Medical Properties Trust (MPW) 10-K 1 Mar 17 2016 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2016	Feb. 24, 2017	Jun. 30, 2016
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	FY
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 Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		320,934,225
Entity Public Float			$ 3,598,495,723
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	FY
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

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Real estate assets
Land	$ 417,368	$ 315,787
Buildings and improvements	3,550,674	2,675,803
Construction in progress and other	53,648	49,165
Intangible lease assets	296,176	256,950
Net investment in direct financing leases	648,102	626,996
Mortgage loans	1,060,400	757,581
Gross investment in real estate assets	6,026,368	4,682,282
Accumulated depreciation	(292,786)	(232,675)
Accumulated amortization	(32,339)	(25,253)
Net investment in real estate assets	5,701,243	4,424,354
Cash and cash equivalents	83,240	195,541
Interest and rent receivables	57,698	46,939
Straight-line rent receivables	116,861	82,155
Other loans	155,721	664,822
Other assets	303,773	195,540
Total Assets	6,418,536	5,609,351
Liabilities
Debt, net	2,909,341	3,322,541
Accounts payable and accrued expenses	207,711	137,356
Deferred revenue	19,933	29,358
Lease deposits and other obligations to tenants	28,323	12,831
Total Liabilities	3,165,308	3,502,086
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 500,000 shares; issued and outstanding - 320,514 shares at December 31, 2016 and 236,744 shares at December 31, 2015	321	237
Limited Partners:
Additional paid-in capital	3,775,336	2,593,827
Distributions in excess of net income	(434,114)	(418,650)
Accumulated other comprehensive loss	(92,903)	(72,884)
Treasury shares, at cost	(262)	(262)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,248,378	2,102,268
Non-controlling interests	4,850	4,997
Total Equity / Capital	3,253,228	2,107,265
Total Liabilities and Equity / Capital	6,418,536	5,609,351
Common Units [Member]
Limited Partners:
Total Equity / Capital	321	237
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	417,368	315,787
Buildings and improvements	3,550,674	2,675,803
Construction in progress and other	53,648	49,165
Intangible lease assets	296,176	256,950
Net investment in direct financing leases	648,102	626,996
Mortgage loans	1,060,400	757,581
Gross investment in real estate assets	6,026,368	4,682,282
Accumulated depreciation	(292,786)	(232,675)
Accumulated amortization	(32,339)	(25,253)
Net investment in real estate assets	5,701,243	4,424,354
Cash and cash equivalents	83,240	195,541
Interest and rent receivables	57,698	46,939
Straight-line rent receivables	116,861	82,155
Other loans	155,721	664,822
Other assets	303,773	195,540
Total Assets	6,418,536	5,609,351
Liabilities
Debt, net	2,909,341	3,322,541
Accounts payable and accrued expenses	132,868	84,628
Deferred revenue	19,933	29,358
Lease deposits and other obligations to tenants	28,323	12,831
Payable due to Medical Properties Trust, Inc.	74,453	52,338
Total Liabilities	3,164,918	3,501,696
Commitments and Contingencies
Limited Partners:
Accumulated other comprehensive loss	(92,903)	(72,884)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	3,248,768	2,102,658
Non-controlling interests	4,850	4,997
Total Equity / Capital	3,253,618	2,107,655
Total Liabilities and Equity / Capital	6,418,536	5,609,351
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Equity / Capital
General partner - issued and outstanding - 3,204 units at December 31, 2016 and 2,363 units at December 31, 2015	33,436	21,773
Limited Partners:
Total Equity / Capital	33,436	21,773
MPT Operating Partnership, L.P. [Member] | Common Units [Member]
Limited Partners:
Limited Partners Capital	$ 3,308,235	$ 2,153,769

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 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	320,514,000	236,744,000
Common stock, shares outstanding	320,514,000	236,744,000
MPT Operating Partnership, L.P. [Member] | Common Units [Member]
Limited Partners, units issued	317,310,000	234,381,000
Limited Partners, units outstanding	317,310,000	234,381,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	3,204,000	2,363,000
General partner, units outstanding	3,204,000	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

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Revenues
Rent billed	$ 327,269	$ 247,604	$ 187,018
Straight-line rent	41,067	23,375	13,507
Income from direct financing leases	64,307	58,715	49,155
Interest and fee income	108,494	112,184	62,852
Total revenues	541,137	441,878	312,532
Expenses
Real estate depreciation and amortization	94,374	69,867	53,938
Impairment charges	7,229		50,128
Property-related	2,712	3,792	1,851
Acquisition expenses	46,273	61,342	26,389
General and administrative	48,911	43,639	37,274
Total operating expenses	199,499	178,640	169,580
Operating income	341,638	263,238	142,952
Other income (expense)
Interest expense	(159,597)	(120,884)	(98,156)
Gain on sale of real estate and other asset dispositions, net	61,224	3,268	2,857
Earnings from equity and other interests	(1,116)	2,849	2,559
Unutilized financing fees/ debt refinancing costs	(22,539)	(4,367)	(1,698)
Other income (expense)	(502)	(2,674)	2,624
Income tax benefit (expense)	6,830	(1,503)	(340)
Net other expenses	(115,700)	(123,311)	(92,154)
Income from continuing operations	225,938	139,927	50,798
Loss from discontinued operations	(1)		(2)
Net income	225,937	139,927	50,796
Net income attributable to non-controlling interests	(889)	(329)	(274)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 225,048	$ 139,598	$ 50,522
Earnings per share - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	260,414	217,997	169,999
Earnings per share - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 327,269	$ 247,604	$ 187,018
Straight-line rent	41,067	23,375	13,507
Income from direct financing leases	64,307	58,715	49,155
Interest and fee income	108,494	112,184	62,852
Total revenues	541,137	441,878	312,532
Expenses
Real estate depreciation and amortization	94,374	69,867	53,938
Impairment charges	7,229		50,128
Property-related	2,712	3,792	1,851
Acquisition expenses	46,273	61,342	26,389
General and administrative	48,911	43,639	37,274
Total operating expenses	199,499	178,640	169,580
Operating income	341,638	263,238	142,952
Other income (expense)
Interest expense	(159,597)	(120,884)	(98,156)
Gain on sale of real estate and other asset dispositions, net	61,224	3,268	2,857
Earnings from equity and other interests	(1,116)	2,849	2,559
Unutilized financing fees/ debt refinancing costs	(22,539)	(4,367)	(1,698)
Other income (expense)	(502)	(2,674)	2,624
Income tax benefit (expense)	6,830	(1,503)	(340)
Net other expenses	(115,700)	(123,311)	(92,154)
Income from continuing operations	225,938	139,927	50,798
Loss from discontinued operations	(1)		(2)
Net income	225,937	139,927	50,796
Net income attributable to non-controlling interests	(889)	(329)	(274)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 225,048	$ 139,598	$ 50,522
Earnings per share - basic
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	260,414	217,997	169,999
Earnings per share - diluted
Income from continuing operations attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Income from discontinued operations attributable to MPT common stockholders (Operating Partnership partners)	0	0	0
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	261,072	218,304	170,540

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Net income	$ 225,937	$ 139,927	$ 50,796
Other comprehensive income (loss):
Unrealized gain on interest rate swap	2,904	3,139	2,964
Foreign currency translation loss	(22,923)	(54,109)	(15,937)
Total comprehensive income	205,918	88,957	37,823
Comprehensive income attributable to non-controlling interests	(889)	(329)	(274)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	205,029	88,628	37,549
MPT Operating Partnership, L.P. [Member]
Net income	225,937	139,927	50,796
Other comprehensive income (loss):
Unrealized gain on interest rate swap	2,904	3,139	2,964
Foreign currency translation loss	(22,923)	(54,109)	(15,937)
Total comprehensive income	205,918	88,957	37,823
Comprehensive income attributable to non-controlling interests	(889)	(329)	(274)
Comprehensive income attributable to MPT common stockholders (Operating Partnership partners)	$ 205,029	$ 88,628	$ 37,549

Consolidated Statements of Equi

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	Additional Paid-in Capital [Member]	Distributions in Excess of Net Income [Member]	Treasury Stock [Member]	Common Par Value [Member]	Accumulated Other Comprehensive Loss [Member]	Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member]Accumulated Other Comprehensive Loss [Member]	MPT Operating Partnership, L.P. [Member]Non- Controlling Interests [Member]	MPT Operating Partnership, L.P. [Member]General Partner [Member]	MPT Operating Partnership, L.P. [Member]Limited Partner [Member]Common Par Value [Member]	MPT Operating Partnership, L.P. [Member]Limited Partner [Member]Long Term Incentive Plan [Member]
Beginning balance at Dec. 31, 2013	$ 1,344,208	$ 1,618,054	$ (264,804)	$ (262)	$ 161	$ (8,941)		$ 1,344,598	$ (8,941)		$ 13,541	$ 1,339,998
Beginning balance (in shares) at Dec. 31, 2013					161,310						1,608	159,702	292
Net income	50,796		50,522				$ 274	50,796		$ 274	$ 508	$ 49,769	$ 245
Unrealized gain on interest rate swap	2,964					2,964		2,964	2,964
Foreign currency translation gain (loss)	(15,937)					(15,937)		(15,937)	(15,937)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	9,165	9,165						9,165			$ 92	$ 9,073
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					777						8	769
Distributions to non-controlling interests	(274)						(274)	(274)		(274)
Proceeds from offering (net of offering costs)	138,173	138,162			$ 11			138,173			$ 1,382	$ 136,791
Proceeds from offering (net of offering costs) (shares)					10,656						106	10,550
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(147,048)		(147,048)					(147,048)			$ (1,468)	$ (145,335)	$ (245)
Ending balance at Dec. 31, 2014	1,382,047	1,765,381	(361,330)	(262)	$ 172	(21,914)		1,382,437	(21,914)		$ 14,055	$ 1,390,296
Ending balance (in shares) at Dec. 31, 2014					172,743						1,722	171,021	292
Net income	139,927		139,598				329	139,927		329	$ 1,399	$ 138,199
Sale of non-controlling interests	5,000						5,000
Sale of non-controlling interests								5,000		5,000
Unrealized gain on interest rate swap	3,139					3,139		3,139	3,139
Foreign currency translation gain (loss)	(54,109)					(54,109)		(54,109)	(54,109)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	11,122	11,120			$ 2			11,122			$ 111	$ 11,011
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					751						8	743
Distributions to non-controlling interests	(332)						(332)	(332)		(332)
Proceeds from offering (net of offering costs)	817,389	817,326			$ 63			817,389			$ 8,175	$ 809,214
Proceeds from offering (net of offering costs) (shares)					63,250						633	62,617
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(196,918)		(196,918)					(196,918)			$ (1,967)	$ (194,951)
Ending balance at Dec. 31, 2015	2,107,265	2,593,827	(418,650)	(262)	$ 237	(72,884)	4,997	2,107,655	(72,884)	4,997	$ 21,773	$ 2,153,769
Ending balance (in shares) at Dec. 31, 2015					236,744						2,363	234,381	292
Net income	225,937		225,048				889	225,937		889	$ 2,251	$ 222,797
Unrealized gain on interest rate swap	2,904					2,904		2,904	2,904
Foreign currency translation gain (loss)	(22,923)					(22,923)		(22,923)	(22,923)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	7,942	7,941			$ 1			7,942			$ 80	$ 7,862
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)					1,021						10	1,011
Distributions to non-controlling interests	(1,036)						(1,036)	(1,036)		(1,036)
Proceeds from offering (net of offering costs)	1,173,651	1,173,568			$ 83			1,173,651			$ 11,737	$ 1,161,914
Proceeds from offering (net of offering costs) (shares)					82,749						831	81,918
Dividends (Distributions) declared ($0.84 in 2014, 0.88 in 2015 and 0.91 in 2016 per common share/ unit)	(240,512)		(240,512)					(240,512)			$ (2,405)	$ (238,107)
Ending balance at Dec. 31, 2016	$ 3,253,228	$ 3,775,336	$ (434,114)	$ (262)	$ 321	$ (92,903)	$ 4,850	$ 3,253,618	$ (92,903)	$ 4,850	$ 33,436	$ 3,308,235
Ending balance (in shares) at Dec. 31, 2016					320,514						3,204	317,310	292

Consolidated Statements of Equ7

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Dividends (Distributions) declared per common share / unit	$ 0.91	$ 0.88	$ 0.84
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 0.91	$ 0.88	$ 0.84

Consolidated Statements of Cash

Consolidated Statements of Cash Flows $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Operating activities
Net income	$ 225,937	$ 139,927	$ 50,796
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	97,601	71,827	55,162
Amortization of deferred financing costs and debt discount	7,613	6,085	5,105
Direct financing lease interest accretion	(9,120)	(8,032)	(6,701)
Straight-line rent revenue	(41,567)	(26,187)	(16,325)
Share / (Unit)-based compensation expense	7,942	11,122	9,165
Gain from sale of real estate and other asset dispositions, net	(61,224)	(3,268)	(2,857)
Impairment charges	7,229		50,128
Straight-line rent and other write-off	3,063	2,812	2,818
Unutilized financing fees/ debt refinancing costs	22,539	4,367	1,698
Other adjustments	3,563	(6,334)	(1,178)
Decrease (increase) in:
Interest and rent receivable	(13,247)	(5,599)	(3,856)
Other assets	(18,357)	(8,297)	764
Accounts payable and accrued expenses	41,583	26,540	6,209
Deferred revenue	(8,872)	2,033	(485)
Net cash provided by operating activities	264,683	206,996	150,443
Investing activities
Cash paid for acquisitions and other related investments	(1,682,409)	(2,218,869)	(767,696)
Net proceeds from sale of real estate	198,767	19,175	34,649
Principal received on loans receivable	906,757	771,785	11,265
Investment in loans receivable	(109,027)	(354,001)	(12,782)
Construction in progress and other	(171,209)	(146,372)	(102,333)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(69,423)	(17,339)	(13,126)
Net cash used for investing activities	(926,544)	(1,945,621)	(850,023)
Financing activities
Proceeds from term debt	1,000,000	681,000	425,000
Payments of term debt	(575,299)	(283)	(100,266)
Payment of deferred financing costs	(15,468)	(7,686)	(14,496)
Revolving credit facilities, net	(810,000)	509,415	490,625
Distributions paid	(218,393)	(182,980)	(144,365)
Lease deposits and other obligations to tenants	14,557	(10,839)	7,892
Proceeds from sale of common shares / units, net of offering costs	1,173,651	817,389	138,173
Other financing activities	(16,485)	(5,326)
Net cash provided by financing activities	552,563	1,800,690	802,563
Increase in cash and cash equivalents for the year	(109,298)	62,065	102,983
Effect of exchange rate changes	(3,003)	(11,065)	(4,421)
Cash and cash equivalents at beginning of year	195,541	144,541	45,979
Cash and cash equivalents at end of year	83,240	195,541	144,541
Interest paid, including capitalized interest of $2,320 in 2016, $1,425 in 2015, and $1,860 in 2014	138,770	107,228	91,890
Supplemental schedule of non-cash investing activities:
Mortgage loan issued from sale of real estate			12,500
Increase in development project construction costs incurred, not paid	15,857	2,684
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	74,521	52,402	38,461
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	225,937	139,927	50,796
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	97,601	71,827	55,162
Amortization of deferred financing costs and debt discount	7,613	6,085	5,105
Direct financing lease interest accretion	(9,120)	(8,032)	(6,701)
Straight-line rent revenue	(41,567)	(26,187)	(16,325)
Share / (Unit)-based compensation expense	7,942	11,122	9,165
Gain from sale of real estate and other asset dispositions, net	(61,224)	(3,268)	(2,857)
Impairment charges	7,229		50,128
Straight-line rent and other write-off	3,063	2,812	2,818
Unutilized financing fees/ debt refinancing costs	22,539	4,367	1,698
Other adjustments	3,563	(6,334)	(1,178)
Decrease (increase) in:
Interest and rent receivable	(13,247)	(5,599)	(3,856)
Other assets	(18,357)	(8,297)	764
Accounts payable and accrued expenses	41,583	26,540	6,209
Deferred revenue	(8,872)	2,033	(485)
Net cash provided by operating activities	264,683	206,996	150,443
Investing activities
Cash paid for acquisitions and other related investments	(1,682,409)	(2,218,869)	(767,696)
Net proceeds from sale of real estate	198,767	19,175	34,649
Principal received on loans receivable	906,757	771,785	11,265
Investment in loans receivable	(109,027)	(354,001)	(12,782)
Construction in progress and other	(171,209)	(146,372)	(102,333)
Investment in unsecured senior notes	(50,000)
Proceeds from sale of unsecured senior notes	50,000
Other investments, net	(69,423)	(17,339)	(13,126)
Net cash used for investing activities	(926,544)	(1,945,621)	(850,023)
Financing activities
Proceeds from term debt	1,000,000	681,000	425,000
Payments of term debt	(575,299)	(283)	(100,266)
Payment of deferred financing costs	(15,468)	(7,686)	(14,496)
Revolving credit facilities, net	(810,000)	509,415	490,625
Distributions paid	(218,393)	(182,980)	(144,365)
Lease deposits and other obligations to tenants	14,557	(10,839)	7,892
Proceeds from sale of common shares / units, net of offering costs	1,173,651	817,389	138,173
Other financing activities	(16,485)	(5,326)
Net cash provided by financing activities	552,563	1,800,690	802,563
Increase in cash and cash equivalents for the year	(109,298)	62,065	102,983
Effect of exchange rate changes	(3,003)	(11,065)	(4,421)
Cash and cash equivalents at beginning of year	195,541	144,541	45,979
Cash and cash equivalents at end of year	83,240	195,541	144,541
Interest paid, including capitalized interest of $2,320 in 2016, $1,425 in 2015, and $1,860 in 2014	138,770	107,228	91,890
Supplemental schedule of non-cash investing activities:
Mortgage loan issued from sale of real estate			12,500
Increase in development project construction costs incurred, not paid	15,857	2,684
Supplemental schedule of non-cash financing activities:
Dividends declared, not paid	$ 74,521	$ 52,402	$ 38,461

Consolidated Statements of Cas9

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Interest paid, capitalized	$ 2,320	$ 1,425	$ 1,860
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 2,320	$ 1,425	$ 1,860

Organization

Organization	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Organization	1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the General Corporation Law of Maryland 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., 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 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 U.S. federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. 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	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Use of Estimates: Principles of Consolidation: non-controlling non-controlling 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, 2016, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities, (including but not limited to Ernest and Vibra). 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 December 31, 2016 (in thousands): VIE Type Maximum Loss Asset Type Classification Carrying Loans, net $ 316,179 Mortgage and other loans $ 235,613 Equity investments $ 13,223 Other assets $ 140 (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 rent receivables), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represent 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 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 and 10 for additional description of the nature, purpose and activities of some of our VIEs and interests therein. Investments in Unconsolidated Entities: 90-day Investments in entities in which we do not control nor do we have the ability to influence (such as our investments in Steward and MEDIAN) are accounted for using the cost method. The initial carrying value of such investments is based on the amount paid to purchase the interest in the investee entity. No income is recorded on our cost method investments until distributions are received. We evaluate our equity and cost 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. Cash and Cash Equivalents: Revenue Recognition: Certain leases may provide for additional rents contingent upon a percentage of the tenant’s revenue in excess of specified base amounts/thresholds (percentage rents). Percentage rents are recognized in the period in which revenue thresholds are met. Rental payments received prior to their recognition as income are classified as deferred revenue. We also receive additional rent (contingent rent) under some leases based on increases in the CPI or when the CPI exceeds the annual minimum percentage increase in the lease. Contingent rents are recorded as rent billed revenue in the period earned. We use DFL accounting to record rent on certain leases deemed to be financing leases, per accounting rules, rather than operating leases. For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. 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 terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. In instances where we have a profits or equity interest in our tenants’ operations, we record income equal to our percentage interest of the tenants’ profits, as defined in the lease or tenants’ operating agreements, once annual thresholds, if any, are met. 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 are generally 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 remaining term of the lease. 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. Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest 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. Tenant payments for certain taxes, insurance, and other operating expenses related to our facilities (most of which are paid directly by our tenants to the government or appropriate third party vendor) are recorded net of the respective expense as generally our leases are “triple-net” Acquired Real Estate Purchase Price Allocation: pre-acquisition We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place lease-up pre-acquisition lease-up We record above-market and below-market in-place in-place in-place non-cancelable 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 these 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. Goodwill: two-step Real Estate and Depreciation: 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, 2016 are as follows: Buildings and improvements 38.8 years Tenant lease intangibles 23.9 years Leasehold improvements 17.9 years Furniture, equipment and other 9.5 years Losses from Rent Receivables: Losses from Operating Lease Receivables: property-by-property Losses on DFL Receivables: property-by-property non-accrual non-accrual Loans: loan-by-loan non-accrual Earnings Per Share/Units: Our unvested restricted stock/unit awards contain non-forfeitable Income Taxes: Our financial statements include the operations of TRSs, including MPT Development Services, Inc. (“MDS”), along with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. Our TRS entities are not entitled to a dividends paid deduction and are subject to 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 they may make loans to and/or investments in our lessees. With the property acquisitions and investments in Europe, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties will flow through our REIT income tax returns. For our TRS 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 receivables/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 the realizability of the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our tax liabilities involve dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. A 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 off-set 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: Deferred Costs: Deferred Financing Costs: re-payment Foreign Currency Translation and Transactions: 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 translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation 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: 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: • Level 1 identical • Level 2 similar • Level 3 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 over-the-counter 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 used by us include discounted cash flow and Monte Carlo valuation models. We also consider our counterparty’s and own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: Recent Accounting Developments: Revenue from Contracts with Customers In May 2014, the FASB issued Accounting Standards Update (“ASU”) No. 2014-09, No. 2014-09. Leases In February 2016, the FASB issued ASU 2016-02, right-of-use Measurement of Credit Losses on Financial Instruments In June 2016, the FASB issued ASU 2016-13, Classification of Certain Cash Receipts and Cash Payments In August 2016, the FASB issued ASU No. 2016-15, zero-coupon Clarifying the Definition of a Business In January 2017, the FASB issued ASU No. 2017-01, 2017-01”). 2017-01 2017-01 2017-01 2017-01 2017-01, Reclassifications and Revisions: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Real Estate and Loans Receivabl

