Document and Entity Information
Document and Entity Information - shares | 9 Months Ended | |
Sep. 30, 2018 | Nov. 02, 2018 | |
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Sep. 30, 2018 | |
Document Fiscal Year Focus | 2,018 | |
Document Fiscal Period Focus | Q3 | |
Trading Symbol | MPW | |
Entity Registrant Name | MEDICAL PROPERTIES TRUST INC | |
Entity Central Index Key | 1,287,865 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Common Stock, Shares Outstanding | 364,941,199 | |
MPT Operating Partnership, L.P. [Member] | ||
Document Information [Line Items] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Sep. 30, 2018 | |
Document Fiscal Year Focus | 2,018 | |
Document Fiscal Period Focus | Q3 | |
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 | |
Entity Small Business | false | |
Entity Emerging Growth Company | false |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 |
Real estate assets | ||
Land, buildings and improvements, intangible lease assets, and other | $ 4,926,462 | $ 5,944,220 |
Mortgage loans | 1,428,069 | 1,778,316 |
Net investment in direct financing leases | 690,897 | 698,727 |
Gross investment in real estate assets | 7,045,428 | 8,421,263 |
Accumulated depreciation and amortization | (432,279) | (455,712) |
Net investment in real estate assets | 6,613,149 | 7,965,551 |
Cash and cash equivalents | 710,965 | 171,472 |
Interest and rent receivables | 87,939 | 78,970 |
Straight-line rent receivables | 195,329 | 185,592 |
Other loans | 482,453 | 150,209 |
Other assets | 684,681 | 468,494 |
Total Assets | 8,774,516 | 9,020,288 |
Liabilities | ||
Debt, net | 4,043,849 | 4,898,667 |
Accounts payable and accrued expenses | 202,033 | 211,188 |
Deferred revenue | 11,162 | 18,178 |
Lease deposits and other obligations to tenants | 30,964 | 57,050 |
Total liabilities | 4,288,008 | 5,185,083 |
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 — 364,858 shares at September 30, 2018 and 364,424 shares at December 31, 2017 | 365 | 364 |
Limited Partners: | ||
Additional paid-in capital | 4,343,768 | 4,333,027 |
Retained earnings (deficit) | 179,703 | (485,932) |
Accumulated other comprehensive loss | (50,569) | (26,049) |
Treasury shares, at cost | (777) | (777) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 4,472,490 | 3,820,633 |
Non-controlling interests | 14,018 | 14,572 |
Total Equity / Capital | 4,486,508 | 3,835,205 |
Total Liabilities and Equity / Capital | 8,774,516 | 9,020,288 |
MPT Operating Partnership, L.P. [Member] | ||
Real estate assets | ||
Land, buildings and improvements, intangible lease assets, and other | 4,926,462 | 5,944,220 |
Mortgage loans | 1,428,069 | 1,778,316 |
Net investment in direct financing leases | 690,897 | 698,727 |
Gross investment in real estate assets | 7,045,428 | 8,421,263 |
Accumulated depreciation and amortization | (432,279) | (455,712) |
Net investment in real estate assets | 6,613,149 | 7,965,551 |
Cash and cash equivalents | 710,965 | 171,472 |
Interest and rent receivables | 87,939 | 78,970 |
Straight-line rent receivables | 195,329 | 185,592 |
Other loans | 482,453 | 150,209 |
Other assets | 684,681 | 468,494 |
Total Assets | 8,774,516 | 9,020,288 |
Liabilities | ||
Debt, net | 4,043,849 | 4,898,667 |
Accounts payable and accrued expenses | 110,155 | 121,465 |
Deferred revenue | 11,162 | 18,178 |
Lease deposits and other obligations to tenants | 30,964 | 57,050 |
Payable due to Medical Properties Trust, Inc. | 91,488 | 89,333 |
Total liabilities | 4,287,618 | 5,184,693 |
Limited Partners: | ||
Accumulated other comprehensive loss | (50,569) | (26,049) |
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital) | 4,472,880 | 3,821,023 |
Non-controlling interests | 14,018 | 14,572 |
Total Equity / Capital | 4,486,898 | 3,835,595 |
Total Liabilities and Equity / Capital | 8,774,516 | 9,020,288 |
MPT Operating Partnership, L.P. [Member] | General Partner [Member] | ||
Equity / Capital | ||
General Partner — issued and outstanding — 3,648 units at September 30, 2018 and 3,644 units at December 31, 2017 | 45,261 | 38,489 |
MPT Operating Partnership, L.P. [Member] | Common Units [Member] | ||
Limited Partners: | ||
Limited Partners Capital | $ 4,478,188 | $ 3,808,583 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares | Sep. 30, 2018 | Dec. 31, 2017 |
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 | 364,858,000 | 364,424,000 |
Common stock, shares outstanding | 364,858,000 | 364,424,000 |
MPT Operating Partnership, L.P. [Member] | Common Units [Member] | ||
Limited Partners, units issued | 361,210,000 | 360,780,000 |
Limited Partners, units outstanding | 361,210,000 | 360,780,000 |
General Partner [Member] | MPT Operating Partnership, L.P. [Member] | ||
General partner, units issued | 3,648,000 | 3,644,000 |
General partner, units outstanding | 3,648,000 | 3,644,000 |
LTIP Units [Member] | MPT Operating Partnership, L.P. [Member] | ||
LTIP Units, shares issued | 232,000 | 292,000 |
LTIP Units, shares outstanding | 232,000 | 292,000 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Net Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017 | |
Revenues | ||||
Rent billed | $ 118,238 | $ 110,930 | $ 369,076 | $ 311,140 |
Straight-line rent | 18,293 | 17,505 | 49,157 | 46,561 |
Income from direct financing leases | 18,998 | 19,115 | 55,613 | 55,307 |
Interest and fee income | 41,467 | 29,030 | 130,098 | 86,776 |
Total revenues | 196,996 | 176,580 | 603,944 | 499,784 |
Expenses | ||||
Interest | 57,215 | 42,759 | 172,364 | 120,498 |
Real estate depreciation and amortization | 29,949 | 31,915 | 100,217 | 88,994 |
Property-related | 2,719 | 1,519 | 6,823 | 4,000 |
General and administrative | 20,982 | 15,011 | 58,352 | 43,287 |
Acquisition costs | 506 | 7,434 | 917 | 20,996 |
Total expenses | 111,371 | 98,638 | 338,673 | 277,775 |
Other income (expense) | ||||
Gain on sale of real estate and other, net | 647,204 | 18 | 672,822 | 7,431 |
Debt refinancing costs | (4,414) | (18,794) | ||
Other | 5,711 | 3,865 | 6,245 | 8,999 |
Total other income (expense) | 652,915 | (531) | 679,067 | (2,364) |
Income before income tax | 738,540 | 77,411 | 944,338 | 219,645 |
Income tax expense | (2,064) | (530) | (4,802) | (783) |
Net income | 736,476 | 76,881 | 939,536 | 218,862 |
Net income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 736,034 | $ 76,464 | $ 938,202 | $ 217,849 |
Earnings per common share — basic | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.01 | $ 0.21 | $ 2.56 | $ 0.63 |
Earnings per common share — diluted | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2 | $ 0.21 | $ 2.56 | $ 0.63 |
Weighted average shares outstanding - basic | 365,024 | 364,315 | 364,934 | 345,076 |
Weighted average shares outstanding - diluted | 366,467 | 365,046 | 365,784 | 345,596 |
Dividends declared per common share | $ 0.25 | $ 0.24 | $ 0.75 | $ 0.72 |
MPT Operating Partnership, L.P. [Member] | ||||
Revenues | ||||
Rent billed | $ 118,238 | $ 110,930 | $ 369,076 | $ 311,140 |
Straight-line rent | 18,293 | 17,505 | 49,157 | 46,561 |
Income from direct financing leases | 18,998 | 19,115 | 55,613 | 55,307 |
Interest and fee income | 41,467 | 29,030 | 130,098 | 86,776 |
Total revenues | 196,996 | 176,580 | 603,944 | 499,784 |
Expenses | ||||
Interest | 57,215 | 42,759 | 172,364 | 120,498 |
Real estate depreciation and amortization | 29,949 | 31,915 | 100,217 | 88,994 |
Property-related | 2,719 | 1,519 | 6,823 | 4,000 |
General and administrative | 20,982 | 15,011 | 58,352 | 43,287 |
Acquisition costs | 506 | 7,434 | 917 | 20,996 |
Total expenses | 111,371 | 98,638 | 338,673 | 277,775 |
Other income (expense) | ||||
Gain on sale of real estate and other, net | 647,204 | 18 | 672,822 | 7,431 |
Debt refinancing costs | (4,414) | (18,794) | ||
Other | 5,711 | 3,865 | 6,245 | 8,999 |
Total other income (expense) | 652,915 | (531) | 679,067 | (2,364) |
Income before income tax | 738,540 | 77,411 | 944,338 | 219,645 |
Income tax expense | (2,064) | (530) | (4,802) | (783) |
Net income | 736,476 | 76,881 | 939,536 | 218,862 |
Net income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 736,034 | $ 76,464 | $ 938,202 | $ 217,849 |
Earnings per common share — basic | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2.01 | $ 0.21 | $ 2.56 | $ 0.63 |
Earnings per common share — diluted | ||||
Net income attributable to MPT common stockholders (Operating Partnership partners) | $ 2 | $ 0.21 | $ 2.56 | $ 0.63 |
Weighted average shares outstanding - basic | 365,024 | 364,315 | 364,934 | 345,076 |
Weighted average shares outstanding - diluted | 366,467 | 365,046 | 365,784 | 345,596 |
Dividends declared per common share | $ 0.25 | $ 0.24 | $ 0.75 | $ 0.72 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Comprehensive Income (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017 | |
Net income | $ 736,476 | $ 76,881 | $ 939,536 | $ 218,862 |
Other comprehensive income: | ||||
Foreign currency translation (loss) gain | (8,216) | 17,426 | (24,520) | 57,738 |
Total comprehensive income | 728,260 | 94,307 | 915,016 | 276,600 |
Comprehensive income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | 727,818 | 93,890 | 913,682 | 275,587 |
MPT Operating Partnership, L.P. [Member] | ||||
Net income | 736,476 | 76,881 | 939,536 | 218,862 |
Other comprehensive income: | ||||
Foreign currency translation (loss) gain | (8,216) | 17,426 | (24,520) | 57,738 |
Total comprehensive income | 728,260 | 94,307 | 915,016 | 276,600 |
Comprehensive income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners) | $ 727,818 | $ 93,890 | $ 913,682 | $ 275,587 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2018 | Sep. 30, 2017 | |
Operating activities | ||
Net income | $ 939,536 | $ 218,862 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 106,508 | 93,805 |
Amortization of deferred financing costs and debt discount | 5,543 | 4,748 |
Direct financing lease interest accretion | (7,213) | (7,276) |
Straight-line rent revenue | (64,840) | (47,678) |
Share / (Unit)-based compensation expense | 11,695 | 7,148 |
Gain from sale of real estate and other, net | (672,822) | (7,431) |
Straight-line rent and other write-off | 17,615 | 1,117 |
Debt refinancing costs | 18,794 | |
Other adjustments | (21,354) | (7,140) |
Changes in: | ||
Interest and rent receivables | (10,158) | (14,613) |
Accounts payable and accrued expenses | (5,387) | (40,378) |
Net cash provided by operating activities | 299,123 | 219,958 |
Investing activities | ||
Cash paid for acquisitions and other related investments | (1,166,618) | (2,152,069) |
Net proceeds from sale of real estate | 1,513,666 | 64,362 |
Principal received on loans receivable | 531,772 | 6,760 |
Investment in loans receivable | (174,494) | (18,574) |
Construction in progress and other | (32,425) | (52,953) |
Other investments, net | (63,080) | (73,982) |
Net cash provided by (used for) investing activities | 608,821 | (2,226,456) |
Financing activities | ||
Proceeds from term debt | 759,735 | 2,355,280 |
Payments of term debt | (688,221) | |
Revolving credit facilities, net | (818,116) | 155,089 |
Distributions paid | (272,360) | (239,211) |
Lease deposits and other obligations to tenants | (25,511) | (8,346) |
Proceeds from sale of common shares, net of offering costs | 548,055 | |
Other financing activities | (3,106) | (27,167) |
Net cash (used for) provided by financing activities | (359,358) | 2,095,479 |
Increase in cash, cash equivalents and restricted cash for period | 548,586 | 88,981 |
Effect of exchange rate changes | (8,313) | 15,136 |
Cash, cash equivalents and restricted cash at beginning of period | 172,247 | 84,882 |
Cash, cash equivalents and restricted cash at end of period | 712,520 | 188,999 |
Interest paid | 175,715 | 131,708 |
Supplemental schedule of non-cash financing activities: | ||
Distributions declared, not paid | 91,547 | 87,519 |
Cash, cash equivalents and restricted cash are comprised of the following: | ||
Cash and cash equivalents at beginning of period | 171,472 | 83,240 |
