Medical Properties Trust (MPW) 10-Q 10 May 16 2016 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2016	May. 05, 2016
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q1
Trading Symbol	MPW
Entity Registrant Name	MEDICAL PROPERTIES TRUST INC
Entity Central Index Key	1,287,865
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		237,871,522
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q1
Entity Registrant Name	MPT OPERATING PARTNERSHIP, L.P.
Entity Central Index Key	1,524,607
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	$ 3,395,836	$ 3,297,705
Mortgage loans	757,578	757,581
Net investment in direct financing leases	630,482	626,996
Gross investment in real estate assets	4,783,896	4,682,282
Accumulated depreciation and amortization	(280,099)	(257,928)
Net investment in real estate assets	4,503,797	4,424,354
Cash and cash equivalents	206,410	195,541
Interest and rent receivables	50,467	46,939
Straight-line rent receivables	90,791	82,155
Other loans	663,259	664,822
Other assets	195,671	195,540
Total Assets	5,710,395	5,609,351
Liabilities
Debt, net	3,396,604	3,322,541
Accounts payable and accrued expenses	139,443	137,356
Deferred revenue	21,585	29,358
Lease deposits and other obligations to tenants	16,615	12,831
Total liabilities	$ 3,574,247	$ 3,502,086
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 500,000 shares; issued and outstanding - 237,242 shares at March 31, 2016 and 236,744 shares at December 31, 2015	$ 237	$ 237
Limited Partners:
Additional paid in capital	2,595,725	2,593,827
Distributions in excess of net income	(413,108)	(418,650)
Accumulated other comprehensive loss	(51,482)	(72,884)
Treasury shares, at cost	(262)	(262)
Total Medical Properties Trust, Inc. Stockholders' Equity	2,131,110	2,102,268
Non-controlling interests	5,038	4,997
Total Equity / Capital	2,136,148	2,107,265
Total Liabilities and Equity / Capital	5,710,395	5,609,351
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land, buildings and improvements, intangible lease assets, and other	3,395,836	3,297,705
Mortgage loans	757,578	757,581
Net investment in direct financing leases	630,482	626,996
Gross investment in real estate assets	4,783,896	4,682,282
Accumulated depreciation and amortization	(280,099)	(257,928)
Net investment in real estate assets	4,503,797	4,424,354
Cash and cash equivalents	206,410	195,541
Interest and rent receivables	50,467	46,939
Straight-line rent receivables	90,791	82,155
Other loans	663,259	664,822
Other assets	195,671	195,540
Total Assets	5,710,395	5,609,351
Liabilities
Debt, net	3,396,604	3,322,541
Accounts payable and accrued expenses	86,731	84,628
Deferred revenue	21,585	29,358
Lease deposits and other obligations to tenants	16,615	12,831
Payable due to Medical Properties Trust, Inc.	52,322	52,338
Total liabilities	3,573,857	3,501,696
Limited Partners:
Accumulated other comprehensive loss	(51,482)	(72,884)
Total Medical Properties Trust, Inc. Stockholders' Equity	2,131,500	2,102,658
Non-controlling interests	5,038	4,997
Total Equity / Capital	2,136,538	2,107,655
Total Liabilities and Equity / Capital	5,710,395	5,609,351
MPT Operating Partnership, L.P. [Member] | Common Units [Member]
Limited Partners:
Limited Partners Capital	2,161,134	2,153,769
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Equity / Capital
General Partner - issued and outstanding - 2,368 units at March 31, 2016 and 2,363 units at December 31, 2015	$ 21,848	$ 21,773

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2016	Dec. 31, 2015
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	500,000,000	500,000,000
Common stock, shares issued	237,242,000	236,744,000
Common stock, shares outstanding	237,242,000	236,744,000
Common Units [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	234,874,000	234,381,000
Limited Partners, units outstanding	234,874,000	234,381,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	2,368,000	2,363,000
General partner, units outstanding	2,368,000	2,363,000
LTIP Units [Member] | MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	292,000	292,000
LTIP Units, shares outstanding	292,000	292,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Revenues
Rent billed	$ 74,061	$ 53,100
Straight-line rent	8,217	4,728
Income from direct financing leases	18,951	12,555
Interest and fee income	33,770	25,578
Total revenues	134,999	95,961
Expenses
Real estate depreciation and amortization	21,142	14,756
Property-related	901	351
General and administrative	11,471	10,905
Acquisition expenses	(1,065)	6,239
Total operating expenses	32,449	32,251
Operating income	102,550	63,710
Other income (expense)
Other income (expense)	369	(796)
Earnings (loss) from equity and other interests	(5,001)	103
Interest expense	(39,373)	(26,666)
Income tax expense	(319)	(375)
Net other expense	(44,324)	(27,734)
Income from continuing operations	58,226	35,976
Loss from discontinued operations	(1)
Net income	58,225	35,976
Net income attributable to non-controlling interests	(298)	(79)
Net income attributable to MPT common stockholders	$ 57,927	$ 35,897
Earnings per share / unit - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.24	$ 0.18
Loss from discontinued operations attributable to MPT common stockholders	0	0
Net income attributable to MPT common stockholders	$ 0.24	$ 0.18
Weighted average shares (units) outstanding - basic	237,510	202,958
Earnings per share / unit - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.24	$ 0.17
Loss from discontinued operations attributable to MPT common stockholders	0	0
Net income attributable to MPT common stockholders	$ 0.24	$ 0.17
Weighted average shares (units) outstanding-diluted	237,819	203,615
Dividends declared per common share / unit	$ 0.22	$ 0.22
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 74,061	$ 53,100
Straight-line rent	8,217	4,728
Income from direct financing leases	18,951	12,555
Interest and fee income	33,770	25,578
Total revenues	134,999	95,961
Expenses
Real estate depreciation and amortization	21,142	14,756
Property-related	901	351
General and administrative	11,471	10,905
Acquisition expenses	(1,065)	6,239
Total operating expenses	32,449	32,251
Operating income	102,550	63,710
Other income (expense)
Other income (expense)	369	(796)
Earnings (loss) from equity and other interests	(5,001)	103
Interest expense	(39,373)	(26,666)
Income tax expense	(319)	(375)
Net other expense	(44,324)	(27,734)
Income from continuing operations	58,226	35,976
Loss from discontinued operations	(1)
Net income	58,225	35,976
Net income attributable to non-controlling interests	(298)	(79)
Net income attributable to MPT common stockholders	$ 57,927	$ 35,897
Earnings per share / unit - basic
Income from continuing operations attributable to MPT common stockholders	$ 0.24	$ 0.18
Loss from discontinued operations attributable to MPT common stockholders	0	0
Net income attributable to MPT common stockholders	$ 0.24	$ 0.18
Weighted average shares (units) outstanding - basic	237,510	202,958
Earnings per share / unit - diluted
Income from continuing operations attributable to MPT common stockholders	$ 0.24	$ 0.17
Loss from discontinued operations attributable to MPT common stockholders	0	0
Net income attributable to MPT common stockholders	$ 0.24	$ 0.17
Weighted average shares (units) outstanding-diluted	237,819	203,615
Dividends declared per common share / unit	$ 0.22	$ 0.22

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Net income	$ 58,225	$ 35,976
Other comprehensive income:
Unrealized gain on interest rate swap	815	585
Foreign currency translation gain (loss)	20,587	(59,593)
Total comprehensive income (loss)	79,627	(23,032)
Comprehensive income (loss) attributable to non-controlling interests	(298)	(79)
Comprehensive income (loss) attributable to MPT common stockholders	79,329	(23,111)
MPT Operating Partnership, L.P. [Member]
Net income	58,225	35,976
Other comprehensive income:
Unrealized gain on interest rate swap	815	585
Foreign currency translation gain (loss)	20,587	(59,593)
Total comprehensive income (loss)	79,627	(23,032)
Comprehensive income (loss) attributable to non-controlling interests	(298)	(79)
Comprehensive income (loss) attributable to MPT common stockholders	$ 79,329	$ (23,111)

