 493 million at December 31, 2024 was paid in full on January 15, 2025. Interest Rate Swaps At December 31, 2024, we had a derivative asset of approximately $ 3 million related to the sterling-denominated term loan interest rate swap (which was terminated on January 15, 2025 with the payoff of the British pound sterling term loan due 2025). At December 31, 2023, we had a derivative asset of approximately $ 43 million related to the combination of the sterling-denominated term loan interest rate swap and the Australian dollar term loan interest rate swap (which was terminated in the second quarter of 2024 as a result of the payoff of the Australian term loan). Derivative assets are included in “Other assets” on our consolidated balance sheets. Senior Unsecured Notes The following are the basic terms of our senior unsecured notes at December 31, 2024 (par value amounts in thousands): Offering Maturity Date Par Value % of Par Interest Payment Frequency 3.325% Senior Unsecured Notes due 2025 March 24, 2017 March 24, 2025 € 500,000 100.000 % Annually 0.993% Senior Unsecured Notes due 2026 October 6, 2021 October 15, 2026 € 500,000 100.000 % Annually 2.500% Senior Unsecured Notes due 2026 March 24, 2021 March 24, 2026 £ 500,000 99.937 % Annually 5.250% Senior Unsecured Notes due 2026 July 22, 2016 August 1, 2026 $ 500,000 100.000 % Semi-annually 5.000% Senior Unsecured Notes due 2027 September 21, 2017 October 15, 2027 $ 1,400,000 100.000 % Semi-annually 3.692% Senior Unsecured Notes due 2028 December 5, 2019 June 5, 2028 £ 600,000 99.998 % Annually 4.625% Senior Unsecured Notes due 2029 July 26, 2019 August 1, 2029 $ 900,000 99.500 % Semi-annually 3.375% Senior Unsecured Notes due 2030 March 24, 2021 April 24, 2030 £ 350,000 99.448 % Annually 3.500% Senior Unsecured Notes due 2031 December 4, 2020 March 15, 2031 $ 1,300,000 100.000 % Semi-annually We may repurchase, redeem, or refinance senior unsecured notes from time-to-time. We may purchase senior notes for cash through open market purchases, privately negotiated transactions, or a tender offer. In some cases, we may redeem some or all of the notes at any time, but may require a redemption premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101 % of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. Redemptions and repurchases of debt, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions, and other factors. Debt Refinancing and Unutilized Financing Costs 2024 Activity In 2024, we incurred $ 4.3 million of debt refinancing and unutilized financing costs. These costs were incurred primarily as a result of the reduction in revolving commitments under our Credit Facility and partial paydowns of our British pound sterling term loan due 2025. 2023 Activity As a result of the early redemption of a portion of the Australian term loan, we incurred approximately $ 0.8 million to accelerate the amortization of related debt issue costs in 2023. This charge was more than offset by the $ 1.1 million gain realized on the purchase of approximately £ 50 million of our 2.550 % Senior Unsecured Notes due 2023 at a discount in 2023. 2022 Activity In 2022, we incurred approximately $ 9.5 million of debt refinancing costs. These costs were incurred as a result of the payoff of our July 2021 Interim Credit Facility with proceeds from the Macquarie Transaction on March 14, 2022, along with the amendment of our Credit Facility on June 29, 2022 . Covenants and Restrictions 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 to 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. On April 12, 2024, the Credit Facility was amended to waive the 10 % cap on unencumbered asset value attributable to tenants subject to a bankruptcy event for purposes of determining compliance with the unsecured leverage ratio for the trailing four fiscal quarter period ended June 30, 2024, and for purposes of determining pro forma compliance with the unsecured leverage ratio for certain asset sales and debt transactions. On August 6, 2024, we entered into an amendment to the Credit Facility to increase the maximum total leverage ratio covenant from 60 % to 65 % and the maximum unsecured leverage ratio covenant from 65 % to 70 % and to decrease the minimum unsecured interest coverage ratio from 1.75 :1.00 to 1.45 :1.00. The amendment was effective as of June 30, 2024 and was to continue in effect through and including September 30, 2025 (the “Modified Covenant Period”) at which point the credit agreement provided that covenants would automatically reset to their prior levels. In addition, the amendment permanently reduced the minimum consolidated adjusted net worth covenant from approximately $ 6.7 billion to $ 5 billion, in each case plus the sum of certain equity proceeds. The amendment also limited the payment of dividends in cash during the Modified Covenant Period to $ 0.08 per share in any fiscal quarter, but the amendment did not provide any additional restrictions on the payment of dividends outside of the Modified Covenant Period. On February 13, 2025 and concurrent with the closing of our private notes offering as discussed in Note 14 , we further amended the Credit Facility and (i) removed the Modified Covenant Period and any restrictions related thereto from the existing Credit Facility, which restrictions included additional mandatory prepayments and a restriction on cash dividends to $ 0.08 per share per fiscal quarter, (ii) permanently removed financial covenants regarding minimum consolidated tangible net worth, maximum unsecured indebtedness to unencumbered asset value and minimum unsecured net operating income to unsecured interest expense, (iii) amended certain definitions used in the financial covenant regarding maximum total indebtedness to total asset value to conform to corresponding definitions in our existing unsecured indentures and the secured notes issued concurrently and set the covenant level at 60 %, (iv) provided notice that we plan to exercise both of our maturity extension options (without changing the other conditions thereof) such that the maturity of the revolving portion of our Credit Facility would move to June 30, 2027 (subject to the satisfaction of the other conditions), (v) reset the interest rate to SOFR plus 225 basis points, (vi) provided for the loans thereunder to be secured and guaranteed ratably with the secured notes issued concurrently, (vii) set the maximum secured leverage ratio at 40 %, and (viii) added mandatory prepayments of senior debt or addition of additional collateral in connection with any failure to (x) maintain a 65 % maximum ratio of secured first lien debt to the undepreciated real estate value of the secured pool properties or (y) maintain a minimum senior secured debt service coverage ratio of 1.15 :1.00 (increasing to 1.30 :1.00 in 12 months). In addition to the covenants and restrictions discussed above, our Credit Facility 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 December 31, 2024 , we were in compliance with all financial and operating covenants, as amended.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	5. Inco me Taxes Medical Properties Trust, Inc. We have maintained and intend to maintain our election as a REIT under the Code. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90 % of our REIT taxable income to our stockholders. As a REIT, we generally will not be subject to U.S. federal income tax if we distribute 100 % of our REIT taxable income to our stockholders and satisfy certain other requirements; instead, income tax is paid directly by our stockholders on the dividends distributed to them. If our REIT taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates. Taxable income from non-REIT activities managed through our TRS entities is subject to applicable U.S. federal, state, and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate. From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands): For the Years Ended December 31, 2024 2023 2022 Current income tax (expense) benefit: Domestic $ 477 $ ( 7,756 ) $ 1,111 Foreign ( 31,589 ) ( 24,257 ) ( 27,751 ) ( 31,112 ) ( 32,013 ) ( 26,640 ) Deferred income tax (expense) benefit: Domestic ( 465 ) 8,926 ( 15,628 ) Foreign ( 12,524 ) 153,766 ( 13,632 ) ( 12,989 ) 162,692 ( 29,260 ) Income tax (expense) benefit $ ( 44,101 ) $ 130,679 $ ( 55,900 ) A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on (loss) income before income taxes for the years ended December 31, 2024, 2023, and 2022 is as follows (in thousands): For the Years Ended December 31, 2024 2023 2022 (Loss) income before income tax $ ( 2,364,186 ) $ ( 686,771 ) $ 959,719 Income tax benefit (expense) at the U.S. statutory federal rate 496,479 144,222 ( 201,541 ) Decrease (increase) in income tax resulting from: Foreign rate differential 4,888 ( 4,122 ) 1,826 State income taxes, net of federal benefit — 1,275 ( 1,886 ) U.S. earnings not subject to federal income tax ( 227,080 ) ( 115,189 ) 165,705 Change in valuation allowance ( 301,468 ) ( 45,692 ) ( 11,281 ) Statutory tax rate change — — ( 941 ) Interest disallowance ( 2,965 ) ( 3,421 ) ( 1,737 ) Tax Impact of UK REIT conversion — 160,641 — Other items, net ( 13,955 ) ( 7,035 ) ( 6,045 ) Total income tax (expense) benefit $ ( 44,101 ) $ 130,679 $ ( 55,900 ) The foreign provision for income taxes is based on foreign profit before income taxes of $ 127.9 million, $ 6.3 million, and $ 159.6 million in 2024, 2023, and 2022, respectively. The domestic provision for income taxes is based on (loss) income before income taxes of $( 1.4 ) billion in 2024 , $( 144.5 ) million in 2023 , and $ 10.8 million in 2022 from our TRS entities. At December 31, 2024 and 2023, components of our deferred tax assets and liabilities were as follows (in thousands): 2024 2023 Deferred tax assets: Operating loss and interest deduction carry forwards $ 263,523 $ 143,683 Depreciation 56,089 45,146 Partnership investments 112,892 15,768 Impairment and other loss reserves 101,834 11,790 Other 8,500 7,109 Total deferred tax assets 542,838 223,496 Valuation allowance ( 418,659 ) ( 117,191 ) Total net deferred tax assets $ 124,179 $ 106,305 Deferred tax liabilities: Property and equipment $ ( 145,835 ) $ ( 158,330 ) Net unbilled revenue ( 82,170 ) ( 65,727 ) Partnership investments ( 21,445 ) — Other ( 3,450 ) ( 10,687 ) Total deferred tax liabilities ( 252,900 ) ( 234,744 ) Net deferred tax asset (liability) $ ( 128,721 ) $ ( 128,439 ) At December 31, 2024, we had net operating losses ("NOL") and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 704,434 $ 453,615 Tax-effected NOL carryforwards $ 151,942 $ 112,111 Valuation allowance ( 151,942 ) ( 6,273 ) Net deferred tax asset - NOL carryforwards $ — $ 105,838 Expiration periods 2025 - indefinite indefinite Valuation Allowance A valuation allowance has been recorded on certain foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies, and recent financial performance. During 2024, a valuation allowance of $ 301.5 million has been recorded against a portion of our deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for NOLs, non-depreciable basis of real property, and other tax attributes that we believe will not be realized. Valuation allowance activity recorded generally follows the activity of the associated deferred tax asset that is not expected to be recognized. From time-to-time, we may acquire deferred tax assets as part of real estate transactions and will assess the need for a valuation allowance as part of the opening balance sheet. Additionally, valuation allowances will be remeasured for foreign currency translation fluctuations through other comprehensive income. We have no material uncertain tax position liabilities and related interest or penalties. REIT Status We have met the annual REIT distribution requirements by payment of at least 90 % of our REIT taxable income in 2024, 2023, and 2022. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes. A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, Per share: 2024 2023 2022 Ordinary dividend (1) $ — $ 1.0639 $ 0.4703 Long-term capital gain (2) — 0.1061 0.6797 Return of capital 0.3800 — — Total $ 0.3800 (3) $ 1.1700 $ 1.1500 (1) For the years ended December 31, 2023 and 2022, includes Section 199A dividends of 1.0639 and 0.4703 , respectively. (2) For the years ended December 31, 2023 and 2022, includes Unrecaptured Section 1250 gains of 0.1061 and 0.2574 , respectively. (3) The dividend declared on November 21, 2024 and paid January 9, 2025 will be applicable to the 2025 tax year and thus is not reflected in the table above. Similar to our U.S. REIT, we have met all requirements of our U.K. REIT as of December 31, 2024. MPT Operating Partnership, L.P. As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed TRS entities on behalf of Medical Properties Trust, Inc., which are subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income taxes associated with our TRS entities and international operations.

Earnings Per Share_Unit

Earnings Per Share/Unit	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Earnings Per Share/Unit	6. Earnings P er Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (in thousands): For the Years Ended December 31, 2024 2023 2022 Numerator: Net (loss) income $ ( 2,408,287 ) $ ( 556,092 ) $ 903,819 Non-controlling interests’ share in earnings ( 1,984 ) ( 384 ) ( 1,222 ) Participating securities’ share in earnings ( 946 ) ( 1,644 ) ( 1,602 ) Net (loss) income, less participating securities’ share in $ ( 2,411,217 ) $ ( 558,120 ) $ 900,995 Denominator: Basic weighted-average common shares 600,248 598,518 598,634 Dilutive potential common shares(1) — — 203 Diluted weighted-average common shares 600,248 598,518 598,837 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (in thousands): For the Years Ended December 31, 2024 2023 2022 Numerator: Net (loss) income $ ( 2,408,287 ) $ ( 556,092 ) $ 903,819 Non-controlling interests’ share in earnings ( 1,984 ) ( 384 ) ( 1,222 ) Participating securities’ share in earnings ( 946 ) ( 1,644 ) ( 1,602 ) Net (loss) income, less participating securities’ share in $ ( 2,411,217 ) $ ( 558,120 ) $ 900,995 Denominator: Basic weighted-average units 600,248 598,518 598,634 Dilutive potential units(1) — — 203 Diluted weighted-average units 600,248 598,518 598,837 (1) The above computation of diluted earnings per share does not include 17,162 and 32,382 potential common shares/units for the years ended December 31, 2024 and 2023, respectively.

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Stock Awards	7. Stoc k Awards 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, RSUs, deferred stock units, stock appreciation rights, performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors ("Board"), and we have reserved 28.9 million shares of common stock for awards, of which 8.9 million shares remain available for future stock awards as of December 31, 2024 . The Equity Incentive Plan contains a limit of 5 million shares as the maximum number of shares of common stock that may be awarded to an individual in any fiscal year. Awards under the Equity Incentive Plan are subject to forfeiture due to termination of employment prior to vesting and/or from not achieving the respective performance/market conditions. In the event of a change in control, outstanding and unvested options will immediately vest, unless otherwise provided in the participant’s award or employment agreement, and restricted stock, restricted stock units, deferred stock units, and other stock-based awards will vest if so provided in the participant’s award agreement. The term of the awards is set by the Compensation Committee, though Incentive Stock Options may not have terms of more than ten years . Forfeited awards (along with shares withheld for payroll tax withholding purposes) are returned to the Equity Incentive Plan and are then available to be re-issued as future awards. For each share of common stock issued by Medical Properties Trust, Inc. pursuant to its Equity Incentive Plan, the Operating Partnership issues a corresponding number of Operating Partnership units. For the past three years, we have only granted restricted stock and RSUs pursuant to our Equity Incentive Plan. These awards have been granted in the form of service-based awards, performance awards based on company-specific performance hurdles, and market-based awards. See below for further details on each of these awards: Service-Based Awards In 2024, 2023, and 2022 , the Compensation Committee granted service-based awards to employees and non-employee directors. Service-based awards vest as the employee/director provides the required service (typically over three years ). Dividends are generally paid on these awards prior to vesting. Performance-Based Awards In 2023 and 2022, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance-based award grants. In 2023 and 2022 , a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee. The performance thresholds were based on a three-year period with the opportunity to earn a portion of the award earlier. More or less shares than the target number of shares are available to be earned based on our performance compared to the set thresholds. At the end of each of the performance periods, any earned shares during such period will vest on January 1 of the following calendar year. The performance thresholds for 2023 were based on strategic transactions (including new investments and proceeds from individual property disposals and larger asset disposals through joint venture transactions) and EBITDA, while 2022 awards were based on funds from operations growth, EBITDA, and acquisitions. Certain performance awards granted were subject to a modifier which increases or decreases the actual shares earned in each performance period. The modifier for the 2023 and 2022 awards was based on two components: 1) how our total shareholder return (“TSR”) compared to the Dow Jones U.S. Real Estate Health Care Index for 2023 and 2022 and 2) how our TSR compared to a threshold set by the Compensation Committee. Market-Based Awards In 2024 and 2023, the Compensation Committee granted market-based awards to employees. Generally, dividends are not paid on market-based awards until the award is earned. See details below of such market-based award grants. On March 8, 2024, the Compensation Committee granted 2,700,000 market-based RSUs to the Company's Chief Executive Officer and Chief Financial Officer at the target level of achievement, which would represent a 67 % increase in the market price of our common stock at time of grant. The RSUs may be settled only in cash and the cash payment will be calculated based on the average closing price of the Company's common stock on the five trading days ending on the vesting date. The RSUs are earned at the same share price target level, with the opportunity to earn up to three times target if the Company's share price reaches higher stock price hurdles and the same trailing 20-trading day average closing price as the 2023 awards discussed below during the four-year period ending December 31, 2027. Earned RSUs will become vested on the earlier of equal quarterly installments over the first year from the date the RSUs are earned or the date that the Committee makes a determination of achievement of the performance metrics following the end of the four-year performance period, subject to the grantee’s continued employment through such date. On December 8, 2023, the Compensation Committee approved market-based restricted stock awards to employees other than the Company's Chief Executive Officer and Chief Financial Officer of 2,500,000 shares of common stock at the target level of achievement. These shares will be earned at the target level only if the Company's share price increases to $ 7.00 per share, with the opportunity to earn more shares (up to three times target), based on higher stock price hurdles. The actual number of shares to be earned pursuant to these awards will be determined based on a trailing 20-trading day average closing price of the Company's common stock during the four-year period following the December 8, 2023 grant date or December 31, 2027, for certain awards granted after December 8, 2023. Earned shares will vest in equal quarterly installments over two years following the date that the Compensation Committee makes a determination of achievement of the performance metrics, subject to the grantee’s continued employment through such date, provided that all unvested earned shares will vest in full following the end of the performance period. The following summarizes award activity in 2024 and 2023 (which includes awards granted in 2024, 2023, and any applicable prior years), respectively: For the Year Ended December 31, 2024: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 1,144,796 $ 13.01 12,576,792 $ 10.20 Awarded 1,519,207 $ 4.36 345,000 $ 7.78 Vested ( 993,312 ) $ 10.62 ( 1,179,631 ) $ 16.81 Forfeited ( 29,191 ) $ 9.58 ( 1,428,940 ) $ 10.40 Nonvested awards at end of year 1,641,500 $ 6.50 10,313,221 $ 9.33 For the Year Ended December 31, 2023: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 810,483 $ 21.02 4,349,081 $ 18.26 Awarded 1,210,448 $ 10.36 10,270,260 $ 8.47 Vested ( 864,482 ) $ 16.60 ( 1,591,846 ) $ 19.65 Forfeited ( 11,653 ) $ 12.27 ( 450,703 ) $ 12.44 Nonvested awards at end of year 1,144,796 $ 13.01 12,576,792 $ 10.20 Additionally, the market-based RSUs granted in 2024 (not included in the tables above) with cash-settlement features are nonvested as of December 31, 2024. These liability-type awards are adjusted to fair value on a quarterly basis using a Monte Carlo valuation model, which used the following assumptions for grant date and quarterly valuations for the year ended December 31, 2024: (i) common stock price at measurement date, (ii) annual equity volatility ranging from 45.0 % to 57.0 %, (iii) risk-free rate ranging from 3.58 % to 4.41 %, and (iv) dividend yield ranging from 8.10 % to 14.35 %. The grant date fair value of these RSUs was $ 13.3 million, and no ne of these RSUs were vested or forfeited as of December 31, 2024. The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2024, 2023, and 2022 , we recorded $ 28.4 million, $ 33.3 million, and $ 49.4 million, respectively, of non-cash compensation expense. For the year ended December 31, 2024, we also recorded $ 4.6 million of compensation expense for the RSUs with cash-settlement features, and we have a corresponding $ 4.6 million liability as of December 31, 2024. The remaining unrecognized cost from equity-settled awards at December 31, 2024 , is $ 29.6 million, which will be recognized over a weighted-average period of 1.27 years. The remaining unrecognized cost from cash-settled awards at December 31, 2024, is $ 11.3 million, which will be recognized over a derived service period of 2.03 years as of December 31, 2024. Stock-based awards that vested in 2024, 2023, and 2022 , had a value of $ 10.9 million, $ 22.5 million, and $ 82.6 million, respectively.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2024
Loss Contingency [Abstract]
Contingencies	8. Contingencies As part of the global settlement with Steward discussed in Note 3 , upon completion of the transfers to the new operators and satisfaction of certain other conditions, in addition to approval by relevant state and local regulators, each of the Company and Steward have agreed, subject to specified exceptions, to the mutual release of claims against each other, including payment by Steward of any accrued or future rent under its master leases with the Company and accrued or future payments of principal and interest on outstanding loans from the Company. Steward’s asset backed lenders also forfeited their right to cause the Company to purchase up to $ 60 million of bridge loans made to Steward during the first quarter of 2024. In connection with the global settlement with Steward and reciprocal release of claims, the Company had an approximate $ 31 million liability at December 31, 2024, for property taxes, other property related expenses, and other obligations due to third parties. We are party to various lawsuits as described below: Securities and Derivative Litigation On April 13, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit alleging false and/or misleading statements and/or omissions resulted in artificially inflated prices for our common stock, filed by a purported stockholder in the United States District Court for the Northern District of Alabama (Case No. 2:23-cv-00486). The complaint seeks class certification on behalf of purchasers of our common stock between July 15, 2019 and February 22, 2023 and unspecified damages including interest and an award of reasonable costs and expenses. This class action complaint was amended on September 22, 2023 and alleges that we made material misstatements or omissions relating to the financial health of certain of our tenants. On September 26, 2024, the Court dismissed the amended complaint with prejudice, and the plaintiff thereafter moved the Court to alter its judgment. That motion has been fully briefed and is currently pending before the Court. Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Northern District of Alabama on October 19, 2023 (Case No. 2:23- cv-01415) and December 7, 2023 (Case No. 2:23-cv-01667). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the Alabama securities lawsuit described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. These derivative actions have been consolidated and stayed pending further developments in the Alabama securities lawsuit. Members of our Board of Directors were also named as defendants in three related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the District of Maryland on February 16, 2024 (Case No. 1:24-cv-00471), June 28, 2024 (Case No. 1:24-cv-01899), and July 26, 2024 (Case No. 1 24-cv-02173). The Company was named as a nominal defendant. These shareholder derivative complaints make allegations similar to those made in the Alabama securities and derivative lawsuits described above relating to purported material misstatements or omissions relating to the financial health of certain of our tenants. Defendants have not been required to respond to these complaints pending further developments in the Alabama securities lawsuit. On September 29, 2023, we and certain of our executives were named as defendants in a putative federal securities class action lawsuit filed by a purported stockholder in the United States District Court for the Southern District of New York (Case No. 1:23-cv- 08597). The complaint seeks class certification on behalf of purchasers of our common stock between May 23, 2023 and August 17, 2023 and alleges false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. This class action complaint was amended on October 30, 2024 and alleges that we made material misstatements or omissions in connection with certain transactions involving Prospect. Defendants filed a motion to dismiss the amended complaint on January 14, 2025. Members of our Board of Directors were also named as defendants in two related shareholder derivative lawsuits filed by purported stockholders in the United States District Court for the Southern District of New York on December 18, 2023 (Case No. 1:23-cv- 10934) and March 1, 2024 (Case No. 1:24-cv-01589). The Company was named as a nominal defendant in both complaints. These shareholder derivative complaints both make allegations similar to those made in the New York securities lawsuit described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. The two cases have been consolidated and stayed pending further developments in the New York securities lawsuit described above. On February 21, 2024, members of our Board of Directors were named as defendants in a shareholder derivative lawsuit filed by a purported stockholder in the United States District Court for the District of Maryland (Case No. 1:24-cv-00527). The Company was named as a nominal defendant. This shareholder derivative complaint makes allegations similar to those made in the New York securities and derivative lawsuits described above relating to purported false and/or misleading statements and/or omissions in connection with certain transactions involving Prospect. This action has been stayed pending further developments in the New York securities action described above. We believe these claims are without merit and intend to defend the remaining open cases vigorously. We have not recorded a liability related to the lawsuits above because, at this time, we are unable to determine whether an unfavorable outcome is probable or to estimate reasonably possible losses. Defamation Litigation On March 30, 2023, we commenced an action in the United States District Court for the Northern District of Alabama (Case No. 2:23-cv-00408), against short-seller Viceroy Research LLC ("Viceroy") and its members. We were seeking injunctive relief and damages for defamation, civil conspiracy, tortious interference, private nuisance, and unjust enrichment based on defamatory statements expressed against us. On June 29, 2023, we won a preliminary ruling in this lawsuit after Viceroy's motion to dismiss the case was denied by a judge in the United States District Court for the Northern District of Alabama. On December 18, 2024, we reached an agreement with Viceroy and its members to mutually settle and dismiss this defamation lawsuit. From time-to-time, we are a party to other legal proceedings, claims, or regulatory inquiries and investigations arising out of, or incidental to, our business. While we are unable to predict with certainty the outcome of any particular matter, 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.

Common Stock_Partner's Capital

Common Stock/Partner's Capital	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/ Partner’s Capital Medical Properties Trust, Inc. On October 9, 2022, the Board of the Company authorized a stock repurchase program (the "Stock Repurchase Program") for up to $ 500 million of common stock, par value $ 0.001 per share. In 2022, we repurchased 1.6 million shares for a total of $ 17.9 million. The Stock Repurchase Program expired on October 10, 2023 . MPT Operating Partnership, L.P. At December 31, 2024 , 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. In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”), the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any U.S. federal income or excise tax liability imposed by the Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes. The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will be allocated pro-rata to the partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership until their adjusted capital balances are reduced to zero, then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. LTIP units must wait two years from the issuance of the LTIP units to be redeemed, and then converted to common units. No LTIP units exist at December 31, 2024. For each share of common stock issued/repurchased by Medical Properties Trust, Inc., the Operating Partnership issues/repurchases a corresponding number of operating partnership units.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	10. Fair Value of F inancial 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): December 31, 2024 December 31, 2023 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 36,327 $ 36,432 $ 45,059 $ 45,476 Loans(1) 467,120 (2) 470,380 1,302,727 (2) 1,202,383 Debt, net ( 8,848,112 ) ( 7,301,395 ) ( 10,064,236 ) ( 8,256,465 ) (1) Excludes the convertible loan made in May 2023 to PHP Holdings 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. (2) Includes $ 7.9 million and $ 162.4 million of mortgage loans, a $ 315.5 million and $ 323.8 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 39.7 million and $ 526.9 million of loans that are part of our investments in unconsolidated operating entities, and $ 104.0 million and $ 289.6 million of other loans at December 31, 2024 and December 31, 2023, respectively. 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, our equity investment in Lifepoint Behavioral (which was sold in March 2024), and our investment in PHP Holdings 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 believed this method was more reflective of current values. At December 31, 2024 and 2023, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2024 As of December 31, 2023 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 111,985 $ 129,968 $ 146,892 $ 146,892 Mortgage loans Equity investment and other loans 154,229 910,594 939,903 912,999 Investments in unconsolidated Our loans to the international joint venture and its subsidiaries are recorded at fair value based on Level 2 and Level 3 inputs by discounting the estimated future contractual cash flows using a credit-adjusted rate of return, which is derived from market rates of return on similar loans with similar credit quality and remaining maturity. Our equity investment in Lifepoint Behavioral (which was sold in March 2024) was recorded at fair value as of December 31, 2023, based on Level 2 inputs by discounting the estimated cash flows expected to be realized as part of the Lifepoint Transaction described in Note 3 to the consolidated financial statements. Our equity investment in the international joint venture and our investment in PHP Holdings are recorded at fair value based on Level 3 inputs, by using a market approach (for our equity investment in the international joint venture) and a market approach based on the agreed upon price in the pending transaction (for our investment in PHP Holdings), which requires significant estimates of our investee, such as projected revenue, expenses, and working capital, and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of these 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 the absence of quoted market prices. For the market approach model used for our investment in PHP Holdings, our unobservable inputs include purchase price adjustments related to expected balance sheet values at the time of the transaction close, and an adjustment for a marketability discount ("DLOM"). In regard to the underlying projections used in the discounted cash flow model, such projections are provided by the investees. However, we may 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 2024, we recorded a net unfavorable adjustment to the investments accounted for under the fair value option method of approximately $ 790 million, primarily related to the loan to the international joint venture (including approximately $ 18 million related to our investment in three hospitals in Colombia) and our investment in PHP Holdings as further discussed in Note 3 to the consolidated financial statements, compared to a favorable adjustment of approximately $ 29 million in 2023. For our investment in PHP Holdings, the discount rate, selected revenue multiple range, and selected EBITDA multiple range were 11 %, 1.1x to 1.3x, and 10x to 14x, respectively, at December 31, 2023. These measures were not used in our valuation as of December 31, 2024, as they were not required for the market approach based on the price of the pending transaction. The DLOM on our investment in PHP Holdings was approximately 14.2 % at December 31, 2024 compared to 8 % at December 31, 2023. The increase in the DLOM used in our fair value analysis of our investment in PHP Holdings compared to December 31, 2023 aligned with the expected value from the Astrana Health deal more fully described in Note 3 to the consolidated financial statements. In arriving at the DLOM, we 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 full basis point variations (in thousands): Basis Point Change in Marketability Discount Estimated Increase + 100 basis points $ ( 1,737 ) - 100 basis points 1,737 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 impairment purposes of our real estate, financial instruments, and for certain equity investments without a readily determinable fair value. Impairment and Fair Value Adjustments of Non-Real Estate Investments 2024 Prior to the global settlement in September 2024 (as described in Note 3 to the consolidated financial statements) in which our claims were released, our non-real estate investments in Steward and related affiliates included our 9.9 % equity investment, working capital and other secured loans, and a loan made to a Steward affiliate in 2021, proceeds of which were used to redeem a similarly sized convertible loan held by Steward’s former private equity sponsor. In addition, the loan to the international joint venture is collateralized by the equity of Steward held by an investor in both Steward and the international joint venture. To assess recovery of these investments, we performed a valuation of Steward’s business at March 31, 2024, with assistance from a third-party, independent valuation firm. The valuation approaches utilized included the cost, market, and income approaches. The fair value analysis was performed under a non-going concern, orderly liquidation premise of value and assuming normal exposure to market participants. We utilized this premise of value due to Steward’s ongoing financial distress and subsequent filing of bankruptcy. Accordingly, the valuation approaches used, including the Level 3 inputs, were based on the financial performance of the Steward assets. For profitable hospitals, Level 3 inputs included a weighted average EBITDA multiple of 6.48x from a selected range of 5x to 7x in reference to comparable transactions. We also used a weighted average discount rate of 15.03 % from a selected range of 15 % to 16 %. For unprofitable hospitals, Level 3 inputs included a weighted average net revenue multiple of 0.275x from a selected range of 0.25x to 0.30x in reference to comparable transactions. We also considered the reported book values inclusive of various adjustments for unprofitable hospitals. After reducing the derived fair value of Steward's business for Steward's secured debt (including our working capital and other secured loans) and their working capital deficit, we arrived at only a nominal remaining value that could not support the carrying value of the loan to a Steward affiliate from 2021 or our remaining 9.9 % equity investment. In addition, the value of the investor's share of the remaining 90.1 % of Steward's equity that collateralized the loan to the international joint venture was deemed insufficient to support recovery of this investment. As a result, we recorded impairment charges and negative fair value adjustments in the 2024 first quarter of approximately $ 625 million, as discussed further in Note 3 to the consolidated financial statements. We updated our fair value analysis of Steward's business at June 30, 2024, using a similar approach as done in the 2024 first quarter resulting in no further impairments or fair value adjustments to non-real estate investments in the 2024 second quarter. In the third quarter of 2024, as a result of the Company’s global settlement with Steward (as discussed further in Note 3 to the consolidated financial statements), the Company recorded impairment charges of approximately $ 425 million for the working capital loans and other secured loans previously advanced to Steward. 2023 To assess recovery of our non-real estate investments in Steward in 2023, along with the $ 219 million loan to the international joint venture that was collateralized by the equity of Steward held by an investor in both Steward and the international joint venture, we performed a valuation of Steward's business at December 31, 2023, with assistance from a third-party, independent valuation firm, using a market valuation approach, with Level 3 inputs including the selected revenue multiple range of 0.50x to 0.60x in reference to comparable transactions. After reducing the derived fair value for the loans to Steward discussed above, we arrived at a fair value for Steward's equity. We then compared our equity investment's carrying value to our 9.9 % share of the fair value of Steward's equity, which resulted in the need for an impairment charge of approximately $ 90 million. The value of the investor's share of the remaining 90.1 % of Steward's equity that collateralizes the loan to the international joint venture was deemed sufficient to support recovery of this investment at that time. 2022 In 2022, we performed an impairment analysis on our investments in financing leases with Prospect using an income approach with Level 3 inputs including the selected market capitalization rate range of 7.5 % to 9.0 %. For these assets, we divided the expected operating income (i.e. rent revenue less expenses, if any) from the underlying properties by a market capitalization rate. We then compared the carrying value of our investment to the derived fair value, which resulted in a $ 170 million impairment to the Pennslyvania assets. Impairment of Real Estate Investments See the Steward and Prospect subheadings under "Leasing Operations (Lessor)" in Note 3 to the consolidated financial statements for a discussion around the use of fair value and related assumptions in the impairment of our real estate investments. Equity Investments Without a Readily Determinable Fair Value For our equity investment in Swiss Medical (which does not have a readily determinable fair value), we marked our investment to fair value in the 2023 third quarter based on the price paid by a new investor in the same security, resulting in a CHF 20 million favorable adjustment.