Real Estate and Loans Receivable	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Real Estate and Loans Receivable	3. Real Estate and Loans Receivable Acquisitions We acquired the following assets: 2016 2015 2014 (in thousands) Assets Acquired Land $ 91,176 $ 120,746 $ 22,569 Building 654,772 741,935 241,242 Intangible lease assets — subject to amortization (weighted average useful life of 28.5 years in 2016, 30.0 years in 2015 and 18.2 years in 2014) 94,614 176,383 22,513 Net investments in direct financing leases 178,000 174,801 — Mortgage loans 600,000 380,000 — Other loans — 523,605 447,664 Equity investments and other assets 70,166 101,716 33,708 Liabilities assumed (6,319 ) (317 ) — Total assets acquired $ 1,682,409 $ 2,218,869 $ 767,696 Loans repaid(1) (193,262 ) (385,851 ) — Total net assets acquired $ 1,489,147 $ 1,833,018 $ 767,696 (1) $93.3 million loans advanced to Capella in 2015 and repaid in 2016 as a part of the Capella transaction, and $100.0 million loans advanced to Prime in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. $385.9 million loans advanced to MEDIAN in 2014 and repaid in 2015 as a part of the MEDIAN transaction. Purchase price allocations attributable to acquisitions made during the 2016 fourth quarter are preliminary. When all relevant information is obtained, resulting changes, if any, to our provisional purchase price allocation will be adjusted to reflect new information obtained about the facts and circumstances that existed as of the respective acquisition dates that, if known, would have affected the measurement of the amounts recognized as of those dates. 2016 Activity Acquisition of Steward Portfolio On October 3, 2016, we closed on a portfolio of nine acute care hospitals in Massachusetts operated by Steward. Our investment in the portfolio includes the acquisition of five hospitals for $600 million, the making of $600 million in mortgage loans on four facilities, and a $50 million minority equity contribution in Steward, for a combined investment of $1.25 billion. The five facilities acquired are being leased to Steward under a master lease agreement that has a 15-year 5-year Other Acquisitions From October 27, 2016 to December 31, 2016, we acquired 12 rehabilitation hospitals in Germany for an aggregate purchase price to us of €85.2 million. Of these acquisitions, five properties (totaling €35.7 million) are leased to affiliates of MEDIAN, pursuant to a master lease agreement reached with MEDIAN in 2015. (See “2015 Activity” below for further details of this master lease). The remaining seven properties (totaling €49.5 million) are leased to affiliates of MEDIAN, pursuant to a third master lease that has terms similar to the original master lease in 2015. On October 21, 2016, we acquired three general acute care hospitals and one free-standing emergency department and health center in New Jersey from Prime (as originally contemplated in the agreements) by reducing the $100 million mortgage loan made in September 2015 and advancing an additional $15 million. We are leasing these properties to Prime pursuant to a fifth master lease, which has a 15-year On July 22, 2016, we acquired an acute care facility in Olympia, Washington in exchange for a $93.3 million loan and an additional $7 million in cash, as contemplated in the initial Capella acquisition transaction in 2015. The terms of the Olympia lease are substantially similar to those of the master lease with Capella post lease amendment. See the Capella Disposal Transaction under the subheading “Disposals” below for further details on the terms of the Capella leases. On June 22, 2016, we closed on the final property of the initial MEDIAN transaction that began in 2014 for a purchase price of € 41.6 million. See “2015 and 2014 Activity” for a description of the initial MEDIAN Transaction. On May 2, 2016, we acquired an acute care hospital in Newark, New Jersey for an aggregate purchase price of $63 million leased to Prime pursuant to the fifth master lease. 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 addition will be added to the basis upon which the lessee will pay us rents. From the respective acquisition dates in 2016 through year-end, the properties acquired during the year ended December 31, 2016, contributed $37.4 million and $31.7 million of revenue and income (excluding related acquisition expenses), respectively, for the year ended December 31, 2016. In addition, we incurred $12.1 million of acquisition-related costs on the 2016 acquisitions for the year ended December 31, 2016. 2015 Activity Acquisition of Capella Portfolio In July 2015, we entered into definitive agreements to acquire a portfolio of seven acute care hospitals owned and operated by Capella for a combined purchase price and investment of approximately $900 million, adjusted for any cash on hand. The transaction included our investments in seven acute care hospitals (two of which were in the form of mortgage loans) for an aggregate investment of approximately $600 million, an acquisition loan for approximately $290 million and a 49% equity interest in the ongoing operator of the facilities. In conjunction with the acquisition, MPT Camaro Opco, LLC, a wholly-owned subsidiary of MDS, formed a joint venture limited liability company, Capella Health Holdings, LLC (“Capella Holdings”), with an entity affiliated with the senior management of Capella (“ManageCo”). MPT Camaro Opco, LLC held 49% of the equity interests in Capella Holdings and the ManageCo held the remaining 51%. Capella and its operating subsidiaries were managed and operated by ManageCo pursuant to the terms of one or more management agreements, the terms of which included base management fees payable to ManageCo and incentive payments tied to agreed benchmarks. Pursuant to the limited liability company agreement of Capella Holdings, ManageCo and MPT Camaro Opco, LLC shared profits and distributions from Capella Holdings according to a distribution waterfall under which, if certain benchmarks were met, after taking into account interest paid on the acquisition loan, ManageCo and MPT Camaro Opco, LLC shared in cash generated by Capella Holdings in a ratio of 35% to ManageCo and 65% to MPT Camaro Opco, LLC. The limited liability company agreement provided that ManageCo managed Capella Holdings and MPT Camaro Opco, LLC had no management authority or control except for certain protective rights consistent with a passive ownership interest, such as a limited right to approve certain components of the annual budgets and the right to approve extraordinary transactions. On August 31, 2015, we closed on six of the seven Capella properties, two of which were in the form of mortgage loans. We closed on the seventh property on July 22, 2016 (as discussed above). We entered into a master lease, a stand-alone lease, and mortgage loans for the acquired properties providing for 15-year 5-year 15-year On October 30, 2015, we acquired an additional acute hospital in Camden, South Carolina for an aggregate purchase price of $25.8 million. We leased this hospital to Capella pursuant to the 2015 master lease. In connection with the transaction, we funded an additional acquisition loan to Capella of $9.2 million. See the Capella Disposal Transaction under the subheading “Disposals” below for an update to this transaction. MEDIAN Transaction During early 2015, we made additional loans (as part of the initial MEDIAN transaction discussed below under “2014 Activity”) of approximately € 240 million on behalf of MEDIAN, to complete step one of a two step process to acquire the healthcare real estate of MEDIAN. On April 29, 2015, we entered into a series of definitive agreements with MEDIAN to complete step two, which involved the acquisition of the real estate assets of 32 hospitals owned by MEDIAN for an aggregate purchase price of approximately € 688 million. Upon acquisition, each property became subject to a master lease between us and MEDIAN providing for the leaseback of the property to MEDIAN. The master lease had an initial term of 27 years and provided for annual escalations of rent at the greater of one percent or 70% of the German consumer price index. At each closing, the purchase price for each facility was reduced and offset against the interim loans made to affiliates of Waterland and MEDIAN and against the amount of any debt assumed or repaid by us in connection with the closing. As part of this transaction, we incurred approximately $37 million of real estate transfer tax in 2015. As of December 31, 2015, we had closed on 31 of the 32 properties for an aggregate amount of € 646 million, and we had no loans outstanding to MEDIAN. Other Acquisitions On December 3, 2015, we acquired a 266-bed On November 18, 2015, we acquired seven acute care hospitals and a freestanding clinic in northern Italy for an aggregate purchase price to us of approximately €90 million. The acquisition was effected through a newly-formed joint venture between us and affiliates of AXA Real Estate, in which we own a 50% interest. The facilities are leased to an Italian acute care hospital operator, pursuant to a long-term master lease. We are accounting for our 50% interest in this joint venture under the equity method. On September 30, 2015, we provided a $100 million mortgage financing to Prime for three general acute care hospitals and one free-standing emergency department and health center in New Jersey. The loan had a five-year term and provided for consumer-priced indexed interest increases, subject to a floor. As previously noted above, we acquired these facilities in October 2016 by reducing the mortgage loan and advancing an additional $15 million. On September 9, 2015, we acquired the real estate of a general acute care hospital under development located in Valencia, Spain. The acquisition was effected through a newly-formed joint venture between us and clients of AXA Real Estate, in which we will own a 50% interest. Our expected share of the aggregate purchase and development price is €21.4 million. Upon completion, the facility will be leased to a Spanish operator of acute care hospitals, pursuant to a long-term lease. We expect construction to be complete on this facility in the second quarter of 2017. On August 31, 2015, we closed on a $30 million mortgage loan transaction with Prime for the acquisition of Lake Huron Medical Center, a 144-bed On June 16, 2015, we acquired the real estate of two facilities in Lubbock, Texas, a 60-bed 37-bed 20-year On February 27, 2015, we acquired an inpatient rehabilitation hospital in Weslaco, Texas for $10.7 million. We have leased this hospital to Ernest pursuant to the 2012 master lease, which had a remaining 17-year On February 13, 2015, we acquired two general acute care hospitals in the Kansas City area for $110 million. Prime is the tenant and operator pursuant to a new master lease that has similar terms and security enhancements as the other master lease agreements entered into in 2013. This master lease has a 10-year 10-year From the respective acquisition dates in 2015 through that year end, the properties and mortgage loans acquired in 2015 contributed $102.7 million and $87.7 million of revenue and income (excluding related acquisition expenses), respectively, for the year ended December 31, 2015. In addition, we incurred $58 million of acquisition related costs on the 2015 acquisitions for the year ended December 31, 2015. 2014 Activity MEDIAN Transaction On October 15, 2014, we entered into definitive agreements pursuant to which we would acquire substantially all the real estate assets of MEDIAN. The transaction was structured using a two step process in partnership with affiliates of Waterland. In the first step, an affiliate of Waterland acquired 94.9% of the outstanding equity interest in MEDIAN pursuant to a stock purchase agreement with MEDIAN’s current owners. We indirectly acquired the remaining 5.1% of the outstanding equity interest and provided or committed to provide interim acquisition loans to Waterland and MEDIAN in aggregate amounts of approximately €425 million, of which €349 million had been advanced at December 31, 2014. These interim loans bore interest at a rate similar to the initial lease rate under the planned sale and leaseback transactions. See “2015 and 2016 Activity” for an update on the second step of this transaction — the sale-leaseback of the real estate. Other Acquisitions In the fourth quarter of 2014, we acquired three RHM (now MEDIAN) rehabilitation facilities in Germany for an aggregate purchase price of € 63.6 million (approximately $81 million based on currency exchange rates at that time) including approximately € 3.0 million (or approximately $3.6 million) of transfer and other taxes that have been expensed as acquisition costs. These facilities included: Bad Mergentheim (211 beds), Bad Tolz (248 beds), and Bad Liebenstein (271 beds). All three properties are included under our initial master lease agreement with MEDIAN in 2013. On October 31, 2014, we acquired a 237-bed 15-year On September 19, 2014, we acquired an acute care hospital in Fairmont, West Virginia for an aggregate purchase price of $15 million from Alecto. The facility was simultaneously leased back to the seller under a 15-year On July 1, 2014, we acquired an acute care hospital in Peasedown St. John, United Kingdom from Circle Health Ltd. (“Circle”), through its subsidiary Circle Hospital (Bath) Ltd. The sale/leaseback transaction, excluding any transfer taxes, was valued at approximately £28.3 million (or approximately $48.0 million based on exchange rates at that time). The lease has an initial term of 15-years On March 31, 2014, we acquired a general acute care hospital and an adjacent parcel of land for an aggregate purchase price of $115 million from a joint venture of LHP Hospital Group, Inc. and Hackensack University Medical Center Mountainside. The facility was simultaneously leased back to the seller under a lease with a 15-year 3-year 12-year From the respective acquisition dates in 2014 through that year end, the 2014 acquisitions contributed $12.4 million and $8.7 million of revenue and income (excluding related acquisition and financing expenses) for the period ended December 31, 2014. In addition, we incurred $26.4 million of acquisition related expenses in 2014, of which $25.2 million (including $5.8 million in transfer taxes as part of our MEDIAN and Circle transactions) related to acquisitions consummated as of December 31, 2014. Pro Forma Information The following unaudited supplemental pro forma operating data is presented below as if each acquisition was completed on January 1, 2015 and January 1, 2014 for the year ended December 31, 2016 and 2015, respectively. The unaudited supplemental pro forma operating data is not necessarily indicative of what the actual would have been assuming the transactions had been completed as set forth above, nor do they purport to represent our results of operations for future periods (in thousands, except per share/unit amounts). For the Year Ended December 31, (Unaudited) 2016 2015 Total revenues $ 627,583 $ 624,443 Net income 310,019 306,756 Net income per share/unit $ 0.97 $ 0.96 Development Activities 2016 Activity During 2016, we completed construction and began recording rental income on the following facilities: • Adeptus Health — We completed 19 acute care facilities for this tenant during 2016. These facilities are leased pursuant to the master leases entered into in both 2014 and 2015 and are cross-defaulted with each other and with the original master lease executed in 2013. • Ernest Toledo — This $18.4 million inpatient rehabilitation facility located in Toledo, Ohio opened on April 1, 2016 and is being leased to Ernest pursuant to the original 2012 master lease. On August 23, 2016, we entered into an agreement to finance the development of and lease an inpatient rehabilitation facility in Flagstaff, Arizona, for $28.1 million, which will be leased to Ernest pursuant to a stand-alone lease, which has terms generally similar to the original master lease. The facility is expected to be completed in the third quarter of 2017. 2015 Activity During 2015, we completed construction and began recording rental income on the following facilities: • Adeptus Health — We completed 17 acute care facilities for this tenant during 2015 totaling $102.6 million. Fourteen of these facilities are leased pursuant to the master lease entered into in 2014 and are cross-defaulted with the original master lease executed with Adeptus Health in 2013. Three properties are leased pursuant to the master lease entered into in 2015 and are cross-defaulted with the master leases entered into in 2014 and 2013. • UAB Medical West — This $8.6 million acute care facility and medical office building located in Birmingham, Alabama is leased to Medical West, an affiliate of The University of Alabama at Birmingham, for 15 years and contains four renewal options of five years each. The rent increases 2% annually. In April 2015, we executed an agreement with Adeptus Health that provides for the acquisition and development of general acute care hospitals and free standing emergency facilities with an aggregate commitment of $250 million. These facilities will be leased to Adeptus Health pursuant to the terms of the 2014 and 2015 master lease agreements that have a 15-year 2014 Activity During 2014, we completed construction and began recording rental income on the following facilities: • Northern Utah Rehabilitation Hospital — This $19 million inpatient rehabilitation facility located in South Ogden, Utah is leased to Ernest pursuant to the 2012 master lease. • Oakleaf Surgical Hospital — This approximately $30 million acute care facility located in Altoona, Wisconsin. This facility is leased to National Surgical Hospitals for 15 years and contains two renewal options of five years each plus an additional option for nearly another five years, and the rent increases annually based on changes in the consumer price-index. • Adeptus Health — We completed 17 acute care facilities for this tenant during 2014 totaling approximately $83.0 million. These facilities are leased pursuant to the master lease entered into in 2013. See table below for a status update on our current development projects (in thousands): Operator Commitment Costs Incurred as of 12/31/16 Estimated Completion Date Adeptus Health $ 5,848 $ 2,710 1Q 2017 Adeptus Health 67,185 44,948 2Q 2017 Ernest Health 28,067 4,342 4Q 2017 Adeptus Health 7,804 1,648 1Q 2018 Adeptus Health 53,866 — Various $ 162,770 $ 53,648 Disposals 2016 Activity Capella Disposal Transaction On March 21, 2016, we entered into definitive agreements with 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 would be merged with RegionalCare, forming RCCH. 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 original Capella acquisition 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 made a new $93.3 million loan for a hospital property in Olympia, Washington (which was subsequently converted to real estate on July 22, 2016 as previously disclosed). Additionally, we and an Apollo affiliate invested $50 million each in unsecured senior notes issued by RegionalCare, which we sold to a large institution on June 20, 2016 at par. The proceeds from this transaction represented the recoverability of our investment in full, except for transaction costs incurred of $6.3 million. We maintained our 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, was amended to shorten the initial fixed lease term (to 13.5 years for the master lease and 11.5 years for the other stand-alone lease) , increase the security deposit, and eliminate the lessees’ purchase option provisions. Due to this lease amendment, we reclassified the lease of the properties under the master lease from a DFL to an operating lease. This reclassification resulted in a write-off Post Acute Transaction On May 23, 2016, we sold five properties (three of which were in Texas and two in Louisiana) that were leased and operated by Post Acute. As part of this transaction, our outstanding loans of $4 million were paid in full, and we recovered our investment in the operations. Total proceeds from this transaction were $71 million, resulting in a net gain of approximately $15 million. Corinth Transaction On June 17, 2016, we sold the Atrium Medical Center real estate located in Corinth, Texas, which was leased and operated by Corinth Investor Holdings. Total proceeds from the transaction were $28 million, resulting in a gain on the sale of real estate of approximately $8 million. This gain on real estate was offset by approximately $9 million of non-cash write-off HealthSouth Transaction On July 20, 2016, we sold three inpatient rehabilitation hospitals located in Texas and operated by HealthSouth for $111.5 million, resulting in a net gain of approximately $45 million. Summary of Operations for Disposed Assets in 2016 The properties sold during 2016 did not meet the definition of discontinued operations. However, the following represents the operating results (excluding gain on sale, transaction costs, and impairment or other non-cash For the Year Ended December 31, 2016 2015 2014 Revenues $ 7,851 $ 18,112 $ 18,225 Real estate depreciation and amortization (1,754 ) (3,795 ) (3,789 ) Property-related expenses (114 ) (121 ) (60 ) Other income (expense) (23 ) 1,079 462 Income from real estate dispositions, net $ 5,960 $ 15,275 $ 14,838 2015 Activity On July 30, 2015, we sold a long-term acute care facility in Luling, Texas for approximately $9.7 million, resulting in a gain of $1.5 million. Due to this sale, we wrote off $0.9 million of straight-line receivables. On August 5, 2015, we sold six wellness centers in the U.S. for total proceeds of approximately $9.5 million (of which $1.5 million is in the form of a promissory note), resulting in a gain of $1.7 million. Due to this sale, we wrote off $0.9 million of billed rent receivables. With these disposals, we accelerated the amortization of the related lease intangible assets resulting in approximately $0.7 million of additional expense. The sale of the Luling facility and the six wellness centers were not strategic shifts in our operations, and therefore the results of operations related to these facilities were not reclassified as discontinued operations. 2014 Activity On December 31, 2014, we sold our La Palma facility for $12.5 million, resulting in a gain of $2.9 million. Due to this sale, we wrote-off On May 20, 2014, the tenant of our Bucks facility gave notice of their intent to exercise the lease’s purchase option. Pursuant to this purchase option, the tenant acquired the facility on August 6, 2014 for $35 million. We wrote down this facility to fair market value less cost to sell, resulting in a $3.1 million real estate impairment charge in the 2014 second quarter. The sale of the Bucks and La Palma facilities was not a strategic shift in our operations, and therefore the results of the Bucks and La Palma operations were not reclassified as discontinued operations. Intangible Assets At December 31, 2016 and 2015, our intangible lease assets were $296.2 million ($263.8 million, net of accumulated amortization) and $257.0 million ($231.7 million, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $13.4 million, $9.1 million, and $7.0 million in 2016, 2015, and 2014, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2017 $ 22,130 2018 22,069 2019 22,021 2020 21,818 2021 21,751 As of December 31, 2016, capitalized lease intangibles have a weighted average remaining life of 22.1 years. Leasing Operations All of our leases are accounted for as operating leases, except we are accounting for 15 Ernest facilities and ten Prime facilities as DFLs. The components of our net investment in DFLs consisted of the following (in thousands): As of December 31, As of December 31, Minimum lease payments receivable $ 2,207,625 $ 2,587,912 Estimated residual values 407,647 393,097 Less unearned income (1,967,170 ) (2,354,013 ) Net investment in direct financing leases $ 648,102 $ 626,996 Minimum rental payments due to us in future periods under operating leases and DFLs, which have non-cancelable Total Under Total Under Total 2017 $ 386,058 $ 62,419 $ 448,477 2018 388,808 63,668 452,476 2019 392,577 64,941 457,518 2020 395,339 66,240 461,579 2021 400,607 67,565 468,172 Thereafter 7,077,794 1,673,600 8,751,394 $ 9,041,183 $ 1,998,433 $ 11,039,616 Adeptus Health On November 1, 2016, Adeptus Health announced their 2016 third quarter results showing a decline in net income over the prior year and disclosing collection issues associated with a third party billing agent among other things. At December 31, 2016, we have no outstanding receivables due from this tenant. Furthermore, Adeptus Health is current on its rent obligations to us through February 2017. In addition, we currently hold letters of credit approximating $12.4 million. At December 31, 2016, we have approximately $400 million invested in 59 properties (including five properties still under development) that are leased, pursuant to master lease agreements, to Adeptus Health, along with additional funding commitments as disclosed earlier. This investment represents approximately 7% of our total assets at December 31, 2016. At December 31, 2016, we believe this investment is fully recoverable; however, no assurances can be made that we will not have any impairment charges related to this investment in the future. Hoboken Facility In the 2015 third quarter, a subsidiary of the operator of our Hoboken facility acquired 10% of our subsidiary that owns the real estate for $5 million, which is reflected in the non-controlling 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. As a result of the lease terminating, we recorded a charge of $1.9 million to reserve against the straight-line rent receivables. In addition, we accelerated the amortization of the related lease intangible asset resulting in $0.5 million of additional expense during 2015. This former tenant has continued to occupy the facility. During the third quarter of 2016, the tenant paid us approximately $2.5 million representing substantially all of amounts owed to us and agreed to general terms of a new lease, which we expect to execute in 2017. The tenant is current on all of its obligations to us through February 2017. Although no assurances can be made that we will not have any impairment charges in the future, we believe our real estate investment in Twelve Oaks at December 31, 2016 is fully recoverable. Monroe Facility During 2014, the previous operator of our Monroe facility continued to underperform and became further behind on payments to us as required by the real estate lease agreement and working capital loan agreement. In August 2014, this operator filed for bankruptcy. Based on these developments and the fair value of our real estate and the underlying collateral of our loan (using Level 2 inputs), we recorded a $47.0 million impairment charge in 2014. Effective December 31, 2014, the bankruptcy court approved the purchase by Prime of the assets of the prior operator. Prime leases the facility from us pursuant to terms under an existing master lease. Prime has been current on its rent since lease inception. At December 31, 2016, our investment in Monroe is approximately $36 million, which we believe is fully recoverable. Loans The following is a summary of our loans ($ amounts in thousands): As of December 31, 2016 As of December 31, 2015 Balance Weighted Average Balance Weighted Average Mortgage loans $ 1,060,400 8.8 % $ 757,581 9.5 % Acquisition loans 121,464 13.7 % 610,469 9.1 % Working capital and other loans 34,257 9.0 % 54,353 10.2 % $ 1,216,121 $ 1,422,403 Our mortgage loans cover 12 of our properties with four operators. The increase in mortgage loans relates to the loans made to Steward totaling $600 million for four properties in October 2016, partially offset by the repayment of two loans for $210 million by RCCH (formally Capella) and the conversion of a $100 million mortgage loan to Prime into a sale/leaseback of the property — See “2016 Activity” under the Disposal and Acquisition sections for more details. Other loans typically consist of loans to our tenants for acquisitions and working capital purposes. At December 31, 2016, acquisition loans include our $115 million of loans to Ernest. The Capella acquisition loans of approximately $489 million at December 31, 2015 were paid in full during 2016 — See “2016 Activity” under the Disposal section for more 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. On October 1, 2016, we converted the remaining $3.3 million of our convertible note into a 15.1% of equity interest in the operator for a total 25% equity interest in the operator. Concentration of Credit Risks Revenue by Operator (Dollar amounts in thousands) For the Years Ended December 31, 2016 2015 Operators (A) Total Percentage of Total Percentage of Prime $ 120,558 22.3 % $ 104,325 23.6 % MEDIAN 93,425 17.3 % 78,540 17.8 % Ernest 67,742 12.5 % 61,988 14.0 % RCCH 52,720 9.7 % 28,567 6.4 % Other operators 206,692 38.2 % 168,458 38.2 % Total $ 541,137 100.0 % $ 441,878 100.0 % (A) Steward is not included herein as the Steward transaction closed on October 3, 2016. Revenue by U.S. State and Country (Dollar amounts in thousands) For the Years Ended December 31, 2016 2015 U.S. States and Other Countries Total Percentage of Total Percentage of Texas $ 96,992 17.9 % $ 87,541 19.8 % California 66,197 12.2 % 66,120 15.0 % New Jersey 39,084 7.2 % 27,688 6.3 % Massachusetts 26,098 4.8 % 69 0.0 % Arizona 23,798 4.4 % 21,188 4.8 % Other States 187,363 34.7 % 156,256 35.3 % Total U.S. $ 439,532 81.2 % $ 358,862 81.2 % Germany $ 97,382 18.0 % $ 78,540 17.8 % United Kingdom, Italy, and Spain 4,223 0.8 % 4,476 1.0 % Total International $ 101,605 18.8 % $ 83,016 18.8 % Total $ 541,137 100.0 % $ 441,878 100.0 % From an asset perspective, approximately 80% of our total assets are in the U.S., while 20% reside in Europe (primarily Germany) as of December 31, 2016, consistent with December 31, 2015. Related Party Transactions Lease and interest revenue earned from tenants in which we have an equity interest in were $282.9 million, $215.4 million and $101.8 million in 2016, 2015 and 2014, respectively.

Debt

Debt	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt ($ amounts in thousands): As of December 31, 2016 2015 Revolving credit facility $ 290,000 $ 1,100,000 Term loans 263,101 263,400 Senior Unsecured Notes due 2016 — 125,000 6.875% Senior Unsecured Notes due 2021 — 450,000 6.375% Senior Unsecured Notes due 2022: Principal amount 350,000 350,000 Unamortized premium 1,814 2,168 351,814 352,168 5.750% Senior Unsecured Notes due 2020 (A) 210,340 217,240 4.000% Senior Unsecured Notes due 2022 (A) 525,850 543,100 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 — 5.250% Senior Unsecured Notes due 2026 500,000 — $ 2,941,105 $ 3,350,908 Debt issue costs, net (31,764 ) (28,367 ) $ 2,909,341 $ 3,322,541 As of December 31, 2016, 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): 2017 $ 320 2018 302,781 2019 250,000 2020 210,340 2021 — Thereafter 2,175,850 Total $ 2,939,291 (A) These notes are Euro-denominated and reflect the exchange rates at December 31, 2016 and 2015, respectively. Revolving Credit Facility On June 19, 2014, we closed on the Credit Facility for $900 million. The Credit Facility was comprised of a $775 million senior unsecured revolving credit facility (the “Revolving credit facility”) and a $125 million senior unsecured term loan facility (the “Term Loan”). The Credit Facility had an accordion feature that allowed us to expand the size of the facility by up to $250 million through increases to the Revolving credit facility, Term Loan, both or as a separate term loan tranche. The Credit Facility replaced our previous $400 million unsecured revolving credit facility and $100 million unsecured term loan. This transaction resulted in a refinancing charge of approximately $0.3 million in the 2014 second quarter. On October 17, 2014, we entered into an amendment to our Credit Facility to exercise the $250 million accordion on the Revolving credit facility. This amendment increased the Credit Facility to $1.15 billion and added a new accordion feature that allowed us to expand our credit facility by another $400 million. On August 4, 2015, we entered into an amendment to our Revolving credit facility and Term Loan agreement to further increase the current aggregate committed size to $1.25 billion and amend certain covenants in order to permit us to consummate and finance the acquisition of Capella. On September 30, 2015, we further amended our Credit Facility to, among other things, increase the aggregate commitment under our Revolving credit facility to $1.3 billion and increase the Term Loan portion to $250 million. In addition, this amendment included a new accordion feature that allowed us to expand the Credit Facility by another $400 million for a total commitment of $1.95 billion. This amendment resulted in a $0.1 million expense in the 2015 third quarter. The Revolving credit facility matures in June 2018 and can be extended for an additional 12 months at our option. The Revolving credit facility’s interest rate was originally set as (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.70% to 1.25% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.70% to 2.25% based on current total leverage. In addition to interest expense, we were required to pay a quarterly commitment fee on the undrawn portion of the revolving credit facility, ranging from 0.25% to 0.35% per year. In November 2014, we received an upgrade to our credit rating resulting in an improvement in our interest rate spreads and commitment fee rates. Effective December 10, 2014, the Revolving credit facility’s interest rate is (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00% plus a fixed spread of 0.40% or (2) LIBOR plus a fixed spread of 1.40%. In regards to commitment fees, we now pay based on the total facility at a rate of 0.30% per year. At December 31, 2016 and 2015, we had $290 million and $1.1 billion, respectively, outstanding on the Revolving credit facility. At December 31, 2016, our availability under our Revolving credit facility was $1 billion. The weighted average interest rate on this facility was 2.0% and 1.7% for 2016 and 2015, respectively. See Note 13 for subsequent event activity impacting our Credit Facility. Term Loans As noted above in the Revolving Credit Facility section, we closed on the Term Loan for $125 million in the second quarter of 2014. Furthermore, as noted above, we amended the credit facility to increase the Term Loan portion to $250 million in the third quarter of 2015. The Term Loan matures in June 2019. The Term Loan’s initial interest rate was (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Eurodollar rate plus 1.00%, plus a spread that was adjustable from 0.60% to 1.20% based on current total leverage, or (2) LIBOR plus a spread that was adjustable from 1.60% to 2.20% based on current total leverage. With the upgrade to our credit rating as discussed above, the Term Loan’s interest rate, effective December 10, 2014, improved to (1) the higher of the “prime rate”, federal funds rate plus 0.50%, or Euro dollar rate plus 1.00% plus a fixed spread of 0.65%, or (2) LIBOR plus a fixed spread of 1.65%. At December 31, 2016 and 2015, the interest rate in effect on the Term Loan was 2.36% and 2.05%, respectively. In connection with our acquisition of the Northland LTACH Hospital on February 14, 2011, we assumed a $14.6 million mortgage. The Northland mortgage loan requires monthly principal and interest payments based on a 30-year See Note 13 for subsequent activity impacting our Credit Facility. Senior Unsecured Notes due 2016 During 2006, we issued $125.0 million of senior unsecured notes (the “Senior Unsecured Notes due 2016”). One of the issuances of the Senior Unsecured Notes due 2016 totaling $65.0 million paid interest quarterly at a floating annual rate of three-month LIBOR plus 2.30% and could be called at par value by us at any time. This portion of the Senior Unsecured Notes due 2016 matured in July 2016. The remaining issuances of Senior Unsecured Notes due 2016 paid interest quarterly at a floating annual rate of three-month LIBOR plus 2.30% and could also be called at par value by us at any time. These remaining notes matured in October 2016. 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 $125 million Senior Unsecured Notes due 2016, 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 Senior Unsecured Notes due 2016 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%. At December 31, 2015, the fair value of the interest rate swaps was $2.9 million, which is reflected in accounts payable and accrued expenses on the consolidated balance sheets. These interest rate swaps expired in 2016 in connection with the maturity of the related notes. We accounted for our interest rate swaps as cash flow hedges. We did not have any hedge ineffectiveness from inception of our interest rate swaps through their expiration in 2016; and therefore, there was no income statement effect recorded during the years ended December 31, 2016, 2015, and 2014. 6.875% Senior Unsecured Notes due 2021 On April 26, 2011, we closed on a private placement of $450 million senior notes (the “6.875% Senior Unsecured Notes due 2021”) to qualified institutional buyers in reliance on Rule 144A under the Securities Act. The notes were subsequently registered under the Securities Act pursuant to an exchange offer. Interest on the notes was payable semi-annually on May 1 and November 1 of each year. The notes paid interest in cash at a rate of 6.875% per year, would have matured on May 1, 2021, and offered a redemption option to redeem some or all of the notes at a premium, plus accrued and unpaid interest to, but not including, the redemption date. On July 22, 2016, we used the net proceeds from the 5.250% Senior Unsecured Notes due 2026 offering (see discussion below for further details on these notes) to redeem our $450 million 6.875% Senior Unsecured Notes due 2021. This redemption resulted in a $22.5 million debt refinancing charge during the 2016 third quarter, consisting of a $15.5 million redemption premium along with the write-off 6.375% Senior Unsecured Notes due 2022 On February 17, 2012, we completed a $200 million offering of senior unsecured notes (“6.375% Senior Unsecured Notes due 2022”), and on August 20, 2013, we completed a $150 million tack on to the notes. These 6.375% Senior Unsecured Notes due 2022 accrue interest at a fixed rate of 6.375% per year and mature on February 15, 2022. The 2013 tack on offering, was issued at a premium (price of 102%), resulting in an effective rate of 5.998%. Interest on these notes is payable semi-annually on February 15 and August 15 of each year. We may redeem some or all of the notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. In the event of a change of control, each holder of the 6.375% Senior Unsecured Notes due 2022 may require us to repurchase some or all of its notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase. 5.750% Senior Unsecured Notes due 2020 On October 10, 2013, we completed a €200 million offering of senior unsecured notes (“5.750% Senior Unsecured Notes due 2020”). Interest on the notes is payable semi-annually on April 1 and October 1 of each year. The 5.750% Senior Unsecured Notes due 2020 pay interest in cash at a rate of 5.750% per year. The notes mature on October 1, 2020. We may redeem some or all of the notes at any time at a “make-whole” redemption price 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. See Note 13 for subsequent event activity related to these notes. 4.000% Senior Unsecured Notes due 2022 On August 19, 2015, we completed a €500 million senior unsecured notes offering (“4.000% Senior Unsecured Notes due 2022”). Interest on the notes is payable annually on August 19 of each year. The notes pay interest in cash at a rate of 4.00% per year. The notes mature on August 19, 2022. We may redeem some or all of the 4.000% Senior Unsecured Notes due 2022 at any time. If the notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by us. 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 the purchase. 5.500% Senior Unsecured Notes due 2024 On April 17, 2014, we completed a $300 million senior unsecured notes offering (“5.500% Senior Unsecured Notes due 2024”). Interest on the notes is payable semi-annually on May 1 and November 1 of each year. The notes pay interest in cash at a rate of 5.50% per year. The notes mature on May 1, 2024. We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 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 May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the notes using the proceeds of one or more equity offerings. 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. 6.375% Senior Unsecured Notes due 2024 On February 22, 2016, we completed a $500 million senior unsecured notes offering (“6.375% Senior Unsecured Notes due 2024”). Interest on the notes is payable on March 1 and September 1 of each year. Interest on the notes is 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. 5.250% Senior Unsecured Notes due 2026 On July 22, 2016, we completed a $500 million senior unsecured notes offering (“5.250% Senior Unsecured Notes due 2026”). Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2017. Interest on the notes is to be paid in cash at a rate of 5.25% per year. The notes mature on August 1, 2026. We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.25% 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. Other Financing On July 27, 2015, we received a commitment to provide a senior unsecured bridge loan facility in the original principal amount of $1.0 billion to fund the acquisition of Capella pursuant to a commitment letter from JPMorgan Chase Bank, N.A. and Goldman, Sachs & Co. Funding under the bridge facility was not necessary as we funded the acquisition through a combination of an equity issuance and other borrowings. We incurred and expensed certain customary structuring and underwriting fees of $3.9 million in the 2015 third quarter related to the bridge commitment. Covenants Our debt facilities impose certain restrictions on us, including restrictions on our ability to: incur debts; create or incur liens; provide guarantees in respect of obligations of any other entity; make redemptions and repurchases of our capital stock; prepay, redeem or repurchase debt; engage in mergers or consolidations; enter into affiliated transactions; dispose of real estate or other assets; and change our business. In addition, the credit agreements governing our Credit Facility limit the amount of dividends we can pay as a percentage of normalized adjusted funds from operations, as defined in the agreements, on a rolling four quarter basis. Through 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 FFO, 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. This Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At December 31, 2016, we were in compliance with all such financial and operating covenants.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income Taxes	5. Income Taxes Medical Properties Trust, Inc. We have maintained and intend to maintain our election as a REIT under the Code of 1986, as amended. 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 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 taxable income to our stockholders and satisfy certain other requirements. Income tax is paid directly by our stockholders on the dividends distributed to them. If our 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, including any applicable alternative minimum tax. Taxable income from non-REIT From our TRSs and our foreign operations, income tax (benefit) expense were as follows (in thousands): For the years ended December 31, 2016 2015 2014 Current income tax expense: Domestic $ 42 $ 147 $ 114 Foreign 1,856 1,614 225 1,898 1,761 339 Deferred income tax (benefit) expense: Domestic 147 (360 ) (23 ) Foreign (8,875 ) 102 24 (8,728 ) (258 ) 1 Income tax (benefit) expense $ (6,830 ) $ 1,503 $ 340 The foreign provision (benefit) for income taxes is based on foreign loss before income taxes of $23.5 million in 2016 as compared with foreign loss before income taxes of $29.4 million in 2015, and foreign loss before income taxes of $7.5 million in 2014. The domestic provision (benefit) for income taxes is based on a loss before income taxes of $1.4 million in 2016 from our taxable REIT subsidiaries as compared with income before income taxes of $7.1 million in 2015, and a loss before income taxes of $20.9 million in 2014. At December 31, 2016 and 2015, components of our deferred tax assets and liabilities were as follows (in thousands): 2016 2015 Deferred tax liabilities: Property and equipment $ (3,781 ) $ (1,636 ) Unbilled rent (7,045 ) (4,495 ) Partnership investments (5,103 ) (3,362 ) Other (6,757 ) (6,141 ) Total deferred tax liabilities $ (22,686 ) $ (15,634 ) Deferred tax assets: Operating loss and interest deduction carry forwards $ 28,289 $ 19,016 Other 10,085 10,314 Total deferred tax assets 38,374 29,330 Valuation allowance (15,975 ) (23,005 ) Total net deferred tax assets $ 22,399 $ 6,325 Net deferred tax (liability) $ (287 ) $ (9,309 ) At December 31, 2016, our U.S. net operating losses (“NOLs”) consisted of $60 million of federal NOLs and $113.5 million of state NOLs available as offsets to future years’ taxable income. We have federal and state capital loss carryforwards of $8.1 million. The NOLs primarily expire between 2021 and 2035 and the capital loss carryforward expires in 2022. We have alternative minimum tax credits of $0.3 million as of December 31, 2016, which may be carried forward indefinitely. At December 31, 2016, we had foreign NOLs of $13.3 million that may be carried forward indefinitely. In the evaluation of the need for a valuation allowance on the U.S. deferred income tax assets, we considered 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. Based on our review of all positive and negative evidence, including a three year U.S. cumulative pre-tax We also evaluated the need for a valuation allowance on our foreign deferred income tax assets. In doing so, we considered all available evidence to determine whether it is more likely than not that the foreign deferred income tax assets will be realized. When comparing 2016 results to prior periods, we noted a significant increase in positive evidence, which included a strong positive trend in foreign earnings and forecasted foreign income projections in 2017 and future periods. For instance, several of our initial foreign subsidiaries achieved a cumulative pre-tax pre-tax 12-18 We have no uncertain tax position liabilities and related interest or penalties recorded at December 31, 2016. A reconciliation of the income tax (benefit) expense at the statutory income tax rate and the effective tax rate for income from continuing operations before income taxes for the years ended December 31, 2016, 2015, and 2014 is as follows (in thousands): 2016 2015 2014 Income from continuing operations (before-tax) $ 219,108 $ 141,430 $ 51,138 Income tax at the US statutory federal rate (35%) 76,688 49,501 17,898 Increase (decrease) resulting from: Rate differential 1,434 5,047 1,145 State income taxes, net of federal benefit 66 (601 ) (337 ) Dividends paid deduction (84,927 ) (57,109 ) (27,873 ) Equity investments 4,297 — — Change in valuation allowance (6,104 ) 6,174 8,988 Other items, net 1,716 (1,509 ) 519 Total income tax (benefit) expense $ (6,830 ) $ 1,503 $ 340 We have met the annual REIT distribution requirements by payment of at least 90% of our estimated taxable income in 2016, 2015, and 2014. 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, 2016 2015 2014 Common share distribution $ 0.900000 $ 0.870000 $ 0.840000 Ordinary income 0.619368 0.769535 0.520692 Capital gains(1) 0.102552 — 0.000276 Unrecaptured Sec. 1250 gain 0.045432 — 0.000276 Return of capital 0.178080 0.100465 0.319032 (1) Capital gains include unrecaptured Sec. 1250 gains. 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 TRSs on behalf of Medical Properties Trust, Inc., which are subject to 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 TRSs and international operations.