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Operating activities
Net income	$ 58,225	$ 35,976
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	21,694	15,074
Direct financing lease interest accretion	(2,612)	(1,604)
Straight-line rent revenue	(8,217)	(4,728)
Share / (Unit)-based compensation expense	2,020	2,825
Amortization and write-off of deferred financing costs and debt discount	1,835	1,377
Other adjustments	(3,178)	(1,290)
Changes in:
Interest and rent receivables	(3,453)	667
Accounts payable and accrued liabilities\expenses	3,022	(6,271)
Net cash provided by operating activities	69,336	42,026
Investing activities
Cash paid for acquisitions and other related investments		(165,700)
Principal received on loans receivable	1,954	1,466
Investment in loans receivable		(80,301)
Construction in progress and other	(55,301)	(46,511)
Net cash used for investing activities	(53,347)	(291,046)
Financing activities
Revolving credit facilities, net	(455,000)	(285,000)
Proceeds from term debt	500,000
Payments of term debt	(74)	(71)
Distributions paid	(52,402)	(38,461)
Proceeds from sale of common shares / units, net of offering costs		479,966
Lease deposits and other obligations to tenants	3,371	(15,319)
Debt issuance costs paid and other financing activities	(8,173)	(126)
Net cash (used for) provided by financing activities	(12,278)	140,989
Increase (decrease) in cash and cash equivalents for period	3,711	(108,031)
Effect of exchange rate changes	7,158	(2,962)
Cash and cash equivalents at beginning of period	195,541	144,541
Cash and cash equivalents at end of period	206,410	33,548
Interest paid	26,470	22,832
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	52,386	46,026
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	58,225	35,976
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	21,694	15,074
Direct financing lease interest accretion	(2,612)	(1,604)
Straight-line rent revenue	(8,217)	(4,728)
Share / (Unit)-based compensation expense	2,020	2,825
Amortization and write-off of deferred financing costs and debt discount	1,835	1,377
Other adjustments	(3,178)	(1,290)
Changes in:
Interest and rent receivables	(3,453)	667
Accounts payable and accrued liabilities\expenses	3,022	(6,271)
Net cash provided by operating activities	69,336	42,026
Investing activities
Cash paid for acquisitions and other related investments		(165,700)
Principal received on loans receivable	1,954	1,466
Investment in loans receivable		(80,301)
Construction in progress and other	(55,301)	(46,511)
Net cash used for investing activities	(53,347)	(291,046)
Financing activities
Revolving credit facilities, net	(455,000)	(285,000)
Proceeds from term debt	500,000
Payments of term debt	(74)	(71)
Distributions paid	(52,402)	(38,461)
Proceeds from sale of common shares / units, net of offering costs		479,966
Lease deposits and other obligations to tenants	3,371	(15,319)
Debt issuance costs paid and other financing activities	(8,173)	(126)
Net cash (used for) provided by financing activities	(12,278)	140,989
Increase (decrease) in cash and cash equivalents for period	3,711	(108,031)
Effect of exchange rate changes	7,158	(2,962)
Cash and cash equivalents at beginning of period	195,541	144,541
Cash and cash equivalents at end of period	206,410	33,548
Interest paid	26,470	22,832
Supplemental schedule of non-cash financing activities:
Distributions declared, unpaid	$ 52,386	$ 46,026

Organization

Organization	3 Months Ended
	Mar. 31, 2016
Accounting Policies [Abstract]
Organization	1. Organization 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 commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P., (the “Operating Partnership”) through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited 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 have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will generally not be subject to federal income tax in the United States (“U.S.”), provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain activities we undertake must be conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U. S., we are subject to local taxes; however, we do not expect to incur additional taxes in the U.S. as such income will flow through our REIT. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services such as operators of general acute care hospitals, inpatient physical rehabilitation hospitals, long-term acute care hospitals, surgery centers, centers for treatment of specific conditions such as cardiac, pulmonary, cancer, and neurological hospitals, and other healthcare-oriented facilities. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time to time, in order to enhance our overall return. We manage our business as a single business segment. All of our properties are located in the U.S. and Europe.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2016
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Unaudited Interim Condensed Consolidated Financial Statements For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2015. During the three months ended March 31, 2016, there were no material changes to these policies. Recent Accounting Developments: Revenue from Contracts with Customers In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers Leases In February 2016, the FASB issued ASU 2016-02 - Leases Variable Interest Entities At March 31, 2016, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities, including Ernest Health, Inc. (“Ernest”) and Capella Healthcare, Inc. (“Capella”). We have determined that we are 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 are presented below at March 31, 2016 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 998,447 Mortgage and other loans $ 921,503 Equity investments $ 55,489 Other assets $ 6,239 (1) 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 rents receivable), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represents the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE 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 March 31, 2016, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which it could be exposed to further losses (e.g., cash short falls). Typically, our loans are collateralized by assets of the borrower (some assets of which are on the premises of facilities owned by us) and further supported by limited guarantees made by certain principals of the borrower. See Note 3 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein.