Leases (Lessee)

Leases (Lessee)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases (Lessee)	11. Lease s (Lessee) We lease the land underlying certain of our facilities (for which we typically sublease to our tenants), along with corporate offices and equipment. Our leases have remaining lease terms that vary in years, and some of the leases have initial fixed terms (or renewal options available) that extend the leases up to, or just beyond, the depreciable life of the properties that occupy the leased land. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at lease commencement date in determining the present value of future payments. The following is a summary of our lease expense (in thousands): Income Statement For the Years Ended December 31, Classification 2024 2023 2022 Operating lease cost (1) (2) $ 10,725 $ 11,653 $ 12,175 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 51 Interest on lease liabilities Interest 128 128 128 Sublease income Other ( 3,259 ) ( 4,178 ) ( 4,485 ) Total lease cost $ 7,645 $ 7,654 $ 7,869 (1) Includes short-term leases. (2) $ 5.1 million, $ 6.0 million, and $ 5.7 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2024, 2023, and 2022, respectively. Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2024 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Net 2025 $ 8,047 $ 131 $ ( 3,503 ) $ 4,675 2026 7,239 133 ( 3,006 ) 4,366 2027 6,698 134 ( 2,715 ) 4,117 2028 6,786 135 ( 2,723 ) 4,198 2029 6,850 137 ( 2,731 ) 4,256 Thereafter 175,000 4,245 ( 39,584 ) 139,661 (1) Total undiscounted minimum lease payments $ 210,620 $ 4,915 $ ( 54,262 ) $ 161,273 Less: interest ( 132,035 ) ( 2,979 ) Present value of lease liabilities $ 78,585 $ 1,936 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases . Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet December 31, December 31, Right of use assets: Operating leases - real estate Land $ 46,881 $ 63,675 Finance leases - real estate Land 1,632 1,683 Total real estate right of use assets $ 48,513 $ 65,358 Operating leases - corporate Other assets 20,701 24,243 Total right of use assets $ 69,214 $ 89,601 Lease liabilities: Operating leases Obligations to tenants and $ 78,585 $ 101,812 Financing leases Obligations to tenants and 1,936 1,938 Total lease liabilities $ 80,521 $ 103,750 Weighted-average remaining lease term: Operating leases 32.6 32.9 Finance leases 31.9 32.9 Weighted-average discount rate: Operating leases 6.1 % 6.2 % Finance leases 6.6 % 6.6 % The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2024 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows used for operating leases $ 8,447 $ 8,210 $ 7,169 Operating cash flows used for finance leases 130 129 128 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases — — 23,066

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2024
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	12. Othe r Assets The following is a summary of our other assets on our consolidated balance sheets (in thousands): As of December 31, 2024 2023 Debt issue costs, net(1) $ 5,675 $ 8,513 Other corporate assets 330,638 275,688 Prepaids and other assets 135,091 173,710 Total other assets $ 471,404 $ 457,911 (1) Relates to our revolving credit facility Other corporate assets include building, land and land improvements associated with our corporate offices, furniture and fixtures, equipment, corporate vehicles, aircraft, enterprise and other software, deposits, and right-of-use assets associated with corporate leases. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), non-tenant receivables, derivative assets, and lease incentives provided to tenants, among other items. Other corporate assets increased in 2024 primarily due to additional funding of our new corporate headquarters. Prepaids and other assets decreased in 2024 primarily due to a reduction in the value of our interest rate swaps as further discussed in Note 4 and the Norwood cash recovery from our casualty insurers in November 2024, partially offset by an increase in prepaid interest at December 31, 2024 compared to December 31, 2023.

Segment Disclosures

Segment Disclosures	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Segment Disclosures	13. Segment Disclosures We manage our business and report financial results as one business segment. This is consistent with the manner in which our chief operating decision maker ("CODM"), our executive team made up of our Chief Executive Officer and Chief Financial Officer , evaluates performance and makes resource and operating decisions for the business. Our primary business strategy and source of revenue is from the acquisition and development of healthcare facilities that are leased to healthcare operating companies under long-term net leases, which require the tenant to bear most of the costs associated with the property. The majority of our leased assets are owned 100 %; however, we do own some leased assets through joint ventures with other partners. We also may 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, typically in conjunction with larger real estate transactions with the tenant, which may enhance our overall return and provide for certain minority rights and protections. Although we generate our revenues from these investments in the U.S. and eight other countries across multiple property types, we centrally manage these business activities on a consolidated basis. The accounting policies of our business segment are the same as those described in the summary of significant accounting policies. The CODM evaluates performance and makes resource and operating decisions for the business on a consolidated basis using consolidated net income from our consolidated statements of net income as our primary GAAP profit measure supplemented by consolidated funds from operations ("FFO"). We use net income and FFO to monitor expected versus actual results to assess performance. The measure of segment assets is total assets as reported on our consolidated balance sheets. We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, which represents consolidated net (loss) income (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization, including amortization related to in-place lease intangibles, and after adjustments for unconsolidated partnerships and joint ventures. Given FFO excludes real estate related depreciation and amortization expense by definition and due to our typical net lease structure which requires our tenants to bear most of the costs associated with our properties (including property taxes, insurance, etc.) , the primary expenses reviewed by the CODM include general and administrative and interest expenses from our consolidated statements of net income . See "Concentration of Credit Risks" in Note 3 to our consolidated financial statements for entity-wide disclosures around major customers, geographic areas, and property types.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2024
Subsequent Events [Abstract]
Subsequent Events	14. Subsequent Events Senior Secured Notes due 2032 On February 13, 2025, we closed on a private offering that consisted of a $ 1.5 billion aggregate principal amount of senior secured notes due 2032 (the "USD Notes") and € 1.0 billion aggregate principal amount of senior secured notes due 2032 (the "Euro Notes"). Interest on the notes is payable semi-annually in arrears on February 15 and August 15 of each year, commencing on August 15, 2025. The USD Notes were issued at 98.710 % of par value, pay interest at a rate of 8.500 % per year and mature on February 15, 2032 . The Euro Notes were issued at 98.645 % of par value, pay interest at a rate of 7.000 % per year and mature on February 15, 2032 . We may redeem some or all of the notes at any time prior to February 15, 2028, at a redemption price equal to 100 % of the principal amount, plus an applicable “make whole” premium and accrued and unpaid interest. On or after February 15, 2028, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to February 15, 2028, we may redeem up to 40 % of the notes at a redemption price equal to 108.500 % and 107.000 % for the USD Notes and Euro Notes, respectively, of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101 % of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. We used the net proceeds from the notes to fund the redemption of our 3.325 % Senior Unsecured Notes due 2025 , 2.500 % Senior Unsecured Notes due 2026 , and 5.250 % Senior Unsecured Notes due 2026 . We used the remaining net proceeds to pay down the revolving portion of our Credit Facility.

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2024
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Schedule II: Valuation and Qualifying Accounts	Schedule II: Valuation and Qualifying Accounts Medical Properties Trust, Inc. and MPT Operating Partnership, L.P. December 31, 2024 Additions Deductions Year Ended December 31, Balance at Charged Charged to Net Balance at (In thousands) 2024 $ 878,318 $ 2,783,001 (2) $ — $ ( 1,495,565 ) (3) $ 2,165,754 2023 $ 393,057 $ 755,627 (4) $ — $ ( 270,366 ) (5) $ 878,318 2022 $ 154,161 $ 294,861 (6) $ — $ ( 55,965 ) (7) $ 393,057 (1) Includes real estate impairment reserves, allowances for doubtful accounts, straight-line rent reserves, credit loss reserves, tax valuation allowances, and other reserves. (2) Represents $ 1.5 billion increase in credit loss reserves on loans and financing-type investments (primarily related to Steward and Prospect as further described in Note 3 to Item 8 of this Annual Report on Form 10-K) and negative fair value adjustment on our investment in the international joint venture, $ 86 million increase to real estate impairment reserves , approximately $ 500 million increase to equity investment impairment reserves, and a $ 384 million increase in accounts receivable reserves. Also includes an approximately $ 302 million increase in valuation allowances to reserve against our net deferred tax assets in 2024. (3) Includes a $ 520 million decrease in accounts receivable reserves and $ 826 million decrease in credit loss reserves on loans (primarily related to the full release of our claims in Steward as a result of the global settlement), along with a $ 138 million decrease to our equity investment reserves (primarily related to the write-off of our Steward equity investment), and a $ 12 million decrease in real estate impairment reserves related to disposals in 2024 . (4) Represents $ 261 million increase in accounts receivable reserves, $ 259 million increase in straight-line rent receivable reserves, $ 90 million increase to equity investment impairment reserves, and $ 89 million increase to real estate impairment reserves, as further described in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an increase of $ 10 million in credit loss reserves and an approximately $ 47 million increase in valuation allowances to reserve against our net deferred tax assets in 2023. (5) Includes a $ 170 million decrease in real estate impairment reserves, an approximately $ 35 million decrease in credit loss reserves related to transitioning properties back to a tenant in exchange for a first-lien mortgage, and a $ 50 million recovery of previously reserved interest satisfied as part of the “Prospect Transaction” as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K. Also includes an approximately $ 11 million write-off of previously reserved accounts receivable. (6) Represents a $ 170.6 million increase to real estate impairment reserves, $ 0.5 million increase in accounts receivable and other reserves, $ 114.0 million increase in credit loss reserves on financing-type receivables, and a $ 9.8 million increase in valuation allowance to reserve against our net deferred tax assets in 2022. (7) Includes a $ 2.9 million decrease in real estate impairment reserves related to disposals in 2022, a $ 11.7 million decrease in accounts receivable and other reserves, a net credit loss recovery of approximately $ 15 million on the Watsonville loans, and a $ 26.4 million decrease of credit loss reserves related to financial instruments sold, repaid, or satisfied in 2022.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2024
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	SCHEDULE III — REAL ESTATE INVEST MENTS AND ACCUMULATED DEPRECIATION December 31, 2024 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Aberdeen, UK Acute care general hospital $ 4,180 $ 99,020 $ — $ — $ 4,180 $ 99,020 $ 103,200 $ 12,419 $ 44,407 1985 January 9, 2020 40 Algeciras, Spain Acute care general hospital 488 7,712 — — 488 7,712 8,200 566 — 1997 April 29, 2022 40 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 7,508 — 2014 August 31, 2014 40 Altrincham, UK Behavioral health facility 14,396 24,713 — — 14,396 24,713 39,109 1,565 — 1890 , 2014 December 9, 2022 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 1,075 — 2014 March 19, 2014 40 Arnold, UK Behavioral health facility 469 9,749 — — 469 9,749 10,218 936 — 2008 June 25, 2021 40 Ashtead, UK Acute care general hospital 37,124 69,603 — — 37,124 69,603 106,727 9,699 — 1981 August 16, 2019 40 Austin, TX Freestanding ER 3,557 4,200 — — 3,557 4,200 7,757 850 — 2017 March 2, 2017 40 Avondale, AZ Behavioral health facility 5,383 64,650 470 — 5,383 65,120 70,503 5,563 — 2016 October 19, 2021 40 Ayr, UK Behavioral health facility 16,703 47,833 — — 16,703 47,833 64,536 4,274 — 2004 June 25, 2021 40 Bad Salzuflen, Germany Rehabilitation hospital 9,852 24,931 — — 9,852 24,931 34,783 4,815 — 1974 , 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 6,695 21,926 — — 6,695 21,926 28,621 4,033 — 1989 , 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,056 2,581 — — 1,056 2,581 3,637 511 — 1973 , 2010 November 30, 2017 40 Bakersfield, CA Rehabilitation hospital 2,178 45,253 — — 2,178 45,253 47,431 3,205 — 2022 May 15, 2020 40 Barby, Germany Rehabilitation hospital 1,708 19,057 — — 1,708 19,057 20,765 927 — 1995 April 19, 2023 40 Basingstoke, UK Acute care general hospital 12,704 49,342 — — 12,704 49,342 62,046 6,230 31,595 1984 January 9, 2020 40 Bassenheim, Germany Rehabilitation hospital 1,046 4,961 — — 1,046 4,961 6,007 814 — 1887 , 1983 February 9, 2019 39 Bath, UK Acute care general hospital 1,483 30,749 — — 1,483 30,749 32,232 8,072 — 2008 , 2009 July 1, 2014 40 Bath, UK Acute care general hospital 7,072 12,833 — — 7,072 12,833 19,905 1,667 15,164 1992 January 9, 2020 40 Beckenham, UK Acute care general hospital 5,369 20,594 — — 5,369 20,594 25,963 2,591 14,629 1981 January 9, 2020 40 Bedford, UK Acute care general hospital 1,514 7,416 — — 1,514 7,416 8,930 939 7,885 1982 January 9, 2020 40 Bellflower, CA Behavioral health facility 2,563 — — — 2,563 — 2,563 — — N/A August 23, 2019 — Big Spring, TX Acute care general hospital 1,655 21,254 815 — 1,655 22,069 23,724 3,485 — 1973 April 12, 2019 41 Birmingham, UK Behavioral health facility 912 9,988 — — 912 9,988 10,900 449 — 1864 , 2009 April 14, 2023 40 Birmingham, UK Acute care general hospital 7,870 41,503 — — 7,870 41,503 49,373 4,669 — 2017 April 3, 2017 40 Birmingham, UK Acute care general hospital 9,695 92,282 — — 9,695 92,282 101,977 11,655 — 1982 January 9, 2020 40 Birmingham, UK Rehabilitation hospital — 17,067 — — — 17,067 17,067 1,920 — 2018 June 29, 2020 40 Birmingham, UK Behavioral health facility 405 18,840 — — 405 18,840 19,245 1,767 — 1900 , 1984 , 2016 June 25, 2021 40 Blackburn, UK Acute care general hospital 2,616 50,140 — — 2,616 50,140 52,756 6,305 23,300 1957 January 9, 2020 40 Blackburn, UK Behavioral health facility 19,692 53,421 — — 19,692 53,421 73,113 5,125 — 1930 June 25, 2021 40 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 6,120 — 1980 February 13, 2015 40 Boardman, OH Long term acute care hospital 79 275 — — 79 275 354 41 — 2008 August 30, 2019 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 1,555 — 2008 February 29, 2012 50 Bolton, UK Acute care general hospital 1,558 43,781 — — 1,558 43,781 45,339 5,491 20,817 1989 January 9, 2020 40 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Bossier City, LA Long term acute care hospital 900 17,818 944 — 900 18,762 19,662 7,648 — 1982 April 1, 2008 40 Bowling Green, KY Rehabilitation hospital 3,486 56,296 3,550 — 3,486 59,846 63,332 8,586 — 1992 August 30, 2019 40 Brandis, Germany Rehabilitation hospital 2,079 22,882 — — 2,079 22,882 24,961 1,141 — 1995 April 19, 2023 40 Braunfels, Germany Acute care general hospital 2,040 12,707 — — 2,040 12,707 14,747 3,051 — 1977 June 30, 2015 40 Bristol, UK Behavioral health facility 4,626 36,724 — — 4,626 36,724 41,350 2,052 — 1790 , 2014 December 9, 2022 40 Bromley, UK Behavioral health facility 7,101 15,259 — — 7,101 15,259 22,360 1,483 — 1714 , 1830 , 2021 June 25, 2021 40 Bury, UK Behavioral health facility 8,366 19,063 — — 8,366 19,063 27,429 1,925 — 2003 June 25, 2021 40 Bussage, UK Behavioral health facility 8,346 3,690 — — 8,346 3,690 12,036 361 — 1970 June 25, 2021 40 Cadiz, Spain Acute care general hospital 281 6,377 — — 281 6,377 6,658 456 — 2000 April 29, 2022 40 Canterbury, UK Acute care general hospital 9,030 27,124 — — 9,030 27,124 36,154 3,418 18,894 1982 January 9, 2020 40 Carmarthen, UK Acute care general hospital 895 25,144 — — 895 25,144 26,039 3,174 14,884 1990 January 9, 2020 40 Carrollton, TX Behavioral health facility 4,941 52,227 — — 4,941 52,227 57,168 4,514 — 2012 October 19, 2021 40 Casper, WY Rehabilitation hospital 1,632 — — — 1,632 — 1,632 — — 2012 February 29, 2012 — Caterham, UK Acute care general hospital 10,374 20,494 — — 10,374 20,494 30,868 2,897 — 1982 August 16, 2019 40 Cayce, SC Rehabilitation hospital 1,022 20,419 — — 1,022 20,419 21,441 766 — 2023 October 21, 2022 40 Cheadle, UK Acute care general hospital 30,414 160,210 — — 30,414 160,210 190,624 20,151 105,255 1981 January 9, 2020 40 Cheadle, UK Behavioral health facility 29,311 93,207 — — 29,311 93,207 122,518 8,826 — 1849 , 2018 June 25, 2021 40 Clarksville, TX Rehabilitation hospital 2,460 25,540 — — 2,460 25,540 28,000 2,840 — 2019 December 17, 2020 39 Cologne, Germany Acute care general hospital 4,152 14,036 — — 4,152 14,036 18,188 2,679 — 2011 June 23, 2017 40 Columbus, OH Behavioral health facility 2,101 44,218 — — 2,101 44,218 46,319 3,859 — 2017 October 19, 2021 40 Conroe, TX Behavioral health facility 3,855 38,892 — — 3,855 38,892 42,747 3,468 — 2018 October 19, 2021 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 1,078 — 2015 April 10, 2015 40 Coral Gables, FL Acute care general hospital 26,215 84,584 2,624 — 26,215 87,208 113,423 7,509 — 1959 August 1, 2021 40 Croydon, UK Acute care general hospital 9,775 41,002 — — 9,775 41,002 50,777 5,192 25,157 1982 January 9, 2020 40 Dahlen, Germany Rehabilitation hospital 1,259 10,635 — — 1,259 10,635 11,894 1,291 — 1994 July 8, 2020 40 Dallas, TX Long term acute care hospital 1,421 13,536 — — 1,421 13,536 14,957 6,176 — 2006 September 5, 2006 40 Darlington, UK Acute care general hospital 2,053 35,213 — — 2,053 35,213 37,266 3,988 33,613 2001 August 7, 2020 40 Darlington, UK Behavioral health facility 20,888 47,447 — — 20,888 47,447 68,335 4,862 — 1935 , 2018 , 2020 June 25, 2021 40 Darlington, UK Behavioral health facility 5,140 25,903 — — 5,140 25,903 31,043 2,388 — 1960 , 1990 June 25, 2021 40 Detroit, MI Long term acute care hospital 1,220 8,323 — — 1,220 8,323 9,543 3,511 — 1956 May 22, 2008 40 Dewsbury, UK B ehavioral health facility 1,101 10,026 — — 1,101 10,026 11,127 474 — 2012 April 14, 2023 40 Diss, UK Behavioral health facility 2,861 10,202 — — 2,861 10,202 13,063 1,095 — 1840 (2) June 25, 2021 40 Dorchester, UK Acute care general hospital 530 30,812 — — 530 30,812 31,342 3,870 — 1981 January 9, 2020 40 Dormagen, Germany Rehabilitation hospital 1,791 5,298 — — 1,791 5,298 7,089 892 — 1993 , 2006 August 28, 2018 40 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Droitwich, UK Acute care general hospital 75 15,040 — — 75 15,040 15,115 1,905 — 1984 January 9, 2020 40 Dublin, OH Behavioral health facility 5,118 69,346 — — 5,118 69,346 74,464 5,931 — 2012 October 19, 2021 40 El Paso, TX Rehabilitation hospital 4,268 21,345 — — 4,268 21,345 25,613 2,479 — 2018 December 17, 2020 38 Englewood, CO Behavioral health facility 3,369 65,480 — — 3,369 65,480 68,849 5,648 — 2017 October 19, 2021 40 Essex, UK Behavioral health facility 4,563 42,462 — — 4,563 42,462 47,025 2,365 — 1790 , 1992 , 2014 December 9, 2022 40 Euxton, UK Acute care general hospital 4,539 34,959 — — 4,539 34,959 39,498 5,015 — 1981 August 16, 2019 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 3,838 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 9,103 — 2012 February 7, 2012 40 Floridablanca, Colombia Acute care general hospital 717 22,411 — — 717 22,411 23,128 1,367 — 1997 July 29, 2022 40 Folsom, CA Long term acute care hospital 3,291 21,293 — — 3,291 21,293 24,584 3,370 — 2009 August 30, 2019 40 Fort Worth, TX Behavioral health facility 3,406 34,627 — — 3,406 34,627 38,033 3,069 — 2014 October 19, 2021 40 Fresno, CA Rehabilitation hospital 5,507 70,473 — — 5,507 70,473 75,980 10,126 — 1991 August 30, 2019 40 Frome, UK Behavioral health facility 2,847 17,249 — — 2,847 17,249 20,096 1,703 — 1980 June 25, 2021 40 Frome, UK Behavioral health facility 10,711 10,530 — — 10,711 10,530 21,241 1,369 — 1700 , 2015 , 2017 June 25, 2021 40 Gainesborough, UK Behavioral health facility 1,503 9,838 — — 1,503 9,838 11,341 580 — 2008 April 14, 2023 40 Gardena, CA Acute care general hospital 14,010 65,282 — — 14,010 65,282 79,292 6,174 — 1966 July 6, 2021 40 Georgetown, TX Behavioral health facility 4,569 23,550 10,561 — 4,569 34,111 38,680 2,283 — 2014 October 19, 2021 40 Gilbert, AZ Behavioral health facility 4,790 45,076 5,411 — 4,790 50,487 55,277 3,821 — 2020 October 19, 2021 40 Glasgow, UK Acute care general hospital 6,333 129,348 — — 6,333 129,348 135,681 16,214 67,611 1983 January 9, 2020 40 Glasgow, UK Behavioral health facility 1,405 15,356 — — 1,405 15,356 16,761 1,456 — 1900 , 1980 June 25, 2021 40 Gloucester, UK Acute care general hospital 5,486 60,337 — — 5,486 60,337 65,823 8,521 — 1990 August 16, 2019 40 Godalming, UK Behavioral health facility 9,198 18,660 — — 9,198 18,660 27,858 1,893 — 1796 , 2007 June 25, 2021 40 Great Missenden, UK Acute care general hospital 11,571 103,391 — — 11,571 103,391 114,962 13,026 54,064 1981 January 9, 2020 40 Grefath, Germany Rehabilitation hospital 1,126 2,841 — — 1,126 2,841 3,967 488 — 1886 , 1983 August 28, 2018 40 Guildford, UK Acute care general hospital 6,765 35,812 — — 6,765 35,812 42,577 4,516 21,507 1989 January 9, 2020 40 Halsall, UK Acute care general hospital 1,980 30,633 — — 1,980 30,633 32,613 4,338 — 1986 August 16, 2019 40 Harrow, UK Acute care general hospital 37,755 39,733 — — 37,755 39,733 77,488 5,035 — 1980 January 9, 2020 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 11,918 — 1999 August 31, 2015 34 Hassocks, UK Behavioral health facility 5,392 28,190 — — 5,392 28,190 33,582 3,032 — 1998 June 25, 2021 40 Hastings, PA Acute care general hospital 603 8,834 — — 603 8,834 9,437 1,816 — 1924 December 17, 2019 30 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 2,632 — 2013 March 1, 2013 40 Heidelberg, Germany Rehabilitation hospital 5,850 33,415 — — 5,850 33,415 39,265 7,139 — 1885 , 1991 June 22, 2016 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 1,130 — 2016 March 10, 2016 40 Helsinki, Finland Acute care general hospital 3,832 63,268 494 — 3,832 63,762 67,594 4,471 — 1992 , 2013 March 11, 2022 40 Hemel Hempstead, UK Behavioral health facility 12,279 6,197 — — 12,279 6,197 18,476 757 — 1901 , 1990 June 25, 2021 40 Hialeah, FL Acute care general hospital 18,802 107,783 3,324 — 18,802 111,107 129,909 9,780 — 1950 August 1, 2021 40 Hialeah, FL Acute care general hospital 75,339 222,271 1,958 — 75,339 224,229 299,568 21,712 — 1969 August 1, 2021 40 Highland Hills, OH Behavioral health facility 3,148 43,891 — — 3,148 43,891 47,039 3,832 — 2015 October 19, 2021 40 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Hill County, TX Acute care general hospital 1,120 17,882 845 — 1,120 18,727 19,847 17,480 — 1980 September 17, 2010 15 Hinckley, UK Behavioral health facility 2,424 16,521 — — 2,424 16,521 18,945 1,566 — 1892 , 2007 June 25, 2021 40 Hook, UK Behavioral health facility 5,324 10,141 — — 5,324 10,141 15,465 1,045 — 1980 June 25, 2021 40 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 2,140 — 2015 May 1, 2015 34 Hoover, AL Freestanding ER — 1,034 296 — — 1,330 1,330 348 — 2015 May 1, 2015 34 Hot Springs, AR Acute care general hospital 5,622 59,432 21,221 — 5,622 80,653 86,275 19,450 — 1985 August 31, 2015 40 Houston, TX Behavioral health facility 6,063 19,881 2,565 — 6,063 22,446 28,509 2,245 — 2020 October 25, 2019 40 Houston, TX Acute care general hospital 28,687 80,168 90,934 — 28,687 171,102 199,789 20,251 — 1940 - 1950 September 29, 2017 41 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 824 — 2016 September 26, 2016 40 Houston, TX Acute care general hospital 3,274 27,324 32,499 — 3,274 59,823 63,097 22,782 — 1960 August 10, 2007 40 Huntington Park, CA Acute care general hospital 3,132 5,002 — — 3,132 5,002 8,134 540 — 1967 July 6, 2021 40 Huntington Park, CA Acute care general hospital 3,935 6,103 — — 3,935 6,103 10,038 645 — 1960 - 1969 July 6, 2021 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 67,951 — 1,822 105,418 107,240 19,747 — 2002 April 1, 2008 40 Idaho Falls, ID Acute care general hospital 1,880 108,303 5,590 — 1,880 113,893 115,773 13,216 — 2020 December 19, 2017 40 Johnstown, PA Acute care general hospital 8,877 247,158 — — 8,877 247,158 256,035 41,793 — 1924 December 17, 2019 30 Kansas City, KS Acute care general hospital 2,351 13,665 — — 2,351 13,665 16,016 1,650 — 2017 June 10, 2019 50 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 16,279 — 1978 February 13, 2015 40 Katy, TX Freestanding ER 1,512 2,870 — — 1,512 2,870 4,382 841 — 2016 October 10, 2016 40 Kuhlungsborn, Germany Rehabilitation hospital 6,292 16,179 — — 6,292 16,179 22,471 732 — 1998 June 1, 2023 40 Kuopio, Finland Acute care general hospital 1,212 40,662 — — 1,212 40,662 41,874 3,015 — 2017 March 11, 2022 29 Lafayette, IN Rehabilitation hospital 800 14,968 ( 25 ) — 800 14,943 15,743 4,442 — 2013 February 1, 2013 40 Lafayette, IN Behavioral health facility 2,829 10,795 — — 2,829 10,795 13,624 1,143 — 2012 October 19, 2021 40 Lander, WY Acute care general hospital 758 42,849 — — 758 42,849 43,607 5,724 — 1983 December 17, 2019 40 Lauderdale Lakes, FL Acute care general hospital 10,657 150,313 2,168 — 10,657 152,481 163,138 14,581 — 1975 August 1, 2021 40 Lawton, OK Acute care general hospital 3,944 63,031 — — 3,944 63,031 66,975 8,462 — 1985 December 17, 2019 40 League City, TX Freestanding ER 1,260 3,901 — — 1,260 3,901 5,161 927 — 2015 June 19, 2015 40 Leawood, KS Acute care general hospital 2,513 13,938 — — 2,513 13,938 16,451 1,672 — 2017 June 10, 2019 50 Leeds, UK Behavioral health facility 2,241 9,360 — — 2,241 9,360 11,601 916 — 1990 June 25, 2021 40 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 19,557 — 1922 May 1, 2017 40 London, UK Acute care general hospital 9,087 59,974 — — 9,087 59,974 69,061 7,522 37,593 1984 January 9, 2020 40 London, UK Behavioral health facility 35,654 51,030 — — 35,654 51,030 86,684 2,858 — 1811 , 2014 December 9, 2022 40 London, UK Acute care general hospital 3,229 4,078 — — 3,229 4,078 7,307 518 — 1987 January 9, 2020 40 London, UK Behavioral health facility 28,447 14,719 — — 28,447 14,719 43,166 940 — 1790 , 1992 , 2014 December 9, 2022 40 London, UK Acute care general hospital 12,241 79,894 — — 12,241 79,894 92,135 9,995 41,283 1977 January 9, 2020 40 London, UK Behavioral health facility 6,057 15,390 — — 6,057 15,390 21,447 1,481 — 1900 , 1960 June 25, 2021 40 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) London, UK Behavioral health facility 13,577 6,695 — — 13,577 6,695 20,272 671 — 1992 June 25, 2021 40 Los Angeles, CA Acute care general hospital 12,562 40,164 394 — 12,562 40,558 53,120 3,631 — 1972 July 6, 2021 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 7,530 — 2008 June 16, 2015 40 Malaga, SP Acute care general hospital 702 10,991 — — 702 10,991 11,693 748 — 2018 April 29, 2022 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 1,096 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER 1,539 5,801 — — 1,539 5,801 7,340 1,233 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER 2,500 4,060 — — 2,500 4,060 6,560 1,285 — 2015 July 31, 2015 30 McKinney, TX Behavioral health facility 2,934 32,268 — — 2,934 32,268 35,202 605 — N/A October 19, 2021 - McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 21,619 — 1996 August 31, 2015 41 Melton Mowbray, UK Behavioral health facility 5,605 15,712 — — 5,605 15,712 21,317 1,573 — 1990 June 25, 2021 40 Mesa, AZ Acute care general hospital 6,140 99,275 4,152 — 6,140 103,427 109,567 30,110 — 2007 September 26, 2013 40 Mesa, AZ Acute care general hospital 2,604 16,400 — — 2,604 16,400 19,004 1,131 — 2019 April 18, 2022 40 Meyersdale, PA Acute care general hospital 390 4,280 — — 390 4,280 4,670 913 — 1960 December 17, 2019 30 Miami, FL Acute care general hospital 44,400 107,203 3,440 — 44,400 110,643 155,043 11,471 — 1955 August 1, 2021 40 Miami, FL Acute care general hospital 20,430 15,750 10,947 — 20,430 26,697 47,127 2,281 — 1958 , 1962 , 1988 , 2016 April 25, 2022 40 Milton Keynes, UK Acute care general hospital 5,157 35,255 — — 5,157 35,255 40,412 4,436 — 1983 January 9, 2020 40 Monmouth, UK Behavioral health facility 15,244 11,357 — — 15,244 11,357 26,601 1,343 — 2017 June 25, 2021 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 27,388 — 1920 - 2000 April 1, 2014 40 Mount Pleasant, SC Long term acute care hospital 597 2,198 — — 597 2,198 2,795 335 — 2012 August 30, 2019 40 New Braunfels, TX Rehabilitation hospital 1,853 10,622 — — 1,853 10,622 12,475 1,126 — 2011 February 29, 2012 40 New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 1,263 — 2016 September 23, 2016 40 Newark, NJ Acute care general hospital 32,957 24,553 — — 32,957 24,553 57,510 2,657 — 1919 , 1920 - 2003 May 2, 2016 40 Newburgh, IN Behavioral health facility 1,215 7,212 — — 1,215 7,212 8,427 690 — 2010 October 19, 2021 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 5,978 — 2007 February 14, 2011 40 Norwalk, CA Acute care general hospital 2,811 5,940 — — 2,811 5,940 8,751 649 — 1959 , 1995 July 6, 2021 40 Norwalk, CA Acute care general hospital 7,946 30,465 7,104 — 7,946 37,569 45,515 3,158 — 1958 - 1978 July 6, 2021 40 Norwood, MA Acute care general hospital 6,373 — — — 6,373 — 6,373 — — N/A June 27, 2018 46 Nottingham, UK Acute care general hospital 4,869 45,175 — — 4,869 45,175 50,044 5,726 32,221 1983 January 9, 2020 40 Nottingham, UK Behavioral health facility 9,842 8,808 — — 9,842 8,808 18,650 1,012 — 2000 June 25, 2021 40 Nottingham, UK Behavioral health facility 9,988 3,191 — — 9,988 3,191 13,179 312 — 1980 June 25, 2021 40 Odessa, TX Acute care general hospital 6,217 123,518 16,600 — 6,217 140,118 146,335 24,157 — 1973 - 2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 4,435 — 2014 March 1, 2014 40 Oklahoma City, OK Behavioral health facility 3,641 3,047 — — 3,641 3,047 6,688 492 — 2017 October 19, 2021 40 Olathe, KS Behavioral health facility 6,882 56,381 11,584 — 6,882 67,965 74,847 4,934 — 2015 October 19, 2021 40 Olathe, KS Acute care general hospital 3,485 14,484 — — 3,485 14,484 17,969 1,756 — 2018 June 10, 2019 50 Orpington, UK Acute care general hospital 10,163 41,992 — — 10,163 41,992 52,155 5,299 24,206 1987 January 9, 2020 40 Ottumwa, IA Acute care general hospital 2,377 48,697 — — 2,377 48,697 51,074 9,057 — 1950 December 17, 2019 30 Oulu, Finland Acute care general hospital 2,976 42,125 — — 2,976 42,125 45,101 3,162 — 2017 March 11, 2022 40 Overland Park, KS Acute care general hospital 2,974 14,405 — — 2,974 14,405 17,379 1,755 — 2017 June 10, 2019 50 Overland Park, KS Acute care general hospital 3,191 14,263 — — 3,191 14,263 17,454 1,825 — 2019 June 10, 2019 50 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 2,869 — 2012 February 1, 2013 40 Palestine, TX Acute care general hospital 1,848 95,257 — — 1,848 95,257 97,105 12,482 — 1988 December 17, 2019 40 Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date computed (Dollar amounts in thousands) Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 2,855 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 924 — 2014 September 8, 2014 40 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 3,762 — 2006 July 1, 2008 40 Phoenix, AZ Behavioral health facility 2,396 7,276 2,985 — 2,396 10,261 12,657 5,014 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 51,834 4,499 — 12,695 56,333 69,028 14,842 — 1968 - 1976 September 29, 2017 43 Plano, TX Freestanding ER 4,077 1,416 — — 4,077 1,416 5,493 584 — 2016 September 30, 2016 40 Poole, UK Acute care general hospital 2,286 37,734 — — 2,286 37,734 40,020 5,620 12,821 1996 April 3, 2019 40 Poplar Bluff, MO Acute care general hospital 2,659 38,694 — — 2,659 38,694 41,353 16,156 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 11,432 76,746 6,877 — 11,432 83,623 95,055 23,087 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 2,531 14,252 — — 2,531 14,252 16,783 4,382 — 1953 , 1973 - 1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 3,785 — 2013 December 31, 2013 40 Preston, UK Behavioral health facility 8,593 31,287 — — 8,593 31,287 39,880 2,487 — 1850 , 2018 , 2021 June 25, 2021 40 Princes Risborough, UK Acute care general hospital 3,345 — — — 3,345 — 3,345 — — N/A January 9, 2020 40 Raleigh, NC Behavioral health facility 3,469 27,514 — — 3,469 27,514 30,983 2,585 — 2018 October 19, 2021 40 Reading, UK Acute care general hospital 34,208 45,393 — — 34,208 45,393 79,601 6,324 — 1990 August 16, 2019 40 Reading, UK Acute care general hospital 25,556 81,890 — — 25,556 81,890 107,446 8,350 22,118 2012 December 18, 2020 40 Remscheid, Germany Rehabilitation hospital 983 2,371 — — 983 2,371 3,354 398 — 1951 , 1983 August 28, 2018 40 Richmond, TX Behavioral health facility 5,380 6,665 10,815 — 5,380 17,480 22,860 867 — 2014 October 19, 2021 40 Richmond, VA Long term acute care hospital 1,293 10,071 — — 1,293 10,071 11,364 1,739 — 1989 August 30, 2019 40 Riverton, WY Acute care general hospital 1,163 29,647 — — 1,163 29,647 30,810 4,594 — 1983 December 17, 2019 36 Roaring Springs, PA Acute care general hospital 1,446 9,549 — — 1,446 9,549 10,995 2,027 — 1924 December 17, 2019 30 Rochdale, MA Long term acute care hospital 654 3,368 — — 654 3,368 4,022 527 — 1989 August 30, 2019 40 Rochdale, MA Acute care general hospital 67 344 — — 67 344 411 54 — 1989 August 30, 2019 40 Rochdale, UK Acute care general hospital 3,517 40,065 — — 3,517 40,065 43,582 5,054 21,903 1965 January 9, 2020 40 Roeland Park, KS Acute care general hospital 1,569 15,103 — — 1,569 15,103 16,672 1,795 — 2018 June 10, 2019 50 Romford, UK Behavioral health facility 5,263 8,618 — — 5,263 8,618 13,881 952 — 1980 June 25, 2021 40 Rosenberg, TX Freestanding ER 1,233 4,505 — — 1,233 4,505 5,738 1,014 — 2016 January 15, 2016 40 Rowley, UK Acute care general hospital 2,859 17,993 — — 2,859 17,993 20,852 2,627 — 1986 August 16, 2019 40 Royston, UK Behavioral health facility 6,620 19,710 — — 6,620 19,710 26,330 2,172 — 1906 , 1970 June 25, 2021 40 Salt Lake City, UT Acute care general hospital 2,913 — — — 2,913 — 2,913 — — N/A September 29, 2017 41 San Antonio, TX Acute care general hospital 8,053 10,851 7,982 — 8,053 18,833 26,886 6,230 — 1978 - 2002 September 29, 2017 41 San Antonio, TX Freestanding ER 3,030 4,801 — — 3,030 4,801 7,831 970 — 2016 December 9, 2016 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 1,061 — 2014 January 1, 2014 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 1,789 — 2012 October 2, 2012 40 San Antonio, TX Freestanding ER 2,343 4,253 — — 2,343 4,253 6,596 868 — 2016 October 27, 2016 40 San Bernardino, CA Acute care general hospital 2,209 37,498 — — 2,209 37,498 39,707 5,464 — 1993 August 30, 2019 40 — Initial Costs Additions Subsequent Cost at December 31, 2024(1) Accumulated Life on which Location Type of Property Land Buildings Improve- Carrying Land Buildings Total Depreciation Encum- Date of Date Acquired computed (Dollar amounts in thousands) Santa Maria de Feira, PT Acute care general hospital 1,744 16,732 — — 1,744 16,732 18,476 1,395 — 2015 October 21, 2021 40 Sharon, PA Acute care general hospital 6,179 9,066 8,513 — 6,179 17,579 23,758 3,984 — 1950 - 1980 May 1, 2017 41 Shawnee, KS Acute care general hospital 3,076 14,945 — — 3,076 14,945 18,021 2,070 — 2018 June 10, 2019 50 Sheffield, UK Acute care general hospital 6,502 43,862 — — 6,502 43,862 50,364 5,564 32,006 2008 January 9, 2020 40 Sherman, TX Acute care general hospital 3,363 10,931 — — 3,363 10,931 14,294 4,595 — 1913 , 1960 - 2010 October 31, 2014 40 Southampton, UK Behavioral health facility 6,336 18,605 — — 6,336 18,605 24,941 2,017 — 1820 , 1985 June 25, 2021 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 4,472 — 2013 August 1, 2013 40 Stirling, UK Acute care general hospital 1,036 19,181 — — 1,036 19,181 20,217 1,754 9,002 1992 July 6, 2021 40 Stockton, CA Rehabilitation hospital 2,757 50,681 — — 2,757 50,681 53,438 2,112 — 2021 November 23, 2020 40 Surrey, UK Behavioral health facility 14,793 8,975 — — 14,793 8,975 23,768 632 — 1950 , 2014 December 9, 2022 40 Swindon, UK Acute care general hospital 5,238 58,763 — — 5,238 58,763 64,001 7,389 30,855 1984 January 9, 2020 40 Tadley, UK Behavioral health facility 20,564 18,739 — — 20,564 18,739 39,303 2,154 — 2020 June 25, 2021 40 Tempe, AZ Acute care general hospital 6,050 10,986 5,239 — 6,050 16,225 22,275 3,325 — 1940 September 29, 2017 41 Texarkana, TX Acute care general hospital 14,562 — — — 14,562 — 14,562 — — N/A September 29, 2017 - The Woodlands, TX Freestanding ER 1,949 4,524 — — 1,949 4,524 6,473 990 — 2016 March 28, 2016 40 Toledo, OH Rehabilitation hospital 1,118 17,740 — — 1,118 17,740 18,858 3,881 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 20,545 — — 1,299 20,545 21,844 8,268 — 2005 December 21, 2010 40 Torquay, UK Acute care general hospital 2,930 35,139 — — 2,930 35,139 38,069 4,832 — 1981 August 16, 2019 40 Turku, Finland Acute care general hospital 1,133 54,582 — — 1,133 54,582 55,715 3,946 — 2018 March 11, 2022 40 Usk, UK Behavioral health facility 1,700 30,500 — — 1,700 30,500 32,200 2,164 — 1770 , 1850 , 1980 June 25, 2021 40 Valencia, SP Acute care general hospital 10,438 65,236 — — 10,438 65,236 75,674 5,797 — 2017 December 2, 2021 40 Valencia, SP Acute care general hospital 24,332 22,785 — — 24,332 22,785 47,117 522 — 1960 , 2024 May 6, 2022 40 Vancouver, WA Behavioral health facility 9,313 12,505 — — 9,313 12,505 21,818 803 — 2018 October 19, 2021 40 Viseu, Portugal Acute care general hospital 2,377 27,091 — — 2,377 27,091 29,468 3,862 — 2016 November 28, 2019 37 Warren, OH Acute care general hospital 5,385 38,374 10,492 — 5,385 48,866 54,251 12,698 — 1982 May 1, 2017 41 Warren, OH Rehabilitation hospital 2,417 15,857 1,737 — 2,417 17,594 20,011 3,983 — 1922 - 2000 May 1, 2017 46 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 11,742 — 2004 December 21, 2010 40 West Chester, OH Behavioral health facility 3,670 61,338 — — 3,670 61,338 65,008 5,364 — 2013 October 19, 2021 40 West Midlands, UK Behavioral health facility 1,890 7,042 — — 1,890 7,042 8,932 342 — 2013 April 14, 2023 40 West Monroe, LA Acute care general hospital 11,702 69,433 19,116 — 12,254 87,997 100,251 23,234 — 1962 September 26, 2013 40 Wichita, KS Rehabilitation hospital 1,019 18,374 — — 1,019 18,374 19,393 7,693 — 1992 April 4, 2008 40 Willenhall, UK Behavioral health facility 7,166 15,987 — — 7,166 15,987 23,153 1,513 — 2000 June 25, 2021 40 Winchester, UK Acute care general hospital 6,377 10,103 — — 6,377 10,103 16,480 1,303 10,248 1911 January 9, 2020 40 Windsor, UK Acute care general hospital 11,978 102,957 — — 11,978 102,957 114,935 12,903 — 1955 January 9, 2020 40 Woking, UK Behavioral health facility 7,117 4,601 — — 7,117 4,601 11,718 493 — 1800 , 2020 June 25, 2021 40 Worthing, UK Acute care general hospital 6,602 29,637 — — 6,602 29,637 36,239 3,736 17,192 1994 January 9, 2020 40 York, UK Behavioral health facility 3,645 6,629 — — 3,645 6,629 10,274 325 — 2008 April 14, 2023 40 York, UK Behavioral health facility 21,270 70,559 — — 21,270 70,559 91,829 6,523 — 1900 , 1980 June 25, 2021 40 Youngstown, OH Acute care general hospital 3,555 3,469 488 — 3,555 3,957 7,512 2,724 — 1929 - 2003 May 1, 2017 41 $ 1,605,243 $ 8,087,849 $ 393,401 $ — $ 1,606,722 $ 8,479,771 $ 10,086,493 $ 1,239,897 $ 790,230 (1) The aggregate cost for federal income tax purposes is $ 11.0 billion. (2) Date of construction is based off of best available information, but note that this facility has had multiple updates since initial construction. The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2024 December 31, 2023 December 31, 2022 COST Balance at beginning of period $ 11,813,175 $ 12,300,524 $ 13,628,749 Acquisitions — 143,882 622,999 Transfers from construction in progress 79,385 72,791 47,431 Additions 73,523 87,873 150,290 Dispositions ( 1,492,320 ) ( 874,519 ) ( 1,471,529 ) Impairments ( 276,572 ) ( 67,671 ) — Other ( 110,698 ) (3) 150,295 (3) ( 677,416 ) (3) Balance at end of period $ 10,086,493 (4) $ 11,813,175 (4) $ 12,300,524 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2024 December 31, 2023 December 31, 2022 ACCUMULATED DEPRECIATION Balance at beginning of period $ 1,227,619 $ 1,008,340 $ 950,369 Depreciation 242,802 270,816 277,032 Depreciation on disposed property ( 220,435 ) ( 73,765 ) ( 185,519 ) Other ( 10,089 ) 22,228 ( 33,542 ) Balance at end of period $ 1,239,897 (5) $ 1,227,619 $ 1,008,340 (3) Includes foreign currency fluctuations for all years. (4) Excludes approximately $ 420 million and $ 400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2024 and 2023, respectively. Includes $ 52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024. (5) Includes $ 18.2 million of accumulated depreciation reflected in real estate held for sale at December 31, 2024.