Earnings Per Share_Unit

Earnings Per Share/Unit	12 Months Ended
	Dec. 31, 2016
Earnings Per Share [Abstract]
Earnings Per Share/Unit	6. Earnings Per Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2016 2015 2014 Numerator: Income from continuing operations $ 225,938 $ 139,927 $ 50,798 Non-controlling (889 ) (329 ) (274 ) Participating securities’ share in earnings (559 ) (1,029 ) (894 ) Income from continuing operations, less participating securities’ share in earnings 224,490 138,569 49,630 Income (loss) from discontinued operations attributable to MPT common stockholders (1 ) — (2 ) Net income, less participating securities’ share in earnings $ 224,489 $ 138,569 $ 49,628 Denominator: Basic weighted-average common shares 260,414 217,997 169,999 Dilutive potential common shares 658 307 541 Diluted weighted-average common shares 261,072 218,304 170,540 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2016 2015 2014 Numerator: Income from continuing operations $ 225,938 $ 139,927 $ 50,798 Non-controlling (889 ) (329 ) (274 ) Participating securities’ share in earnings (559 ) (1,029 ) (894 ) Income from continuing operations, less participating securities’ share in earnings 224,490 138,569 49,630 Income (loss) from discontinued operations attributable to MPT Operating Partnership partners (1 ) — (2 ) Net income, less participating securities’ share in earnings $ 224,489 $ 138,569 $ 49,628 Denominator: Basic weighted-average units 260,414 217,997 169,999 Dilutive potential units 658 307 541 Diluted weighted-average units 261,072 218,304 170,540

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Awards	7. Stock Awards Stock Awards Our Equity Incentive Plan 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. Our 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 and 5,265,916 shares remain available for future stock awards as of December 31, 2016. The Equity Incentive Plan contains a limit of 5,000,000 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. 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 are returned to the Equity Incentive Plan and are then available to be re-issued The following awards have been granted pursuant to our Equity Incentive Plan (and its predecessor plan): Restricted Equity Awards These stock-based awards are in the form of service-based awards and performance awards based on certain market conditions. The service-based awards vest as the employee provides the required service (typically three to five years). Service based awards are valued at the average price per share of common stock on the date of grant. In 2016, 2015, and 2014, the Compensation Committee granted performance — based awards to employees which vest based on us achieving certain total shareholder returns or comparisons of our total shareholder returns to peer total return indices. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance award grants: 2016 performance awards — The 2016 performance awards were granted in two parts: 1) One-half 2) The remainder of the 2016 performance awards will be earned if our total shareholder return outpaces that of the MSCI U.S. REIT Index (“Index”) over the cumulative period from January 1, 2016 to December 31, 2018. Our total shareholder return must be within 3% of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 3% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on January 1, 2019, 2020, and 2021. The fair value of this award was estimated on the dates of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.0%; expected volatility of 24.4%; expected dividend yield of 7.0%; and expected service period of 5 years. No 2016 performance awards were earned and vested in 2016, and 2,400 performance awards were forfeited in 2016. At December 31, 2016, we have 797,404 of 2016 performance awards remaining to be earned. 2015 performance awards — The 2015 performance awards were granted in three parts: 1) Approximately 40% of the 2015 performance awards were based on us achieving a simple 9.0% annual total shareholder return. For the three-year period from January 1, 2015 through December 31, 2017, one-third 2) Approximately 30% of the 2015 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2015 to December 31, 2017. The minimum total shareholder return needed to earn a portion of this award is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2017, 2018, and 2019. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.1%; expected volatility of 20%; expected dividend yield of 7.2%; and expected service period of 5 years. 3) The remainder of the 2015 performance awards will be earned if our total shareholder return outpaces the Index over the cumulative period from January 1, 2015 to December 31, 2017. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2017, 2018, and 2019. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.1%; expected volatility of 20%; expected dividend yield of 7.2%; and expected service period of 5 years. In 2016, 98,526 shares were earned and vested, and 66,792 performance awards were forfeited in 2016. No 2015 performance awards were earned and vested in 2015, and 4,500 performance awards were forfeited in 2015. At December 31, 2016, we have 702,070 of 2015 performance awards remaining to be earned. 2014 performance awards — The 2014 performance awards were granted in three parts: 1) Approximately 40% of the 2014 performance awards were based on us achieving a simple 9.0% annual total shareholder return. For the five-year period from January 1, 2014 through December 31, 2018, one-third 2) Approximately 30% of the 2014 performance awards were based on us achieving a cumulative total shareholder return from January 1, 2014 to December 31, 2016. The minimum total shareholder return needed to earn a portion of this award is 27.0% with 100% of the award earned if our total shareholder return reaches 35.0%. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017, and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years. 3) The remainder of the 2014 performance awards were to be earned if our total shareholder return outpaced that of the Index over the cumulative period from January 1, 2014 to December 31, 2016. Our total shareholder return must exceed that of the Index to earn the minimum number of shares under this award, while it must exceed the Index by 6% to earn 100% of the award. If any shares are earned from this award, the shares will vest in equal annual amounts on December 31, 2016, 2017, and 2018. The fair value of this award was estimated on the date of grant using a Monte Carlo valuation model that assumed the following: risk free interest rate of 0.8%; expected volatility of 27%; expected dividend yield of 8.0%; and expected service period of 5 years. In 2014 and 2016, 108,261 and 99,959 shares were earned and vested under the 2014 performance awards, respectively. No such awards were earned and vested in 2015. In 2016, 500,000 shares, which related to the latter two parts of the award as described above, were forfeited as the three-year cumulative total shareholder return hurdles from January 1, 2014 to December 31, 2016 were not met. An additional 72,003 performance shares were forfeited prior to the measurement date in 2016. At December 31, 2016, we have 99,935 of 2014 performance awards remaining to be earned. The following summarizes restricted equity award activity in 2016 and 2015 (which includes awards granted in 2016, 2015, 2014, and any applicable prior years), respectively: For the Year Ended December 31, 2016: Vesting Based on Service Vesting Based on Market/ Shares Weighted Average Shares Weighted Average Nonvested awards at beginning of the year 509,634 $ 13.25 2,331,152 $ 6.38 Awarded 254,574 $ 13.07 799,804 $ 7.30 Vested (349,356 ) $ 13.07 (671,983 ) $ 6.50 Forfeited (67,724 ) $ 13.06 (647,298 ) $ 6.28 Nonvested awards at end of year 347,128 $ 13.35 1,811,675 $ 6.78 For the Year Ended December 31, 2015: Vesting Based Vesting Based on Shares Weighted Average Shares Weighted Average Nonvested awards at beginning of the year 452,263 $ 12.11 2,428,518 $ 5.81 Awarded 407,969 $ 13.94 871,888 $ 6.62 Vested (343,904 ) $ 12.56 (406,970 ) $ 4.94 Forfeited (6,694 ) $ 13.08 (562,284 ) $ 5.33 Nonvested awards at end of year 509,634 $ 13.25 2,331,152 $ 6.38 The value of stock-based awards is charged to compensation expense over the vesting periods. In the years ended December 31, 2016, 2015, and 2014, we recorded $7.9 million, $11.1 million, and $9.2 million, respectively, of non-cash

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Commitments On July 20, 2016, we entered into definitive agreements to acquire 20 rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €215.7 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to a new master lease with a term of approximately 27 years. Closing of the transaction, which began during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. As discussed in Note 3, we have closed seven of the 20 facilities in the amount of €49.5 million on December 31, 2016. On September 9, 2016, we entered into definitive agreements to acquire six rehabilitation hospitals in Germany for an aggregate purchase price to us of approximately €44.1 million. Upon closing, the facilities will be leased to affiliates of MEDIAN, pursuant to the existing long-term master lease. Closing of the transaction, which began during the fourth quarter of 2016, is subject to customary real estate, regulatory and other closing conditions. As discussed in Note 3, we have closed on five of the six facilities in the amount of €35.7 million as of December 31, 2016. We closed on the final property on January 27, 2017, in the amount of €8.4 million. On September 28, 2016, we entered into definitive agreements to acquire two acute care hospitals in Washington and Idaho for an aggregate purchase price to us of approximately $105 million. Upon closing, the facilities will be leased to RCCH, pursuant to the current master lease. Closing of the transaction, which is expected to be completed in the first half of 2017, is subject to customary real estate, regulatory and other closing conditions. Operating leases, in which we are the lessee, primarily consist of ground leases on which certain of our facilities or other related property reside along with corporate office and equipment leases. The ground leases are long-term leases (almost all having terms of 30 years or more), some of which contain escalation provisions and one contains a purchase option. Properties subject to these ground leases are subleased to our tenants. Lease and rental expense (which is recorded on the straight-line method) for 2016, 2015 and 2014, respectively, were $6.8 million, $4.6 million, and $2.3 million, which was offset by sublease rental income of $4.2 million, $2.3 million, and $0.3 million for 2016, 2015, and 2014, respectively. Fixed minimum payments due under operating leases with non-cancelable non-cancelable Fixed Amounts to Net 2017 $ 7,328 $ (4,725 ) $ 2,603 2018 7,249 (4,731 ) 2,518 2019 6,925 (4,755 ) 2,170 2020 6,944 (4,860 ) 2,084 2021 6,024 (4,966 ) 1,058 Thereafter 251,981 (249,662 ) 2,319 $ 286,451 $ (273,699 ) $ 12,752 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 these 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, 2016
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 2016 Activity On October 7, 2016, we sold 10.3 million shares of common stock in a private placement to an affiliate of Cerberus, the controlling member of Steward, and certain members of Steward management. We sold these shares at a price per share of $14.50, equal to the public offering price of our September 2016 equity offering, generating total proceeds of $150 million. On September 30, 2016, we completed an underwritten public offering of 57.5 million shares (including the exercise of the underwriters’ 30-day On March 1, 2016, we updated our at-the-market at-the-market 2015 Activity On August 11, 2015, we completed an underwritten public offering of 28.75 million shares (including the exercise of the underwriters’ 30-day On August 4, 2015, we filed Articles of Amendment to our charter with the Maryland State Department of Assessments and Taxation increasing the number of authorized shares of common stock, par value $0.001 per share available for issuance from 250,000,000 to 500,000,000. On January 14, 2015, we completed an underwritten public offering of 34.5 million shares (including the exercise of the underwriters’ 30-day MPT Operating Partnership, L.P. 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 three other partners. By virtue of its ownership of the General Partner, the Company has a 99.9% ownership interest in Operating Partnership via its ownership of all the common units. The remaining ownership interest is held by the two employees and one director via their ownership of LTIP units. These LTIP units were issued pursuant to the 2007 Multi-Year Incentive Plan, which is now part of the Equity Incentive Plan discussed in Note 7 and once vested in accordance with their award agreement, may be converted to common units per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”). 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 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 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 limited partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will generally be allocated first to the limited partners until their capital account is zero and 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 For each share of common stock issued by Medical Properties Trust, Inc., the Operating Partnership issues a corresponding number of operating partnership units.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	10. 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 at December 31, 2015, were our interest rate swaps, which were 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 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, 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 possible and may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2016 December 31, Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 57,698 $ 57,707 $ 46,939 $ 46,858 Loans(1) 986,987 1,017,428 508,851 543,859 Debt, net (2,909,341 ) (2,966,759 ) (3,322,541 ) (3,372,773 ) (1) Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value as discussed below. Items Measured at Fair Value on a Recurring Basis Our equity interest in Ernest, Capella (2015 only) and related loans, as discussed in Note 2, 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 December 31, 2016, the amounts recorded under the fair value option method were as follows (in thousands): Asset (Liability) Fair Cost Asset Type Mortgage loan $ 112,836 $ 112,836 Mortgage loans Acquisition and other loans 116,298 116,298 Other loans Equity investment 3,300 3,300 Other assets $ 232,434 $ 232,434 At December 31, 2015, the amounts recorded under the fair value option method were as follows (in thousands): Asset (Liability) Fair Cost Asset Type Mortgage loan $ 310,000 $ 310,000 Mortgage loans Acquisition and other loans 603,552 603,552 Other loans Equity investment 7,349 7,349 Other assets $ 920,901 $ 920,901 Our mortgage and other loans with Ernest and Capella (2015 only) 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 equity investments in Ernest and Capella (2015 only) 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 forecasted assumptions associated with the investee. We classify the 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 DLOM on our equity investment of 40% at December 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 (2015 only), respectively. However, we will modify such projections (including underlying assumptions used) as needed based on our review and analysis of their 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) +100 basis points $ (49 ) - 100 basis points 49 Because the fair value of Ernest and Capella (2015 only) investments noted above approximate their original cost, we did not recognize any unrealized gains/losses during 2016, 2015, or 2014. To date, we have not received any distribution payments from our equity investment in Ernest. In regards to the Capella investment, we sold this investment in 2016 at our original cost (see Note 3 for further details of this disposal).

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2016
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	11. Other Assets The following is a summary of our other assets (in thousands): At December 31, 2016 2015 Debt issue costs, net(1) $ 4,478 $ 7,628 Equity investments 177,430 129,337 Other corporate assets 77,580 31,547 Prepaids and other assets 44,285 27,028 Total other assets $ 303,773 $ 195,540 (1) Relates to Revolving credit facility Equity investments have increased over the prior year primarily due to our new investment in Steward — see Note 3 for further details. Other corporate assets include leasehold improvements associated with our corporate office space, furniture and fixtures, equipment, software, deposits, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, goodwill, deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items.

Quarterly Financial Data (unaud

Quarterly Financial Data (unaudited)	12 Months Ended
	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data (unaudited)	12. Quarterly Financial Data (unaudited) Medical Properties Trust, Inc. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2016 and 2015: (amounts in thousands, except for per share data) For the Three Month Periods in 2016 Ended March 31 June 30 September 30 December 31 Revenues $ 134,999 $ 126,300 $ 126,555 $ 153,283 Income from continuing operations 58,226 53,924 70,543 43,245 Net income 58,225 53,924 70,543 43,245 Net income attributable to MPT common stockholders 57,927 53,724 70,358 43,039 Net income attributable to MPT common stockholders per share — basic $ 0.24 $ 0.23 $ 0.29 $ 0.13 Weighted average shares outstanding — basic 237,510 238,082 246,230 319,833 Net income attributable to MPT common stockholders per share — diluted $ 0.24 $ 0.22 $ 0.28 $ 0.13 Weighted average shares outstanding — diluted 237,819 239,008 247,468 319,994 For the Three Month Periods in 2015 Ended March 31 June 30 September 30 December 31 Revenues $ 95,961 $ 99,801 $ 114,570 $ 131,546 Income from continuing operations 35,976 22,489 23,123 58,339 Net income 35,976 22,489 23,123 58,339 Net income attributable to MPT common stockholders 35,897 22,407 23,057 58,237 Net income attributable to MPT common stockholders per share — basic $ 0.18 $ 0.11 $ 0.10 $ 0.24 Weighted average shares outstanding — basic 202,958 208,071 223,948 237,011 Net income attributable to MPT common stockholders per share —diluted $ 0.17 $ 0.11 $ 0.10 $ 0.24 Weighted average shares outstanding — diluted 203,615 208,640 223,948 237,011 MPT Operating Partnership, L.P. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2016 and 2015: (amounts in thousands, except for per unit data) For the Three Month Periods in 2016 Ended March 31 June 30 September 30 December 31 Revenues $ 134,999 $ 126,300 $ 126,555 $ 153,283 Income from continuing operations 58,226 53,924 70,543 43,245 Net income 58,225 53,924 70,543 43,245 Net income attributable to MPT Operating Partnership partners 57,927 53,724 70,358 43,039 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.24 $ 0.23 $ 0.29 $ 0.13 Weighted average units outstanding — basic 237,510 238,082 246,230 319,833 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.24 $ 0.22 $ 0.28 $ 0.13 Weighted average units outstanding — diluted 237,819 239,008 247,468 319,994 For the Three Month Periods in 2015 Ended March 31 June 30 September 30 December 31 Revenues $ 95,961 $ 99,801 $ 114,570 $ 131,546 Income from continuing operations 35,976 22,489 23,123 58,339 Net income 35,976 22,489 23,123 58,339 Net income attributable to MPT Operating Partnership partners 35,897 22,407 23,057 58,237 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.18 $ 0.11 $ 0.10 $ 0.24 Weighted average units outstanding — basic 202,958 208,071 223,948 237,011 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.17 $ 0.11 $ 0.10 $ 0.24 Weighted average units outstanding — diluted 203,615 208,640 223,948 237,011

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2016
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On February 1, 2017, we replaced our Credit Facility with a new revolving credit and term loan agreement. The new agreement includes a $1.3 billion unsecured revolving loan facility, a $200 million unsecured term loan facility, and a €200 million unsecured term loan facility. The new unsecured revolving loan facility matures in February 2021 and can be extended for an additional 12 months at our option. The $200 million unsecured term loan facility matures on February 1, 2022 and the €200 million unsecured term loan facility matures on January 31, 2020, and can be extended for an additional 12 months at our option. The commitment fee on the total facility is paid at a rate of 0.25%. The term loan and/or revolving loan commitments may be increased in an aggregate amount not to exceed $500 million. At our election, loans under the new credit facility may be made as either ABR Loans or Eurodollar Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.95% based on our current credit rating. The applicable margin for term loans that are Eurodollar Loans is adjustable on a sliding scale from 0.90% to 1.95% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.65% based on our current credit rating. The applicable margin for revolving loans that are Eurodollar Loans is adjustable on a sliding scale from 0.875% to 1.65% based on our current credit rating. The facility fee is adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and is payable on the revolving loan facility. On February 2, 2017, we delivered an irrevocable notice of full redemption to the holders of the €200 million aggregate principal amount of our 5.750% Senior Notes due 2020 and set a redemption date of March 4, 2017. To fund such redemption, including any premium and accrued interest, we plan to use the proceeds of the new euro term loan together with cash on hand. With the new revolving credit facility and term loans along with the redemption of the 5.750% Senior Notes due 2020, we expect to incur a one-time