Real Estate and Lending Activit

Real Estate and Lending Activities	3 Months Ended
	Mar. 31, 2016
Text Block [Abstract]
Real Estate and Lending Activities	3. Real Estate and Lending Activities Acquisitions We acquired the following assets (in thousands): Three Months Ended March 31, 2016 2015 Assets Acquired Land $ — $ 14,844 Building — 87,914 Intangible lease assets — subject to amortization (weighted average useful life 20 years) — 7,242 Mortgage loans — 40,000 Net investments in direct financing leases — 10,700 Other loans — 5,000 Total assets acquired $ — $ 165,700 On February 13, 2015, we acquired two general acute care hospitals in the Kansas City area for $110 million. Affiliates of Prime Healthcare Services, Inc. (“Prime”) is the tenant and operator pursuant to a master lease with a 10-year initial fixed term with two extension options of five years each. The lease provides for consumer-price-indexed annual rent increases, subject to a specified floor. In addition, we funded a mortgage loan in the amount of $40 million, which has a 10-year term. On February 27, 2015, we acquired an inpatient rehabilitation hospital in Weslaco, Texas for $10.7 million leased to Ernest pursuant to the 2012 master lease which had an initial 20-year fixed term and three five year extension options. This lease provides for consumer-priced-indexed annual rent increases, subject to a floor and a cap. In addition, we funded an acquisition loan in the amount of $5 million. Development Activities During the 2016 first quarter, we completed construction and began recording rental income on five acute care facilities that are leased to Adeptus Health Inc. (“Adeptus Health”), pursuant to the 2014 master lease agreement. In the first quarter of 2016, we began construction on four additional facilities pursuant to the master funding and development agreement with Adeptus Health executed in 2014. See table below for a status update on our current development projects (in thousands): Operator Commitment Costs Incurred as of March 31, 2016 Estimated Completion Date Ernest $ 19,212 $ 16,894 2Q 2016 Adeptus Health 12,639 8,734 2Q 2016 Adeptus Health 62,155 36,257 3Q 2016 Adeptus Health 61,997 8,745 2Q 2017 Adeptus Health 123,033 — Various $ 279,036 $ 70,630 Leasing Operations All of our leases are accounted for as operating leases except for the master lease of 15 Ernest facilities, five Prime facilities, and four Capella facilities which are accounted for as direct financing leases (“DFLs”). The components of our net investment in DFLs consisted of the following (in thousands): As of March 31, 2016 As of December 31, 2015 Minimum lease payments receivable $ 2,571,638 $ 2,587,912 Estimated residual values 393,970 393,097 Less: Unearned income (2,335,126 ) (2,354,013 ) Net investment in direct financing leases $ 630,482 $ 626,996 Twelve Oaks Facility In the third quarter of 2015, we sent notice of termination of the lease to the tenant at our Twelve Oaks facility. This former tenant continues to operate the facility and has made payments of approximately $1.5 million in 2016. We called their letter of credit for approximately $0.5 million in the 2016 first quarter. At March 31, 2016, we have less than $0.1 million of receivables outstanding with this tenant (net of reserves). Although no assurances can be made that we will not have any impairment charges or write-offs of receivables in the future, we believe our investment in Twelve Oaks at March 31, 2016 is fully recoverable. Loans The following is a summary of our loans (in thousands): As of March 31, 2016 As of December 31, 2015 Mortgage loans $ 757,578 $ 757,581 Acquisition loans 610,003 610,469 Working capital and other loans 53,256 54,353 $ 1,420,837 $ 1,422,403 Our non-mortgage loans typically consist of loans to our tenants for acquisitions and working capital purposes. At March 31, 2016, acquisition loans includes $114.4 million in loans to Ernest plus $487.7 million related to Capella (which was repaid in full as of April 30, 2016 – see Note 10 for further details). On March 1, 2012, pursuant to our convertible note agreement, we converted $1.7 million of our $5.0 million convertible note into a 9.9% equity interest in the operator of our Hoboken University Medical Center facility. At March 31, 2016, $3.3 million remains outstanding on the convertible note, and we retain the option, subject to regulatory approvals, to convert this remainder into an additional 15.1% equity interest in the operator. Concentrations of Credit Risk Our revenue concentration for the three months ended March 31, 2016 as compared to the prior year is as follows (dollars in thousands): Revenue by Operator For the Three Months Ended March 31, 2016 For the Three Months Ended March 31, 2015 Operators Total Revenue Percentage of Total Revenue Total Revenue Percentage of Total Revenue Prime $ 28,897 21.4 % $ 24,021 25.0 % MEDIAN 23,510 17.4 % 15,210 15.9 % Capella 21,477 15.9 % — — Ernest 16,406 12.2 % 14,700 15.3 % Adeptus Health 7,676 5.7 % 3,405 3.6 % Revenue by U.S. State and Country For the Three Months Ended March 31, 2016 For the Three Months Ended March 31, 2015 U.S. States and Other Countries Total Revenue Percentage of Total Revenue Total Revenue Percentage of Total Revenue Texas $ 24,472 18.1 % $ 21,016 21.9 % California 16,597 12.3 % 16,539 17.2 % All other states 69,315 51.4 % 42,114 43.9 % Total U.S. $ 110,384 81.8 % $ 79,669 83.0 % Germany $ 23,510 17.4 % $ 15,210 15.9 % United Kingdom, Italy, and Spain 1,105 0.8 % 1,082 1.1 % Total International $ 24,615 18.2 % $ 16,292 17.0 % Grand Total $ 134,999 100.0 % $ 95,961 100.0 % From an asset basis, our concentration as of March 31, 2016 as compared to December 31, 2015 is as follows (dollars in thousands): Gross Assets by Operator As of March 31, 2016 As of December 31, 2015 Operators Total Gross Assets Percentage of Total Gross Assets Percentage of (A) (A) Prime $ 1,125,994 19.9 % $ 1,032,353 17.1 % MEDIAN 1,080,381 19.1 % 1,031,039 17.1 % Ernest 581,087 10.3 % 579,182 9.6 % Capella 510,895 9.0 % 1,059,989 17.6 % Adeptus Health 500,000 8.8 % 500,000 8.3 % Gross Assets by U.S. State and Country As of March 31, 2016 As of December 31, 2015 U.S. States and Other Countries Total Gross Assets Percentage of Total Gross Assets Percentage of (A) (A) Texas $ 1,077,738 19.0 % $ 1,060,990 17.6 % California 547,082 9.7 % 547,085 9.1 % All other states 2,588,647 45.7 % 3,047,204 50.4 % Other domestic assets 185,394 3.3 % 177,317 3.1 % Total U.S. $ 4,398,861 77.7 % $ 4,832,596 80.2 % Germany $ 1,080,381 19.1 % $ 1,031,039 17.1 % United Kingdom, Italy, and Spain 161,880 2.9 % 161,317 2.7 % Other international assets 21,708 0.3 % 10,970 — Total International $ 1,263,969 22.3 % $ 1,203,326 19.8 % Grand Total $ 5,662,830 100.0 % $ 6,035,922 100.0 % (A) Gross Assets represents total assets plus accumulated depreciation/amortization assuming all real estate commitments as of the period end are fully funded and the completion of the subsequent Capella transaction. On an individual property basis, we had no investment of any single property greater than 2.0% of our total assets as of March 31, 2016.

Debt

Debt	3 Months Ended
	Mar. 31, 2016
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt (dollar amounts in thousands): As of March 31, 2016 As of December 31, 2015 Balance Interest Rate Balance Interest Rate Revolving credit facility $ 645,000 Variable $ 1,100,000 Variable 2006 Senior Unsecured Notes 125,000 Various 125,000 Various 2011 Senior Unsecured Notes 450,000 6.875 % 450,000 6.875 % 2012 Senior Unsecured Notes: Principal amount 350,000 6.375 % 350,000 6.375 % Unamortized premium 2,079 2,168 352,079 352,168 2013 Senior Unsecured Notes (A) 227,600 5.750 % 217,240 5.750 % 2014 Senior Unsecured Notes 300,000 5.500 % 300,000 5.500 % 2015 Senior Unsecured Notes (A) 569,000 4.000 % 543,100 4.000 % 2016 Senior Unsecured Notes 500,000 6.375 % — — Term loans 263,326 Various 263,400 Various $ 3,432,005 $ 3,350,908 Debt issue costs, net (35,401 ) (28,367 ) $ 3,396,604 $ 3,322,541 (A) These notes are Euro-denominated and reflect the exchange rate at March 31, 2016 and December 31, 2015, respectively. As of March 31, 2016, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands): 2016 $ 125,225 2017 320 2018 657,781 2019 250,000 2020 227,600 Thereafter 2,169,000 Total $ 3,429,926 On February 22, 2016, we completed a $500 million senior unsecured notes offering (“2016 Senior Unsecured Notes”), proceeds of which were used to repay borrowings under our Revolving credit facility. Interest on the notes will be payable on March 1 and September 1 of each year, commencing on September 1, 2016, Interest on the notes will be paid in cash at a rate of 6.375% per year. The notes mature on March 1, 2024. We may redeem some or all of the notes at any time prior to March 1, 2019 at a “make whole” redemption price. On or after March 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% 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. During the second quarter 2010, we entered into an interest rate swap to manage our exposure to variable interest rates by fixing $65 million of our 2006 Senior Unsecured Notes, which started July 31, 2011 (date on which the interest rate turned variable) through maturity date (or July 2016), at a rate of 5.507%. We also entered into an interest rate swap to fix $60 million of our 2006 Senior Unsecured Notes which started October 31, 2011 (date on which the related interest rate turned variable) through the maturity date (or October 2016) at a rate of 5.675%. The fair value of the interest rate swaps was $2.1 million and $2.9 million as of March 31, 2016 and December 31, 2015, respectively, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets. We account for our interest rate swaps as cash flow hedges. Accordingly, the effective portion of changes in the fair value of our swaps is recorded as a component of accumulated other comprehensive income/loss on the balance sheet and reclassified into earnings in the same period, or periods, during which the hedged transactions effect earnings, while any ineffective portion is recorded through earnings immediately. We did not have any hedge ineffectiveness from inception of our interest rate swaps through March 31, 2016 and therefore, there was no income statement effect recorded during the three month periods ended March 31, 2016 or 2015. We do expect current losses included in accumulated other comprehensive loss to be reclassified into earnings in the next 12 months. At March 31, 2016 and December 31, 2015, we have posted $1.2 million and $1.7 million of collateral related to our interest rate swaps, respectively, which is reflected in other assets on our consolidated balance sheets. Covenants Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our revolving credit facility and term loan limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations, as defined in the agreements, on a rolling four quarter basis. At March 31, 2016, the dividend restriction was 95% of normalized adjusted FFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of funds from operations, 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 revolving credit facility and term loan contain 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. This facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations and failure to comply with our covenants. If an event of default occurs and is continuing under the facility, the entire outstanding balance may become immediately due and payable. At March 31, 2016, we were in compliance with all such financial and operating covenants. At March 31, 2016, the total leverage ratio covenant in our credit facility was 70% and the unsecured leverage ratio covenant was 77.5%. In June 2016, the total leverage ratio will reset to 60%, and in September 2016, the unsecured leverage ratio will reset to 65%. With the subsequent sale of certain assets as more fully described in Note 10, we are currently in compliance with the reset leverage covenants.