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2024
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE MEDICAL PROPERTIES TRUST, INC. AND MPT OPERATING PARTNERSHIP, L.P. December 31, 2024 Column A Column B Column C Column D Column E Column F Column G(1) Column H Description Interest Final Periodic Payment Prior Face Carrying Principal (Dollar amounts in thousands) Long-term first mortgage loan: Colombia(2) 11.61 % 2035 (4 ) (6 ) $ 129,968 $ 111,985 (8 ) Vibra 11.50 % 2026 (5 ) (6 ) 7,986 7,927 (8 ) Prospect(3) 9.00 % 2028 (4 ) (6 ) 155,223 — (8 ) $ 293,177 $ 119,912 (7 ) (1) The aggregate cost for federal income tax purposes is $ 293.2 million. (2) Mortgage loans covering three properties. (3) Mortgage loans covering four properties. (4) Payable in monthly installments of interest plus principal payable in full at maturity. (5) Payable in monthly installments of principal and interest. (6) There were no prior liens on loans as of December 31, 2024. (7) Includes reserves/writedowns of approximately $ 18 million for Colombia and $ 155 million for Prospect in 2024. The Vibra loan includes a credit loss reserve of approximately $ 0.1 million. (8) Mortgage loans were not delinquent with respect to principal or interest, except for interest payments on the Colombia loan. Changes in mortgage loans (excluding allowance for credit loss) for the years ended December 31, 2024, 2023, and 2022 are summarized as follows: Year Ended December 31, 2024 2023 2022 (Dollar amounts in thousands) Balance at beginning of year $ 310,101 $ 364,420 $ 213,320 Additions during year: New mortgage loans and additional advances 100,824 155,223 177,924 Exchange rate fluctuations ( 17,748 ) 31,530 ( 15,824 ) 393,177 551,173 375,420 Deductions during year: Collection of principal ( 100,000 ) ( 241,072 ) (9) ( 11,000 ) Other ( 173,265 ) (7) — — ( 273,265 ) ( 241,072 ) ( 11,000 ) Balance at end of year $ 119,912 $ 310,101 $ 364,420 (9) Includes a $ 151 million mortgage loan satisfied in exchange for non-controlling ownership interest in PHP Holdings as part of the Prospect Transaction in the second quarter of 2023 as more fully described in Note 3 to Item 8 of this Annual Report on Form 10-K.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. 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 financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements at December 31, 2024 are reasonable and supportable based on the information available (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 those estimates.
Principles of Consolidation	Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100 % of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity ("VIE"). If we determine that we have a variable interest in a VIE, we then evaluate if we are the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. We consolidate each VIE in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2024, we had loans and/or equity investments in certain VIEs, which may also be tenants of our facilities. We have determined that we were not the primary beneficiary of these VIEs. The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at December 31, 2024 are presented below (in thousands): VIE Type Carrying Asset Type Maximum Loss Loans, net and equity investments $ 149,027 Investments in Unconsolidated $ 149,027 Loans, net 117,187 Mortgage and other loans 117,268 (1) Carrying amount only reflects the net book value of our loan or equity investment in the VIE. (2) Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities. For the VIE types above, we do not consolidate the VIEs because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE's economic performance. As of December 31, 2024, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g. cash short falls).
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method. This includes the five investments in unconsolidated real estate joint ventures at December 31, 2024. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “(Loss) earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop Holdings S.à.r.l. ("Primotop") (for which we handle the accounting of), we have elected to record our share of such investee’s earnings or losses on a lag basis (not to exceed three months). The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is other-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income.
Cash and Cash Equivalents	Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets.
Revenue Recognition	Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards Codification (“ASC”) 842, “Leases”, (“ASC 842”). ASC 842 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). For lessors, we apply this standard as follows: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the cash basis method, when collectability of the lease payments is not deemed probable. Rent revenue from base rents is recorded on the straight-line method, when collectability of the lease payments is deemed probable, over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under ASC 842, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method. Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received on operating lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease on the straight-line method. Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.
Acquired Real Estate Purchase Price Allocation	Acquired Real Estate Purchase Price Allocation: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months , but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time.
Real Estate and Depreciation	Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, is maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements, which improve and/or extend the useful life of the asset, are capitalized and depreciated over their estimated useful lives. We review real estate investments for impairment when events and circumstances indicate that the assets may not be recoverable. We analyze recoverability by comparing the carrying value of the real estate assets to a probability-weighted set of estimated undiscounted cash flows to be generated by those assets, including an estimated liquidation amount, during the expected holding periods. Assumptions used in determining undiscounted cash flows may include, but are not limited to, market rental rates, capitalization rates, and holding periods. If the recoverability analysis indicates that the carrying value of the real estate asset is greater than the expected future undiscounted cash flows, impairment losses are measured as the difference between carrying value and fair value of the assets. Future cash flows are discounted when determining fair value of an asset. Estimated future cash flows used in such analysis are based on our plans for the real estate asset and our view of market economic conditions. Assumptions used in determining fair value may include, but are not limited to, market rental rates, discount rates, and capitalization rates. When a real estate investment is designated as held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is typically based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2024 are as follows: Buildings and improvements 38.6 years Lease intangibles 28.3 years Leasehold improvements 14.3 years Furniture, equipment, and other 5.2 years
Losses from Rent Receivables	Credit Losses: Losses from Rent Receivables: For our leases, we review tenant provided financial data and monitor the performance of our tenants in areas generally consisting of: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenant's operating margins both to facility rent and to facility rent plus other fixed costs; trends in revenue, cash collections, patient mix; and the effect of evolving healthcare regulations, adverse economic and political conditions, such as rising inflation and interest rates, and other events ongoing on a tenant's profitability and liquidity. Losses from Operating Lease Receivables: We utilize the information above along with the tenant’s payment and default history in evaluating (on a property-by-property basis) whether or not a provision for losses on outstanding billed rent and/or straight-line rent receivables is needed. A provision for losses on rent receivables (including straight-line rent receivables) is ultimately recorded when it becomes probable that the receivable will not be collected in full. The provision is an amount which reduces lease income to the lesser of a) lease payments that have been collected (cash basis) or b) income under the straight-line method. Losses on Financing Lease Receivables: We apply a forward-looking “expected credit loss” model to all of our financing receivables, including financing leases and loans. To do this, we group our financial instruments into two primary pools of similar credit risk: secured and unsecured. The secured instruments include our investments in financing receivables as all are secured by the underlying real estate, among other collateral. Within the two primary pools, we further group our instruments into sub-pools based on several tenant/borrower characteristics, including years of experience in the healthcare industry and in a particular market or region and overall capitalization. We then determine a credit loss percentage per pool based on our history over a period of time that closely matches the remaining terms of the financial instruments being analyzed and adjust as needed for current trends or unusual circumstances. We apply these credit loss percentages to the book value of the related instruments to establish a credit loss reserve on our financing lease receivables and such credit loss reserve (including the underlying assumptions) is reviewed and adjusted quarterly. If a financing receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adjust the credit loss reserve based on the fair value of the underlying collateral. We made the accounting policy election to exclude interest receivables from the credit loss reserve model. Instead, such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.
Loans	Loans : Loans consist of mortgage loans, working capital loans, and other loans. Mortgage loans are collateralized by interests in real property. Working capital and other loans are typically collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. Like our financing lease receivables, we establish credit loss reserves on all outstanding loans based on historical credit losses of similar instruments. Such credit loss reserves, including the underlying assumptions, are reviewed and adjusted quarterly. If a loan’s performance worsens and foreclosure is deemed probable for our collateral-based loans (after considering the borrower’s overall financial condition as described above for leases), we will adjust the allowance for expected credit losses based on the current fair value of such collateral at the time the loan is deemed uncollectible. If the loan is not collateralized, the loan will be reserved for/written-off once it is determined that such loan is no longer collectible. Interest receivables on loans are excluded from the forward looking credit loss reserve model; however, we assess their collectability similar to how we assess collectability for interest receivables on financing leases described above. The following table summarizes our credit loss reserves (in thousands): December 31, 2024 December 31, 2023 Balance at beginning of the year $ 96,001 $ 121,146 Provision for credit loss, net 1,241,020 10,194 Expected credit loss reserve written off or related to financial ( 825,548 ) ( 35,339 ) Balance at end of year $ 511,473 $ 96,001
Earnings Per Share/Units	Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income by the weighted-average number of shares/units outstanding during the period. Diluted earnings per common share/unit is calculated by including the effect of dilutive securities. Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit.
Income Taxes	Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90 % of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for U.S. federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of TRS entities. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities. With the property acquisitions and investments in Europe and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes, of a significant nature, in the U.S. as the majority of such income from our international properties flows through our REIT income tax returns. For our TRS entities and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.
Stock-Based Compensation	Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019, which was amended during the second quarter of 2022. Equity awards of restricted stock with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years ), using the straight-line method. Equity awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years , using the straight-line method. Equity awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. In 2024, certain market-based restricted stock units ("RSUs") were issued with cash-settlement features. These liability-type awards are adjusted to fair value (using a Monte Carlo valuation model) on a quarterly basis and amortized over the derived service period, which is also adjusted on a quarterly basis. Forfeitures of stock-based awards are recognized as they occur.
Deferred Costs	Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other third-party leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.
Deferred Financing Costs	Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within “Debt, net” on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility, the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “Other assets” on our consolidated balance sheets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity/partnership capital on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income (expense) in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets.
Derivative Financial Investments and Hedging Activities	Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in accumulated other comprehensive income (loss) on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivative offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur.
Fair Value Measurement	Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for identical instruments in active markets; • Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2. If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques that have been used by us include discounted cash flow, market approach valuations, and Monte Carlo valuation models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity investment in the international joint venture and PHP Holdings, along with any related investments such as loans (see Note 10 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other investments that exist at December 31, 2024 .
Leases (Lessee)	Leases (Lessee) Pursuant to ASC 842, we are required to apply a dual approach, classifying leases (in which we are the lessee) as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase. This classification determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. We record a right-of-use asset and a lease liability for all material leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less are off balance sheet with lease expense recognized on a straight-line basis over the lease term.
Segment Reporting	Segment Reporting In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU 2023-07, "Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures" ("ASU 2023-07") to improve reportable segment disclosure requirements. We adopted this guidance in the fourth quarter of 2024 and have included the required disclosures within Note 13 - Segment Disclosures .
Reclassification	Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.
Recent Accounting Developments	Recent Accounting Developments Income Taxes In December 2023, the FASB issued ASU 2023-09, "Income Taxes (Topic 740): Improvements to Income Tax Disclosures" ("ASU 2023-09") which focuses on income tax disclosures regarding effective tax rates and cash income taxes paid. This standard requires public entities to disclose (1) specific categories in the rate reconciliation, (2) the income or loss from continuing operations before income tax expense or benefit disaggregated by domestic and foreign, and (3) provide additional information for certain reconciling items at or above a quantitative threshold of 5 % of the statutory tax. Additionally, this standard requires disclosure of income taxes paid (net of refunds), separated by international, federal, state, and local jurisdictions. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. We plan to adopt and include the necessary additional required disclosures in our filings in 2025. Disaggregation of Income Statement Expenses In November 2024, the FASB issued ASU 2024-03, "Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses" ("ASU 2024-03") to improve the disclosures about a public company's expenses and address requests from investors for more detailed information about the types of expenses in commonly presented expense captions. ASU 2024-03 is effective for annual periods beginning after December 15, 2026. We are currently evaluating the potential impact of the adoption of this standard on our consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Summary of Carrying Value and Classification of the Assets and Maximum Exposure	The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs at December 31, 2024 are presented below (in thousands): VIE Type Carrying Asset Type Maximum Loss Loans, net and equity investments $ 149,027 Investments in Unconsolidated $ 149,027 Loans, net 117,187 Mortgage and other loans 117,268 (1) Carrying amount only reflects the net book value of our loan or equity investment in the VIE. (2) Our maximum loss exposure related to loans with VIEs represents our current aggregate gross carrying value of the loan plus accrued interest and any other related assets (such as rent receivables), less any liabilities. Our maximum loss exposure related to our equity investments in VIEs represents the current carrying values of such investments plus any other related assets (such as rent receivables), less any liabilities.
Estimated Useful Lives of Related Real Estate and Other Assets	Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2024 are as follows: Buildings and improvements 38.6 years Lease intangibles 28.3 years Leasehold improvements 14.3 years Furniture, equipment, and other 5.2 years
Summary of Credit Loss Reserves	The following table summarizes our credit loss reserves (in thousands): December 31, 2024 December 31, 2023 Balance at beginning of the year $ 96,001 $ 121,146 Provision for credit loss, net 1,241,020 10,194 Expected credit loss reserve written off or related to financial ( 825,548 ) ( 35,339 ) Balance at end of year $ 511,473 $ 96,001

Real Estate and Other Activit_2

Real Estate and Other Activities (Tables)	12 Months Ended
	Dec. 31, 2024
Real Estate [Abstract]
Net Assets Acquired	For the years ended December 31, 2024, 2023, and 2022, we acquired or invested in the following net assets (in thousands): 2024 2023 2022 Land and land improvements $ — $ 28,916 $ 135,301 Buildings — 114,966 487,698 Intangible lease assets — subject to amortization 24.8 years in 2023 21.3 years in 2022) — 16,305 45,394 Mortgage loans — — 159,735 Investments in unconsolidated real estate joint ventures 107,908 — 399,456 Investments in unconsolidated operating entities — 50,000 131,105 Other loans — 25,000 — Liabilities assumed ( 2,290 ) — ( 25,727 ) $ 105,618 $ 235,187 $ 1,332,962 Loans repaid(1) — ( 22,900 ) — Total net assets acquired $ 105,618 $ 212,287 $ 1,332,962 (1) The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.
Summary of Status on Current Development and Capital Addition Projects	See table below for a status summary of our current development and capital addition projects (in thousands): Property Commitment Costs Cost Remaining Lifepoint Behavioral (Arizona) $ 10,504 $ 5,411 $ 5,093 Lifepoint Behavioral (Kansas) 20,183 11,584 8,599 Surgery Partners (Idaho) 15,993 5,590 10,403 Lifepoint Behavioral (Arizona) 10,659 470 10,189 IMED Hospitales (Spain) 49,749 21,355 28,394 IMED Hospitales (Spain) 36,294 29,261 7,033 Other (Various) 799 494 305 $ 144,181 $ 74,165 $ 70,016
Summary of Operating Results from Properties	The following represents the operating results from properties sold for 2024 and properties designated as held for sale at December 31, 2024 (in thousands): For the Year Ended December 31, 2024 2023 2022 Revenues(1) $ 72,362 $ 88,938 $ 220,183 Real estate depreciation and amortization(2) ( 26,476 ) ( 331,099 ) ( 53,350 ) Property-related expenses ( 8,277 ) ( 4,697 ) ( 1,759 ) Real estate impairment charges(3) ( 129,159 ) — — Other (expense) income(4) 480,416 ( 90 ) ( 19 ) (Loss) income from real estate dispositions, net $ 388,866 $ ( 246,948 ) $ 165,055 (1) The 2023 column includes an approximate $ 95 million write-off of straight-line rent receivables related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023. (2) The 2023 column includes approximately $ 286 million of lease intangible amortization acceleration related to the hospital operations of the five Utah facilities that were acquired by CommonSpirit on May 1, 2023. (3) Includes the charge associated with the three Space Coast facilities in the third quarter of 2024 due to the global settlement reached with Steward and its lenders. (4) The 2024 column includes approximately $ 24 million of gains (net of approximately $ 16 million write-off of straight line receivables) related to the UCHealth disposal and $ 65 million of gains (net of approximately $ 20 million write-off of straight-line rent receivables) related to the Dignity disposal. In addition, the 2024 column includes $ 360 million of gains (net of approximately $ 20 million write-off of straight-line rent receivables) related to the Utah Transaction and $ 23 million of gains (net of $ 30 million write-off of straight-line rent receivables) related to the sale of five Prime properties.
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $ 205.6 million (including $ 170 million for accelerating the amortization of the in-place lease intangibles associated with two master leases, including the Steward master lease that was terminated effective September 11, 2024), $ 332.5 million (including $ 286 million for accelerating the amortization of the in-place lease intangibles related to re-leasing the Utah properties to CommonSpirit as described in this same Note 3 ), and $ 55.9 million in 2024, 2023, and 2022, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2025 $ 29,201 2026 29,052 2027 28,730 2028 28,566 2029 26,726
Summary of Total Future Contractual Minimum Lease Payments to be Received	The following table summarizes total future contractual minimum lease payments, excluding operating expense reimbursements, tenant recoveries, and other lease/loan-related adjustments to revenue (i.e., straight-line rents, deferred revenues, or reserves/write-offs), from tenants under noncancelable leases as of December 31, 2024 (amounts in thousands): Total Under Total Under Total 2025 $ 721,305 $ 118,855 $ 840,160 2026 810,002 121,289 931,291 2027 856,426 123,772 980,198 2028 868,390 126,304 994,694 2029 869,681 128,887 998,568 Thereafter 20,744,147 3,075,567 23,819,714 $ 24,869,951 $ 3,694,674 $ 28,564,625
Components of Total Investment in Financing Leases	The components of our total investment in financing leases consisted of the following (in thousands): As of December 31, 2024 As of December 31, 2023 Minimum lease payments receivable $ 591,142 $ 611,669 Estimated unguaranteed residual values 203,818 203,818 Less: Unearned income and allowance for credit loss ( 547,770 ) ( 571,059 ) Net investment in direct financing leases 247,190 244,428 Other financing leases (net of allowance for credit loss) 810,580 987,202 Total investment in financing leases $ 1,057,770 $ 1,231,630
Schedule of Real Estate and Other Impairment Charges, Net	Due to the events discussed above, we recorded various impairment charges during 2024 and 2023, which included the following (in millions): For the Years Ended December 31, Description 2024 2023 Income Statement Reserve for unpaid rent and interest and straight-line $ — $ 413 Total revenues Working capital and other loans(1) 787 — Real estate and other Investment in Massachusetts partnership(2) 445 30 (Loss) earnings from Real estate(2) 277 100 Real estate and other Equity investment and other(1) 54 171 Real estate and other Total $ 1,563 $ 714 (1) For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which was no value after the global settlement and our release of claims against Steward as discussed above. (2) The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $ 180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8 % to 10 %).
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 Ownership Percentage As of December 31, 2024 As of December 31, 2023 Swiss Medical Network 70 % $ 483,770 $ 472,434 MEDIAN 50 % 431,964 471,336 CommonSpirit (Utah partnership) 25 % 113,202 — Policlinico di Monza 50 % 77,592 80,562 HM Hospitales 45 % 49,869 56,071 Steward (Macquarie partnership) 50 % — 394,052 Total $ 1,156,397 $ 1,474,455 The following is a summary of our investments in unconsolidated operating entities (amounts in thousands): Operator As of December 31, As of December 31, Swiss Medical Network $ 172,453 $ 186,113 PHP Holdings 149,027 699,535 Aevis Victoria SA ("Aevis") 63,409 77,345 Priory 38,739 163,837 Aspris Children's Services ("Aspris") 15,950 15,986 Steward (loan investment) — 361,591 International joint venture — 225,960 Steward (equity investment) — 35,696 Lifepoint Behavioral — 11,429 Caremax — 1,148 Total $ 439,578 $ 1,778,640
Schedule of Concentrations of Credit Risk	See below for our concentration details (dollars in thousands): Total Assets by Operator As of December 31, 2024 As of December 31, 2023 Operators Total Assets (1) Percentage of Total Assets (1) Percentage of Circle $ 2,026,778 14.2 % $ 2,119,392 11.6 % Priory 1,233,462 8.6 % 1,391,005 7.6 % Healthcare Systems of America 1,187,006 8.3 % — — Lifepoint Behavioral 813,584 5.7 % 813,527 4.4 % Swiss Medical Network 719,632 5.1 % 735,891 4.0 % Steward — — 3,518,537 19.2 % Other operators 6,624,256 46.3 % 7,709,095 42.2 % Other assets 1,689,876 (2) 11.8 % 2,017,397 (2) 11.0 % Total $ 14,294,594 100.0 % $ 18,304,844 100.0 % (1) Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans. (2) Includes our investment in PHP Holdings of approximately $ 150 million and $ 700 million as of December 31, 2024 and 2023, respectively — see Prospect Transaction and tenant update described previously in this same Note 3 for more information. Total Assets by U.S. State and Country (1) As of December 31, 2024 As of December 31, 2023 U.S. States and Other Countries Total Assets Percentage of Total Assets Percentage of Texas $ 1,394,296 9.8 % $ 1,891,482 10.3 % California 935,470 6.4 % 1,252,674 6.8 % Florida 840,876 5.9 % 1,348,210 7.4 % Arizona 379,801 2.7 % 547,789 3.0 % Ohio 327,577 2.3 % 349,140 1.9 % All other states 2,636,587 18.5 % 4,385,814 24.0 % Other domestic assets 951,486 6.6 % 1,397,170 7.6 % Total U.S. $ 7,466,093 52.2 % $ 11,172,279 61.0 % United Kingdom $ 3,985,672 27.9 % $ 4,261,944 23.3 % Switzerland 719,632 5.0 % 735,891 4.0 % Germany 672,343 4.7 % 734,630 4.0 % Spain 247,996 1.7 % 252,529 1.4 % Finland 199,721 1.4 % 218,322 1.2 % All other countries 264,747 1.9 % 309,022 1.7 % Other international assets 738,390 5.2 % 620,227 3.4 % Total international $ 6,828,501 47.8 % $ 7,132,565 39.0 % Grand total $ 14,294,594 100.0 % $ 18,304,844 100.0 % Total Assets by Facility Type (1) As of December 31, 2024 As of December 31, 2023 Facility Types Total Assets Percentage of Total Assets Percentage of General acute care hospitals $ 8,493,331 59.4 % $ 11,764,151 64.3 % Behavioral health facilities 2,376,460 16.7 % 2,576,983 14.1 % Post acute care facilities 1,617,596 11.3 % 1,716,248 9.4 % Freestanding ER/urgent care facilities 117,331 0.8 % 230,065 1.2 % Other assets 1,689,876 11.8 % 2,017,397 11.0 % Total $ 14,294,594 100.0 % $ 18,304,844 100.0 % (1) For geographic and facility type concentration metrics in the tables above, we allocate our investments in unconsolidated operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period. On a revenue basis, concentration for the year ended December 31, 2024 as compared to the two prior years is as follows: The following shows those tenants that represented 10% or more of our total revenues by year (in thousands): 2024 Operator Total Revenues Percentage of Circle $ 205,582 20.7 % Priory 101,675 10.2 % 2023 Operator Total Revenues Percentage of Circle $ 194,390 22.3 % Priory 107,557 12.3 % 2022 Operator Total Revenues Percentage of Steward $ 427,912 27.7 % Circle 189,565 12.3 % Prospect 169,335 11.0 % Total Revenues by Geographic Location For the Years Ended December 31, 2024 2023 2022 Geographic Location Total Revenues Percentage of Total Revenues Percentage of Total Revenues Percentage of Total U.S. $ 561,673 56.4 % $ 407,329 46.7 % $ 1,096,465 71.1 % United Kingdom 359,991 36.2 % 352,594 40.4 % 317,013 20.5 % All other countries 73,883 7.4 % 111,876 12.9 % 129,373 8.4 % Grand total $ 995,547 100.0 % $ 871,799 100.0 % $ 1,542,851 100.0 % Total Revenues by Facility Type For the Years Ended December 31, 2024 2023 2022 Facility Types Total Revenues Percentage of Total Revenues Percentage of Total Revenues Percentage of General acute care hospitals $ 628,622 63.1 % $ 541,888 62.2 % $ 1,167,233 75.7 % Behavioral health facilities 209,668 21.1 % 213,292 24.5 % 204,420 13.2 % Post acute care facilities 139,859 14.0 % 92,787 10.6 % 146,780 9.5 % Freestanding ER/urgent care 17,398 1.8 % 23,832 2.7 % 24,418 1.6 % Total $ 995,547 100.0 % $ 871,799 100.0 % $ 1,542,851 100.0 %