Restricted cash, included in Other assets at beginning of period | $ 775 | $ 1,642 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at beginning of period | $ 172,247 | $ 84,882 |
Cash and cash equivalents at end of period | 710,965 | 188,224 |
Restricted cash, included in Other assets at end of period | $ 1,555 | $ 775 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at end of period | $ 712,520 | $ 188,999 |
MPT Operating Partnership, L.P. [Member] | ||
Operating activities | ||
Net income | 939,536 | 218,862 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 106,508 | 93,805 |
Amortization of deferred financing costs and debt discount | 5,543 | 4,748 |
Direct financing lease interest accretion | (7,213) | (7,276) |
Straight-line rent revenue | (64,840) | (47,678) |
Share / (Unit)-based compensation expense | 11,695 | 7,148 |
Gain from sale of real estate and other, net | (672,822) | (7,431) |
Straight-line rent and other write-off | 17,615 | 1,117 |
Debt refinancing costs | 18,794 | |
Other adjustments | (21,354) | (7,140) |
Changes in: | ||
Interest and rent receivables | (10,158) | (14,613) |
Accounts payable and accrued expenses | (5,387) | (40,378) |
Net cash provided by operating activities | 299,123 | 219,958 |
Investing activities | ||
Cash paid for acquisitions and other related investments | (1,166,618) | (2,152,069) |
Net proceeds from sale of real estate | 1,513,666 | 64,362 |
Principal received on loans receivable | 531,772 | 6,760 |
Investment in loans receivable | (174,494) | (18,574) |
Construction in progress and other | (32,425) | (52,953) |
Other investments, net | (63,080) | (73,982) |
Net cash provided by (used for) investing activities | 608,821 | (2,226,456) |
Financing activities | ||
Proceeds from term debt | 759,735 | 2,355,280 |
Payments of term debt | (688,221) | |
Revolving credit facilities, net | (818,116) | 155,089 |
Distributions paid | (272,360) | (239,211) |
Lease deposits and other obligations to tenants | (25,511) | (8,346) |
Proceeds from sale of common shares, net of offering costs | 548,055 | |
Other financing activities | (3,106) | (27,167) |
Net cash (used for) provided by financing activities | (359,358) | 2,095,479 |
Increase in cash, cash equivalents and restricted cash for period | 548,586 | 88,981 |
Effect of exchange rate changes | (8,313) | 15,136 |
Cash, cash equivalents and restricted cash at beginning of period | 172,247 | 84,882 |
Cash, cash equivalents and restricted cash at end of period | 712,520 | 188,999 |
Interest paid | 175,715 | 131,708 |
Supplemental schedule of non-cash financing activities: | ||
Distributions declared, not paid | 91,547 | 87,519 |
Cash, cash equivalents and restricted cash are comprised of the following: | ||
Cash and cash equivalents at beginning of period | 171,472 | 83,240 |
Restricted cash, included in Other assets at beginning of period | $ 775 | $ 1,642 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at beginning of period | $ 172,247 | $ 84,882 |
Cash and cash equivalents at end of period | 710,965 | 188,224 |
Restricted cash, included in Other assets at end of period | $ 1,555 | $ 775 |
Restricted cash and cash equivalents, noncurrent, asset, statement of financial position [Extensible List] | us-gaap:OtherAssets | us-gaap:OtherAssets |
Cash, cash equivalents and restricted cash at end of period | $ 712,520 | $ 188,999 |
Organization
Organization | 9 Months Ended |
Sep. 30, 2018 | |
Accounting Policies [Abstract] | |
Organization | 1. Organization Medical Properties Trust, Inc., a Maryland corporation, was formed on August 27, 2003, under the Maryland General Corporation Law for the purpose of engaging in the business of investing in, owning, and leasing commercial real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P. (the “Operating Partnership”), through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis except where material differences exist. We have operated as a real estate investment trust (“REIT”) since 2004. Accordingly, we will generally not be subject to federal income tax in the United States (“U.S.”), provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain non-real estate activities we undertake are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties located outside the U.S., we are subject to local taxes; however, we do not expect to incur additional taxes in the U.S. as such real estate related income currently flows through our REIT. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services, such as operators of general acute care hospitals, 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. Our properties are located in the U.S. and Europe. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 9 Months Ended |
Sep. 30, 2018 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies Unaudited Interim Condensed Consolidated Financial Statements : The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three and nine months ended September 30, 2018, are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. The condensed consolidated balance sheet at December 31, 2017 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2017, and as updated in our Form 10-Q for the quarters ended March 31, 2018 and June 30, 2018. There have been no material changes to these significant accounting policies. Recent Accounting Developments: Leases In February 2016, the Financial Accounting Standards Board (the “FASB”) issued ASU 2016-02, “Leases”, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The new standard requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. In July 2018, the FASB issued ASU 2018-11, “Leases (Topic 842): Targeted Improvements” (“ASU 2018-11”), allowing companies to record a cumulative adjustment to retained earnings in the period of adoption rather than requiring the restatement of prior periods. We will adopt this new standard on January 1, 2019. We are continuing to evaluate this standard and the impact to us from both a lessor and lessee perspective. We do have leases in which we are the lessee, including ground leases, on which certain of our facilities reside, along with corporate office and equipment leases. Although we do not expect any change in the current operating lease classification of these leases, we will record a right-of-use asset and a lease liability on our balance sheet upon adoption of this standard, with any difference recorded as a cumulative adjustment in equity. From a lessor perspective, we do not expect any change in the current classification and accounting of our existing leases. However, we do expect certain non-lease components (such as certain operating expenses that we pay and our tenants reimburse us for pursuant to our “triple-net” leases) to be recorded gross versus net of the respective expenses upon adoption of this standard in 2019 in accordance with ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. For those operating expenses that our tenants pay directly to third parties pursuant to our leases, we will continue to present on a net basis. Reclassifications Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. Variable Interest Entities At September 30, 2018, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities. 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 September 30, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 329,340 Mortgage and other loans $ 228,960 Equity investments $ 14,616 Other assets $ - (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 represents the current carrying values of such investment plus any other related assets (such as rent receivables), less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE’s economic performance. As of September 30, 2018, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g., cash short falls). 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, Note 7 and Note 10 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein, including Ernest Health Inc. (“Ernest”), which makes up $329 million of the maximum loss exposure above at September 30, 2018. |
Real Estate and Lending Activit
Real Estate and Lending Activities | 9 Months Ended |
Sep. 30, 2018 | |
Text Block [Abstract] | |
Real Estate and Lending Activities | 3. Real Estate and Lending Activities Acquisitions We acquired the following assets (in thousands): For the Nine Months Ended September 30, 2018 2017 Assets Acquired Land and land improvements $ 57,452 $ 220,864 Building 467,164 928,687 Intangible lease assets — subject to amortization (weighted average useful life 27.8 years for 2018 and 27.2 years for 2017) 60,277 162,946 Net investments in direct financing leases - 40,450 Other loans 336,458 - Mortgage loans - 700,000 Equity investments 245,267 100,000 Liabilities assumed - (878 ) Total assets acquired $ 1,166,618 $ 2,152,069 Loans repaid (525,426 ) - Total net assets acquired $ 641,192 $ 2,152,069 2018 Activity Joint Venture Transaction On August 31, 2018, we completed a joint venture arrangement with Primotop Holdings S.à.r.l. (“Primotop”) pursuant to which we contributed 71 of our post-acute hospitals in Germany, with an aggregate fair value of €1.635 billion, for a 50% interest, while Primotop contributed cash for its 50% interest in the joint venture. As part of the transaction, we received an aggregate amount of approximately €1.14 billion, from the proceeds of the cash contributed by Primotop and the secured debt financing placed on the joint venture’s real estate (as more fully discussed in Note 4), and we recognized an approximate €500 million gain on sale. Our interest in the joint venture is made up of a 50% equity investment valued at approximately €211 million (included in “Other assets” on the condensed consolidated balance sheets), which is being accounted for under the equity method of accounting, and a €290 million shareholder loan (with terms identical to Primotop’s shareholder loan). Other Transactions On August 31, 2018, we acquired an acute care facility in Pasco, Washington for $17.5 million. The property is leased to RCCH Healthcare Partners (“RCCH”), pursuant to the existing long-term master lease entered into with RCCH in April 2016. On August 28, 2018, we acquired three inpatient rehabilitation hospitals in Germany for €17.3 million (including real estate transfer taxes). These hospitals are part of a four-hospital portfolio that we agreed to purchase for an aggregate amount of €23 million (including real estate transfer taxes). The final property is expected to close in the fourth quarter of 2018. The properties are leased to affiliates of Median Kliniken S.à.r.l. (“MEDIAN”), pursuant to a new 27-year master lease with annual escalators at the greater of 1% or 70% of the change in German consumer price index (“CPI”). During the second and third quarters of 2018, we acquired the fee simple real estate of four general acute care hospitals, three of which are located in Massachusetts and one located in Texas, from Steward Health Care System LLC (“Steward”) in exchange for the reduction of $525.4 million of mortgage loans made to Steward in October 2016 and March 2018, along with additional cash consideration. These properties are being leased to Steward pursuant to the original master lease from October 2016 that had an initial 15-year term with three five-year extension options, plus CPI increases. 