Common Stock_Partner's Capital

Common Stock/Partner's Capital	3 Months Ended
	Mar. 31, 2016
Equity [Abstract]
Common Stock/Partner's Capital	5. Common Stock/Partner’s Capital Medical Properties Trust, Inc. On March 1, 2016, we updated our at-the-market equity offering program, which gives us the ability to sell up to $227 million of stock with a commission rate of 1.25%. We did not sell any stock under this program during the three month period ending March 31, 2016. On January 14, 2015, we completed an underwritten public offering of 34.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 4.5 million shares) of our common stock, resulting in net proceeds of approximately $480 million, after deducting estimated offering expenses. MPT Operating Partnership, L.P. At March 31, 2016, the Company has a 99.8% ownership interest in the Operating Partnership with the remainder owned by three other partners, two of whom are employees and one of whom is a director. During the three months ended March 31, 2015, the partnership issued 34.5 million units in direct response to the common stock offerings by Medical Properties Trust, Inc.

Stock Awards

Stock Awards	3 Months Ended
	Mar. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Awards	6. Stock Awards We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during second quarter of 2013, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 8,196,770 shares of common stock for awards under the Equity Incentive Plan for which 5,615,497 shares remain available for future stock awards as of March 31, 2016. We awarded the following during the 2016 and 2015 first quarters: Time-based awards Performance-based awards Multi-year Performance-based awards

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	7. Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents, and accounts payable and accrued expenses approximate their fair values. Included in our accounts payable and accrued expenses are our interest rate swaps, which are recorded at fair value based on Level 2 observable market assumptions using standardized derivative pricing models. 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 working capital 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 (excluding our 2006 Senior Unsecured Notes) using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our 2006 Senior Unsecured Notes, 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 possible and may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): March 31, 2016 December 31, 2015 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 50,467 $ 50,407 $ 46,939 $ 46,858 Loans (1) 507,285 541,228 508,851 543,859 Debt, net (3,396,604 ) (3,488,845 ) (3,322,541 ) (3,372,773 ) (1) Excludes loans related to Ernest and Capella since they are recorded at fair value and discussed below. Items Measured at Fair Value on a Recurring Basis Our equity interest in Ernest and Capella along with their related loans are being measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method. 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 equity interests or loans in or prior to 2016. At March 31, 2016, these amounts were as follows (in thousands): Asset Type Fair Value Cost Asset Type Classification Mortgage loans $ 310,000 $ 310,000 Mortgage loans Acquisition and other loans 603,552 603,552 Other loans Equity investments 7,349 7,349 Other assets $ 920,901 $ 920,901 Our mortgage loans with Ernest and Capella are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our acquisition loans and equity investments in Ernest and Capella are recorded at fair value based on Level 3 inputs, by using a discounted cash flow model, which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecast assumptions associated with the investee. We classify these loans and equity investments as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuation requires management judgment due to the absence of quoted market prices. For these cash flow models, our observable inputs include use of a capitalization rate, discount rate (which is based on a weighted-average cost of capital), and market interest rates, and our unobservable input includes an adjustment for a marketability discount (“DLOM”) on our equity investment of 40% at March 31, 2016. In regards to the underlying projection of revenues and expenses used in the discounted cash flow model, such projections are provided by Ernest and Capella. However, we will modify such projections (including underlying assumptions used) as needed based on our review and analysis of Ernest and Capella’s historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry. In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated Increase (Decrease) In Fair Value +100 basis points $ (135 ) - 100 basis points 135 Because the fair value of the Ernest and Capella investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during the first quarter of 2016 or 2015. To date, we have not received any distribution payments from our equity investment in Ernest or Capella. As more fully described in Note 10, in April 2016, we sold our equity interest in Capella at our cost and all loans were repaid in full.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2016
Earnings Per Share [Abstract]
Earnings Per Share	8. Earnings Per Share Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months Ended March 31, 2016 2015 Numerator: Income from continuing operations $ 58,226 $ 35,976 Non-controlling interests’ share in net income (298 ) (79 ) Participating securities’ share in earnings (144 ) (266 ) Income from continuing operations, less participating securities’ share in earnings 57,784 35,631 Loss from discontinued operations (1 ) — Net income, less participating securities’ share in earnings $ 57,783 $ 35,631 Denominator: Basic weighted-average common shares 237,510 202,958 Dilutive potential common shares 309 657 Dilutive weighted-average common shares 237,819 203,615 MPT Operating Partnership, L.P. Our earnings per common unit were calculated based on the following (amounts in thousands): For the Three Months Ended March 31, 2016 2015 Numerator: Income from continuing operations $ 58,226 $ 35,976 Non-controlling interests’ share in net income (298 ) (79 ) Participating securities’ share in earnings (144 ) (266 ) Income from continuing operations, less participating securities’ share in earnings 57,784 35,631 Loss from discontinued operations (1 ) — Net income, less participating securities’ share in earnings $ 57,783 $ 35,631 Denominator: Basic weighted-average units 237,510 202,958 Dilutive potential units 309 657 Diluted weighted-average units 237,819 203,615