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt (dollar amounts in thousands): As of December 31, As of December 31, Revolving credit facility(A) $ 361,726 $ 1,514,420 Term loan 200,000 200,000 British pound sterling secured term loan due 2024(B) — 133,484 Australian term loan facility(B) — 320,164 British pound sterling term loan due 2025(B) 617,039 891,170 British pound sterling secured term loan due 2034(B) 790,234 — 3.325 % Senior Unsecured Notes due 2025(B) 517,700 551,950 0.993 % Senior Unsecured Notes due 2026(B) 517,700 551,950 2.500 % Senior Unsecured Notes due 2026(B) 625,800 636,550 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) 750,960 763,860 4.625 % Senior Unsecured Notes due 2029 900,000 900,000 3.375 % Senior Unsecured Notes due 2030(B) 438,060 445,585 3.500 % Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 8,919,219 $ 10,109,133 Debt issue costs and discount, net ( 71,107 ) ( 44,897 ) $ 8,848,112 $ 10,064,236 (A) Includes £- million and £ 322 million of GBP-denominated borrowings and € 303 million and € 303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2024 and December 31, 2023, respectively. (B) Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.
Principal Payments Due on Debt	As of December 31, 2024, 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): 2025 $ 1,134,739 2026 2,005,226 2027 1,600,000 2028 750,960 2029 900,000 Thereafter 2,528,294 Total $ 8,919,219
Basic Terms of Senior Unsecured Notes	The following are the basic terms of our senior unsecured notes at December 31, 2024 (par value amounts in thousands): Offering Maturity Date Par Value % of Par Interest Payment Frequency 3.325% Senior Unsecured Notes due 2025 March 24, 2017 March 24, 2025 € 500,000 100.000 % Annually 0.993% Senior Unsecured Notes due 2026 October 6, 2021 October 15, 2026 € 500,000 100.000 % Annually 2.500% Senior Unsecured Notes due 2026 March 24, 2021 March 24, 2026 £ 500,000 99.937 % Annually 5.250% Senior Unsecured Notes due 2026 July 22, 2016 August 1, 2026 $ 500,000 100.000 % Semi-annually 5.000% Senior Unsecured Notes due 2027 September 21, 2017 October 15, 2027 $ 1,400,000 100.000 % Semi-annually 3.692% Senior Unsecured Notes due 2028 December 5, 2019 June 5, 2028 £ 600,000 99.998 % Annually 4.625% Senior Unsecured Notes due 2029 July 26, 2019 August 1, 2029 $ 900,000 99.500 % Semi-annually 3.375% Senior Unsecured Notes due 2030 March 24, 2021 April 24, 2030 £ 350,000 99.448 % Annually 3.500% Senior Unsecured Notes due 2031 December 4, 2020 March 15, 2031 $ 1,300,000 100.000 % Semi-annually

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Income Tax (Expense) Benefit	From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands): For the Years Ended December 31, 2024 2023 2022 Current income tax (expense) benefit: Domestic $ 477 $ ( 7,756 ) $ 1,111 Foreign ( 31,589 ) ( 24,257 ) ( 27,751 ) ( 31,112 ) ( 32,013 ) ( 26,640 ) Deferred income tax (expense) benefit: Domestic ( 465 ) 8,926 ( 15,628 ) Foreign ( 12,524 ) 153,766 ( 13,632 ) ( 12,989 ) 162,692 ( 29,260 ) Income tax (expense) benefit $ ( 44,101 ) $ 130,679 $ ( 55,900 )
Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes	A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on (loss) income before income taxes for the years ended December 31, 2024, 2023, and 2022 is as follows (in thousands): For the Years Ended December 31, 2024 2023 2022 (Loss) income before income tax $ ( 2,364,186 ) $ ( 686,771 ) $ 959,719 Income tax benefit (expense) at the U.S. statutory federal rate 496,479 144,222 ( 201,541 ) Decrease (increase) in income tax resulting from: Foreign rate differential 4,888 ( 4,122 ) 1,826 State income taxes, net of federal benefit — 1,275 ( 1,886 ) U.S. earnings not subject to federal income tax ( 227,080 ) ( 115,189 ) 165,705 Change in valuation allowance ( 301,468 ) ( 45,692 ) ( 11,281 ) Statutory tax rate change — — ( 941 ) Interest disallowance ( 2,965 ) ( 3,421 ) ( 1,737 ) Tax Impact of UK REIT conversion — 160,641 — Other items, net ( 13,955 ) ( 7,035 ) ( 6,045 ) Total income tax (expense) benefit $ ( 44,101 ) $ 130,679 $ ( 55,900 )
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2024 and 2023, components of our deferred tax assets and liabilities were as follows (in thousands): 2024 2023 Deferred tax assets: Operating loss and interest deduction carry forwards $ 263,523 $ 143,683 Depreciation 56,089 45,146 Partnership investments 112,892 15,768 Impairment and other loss reserves 101,834 11,790 Other 8,500 7,109 Total deferred tax assets 542,838 223,496 Valuation allowance ( 418,659 ) ( 117,191 ) Total net deferred tax assets $ 124,179 $ 106,305 Deferred tax liabilities: Property and equipment $ ( 145,835 ) $ ( 158,330 ) Net unbilled revenue ( 82,170 ) ( 65,727 ) Partnership investments ( 21,445 ) — Other ( 3,450 ) ( 10,687 ) Total deferred tax liabilities ( 252,900 ) ( 234,744 ) Net deferred tax asset (liability) $ ( 128,721 ) $ ( 128,439 )
Schedule of Net Operating Losses ("NOL") and Other Tax Attribute Carryforwards	At December 31, 2024, we had net operating losses ("NOL") and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 704,434 $ 453,615 Tax-effected NOL carryforwards $ 151,942 $ 112,111 Valuation allowance ( 151,942 ) ( 6,273 ) Net deferred tax asset - NOL carryforwards $ — $ 105,838 Expiration periods 2025 - indefinite indefinite
Schedule of Per Share Distributions to Stockholders	A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, Per share: 2024 2023 2022 Ordinary dividend (1) $ — $ 1.0639 $ 0.4703 Long-term capital gain (2) — 0.1061 0.6797 Return of capital 0.3800 — — Total $ 0.3800 (3) $ 1.1700 $ 1.1500 (1) For the years ended December 31, 2023 and 2022, includes Section 199A dividends of 1.0639 and 0.4703 , respectively. (2) For the years ended December 31, 2023 and 2022, includes Unrecaptured Section 1250 gains of 0.1061 and 0.2574 , respectively. (3) The dividend declared on November 21, 2024 and paid January 9, 2025 will be applicable to the 2025 tax year and thus is not reflected in the table above.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Calculation of Earnings Per Share	Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (in thousands): For the Years Ended December 31, 2024 2023 2022 Numerator: Net (loss) income $ ( 2,408,287 ) $ ( 556,092 ) $ 903,819 Non-controlling interests’ share in earnings ( 1,984 ) ( 384 ) ( 1,222 ) Participating securities’ share in earnings ( 946 ) ( 1,644 ) ( 1,602 ) Net (loss) income, less participating securities’ share in $ ( 2,411,217 ) $ ( 558,120 ) $ 900,995 Denominator: Basic weighted-average common shares 600,248 598,518 598,634 Dilutive potential common shares(1) — — 203 Diluted weighted-average common shares 600,248 598,518 598,837 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (in thousands): For the Years Ended December 31, 2024 2023 2022 Numerator: Net (loss) income $ ( 2,408,287 ) $ ( 556,092 ) $ 903,819 Non-controlling interests’ share in earnings ( 1,984 ) ( 384 ) ( 1,222 ) Participating securities’ share in earnings ( 946 ) ( 1,644 ) ( 1,602 ) Net (loss) income, less participating securities’ share in $ ( 2,411,217 ) $ ( 558,120 ) $ 900,995 Denominator: Basic weighted-average units 600,248 598,518 598,634 Dilutive potential units(1) — — 203 Diluted weighted-average units 600,248 598,518 598,837 (1) The above computation of diluted earnings per share does not include 17,162 and 32,382 potential common shares/units for the years ended December 31, 2024 and 2023, respectively.

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Stock-based Award Activity	The following summarizes award activity in 2024 and 2023 (which includes awards granted in 2024, 2023, and any applicable prior years), respectively: For the Year Ended December 31, 2024: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 1,144,796 $ 13.01 12,576,792 $ 10.20 Awarded 1,519,207 $ 4.36 345,000 $ 7.78 Vested ( 993,312 ) $ 10.62 ( 1,179,631 ) $ 16.81 Forfeited ( 29,191 ) $ 9.58 ( 1,428,940 ) $ 10.40 Nonvested awards at end of year 1,641,500 $ 6.50 10,313,221 $ 9.33 For the Year Ended December 31, 2023: Vesting Based Vesting Based on Shares Weighted-Average Shares Weighted-Average Nonvested awards at beginning of the year 810,483 $ 21.02 4,349,081 $ 18.26 Awarded 1,210,448 $ 10.36 10,270,260 $ 8.47 Vested ( 864,482 ) $ 16.60 ( 1,591,846 ) $ 19.65 Forfeited ( 11,653 ) $ 12.27 ( 450,703 ) $ 12.44 Nonvested awards at end of year 1,144,796 $ 13.01 12,576,792 $ 10.20

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2024
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): December 31, 2024 December 31, 2023 Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 36,327 $ 36,432 $ 45,059 $ 45,476 Loans(1) 467,120 (2) 470,380 1,302,727 (2) 1,202,383 Debt, net ( 8,848,112 ) ( 7,301,395 ) ( 10,064,236 ) ( 8,256,465 ) (1) Excludes the convertible loan made in May 2023 to PHP Holdings 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. (2) Includes $ 7.9 million and $ 162.4 million of mortgage loans, a $ 315.5 million and $ 323.8 million shareholder loan included in investments in unconsolidated real estate joint ventures, $ 39.7 million and $ 526.9 million of loans that are part of our investments in unconsolidated operating entities, and $ 104.0 million and $ 289.6 million of other loans at December 31, 2024 and December 31, 2023, respectively.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At December 31, 2024 and 2023, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2024 As of December 31, 2023 Asset (Liability) Fair Value Original Fair Value Original Asset Type Classification Mortgage loans $ 111,985 $ 129,968 $ 146,892 $ 146,892 Mortgage loans Equity investment and other loans 154,229 910,594 939,903 912,999 Investments in unconsolidated
Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations	Basis Point Change in Marketability Discount Estimated Increase + 100 basis points $ ( 1,737 ) - 100 basis points 1,737

Leases (Lessee) (Tables)

Leases (Lessee) (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Summary of Lease Expense	The following is a summary of our lease expense (in thousands): Income Statement For the Years Ended December 31, Classification 2024 2023 2022 Operating lease cost (1) (2) $ 10,725 $ 11,653 $ 12,175 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 51 Interest on lease liabilities Interest 128 128 128 Sublease income Other ( 3,259 ) ( 4,178 ) ( 4,485 ) Total lease cost $ 7,645 $ 7,654 $ 7,869 (1) Includes short-term leases. (2) $ 5.1 million, $ 6.0 million, and $ 5.7 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2024, 2023, and 2022, respectively.
Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments	Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2024 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Net 2025 $ 8,047 $ 131 $ ( 3,503 ) $ 4,675 2026 7,239 133 ( 3,006 ) 4,366 2027 6,698 134 ( 2,715 ) 4,117 2028 6,786 135 ( 2,723 ) 4,198 2029 6,850 137 ( 2,731 ) 4,256 Thereafter 175,000 4,245 ( 39,584 ) 139,661 (1) Total undiscounted minimum lease payments $ 210,620 $ 4,915 $ ( 54,262 ) $ 161,273 Less: interest ( 132,035 ) ( 2,979 ) Present value of lease liabilities $ 78,585 $ 1,936 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases .
Summary of Supplemental Balance Sheet Information	Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet December 31, December 31, Right of use assets: Operating leases - real estate Land $ 46,881 $ 63,675 Finance leases - real estate Land 1,632 1,683 Total real estate right of use assets $ 48,513 $ 65,358 Operating leases - corporate Other assets 20,701 24,243 Total right of use assets $ 69,214 $ 89,601 Lease liabilities: Operating leases Obligations to tenants and $ 78,585 $ 101,812 Financing leases Obligations to tenants and 1,936 1,938 Total lease liabilities $ 80,521 $ 103,750 Weighted-average remaining lease term: Operating leases 32.6 32.9 Finance leases 31.9 32.9 Weighted-average discount rate: Operating leases 6.1 % 6.2 % Finance leases 6.6 % 6.6 %
Summary of Supplemental Cash Flow Information	The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2024 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows used for operating leases $ 8,447 $ 8,210 $ 7,169 Operating cash flows used for finance leases 130 129 128 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases — — 23,066

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2024
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Summary of Other Assets	The following is a summary of our other assets on our consolidated balance sheets (in thousands): As of December 31, 2024 2023 Debt issue costs, net(1) $ 5,675 $ 8,513 Other corporate assets 330,638 275,688 Prepaids and other assets 135,091 173,710 Total other assets $ 471,404 $ 457,911 (1) Relates to our revolving credit facility

Organization - Additional Infor

Organization - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2024 State Facility Country
Business Acquisition [Line Items]
Percentage of leased assets owned	100%
Number of facilities | Facility	396
Number of states | State	31
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_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100%
Expected lease-up periods for estimating lost rentals, in months	6 months
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90%	90%	90%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
Real estate and other impairment charges, net	$ 1,825,402	$ 376,907	$ 268,375
Minimum percentage of reconciling items quantitative threshold of the statutory tax	5%
Time-Based Awards [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] | Minimum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] | Maximum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	5 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Summary of Carrying Value and Classification of the Assets and Maximum Exposure (Details) - Variable Interest Entity, Not Primary Beneficiary [Member] $ in Thousands	Dec. 31, 2024 USD ($)
Investments in Unconsolidated Operating Entities [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 149,027
Mortgage and Other Loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	117,187
Loans, Net And Equity Investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	149,027
Loans, Net Two [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 117,268

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)	Dec. 31, 2024
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	38 years 7 months 6 days
Lease Intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	28 years 3 months 18 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	14 years 3 months 18 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	5 years 2 months 12 days

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Summary of Credit Loss Reserves (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Balance at beginning of the year	$ 96,001	$ 121,146
Provision for credit loss, net	1,241,020	10,194
Expected credit loss reserve written off or related to financial instruments sold, repaid, or satisfied	(825,548)	(35,339)
Balance at end of year	$ 511,473	$ 96,001

Real Estate and Other Activit_3

Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Total assets acquired		$ 105,618	$ 235,187	$ 1,332,962
Liabilities assumed		(2,290)		(25,727)
Loans repaid	[1]	0	(22,900)	0
Total net assets acquired		105,618	212,287	1,332,962
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired		0	28,916	135,301
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		0	114,966	487,698
Intangible Lease Assets [Member]
Business Acquisition [Line Items]
Total assets acquired		0	16,305	45,394
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		0	0	159,735
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		0	25,000	0
Investments in Unconsolidated Real Estate Joint Ventures [Member]
Business Acquisition [Line Items]
Total assets acquired		107,908	0	399,456
Investments In Unconsolidated Operating Entities [Member]
Business Acquisition [Line Items]
Total assets acquired		$ 0	$ 50,000	$ 131,105
[1] The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.

Real Estate and Other Activit_4

Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail) $ in Thousands, £ in Millions		12 Months Ended
		Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2023 GBP (£)
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		23 years 6 months
Advanced to the mortgage loan | $	[1]	$ 0	$ 22,900	$ 0
Mortgage Loans [Member] | Springstone Health Opco, LLC [Member]
Business Acquisition [Line Items]
Advanced to the mortgage loan | £					£ 23
Intangible Lease Assets [Member]
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)			24 years 9 months 18 days	21 years 3 months 18 days
[1] The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.

Real Estate and Other Activit_5

Real Estate and Other Activities - 2024 Activity - Additional Information (Details) $ in Thousands		12 Months Ended
	Apr. 12, 2024 USD ($) Hospital	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Gain (loss) on real estate dispositions				$ 100,000
Investments in unconsolidated real estate joint ventures		$ 1,156,397	$ 1,474,455
Payments of term debt		$ (701,809)	$ (988,162)	$ (869,606)
Derivative Liability Statement of Financial Position Extensible Enumeration Not Disclosed Flag		true
CommonSpirit Health [Member]
Business Acquisition [Line Items]
Leased real estate acquire lease base	$ 1,200,000
Derivative liability	$ 2,300
Institutional Asset Manager [Member]
Business Acquisition [Line Items]
Number Of Utah Hospitals Sold | Hospital	5
Agreegate agreed valuation	$ 1,200,000
Gain (loss) on real estate dispositions	380,000	$ 360,000
Write-off of unbilled straight-line rent receivables	$ 20,000
Percentage Of Interest Retained In Venture	25%
Investments in unconsolidated real estate joint ventures	$ 108,000
Percentage of interest sold in venture	75%
Proceeds from divestiture of interest in joint venture	$ 886,000
Additional cash proceeds of non-recourse secured finance	190,000
Payments of term debt	$ (1,100,000)

Real Estate and Other Activit_6

Real Estate and Other Activities - 2023 Activity - Additional Information (Detail) $ in Thousands, £ in Millions

1 Months Ended

3 Months Ended

12 Months Ended

May 23, 2023 USD ($)

Apr. 14, 2023 USD ($) Facility

Apr. 14, 2023 GBP (£) Facility

Feb. 07, 2023 USD ($) Facility

Jul. 29, 2022 USD ($)

Apr. 25, 2022 USD ($) Facility

Aug. 31, 2019 USD ($) Hospital

Mar. 31, 2024 USD ($)

Jun. 30, 2023 USD ($) Facility

Jun. 30, 2023 GBP (£) Facility

Mar. 31, 2023 USD ($)

Dec. 31, 2022 USD ($)

Dec. 31, 2024 USD ($)

Dec. 31, 2023 USD ($)

Dec. 31, 2022 USD ($) Facility

Jun. 30, 2022 USD ($)

Business Acquisition [Line Items]

Net impairment charge

$ 225,000

$ 79,000

$ 180,000

Additional mortgage loan

$ 1,332,962

105,618

$ 235,187

$ 1,332,962

PHP Holdings [Member]

Business Acquisition [Line Items]

Capital restructuring costs

654,000

Equity investment

68,000

Convertible loan

$ 586,000

Prospect [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 1,500,000

Term loan

$ 112,900

Net impairment charge

280,000

Additional mortgage loan

$ 100,000

Investment, Type [Extensible Enumeration]

Mortgage Loans [Member]

Pay down of debt instruments

$ 375,000

Reconstitution of asset

1,700,000

Prospect [Member] | Maximum [Member]

Business Acquisition [Line Items]

First lien secured loan

75,000

Prospect [Member] | Acute Care Campus [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

14

Prospect [Member] | Mortgage Loans [Member]

Business Acquisition [Line Items]

First lien secured loan

150,000

Prospect [Member] | PHP Holdings [Member]

Business Acquisition [Line Items]

Revenue for rent and interest

$ 82,000

Unpaid rent and interest

112,900

Convertible loan

$ 50,000

Prospect [Member] | PHP Holdings [Member] | Mortgage Loans [Member]

Business Acquisition [Line Items]

Unpaid rent and interest

$ 151,000

$ 151,000

Prospect [Member] | Pennsylvania [Member]

Business Acquisition [Line Items]

Carrying value of lease requiring residual value guarantee

170,000

170,000

Unbilled rent accruals

$ 112,000

Prospect [Member] | Pennsylvania [Member] | Maximum [Member]

Business Acquisition [Line Items]

Carrying value of lease requiring residual value guarantee

$ 250,000

$ 250,000

General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 26,000

$ 80,000

Number of facilities acquired | Facility

8

2

6

Lease extension expiration term

5 years

Lease extension expiration year

2041

Behavioral Health Hospitals [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

5

5

3

3

Payment for acquisition

$ 58,000

£ 44

$ 77,000

£ 70

Number of leased facilities | Facility

5

5

Springstone Health Opco, LLC [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 250,000

Additional mortgage loan

$ 205,000

Business Combination, Consideration Transferred, Equity Interests Issued and Issuable

$ 12,000

Real Estate and Other Activit_7

Real Estate and Other Activities - 2022 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions

12 Months Ended

Feb. 07, 2023 Facility

Dec. 09, 2022 USD ($) Facility

Dec. 09, 2022 GBP (£) Facility

Jul. 29, 2022 USD ($)

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 (£)

Dec. 31, 2024 USD ($)

Dec. 31, 2022 USD ($) Facility

Dec. 31, 2023 USD ($)

Business Acquisition [Line Items]

Gain (loss) on real estate dispositions

$ 100,000

Investments in unconsolidated real estate joint ventures

$ 1,156,397

$ 1,474,455

Acquisition loan

105,618

$ 1,332,962

$ 235,187

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

Corporate Joint Venture [Member]

Business Acquisition [Line Items]

Investments in unconsolidated real estate joint ventures

$ 400,000

United Kingdom [Member] | Behavioral Health Facilities [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

6

6

Purchase price of acquisition

$ 286,000

£ 233

Real estate financing by third party seller | £

£ 105

Real Estate Partnership [Member]

Business Acquisition [Line Items]

Percentage of equity investment

50%

General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

8

2

6

Purchase price of acquisition

$ 26,000

$ 80,000

Lease extension expiration year

2041

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

General Acute Care Hospitals [Member] | Arizona [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

1

General Acute Care Hospitals [Member] | Spain [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

3

Purchase price of acquisition | €

€ 27

Massachusetts-based General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

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

Massachusetts-based General Acute Care Hospitals [Member] | Macquarie Asset Management [Member]

Business Acquisition [Line Items]

Percentage of equity investment

50%

Real Estate and Other Activit_8

Real Estate and Other Activities - 2021 Activity - Additional Information (Detail) $ in Millions					12 Months Ended
	Feb. 07, 2023 Facility	Jul. 29, 2022 USD ($)	Apr. 25, 2022 USD ($) Facility	Mar. 14, 2022 USD ($) Facility	Dec. 31, 2022 Facility	Mar. 11, 2022 USD ($)
Business Acquisition [Line Items]
Deferred income tax liabilities and other liabilities, incurred						$ 26
General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition		$ 26	$ 80
Number of facilities acquired | Facility	8		2		6
Lease extension expiration term	5 years
Lease extension expiration year	2041
Massachusetts Based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Purchase price of acquisition				$ 1,700
Nonrecourse Secured Debt Percentage Of Asset Value				55%
Number of facilities acquired | Facility				8

Real Estate and Other Activit_9

Real Estate and Other Activities - Development and Capital Addition Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
Business Acquisition [Line Items]
Commitment	$ 144,181
Costs Paid as of December 31, 2024	74,165
Cost remaining	70,016
Lifepoint Behavioral [Member] | ARIZONA
Business Acquisition [Line Items]
Commitment	10,504
Costs Paid as of December 31, 2024	5,411
Cost remaining	5,093
Lifepoint Behavioral [Member] | KANSAS
Business Acquisition [Line Items]
Commitment	20,183
Costs Paid as of December 31, 2024	11,584
Cost remaining	8,599
Lifepoint Behavioral [Member] | ARIZONA
Business Acquisition [Line Items]
Commitment	10,659
Costs Paid as of December 31, 2024	470
Cost remaining	10,189
Surgery Partners [Member] | Idaho [Member]
Business Acquisition [Line Items]
Commitment	15,993
Costs Paid as of December 31, 2024	5,590
Cost remaining	10,403
IMED [Member] | Spain [Member]
Business Acquisition [Line Items]
Commitment	36,294
Costs Paid as of December 31, 2024	29,261
Cost remaining	7,033
IMED [Member] | Spain [Member]
Business Acquisition [Line Items]
Commitment	49,749
Costs Paid as of December 31, 2024	21,355
Cost remaining	28,394
Other [Member] | Various [Member]
Business Acquisition [Line Items]
Commitment	799
Costs Paid as of December 31, 2024	494
Cost remaining	$ 305

Real Estate and Other Activi_10

Real Estate and Other Activities - Development and Capital Addition Activities - Additional Information (Details) € in Millions, $ in Millions	3 Months Ended
	Dec. 31, 2024 USD ($) Projects	Mar. 31, 2024 USD ($)	Mar. 31, 2024 EUR (€)
Business Acquisition [Line Items]
Construction amount	$ 30
Behavioral Health Hospitals [Member]
Business Acquisition [Line Items]
Profit (loss) from real estate operations		$ 35.4
General Acute Care Facility [Member]
Business Acquisition [Line Items]
Profit (loss) from real estate operations		$ 49	€ 46
Massachusetts [Member]
Business Acquisition [Line Items]
Redevelopment of recovery received from settlement excess of damage to property	$ 24
TEXAS And MASSACHUSETTS [Member]
Business Acquisition [Line Items]
Number of other development projects | Projects	2
Idaho [Member]
Business Acquisition [Line Items]
Profit (loss) from real estate operations	$ 50

Real Estate and Other Activi_11

Real Estate and Other Activities - Disposals - 2024 Activity Additional Information (Detail) $ in Thousands, € in Millions

3 Months Ended

12 Months Ended

Sep. 18, 2024 Facility

Aug. 14, 2024 USD ($) Freestanding

Jul. 23, 2024 USD ($) Bed Freestanding

Apr. 12, 2024 USD ($) Hospital

Apr. 09, 2024 USD ($) Property

May 01, 2023 USD ($)

Sep. 01, 2022 USD ($) Property

Dec. 31, 2024 USD ($)

Sep. 30, 2024 USD ($)

Mar. 31, 2024 USD ($)

Mar. 31, 2024 EUR (€)

Mar. 31, 2023 Facility

Dec. 31, 2024 USD ($) Facility

Dec. 31, 2023 USD ($)

Dec. 31, 2022 USD ($) Facility

Debt Instrument [Line Items]

Investments in unconsolidated real estate joint ventures

$ 1,156,397

$ 1,156,397

$ 1,474,455

Revolving credit facility amount paid

701,809

988,162

$ 869,606

Number of facilities sold | Facility

3

15

Real estate held for sale

34,019

34,019

0

Proceeds from sale of facilities

$ 522,000

Gain (loss) on sale of real estate

478,693

$ (1,815)

536,755

Gain (loss) on real estate dispositions

$ 100,000

Idaho [Member]

Debt Instrument [Line Items]

Profit (loss) from real estate operations

50,000

Five Prime Properties

Debt Instrument [Line Items]

Gain (loss) on real estate dispositions

23,000

Straight-line rent write-offs

30,000

Dignity health

Debt Instrument [Line Items]

Gain (loss) on real estate dispositions

65,000

Straight-line rent write-offs

20,000

UCHealth

Debt Instrument [Line Items]

Gain (loss) on real estate dispositions

24,000

Straight-line rent write-offs

16,000

Freestanding emergency departments | Dignity health

Debt Instrument [Line Items]

Number of facilities sold | Freestanding

7

Freestanding emergency departments | UCHealth

Debt Instrument [Line Items]

Number of facilities sold | Freestanding

11

General hospital and freestanding emergency departments

Debt Instrument [Line Items]

Gain (loss) on sale of real estate

$ 40,000

$ 85,000

Non-cash straight-line rent receivables

16,000

20,000

General hospital and freestanding emergency departments | Dignity health

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 160,000

General hospital and freestanding emergency departments | UCHealth

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 86,000

Arizona General Hospital | Dignity health

Debt Instrument [Line Items]

Number of bed sold | Bed

50

Space Coast Properties

Debt Instrument [Line Items]

Proceeds from sale of facilities

440,000

Space Coast Properties | Orlando Health

Debt Instrument [Line Items]

Gain (loss) on sale of real estate

2,000

Space Coast Properties | Florida | Orlando Health

Debt Instrument [Line Items]

Number of facilities sold | Facility

3

Watsonville Facility | Pajaro Valley Healthcare District Corporation

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 40,000

Gain (loss) on sale of real estate

$ 4,000

Institutional Asset Manager [Member]

Debt Instrument [Line Items]

Number of Utah hospitals sold | Hospital

5

Agreegate agreed valuation

$ 1,200,000

Percentage of interest sold in venture

75%

Percentage of interest retained in venture

25%

Investments in unconsolidated real estate joint ventures

$ 108,000

Proceeds from divestiture of interest in joint venture

886,000

Additional cash proceeds of non-recourse secured finance

190,000

Revolving credit facility amount paid

1,100,000

Gain (loss) on real estate dispositions

380,000

360,000

Write-off of unbilled straight-line rent receivables

20,000

Prime Healthcare Services, Inc. Facilities [Member]

Debt Instrument [Line Items]