2017 Activity Steward Transactions On September 29, 2017, we acquired from IASIS Healthcare LLC (“IASIS”) a portfolio of ten acute care hospitals and one behavioral health facility, along with ancillary land and buildings, that are located in Arizona, Utah, Texas, and Arkansas. The portfolio is now operated by Steward, which separately completed its acquisition of IASIS on September 29, 2017. Our investment in the portfolio included the acquisition of eight acute care hospitals and one behavioral health facility for approximately $700 million, the origination of $700 million in mortgage loans on two acute care hospitals, and a $100 million minority equity contribution in Steward, for a combined investment of approximately $1.5 billion. The nine facilities acquired are being leased to Steward pursuant to the original long-term master lease agreement entered into in October 2016. On May 1, 2017, we acquired eight hospitals previously affiliated with Community Health Systems, Inc. in Florida, Ohio, and Pennsylvania for an aggregate purchase price of $301.3 million. These facilities are leased to Steward, pursuant to the original long-term master lease entered into in October 2016. MEDIAN Transactions During the third quarter of 2017, we acquired two rehabilitation hospitals in Germany for an aggregate purchase price of €39.2 million, in addition to 11 rehabilitation hospitals in Germany that we acquired in the second quarter of 2017 for an aggregate purchase price of €127 million. These 13 properties are leased to MEDIAN, pursuant to a third master lease that has a fixed term ending in August 2043 with annual escalators at the greater of 1% or 70% of the change in German CPI. These acquisitions are the final properties of the portfolio of 20 properties in Germany that we agreed to acquire in July 2016 for €215.7 million, of which seven properties totaling €49.5 million closed in December 2016. On June 22, 2017, we acquired an acute care hospital in Germany for a purchase price of €19.4 million. This property is leased to MEDIAN pursuant to the original master lease agreement effective in 2015 and expiring December 2042 with annual escalators at the greater of 1% or 70% of the change in German CPI. On January 30, 2017, we acquired an inpatient rehabilitation hospital in Germany for €8.4 million. This acquisition was the final property to close as part of the six hospital portfolio that we agreed to acquire in September 2016 for an aggregate amount of €44.1 million. This property is leased to MEDIAN, pursuant to the original long-term master lease agreement reached with MEDIAN in 2015 and as described above. Other Transactions On June 1, 2017, we acquired the real estate assets of Ohio Valley Medical Center, a 218-bed acute care hospital located in Wheeling, West Virginia, and the East Ohio Regional Hospital, a 139-bed acute care hospital in Martins Ferry, Ohio, from Ohio Valley Health Services, a not-for-profit entity in West Virginia, for an aggregate purchase price of approximately $40 million. We simultaneously leased the facilities to Alecto Healthcare Services LLC (“Alecto”), pursuant to a lease with a 15-year initial term with 2% annual minimum rent increases and three 5-year extension options. The facilities are cross-defaulted and cross-collateralized with our other hospitals operated by Alecto. With these acquisitions, we also obtained a 20% interest in the operator of these facilities. On May 1, 2017, we acquired the real estate of St. Joseph Regional Medical Center, a 145-bed acute care hospital in Lewiston, Idaho for $87.5 million. This facility is leased to RCCH, pursuant to the existing long-term master lease entered into with RCCH in April 2016. From the respective acquisition dates, the properties acquired in 2017 contributed $16.7 million of revenue and $12.7 million of income (excluding related acquisition expenses and taxes) for the three months ended September 30, 2017, and $25.1 million of revenue and $18.8 million of income (excluding related acquisition expenses and taxes) for the nine months ended September 30, 2017. In addition, we expensed $5.4 million and $15.6 million of acquisition-related costs on these 2017 acquisitions for the three and nine months ended September 30, 2017, respectively. Development Activities During the first nine months of 2018, we completed the construction on Ernest Flagstaff. This $25.5 million inpatient rehabilitation facility located in Flagstaff, Arizona opened on March 1, 2018 and is being leased to Ernest pursuant to a stand-alone lease, with terms similar to the original master lease. See table below for a status update on our current development projects (in thousands): Property Commitment Costs Incurred as of September 30, 2018 Estimated Rent Commencement Date Circle Health (Birmingham, England) $ 44,228 $ 24,113 1Q 2019 Circle Health Rehabilitation (Birmingham, England) 21,973 5,304 3Q 2019 Surgery Partners (Idaho Falls, Idaho) 113,468 30,379 1Q 2020 $ 179,669 $ 59,796 Disposals 2018 Activity On August 31, 2018, we completed the previously described joint venture arrangement with Primotop, in which we contributed the real estate of 71 of our post-acute hospitals in Germany, with a fair value of approximately €1.635 billion, resulting in a gain of approximately €500 million. See “Acquisitions” in this Note 3 for further details on this transaction. On August 31, 2018, we sold a general acute care hospital located in Houston, Texas that was leased and operated by North Cypress for $148 million. The transaction resulted in a gain on sale of $102.4 million, which was partially offset by a net $2.5 million non-cash charge to revenue to write-off related straight-line rent receivables. On June 4, 2018, we sold three long-term acute care hospitals located in California, Texas, and Oregon, that were leased and operated by Vibra Healthcare, LLC (“Vibra”), which included our equity investment in operations of the Texas facility. Total proceeds from the transaction were $53.3 million in cash, a mortgage loan in the amount of $18.3 million, and a $1.5 million working capital loan. The transaction resulted in a gain on real estate of $24.2 million, which was partially offset by a $5.1 million non-cash charge to revenue to write-off related straight-line rent receivables. On March 1, 2018, we sold the real estate of St. Joseph Medical Center in Houston, Texas, for approximately $148 million to Steward. In return, we received a mortgage loan equal to the purchase price, with such loan secured by the underlying real estate. The mortgage loan had terms consistent with the other mortgage loans in the Steward portfolio. This transaction resulted in a gain of $1.5 million, offset by a $1.7 million non-cash charge to revenue to write-off related straight-line rent receivables on this property. 2017 Activity On March 31, 2017, we sold the EASTAR Health System real estate located in Muskogee, Oklahoma, which was leased to RCCH. Total proceeds from this transaction were approximately $64 million, resulting in a gain of $7.4 million, partially offset by a $0.6 million non-cash charge to revenue to write-off related straight-line rent receivables on this property. Summary of Operations for Disposed Assets in 2018 The properties sold during 2018 For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 Revenues(1) $ 20,115 $ 35,846 $ 88,838 $ 95,320 Real estate depreciation and amortization(2) (237 ) (8,786 ) (15,849 ) (23,092 ) Property-related expenses (265 ) (388 ) (531 ) (394 ) Other(3) 692,362 (3,303 ) 715,246 (11,211 ) Income from real estate dispositions, net $ 711,975 $ 23,369 $ 787,704 $ 60,623 (1) Includes $2.5 million and $7.6 million of straight-line rent and other write-offs associated with the disposal transactions for the three and nine months ended September 30, 2018, respectively. (2) Lower in 2018 as we stopped depreciation on properties once deemed held for sale, such as with the 71 properties on June 30, 2018. (3) Includes $695.2 million of gains on sale for the three months ended September 30, 2018 and $719.4 million for the nine months ended September 30, 2018. Leasing Operations At September 30, 2018, leases on 14 Ernest facilities, ten Prime Healthcare Services, Inc. (“Prime”) facilities, and two Alecto facilities are accounted for as direct financing leases (“DFLs”). The components of our net investment in DFLs consisted of the following (in thousands): As of September 30, 2018 As of December 31, 2017 Minimum lease payments receivable $ 2,190,840 $ 2,294,081 Estimated residual values 434,769 448,339 Less: Unearned income (1,934,712 ) (2,043,693 ) Net investment in direct financing leases $ 690,897 $ 698,727 On March 15, 2018, we entered into a new lease agreement of our long-term acute care facility in Boise, Idaho with a joint venture formed by Vibra and Ernest. The new lease has an initial 15-year fixed term (ending March 2033) with three extension options of five years each. With this transaction, we incurred a non-cash charge of $1.5 million to write-off DFL unbilled interest associated with the previous lease to Ernest on this property. Adeptus Health – Transition Properties As noted in previous filings, we have 16 properties transitioning away from Adeptus Health in stages over a two year period as part of Adeptus Health’s confirmed plan of reorganization under Chapter 11 of the Bankruptcy Code. Through October 1, 2018, Adeptus Health vacated and stopped making rent payments on 15 properties. As a result of the shortening of our lease term on these properties, we recorded a $4 million charge to accelerate the amortization of the straight-line rent receivables in the first nine months of 2018. The final property will be transitioned away from Adeptus Health on October 1, 2019. In August and early October 2018, we re-leased three of the vacant facilities in the Houston market and five in the San Antonio market, respectively, at rates consistent with that of the previous Adeptus Health lease. At September 30, 2018, our investment in the remaining eight transition facilities (that have not been re-leased) approximates less than 1% of our total assets. Although we expect to re-tenant and/or sell the remaining eight facilities in the near future, we lowered the carrying value of the seven remaining vacant facilities by $18 million to fair value in the three months ended September 30, 2018, based on market data received during the 2018 third quarter. Gilbert and Florence Facilities In the first quarter of 2018, we terminated the lease at our Gilbert and Florence, Arizona facilities due to the tenant not meeting its rent obligations pursuant to the lease. As a result of the lease terminating, we recorded a charge of $1.1 million to reserve against the straight-line rent receivables in February 2018. On April 25, 2018, this former tenant filed for involuntary bankruptcy. At September 30, 2018, all outstanding receivables were completely reserved. Although no assurances can be made that we will not have any impairment charges in the future, we believe our investment in the Gilbert and Florence facilities of $37.5 million or 0.4% of total assets at September 30, 2018, is fully recoverable. Alecto Healthcare facilities At September 30, 2018, we own four acute care facilities that are leased to Alecto and have a mortgage loan on a fifth property. Our total investment in these properties is approximately 1% of our total assets. Through October 2018, Alecto is current on its rent and interest obligations to us. However, we have seen continued softening in their markets through the 2018 third quarter, which could impact their ability to meet future obligations to us. Thus, in the 2018 third quarter, we lowered the carrying value of the four owned properties by $30 million to fair value. Loans The following is a summary of our loans (in thousands): As of September 30, 2018 As of December 31, 2017 Mortgage loans $ 1,428,069 $ 1,778,316 Acquisition loans 117,376 118,448 Working capital and other loans 365,077 31,761 $ 1,910,522 $ 1,928,525 The decrease in mortgage loans relates to the use of four Steward mortgage loans to fund our acquisition of the related fee simple real estate of the four facilities during 2018, while the increase to working capital and other loans primarily relates to our €290 million shareholder loan to the joint venture with Primotop – see “Acquisitions” in this Note 3 for further information. At September 30, 2018, acquisition loans includes $113.3 million in loans to Ernest; however, as described in Note 10, the full Ernest acquisition loan balance was repaid on October 4, 2018. Concentrations of Credit Risk We monitor concentration risk in several ways due to the nature of our real estate assets that are vital to the communities in which they are located and given our history of being able to replace inefficient operators of our facilities if needed, with more effective operators: 1) Facility concentration – At September 30, 2018, we had no investment of any single property greater than 4% of our total assets, which is consistent with December 31, 2017. 2) Operator concentration – For the nine months ended September 30, 2018, revenue from Steward, Prime, MEDIAN, and Ernest represented 37%, 16%, 16% and 9%, respectively. In comparison, these operators represented 23%, 19%, 15% and 11%, respectively, for the first nine months of 2017. 3) Geographic concentration – At September 30, 2018, investments in the U.S. and Europe represented approximately 80% and 20%, respectively, of our total assets, which is consistent with December 31, 2017. 4) Facility type concentration – For the nine months ended September 30, 2018, approximately 72% of our revenues are from our general acute care facilities, while rehabilitation and long-term acute care facilities make up 24% and 4%, respectively. These percentages are similar to those for the first nine months of 2017. |