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2016
Valuation and Qualifying Accounts [Abstract]
Schedule II: Valuation and Qualifying Accounts	Medical Properties Trust, Inc. and MPT Operating Partnership, L.P. Schedule II: Valuation and Qualifying Accounts December 31, 2016 Additions Deductions Year Ended December 31, Balance at Charged Net Balance at (In thousands) 2016 $ 27,384 $ 2,722 (2) $ (11,254 )(3) $ 18,852 2015 $ 20,129 $ 8,205 (4) $ (950 )(5) $ 27,384 2014 $ 41,573 $ 65,512 (6) $ (86,956 )(7) $ 20,129 (1) Includes allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves. (2) Includes $1.9 million of rent reserves related to our Twelve Oaks facility and $0.8 million of rent reserves related to our Corinth facility. (3) Includes writeoffs of $3.3 million related to payment of rent, late fees, and loans for our Twelve Oaks facility; $0.8 million of writeoffs for rent and interest reserves related to the sale of the Corinth facility; $0.1 million of writeoffs related to the McLeod Healthcare loan; and $6.9 million decrease in valuation allowance to reserve our net deferred tax assets. (4) Includes $1.5 million of rent and late fee reserves related to our Twelve Oaks facility; $0.5 million of rent reserves related to our Healthtrax properties; and $6.2 million to fully reserve our net deferred tax assets. (5) Writeoffs of rent and interest reserves related to sale of Healthtrax properties. (6) Includes the $47 million of impairment charges related to the Monroe property, $9.5 million of rent and interest reserves primarily related to the Monroe property (prior to change in operators — see Note 3 to Item 8 of this Annual Report on Form 10-K (7) Writeoffs of loans and other receivables related to the Monroe facility due to change in operators.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2016
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	December 31, 2016 Initial Costs Additions Subsequent Cost at December 31, 2016(1) Accumulated Life on Location Type of Property Land Buildings Improvements Carrying Land Buildings Total Depreciation Encumbrances Date of Date Acquired (Dollar amounts in thousands) Bad Rappenau, Germany Rehabilitation hospital $ — $ 9,159 $ — $ — $ — $ 9,159 $ 9,159 $ 706 $ — 1994 November 30, 2013 40 Dahlen, Germany Rehabilitation hospital 360 19,863 — — 360 19,863 20,223 1,531 — 1996 November 30, 2013 40 Bad Dürkheim, Germany Rehabilitation hospital 3,074 14,531 — — 3,074 14,531 17,605 1,120 — 1960 November 30, 2013 40 Bad Liebenwerda, Germany Rehabilitation hospital 335 17,307 — — 335 17,307 17,642 1,334 — 1994 November 30, 2013 40 Ortenberg, Germany Rehabilitation hospital 89 5,070 — — 89 5,070 5,159 391 — 1981 November 30, 2013 40 Wiesbaden, Germany Rehabilitation hospital 2,980 14,334 — — 2,980 14,334 17,314 1,105 — 1977 November 30, 2013 40 Bad Dürkheim, Germany Rehabilitation hospital — 28,758 — — — 28,758 28,758 2,217 — 1992 November 30, 2013 40 Bad Liebenwerda, Germany Rehabilitation hospital 522 14,469 — — 522 14,469 14,991 1,115 — 1904, 1995 November 30, 2013 40 Bad Dürkheim, Germany Rehabilitation hospital 705 6,337 — — 705 6,337 7,042 488 — 1980 November 30, 2013 40 Bad Dürkheim, Germany Rehabilitation hospital 5,649 15,597 — — 5,649 15,597 21,246 1,202 — 1930 November 30, 2013 40 Bad Rappenau, Germany Rehabilitation hospital 3,312 5,642 — — 3,312 5,642 8,954 435 — 1986 November 30, 2013 40 Bad Tölz, Germany Rehabilitation hospital 2,134 9,187 — — 2,134 9,187 11,321 478 — 1974 November 19, 2014 40 Bad Liebenstein, Germany Rehabilitation hospital 1,554 32,836 — — 1,554 32,836 34,390 1,779 — 1954, 1992 November 5, 2014 40 Bad Mergentheim, Germany Rehabilitation hospital — 10,891 — — — 10,891 10,891 567 — 1988, 1995 December 11, 2014 40 Bath, UK Acute care general hospital 1,463 30,316 — — 1,463 30,316 31,779 1,895 — 2008, 2009 July 1, 2014 40 Ottenhöfen, Germany Rehabilitation hospital 2,182 12,278 105 — 2,287 12,278 14,565 471 — 1956/1957 July 3, 2015 40 Bad Berka, Germany Rehabilitation hospital 3,124 14,569 163 — 3,287 14,569 17,856 531 — 1997 July 22, 2015 40 Wiesbaden, Germany Rehabilitation hospital 1,557 7,220 37 — 1,594 7,220 8,814 274 — 1974 June 30, 2015 40 Bad Lausick, Germany Rehabilitation hospital 1,677 15,176 147 — 1,824 15,176 17,000 584 — 1993 June 30, 2015 40 Bad Sülze, Germany Rehabilitation hospital 2,224 19,184 189 — 2,413 19,184 21,597 738 — 1993 June 30, 2015 40 Kurort Berggießhübel, Germany Rehabilitation hospital 2,966 14,961 131 — 3,097 14,961 18,058 542 — 1993 July 21, 2015 40 Braunfels, Germany Acute care general hospital 2,019 12,907 53 — 2,072 12,907 14,979 489 — 1977 June 30, 2015 40 Bernkastel-Kues, Germany Rehabilitation hospital 3,386 14,709 42 — 3,428 14,709 18,137 525 — 1982 July 15, 2015 40 Flechtingen, Germany Rehabilitation hospital 2,692 13,590 142 — 2,834 13,590 16,424 524 — 1993 June 30, 2015 40 Flechtingen, Germany Rehabilitation hospital 2,692 21,291 210 — 2,902 21,291 24,193 819 — 1993-1995 June 30, 2015 40 Nordrach, Germany Rehabilitation hospital 294 2,818 79 — 373 2,818 3,191 114 — 1960 July 7, 2015 40 Bad Gottleuba, Germany Rehabilitation hospital 49 14,462 835 — 884 14,462 15,346 417 — 1913 December 16, 2015 40 Grünheide, Germany Rehabilitation hospital 2,674 39,306 321 — 2,995 39,306 42,301 1,422 — 1994/2014 July 31, 2015 40 Baden-Baden, Germany Rehabilitation hospital 1,230 8,652 121 — 1,351 8,652 10,003 337 — 1900/2002- June 30, 2015 40 Gyhum, Germany Rehabilitation hospital 3,755 21,461 330 — 4,085 21,461 25,546 838 — 1994 June 30, 2015 40 Hannover, Germany Rehabilitation hospital 3,081 14,562 300 — 3,381 14,562 17,943 416 — 1900 December 1, 2015 40 Heiligendamm, Germany Rehabilitation hospital 4,049 25,235 200 — 4,249 25,235 29,484 966 — 1995 June 30, 2015 40 Bad Camberg, Germany Rehabilitation hospital 1,961 14,956 252 — 2,213 14,956 17,169 586 — 1973 June 30, 2015 40 Hoppegarten, Germany Rehabilitation hospital 3,770 23,351 231 — 4,001 23,351 27,352 849 — 1994 July 27, 2015 40 Ban Nauheim, Germany Rehabilitation hospital 2,976 15,036 137 — 3,113 15,036 18,149 578 — 1977 June 30, 2015 40 Kalbe, Germany Rehabilitation hospital 3,292 21,994 158 — 3,450 21,994 25,444 841 — 1995 July 6, 2015 40 Bad Soden-Salmünster, Germany Rehabilitation hospital 904 6,276 116 — 1,020 6,276 7,296 247 — 1974 June 30, 2015 40 Berlin, Germany Rehabilitation hospital — 20,107 179 — 179 20,107 20,286 775 — 1998 July 16, 2015 40 Bad Lobenstein, Germany Rehabilitation hospital 3,429 19,442 174 — 3,603 19,442 23,045 746 — 1994 June 30, 2015 40 Bernkastel-Kues, Germany Rehabilitation hospital 757 10,926 126 — 883 10,926 11,809 422 — 1993 July 14, 2015 40 Magdeburg, Germany Rehabilitation hospital 13,931 51,674 242 — 14,173 51,674 65,847 1,853 — 1999/2014 July 22, 2015 40 Schlangenbad, Germany Rehabilitation hospital 1,015 3,302 258 — 1,273 3,302 4,575 150 — 1973 June 30, 2015 40 Bad Dürrheim, Germany Rehabilitation hospital 1,346 11,038 221 — 1,567 11,038 12,605 412 — 1960-1970 July 24, 2015 40 Bad Krozingen, Germany Rehabilitation hospital 1,425 10,392 110 — 1,535 10,392 11,927 378 — 2008 July 24, 2015 40 Bad Nauheim, Germany Rehabilitation hospital 1,704 8,906 53 — 1,757 8,906 10,663 339 — 1972-1973 June 30, 2015 40 Bad Tennstedt, Germany Rehabilitation hospital 3,560 26,396 195 — 3,755 26,396 30,151 1,009 — 1993 June 30, 2015 40 Wismar, Germany Rehabilitation hospital 3,355 19,989 189 — 3,544 19,989 23,533 769 — 1996 June 30, 2015 40 Heidelberg, Germany Rehabilitation hospital 5,757 33,689 438 — 6,195 33,689 39,884 436 — 1885/1991 June 22, 2016 40 Bad Kösen, Germany Rehabilitation hospital 1,189 6,941 — — 1,189 6,941 8,130 29 — 1992 October 27, 2016 40 Bad Kösen, Germany Rehabilitation hospital 1,203 7,095 — — 1,203 7,095 8,298 30 — 1996 October 27, 2016 40 Bad Kösen, Germany Rehabilitation hospital 717 4,473 — — 717 4,473 5,190 19 — 1997 October 27, 2016 40 Bad Salzdetfurth, Germany Rehabilitation hospital 1,129 6,556 — — 1,129 6,556 7,685 14 — 1987 November 23, 2016 40 Bad Bertrich, Germany Rehabilitation hospital 631 3,787 — — 631 3,787 4,418 8 — 1910,1980- November 30, 2016 40 Lübeck, Germany Rehabilitation hospital 673 4,922 38 — 711 4,922 5,633 — — 1900/2011 December 31, 2016 40 Vitense-Parber, Germany Rehabilitation hospital 540 3,938 30 — 570 3,938 4,508 — — 1800/1995 December 31, 2016 40 Breuberg-Sandbach, Germany Rehabilitation hospital 1,554 11,485 88 — 1,642 11,485 13,127 — — 1901/1984 December 31, 2016 40 Ravensrush, Germany Rehabilitation hospital 407 3,199 25 — 432 3,199 3,631 — — 1860/1992 December 31, 2016 40 Wildeck, Germany Rehabilitation hospital 731 5,250 40 — 771 5,250 6,021 — — 1600/2013 December 31, 2016 40 Römhild, Germany Rehabilitation hospital 169 8,039 62 — 231 8,039 8,270 — — 1902/2000 December 31, 2016 40 Bad Hersfield, Germany Rehabilitation hospital 507 3,773 29 — 536 3,773 4,309 — — 1930/2014 December 31, 2016 40 Houston, TX Acute care general hospital 3,501 34,530 8,477 16,589 3,274 59,823 63,097 9,663 — 1960 August 10, 2007 40 Allen, TX Freestanding ER 1,550 3,921 — — 1,550 3,921 5,471 245 — 2014 July 14, 2014 40 San Diego, CA Acute care general hospital 12,663 52,432 — — 12,663 52,432 65,095 7,755 — 1973 February 9, 2011 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 258 — 2014 March 19, 2014 40 Houston, TX Freestanding ER 950 4,576 — — 950 4,576 5,526 29 — 2016 September 26, 2016 40 Aurora, CO Freestanding ER — 4,812 — — — 4,812 4,812 150 — 2015 September 17, 2015 40 Ft. Worth, TX Freestanding ER — 4,392 — — — 4,392 4,392 192 — 2015 March 27, 2015 40 Bayonne, NJ Acute care general hospital 2,003 51,495 — — 2,003 51,495 53,498 15,234 — 1918 February 4, 2011 20 Bennettsville, SC Acute care general hospital 794 15,772 — — 794 15,772 16,566 3,419 — 1984 April 1, 2008 40 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 1,183 — 1980 February 13, 2015 40 Bossier City, LA Long term acute care hospital 900 17,818 — — 900 17,818 18,718 3,895 — 1982 April 1, 2008 40 Brighton, MA Acute care general hospital 18,638 147,266 — — 18,638 147,266 165,904 922 — 1917-2009 October 3, 2016 41 Brockton, MA Acute care general hospital 18,141 66,562 — — 18,141 66,562 84,703 526 — 1965-2010 October 3, 2016 41 Austin, TX Freestanding ER 1,140 3,853 — — 1,140 3,853 4,993 249 — 2014 May 29, 2014 40 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 243 — 2014 July 3, 2014 40 Glendale, AZ Freestanding ER 1,144 6,005 — — 1,144 6,005 7,149 25 — 2016 October 21, 2016 40 New Orleans, LA Freestanding ER 2,850 5,599 — — 2,850 5,599 8,449 35 — 2016 September 23, 2016 40 Carrollton, TX Acute care general hospital 729 34,342 — — 729 34,342 35,071 1,216 — 2015 July 17, 2015 40 Cedar Hill. TX Freestanding ER 1,122 3,644 — — 1,122 3,644 4,766 228 — 2014 June 23, 2014 40 Spring, TX Freestanding ER 1,310 4,203 — — 1,310 4,203 5,513 263 — 2014 July 15, 2014 40 Chandler, AZ Freestanding ER — 4,783 — — — 4,783 4,783 199 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,852 — — 750 3,852 4,602 120 — 2015 October 7, 2015 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 4,242 — 1982 April 1, 2008 40 Katy, TX Freestanding ER — 3,873 — — — 3,873 3,873 113 — 2015 October 21, 2015 40 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 5,063 — 2004 December 21, 2010 40 Commerce City, TX Freestanding ER 707 4,236 — — 707 4,236 4,943 221 — 2014 December 11, 2014 40 Conroe, TX Freestanding ER 1,338 3,712 — — 1,338 3,712 5,050 131 — 2015 July 29, 2015 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 194 — 2015 April 10, 2015 40 The Woodlands, TX Freestanding ER — 4,740 — — — 4,740 4,740 89 — 2016 March 28, 2016 40 Dallas, TX Long term acute care hospital 1,000 13,589 — 368 1,421 13,536 14,957 3,496 — 2006 September 5, 2006 40 Denver, CO Freestanding ER — 4,276 — — — 4,276 4,276 169 — 2015 June 8, 2015 40 DeSoto, TX Freestanding ER 750 4,569 — — 750 4,569 5,319 67 — 2016 May 23, 2016 40 DeSoto, TX Long term acute care hospital 1,067 10,701 86 8 1,161 10,701 11,862 1,476 — 2008 July 18, 2011 40 Detroit, MI Long term acute care hospital 1,220 8,687 — (365 ) 1,220 8,322 9,542 1,862 — 1956 May 22, 2008 40 San Antonio, TX Freestanding ER — 5,157 — — — 5,157 5,157 11 — 2016 December 9, 2016 40 Dulles, TX Freestanding ER 1,076 3,784 — — 1,076 3,784 4,860 220 — 2014 September 12, 2014 40 Houston, TX Freestanding ER 1,345 3,678 — — 1,345 3,678 5,023 230 — 2014 June 20, 2014 40 Fairmont, CA Acute care general hospital 1,000 12,301 3,928 — 1,277 15,952 17,229 857 — 1939,1972,1985 September 19, 2014 40 Fall River, MA Acute care general hospital 2,406 82,358 — — 2,406 82,358 84,764 526 — 1950-2012 October 3, 2016 41 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 256 — 2014 June 6, 2014 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 3,388 — 2012 February 7, 2012 40 Fort Lauderdale, FL Rehabilitation hospital 3,499 21,939 — 1 3,499 21,940 25,439 4,763 — 1985 April 22, 2008 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 250 — 2014 July 31, 2014 40 Frisco, TX Freestanding ER — 4,735 — — — 4,735 4,735 99 — 2016 March 4, 2016 40 Frisco, TX Freestanding ER 2,441 4,474 — — 2,441 4,474 6,915 130 — 2015 November 13, 2015 40 Frisco, TX Freestanding ER 1,500 3,863 27 (89 ) 1,411 3,890 5,301 251 — 2014 June 13, 2014 40 Garden Grove, CA Acute care general hospital 5,502 10,748 — 51 5,502 10,799 16,301 2,196 — 1982 November 25, 2008 40 Garland, TX Freestanding ER — 4,954 — — — 4,954 4,954 21 — 2016 November 15, 2016 40 Garden Grove, CA Medical Office Building 862 7,888 — 28 862 7,916 8,778 1,603 — 1982 November 25, 2008 40 Gilbert, AZ Acute care general hospital 150 15,553 — — 150 15,553 15,703 2,333 — 2005 January 4, 2011 40 Gilbert, AZ Freestanding ER 1,518 4,660 — — 1,518 4,660 6,178 165 — 2015 July 22, 2015 40 Glendale, AZ Freestanding ER — 4,046 — — — 4,046 4,046 160 — 2015 June 5, 2015 40 Goodyear, AZ Freestanding ER 1,800 4,709 — — 1,800 4,709 6,509 88 — 2016 April 4, 2016 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 957 — 1999 August 31, 2015 34 Hausman, TX Acute care general hospital 1,500 8,958 — — 1,500 8,958 10,458 835 — 2013 March 1, 2013 40 Helotes, TX Freestanding ER 1,900 5,297 — — 1,900 5,297 7,197 110 — 2016 March 10, 2016 40 Highland Village, TX Freestanding ER — 4,016 — — — 4,016 4,016 126 — 2015 September 22, 2015 40 Hill County, TX Acute care general hospital 1,120 17,882 — — 1,120 17,882 19,002 7,492 — 1980 September 17, 2010 40 Hoboken, NJ Acute care general hospital 1,387 44,351 — — 1,387 44,351 45,738 11,394 — 1863 November 4, 2011 20 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 369 — 2015 May 1, 2015 34 Hoover, AL Medical Office Building — 1,034 — — — 1,034 1,034 50 — 2015 May 1, 2015 34 Hot Springs, AR Acute care general hospital 7,100 59,432 19,113 — 7,100 78,545 85,645 2,480 — 1985 August 31, 2015 40 Highlands Ranch, CO Freestanding ER 4,200 4,763 — — 4,200 4,763 8,963 50 — 2016 July 25, 2016 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 — 4,665 1,822 42,132 43,954 9,086 — 2002 April 1, 2008 40 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 3,146 — 1978 February 13, 2015 40 Katy, TX Freestanding ER — 4,671 — — — 4,671 4,671 29 — 2016 October 10, 2016 40 Camden, SC Acute care general hospital — 22,739 — — — 22,739 22,739 384 — 1954-2004 October 30, 2015 20 Lafayette, IN Rehabilitation hospital 800 14,968 (25 ) — 800 14,943 15,743 1,450 — 2013 February 1, 2013 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 266 — 2013 December 1, 2013 40 Longmont, CO Freestanding ER — 4,770 — — — 4,770 4,770 109 — 2016 February 10, 2016 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 705 — 1,376 28,997 30,373 1,072 — 2008 June 16, 2015 40 Mandeville, LA Freestanding ER 2,800 5,004 — — 2,800 5,004 7,804 21 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER — 5,756 — — — 5,756 5,756 72 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER — 4,060 — — — 4,060 4,060 193 — 2015 July 31, 2015 30 McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 1,663 — 1996 August 31, 2015 41 Mesa, AZ Acute care general hospital 4,900 97,980 2,242 — 7,142 97,980 105,122 8,576 — 2007 September 26, 2013 40 Methuen, MA Acute general care hospital 23,809 89,505 — — 23,809 89,505 113,314 638 — 1950-2011 October 3, 2016 41 Bloomington, IN Acute care general hospital 2,392 28,212 5,000 408 2,392 33,620 36,012 8,483 — 2006 August 8, 2006 40 Montclair, NJ Acute care general hospital 7,900 99,632 585 — 8,477 99,640 108,117 7,152 — 1920-2000 April 1, 2014 40 Muskogee, OK Acute care general hospital 1,420 51,953 — — 1,420 51,953 53,373 1,046 — 1959,2009 August 31, 2015 30 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 271 — 2014 January 1, 2014 40 Houston, TX Acute care general hospital 4,757 56,238 (37 ) 1,259 5,427 56,790 62,217 14,270 — 2006 December 1, 2006 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 274 — 2014 June 5, 2014 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 2,542 13,101 2007 February 14, 2011 40 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 1,695 — 2014 August 31, 2014 40 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 1,150 — 2014 March 1, 2014 40 Olympia, WA Acute care general hospital 7,220 89,348 — — 7,220 89,348 96,568 993 — 1984 July 22, 2016 40 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 926 — 2012 February 1, 2013 40 San Diego, CA Acute care general hospital 6,550 15,653 — 77 6,550 15,730 22,280 3,799 — 1964 May 9, 2007 40 Parker, CO Freestanding ER 1,301 4,448 — — 1,301 4,448 5,749 130 — 2015 November 6, 2015 40 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 209 — 2014 September 8, 2014 40 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 1,938 — 2006 July 1, 2008 40 Plano, TX Freestanding ER — 5,060 — — — 5,060 5,060 32 — 2016 September 30, 2016 40 Poplar Bluff, MO Acute care general hospital 2,659 38,694 — 1 2,660 38,694 41,354 8,400 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 3,000 72,341 1,062 — 4,062 72,341 76,403 6,071 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 3,029 14,622 — — 3,029 14,622 17,651 490 — 1953, 1973-1983 December 31, 2015 40 Portland, OR Long term acute care hospital 3,085 17,859 — 2,559 3,071 20,432 23,503 4,897 — 1964 April 18, 2007 40 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 1,039 — 2013 December 31, 2013 40 San Antonio, TX Freestanding ER — 4,837 — — — 4,837 4,837 20 — 2016 October 27, 2016 40 Redding, CA Acute care general hospital 1,555 53,863 — 13 1,555 53,876 55,431 12,692 — 1974 August 10, 2007 40 Redding, CA Long term acute care hospital — 19,952 — 4,360 1,629 22,683 24,312 6,406 — 1991 June 30, 2005 40 Rosenberg, TX Freestanding ER — 4,731 — — — 4,731 4,731 118 — 2016 January 15, 2016 40 San Dimas, CA Acute care general hospital 6,160 6,839 — 34 6,160 6,873 13,033 1,390 — 1972 November 25, 2008 40 San Dimas, CA Medical Office Building 1,915 5,085 — 18 1,915 5,103 7,018 1,033 — 1979 November 25, 2008 40 Sherman, TX Acute care general hospital 4,491 24,802 — — 4,491 24,802 29,293 1,418 — 1913, 1960- October 31, 2014 40 Sienna, TX Freestanding ER 999 3,591 — — 999 3,591 4,590 209 — 2014 August 20, 2014 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 1,325 — 2013 August 1, 2013 40 Houston, TX Freestanding ER 1,423 3,770 — — 1,423 3,770 5,193 173 — 2015 February 18, 2015 40 Taunton, MA Acute care general hospital 4,428 73,433 — — 4,428 73,433 77,861 488 — 1940-2015 October 3, 2016 41 Thornton, CO Freestanding ER 1,350 4,259 — — 1,350 4,259 5,609 248 — 2014 August 29, 2014 40 Toledo, OH Rehabilitation hospital — 17,740 — — — 17,740 17,740 333 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 23,982 — — 1,299 23,982 25,281 3,597 — 2005 December 21, 2010 40 Houston, TX Acute care general hospital 4,047 41,914 — — 4,047 41,914 45,961 524 — 2016 July 7, 2016 40 League City, TX Freestanding ER — 3,901 — — — 3,901 3,901 146 — 2015 June 19, 2015 40 Anaheim, CA Acute care general hospital 1,875 21,814 — 10 1,875 21,824 23,699 5,547 — 1964 November 8, 2006 40 West Monroe, LA Acute care general hospital 12,000 69,433 552 — 12,552 69,433 81,985 5,822 — 1962 September 26, 2013 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 609 — 2012 October 2, 2012 40 West Valley City, UT Acute care general hospital 5,516 58,314 2,036 (114 ) 5,402 60,350 65,752 12,716 — 1980 April 22, 2008 40 Wichita, KS Rehabilitation hospital 1,019 18,373 — 1 1,019 18,374 19,393 4,018 — 1992 April 4, 2008 40 $ 403,141 $ 3,482,455 $ 52,564 $ 29,882 $ 417,368 $ 3,550,674 $ 3,968,042 $ 292,786 $ 13,101 (1) The aggregate cost for federal income tax purposes is $4,471,179. The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in direct financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2016 December 31, 2015 December 31, 2014 COST Balance at beginning of period $ 2,991,590 $ 2,040,727 $ 1,733,194 Acquisitions 745,948 975,239 263,811 Transfers from construction in progress 163,080 23,163 41,772 Additions 33,279 7,376 84,831 Dispositions (138,886 ) (24,701 ) (56,590 ) Other 173,031 (30,214 ) (26,291 ) Balance at end of period $ 3,968,042 $ 2,991,590 $ 2,040,727 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2016 December 31, 2015 December 31, 2014 ACCUMULATED DEPRECIATION Balance at beginning of period $ 232,675 $ 181,441 $ 144,235 Depreciation 81,010 60,796 46,935 Depreciation on disposed property (19,086 ) (8,887 ) (9,213 ) Other (1,813 ) (675 ) (516 ) Balance at end of period $ 292,786 $ 232,675 $ 181,441

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2016
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. Column A Column B Column C Column D Column E Column F Column G(3) Column H Description Interest Final Periodic Payment Prior Face Carrying Principal (Dollar amounts in thousands) Long-term first mortgage loan: Payable in monthly Desert Valley Hospital 11.0 % 2022 (1) $ 70,000 $ 70,000 (2) Desert Valley Hospital 11.6 % 2022 (1) 20,000 20,000 (2) Desert Valley Hospital 11.0 % 2022 (1) 12,500 12,500 (2) Chino Valley Medical Center 11.0 % 2022 (1) 50,000 50,000 (2) Paradise Valley Hospital 10.6 % 2022 (1) 25,000 25,000 (2) Ernest Mortgage Loan(4) 9.6 % 2032 (1) 112,836 112,836 (2) Centinela Hospital Medical Center 11.0 % 2022 (1) 100,000 100,000 (2) Olympia Medical Center 11.2 % 2024 (1) 20,000 20,000 (2) St. Joseph Medical Center 8.5 % 2025 (1) 30,000 30,000 (2) St. Mary’s Medical Center 8.5 % 2025 (1) 10,000 10,000 (2) Lake Huron Medical Center 8.5 % 2020 (1) 10,000 10,000 (2) Steward Mortgage Loan(6) 7.5 % 2031 (1) 600,000 600,000 (2) $ 1,060,336 $ 1,060,336 (5) (1) There were no prior liens on loans as of December 31, 2016. (2) The mortgage loan was not delinquent with respect to principal or interest. (3) The aggregate cost for federal income tax purposes is $1,060,336. (4) Mortgage loans covering four properties in two tranches. Interest rate is weighted average of both tranches. (5) Excludes unamortized loan issue costs of $0.1 million at December 31, 2016. (6) Mortgage loans covering four properties. Changes in mortgage loans (excluding unamortized loan issue costs) for the years ended December 31, 2016, 2015, and 2014 are summarized as follows: Year Ended December 31, 2016 2015 2014 (Dollar amounts in thousands) Balance at beginning of year $ 757,500 $ 397,500 $ 388,650 Additions during year: New mortgage loans and additional advances on existing loans 612,836 380,000 12,500 1,370,336 777,500 401,150 Deductions during year: Collection of principal (310,000 ) (20,000 ) (3,650 ) (310,000 ) (20,000 ) (3,650 ) Balance at end of year $ 1,060,336 $ 757,500 $ 397,500

Summary of Significant Accoun26

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates:
Principles of Consolidation	Principles of Consolidation: non-controlling non-controlling 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, 2016, we had loans and/or equity investments in certain VIEs, which are also tenants of our facilities, (including but not limited to Ernest and Vibra). 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 December 31, 2016 (in thousands): VIE Type Maximum Loss Asset Type Classification Carrying Loans, net $ 316,179 Mortgage and other loans $ 235,613 Equity investments $ 13,223 Other assets $ 140 (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 rent receivables), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represent 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 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 and 10 for additional description of the nature, purpose and activities of some of our VIEs and interests therein.
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities: 90-day Investments in entities in which we do not control nor do we have the ability to influence (such as our investments in Steward and MEDIAN) are accounted for using the cost method. The initial carrying value of such investments is based on the amount paid to purchase the interest in the investee entity. No income is recorded on our cost method investments until distributions are received. We evaluate our equity and cost 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.
Cash and Cash Equivalents	Cash and Cash Equivalents:
Revenue Recognition	Revenue Recognition: Certain leases may provide for additional rents contingent upon a percentage of the tenant’s revenue in excess of specified base amounts/thresholds (percentage rents). Percentage rents are recognized in the period in which revenue thresholds are met. Rental payments received prior to their recognition as income are classified as deferred revenue. We also receive additional rent (contingent rent) under some leases based on increases in the CPI or when the CPI exceeds the annual minimum percentage increase in the lease. Contingent rents are recorded as rent billed revenue in the period earned. We use DFL accounting to record rent on certain leases deemed to be financing leases, per accounting rules, rather than operating leases. For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. 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 terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. In instances where we have a profits or equity interest in our tenants’ operations, we record income equal to our percentage interest of the tenants’ profits, as defined in the lease or tenants’ operating agreements, once annual thresholds, if any, are met. 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 are generally 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 remaining term of the lease. 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. Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest 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. Tenant payments for certain taxes, insurance, and other operating expenses related to our facilities (most of which are paid directly by our tenants to the government or appropriate third party vendor) are recorded net of the respective expense as generally our leases are “triple-net”
Acquired Real Estate Purchase Price Allocation	Acquired Real Estate Purchase Price Allocation: pre-acquisition We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place lease-up pre-acquisition lease-up We record above-market and below-market in-place in-place in-place non-cancelable 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 these 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.
Goodwill	Goodwill: two-step
Real Estate and Depreciation	Real Estate and Depreciation: 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, 2016 are as follows: Buildings and improvements 38.8 years Tenant lease intangibles 23.9 years Leasehold improvements 17.9 years Furniture, equipment and other 9.5 years
Losses from Rent Receivables	Losses from Rent Receivables: Losses from Operating Lease Receivables: property-by-property Losses on DFL Receivables: property-by-property non-accrual non-accrual
Loans	Loans: loan-by-loan non-accrual
Earnings Per Share/Units	Earnings Per Share/Units: Our unvested restricted stock/unit awards contain non-forfeitable
Income Taxes	Income Taxes: Our financial statements include the operations of TRSs, including MPT Development Services, Inc. (“MDS”), along with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. Our TRS entities are not entitled to a dividends paid deduction and are subject to 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 they may make loans to and/or investments in our lessees. With the property acquisitions and investments in Europe, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties will flow through our REIT income tax returns. For our TRS 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 receivables/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 the realizability of the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our tax liabilities involve dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. A 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 off-set 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:
Deferred Costs	Deferred Costs:
Deferred Financing Costs	Deferred Financing Costs: re-payment
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions: 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 translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation 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: 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: • Level 1 identical • Level 2 similar • Level 3 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 over-the-counter 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 used by us include discounted cash flow and Monte Carlo valuation models. We also consider our counterparty’s and own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election:
Recent Accounting Developments	Recent Accounting Developments: Revenue from Contracts with Customers In May 2014, the FASB issued Accounting Standards Update (“ASU”) No. 2014-09, No. 2014-09. Leases In February 2016, the FASB issued ASU 2016-02, right-of-use Measurement of Credit Losses on Financial Instruments In June 2016, the FASB issued ASU 2016-13, Classification of Certain Cash Receipts and Cash Payments In August 2016, the FASB issued ASU No. 2016-15, zero-coupon Clarifying the Definition of a Business In January 2017, the FASB issued ASU No. 2017-01, 2017-01”). 2017-01 2017-01 2017-01 2017-01 2017-01,
Reclassifications and Revisions	Reclassifications and Revisions: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.

Summary of Significant Accoun27

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 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 December 31, 2016 (in thousands): VIE Type Maximum Loss Asset Type Classification Carrying Loans, net $ 316,179 Mortgage and other loans $ 235,613 Equity investments $ 13,223 Other assets $ 140 (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 rent receivables), less any liabilities. Our maximum loss exposure related to our equity investment in VIEs represent 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.
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, 2016 are as follows: Buildings and improvements 38.8 years Tenant lease intangibles 23.9 years Leasehold improvements 17.9 years Furniture, equipment and other 9.5 years

Real Estate and Loans Receiva28

Real Estate and Loans Receivable (Tables)	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Assets Acquired	We acquired the following assets: 2016 2015 2014 (in thousands) Assets Acquired Land $ 91,176 $ 120,746 $ 22,569 Building 654,772 741,935 241,242 Intangible lease assets — subject to amortization (weighted average useful life of 28.5 years in 2016, 30.0 years in 2015 and 18.2 years in 2014) 94,614 176,383 22,513 Net investments in direct financing leases 178,000 174,801 — Mortgage loans 600,000 380,000 — Other loans — 523,605 447,664 Equity investments and other assets 70,166 101,716 33,708 Liabilities assumed (6,319 ) (317 ) — Total assets acquired $ 1,682,409 $ 2,218,869 $ 767,696 Loans repaid(1) (193,262 ) (385,851 ) — Total net assets acquired $ 1,489,147 $ 1,833,018 $ 767,696 (1) $93.3 million loans advanced to Capella in 2015 and repaid in 2016 as a part of the Capella transaction, and $100.0 million loans advanced to Prime in 2015 and repaid in 2016 as part of the sale leaseback conversion of four properties in New Jersey. $385.9 million loans advanced to MEDIAN in 2014 and repaid in 2015 as a part of the MEDIAN transaction.
Schedule of Unaudited Supplemental Pro Forma Operating Data	The following unaudited supplemental pro forma operating data is presented below as if each acquisition was completed on January 1, 2015 and January 1, 2014 for the year ended December 31, 2016 and 2015, respectively. The unaudited supplemental pro forma operating data is not necessarily indicative of what the actual would have been assuming the transactions had been completed as set forth above, nor do they purport to represent our results of operations for future periods (in thousands, except per share/unit amounts). For the Year Ended December 31, (Unaudited) 2016 2015 Total revenues $ 627,583 $ 624,443 Net income 310,019 306,756 Net income per share/unit $ 0.97 $ 0.96
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 12/31/16 Estimated Completion Date Adeptus Health $ 5,848 $ 2,710 1Q 2017 Adeptus Health 67,185 44,948 2Q 2017 Ernest Health 28,067 4,342 4Q 2017 Adeptus Health 7,804 1,648 1Q 2018 Adeptus Health 53,866 — Various $ 162,770 $ 53,648
Summary of Operations for Disposed Assets in 2016	The properties sold during 2016 did not meet the definition of discontinued operations. However, the following represents the operating results (excluding gain on sale, transaction costs, and impairment or other non-cash For the Year Ended December 31, 2016 2015 2014 Revenues $ 7,851 $ 18,112 $ 18,225 Real estate depreciation and amortization (1,754 ) (3,795 ) (3,789 ) Property-related expenses (114 ) (121 ) (60 ) Other income (expense) (23 ) 1,079 462 Income from real estate dispositions, net $ 5,960 $ 15,275 $ 14,838
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $13.4 million, $9.1 million, and $7.0 million in 2016, 2015, and 2014, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows: (amounts in thousands) For the Year Ended December 31: 2017 $ 22,130 2018 22,069 2019 22,021 2020 21,818 2021 21,751
Components of Net Investment in Direct Financing Leases	The components of our net investment in DFLs consisted of the following (in thousands): As of December 31, As of December 31, Minimum lease payments receivable $ 2,207,625 $ 2,587,912 Estimated residual values 407,647 393,097 Less unearned income (1,967,170 ) (2,354,013 ) Net investment in direct financing leases $ 648,102 $ 626,996
Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms	Minimum rental payments due to us in future periods under operating leases and DFLs, which have non-cancelable Total Under Total Under Total 2017 $ 386,058 $ 62,419 $ 448,477 2018 388,808 63,668 452,476 2019 392,577 64,941 457,518 2020 395,339 66,240 461,579 2021 400,607 67,565 468,172 Thereafter 7,077,794 1,673,600 8,751,394 $ 9,041,183 $ 1,998,433 $ 11,039,616
Summary of Loans	The following is a summary of our loans ($ amounts in thousands): As of December 31, 2016 As of December 31, 2015 Balance Weighted Average Balance Weighted Average Mortgage loans $ 1,060,400 8.8 % $ 757,581 9.5 % Acquisition loans 121,464 13.7 % 610,469 9.1 % Working capital and other loans 34,257 9.0 % 54,353 10.2 % $ 1,216,121 $ 1,422,403
Schedule of Revenue by Operator	Revenue by Operator (Dollar amounts in thousands) For the Years Ended December 31, 2016 2015 Operators (A) Total Percentage of Total Percentage of Prime $ 120,558 22.3 % $ 104,325 23.6 % MEDIAN 93,425 17.3 % 78,540 17.8 % Ernest 67,742 12.5 % 61,988 14.0 % RCCH 52,720 9.7 % 28,567 6.4 % Other operators 206,692 38.2 % 168,458 38.2 % Total $ 541,137 100.0 % $ 441,878 100.0 % (A) Steward is not included herein as the Steward transaction closed on October 3, 2016.
Schedule of Revenue from External Customers by Geographic Areas	Revenue by U.S. State and Country (Dollar amounts in thousands) For the Years Ended December 31, 2016 2015 U.S. States and Other Countries Total Percentage of Total Percentage of Texas $ 96,992 17.9 % $ 87,541 19.8 % California 66,197 12.2 % 66,120 15.0 % New Jersey 39,084 7.2 % 27,688 6.3 % Massachusetts 26,098 4.8 % 69 0.0 % Arizona 23,798 4.4 % 21,188 4.8 % Other States 187,363 34.7 % 156,256 35.3 % Total U.S. $ 439,532 81.2 % $ 358,862 81.2 % Germany $ 97,382 18.0 % $ 78,540 17.8 % United Kingdom, Italy, and Spain 4,223 0.8 % 4,476 1.0 % Total International $ 101,605 18.8 % $ 83,016 18.8 % Total $ 541,137 100.0 % $ 441,878 100.0 %

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt ($ amounts in thousands): As of December 31, 2016 2015 Revolving credit facility $ 290,000 $ 1,100,000 Term loans 263,101 263,400 Senior Unsecured Notes due 2016 — 125,000 6.875% Senior Unsecured Notes due 2021 — 450,000 6.375% Senior Unsecured Notes due 2022: Principal amount 350,000 350,000 Unamortized premium 1,814 2,168 351,814 352,168 5.750% Senior Unsecured Notes due 2020 (A) 210,340 217,240 4.000% Senior Unsecured Notes due 2022 (A) 525,850 543,100 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 — 5.250% Senior Unsecured Notes due 2026 500,000 — $ 2,941,105 $ 3,350,908 Debt issue costs, net (31,764 ) (28,367 ) $ 2,909,341 $ 3,322,541
Principal Payments Due on Debt	As of December 31, 2016, 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): 2017 $ 320 2018 302,781 2019 250,000 2020 210,340 2021 — Thereafter 2,175,850 Total $ 2,939,291 (A) These notes are Euro-denominated and reflect the exchange rates at December 31, 2016 and 2015, respectively.

