Medical Properties Trust (MPW) 10-K 26 Feb 20 2019 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2019	Feb. 21, 2020	Jun. 30, 2019
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Trading Symbol	MPW
Entity Registrant Name	Medical Properties Trust, Inc
Entity Central Index Key	0001287865
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		520,927,310
Entity Public Float			$ 6,838,816,594
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
Entity File Number	001-32559
Entity Tax Identification Number	20-0191742
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	(205)
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	MD
Document Annual Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Documents Incorporated by Reference	Portions of the definitive Proxy Statement of Medical Properties Trust, Inc. for the Annual Meeting of Stockholders to be held on May 21, 2020 are incorporated by reference into Items 10 through 14 of Part III, of this Annual Report on Form 10-K.
MPT Operating Partnership, L.P. [Member]
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Entity Registrant Name	MPT Operating Partnership, L.P.
Entity Central Index Key	0001524607
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Non-accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Tax Identification Number	20-0242069
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	(205)
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	DE
Entity Interactive Data Current	Yes

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Real estate assets
Land	$ 1,017,402	$ 547,894
Buildings and improvements	6,295,084	4,233,255
Construction in progress	168,212	84,172
Intangible lease assets	622,056	403,138
Investment in financing leases	2,060,302	684,053
Mortgage loans	1,275,022	1,213,322
Gross investment in real estate assets	11,438,078	7,165,834
Accumulated depreciation	(504,651)	(414,331)
Accumulated amortization	(65,391)	(50,653)
Net investment in real estate assets	10,868,036	6,700,850
Cash and cash equivalents	1,462,286	820,868
Interest and rent receivables	31,357	25,855
Straight-line rent receivables	334,231	220,848
Equity investments	926,990	520,058
Other loans	544,832	373,198
Other assets	299,599	181,966
Total Assets	14,467,331	8,843,643
Liabilities
Debt, net	7,023,679	4,037,389
Accounts payable and accrued expenses	291,489	204,325
Deferred revenue	16,098	13,467
Obligations to tenants and other lease liabilities	107,911	27,524
Total Liabilities	7,439,177	4,282,705
Commitments and Contingencies
Equity / Capital
Preferred stock, $0.001 par value. Authorized 10,000 shares; no shares outstanding
Common stock, $0.001 par value. Authorized 750,000 shares; issued and outstanding — 517,522 shares at December 31, 2019 and 370,637 shares at December 31, 2018	518	371
Limited Partners:
Additional paid-in capital	7,008,199	4,442,948
Retained earnings	83,012	162,768
Accumulated other comprehensive loss	(62,905)	(58,202)
Treasury shares, at cost	(777)	(777)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,028,047	4,547,108
Non-controlling interests	107	13,830
Total Equity / Capital	7,028,154	4,560,938
Total Liabilities and Equity / Capital	14,467,331	8,843,643
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,017,402	547,894
Buildings and improvements	6,295,084	4,233,255
Construction in progress	168,212	84,172
Intangible lease assets	622,056	403,138
Investment in financing leases	2,060,302	684,053
Mortgage loans	1,275,022	1,213,322
Gross investment in real estate assets	11,438,078	7,165,834
Accumulated depreciation	(504,651)	(414,331)
Accumulated amortization	(65,391)	(50,653)
Net investment in real estate assets	10,868,036	6,700,850
Cash and cash equivalents	1,462,286	820,868
Interest and rent receivables	31,357	25,855
Straight-line rent receivables	334,231	220,848
Equity investments	926,990	520,058
Other loans	544,832	373,198
Other assets	299,599	181,966
Total Assets	14,467,331	8,843,643
Liabilities
Debt, net	7,023,679	4,037,389
Accounts payable and accrued expenses	152,999	108,574
Deferred revenue	16,098	13,467
Obligations to tenants and other lease liabilities	107,911	27,524
Payable due to Medical Properties Trust, Inc.	138,100	95,361
Total Liabilities	7,438,787	4,282,315
Commitments and Contingencies
Limited Partners:
Accumulated other comprehensive loss	(62,905)	(58,202)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	7,028,437	4,547,498
Non-controlling interests	107	13,830
Total Equity / Capital	7,028,544	4,561,328
Total Liabilities and Equity / Capital	14,467,331	8,843,643
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners:
Total Equity / Capital	70,939	46,084
General partner — issued and outstanding — 5,176 units at December 31, 2019 and 3,706 units at December 31, 2018	70,939	46,084
Common Units [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners:
Common units — issued and outstanding — 512,346 units at December 31, 2019 and 366,931 units at December 31, 2018	$ 7,020,403	$ 4,559,616

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2019	Dec. 31, 2018
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	750,000,000	750,000,000
Common stock, shares issued	517,522,000	370,637,000
Common stock, shares outstanding	517,522,000	370,637,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,176,000	3,706,000
General partner, units outstanding	5,176,000	3,706,000
Common Units [Member] | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	512,346,000	366,931,000
Limited Partners, units outstanding	512,346,000	366,931,000
LTIP Units [Member] | MPT Operating Partnership, L.P. [Member]
LTIP Units, shares issued	232,000	232,000
LTIP Units, shares outstanding	232,000	232,000

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Revenues
Rent billed	$ 474,151	$ 473,343	$ 435,782
Straight-line rent	110,456	74,741	65,468
Income from direct financing leases	119,617	73,983	74,495
Interest and other income	149,973	162,455	129,000
Total revenues	854,197	784,522	704,745
Expenses
Interest expense	237,830	223,274	176,954
Real estate depreciation and amortization	152,313	133,083	125,106
Property-related	23,992	9,237	5,811
General and administrative	96,411	80,086	58,599
Acquisition costs		917	29,645
Total expenses	510,546	446,597	396,115
Other income (expense)
Gain on sale of real estate and other	41,560	719,392	7,431
Impairment charges	(21,031)	(48,007)
Earnings from equity interests	16,051	14,165	10,058
Debt refinancing and unutilized financing costs	(6,106)		(32,574)
Other	(345)	(4,071)	374
Total other income (expense)	30,129	681,479	(14,711)
Income before income tax	373,780	1,019,404	293,919
Income tax benefit (expense)	2,621	(927)	(2,681)
Net income	376,401	1,018,477	291,238
Net income attributable to non-controlling interests	(1,717)	(1,792)	(1,445)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 374,684	$ 1,016,685	$ 289,793
Earnings per share (unit) — basic
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.87	$ 2.77	$ 0.82
Weighted average shares (units) outstanding — basic	427,075	365,364	349,902
Earnings per share (unit) — diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.87	$ 2.76	$ 0.82
Weighted average shares (units) outstanding — diluted	428,299	366,271	350,441
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 474,151	$ 473,343	$ 435,782
Straight-line rent	110,456	74,741	65,468
Income from direct financing leases	119,617	73,983	74,495
Interest and other income	149,973	162,455	129,000
Total revenues	854,197	784,522	704,745
Expenses
Interest expense	237,830	223,274	176,954
Real estate depreciation and amortization	152,313	133,083	125,106
Property-related	23,992	9,237	5,811
General and administrative	96,411	80,086	58,599
Acquisition costs		917	29,645
Total expenses	510,546	446,597	396,115
Other income (expense)
Gain on sale of real estate and other	41,560	719,392	7,431
Impairment charges	(21,031)	(48,007)
Earnings from equity interests	16,051	14,165	10,058
Debt refinancing and unutilized financing costs	(6,106)		(32,574)
Other	(345)	(4,071)	374
Total other income (expense)	30,129	681,479	(14,711)
Income before income tax	373,780	1,019,404	293,919
Income tax benefit (expense)	2,621	(927)	(2,681)
Net income	376,401	1,018,477	291,238
Net income attributable to non-controlling interests	(1,717)	(1,792)	(1,445)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 374,684	$ 1,016,685	$ 289,793
Earnings per share (unit) — basic
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.87	$ 2.77	$ 0.82
Weighted average shares (units) outstanding — basic	427,075	365,364	349,902
Earnings per share (unit) — diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.87	$ 2.76	$ 0.82
Weighted average shares (units) outstanding — diluted	428,299	366,271	350,441

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Net income	$ 376,401	$ 1,018,477	$ 291,238
Other comprehensive income (loss):
Unrealized loss on interest rate swap	(9,033)	(3,317)
Foreign currency translation gain (loss)	4,330	(28,836)	66,854
Total comprehensive income	371,698	986,324	358,092
Comprehensive income attributable to non-controlling interests	(1,717)	(1,792)	(1,445)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	369,981	984,532	356,647
MPT Operating Partnership, L.P. [Member]
Net income	376,401	1,018,477	291,238
Other comprehensive income (loss):
Unrealized loss on interest rate swap	(9,033)	(3,317)
Foreign currency translation gain (loss)	4,330	(28,836)	66,854
Total comprehensive income	371,698	986,324	358,092
Comprehensive income attributable to non-controlling interests	(1,717)	(1,792)	(1,445)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 369,981	$ 984,532	$ 356,647

Consolidated Statements of Equi

Consolidated Statements of Equity / Capital - USD ($) shares in Thousands, $ in Thousands	Total	MPT Operating Partnership, L.P. [Member]	MPT Operating Partnership, L.P. [Member]General Partner [Member]	Common Par Value [Member]	Common Par Value [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]	Additional Paid-in Capital [Member]	Retained Earnings (Deficit) [Member]	Accumulated Other Comprehensive Loss [Member]	Accumulated Other Comprehensive Loss [Member]MPT Operating Partnership, L.P. [Member]	Treasury Shares [Member]	Non-Controlling Interests [Member]	Non-Controlling Interests [Member]MPT Operating Partnership, L.P. [Member]	Long Term Incentive Plan [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]
Beginning balance at Dec. 31, 2016	$ 3,253,228	$ 3,253,618	$ 33,436	$ 321	$ 3,308,235	$ 3,775,336	$ (434,114)	$ (92,903)	$ (92,903)	$ (262)	$ 4,850	$ 4,850
Beginning balance (in shares) at Dec. 31, 2016			3,204	320,514	317,310								292
Net income	291,238	291,238	$ 2,898		$ 286,895		289,793				1,445	1,445
Sale of non-controlling interests	10,000										10,000
Foreign currency translation gain (loss)	66,854	66,854						66,854	66,854
Stock (Unit) vesting and amortization of stock (unit)-based compensation	9,949	9,949	$ 99		$ 9,850	9,949
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			9	785	776
Treasury shares acquired (41,270 shares)	(515)									(515)
Distributions to non-controlling interests, net	(1,723)	(1,723)									(1,723)	(1,723)
Proceeds from offering (net of offering costs)	547,785	547,785	$ 5,478	$ 43	$ 542,307	547,742
Proceeds from offering (net of offering costs) (shares)			431	43,125	42,694
Dividends (Distributions) declared	(341,611)	(341,611)	$ (3,416)		$ (338,195)		(341,611)
Ending balance at Dec. 31, 2017	3,835,205	3,835,595	$ 38,489	$ 364	$ 3,808,583	4,333,027	(485,932)	(26,049)	(26,049)	(777)	14,572	14,572
Ending balance (in shares) at Dec. 31, 2017			3,644	364,424	360,780								292
Sale of non-controlling interests		10,000										10,000
Treasury units acquired (41,270 units)		(515)	$ (6)		$ (509)
Net income	1,018,477	1,018,477	10,167		1,006,518		1,016,685				1,792	1,792
Cumulative effect of change in accounting principles	1,938	1,938	19		1,919		1,938
Unrealized loss on interest rate swap	(3,317)	(3,317)						(3,317)	(3,317)
Foreign currency translation gain (loss)	(28,836)	(28,836)						(28,836)	(28,836)
Stock (Unit) vesting and amortization of stock (unit)-based compensation	16,505	16,505	$ 165	$ 1	$ 16,340	16,504
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			6	599	593
Redemption of MOP units/common units	(816)	(816)			$ (816)	(816)
Distributions to non-controlling interests, net	(2,534)	(2,534)									(2,534)	(2,534)
Proceeds from offering (net of offering costs)	94,239	94,239	$ 942	$ 6	$ 93,297	94,233
Proceeds from offering (net of offering costs) (shares)			56	5,614	5,558
Dividends (Distributions) declared	(369,923)	(369,923)	$ (3,698)		$ (366,225)		(369,923)
Ending balance at Dec. 31, 2018	4,560,938	4,561,328	$ 46,084	$ 371	$ 4,559,616	4,442,948	162,768	(58,202)	(58,202)	(777)	13,830	13,830
Ending balance (in shares) at Dec. 31, 2018			3,706	370,637	366,931								232
Conversion of LTIP units to common units (shares)					60								(60)
Redemption of common units (shares)					(60)
Net income	376,401	376,401	$ 3,746		$ 370,938		374,684				1,717	1,717
Unrealized loss on interest rate swap	(9,033)	(9,033)						(9,033)	(9,033)
Foreign currency translation gain (loss)	4,330	4,330						4,330	4,330
Stock (Unit) vesting and amortization of stock (unit)-based compensation	32,188	32,188	$ 322	$ 2	$ 31,866	32,186
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			15	1,536	1,521
Distributions to non-controlling interests, net	(15,440)	(15,440)									(15,440)	(15,440)
Proceeds from offering (net of offering costs)	2,533,210	2,533,210	$ 25,332	$ 145	$ 2,507,878	2,533,065
Proceeds from offering (net of offering costs) (shares)			1,455	145,349	143,894
Dividends (Distributions) declared	(454,440)	(454,440)	$ (4,545)		$ (449,895)		(454,440)
Ending balance at Dec. 31, 2019	$ 7,028,154	$ 7,028,544	$ 70,939	$ 518	$ 7,020,403	$ 7,008,199	$ 83,012	$ (62,905)	$ (62,905)	$ (777)	$ 107	$ 107
Ending balance (in shares) at Dec. 31, 2019			5,176	517,522	512,346								232

Consolidated Statements of Eq_2

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares shares in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Treasury shares acquired (shares)			41,270
Dividends (Distributions) declared per common share / unit	$ 1.02	$ 1	$ 0.96
MPT Operating Partnership, L.P. [Member]
Treasury shares acquired (shares)			41,270
Dividends (Distributions) declared per common share / unit	1.02	1	$ 0.96
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Treasury shares acquired (shares)			41,270
Dividends (Distributions) declared per common share / unit	1.02	1	$ 0.96
Retained Earnings (Deficit) [Member]
Dividends (Distributions) declared per common share / unit	1.02	1	$ 0.96
Treasury Shares [Member]
Treasury shares acquired (shares)			41,270
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Treasury shares acquired (shares)			41,270
Dividends (Distributions) declared per common share / unit	$ 1.02	$ 1	$ 0.96