Debt
Debt | 9 Months Ended |
Sep. 30, 2018 | |
Debt Disclosure [Abstract] | |
Debt | 4. Debt The following is a summary of our debt (in thousands): As of September 30, 2018 As of December 31, 2017 Revolving credit facility(A) $ 22,153 $ 840,810 Term loan 200,000 200,000 4.000% Senior Unsecured Notes due 2022(B) 580,200 600,250 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 500,000 3.325% Senior Unsecured Notes due 2025(B) 580,200 600,250 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 $ 4,082,553 $ 4,941,310 Debt issue costs, net (38,704 ) (42,643 ) $ 4,043,849 $ 4,898,667 (A) Includes £17 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. (B) These notes are Euro-denominated and reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. As of September 30, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands): 2018 $ - 2019 - 2020 - 2021 22,153 2022 780,200 Thereafter 3,280,200 Total $ 4,082,553 2018 Activity In preparation of the joint venture with Primotop described under “Acquisitions” in Note 3, we issued secured debt on August 3, 2018, resulting in gross proceeds of €655 million. Subsequently, on August 31, 2018, the secured debt was contributed along with the related real estate of 71 properties to form the joint venture. Provisions of the secured debt include a term of seven years and a swapped fixed rate of approximately 2.3%. 2017 Activity On February 1, 2017, we replaced our previous unsecured credit facility with a new revolving credit and term loan agreement (“Credit Facility”). The Credit Facility includes a $1.3 billion unsecured revolving loan facility, a $200 million unsecured term loan facility ($50 million lower than the previous term loan), and a new €200 million unsecured term loan facility. On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020. On March 24, 2017, we completed a €500 million senior unsecured notes offering (“3.325% Senior Unsecured Notes due 2025”). A portion of the proceeds from this offering were used to prepay and extinguish the €200 million term loan facility portion of our Credit Facility on March 30, 2017. On September 7, 2017, we completed a $1.4 billion senior unsecured notes offering (“5.000% Senior Unsecured Notes due 2027”). We used a portion of the net proceeds from the 5.000% Senior Unsecured Notes due 2027 offering to redeem the $350 million aggregate principal amount of our 6.375% Senior Unsecured Notes due 2022 on October 7, 2017. Furthermore, the completion of the 5.000% Senior Unsecured Notes due 2027 offering resulted in the cancellation of the $1.0 billion term loan facility commitment from JP Morgan Chase Bank, N.A. that we received to assist in funding the September 2017 Steward transaction. With this commitment, we paid $5.2 million of underwriting and other fees, which we fully expensed upon the cancellation of the commitment. On September 29, 2017, we prepaid the principal amount of the mortgage loan on our property in Kansas City, Missouri at par in the amount of $12.9 million. To fund such prepayment, including accrued and unpaid interest thereon, we used borrowings from the revolving credit facility portion of our Credit Facility. With the replacement of our old credit facility, the redemption of the 5.750% Senior Unsecured Notes due 2020, the payoff of our €200 million euro term loan, the cancellation of the $1.0 billion term loan facility commitment, and the payment of our $12.9 million mortgage loan, we incurred a debt refinancing charge of $18.8 million in the first nine months of 2017. 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. At September 30, 2018, the dividend restriction was 95% of normalized adjusted funds from operations (“NAFFO”). The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness. In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. The Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At September 30, 2018, we were in compliance with all such financial and operating covenants. |
Common Stock_Partner's Capital
Common Stock/Partner's Capital | 9 Months Ended |
Sep. 30, 2018 | |
Equity [Abstract] | |
Common Stock/Partner's Capital | 5. Common Stock/Partners’ Capital Medical Properties Trust, Inc. On May 1, 2017, we completed an underwritten public offering of approximately 43.1 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 5.6 million shares) of our common stock, resulting in net proceeds of approximately $548 million, after deducting offering expenses. MPT Operating Partnership, L.P. At September 30, 2018, the Company has a 99.92% ownership interest in the Operating Partnership with the remainder owned by two other partners, who are employees. During the nine months ended September 30, 2017, the Operating Partnership issued approximately 43.1 million units in direct response to the common stock offerings by Medical Properties Trust, Inc. during the same period. |
Stock Awards
Stock Awards | 9 Months Ended |
Sep. 30, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Stock Awards | 6. Stock Awards We adopted the 2013 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2013, which authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units and awards of interests in our Operating Partnership. The Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 8,196,770 shares of common stock for awards under the Equity Incentive Plan, out of which 1,697,002 shares remain available for future stock awards as of September 30, 2018. Share-based compensation expense totaled $11.7 million and $7.1 million for the nine months ended September 30, 2018 and 2017, respectively. |
Fair Value of Financial Instrum
Fair Value of Financial Instruments | 9 Months Ended |
Sep. 30, 2018 | |
Fair Value Disclosures [Abstract] | |
Fair Value of Financial Instruments | 7. Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and working capital loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes 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 loan 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): As of As of September 30, 2018 December 31, 2017 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 87,939 $ 87,067 $ 78,970 $ 78,028 Loans (1) 1,681,562 1,700,346 1,698,471 1,722,101 Debt, net (4,043,849 ) (4,087,207 ) (4,898,667 ) (5,073,707 ) (1) Excludes loans related to Ernest since they are recorded at fair value and discussed below. Items Measured at Fair Value on a Recurring Basis Our equity interest in Ernest along with their related loans are 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 currently existing equity interests or loans. At September 30, 2018, these amounts were as follows (in thousands): Asset Type Fair Value Original Cost Asset Type Classification Mortgage loans $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans 108,373 117,260 Other loans/other assets $ 223,373 $ 232,260 Our equity investment and other loans with Ernest are recorded at fair value using a Level 1 input based on the proceeds of the October 4, 2018 transaction in which such equity investment was sold and such loans were repaid, as more fully described in Note 10 to this Form 10-Q. Our mortgage loans are recorded at fair value based on Level 2 inputs by discounting the estimated future cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Because the fair value of the Ernest investments noted above is below our original cost, we recognized an unrealized loss during the nine months of 2018. No unrealized gain/loss on the Ernest investments was recorded in the first nine months of 2017. |
Earnings Per Share
Earnings Per Share | 9 Months Ended |
Sep. 30, 2018 | |
Earnings Per Share [Abstract] | |
Earnings Per Share | 8. Earnings Per Share Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months Ended September 30, 2018 2017 Numerator: Net income $ 736,476 $ 76,881 Non-controlling interests’ share in net income (442 ) (417 ) Participating securities’ share in earnings (290 ) (82 ) Net income, less participating securities’ share in earnings $ 735,744 $ 76,382 Denominator: Basic weighted-average common shares 365,024 364,315 Dilutive potential common shares 1,443 731 Dilutive weighted-average common shares 366,467 365,046 For the Nine Months Ended September 30, 2018 2017 Numerator: Net income $ 939,536 $ 218,862 Non-controlling interests’ share in net income (1,334 ) (1,013 ) Participating securities’ share in earnings (808 ) (307 ) Net income, less participating securities’ share in earnings $ 937,394 $ 217,542 Denominator: Basic weighted-average common shares 364,934 345,076 Dilutive potential common shares 850 520 Dilutive weighted-average common shares 365,784 345,596 MPT Operating Partnership, L.P. Our earnings per common unit were calculated based on the following (in thousands): For the Three Months Ended September 30, 2018 2017 Numerator: Net income $ 736,476 $ 76,881 Non-controlling interests’ share in net income (442 ) (417 ) Participating securities’ share in earnings (290 ) (82 ) Net income, less participating securities’ share in earnings $ 735,744 $ 76,382 Denominator: Basic weighted-average units 365,024 364,315 Dilutive potential units 1,443 731 Diluted weighted-average units 366,467 365,046 For the Nine Months Ended September 30, 2018 2017 Numerator: Net income $ 939,536 $ 218,862 Non-controlling interests’ share in net income (1,334 ) (1,013 ) Participating securities’ share in earnings (808 ) (307 ) Net income, less participating securities’ share in earnings $ 937,394 $ 217,542 Denominator: Basic weighted-average units 364,934 345,076 Dilutive potential units 850 520 Diluted weighted-average units 365,784 345,596 |
Commitments and Contingencies
Commitments and Contingencies | 9 Months Ended |
Sep. 30, 2018 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 9. Commitments and Contingencies Commitments On June 6, 2018, we entered into a definitive agreement to acquire four rehabilitation hospitals in Germany for a purchase price of approximately €23 million (including real estate transfer taxes). We have closed on three of the facilities during the third quarter of 2018, with the remaining facility expected to close in the fourth quarter of 2018 for approximately €5.8 million (including real estate transfer taxes). See Note 3 “Acquisitions” for more details on this transaction. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations or cash flows. |
Subsequent Events
Subsequent Events | 9 Months Ended |
Sep. 30, 2018 | |
Subsequent Events [Abstract] | |