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Schedule of Income Tax (Benefit) Expense	From our TRSs and our foreign operations, income tax (benefit) expense were as follows (in thousands): For the years ended December 31, 2016 2015 2014 Current income tax expense: Domestic $ 42 $ 147 $ 114 Foreign 1,856 1,614 225 1,898 1,761 339 Deferred income tax (benefit) expense: Domestic 147 (360 ) (23 ) Foreign (8,875 ) 102 24 (8,728 ) (258 ) 1 Income tax (benefit) expense $ (6,830 ) $ 1,503 $ 340
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2016 and 2015, components of our deferred tax assets and liabilities were as follows (in thousands): 2016 2015 Deferred tax liabilities: Property and equipment $ (3,781 ) $ (1,636 ) Unbilled rent (7,045 ) (4,495 ) Partnership investments (5,103 ) (3,362 ) Other (6,757 ) (6,141 ) Total deferred tax liabilities $ (22,686 ) $ (15,634 ) Deferred tax assets: Operating loss and interest deduction carry forwards $ 28,289 $ 19,016 Other 10,085 10,314 Total deferred tax assets 38,374 29,330 Valuation allowance (15,975 ) (23,005 ) Total net deferred tax assets $ 22,399 $ 6,325 Net deferred tax (liability) $ (287 ) $ (9,309 )
Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes	A reconciliation of the income tax (benefit) expense at the statutory income tax rate and the effective tax rate for income from continuing operations before income taxes for the years ended December 31, 2016, 2015, and 2014 is as follows (in thousands): 2016 2015 2014 Income from continuing operations (before-tax) $ 219,108 $ 141,430 $ 51,138 Income tax at the US statutory federal rate (35%) 76,688 49,501 17,898 Increase (decrease) resulting from: Rate differential 1,434 5,047 1,145 State income taxes, net of federal benefit 66 (601 ) (337 ) Dividends paid deduction (84,927 ) (57,109 ) (27,873 ) Equity investments 4,297 — — Change in valuation allowance (6,104 ) 6,174 8,988 Other items, net 1,716 (1,509 ) 519 Total income tax (benefit) expense $ (6,830 ) $ 1,503 $ 340
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, 2016 2015 2014 Common share distribution $ 0.900000 $ 0.870000 $ 0.840000 Ordinary income 0.619368 0.769535 0.520692 Capital gains(1) 0.102552 — 0.000276 Unrecaptured Sec. 1250 gain 0.045432 — 0.000276 Return of capital 0.178080 0.100465 0.319032 (1) Capital gains include unrecaptured Sec. 1250 gains.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 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 Years Ended December 31, 2016 2015 2014 Numerator: Income from continuing operations $ 225,938 $ 139,927 $ 50,798 Non-controlling (889 ) (329 ) (274 ) Participating securities’ share in earnings (559 ) (1,029 ) (894 ) Income from continuing operations, less participating securities’ share in earnings 224,490 138,569 49,630 Income (loss) from discontinued operations attributable to MPT common stockholders (1 ) — (2 ) Net income, less participating securities’ share in earnings $ 224,489 $ 138,569 $ 49,628 Denominator: Basic weighted-average common shares 260,414 217,997 169,999 Dilutive potential common shares 658 307 541 Diluted weighted-average common shares 261,072 218,304 170,540 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2016 2015 2014 Numerator: Income from continuing operations $ 225,938 $ 139,927 $ 50,798 Non-controlling (889 ) (329 ) (274 ) Participating securities’ share in earnings (559 ) (1,029 ) (894 ) Income from continuing operations, less participating securities’ share in earnings 224,490 138,569 49,630 Income (loss) from discontinued operations attributable to MPT Operating Partnership partners (1 ) — (2 ) Net income, less participating securities’ share in earnings $ 224,489 $ 138,569 $ 49,628 Denominator: Basic weighted-average units 260,414 217,997 169,999 Dilutive potential units 658 307 541 Diluted weighted-average units 261,072 218,304 170,540

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Restricted Equity Awards Activity	The following summarizes restricted equity award activity in 2016 and 2015 (which includes awards granted in 2016, 2015, 2014, and any applicable prior years), respectively: For the Year Ended December 31, 2016: Vesting Based on Service Vesting Based on Market/ Shares Weighted Average Shares Weighted Average Nonvested awards at beginning of the year 509,634 $ 13.25 2,331,152 $ 6.38 Awarded 254,574 $ 13.07 799,804 $ 7.30 Vested (349,356 ) $ 13.07 (671,983 ) $ 6.50 Forfeited (67,724 ) $ 13.06 (647,298 ) $ 6.28 Nonvested awards at end of year 347,128 $ 13.35 1,811,675 $ 6.78 For the Year Ended December 31, 2015: Vesting Based Vesting Based on Shares Weighted Average Shares Weighted Average Nonvested awards at beginning of the year 452,263 $ 12.11 2,428,518 $ 5.81 Awarded 407,969 $ 13.94 871,888 $ 6.62 Vested (343,904 ) $ 12.56 (406,970 ) $ 4.94 Forfeited (6,694 ) $ 13.08 (562,284 ) $ 5.33 Nonvested awards at end of year 509,634 $ 13.25 2,331,152 $ 6.38

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Fixed Minimum Rental Payable under Operating Leases Sublease Receivable And Net Payments Due with Non-cancelable Terms	Fixed minimum payments due under operating leases with non-cancelable non-cancelable Fixed Amounts to Net 2017 $ 7,328 $ (4,725 ) $ 2,603 2018 7,249 (4,731 ) 2,518 2019 6,925 (4,755 ) 2,170 2020 6,944 (4,860 ) 2,084 2021 6,024 (4,966 ) 1,058 Thereafter 251,981 (249,662 ) 2,319 $ 286,451 $ (273,699 ) $ 12,752

Fair Value of Financial Instr34

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 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): December 31, 2016 December 31, Asset (Liability) Book Fair Book Fair Interest and rent receivables $ 57,698 $ 57,707 $ 46,939 $ 46,858 Loans(1) 986,987 1,017,428 508,851 543,859 Debt, net (2,909,341 ) (2,966,759 ) (3,322,541 ) (3,372,773 ) (1) Excludes loans related to Ernest and Capella (2015 only) since they are recorded at fair value as discussed below.
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At December 31, 2016, the amounts recorded under the fair value option method were as follows (in thousands): Asset (Liability) Fair Cost Asset Type Mortgage loan $ 112,836 $ 112,836 Mortgage loans Acquisition and other loans 116,298 116,298 Other loans Equity investment 3,300 3,300 Other assets $ 232,434 $ 232,434 At December 31, 2015, the amounts recorded under the fair value option method were as follows (in thousands): Asset (Liability) Fair Cost Asset Type Mortgage loan $ 310,000 $ 310,000 Mortgage loans Acquisition and other loans 603,552 603,552 Other loans Equity investment 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) +100 basis points $ (49 ) - 100 basis points 49

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2016
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Summary of Other Assets	The following is a summary of our other assets (in thousands): At December 31, 2016 2015 Debt issue costs, net(1) $ 4,478 $ 7,628 Equity investments 177,430 129,337 Other corporate assets 77,580 31,547 Prepaids and other assets 44,285 27,028 Total other assets $ 303,773 $ 195,540 (1) Relates to Revolving credit facility

Quarterly Financial Data (una36

Quarterly Financial Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2016
Medical Properties Trust, Inc. [Member]
Unaudited Quarterly Financial Information	The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2016 and 2015: (amounts in thousands, except for per share data) For the Three Month Periods in 2016 Ended March 31 June 30 September 30 December 31 Revenues $ 134,999 $ 126,300 $ 126,555 $ 153,283 Income from continuing operations 58,226 53,924 70,543 43,245 Net income 58,225 53,924 70,543 43,245 Net income attributable to MPT common stockholders 57,927 53,724 70,358 43,039 Net income attributable to MPT common stockholders per share — basic $ 0.24 $ 0.23 $ 0.29 $ 0.13 Weighted average shares outstanding — basic 237,510 238,082 246,230 319,833 Net income attributable to MPT common stockholders per share — diluted $ 0.24 $ 0.22 $ 0.28 $ 0.13 Weighted average shares outstanding — diluted 237,819 239,008 247,468 319,994 For the Three Month Periods in 2015 Ended March 31 June 30 September 30 December 31 Revenues $ 95,961 $ 99,801 $ 114,570 $ 131,546 Income from continuing operations 35,976 22,489 23,123 58,339 Net income 35,976 22,489 23,123 58,339 Net income attributable to MPT common stockholders 35,897 22,407 23,057 58,237 Net income attributable to MPT common stockholders per share — basic $ 0.18 $ 0.11 $ 0.10 $ 0.24 Weighted average shares outstanding — basic 202,958 208,071 223,948 237,011 Net income attributable to MPT common stockholders per share —diluted $ 0.17 $ 0.11 $ 0.10 $ 0.24 Weighted average shares outstanding — diluted 203,615 208,640 223,948 237,011
MPT Operating Partnership, L.P. [Member]
Unaudited Quarterly Financial Information	The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2016 and 2015: (amounts in thousands, except for per unit data) For the Three Month Periods in 2016 Ended March 31 June 30 September 30 December 31 Revenues $ 134,999 $ 126,300 $ 126,555 $ 153,283 Income from continuing operations 58,226 53,924 70,543 43,245 Net income 58,225 53,924 70,543 43,245 Net income attributable to MPT Operating Partnership partners 57,927 53,724 70,358 43,039 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.24 $ 0.23 $ 0.29 $ 0.13 Weighted average units outstanding — basic 237,510 238,082 246,230 319,833 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.24 $ 0.22 $ 0.28 $ 0.13 Weighted average units outstanding — diluted 237,819 239,008 247,468 319,994 For the Three Month Periods in 2015 Ended March 31 June 30 September 30 December 31 Revenues $ 95,961 $ 99,801 $ 114,570 $ 131,546 Income from continuing operations 35,976 22,489 23,123 58,339 Net income 35,976 22,489 23,123 58,339 Net income attributable to MPT Operating Partnership partners 35,897 22,407 23,057 58,237 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.18 $ 0.11 $ 0.10 $ 0.24 Weighted average units outstanding — basic 202,958 208,071 223,948 237,011 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.17 $ 0.11 $ 0.10 $ 0.24 Weighted average units outstanding — diluted 203,615 208,640 223,948 237,011

Summary of Significant Accoun37

Summary of Significant Accounting Policies - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Summary Of Significant Accounting Policies [Line Items]
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	90.00%	90.00%	90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	10 years
Consolidated Entities [Member]
Summary Of Significant Accounting Policies [Line Items]
Equity method investment, ownership percentage	100.00%
Time-Based Awards [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	3 years
Market Conditions Based Awards [Member] | Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	3 years
Market Conditions Based Awards [Member] | Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Stock award vesting period in years	5 years

Summary of Significant Accoun38

Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail)	Dec. 31, 2016USD ($)
Mortgage and other loans [Member]
Variable Interest Entity [Line Items]
Carrying Amount	$ 235,613,000
Loans, net [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	316,179,000
Other Assets [Member]
Variable Interest Entity [Line Items]
Carrying Amount	140,000
Equity investments [Member]
Variable Interest Entity [Line Items]
Maximum Loss Exposure	$ 13,223,000

Summary of Significant Accoun39

Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)	12 Months Ended
	Dec. 31, 2016
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	38 years 9 months 18 days
Tenant lease intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	23 years 10 months 24 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years 10 months 24 days
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	9 years 6 months

Real Estate and Loans Receiva40

Real Estate and Loans Receivable - Assets Acquired (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Equity investments and other assets	$ 70,166	$ 101,716	$ 33,708
Liabilities assumed	(6,319)	(317)
Total assets acquired	1,682,409	2,218,869	767,696
Loans repaid	(193,262)	(385,851)
Total net assets acquired	1,489,147	1,833,018	767,696
Land [Member]
Business Acquisition [Line Items]
Total assets acquired	91,176	120,746	22,569
Building [Member]
Business Acquisition [Line Items]
Total assets acquired	654,772	741,935	241,242
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired	94,614	176,383	22,513
Net Investments in Direct Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired	178,000	174,801
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		523,605	$ 447,664
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired	$ 600,000	$ 380,000

Real Estate and Loans Receiva41

Real Estate and Loans Receivable - Assets Acquired (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Loans repaid	$ 193,262	$ 385,851
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)	28 years 6 months	30 years	18 years 2 months 12 days
Capella [Member]
Business Acquisition [Line Items]
Loans repaid	$ 93,300
Median [Member]
Business Acquisition [Line Items]
Loans repaid		$ 385,900
Prime [Member]
Business Acquisition [Line Items]
Loans repaid	$ 100,000

Real Estate and Loans Receiva42

Real Estate and Loans Receivable - 2016 Activity - Additional Information (Detail) $ in Thousands, € in Millions	Oct. 21, 2016USD ($)RenewalOptionsHospital	Oct. 03, 2016USD ($)RenewalOptionsFacilityHospital	Jul. 22, 2016USD ($)	May 02, 2016USD ($)	Sep. 30, 2015USD ($)	Dec. 31, 2016USD ($)Hospital	Dec. 31, 2016EUR (€)Hospital	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)	Jun. 22, 2016EUR (€)
Business Acquisition [Line Items]
Loans repaid						$ 193,262		$ 385,851
Mortgage financing						612,836		380,000	$ 12,500
Mortgage financing funded						310,000		20,000	3,650
Acquisition related costs						$ 46,273		61,342	$ 26,389
Median [Member]
Business Acquisition [Line Items]
Loans repaid								$ 385,900
2016 [Member] | General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Term of lease, years	15 years
Number of lease extension options | RenewalOptions	3
Number of facilities acquired | Hospital	3
Number of free-standing emergency department and health center | Hospital	1
Mortgage financing					$ 100,000
Mortgage financing funded	$ 15,000
2016 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital						12	12
Acquisition costs | €							€ 85.2
2016 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | 2015 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital						5	5
Acquisition costs | €							€ 35.7
2016 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Third Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital						7	7
Acquisition costs | €							€ 49.5
2016 [Member] | Median [Member]
Business Acquisition [Line Items]
Value of properties closed | €										€ 41.6
2016 [Member] | Steward [Member]
Business Acquisition [Line Items]
Number of hospitals closed | Hospital		9
Combined purchase price and investment amount		$ 1,250,000
Number of licensed hospitals | Hospital		5
Cash paid for acquisition transaction		$ 600,000
Loans repaid		600,000
Equity interest acquired		$ 50,000
Term of lease, years		15 years
Number of lease extension options | RenewalOptions		3
Number of facilities for making mortgage loans | Facility		4
Acute Care Hospital [Member] | 2016 [Member] | New Jersey [Member]
Business Acquisition [Line Items]
Acquisition costs				$ 63,000
Commitment to advance an additional amount for capital additions				$ 30,000
Commitment period to advance an additional amount for capital additions				3 years
Business Acquisitions [Member] | 2016 [Member]
Business Acquisition [Line Items]
Revenue contributed by the acquired entity						$ 37,400
Income contributed by the acquired entity						31,700
Acquisition related costs						12,100
Capella [Member]
Business Acquisition [Line Items]
Loans repaid						$ 93,300
Capella [Member] | 2016 [Member] | Olympia, Washington [Member]
Business Acquisition [Line Items]
Cash paid for acquisition transaction			$ 7,000
Loans repaid			$ 93,300

Real Estate and Loans Receiva43

Real Estate and Loans Receivable - 2015 Activity - Additional Information (Detail) $ in Thousands

Dec. 31, 2015USD ($)PropertyHospital

Dec. 03, 2015EUR (€)Bed

Nov. 18, 2015EUR (€)Facility

Oct. 30, 2015USD ($)

Sep. 30, 2015USD ($)Hospital

Sep. 09, 2015EUR (€)

Aug. 31, 2015USD ($)BedInvestment

Jun. 16, 2015USD ($)BedRenewalOptionsProperty

Apr. 29, 2015EUR (€)Hospital

Feb. 27, 2015USD ($)RenewalOptions

Feb. 13, 2015USD ($)RenewalOptionsFacility

Aug. 31, 2015InvestmentPropertyLeases

Jul. 31, 2015USD ($)Investment

Dec. 31, 2016USD ($)

Dec. 31, 2015USD ($)

Dec. 31, 2014USD ($)

Dec. 31, 2015EUR (€)

Business Acquisition [Line Items]

Mortgage financing

$ 612,836

$ 380,000

$ 12,500

Mortgage financing funded

310,000

20,000

3,650

Acquisition related costs

$ 46,273

61,342

$ 26,389

2015 [Member] | Lake Huron Medical Center [Member]

Business Acquisition [Line Items]

Acquisition costs

20,000

Mortgage financing

$ 30,000

Mortgage financing term

5 years

2015 [Member] | Ernest [Member]

Business Acquisition [Line Items]

Acquisition costs

$ 31,500

Loans provided for acquisition

$ 12,000

Term of lease, years

20 years

Number of lease extension options | RenewalOptions

3

Term of lease extension, years

5 years

Number of properties acquired | Property

2

2015 [Member] | AXA Real Estate [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

50.00%

2015 [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Facility

7

Purchase price of acquisition | €

€ 90,000,000

2015 [Member] | Acute Care Hospital [Member] | Kansas [Member]

Business Acquisition [Line Items]

Term of lease, years

10 years

Number of lease extension options | RenewalOptions

2

Term of lease extension, years

5 years

Number of facilities acquired | Facility

2

Purchase price of acquisition

$ 110,000

Mortgage financing

$ 40,000

Mortgage financing term

10 years

2015 [Member] | Acute Care Hospital [Member] | Ernest [Member]

Business Acquisition [Line Items]

Number of beds acquired | Bed

37

2015 [Member] | Acute Care Hospital [Member] | AXA Real Estate [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

50.00%

Estimated total development cost | €

€ 21,400,000

2015 [Member] | RHM Rehabilitation Clinic [Member] | Germany [Member]

Business Acquisition [Line Items]

Acquisition costs | €

€ 18,700,000

Term of lease, years

25 years

Number of beds acquired | Bed

266

Cumulative increases in the German consumer price index

70.00%

2015 [Member] | RHM Rehabilitation Clinic [Member] | Germany [Member] | From 2015 through 2017 [Member]

Business Acquisition [Line Items]

Rent escalations percentage

2.00%

2015 [Member] | RHM Rehabilitation Clinic [Member] | Germany [Member] | After 2017 [Member]

Business Acquisition [Line Items]

Rent escalations percentage

0.50%

2015 [Member] | General Acute Care Hospital and Healthcare System [Member]

Business Acquisition [Line Items]

Mortgage financing

$ 100,000

Number of licensed hospitals | Hospital

3

Number of free-standing emergency department and health center | Hospital

1

Mortgage financing term

5 years

Mortgage financing funded

$ 15,000

2015 [Member] | General Acute Care Hospital [Member] | Lake Huron Medical Center [Member]

Business Acquisition [Line Items]

Number of beds acquired | Bed

144

2015 [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Ernest [Member]

Business Acquisition [Line Items]

Number of beds acquired | Bed

60

2015 [Member] | Inpatient Rehabilitation Hospital [Member] | Ernest [Member] | Weslaco Texas [Member]

Business Acquisition [Line Items]

Acquisition costs

$ 10,700

Term of lease, years

17 years

Number of lease extension options | RenewalOptions

3

Term of lease extension, years

5 years

Payments to fund long-term loans to related parties

$ 5,000

2015 [Member] | Median [Member]

Business Acquisition [Line Items]

Acquisition costs | €

€ 688,000,000

Loans provided for acquisition | €

€ 240,000,000

Term of lease, years

27 years

Number of properties closed | Property

31

Number of hospitals acquired | Hospital

32

32

Lease rent increase percentage

70.00%

Value of properties closed | €

646,000,000

Real estate transfer tax

$ 37,000

37,000

Loan amount outstanding | €

€ 0

2015 [Member] | Capella [Member]

Business Acquisition [Line Items]

Combined purchase price and investment amount

$ 900,000

Ownership interests acquired

49.00%

Acquisition costs

$ 25,800

$ 600,000

Loans provided for acquisition

$ 9,200

$ 290,000

Term of lease, years

15 years

Number of lease extension options | Leases

4

Term of lease extension, years

5 years

Number of properties closed | Property

6

Increase in consumer price-index, floor rate

2.00%

Increase in consumer price-index, ceiling rate

4.00%

2015 [Member] | Capella [Member] | MPT Camaro Opco [Member]

Business Acquisition [Line Items]

Ownership interests acquired

49.00%

2015 [Member] | Capella [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of portfolio investments | Investment

7

7

7

Number of investment in form of mortgage loan | Investment

2

2

2

2015 [Member] | Capella [Member] | Joint Venture Partner [Member]

Business Acquisition [Line Items]

Fixed interest rate

8.00%

8.00%

2015 [Member] | Capella [Member] | Joint Venture Partner [Member] | ManageCo [Member]

Business Acquisition [Line Items]

Ownership interests acquired

51.00%

2015 [Member] | Business Acquisitions [Member]

Business Acquisition [Line Items]

Revenue contributed by the acquired entity

102,700

Income contributed by the acquired entity

87,700

Acquisition related costs

$ 58,000

Real Estate and Loans Receiva44

Real Estate and Loans Receivable - 2014 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions

Oct. 31, 2014USD ($)Bed

Oct. 15, 2014EUR (€)

Sep. 19, 2014USD ($)RenewalOptions

Jul. 01, 2014USD ($)

Jul. 01, 2014GBP (£)

Mar. 31, 2014USD ($)

Dec. 31, 2014USD ($)BedFacility

Dec. 31, 2016USD ($)

Dec. 31, 2015USD ($)

Dec. 31, 2014USD ($)Bed

Dec. 31, 2014EUR (€)Bed

Jul. 01, 2014GBP (£)

Business Acquisition [Line Items]

Acquisition related costs

$ 46,273

$ 61,342

$ 26,389

Income contributed by the acquired entity

$ 310,019

$ 306,756

2014 [Member]

Business Acquisition [Line Items]

Acquired percentage of the outstanding equity interest

5.10%

2014 [Member] | Circle Health Ltd. [Member]

Business Acquisition [Line Items]

Acquired facility, carrying value of sale/leaseback transaction

$ 48,000

£ 28.3

Sale/leaseback transaction, initial term period

15 years

15 years

Sale/leaseback transaction, additional term period

15 years

15 years

Percentage change in annual retail price index, floor rate

2.00%

2.00%

Percentage change in annual retail price index, cap rate

5.00%

5.00%

Acquisition related costs

$ 1,900

£ 1.1

2014 [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Acquisition costs

$ 115,000

Term of lease, years

15 years

Term of lease extension, years

3 years

2014 [Member] | Acute Care Hospital [Member] | Fair value market [Member]

Business Acquisition [Line Items]

Term of lease extension, years

12 years

2014 [Member] | Acute Care Hospital [Member] | Alecto Healthcare Services [Member] | Fairmont West Virginia [Member]

Business Acquisition [Line Items]

Ownership interest, percentage

20.00%

Acquisition costs

$ 15,000

Term of lease, years

15 years

Term of lease extension, years

5 years

Number of lease extension options in current lease contract | RenewalOptions

3

Working capital loan to the tenant

$ 5,000

Additional lease period

5 years

Additional fund committed to the tenant for capital improvements

$ 5,000

2014 [Member] | Median and Waterland [Member]

Business Acquisition [Line Items]

Interim acquisition loans aggregate amount | €

€ 425

Interim acquisition loans advanced | €

€ 349

2014 [Member] | Median [Member] | Waterland [Member]

Business Acquisition [Line Items]

Acquired percentage of the outstanding equity interest

94.90%

2014 [Member] | Business Acquisitions [Member]

Business Acquisition [Line Items]

Acquisition related costs

26,400

Revenue contributed by the acquired entity

12,400

Income contributed by the acquired entity

8,700

Acquisition-related costs on consummated deals

25,200

Acquisition related costs - transfer taxes on consummated deals

5,800

2014 [Member] | Germany [Member] | RHM Rehabilitation Facilities [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 81,000

81,000

63.6

Applicable transfer and other taxes on purchase price

$ 3,600

$ 3,600

€ 3

Number of facilities acquired | Facility

3

2014 [Member] | Germany [Member] | Bad Mergentheim [Member] | RHM Rehabilitation Facilities [Member]

Business Acquisition [Line Items]

Number of beds | Bed

211

211

211

2014 [Member] | Germany [Member] | Bad Tolz [Member] | RHM Rehabilitation Facilities [Member]

Business Acquisition [Line Items]

Number of beds | Bed

248

248

248

2014 [Member] | Germany [Member] | Bad Liebenstein [Member] | RHM Rehabilitation Facilities [Member]

Business Acquisition [Line Items]

Number of beds | Bed

271

271

271

2014 [Member] | Sherman, TX [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 32,500

2014 [Member] | Sherman, TX [Member] | Alecto Healthcare Services [Member]

Business Acquisition [Line Items]

Working capital loan

$ 7,500

Initial leaseback term

15 years

Ownership interest, percentage

20.00%

2014 [Member] | Sherman, TX [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of beds | Bed

237

Real Estate and Loans Receiva45

Real Estate and Loans Receivable - Schedule of Unaudited Supplemental Pro Forma Operating Data (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition, Pro Forma Information [Abstract]
Total revenues	$ 627,583	$ 624,443
Net income	$ 310,019	$ 306,756
Net income per share/unit	$ 0.97	$ 0.96

Real Estate and Loans Receiva46

Real Estate and Loans Receivable - Development Activities - Additional Information (Detail) $ in Thousands	Apr. 30, 2015USD ($)Leases	Dec. 31, 2016USD ($)Facility	Dec. 31, 2015USD ($)RenewalOptionsFacilityProperty	Dec. 31, 2014USD ($)RenewalOptions	Aug. 23, 2016USD ($)
Business Acquisition [Line Items]
Current development project		$ 162,770
Ernest [Member]
Business Acquisition [Line Items]
Current development project		28,067
Ernest [Member] | Inpatient Rehabilitation Hospital [Member] | Flagstaff Arizona [Member]
Business Acquisition [Line Items]
Current development project					$ 28,100
Ernest [Member] | Rehabilitation Hospital of Northwestern Ohio [Member] | Inpatient Rehabilitation Hospital [Member] | Toledo, OH [Member]
Business Acquisition [Line Items]
Current development project		$ 18,400
Adeptus Health [Member]
Business Acquisition [Line Items]
Term of lease extension, years	5 years
Aggregate commitment amount	$ 250,000
Lease agreement term	15 years
Number of lease extension options | Leases	3
Percentage of increase in annual rent	2.00%
Development Activities [Member] | Acute Care Facilities in Altoona [Member]
Business Acquisition [Line Items]
Number of facilities constructed | Facility		19
Development Activities [Member] | Oakleaf Surgical Hospital [Member] | Acute Care Hospital [Member] | Altoona, WI [Member] | National Surgical Hospitals [Member]
Business Acquisition [Line Items]
Current development project			$ 30,000
Term of lease, years			15 years
Number of lease extension options in current lease contract | RenewalOptions			2
Term of lease extension, years			5 years
Development Activities [Member] | UAB Medical West [Member]
Business Acquisition [Line Items]
Estimated total development cost			$ 8,600
Term of lease, years			15 years
Number of lease extension options in current lease contract | RenewalOptions			4
Term of lease extension, years			5 years
Lease rent increase percentage			2.00%
Development Activities [Member] | Adeptus Health [Member]
Business Acquisition [Line Items]
Aggregate commitment amount		$ 500,000
Number of facilities completed | Facility		54
Number of facilities under construction | Facility		5
Development Activities [Member] | Northern Utah Rehabilitation Hospital [Member]
Business Acquisition [Line Items]
Estimated total development cost		$ 19,000
Development Activities [Member] | First Choice [Member]
Business Acquisition [Line Items]
Number of facilities leased | RenewalOptions				17
Estimated total development cost				$ 83,000
Development Activities [Member] | Acute Care Facilities in Altoona [Member]
Business Acquisition [Line Items]
Number of property leased | Property			3
Development Activities [Member] | Acute Care Facilities in Altoona [Member] | 2015 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities leased | Facility			17
Estimated total development cost			$ 102,600
Development Activities [Member] | Acute Care Facilities in Altoona [Member] | 2014 Master Lease [Member]
Business Acquisition [Line Items]
Number of facilities leased | Facility			14

Real Estate and Loans Receiva47

Real Estate and Loans Receivable - Summary of Status Update on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Business Acquisition [Line Items]
Commitment	$ 162,770
Costs Incurred as of 12/31/2016	53,648
Adeptus Health Two [Member]
Business Acquisition [Line Items]
Commitment	5,848
Costs Incurred as of 12/31/2016	$ 2,710
Estimated Completion Date	1Q 2017
Adeptus Health Three [Member]
Business Acquisition [Line Items]
Commitment	$ 67,185
Costs Incurred as of 12/31/2016	$ 44,948
Estimated Completion Date	2Q 2017
Ernest [Member]
Business Acquisition [Line Items]
Commitment	$ 28,067
Costs Incurred as of 12/31/2016	$ 4,342
Estimated Completion Date	4Q 2017
Adeptus Health Four [Member]
Business Acquisition [Line Items]
Commitment	$ 7,804
Costs Incurred as of 12/31/2016	$ 1,648
Estimated Completion Date	1Q 2018
Adeptus Health Five [Member]
Business Acquisition [Line Items]
Commitment	$ 53,866
Estimated Completion Date	Various

Real Estate and Loans Receiva48

Real Estate and Loans Receivable - Disposals - Additional Information (Detail) $ in Thousands

Jul. 20, 2016USD ($)Hospital

Jun. 17, 2016USD ($)

May 23, 2016USD ($)Property

Apr. 30, 2016USD ($)

Aug. 05, 2015USD ($)Hospital

Jul. 30, 2015USD ($)

May 20, 2014USD ($)

Jun. 30, 2016USD ($)

Jun. 30, 2016Hospital

Dec. 31, 2016USD ($)

Dec. 31, 2015USD ($)

Dec. 31, 2014USD ($)

Debt Instrument [Line Items]

New loan for hospital property

$ 612,836

$ 380,000

$ 12,500

Proceeds from sale of real estate

198,767

$ 19,175

34,649

Disposals [Member]

Debt Instrument [Line Items]

Acquisition costs

$ 35,000

Real estate impairment charge

$ 3,100

Disposals [Member] | La Palma Facility [Member]

Debt Instrument [Line Items]

Gain (loss) on sale of real estate

2,900

Proceeds from sale of real estate

12,500

Straight line rent receivables write-off

$ 1,300

Texas [Member]

Debt Instrument [Line Items]

Gain (loss) on sale of real estate

$ 1,500

Proceeds from sale of real estate

9,700

Straight line rent receivables write-off

$ 900

United States [Member]

Debt Instrument [Line Items]

Gain (loss) on sale of real estate

$ 1,700

Number of hospitals sold | Hospital

6

Proceeds from sale of real estate

$ 9,500

Consideration received as note receivable

1,500

Billed rent receivables write-off

$ 900

Amortization of the related lease intangible asset

$ 700

Capella [Member]

Debt Instrument [Line Items]

Net proceeds from transaction

$ 550,000

Net proceeds from equity investment and loans

492,000

Proceeds from prepayment of mortgage loans

210,000

New loan for hospital property

93,300

Investment on unsecured senior notes

50,000

Transaction costs incurred

$ 6,300

Number of hospital owned | Hospital

5

Write off of unbilled direct finance lease rent

$ 2,600

Capella [Member] | Master Lease [Member]

Debt Instrument [Line Items]

Term of lease, years

13 years 6 months

Capella [Member] | Other Stand-Alone Lease [Member]

Debt Instrument [Line Items]

Term of lease, years

11 years 6 months

Post Acute [Member]