Consolidated Statements of Cash

Consolidated Statements of Cash Flows $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Operating activities
Net income	$ 376,401	$ 1,018,477	$ 291,238
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	156,575	141,492	131,979
Amortization of deferred financing costs and debt discount	8,881	7,363	6,521
Straight-line rent revenue and other	(138,806)	(100,594)	(80,741)
Share / (Unit)-based compensation expense	32,188	16,505	9,949
Gain from sale of real estate and other	(41,560)	(719,392)	(7,431)
Impairment charges	21,031	48,007
Straight-line rent and other write-off	15,539	18,002	5,340
Debt refinancing and unutilized financing costs	6,106		32,574
Other adjustments	4,637	(3,768)	(1,204)
Changes in:
Interest and rent receivables	12,906	46,498	(21,116)
Other assets	(4,992)	(18,051)	(5,318)
Accounts payable and accrued expenses	39,630	(5,596)	2,494
Deferred revenue	5,581	145	(2,050)
Net cash provided by operating activities	494,117	449,088	362,235
Investing activities
Cash paid for acquisitions and other related investments	(4,565,594)	(1,430,995)	(2,246,788)
Net proceeds from sale of real estate	111,766	1,513,666	64,362
Principal received on loans receivable	920	885,917	8,480
Investment in loans receivable	(54,088)	(212,002)	(19,338)
Construction in progress and other	(83,798)	(53,967)	(73,812)
Capital additions and other investments, net	(293,163)	(138,441)	(94,970)
Net cash (used for) provided by investing activities	(4,883,957)	564,178	(2,362,066)
Financing activities
Proceeds from term debt, net of discount	3,048,424	759,735	2,355,280
Payments of term debt			(1,038,221)
Payment of deferred financing costs	(30,186)		(32,794)
Revolving credit facilities, net	(65,736)	(811,718)	550,415
Distributions paid	(411,697)	(363,906)	(326,729)
Lease deposits and other obligations to tenants	(12,260)	(20,606)	27,525
Proceeds from sale of common shares, net of offering costs	2,533,210	94,239	547,785
Other financing activities	(19,871)	(3,614)	(12,984)
Net cash provided by (used for) financing activities	5,041,884	(345,870)	2,070,277
Increase in cash, cash equivalents, and restricted cash for the year	652,044	667,396	70,446
Effect of exchange rate changes	(6,478)	(17,218)	16,920
Cash, cash equivalents, and restricted cash at beginning of year	822,425	172,247	84,881
Cash, cash equivalents, and restricted cash at end of year	1,467,991	822,425	172,247
Interest paid, including capitalized interest of $3,936 in 2019, $1,480 in 2018, and $840 in 2017	211,163	221,779	149,798
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	138,161	95,419	89,403
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	820,868	171,472	83,240
Restricted cash, included in Other assets at beginning of period	$ 1,557	$ 775	$ 1,641
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of year	$ 822,425	$ 172,247	$ 84,881
Cash and cash equivalents at end of period	1,462,286	820,868	171,472
Restricted cash, included in Other assets at end of period	$ 5,705	$ 1,557	$ 775
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of year	$ 1,467,991	$ 822,425	$ 172,247
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	376,401	1,018,477	291,238
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	156,575	141,492	131,979
Amortization of deferred financing costs and debt discount	8,881	7,363	6,521
Straight-line rent revenue and other	(138,806)	(100,594)	(80,741)
Share / (Unit)-based compensation expense	32,188	16,505	9,949
Gain from sale of real estate and other	(41,560)	(719,392)	(7,431)
Impairment charges	21,031	48,007
Straight-line rent and other write-off	15,539	18,002	5,340
Debt refinancing and unutilized financing costs	6,106		32,574
Other adjustments	4,637	(3,768)	(1,204)
Changes in:
Interest and rent receivables	12,906	46,498	(21,116)
Other assets	(4,992)	(18,051)	(5,318)
Accounts payable and accrued expenses	39,630	(5,596)	2,494
Deferred revenue	5,581	145	(2,050)
Net cash provided by operating activities	494,117	449,088	362,235
Investing activities
Cash paid for acquisitions and other related investments	(4,565,594)	(1,430,995)	(2,246,788)
Net proceeds from sale of real estate	111,766	1,513,666	64,362
Principal received on loans receivable	920	885,917	8,480
Investment in loans receivable	(54,088)	(212,002)	(19,338)
Construction in progress and other	(83,798)	(53,967)	(73,812)
Capital additions and other investments, net	(293,163)	(138,441)	(94,970)
Net cash (used for) provided by investing activities	(4,883,957)	564,178	(2,362,066)
Financing activities
Proceeds from term debt, net of discount	3,048,424	759,735	2,355,280
Payments of term debt			(1,038,221)
Payment of deferred financing costs	(30,186)		(32,794)
Revolving credit facilities, net	(65,736)	(811,718)	550,415
Distributions paid	(411,697)	(363,906)	(326,729)
Lease deposits and other obligations to tenants	(12,260)	(20,606)	27,525
Proceeds from sale of units, net of offering costs	2,533,210	94,239	547,785
Other financing activities	(19,871)	(3,614)	(12,984)
Net cash provided by (used for) financing activities	5,041,884	(345,870)	2,070,277
Increase in cash, cash equivalents, and restricted cash for the year	652,044	667,396	70,446
Effect of exchange rate changes	(6,478)	(17,218)	16,920
Cash, cash equivalents, and restricted cash at beginning of year	822,425	172,247	84,881
Cash, cash equivalents, and restricted cash at end of year	1,467,991	822,425	172,247
Interest paid, including capitalized interest of $3,936 in 2019, $1,480 in 2018, and $840 in 2017	211,163	221,779	149,798
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	138,161	95,419	89,403
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	820,868	171,472	83,240
Restricted cash, included in Other assets at beginning of period	$ 1,557	$ 775	$ 1,641
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at beginning of year	$ 822,425	$ 172,247	$ 84,881
Cash and cash equivalents at end of period	1,462,286	820,868	171,472
Restricted cash, included in Other assets at end of period	$ 5,705	$ 1,557	$ 775
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets	us-gaap:OtherAssets	us-gaap:OtherAssets
Cash, cash equivalents, and restricted cash at end of year	$ 1,467,991	$ 822,425	$ 172,247

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Interest paid, capitalized	$ 3,936	$ 1,480	$ 840
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 3,936	$ 1,480	$ 840

Organization

Organization	12 Months Ended
	Dec. 31, 2019
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., through which we conduct all of our operations, was formed in September 2003. Through another wholly-owned subsidiary, Medical Properties Trust, LLC, we are the sole general partner of the Operating Partnership. At present, we directly own substantially all of the limited partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist. We have operated as a real estate investment trust (“REIT”) since April 6, 2004, and accordingly, elected REIT status upon the filing in September 2005 of the calendar year 2004 federal income tax return. Accordingly, we will generally not be subject to United States (“U.S.”) federal income tax, provided that we continue to qualify as a REIT and our distributions to our stockholders equal or exceed our taxable income. Certain non-real estate activities we undertake are conducted by entities which we elected to be treated as taxable REIT subsidiaries (“TRS”). Our TRS entities are subject to both U.S. federal and state income taxes. For our properties, located outside the U.S., we are subject to the local taxes of the jurisdictions where our properties reside and/or legal entities are domiciled; however, we do not expect to incur additional taxes in the U.S. as the majority of such income flows through our REIT. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services, such as operators of general acute care hospitals, inpatient physical rehabilitation hospitals, and long-term acute care hospitals. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time to time, in order to enhance our overall return. We manage our business as a single business segment. All of our properties are located in the U.S., Europe, and Australia.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Use of Estimates: The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity. If we determine that we have a variable interest in a variable interest entity, we then evaluate if we are the primary beneficiary of the variable interest entity. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a variable interest entity that most significantly impact the entity’s economic performance. We consolidate each variable interest entity in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2019 and 2018, we determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities. Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) as discussed in Note 3. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is o ther-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. For similar investments but for which there are readily determinable fair values, such investments are measured at fair value quarterly, with unrealized gains and losses recorded in income. Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets. Revenue Recognition: Our revenues are primarily from leases and mortgage loans. On January 1, 2019, we adopted Accounting Standards Update (“ASU”) 2016-02, “Leases”, (“ASU 2016-02”). ASU 2016-02 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). We adopted this standard using the modified retrospective approach and have elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things permits the following: no reassessment of whether existing contracts are or contain a lease and no reassessment of lease classification for existing leases. In addition, we made certain elections permitted which (1) permits entities to apply the transition provisions of the new standard at its adoption date instead of at the earliest comparative period presented and (2) permits lessors to account for lease and non-lease components as a single lease component in a contract if certain criteria are met. For lessors, this new standard of accounting for leases is substantially equivalent to previous guidance, but there are some differences which we highlight below: Operating Lease Revenue We receive income from operating leases based on the fixed, minimum required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rent earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the consolidated statements of net income is presented as two amounts: rent billed and straight-line rent revenue. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivable. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under the new lease accounting rules adopted on January 1, 2019, if an acquisition and subsequent lease of a property to the seller does not meet the definition of a sale, we must account for the transaction as a financing with income recognized using the imputed interest method. Another type of financing lease that we carried forward from the previous lease accounting guidance is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Starting January 1, 2019 (with the adoption of ASU 2016-02), tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis, consistent with how all tenant payments or reimbursements pursuant to our “triple-net” leases were accounted for prior to ASU 2016-02. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method. Acquired Real Estate Purchase Price Allocation: Since January 1, 2018 with adoption of ASU No. 2017-01, “Clarifying the Definition of a Business” (“ASU 2017-01”), all of our property acquisitions have been accounted for as asset acquisitions. Prior to 2018, properties acquired for leasing purposes were accounted for using business combination accounting rules. The primary impact to us from this change in accounting is the capitalization of third party transaction costs that are directly related to the acquisition as these costs were expensed under business combination accounting rules. Under either accounting method, we allocate the purchase price of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time to time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition or financing of the respective property, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of these intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2019 are as follows: Buildings and improvements 39.0 years Tenant lease intangibles 23.7 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.7 years Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenants’ operating margins both to facility rent and to facility rent plus other fixed costs; trends in cash collections; trends in revenue and patient mix; and the effect of evolving healthcare regulations on tenants’ profitability and liquidity. Losses from Operating Lease Receivables: Losses on Financing Lease Receivables: Loans: Loans consist of mortgage loans, working capital loans, and other long-term loans. Mortgage loans are collateralized by interests in real property. Working capital and other long-term loans are generally collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. We evaluate the collectability of both interest and principal on a loan-by-loan basis (using the same process as we do for assessing the collectability of rents) to determine whether they are impaired. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due according to the existing contractual terms. When a loan is considered to be impaired, the amount of the allowance is calculated by comparing the recorded investment to either the value determined by discounting the expected future cash flows using the loan’s effective interest rate or to the fair value of the collateral, if the loan is collateral dependent. If a loan is deemed to be impaired, we generally place the loan on non-accrual status and record interest income only upon receipt of cash. Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income applicable to common shares/units by the weighted-average number of shares/units of common stock/units outstanding during the period. Diluted earnings per common share/units is calculated by including the effect of dilutive securities. Our unvested restricted stock/unit awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit. Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of a TRS, MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity. With the property acquisitions and investments in Europe and Australia, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. Awards of restricted stock and other equity-based awards with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur. Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan. Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within Debt, net on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility , the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “ Other a ssets ” on our consolidated balance sheets. Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in “Accumulated other comprehensive income (loss)”, a component of stockholders’ equity on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation effects on our long-term investments are recorded in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets. Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivatives offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur. Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for identical instruments in active markets; • Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2. If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques that have been used by us include discounted cash flow and Monte Carlo valuat ion models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity interest in Ernest Health, Inc. (“Ernest”) along with any related loans (all of which other than the mortgage loans were sold or paid off on October 4, 2018 - see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans that existed at De