Subsequent Events | 10. Subsequent Events On October 4, 2018, we finalized a recapitalization agreement to sell our investment in the operations of Ernest Health Holdings, LLC and be repaid for our outstanding acquisition loans, working capital loans, and any unpaid interest. Total proceeds received from this transaction approximated $176 million. We will retain ownership of the real estate and secured mortgage loans of our Ernest properties. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 9 Months Ended |
Sep. 30, 2018 | |
Accounting Policies [Abstract] | |
Unaudited Interim Condensed Consolidated Financial Statements | Unaudited Interim Condensed Consolidated Financial Statements : The accompanying unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the U.S. for interim financial information, including rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles (“GAAP”) for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. Operating results for the three and nine months ended September 30, 2018, are not necessarily indicative of the results that may be expected for the year ending December 31, 2018. The condensed consolidated balance sheet at December 31, 2017 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. For information about significant accounting policies, refer to the consolidated financial statements and footnotes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2017, and as updated in our Form 10-Q for the quarters ended March 31, 2018 and June 30, 2018. There have been no material changes to these significant accounting policies. |
Recent Accounting Developments | Recent Accounting Developments: Leases In February 2016, the Financial Accounting Standards Board (the “FASB”) issued ASU 2016-02, “Leases”, which sets out the principles for the recognition, measurement, presentation and disclosure of leases for both parties to a contract (i.e. lessees and lessors). The new standard requires lessees to apply a dual approach, classifying leases as either financing or operating leases based on the principle of whether or not the lease is effectively a financed purchase by the lessee. This classification will determine whether lease expense is recognized based on an effective interest method or on a straight-line basis over the term of the lease. A lessee is also required to record a right-of-use asset and a lease liability for all leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less will be accounted for similar to existing guidance for operating leases today. The new standard requires lessors to account for leases using an approach that is substantially equivalent to existing guidance for sales-type leases, direct financing leases and operating leases. In July 2018, the FASB issued ASU 2018-11, “Leases (Topic 842): Targeted Improvements” (“ASU 2018-11”), allowing companies to record a cumulative adjustment to retained earnings in the period of adoption rather than requiring the restatement of prior periods. We will adopt this new standard on January 1, 2019. We are continuing to evaluate this standard and the impact to us from both a lessor and lessee perspective. We do have leases in which we are the lessee, including ground leases, on which certain of our facilities reside, along with corporate office and equipment leases. Although we do not expect any change in the current operating lease classification of these leases, we will record a right-of-use asset and a lease liability on our balance sheet upon adoption of this standard, with any difference recorded as a cumulative adjustment in equity. From a lessor perspective, we do not expect any change in the current classification and accounting of our existing leases. However, we do expect certain non-lease components (such as certain operating expenses that we pay and our tenants reimburse us for pursuant to our “triple-net” leases) to be recorded gross versus net of the respective expenses upon adoption of this standard in 2019 in accordance with ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)”. For those operating expenses that our tenants pay directly to third parties pursuant to our leases, we will continue to present on a net basis. |
Reclassifications | Reclassifications Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation. |
Variable Interest Entities | Variable Interest Entities At September 30, 2018, we had loans to and/or equity investments in certain variable interest entities (“VIEs”), which are also tenants of our facilities. 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 September 30, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 329,340 Mortgage and other loans $ 228,960 Equity investments $ 14,616 Other assets $ - (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 represents the current carrying values of such investment plus any other related assets (such as rent receivables), less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE. For the VIE types above, we do not consolidate the VIE because we do not have the ability to control the activities (such as the day-to-day healthcare operations of our borrowers or investees) that most significantly impact the VIE’s economic performance. As of September 30, 2018, we were not required to provide financial support through a liquidity arrangement or otherwise to our unconsolidated VIEs, including circumstances in which they could be exposed to further losses (e.g., cash short falls). 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, Note 7 and Note 10 for additional description of the nature, purpose and activities of our more significant VIEs and interests therein, including Ernest Health Inc. (“Ernest”), which makes up $329 million of the maximum loss exposure above at September 30, 2018. |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 9 Months Ended |
Sep. 30, 2018 | |
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 September 30, 2018 (in thousands): VIE Type Maximum Loss Exposure(1) Asset Type Classification Carrying Amount(2) Loans, net $ 329,340 Mortgage and other loans $ 228,960 Equity investments $ 14,616 Other assets $ - (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 represents the current carrying values of such investment plus any other related assets (such as rent receivables), less any liabilities. (2) Carrying amount reflects the net book value of our loan or equity interest only in the VIE. |
Real Estate and Lending Activ_2
Real Estate and Lending Activities (Tables) | 9 Months Ended |
Sep. 30, 2018 | |
Text Block [Abstract] | |
Assets Acquired | We acquired the following assets (in thousands): For the Nine Months Ended September 30, 2018 2017 Assets Acquired Land and land improvements $ 57,452 $ 220,864 Building 467,164 928,687 Intangible lease assets — subject to amortization (weighted average useful life 27.8 years for 2018 and 27.2 years for 2017) 60,277 162,946 Net investments in direct financing leases - 40,450 Other loans 336,458 - Mortgage loans - 700,000 Equity investments 245,267 100,000 Liabilities assumed - (878 ) Total assets acquired $ 1,166,618 $ 2,152,069 Loans repaid (525,426 ) - Total net assets acquired $ 641,192 $ 2,152,069 |
Summary of Status Update on Current Development Projects | See table below for a status update on our current development projects (in thousands): Property Commitment Costs Incurred as of September 30, 2018 Estimated Rent Commencement Date Circle Health (Birmingham, England) $ 44,228 $ 24,113 1Q 2019 Circle Health Rehabilitation (Birmingham, England) 21,973 5,304 3Q 2019 Surgery Partners (Idaho Falls, Idaho) 113,468 30,379 1Q 2020 $ 179,669 $ 59,796 |
Summary of Operations for Disposed Assets in 2018 | The properties sold during 2018 For the Three Months Ended September 30, For the Nine Months Ended September 30, 2018 2017 2018 2017 Revenues(1) $ 20,115 $ 35,846 $ 88,838 $ 95,320 Real estate depreciation and amortization(2) (237 ) (8,786 ) (15,849 ) (23,092 ) Property-related expenses (265 ) (388 ) (531 ) (394 ) Other(3) 692,362 (3,303 ) 715,246 (11,211 ) Income from real estate dispositions, net $ 711,975 $ 23,369 $ 787,704 $ 60,623 (1) Includes $2.5 million and $7.6 million of straight-line rent and other write-offs associated with the disposal transactions for the three and nine months ended September 30, 2018, respectively. (2) Lower in 2018 as we stopped depreciation on properties once deemed held for sale, such as with the 71 properties on June 30, 2018. (3) Includes $695.2 million of gains on sale for the three months ended September 30, 2018 and $719.4 million for the nine months ended September 30, 2018. |
Components of Net Investment in Direct Financing Leases | The components of our net investment in DFLs consisted of the following (in thousands): As of September 30, 2018 As of December 31, 2017 Minimum lease payments receivable $ 2,190,840 $ 2,294,081 Estimated residual values 434,769 448,339 Less: Unearned income (1,934,712 ) (2,043,693 ) Net investment in direct financing leases $ 690,897 $ 698,727 |
Summary of Loans | The following is a summary of our loans (in thousands): As of September 30, 2018 As of December 31, 2017 Mortgage loans $ 1,428,069 $ 1,778,316 Acquisition loans 117,376 118,448 Working capital and other loans 365,077 31,761 $ 1,910,522 $ 1,928,525 |
Debt (Tables)
Debt (Tables) | 9 Months Ended |
Sep. 30, 2018 | |
Debt Disclosure [Abstract] | |
Summary of Debt | The following is a summary of our debt (in thousands): As of September 30, 2018 As of December 31, 2017 Revolving credit facility(A) $ 22,153 $ 840,810 Term loan 200,000 200,000 4.000% Senior Unsecured Notes due 2022(B) 580,200 600,250 5.500% Senior Unsecured Notes due 2024 300,000 300,000 6.375% Senior Unsecured Notes due 2024 500,000 500,000 3.325% Senior Unsecured Notes due 2025(B) 580,200 600,250 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 $ 4,082,553 $ 4,941,310 Debt issue costs, net (38,704 ) (42,643 ) $ 4,043,849 $ 4,898,667 (A) Includes £17 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. (B) These notes are Euro-denominated and reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. |
Principal Payments Due on Debt | As of September 30, 2018, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows (in thousands): 2018 $ - 2019 - 2020 - 2021 22,153 2022 780,200 Thereafter 3,280,200 Total $ 4,082,553 |
Fair Value of Financial Instr_2
Fair Value of Financial Instruments (Tables) | 9 Months Ended |
Sep. 30, 2018 | |
Fair Value Disclosures [Abstract] | |
Summary of Fair Value Information of Financial Instruments | The following table summarizes fair value estimates for our financial instruments (in thousands): As of As of September 30, 2018 December 31, 2017 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 87,939 $ 87,067 $ 78,970 $ 78,028 Loans (1) 1,681,562 1,700,346 1,698,471 1,722,101 Debt, net (4,043,849 ) (4,087,207 ) (4,898,667 ) (5,073,707 ) (1) Excludes loans related to Ernest since they are recorded at fair value and discussed below. |
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis | At September 30, 2018, these amounts were as follows (in thousands): Asset Type Fair Value Original Cost Asset Type Classification Mortgage loans $ 115,000 $ 115,000 Mortgage loans Equity investment and other loans 108,373 117,260 Other loans/other assets $ 223,373 $ 232,260 |
Earnings Per Share (Tables)
Earnings Per Share (Tables) | 9 Months Ended |
Sep. 30, 2018 | |
Earnings Per Share [Abstract] | |