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Contingencies	9. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations or cash flows.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2016
Subsequent Events [Abstract]
Subsequent Events	10. Subsequent Events Capella Transaction On March 21, 2016, we entered into definitive agreements with RegionalCare Hospital Partners, Inc. (“RegionalCare”), an affiliate of certain funds managed by affiliates of Apollo Global Management, LLC (together with its consolidated subsidiaries, “Apollo”), under which our investment in the operations of Capella Healthcare, Inc. (“Capella”) would be merged with and into RegionalCare. On April 29, 2016, this transaction closed and funded, effective April 30, 2016. As part of the transaction, we received net proceeds of approximately $550 million including approximately $492 million for our equity investment and loans made as part of the Capella transaction that closed on August 31, 2015. In addition, we received $210 million in prepayment of two mortgage loans for hospitals in Russellville, Arkansas, and Lawton, Oklahoma, that we made to subsidiaries of Capella in connection with the Capella transaction on August 31, 2015. We have made a new $93 million loan for a hospital property in Olympia, Washington, that is expected to be converted to a sale and leaseback arrangement upon regulatory approval. Additionally, we and an Apollo affiliate have invested $50 million each in unsecured senior notes issued by RegionalCare. The net proceeds from this transaction represent the recoverability of our investment in full; therefore, no gain or loss will be recorded in the 2016 second quarter, except for transaction costs incurred, which we estimate to be approximately $5 to $8 million. We used proceeds from this transaction to further pay down our revolving credit facility. MPT will maintain its ownership of five Capella hospitals in Hot Springs, Arkansas; Camden, South Carolina; Hartsville, South Carolina; Muskogee, Oklahoma; and McMinnville, Oregon. Pursuant to the transaction described above, the underlying leases, one of which is a master lease covering all but one property, have been amended for various things, including a slight shortening of the initial fixed lease term, increase in the security deposit, and the elimination of the lessees’ purchase option provisions. Other Activity Subseqent to April 30, 2016, we acquired an acute hospital in Newark, New Jersey for an aggregate purchase price of $63 million leased to Prime pursuant to a fifth master lease, which has a 15-year term with three five-year extension options, plus consumer price-indexed increases, limited to a 2% floor. Furthermore, we committed to advance an additional $30 million to Prime over a three-year period to be used solely for capital additions to the real estate; any such additions will be added to the basis upon which the lessee will pay us rents.

Summary of Significant Accoun17

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2016
Accounting Policies [Abstract]
Unaudited Interim Condensed Consolidated Financial Statements	Unaudited Interim Condensed Consolidated Financial Statements For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2015. During the three months ended March 31, 2016, there were no material changes to these policies.
Recent Accounting Developments	Recent Accounting Developments: Revenue from Contracts with Customers In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers Leases In February 2016, the FASB issued ASU 2016-02 - Leases
Variable Interest Entities	Variable Interest Entities At March 31, 2016, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities, including Ernest Health, Inc. (“Ernest”) and Capella Healthcare, Inc. (“Capella”). We have determined that we are 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 are presented below at March 31, 2016 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 998,447 Mortgage and other loans $ 921,503 Equity investments $ 55,489 Other assets $ 6,239 (1) 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 rents receivable), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represents the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE 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 March 31, 2016, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which it could be exposed to further losses (e.g., cash short falls). Typically, our loans are collateralized by assets of the borrower (some assets of which are on the premises of facilities owned by us) and further supported by limited guarantees made by certain principals of the borrower. See Note 3 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein.

Summary of Significant Accoun18

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2016
Accounting Policies [Abstract]
Carrying Value and Classification of Related Assets and Maximum Exposure to Loss	The carrying value and classification of the related assets and maximum exposure to loss as a result of our involvement with these VIEs are presented below at March 31, 2016 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 998,447 Mortgage and other loans $ 921,503 Equity investments $ 55,489 Other assets $ 6,239 (1) 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 rents receivable), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represents the current carrying values of such investment plus any other related assets (such as rent receivables) less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE.

Real Estate and Lending Activ19

Real Estate and Lending Activities (Tables)	3 Months Ended
	Mar. 31, 2016
Text Block [Abstract]
Assets Acquired	We acquired the following assets (in thousands): Three Months Ended March 31, 2016 2015 Assets Acquired Land $ — $ 14,844 Building — 87,914 Intangible lease assets — subject to amortization (weighted average useful life 20 years) — 7,242 Mortgage loans — 40,000 Net investments in direct financing leases — 10,700 Other loans — 5,000 Total assets acquired $ — $ 165,700
Summary of Status Update on Current Development Projects	See table below for a status update on our current development projects (in thousands): Operator Commitment Costs Incurred as of March 31, 2016 Estimated Completion Date Ernest $ 19,212 $ 16,894 2Q 2016 Adeptus Health 12,639 8,734 2Q 2016 Adeptus Health 62,155 36,257 3Q 2016 Adeptus Health 61,997 8,745 2Q 2017 Adeptus Health 123,033 — Various $ 279,036 $ 70,630
Components of Net Investment in Direct Financing Leases	The components of our net investment in DFLs consisted of the following (in thousands): As of March 31, 2016 As of December 31, 2015 Minimum lease payments receivable $ 2,571,638 $ 2,587,912 Estimated residual values 393,970 393,097 Less: Unearned income (2,335,126 ) (2,354,013 ) Net investment in direct financing leases $ 630,482 $ 626,996
Summary of Loans	The following is a summary of our loans (in thousands): As of March 31, 2016 As of December 31, 2015 Mortgage loans $ 757,578 $ 757,581 Acquisition loans 610,003 610,469 Working capital and other loans 53,256 54,353 $ 1,420,837 $ 1,422,403
Schedule of Revenue by Operator	Revenue by Operator For the Three Months Ended March 31, 2016 For the Three Months Ended March 31, 2015 Operators Total Revenue Percentage of Total Revenue Total Revenue Percentage of Total Revenue Prime $ 28,897 21.4 % $ 24,021 25.0 % MEDIAN 23,510 17.4 % 15,210 15.9 % Capella 21,477 15.9 % — — Ernest 16,406 12.2 % 14,700 15.3 % Adeptus Health 7,676 5.7 % 3,405 3.6 %
Schedule of Revenue from External Customers by Geographic Areas	Revenue by U.S. State and Country For the Three Months Ended March 31, 2016 For the Three Months Ended March 31, 2015 U.S. States and Other Countries Total Revenue Percentage of Total Revenue Total Revenue Percentage of Total Revenue Texas $ 24,472 18.1 % $ 21,016 21.9 % California 16,597 12.3 % 16,539 17.2 % All other states 69,315 51.4 % 42,114 43.9 % Total U.S. $ 110,384 81.8 % $ 79,669 83.0 % Germany $ 23,510 17.4 % $ 15,210 15.9 % United Kingdom, Italy, and Spain 1,105 0.8 % 1,082 1.1 % Total International $ 24,615 18.2 % $ 16,292 17.0 % Grand Total $ 134,999 100.0 % $ 95,961 100.0 %
Schedule of Gross Assets by Operator	Gross Assets by Operator As of March 31, 2016 As of December 31, 2015 Operators Total Gross Assets Percentage of Total Gross Assets Percentage of (A) (A) Prime $ 1,125,994 19.9 % $ 1,032,353 17.1 % MEDIAN 1,080,381 19.1 % 1,031,039 17.1 % Ernest 581,087 10.3 % 579,182 9.6 % Capella 510,895 9.0 % 1,059,989 17.6 % Adeptus Health 500,000 8.8 % 500,000 8.3 %
Schedule of Gross Assets by Geographic Areas	Gross Assets by U.S. State and Country As of March 31, 2016 As of December 31, 2015 U.S. States and Other Countries Total Gross Assets Percentage of Total Gross Assets Percentage of (A) (A) Texas $ 1,077,738 19.0 % $ 1,060,990 17.6 % California 547,082 9.7 % 547,085 9.1 % All other states 2,588,647 45.7 % 3,047,204 50.4 % Other domestic assets 185,394 3.3 % 177,317 3.1 % Total U.S. $ 4,398,861 77.7 % $ 4,832,596 80.2 % Germany $ 1,080,381 19.1 % $ 1,031,039 17.1 % United Kingdom, Italy, and Spain 161,880 2.9 % 161,317 2.7 % Other international assets 21,708 0.3 % 10,970 — Total International $ 1,263,969 22.3 % $ 1,203,326 19.8 % Grand Total $ 5,662,830 100.0 % $ 6,035,922 100.0 % (A) Gross Assets represents total assets plus accumulated depreciation/amortization assuming all real estate commitments as of the period end are fully funded and the completion of the subsequent Capella transaction.