Real Estate Activities

Real Estate Activities	12 Months Ended
	Dec. 31, 2019
Real Estate [Abstract]
Real Estate Activities	3. Real Estate Activities Acquisitions For the years ended December 31, 2019, 2018, and 2017, we acquired the following assets: 2019 2018 2017 (in thousands) Assets Acquired Land $ 400,539 $ 71,880 $ 240,993 Building 1,951,066 686,739 985,219 Intangible lease assets — subject to amortization (weighted-average useful life of 19.1 years in 2019, 27.9 years in 2018, and 27.7 years in 2017) 227,468 90,651 181,004 Investment in financing leases 1,386,797 — 40,450 Mortgage loans 51,267 — 700,000 Other loans 135,258 336,458 — Equity investments and other assets 415,836 245,267 100,000 Liabilities assumed (2,637 ) — (878 ) Total assets acquired $ 4,565,594 $ 1,430,995 $ 2,246,788 Loans repaid(1) — (764,447 ) — Total net assets acquired $ 4,565,594 $ 666,548 $ 2,246,788 (1) The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below. 2019 Activity LifePoint Acquisition On December 17, 2019, we acquired a portfolio of 10 acute care hospitals owned and operated by LifePoint Health, Inc. (“LifePoint”) for a combined purchase price of approximately $700.0 million. The properties are leased to LifePoint under one master lease agreement. The master lease has a 20-year initial term and two five-year Prospect Transaction On August 23, 2019, we invested in a portfolio of 14 acute care hospitals and two behavioral health facilities operated by Prospect Medical Holdings, Inc. (“Prospect”) for a combined purchase price of approximately $1.55 billion. Our investment includes the acquisition of the real estate of 11 acute care hospitals and two behavioral health facilities for $1.4 billion. We are accounting for these properties as a financing (as presented in the “Investment in financing leases” line of the consolidated balance sheets) under the new lease accounting rules due to certain lessee end-of-term purchase options. In addition, we originated a $51.3 million mortgage loan, secured by a first mortgage on an acute care hospital, and a $112.9 million term loan which we expect will be converted into the acquisition of two additional acute care hospitals upon the satisfaction of certain conditions. The master leases and mortgage loan have substantially similar terms, with a 15-year fixed term subject to three extension options, plus annual inflation-based escalators. The agreements provide for the potential for a future purchase price adjustment of up to an additional $250.0 million, based on achievement of certain performance thresholds over a three-year Ramsay Acquisition On August 16, 2019, we acquired freehold interests in eight acute care hospitals located throughout England for an aggregate purchase price of approximately £347 million. The hospitals are leased to Ramsay pursuant to in-place net leases with approximate 18-year remaining lease terms and include annual fixed and periodic market-based escalations. Australia Transaction On June 6, 2019, we acquired 11 hospitals in Australia for a purchase price of approximately AUD $1.2 billion plus stamp duties and registration fees of AUD $66.6 million. The properties are leased to Healthscope, pursuant to master lease agreements that have an average initial term of 20 years with annual fixed escalations and multiple extension options. Healthscope was acquired in a simultaneous transaction by Brookfield Business Partners L.P. and certain of its institutional partners. Switzerland Transactions On May 27, 2019, we invested in a portfolio of 13 acute care campuses and two additional properties in Switzerland for an aggregate purchase price of approximately CHF 236.6 million. The investment was effected through our purchase of a 46% stake in a Swiss healthcare real estate company, Infracore SA, from the previous majority shareholder, Aevis Victoria SA (“Aevis”). The facilities are leased to Swiss Medical Network, a wholly-owned Aevis subsidiary, pursuant to leases with an average 23-year remaining term subject to annual escalation provisions. We are accounting for our 46% interest in this joint venture under the equity method. Additionally, we purchased a 4.9% stake in Aevis for approximately CHF 47 million on June 28, 2019 that we are marking to fair value through income each quarter. Other Transactions On December 3, 2019, we invested in two acute care hospitals in Spain for a purchase price of approximately €117.3 million. The investment was effected through our purchase of a 45% stake in a Spanish entity. The facilities are leased to HM Hospitales pursuant to a master lease with an initial lease term of 25 years. The lease provides for annual inflation-based escalators. We are accounting for our 45% interest in this joint venture under the equity method. On November 28, 2019, we acquired an acute care hospital in Portugal for approximately €28.2 On August 30, 2019, we invested in a portfolio of facilities throughout various states for approximately $254 million. The properties are leased to Vibra Healthcare, LLC (“Vibra”) five-year On June 10, 2019, we acquired seven community hospitals in Kansas for approximately $145.4 million. The properties are leased to an affiliate of Saint Luke’s Health System (“SLHS”) pursuant to seven individual in-place leases that have an average remaining lease term of 14 years. The leases provide for fixed escalations every five years and include two five-year Other acquisitions during 2019 included three acute care hospitals and one inpatient rehabilitation second third 2018 Activity Joint Venture Transaction On August 31, 2018, we completed a joint venture arrangement with 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, and we recognized an approximate €500 million gain on sale. At inception, our interest in the joint venture was made up of a 50% equity investment valued at approximately €210 million, 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 LifePoint, pursuant to the existing long-term master lease. 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) in June 2018. The properties are leased to MEDIAN, pursuant to a new 27-year master lease with annual inflation-based escalators. During 2018, we acquired the fee simple real estate of five general acute care hospitals, four of which are located in Massachusetts and one located in Texas, from Steward in exchange for the reduction of $764.4 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. 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 the operations of IASIS on September 29, 2017. Our investment in the portfolio includes the acquisition of eight acute care hospitals and one behavioral health facility for approximately $700 million, the making 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. 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. MEDIAN Transactions On November 29, 2017, we acquired three rehabilitation hospitals in Germany for an aggregate purchase price of €80 million. The facilities are leased to affiliates of MEDIAN, pursuant to a new long-term master lease. The lease began on November 30, 2017, and the term is for 27 years (ending in November 2044). The lease provides for annual inflation-based escalators. 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 affiliates of MEDIAN, pursuant to a third master lease entered into in 2016. 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, of which €18.6 million was paid upon closing with the remainder being paid over four years. This property is leased to affiliates of MEDIAN, pursuant to an existing master lease agreement that ends in December 2042 with annual inflation-based escalators. 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 buy in September 2016 for an aggregate amount of €44.1 million. This property is leased to affiliates of MEDIAN pursuant to the original long-term master lease agreement reached with MEDIAN in 2015. Other Transactions On June 1, 2017, we acquired the real estate assets of Ohio Valley Medical Center located in Wheeling, West Virginia, and the East Ohio Regional 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”). 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 LifePoint, pursuant to the existing long-term master lease entered into with LifePoint in April 2016. Development Activities 2019 Activity On October 25, 2019, we entered into an agreement to finance the development of and lease a behavioral hospital in Houston, Texas, for $27.5 million. This facility will be leased to NeuroPsychiatric Hospitals pursuant to a long-term lease and is expected to commence rent in the fourth quarter of 2020. 2018 Activity During the year ended December 31, 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. 2017 Activity During 2017, we completed construction and began recording rental income on the following facilities: • Adeptus Health, Inc. (“Adeptus”) — We completed four acute care facilities totaling approximately $68 million in development costs. • IMED Group (“IMED”) — A general acute facility located in Valencia, Spain opened on March 31, 2017, and is being leased to IMED pursuant to a 30-year lease that provides for quarterly fixed rent payments that started on October 1, 2017 with annual increases of 1% beginning April 1, 2020. Our ownership in this facility is effected through a joint venture between us and clients of AXA Real Estate, in which we own a 50% interest. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2019 Estimated Rent Commencement Date Circle (Birmingham, England) $ 47,532 $ 41,920 2Q 2020 Circle Rehabilitation (Birmingham, England) 21,427 17,385 2Q 2020 Surgery Partners (Idaho Falls, Idaho) 113,468 96,639 1Q 2020 NeuroPsychiatric Hospitals (Houston, Texas) 27,500 12,268 4Q 2020 $ 209,927 $ 168,212 Disposals 2019 Activity During 2019, we completed the sale of five facilities for net proceeds to us of approximately $97.0 million. The transactions resulted in a gain on real estate of $41.6 million. 2018 Activity On October 4, 2018, we finalized a recapitalization agreement in which we sold our investment in the operations of Ernest and were repaid for our outstanding acquisition loans, working capital loans, and any unpaid interest. Total proceeds received from this transaction approximated $176 million. We retained ownership of the real estate and secured mortgage loans of our Ernest properties. 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 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, 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. Summary of Operations for Disposed Assets in 2018 The following represents the operating results (excluding the St. Joseph sale in March 2018) of the properties sold in 2018 for the periods presented (in thousands): For the Year Ended 2018 2017 Revenues $ 88,838 $ 132,039 Real estate depreciation and amortization (15,849 ) (31,870 ) Property-related expenses (531 ) (404 ) Other(1) 709,717 (14,168 ) Income from real estate dispositions, net $ 782,175 $ 85,597 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018. 2017 Activity On March 31, 2017, we sold the EASTAR Health System real estate located in Muskogee, Oklahoma, which was leased to LifePoint. 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. The property disposals in 2019, 2018, and 2017 were not strategic shifts in our operations and therefore the results of operations of those properties were not reclassified to discontinued operations. Intangible Assets At December 31, 2019 and 2018, our intangible lease assets were $622.1 million ($556.7 million, net of accumulated amortization) and $403.1 million ($352.5 million, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $21.5 million, $17.6 million, and $15.8 million in 2019, 2018, and 2017, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2020 $ 27,795 2021 27,781 2022 27,767 2023 27,702 2024 27,668 As of December 31, 2019, capitalized lease intangibles have a weighted-average remaining life of 21.6 years. Leasing Operations (Lessor) As noted earlier, we acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases (typical initial fixed terms ranging from 10 to 15 years) and most include renewal options at the election of our tenants, generally in five year increments. More than 97% of our leases provide annual rent escalations based on increases in the CPI (or similar index outside the U.S.) and/or fixed minimum annual rent escalations ranging from 0.5% to 3.0%. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total investment. For five properties with a carrying value of $210 million, our leases require a residual value guarantee from the tenant. Our leases typically require the tenant to handle and bear most of the costs associated with our properties including repair/maintenance, property taxes, and insurance. We routinely inspect our properties to ensure the residual value of each of our assets is being maintained. Except for leases classified as financing leases, all of our leases are classified as operating leases. The following table summarizes total future minimum lease payments to be received, excluding operating expense reimbursements, from tenants under noncancelable leases as of December 31, 2019 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2020 $ 589,140 $ 166,067 $ 755,207 2021 604,653 169,388 774,041 2022 612,427 172,776 785,203 2023 623,590 176,231 799,821 2024 633,197 179,756 812,953 Thereafter 12,779,610 4,902,534 17,682,144 $ 15,842,617 $ 5,766,752 $ 21,609,369 At December 31, 2019, leases on 14 Ernest facilities and ten Prime Healthcare Services, Inc. (“Prime”) facilities are accounted for as DFLs, and leases on 13 of our Prospect facilities are accounted for as a financing. The components of our total investment in financing leases consisted of the following (in thousands): As of December 31, 2019 As of December 31, 2018 Minimum lease payments receivable $ 1,884,921 $ 2,091,504 Estimated residual values 394,195 424,719 Less unearned income (1,618,252 ) (1,832,170 ) Net investment in direct financing leases $ 660,864 $ 684,053 Other financing leases 1,399,438 — Total investment in financing leases $ 2,060,302 $ 684,053 Adeptus Health Transition Properties As noted in previous filings and effective October 2, 2017, we had 16 properties transitioning away from Adeptus in stages over a two year period as part of Adeptus’ confirmed plan of reorganization under Chapter 11 of the Bankruptcy Code. Due to this transition, we accelerated the amortization of the straight-line rent receivables resulting in a $1.5 million and $6.1 million impact to 2019 and 2018, respectively, and recorded a $0.5 million and $18 million real estate impairment charge in 2019 and 2018, respectively, on certain of these facilities. At December 31, 2019, three of the original 16 properties (representing less than 0.1% of our total assets) are vacant. Alecto Healthcare facilities At December 31, 2019, we own four acute care facilities and have a mortgage loan on a fifth property, representing less than 0.6% of our total assets. During the fourth quarter of 2019, we terminated the lease on two Alecto facilities in Ohio and West Virginia resulting in a real estate impairment charge of approximately $20.0 million. This adjustment was in addition to the $30 million impairment recorded on Alecto properties in 2018. Loans The following is a summary of our loans ($ amounts in thousands): As of December 31, 2019 As of December 31, 2018 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 1,275,022 9.0 % $ 1,213,322 8.8 % Acquisition loans 123,893 7.7 % 3,454 10.8 % Other loans 420,939 5.7 % 369,744 5.4 % $ 1,819,854 $ 1,586,520 Our mortgage loans cover 11 of our properties with five operators with the increase year-over-year related to the $51.3 million mortgage loan on a Prospect property. Acquisition loans are primarily related to the $112.9 million loan to Prospect, which we expect will be converted into the acquisition of two acute care hospitals upon the satisfaction of certain conditions. Other loans consist of loans to our tenants for working capital and other purposes and include our shareholder loan made to the joint venture with Primotop on August 31, 2018 (as more fully described above in this Note 3) in the amount of €290 million. Concentration of Credit Risks 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 December 31, 2019, we had no investment in any single property greater than 2.6% of our total assets, compared to 4% at December 31, 2018. 2) Operator concentration – For the year ended December 31, 2019, revenue from Steward and Prime represented 42% and 15%, respectively, of our total revenues. In comparison, these operators represented 39% and 16%, respectively, of our total revenues for the year ended December 31, 2018. Due to new investments made during 2019, Steward (when including leases and mortgage loans) represents 24% of our total assets at December 31, 2019, compared to 38% at December 31, 2018. 3) Geographic concentration – At December 31, 2019, investments in the U.S, Europe, and Australia represented approximately 74%, 20%, and 6%, respectively, of our total assets. In comparison, investments in the U.S. and Europe represented approximately 80% and 20%, respectively, of our total assets at December 31, 2018. 4) Facility type concentration – For the year ended December 31, 2019, approximately 87% of our revenues are from our general acute care facilities, while rehabilitation and long-term acute care facilities made up 10% and 3%, respectively. In comparison, general acute care, rehabilitation, and long-term acute care facilities made up 76%, 20%, and 4%, respectively, of our total revenues for the year ended December 31, 2018. Related Party Transactions Lease and interest revenue earned from tenants in which we have or had an equity interest in during the year were $451.1 million, $501.4 million, and $422.4 million in 2019, 2018, and 2017, respectively.