Calculation of Earnings Per Share | Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Three Months Ended September 30, 2018 2017 Numerator: Net income $ 736,476 $ 76,881 Non-controlling interests’ share in net income (442 ) (417 ) Participating securities’ share in earnings (290 ) (82 ) Net income, less participating securities’ share in earnings $ 735,744 $ 76,382 Denominator: Basic weighted-average common shares 365,024 364,315 Dilutive potential common shares 1,443 731 Dilutive weighted-average common shares 366,467 365,046 For the Nine Months Ended September 30, 2018 2017 Numerator: Net income $ 939,536 $ 218,862 Non-controlling interests’ share in net income (1,334 ) (1,013 ) Participating securities’ share in earnings (808 ) (307 ) Net income, less participating securities’ share in earnings $ 937,394 $ 217,542 Denominator: Basic weighted-average common shares 364,934 345,076 Dilutive potential common shares 850 520 Dilutive weighted-average common shares 365,784 345,596 MPT Operating Partnership, L.P. Our earnings per common unit were calculated based on the following (in thousands): For the Three Months Ended September 30, 2018 2017 Numerator: Net income $ 736,476 $ 76,881 Non-controlling interests’ share in net income (442 ) (417 ) Participating securities’ share in earnings (290 ) (82 ) Net income, less participating securities’ share in earnings $ 735,744 $ 76,382 Denominator: Basic weighted-average units 365,024 364,315 Dilutive potential units 1,443 731 Diluted weighted-average units 366,467 365,046 For the Nine Months Ended September 30, 2018 2017 Numerator: Net income $ 939,536 $ 218,862 Non-controlling interests’ share in net income (1,334 ) (1,013 ) Participating securities’ share in earnings (808 ) (307 ) Net income, less participating securities’ share in earnings $ 937,394 $ 217,542 Denominator: Basic weighted-average units 364,934 345,076 Dilutive potential units 850 520 Diluted weighted-average units 365,784 345,596 |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies - Carrying Value and Classification of Related Assets and Maximum Exposure to Loss (Detail) | Sep. 30, 2018USD ($) |
Mortgage and other loans [Member] | |
Variable Interest Entity [Line Items] | |
Carrying Amount | $ 228,960,000 |
Loans, net [Member] | |
Variable Interest Entity [Line Items] | |
Maximum Loss Exposure | 329,340,000 |
Equity investments [Member] | |
Variable Interest Entity [Line Items] | |
Maximum Loss Exposure | $ 14,616,000 |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies - Additional Information (Detail) - Loans, net [Member] | Sep. 30, 2018USD ($) |
Significant Accounting Policies [Line Items] | |
Maximum loss exposure | $ 329,340,000 |
Ernest Health Inc [Member] | |
Significant Accounting Policies [Line Items] | |
Maximum loss exposure | $ 329,000,000 |
Real Estate and Lending Activ_3
Real Estate and Lending Activities - Assets Acquired (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Sep. 30, 2017 |
Business Acquisition [Line Items] | ||
Total assets acquired | $ 1,166,618 | $ 2,152,069 |
Equity investments | 245,267 | 100,000 |
Liabilities assumed | (878) | |
Loans repaid | (525,426) | |
Total net assets acquired | 641,192 | 2,152,069 |
Other Loans [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | 336,458 | |
Mortgage Loans [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | 700,000 | |
Land and Land Improvements [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | 57,452 | 220,864 |
Building [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | 467,164 | 928,687 |
Intangible Lease Assets - Subject to Amortization [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | $ 60,277 | 162,946 |
Net Investments in Direct Financing Leases [Member] | ||
Business Acquisition [Line Items] | ||
Total assets acquired | $ 40,450 |
Real Estate and Lending Activ_4
Real Estate and Lending Activities - Assets Acquired (Parenthetical) (Detail) | 9 Months Ended | |
Sep. 30, 2018 | Sep. 30, 2017 | |
Intangible Lease Assets - Subject to Amortization [Member] | ||
Business Acquisition [Line Items] | ||
Weighted average useful life of acquired intangible lease assets (in years) | 27 years 9 months 18 days | 27 years 2 months 12 days |
Real Estate and Lending Activ_5
Real Estate and Lending Activities - 2018 Activity - Additional Information (Detail) $ in Thousands, € in Millions | Aug. 31, 2018USD ($) | Aug. 28, 2018EUR (€)Hospital | Jun. 06, 2018EUR (€)Hospital | Mar. 31, 2017USD ($) | Jan. 30, 2017EUR (€) | Aug. 31, 2018USD ($)Hospital | Aug. 31, 2018EUR (€)Hospital | Mar. 31, 2018USD ($) | Oct. 31, 2016USD ($)RenewalOption | Dec. 31, 2018EUR (€)Hospital | Sep. 30, 2018USD ($)Hospital | Jun. 30, 2018Hospital | Jan. 30, 2017EUR (€)Hospital | Sep. 30, 2018USD ($) |
Business Acquisition [Line Items] | ||||||||||||||
Gain on sale of real estate | $ | $ 7,400 | |||||||||||||
Germany [Member] | Acute Care Hospital [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Gain on sale of real estate | $ | $ 695,200 | $ 719,400 | ||||||||||||
Purchase price of acquisition | € 23 | |||||||||||||
Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 4 | 6 | ||||||||||||
Purchase price of acquisition | € 8.4 | € 44.1 | ||||||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Gain on sale of real estate | $ | $ 500 | |||||||||||||
2018 [Member] | General Acute Care Hospital and Healthcare System [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 4 | 4 | ||||||||||||
Term of lease | 15 years | |||||||||||||
Mortgage financing | $ | $ 525,400 | $ 525,400 | ||||||||||||
Number of lease extension options | RenewalOption | 3 | |||||||||||||
Term of lease extension, years | 5 years | |||||||||||||
2018 [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Ownership interest in joint venture under the equity method | 50.00% | |||||||||||||
Ownership interest in joint venture under the equity method value included in other assets | € 211 | |||||||||||||
Shareholder loan to joint venture | 290 | |||||||||||||
Gain on sale of real estate | 500 | |||||||||||||
2018 [Member] | Germany [Member] | Acute Care Hospital [Member] | Fair Value [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Aggregate fair value of ownership interest | € 1,635 | |||||||||||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 3 | |||||||||||||
Purchase price of acquisition | € 17.3 | |||||||||||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Term of lease | 27 years | |||||||||||||
Lease rent increase percentage | 70.00% | |||||||||||||
Lease rate | 1.00% | |||||||||||||
2018 [Member] | Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Scenario, Forecast [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 4 | |||||||||||||
Purchase price of acquisition | € 23 | |||||||||||||
2018 [Member] | Pasco, Washington [Member] | Acute Care Hospital [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ | $ 17,500 | |||||||||||||
2018 [Member] | Massachusetts [Member] | General Acute Care Hospital and Healthcare System [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 3 | 3 | ||||||||||||
2018 [Member] | Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward Health Care System LLC [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 1 | 1 | ||||||||||||
2018 [Member] | Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Ownership interest in joint venture under the equity method | 50.00% | |||||||||||||
Number of facilities acquired | Hospital | 71 | 71 | ||||||||||||
Proceeds from joint venture | € 1,140 |
Real Estate and Lending Activ_6
Real Estate and Lending Activities - 2017 Activity - Additional Information (Detail) € in Millions, $ in Millions | Jun. 06, 2018EUR (€)Hospital | Sep. 29, 2017USD ($)HospitalHealth_CenterFacility | Jun. 22, 2017EUR (€) | Jun. 01, 2017USD ($)RenewalOptionBed | May 01, 2017USD ($)HospitalBed | Jan. 30, 2017EUR (€) | Dec. 31, 2016EUR (€)Property | Jul. 31, 2016EUR (€)Property | Sep. 30, 2018Facility | Sep. 30, 2017USD ($)Hospital | Sep. 30, 2017EUR (€)Hospital | Jun. 30, 2017EUR (€)Hospital | Jan. 30, 2017EUR (€)Hospital | Sep. 30, 2017USD ($) |
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities closed | Facility | 3 | |||||||||||||
Acute Care Hospital [Member] | Germany [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | € | € 23 | |||||||||||||
Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 4 | 6 | ||||||||||||
Purchase price of acquisition | € | € 8.4 | € 44.1 | ||||||||||||
2017 [Member] | Business Acquisitions [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Revenue contributed by the acquired entity | $ 16.7 | $ 25.1 | ||||||||||||
Income contributed by the acquired entity | 12.7 | 18.8 | ||||||||||||
Acquisition related costs | $ 5.4 | $ 15.6 | ||||||||||||
2017 [Member] | Subsidiaries [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Facility | 9 | |||||||||||||
Equity interest acquired | $ 100 | |||||||||||||
Combined purchase price and investment amount | 1,500 | |||||||||||||
2017 [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | 700 | |||||||||||||
2017 [Member] | Subsidiaries [Member] | Mortgage [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Mortgage financing | $ 700 | |||||||||||||
Number of mortgage facilities | Hospital | 2 | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | Germany [Member] | MEDIAN [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | € | € 19.4 | |||||||||||||
Lease agreement, end date | 2042-12 | |||||||||||||
Lease rate | 1.00% | |||||||||||||
Lease rent increase percentage | 70.00% | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | West Virginia and Ohio [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ 40 | |||||||||||||
Term of lease | 15 years | |||||||||||||
Percentage of increase in annual rent | 2.00% | |||||||||||||
Number of lease extension options | RenewalOption | 3 | |||||||||||||
Term of lease extension, years | 5 years | |||||||||||||
Ownership interest percentage in operator facility | 20.00% | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | IDAHO, Lewiston | St. Joseph Regional Medical Center [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Purchase price of acquisition | $ 87.5 | |||||||||||||
Number of beds acquired | Bed | 145 | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities closed | Hospital | 10 | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | Ohio Valley Medical Center [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of beds acquired | Bed | 218 | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | East Ohio Regional Hospital [Member] | Alecto Healthcare Services [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of beds acquired | Bed | 139 | |||||||||||||
2017 [Member] | Acute Care Hospital [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 8 | |||||||||||||
2017 [Member] | Behavioral Health Care Facility [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities closed | Health_Center | 1 | |||||||||||||
2017 [Member] | Behavioral Health Care Facility [Member] | Subsidiaries [Member] | IASIS Healthcare [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Health_Center | 1 | |||||||||||||
2017 [Member] | Community Health Systems, Inc. [Member] | Florida, Ohio, and Pennsylvania [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 8 | |||||||||||||
Purchase price of acquisition | $ 301.3 | |||||||||||||
2017 [Member] | Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | Third Master Lease [Member] | ||||||||||||||
Business Acquisition [Line Items] | ||||||||||||||
Number of facilities acquired | 20 | 2 | 2 | 11 | ||||||||||
Acquisition costs | € | € 215.7 | € 39.2 | € 127 | |||||||||||
Lease agreement, end date | 2043-08 | 2043-08 | ||||||||||||
Lease rate | 1.00% | 1.00% | 1.00% | |||||||||||
Lease rent increase percentage | 70.00% | 70.00% | ||||||||||||
Number of properties closed | Property | 7 | |||||||||||||
Amount of properties closed | € | € 49.5 |
Real Estate and Lending Activ_7
Real Estate and Lending Activities - Acquisitions - Additional Information (Detail) - Germany [Member] - Rehabilitation Hospital with Covenant Health System [Member] € in Millions | Jun. 06, 2018Hospital | Jan. 30, 2017EUR (€) | Jan. 30, 2017EUR (€)Hospital |
Business Acquisition [Line Items] | |||
Purchase price of acquisition | € | € 8.4 | € 44.1 | |
Number of facilities acquired | Hospital | 4 | 6 |
Real Estate and Lending Activ_8
Real Estate and Lending Activities - Development Activities - Additional Information (Detail) $ in Millions | 9 Months Ended |
Sep. 30, 2018USD ($) | |
Ernest [Member] | Development Activities [Member] | |
Business Acquisition [Line Items] | |
Estimated total development cost | $ 25.5 |
Real Estate and Lending Activ_9