Debt Instrument [Line Items]

Number of properties sold | Property

5

Outstanding loans paid in full

$ 4,000

Proceeds from sale of facilities

$ 28,000

71,000

Gain on real estate dispositions

$ 15,000

Gain (loss) on sale of real estate

8,000

Post Acute [Member] | Texas [Member]

Debt Instrument [Line Items]

Number of properties sold | Property

3

Gain offset by non-cash charges

$ 9,000

Post Acute [Member] | Louisiana [Member]

Debt Instrument [Line Items]

Number of properties sold | Property

2

HealthSouth [Member]

Debt Instrument [Line Items]

Proceeds from sale of facilities

$ 111,500

Gain on real estate dispositions

$ 45,000

HealthSouth [Member] | Texas [Member]

Debt Instrument [Line Items]

Number of hospitals sold | Hospital

3

Real Estate and Loans Receiva49

Real Estate and Loans Receivable - Summary of Operations for Disposed Assets in 2016 (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Disposal Group, Including Discontinued Operation, Income Statement Disclosures [Abstract]
Revenues	$ 7,851	$ 18,112	$ 18,225
Real estate depreciation and amortization	(1,754)	(3,795)	(3,789)
Property-related expenses	(114)	(121)	(60)
Other income (expense)	(23)	1,079	462
Income from real estate dispositions, net	$ 5,960	$ 15,275	$ 14,838

Real Estate and Loans Receiva50

Real Estate and Loans Receivable - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Intangible lease assets	$ 296,176	$ 256,950
Intangible Assets [Member]
Debt Instrument [Line Items]
Intangible lease assets	296,200	257,000
Accumulated amortization, net	263,800	231,700
Amortization expense related to intangible lease assets	$ 13,400	$ 9,100	$ 7,000
Capitalized lease intangibles, weighted average life (in years)	22 years 1 month 6 days

Real Estate and Loans Receiva51

Real Estate and Loans Receivable - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Business Combinations [Abstract]
2,017	$ 22,130
2,018	22,069
2,019	22,021
2,020	21,818
2,021	$ 21,751

Real Estate and Loans Receiva52

Real Estate and Loans Receivable - Leasing Operations - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016Leases
Ernest [Member]
Business Acquisition [Line Items]
Number of direct financing leases	15
Prime Facilities [Member]
Business Acquisition [Line Items]
Number of direct financing leases	10

Real Estate and Loans Receiva53

Real Estate and Loans Receivable - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Business Combinations [Abstract]
Minimum lease payments receivable	$ 2,207,625	$ 2,587,912
Estimated residual values	407,647	393,097
Less unearned income	(1,967,170)	(2,354,013)
Net investment in direct financing leases	$ 648,102	$ 626,996

Real Estate and Loans Receiva54

Real Estate and Loans Receivable - Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Leases User Charges And Commitments [Line Items]
2,017	$ 7,328
2,018	7,249
2,019	6,925
2,020	6,944
2,021	6,024
Thereafter	251,981
Minimum rental payments, total	286,451
Minimum Rental Payments [Member]
Leases User Charges And Commitments [Line Items]
2,017	448,477
2,018	452,476
2,019	457,518
2,020	461,579
2,021	468,172
Thereafter	8,751,394
Minimum rental payments, total	11,039,616
Minimum Rental Payments [Member] | Operating Leases [Member]
Leases User Charges And Commitments [Line Items]
2,017	386,058
2,018	388,808
2,019	392,577
2,020	395,339
2,021	400,607
Thereafter	7,077,794
Minimum rental payments, total	9,041,183
Minimum Rental Payments [Member] | Direct Financing Leases [Member]
Leases User Charges And Commitments [Line Items]
2,017	62,419
2,018	63,668
2,019	64,941
2,020	66,240
2,021	67,565
Thereafter	1,673,600
Minimum rental payments, total	$ 1,998,433

Real Estate and Loans Receiva55

Real Estate and Loans Receivable - Adeptus Health - Additional Information (Detail) - Adeptus Health [Member]	1 Months Ended
	Dec. 31, 2016USD ($)Property
Business Acquisition [Line Items]
Outstanding rent receivables	$ 0
Letter of credit outstanding	12,400,000
Net investment	$ 400,000,000
Number of leased properties | Property	59
Investment percentage of total assets	7.00%

Real Estate and Loans Receiva56

Real Estate and Loans Receivable - Hoboken Facility - Additional Information (Detail) - Hoboken Facility [Member] $ in Millions	Sep. 30, 2015USD ($)
Business Acquisition [Line Items]
Percentage of ownership in subsidiary	10.00%
Real estate investment	$ 5

Real Estate and Loans Receiva57

Real Estate and Loans Receivable - Twelve Oaks Facility - Additional Information (Detail) - Twelve Oaks Facility [Member] - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Sep. 30, 2015	Dec. 31, 2015	Sep. 30, 2016
Business Acquisition [Line Items]
Outstanding amount receivable from tenant past due including interest			$ 2.5
Gain offset by non-cash charges	$ 1.9
Amortization of leased intangible assets		$ 0.5

Real Estate and Loans Receiva58

Real Estate and Loans Receivable - Monroe Facility - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2014
Business Acquisition [Line Items]
Impairment charges	$ 7,229	$ 50,128
Monroe Properties [Member]
Business Acquisition [Line Items]
Impairment charges		$ 47,000
Net investment	$ 36,000

Real Estate and Loans Receiva59

Real Estate and Loans Receivable - Summary of Loans (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Loans [Line Items]
Loans, Balance	$ 1,216,121	$ 1,422,403
Mortgage Loans [Member]
Loans [Line Items]
Loans, Balance	$ 1,060,400	$ 757,581
Loans, Weighted Average Interest Rate	8.80%	9.50%
Acquisition Loans [Member]
Loans [Line Items]
Loans, Balance	$ 121,464	$ 610,469
Loans, Weighted Average Interest Rate	13.70%	9.10%
Working Capital and Other Loans [Member]
Loans [Line Items]
Loans, Balance	$ 34,257	$ 54,353
Loans, Weighted Average Interest Rate	9.00%	10.20%

Real Estate and Loans Receiva60

Real Estate and Loans Receivable - Loans - Additional Information (Detail) - USD ($) $ in Thousands	Oct. 03, 2016	Oct. 01, 2016	Apr. 30, 2016	Mar. 01, 2012	Sep. 30, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Business Acquisition [Line Items]
Mortgage financing						$ 612,836	$ 380,000	$ 12,500
Existing mortgage loans						$ 1,060,336	$ 757,500	$ 397,500	$ 388,650
Amount of convertible note converted into equity interest				$ 1,700
Convertible note				$ 5,000
Percentage of equity shares from convertible debt		15.10%		9.90%		25.00%
Remaining convertible debt after conversion of part of debt						$ 3,300
Capella [Member]
Business Acquisition [Line Items]
Outstanding loans paid						489,000
Steward [Member] | 2016 [Member]
Business Acquisition [Line Items]
Increase in mortgage loans	$ 600,000
Capella [Member]
Business Acquisition [Line Items]
Proceeds from prepayment of mortgage loans			$ 210,000
Mortgage financing			$ 93,300
General Acute Care Hospital and Healthcare System [Member] | 2016 [Member]
Business Acquisition [Line Items]
Mortgage financing					$ 100,000
Ernest Transaction and Other Acquisitions [Member]
Business Acquisition [Line Items]
Existing mortgage loans						$ 115,000

Real Estate and Loans Receiva61

Real Estate and Loans Receivable - Schedule of Revenue by Operator (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Investment And Revenue From External Customers [Line Items]
Total Revenue	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Revenue [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 541,137	$ 441,878
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									$ 120,558	$ 104,325
Percentage of Total Revenue									22.30%	23.60%
Revenue [Member] | Credit Concentration Risk [Member] | Median [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 93,425	$ 78,540
Percentage of Total Revenue									17.30%	17.80%
Revenue [Member] | Credit Concentration Risk [Member] | Ernest [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 67,742	$ 61,988
Percentage of Total Revenue									12.50%	14.00%
Revenue [Member] | Credit Concentration Risk [Member] | RCCH [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 52,720	$ 28,567
Percentage of Total Revenue									9.70%	6.40%
Revenue [Member] | Credit Concentration Risk [Member] | Other Operators [Member]
Investment And Revenue From External Customers [Line Items]
Total Revenue									$ 206,692	$ 168,458
Percentage of Total Revenue									38.20%	38.20%

Real Estate and Loans Receiva62

Real Estate and Loans Receivable - Schedule of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Revenue [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 541,137	$ 441,878
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									$ 96,992	$ 87,541
Percentage of Total Revenue									17.90%	19.80%
Revenue [Member] | California [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 66,197	$ 66,120
Percentage of Total Revenue									12.20%	15.00%
Revenue [Member] | New Jersey [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 39,084	$ 27,688
Percentage of Total Revenue									7.20%	6.30%
Revenue [Member] | Massachusetts [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 26,098	$ 69
Percentage of Total Revenue									4.80%	0.00%
Revenue [Member] | Arizona [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 23,798	$ 21,188
Percentage of Total Revenue									4.40%	4.80%
Revenue [Member] | Other States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 187,363	$ 156,256
Percentage of Total Revenue									34.70%	35.30%
Revenue [Member] | United States [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 439,532	$ 358,862
Percentage of Total Revenue									81.20%	81.20%
Revenue [Member] | Germany [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 97,382	$ 78,540
Percentage of Total Revenue									18.00%	17.80%
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									$ 4,223	$ 4,476
Percentage of Total Revenue									0.80%	1.00%
Revenue [Member] | International [Member] | Credit Concentration Risk [Member]
Investment And Revenue From External Customers By Geographic Area [Line Items]
Total Revenue									$ 101,605	$ 83,016
Percentage of Total Revenue									18.80%	18.80%

Real Estate and Loans Receiva63

Real Estate and Loans Receivable - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants	$ 282.9	$ 215.4	$ 101.8
Assets, Total [Member] | Geographic Concentration Risk [Member] | United States [Member]
Business Acquisition [Line Items]
Percentage of total assets accounted	80.00%
Assets, Total [Member] | Geographic Concentration Risk [Member] | Europe (primarily Germany) [Member]
Business Acquisition [Line Items]
Percentage of total assets accounted	20.00%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Principal amount	$ 2,939,291
Debt issue costs, net	(31,764)	$ (28,367)
Debt	2,909,341	3,322,541
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	290,000	1,100,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt	263,101	263,400
Senior Unsecured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Debt		125,000
6.875% Senior Unsecured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Debt		450,000
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Principal amount	350,000	350,000
Unamortized premium	1,814	2,168
Debt	351,814	352,168
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Debt	210,340	217,240
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Debt	525,850	543,100
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt	300,000	300,000
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Debt	500,000
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt	500,000
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt	$ 2,941,105	$ 3,350,908

Debt - Summary of Debt (Parenth

Debt - Summary of Debt (Parenthetical) (Detail)	Dec. 31, 2016	Jul. 22, 2016	Dec. 31, 2015	Apr. 17, 2014	Oct. 10, 2013	Feb. 17, 2012	Apr. 26, 2011
6.875% Senior Unsecured Notes Due 2021 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.875%		6.875%				6.875%
6.375% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%		6.375%			6.375%
5.750% Senior Unsecured Notes Due 2020 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.75%		5.75%		5.75%
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	4.00%		4.00%
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.50%			5.50%
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	6.375%
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	5.25%	5.25%

Debt - Principal Payments Due f

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Debt Disclosure [Abstract]
2,017	$ 320
2,018	302,781
2,019	250,000
2,020	210,340
2,021	0
Thereafter	2,175,850
Total	$ 2,939,291

Debt - Revolving Credit Facilit

Debt - Revolving Credit Facility - Additional Information (Detail) - USD ($)	Jun. 19, 2014	Sep. 30, 2015	Nov. 30, 2014	Dec. 31, 2016	Dec. 31, 2015	Aug. 04, 2015	Oct. 17, 2014
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		$ 1,950,000,000
Credit facility, amendment fees incurred		100,000
Term Loans [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		250,000,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	$ 900,000,000
Accordion to credit facility		400,000,000					$ 250,000,000
Aggregate committed amount of credit facility		$ 1,300,000,000				$ 1,250,000,000	1,150,000,000
Revolving Credit Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Accordion to credit facility							$ 400,000,000
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	775,000,000
Credit facilities, amount outstanding				$ 290,000,000	$ 1,100,000,000
Refinancing charge	300,000
Aggregate committed amount of credit facility				$ 1,000,000,000
Debt instrument, basis spread of interest rate			0.40%
Credit facilities, percentage of commitment fee on unused capacity			0.30%
Credit facilities, weighted average interest rate				2.00%	1.70%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.50%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.00%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.40%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	400,000,000
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Credit facilities, amount outstanding	100,000,000
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				0.50%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Euro Dollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.00%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				0.70%
Credit facilities, percentage of commitment fee on unused capacity				0.25%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Minimum [Member] | London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.70%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				1.25%
Credit facilities, percentage of commitment fee on unused capacity				0.35%
Revolving Credit Facility [Member] | Unsecured Revolving Credit Facility [Member] | Revolving Credit Facility Matures in June 2018 [Member] | Maximum [Member] | London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate				2.25%
Revolving Credit Facility [Member] | Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured credit facility paid off	250,000,000
Amount of senior unsecured debt	$ 125,000,000

Debt - Term Loans - Additional

Debt - Term Loans - Additional Information (Detail) - USD ($)	Feb. 14, 2011	Jun. 30, 2014	Dec. 31, 2016	Dec. 31, 2015	Sep. 30, 2015
Debt Instrument [Line Items]
Aggregate committed amount of credit facility					$ 1,950,000,000
2014 Term Loan [Member]
Debt Instrument [Line Items]
Paid off term loan		$ 125,000,000
Aggregate committed amount of credit facility					$ 250,000,000
Debt instrument, maturity date			Jun. 30, 2019
Interest rate at end of period			2.36%	2.05%
2014 Term Loan [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.60%
2014 Term Loan [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.20%
2014 Term Loan [Member] | Federal Funds Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		0.50%	0.50%
2014 Term Loan [Member] | Eurodollar Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		1.00%	1.00%
2014 Term Loan [Member] | Initial Spread [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			0.65%
2014 Term Loan [Member] | London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.65%
2014 Term Loan [Member] | London Interbank Offered Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			1.60%
2014 Term Loan [Member] | London Interbank Offered Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate			2.20%
Mortgage Loans [Member] | Northland LTACH Hospital [Member]
Debt Instrument [Line Items]
Debt instrument, maturity date			Jan. 1, 2018
Liabilities acquired	$ 14,600,000
Amortization period			30 years
Interest rate			6.20%
Collateralized real estate property			$ 16,400,000	$ 16,900,000
Term Loans [Member]
Debt Instrument [Line Items]
Debt instrument face amount			$ 13,100,000

Debt - Senior Unsecured Notes D

Debt - Senior Unsecured Notes Due 2016 - Additional Information (Detail) - Senior Unsecured Notes Due 2016 [Member] - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2006
Debt Instrument [Line Items]
Senior unsecured notes, value of offering		$ 125
Credit facilities, periodic payments of interest		$ 65
Senior notes frequency of periodic payment	Quarterly
Unsecured senior notes, year of maturity		2016-07
London Interbank Offered Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread of interest rate		2.30%

Debt - Interest Rate Swap - Add

Debt - Interest Rate Swap - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended	12 Months Ended
	Oct. 31, 2011	Jun. 30, 2010	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Interest Rate Swap [Member]
Debt Instrument [Line Items]
Hedge ineffectiveness and income statement effect in period			$ 0	$ 0	$ 0
Senior Unsecured Notes Due 2016 [Member]
Debt Instrument [Line Items]
Portion of debt instrument face amount		$ 65,000,000
Senior Unsecured Notes Due 2016 [Member] | Interest Rate Contract [Member]
Debt Instrument [Line Items]
Fair value of the interest rate swaps				$ 2,900,000
Senior Unsecured Notes Due 2016 [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
Senior Unsecured Notes Due 2016 [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%

Debt - 6.875% Senior Unsecured

Debt - 6.875% Senior Unsecured Notes Due 2021 - Additional Information (Detail) - 6.875% Senior Unsecured Notes Due 2021 [Member] - USD ($) $ in Millions	Jul. 22, 2016	Sep. 30, 2016	Dec. 31, 2016	Dec. 31, 2015	Apr. 26, 2011
Debt Instrument [Line Items]
Debt instrument face amount					$ 450
Senior unsecured notes, interest rate			6.875%	6.875%	6.875%
Senior notes frequency of periodic payment			Interest on the notes was payable semi-annually on May 1 and November 1 of each year.
Notes redeemed	$ 450
Debt refinancing charge		$ 22.5
Redemption premium		$ 15.5

Debt - 6.375% Senior Unsecured

Debt - 6.375% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 6.375% Senior Unsecured Notes Due 2022 [Member] - USD ($)	Aug. 20, 2013	Feb. 17, 2012	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 150,000,000	$ 200,000,000
Senior unsecured notes, maturity date		Feb. 15, 2022
Senior unsecured notes, interest rate		6.375%	6.375%	6.375%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest		101.00%
Debt instrument redemption price	102.00%
Debt instrument effective rate	5.998%
Senior notes frequency of periodic payment			Interest on these notes is payable semi-annually on February 15 and August 15 of each year.
Senior unsecured notes, redemption description			We may redeem some or all of the notes at a premium that will decrease over time, plus accrued and unpaid interest to, but not including, the redemption date. In the event of a change of control, each holder of the 6.375% Senior Unsecured Notes due 2022 may require us to repurchase some or all of its notes at a repurchase price equal to 101% of the aggregate principal amount plus accrued and unpaid interest to the date of purchase.

Debt - 5.750% Senior Unsecured

Debt - 5.750% Senior Unsecured Notes Due 2020 - Additional Information (Detail) - 5.750% Senior Unsecured Notes Due 2020 [Member] - EUR (€) € in Millions	Oct. 10, 2013	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Senior unsecured notes, value of offering	€ 200
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, interest rate	5.75%	5.75%	5.75%
Debt instrument, maturity date	Oct. 1, 2020
Senior unsecured notes, payable term		Interest on the notes is payable semi-annually on April 1 and October 1 of each year.
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time at a "make-whole" redemption price 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.

Debt - 4.000% Senior Unsecured

Debt - 4.000% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 4.000% Senior Unsecured Notes Due 2022 [Member] - EUR (€)	Aug. 19, 2015	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 500,000,000
Senior unsecured notes, interest rate	4.00%
Senior unsecured notes, payable term		Interest on the notes is payable annually on August 19 of each year.
Senior unsecured notes, redemption price percentage	101.00%
Senior unsecured notes, maturity date	Aug. 19, 2022
Senior unsecured notes, redemption period	90 days
Senior unsecured notes, redemption description		Notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by the Company. 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 the purchase.
Redeemed Prior to 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%
Redeemed Beginning on or After 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%

Debt - 5.500% Senior Unsecured

Debt - 5.500% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 5.500% Senior Unsecured Notes Due 2024 [Member] - USD ($)	Apr. 17, 2014	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 300,000,000
Senior unsecured notes, maturity date	May 1, 2024
Senior unsecured notes, interest rate	5.50%	5.50%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, payable term		Interest on the notes is payable semi-annually on May 1 and November 1 of each year
Senior notes, earliest redemption date	May 1, 2019
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 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 May 1, 2017, we may redeem up to 35% of the aggregate principal amount of the notes using the proceeds of one or more equity offerings. 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.
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 6.375% Senior Unsecure76

Debt - 6.375% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 6.375% Senior Unsecured Notes Due 2024 [Member] - Revolving Credit Facility [Member] - USD ($)	Feb. 22, 2016	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes 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 is payable on March 1 and September 1 of each year
Senior notes, earliest redemption date	Mar. 1, 2019
Senior unsecured notes, redemption description		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.
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 5.250% Senior Unsecured

Debt - 5.250% Senior Unsecured Notes Due 2026 - Additional Information (Detail) - 5.250% Senior Unsecured Notes Due 2026 [Member] - USD ($)	Jul. 22, 2016	Dec. 31, 2016
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on February 1 and August 1 of each year
Senior unsecured notes commencing date of payment	Feb. 1, 2017
Senior unsecured notes, interest rate	5.25%	5.25%
Senior unsecured notes, maturity date	Aug. 1, 2026
Senior notes, earliest redemption date	Aug. 1, 2021
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.25% 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.
Debt instrument, redemption price percentage	105.25%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - Other Financing - Additi

Debt - Other Financing - Additional Information (Detail) - USD ($)	3 Months Ended
	Sep. 30, 2015	Jul. 27, 2015
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	$ 1,950,000,000
Capella [Member]
Debt Instrument [Line Items]
Underwriting fees	$ 3,900,000
Bridge Loan [Member] | Capella [Member]
Debt Instrument [Line Items]
Aggregate committed amount of credit facility		$ 1,000,000,000

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
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%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption	100.00%
Amount of foreign loss before income taxes	$ 23,500,000	$ 29,400,000	$ 7,500,000
Amount of domestic income (loss) before income taxes	(1,400,000)	7,100,000	$ (20,900,000)
U.S federal NOLs	60,000,000
U.S. state NOLs	113,500,000
U.S. federal and state capital loss carryforwards	$ 8,100,000
U.S. federal and state NOLs, expiration period	Between 2021 and 2035
U.S. federal and state capital loss, expiration year	2,022
U.S federal alternative minimum tax credits carry forward	$ 300,000
Foreign NOLs	$ 13,300,000
Cumulative pre-tax loss position period	3 years
Valuation allowance	$ 15,975,000	$ 23,005,000
Uncertain tax position liabilities and related interest or penalties	0
Valuation Allowance of Deferred Tax Assets [Member]
Income Taxes [Line Items]
Valuation allowance	4,000,000
Valuation Allowance of Deferred Tax Assets Foreign [Member]
Income Taxes [Line Items]
Valuation allowance	2,200,000
Valuation Allowance of Deferred Tax Assets Foreign [Member] | Current Year Earnings [Member]
Income Taxes [Line Items]
Valuation allowance	$ 2,000,000

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax (Benefit) Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current income tax expense:
Domestic	$ 42	$ 147	$ 114
Foreign	1,856	1,614	225
Total income tax expense	1,898	1,761	339
Deferred income tax (benefit) expense:
Domestic	147	(360)	(23)
Foreign	(8,875)	102	24
Total income tax expense	(8,728)	(258)	1
Income tax (benefit) expense	$ (6,830)	$ 1,503	$ 340

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred tax liabilities:
Property and equipment	$ (3,781)	$ (1,636)
Unbilled rent	(7,045)	(4,495)
Partnership investments	(5,103)	(3,362)
Other	(6,757)	(6,141)
Total deferred tax liabilities	(22,686)	(15,634)
Deferred tax assets:
Operating loss and interest deduction carry forwards	28,289	19,016
Other	10,085	10,314
Total deferred tax assets	38,374	29,330
Valuation allowance	(15,975)	(23,005)
Total net deferred tax assets	22,399	6,325
Net deferred tax (liability)	$ (287)	$ (9,309)

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Income from continuing operations (before-tax)	$ 219,108	$ 141,430	$ 51,138
Income tax at the US statutory federal rate (35%)	76,688	49,501	17,898
Increase (decrease) resulting from:
Rate differential	1,434	5,047	1,145
State income taxes, net of federal benefit	66	(601)	(337)
Dividends paid deduction	(84,927)	(57,109)	(27,873)
Equity Investments	4,297
Change in valuation allowance	(6,104)	6,174	8,988
Other items, net	1,716	(1,509)	519
Income tax (benefit) expense	$ (6,830)	$ 1,503	$ 340

Income Taxes - Summary of Rec84

Income Taxes - Summary of Reconciliation of the Income Tax (Benefit) Expense at the Statutory Income Tax Rate and the Effective Tax Rate for Income from Continuing Operations before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	35.00%	35.00%	35.00%

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Common share distribution	$ 0.900000	$ 0.870000	$ 0.840000
Ordinary income	0.619368	0.769535	0.520692
Capital gains	0.102552		0.000276
Unrecaptured Sec. 1250 gain	0.045432		0.000276
Return of capital	$ 0.178080	$ 0.100465	$ 0.319032

Earnings Per Share_Unit - Calcu

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 43,245	$ 70,543	$ 53,924	$ 58,226	$ 58,339	$ 23,123	$ 22,489	$ 35,976	$ 225,938	$ 139,927	$ 50,798
Non-controlling interests' share in continuing operations									(889)	(329)	(274)
Participating securities' share in earnings									(559)	(1,029)	(894)
Income from continuing operations, less participating securities' share in earnings									224,490	138,569	49,630
Income (loss) from discontinued operations attributable to MPT									(1)		(2)
Net income, less participating securities' share in earnings									$ 224,489	$ 138,569	$ 49,628
Basic weighted-average common shares	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Dilutive potential common shares									658	307	541
Diluted weighted-average common shares	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Income from continuing operations	$ 43,245	$ 70,543	$ 53,924	$ 58,226	$ 58,339	$ 23,123	$ 22,489	$ 35,976	$ 225,938	$ 139,927	$ 50,798
Non-controlling interests' share in continuing operations									(889)	(329)	(274)
Participating securities' share in earnings									(559)	(1,029)	(894)
Income from continuing operations, less participating securities' share in earnings									224,490	138,569	49,630
Income (loss) from discontinued operations attributable to MPT									(1)		(2)
Net income, less participating securities' share in earnings									$ 224,489	$ 138,569	$ 49,628
Basic weighted-average common shares	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Dilutive potential common shares									658	307	541
Diluted weighted-average common shares	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 7.9	$ 11.1	$ 9.2
Stock-based compensation expense, unrecognized cost	$ 12.4
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	2 years 9 months 11 days
Restricted equity awards, fair value	$ 12.7	$ 10.2	$ 10.2
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 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	5,265,916
Maximum number of shares of common stock that may be awarded	5,000,000
Service-Based Awards [Member] | Minimum [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
Service-Based Awards [Member] | Maximum [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)	5 years
50% of 2016 Performance 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)	5 years
Percentage of performance award grant in period	50.00%
Stock-based awards expiration date	Dec. 31, 2018
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Common stock options awarded, dividend yield	7.00%
Share based payment award, weighted average risk-free rate of return	1.00%
Share based payment award, expected volatility rate	24.40%
50% of 2016 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on January 1, 2019, 2020, and 2021.
50% of 2016 Performance Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	27.00%
50% of 2016 Performance Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned	35.00%
Remaining % of 2016 Performance 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)	5 years
Stock-based awards expiration date	Dec. 31, 2018
Percentage of shareholder return to be earned	3.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit	100.00%
Common stock options awarded, dividend yield	7.00%
Share based payment award, weighted average risk-free rate of return	1.00%
Share based payment award, expected volatility rate	24.40%
Remaining % of 2016 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on January 1, 2019, 2020, and 2021.
2016 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	2,400
Number of performance awards earned and vested	0
Number of performance awards to be earned	797,404
40% Of 2015 Performance 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
Percentage of performance award grant in period		40.00%
Stock-based awards expiration date	Dec. 31, 2017
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
Percentage of shareholder return annually		9.00%
Annual total shareholder return (in years)		3 years
30% of 2015 Performance 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)		5 years
Percentage of performance award grant in period		30.00%
Stock-based awards expiration date	Dec. 31, 2017
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
30% of 2015 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2017, 2018, and 2019.
30% of 2015 Performance Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		27.00%
30% of 2015 Performance Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned		35.00%
Remaining % of 2015 Performance 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)		5 years
Stock-based awards expiration date	Dec. 31, 2017
Percentage of shareholder return to be earned		6.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit		100.00%
Common stock options awarded, dividend yield		7.20%
Share based payment award, weighted average risk-free rate of return		1.10%
Share based payment award, expected volatility rate		20.00%
Remaining % of 2015 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2017, 2018, and 2019.
2015 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	66,792	4,500
Number of performance awards earned and vested	98,526	0
Number of performance awards to be earned	702,070
40% of 2014 Performance 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
Percentage of performance award grant in period			40.00%
Stock-based awards expiration date	Dec. 31, 2018
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			1.70%
Share based payment award, expected volatility rate			27.00%
Percentage of shareholder return annually			9.00%
Annual total shareholder return (in years)			5 years
30% of 2014 Performance 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)			5 years
Percentage of performance award grant in period			30.00%
Stock-based awards expiration date	Dec. 31, 2016
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			0.80%
Share based payment award, expected volatility rate			27.00%
30% of 2014 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2016, 2017, and 2018.
30% of 2014 Performance Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			27.00%
30% of 2014 Performance Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of shareholder return to be earned			35.00%
Remaining % of 2014 Performance 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)			5 years
Stock-based awards expiration date	Dec. 31, 2016
Percentage of shareholder return to be earned			6.00%
Percentage of performance award to be earned of shareholder return reaches shareholder limit			100.00%
Common stock options awarded, dividend yield			8.00%
Share based payment award, weighted average risk-free rate of return			0.80%
Share based payment award, expected volatility rate			27.00%
Remaining % of 2014 Performance Awards [Member] | If Any Shares Are Earned From This Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation award vesting rights	Vest in equal annual amounts on December 31, 2016, 2017, and 2018.
2014 Performance Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of performance awards forfeited	500,000
Number of performance awards earned and vested	99,959	0	108,261
Number of performance awards to be earned	99,935
Number of additional performance awards forfeited	72,003

Stock Awards - Restricted Equit

Stock Awards - Restricted Equity Awards Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	509,634	452,263
Awarded, Shares	254,574	407,969
Vested, Shares	(349,356)	(343,904)
Forfeited, Shares	(67,724)	(6,694)
Nonvested awards at end of year, Shares	347,128	509,634
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 13.25	$ 12.11
Awarded, Weighted Average Value at Award Date	13.07	13.94
Vested, Weighted Average Value at Award Date	13.07	12.56
Forfeited, Weighted Average Value at Award Date	13.06	13.08
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 13.35	$ 13.25
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	2,331,152	2,428,518
Awarded, Shares	799,804	871,888
Vested, Shares	(671,983)	(406,970)
Forfeited, Shares	(647,298)	(562,284)
Nonvested awards at end of year, Shares	1,811,675	2,331,152
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 6.38	$ 5.81
Awarded, Weighted Average Value at Award Date	7.30	6.62
Vested, Weighted Average Value at Award Date	6.50	4.94
Forfeited, Weighted Average Value at Award Date	6.28	5.33
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 6.78	$ 6.38