Debt

Debt	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt ($ amounts in thousands): As of December 31, 2019 As of December 31, 2018 Revolving credit facility(A) $ — $ 28,059 Term loan 200,000 200,000 Australian term loan facility(B) 842,520 — 4.000% Senior Unsecured Notes due 2022(B) 560,650 573,350 2.550% Senior Unsecured Notes due 2023(B) 530,280 — 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) 560,650 573,350 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 3.692% Senior Unsecured Notes due 2028(B) 795,420 — 4.625% Senior Unsecured Notes due 2029 900,000 — $ 7,089,520 $ 4,074,759 Debt issue costs and discount, net (65,841 ) (37,370 ) $ 7,023,679 $ 4,037,389 (A) Includes £22 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period end. As of December 31, 2019, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows ($ amounts in thousands): 2020 $ — 2021 — 2022 760,650 2023 530,280 2024 1,642,520 Thereafter 4,156,070 Total $ 7,089,520 Credit Facility On February 1, 2017, we replaced our previous unsecured credit facility with a new revolving credit and term loan agreement. The new agreement included a $1.3 billion unsecured revolving loan facility, a $200 million unsecured term loan facility, and a new €200 million unsecured term loan facility. The unsecured revolving loan facility matures in February 2021 At our election, loans under the Credit Facility may be made as either ABR Loans or Eurodollar Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.95% based on our current credit rating. The applicable margin for term loans that are Eurodollar Loans is adjustable on a sliding scale from 0.90% to 1.95% based on our current credit rating. The applicable margin for revolving loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.65% based on our current credit rating. The applicable margin for revolving loans that are Eurodollar Loans is adjustable on a sliding scale from 0.875% to 1.65% based on our current credit rating. The commitment fee is adjustable on a sliding scale from 0.125% to 0.30% based on our current credit rating and is payable on the revolving loan facility. At December 31, 2019 and 2018, we had $0 and $28.1 million, respectively, outstanding on the revolving credit facility. At December 31, 2019, our availability under our revolving credit facility was $1.3 billion. The weighted-average interest rate on this facility was 2.0% and 2.7% during 2019 and 2018, respectively. At December 31, 2019 and 2018, the interest rate in effect on our term loan was 3.30% and 3.89%, respectively. Australian Term Loan Facility On May 23, 2019, we entered into an AUD $1.2 billion term loan facility agreement with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan facility matures on May 23, 2024. The interest rate under the term loan is adjustable based on a pricing grid from 0.85% to 1.65%, dependent on our current senior unsecured credit rating. On June 27, 2019, we entered into an interest rate swap transaction (effective July 3, 2019) to fix the interest rate to approximately 1.20% for the duration of the loan. The current applicable margin for the pricing grid (which can vary based on the Company’s credit rating) is 1.25% for an all-in fixed rate of 2.45%. 4.000% Senior Unsecured Notes due 2022 On August 19, 2015, we completed a €500 million senior unsecured notes offering (“4.000% Senior Unsecured Notes due 2022”). Interest on the notes is payable annually on August 19 of each year. The notes pay interest in cash at a rate of 4.000% per year. The notes mature on August 19, 2022. We may redeem some or all of the 4.000% Senior Unsecured Notes due 2022 at any time. If the notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase. 2.550% Senior Unsecured Notes due 2023 On December 5, 2019, we completed a £400 million senior unsecured notes offering (“2.550% Senior Unsecured Notes due 2023”). Interest on the notes is payable annually on December 5 of each year. The notes pay interest in cash at a rate of 2.550% per year. The notes mature on December 5, 2023. We may redeem some or all of the 2.550% Senior Unsecured Notes due 2023 at any time. If the notes are redeemed prior to 30 days before maturity, the redemption price will be equal to 100% of the principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 2.550% Senior Unsecured Notes due 2023 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase. 5.500% Senior Unsecured Notes due 2024 On April 17, 2014, we completed a $300 million senior unsecured notes offering (“5.500% Senior Unsecured Notes due 2024”). Interest on the notes is payable semi-annually on May 1 and November 1 of each year. The notes pay interest in cash at a rate of 5.500% per year. The notes mature on May 1, 2024. We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 6.375% Senior Unsecured Notes due 2024 On February 22, 2016, we completed a $500 million senior unsecured notes offering (“6.375% Senior Unsecured Notes due 2024”). Interest on the notes is payable on March 1 and September 1 of each year. Interest on the notes is paid in cash at a rate of 6.375% per year. The notes mature on March 1, 2024. We may redeem some or all of the notes at any time prior to March 1, 2019 at a “make whole” redemption price. On or after March 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to March 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 3.325% Senior Unsecured Notes due 2025 their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101 % of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase . 5.250% Senior Unsecured Notes due 2026 On July 22, 2016, we completed a $500 million senior unsecured notes offering (“5.250% Senior Unsecured Notes due 2026”). Interest on the notes is payable on February 1 and August 1 of each year. Interest on the notes is to be paid in cash at a rate of 5.250% per year. The notes mature on August 1, 2026. We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.250% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 5.000% Senior Unsecured Notes due 2027 On September 7, 2017, we completed a $1.4 billion senior unsecured notes offering (“5.000% Senior Unsecured Notes due 2027”). Interest on the notes is payable on April 15 and October 15 of each year. The notes pay interest in cash at a rate of 5.000% per year. The notes mature on October 15, 2027. We may redeem some or all of the notes at any time prior to October 15, 2022 at a “make whole” redemption price. On or after October 15, 2022, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to October 15, 2020, we may redeem up to 40% of the notes at a redemption price equal to 105% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. 3.692% Senior Unsecured Notes due 2028 On December 5, 2019, we completed a £600 million senior unsecured notes offering (“3.692% Senior Unsecured Notes due 2028”). The notes were issued at 99.998% of par value. Interest on the notes is payable on June 5 of each year. The notes pay interest in cash at a rate of 3.692% per year. The notes mature on June 5, 2028. We may redeem some or all of the 3.692% Senior Unsecured Notes due 2028 at any time. If the notes are redeemed prior to 30 days before maturity, the redemption price will be equal to 100% of the principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.692% Senior Unsecured Notes due 2028 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase. 4.625% Senior Unsecured Notes due 2029 On July 26, 2019, we completed a $900 million senior unsecured notes offering (“4.625% Senior Unsecured Notes due 2029”). Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2020. The notes were issued at 99.5% of par value, pay interest at a rate of 4.625% per year and mature on August 1, 2029. We may redeem some or all of the notes at any time prior to August 1, 2024 at a “make whole” redemption price. On or after August 1, 2024, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2022, we may redeem up to 40% of the notes at a redemption price equal to 104.625% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. Other Activity In preparation of the joint venture with Primotop described under “2018 Activity” in Note 3, we issued secured debt on August 3, 2018, resulting in gross proceeds of €655 million. Provisions of the secured debt included a term of seven years and a swapped fixed rate of approximately 2.3%. Subsequently, on August 31, 2018, the secured debt was contributed along with the related real estate of 71 properties to form the joint venture. Debt Refinancing and Unutilized Financing Cost s 2019 On July 10, 2019, we received a commitment to provide a senior unsecured bridge loan facility to fund our investment in Prospect. With this commitment, we paid $4.2 million of underwriting and other fees. However, this commitment was cancelled with the completion of the debt and equity offerings in July 2019, which resulted in fully expensing the total amount of underwriting and other fees that were paid . In anticipation of funding our Australian acquisition in June 2019 and the Circle Health Ltd. (“Circle”) transaction in January 2020, we entered into term loans on the date these deals were signed that had a delayed draw feature. This feature allowed for us to not draw on the term loans until needed to fund these transactions. However, with this type of structure, we incurred approximately $2.0 million in accelerated debt issue cost amortization expense during 2019. 2017 With the replacement of our previous credit facility, the early redemption of senior unsecured notes, the payoff of our €200 million term loan, the cancellation of a $1.0 billion term loan facility commitment, and the pre-payment of a $12.9 million mortgage loan, we incurred a charge of $32.6 million (including redemption premiums and accelerated amortization of deferred debt issuance cost and commitment fees) during the year ended December 31, 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 (“NAFFO”), as defined in the agreements, on a rolling four quarter basis. Through 2019, the dividend restriction was 95% of NAFFO. The indentures governing our senior unsecured notes also limit the amount of dividends we can pay based on the sum of 95% of NAFFO, proceeds of equity issuances and certain other net cash proceeds. Finally, our senior unsecured notes require us to maintain total unencumbered assets (as defined in the related indenture) of not less than 150% of our unsecured indebtedness. In addition to these restrictions, the Credit Facility contains customary financial and operating covenants, including covenants relating to our total leverage ratio, fixed charge coverage ratio, secured leverage ratio, consolidated adjusted net worth, unsecured leverage ratio, and unsecured interest coverage ratio. The Credit Facility also contains customary events of default, including among others, nonpayment of principal or interest, material inaccuracy of representations, and failure to comply with our covenants. If an event of default occurs and is continuing under the Credit Facility, the entire outstanding balance may become immediately due and payable. At December 31, 2019, we were in compliance with all such financial and operating covenants.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	5. Income Taxes Medical Properties Trust, Inc. We have maintained and intend to maintain our election as a REIT under the Code. To qualify as a REIT, we must meet a number of organizational and operational requirements, including a requirement to distribute at least 90% of our taxable income to our stockholders. As a REIT, we generally will not be subject to U.S. federal income tax if we distribute 100% of our taxable income to our stockholders and satisfy certain other requirements; instead, income tax is paid directly by our stockholders on the dividends distributed to them. If our taxable income exceeds our dividends in a tax year, REIT tax rules allow us to designate dividends from the subsequent tax year in order to avoid current taxation on undistributed income. If we fail to qualify as a REIT in any taxable year, we will be subject to federal income taxes at regular corporate rates, including any applicable alternative minimum tax. Taxable income from non-REIT activities managed through our TRS is subject to applicable U.S. federal, state, and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate. From our TRS and our foreign operations, income tax benefit (expense) were as follows (in thousands): For the Years Ended December 31, 2019 2018 2017 Current income tax benefit (expense): Domestic $ 61 $ 125 $ 41 Foreign (1,669 ) (3,294 ) (3,062 ) (1,608 ) (3,169 ) (3,021 ) Deferred income tax benefit (expense): Domestic 5,490 3,713 233 Foreign (1,261 ) (1,471 ) 107 4,229 2,242 340 Income tax benefit (expense) $ 2,621 $ (927 ) $ (2,681 ) A reconciliation of the income tax benefit (expense) at the statutory income tax rate and the effective tax rate for income before income taxes for the years ended December 31, 2019, 2018, and 2017 is as follows (in thousands): For the Years Ended December 31, 2019 2018 2017 Income before income tax $ 373,780 $ 1,019,404 $ 293,919 Income tax at the U.S. statutory federal rate ( 21% 2019 and 2018 and 35% in 2017) (78,494 ) (214,075 ) (102,872 ) Decrease (increase) in income tax resulting from: Foreign rate differential 438 2,643 2,326 State income taxes, net of federal benefit 1,621 (379 ) — U.S. earnings not subject to federal income tax 85,495 208,472 98,026 Equity investments 1,091 46 (3,293 ) Change in valuation allowance (7,911 ) 2,668 5,391 Other items, net 381 (302 ) (2,259 ) Total income tax benefit (expense) $ 2,621 $ (927 ) $ (2,681 ) The foreign provision for income taxes is based on foreign profit before income taxes of $10.7 million in 2019 as compared with foreign profit before income taxes of $18.6 million in 2018, and foreign losses before income taxes of $(0.1) million in 2017. The domestic provision for income taxes is based on a loss before income taxes of $(44.1) million in 2019 from our TRS as compared with income before income taxes of $8.0 million in 2018 and $13.9 million in 2017. At December 31, 2019 and 2018, components of our deferred tax assets and liabilities were as follows (in thousands): 2019 2018 Deferred tax assets: Operating loss and interest deduction carry forwards $ 28,684 $ 21,984 Other 1,711 277 Total deferred tax assets 30,395 22,261 Valuation allowance (11,355 ) (3,444 ) Total net deferred tax assets $ 19,040 $ 18,817 Deferred tax liabilities: Property and equipment $ (7,324 ) $ (12,359 ) Net unbilled revenue (1,449 ) (1,633 ) Partnership investments — — Other (737 ) (300 ) Total deferred tax liabilities (9,510 ) (14,292 ) Net deferred tax asset (liability) $ 9,530 $ 4,525 At December 31, 2019, we had net NOL carryforwards as follows (in thousands): U.S. Luxembourg Germany U.K. Australia Gross NOL carryforwards $ 192,358 $ 9,946 $ 1,426 $ 5,416 $ 12,939 Tax-effected NOL carryforwards 22,960 2,481 226 921 1,941 Valuation allowance (6,212 ) (2,481 ) (226 ) (921 ) — Net deferred tax asset - NOL carryforwards $ 16,748 $ — $ — $ — $ 1,941 Expiration periods 2027-indefinite 2034-indefinite Indefinite Indefinite Indefinite Valuation Allowance A valuation allowance has been recorded on foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies, and recent financial performance. During 2019, a valuation allowance of $5.9 million has been recorded against a portion of our domestic deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for federal and state NOLs that we believe will not be realized due to the economic cost that would be incurred to realize these assets. This includes NOLs in states where we no longer maintain nexus and federal and state NOLs that are only available for partial offset of future taxable income. We also evaluated the need for a valuation allowance on our foreign deferred income tax assets. In doing so, we considered all available evidence to determine whether it is more likely than not that the foreign deferred income tax assets will be realized. Based on our review of all positive and negative evidence, we recorded a partial valuation allowance of $2 million against certain foreign deferred income tax assets generated during the year. Furthermore, we determined the partial valuation allowances recorded in previous years should remain against certain foreign deferred income tax assets that are not expected to be realized through future sources of taxable income. We have no material uncertain tax position liabilities and related interest or penalties. REIT Status We have met the annual REIT distribution requirements by payment of at least 90% of our taxable income in 2019, 2018, and 2017. Earnings and profits, which determine the taxability of such distributions, will differ from net income reported for financial reporting purposes due primarily to differences in cost basis, differences in the estimated useful lives used to compute depreciation, and differences between the allocation of our net income and loss for financial reporting purposes and for tax reporting purposes. A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, 2019 2018 2017 Common share distribution $ 1.010000 $ 0.990000 $ 0.950000 Ordinary income 0.701910 0.438792 0.655535 Capital gains(1) 0.275040 0.551208 0.021022 Unrecaptured Sec. 1250 gain 0.041160 0.132280 0.004647 Section 199A Dividends 0.701910 0.438792 — Return of capital 0.033050 — 0.273443 (1)Capital gains include unrecaptured Sec. 1250 gains. MPT Operating Partnership, L.P. As a partnership, the allocated share of income of the Operating Partnership is included in the income tax returns of the general and limited partners. Accordingly, no accounting for income taxes is generally required for such income of the Operating Partnership. However, the Operating Partnership has formed a TRS on behalf of Medical Properties Trust, Inc., which is subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of incom e taxes associated with our TRS and international operations.

Earnings Per Share_Unit

Earnings Per Share/Unit	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Earnings Per Share/Unit	6. Earnings Per Share/Unit Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2019 2018 2017 Numerator: Net income $ 376,401 $ 1,018,477 $ 291,238 Non-controlling interests’ share in earnings (1,717 ) (1,792 ) (1,445 ) Participating securities’ share in earnings (2,308 ) (3,685 ) (1,409 ) Net income, less participating securities’ share in earnings $ 372,376 $ 1,013,000 $ 288,384 Denominator: Basic weighted-average common shares 427,075 365,364 349,902 Dilutive potential common shares 1,224 907 539 Diluted weighted-average common shares 428,299 366,271 350,441 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2019 2018 2017 Numerator: Net income $ 376,401 $ 1,018,477 $ 291,238 Non-controlling interests’ share in earnings (1,717 ) (1,792 ) (1,445 ) Participating securities’ share in earnings (2,308 ) (3,685 ) (1,409 ) Net income, less participating securities’ share in earnings $ 372,376 $ 1,013,000 $ 288,384 Denominator: Basic weighted-average units 427,075 365,364 349,902 Dilutive potential units 1,224 907 539 Diluted weighted-average units 428,299 366,271 350,441

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Awards	7. Stock Awards Stock Awards Our Equity Incentive Plan, adopted during the second quarter of 2019 and replaced the previous plan, authorizes the issuance of common stock options, restricted stock, restricted stock units, deferred stock units, stock appreciation rights, performance units, and awards of interests in our Operating Partnership. Our Equity Incentive Plan is administered by the Compensation Committee of the Board of Directors. We have reserved 12,900,000 ten years For the past three years, we have only granted restricted stock and restricted stock units pursuant to our Equity Incentive Plan. These stock-based awards have been granted in the form of service-based awards, performance awards based on company-specific performance hurdles, and market-based awards. See below for further details on each of these stock-based awards: Service-Based Awards In 2019, 2018, and 2017, the Compensation Committee granted service-based awards to employees and non-employee directors. Service-based awards vest as the employee/director provides the required service (typically over three years Performance-Based Awards In 2019, 2018, and 2017, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance-based award grants: 2019 and 2018 In 2019 and 2018, a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee that included return on equity, EBITDA, and acquisitions. The performance thresholds were based on a three-year Certain performance awards granted in 2019 and 2018 were subject to a modifier (which increases or decreases the actual shares earned in each performance period) based on how our total shareholder return compared to the SNL U.S. REIT Healthcare Index (“SNL Index”). 2017 In 2017, a target number of stock awards were granted to certain employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee that included return on equity and general and administrative expenses as a percentage of revenue. The performance thresholds were based on a one-year Market-Based Awards In 2017, the Compensation Committee granted three-types of market-based awards to certain employees. Generally, dividends are not paid on market-based awards until the award is earned. The first award included a target number of stock awards that could be earned based on how our total shareholder return performed against the SNL Index for the year. More or less shares than the target number of shares were available to be earned based on our performance compared to the set thresholds. At the end of the performance period, any earned shares during such period vested ratably on an annual basis over the next three years starting on January 1, 2018. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of three years. The second market-based award was based on the achievement of a multi-year cumulative total shareholder return as compared to pre-established returns set by our Compensation Committee. The performance period was five years ending December 31, 2021 with the option to earn a portion of the award earlier. At the end of the performance period, any earned shares during such period vest on January 1 of the following calendar year. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.9%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of five years. The third market-based award could be earned based on how our total shareholder return performed against the SNL Index over a three-year period ending December 31, 2019. At the end of the performance period, any earned shares during such period vested ratably on an annual basis over the next three years starting on January 1, 2020. The fair value of this award was estimated on the grant date using a Monte Carlo valuation model that assumed the following: risk free interest rate of 1.5%; expected volatility of 25%; expected dividend yield of 6.9%; and expected service period of three years. The following summarizes stock-based award activity in 2019 and 2018 (which includes awards granted in 2019, 2018, 2017, and any applicable prior years), respectively For the Year Ended December 31, 2019: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 923,848 $ 14.29 4,133,435 $ 9.21 Awarded 681,378 $ 19.24 2,438,292 $ 15.25 Vested (478,104 ) $ 14.73 (1,051,637 ) $ 10.43 Forfeited (4,682 ) $ 13.44 (38,935 ) $ 10.13 Nonvested awards at end of year 1,122,440 $ 17.11 5,481,155 $ 11.66 For the Year Ended December 31, 2018: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 276,280 $ 12.68 2,676,755 $ 7.86 Awarded 958,480 $ 14.31 1,750,834 $ 11.61 Vested (307,275 ) $ 12.92 (288,404 ) $ 11.25 Forfeited (3,637 ) $ 13.05 (5,750 ) $ 9.35 Nonvested awards at end of year 923,848 $ 14.29 4,133,435 $ 9.21 The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2019, 2018, and 2017, we recorded $32.2 million, $16.5 million, and $9.9 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from stock-based awards at December 31, 2019, is $53.2 million, which will be recognized over a weighted-average period of 1.6 years. Stock-based awards that vested in 2019, 2018, and 2017, had a value of $25.9 million, $8.4 million, and $10.4 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2019
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Commitments On December 23, 2019, we entered into definitive agreements to acquire a portfolio of 30 acute care hospitals located throughout the United Kingdom for approximately £1.5 billion from affiliates of BMI. In a related transaction, affiliates of Circle entered into definitive agreements to acquire BMI and assume operations of its 52 facilities in the United Kingdom. Upon closing of the transaction on January 8, 2020, we leased back the hospitals to affiliates of Circle under 30 cross-defaulted leases guaranteed by Circle. The leases have initial fixed terms ending in 2050, with two five-year five-year Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to these proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows.