Real Estate and Lending Activities - Summary of Status Update on Current Development Projects (Detail) $ in Thousands | 9 Months Ended |
Sep. 30, 2018USD ($) | |
Business Acquisition [Line Items] | |
Commitment | $ 179,669 |
Costs Incurred as of September 30, 2018 | 59,796 |
Circle Health [Member] | Birmingham, England [Member] | |
Business Acquisition [Line Items] | |
Commitment | 44,228 |
Costs Incurred as of September 30, 2018 | $ 24,113 |
Estimated Rent Commencement Date | 1Q 2019 |
Circle Health Rehabilitation [Member] | Birmingham, England [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 21,973 |
Costs Incurred as of September 30, 2018 | $ 5,304 |
Estimated Rent Commencement Date | 3Q 2019 |
Surgery Partners [Member] | Idaho Falls, ID [Member] | |
Business Acquisition [Line Items] | |
Commitment | $ 113,468 |
Costs Incurred as of September 30, 2018 | $ 30,379 |
Estimated Rent Commencement Date | 1Q 2020 |
Real Estate and Lending Acti_10
Real Estate and Lending Activities - Disposals - Additional Information (Detail) $ in Thousands, € in Millions | Aug. 31, 2018USD ($)Hospital | Aug. 31, 2018EUR (€)Hospital | Jun. 04, 2018USD ($)Hospital | Mar. 01, 2018USD ($) | Mar. 31, 2017USD ($) | Sep. 30, 2018USD ($) | Jun. 30, 2018Hospital | Sep. 30, 2018USD ($) | Sep. 30, 2017USD ($) | Dec. 31, 2017USD ($) |
Debt Instrument [Line Items] | ||||||||||
Proceeds from sale of facilities | $ 64,000 | |||||||||
Gain on real estate dispositions | 7,400 | |||||||||
Gain offset by non-cash charges | $ 600 | |||||||||
Loans, Balance | $ 1,910,522 | $ 1,910,522 | $ 1,928,525 | |||||||
Net proceeds from sale of real estate | 1,513,666 | $ 64,362 | ||||||||
Working Capital Loans [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Loans, Balance | 365,077 | 365,077 | 31,761 | |||||||
Mortgage Loans [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Loans, Balance | 1,428,069 | 1,428,069 | $ 1,778,316 | |||||||
Houston, Texas [Member] | Steward Health Care System LLC [Member] | St. Joseph Medical Center [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Gain on real estate dispositions | $ 1,500 | |||||||||
Gain offset by non-cash charges | 1,700 | |||||||||
Net proceeds from sale of real estate | $ 148,000 | |||||||||
Houston, Texas [Member] | North Cypress [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Proceeds from sale of facilities | $ 148,000 | |||||||||
Gain on real estate dispositions | 102,400 | |||||||||
Gain offset by non-cash charges | $ 2,500 | |||||||||
General Acute Care Hospital and Healthcare System [Member] | Houston, Texas [Member] | North Cypress [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Number of properties sold | Hospital | 1 | 1 | ||||||||
Germany [Member] | Acute Care Hospital [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Gain on real estate dispositions | $ 695,200 | $ 719,400 | ||||||||
California, Texas, and Oregon [Member] | Vibra Healthcare, LLC [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Proceeds from sale of facilities | $ 53,300 | |||||||||
Gain on real estate dispositions | 24,200 | |||||||||
Gain offset by non-cash charges | 5,100 | |||||||||
California, Texas, and Oregon [Member] | Vibra Healthcare, LLC [Member] | Working Capital Loans [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Loans, Balance | 1,500 | |||||||||
California, Texas, and Oregon [Member] | Vibra Healthcare, LLC [Member] | Mortgage Loans [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Loans, Balance | $ 18,300 | |||||||||
California, Texas, and Oregon [Member] | Long-term Acute Care Hospital [Member] | Vibra Healthcare, LLC [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Number of properties sold | Hospital | 3 | |||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||
Debt Instrument [Line Items] | ||||||||||
Number of properties sold | Hospital | 71 | 71 | 71 | |||||||
Proceeds from sale of facilities | € | € 1,635 | |||||||||
Gain on real estate dispositions | $ 500 |
Real Estate and Lending Acti_11
Real Estate and Lending Activities - Summary of Operations for Disposed Assets in 2018 (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017 | ||
Disposal Group Not Discontinued Operation Income Statement Disclosures [Abstract] | |||||
Revenues | [1] | $ 20,115 | $ 35,846 | $ 88,838 | $ 95,320 |
Real estate depreciation and amortization | [2] | (237) | (8,786) | (15,849) | (23,092) |
Property-related expenses | (265) | (388) | (531) | (394) | |
Other | [3] | 692,362 | (3,303) | 715,246 | (11,211) |
Income from real estate dispositions, net | $ 711,975 | $ 23,369 | $ 787,704 | $ 60,623 | |
[1] | Includes $2.5 million and $7.6 million of straight-line rent and other write-offs associated with the disposal transactions for the three and nine months ended September 30, 2018, respectively. | ||||
[2] | Lower in 2018 as we stopped depreciation on properties once deemed held for sale, such as with the 71 properties on June 30, 2018. | ||||
[3] | Includes $695.2 million of gains on sale for the three months ended September 30, 2018 and $719.4 million for the nine months ended September 30, 2018 |
Real Estate and Lending Acti_12
Real Estate and Lending Activities - Summary of Operations for Disposed Assets in 2018 (Parenthetical) (Detail) $ in Thousands | Aug. 31, 2018USD ($)Hospital | Mar. 31, 2017USD ($) | Sep. 30, 2018USD ($) | Jun. 30, 2018Hospital | Sep. 30, 2018USD ($) |
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | |||||
Gain on sale of real estate | $ 7,400 | ||||
Germany [Member] | Acute Care Hospital [Member] | |||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | |||||
Straight-line rent and other write-offs | $ 2,500 | $ 7,600 | |||
Gain on sale of real estate | $ 695,200 | $ 719,400 | |||
Germany [Member] | Acute Care Hospital [Member] | Primotop Holdings S.a.r.l. [Member] | |||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | |||||
Number of properties sold | Hospital | 71 | 71 | |||
Gain on sale of real estate | $ 500 |
Real Estate and Lending Acti_13
Real Estate and Lending Activities - Leasing Operations - Additional Information (Detail) $ in Millions | Mar. 15, 2018USD ($)RenewalOption | Sep. 30, 2018Lease |
Ernest [Member] | ||
Business Acquisition [Line Items] | ||
Number of direct financing leases | 14 | |
Prime Facilities [Member] | ||
Business Acquisition [Line Items] | ||
Number of direct financing leases | 10 | |
Alecto Healthcare Services [Member] | ||
Business Acquisition [Line Items] | ||
Number of direct financing leases | 2 | |
Vibra Healthcare, LLC [Member] | Acute Care Hospital [Member] | ||
Business Acquisition [Line Items] | ||
Term of lease, years | 15 years | |
Number of lease extension options | RenewalOption | 3 | |
Term of lease extension, years | 5 years | |
Write off of unbilled direct finance lease rent | $ | $ 1.5 |
Real Estate and Lending Acti_14
Real Estate and Lending Activities - Components of Net Investment in Direct Financing Leases (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 |
Business Combinations [Abstract] | ||
Minimum lease payments receivable | $ 2,190,840 | $ 2,294,081 |
Estimated residual values | 434,769 | 448,339 |
Less: Unearned income | (1,934,712) | (2,043,693) |
Net investment in direct financing leases | $ 690,897 | $ 698,727 |
Real Estate and Lending Acti_15
Real Estate and Lending Activities - Adeptus Health - Additional Information (Detail) $ in Thousands | Oct. 01, 2018Property | Oct. 02, 2017Facility | Oct. 31, 2018Facility | Aug. 31, 2018Facility | Sep. 30, 2018USD ($)Facility | Sep. 30, 2018USD ($) | Sep. 30, 2017USD ($) |
Business Acquisition [Line Items] | |||||||
Real estate impairment charge | $ | $ 17,615 | $ 1,117 | |||||
Adeptus Health [Member] | |||||||
Business Acquisition [Line Items] | |||||||
Amortization of straight line rent receivables | $ | $ 4,000 | ||||||
Number of facilities transitioned | 16 | ||||||
Number of properties re-leased | 3 | ||||||
Number of transitioned facilities not re-leased | 8 | ||||||
Percentage of investment in remaining transition facilities on total assets | 1.00% | ||||||
Real estate impairment charge | $ | $ 18,000 | ||||||
Adeptus Health [Member] | Subsequent Event [Member] | |||||||
Business Acquisition [Line Items] | |||||||
Number of properties closed | Property | 15 | ||||||
Number of properties re-leased | 5 |
Real Estate and Lending Acti_16
Real Estate and Lending Activities - Gilbert and Florence Facilities - Additional Information (Detail) - USD ($) $ in Millions | Mar. 31, 2017 | Sep. 30, 2018 |
Business Acquisition [Line Items] | ||
Gain offset by non-cash charges | $ 0.6 | |
Gilbert and Florence Facilities [Member] | ||
Business Acquisition [Line Items] | ||
Gain offset by non-cash charges | $ 1.1 | |
Total budgeted investment | $ 37.5 | |
Gilbert and Florence Facilities [Member] | Total Gross Assets [Member] | Credit Concentration Risk [Member] | ||
Business Acquisition [Line Items] | ||
Percentage of Total Gross Assets | 0.40% |
Real Estate and Lending Acti_17
Real Estate and Lending Activities - Alecto Healthcare facilities - Additional Information (Detail) $ in Thousands | 3 Months Ended | 9 Months Ended | |
Sep. 30, 2018USD ($) | Sep. 30, 2018USD ($)Property | Sep. 30, 2017USD ($) | |
Business Acquisition [Line Items] | |||
Real estate impairment charge | $ 17,615 | $ 1,117 | |
Alecto Healthcare Services [Member] | |||
Business Acquisition [Line Items] | |||
Number of leased properties | Property | 4 | ||
Real estate impairment charge | $ 30,000 | ||
Alecto Healthcare Services [Member] | Total Gross Assets [Member] | Customer Concentration Risk | |||
Business Acquisition [Line Items] | |||
Percentage of Total Gross Assets | 1.00% |
Real Estate and Lending Acti_18
Real Estate and Lending Activities - Summary of Loans (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 |
Loans [Line Items] | ||
Loans, Balance | $ 1,910,522 | $ 1,928,525 |
Mortgage Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | 1,428,069 | 1,778,316 |
Acquisition Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | 117,376 | 118,448 |
Working Capital and Other Loans [Member] | ||
Loans [Line Items] | ||
Loans, Balance | $ 365,077 | $ 31,761 |
Real Estate and Lending Acti_19
Real Estate and Lending Activities - Loans - Additional Information (Detail) $ in Millions | Sep. 30, 2018USD ($) |
Ernest Transaction and Other Acquisitions [Member] | |
Business Acquisition [Line Items] | |
Existing mortgage loans | $ 113.3 |
Real Estate and Lending Acti_20
Real Estate and Lending Activities - Concentrations of Credit Risk - Additional Information (Detail) - Investment | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2018 | Sep. 30, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | |
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 80.00% | |||
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 20.00% | |||
Revenue [Member] | Credit Concentration Risk [Member] | Steward [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 37.00% | 23.00% | ||
Revenue [Member] | Credit Concentration Risk [Member] | Prime [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 16.00% | 19.00% | ||
Revenue [Member] | Credit Concentration Risk [Member] | MEDIAN [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 16.00% | 15.00% | ||
Revenue [Member] | Credit Concentration Risk [Member] | Ernest [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 9.00% | 11.00% | ||
Revenue [Member] | Customer Concentration Risk | General Acute Care Hospital and Healthcare System [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 72.00% | |||
Revenue [Member] | Customer Concentration Risk | Rehabilitation Hospital with Covenant Health System [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 24.00% | |||
Revenue [Member] | Customer Concentration Risk | Long-term Acute Care Hospital [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 4.00% | |||
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk | ||||