Number of properties sold | Property

5

11

Profit (loss) from real estate operations

$ 14,000

Number of facilities sold | Facility

6

Number of ancillary facilities sold | Facility

2

Proceeds from sale of facilities

$ 250,000

$ 366,000

Gain (loss) on real estate dispositions

53,000

Proceeds from interest-bearing mortgage loan

100,000

Non-cash straight-line rent write-offs

30,000

Lease purchase option value

238,000

Lease purchase option price reverts

$ 260,000

Prime Healthcare Services, Inc. Facilities [Member] | Minimum [Member]

Debt Instrument [Line Items]

Inflation-based Percentage for Amended Lease

2%

Prime Healthcare Services, Inc. Facilities [Member] | Maximum [Member]

Debt Instrument [Line Items]

Inflation-based Percentage for Amended Lease

4%

Behavioral Health Hospitals [Member]

Debt Instrument [Line Items]

Profit (loss) from real estate operations

$ 35,400

General Acute Care Facility [Member]

Debt Instrument [Line Items]

Profit (loss) from real estate operations

$ 49,000

€ 46

CommonSpirit Health [Member]

Debt Instrument [Line Items]

Leased real estate acquire lease base

1,200,000

Derivative liability

$ 2,300

Straight-line rent write-offs

$ 95,000

$ 20,000

Amortization of Intangible Assets

$ 286,000

Steward Health Care System LLC [Member]

Debt Instrument [Line Items]

Bankruptcy claims amount settled

$ 395,000

$ 395,000

Real Estate and Other Activi_12

Real Estate and Other Activities - Disposals - 2023 Activity Additional Information (Detail) $ in Millions, $ in Millions

1 Months Ended

3 Months Ended

12 Months Ended

Sep. 18, 2024 USD ($)

Apr. 09, 2024 USD ($)

Oct. 10, 2023 AUD ($) Facility

May 18, 2023 AUD ($) Facility

Mar. 29, 2023 Facility

Mar. 08, 2023 USD ($)

Sep. 01, 2022 USD ($)

Oct. 31, 2024 USD ($)

Mar. 31, 2024 USD ($)

Mar. 31, 2023 USD ($) Facility

Mar. 31, 2023 AUD ($) Facility

Dec. 31, 2024 USD ($) Facility

Dec. 31, 2022 USD ($) Facility

Debt Instrument [Line Items]

Number of facilities sold | Facility

3

3

15

Proceeds from sale of facilities

$ 522

Net impairment charge

$ 225

$ 79

$ 180

Straight-line rent receivables

37.4

Estimated fees to sell the hospitals

8

Deferred gains from our interest rate swap and foreign currency translation in AOCI

$ 16

Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]

Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax

Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax

General Acute Care Facility [Member] | Australia [Member]

Debt Instrument [Line Items]

Number of facilities sold | Facility

11

Australia Transaction [Member]

Debt Instrument [Line Items]

Number of facilities sold | Facility

7

Proceeds from sale of facilities

$ 470

$ 730

$ 1,200

Number of remaining facilities sold | Facility

4

Steward Health Care System LLC [Member]

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 40

$ 47

Prime Healthcare Services, Inc. Facilities [Member]

Debt Instrument [Line Items]

Number of facilities sold | Facility

6

Proceeds from sale of facilities

$ 250

$ 366

Prime [Member]

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 100

Non-cash impairment charge

$ 11

Real Estate and Other Activi_13

Real Estate and Other Activities - Disposals - 2022 Activity Additional Information (Detail) $ in Millions				3 Months Ended	12 Months Ended
	Apr. 09, 2024 USD ($) Property	Sep. 01, 2022 USD ($) Property	Mar. 14, 2022 USD ($) Facility	Mar. 31, 2023 Facility	Dec. 31, 2024 Facility	Dec. 31, 2022 USD ($) Facility Property
Debt Instrument [Line Items]
Number of facilities sold | Facility				3		15
Proceeds from sale of facilities						$ 522
Number of ancillary properties sold | Property						5
Gain (loss) on real estate dispositions						$ 100
Disposal Group, Not Discontinued Operations [Member]
Debt Instrument [Line Items]
Straight-line rent write-offs						$ 42
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
Prime Healthcare Services, Inc. Facilities [Member]
Debt Instrument [Line Items]
Number of facilities sold | Facility					6
Number of properties sold | Property	5	11
Proceeds from sale of facilities	$ 250	$ 366
Gain (loss) on real estate dispositions	$ 53

Real Estate and Other Activi_14

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Revenues			$ 995,547	$ 871,799	$ 1,542,851
Real estate depreciation and amortization			(447,657)	(603,360)	(332,977)
Real estate impairment charges	$ (225,000)	$ (79,000)	(180,000)
Other (expense) income			(615,565)	7,586	15,344
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Revenues			72,362	88,938	220,183
Real estate depreciation and amortization			(26,476)	(331,099)	(53,350)
Property-related expenses			(8,277)	(4,697)	(1,759)
Real estate impairment charges			(129,159)	0	0
Other (expense) income			480,416	(90)	(19)
(Loss) Income from real estate dispositions, net			$ 388,866	$ (246,948)	$ 165,055

Real Estate and Other Activi_15

Real Estate and Other Activities - Summary of Operating Results from Properties Sold (Parenthetical) (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Net impairment charge	$ 225,000	$ 79,000	$ 180,000
Prime [Member]
Business Acquisition [Line Items]
Non-cash impairment charge		$ 11,000
Disposal Group, Not Discontinued Operations [Member]
Business Acquisition [Line Items]
Straight-line rent write-offs					$ 42,000
Net impairment charge			$ 129,159	$ 0	$ 0

Real Estate and Other Activi_16

Real Estate and Other Activities - Other Disposal Transactions - Additional Information (Detail) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2023 Facility	Dec. 31, 2022 USD ($) Facility
Business Acquisition [Line Items]
Proceeds from sale of facilities		$ 522
Gain (loss) on real estate dispositions		$ 100
Number of facilities sold | Facility	3	15

Real Estate and Other Activi_17

Real Estate and Other Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Sep. 11, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Intangible lease assets		$ 804,081	$ 1,034,810
Accumulated amortization, net		600,000	900,000
Amortization expense related to intangible lease assets	$ 205,600	$ 332,500	55,900	$ 55,900
Capitalized lease intangibles, weighted average life (in years)		23 years 6 months
In-place lease intangibles [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets	$ 170,000	$ 149,000	$ 286,000

Real Estate and Other Activi_18

Real Estate and Other Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2024 USD ($)
Business Combinations [Abstract]
2025	$ 29,201
2026	29,052
2027	28,730
2028	28,566
2029	$ 26,726

Real Estate and Other Activi_19

Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2024 Lease Property
Lessor Lease Description [Line Items]
Lease renewal term	5 years
Annual rent escalations	99%
Minimum [Member]
Lessor Lease Description [Line Items]
Term of lease	15 years
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	13
Number of financing leases	5
Prospect [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases | Property	9

Real Estate and Other Activi_20

Real Estate and Other Activities - Summary of Total Future Contractual Minimum Lease Payments to be Received (Detail) $ in Thousands	Dec. 31, 2024 USD ($)
Lessor Lease Description [Line Items]
2025	$ 840,160
2026	931,291
2027	980,198
2028	994,694
2029	998,568
Thereafter	23,819,714
Future minimum lease payments to be received	28,564,625
Operating Leases [Member]
Lessor Lease Description [Line Items]
2025	721,305
2026	810,002
2027	856,426
2028	868,390
2029	869,681
Thereafter	20,744,147
Future minimum lease payments to be received	24,869,951
Financing Leases [Member]
Lessor Lease Description [Line Items]
2025	118,855
2026	121,289
2027	123,772
2028	126,304
2029	128,887
Thereafter	3,075,567
Future minimum lease payments to be received	$ 3,694,674

Real Estate and Other Activi_21

Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 591,142	$ 611,669
Estimated unguaranteed residual values	203,818	203,818
Less: Unearned income and allowance for credit loss	(547,770)	(571,059)
Net investment in direct financing leases	247,190	244,428
Other financing leases (net of allowance for credit loss)	810,580	987,202
Total investment in financing leases	$ 1,057,770	$ 1,231,630

Real Estate and Other Activi_22

Real Estate and Other Activities - Other Leasing Activities - Additional Information (Details)	Dec. 31, 2024
Business Combinations [Abstract]
Percentage of vacant on leased property	1%

Real Estate and Other Activi_23

Real Estate and Other Activities - Steward Health Care System - Additional Information (Details) $ in Thousands			1 Months Ended	12 Months Ended
	Sep. 18, 2024 USD ($) Property	Sep. 11, 2024 USD ($)	Oct. 31, 2024 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Business Acquisition [Line Items]
Proceeds from sale of facilities						$ 522,000
Real estate and other impairment charges, net				$ 1,825,402	$ 376,907	$ 268,375
In-place lease intangibles [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets		$ 170,000		$ 149,000	$ 286,000
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of properties | Property	23
Proceeds from sale of facilities	$ 40,000		$ 47,000

Real Estate and Other Activi_24

Real Estate and Other Activities - Schedule of Impairment Charges, Net (Details) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Total revenues		$ 995,547	$ 871,799	$ 1,542,851
Real estate and other impairment charges, net		(1,825,402)	(376,907)	(268,375)
(Loss) earnings from equity interests		(366,642)	13,967	$ 40,800
Steward Health Care System L L C [Member]
Business Acquisition [Line Items]
Total		1,563	714
Steward Health Care System L L C [Member] | Reserve for unpaid rent and interest and straight-line rent receivables [Member]
Business Acquisition [Line Items]
Total revenues		0	413
Steward Health Care System L L C [Member] | Working capital and other loans [Member]
Business Acquisition [Line Items]
Real estate and other impairment charges, net	[1]	787	0
Steward Health Care System L L C [Member] | Investment in Massachusetts partnership [Member]
Business Acquisition [Line Items]
(Loss) earnings from equity interests	[2]	445	30
Steward Health Care System L L C [Member] | Real estate [Member]
Business Acquisition [Line Items]
Real estate and other impairment charges, net	[2]	277	100
Steward Health Care System L L C [Member] | Equity investment and other [Member]
Business Acquisition [Line Items]
Real estate and other impairment charges, net	[1]	$ 54	$ 171
[1] For our non-real estate investments in Steward, we compared our carrying value of all such investments to the fair value of the underlying collateral, which was no value after the global settlement and our release of claims against Steward as discussed above. The three Space Coast properties and certain excess properties previously leased to Steward were deemed held for sale in the 2024 third quarter. We recognized a real estate impairment charge of approximately $ 180 million to adjust our net book value to align with fair value less cost to sell based on expected proceeds, including from a binding agreement for the Space Coast properties. For the other real estate held for use, we made a comparison of the projected undiscounted future cash flows with the net book value of each asset. For those properties where the carrying value was deemed not recoverable, we recorded an impairment charge to reduce the carrying value to its estimated fair value. For the real estate in the Massachusetts partnership, there was no fair value as we transitioned those properties to the mortgage lender to satisfy the mortgage debt. For the remaining properties (less than 10 in total in 2024 and 2023), we, along with assistance from a third-party, independent valuation firm, estimated fair value using a combination of cost, market, and income approaches using Level 3 inputs. The cost approach used comparable sales to value the land and cost manuals to value the improvements. The value derived from the market approach was based on sale prices of similar properties. For the income approach, we divided the expected operating income (rent revenue less expenses, if any) from the property by a market capitalization rate (range from 8 % to 10 %).

Real Estate and Other Activi_25

Real Estate and Other Activities - Schedule of Impairment Charges Net (Parenthetical) (Details) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2024
Business Acquisition [Line Items]
Real estate impairment charges	$ 225	$ 79	$ 180
Steward Health Care System LLC [Member] | Income Valuation Approach [Member] | Level 3 Inputs [Member] | Minimum [Member]
Business Acquisition [Line Items]
Market capitalization rate			8%
Steward Health Care System LLC [Member] | Income Valuation Approach [Member] | Level 3 Inputs [Member] | Maximum [Member]
Business Acquisition [Line Items]
Market capitalization rate			10%

Real Estate and Other Activi_26

Real Estate and Other Activities - Re-tenanting Activity - Additional Information (Detail) - Retenanting Activity [Member] $ in Millions	3 Months Ended		12 Months Ended
	Jun. 30, 2026	Dec. 31, 2025	Dec. 31, 2026	Dec. 31, 2024 USD ($) Property	Sep. 18, 2024 Property
Business Acquisition [Line Items]
Number of properties					23
Number of operators					6
Number of leased facilities				18
Short term working capital loan to operators | $				$ 100
Percentage of net book value of total assets re-tenanted or sold				1%
Forecast [Member]
Business Acquisition [Line Items]
Percentage of contractual rent	78%	57%	100%

Real Estate and Other Activi_27

Real Estate and Other Activities - Other Activity - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($)
Business Acquisition [Line Items]
Received rent	$ 38
Steward [Member]
Business Acquisition [Line Items]
Rent and interest revenue	40
Massachusetts-Based Steward [Member]
Business Acquisition [Line Items]
Received rent	$ 76

Real Estate and Other Activi_28

Real Estate and Other Activities - Prospect - Additional Information (Details) $ in Thousands		1 Months Ended	3 Months Ended			9 Months Ended	12 Months Ended
	Oct. 05, 2022 USD ($) Facility	May 31, 2023 USD ($)	Dec. 31, 2024 USD ($)	Sep. 30, 2024 USD ($)	Mar. 31, 2023 Facility	Sep. 30, 2024 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($) Facility
Business Acquisition [Line Items]
Revenues							$ 995,547	$ 871,799	$ 1,542,851
Number of facilities sold | Facility					3				15
Real estate and other impairment charges, net							(1,825,402)	(376,907)	$ (268,375)
Loan impairment charges				$ 425,000
Prospect [Member]
Business Acquisition [Line Items]
Rental Revenue							25,000	14,000
Interest received on asset-backed loan							3,800
Revenues								96,000
Asset backed loan outstanding							75,000
Recover of investments in Prospect			$ 835,000				835,000
Prospect [Member] | PHP Holdings [Member]
Business Acquisition [Line Items]
Investment received in lieu of cash								$ 82,000
Change in fair value adjustments						$ 498,000	50,000
Investments			150,000				$ 150,000
Asset backed loan outstanding		$ 75,000
Loan impairment charges			$ 400,000
Prospect [Member] | Prospect [Member] | Connecticut [Member]
Business Acquisition [Line Items]
Number of facilities sold | Facility	3
Excepted proceeds in cash	$ 355,000
Prospect [Member] | Minimum [Member] | Level 3 Inputs [Member] | Income Valuation Approach [Member]
Business Acquisition [Line Items]
Market capitalization rate							8.25%
Prospect [Member] | Maximum [Member] | Level 3 Inputs [Member] | Income Valuation Approach [Member]
Business Acquisition [Line Items]
Market capitalization rate							8.50%

Real Estate and Other Activi_29

Real Estate and Other Activities - Pipeline Health System - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2024	Feb. 07, 2023
Pipeline Health System [Member]
Business Acquisition [Line Items]
Cash rent	$ 5	$ 6

Real Estate and Other Activi_30

Real Estate and Other Activities - International Joint Venture - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2024
Business Combinations [Abstract]
Real estate	$ 225	$ 79	$ 180

Real Estate and Other Activi_31

Real Estate and Other Activities - Common Spirit Additional Information (Detail) $ in Millions			12 Months Ended
	Sep. 11, 2024 USD ($)	May 01, 2023 USD ($) Facility	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Common Spirit [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Facility		5
Amortization of Intangible Assets		$ 286
Straight-line rent write-offs		$ 95	$ 20
Catholic Health Initiatives Colorado [Member] | Common Spirit [Member]
Business Acquisition [Line Items]
Initial lease term		15 years
In-place lease intangibles [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets	$ 170		$ 149	$ 286
In-place lease intangibles [Member] | Common Spirit [Member]
Business Acquisition [Line Items]
Amortization of Intangible Assets		$ 286

Real Estate and Other Activi_32

Real Estate and Other Activities - Other Tenant Matters - Additional Information (Detail) - Other Tenant Updates [Member] $ in Millions	3 Months Ended		12 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Dec. 31, 2024 USD ($) Property
Business Acquisition [Line Items]
Percentage of assets representing properties leased and loan to internation joint ventures		1%
Reserve billed and straight line rent receivables		$ 49
Repayment Of Unpaid Rent			$ 10
Amortization of Intangible Assets	$ 22
Net Book Value Of Unpaid Rent			$ 39
Number of properties | Property			3
Lease Agreement Term			20 years
Repayment of mortgage loan			$ 3
Net book value of property			156
Unpaid rent receivables			45
Secured loan			$ 10

Real Estate and Other Activi_33

Real Estate and Other Activities - Prospect Medical Holdings Additional Information (Detail) $ in Thousands	1 Months Ended	3 Months Ended			12 Months Ended
	Aug. 31, 2019 USD ($) Hospital	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Jun. 30, 2022 USD ($)
Business Acquisition [Line Items]
Additional mortgage loan				$ 1,332,962	$ 105,618	$ 235,187
Net impairment charge		$ 225,000	$ 79,000		180,000
Mortgage Loans [Member]
Business Acquisition [Line Items]
Additional mortgage loan				159,735	$ 0	$ 0
Prospect [Member]
Business Acquisition [Line Items]
Purchase price of acquisition	$ 1,500,000
Additional mortgage loan							$ 100,000
Term loan	$ 112,900
Net impairment charge				280,000
Prospect [Member] | Pennsylvania [Member]
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee				170,000
Prospect [Member] | Pennsylvania [Member] | Maximum [Member]
Business Acquisition [Line Items]
Carrying value of lease requiring residual value guarantee				$ 250,000
Acute Care Campus [Member] | Prospect [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital	14

Real Estate and Other Activi_34

Real Estate and Other Activities - Alecto Facilities - Additional Information (Detail) - USD ($) $ in Millions		3 Months Ended		12 Months Ended
		Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Real estate impairment charges		$ 225	$ 79	$ 180
Total Gross Assets [Member] | Customer Concentration Risk [Member]
Business Acquisition [Line Items]
Percentage of total assets	[1]			100%	100%
[1] For geographic and facility type concentration metrics in the tables above, we allocate our investments in unconsolidated operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Real Estate and Other Activi_35

Real Estate and Other Activities - Watsonville Community Hospital - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2022	Dec. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Loans repaid	[1]	$ 0	$ 0	$ 22,900
Watsonville, California [Member]
Business Acquisition [Line Items]
Provision (recovery) for credit loss		$ 15,000
[1] The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.

Real Estate and Other Activi_36

Real Estate and Other Activities - Other Leasing Activities - Additional Information (Detail)	Dec. 31, 2024
Business Acquisition [Line Items]
Percentage of vacant on leased property	1%

Real Estate and Other Activi_37

Real Estate and Other Activities - Investments in Unconsolidated Real Estate Joint Ventures - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended	12 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Dec. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Investments in unconsolidated real estate joint ventures			$ 1,156,397	$ 1,474,455
Investments in Unconsolidated Real Estate Joint Ventures [Member]
Business Acquisition [Line Items]
Percentage of equity investment			100%
Dividend income			$ 45,000	69,000
Capital contributions	$ 40,000
Percentage of interest retained in venture		25%
Investments in Unconsolidated Real Estate Joint Ventures [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of equity investment			100%
Common Spirit [Member]
Business Acquisition [Line Items]
Percentage of equity investment			25%
Investments in unconsolidated real estate joint ventures			$ 113,202	$ 0

Real Estate and Other Activi_38

Real Estate and Other Activities - Summary of Investments in Unconsolidated Real Estate Joint Ventures by Operator (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated real estate joint ventures	$ 1,156,397	$ 1,474,455
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	70%
Investments in unconsolidated real estate joint ventures	$ 483,770	472,434
MEDIAN [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 431,964	471,336
Common Spirit [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	25%
Investments in unconsolidated real estate joint ventures	$ 113,202	0
Policlinico di Monza [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 77,592	80,562
HM Hospital [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	45%
Investments in unconsolidated real estate joint ventures	$ 49,869	56,071
Steward [Member]
Schedule of Equity Method Investments [Line Items]
Ownership interest	50%
Investments in unconsolidated real estate joint ventures	$ 0	$ 394,052

Real Estate and Other Activi_39

Real Estate and Other Activities - Summary of Investments in Unconsolidated Operating Entities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 439,578	$ 1,778,640
Swiss Medical Network [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	172,453	186,113
PHP Holdings [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	149,027	699,535
Steward Loan Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	0	361,591
International Joint Venture [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	0	225,960
Priory [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	38,739	163,837
Steward Equity Investment [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	0	35,696
Aevis Victoria SA [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	63,409	77,345
Aspris Children's Services [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	15,950	15,986
Lifepoint Behavioral [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	0	11,429
Caremax [Member]
Schedule of Equity Method Investments [Line Items]
Investments in unconsolidated operating entities	$ 0	$ 1,148

Real Estate and Other Activi_40

Real Estate and Other Activities - Investments in Unconsolidated Operating Entities - Additional Information (Details) £ in Millions, SFr in Millions, $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2024 USD ($)	Mar. 31, 2024 GBP (£)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2023 CHF (SFr)
Swiss Medical Network [Member]
Business Acquisition [Line Items]
Favorable fair market value adjustment on investment | SFr					SFr 20
PHP Holdings Equity Investment [Member]
Business Acquisition [Line Items]
Favorable fair market value adjustment on investment				$ 45
Syndicated Term Loan [Member]
Business Acquisition [Line Items]
Proceed from sale of interest in syndicated term loan	$ 115	£ 90
Gain (loss) on sale of interest in syndicated term loan	(7.8)	£ (6)
Other [Member]
Business Acquisition [Line Items]
Unfavorable fair market value adjustment on investment	$ 225		$ 550
COVID-19 Pandemic [Member] | Other [Member]
Business Acquisition [Line Items]
Favorable non-cash fair value adjustment on investment				$ 45
Unfavorable non-cash fair value adjustment on investment			$ 794

Real Estate and Other Activi_41

Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) SFr in Millions, $ in Millions			3 Months Ended
	Nov. 03, 2023 USD ($)	Aug. 17, 2023 USD ($)	Sep. 30, 2024 USD ($)	Jun. 30, 2023 CHF (SFr)	Sep. 30, 2023 USD ($)
Business Acquisition [Line Items]
Loan impairment charges			$ 425
Steward Health Care System L L C [Member]
Business Acquisition [Line Items]
Other investment on secured loan with credit facility collateral					$ 40
Repayment received on credit facility availed	$ 2
Repayments of mortgage loan | SFr				SFr 60
Steward Health Care System L L C [Member] | Asset-Backed Securities [Member]
Business Acquisition [Line Items]
Investments					$ 105
Sale of investment		$ 105
Global Asset Manager [Member]
Business Acquisition [Line Items]
Sale of investment		$ 100

Real Estate and Other Activi_42

Real Estate and Other Activities - Schedule of Concentrations of Credit Risk - (Details) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Total Assets		$ 14,294,594	$ 18,304,844
Total revenues		995,547	871,799	$ 1,542,851
Prospect [Member]
Business Acquisition [Line Items]
Total revenues			96,000
Operator Concentration Risk [Member] | Total Gross Assets [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 14,294,594	$ 18,304,844
Percentage of concentration risk		100%	100%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	[2]	11.80%	11%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Circle [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 2,026,778	$ 2,119,392
Percentage of concentration risk		14.20%	11.60%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Priory [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 1,233,462	$ 1,391,005
Percentage of concentration risk		8.60%	7.60%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Healthcare Systems of America [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 1,187,006	$ 0
Percentage of concentration risk		8.30%	0%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Lifepoint Behavioral [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 813,584	$ 813,527
Percentage of concentration risk		5.70%	4.40%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Swiss Medical Network [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 719,632	$ 735,891
Percentage of concentration risk		5.10%	4%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Steward [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 0	$ 3,518,537
Percentage of concentration risk		0%	19.20%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Operators [Member]
Business Acquisition [Line Items]
Total Assets	[1]	$ 6,624,256	$ 7,709,095
Percentage of concentration risk		46.30%	42.20%
Operator Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets by Operator [Member]
Business Acquisition [Line Items]
Total Assets	[1],[2]	$ 1,689,876	$ 2,017,397
Operator Concentration Risk [Member] | Revenue [Member] | Prospect [Member]
Business Acquisition [Line Items]
Percentage of concentration risk				11%
Total revenues				$ 169,335
Operator Concentration Risk [Member] | Revenue [Member] | Circle [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		20.70%	22.30%	12.30%
Total revenues		$ 205,582	$ 194,390	$ 189,565
Operator Concentration Risk [Member] | Revenue [Member] | Priory [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		10.20%	12.30%
Total revenues		$ 101,675	$ 107,557
Operator Concentration Risk [Member] | Revenue [Member] | Steward [Member]
Business Acquisition [Line Items]
Percentage of concentration risk				27.70%
Total revenues				$ 427,912
Geographic Concentration Risk [Member] | Total Gross Assets [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 14,294,594	$ 18,304,844
Percentage of concentration risk	[3]	100%	100%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Texas [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 1,394,296	$ 1,891,482
Percentage of concentration risk	[3]	9.80%	10.30%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | California [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 935,470	$ 1,252,674
Percentage of concentration risk	[3]	6.40%	6.80%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Florida [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 840,876	$ 1,348,210
Percentage of concentration risk	[3]	5.90%	7.40%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Arizona [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 379,801	$ 547,789
Percentage of concentration risk	[3]	2.70%	3%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Ohio [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 327,577	$ 349,140
Percentage of concentration risk	[3]	2.30%	1.90%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other States [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 2,636,587	$ 4,385,814
Percentage of concentration risk	[3]	18.50%	24%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other Domestic Assets [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 951,486	$ 1,397,170
Percentage of concentration risk	[3]	6.60%	7.60%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total U.S. [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 7,466,093	$ 11,172,279
Percentage of concentration risk	[3]	52.20%	61%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | United Kingdom [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 3,985,672	$ 4,261,944
Percentage of concentration risk	[3]	27.90%	23.30%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Switzerland [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 719,632	$ 735,891
Percentage of concentration risk	[3]	5%	4%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Germany [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 672,343	$ 734,630
Percentage of concentration risk	[3]	4.70%	4%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Spain [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 247,996	$ 252,529
Percentage of concentration risk	[3]	1.70%	1.40%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Finland [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 199,721	$ 218,322
Percentage of concentration risk	[3]	1.40%	1.20%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | All Other Countries [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 264,747	$ 309,022
Percentage of concentration risk	[3]	1.90%	1.70%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Other International Assets [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 738,390	$ 620,227
Percentage of concentration risk	[3]	5.20%	3.40%
Geographic Concentration Risk [Member] | Total Gross Assets [Member] | Total International [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 6,828,501	$ 7,132,565
Percentage of concentration risk	[3]	47.80%	39%
Geographic Concentration Risk [Member] | Revenue [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		100%	100%	100%
Total revenues		$ 995,547	$ 871,799	$ 1,542,851
Geographic Concentration Risk [Member] | Revenue [Member] | Total U.S. [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		56.40%	46.70%	71.10%
Total revenues		$ 561,673	$ 407,329	$ 1,096,465
Geographic Concentration Risk [Member] | Revenue [Member] | United Kingdom [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		36.20%	40.40%	20.50%
Total revenues		$ 359,991	$ 352,594	$ 317,013
Geographic Concentration Risk [Member] | Revenue [Member] | All Other Countries [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		7.40%	12.90%	8.40%
Total revenues		$ 73,883	$ 111,876	$ 129,373
Customer Concentration Risk [Member] | Total Gross Assets [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 14,294,594	$ 18,304,844
Percentage of concentration risk	[3]	100%	100%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	[3]	11.80%	11%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 8,493,331	$ 11,764,151
Percentage of concentration risk	[3]	59.40%	64.30%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 2,376,460	$ 2,576,983
Percentage of concentration risk	[3]	16.70%	14.10%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Post acute care facilities [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 1,617,596	$ 1,716,248
Percentage of concentration risk	[3]	11.30%	9.40%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Freestanding E R Urgent Care Facilities [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 117,331	$ 230,065
Percentage of concentration risk	[3]	0.80%	1.20%
Customer Concentration Risk [Member] | Total Gross Assets [Member] | Other Assets By Facility [Member]
Business Acquisition [Line Items]
Total Assets	[3]	$ 1,689,876	$ 2,017,397
Customer Concentration Risk [Member] | Revenue [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		100%	100%	100%
Total revenues		$ 995,547	$ 871,799	$ 1,542,851
Customer Concentration Risk [Member] | Revenue [Member] | General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		63.10%	62.20%	75.70%
Total revenues		$ 628,622	$ 541,888	$ 1,167,233
Customer Concentration Risk [Member] | Revenue [Member] | Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		21.10%	24.50%	13.20%
Total revenues		$ 209,668	$ 213,292	$ 204,420
Customer Concentration Risk [Member] | Revenue [Member] | Post acute care facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		14%	10.60%	9.50%
Total revenues		$ 139,859	$ 92,787	$ 146,780
Customer Concentration Risk [Member] | Revenue [Member] | Freestanding E R Urgent Care Facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		1.80%	2.70%	1.60%
Total revenues		$ 17,398	$ 23,832	$ 24,418
[1] Total assets by operator are generally comprised of real estate assets, mortgage loans, investments in unconsolidated real estate joint ventures, investments in unconsolidated operating entities, and other loans. Includes our investment in PHP Holdings of approximately $ 150 million and $ 700 million as of December 31, 2024 and 2023, respectively — see Prospect Transaction and tenant update described previously in this same Note 3 for more information. For geographic and facility type concentration metrics in the tables above, we allocate our investments in unconsolidated operating entities pro rata based on the gross book value of the real estate. Such pro rata allocations are subject to change from period to period.