Common Stock_Partner's Capital

Common Stock/Partner's Capital	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 2019 Activity On November 4, 2019, we filed Articles of Amendment to our charter with the Maryland State Department of Assessments and Taxation increasing the number of authorized shares of common stock, par value $0.001 per share, available for issuance from 500 million to 750 million. On November 8, 2019, we completed an underwritten public offering of 57.5 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 7.5 million shares) of our common stock, resulting in net proceeds of $1.026 billion, after deducting underwriting discounts and commissions and offering expenses. On July 18, 2019, we completed an underwritten public offering of 51.75 million shares (including the exercise of the underwriters’ 30-day option to purchase an additional 6.75 million shares) of our common stock, resulting in net proceeds of $858.1 million, after deducting underwriting discounts and commissions and offering expenses. In 2019, we sold 36.1 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $650 million. On December 27, 2019, we entered into a new at-the-market equity offering program, which gives us the ability to sell up to $1.0 billion of stock with a commission rate up to 2.0%. Through February 21, 2020, we have sold 2.4 million shares of our common stock under this program. 2018 Activity In the 2018 fourth quarter, we sold 5.6 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $95 million. 2017 Activity On May 1, 2017, we completed an underwritten public offering of 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 December 31, 2019, the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and two other partners. By virtue of its ownership of the General Partner, the Company has a 99.9% ownership interest in Operating Partnership via its ownership of all the common units. The remaining ownership interest is held by two employees via awards (“LTIP units”) granted in 2007 under the Equity Incentive Plan. In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”), the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any U.S. federal income or excise tax liability imposed by the Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes. The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the limited partners in accordance with their respective percentage interests in the common units issued by the Operating Partnership. Any losses of the Operating Partnership will generally be allocated first to the limited partners until their capital account is zero and then to the General Partner. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for purposes of income and loss allocations. Limited partners have the right to require the Operating Partnership to redeem part or all of their common units. It is at the Operating Partnership’s discretion to redeem such common units for cash based on the fair market value of an equivalent number of shares of the Company’s common stock at the time of redemption or, alternatively, redeem the common units for shares of the Company’s common stock on a one-for-one basis, subject to adjustment in the event of stock splits, stock dividends, or similar events. LTIP units must wait two years from the issuance of the LTIP units to be redeemed, and then converted to common units. In 2018, approximately 60 thousand LTIP units were converted to common units and then redeemed for approximately $0.8 million of cash. For each share of common stock issued by Medical Properties Trust, Inc., the Operating Partnership issues a corresponding number of operating partnership units.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	10. Fair Value of Financial Instruments We have various assets and liabilities that are considered financial instruments. We estimate that the carrying value of cash and cash equivalents and accounts payable and accrued expenses approximate their fair values. We estimate the fair value of our interest and rent receivables using Level 2 inputs such as discounting the estimated future cash flows using the current rates at which similar receivables would be made to others with similar credit ratings and for the same remaining maturities. The fair value of our mortgage loans and other loans are estimated by using Level 2 inputs such as discounting the estimated future cash flows using the current rates which similar loans would be made to borrowers with similar credit ratings and for the same remaining maturities. We determine the fair value of our senior unsecured notes using Level 2 inputs such as quotes from securities dealers and market makers. We estimate the fair value of our revolving credit facility and term loans using Level 2 inputs based on the present value of future payments, discounted at a rate which we consider appropriate for such debt. Fair value estimates are made at a specific point in time, are subjective in nature, and involve uncertainties and matters of significant judgment. Settlement of such fair value amounts may not be a prudent management decision. The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2019 December 31, 2018 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 31,357 $ 30,472 $ 25,855 $ 24,942 Loans(1) 1,704,854 1,742,153 1,471,520 1,490,758 Debt, net (7,023,679 ) (7,331,816 ) (4,037,389 ) (3,947,795 ) (1) Excludes mortgage loans related to Ernest since they are recorded at fair value and discussed below. Items Measured at Fair Value on a Recurring Basis Our Ernest mortgage loans are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option method in 2012 when we acquired an equity interest in and made an acquisition loan to Ernest. Such equity interest was sold and the acquisition loan was paid off in October 2018. We elected to account for these investments at fair value due to the size of the investments and because we believe this method was more reflected of current values. We have not made a similar election for other investments existing at December 31, 2019 or December 31, 2018. At December 31, 2019 and 2018, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2019 As of December 31, 2018 Asset Type Asset (Liability) Fair Value Original Cost Fair Value Original Cost Classification Mortgage loans $ 115,000 $ 115,000 $ 115,000 $ 115,000 Mortgage loans Our mortgage loans with Ernest are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured at fair value on a nonrecurring basis, such as long-lived asset impairments (see Note 3). Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest by using either Level 2 or 3 inputs as more fully described in Note 2.

Leases (Lessee)

Leases (Lessee)	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Leases (Lessee)	11. Leases (Lessee) We lease the land underlying certain of our facilities (for which we sublease to our tenants), along with corporate office and equipment. Our leases have remaining lease terms ranging from 4.5 years to 54 years, and some of the leases include options to extend the leases up to, or just beyond, the depreciable life of the properties that occupy the leased land. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at lease commencement date in determining the present value of future payments. The following is a summary of our lease expense (in thousands): Income Statement For the Year Ended December 31, Classification 2019 Operating lease cost (1) (2) $ 9,262 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 Interest on lease liabilities Interest 117 Sublease income Other (3,478 ) Total lease cost $ 5,952 (1) Includes short-term leases. (2) $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income. For 2018 and 2017, our total lease expense was $9.4 million and $9.8 million, respectively, which was offset by sublease rental income of $4.3 million and $6.6 million, respectively. Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2019 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2020 $ 6,098 $ 125 $ (3,156 ) $ 3,067 2021 6,279 126 (3,498 ) 2,907 2022 6,470 128 (3,630 ) 2,968 2023 6,533 129 (3,632 ) 3,030 2024 5,635 130 (3,651 ) 2,114 Thereafter 180,280 4,915 (90,199 ) 94,996 (1) Total undiscounted minimum lease payments $ 211,295 $ 5,553 $ (107,766 ) $ 109,082 Less: interest (134,942 ) (3,621 ) Present value of lease liabilities $ 76,353 $ 1,932 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases. Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet Classification December 31, 2019 Right of use assets: Operating leases - real estate Land $ 59,492 Finance leases - real estate Land 1,888 Real estate right of use assets, net $ 61,380 Operating leases - corporate Other assets 9,866 Total right of use assets, net $ 71,246 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 76,353 Financing leases Obligations to tenants and other lease liabilities 1,932 Total lease liabilities $ 78,285 Weighted-average remaining lease term: Operating leases 31.9 Finance leases 36.9 Weighted-average discount rate: Operating leases 6.3 % Finance leases 6.6 % The following is supplemental cash flow information (in thousands): For the Year Ended December 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 5,937 Operating cash flows from finance leases 114 Financing cash flows from finance leases 10 Right-of-use assets obtained in exchange for lease obligations: Operating leases 1,818 Finance leases —

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2019
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Other Assets	12. Other Assets The following is a summary of our other assets on our consolidated balance sheets (in thousands): At December 31, 2019 2018 Debt issue costs, net(1) $ 2,492 $ 4,793 Other corporate assets 206,765 115,416 Prepaids and other assets 90,342 61,757 Total other assets $ 299,599 $ 181,966 (1) Other corporate assets include leasehold improvements associated with our corporate offices, furniture and fixtures, equipment, software, deposits, right-of-use assets associated with corporate leases, etc. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items. In addition to the assets above, we have equity investments of $927 million and $520 million at December 31, 2019 and 2018, respectively. Our largest equity investment is in the joint venture with Primotop.

Quarterly Financial Data (unaud

Quarterly Financial Data (unaudited)	12 Months Ended
	Dec. 31, 2019
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data (unaudited)	13. Quarterly Financial Data (unaudited) Medical Properties Trust, Inc. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2019 and 2018: (amounts in thousands, except for per share data) For the Three Month Periods in 2019 Ended March 31 June 30 September 30 December 31 Revenues $ 180,454 $ 192,549 $ 224,756 $ 256,438 Net income 76,291 79,920 90,267 129,923 Net income attributable to MPT common stockholders 75,822 79,438 89,786 129,638 Net income attributable to MPT common stockholders per share — basic $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average shares outstanding — basic 380,551 394,574 439,581 493,593 Net income attributable to MPT common stockholders per share — diluted $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average shares outstanding — diluted 381,675 395,692 440,933 494,893 For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT common stockholders 90,601 111,567 736,034 78,483 Net income attributable to MPT common stockholders per share — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted-average shares outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT common stockholders per share —diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted-average shares outstanding — diluted 365,343 365,541 366,467 367,732 MPT Operating Partnership, L.P. The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2019 and 2018: (amounts in thousands, except for per unit data) For the Three Month Periods in 2019 Ended March 31 June 30 September 30 December 31 Revenues $ 180,454 $ 192,549 $ 224,756 $ 256,438 Net income 76,291 79,920 90,267 129,923 Net income attributable to MPT Operating Partnership partners 75,822 79,438 89,786 129,638 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average units outstanding — basic 380,551 394,574 439,581 493,593 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average units outstanding — diluted 381,675 395,692 440,933 494,893 For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT Operating Partnership partners 90,601 111,567 736,034 78,483 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted-average units outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted-average units outstanding — diluted 365,343 365,541 366,467 367,732