Business Acquisition [Line Items] | ||||
Number of investment in property | 0 | 0 | ||
Maximum percentage of entity's assets invested on single property | 4.00% | 4.00% | ||
Scenario, Forecast [Member] | Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 80.00% | |||
Scenario, Forecast [Member] | Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member] | ||||
Business Acquisition [Line Items] | ||||
Percentage of revenue from affiliates of total revenue | 20.00% |
Debt - Summary of Debt (Detail)
Debt - Summary of Debt (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 | |
Debt Instrument [Line Items] | |||
Debt | $ 4,082,553 | $ 4,941,310 | |
Debt issue costs, net | (38,704) | (42,643) | |
Debt, net | 4,043,849 | 4,898,667 | |
Revolving Credit Facility [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [1] | 22,153 | 840,810 |
Term Loan [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 200,000 | 200,000 | |
4.000% Senior Unsecured Notes due 2022 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 580,200 | 600,250 |
5.500% Senior Unsecured Notes Due 2024 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 300,000 | 300,000 | |
3.325% Senior Unsecured Notes Due 2025 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | [2] | 580,200 | 600,250 |
6.375% Senior Unsecured Notes due 2024 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 500,000 | 500,000 | |
5.250% Senior Unsecured Notes Due 2026 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | 500,000 | 500,000 | |
5.000% Senior Unsecured Notes Due 2027 [Member] | |||
Debt Instrument [Line Items] | |||
Debt | $ 1,400,000 | $ 1,400,000 | |
[1] | Includes £17 million and £8 million of GBP-denominated borrowings that reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. | ||
[2] | These notes are Euro-denominated and reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. |
Debt - Summary of Debt (Parenth
Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, £ in Millions | Sep. 30, 2018USD ($) | Sep. 30, 2018GBP (£) | Dec. 31, 2017USD ($) | Dec. 31, 2017GBP (£) | Sep. 07, 2017 | Mar. 24, 2017 | |||
Debt Instrument [Line Items] | |||||||||
Debt | $ 4,082,553 | $ 4,941,310 | |||||||
GBP-denominated Borrowings [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Debt | £ | £ 17 | £ 8 | |||||||
4.000% Senior Unsecured Notes due 2022 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | [1] | 4.00% | 4.00% | ||||||
Debt | [1] | $ 580,200 | 600,250 | ||||||
5.500% Senior Unsecured Notes Due 2024 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 5.50% | 5.50% | |||||||
Debt | $ 300,000 | 300,000 | |||||||
6.375% Senior Unsecured Notes due 2024 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 6.375% | 6.375% | |||||||
Debt | $ 500,000 | 500,000 | |||||||
3.325% Senior Unsecured Notes Due 2025 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 3.325% | [1] | 3.325% | [1] | 3.325% | ||||
Debt | [1] | $ 580,200 | 600,250 | ||||||
5.000% Senior Unsecured Notes Due 2027 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 5.00% | 5.00% | 5.00% | ||||||
Debt | $ 1,400,000 | 1,400,000 | |||||||
5.250% Senior Unsecured Notes Due 2026 [Member] | |||||||||
Debt Instrument [Line Items] | |||||||||
Senior unsecured notes, interest rate | 5.25% | 5.25% | |||||||
Debt | $ 500,000 | $ 500,000 | |||||||
[1] | These notes are Euro-denominated and reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. |
Debt - Principal Payments Due f
Debt - Principal Payments Due for Debt (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 |
Debt Disclosure [Abstract] | ||
2,021 | $ 22,153 | |
2,022 | 780,200 | |
Thereafter | 3,280,200 | |
Total | $ 4,082,553 | $ 4,941,310 |
Debt - Additional Information (
Debt - Additional Information (Detail) $ in Thousands | Aug. 31, 2018Hospital | Aug. 03, 2018EUR (€) | Oct. 07, 2017USD ($) | Sep. 29, 2017USD ($) | Sep. 07, 2017USD ($) | Mar. 30, 2017EUR (€) | Mar. 04, 2017EUR (€) | Feb. 01, 2017USD ($) | Sep. 30, 2017USD ($) | Sep. 30, 2018 | Sep. 30, 2017USD ($) | Mar. 24, 2017EUR (€) | Feb. 01, 2017EUR (€) | |
Debt Instrument [Line Items] | ||||||||||||||
Payments of term debt | $ 688,221 | |||||||||||||
Debt refinancing charge | $ 4,414 | $ 18,794 | ||||||||||||
5.750% Senior Unsecured Notes Due 2020 [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Senior notes, redemption date | Mar. 4, 2017 | |||||||||||||
Amount of senior unsecured debt redeemed | € | € 200,000,000 | |||||||||||||
Senior unsecured notes, interest rate | 5.75% | |||||||||||||
Senior unsecured notes, redemption description | On March 4, 2017, we redeemed the €200 million aggregate principal amount of our 5.750% Senior Unsecured Notes due 2020. | |||||||||||||
3.325% Senior Unsecured Notes Due 2025 [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Senior unsecured notes, interest rate | 3.325% | [1] | 3.325% | |||||||||||
Senior unsecured notes face amount | € | € 500,000,000 | |||||||||||||
5.000% Senior Unsecured Notes Due 2027 [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Senior unsecured notes, interest rate | 5.00% | 5.00% | ||||||||||||
Senior unsecured notes face amount | $ 1,400,000 | |||||||||||||
6.375% Senior Unsecured Notes Due 2022 [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Senior unsecured notes, interest rate | 6.375% | |||||||||||||
Payments of term debt | $ 350,000 | |||||||||||||
Unsecured Revolving Credit Facility [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Amount of senior unsecured debt | $ 1,300,000 | |||||||||||||
Term Loan [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Amount of senior unsecured debt | 200,000 | € 200,000,000 | ||||||||||||
Decrease in unsecured debt from previous facility | $ 50,000 | |||||||||||||
Prepaid and extinguished term loans | $ 12,900 | € 200,000,000 | ||||||||||||
Term Loan [Member] | J P Morgan Chase Bank [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Prepaid and extinguished term loans | 1,000,000 | |||||||||||||
Cancellation fees | $ 5,200 | |||||||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Proceeds from issuance of new secured debt | € | € 655,000,000 | |||||||||||||
Primotop Holdings S.a.r.l. [Member] | Germany [Member] | Acute Care Hospital [Member] | Secured Debt [Member] | ||||||||||||||
Debt Instrument [Line Items] | ||||||||||||||
Number of facilities acquired | Hospital | 71 | |||||||||||||
Debt instrument term | 7 years | |||||||||||||
Debt instrument swapped fixed rate | 2.30% | |||||||||||||
[1] | These notes are Euro-denominated and reflect the exchange rate at September 30, 2018 and December 31, 2017, respectively. |
Debt - Covenants - Additional I
Debt - Covenants - Additional Information (Detail) | 9 Months Ended |
Sep. 30, 2018 | |
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% |
Common Stock_Partners' Capital
Common Stock/Partners' Capital - Additional Information (Detail) shares in Thousands, $ in Thousands | May 01, 2017USD ($)shares | Sep. 30, 2018Partnershares | Sep. 30, 2017USD ($)shares | Dec. 31, 2017shares |
Class of Stock [Line Items] | ||||
Common stock, shares issued | 364,858 | 364,424 | ||
Proceeds from sale of common shares / units, net of offering costs | $ | $ 548,055 | |||
MPT Operating Partnership, L.P. [Member] | ||||
Class of Stock [Line Items] | ||||
Proceeds from sale of common shares / units, net of offering costs | $ | $ 548,055 | |||
Ownership interest in equity | 99.92% | |||
Number of other partners | Partner | 2 | |||
Number of units sold | 43,100 | |||
Public Offering [Member] | ||||
Class of Stock [Line Items] | ||||
Common stock, shares issued | 43,100 | |||
Additional shares purchased by underwriters | 5,600 | |||
Proceeds from sale of common shares / units, net of offering costs | $ | $ 548,000 |
Stock Awards - Additional Infor
Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands | 9 Months Ended | |
Sep. 30, 2018 | Sep. 30, 2017 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Share / (Unit)-based compensation expense | $ 11,695 | $ 7,148 |
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 | 1,697,002 |
Fair Value of Financial Instr_3
Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands | Sep. 30, 2018 | Dec. 31, 2017 |
Fair Value Disclosures [Abstract] | ||
Interest and rent receivables, Book value | $ 87,939 | $ 78,970 |
Loans, Book value | 1,681,562 | 1,698,471 |
Debt, net Book value | (4,043,849) | (4,898,667) |
Interest and rent receivables, Fair value | 87,067 | 78,028 |
Loans, Fair value | 1,700,346 | 1,722,101 |
Debt, net Fair value | $ (4,087,207) | $ (5,073,707) |
Fair Value of Financial Instr_4
Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) $ in Thousands | Sep. 30, 2018USD ($) |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |
Fair Value | $ 223,373 |
Original Cost | 232,260 |
Fair Value Measurements, Recurring [Member] | Equity Method Investment and Other Loans [Member] | Other Loans and Other Assets [Member] | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |
Fair Value | 108,373 |
Original Cost | 117,260 |
Fair Value Measurements, Recurring [Member] | Mortgage Loans [Member] | Mortgage Loans [Member] | |
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items] | |
Fair Value | 115,000 |
Original Cost | $ 115,000 |
Fair Value of Financial Instr_5
Fair Value of Financial Instruments - Additional information (Detail) | 9 Months Ended |
Sep. 30, 2017USD ($) | |
Ernest [Member] | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items] | |
Unrealized gain/loss on investments | $ 0 |
Earnings Per Share - Calculatio
Earnings Per Share - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017 | |
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | ||||
Net income | $ 736,476 | $ 76,881 | $ 939,536 | $ 218,862 |
Net income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Participating securities’ share in earnings | (290) | (82) | (808) | (307) |
Net income, less participating securities’ share in earnings | $ 735,744 | $ 76,382 | $ 937,394 | $ 217,542 |
Basic weighted-average common shares | 365,024 | 364,315 | 364,934 | 345,076 |
Dilutive potential common shares | 1,443 | 731 | 850 | 520 |
Dilutive weighted-average common shares | 366,467 | 365,046 | 365,784 | 345,596 |
MPT Operating Partnership, L.P. [Member] | ||||
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items] | ||||
Net income | $ 736,476 | $ 76,881 | $ 939,536 | $ 218,862 |
Net income attributable to non-controlling interests | (442) | (417) | (1,334) | (1,013) |
Participating securities’ share in earnings | (290) | (82) | (808) | (307) |
Net income, less participating securities’ share in earnings | $ 735,744 | $ 76,382 | $ 937,394 | $ 217,542 |
Basic weighted-average common shares | 365,024 | 364,315 | 364,934 | 345,076 |
Dilutive potential common shares | 1,443 | 731 | 850 | 520 |
Dilutive weighted-average common shares | 366,467 | 365,046 | 365,784 | 345,596 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) € in Millions | Jun. 06, 2018EUR (€)Hospital | Jan. 30, 2017EUR (€) | Dec. 31, 2018EUR (€) | Sep. 30, 2018Facility | Jan. 30, 2017EUR (€)Hospital |
Commitment And Contingencies [Line Items] | |||||
Number of facilities closed | Facility | 3 | ||||
Scenario, Forecast [Member] | |||||
Commitment And Contingencies [Line Items] | |||||
Consideration expected to be receive at closing | € 5.8 | ||||
Germany [Member] | Acute Care Hospital [Member] | |||||
Commitment And Contingencies [Line Items] | |||||
Purchase price of acquisition | € 23 | ||||
Germany [Member] | Rehabilitation Hospitals [Member] | |||||
Commitment And Contingencies [Line Items] | |||||
Purchase price of acquisition | € 8.4 | € 44.1 | |||
Number of facilities acquired | Hospital | 4 | 6 |
Subsequent Events - Additional
Subsequent Events - Additional Information (Detail) $ in Millions | Oct. 04, 2018USD ($) |
Ernest [Member] | Subsequent Event [Member] | |
Subsequent Event [Line Items] | |
Proceeds From Sale of Investment in Operations under Recapitalization Agreement | $ 176 |