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2016
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt (dollar amounts in thousands): As of March 31, 2016 As of December 31, 2015 Balance Interest Rate Balance Interest Rate Revolving credit facility $ 645,000 Variable $ 1,100,000 Variable 2006 Senior Unsecured Notes 125,000 Various 125,000 Various 2011 Senior Unsecured Notes 450,000 6.875 % 450,000 6.875 % 2012 Senior Unsecured Notes: Principal amount 350,000 6.375 % 350,000 6.375 % Unamortized premium 2,079 2,168 352,079 352,168 2013 Senior Unsecured Notes (A) 227,600 5.750 % 217,240 5.750 % 2014 Senior Unsecured Notes 300,000 5.500 % 300,000 5.500 % 2015 Senior Unsecured Notes (A) 569,000 4.000 % 543,100 4.000 % 2016 Senior Unsecured Notes 500,000 6.375 % — — Term loans 263,326 Various 263,400 Various $ 3,432,005 $ 3,350,908 Debt issue costs, net (35,401 ) (28,367 ) $ 3,396,604 $ 3,322,541 (A) These notes are Euro-denominated and reflect the exchange rate at March 31, 2016 and December 31, 2015, respectively.
Principal Payments Due on Debt	As of March 31, 2016, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands): 2016 $ 125,225 2017 320 2018 657,781 2019 250,000 2020 227,600 Thereafter 2,169,000 Total $ 3,429,926

Fair Value of Financial Instr21

Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2016
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): March 31, 2016 December 31, 2015 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 50,467 $ 50,407 $ 46,939 $ 46,858 Loans (1) 507,285 541,228 508,851 543,859 Debt, net (3,396,604 ) (3,488,845 ) (3,322,541 ) (3,372,773 ) (1) Excludes loans related to Ernest and Capella since they are recorded at fair value and discussed below.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At March 31, 2016, these amounts were as follows (in thousands): Asset Type Fair Value Cost Asset Type Classification Mortgage loans $ 310,000 $ 310,000 Mortgage loans Acquisition and other loans 603,552 603,552 Other loans Equity investments 7,349 7,349 Other assets $ 920,901 $ 920,901
Summary Showing Sensitivity Analysis by Using Basis Point Variations	To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated Increase (Decrease) In Fair Value +100 basis points $ (135 ) - 100 basis points 135

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2016
Earnings Per Share [Abstract]
Calculation of Earnings Per Share	Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months Ended March 31, 2016 2015 Numerator: Income from continuing operations $ 58,226 $ 35,976 Non-controlling interests’ share in net income (298 ) (79 ) Participating securities’ share in earnings (144 ) (266 ) Income from continuing operations, less participating securities’ share in earnings 57,784 35,631 Loss from discontinued operations (1 ) — Net income, less participating securities’ share in earnings $ 57,783 $ 35,631 Denominator: Basic weighted-average common shares 237,510 202,958 Dilutive potential common shares 309 657 Dilutive weighted-average common shares 237,819 203,615 MPT Operating Partnership, L.P. Our earnings per common unit were calculated based on the following (amounts in thousands): For the Three Months Ended March 31, 2016 2015 Numerator: Income from continuing operations $ 58,226 $ 35,976 Non-controlling interests’ share in net income (298 ) (79 ) Participating securities’ share in earnings (144 ) (266 ) Income from continuing operations, less participating securities’ share in earnings 57,784 35,631 Loss from discontinued operations (1 ) — Net income, less participating securities’ share in earnings $ 57,783 $ 35,631 Denominator: Basic weighted-average units 237,510 202,958 Dilutive potential units 309 657 Diluted weighted-average units 237,819 203,615

Summary of Significant Accoun23

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Mar. 31, 2016USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 921,503,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	998,447,000
Other Assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	6,239,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 55,489,000

Real Estate and Lending Activ24

Real Estate and Lending Activities - Assets Acquired (Detail) $ in Thousands	Mar. 31, 2015USD ($)
Business Acquisition [Line Items]
Total assets acquired	$ 165,700
Land [Member]
Business Acquisition [Line Items]
Total assets acquired	14,844
Building [Member]
Business Acquisition [Line Items]
Total assets acquired	87,914
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired	7,242
Net Investments in Direct Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired	10,700
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	5,000
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 40,000

Real Estate and Lending Activ25

Real Estate and Lending Activities - Assets Acquired (Parenthetical) (Detail)	3 Months Ended
	Mar. 31, 2015
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	20 years

Real Estate and Lending Activ26

Real Estate and Lending Activities - 2015 Activity - Additional Information (Detail) - 2015 [Member] $ in Millions	Feb. 27, 2015USD ($)Leases	Feb. 13, 2015USD ($)RenewalOptionsFacility
Acute Care Hospital [Member] | Kansas [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Facility		2
Purchase price of acquisition		$ 110
Term of lease, years		10 years
Number of lease extension options in current lease contract | RenewalOptions		2
Term of lease extension, years		5 years
Mortgage financing		$ 40
Mortgage financing term		10 years
Inpatient Rehabilitation Hospital [Member] | Ernest [Member] | Weslaco Texas [Member]
Business Acquisition [Line Items]
Term of lease extension, years	5 years
Acquisition costs	$ 10.7
Payments to fund long-term loans to related parties	$ 5
Lease remaining term	20 years
Number of lease extension options | Leases	3

Real Estate and Lending Activ27

Real Estate and Lending Activities - Development Activities - Additional Information (Detail) - Development Activities [Member]	3 Months Ended
	Mar. 31, 2016Facility
Business Acquisition [Line Items]
Number of facilities under construction	4
Acute Care Facilities in Altoona [Member]
Business Acquisition [Line Items]
Number of facilities constructed	5
Number of facilities leased	5

Real Estate and Lending Activ28

Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)
Business Acquisition [Line Items]
Commitment	$ 279,036
Costs Incurred as of 03/31/16	70,630
Ernest [Member]
Business Acquisition [Line Items]
Commitment	19,212
Costs Incurred as of 03/31/16	$ 16,894
Estimated Completion Date	2Q 2016
Adeptus Health One [Member]
Business Acquisition [Line Items]
Commitment	$ 12,639
Costs Incurred as of 03/31/16	$ 8,734
Estimated Completion Date	2Q 2016
Adeptus Health Two [Member]
Business Acquisition [Line Items]
Commitment	$ 62,155
Costs Incurred as of 03/31/16	$ 36,257
Estimated Completion Date	3Q 2016
Adeptus Health Three [Member]
Business Acquisition [Line Items]
Commitment	$ 61,997
Costs Incurred as of 03/31/16	$ 8,745
Estimated Completion Date	2Q 2017
Adeptus Health Four [Member]
Business Acquisition [Line Items]
Commitment	$ 123,033
Estimated Completion Date	Various

Real Estate and Lending Activ29

Real Estate and Lending Activities - Leasing Operations - Additional Information (Detail) - Leasing Operations [Member]	3 Months Ended
	Mar. 31, 2016Leases
Capella [Member]
Business Acquisition [Line Items]
Number of direct financing leases	4
Ernest [Member]
Business Acquisition [Line Items]
Number of direct financing leases	15
Prime Facilities [Member]
Business Acquisition [Line Items]
Number of direct financing leases	5

Real Estate and Lending Activ30

Real Estate and Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Business Combinations [Abstract]
Minimum lease payments receivable	$ 2,571,638	$ 2,587,912
Estimated residual values	393,970	393,097
Less: Unearned income	(2,335,126)	(2,354,013)
Net investment in direct financing leases	$ 630,482	$ 626,996