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2019
Valuation And Qualifying Accounts [Abstract]
Schedule II: Valuation and Qualifying Accounts	Schedule II: Valuation and Qualifying Accounts Medical Properties Trust, Inc. and MPT Operating Partnership, L.P. December 31, 2019 Additions Deductions Year Ended December 31, Balance at Beginning of Year(1) Charged Against Operations(1) Net Recoveries/ Write-offs(1) Balance at End of Year(1) (In thousands) 2019 $ 66,131 $ 50,893 (2) $ (7,221 ) (3) $ 109,803 2018 $ 16,397 $ 57,285 (4) $ (7,551 ) (5) $ 66,131 2017 $ 18,852 $ 2,525 (6) $ (4,980 ) (7) $ 16,397 (1) Includes real estate impairment reserves, allowance for doubtful accounts, straight-line rent reserves, allowance for loan losses, tax valuation allowances and other reserves. (2) Represents $21.0 million increase to real estate impairment reserves, $22.0 million increase in accounts receivable and other reserves, and a $7.9 million increase in our tax valuation allowance to reserve against an increase in our net deferred tax assets in 2019. (3) Includes $7.2 million decrease in real estate impairment reserve related to disposals in 2019. ( 4 ) Represents $48 million increase to real estate impairment reserve and $9.3 million increases in accounts receivable reserves during 2018. ( 5 ) Includes $7.7 million decrease in valuation allowance (which includes the $4.4 million release of domestic valuation allowances in the 2018 fourth quarter) that was originally recorded to reserve against our net deferred tax assets. ( 6 ) Represents increases in accounts receivable reserves during 2017. ( 7 ) Includes $4.9 million decrease in valuation allowance that was originally recorded to reserve against our net deferred tax assets.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2019
Real Estate And Accumulated Depreciation Disclosure [Abstract]
SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	SCHEDULE III — REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION December 31, 2019 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2019(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Ashtead, UK Acute care general hospital $ 38,324 $ 73,722 $ 998 $ — $ 39,322 $ 73,722 $ 113,044 $ 642 $ — 1981 August 16, 2019 40 Bassenheim, Germany Rehabilitation hospital 998 5,372 168 — 1,166 5,372 6,538 136 — 1887, 1983 February 9, 2019 40 Bath, UK Acute care general hospital 1,571 32,569 — — 1,571 32,569 34,140 4,478 — 2008, 2009 July 1, 2014 40 Birmingham, UK Acute care general hospital 9,313 — — — 9,313 — 9,313 — — 2017 April 3, 2017 — Braunfels, Germany Acute care general hospital 2,153 13,761 56 — 2,209 13,761 15,970 1,565 — 1977 June 30, 2015 40 Heidelberg, Germany Rehabilitation hospital 6,262 36,187 73 — 6,335 36,187 42,522 3,183 — 1885, 1991 June 22, 2016 40 Cologne, Germany Acute care general hospital 4,394 15,201 101 — 4,495 15,201 19,696 967 — 2011 June 23, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 9,752 27,000 917 — 10,669 27,000 37,669 1,534 — 1974, 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 6,905 23,745 345 — 7,250 23,745 30,995 1,285 — 1989, 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,019 2,795 124 — 1,143 2,795 3,938 163 — 1973, 2010 November 30, 2017 40 Dormagen, Germany Rehabilitation hospital 1,802 5,737 137 — 1,939 5,737 7,676 203 — 1993, 2006 August 28, 2018 40 Grefath, Germany Rehabilitation hospital 1,120 3,076 99 — 1,219 3,076 4,295 111 — 1886, 1983 August 28, 2018 40 Remscheid, Germany Rehabilitation hospital 1,007 2,567 58 — 1,065 2,567 3,632 91 — 1951, 1983 August 28, 2018 40 Houston, TX Acute care general hospital 3,501 34,530 8,477 16,589 3,274 59,823 63,097 14,583 — 1960 August 10, 2007 40 Allen, TX Freestanding ER 1,550 414 — — 1,550 414 1,964 465 — 2014 July 14, 2014 40 San Diego, CA Acute care general hospital 12,663 52,431 — — 12,663 52,431 65,094 11,688 — 1973 February 9, 2011 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 564 — 2014 March 19, 2014 40 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 325 — 2016 September 26, 2016 40 Aurora, CO Freestanding ER 2,989 4,812 — — 2,989 4,812 7,801 511 — 2015 September 17, 2015 40 Ft. Worth, TX Freestanding ER 2,782 4,392 — — 2,782 4,392 7,174 522 — 2015 March 27, 2015 40 Ayer, MA Acute care general hospital 9,048 77,913 2,299 — 9,048 80,212 89,260 2,768 — 1970-2013 June 27, 2018 47 Bennettsville, SC Acute care general hospital 794 15,773 — — 794 15,773 16,567 4,525 — 1984 April 1, 2008 42 Big Spring, TX Acute care general hospital 1,655 21,254 — — 1,655 21,254 22,909 453 — 1973 April 12, 2019 41 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 3,034 — 1980 February 13, 2015 40 Boardman, OH Long term acute care hospital 79 275 — — 79 275 354 3 — 2008 August 30, 2019 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 403 — 2008 February 29, 2012 50 Bossier City, LA Long term acute care hospital 900 17,818 800 — 900 18,618 19,518 5,255 — 1982 April 1, 2008 40 Bowling Green, KY Rehabilitation hospital 3,486 56,296 — — 3,486 56,296 59,782 523 — 1992 August 30, 2019 40 Brighton, MA Acute care general hospital 18,540 146,491 39,036 — 18,540 185,527 204,067 12,301 — 1917-2009 October 3, 2016 41 Brockton, MA Acute care general hospital 18,328 67,248 4,937 — 18,328 72,185 90,513 7,037 — 1965-2010 October 3, 2016 41 Austin, TX Freestanding ER 1,140 1,693 — — 1,140 1,693 2,833 483 — 2014 May 29, 2014 40 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 536 — 2014 July 3, 2014 40 Bundoora, Australia Acute care general hospital 6,432 61,961 276 — 6,708 61,961 68,669 995 — 1979 June 7, 2019 37 Casper, WY Rehabilitation hospital 1,888 — — — 1,888 — 1,888 0 — 2012 February 29, 2012 — Glendale, AZ Freestanding ER 1,144 6,087 — — 1,144 6,087 7,231 482 — 2016 October 21, 2016 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2019(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 498 — 2016 September 23, 2016 40 Campbelltown, Australia Acute care general hospital 1,019 52,932 50 — 1,069 52,932 54,001 774 — 2007 June 7, 2019 40 Carrollton, TX Acute care general hospital 729 34,342 222 — 729 34,564 35,293 3,817 — 2015 July 17, 2015 40 Caterham, UK Acute care general hospital 10,596 21,707 391 — 10,987 21,707 32,694 192 — 1982 August 16, 2019 40 Cedar Hill. TX Freestanding ER 1,122 3,644 — — 1,122 3,644 4,766 501 — 2014 June 23, 2014 40 Spring, TX Freestanding ER 1,310 3,639 — — 1,310 3,639 4,949 500 — 2014 July 15, 2014 40 Chandler, AZ Freestanding ER 3,732 4,783 — — 3,732 4,783 8,515 558 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,853 — — 750 3,853 4,603 409 — 2015 October 7, 2015 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 5,616 — 1982 April 1, 2008 42 Crown Point, IN Long term acute care hospital 302 528 — — 302 528 830 6 — 2008 August 30, 2019 40 Katy, TX Freestanding ER 2,245 3,873 — — 2,245 3,873 6,118 403 — 2015 October 21, 2015 40 Webster, TX Long term acute care hospital 663 33,751 — — 663 33,751 34,414 7,594 — 2004 December 21, 2010 40 Commerce City, TX Freestanding ER 707 4,248 — — 707 4,248 4,955 540 — 2014 December 11, 2014 40 Conroe, TX Freestanding ER 1,338 3,712 — — 1,338 3,712 5,050 410 — 2015 July 29, 2015 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 525 — 2015 April 10, 2015 40 The Woodlands, TX Freestanding ER 2,050 4,524 — — 2,050 4,524 6,574 424 — 2016 March 28, 2016 40 Houston, TX Freestanding ER 1,903 4,267 — — 1,903 4,267 6,170 325 — 2017 May 8, 2017 35 Dallas, TX Long term acute care hospital 1,000 13,589 — 368 1,421 13,536 14,957 4,512 — 2006 September 5, 2006 40 Denver, CO Freestanding ER 1,314 4,276 — — 1,314 4,276 5,590 490 — 2015 June 8, 2015 40 DeSoto, TX Freestanding ER 750 4,234 — — 750 4,234 4,984 379 — 2016 May 23, 2016 40 Detroit, MI Long term acute care hospital 1,220 8,687 — (364 ) 1,220 8,323 9,543 2,480 — 1956 May 22, 2008 40 San Antonio, TX Freestanding ER 3,267 4,801 — — 3,267 4,801 8,068 370 — 2016 December 9, 2016 40 Dodge City, KS Acute care general hospital 1,124 52,705 — — 1,124 52,705 53,829 — — 1976 December 17, 2019 40 Dorchester, MA Acute care general hospital 14,428 219,575 6,638 — 14,428 226,213 240,641 6,885 — 1953-2015 October 15, 2018 42 Dulles, TX Freestanding ER 1,076 3,784 — — 1,076 3,784 4,860 504 — 2014 September 12, 2014 40 Easton, PA Acute care general hospital 13,898 40,245 5,511 — 13,898 45,756 59,654 2,948 — 1930-2005 May 1, 2017 41 Euxton, UK Acute care general hospital 3,964 37,028 844 — 4,808 37,028 41,836 332 — 1981 August 16, 2019 40 Houston, TX Freestanding ER 1,345 3,678 — — 1,345 3,678 5,023 506 — 2014 June 20, 2014 40 Fairmont, CA Acute care general hospital 1,000 6,072 5,278 — 1,277 11,073 12,350 2,044 — 1939, 1972, 1985 September 19, 2014 40 Fall River, MA Acute care general hospital 3,526 82,358 24,463 — 3,526 106,821 110,347 7,843 — 1950-2012 October 3, 2016 41 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 553 — 2014 June 6, 2014 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 1,030 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 5,531 — 2012 February 7, 2012 40 Folsom, CA Long term acute care hospital 3,291 21,293 — — 3,291 21,293 24,584 211 — 2009 August 30, 2019 40 Fort Lauderdale, FL Rehabilitation hospital 3,499 21,939 — 1 3,499 21,940 25,439 6,412 — 1985 April 22, 2008 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 559 — 2014 July 31, 2014 40 Fresno, CA Rehabilitation hospital 5,507 70,564 — — 5,507 70,564 76,071 633 — 1991 August 30, 2019 40 Frisco, TX Freestanding ER 1,500 3,863 27 (89 ) 1,411 3,890 5,301 543 — 2014 June 13, 2014 40 Garden Grove, CA Acute care general hospital 5,502 10,748 — 51 5,502 10,799 16,301 3,006 — 1982 November 25, 2008 40 Garland, TX Freestanding ER 2,643 4,648 — — 2,643 4,648 7,291 368 — 2016 November 15, 2016 40 Garden Grove, CA Medical Office Building 862 7,888 — 28 862 7,916 8,778 2,198 — 1982 November 25, 2008 40 Gilbert, AZ Acute care general hospital 150 10,449 — — 150 10,449 10,599 3,499 — 2005 January 4, 2011 40 Gilbert, AZ Freestanding ER 1,517 4,661 — — 1,517 4,661 6,178 515 — 2015 July 22, 2015 40 Glen Waverly, Australia Rehabilitation hospital 29,739 22,976 807 — 30,546 22,976 53,522 478 — 1972 June 7, 2019 32 Glendale, AZ Freestanding ER 1,248 4,046 — — 1,248 4,046 5,294 464 — 2015 June 5, 2015 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2019(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Gloucester, UK Acute care general hospital 4,770 63,907 1,041 — 5,811 63,907 69,718 564 — 1990 August 16, 2019 40 Goodyear, AZ Freestanding ER 1,800 4,713 — — 1,800 4,713 6,513 442 — 2016 April 4, 2016 40 Halsall, UK Acute care general hospital 1,493 32,446 605 — 2,098 32,446 34,544 287 — 1986 August 16, 2019 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 5,263 — 1999 August 31, 2015 34 Hastings, PA Acute care general hospital 603 8,834 — — 603 8,834 9,437 — — 1924 December 17, 2019 30 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 1,509 — 2013 March 1, 2013 40 Haverhill, MA Acute care general hospital 5,651 105,848 3,384 — 5,651 109,232 114,883 3,794 — 1982-2005 August 31, 2018 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 490 — 2016 March 10, 2016 40 Highland Village, TX Freestanding ER 3,501 1,551 — — 3,501 1,551 5,052 344 — 2015 September 22, 2015 40 Hill County, TX Acute care general hospital 1,120 17,882 — — 1,120 17,882 19,002 11,089 — 1980 September 17, 2010 15 Warren, OH Rehabilitation hospital 2,417 15,857 1,384 — 2,417 17,241 19,658 1,440 — 1922-2000 May 1, 2017 46 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 1,033 — 2015 May 1, 2015 34 Hoover, AL Medical Office Building — 1,034 296 — — 1,330 1,330 148 — 2015 May 1, 2015 34 Hope, AR Acute care general hospital 1,651 3,359 2,274 — 1,651 5,633 7,284 418 — 1984-2001 September 29, 2017 41 Hot Springs, AR Acute care general hospital 7,100 59,432 21,221 — 7,100 80,653 87,753 8,904 — 1985 August 31, 2015 40 Houston, TX Acute care general hospital 28,687 104,028 17,462 — 28,687 121,490 150,177 3,695 — 1940-1950 September 29, 2017 41 Highlands Ranch, CO Freestanding ER 4,200 4,779 — — 4,200 4,779 8,979 408 — 2016 July 25, 2016 40 Idaho Falls, ID Acute care general hospital 1,822 37,467 8,235 4,665 1,822 50,367 52,189 12,258 — 2002 April 1, 2008 40 Johnstown, PA Acute care general hospital 8,877 247,042 — — 8,877 247,042 255,919 — — 1924 December 17, 2019 30 Kansas City, KS Acute care general hospital 2,351 13,665 — — 2,351 13,665 16,016 172 — 2017 June 10, 2019 50 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 8,071 — 1978 February 13, 2015 40 Katy, TX Freestanding ER 1,629 4,174 — — 1,629 4,174 5,803 339 — 2016 October 10, 2016 40 Kingswood, Australia Acute care general hospital 23,473 77,806 453 — 23,926 77,806 101,732 1,155 — 2000 June 7, 2019 40 Camden, SC Acute care general hospital — 22,739 — — — 22,739 22,739 2,138 — 1954-2004 October 30, 2015 39 Lafayette, IN Rehabilitation hospital 800 14,968 (25 ) — 800 14,943 15,743 2,572 — 2013 February 1, 2013 40 Lafayette, LA Long term acute care hospital 599 1,401 — — 599 1,401 2,000 17 — 1995 August 30, 2019 40 Lander, WY Acute care general hospital 761 42,849 — — 761 42,849 43,610 — — 1983 December 17, 2019 40 Lawton, OK Acute care general hospital 3,944 63,031 — — 3,944 63,031 66,975 — — 1985 December 17, 2019 40 Leawood, KS Acute care general hospital 2,513 13,938 — — 2,513 13,938 16,451 175 — 2017 June 10, 2019 50 Lehi, UT Acute care general hospital 13,403 29,950 601 (35 ) 13,368 30,551 43,919 2,000 — 2015 September 29, 2017 45 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 6,802 — 1922 May 1, 2017 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 528 — 2013 December 1, 2013 40 Liverpool, Australia Acute care general hospital 13,327 41,769 93 — 13,420 41,769 55,189 817 — 1975 June 7, 2019 30 Longmont, CO Freestanding ER 1,855 4,181 — — 1,855 4,181 6,036 409 — 2016 February 10, 2016 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 3,469 — 2008 June 16, 2015 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 425 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER 1,658 5,801 — — 1,658 5,801 7,459 508 — 2016 July 15, 2016 40 Martin's Ferry, OH Acute care general hospital 1,380 4,620 — — 1,380 4,620 6,000 — — 1920, 1944-2004 June 1, 2017 8 McKinney, TX Freestanding ER 2,775 4,060 — — 2,775 4,060 6,835 603 — 2015 July 31, 2015 30 McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 9,146 — 1996 August 31, 2015 41 Melbourne, FL Acute care general hospital 5,642 17,087 2,686 — 5,642 19,773 25,415 1,522 — 2002 May 1, 2017 42 Mesa, AZ Acute care general hospital 6,534 100,042 1,885 — 6,534 101,927 108,461 16,494 — 2007 September 26, 2013 40 Meyersdale, PA Acute care general hospital 390 4,280 — — 390 4,280 4,670 — — 1960 December 17, 2019 30 Milwaukee, WI Long term acute care hospital 558 1,442 — — 558 1,442 2,000 15 — 1983 August 30, 2019 40 Mount Pleasant, SC Long term acute care hospital 597 2,198 — — 597 2,198 2,795 21 — 2012 August 30, 2019 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2019(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Phoenix, AZ Acute care general hospital 5,576 45,782 — — 5,576 45,782 51,358 3,338 — 2017 February 10, 2017 40 Methuen, MA Acute care general hospital 23,809 89,505 9,184 — 23,809 98,689 122,498 8,500 — 1950-2011 October 3, 2016 41 Bloomington, IN Acute care general hospital 2,392 28,212 5,016 408 2,392 33,636 36,028 10,877 — 2006 August 8, 2006 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 14,741 — 1920-2000 April 1, 2014 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 567 — 2014 January 1, 2014 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 591 — 2014 June 5, 2014 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 3,830 — 2007 February 14, 2011 40 Norwood, MA Acute care general hospital 7,073 154,496 27,385 — 7,073 181,881 188,954 5,392 — 1926-2001 June 27, 2018 46 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 3,875 — 2014 August 31, 2014 40 Odessa, TX Acute care general hospital 6,535 123,518 1,961 — 6,535 125,479 132,014 7,122 — 1973-2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 2,382 — 2014 March 1, 2014 40 Olathe, KS Acute care general hospital 3,485 14,484 — — 3,485 14,484 17,969 183 — 2018 June 10, 2019 50 Olympia, WA Acute care general hospital 7,220 89,348 15,930 — 7,220 105,278 112,498 8,935 — 1984 July 22, 2016 40 Ottumwa, IA Acute care general hospital 2,377 48,697 — — 2,377 48,697 51,074 — — 1950 December 17, 2019 30 Overland Park, KS Acute care general hospital 2,974 14,405 — — 2,974 14,405 17,379 183 — 2017 June 10, 2019 50 Overland Park, KS Acute care general hospital 3,191 14,264 — — 3,191 14,264 17,455 191 — 2019 June 10, 2019 50 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 1,654 — 2012 February 1, 2013 40 Palestine, TX Acute care general hospital 1,848 95,258 — — 1,848 95,258 97,106 — — 1988 December 17, 2019 40 San Diego, CA Acute care general hospital 6,550 15,653 — 77 6,550 15,730 22,280 4,979 — 1964 May 9, 2007 40 Parker, CO Freestanding ER 1,300 4,448 — — 1,300 4,448 5,748 463 — 2015 November 6, 2015 40 Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 601 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 477 — 2014 September 8, 2014 40 Perth, Australia Acute care general hospital 102,488 36,399 213 — 102,701 36,399 139,100 723 — 1965 June 7, 2019 30 Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 2,622 — 2006 July 1, 2008 40 Phoenix, AZ Acute care general hospital 2,396 26,521 12,253 — 2,396 38,774 41,170 1,583 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 73,773 4,978 — 12,695 78,751 91,446 4,580 — 1968-1976 September 29, 2017 43 Plano, TX Freestanding ER 4,418 2,492 — — 4,418 2,492 6,910 316 — 2016 September 30, 2016 40 Poole, UK Acute care general hospital 1,883 39,969 538 — 2,421 39,969 42,390 776 — 1996 April 3, 2019 40 Poplar Bluff, MO Acute care general hospital 2,659 38,693 — 1 2,659 38,694 41,353 11,309 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 12,972 78,051 3,384 — 12,972 81,435 94,407 12,241 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 2,531 14,252 — — 2,531 14,252 16,783 1,947 — 1953, 1973-1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 2,069 — 2013 December 31, 2013 40 San Antonio, TX Freestanding ER 2,525 4,253 — — 2,525 4,253 6,778 337 — 2016 October 27, 2016 40 Reading, UK Acute care general hospital 35,747 48,080 486 — 36,233 48,080 84,313 419 — 1990 August 16, 2019 40 Redding, CA Acute care general hospital 1,555 53,863 — 13 1,555 53,876 55,431 16,732 — 1974 August 10, 2007 40 Richmond, VA Long term acute care hospital 1,307 10,071 — — 1,307 10,071 11,378 109 — 1989 August 30, 2019 40 Ringwood, Australia Acute care general hospital 4,027 18,679 134 — 4,161 18,679 22,840 321 — 1973 June 7, 2019 35 Riverton, WY Acute care general hospital 1,163 29,647 — — 1,163 29,647 30,810 — — 1983 December 17, 2019 36 Austin, TX Freestanding ER 3,846 4,200 — — 3,846 4,200 8,046 330 — 2017 March 2, 2017 40 Roaring Springs, PA Acute care general hospital 1,447 9,549 — — 1,447 9,549 10,996 — — 1924 December 17, 2019 30 Rochdale, MA Long term acute care hospital 654 3,368 — — 654 3,368 4,022 33 — 1989 August 30, 2019 40 Rochdale, MA Acute care general hospital 67 344 — — 67 344 411 3 — 1989 August 30, 2019 40 Rockledge, FL Acute care general hospital 13,919 23,282 5,512 — 13,919 28,794 42,713 2,404 — 1950, 1970 May 1, 2017 42 Roeland Park, KS Acute care general hospital 1,569 15,103 — — 1,569 15,103 16,672 188 — 2018 June 10, 2019 50 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2019(1) Accumulated Life on which depreciation in latest income statements is Location Type of Property Land Buildings Improve- ments Carrying Costs Land Buildings Total Depreciation Encum- brances Date of Construction Date Acquired computed (Years) (Dollar amounts in thousands) Rosenberg, TX Freestanding ER 1,331 4,505 — — 1,331 4,505 5,836 450 — 2016 January 15, 2016 40 Rowley, UK Acute care general hospital 2,439 19,057 590 — 3,029 19,057 22,086 174 — 1986 August 16, 2019 40 Columbus, OH Freestanding ER 1,726 — — — 1,726 — 1,726 — — 2016 August 30, 2016 - Salt Lake City, UT Acute care general hospital 13,590 101,915 15,109 — 13,590 117,024 130,614 5,822 — 1906-1987 September 29, 2017 41 San Antonio, TX Acute care general hospital 8,053 29,333 1,945 — 8,053 31,278 39,331 1,868 — 1978-2002 September 29, 2017 41 San Bernardino, CA Acute care general hospital 2,209 37,498 — — 2,209 37,498 39,707 341 — 1993 August 30, 2019 40 San Dimas, CA Acute care general hospital 6,160 6,839 — 34 6,160 6,873 13,033 1,907 — 1972 November 25, 2008 40 San Dimas, CA Medical Office Building 1,915 5,085 — 18 1,915 5,103 7,018 1,417 — 1979 November 25, 2008 40 Phoenix, AZ Freestanding ER 1,132 5,052 — — 1,132 5,052 6,184 347 — 2017 April 13, 2017 40 Sebastian, FL Acute care general hospital 5,733 49,136 38,272 — 5,733 87,408 93,141 3,736 — 1974 May 1, 2017 41 Sharon, PA Acute care general hospital 6,179 9,066 6,435 — 6,179 15,501 21,680 1,826 — 1950-1980 May 1, 2017 41 Shawnee, KS Acute care general hospital 3,076 14,945 — — 3,076 14,945 18,021 216 — 2018 June 10, 2019 50 Sherman, TX Acute care general hospital 4,493 10,690 — — 4,493 10,690 15,183 2,934 — 1913, 1960-2010 October 31, 2014 40 Sienna, TX Freestanding ER 1,000 3,591 — — 1,000 3,591 4,591 479 — 2014 August 20, 2014 40 Spartanburg, SC Rehabilitation hospital 1,135 15,717 — — 1,135 15,717 16,852 2,505 — 2013 August 1, 2013 40 Springfield, IL Long term acute care hospital 542 1,458 — — 542 1,458 2,000 14 — 2009 August 30, 2019 40 St. Albans Park, Australia Acute care general hospital 2,097 21,421 544 — 2,641 21,421 24,062 339 — 1985 June 7, 2019 40 Strathpine, Australia Acute care general hospital 2,538 35,542 301 — 2,839 35,542 38,381 533 — 1985 June 7, 2019 40 Sunnybank, Australia Acute care general hospital 5,819 44,225 346 — 6,165 44,225 50,390 779 — 1979 June 7, 2019 34 Houston, TX Freestanding ER 1,423 3,772 — — 1,423 3,772 5,195 456 — 2015 February 18, 2015 40 Taunton, MA Acute care general hospital 4,428 73,228 6,852 — 4,428 80,080 84,508 6,446 — 1940-2015 October 3, 2016 41 Tempe, AZ Acute care general hospital 6,050 10,986 6,773 — 6,050 17,759 23,809 903 — 1940 September 29, 2017 41 Texarkana, TX Acute care general hospital 14,562 — — — 14,562 — 14,562 — — 2017 September 29, 2017 - Thornton, CO Freestanding ER 1,350 4,259 — — 1,350 4,259 5,609 568 — 2014 August 29, 2014 40 Toledo, OH Rehabilitation hospital 1,205 17,740 — — 1,205 17,740 18,945 1,663 — 2016 April 1, 2016 40 Tomball, TX Long term acute care hospital 1,299 23,982 — — 1,299 23,982 25,281 5,396 — 2005 December 21, 2010 40 Torquay, UK Acute care general hospital 2,754 37,219 349 — 3,103 37,219 40,322 320 — 1981 August 16, 2019 40 Tulsa, OK Long term acute care hospital 1,128 4,477 — — 1,128 4,477 5,605 44 — 1989 August 30, 2019 40 Houston, TX Acute care general hospital 4,047 36,862 — — 4,047 36,862 40,909 3,225 — 2016 July 7, 2016 40 League City, TX Freestanding ER 1,356 3,901 — — 1,356 3,901 5,257 439 — 2015 June 19, 2015 40 Anaheim, CA Acute care general hospital 1,875 21,813 — 10 1,875 21,823 23,698 7,183 — 1964 November 8, 2006 40 Viseu, Portugal Acute care general hospital 2,128 29,228 446 — 2,574 29,228 31,802 85 — 2016 November 28, 2019 37 Wantirna, Australia Acute care general hospital 25,419 209,087 958 — 26,377 209,087 235,464 3,095 — 1984 June 7, 2019 40 Warren, OH Acute care general hospital 5,387 47,586 9,894 — 5,387 57,480 62,867 4,186 — 1982 May 1, 2017 41 Watsonville, CA Acute care general hospital 16,488 17,800 — — 16,488 17,800 34,288 163 — 1983 September 30, 2019 39 West Monroe, LA Acute care general hospital 12,000 69,433 16,187 — 12,552 85,068 97,620 11,845 — 1962 September 26, 2013 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 1,052 — 2012 October 2, 2012 40 West Valley City, UT Acute care general hospital 5,516 58,314 7,150 (114 ) 5,402 65,464 70,866 17,332 — 1980 April 22, 2008 40 Wheeling, WV Acute care general hospital 1,480 7,920 — — 1,480 7,920 9,400 — — 1914, 1925-1983 June 1, 2017 8 Wichita, KS Rehabilitation hospital 1,019 18,373 — 1 1,019 18,374 19,393 5,396 — 1992 April 4, 2008 40 Youngstown, OH Acute care general hospital 4,335 3,565 824 — 4,335 4,389 8,724 1,561 — 1929-2003 May 1, 2017 41 $ 1,003,149 $ 5,916,757 $ 370,918 $ 21,662 $ 1,017,402 $ 6,295,084 $ 7,312,486 $ 504,651 (1) The aggregate cost for federal income tax purposes is $7.8 billion. The changes in total real estate assets (excluding construction in progress, intangible le ase assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2019 December 31, 2018 December 31, 2017 COST Balance at beginning of period $ 4,781,149 $ 5,438,148 $ 3,968,042 Acquisitions 2,436,265 758,619 1,256,245 Transfers from construction in progress — 25,513 74,441 Additions 173,785 96,775 36,828 Dispositions (106,536 ) (1,318,238 ) (53,372 ) Other 27,823 (2) (219,668 ) (2) 155,964 (2) Balance at end of period $ 7,312,486 $ 4,781,149 $ 5,438,148 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2019 December 31, 2018 December 31, 2017 ACCUMULATED DEPRECIATION Balance at beginning of period $ 414,331 $ 407,349 $ 292,786 Depreciation 130,851 115,497 109,307 Depreciation on disposed property (40,952 ) (101,967 ) (1,438 ) Other 421 (6,548 ) 6,694 Balance at end of period $ 504,651 $ 414,331 $ 407,349 (2) Includes foreign currency fluctuations for all years, $61.4 million of right-of-use assets (2019 only), and purchase price allocation adjustments (2017 only).