Real Estate and Other Activi_43

Real Estate and Other Activities - Schedule of Concentrations of Credit Risk (Parenthetical) (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Investments in unconsolidated operating entities	$ 439,578	$ 1,778,640
PHP Holdings [Member]
Business Acquisition [Line Items]
Investments in unconsolidated operating entities	149,027	699,535
PHP Holdings [Member] | Other Assets by Operator [Member]
Business Acquisition [Line Items]
Investments in unconsolidated operating entities	$ 150,000	$ 700,000

Real Estate and Other Activi_44

Real Estate and Other Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Related Party Transactions [Member]
Business Acquisition [Line Items]
Revenues earned from tenants	$ 33.9	$ 83	$ 135.5
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Behavioral health facilities
Business Acquisition [Line Items]
Maximum percentage of entity's assets invested on single property	2%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands		Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Debt		$ 8,919,219	$ 10,109,133
Debt issue costs and discount, net		(71,107)	(44,897)
Debt, net		8,848,112	10,064,236
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	[1]	361,726	1,514,420
Term Loan [Member]
Debt Instrument [Line Items]
Debt		200,000	200,000
Term Loan [Member] | Australia [Member]
Debt Instrument [Line Items]
Debt	[2]	0	320,164
Secured term loan due 2024 | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	0	133,484
Term loan due 2025 | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	617,039	891,170
Secured term loan due 2034 | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	790,234	0
3.325% Senior Unsecured Notes due 2025 [Member]
Debt Instrument [Line Items]
Debt	[2]	517,700	551,950
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	517,700	551,950
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	625,800	636,550
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]	750,960	763,860
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]	438,060	445,585
3.500% Senior Unsecured Notes due 2031 [Member]
Debt Instrument [Line Items]
Debt		$ 1,300,000	$ 1,300,000
[1] Includes £- million and £ 322 million of GBP-denominated borrowings and € 303 million and € 303 million of Euro-denominated borrowings that reflect the applicable exchange rates at December 31, 2024 and December 31, 2023, respectively. Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Debt - Summary of Debt (Parenth

Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, € in Millions, £ in Millions		Dec. 31, 2024 USD ($)	Dec. 31, 2024 EUR (€)	Dec. 31, 2023 USD ($)	Dec. 31, 2023 GBP (£)	Dec. 31, 2023 EUR (€)
Debt Instrument [Line Items]
Debt		$ 8,919,219		$ 10,109,133
GBP-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | £					£ 322
EURO-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | €			€ 303			€ 303
3.325% Senior Unsecured Notes due 2025 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.325%	3.325%	3.325%	3.325%	3.325%
Debt	[1]	$ 517,700		$ 551,950
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		0.993%	0.993%	0.993%	0.993%	0.993%
Debt	[1]	$ 517,700		$ 551,950
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.50%	2.50%	2.50%	2.50%	2.50%
Debt	[1]	$ 625,800		$ 636,550
5.250% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.25%	5.25%	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%	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		3.692%	3.692%	3.692%	3.692%	3.692%
Debt	[1]	$ 750,960		$ 763,860
4.625% Senior Unsecured Notes due 2029 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.625%	4.625%	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%	3.375%	3.375%	3.375%	3.375%
Debt	[1]	$ 438,060		$ 445,585
3.500% Senior Unsecured Notes due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.50%	3.50%	3.50%	3.50%	3.50%
Debt		$ 1,300,000		$ 1,300,000
[1] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Debt - Principal Payments Due f

Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Debt Disclosure [Abstract]
2025	$ 1,134,739
2026	2,005,226
2027	1,600,000
2028	750,960
2029	900,000
Thereafter	2,528,294
Total	$ 8,919,219	$ 10,109,133

Debt - 2024 Activity - Addition

Debt - 2024 Activity - Additional Information (Details) $ in Thousands, £ in Millions, $ in Millions

3 Months Ended

12 Months Ended

Apr. 18, 2024 USD ($)

Apr. 18, 2024 AUD ($)

Oct. 10, 2023 Facility

May 18, 2023 Facility

Mar. 31, 2023 Facility

Dec. 31, 2024 USD ($)

Dec. 31, 2024 GBP (£)

Dec. 31, 2023 USD ($)

Dec. 31, 2023 AUD ($)

Dec. 31, 2022 USD ($) Facility

Dec. 31, 2024 GBP (£)

May 24, 2024 USD ($)

May 24, 2024 GBP (£)

Debt Instrument [Line Items]

Amount of term loan paid

$ 701,809

$ 988,162

$ 869,606

Number of facilities sold | Facility

3

15

Australia Facility [Member]

Debt Instrument [Line Items]

Term loan paid off and terminated with proceeds from Utah transaction

$ 306,000

$ 470

Revolving Credit Facility [Member]

Debt Instrument [Line Items]

Line of credit facility, Borrowing capacity

1,800,000

Revolving credit facility amount paid

375,000

Additional amount of revolving credit facility paid

756,000

Australia Transaction [Member]

Debt Instrument [Line Items]

Number of facilities sold | Facility

7

Number of remaining facilities sold | Facility

4

Proceeds from the sale of first tranche prepay

475,000

$ 730

Term loan

$ 1,200,000

Secured term loan due 2034 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Principal amount

$ 800,000

£ 631

$ 800,000

£ 631

Debt instrument maturity year

2034

2034

Term loan due 2025 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt instrument maturity year

2025

2025

Amount of term loan paid | £

£ 105

Additional amount of term loan paid | £

£ 102

Secured term loan due 2024 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt instrument maturity year

2024

2024

Amount of term loan paid

$ 105,000

Debt - 2023 Activity - Addition

Debt - 2023 Activity - Additional Information (Details) $ in Thousands, £ in Millions, $ in Millions		12 Months Ended
	Dec. 05, 2023 GBP (£)	Dec. 31, 2023 USD ($)	Dec. 31, 2023 GBP (£)	Dec. 31, 2023 AUD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 GBP (£)
Debt Instrument [Line Items]
Principal amount		$ 10,109,133			$ 8,919,219
Australia Transaction [Member]
Debt Instrument [Line Items]
Proceeds from the sale of first tranche prepay		475,000		$ 730
Term loan		$ 1,200,000
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Principal amount | £						£ 50
Senior unsecured notes, interest rate	2.55%	2.55%				2.55%
Purchase yield average percentage		13%				13%
Gain on prepayment of Debt		$ 1,100	£ 1.1
Debt instrument paid off | £	£ 350
Term Loan [Member]
Debt Instrument [Line Items]
Principal amount		$ 200,000			$ 200,000

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Detail) - USD ($) $ in Millions			12 Months Ended
	Aug. 06, 2024	Apr. 12, 2024	Dec. 31, 2024	Dec. 31, 2023	Jun. 29, 2022
Debt Instrument [Line Items]
Adjustments to applicable margin				0.375%
Commitment fee			0.30%	0.25%
Line of credit facility, description				Prior to the 2024 amendments and at our election, loans were made as either alternate base rate loans ("ABR Loans") or loans for an interest period of either one, three, or six months ("Term Benchmark Loans").
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee				0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee				0.30%
Alternate Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan				0%
Applicable margin for revolving loans				0%
Alternate Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan				0.70%
Applicable margin for revolving loans				0.50%
Term Benchmark Loans or RFR Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans				0.80%
Term Benchmark Loans or RFR Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for revolving loans				1.50%
British Pound Sterling [Member] | Term loan due 2025
Debt Instrument [Line Items]
Debt instrument maturity year			2025
Modified Covenant During the Period [Member]
Debt Instrument [Line Items]
Basis Points	3%
Percentage of proceeds of future asset sales and debt transactions	15%
Modified Covenant During the Period [Member] | British Pound Sterling [Member] | Term loan due 2025
Debt Instrument [Line Items]
Percentage of proceeds of future asset sales and debt transactions	50%
Debt instrument maturity year	2025	2025
Modified Covenant After the Period [Member]
Debt Instrument [Line Items]
Basis Points	2.25%
Credit Facility Amendment [Member]
Debt Instrument [Line Items]
Credit facility, current borrowing capacity	$ 1,280	$ 1,400			$ 1,800
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity			$ 1,800
Revolver [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding			400	$ 1,500
Line of credit facility, Borrowing capacity			$ 900	$ 300
Credit facilities, weighted average interest rate			6.60%	5.90%
Term Loan [Member]
Debt Instrument [Line Items]
Debt, face amount			$ 200
Interest rate at end of period			7.50%	7.20%
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 - British Pound Sterling T

Debt - British Pound Sterling Term Loan - Additional Information (Detail) $ in Thousands, € in Millions

12 Months Ended

May 24, 2024 USD ($) Property

Mar. 04, 2020

Jan. 06, 2020 GBP (£)

Dec. 31, 2024 USD ($)

Dec. 31, 2024 GBP (£)

Dec. 31, 2024 EUR (€)

Dec. 31, 2023 USD ($)

Dec. 31, 2022 USD ($)

Dec. 31, 2024 GBP (£)

Aug. 06, 2024

May 24, 2024 GBP (£) Property

Mar. 10, 2023

Mar. 09, 2023

Debt Instrument [Line Items]

Amount of term loan paid

$ 701,809

$ 988,162

$ 869,606

Revolving Credit Facility [Member]

Debt Instrument [Line Items]

Line of Credit Facility, Maximum Borrowing Capacity

1,800,000

Revolving credit facility amount paid

375,000

Secured term loan due 2034 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Principal amount

$ 800,000

$ 800,000

£ 631,000,000

£ 631,000,000

Number of properties | Property

27

27

Senior unsecured notes, interest rate

6.877%

6.877%

Debt insrtument term

10 years

Debt instrument maturity year

2034

2034

2034

Term loan due 2025 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt instrument maturity year

2025

2025

2025

Amount of term loan paid | £

£ 105,000,000

Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member]

Debt Instrument [Line Items]

Line of Credit Facility, Maximum Borrowing Capacity | £

£ 700,000,000

Debt instrument effective date

Mar. 06, 2020

Effective interest rate

0.70%

Variable interest rate

1.65%

1.25%

Senior unsecured notes, interest rate

2.349%

3.70%

Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member] | Minimum [Member]

Debt Instrument [Line Items]

Applicable margin adjustable based on pricing grid, percentage

0.85%

Term loan due 2025 | Bank of America, N.A | British Pound Sterling [Member] | Maximum [Member]

Debt Instrument [Line Items]

Applicable margin adjustable based on pricing grid, percentage

1.65%

Secured term loan due 2024 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt instrument maturity year

2024

2024

2024

Amount of term loan paid

$ 105,000

Secured term loan due 2025

Debt Instrument [Line Items]

Amount of term loan paid | €

€ 493

Secured term loan due 2025 | British Pound Sterling [Member]

Debt Instrument [Line Items]

Debt instrument maturity year

2025

2025

2025

Amount of term loan paid | €

€ 207

Debt - Interest Rate Swaps - Ad

Debt - Interest Rate Swaps - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Derivative asset	$ 3	$ 43
Derivative Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets

Debt - Basic Terms of Senior Un

Debt - Basic Terms of Senior Unsecured Notes (Details) - 12 months ended Dec. 31, 2024	GBP (£)	USD ($)	EUR (€)
3.325% Senior Unsecured Notes due 2025 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2017
Debt instrument maturity date	Mar. 24, 2025
Par Value | €			€ 500,000,000
% of Par Value	100%
Interest Payment Frequency	Annually
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Oct. 06, 2021
Debt instrument maturity date	Oct. 15, 2026
Par Value | €			€ 500,000,000
% of Par Value	100%
Interest Payment Frequency	Annually
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Mar. 24, 2026
Par Value | £	£ 500,000,000
% of Par Value	99.937%
Interest Payment Frequency	Annually
5.250% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 22, 2016
Debt instrument maturity date	Aug. 01, 2026
Par Value		$ 500,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually
5.000% Senior Unsecured Notes due 2027 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Sep. 21, 2017
Debt instrument maturity date	Oct. 15, 2027
Par Value		1,400,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 05, 2019
Debt instrument maturity date	Jun. 05, 2028
Par Value | £	£ 600,000,000
% of Par Value	99.998%
Interest Payment Frequency	Annually
4.625% Senior Unsecured Notes due 2029 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 26, 2019
Debt instrument maturity date	Aug. 01, 2029
Par Value		900,000,000
% of Par Value	99.50%
Interest Payment Frequency	Semi-annually
3.375% Senior Unsecured Notes due 2030 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Apr. 24, 2030
Par Value | £	£ 350,000,000
% of Par Value	99.448%
Interest Payment Frequency	Annually
3.500% Senior Unsecured Notes due 2031 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 04, 2020
Debt instrument maturity date	Mar. 15, 2031
Par Value		$ 1,300,000,000
% of Par Value	100%
Interest Payment Frequency	Semi-annually

Debt - Senior Unsecured Notes -

Debt - Senior Unsecured Notes - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2024
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101%

Debt - Additional Information (

Debt - Additional Information (Detail) $ in Thousands, £ in Millions		12 Months Ended
		Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2023 GBP (£)	Dec. 31, 2022 USD ($)	Dec. 31, 2023 GBP (£)	Dec. 05, 2023
Debt Instrument [Line Items]
Debt refinancing and unutilized financing costs		$ 4,292	$ (285)		$ 9,452
Principal amount		8,919,219	10,109,133
Accelerated amortization debt issue costs			800
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Principal amount	[1]	$ 517,700	$ 551,950
Senior unsecured notes, interest rate		0.993%	0.993%			0.993%
Debt instrument maturity date		Oct. 15, 2026
Term Loans [Member]
Debt Instrument [Line Items]
Principal amount		$ 200,000	$ 200,000
Term Loans [Member] | Australia [Member]
Debt Instrument [Line Items]
Principal amount	[1]	0	320,164
3.500% Senior Unsecured Notes due 2031 [Member]
Debt Instrument [Line Items]
Principal amount		$ 1,300,000	$ 1,300,000
Senior unsecured notes, interest rate		3.50%	3.50%			3.50%
Debt instrument maturity date		Mar. 15, 2031
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Gain on prepayment of Debt			$ 1,100	£ 1.1
Principal amount | £						£ 50
Senior unsecured notes, interest rate			2.55%			2.55%	2.55%
Waterland Private Equity Fund VII C.V. [Member] | Interim Credit Facility [Member]
Debt Instrument [Line Items]
Debt refinancing costs					$ 9,500
Debt instrument maturity date					Jun. 29, 2022
[1] Non-U.S. dollar denominated debt that reflects the exchange rates at period-end.

Debt - Covenants and Restrictio

Debt - Covenants and Restrictions - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Billions		12 Months Ended
	Feb. 13, 2025	Dec. 31, 2024	Aug. 06, 2024	Apr. 12, 2024
Debt Instrument [Line Items]
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%
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration]	Secured Overnight Financing Rate (SOFR) [Member]
Credit Facility Amendment [Member]
Debt Instrument [Line Items]
Permitted ratio				10%
Maximum total leverage ratio	60%
Secured leverage ratio	40%
Unsecured interest coverage ratio	225
Payment of dividends in cash during modified covenant period	$ 0.08		$ 0.08
Maximum ratio of secured first lien debt	65%
Credit Facility Amendment [Member] | Maximum [Member]
Debt Instrument [Line Items]
Maximum total leverage ratio			65%
Unsecured leverage ratio			70%
Unsecured interest coverage ratio	1.3		1.45
Net worth covenant			$ 6.7
Credit Facility Amendment [Member] | Minimum [Member]
Debt Instrument [Line Items]
Maximum total leverage ratio			60%
Unsecured leverage ratio			65%
Unsecured interest coverage ratio	1.15		1.75
Net worth covenant			$ 5

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90%	90%	90%
Percentage of taxable income to be distributed for federal income tax assumption	100%
Amount of foreign income (loss) before income taxes	$ 127,900,000	$ 6,300,000	$ 159,600,000
Amount of domestic income (loss) before income taxes	(1,400,000,000)	$ (144,500,000)	$ 10,800,000
Valuation allowance not expected to be realized	301,500,000
Uncertain tax position liabilities and related interest or penalties	$ 0

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax (Expense) Benefit (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Current income tax (expense) benefit:
Domestic	$ 477	$ (7,756)	$ 1,111
Foreign	(31,589)	(24,257)	(27,751)
Total income tax expense	(31,112)	(32,013)	(26,640)
Deferred income tax (expense) benefit:
Domestic	(465)	8,926	(15,628)
Foreign	(12,524)	153,766	(13,632)
Total income tax expense	(12,989)	162,692	(29,260)
Total income tax (expense) benefit	$ (44,101)	$ 130,679	$ (55,900)

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of Income Tax Benefit (Expense) Benefit from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
(Loss) income before income tax	$ (2,364,186)	$ (686,771)	$ 959,719
Income tax benefit (expense) at the U.S. statutory federal rate	496,479	144,222	(201,541)
Decrease (increase) in income tax resulting from:
Foreign rate differential	4,888	(4,122)	1,826
State income taxes, net of federal benefit		1,275	(1,886)
U.S. earnings not subject to federal income tax	(227,080)	(115,189)	165,705
Change in valuation allowance	(301,468)	(45,692)	(11,281)
Statutory tax rate change			(941)
Interest disallowance	(2,965)	(3,421)	(1,737)
Tax Impact of UK REIT conversion		160,641
Other items, net	(13,955)	(7,035)	(6,045)
Total income tax (expense) benefit	$ (44,101)	$ 130,679	$ (55,900)

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 263,523	$ 143,683
Depreciation	56,089	45,146
Partnership investments	112,892	15,768
Impairment and other loss reserves	101,834	11,790
Other	8,500	7,109
Total deferred tax assets	542,838	223,496
Valuation allowance	(418,659)	(117,191)
Total net deferred tax assets	124,179	106,305
Property and equipment	(145,835)	(158,330)
Net unbilled revenue	(82,170)	(65,727)
Partnership investments	(21,445)
Other	(3,450)	(10,687)
Total deferred tax liabilities	(252,900)	(234,744)
Net deferred tax asset (liability)	$ (128,721)	$ (128,439)

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net Operating Losses ("NOL") and Other Tax Attribute Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 704,434
Tax-effected NOL carryforwards	151,942
Valuation allowance	$ (151,942)
Expiration periods	2025
Expiration periods	indefinite
Foreign [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 453,615
Tax-effected NOL carryforwards	112,111
Valuation allowance	(6,273)
Net deferred tax asset - NOL carryforwards	$ 105,838
Expiration periods	indefinite

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Ordinary dividend		$ 1.0639	$ 0.4703
Long-term capital gain		0.1061	0.6797
Return of capital	$ 0.38
Total	$ 0.38	$ 1.17	$ 1.15

Income Taxes - Schedule of Pe_2

Income Taxes - Schedule of Per Share Distributions to Stockholders (Parenthetical) (Details) - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Taxes [Line Items]
Section 199A Dividends		$ 1.0639	$ 0.4703
Unrecaptured Sec. 1250 gain		$ 0.1061	$ 0.2574
O2026 A Dividends [Member]
Income Taxes [Line Items]
Dividend declared date	Nov. 21, 2024
Dividend paid date	Jan. 09, 2025

Earnings Per Share_Unit - Calcu

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net (loss) income	$ (2,408,287)	$ (556,092)	$ 903,819
Non-controlling interests’ share in earnings	(1,984)	(384)	(1,222)
Participating securities’ share in earnings	(946)	(1,644)	(1,602)
Net (loss) income, less participating securities' share in earnings	$ (2,411,217)	$ (558,120)	$ 900,995
Basic weighted-average common shares	600,248	598,518	598,634
Dilutive potential common shares			203
Diluted weighted-average common shares	600,248	598,518	598,837
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net (loss) income	$ (2,408,287)	$ (556,092)	$ 903,819
Non-controlling interests’ share in earnings	(1,984)	(384)	(1,222)
Participating securities’ share in earnings	(946)	(1,644)	(1,602)
Net (loss) income, less participating securities' share in earnings	$ (2,411,217)	$ (558,120)	$ 900,995
Basic weighted-average common shares	600,248	598,518	598,634
Dilutive potential common shares			203
Diluted weighted-average common shares	600,248	598,518	598,837

Earnings Per Share_Unit - Cal_2

Earnings Per Share/Unit - Calculation of Earnings Per Share (Parenthetical) (Detail) - shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potential common shares/units inclusion of shares	17,162	32,382
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potential common shares/units inclusion of shares	17,162	32,382

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands			12 Months Ended
	Mar. 08, 2024	Dec. 08, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock / (Unit)-based compensation expense			$ 32,976	$ 33,250	$ 49,421
Stock-based awards, fair value			$ 10,900	$ 22,500	$ 82,600
RSUs vested			0
RSUs forfeited			0
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years			10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of new common stock for awards under the Equity Incentive Plan			28,900,000
Common stock remaining for future stock awards transferred to the equity incentive plan			8,900,000
Maximum number of shares of common stock that may be awarded			5,000,000
Service-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)			3 years
Stock / (Unit)-based compensation expense			$ 28,400
Performance-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)			3 years
Market-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of increase in share price	67%	7%
Common stock remaining for future stock awards transferred to the equity incentive plan	2,700,000	2,500,000
Stock awards vesting period in years	4 years
Cash Settled Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense, unrecognized cost			$ 11,300
Stock-based compensation expense, unrecognized cost, reorganization period (in years)			2 years 10 days
Equity Settled Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense, unrecognized cost			$ 29,600
Stock-based compensation expense, unrecognized cost, reorganization period (in years)			1 year 3 months 7 days
RSUs [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock / (Unit)-based compensation expense			$ 4,600
Corresponding liability			4,600
Grant date fair value			$ 13,300
RSUs [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual equity volatility			57%
Risk-free rate			4.41%
Dividend yield			14.35%
RSUs [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual equity volatility			45%
Risk-free rate			3.58%
Dividend yield			8.10%

Stock Awards - Stock-based Awar

Stock Awards - Stock-based Award Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	1,144,796	810,483
Awarded, Shares	1,519,207	1,210,448
Vested, Shares	(993,312)	(864,482)
Forfeited, Shares	(29,191)	(11,653)
Nonvested awards at end of year, Shares	1,641,500	1,144,796
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 13.01	$ 21.02
Awarded, Weighted Average Value at Award Date	4.36	10.36
Vested, Weighted Average Value at Award Date	10.62	16.60
Forfeited, Weighted Average Value at Award Date	9.58	12.27
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 6.50	$ 13.01
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	12,576,792	4,349,081
Awarded, Shares	345,000	10,270,260
Vested, Shares	(1,179,631)	(1,591,846)
Forfeited, Shares	(1,428,940)	(450,703)
Nonvested awards at end of year, Shares	10,313,221	12,576,792
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 10.20	$ 18.26
Awarded, Weighted Average Value at Award Date	7.78	8.47
Vested, Weighted Average Value at Award Date	16.81	19.65
Forfeited, Weighted Average Value at Award Date	10.40	12.44
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 9.33	$ 10.20

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2024	Mar. 31, 2024
Steward Health Care System LLC [Member]
Loss Contingencies [Line Items]
Bridge financing to affiliate forfeited	$ 31	$ 60

Common Stock_Partners' Capital

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($)		12 Months Ended
	Oct. 09, 2022	Dec. 31, 2024	Dec. 31, 2022	Dec. 31, 2023
Class Of Stock [Line Items]
Common stock, shares issued		600,403,000		598,991,000
Shares issued price per share	$ 0.001
Stock repurchase, Value			$ 17,940,000
Stock repurchase program expiration date	Oct. 10, 2023
Maximum [Member]
Class Of Stock [Line Items]
Stock repurchase program, authorized amount	$ 500,000,000
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Stock repurchase, Value			$ 17,940,000
Redemption of common units		$ 0
MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Class Of Stock [Line Items]
Stock repurchase, Shares			1,629,000
Stock repurchase, Value			$ 17,761,000
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%
Common Units [Member]
Class Of Stock [Line Items]
Stock repurchase, Shares			1,645,000
Stock repurchase, Value			$ 2,000

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 36,327	$ 45,059
Loans, Book value	467,120	1,302,727
Debt, net Book value	(8,848,112)	(10,064,236)
Interest and rent receivables, Fair value	36,432	45,476
Loans, Fair value	470,380	1,202,383
Debt, net Fair value	$ (7,301,395)	$ (8,256,465)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) Health_Center	Dec. 31, 2023 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	$ 119,912	$ 309,315
Investments in unconsolidated real estate joint ventures	1,156,397	1,474,455
Investments in unconsolidated operating entities	439,578	1,778,640
Shareholder Loan [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Mortgage loans	7,900	162,400
Investments in unconsolidated real estate joint ventures	315,500	323,800
Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments in unconsolidated operating entities	39,700	526,900
Other loans	$ 104,000	$ 289,600
Fair Value, Recurring | 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) SFr in Millions, $ in Millions	3 Months Ended			12 Months Ended
	Sep. 30, 2024 USD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 31, 2024 USD ($) Health_Center	Dec. 31, 2023 USD ($)	Dec. 31, 2023 CHF (SFr)	Dec. 31, 2022 USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Impairment charge, working capital loans and other secured loans	$ 425
Real estate impairment charges		$ 225	$ 79	$ 180
Impairment of assets				$ (12)	$ (170)		$ (2.9)
Maximum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Market capitalization percentage							9%
Minimum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Market capitalization percentage							7.50%
Steward's Equity [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Equity impairment charges					$ 90
Equity investments percentage				9.90%	9.90%	9.90%
Impairment charge, working capital loans and other secured loans	$ 425	$ 625
Steward's Equity [Member] | Equity Securities [Member] | International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Remaining equity investment percentage				90.10%	90.10%	90.10%
Steward and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Real estate investments, joint ventures					$ 219
Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member] | Weighted Average [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments measurement input				0.1503
Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member] | Minimum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments measurement input				0.15
Fair Value, Inputs, Level 3 [Member] | Steward's Equity [Member] | Measurement Input, Discount Rate [Member] | Maximum [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Investments measurement input				0.16
Springstone Inc. and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Unfavorable fair market value adjustment on investment				$ 790
Favorable fair market value adjustment on investment					$ 29
PHP Holdings [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Discount rate on investment					11%
Discount for lack of marketability percentage on Springstone equity investment				14.20%	8%
Swiss Medical Network [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Favorable fair market value adjustment on investment | SFr						SFr 20
Colombia [Member] | Springstone Inc. and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Unfavorable fair market value adjustment on investment				$ 18
Pennsylvania [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Impairment of assets							$ 170
Fair Value, Recurring | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center				3
Fair Value, Recurring | Colombia [Member] | Acquisition Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired | Health_Center				3

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	Dec. 31, 2024	Dec. 31, 2023
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 111,985	$ 146,892
Original Cost	129,968	146,892
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	154,229	939,903
Original Cost	$ 910,594	$ 912,999

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 (Detail) - PHP Holdings $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
+ 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ (1,737)
- 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ 1,737

Leases (Lessee) - Summary of Le

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 10,725	$ 11,653	$ 12,175
Finance lease cost:
Total lease cost		7,645	7,654	7,869
Real Estate Depreciation and Amortization [Member]
Finance lease cost:
Amortization of right-of-use assets		51	51	51
Interest [Member]
Finance lease cost:
Interest on lease liabilities		128	128	128
Other [Member]
Finance lease cost:
Sublease income		$ (3,259)	$ (4,178)	$ (4,485)
[1] $ 5.1 million, $ 6.0 million, and $ 5.7 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2024, 2023, and 2022, respectively. Includes short-term leases.

Leases (Lessee) - Summary of _2

Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 10,725	$ 11,653	$ 12,175
Property-related [Member]
Lessee Lease Description [Line Items]
Operating lease cost		$ 5,100	$ 6,000	$ 5,700
[1] $ 5.1 million, $ 6.0 million, and $ 5.7 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2024, 2023, and 2022, respectively. Includes short-term leases.

Leases (Lessee) - Schedule of F

Leases (Lessee) - Schedule of Fixed Minimum Rental Payments Due under Leases with Non-Cancelable Terms (Detail) - USD ($) $ in Thousands		Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating Leases, 2025		$ 8,047
Operating Leases, 2026		7,239
Operating Leases, 2027		6,698
Operating Leases, 2028		6,786
Operating Leases, 2029		6,850
Operating Leases, Thereafter		175,000
Operating Leases, Total undiscounted minimum lease payments		210,620
Operating Leases, Less: interest		(132,035)
Operating Leases, Present value of lease liabilities		78,585	$ 101,812
Finance Leases, 2025		131
Finance Leases, 2026		133
Finance Leases, 2027		134
Finance Leases, 2028		135
Finance Leases, 2029		137
Finance Leases, Thereafter		4,245
Finance Leases, Total undiscounted minimum lease payments		4,915
Finance Leases, Less: interest		(2,979)
Finance Leases, Present value of lease liabilities		1,936	$ 1,938
Amounts To Be Received From Subleases, 2025		(3,503)
Amounts To Be Received From Subleases, 2026		(3,006)
Amounts To Be Received From Subleases, 2027		(2,715)
Amounts To Be Received From Subleases, 2028		(2,723)
Amounts To Be Received From Subleases, 2029		(2,731)
Amounts To Be Received From Subleases, Thereafter		(39,584)
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments		(54,262)
Net Payments, 2025		4,675
Net Payments, 2026		4,366
Net Payments, 2027		4,117
Net Payments, 2028		4,198
Net Payments, 2029		4,256
Net Payments, Thereafter	[1]	139,661
Net Payments, Total undiscounted minimum lease payments		$ 161,273
[1] Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or attempt to early terminate the ground lease to reduce or avoid any significant impact from such ground leases

Leases (Lessee) - Summary of Su

Leases (Lessee) - Summary of Supplemental Balance Sheet Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Right of use assets:
Finance leases	$ 1,632	$ 1,683
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Land	Land
Total real estate right of use assets	$ 48,513	$ 65,358
Total right of use assets	69,214	89,601
Lease liabilities:
Operating leases	$ 78,585	$ 101,812
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Financing leases	$ 1,936	$ 1,938
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Total lease liabilities	$ 80,521	$ 103,750
Weighted-average remaining lease term:
Operating leases	32 years 7 months 6 days	32 years 10 months 24 days
Finance leases	31 years 10 months 24 days	32 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.10%	6.20%
Finance leases	6.60%	6.60%
Corporate [Member]
Right of use assets:
Operating leases	$ 20,701	$ 24,243
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Real Estate [Member]
Right of use assets:
Operating leases	$ 46,881	$ 63,675
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Land	Land

Leases (Lessee) - Summary of _3

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows used for operating leases	$ 8,447	$ 8,210	$ 7,169
Operating cash flows used for finance leases	$ 130	$ 129	128
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases			$ 23,066

Other Assets - Summary of Other

Other Assets - Summary of Other Assets on our Condensed Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Other Assets [Abstract]
Debt issue costs, net	$ 5,675	$ 8,513
Other corporate assets	330,638	275,688
Prepaids and other assets	135,091	173,710
Total other assets	$ 471,404	$ 457,911

Segment Disclosures - Additiona

Segment Disclosures - Additional Information (Details)	12 Months Ended
	Dec. 31, 2024 Segment
Segment Reporting [Abstract]
Leased assets	100%
Number of segment	1
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	Chief Executive Officer And Chief Financial Officer [Member]
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	We compute FFO in accordance with the definition provided by the National Association of Real Estate Investment Trusts, which represents consolidated net (loss) income (computed in accordance with GAAP), excluding gains (losses) on sales of real estate and impairment charges on real estate assets, plus real estate depreciation and amortization, including amortization related to in-place lease intangibles, and after adjustments for unconsolidated partnerships and joint ventures. Given FFO excludes real estate related depreciation and amortization expense by definition and due to our typical net lease structure which requires our tenants to bear most of the costs associated with our properties (including property taxes, insurance, etc.)
Segment Reporting, Expense Information Used by CODM, Description	the primary expenses reviewed by the CODM include general and administrative and interest expenses from our consolidated statements of net income.
Segment Reporting, Expense Information Used by CODM, Type [Extensible Enumeration]	General and Administrative Expense, Interest Expense, Operating and Nonoperating

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) $ in Thousands, € in Billions	Feb. 13, 2025 USD ($)	Feb. 13, 2025 EUR (€)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Subsequent Event [Line Items]
Principal amount			$ 8,919,219	$ 10,109,133
Subsequent Event [Member]
Subsequent Event [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101%
Subsequent Event [Member] | Euro Notes
Subsequent Event [Line Items]
Principal amount | €		€ 1
Percentage of Par Value	98.645%
Debt instrument maturity date	Feb. 15, 2032
Debt Instrument, interest rate	7%	7%
Subsequent Event [Member] | Euro Notes | Prior to February 15, 2028
Subsequent Event [Line Items]
Debt Instrument Redemption Percent	107%	107%
Subsequent Event [Member] | USD Notes
Subsequent Event [Line Items]
Principal amount	$ 1,500,000
Percentage of Par Value	98.71%
Debt instrument maturity date	Feb. 15, 2032
Debt Instrument, interest rate	8.50%	8.50%
Subsequent Event [Member] | USD Notes | Prior to February 15, 2028
Subsequent Event [Line Items]
Debt Instrument Redemption Percent	108.50%	108.50%
Subsequent Event [Member] | 3.325% of Senior Unsecured Notes Due 2025
Subsequent Event [Line Items]
Debt Instrument, interest rate	3.325%	3.325%
Senior unsecured notes, maturity year	2025
Subsequent Event [Member] | 2.500% of Senior Unsecured Notes Due 2026
Subsequent Event [Line Items]
Debt Instrument, interest rate	2.50%	2.50%
Senior unsecured notes, maturity year	2026
Subsequent Event [Member] | 5.25% of Senior Unsecured Notes Due 2026
Subsequent Event [Line Items]
Debt Instrument, interest rate	5.25%	5.25%
Senior unsecured notes, maturity year	2026
Subsequent Event [Member] | Maximum [Member]
Subsequent Event [Line Items]
Debt Instrument Redemption Percent	100%	100%
Subsequent Event [Member] | Maximum [Member] | Prior to February 15, 2028
Subsequent Event [Line Items]
Debt Instrument Redemption Percent	40%	40%

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 878,318	$ 393,057	$ 154,161
Additions, Charged Against Operations	2,783,001	755,627	294,861
Deductions, Net Recoveries/Write-offs	(1,495,565)	(270,366)	(55,965)
Balance at End of Year	$ 2,165,754	$ 878,318	$ 393,057

Schedule II - Schedule of Val_2

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Increase in accounts receivable reserves	$ 384	$ 261
Decrease in accounts receivable reserves	520
Increase in straight-line rent receivable reserves		259
Increase (decrease) in real estate impairment reserves	86	89	$ 170.6
Write-off of previously reserved accounts receivable		11
Equity investment impairments reserves related to disposals	138
Increase in accounts receivable and other reserves			0.5
Decrease in accounts receivable and other reserves			11.7
Increase (decrease) in real estate impairment reserves related to disposals	(12)	(170)	(2.9)
Increase in credit loss reserves on financing-type receivables	1,500	10	114
Decrease in credit loss reserves on financing-type receivables	826	35	26.4
Increase in equity investment impairments	500	90
Recovery of previously reserved interest		50
Watsonville, California [Member]
Provision (recovery) for credit loss			15
Valuation Allowance, Deferred Tax Asset [Member]
Increase (decrease) in valuation allowances	$ 302	$ 47	$ 9.8