Real Estate and Lending Activ31

Real Estate and Lending Activities - Twelve Oaks Facility - Additional Information (Detail) - Twelve Oaks Facility [Member]	3 Months Ended
	Mar. 31, 2016USD ($)
Business Acquisition [Line Items]
Straight line rent receivables write-off	$ 0
Outstanding amount receivable from tenant	100,000
Letter of credit outstanding	500,000
Lease termination payment	$ 1,500,000

Real Estate and Lending Activ32

Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Loans [Line Items]
Loans, Balance	$ 1,420,837	$ 1,422,403
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	757,578	757,581
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	610,003	610,469
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 53,256	$ 54,353

Real Estate and Loans Receivabl

Real Estate and Loans Receivable - Loans - Additional Information (Detail) - USD ($) $ in Millions	Mar. 01, 2012	Mar. 31, 2016
Business Acquisition [Line Items]
Amount of convertible note converted into equity interest	$ 1.7
Convertible note	$ 5
Percentage of equity shares from convertible debt	9.90%	15.10%
Remaining convertible debt after conversion of part of debt		$ 3.3
Capella [Member]
Business Acquisition [Line Items]
Existing mortgage loans		487.7
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans		$ 114.4

Real Estate and Lending Activ34

Real Estate and Lending Activities - Schedule of Revenue by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 134,999	$ 95,961
Revenue [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 134,999	$ 95,961
Percentage of Total Revenue	100.00%	100.00%
Revenue [Member] | Credit Concentration Risk [Member] | Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 28,897	$ 24,021
Percentage of Total Revenue	21.40%	25.00%
Revenue [Member] | Credit Concentration Risk [Member] | Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 23,510	$ 15,210
Percentage of Total Revenue	17.40%	15.90%
Revenue [Member] | Credit Concentration Risk [Member] | Capella [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 21,477
Percentage of Total Revenue	15.90%
Revenue [Member] | Credit Concentration Risk [Member] | Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 16,406	$ 14,700
Percentage of Total Revenue	12.20%	15.30%
Revenue [Member] | Credit Concentration Risk [Member] | Adeptus Health [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 7,676	$ 3,405
Percentage of Total Revenue	5.70%	3.60%

Real Estate and Lending Activ35

Real Estate and Lending Activities - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 134,999	$ 95,961
Revenue [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 134,999	$ 95,961
Percentage of Total Revenue	100.00%	100.00%
Revenue [Member] | Texas [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 24,472	$ 21,016
Percentage of Total Revenue	18.10%	21.90%
Revenue [Member] | California [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 16,597	$ 16,539
Percentage of Total Revenue	12.30%	17.20%
Revenue [Member] | All Other States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 69,315	$ 42,114
Percentage of Total Revenue	51.40%	43.90%
Revenue [Member] | United States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 110,384	$ 79,669
Percentage of Total Revenue	81.80%	83.00%
Revenue [Member] | Germany [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 23,510	$ 15,210
Percentage of Total Revenue	17.40%	15.90%
Revenue [Member] | United Kingdom, Italy, and Spain [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 1,105	$ 1,082
Percentage of Total Revenue	0.80%	1.10%
Revenue [Member] | International [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 24,615	$ 16,292
Percentage of Total Revenue	18.20%	17.00%

Real Estate and Lending Activ36

Real Estate and Lending Activities - Schedule of Gross Assets by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 5,710,395		$ 5,609,351
Assets, Total [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 5,662,830	$ 6,035,922
Percentage of Total Gross Assets	100.00%	100.00%
Assets, Total [Member] | Credit Concentration Risk [Member] | Prime [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,125,994	$ 1,032,353
Percentage of Total Gross Assets	19.90%	17.10%
Assets, Total [Member] | Credit Concentration Risk [Member] | Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 1,080,381	$ 1,031,039
Percentage of Total Gross Assets	19.10%	17.10%
Assets, Total [Member] | Credit Concentration Risk [Member] | Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 581,087	$ 579,182
Percentage of Total Gross Assets	10.30%	9.60%
Assets, Total [Member] | Credit Concentration Risk [Member] | Capella [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 510,895	$ 1,059,989
Percentage of Total Gross Assets	9.00%	17.60%
Assets, Total [Member] | Credit Concentration Risk [Member] | Adeptus Health [Member]
Investment And Revenue From External Customers [Line Items]
Total Gross Assets	$ 500,000	$ 500,000
Percentage of Total Gross Assets	8.80%	8.30%

Real Estate and Lending Activ37

Real Estate and Lending Activities - Schedule of Gross Assets by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 5,710,395		$ 5,609,351
Assets, Total [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 5,662,830	$ 6,035,922
Percentage of Total Gross Assets	100.00%	100.00%
Assets, Total [Member] | Texas [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,077,738	$ 1,060,990
Percentage of Total Gross Assets	19.00%	17.60%
Assets, Total [Member] | California [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 547,082	$ 547,085
Percentage of Total Gross Assets	9.70%	9.10%
Assets, Total [Member] | All Other States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 2,588,647	$ 3,047,204
Percentage of Total Gross Assets	45.70%	50.40%
Assets, Total [Member] | Other Domestic Assets [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 185,394	$ 177,317
Percentage of Total Gross Assets	3.30%	3.10%
Assets, Total [Member] | United States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 4,398,861	$ 4,832,596
Percentage of Total Gross Assets	77.70%	80.20%
Assets, Total [Member] | Germany [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,080,381	$ 1,031,039
Percentage of Total Gross Assets	19.10%	17.10%
Assets, Total [Member] | United Kingdom, Italy, and Spain [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 161,880	$ 161,317
Percentage of Total Gross Assets	2.90%	2.70%
Assets, Total [Member] | Other International Assets [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 21,708	$ 10,970
Percentage of Total Gross Assets	0.30%
Assets, Total [Member] | International [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Gross Assets	$ 1,263,969	$ 1,203,326
Percentage of Total Gross Assets	22.30%	19.80%

Real Estate and Lending Activ38

Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Assets, Total [Member] - Customer Concentration Risk [Member]	Mar. 31, 2016Investment
Business Acquisition [Line Items]
Number of investment in property	0
Maximum percentage of entity's total assets invested on single property	0.02%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2016	Dec. 31, 2015	Feb. 22, 2016
Debt Instrument [Line Items]
Principal amount	$ 3,429,926
Debt issue costs, net	(35,401)	$ (28,367)
Debt	$ 3,396,604	$ 3,322,541
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Interest rate	Variable	Variable
Debt	$ 645,000	$ 1,100,000
2006 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 125,000	$ 125,000
2011 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.875%	6.875%
Debt	$ 450,000	$ 450,000
2012 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Principal amount	$ 350,000	$ 350,000
Senior unsecured notes, interest rate	6.375%	6.375%
Unamortized premium	$ 2,079	$ 2,168
Debt	$ 352,079	$ 352,168
2013 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.75%	5.75%
Debt	$ 227,600	$ 217,240
2014 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.50%	5.50%
Debt	$ 300,000	$ 300,000
2015 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	4.00%	4.00%
Debt	$ 569,000	$ 543,100
2016 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%
Debt	$ 500,000
2016 Senior Unsecured Notes [Member] | Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate			6.375%
Term Loans [Member]
Debt Instrument [Line Items]
Interest rate	Various	Various
Debt	$ 263,326	$ 263,400
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt	$ 3,432,005	$ 3,350,908

Debt - Principal Payments Due f

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Mar. 31, 2016USD ($)
Debt Disclosure [Abstract]
2,016	$ 125,225
2,017	320
2,018	657,781
2,019	250,000
2,020	227,600
Thereafter	2,169,000
Total	$ 3,429,926