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2019
Mortgage Loans On Real Estate [Abstract]
SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	SCHEDULE IV — MORTGAGE LOANS ON REAL ESTATE MEDICAL PROPERTIES TRUST, INC. AND MPT OPERATING PARTNERSHIP, L.P. December 31, 2019 Column A Column B Column C Column D Column E Column F Column G(3) Column H Description Interest Rate Final Maturity Date Periodic Payment Terms Prior Liens Face Amount of Mortgages Carrying Amount of Mortgages Principal Amount of Loans Subject to Delinquent Principal or Interest (Dollar amounts in thousands) Long-term first mortgage loan: Payable in monthly installments of interest plus principal payable in full at maturity Desert Valley Hospital 11.0 % 2022 (1 ) $ 70,000 $ 70,000 (2 ) Desert Valley Hospital 12.4 % 2022 (1 ) 20,000 20,000 (2 ) Desert Valley Hospital 11.0 % 2021 (1 ) 12,500 12,500 (2 ) Chino Valley Medical Center 11.0 % 2022 (1 ) 50,000 50,000 (2 ) Paradise Valley Hospital 11.2 % 2022 (1 ) 25,000 25,000 (2 ) Ernest(4) 10.2 % 2032 (1 ) 115,000 115,000 (2 ) Centinela Hospital Medical Center 11.9 % 2022 (1 ) 100,000 100,000 (2 ) Olympia Medical Center 10.9 % 2024 (1 ) 25,000 25,000 (2 ) St. Joseph Medical Center 9.3 % 2025 (1 ) 30,000 30,000 (2 ) St. Mary’s Medical Center 9.3 % 2025 (1 ) 10,000 10,000 (2 ) Lake Huron Medical Center 9.3 % 2025 (1 ) 10,000 10,000 (2 ) Steward(6) 7.8 % 2031 (1 ) 737,242 737,242 (2 ) Vibra 11.5 % 2024 (1 ) 18,986 18,986 (2 ) Prospect 7.5 % 2034 (1 ) 51,267 51,267 (2 ) $ 1,274,995 $ 1,274,995 (5 ) (1) There were no prior liens on loans as of December 31, 2019. (2) The mortgage loan was not delinquent with respect to principal or interest. (3) The aggregate cost for federal income tax purposes is $1.3 billion. (4) Mortgage loans covering four properties in two tranches. Interest rate is weighted-average of both tranches. (5) Excludes unamortized loan issue costs of $0.03 million at December 31, 2019. (6) Mortgage loans covering two properties. Changes in mortgage loans (excluding unamortized loan issue costs) for the years ended December 31, 2019, 2018, and 2017 are summarized as follows: Year Ended December 31, 2019 2018 2017 (Dollar amounts in thousands) Balance at beginning of year $ 1,213,283 $ 1,778,264 $ 1,060,336 Additions during year: New mortgage loans and additional advances on existing loans 61,712 50,783 717,928 1,274,995 1,829,047 1,778,264 Deductions during year: Collection of principal — (615,764 ) — — (615,764 ) — Balance at end of year $ 1,274,995 $ 1,213,283 $ 1,778,264