Schedule III - Real Estate In_2

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024		Dec. 31, 2023	[1]	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 1,605,243
Initial costs, buildings	8,087,849
Additions subsequent to acquisition, Improvements	393,401
Land at cost	1,606,722
Buildings at cost	8,479,771
Total at cost	10,086,493	[1]	$ 11,813,175		$ 12,300,524	$ 13,628,749
Accumulated Depreciation	1,239,897
Encumbrances	$ 790,230
Princes Risborough, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,345
Land at cost	3,345
Total at cost	3,345
Encumbrances	$ 0
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Ashtead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 37,124
Initial costs, buildings	69,603
Land at cost	37,124
Buildings at cost	69,603
Total at cost	106,727
Accumulated Depreciation	9,699
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Beckenham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,369
Initial costs, buildings	20,594
Land at cost	5,369
Buildings at cost	20,594
Total at cost	25,963
Accumulated Depreciation	2,591
Encumbrances	$ 14,629
Date of Construction	1981
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,414
Initial costs, buildings	160,210
Land at cost	30,414
Buildings at cost	160,210
Total at cost	190,624
Accumulated Depreciation	20,151
Encumbrances	$ 105,255
Date of Construction	1981
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Dorchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 530
Initial costs, buildings	30,812
Land at cost	530
Buildings at cost	30,812
Total at cost	31,342
Accumulated Depreciation	3,870
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Euxton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,539
Initial costs, buildings	34,959
Land at cost	4,539
Buildings at cost	34,959
Total at cost	39,498
Accumulated Depreciation	5,015
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Great Missenden, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 11,571
Initial costs, buildings	103,391
Land at cost	11,571
Buildings at cost	103,391
Total at cost	114,962
Accumulated Depreciation	13,026
Encumbrances	$ 54,064
Date of Construction	1981
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Torquay, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,930
Initial costs, buildings	35,139
Land at cost	2,930
Buildings at cost	35,139
Total at cost	38,069
Accumulated Depreciation	4,832
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Arnold, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 469
Initial costs, buildings	9,749
Land at cost	469
Buildings at cost	9,749
Total at cost	10,218
Accumulated Depreciation	936
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,483
Initial costs, buildings	30,749
Land at cost	1,483
Buildings at cost	30,749
Total at cost	32,232
Accumulated Depreciation	8,072
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Boardman, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 79
Initial costs, buildings	275
Land at cost	79
Buildings at cost	275
Total at cost	354
Accumulated Depreciation	41
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Boise, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,558
Initial costs, buildings	11,027
Land at cost	1,558
Buildings at cost	11,027
Total at cost	12,585
Accumulated Depreciation	1,555
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	50 years
2008 [Member] | Gainesborough UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,503
Initial costs, buildings	9,838
Land at cost	1,503
Buildings at cost	9,838
Total at cost	11,341
Accumulated Depreciation	$ 580
Date of Construction	2008
Date Acquired	Apr. 14, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Lubbock, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,376
Initial costs, buildings	28,292
Additions subsequent to acquisition, Improvements	3,648
Land at cost	1,376
Buildings at cost	31,940
Total at cost	33,316
Accumulated Depreciation	7,530
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jun. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Sheffield, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,502
Initial costs, buildings	43,862
Land at cost	6,502
Buildings at cost	43,862
Total at cost	50,364
Accumulated Depreciation	5,564
Encumbrances	$ 32,006
Date of Construction	2008
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,645
Initial costs, buildings	6,629
Land at cost	3,645
Buildings at cost	6,629
Total at cost	10,274
Accumulated Depreciation	$ 325
Date of Construction	2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1811 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 35,654
Initial costs, buildings	51,030
Land at cost	35,654
Buildings at cost	51,030
Total at cost	86,684
Accumulated Depreciation	2,858
Encumbrances	$ 0
Date of Construction	1811
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1890 [Member] | Altrincham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,396
Initial costs, buildings	24,713
Land at cost	14,396
Buildings at cost	24,713
Total at cost	39,109
Accumulated Depreciation	1,565
Encumbrances	$ 0
Date of Construction	1890
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | Bristol, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,626
Initial costs, buildings	36,724
Land at cost	4,626
Buildings at cost	36,724
Total at cost	41,350
Accumulated Depreciation	2,052
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,563
Initial costs, buildings	42,462
Land at cost	4,563
Buildings at cost	42,462
Total at cost	47,025
Accumulated Depreciation	2,365
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1790 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 28,447
Initial costs, buildings	14,719
Land at cost	28,447
Buildings at cost	14,719
Total at cost	43,166
Accumulated Depreciation	940
Encumbrances	$ 0
Date of Construction	1790
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altoona, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 29,062
Buildings at cost	29,062
Total at cost	29,062
Accumulated Depreciation	7,508
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altrincham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,396
Initial costs, buildings	24,713
Land at cost	14,396
Buildings at cost	24,713
Total at cost	39,109
Accumulated Depreciation	1,565
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Alvin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 105
Initial costs, buildings	4,087
Land at cost	105
Buildings at cost	4,087
Total at cost	4,192
Accumulated Depreciation	1,075
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Bristol, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,626
Initial costs, buildings	36,724
Land at cost	4,626
Buildings at cost	36,724
Total at cost	41,350
Accumulated Depreciation	2,052
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,563
Initial costs, buildings	42,462
Land at cost	4,563
Buildings at cost	42,462
Total at cost	47,025
Accumulated Depreciation	2,365
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Fort Worth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,406
Initial costs, buildings	34,627
Land at cost	3,406
Buildings at cost	34,627
Total at cost	38,033
Accumulated Depreciation	3,069
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Georgetown, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,569
Initial costs, buildings	23,550
Additions subsequent to acquisition, Improvements	10,561
Land at cost	4,569
Buildings at cost	34,111
Total at cost	38,680
Accumulated Depreciation	2,283
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 35,654
Initial costs, buildings	51,030
Land at cost	35,654
Buildings at cost	51,030
Total at cost	86,684
Accumulated Depreciation	2,858
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Ogden, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,759
Initial costs, buildings	16,414
Land at cost	1,759
Buildings at cost	16,414
Total at cost	18,173
Accumulated Depreciation	4,435
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Pearland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,075
Initial costs, buildings	3,577
Land at cost	1,075
Buildings at cost	3,577
Total at cost	4,652
Accumulated Depreciation	924
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 08, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 351
Initial costs, buildings	3,952
Land at cost	351
Buildings at cost	3,952
Total at cost	4,303
Accumulated Depreciation	1,061
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jan. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Richmond, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,380
Initial costs, buildings	6,665
Additions subsequent to acquisition, Improvements	10,815
Land at cost	5,380
Buildings at cost	17,480
Total at cost	22,860
Accumulated Depreciation	867
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Surrey, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,793
Initial costs, buildings	8,975
Land at cost	14,793
Buildings at cost	8,975
Total at cost	23,768
Accumulated Depreciation	632
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2014-2 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 28,447
Initial costs, buildings	14,719
Land at cost	28,447
Buildings at cost	14,719
Total at cost	43,166
Accumulated Depreciation	940
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1887 [Member] | Bassenheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,046
Initial costs, buildings	4,961
Land at cost	1,046
Buildings at cost	4,961
Total at cost	6,007
Accumulated Depreciation	814
Encumbrances	$ 0
Date of Construction	1887
Date Acquired	Feb. 09, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1974 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 9,852
Initial costs, buildings	24,931
Land at cost	9,852
Buildings at cost	24,931
Total at cost	34,783
Accumulated Depreciation	4,815
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,557
Initial costs, buildings	4,200
Land at cost	3,557
Buildings at cost	4,200
Total at cost	7,757
Accumulated Depreciation	850
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 02, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,870
Initial costs, buildings	41,503
Land at cost	7,870
Buildings at cost	41,503
Total at cost	49,373
Accumulated Depreciation	4,669
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 03, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Columbus OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,101
Initial costs, buildings	44,218
Land at cost	2,101
Buildings at cost	44,218
Total at cost	46,319
Accumulated Depreciation	3,859
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Englewood, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,369
Initial costs, buildings	65,480
Land at cost	3,369
Buildings at cost	65,480
Total at cost	68,849
Accumulated Depreciation	5,648
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 10,711
Initial costs, buildings	10,530
Land at cost	10,711
Buildings at cost	10,530
Total at cost	21,241
Accumulated Depreciation	1,369
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Kansas City, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,351
Initial costs, buildings	13,665
Land at cost	2,351
Buildings at cost	13,665
Total at cost	16,016
Accumulated Depreciation	1,650
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Kuopio, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,212
Initial costs, buildings	40,662
Land at cost	1,212
Buildings at cost	40,662
Total at cost	41,874
Accumulated Depreciation	3,015
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	29 years
2017 [Member] | Leawood, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,513
Initial costs, buildings	13,938
Land at cost	2,513
Buildings at cost	13,938
Total at cost	16,451
Accumulated Depreciation	1,672
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Oulu, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,976
Initial costs, buildings	42,125
Land at cost	2,976
Buildings at cost	42,125
Total at cost	45,101
Accumulated Depreciation	3,162
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,974
Initial costs, buildings	14,405
Land at cost	2,974
Buildings at cost	14,405
Total at cost	17,379
Accumulated Depreciation	1,755
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Monmouth, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 15,244
Initial costs, buildings	11,357
Land at cost	15,244
Buildings at cost	11,357
Total at cost	26,601
Accumulated Depreciation	1,343
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Oklahoma City, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,641
Initial costs, buildings	3,047
Land at cost	3,641
Buildings at cost	3,047
Total at cost	6,688
Accumulated Depreciation	492
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Texarkana, Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,562
Land at cost	14,562
Total at cost	14,562
Accumulated Depreciation	0
Encumbrances	$ 0
Date Acquired	Sep. 29, 2017
2017 [Member] | Valencia, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,438
Initial costs, buildings	65,236
Land at cost	10,438
Buildings at cost	65,236
Total at cost	75,674
Accumulated Depreciation	5,797
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Dec. 02, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2024 [Member] | Valencia, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 24,332
Initial costs, buildings	22,785
Land at cost	24,332
Buildings at cost	22,785
Total at cost	47,117
Accumulated Depreciation	$ 522
Date of Construction	2024
Date Acquired	May 06, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1864 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 912
Initial costs, buildings	9,988
Land at cost	912
Buildings at cost	9,988
Total at cost	10,900
Accumulated Depreciation	449
Encumbrances
Date of Construction	1864
Date Acquired	Apr. 14, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Avondale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,383
Initial costs, buildings	64,650
Additions subsequent to acquisition, Improvements	470
Land at cost	5,383
Buildings at cost	65,120
Total at cost	70,503
Accumulated Depreciation	5,563
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 9,852
Initial costs, buildings	24,931
Land at cost	9,852
Buildings at cost	24,931
Total at cost	34,783
Accumulated Depreciation	4,815
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 405
Initial costs, buildings	18,840
Land at cost	405
Buildings at cost	18,840
Total at cost	19,245
Accumulated Depreciation	1,767
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Flagstaff, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,049
Initial costs, buildings	22,464
Land at cost	3,049
Buildings at cost	22,464
Total at cost	25,513
Accumulated Depreciation	3,838
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Aug. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Helotes, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,900
Initial costs, buildings	5,115
Land at cost	1,900
Buildings at cost	5,115
Total at cost	7,015
Accumulated Depreciation	1,130
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 950
Initial costs, buildings	3,996
Land at cost	950
Buildings at cost	3,996
Total at cost	4,946
Accumulated Depreciation	824
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 26, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,512
Initial costs, buildings	2,870
Land at cost	1,512
Buildings at cost	2,870
Total at cost	4,382
Accumulated Depreciation	841
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Mandeville, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,800
Initial costs, buildings	5,370
Land at cost	2,800
Buildings at cost	5,370
Total at cost	8,170
Accumulated Depreciation	1,096
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Marrero, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,539
Initial costs, buildings	5,801
Land at cost	1,539
Buildings at cost	5,801
Total at cost	7,340
Accumulated Depreciation	1,233
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	15,750
Additions subsequent to acquisition, Improvements	10,947
Land at cost	20,430
Buildings at cost	26,697
Total at cost	47,127
Accumulated Depreciation	2,281
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 25, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | New Orleans, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,850
Initial costs, buildings	6,125
Land at cost	2,850
Buildings at cost	6,125
Total at cost	8,975
Accumulated Depreciation	1,263
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,030
Initial costs, buildings	4,801
Land at cost	3,030
Buildings at cost	4,801
Total at cost	7,831
Accumulated Depreciation	970
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Dec. 09, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Plano, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,077
Initial costs, buildings	1,416
Land at cost	4,077
Buildings at cost	1,416
Total at cost	5,493
Accumulated Depreciation	584
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Rosenberg, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,233
Initial costs, buildings	4,505
Land at cost	1,233
Buildings at cost	4,505
Total at cost	5,738
Accumulated Depreciation	1,014
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jan. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,343
Initial costs, buildings	4,253
Land at cost	2,343
Buildings at cost	4,253
Total at cost	6,596
Accumulated Depreciation	868
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | The Woodlands, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,949
Initial costs, buildings	4,524
Land at cost	1,949
Buildings at cost	4,524
Total at cost	6,473
Accumulated Depreciation	990
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Toledo, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,118
Initial costs, buildings	17,740
Land at cost	1,118
Buildings at cost	17,740
Total at cost	18,858
Accumulated Depreciation	3,881
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 01, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Viseu, Portugal [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,377
Initial costs, buildings	27,091
Land at cost	2,377
Buildings at cost	27,091
Total at cost	29,468
Accumulated Depreciation	3,862
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 28, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1989 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,695
Initial costs, buildings	21,926
Land at cost	6,695
Buildings at cost	21,926
Total at cost	28,621
Accumulated Depreciation	4,033
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Bolton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,558
Initial costs, buildings	43,781
Land at cost	1,558
Buildings at cost	43,781
Total at cost	45,339
Accumulated Depreciation	5,491
Encumbrances	$ 20,817
Date of Construction	1989
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Guildford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,765
Initial costs, buildings	35,812
Land at cost	6,765
Buildings at cost	35,812
Total at cost	42,577
Accumulated Depreciation	4,516
Encumbrances	$ 21,507
Date of Construction	1989
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Richmond, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,293
Initial costs, buildings	10,071
Land at cost	1,293
Buildings at cost	10,071
Total at cost	11,364
Accumulated Depreciation	1,739
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Rochdale, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 654
Initial costs, buildings	3,368
Land at cost	654
Buildings at cost	3,368
Total at cost	4,022
Accumulated Depreciation	527
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Rochdale, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 67
Initial costs, buildings	344
Land at cost	67
Buildings at cost	344
Total at cost	411
Accumulated Depreciation	54
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Ayr, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 16,703
Initial costs, buildings	47,833
Land at cost	16,703
Buildings at cost	47,833
Total at cost	64,536
Accumulated Depreciation	4,274
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,217
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	16,600
Land at cost	6,217
Buildings at cost	140,118
Total at cost	146,335
Accumulated Depreciation	24,157
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2004 [Member] | Webster, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 663
Initial costs, buildings	33,751
Land at cost	663
Buildings at cost	33,751
Total at cost	34,414
Accumulated Depreciation	11,742
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,056
Initial costs, buildings	2,581
Land at cost	1,056
Buildings at cost	2,581
Total at cost	3,637
Accumulated Depreciation	511
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Big Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,655
Initial costs, buildings	21,254
Additions subsequent to acquisition, Improvements	815
Land at cost	1,655
Buildings at cost	22,069
Total at cost	23,724
Accumulated Depreciation	3,485
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Apr. 12, 2019
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,217
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	16,600
Land at cost	6,217
Buildings at cost	140,118
Total at cost	146,335
Accumulated Depreciation	24,157
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	4,382
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2015 [Member] | Converse, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,423
Land at cost	750
Buildings at cost	4,423
Total at cost	5,173
Accumulated Depreciation	1,078
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Apr. 10, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 10,711
Initial costs, buildings	10,530
Land at cost	10,711
Buildings at cost	10,530
Total at cost	21,241
Accumulated Depreciation	1,369
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Highland Hills, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,148
Initial costs, buildings	43,891
Land at cost	3,148
Buildings at cost	43,891
Total at cost	47,039
Accumulated Depreciation	3,832
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 0
Initial costs, buildings	7,581
Land at cost	0
Buildings at cost	7,581
Total at cost	7,581
Accumulated Depreciation	2,140
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 01, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
2015 [Member] | League City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,260
Initial costs, buildings	3,901
Land at cost	1,260
Buildings at cost	3,901
Total at cost	5,161
Accumulated Depreciation	927
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 19, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | McKinney, Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,500
Initial costs, buildings	4,060
Land at cost	2,500
Buildings at cost	4,060
Total at cost	6,560
Accumulated Depreciation	1,285
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2015 [Member] | Olathe, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,882
Initial costs, buildings	56,381
Additions subsequent to acquisition, Improvements	11,584
Land at cost	6,882
Buildings at cost	67,965
Total at cost	74,847
Accumulated Depreciation	4,934
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Santa Maria de Feira, PT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,744
Initial costs, buildings	16,732
Land at cost	1,744
Buildings at cost	16,732
Total at cost	18,476
Accumulated Depreciation	1,395
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 21, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1970 [Member] | Bussage, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,346
Initial costs, buildings	3,690
Land at cost	8,346
Buildings at cost	3,690
Total at cost	12,036
Accumulated Depreciation	361
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1970 [Member] | Royston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,620
Initial costs, buildings	19,710
Land at cost	6,620
Buildings at cost	19,710
Total at cost	26,330
Accumulated Depreciation	2,172
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,072
Initial costs, buildings	12,833
Land at cost	7,072
Buildings at cost	12,833
Total at cost	19,905
Accumulated Depreciation	1,667
Encumbrances	$ 15,164
Date of Construction	1992
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bowling Green, KY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,486
Initial costs, buildings	56,296
Additions subsequent to acquisition, Improvements	3,550
Land at cost	3,486
Buildings at cost	59,846
Total at cost	63,332
Accumulated Depreciation	8,586
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Essex, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,563
Initial costs, buildings	42,462
Land at cost	4,563
Buildings at cost	42,462
Total at cost	47,025
Accumulated Depreciation	2,365
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Helsinki, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,832
Initial costs, buildings	63,268
Additions subsequent to acquisition, Improvements	494
Land at cost	3,832
Buildings at cost	63,762
Total at cost	67,594
Accumulated Depreciation	4,471
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 28,447
Initial costs, buildings	14,719
Land at cost	28,447
Buildings at cost	14,719
Total at cost	43,166
Accumulated Depreciation	940
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Stirling, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,036
Initial costs, buildings	19,181
Land at cost	1,036
Buildings at cost	19,181
Total at cost	20,217
Accumulated Depreciation	1,754
Encumbrances	$ 9,002
Date of Construction	1992
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Wichita, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	18,374
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	7,693
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Apr. 04, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 - 2 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 13,577
Initial costs, buildings	6,695
Land at cost	13,577
Buildings at cost	6,695
Total at cost	20,272
Accumulated Depreciation	671
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Basingstoke, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,704
Initial costs, buildings	49,342
Land at cost	12,704
Buildings at cost	49,342
Total at cost	62,046
Accumulated Depreciation	6,230
Encumbrances	$ 31,595
Date of Construction	1984
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 405
Initial costs, buildings	18,840
Land at cost	405
Buildings at cost	18,840
Total at cost	19,245
Accumulated Depreciation	1,767
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Droitwich, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 75
Initial costs, buildings	15,040
Land at cost	75
Buildings at cost	15,040
Total at cost	15,115
Accumulated Depreciation	1,905
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,229
Initial costs, buildings	59,974
Land at cost	3,229
Buildings at cost	4,078
Total at cost	7,307
Accumulated Depreciation	518
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Swindon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,238
Initial costs, buildings	58,763
Land at cost	5,238
Buildings at cost	58,763
Total at cost	64,001
Accumulated Depreciation	7,389
Encumbrances	$ 30,855
Date of Construction	1984
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Blue Springs, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,347
Initial costs, buildings	23,494
Land at cost	4,347
Buildings at cost	23,494
Total at cost	27,841
Accumulated Depreciation	6,120
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,847
Initial costs, buildings	17,249
Land at cost	2,847
Buildings at cost	17,249
Total at cost	20,096
Accumulated Depreciation	1,703
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,405
Initial costs, buildings	15,356
Land at cost	1,405
Buildings at cost	15,356
Total at cost	16,761
Accumulated Depreciation	1,456
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Harrow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 37,755
Initial costs, buildings	39,733
Land at cost	37,755
Buildings at cost	39,733
Total at cost	77,488
Accumulated Depreciation	5,035
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Hill County, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,120
Initial costs, buildings	17,882
Additions subsequent to acquisition, Improvements	845
Land at cost	1,120
Buildings at cost	18,727
Total at cost	19,847
Accumulated Depreciation	17,480
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Sep. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	15 years
1980 [Member] | Hook, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,324
Initial costs, buildings	10,141
Land at cost	5,324
Buildings at cost	10,141
Total at cost	15,465
Accumulated Depreciation	1,045
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,842
Initial costs, buildings	8,808
Land at cost	9,842
Buildings at cost	8,808
Total at cost	18,650
Accumulated Depreciation	1,012
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Poplar Bluff, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,659
Initial costs, buildings	38,694
Land at cost	2,659
Buildings at cost	38,694
Total at cost	41,353
Accumulated Depreciation	16,156
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Romford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,263
Initial costs, buildings	8,618
Land at cost	5,263
Buildings at cost	8,618
Total at cost	13,881
Accumulated Depreciation	952
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Sharon, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	8,513
Land at cost	6,179
Buildings at cost	17,579
Total at cost	23,758
Accumulated Depreciation	3,984
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1980 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,700
Initial costs, buildings	30,500
Land at cost	1,700
Buildings at cost	30,500
Total at cost	32,200
Accumulated Depreciation	2,164
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 21,270
Initial costs, buildings	70,559
Land at cost	21,270
Buildings at cost	70,559
Total at cost	91,829
Accumulated Depreciation	6,523
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Aberdeen, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,180
Initial costs, buildings	99,020
Land at cost	4,180
Buildings at cost	99,020
Total at cost	103,200
Accumulated Depreciation	12,419
Encumbrances	$ 44,407
Date of Construction	1985
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Hot Springs, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,622
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	21,221
Land at cost	5,622
Buildings at cost	80,653
Total at cost	86,275
Accumulated Depreciation	19,450
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Lawton, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,944
Initial costs, buildings	63,031
Land at cost	3,944
Buildings at cost	63,031
Total at cost	66,975
Accumulated Depreciation	8,462
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Southampton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,336
Initial costs, buildings	18,605
Land at cost	6,336
Buildings at cost	18,605
Total at cost	24,941
Accumulated Depreciation	2,017
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1997 [Member] | Algeciras, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 488
Initial costs, buildings	7,712
Land at cost	488
Buildings at cost	7,712
Total at cost	8,200
Accumulated Depreciation	566
Encumbrances	$ 0
Date of Construction	1997
Date Acquired	Apr. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1997 [Member] | Floridablanca, Colombia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 717
Initial costs, buildings	22,411
Land at cost	717
Buildings at cost	22,411
Total at cost	23,128
Accumulated Depreciation	1,367
Encumbrances	$ 0
Date of Construction	1997
Date Acquired	Jul. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bedford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,514
Initial costs, buildings	7,416
Land at cost	1,514
Buildings at cost	7,416
Total at cost	8,930
Accumulated Depreciation	939
Encumbrances	$ 7,885
Date of Construction	1982
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,695
Initial costs, buildings	92,282
Land at cost	9,695
Buildings at cost	92,282
Total at cost	101,977
Accumulated Depreciation	11,655
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bossier City, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 900
Initial costs, buildings	17,818
Additions subsequent to acquisition, Improvements	944
Land at cost	900
Buildings at cost	18,762
Total at cost	19,662
Accumulated Depreciation	7,648
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Caterham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,374
Initial costs, buildings	20,494
Land at cost	10,374
Buildings at cost	20,494
Total at cost	30,868
Accumulated Depreciation	2,897
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Canterbury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,030
Initial costs, buildings	27,124
Land at cost	9,030
Buildings at cost	27,124
Total at cost	36,154
Accumulated Depreciation	3,418
Encumbrances	$ 18,894
Date of Construction	1982
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Croydon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,775
Initial costs, buildings	41,002
Land at cost	9,775
Buildings at cost	41,002
Total at cost	50,777
Accumulated Depreciation	5,192
Encumbrances	$ 25,157
Date of Construction	1982
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,385
Initial costs, buildings	38,374
Additions subsequent to acquisition, Improvements	10,492
Land at cost	5,385
Buildings at cost	48,866
Total at cost	54,251
Accumulated Depreciation	12,698
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2023 [Member] | Cayce, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,022
Initial costs, buildings	20,419
Land at cost	1,022
Buildings at cost	20,419
Total at cost	21,441
Accumulated Depreciation	766
Encumbrances	$ 0
Date of Construction	2023
Date Acquired	Oct. 21, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 17,067
Buildings at cost	17,067
Total at cost	17,067
Accumulated Depreciation	1,920
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 29, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Conroe, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,855
Initial costs, buildings	38,892
Land at cost	3,855
Buildings at cost	38,892
Total at cost	42,747
Accumulated Depreciation	3,468
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 29,311
Initial costs, buildings	93,207
Land at cost	29,311
Buildings at cost	93,207
Total at cost	122,518
Accumulated Depreciation	8,826
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,888
Initial costs, buildings	47,447
Land at cost	20,888
Buildings at cost	47,447
Total at cost	68,335
Accumulated Depreciation	4,862
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | El Paso, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 4,268
Initial costs, buildings	21,345
Land at cost	4,268
Buildings at cost	21,345
Total at cost	25,613
Accumulated Depreciation	2,479
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	38 years
2018 [Member] | Malaga, SP [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 702
Initial costs, buildings	10,991
Land at cost	702
Buildings at cost	10,991
Total at cost	11,693
Accumulated Depreciation	748
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Apr. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Olathe, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,485
Initial costs, buildings	14,484
Land at cost	3,485
Buildings at cost	14,484
Total at cost	17,969
Accumulated Depreciation	1,756
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,593
Initial costs, buildings	31,287
Land at cost	8,593
Buildings at cost	31,287
Total at cost	39,880
Accumulated Depreciation	2,487
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Raleigh, NC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,469
Initial costs, buildings	27,514
Land at cost	3,469
Buildings at cost	27,514
Total at cost	30,983
Accumulated Depreciation	2,585
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Roeland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,569
Initial costs, buildings	15,103
Land at cost	1,569
Buildings at cost	15,103
Total at cost	16,672
Accumulated Depreciation	1,795
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Shawnee, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,076
Initial costs, buildings	14,945
Land at cost	3,076
Buildings at cost	14,945
Total at cost	18,021
Accumulated Depreciation	2,070
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Turku, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,133
Initial costs, buildings	54,582
Land at cost	1,133
Buildings at cost	54,582
Total at cost	55,715
Accumulated Depreciation	3,946
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Vancouver, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,313
Initial costs, buildings	12,505
Land at cost	9,313
Buildings at cost	12,505
Total at cost	21,818
Accumulated Depreciation	$ 803
Date of Construction	2018
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 405
Initial costs, buildings	18,840
Land at cost	405
Buildings at cost	18,840
Total at cost	19,245
Accumulated Depreciation	1,767
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Bellflower, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,563
Land at cost	2,563
Total at cost	2,563
Encumbrances	$ 0
Date Acquired	Aug. 23, 2019
1972 [Member] | Los Angeles, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,562
Initial costs, buildings	40,164
Additions subsequent to acquisition, Improvements	394
Land at cost	12,562
Buildings at cost	40,558
Total at cost	53,120
Accumulated Depreciation	3,631
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1957 [Member] | Blackburn, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,616
Initial costs, buildings	50,140
Land at cost	2,616
Buildings at cost	50,140
Total at cost	52,756
Accumulated Depreciation	6,305
Encumbrances	$ 23,300
Date of Construction	1957
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dallas, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,421
Initial costs, buildings	13,536
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	6,176
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Sep. 05, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,791
Initial costs, buildings	5,298
Land at cost	1,791
Buildings at cost	5,298
Total at cost	7,089
Accumulated Depreciation	892
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Petersburg, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	3,762
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Jul. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1930 [Member] | Blackburn, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 19,692
Initial costs, buildings	53,421
Land at cost	19,692
Buildings at cost	53,421
Total at cost	73,113
Accumulated Depreciation	5,125
Encumbrances	$ 0
Date of Construction	1930
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,483
Initial costs, buildings	30,749
Land at cost	1,483
Buildings at cost	30,749
Total at cost	32,232
Accumulated Depreciation	8,072
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Jul. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 912
Initial costs, buildings	9,988
Land at cost	912
Buildings at cost	9,988
Total at cost	10,900
Accumulated Depreciation	449
Encumbrances
Date of Construction	2009
Date Acquired	Apr. 14, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Folsom, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 3,291
Initial costs, buildings	21,293
Land at cost	3,291
Buildings at cost	21,293
Total at cost	24,584
Accumulated Depreciation	3,370
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Bassenheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,046
Initial costs, buildings	4,961
Land at cost	1,046
Buildings at cost	4,961
Total at cost	6,007
Accumulated Depreciation	814
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Feb. 09, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1983 [Member] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,333
Initial costs, buildings	129,348
Land at cost	6,333
Buildings at cost	129,348
Total at cost	135,681
Accumulated Depreciation	16,214
Encumbrances	$ 67,611
Date of Construction	1983
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,126
Initial costs, buildings	2,841
Land at cost	1,126
Buildings at cost	2,841
Total at cost	3,967
Accumulated Depreciation	488
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Lander, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 758
Initial costs, buildings	42,849
Land at cost	758
Buildings at cost	42,849
Total at cost	43,607
Accumulated Depreciation	5,724
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,869
Initial costs, buildings	45,175
Land at cost	4,869
Buildings at cost	45,175
Total at cost	50,044
Accumulated Depreciation	5,726
Encumbrances	$ 32,221
Date of Construction	1983
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Milton Keynes, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,157
Initial costs, buildings	35,255
Land at cost	5,157
Buildings at cost	35,255
Total at cost	40,412
Accumulated Depreciation	4,436
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	4,382
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1983 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 983
Initial costs, buildings	2,371
Land at cost	983
Buildings at cost	2,371
Total at cost	3,354
Accumulated Depreciation	398
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Riverton, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,163
Initial costs, buildings	29,647
Land at cost	1,163
Buildings at cost	29,647
Total at cost	30,810
Accumulated Depreciation	4,594
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	36 years
2016 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,695
Initial costs, buildings	21,926
Land at cost	6,695
Buildings at cost	21,926
Total at cost	28,621
Accumulated Depreciation	4,033
Encumbrances	$ 0
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,056
Initial costs, buildings	2,581
Land at cost	1,056
Buildings at cost	2,581
Total at cost	3,637
Accumulated Depreciation	511
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Newburgh, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,215
Initial costs, buildings	7,212
Land at cost	1,215
Buildings at cost	7,212
Total at cost	8,427
Accumulated Depreciation	690
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,931
Land at cost	3,363
Buildings at cost	10,931
Total at cost	14,294
Accumulated Depreciation	4,595
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2022 [Member] | Bakersfield, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,178
Initial costs, buildings	45,253
Land at cost	2,178
Buildings at cost	45,253
Total at cost	47,431
Accumulated Depreciation	3,205
Encumbrances	$ 0
Date of Construction	2022
Date Acquired	May 15, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Lewiston, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,389
Initial costs, buildings	75,435
Land at cost	5,389
Buildings at cost	75,435
Total at cost	80,824
Accumulated Depreciation	19,557
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,737
Land at cost	2,417
Buildings at cost	17,594
Total at cost	20,011
Accumulated Depreciation	3,983
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
2013 [Member] | Hausman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,500
Initial costs, buildings	8,957
Land at cost	1,500
Buildings at cost	8,957
Total at cost	10,457
Accumulated Depreciation	2,632
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Helsinki, Finland [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,832
Initial costs, buildings	63,268
Additions subsequent to acquisition, Improvements	494
Land at cost	3,832
Buildings at cost	63,762
Total at cost	67,594
Accumulated Depreciation	4,471
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 11, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 800
Initial costs, buildings	14,968
Additions subsequent to acquisition, Improvements	(25)
Land at cost	800
Buildings at cost	14,943
Total at cost	15,743
Accumulated Depreciation	4,442
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Feb. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Post Falls Idaho
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 417
Initial costs, buildings	12,175
Additions subsequent to acquisition, Improvements	1,905
Land at cost	767
Buildings at cost	13,730
Total at cost	14,497
Accumulated Depreciation	3,785
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Spartanburg, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,135
Initial costs, buildings	15,717
Land at cost	1,135
Buildings at cost	15,717
Total at cost	16,852
Accumulated Depreciation	4,472
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Aug. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | West Chester, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,670
Initial costs, buildings	61,338
Land at cost	3,670
Buildings at cost	61,338
Total at cost	65,008
Accumulated Depreciation	5,364
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | West Midlands, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,890
Initial costs, buildings	7,042
Land at cost	1,890
Buildings at cost	7,042
Total at cost	8,932
Accumulated Depreciation	$ 342
Date of Construction	2013
Date Acquired	Apr. 14, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	51,834
Additions subsequent to acquisition, Improvements	4,499
Land at cost	12,695
Buildings at cost	56,333
Total at cost	69,028
Accumulated Depreciation	14,842
Encumbrances	$ 0
Date of Construction	1968
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
2007 [Member] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,198
Initial costs, buildings	18,660
Land at cost	9,198
Buildings at cost	18,660
Total at cost	27,858
Accumulated Depreciation	1,893
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Hinckley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,424
Initial costs, buildings	16,521
Land at cost	2,424
Buildings at cost	16,521
Total at cost	18,945
Accumulated Depreciation	1,566
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 834
Initial costs, buildings	17,182
Land at cost	834
Buildings at cost	17,182
Total at cost	18,016
Accumulated Depreciation	5,978
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,140
Initial costs, buildings	99,275
Additions subsequent to acquisition, Improvements	4,152
Land at cost	6,140
Buildings at cost	103,427
Total at cost	109,567
Accumulated Depreciation	30,110
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 0
Initial costs, buildings	1,034
Additions subsequent to acquisition, Improvements	296
Land at cost	0
Buildings at cost	1,330
Total at cost	1,330
Accumulated Depreciation	348
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 01, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
1978 [Member] | Kansas City, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,497
Initial costs, buildings	64,419
Land at cost	10,497
Buildings at cost	64,419
Total at cost	74,916
Accumulated Depreciation	16,279
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,946
Initial costs, buildings	30,465
Additions subsequent to acquisition, Improvements	7,104
Land at cost	7,946
Buildings at cost	37,569
Total at cost	45,515
Accumulated Depreciation	3,158
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	10,851
Additions subsequent to acquisition, Improvements	7,982
Land at cost	8,053
Buildings at cost	18,833
Total at cost	26,886
Accumulated Depreciation	6,230
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1977 [Member] | Braunfels, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,040
Initial costs, buildings	12,707
Land at cost	2,040
Buildings at cost	12,707
Total at cost	14,747
Accumulated Depreciation	3,051
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1977 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,241
Initial costs, buildings	79,894
Land at cost	12,241
Buildings at cost	79,894
Total at cost	92,135
Accumulated Depreciation	9,995
Encumbrances	$ 41,283
Date of Construction	1977
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1965 [Member] | Rochdale, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,517
Initial costs, buildings	40,065
Land at cost	3,517
Buildings at cost	40,065
Total at cost	43,582
Accumulated Depreciation	5,054
Encumbrances	$ 21,903
Date of Construction	1965
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1714 [Member] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,101
Initial costs, buildings	15,259
Land at cost	7,101
Buildings at cost	15,259
Total at cost	22,360
Accumulated Depreciation	1,483
Encumbrances	$ 0
Date of Construction	1714
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,396
Initial costs, buildings	7,276
Additions subsequent to acquisition, Improvements	2,985
Land at cost	2,396
Buildings at cost	10,261
Total at cost	12,657
Accumulated Depreciation	5,014
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
2012 [Member] | Carrollton, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,941
Initial costs, buildings	52,227
Land at cost	4,941
Buildings at cost	52,227
Total at cost	57,168
Accumulated Depreciation	4,514
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Casper, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,632
Land at cost	1,632
Total at cost	1,632
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 29, 2012
2012 [Member] | Dewsburry, UK
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	ehavioral health facility
Initial costs, land	$ 1,101
Initial costs, buildings	10,026
Land at cost	1,101
Buildings at cost	10,026
Total at cost	11,127
Accumulated Depreciation	474
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Apr. 14, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Dublin, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,118
Initial costs, buildings	69,346
Land at cost	5,118
Buildings at cost	69,346
Total at cost	74,464
Accumulated Depreciation	5,931
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Florence, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 900
Initial costs, buildings	28,462
Additions subsequent to acquisition, Improvements	105
Land at cost	900
Buildings at cost	28,567
Total at cost	29,467
Accumulated Depreciation	9,103
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 07, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,829
Initial costs, buildings	10,795
Land at cost	2,829
Buildings at cost	10,795
Total at cost	13,624
Accumulated Depreciation	1,143
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Overlook, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,452
Initial costs, buildings	9,666
Additions subsequent to acquisition, Improvements	7
Land at cost	2,452
Buildings at cost	9,673
Total at cost	12,125
Accumulated Depreciation	2,869
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 01, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Mount Pleasant, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 597
Initial costs, buildings	2,198
Land at cost	597
Buildings at cost	2,198
Total at cost	2,795
Accumulated Depreciation	335
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,248
Initial costs, buildings	5,880
Land at cost	2,248
Buildings at cost	5,880
Total at cost	8,128
Accumulated Depreciation	1,789
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 02, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 25,556
Initial costs, buildings	81,890
Land at cost	25,556
Buildings at cost	81,890
Total at cost	107,446
Accumulated Depreciation	8,350
Encumbrances	$ 22,118
Date of Construction	2012
Date Acquired	Dec. 18, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Bury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,366
Initial costs, buildings	19,063
Land at cost	8,366
Buildings at cost	19,063
Total at cost	27,429
Accumulated Depreciation	1,925
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	2,657
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 02, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Youngstown, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,555
Initial costs, buildings	3,469
Additions subsequent to acquisition, Improvements	488
Land at cost	3,555
Buildings at cost	3,957
Total at cost	7,512
Accumulated Depreciation	2,724
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1990 [Member] | Carmarthen, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 895
Initial costs, buildings	25,144
Land at cost	895
Buildings at cost	25,144
Total at cost	26,039
Accumulated Depreciation	3,174
Encumbrances	$ 14,884
Date of Construction	1990
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,140
Initial costs, buildings	25,903
Land at cost	5,140
Buildings at cost	25,903
Total at cost	31,043
Accumulated Depreciation	2,388
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Gloucester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,486
Initial costs, buildings	60,337
Land at cost	5,486
Buildings at cost	60,337
Total at cost	65,823
Accumulated Depreciation	8,521
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Hemel Hempstead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 12,279
Initial costs, buildings	6,197
Land at cost	12,279
Buildings at cost	6,197
Total at cost	18,476
Accumulated Depreciation	757
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Leeds, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,241
Initial costs, buildings	9,360
Land at cost	2,241
Buildings at cost	9,360
Total at cost	11,601
Accumulated Depreciation	916
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Melton Mowbray, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,605
Initial costs, buildings	15,712
Land at cost	5,605
Buildings at cost	15,712
Total at cost	21,317
Accumulated Depreciation	1,573
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 34,208
Initial costs, buildings	45,393
Land at cost	34,208
Buildings at cost	45,393
Total at cost	79,601
Accumulated Depreciation	6,324
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1956 [Member] | Detroit, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,220
Initial costs, buildings	8,323
Land at cost	1,220
Buildings at cost	8,323
Total at cost	9,543
Accumulated Depreciation	3,511
Encumbrances	$ 0
Date of Construction	1956
Date Acquired	May 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1953 [Member] | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	4,382
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1849 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 29,311
Initial costs, buildings	93,207
Land at cost	29,311
Buildings at cost	93,207
Total at cost	122,518
Accumulated Depreciation	8,826
Encumbrances	$ 0
Date of Construction	1849
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1976 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	51,834
Additions subsequent to acquisition, Improvements	4,499
Land at cost	12,695
Buildings at cost	56,333
Total at cost	69,028
Accumulated Depreciation	14,842
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
2019 [Member] | Clarksville, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,460
Initial costs, buildings	25,540
Land at cost	2,460
Buildings at cost	25,540
Total at cost	28,000
Accumulated Depreciation	2,840
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	39 years
2019 [Member] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,604
Initial costs, buildings	16,400
Land at cost	2,604
Buildings at cost	16,400
Total at cost	19,004
Accumulated Depreciation	1,131
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Apr. 18, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2019 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,191
Initial costs, buildings	14,263
Land at cost	3,191
Buildings at cost	14,263
Total at cost	17,454
Accumulated Depreciation	1,825
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2011 [Member] | Cologne Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,152
Initial costs, buildings	14,036
Land at cost	4,152
Buildings at cost	14,036
Total at cost	18,188
Accumulated Depreciation	2,679
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Jun. 23, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2011 [Member] | New Braunfels, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,853
Initial costs, buildings	10,622
Land at cost	1,853
Buildings at cost	10,622
Total at cost	12,475
Accumulated Depreciation	1,126
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [Member] | Coral Gables, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 26,215
Initial costs, buildings	84,584
Additions subsequent to acquisition, Improvements	2,624
Land at cost	26,215
Buildings at cost	87,208
Total at cost	113,423
Accumulated Depreciation	7,509
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,811
Initial costs, buildings	5,940
Land at cost	2,811
Buildings at cost	5,940
Total at cost	8,751
Accumulated Depreciation	649
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Dahlen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,259
Initial costs, buildings	10,635
Land at cost	1,259
Buildings at cost	10,635
Total at cost	11,894
Accumulated Depreciation	1,291
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jul. 08, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Worthing, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,602
Initial costs, buildings	29,637
Land at cost	6,602
Buildings at cost	29,637
Total at cost	36,239
Accumulated Depreciation	3,736
Encumbrances	$ 17,192
Date of Construction	1994
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,053
Initial costs, buildings	35,213
Land at cost	2,053
Buildings at cost	35,213
Total at cost	37,266
Accumulated Depreciation	3,988
Encumbrances	$ 33,613
Date of Construction	2001
Date Acquired	Aug. 07, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Norwood, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,373
Land at cost	6,373
Total at cost	$ 6,373
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
1935 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,888
Initial costs, buildings	47,447
Land at cost	20,888
Buildings at cost	47,447
Total at cost	68,335
Accumulated Depreciation	4,862
Encumbrances	$ 0
Date of Construction	1935
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,140
Initial costs, buildings	25,903
Land at cost	5,140
Buildings at cost	25,903
Total at cost	31,043
Accumulated Depreciation	2,388
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,274
Initial costs, buildings	27,324
Additions subsequent to acquisition, Improvements	32,499
Land at cost	3,274
Buildings at cost	59,823
Total at cost	63,097
Accumulated Depreciation	22,782
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,935
Initial costs, buildings	6,103
Land at cost	3,935
Buildings at cost	6,103
Total at cost	10,038
Accumulated Depreciation	645
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,057
Initial costs, buildings	15,390
Land at cost	6,057
Buildings at cost	15,390
Total at cost	21,447
Accumulated Depreciation	1,481
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Meyersdale, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 390
Initial costs, buildings	4,280
Land at cost	390
Buildings at cost	4,280
Total at cost	4,670
Accumulated Depreciation	913
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1960 [Member] | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,931
Land at cost	3,363
Buildings at cost	10,931
Total at cost	14,294
Accumulated Depreciation	4,595
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Valencia, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 24,332
Initial costs, buildings	22,785
Land at cost	24,332
Buildings at cost	22,785
Total at cost	47,117
Accumulated Depreciation	$ 522
Date of Construction	1960
Date Acquired	May 06, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1840 [Member] | Diss, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,861
Initial costs, buildings	10,202
Land at cost	2,861
Buildings at cost	10,202
Total at cost	13,063
Accumulated Depreciation	1,095
Encumbrances	$ 0
Date of Construction	1840
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,791
Initial costs, buildings	5,298
Land at cost	1,791
Buildings at cost	5,298
Total at cost	7,089
Accumulated Depreciation	892
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | San Bernardino, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,209
Initial costs, buildings	37,498
Land at cost	2,209
Buildings at cost	37,498
Total at cost	39,707
Accumulated Depreciation	5,464
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1830 [Member] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,101
Initial costs, buildings	15,259
Land at cost	7,101
Buildings at cost	15,259
Total at cost	22,360
Accumulated Depreciation	1,483
Encumbrances	$ 0
Date of Construction	1830
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1969 [Member] | Hialeah, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 75,339
Initial costs, buildings	222,271
Additions subsequent to acquisition, Improvements	1,958
Land at cost	75,339
Buildings at cost	224,229
Total at cost	299,568
Accumulated Depreciation	21,712
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1969 [Member] | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,935
Initial costs, buildings	6,103
Land at cost	3,935
Buildings at cost	6,103
Total at cost	10,038
Accumulated Depreciation	645
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,101
Initial costs, buildings	15,259
Land at cost	7,101
Buildings at cost	15,259
Total at cost	22,360
Accumulated Depreciation	1,483
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | McKinney, Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,934
Initial costs, buildings	32,268
Land at cost	2,934
Buildings at cost	32,268
Total at cost	35,202
Accumulated Depreciation	605
Encumbrances	$ 0
Date Acquired	Oct. 19, 2021
2021 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,593
Initial costs, buildings	31,287
Land at cost	8,593
Buildings at cost	31,287
Total at cost	39,880
Accumulated Depreciation	2,487
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | Stockton, California [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,757
Initial costs, buildings	50,681
Land at cost	2,757
Buildings at cost	50,681
Total at cost	53,438
Accumulated Depreciation	2,112
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Nov. 23, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,888
Initial costs, buildings	47,447
Land at cost	20,888
Buildings at cost	47,447
Total at cost	68,335
Accumulated Depreciation	4,862
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,790
Initial costs, buildings	45,076
Additions subsequent to acquisition, Improvements	5,411
Land at cost	4,790
Buildings at cost	50,487
Total at cost	55,277
Accumulated Depreciation	3,821
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,063
Initial costs, buildings	19,881
Additions subsequent to acquisition, Improvements	2,565
Land at cost	6,063
Buildings at cost	22,446
Total at cost	28,509
Accumulated Depreciation	2,245
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 25, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,880
Initial costs, buildings	108,303
Additions subsequent to acquisition, Improvements	5,590
Land at cost	1,880
Buildings at cost	113,893
Total at cost	115,773
Accumulated Depreciation	13,216
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Dec. 19, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Tadley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,564
Initial costs, buildings	18,739
Land at cost	20,564
Buildings at cost	18,739
Total at cost	39,303
Accumulated Depreciation	2,154
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Woking, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,117
Initial costs, buildings	4,601
Land at cost	7,117
Buildings at cost	4,601
Total at cost	11,718
Accumulated Depreciation	493
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 [Member] | Halsall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,980
Initial costs, buildings	30,633
Land at cost	1,980
Buildings at cost	30,633
Total at cost	32,613
Accumulated Depreciation	4,338
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 [Member] | Rowley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,859
Initial costs, buildings	17,993
Land at cost	2,859
Buildings at cost	17,993
Total at cost	20,852
Accumulated Depreciation	2,627
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1999 [Member] | Hartsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,050
Initial costs, buildings	43,970
Land at cost	2,050
Buildings at cost	43,970
Total at cost	46,020
Accumulated Depreciation	11,918
Encumbrances	$ 0
Date of Construction	1999
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
1924 [Member] | Hastings, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 603
Initial costs, buildings	8,834
Land at cost	603
Buildings at cost	8,834
Total at cost	9,437
Accumulated Depreciation	1,816
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1924 [Member] | Johnstown, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,877
Initial costs, buildings	247,158
Land at cost	8,877
Buildings at cost	247,158
Total at cost	256,035
Accumulated Depreciation	41,793
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1924 [Member] | Roaring Springs, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,446
Initial costs, buildings	9,549
Land at cost	1,446
Buildings at cost	9,549
Total at cost	10,995
Accumulated Depreciation	2,027
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1950 [Member] | Hialeah, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,802
Initial costs, buildings	107,783
Additions subsequent to acquisition, Improvements	3,324
Land at cost	18,802
Buildings at cost	111,107
Total at cost	129,909
Accumulated Depreciation	9,780
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	80,168
Additions subsequent to acquisition, Improvements	90,934
Land at cost	28,687
Buildings at cost	171,102
Total at cost	199,789
Accumulated Depreciation	20,251
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Ottumwa, IA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,377
Initial costs, buildings	48,697
Land at cost	2,377
Buildings at cost	48,697
Total at cost	51,074
Accumulated Depreciation	9,057
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1950 [Member] | Sharon, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	8,513
Land at cost	6,179
Buildings at cost	17,579
Total at cost	23,758
Accumulated Depreciation	3,984
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Surrey, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,793
Initial costs, buildings	8,975
Land at cost	14,793
Buildings at cost	8,975
Total at cost	23,768
Accumulated Depreciation	632
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 09, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Fresno, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,507
Initial costs, buildings	70,473
Land at cost	5,507
Buildings at cost	70,473
Total at cost	75,980
Accumulated Depreciation	10,126
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,850
Initial costs, buildings	33,415
Land at cost	5,850
Buildings at cost	33,415
Total at cost	39,265
Accumulated Depreciation	7,139
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1700 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 10,711
Initial costs, buildings	10,530
Land at cost	10,711
Buildings at cost	10,530
Total at cost	21,241
Accumulated Depreciation	1,369
Encumbrances	$ 0
Date of Construction	1700
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1966 [Member] | Gardena, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,010
Initial costs, buildings	65,282
Land at cost	14,010
Buildings at cost	65,282
Total at cost	79,292
Accumulated Depreciation	6,174
Encumbrances	$ 0
Date of Construction	1966
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,405
Initial costs, buildings	15,356
Land at cost	1,405
Buildings at cost	15,356
Total at cost	16,761
Accumulated Depreciation	1,456
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,057
Initial costs, buildings	15,390
Land at cost	6,057
Buildings at cost	15,390
Total at cost	21,447
Accumulated Depreciation	1,481
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 21,270
Initial costs, buildings	70,559
Land at cost	21,270
Buildings at cost	70,559
Total at cost	91,829
Accumulated Depreciation	6,523
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1796 [Member] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,198
Initial costs, buildings	18,660
Land at cost	9,198
Buildings at cost	18,660
Total at cost	27,858
Accumulated Depreciation	1,893
Encumbrances	$ 0
Date of Construction	1796
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1886 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,126
Initial costs, buildings	2,841
Land at cost	1,126
Buildings at cost	2,841
Total at cost	3,967
Accumulated Depreciation	488
Encumbrances	$ 0
Date of Construction	1886
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1998 [Member] | Kuhlungsborn Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,292
Initial costs, buildings	16,179
Land at cost	6,292
Buildings at cost	16,179
Total at cost	22,471
Accumulated Depreciation	$ 732
Date of Construction	1998
Date Acquired	Jun. 01, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
1998 [Member] | Hassocks, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,392
Initial costs, buildings	28,190
Land at cost	5,392
Buildings at cost	28,190
Total at cost	33,582
Accumulated Depreciation	3,032
Encumbrances	$ 0
Date of Construction	1998
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1885 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,850
Initial costs, buildings	33,415
Land at cost	5,850
Buildings at cost	33,415
Total at cost	39,265
Accumulated Depreciation	7,139
Encumbrances	$ 0
Date of Construction	1885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1901 [Member] | Hemel Hempstead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 12,279
Initial costs, buildings	6,197
Land at cost	12,279
Buildings at cost	6,197
Total at cost	18,476
Accumulated Depreciation	757
Encumbrances	$ 0
Date of Construction	1901
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Port Arthur, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 11,432
Initial costs, buildings	76,746
Additions subsequent to acquisition, Improvements	6,877
Land at cost	11,432
Buildings at cost	83,623
Total at cost	95,055
Accumulated Depreciation	23,087
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Tomball, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,299
Initial costs, buildings	20,545
Land at cost	1,299
Buildings at cost	20,545
Total at cost	21,844
Accumulated Depreciation	8,268
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,822
Initial costs, buildings	37,467
Additions subsequent to acquisition, Improvements	67,951
Land at cost	1,822
Buildings at cost	105,418
Total at cost	107,240
Accumulated Depreciation	19,747
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Apr. 01, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	10,851
Additions subsequent to acquisition, Improvements	7,982
Land at cost	8,053
Buildings at cost	18,833
Total at cost	26,886
Accumulated Depreciation	6,230
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1892 [Member] | Hinckley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,424
Initial costs, buildings	16,521
Land at cost	2,424
Buildings at cost	16,521
Total at cost	18,945
Accumulated Depreciation	1,566
Encumbrances	$ 0
Date of Construction	1892
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Cadiz Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 281
Initial costs, buildings	6,377
Land at cost	281
Buildings at cost	6,377
Total at cost	6,658
Accumulated Depreciation	456
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 29, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,640
Additions subsequent to acquisition, Improvements	577
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	27,388
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,988
Initial costs, buildings	3,191
Land at cost	9,988
Buildings at cost	3,191
Total at cost	13,179
Accumulated Depreciation	312
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,737
Land at cost	2,417
Buildings at cost	17,594
Total at cost	20,011
Accumulated Depreciation	3,983
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
2000 [Member] | Willenhall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,166
Initial costs, buildings	15,987
Land at cost	7,166
Buildings at cost	15,987
Total at cost	23,153
Accumulated Depreciation	1,513
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1967 [Member] | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,132
Initial costs, buildings	5,002
Land at cost	3,132
Buildings at cost	5,002
Total at cost	8,134
Accumulated Depreciation	540
Encumbrances	$ 0
Date of Construction	1967
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1975 [Member] | Lauderdale Lakes, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,657
Initial costs, buildings	150,313
Additions subsequent to acquisition, Improvements	2,168
Land at cost	10,657
Buildings at cost	152,481
Total at cost	163,138
Accumulated Depreciation	14,581
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,087
Initial costs, buildings	4,078
Land at cost	9,087
Buildings at cost	59,974
Total at cost	69,061
Accumulated Depreciation	7,522
Encumbrances	$ 37,593
Date of Construction	1984
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Orpington, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,163
Initial costs, buildings	41,992
Land at cost	10,163
Buildings at cost	41,992
Total at cost	52,155
Accumulated Depreciation	5,299
Encumbrances	$ 24,206
Date of Construction	1987
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Salt Lake City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,913
Initial costs, buildings	0
Additions subsequent to acquisition, Improvements	0
Land at cost	2,913
Buildings at cost	0
Total at cost	2,913
Accumulated Depreciation	0
Encumbrances	$ 0
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1996 [Member] | Mcminnville, OR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,000
Initial costs, buildings	97,900
Land at cost	5,000
Buildings at cost	97,900
Total at cost	102,900
Accumulated Depreciation	21,619
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	41 years
1996 [Member] | Poole, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,286
Initial costs, buildings	37,734
Land at cost	2,286
Buildings at cost	37,734
Total at cost	40,020
Accumulated Depreciation	5,620
Encumbrances	$ 12,821
Date of Construction	1996
Date Acquired	Apr. 03, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1955 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 44,400
Initial costs, buildings	107,203
Additions subsequent to acquisition, Improvements	3,440
Land at cost	44,400
Buildings at cost	110,643
Total at cost	155,043
Accumulated Depreciation	11,471
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Aug. 01, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1955 [Member] | Windsor, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 11,978
Initial costs, buildings	102,957
Land at cost	11,978
Buildings at cost	102,957
Total at cost	114,935
Accumulated Depreciation	12,903
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1988 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	15,750
Additions subsequent to acquisition, Improvements	10,947
Land at cost	20,430
Buildings at cost	26,697
Total at cost	47,127
Accumulated Depreciation	2,281
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Apr. 25, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1988 [Member] | Palestine, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,848
Initial costs, buildings	95,257
Land at cost	1,848
Buildings at cost	95,257
Total at cost	97,105
Accumulated Depreciation	12,482
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,640
Additions subsequent to acquisition, Improvements	577
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	27,388
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Apr. 01, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | Pasco, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,594
Initial costs, buildings	13,195
Land at cost	2,594
Buildings at cost	13,195
Total at cost	15,789
Accumulated Depreciation	2,855
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	30 years
1920 [Member] | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	2,657
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	May 02, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1919 [Member] | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	2,657
Encumbrances	$ 0
Date of Construction	1919
Date Acquired	May 02, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1958 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	15,750
Additions subsequent to acquisition, Improvements	10,947
Land at cost	20,430
Buildings at cost	26,697
Total at cost	47,127
Accumulated Depreciation	2,281
Encumbrances	$ 0
Date of Construction	1958
Date Acquired	Apr. 25, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1958 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,946
Initial costs, buildings	30,465
Additions subsequent to acquisition, Improvements	7,104
Land at cost	7,946
Buildings at cost	37,569
Total at cost	45,515
Accumulated Depreciation	3,158
Encumbrances	$ 0
Date of Construction	1958
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] | Barby, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,708
Initial costs, buildings	19,057
Land at cost	1,708
Buildings at cost	19,057
Total at cost	20,765
Accumulated Depreciation	927
Encumbrances	$ 0
Date of Construction	1995
Date Acquired	Apr. 19, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] | Brandis, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 2,079
Initial costs, buildings	22,882
Land at cost	2,079
Buildings at cost	22,882
Total at cost	24,961
Accumulated Depreciation	1,141
Encumbrances
Date of Construction	1995
Date Acquired	Apr. 19, 2023
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,811
Initial costs, buildings	5,940
Land at cost	2,811
Buildings at cost	5,940
Total at cost	8,751
Accumulated Depreciation	649
Encumbrances	$ 0
Date of Construction	1995
Date Acquired	Jul. 06, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1906 [Member] | Salt Lake City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,913
Initial costs, buildings	0
Additions subsequent to acquisition, Improvements	0
Land at cost	2,913
Buildings at cost	0
Total at cost	2,913
Accumulated Depreciation	0
Encumbrances	$ 0
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1906 [Member] | Royston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,620
Initial costs, buildings	19,710
Land at cost	6,620
Buildings at cost	19,710
Total at cost	26,330
Accumulated Depreciation	2,172
Encumbrances	$ 0
Date of Construction	1906
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1850 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,593
Initial costs, buildings	31,287
Land at cost	8,593
Buildings at cost	31,287
Total at cost	39,880
Accumulated Depreciation	2,487
Encumbrances	$ 0
Date of Construction	1850
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1850 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,700
Initial costs, buildings	30,500
Land at cost	1,700
Buildings at cost	30,500
Total at cost	32,200
Accumulated Depreciation	2,164
Encumbrances	$ 0
Date of Construction	1850
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1951 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 983
Initial costs, buildings	2,371
Land at cost	983
Buildings at cost	2,371
Total at cost	3,354
Accumulated Depreciation	398
Encumbrances	$ 0
Date of Construction	1951
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1913 [Member] | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,931
Land at cost	3,363
Buildings at cost	10,931
Total at cost	14,294
Accumulated Depreciation	4,595
Encumbrances	$ 0
Date of Construction	1913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1820 [Member] | Southampton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,336
Initial costs, buildings	18,605
Land at cost	6,336
Buildings at cost	18,605
Total at cost	24,941
Accumulated Depreciation	2,017
Encumbrances	$ 0
Date of Construction	1820
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1940 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	80,168
Additions subsequent to acquisition, Improvements	90,934
Land at cost	28,687
Buildings at cost	171,102
Total at cost	199,789
Accumulated Depreciation	20,251
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1940 [Member] | Tempe, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,050
Initial costs, buildings	10,986
Additions subsequent to acquisition, Improvements	5,239
Land at cost	6,050
Buildings at cost	16,225
Total at cost	22,275
Accumulated Depreciation	3,325
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1770 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,700
Initial costs, buildings	30,500
Land at cost	1,700
Buildings at cost	30,500
Total at cost	32,200
Accumulated Depreciation	2,164
Encumbrances	$ 0
Date of Construction	1770
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1962 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 20,430
Initial costs, buildings	15,750
Additions subsequent to acquisition, Improvements	10,947
Land at cost	20,430
Buildings at cost	26,697
Total at cost	47,127
Accumulated Depreciation	2,281
Encumbrances	$ 0
Date of Construction	1962
Date Acquired	Apr. 25, 2022
Life on which depreciation in latest income statements is computed (Years)	40 years
1962 [Member] | West Monroe, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 11,702
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	19,116
Land at cost	12,254
Buildings at cost	87,997
Total at cost	100,251
Accumulated Depreciation	23,234
Encumbrances	$ 0
Date of Construction	1962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1911 [Member] | Winchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,377
Initial costs, buildings	10,103
Land at cost	6,377
Buildings at cost	10,103
Total at cost	16,480
Accumulated Depreciation	1,303
Encumbrances	$ 10,248
Date of Construction	1911
Date Acquired	Jan. 09, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1800 [Member] | Woking, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,117
Initial costs, buildings	4,601
Land at cost	7,117
Buildings at cost	4,601
Total at cost	11,718
Accumulated Depreciation	493
Encumbrances	$ 0
Date of Construction	1800
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1929 [Member] | Youngstown, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,555
Initial costs, buildings	3,469
Additions subsequent to acquisition, Improvements	488
Land at cost	3,555
Buildings at cost	3,957
Total at cost	7,512
Accumulated Depreciation	2,724
Encumbrances	$ 0
Date of Construction	1929
Date Acquired	May 01, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
[1] Excludes approximately $ 420 million and $ 400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2024 and 2023, respectively. Includes $ 52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024.