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) € in Millions, $ in Millions	Jan. 27, 2017EUR (€)Facility	Dec. 31, 2016EUR (€)Facility	Sep. 28, 2016USD ($)Hospital	Sep. 09, 2016EUR (€)Hospital	Jul. 20, 2016EUR (€)Hospital	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)
Commitment And Contingencies [Line Items]
Term of lease period						30 years or more
Lease and Rental Expenses | $						$ 6.8	$ 4.6	$ 2.3
Sublease rental income | $						$ 4.2	$ 2.3	$ 0.3
Washington and Idaho [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals | Hospital			2
Purchase price of acquisition | $			$ 105
Germany [Member] | Facility Closing One [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals | Hospital					20
Purchase price of acquisition					€ 215.7
Number of facilities closed | Facility		7
Consideration received on closing of facilities		€ 49.5
Term of lease, years					27 years
Germany [Member] | Facility Closing Two [Member]
Commitment And Contingencies [Line Items]
Number of rehabilitation hospitals | Hospital				6
Purchase price of acquisition				€ 44.1
Number of facilities closed | Facility		5
Consideration received on closing of facilities		€ 35.7
Germany [Member] | Facility Closing Two [Member] | Subsequent Event [Member]
Commitment And Contingencies [Line Items]
Number of facilities closed | Facility	1
Consideration received on closing of facilities	€ 8.4

Commitments and Contingencies90

Commitments and Contingencies - Fixed Minimum Rental Payments Due under Operating Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Commitments and Contingencies Disclosure [Abstract]
2,017	$ 7,328
2,018	7,249
2,019	6,925
2,020	6,944
2,021	6,024
Thereafter	251,981
Minimum rental payments, total	286,451
2,017	(4,725)
2,018	(4,731)
2,019	(4,755)
2,020	(4,860)
2,021	(4,966)
Thereafter	(249,662)
Sub lease minimum rental payments receivable, total	(273,699)
2,017	2,603
2,018	2,518
2,019	2,170
2,020	2,084
2,021	1,058
Thereafter	2,319
Minimum rental payments, total	$ 12,752

Common Stock_Partner's Capital

Common Stock/Partner's Capital - Additional Information (Detail) $ / shares in Units, $ in Thousands	Oct. 07, 2016USD ($)$ / sharesshares	Sep. 30, 2016USD ($)shares	Mar. 01, 2016USD ($)	Aug. 11, 2015USD ($)shares	Jan. 14, 2015USD ($)shares	Dec. 31, 2016USD ($)PartnerDirectorEmployee$ / sharesshares	Dec. 31, 2015USD ($)$ / sharesshares	Dec. 31, 2014USD ($)shares	Aug. 04, 2015$ / sharesshares	Jun. 30, 2015$ / sharesshares
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs | $						$ 1,173,651	$ 817,389	$ 138,173
Common stock, shares issued | shares						320,514,000	236,744,000
Common stock, shares authorized | shares						500,000,000	500,000,000		500,000,000	250,000,000
Common stock, par value | $ / shares						$ 0.001	$ 0.001		$ 0.001	$ 0.001
Common Units [Member]
Class of Stock [Line Items]
Number of share sold | shares						82,749,000	63,250,000	10,656,000
Common Units [Member] | Private Placement [Member] | Cerberus Capital Management [Member]
Class of Stock [Line Items]
Number of share sold | shares	10,300,000
Sale of Stock, price per share | $ / shares	$ 14.50
Proceeds from sale of common shares / units, net of offering costs | $	$ 150,000
MPT Operating Partnership, L.P. [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs | $						$ 1,173,651	$ 817,389	$ 138,173
Ownership interest in equity						99.90%
Percentage of ownership of general partner						100.00%
Number of other partners | Partner						3
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]
Proceeds from sale of common shares / units, net of offering costs | $						$ 224,000
Common stock, shares issued | shares						15,000,000
Sales commission percentage			1.25%
Sales commissions, amount | $						$ 2,800
Market Equity Offering Program [Member] | Maximum [Member]
Class of Stock [Line Items]
Value of stock | $			$ 227,000
Public Offering [Member]
Class of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs | $		$ 799,500		$ 337,000	$ 480,000
Common stock, shares issued | shares		57,500,000		28,750,000	34,500,000
Additional shares purchased by underwriters | shares		7,500,000		3,800,000	4,500,000

Fair Value of Financial Instr92

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 57,698	$ 46,939
Loans, Book value	986,987	508,851
Debt, net Book value	(2,909,341)	(3,322,541)
Interest and rent receivables, Fair value	57,707	46,858
Loans, Fair value	1,017,428	543,859
Debt, net Fair value	$ (2,966,759)	$ (3,372,773)

Fair Value of Financial Instr93

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 232,434	$ 920,901
Cost	232,434	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	3,300	7,349
Cost	3,300	7,349
Fair Value Measurements, Recurring [Member] | Acquisition and Other Loans [Member] | Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	116,298	603,552
Cost	116,298	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	112,836	310,000
Cost	$ 112,836	$ 310,000

Fair Value of Financial Instr94

Fair Value of Financial Instruments - Additional information (Detail)	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Adjustment for DLOM on our equity investment	40.00%

Fair Value of Financial Instr95

Fair Value of Financial Instruments - Summary Showing Sensitivity Analysis by Using Basis Point Variations (Detail) $ in Thousands	12 Months Ended
	Dec. 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	$ (49)
- 100 basis points [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated Increase (Decrease) In Fair Value of Financial Instruments	$ 49

Other Assets - Summary of Other

Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Other Assets [Abstract]
Debt issue costs, net	$ 4,478	$ 7,628
Equity investments	177,430	129,337
Other corporate assets	77,580	31,547
Prepaids and other assets	44,285	27,028
Total other assets	$ 303,773	$ 195,540

Quarterly Financial Data (Una97

Quarterly Financial Data (Unaudited) - Unaudited Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Quarterly Financial Information [Line Items]
Revenues	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Income from continuing operations	43,245	70,543	53,924	58,226	58,339	23,123	22,489	35,976	225,938	139,927	50,798
Net income	43,245	70,543	53,924	58,225	58,339	23,123	22,489	35,976	225,937	139,927	50,796
Net income attributable to MPT common stockholders	$ 43,039	$ 70,358	$ 53,724	$ 57,927	$ 58,237	$ 23,057	$ 22,407	$ 35,897	$ 225,048	$ 139,598	$ 50,522
Net income attributable to MPT common stockholders per share - basic	$ 0.13	$ 0.29	$ 0.23	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.18	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Net income attributable to MPT common stockholders per share - diluted	$ 0.13	$ 0.28	$ 0.22	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.17	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540
MPT Operating Partnership, L.P. [Member]
Quarterly Financial Information [Line Items]
Revenues	$ 153,283	$ 126,555	$ 126,300	$ 134,999	$ 131,546	$ 114,570	$ 99,801	$ 95,961	$ 541,137	$ 441,878	$ 312,532
Income from continuing operations	43,245	70,543	53,924	58,226	58,339	23,123	22,489	35,976	225,938	139,927	50,798
Net income	43,245	70,543	53,924	58,225	58,339	23,123	22,489	35,976	225,937	139,927	50,796
Net income attributable to MPT common stockholders	$ 43,039	$ 70,358	$ 53,724	$ 57,927	$ 58,237	$ 23,057	$ 22,407	$ 35,897	$ 225,048	$ 139,598	$ 50,522
Net income attributable to MPT common stockholders per share - basic	$ 0.13	$ 0.29	$ 0.23	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.18	$ 0.86	$ 0.64	$ 0.29
Weighted average shares outstanding - basic	319,833	246,230	238,082	237,510	237,011	223,948	208,071	202,958	260,414	217,997	169,999
Net income attributable to MPT common stockholders per share - diluted	$ 0.13	$ 0.28	$ 0.22	$ 0.24	$ 0.24	$ 0.10	$ 0.11	$ 0.17	$ 0.86	$ 0.63	$ 0.29
Weighted average shares outstanding - diluted	319,994	247,468	239,008	237,819	237,011	223,948	208,640	203,615	261,072	218,304	170,540

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) € in Millions	Feb. 02, 2017EUR (€)	Feb. 01, 2017USD ($)	Oct. 10, 2013EUR (€)	Mar. 31, 2017USD ($)	Dec. 31, 2016	Feb. 01, 2017EUR (€)	Dec. 31, 2015	Sep. 30, 2015USD ($)
Subsequent Event [Line Items]
Aggregate committed amount of credit facility								$ 1,950,000,000
Subsequent Event [Member]
Subsequent Event [Line Items]
Total Facility amount at a rate		0.25%
Aggregate committed amount of credit facility		$ 500,000,000
Minimum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Facility fee		0.125%
Maximum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Facility fee		0.30%
Unsecured Revolving Credit Facility [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt		$ 1,300,000,000
Debt instrument, maturity date		Feb. 28, 2021
Term Loans [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt		$ 200,000,000				€ 200
Debt instrument, maturity date		Feb. 1, 2022
Alternate Base Rate [Member] | Minimum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.00%
Applicable margin for revolving loans		0.00%
Alternate Base Rate [Member] | Maximum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.95%
Applicable margin for revolving loans		0.65%
Eurodollar Loans [Member] | Minimum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		0.90%
Applicable margin for revolving loans		0.875%
Eurodollar Loans [Member] | Maximum [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Applicable margin		1.95%
Applicable margin for revolving loans		1.65%
Euro [Member] | Term Loans [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Debt instrument, maturity date		Jan. 31, 2020
5.750% Senior Unsecured Notes Due 2020 [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt | €			€ 200
Debt instrument, maturity date			Oct. 1, 2020
Senior unsecured notes, interest rate			5.75%		5.75%		5.75%
Senior unsecured notes, redemption description					We may redeem some or all of the notes at any time at a "make-whole" redemption price 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.
5.750% Senior Unsecured Notes Due 2020 [Member] | Subsequent Event [Member]
Subsequent Event [Line Items]
Amount of senior unsecured debt | €	€ 200
Senior unsecured notes, interest rate	5.75%
Senior notes, redemption date	Mar. 4, 2017
Senior unsecured notes, redemption description	We delivered an irrevocable notice of full redemption to the holders of the â,¬200 million aggregate principal amount of our 5.750% Senior Notes due 2020 and set a redemption date of March 4, 2017. To fund such redemption, including any premium and accrued interest, we plan to use the proceeds of the new euro term loan together with cash on hand.
5.750% Senior Unsecured Notes Due 2020 [Member] | Scenario, Forecast [Member]
Subsequent Event [Line Items]
Debt refinancing charge				$ 13,000,000
Redemption premium				$ 9,000,000

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Valuation and Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 27,384	$ 20,129	$ 41,573
Additions charged against operations	2,722	8,205	65,512
Deductions,Net recoveries/write offs	(11,254)	(950)	(86,956)
Balance at end of year	$ 18,852	$ 27,384	$ 20,129

Schedule II - Schedule of Va100

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2014	Dec. 31, 2015
Impairment charges	$ 7,229	$ 50,128
Increase (decrease) in valuation allowance	(6,900)
Net deferred tax assets reserve			$ 6,200
Twelve Oaks Facility [Member]
Rent reserves	1,900
Write offs related to payment of rent, late fees, and loans	3,300
Rent and late fee reserves			1,500
Corinth Facility [Member]
Rent reserves	800
Write offs for rent and interest reserves	800
M/C Healthcare Loan [Member]
Write offs related to loan	$ 100
Healthtrax Properties [Member]
Rent reserves			$ 500
Monroe Properties [Member]
Impairment charges		47,000
Write offs for rent and interest reserves		9,500
Increase (decrease) in valuation allowance		$ 9,000