Debt - Additional Information (

Debt - Additional Information (Detail) - USD ($)	Feb. 22, 2016	Oct. 31, 2011	Mar. 31, 2016	Dec. 31, 2015	Jun. 30, 2010
2016 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate			6.375%
2006 Senior Unsecured Notes [Member] | Interest Rate Swap [Member]
Debt Instrument [Line Items]
Portion of debt instrument face amount					$ 65,000,000
2006 Senior Unsecured Notes [Member] | Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps			$ 2,100,000	$ 2,900,000
2006 Senior Unsecured Notes [Member] | Interest Rate Contract One [Member]
Debt Instrument [Line Items]
Interest rate of interest rate derivative instrument					5.507%
Maturity date of interest rate swap			2016-07
2006 Senior Unsecured Notes [Member] | Interest Rate Contract Two [Member]
Debt Instrument [Line Items]
Maturity date of interest rate swap			2016-07
Interest rate swap, amount fixed		$ 60,000,000
Interest rate of derivative instrument		5.675%
Revolving Credit Facility [Member] | 2016 Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Portion of debt instrument face amount	$ 500,000,000
Senior unsecured notes, maturity date	Mar. 1, 2024
Senior unsecured notes, interest rate	6.375%
Debt instrument, redemption price percentage	106.375%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, payable term	Interest on the notes will be payable on March 1 and September 1 of each year
Senior unsecured notes commencing date of payment	Sep. 1, 2016
Senior notes, earliest redemption date	Mar. 1, 2019
Senior unsecured notes, redemption description	We may redeem some or all of the notes at any time prior to March 1, 2019 at a “make whole” redemption price. On or after March 1, 2019, we may redeem some or all of the nates at a premium that will decrease over time. In addition, at any time prior to March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% 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.
Revolving Credit Facility [Member] | 2016 Senior Unsecured Notes [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - Interest Rate Swap - Add

Debt - Interest Rate Swap - Additional Information (Detail) - Interest Rate Swap [Member] - USD ($)	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015	Dec. 31, 2015
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period	$ 0	$ 0
Other assets, collateral	$ 1,200,000		$ 1,700,000

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2016	Sep. 30, 2016	Jun. 30, 2016
Debt Instrument [Line Items]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Leverage ratio	70.00%
Unsecured leverage ratio	77.50%
Scenario, Forecast [Member] | Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Leverage ratio			60.00%
Unsecured leverage ratio		65.00%

Common Stock_Partner's Capital

Common Stock/Partner's Capital - Additional Information (Detail) shares in Thousands	Mar. 01, 2016USD ($)	Jan. 14, 2015USD ($)shares	Mar. 31, 2016USD ($)DirectorEmployeePartnershares	Mar. 31, 2015USD ($)	Dec. 31, 2015USD ($)shares
Class of Stock [Line Items]
Value of stock sold under plan			$ 237,000		$ 237,000
Common stock, shares issued | shares			237,242		236,744
Proceeds from sale of common shares / units, net of offering costs				$ 479,966,000
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs				$ 479,966,000
Ownership interest in equity			99.80%
Number of other partners | Partner			3
Number of units sold | shares			34,500
Employee [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage | Employee			2
Director [Member]
Class of Stock [Line Items]
Number of partners shared remaining ownership percentage | Director			1
Market Equity Offering Program [Member]
Class of Stock [Line Items]
Sales commission percentage	1.25%
Value of stock sold under plan			$ 0
Market Equity Offering Program [Member] | Maximum [Member]
Class of Stock [Line Items]
Value of stock	$ 227,000,000
Public Offering [Member]
Class of Stock [Line Items]
Common stock, shares issued | shares		34,500
Additional shares purchased by underwriters | shares		4,500
Proceeds from sale of common shares / units, net of offering costs		$ 480,000,000

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Time-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	45,528	217,177
Stock awards vesting period in years	3 years
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	0	176,046
Stock awards vesting period in years	3 years
Multi-year performance-based awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation, multi-year performance-based awards	0	505,050
Stock awards vesting period in years	3 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of common stock for awards under the Equity Incentive Plan	8,196,770
Common stock remaining for future stock awards transferred to the equity incentive plan	5,615,497

Fair Value of Financial Instr46

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2016	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 50,467	$ 46,939
Loans, Book value	507,285	508,851
Debt, net Book value	(3,396,604)	(3,322,541)
Interest and rent receivables, Fair value	50,407	46,858
Loans, Fair value	541,228	543,859
Debt, net Fair value	$ (3,488,845)	$ (3,372,773)

Fair Value of Financial Instr47

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	Mar. 31, 2016USD ($)
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 920,901
Cost	920,901
Fair Value Measurements, Recurring [Member] | Equity investments [Member] | Other Assets [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	7,349
Cost	7,349
Fair Value Measurements, Recurring [Member] | Acquisition Loans [Member] | Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	603,552
Cost	603,552
Fair Value Measurements, Recurring [Member] | Mortgage Loans [Member] | Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	310,000
Cost	$ 310,000

Fair Value of Financial Instr48

Fair Value of Financial Instruments - Additional information (Detail)	3 Months Ended
	Mar. 31, 2016
Fair Value Disclosures [Abstract]
Adjustment for marketability discount	40.00%

Fair Value of Financial Instr49

Fair Value of Financial Instruments - Summary Showing Sensitivity Analysis by Using Basis Point Variations (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2016USD ($)
+100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ (135)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 135

Earnings Per Share - Calculatio

Earnings Per Share - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2016	Mar. 31, 2015
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 58,226	$ 35,976
Non-controlling interests' share in net income	(298)	(79)
Participating securities' share in earnings	(144)	(266)
Income from continuing operations, less participating securities' share in earnings	57,784	35,631
Loss from discontinued operations	(1)
Net income, less participating securities' share in earnings	$ 57,783	$ 35,631
Basic weighted-average common shares	237,510	202,958
Dilutive potential common shares	309	657
Dilutive weighted-average common shares	237,819	203,615
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 58,226	$ 35,976
Non-controlling interests' share in net income	(298)	(79)
Participating securities' share in earnings	(144)	(266)
Income from continuing operations, less participating securities' share in earnings	57,784	35,631
Loss from discontinued operations	(1)
Net income, less participating securities' share in earnings	$ 57,783	$ 35,631
Basic weighted-average common shares	237,510	202,958
Dilutive potential common shares	309	657
Dilutive weighted-average common shares	237,819	203,615

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail)	Apr. 30, 2016USD ($)Leases	Jun. 30, 2016USD ($)	Mar. 31, 2016Hospital
MPT Operating Partnership, L.P. [Member]
Subsequent Event [Line Items]
Number of hospital owned | Hospital			5
Capella [Member] | Scenario, Forecast [Member]
Subsequent Event [Line Items]
Gain (loss) recorded on transaction		$ 0
Capella [Member] | Scenario, Forecast [Member] | Minimum [Member]
Subsequent Event [Line Items]
Transaction costs incurred		5,000,000
Capella [Member] | Scenario, Forecast [Member] | Maximum [Member]
Subsequent Event [Line Items]
Transaction costs incurred		$ 8,000,000
Subsequent Event [Member] | Capella [Member]
Subsequent Event [Line Items]
Net proceeds from transaction	$ 550,000,000
Net proceeds from equity investment and loans	492,000,000
Proceeds from prepayment of mortgage loans	210,000,000
New loan for hospital property	93,000,000
Investment on unsecured senior notes	$ 50,000,000
Subsequent Event [Member] | Acute Care Hospital [Member] | New Jersey [Member]
Subsequent Event [Line Items]
Term of lease, years	15 years
Number of lease extension options | Leases	3
Increase in consumer price-index, floor rate	2.00%
Commitment to advance an additional amount for capital additions	$ 30,000,000
Commitment period to advance an additional amount for capital additions	3 years
Acquisition costs	$ 63,000,000