Schedule III - Real Estate In_3

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Billions	Dec. 31, 2024 USD ($)
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 11

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2024		Dec. 31, 2023		Dec. 31, 2022
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period		$ 11,813,175	[1]	$ 12,300,524		$ 13,628,749
Acquisitions		0		143,882		622,999
Transfers from construction in progress		79,385		72,791		47,431
Additions		73,523		87,873		150,290
Dispositions		(1,492,320)		(874,519)		(1,471,529)
Impairments		(276,572)		(67,671)
Other	[2]	(110,698)		150,295		(677,416)
Balance at end of period		$ 10,086,493	[1]	$ 11,813,175	[1]	$ 12,300,524
[1] Excludes approximately $ 420 million and $ 400 million of construction and building improvements in progress reflected in buildings and improvements at December 31, 2024 and 2023, respectively. Includes $ 52.2 million of land and building cost reflected in real estate held for sale at December 31, 2024. Includes foreign currency fluctuations for all years.

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024		Dec. 31, 2023	Dec. 31, 2022
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 1,227,619		$ 1,008,340	$ 950,369
Depreciation	242,802		270,816	277,032
Depreciation on disposed property	(220,435)		(73,765)	(185,519)
Other	(10,089)		22,228	(33,542)
Balance at end of period	$ 1,239,897	[1]	$ 1,227,619	$ 1,008,340
[1] Includes $ 18.2 million of accumulated depreciation reflected in real estate held for sale at December 31, 2024.

Schedule III - Changes in Acc_2

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Construction and building improvements in progress	$ 420	$ 400
Land and building cost reflected in real estate held for sale	52.2
Accumulated depreciation, real estate held for sale	$ 18.2

Schedule IV - Schedule of Mortg

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Mortgage Loans on Real Estate [Line Items]
Face Amount of Mortgages	$ 293,177
Carrying Amount of Mortgages	$ 119,912	$ 310,101	$ 364,420	$ 213,320
Long-Term First Mortgage Loan [Member] | Colombia [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.61%
Final Maturity Date	2035
Face Amount of Mortgages	$ 129,968
Carrying Amount of Mortgages	$ 111,985
Long-Term First Mortgage Loan [Member] | Vibra [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.50%
Final Maturity Date	2026
Face Amount of Mortgages	$ 7,986
Carrying Amount of Mortgages	$ 7,927
Long-Term First Mortgage Loan [Member] | Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	9%
Final Maturity Date	2028
Face Amount of Mortgages	$ 155,223
Carrying Amount of Mortgages	$ 0

Schedule IV - Schedule of Mor_2

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2024 USD ($) Property	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	293,200,000
Credit loss reserve	1,500,000,000	$ 10,000,000	$ 114,000,000
Vibra [Member]
Mortgage Loans on Real Estate [Line Items]
Credit loss reserve	100,000
Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Reserves/writedowns	$ 155,000,000
Prospect [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	4
Colombia [Member]
Mortgage Loans on Real Estate [Line Items]
Reserves/writedowns	$ 18,000,000
Colombia [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	3

Schedule IV - Changes in Mortga

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
SEC Schedule, 12-29, Real Estate Companies, Investment in Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 310,101	$ 364,420	$ 213,320
New mortgage loans and additional advances on existing loans	100,824	155,223	177,924
Exchange rate fluctuations	(17,748)	31,530	(15,824)
Mortgage loans on real estate including additions during year	393,177	551,173	375,420
Collection of principal	(100,000)	(241,072)	(11,000)
Other	(173,265)
Deductions during year	(273,265)	(241,072)	(11,000)
Balance at end of year	$ 119,912	$ 310,101	$ 364,420

Schedule IV - Changes in Mort_2

Schedule IV - Changes in Mortgage Loans Excluding Allowance for Credit Loss (Parenthetical) (Detail) - USD ($) $ in Thousands			12 Months Ended
		May 23, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Mortgage Loans on Real Estate [Line Items]
Advanced to the mortgage loan	[1]		$ 0	$ 22,900	$ 0
PHP Holdings [Member] | Prospect Medical Holdings Inc [Member]
Mortgage Loans on Real Estate [Line Items]
Unpaid rent and interest		$ 112,900
Mortgage Loans [Member] | PHP Holdings [Member] | Prospect Medical Holdings Inc [Member]
Mortgage Loans on Real Estate [Line Items]
Unpaid rent and interest		$ 151,000	$ 151,000
[1] The 2023 column includes a $ 23 million mortgage loan that was converted to fee simple ownership of one property as described under the Lifepoint Transaction below.