Schedule III - Real Estate I101

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 13,101
Initial costs, land	403,141
Initial costs, buildings	3,482,455
Additions subsequent to acquisition, Improvements	52,564
Additions subsequent to acquisition, carrying costs	29,882
Land at cost	417,368
Buildings at cost	3,550,674
Total at cost	3,968,042	$ 2,991,590	$ 2,040,727	$ 1,733,194
Accumulated Depreciation	$ 292,786	$ 232,675	$ 181,441	$ 144,235
Wiesbaden, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,557
Initial costs, buildings	7,220
Additions subsequent to acquisition, Improvements	37
Land at cost	1,594
Buildings at cost	7,220
Total at cost	8,814
Accumulated Depreciation	$ 274
Date of Construction	1,974
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Liebenstein [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,554
Initial costs, buildings	32,836
Land at cost	1,554
Buildings at cost	32,836
Total at cost	34,390
Accumulated Depreciation	$ 1,779
Date of Construction	1,992
Date Acquired	Nov. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Mergentheim [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 10,891
Buildings at cost	10,891
Total at cost	10,891
Accumulated Depreciation	$ 567
Date of Construction	1,995
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,463
Initial costs, buildings	30,316
Land at cost	1,463
Buildings at cost	30,316
Total at cost	31,779
Accumulated Depreciation	$ 1,895
Date of Construction	2,009
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Ottenhofen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,182
Initial costs, buildings	12,278
Additions subsequent to acquisition, Improvements	105
Land at cost	2,287
Buildings at cost	12,278
Total at cost	14,565
Accumulated Depreciation	$ 471
Date of Construction	1,957
Date Acquired	Jul. 3, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Berka, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,124
Initial costs, buildings	14,569
Additions subsequent to acquisition, Improvements	163
Land at cost	3,287
Buildings at cost	14,569
Total at cost	17,856
Accumulated Depreciation	$ 531
Date of Construction	1,997
Date Acquired	Jul. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Lausick, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,677
Initial costs, buildings	15,176
Additions subsequent to acquisition, Improvements	147
Land at cost	1,824
Buildings at cost	15,176
Total at cost	17,000
Accumulated Depreciation	$ 584
Date of Construction	1,993
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Sulze, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,224
Initial costs, buildings	19,184
Additions subsequent to acquisition, Improvements	189
Land at cost	2,413
Buildings at cost	19,184
Total at cost	21,597
Accumulated Depreciation	$ 738
Date of Construction	1,993
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Kurort Berggiebhubel, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,966
Initial costs, buildings	14,961
Additions subsequent to acquisition, Improvements	131
Land at cost	3,097
Buildings at cost	14,961
Total at cost	18,058
Accumulated Depreciation	$ 542
Date of Construction	1,993
Date Acquired	Jul. 21, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Braunfels, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,019
Initial costs, buildings	12,907
Additions subsequent to acquisition, Improvements	53
Land at cost	2,072
Buildings at cost	12,907
Total at cost	14,979
Accumulated Depreciation	$ 489
Date of Construction	1,977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bernkastel-Kues, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,386
Initial costs, buildings	14,709
Additions subsequent to acquisition, Improvements	42
Land at cost	3,428
Buildings at cost	14,709
Total at cost	18,137
Accumulated Depreciation	$ 525
Date of Construction	1,982
Date Acquired	Jul. 15, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Flechtingen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,692
Initial costs, buildings	13,590
Additions subsequent to acquisition, Improvements	142
Land at cost	2,834
Buildings at cost	13,590
Total at cost	16,424
Accumulated Depreciation	$ 524
Date of Construction	1,993
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Nordrach, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 294
Initial costs, buildings	2,818
Additions subsequent to acquisition, Improvements	79
Land at cost	373
Buildings at cost	2,818
Total at cost	3,191
Accumulated Depreciation	$ 114
Date of Construction	1,960
Date Acquired	Jul. 7, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Gottleuba, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 49
Initial costs, buildings	14,462
Additions subsequent to acquisition, Improvements	835
Land at cost	884
Buildings at cost	14,462
Total at cost	15,346
Accumulated Depreciation	$ 417
Date of Construction	1,913
Date Acquired	Dec. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Grunheide, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,674
Initial costs, buildings	39,306
Additions subsequent to acquisition, Improvements	321
Land at cost	2,995
Buildings at cost	39,306
Total at cost	42,301
Accumulated Depreciation	$ 1,422
Date of Construction	2,014
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Baden-Baden, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,230
Initial costs, buildings	8,652
Additions subsequent to acquisition, Improvements	121
Land at cost	1,351
Buildings at cost	8,652
Total at cost	10,003
Accumulated Depreciation	$ 337
Date of Construction	2,003
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Gyhum, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,755
Initial costs, buildings	21,461
Additions subsequent to acquisition, Improvements	330
Land at cost	4,085
Buildings at cost	21,461
Total at cost	25,546
Accumulated Depreciation	$ 838
Date of Construction	1,994
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Hannover, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,081
Initial costs, buildings	14,562
Additions subsequent to acquisition, Improvements	300
Land at cost	3,381
Buildings at cost	14,562
Total at cost	17,943
Accumulated Depreciation	$ 416
Date of Construction	1,900
Date Acquired	Dec. 1, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Heiligendamm, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 4,049
Initial costs, buildings	25,235
Additions subsequent to acquisition, Improvements	200
Land at cost	4,249
Buildings at cost	25,235
Total at cost	29,484
Accumulated Depreciation	$ 966
Date of Construction	1,995
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Camberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,961
Initial costs, buildings	14,956
Additions subsequent to acquisition, Improvements	252
Land at cost	2,213
Buildings at cost	14,956
Total at cost	17,169
Accumulated Depreciation	$ 586
Date of Construction	1,973
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Hoppegarten, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,770
Initial costs, buildings	23,351
Additions subsequent to acquisition, Improvements	231
Land at cost	4,001
Buildings at cost	23,351
Total at cost	27,352
Accumulated Depreciation	$ 849
Date of Construction	1,994
Date Acquired	Jul. 27, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Ban Nauheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,976
Initial costs, buildings	15,036
Additions subsequent to acquisition, Improvements	137
Land at cost	3,113
Buildings at cost	15,036
Total at cost	18,149
Accumulated Depreciation	$ 578
Date of Construction	1,977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Kalbe, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,292
Initial costs, buildings	21,994
Additions subsequent to acquisition, Improvements	158
Land at cost	3,450
Buildings at cost	21,994
Total at cost	25,444
Accumulated Depreciation	$ 841
Date of Construction	1,995
Date Acquired	Jul. 6, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Soden-Salmunster, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 904
Initial costs, buildings	6,276
Additions subsequent to acquisition, Improvements	116
Land at cost	1,020
Buildings at cost	6,276
Total at cost	7,296
Accumulated Depreciation	$ 247
Date of Construction	1,974
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Berlin, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 20,107
Additions subsequent to acquisition, Improvements	179
Land at cost	179
Buildings at cost	20,107
Total at cost	20,286
Accumulated Depreciation	$ 775
Date of Construction	1,998
Date Acquired	Jul. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Lobenstein, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,429
Initial costs, buildings	19,442
Additions subsequent to acquisition, Improvements	174
Land at cost	3,603
Buildings at cost	19,442
Total at cost	23,045
Accumulated Depreciation	$ 746
Date of Construction	1,994
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Magdeburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 13,931
Initial costs, buildings	51,674
Additions subsequent to acquisition, Improvements	242
Land at cost	14,173
Buildings at cost	51,674
Total at cost	65,847
Accumulated Depreciation	$ 1,853
Date of Construction	2,014
Date Acquired	Jul. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Schlangenbad, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,015
Initial costs, buildings	3,302
Additions subsequent to acquisition, Improvements	258
Land at cost	1,273
Buildings at cost	3,302
Total at cost	4,575
Accumulated Depreciation	$ 150
Date of Construction	1,973
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Durrheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,346
Initial costs, buildings	11,038
Additions subsequent to acquisition, Improvements	221
Land at cost	1,567
Buildings at cost	11,038
Total at cost	12,605
Accumulated Depreciation	$ 412
Date of Construction	1,970
Date Acquired	Jul. 24, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Krozingen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,425
Initial costs, buildings	10,392
Additions subsequent to acquisition, Improvements	110
Land at cost	1,535
Buildings at cost	10,392
Total at cost	11,927
Accumulated Depreciation	$ 378
Date of Construction	2,008
Date Acquired	Jul. 24, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Nauheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,704
Initial costs, buildings	8,906
Additions subsequent to acquisition, Improvements	53
Land at cost	1,757
Buildings at cost	8,906
Total at cost	10,663
Accumulated Depreciation	$ 339
Date of Construction	1,973
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Tennstedt, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,560
Initial costs, buildings	26,396
Additions subsequent to acquisition, Improvements	195
Land at cost	3,755
Buildings at cost	26,396
Total at cost	30,151
Accumulated Depreciation	$ 1,009
Date of Construction	1,993
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Wismar, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,355
Initial costs, buildings	19,989
Additions subsequent to acquisition, Improvements	189
Land at cost	3,544
Buildings at cost	19,989
Total at cost	23,533
Accumulated Depreciation	$ 769
Date of Construction	1,996
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,757
Initial costs, buildings	33,689
Additions subsequent to acquisition, Improvements	438
Land at cost	6,195
Buildings at cost	33,689
Total at cost	39,884
Accumulated Depreciation	$ 436
Date of Construction	1,991
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Kosen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 717
Initial costs, buildings	4,473
Land at cost	717
Buildings at cost	4,473
Total at cost	5,190
Accumulated Depreciation	$ 19
Date of Construction	1,997
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Salzdetfurth, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,129
Initial costs, buildings	6,556
Land at cost	1,129
Buildings at cost	6,556
Total at cost	7,685
Accumulated Depreciation	$ 14
Date of Construction	1,987
Date Acquired	Nov. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Lubeck, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 673
Initial costs, buildings	4,922
Additions subsequent to acquisition, Improvements	38
Land at cost	711
Buildings at cost	4,922
Total at cost	$ 5,633
Date of Construction	2,011
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Vitense-Parber, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 540
Initial costs, buildings	3,938
Additions subsequent to acquisition, Improvements	30
Land at cost	570
Buildings at cost	3,938
Total at cost	$ 4,508
Date of Construction	1,995
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Breuberg-Sandbach, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,554
Initial costs, buildings	11,485
Additions subsequent to acquisition, Improvements	88
Land at cost	1,642
Buildings at cost	11,485
Total at cost	$ 13,127
Date of Construction	1,984
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Ravensrush, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 407
Initial costs, buildings	3,199
Additions subsequent to acquisition, Improvements	25
Land at cost	432
Buildings at cost	3,199
Total at cost	$ 3,631
Date of Construction	1,992
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Wildeck, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 731
Initial costs, buildings	5,250
Additions subsequent to acquisition, Improvements	40
Land at cost	771
Buildings at cost	5,250
Total at cost	$ 6,021
Date of Construction	2,013
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Romhild, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 169
Initial costs, buildings	8,039
Additions subsequent to acquisition, Improvements	62
Land at cost	231
Buildings at cost	8,039
Total at cost	$ 8,270
Date of Construction	2,000
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Bad Hersfield, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 507
Initial costs, buildings	3,773
Additions subsequent to acquisition, Improvements	29
Land at cost	536
Buildings at cost	3,773
Total at cost	$ 4,309
Date of Construction	2,014
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,047
Initial costs, buildings	41,914
Land at cost	4,047
Buildings at cost	41,914
Total at cost	45,961
Accumulated Depreciation	$ 524
Date of Construction	2,016
Date Acquired	Jul. 7, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Allen, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,550
Initial costs, buildings	3,921
Land at cost	1,550
Buildings at cost	3,921
Total at cost	5,471
Accumulated Depreciation	$ 245
Date of Construction	2,014
Date Acquired	Jul. 14, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,550
Initial costs, buildings	15,653
Additions subsequent to acquisition, carrying costs	77
Land at cost	6,550
Buildings at cost	15,730
Total at cost	22,280
Accumulated Depreciation	$ 3,799
Date of Construction	1,964
Date Acquired	May 9, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 258
Date of Construction	2,014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Aurora, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,812
Buildings at cost	4,812
Total at cost	4,812
Accumulated Depreciation	$ 150
Date of Construction	2,015
Date Acquired	Sep. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Ft. Worth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,392
Buildings at cost	4,392
Total at cost	4,392
Accumulated Depreciation	$ 192
Date of Construction	2,015
Date Acquired	Mar. 27, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Bayonne, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,003
Initial costs, buildings	51,495
Land at cost	2,003
Buildings at cost	51,495
Total at cost	53,498
Accumulated Depreciation	$ 15,234
Date of Construction	1,918
Date Acquired	Feb. 4, 2011
Life on which depreciation in latest income statements is computed (Years)	20 years
Bennettsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 794
Initial costs, buildings	15,772
Land at cost	794
Buildings at cost	15,772
Total at cost	16,566
Accumulated Depreciation	$ 3,419
Date of Construction	1,984
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 1,183
Date of Construction	1,980
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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
Land at cost	900
Buildings at cost	17,818
Total at cost	18,718
Accumulated Depreciation	$ 3,895
Date of Construction	1,982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,638
Initial costs, buildings	147,266
Land at cost	18,638
Buildings at cost	147,266
Total at cost	165,904
Accumulated Depreciation	$ 922
Date of Construction	2,009
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,141
Initial costs, buildings	66,562
Land at cost	18,141
Buildings at cost	66,562
Total at cost	84,703
Accumulated Depreciation	$ 526
Date of Construction	2,010
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,140
Initial costs, buildings	3,853
Land at cost	1,140
Buildings at cost	3,853
Total at cost	4,993
Accumulated Depreciation	$ 249
Date of Construction	2,014
Date Acquired	May 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Broomfield, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 825
Initial costs, buildings	3,895
Land at cost	825
Buildings at cost	3,895
Total at cost	4,720
Accumulated Depreciation	$ 243
Date of Construction	2,014
Date Acquired	Jul. 3, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Glendale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,046
Buildings at cost	4,046
Total at cost	4,046
Accumulated Depreciation	$ 160
Date of Construction	2,015
Date Acquired	Jun. 5, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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	5,599
Land at cost	2,850
Buildings at cost	5,599
Total at cost	8,449
Accumulated Depreciation	$ 35
Date of Construction	2,016
Date Acquired	Sep. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Carrollton, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 729
Initial costs, buildings	34,342
Land at cost	729
Buildings at cost	34,342
Total at cost	35,071
Accumulated Depreciation	$ 1,216
Date of Construction	2,015
Date Acquired	Jul. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Cedar Hill, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,122
Initial costs, buildings	3,644
Land at cost	1,122
Buildings at cost	3,644
Total at cost	4,766
Accumulated Depreciation	$ 228
Date of Construction	2,014
Date Acquired	Jun. 23, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,310
Initial costs, buildings	4,203
Land at cost	1,310
Buildings at cost	4,203
Total at cost	5,513
Accumulated Depreciation	$ 263
Date of Construction	2,014
Date Acquired	Jul. 15, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	3,852
Land at cost	750
Buildings at cost	3,852
Total at cost	4,602
Accumulated Depreciation	$ 120
Date of Construction	2,015
Date Acquired	Oct. 7, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Cheraw, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 657
Initial costs, buildings	19,576
Land at cost	657
Buildings at cost	19,576
Total at cost	20,233
Accumulated Depreciation	$ 4,242
Date of Construction	1,982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 3,873
Buildings at cost	3,873
Total at cost	3,873
Accumulated Depreciation	$ 113
Date of Construction	2,015
Date Acquired	Oct. 21, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 5,063
Date of Construction	2,004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Commerce City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 707
Initial costs, buildings	4,236
Land at cost	707
Buildings at cost	4,236
Total at cost	4,943
Accumulated Depreciation	$ 221
Date of Construction	2,014
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Conroe, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,338
Initial costs, buildings	3,712
Land at cost	1,338
Buildings at cost	3,712
Total at cost	5,050
Accumulated Depreciation	$ 131
Date of Construction	2,015
Date Acquired	Jul. 29, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 194
Date of Construction	2,015
Date Acquired	Apr. 10, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
The Woodlands, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,740
Buildings at cost	4,740
Total at cost	4,740
Accumulated Depreciation	$ 89
Date of Construction	2,016
Date Acquired	Mar. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Dallas, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,000
Initial costs, buildings	13,589
Additions subsequent to acquisition, carrying costs	368
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	$ 3,496
Date of Construction	2,006
Date Acquired	Sep. 5, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
Denver, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,276
Buildings at cost	4,276
Total at cost	4,276
Accumulated Depreciation	$ 169
Date of Construction	2,015
Date Acquired	Jun. 8, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
DeSoto, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,067
Initial costs, buildings	10,701
Additions subsequent to acquisition, Improvements	86
Additions subsequent to acquisition, carrying costs	8
Land at cost	1,161
Buildings at cost	10,701
Total at cost	11,862
Accumulated Depreciation	$ 1,476
Date of Construction	2,008
Date Acquired	Jul. 18, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
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	8,687
Additions subsequent to acquisition, carrying costs	(365)
Land at cost	1,220
Buildings at cost	8,322
Total at cost	9,542
Accumulated Depreciation	$ 1,862
Date of Construction	1,956
Date Acquired	May 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 609
Date of Construction	2,012
Date Acquired	Oct. 2, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
Dulles, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,076
Initial costs, buildings	3,784
Land at cost	1,076
Buildings at cost	3,784
Total at cost	4,860
Accumulated Depreciation	$ 220
Date of Construction	2,014
Date Acquired	Sep. 12, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	3,928
Land at cost	1,277
Buildings at cost	15,952
Total at cost	17,229
Accumulated Depreciation	$ 857
Date of Construction	1,985
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,406
Initial costs, buildings	82,358
Land at cost	2,406
Buildings at cost	82,358
Total at cost	84,764
Accumulated Depreciation	$ 526
Date of Construction	2,012
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
Firestone, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 495
Initial costs, buildings	3,963
Land at cost	495
Buildings at cost	3,963
Total at cost	4,458
Accumulated Depreciation	$ 256
Date of Construction	2,014
Date Acquired	Jun. 6, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 3,388
Date of Construction	2,012
Date Acquired	Feb. 7, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
Fort Lauderdale, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,499
Initial costs, buildings	21,939
Additions subsequent to acquisition, carrying costs	1
Land at cost	3,499
Buildings at cost	21,940
Total at cost	25,439
Accumulated Depreciation	$ 4,763
Date of Construction	1,985
Date Acquired	Aug. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Fountain, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,508
Initial costs, buildings	4,131
Land at cost	1,508
Buildings at cost	4,131
Total at cost	5,639
Accumulated Depreciation	$ 250
Date of Construction	2,014
Date Acquired	Jul. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Frisco, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,500
Initial costs, buildings	3,863
Additions subsequent to acquisition, Improvements	27
Additions subsequent to acquisition, carrying costs	(89)
Land at cost	1,411
Buildings at cost	3,890
Total at cost	5,301
Accumulated Depreciation	$ 251
Date of Construction	2,014
Date Acquired	Jun. 13, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,502
Initial costs, buildings	10,748
Additions subsequent to acquisition, carrying costs	51
Land at cost	5,502
Buildings at cost	10,799
Total at cost	16,301
Accumulated Depreciation	$ 2,196
Date of Construction	1,982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Garland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,954
Buildings at cost	4,954
Total at cost	4,954
Accumulated Depreciation	$ 21
Date of Construction	2,016
Date Acquired	Nov. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 150
Initial costs, buildings	15,553
Land at cost	150
Buildings at cost	15,553
Total at cost	15,703
Accumulated Depreciation	$ 2,333
Date of Construction	2,005
Date Acquired	Jan. 4, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,518
Initial costs, buildings	4,660
Land at cost	1,518
Buildings at cost	4,660
Total at cost	6,178
Accumulated Depreciation	$ 165
Date of Construction	2,015
Date Acquired	Jul. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Goodyear, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,800
Initial costs, buildings	4,709
Land at cost	1,800
Buildings at cost	4,709
Total at cost	6,509
Accumulated Depreciation	$ 88
Date of Construction	2,016
Date Acquired	Apr. 4, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 957
Date of Construction	1,999
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
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	8,958
Land at cost	1,500
Buildings at cost	8,958
Total at cost	10,458
Accumulated Depreciation	$ 835
Date of Construction	2,013
Date Acquired	Mar. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
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	5,297
Land at cost	1,900
Buildings at cost	5,297
Total at cost	7,197
Accumulated Depreciation	$ 110
Date of Construction	2,016
Date Acquired	Mar. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Highland Village, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,016
Buildings at cost	4,016
Total at cost	4,016
Accumulated Depreciation	$ 126
Date of Construction	2,015
Date Acquired	Sep. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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
Land at cost	1,120
Buildings at cost	17,882
Total at cost	19,002
Accumulated Depreciation	$ 7,492
Date of Construction	1,980
Date Acquired	Sep. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
Hoboken, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,387
Initial costs, buildings	44,351
Land at cost	1,387
Buildings at cost	44,351
Total at cost	45,738
Accumulated Depreciation	$ 11,394
Date of Construction	1,863
Date Acquired	Nov. 4, 2011
Life on which depreciation in latest income statements is computed (Years)	20 years
Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 7,581
Buildings at cost	7,581
Total at cost	7,581
Accumulated Depreciation	$ 369
Date of Construction	2,015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
Hoover, AL [Member ]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, buildings	$ 1,034
Buildings at cost	1,034
Total at cost	1,034
Accumulated Depreciation	$ 50
Date of Construction	2,015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
Hot Springs, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,100
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	19,113
Land at cost	7,100
Buildings at cost	78,545
Total at cost	85,645
Accumulated Depreciation	$ 2,480
Date of Construction	1,985
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Highlands Ranch, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,200
Initial costs, buildings	4,763
Land at cost	4,200
Buildings at cost	4,763
Total at cost	8,963
Accumulated Depreciation	$ 50
Date of Construction	2,016
Date Acquired	Jul. 25, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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, carrying costs	4,665
Land at cost	1,822
Buildings at cost	42,132
Total at cost	43,954
Accumulated Depreciation	$ 9,086
Date of Construction	2,002
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 3,146
Date of Construction	1,978
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,671
Buildings at cost	4,671
Total at cost	4,671
Accumulated Depreciation	$ 29
Date of Construction	2,016
Date Acquired	Oct. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	$ 384
Date of Construction	2,004
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	20 years
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	$ 1,450
Date of Construction	2,013
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Little Elm, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,241
Initial costs, buildings	3,491
Land at cost	1,241
Buildings at cost	3,491
Total at cost	4,732
Accumulated Depreciation	$ 266
Date of Construction	2,013
Date Acquired	Dec. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Longmont, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,770
Buildings at cost	4,770
Total at cost	4,770
Accumulated Depreciation	$ 109
Date of Construction	2,016
Date Acquired	Feb. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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	705
Land at cost	1,376
Buildings at cost	28,997
Total at cost	30,373
Accumulated Depreciation	$ 1,072
Date of Construction	2,008
Date Acquired	Jun. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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	5,004
Land at cost	2,800
Buildings at cost	5,004
Total at cost	7,804
Accumulated Depreciation	$ 21
Date of Construction	2,016
Date Acquired	Oct. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Marrero, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 5,756
Buildings at cost	5,756
Total at cost	5,756
Accumulated Depreciation	$ 72
Date of Construction	2,016
Date Acquired	Jul. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
McKinney, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,060
Buildings at cost	4,060
Total at cost	4,060
Accumulated Depreciation	$ 193
Date of Construction	2,015
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
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	$ 1,663
Date of Construction	1,996
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	41 years
Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,900
Initial costs, buildings	97,980
Additions subsequent to acquisition, Improvements	2,242
Land at cost	7,142
Buildings at cost	97,980
Total at cost	105,122
Accumulated Depreciation	$ 8,576
Date of Construction	2,007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Land at cost	23,809
Buildings at cost	89,505
Total at cost	113,314
Accumulated Depreciation	$ 638
Date of Construction	2,011
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
Bloomington, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,392
Initial costs, buildings	28,212
Additions subsequent to acquisition, Improvements	5,000
Additions subsequent to acquisition, carrying costs	408
Land at cost	2,392
Buildings at cost	33,620
Total at cost	36,012
Accumulated Depreciation	$ 8,483
Date of Construction	2,006
Date Acquired	Aug. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
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	99,632
Additions subsequent to acquisition, Improvements	585
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	$ 7,152
Date of Construction	2,000
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Muskogee, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,420
Initial costs, buildings	51,953
Land at cost	1,420
Buildings at cost	51,953
Total at cost	53,373
Accumulated Depreciation	$ 1,046
Date of Construction	2,009
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,837
Buildings at cost	4,837
Total at cost	4,837
Accumulated Depreciation	$ 20
Date of Construction	2,016
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Colorado Springs, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 600
Initial costs, buildings	4,231
Land at cost	600
Buildings at cost	4,231
Total at cost	4,831
Accumulated Depreciation	$ 274
Date of Construction	2,014
Date Acquired	Jun. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Encumbrances	$ 13,101
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	$ 2,542
Date of Construction	2,007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 1,695
Date of Construction	2,014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 1,150
Date of Construction	2,014
Date Acquired	Mar. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Olympia, Washington [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,220
Initial costs, buildings	89,348
Land at cost	7,220
Buildings at cost	89,348
Total at cost	96,568
Accumulated Depreciation	$ 993
Date of Construction	1,984
Date Acquired	Jul. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 926
Date of Construction	2,012
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Parker, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,301
Initial costs, buildings	4,448
Land at cost	1,301
Buildings at cost	4,448
Total at cost	5,749
Accumulated Depreciation	$ 130
Date of Construction	2,015
Date Acquired	Nov. 6, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 209
Date of Construction	2,014
Date Acquired	Sep. 8, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 1,938
Date of Construction	2,006
Date Acquired	Jul. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Plano Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 5,060
Buildings at cost	5,060
Total at cost	5,060
Accumulated Depreciation	$ 32
Date of Construction	2,016
Date Acquired	Sep. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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
Additions subsequent to acquisition, carrying costs	1
Land at cost	2,660
Buildings at cost	38,694
Total at cost	41,354
Accumulated Depreciation	$ 8,400
Date of Construction	1,980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Port Arthur, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,000
Initial costs, buildings	72,341
Additions subsequent to acquisition, Improvements	1,062
Land at cost	4,062
Buildings at cost	72,341
Total at cost	76,403
Accumulated Depreciation	$ 6,071
Date of Construction	2,005
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,029
Initial costs, buildings	14,622
Land at cost	3,029
Buildings at cost	14,622
Total at cost	17,651
Accumulated Depreciation	$ 490
Date of Construction	1,983
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Portland, OR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 3,085
Initial costs, buildings	17,859
Additions subsequent to acquisition, carrying costs	2,559
Land at cost	3,071
Buildings at cost	20,432
Total at cost	23,503
Accumulated Depreciation	$ 4,897
Date of Construction	1,964
Date Acquired	Apr. 18, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
Post Falls, ID [Member]
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	$ 1,039
Date of Construction	2,013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, buildings	$ 19,952
Additions subsequent to acquisition, carrying costs	4,360
Land at cost	1,629
Buildings at cost	22,683
Total at cost	24,312
Accumulated Depreciation	$ 6,406
Date of Construction	1,991
Date Acquired	Jun. 30, 2005
Life on which depreciation in latest income statements is computed (Years)	40 years
Rosenberg, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,731
Buildings at cost	4,731
Total at cost	4,731
Accumulated Depreciation	$ 118
Date of Construction	2,016
Date Acquired	Jan. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 1,915
Initial costs, buildings	5,085
Additions subsequent to acquisition, carrying costs	18
Land at cost	1,915
Buildings at cost	5,103
Total at cost	7,018
Accumulated Depreciation	$ 1,033
Date of Construction	1,979
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 1,418
Date of Construction	2,010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Sienna, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 999
Initial costs, buildings	3,591
Land at cost	999
Buildings at cost	3,591
Total at cost	4,590
Accumulated Depreciation	$ 209
Date of Construction	2,014
Date Acquired	Aug. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
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	$ 1,325
Date of Construction	2,013
Date Acquired	Aug. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,433
Land at cost	4,428
Buildings at cost	73,433
Total at cost	77,861
Accumulated Depreciation	$ 488
Date of Construction	2,015
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
Thornton, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,350
Initial costs, buildings	4,259
Land at cost	1,350
Buildings at cost	4,259
Total at cost	5,609
Accumulated Depreciation	$ 248
Date of Construction	2,014
Date Acquired	Aug. 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Toledo, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 17,740
Buildings at cost	17,740
Total at cost	17,740
Accumulated Depreciation	$ 333
Date of Construction	2,016
Date Acquired	Apr. 1, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
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	23,982
Land at cost	1,299
Buildings at cost	23,982
Total at cost	25,281
Accumulated Depreciation	$ 3,597
Date of Construction	2,005
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
League City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 3,901
Buildings at cost	3,901
Total at cost	3,901
Accumulated Depreciation	$ 146
Date of Construction	2,015
Date Acquired	Jun. 19, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Anaheim, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,875
Initial costs, buildings	21,814
Additions subsequent to acquisition, carrying costs	10
Land at cost	1,875
Buildings at cost	21,824
Total at cost	23,699
Accumulated Depreciation	$ 5,547
Date of Construction	1,964
Date Acquired	Nov. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
West Monroe, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,000
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	552
Land at cost	12,552
Buildings at cost	69,433
Total at cost	81,985
Accumulated Depreciation	$ 5,822
Date of Construction	1,962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
West Valley City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,516
Initial costs, buildings	58,314
Additions subsequent to acquisition, Improvements	2,036
Additions subsequent to acquisition, carrying costs	(114)
Land at cost	5,402
Buildings at cost	60,350
Total at cost	65,752
Accumulated Depreciation	$ 12,716
Date of Construction	1,980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
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	18,373
Additions subsequent to acquisition, carrying costs	1
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	$ 4,018
Date of Construction	1,992
Date Acquired	Apr. 4, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Bad Rappenau, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 9,159
Buildings at cost	9,159
Total at cost	9,159
Accumulated Depreciation	$ 706
Date of Construction	1,994
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Bad Liebenwerda, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 335
Initial costs, buildings	17,307
Land at cost	335
Buildings at cost	17,307
Total at cost	17,642
Accumulated Depreciation	$ 1,334
Date of Construction	1,994
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Grunheide, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,674
Initial costs, buildings	39,306
Additions subsequent to acquisition, Improvements	321
Land at cost	2,995
Buildings at cost	39,306
Total at cost	42,301
Accumulated Depreciation	$ 1,422
Date of Construction	1,994
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1996 [Member] | Dahlen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 360
Initial costs, buildings	19,863
Land at cost	360
Buildings at cost	19,863
Total at cost	20,223
Accumulated Depreciation	$ 1,531
Date of Construction	1,996
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1996 [Member] | Bad Kosen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,203
Initial costs, buildings	7,095
Land at cost	1,203
Buildings at cost	7,095
Total at cost	8,298
Accumulated Depreciation	$ 30
Date of Construction	1,996
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Bad Durkheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,074
Initial costs, buildings	14,531
Land at cost	3,074
Buildings at cost	14,531
Total at cost	17,605
Accumulated Depreciation	$ 1,120
Date of Construction	1,960
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Bad Durrheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,346
Initial costs, buildings	11,038
Additions subsequent to acquisition, Improvements	221
Land at cost	1,567
Buildings at cost	11,038
Total at cost	12,605
Accumulated Depreciation	$ 412
Date of Construction	1,960
Date Acquired	Jul. 24, 2015
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	$ 3,501
Initial costs, buildings	34,530
Additions subsequent to acquisition, Improvements	8,477
Additions subsequent to acquisition, carrying costs	16,589
Land at cost	3,274
Buildings at cost	59,823
Total at cost	63,097
Accumulated Depreciation	$ 9,663
Date of Construction	1,960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 1,418
Date of Construction	1,960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Ortenberg, Germany[Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 89
Initial costs, buildings	5,070
Land at cost	89
Buildings at cost	5,070
Total at cost	5,159
Accumulated Depreciation	$ 391
Date of Construction	1,981
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1977 [Member] | Wiesbaden, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,980
Initial costs, buildings	14,334
Land at cost	2,980
Buildings at cost	14,334
Total at cost	17,314
Accumulated Depreciation	$ 1,105
Date of Construction	1,977
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bad Durkheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 28,758
Buildings at cost	28,758
Total at cost	28,758
Accumulated Depreciation	$ 2,217
Date of Construction	1,992
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bad Kosen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,189
Initial costs, buildings	6,941
Land at cost	1,189
Buildings at cost	6,941
Total at cost	8,130
Accumulated Depreciation	$ 29
Date of Construction	1,992
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1904 [Member] | Bad Liebenwerda, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 522
Initial costs, buildings	14,469
Land at cost	522
Buildings at cost	14,469
Total at cost	14,991
Accumulated Depreciation	$ 1,115
Date of Construction	1,904
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] | Bad Liebenwerda, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 522
Initial costs, buildings	14,469
Land at cost	522
Buildings at cost	14,469
Total at cost	14,991
Accumulated Depreciation	$ 1,115
Date of Construction	1,995
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member] | Flechtingen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,692
Initial costs, buildings	21,291
Additions subsequent to acquisition, Improvements	210
Land at cost	2,902
Buildings at cost	21,291
Total at cost	24,193
Accumulated Depreciation	$ 819
Date of Construction	1,995
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Bad Durkheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 705
Initial costs, buildings	6,337
Land at cost	705
Buildings at cost	6,337
Total at cost	7,042
Accumulated Depreciation	$ 488
Date of Construction	1,980
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Bad Bertrich, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 631
Initial costs, buildings	3,787
Land at cost	631
Buildings at cost	3,787
Total at cost	4,418
Accumulated Depreciation	$ 8
Date of Construction	1,980
Date Acquired	Nov. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1930 [Member] | Bad Durkheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,649
Initial costs, buildings	15,597
Land at cost	5,649
Buildings at cost	15,597
Total at cost	21,246
Accumulated Depreciation	$ 1,202
Date of Construction	1,930
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1930 [Member] | Bad Hersfield, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 507
Initial costs, buildings	3,773
Additions subsequent to acquisition, Improvements	29
Land at cost	536
Buildings at cost	3,773
Total at cost	$ 4,309
Date of Construction	1,930
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 [Member] | Bad Rappenau, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,312
Initial costs, buildings	5,642
Land at cost	3,312
Buildings at cost	5,642
Total at cost	8,954
Accumulated Depreciation	$ 435
Date of Construction	1,986
Date Acquired	Nov. 30, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Bad Tolz, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,134
Initial costs, buildings	9,187
Land at cost	2,134
Buildings at cost	9,187
Total at cost	11,321
Accumulated Depreciation	$ 478
Date of Construction	1,974
Date Acquired	Nov. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,555
Initial costs, buildings	53,863
Additions subsequent to acquisition, carrying costs	13
Land at cost	1,555
Buildings at cost	53,876
Total at cost	55,431
Accumulated Depreciation	$ 12,692
Date of Construction	1,974
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1954 [Member] | Bad Liebenstein [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,554
Initial costs, buildings	32,836
Land at cost	1,554
Buildings at cost	32,836
Total at cost	34,390
Accumulated Depreciation	$ 1,779
Date of Construction	1,954
Date Acquired	Nov. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1954 [Member] | Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	$ 384
Date of Construction	1,954
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	20 years
1988 [Member] | Bad Mergentheim [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 10,891
Buildings at cost	10,891
Total at cost	10,891
Accumulated Depreciation	$ 567
Date of Construction	1,988
Date Acquired	Dec. 11, 2014
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	$ 1,463
Initial costs, buildings	30,316
Land at cost	1,463
Buildings at cost	30,316
Total at cost	31,779
Accumulated Depreciation	$ 1,895
Date of Construction	2,008
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1956 [Member] | Ottenhofen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,182
Initial costs, buildings	12,278
Additions subsequent to acquisition, Improvements	105
Land at cost	2,287
Buildings at cost	12,278
Total at cost	14,565
Accumulated Depreciation	$ 471
Date of Construction	1,956
Date Acquired	Jul. 3, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Bernkastel-Kues, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 757
Initial costs, buildings	10,926
Additions subsequent to acquisition, Improvements	126
Land at cost	883
Buildings at cost	10,926
Total at cost	11,809
Accumulated Depreciation	$ 422
Date of Construction	1,993
Date Acquired	Jul. 14, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Flechtingen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,692
Initial costs, buildings	21,291
Additions subsequent to acquisition, Improvements	210
Land at cost	2,902
Buildings at cost	21,291
Total at cost	24,193
Accumulated Depreciation	$ 819
Date of Construction	1,993
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Baden-Baden, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,230
Initial costs, buildings	8,652
Additions subsequent to acquisition, Improvements	121
Land at cost	1,351
Buildings at cost	8,652
Total at cost	10,003
Accumulated Depreciation	$ 337
Date of Construction	1,900
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Lubeck, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 673
Initial costs, buildings	4,922
Additions subsequent to acquisition, Improvements	38
Land at cost	711
Buildings at cost	4,922
Total at cost	$ 5,633
Date of Construction	1,900
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Baden-Baden, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,230
Initial costs, buildings	8,652
Additions subsequent to acquisition, Improvements	121
Land at cost	1,351
Buildings at cost	8,652
Total at cost	10,003
Accumulated Depreciation	$ 337
Date of Construction	2,002
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Renovations in 1997 [Member] | Hannover, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,081
Initial costs, buildings	14,562
Additions subsequent to acquisition, Improvements	300
Land at cost	3,381
Buildings at cost	14,562
Total at cost	17,943
Accumulated Depreciation	$ 416
Date of Construction	1,997
Date Acquired	Dec. 1, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Renovations in 2000 [Member] | Hannover, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,081
Initial costs, buildings	14,562
Additions subsequent to acquisition, Improvements	300
Land at cost	3,381
Buildings at cost	14,562
Total at cost	17,943
Accumulated Depreciation	$ 416
Date of Construction	2,000
Date Acquired	Dec. 1, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Renovations in 2009 [Member] | Hannover, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,081
Initial costs, buildings	14,562
Additions subsequent to acquisition, Improvements	300
Land at cost	3,381
Buildings at cost	14,562
Total at cost	17,943
Accumulated Depreciation	$ 416
Date of Construction	2,009
Date Acquired	Dec. 1, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1999 [Member] | Magdeburg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 13,931
Initial costs, buildings	51,674
Additions subsequent to acquisition, Improvements	242
Land at cost	14,173
Buildings at cost	51,674
Total at cost	65,847
Accumulated Depreciation	$ 1,853
Date of Construction	1,999
Date Acquired	Jul. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Bad Nauheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,704
Initial costs, buildings	8,906
Additions subsequent to acquisition, Improvements	53
Land at cost	1,757
Buildings at cost	8,906
Total at cost	10,663
Accumulated Depreciation	$ 339
Date of Construction	1,972
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	3,928
Land at cost	1,277
Buildings at cost	15,952
Total at cost	17,229
Accumulated Depreciation	$ 857
Date of Construction	1,972
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,160
Initial costs, buildings	6,839
Additions subsequent to acquisition, carrying costs	34
Land at cost	6,160
Buildings at cost	6,873
Total at cost	13,033
Accumulated Depreciation	$ 1,390
Date of Construction	1,972
Date Acquired	Nov. 25, 2008
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	$ 5,757
Initial costs, buildings	33,689
Additions subsequent to acquisition, Improvements	438
Land at cost	6,195
Buildings at cost	33,689
Total at cost	39,884
Accumulated Depreciation	$ 436
Date of Construction	1,885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1910 [Member] | Bad Bertrich, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 631
Initial costs, buildings	3,787
Land at cost	631
Buildings at cost	3,787
Total at cost	4,418
Accumulated Depreciation	$ 8
Date of Construction	1,910
Date Acquired	Nov. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Bad Bertrich, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 631
Initial costs, buildings	3,787
Land at cost	631
Buildings at cost	3,787
Total at cost	4,418
Accumulated Depreciation	$ 8
Date of Construction	1,985
Date Acquired	Nov. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1800 [Member] | Vitense-Parber, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 540
Initial costs, buildings	3,938
Additions subsequent to acquisition, Improvements	30
Land at cost	570
Buildings at cost	3,938
Total at cost	$ 4,508
Date of Construction	1,800
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1901 [Member] | Breuberg-Sandbach, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,554
Initial costs, buildings	11,485
Additions subsequent to acquisition, Improvements	88
Land at cost	1,642
Buildings at cost	11,485
Total at cost	$ 13,127
Date of Construction	1,901
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1860 [Member] | Ravensrush, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 407
Initial costs, buildings	3,199
Additions subsequent to acquisition, Improvements	25
Land at cost	432
Buildings at cost	3,199
Total at cost	$ 3,631
Date of Construction	1,860
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1600 [Member] | Wildeck, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 731
Initial costs, buildings	5,250
Additions subsequent to acquisition, Improvements	40
Land at cost	771
Buildings at cost	5,250
Total at cost	$ 6,021
Date of Construction	1,600
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1902 [Member] | Romhild, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 169
Initial costs, buildings	8,039
Additions subsequent to acquisition, Improvements	62
Land at cost	231
Buildings at cost	8,039
Total at cost	$ 8,270
Date of Construction	1,902
Date Acquired	Dec. 31, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,663
Initial costs, buildings	52,432
Land at cost	12,663
Buildings at cost	52,432
Total at cost	65,095
Accumulated Depreciation	$ 7,755
Date of Construction	1,973
Date Acquired	Feb. 9, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,029
Initial costs, buildings	14,622
Land at cost	3,029
Buildings at cost	14,622
Total at cost	17,651
Accumulated Depreciation	$ 490
Date of Construction	1,973
Date Acquired	Dec. 31, 2015
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	4,576
Land at cost	950
Buildings at cost	4,576
Total at cost	5,526
Accumulated Depreciation	$ 29
Date of Construction	2,016
Date Acquired	Sep. 26, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Glendale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,144
Initial costs, buildings	6,005
Land at cost	1,144
Buildings at cost	6,005
Total at cost	7,149
Accumulated Depreciation	$ 25
Date of Construction	2,016
Date Acquired	Oct. 21, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | DeSoto, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,569
Land at cost	750
Buildings at cost	4,569
Total at cost	5,319
Accumulated Depreciation	$ 67
Date of Construction	2,016
Date Acquired	May 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, buildings	$ 5,157
Buildings at cost	5,157
Total at cost	5,157
Accumulated Depreciation	$ 11
Date of Construction	2,016
Date Acquired	Dec. 9, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Frisco, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,735
Buildings at cost	4,735
Total at cost	4,735
Accumulated Depreciation	$ 99
Date of Construction	2,016
Date Acquired	Mar. 4, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1917 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,638
Initial costs, buildings	147,266
Land at cost	18,638
Buildings at cost	147,266
Total at cost	165,904
Accumulated Depreciation	$ 922
Date of Construction	1,917
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1965 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,141
Initial costs, buildings	66,562
Land at cost	18,141
Buildings at cost	66,562
Total at cost	84,703
Accumulated Depreciation	$ 526
Date of Construction	1,965
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2015 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,423
Initial costs, buildings	3,770
Land at cost	1,423
Buildings at cost	3,770
Total at cost	5,193
Accumulated Depreciation	$ 173
Date of Construction	2,015
Date Acquired	Feb. 18, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 4,783
Buildings at cost	4,783
Total at cost	4,783
Accumulated Depreciation	$ 199
Date of Construction	2,015
Date Acquired	Apr. 24, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,345
Initial costs, buildings	3,678
Land at cost	1,345
Buildings at cost	3,678
Total at cost	5,023
Accumulated Depreciation	$ 230
Date of Construction	2,014
Date Acquired	Jun. 20, 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	$ 271
Date of Construction	2,014
Date Acquired	Jan. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1939 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	12,301
Additions subsequent to acquisition, Improvements	3,928
Land at cost	1,277
Buildings at cost	15,952
Total at cost	17,229
Accumulated Depreciation	$ 857
Date of Construction	1,939
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,406
Initial costs, buildings	82,358
Land at cost	2,406
Buildings at cost	82,358
Total at cost	84,764
Accumulated Depreciation	$ 526
Date of Construction	1,950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Land at cost	23,809
Buildings at cost	89,505
Total at cost	113,314
Accumulated Depreciation	$ 638
Date of Construction	1,950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2015 [Member] | Frisco, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,441
Initial costs, buildings	4,474
Land at cost	2,441
Buildings at cost	4,474
Total at cost	6,915
Accumulated Depreciation	$ 130
Date of Construction	2,015
Date Acquired	Nov. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 862
Initial costs, buildings	7,888
Additions subsequent to acquisition, carrying costs	28
Land at cost	862
Buildings at cost	7,916
Total at cost	8,778
Accumulated Depreciation	$ 1,603
Date of Construction	1,982
Date Acquired	Nov. 25, 2008
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	99,632
Additions subsequent to acquisition, Improvements	585
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	$ 7,152
Date of Construction	1,920
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1959 [Member] | Muskogee, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,420
Initial costs, buildings	51,953
Land at cost	1,420
Buildings at cost	51,953
Total at cost	53,373
Accumulated Depreciation	$ 1,046
Date of Construction	1,959
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2006 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,757
Initial costs, buildings	56,238
Additions subsequent to acquisition, Improvements	(37)
Additions subsequent to acquisition, carrying costs	1,259
Land at cost	5,427
Buildings at cost	56,790
Total at cost	62,217
Accumulated Depreciation	$ 14,270
Date of Construction	2,006
Date Acquired	Dec. 1, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
1953 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,029
Initial costs, buildings	14,622
Land at cost	3,029
Buildings at cost	14,622
Total at cost	17,651
Accumulated Depreciation	$ 490
Date of Construction	1,953
Date Acquired	Dec. 31, 2015
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	$ 4,491
Initial costs, buildings	24,802
Land at cost	4,491
Buildings at cost	24,802
Total at cost	29,293
Accumulated Depreciation	$ 1,418
Date of Construction	1,913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1940 [Member] | Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,433
Land at cost	4,428
Buildings at cost	73,433
Total at cost	77,861
Accumulated Depreciation	$ 488
Date of Construction	1,940
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years

Schedule III - Real Estate I102

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Thousands	Dec. 31, 2016USD ($)
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 4,471,179

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 2,991,590	$ 2,040,727	$ 1,733,194
Acquisitions	745,948	975,239	263,811
Transfers from construction in progress	163,080	23,163	41,772
Additions	33,279	7,376	84,831
Dispositions	(138,886)	(24,701)	(56,590)
Other	173,031	(30,214)	(26,291)
Balance at end of period	$ 3,968,042	$ 2,991,590	$ 2,040,727

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
SEC Schedule III, Real Estate and Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 232,675	$ 181,441	$ 144,235
Depreciation	81,010	60,796	46,935
Depreciation on disposed property	(19,086)	(8,887)	(9,213)
Other	(1,813)	(675)	(516)
Balance at end of period	$ 292,786	$ 232,675	$ 181,441

Schedule IV - Schedule of Mortg

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail)	12 Months Ended
	Dec. 31, 2016USD ($)
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	1,060,336,000
Carrying Amount of Mortgages	1,060,336,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthly installments of interest plus principal payable in full at maturity
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.00%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 70,000,000
Carrying Amount of Mortgages	70,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.60%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 20,000,000
Carrying Amount of Mortgages	20,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.00%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 12,500,000
Carrying Amount of Mortgages	12,500,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Chino Valley Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.00%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 50,000,000
Carrying Amount of Mortgages	50,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Paradise Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	10.60%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 25,000,000
Carrying Amount of Mortgages	25,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Ernest Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	9.60%
Final Maturity Date	2,032
Face Amount of Mortgages	$ 112,836,000
Carrying Amount of Mortgages	112,836,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Centinela Hospital Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.00%
Final Maturity Date	2,022
Face Amount of Mortgages	$ 100,000,000
Carrying Amount of Mortgages	100,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Olympia Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	11.20%
Final Maturity Date	2,024
Face Amount of Mortgages	$ 20,000,000
Carrying Amount of Mortgages	20,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | St. Joseph Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	8.50%
Final Maturity Date	2,025
Face Amount of Mortgages	$ 30,000,000
Carrying Amount of Mortgages	30,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | St. Mary's Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	8.50%
Final Maturity Date	2,025
Face Amount of Mortgages	$ 10,000,000
Carrying Amount of Mortgages	10,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Lake Huron Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	8.50%
Final Maturity Date	2,020
Face Amount of Mortgages	$ 10,000,000
Carrying Amount of Mortgages	10,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Steward Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Interest rate	7.50%
Final Maturity Date	2,031
Face Amount of Mortgages	$ 600,000,000
Carrying Amount of Mortgages	600,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0

Schedule IV - Schedule of Mo106

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	Dec. 31, 2016USD ($)Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	1,060,000
Unamortized loan issue costs	$ 100,000
Ernest Mortgage Loan [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	4
Capella Mortgage Loan [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	4

Schedule IV - Changes in Mortga

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Mortgage Loans on Real Estate [Abstract]
Balance at beginning of year	$ 757,500	$ 397,500	$ 388,650
New mortgage loans and additional advances on existing loans	612,836	380,000	12,500
Mortgage loans on real estate including additions during year	1,370,336	777,500	401,150
Collection of principal	(310,000)	(20,000)	(3,650)
Deductions during year	(310,000)	(20,000)	(3,650)
Balance at end of year	$ 1,060,336	$ 757,500	$ 397,500