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates: The preparation of financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Principles of Consolidation	Principles of Consolidation: Property holding entities and other subsidiaries of which we own 100% of the equity or have a controlling financial interest evidenced by ownership of a majority voting interest are consolidated. All inter-company balances and transactions are eliminated. For entities in which we own less than 100% of the equity interest, we consolidate the property if we have the direct or indirect ability to control the entities’ activities based upon the terms of the respective entities’ ownership agreements. For these entities, we record a non-controlling interest representing equity held by non-controlling interests. We continually evaluate all of our transactions and investments to determine if they represent variable interests in a variable interest entity. If we determine that we have a variable interest in a variable interest entity, we then evaluate if we are the primary beneficiary of the variable interest entity. The evaluation is a qualitative assessment as to whether we have the ability to direct the activities of a variable interest entity that most significantly impact the entity’s economic performance. We consolidate each variable interest entity in which we, by virtue of or transactions with our investments in the entity, are considered to be the primary beneficiary. At December 31, 2019 and 2018, we determined that we were not the primary beneficiary of any variable interest entity in which we hold a variable interest because we do not control the activities (such as the day-to-day operations) that most significantly impact the economic performance of these entities.
Investments in Unconsolidated Entities	Investments in Unconsolidated Entities: Investments in entities in which we have the ability to significantly influence (but not control) are accounted for by the equity method, such as our joint venture with Primotop Holdings S.à.r.l. (“Primotop”) as discussed in Note 3. Under the equity method of accounting, our share of the investee’s earnings or losses are included in the “Earnings from equity interests” line of our consolidated statements of net income. Except for our joint venture with Primotop, we have elected to record our share of such investee’s earnings or losses on a lag basis. The initial carrying value of investments in unconsolidated entities is based on the amount paid to purchase the interest in the investee entity. Subsequently, our investments are increased/decreased by our share in the investees’ earnings/losses and decreased by cash distributions from our investees. To the extent that our cost basis is different from the basis reflected at the investee entity level, the basis difference is generally amortized over the lives of the related assets and liabilities, and such amortization is included in our share of equity in earnings of the investee. We evaluate our equity method investments for impairment based upon a comparison of the fair value of the equity method investment to its carrying value, when impairment indicators exist. If we determine a decline in the fair value of an investment in an unconsolidated investee entity below its carrying value is o ther-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investments in Steward Health Care System LLC (“Steward”) and Median Kliniken S.á.r.l. (“MEDIAN”) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. For similar investments but for which there are readily determinable fair values, such investments are measured at fair value quarterly, with unrealized gains and losses recorded in income.
Cash and Cash Equivalents	Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets.
Revenue Recognition	Revenue Recognition: Our revenues are primarily from leases and mortgage loans. On January 1, 2019, we adopted Accounting Standards Update (“ASU”) 2016-02, “Leases”, (“ASU 2016-02”). ASU 2016-02 sets out the principles for the recognition, measurement, presentation, and disclosure of leases for both parties to a contract (i.e. lessees and lessors). We adopted this standard using the modified retrospective approach and have elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things permits the following: no reassessment of whether existing contracts are or contain a lease and no reassessment of lease classification for existing leases. In addition, we made certain elections permitted which (1) permits entities to apply the transition provisions of the new standard at its adoption date instead of at the earliest comparative period presented and (2) permits lessors to account for lease and non-lease components as a single lease component in a contract if certain criteria are met. For lessors, this new standard of accounting for leases is substantially equivalent to previous guidance, but there are some differences which we highlight below: Operating Lease Revenue We receive income from operating leases based on the fixed, minimum required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the straight-line method over the terms of the related lease agreements for new leases and the remaining terms of existing leases for those acquired as part of a property acquisition. The straight-line method records the periodic average amount of base rent earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in the consolidated statements of net income is presented as two amounts: rent billed and straight-line rent revenue. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivable. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under the new lease accounting rules adopted on January 1, 2019, if an acquisition and subsequent lease of a property to the seller does not meet the definition of a sale, we must account for the transaction as a financing with income recognized using the imputed interest method. Another type of financing lease that we carried forward from the previous lease accounting guidance is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable. The difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease terms to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Starting January 1, 2019 (with the adoption of ASU 2016-02), tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis, consistent with how all tenant payments or reimbursements pursuant to our “triple-net” leases were accounted for prior to ASU 2016-02. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received from lessees for development and leasing services are initially recorded as deferred revenue and recognized as income over the initial term of a lease to produce a constant effective yield on the lease (interest method). Commitment and origination fees from lending services are also recorded as deferred revenue initially and recognized as income over the life of the loan using the interest method.
Acquired Real Estate Purchase Price Allocation	Acquired Real Estate Purchase Price Allocation: Since January 1, 2018 with adoption of ASU No. 2017-01, “Clarifying the Definition of a Business” (“ASU 2017-01”), all of our property acquisitions have been accounted for as asset acquisitions. Prior to 2018, properties acquired for leasing purposes were accounted for using business combination accounting rules. The primary impact to us from this change in accounting is the capitalization of third party transaction costs that are directly related to the acquisition as these costs were expensed under business combination accounting rules. Under either accounting method, we allocate the purchase price of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time to time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition or financing of the respective property, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of these intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense.
Real Estate and Depreciation	Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, are maintained at cost. Although typically paid by our tenants, any expenditure for ordinary maintenance and repairs that we pay are expensed to operations as incurred. Significant renovations and improvements which improve and/or extend the useful life of the asset are capitalized and depreciated over their estimated useful lives. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets, including an estimated liquidation amount, during the expected holding periods are less than the carrying amounts of those assets. Impairment losses are measured as the difference between carrying value and fair value of the assets. For assets held for sale, we cease recording depreciation expense and adjust the assets’ value to the lower of its carrying value or fair value, less cost of disposal. Fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest. We classify real estate assets as held for sale when we have commenced an active program to sell the assets, and in the opinion of management, it is probable the asset will be sold within the next 12 months. Construction in progress includes the cost of land, the cost of construction of buildings, improvements, and fixed equipment, and costs for design and engineering. Other costs, such as interest, legal, property taxes, and corporate project supervision, which can be directly associated with the project during construction, are also included in construction in progress. We commence capitalization of costs associated with a development project when the development of the future asset is probable and activities necessary to get the underlying property ready for its intended use have been initiated. We stop the capitalization of costs when the property is substantially complete and ready for its intended use. Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2019 are as follows: Buildings and improvements 39.0 years Tenant lease intangibles 23.7 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.7 years
Losses from Rent Receivables	Losses from Rent Receivables: For all leases, we continuously monitor the performance of our existing tenants including, but not limited to: admission levels and surgery/procedure volumes by type; current operating margins; ratio of our tenants’ operating margins both to facility rent and to facility rent plus other fixed costs; trends in cash collections; trends in revenue and patient mix; and the effect of evolving healthcare regulations on tenants’ profitability and liquidity. Losses from Operating Lease Receivables: Losses on Financing Lease Receivables:
Loans	Loans: Loans consist of mortgage loans, working capital loans, and other long-term loans. Mortgage loans are collateralized by interests in real property. Working capital and other long-term loans are generally collateralized by interests in receivables and corporate and individual guarantees. We record loans at cost. We evaluate the collectability of both interest and principal on a loan-by-loan basis (using the same process as we do for assessing the collectability of rents) to determine whether they are impaired. A loan is considered impaired when, based on current information and events, it is probable that we will be unable to collect all amounts due according to the existing contractual terms. When a loan is considered to be impaired, the amount of the allowance is calculated by comparing the recorded investment to either the value determined by discounting the expected future cash flows using the loan’s effective interest rate or to the fair value of the collateral, if the loan is collateral dependent. If a loan is deemed to be impaired, we generally place the loan on non-accrual status and record interest income only upon receipt of cash.
Earnings Per Share/Units	Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income applicable to common shares/units by the weighted-average number of shares/units of common stock/units outstanding during the period. Diluted earnings per common share/units is calculated by including the effect of dilutive securities. Our unvested restricted stock/unit awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit.
Income Taxes	Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of a TRS, MPT Development Services, Inc. (“MDS”), and with many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. MDS is not entitled to a dividends paid deduction and is subject to U.S. federal, state, and local income taxes. MDS is authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through this entity. With the property acquisitions and investments in Europe and Australia, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes in the U.S. as such income from our international properties flows through our REIT income tax returns. For our TRS and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets/liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.
Stock-Based Compensation	Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. Awards of restricted stock and other equity-based awards with service conditions are valued at the average stock price per share on the date of grant and are amortized to compensation expense over the service periods (typically three years), using the straight-line method. Awards that contain market conditions are valued on the grant date using a Monte Carlo valuation model and are amortized to compensation expense over the derived service periods, which correspond to the periods over which we estimate the awards will be earned, which generally range from three to five years, using the straight-line method. Awards with performance conditions are valued at the average stock price per share on the date of grant and are amortized using the straight-line method over the service period, adjusted for the probability of achieving the performance conditions. Forfeitures of stock-based awards are recognized as they occur.
Deferred Costs	Deferred Costs: Costs incurred that directly relate to the offerings of stock are deferred and netted against proceeds received from the offering. Leasing commissions and other leasing costs that would not have been incurred if the lease was not obtained are capitalized as deferred leasing costs and amortized on the straight-line method over the terms of the related lease agreements. Costs identifiable with loans made to borrowers are capitalized and recognized as a reduction in interest income over the life of the loan.
Deferred Financing Costs	Deferred Financing Costs: We generally capitalize financing costs incurred in connection with new financings and refinancings of debt. These costs are amortized over the lives of the related debt as an addition to interest expense. For debt with defined principal re-payment terms, the deferred costs are amortized to produce a constant effective yield on the debt (interest method) and are included within Debt, net on our consolidated balance sheets. For debt without defined principal repayment terms, such as our revolving credit facility , the deferred costs are amortized on the straight-line method over the term of the debt and are included as a component of “ Other a ssets ” on our consolidated balance sheets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in “Accumulated other comprehensive income (loss)”, a component of stockholders’ equity on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are translated into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of transaction gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the translation effects on our long-term investments are recorded in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets.
Derivative Financial Investments and Hedging Activities	Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in “Accumulated other comprehensive income (loss)” on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the derivatives offsets the change in the estimated fair value of the hedged item, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. To qualify for hedge accounting, we formally document all relationships between hedging instruments and hedged items, as well as our risk management objective and strategy for undertaking the hedge prior to entering into a derivative transaction. This process includes specific identification of the hedging instrument and the hedge transaction, the nature of the risk being hedged and how the hedging instrument’s effectiveness in hedging the exposure to the hedged transaction’s variability in cash flows attributable to the hedged risk will be assessed. Both at the inception of the hedge and on an ongoing basis, we assess whether the derivatives that are used in hedging transactions are highly effective in offsetting changes in cash flows or fair values of hedged items. In addition, for cash flow hedges, we assess whether the underlying forecasted transaction will occur. We discontinue hedge accounting if a derivative is not determined to be highly effective as a hedge or that it is probable that the underlying forecasted transaction will not occur.
Fair Value Measurement	Fair Value Measurement: We measure and disclose the estimated fair value of financial assets and liabilities utilizing a hierarchy of valuation techniques based on whether the inputs to a fair value measurement are considered to be observable or unobservable in a marketplace. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our market assumptions. This hierarchy requires the use of observable market data when available. These inputs have created the following fair value hierarchy: • Level 1 — quoted prices for identical instruments in active markets; • Level 2 — quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; and model-derived valuations in which significant inputs and significant value drivers are observable in active markets; and • Level 3 — fair value measurements derived from valuation techniques in which one or more significant inputs or significant value drivers are unobservable . We measure fair value using a set of standardized procedures that are outlined herein for all assets and liabilities which are required to be measured at their estimated fair value on either a recurring or non-recurring basis. When available, we utilize quoted market prices from an independent third party source to determine fair value and classify such items in Level 1. In some instances where a market price is available, but the instrument is in an inactive or over-the-counter market, we apply the dealer (market maker) pricing estimate and classify the asset or liability in Level 2. If quoted market prices or inputs are not available, fair value measurements are based upon valuation models that utilize current market or independently sourced market inputs, such as interest rates, option volatilities, credit spreads, market capitalization rates, etc. Items valued using such internally-generated valuation techniques are classified according to the lowest level input that is significant to the fair value measurement. As a result, the asset or liability could be classified in either Level 2 or 3 even though there may be some significant inputs that are readily observable. Internal fair value models and techniques that have been used by us include discounted cash flow and Monte Carlo valuat ion models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity interest in Ernest Health, Inc. (“Ernest”) along with any related loans (all of which other than the mortgage loans were sold or paid off on October 4, 2018 - see Note 3 for more details), we have elected to account for these investments at fair value due to the size of the investments and because we believe this method is more reflective of current values. We have not made a similar election for other equity interests or loans that existed at December 31, 2019.
Leases (Lessee)	Leases (Lessee) Pursuant to ASU 2016-02, we are required 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 determines whether lease expense is recognized based on an effective interest method (for finance leases) or on a straight-line basis (for operating leases) over the term of the lease. Starting January 1, 2019, we are 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 are off balance sheet with lease expense recognized on a straight-line basis over the lease term, similar to previous guidance for operating leases. For our leases in which we are the lessee, including ground leases on which certain of our facilities reside, along with corporate office and equipment leases, we recorded a right-of-use asset and offsetting lease liability of approximately $84 million upon adoption of this standard - resulting in no material cumulative effect adjustment.
Reclassification	Reclassifications: Certain amounts in the consolidated financial statements for prior periods have been reclassified to conform to the current period presentation.
Recent Accounting Developments	Recent Accounting Developments Measurement of Credit Losses on Financial Instruments In June 2016, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2016-13, “Measurement of Credit Losses on Financial Instruments" ("ASU 2016-13"). This standard requires a new forward-looking “expected loss” model to be used for our financing receivables, including financing leases and loans, which the FASB believes will result in more timely recognition of such losses. ASU 2016-13 is effective for us on January 1, 2020. Upon adoption of this standard, we expect to record a credit loss reserve on January 1, 2020, of between $5 million and $15 million with the effect recorded as a cumulative adjustment in retained earnings.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Estimated Useful Lives of Related Real Estate and Other Assets	Depreciation is calculated on the straight-line method over the estimated useful lives of the related real estate and other assets. Our weighted-average useful lives at December 31, 2019 are as follows: Buildings and improvements 39.0 years Tenant lease intangibles 23.7 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.7 years

Real Estate Activities (Tables)

Real Estate Activities (Tables)	12 Months Ended
	Dec. 31, 2019
Real Estate [Line Items]
Assets Acquired	For the years ended December 31, 2019, 2018, and 2017, we acquired the following assets: 2019 2018 2017 (in thousands) Assets Acquired Land $ 400,539 $ 71,880 $ 240,993 Building 1,951,066 686,739 985,219 Intangible lease assets — subject to amortization (weighted-average useful life of 19.1 years in 2019, 27.9 years in 2018, and 27.7 years in 2017) 227,468 90,651 181,004 Investment in financing leases 1,386,797 — 40,450 Mortgage loans 51,267 — 700,000 Other loans 135,258 336,458 — Equity investments and other assets 415,836 245,267 100,000 Liabilities assumed (2,637 ) — (878 ) Total assets acquired $ 4,565,594 $ 1,430,995 $ 2,246,788 Loans repaid(1) — (764,447 ) — Total net assets acquired $ 4,565,594 $ 666,548 $ 2,246,788 (1) The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.
Summary of Status on Current Development Projects	See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2019 Estimated Rent Commencement Date Circle (Birmingham, England) $ 47,532 $ 41,920 2Q 2020 Circle Rehabilitation (Birmingham, England) 21,427 17,385 2Q 2020 Surgery Partners (Idaho Falls, Idaho) 113,468 96,639 1Q 2020 NeuroPsychiatric Hospitals (Houston, Texas) 27,500 12,268 4Q 2020 $ 209,927 $ 168,212
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $21.5 million, $17.6 million, and $15.8 million in 2019, 2018, and 2017, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2020 $ 27,795 2021 27,781 2022 27,767 2023 27,702 2024 27,668
Summary of Total Future Minimum Lease Payments to be Received	The following table summarizes total future minimum lease payments to be received, excluding operating expense reimbursements, from tenants under noncancelable leases as of December 31, 2019 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2020 $ 589,140 $ 166,067 $ 755,207 2021 604,653 169,388 774,041 2022 612,427 172,776 785,203 2023 623,590 176,231 799,821 2024 633,197 179,756 812,953 Thereafter 12,779,610 4,902,534 17,682,144 $ 15,842,617 $ 5,766,752 $ 21,609,369
Components of Total Investment in Financing Leases	The components of our total investment in financing leases consisted of the following (in thousands): As of December 31, 2019 As of December 31, 2018 Minimum lease payments receivable $ 1,884,921 $ 2,091,504 Estimated residual values 394,195 424,719 Less unearned income (1,618,252 ) (1,832,170 ) Net investment in direct financing leases $ 660,864 $ 684,053 Other financing leases 1,399,438 — Total investment in financing leases $ 2,060,302 $ 684,053
Summary of Loans	The following is a summary of our loans ($ amounts in thousands): As of December 31, 2019 As of December 31, 2018 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 1,275,022 9.0 % $ 1,213,322 8.8 % Acquisition loans 123,893 7.7 % 3,454 10.8 % Other loans 420,939 5.7 % 369,744 5.4 % $ 1,819,854 $ 1,586,520
2018 [Member]
Real Estate [Line Items]
Summary of Operations for Disposed Assets	The following represents the operating results (excluding the St. Joseph sale in March 2018) of the properties sold in 2018 for the periods presented (in thousands): For the Year Ended 2018 2017 Revenues $ 88,838 $ 132,039 Real estate depreciation and amortization (15,849 ) (31,870 ) Property-related expenses (531 ) (404 ) Other(1) 709,717 (14,168 ) Income from real estate dispositions, net $ 782,175 $ 85,597 (1) Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018.

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt ($ amounts in thousands): As of December 31, 2019 As of December 31, 2018 Revolving credit facility(A) $ — $ 28,059 Term loan 200,000 200,000 Australian term loan facility(B) 842,520 — 4.000% Senior Unsecured Notes due 2022(B) 560,650 573,350 2.550% Senior Unsecured Notes due 2023(B) 530,280 — 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) 560,650 573,350 5.250% Senior Unsecured Notes due 2026 500,000 500,000 5.000% Senior Unsecured Notes due 2027 1,400,000 1,400,000 3.692% Senior Unsecured Notes due 2028(B) 795,420 — 4.625% Senior Unsecured Notes due 2029 900,000 — $ 7,089,520 $ 4,074,759 Debt issue costs and discount, net (65,841 ) (37,370 ) $ 7,023,679 $ 4,037,389 (A) Includes £22 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period end.
Principal Payments Due on Debt	As of December 31, 2019, principal payments due on our debt (which exclude the effects of any discounts, premiums, or debt issue costs recorded) are as follows ($ amounts in thousands): 2020 $ — 2021 — 2022 760,650 2023 530,280 2024 1,642,520 Thereafter 4,156,070 Total $ 7,089,520

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Schedule of Income Tax Benefit (Expense)	From our TRS and our foreign operations, income tax benefit (expense) were as follows (in thousands): For the Years Ended December 31, 2019 2018 2017 Current income tax benefit (expense): Domestic $ 61 $ 125 $ 41 Foreign (1,669 ) (3,294 ) (3,062 ) (1,608 ) (3,169 ) (3,021 ) Deferred income tax benefit (expense): Domestic 5,490 3,713 233 Foreign (1,261 ) (1,471 ) 107 4,229 2,242 340 Income tax benefit (expense) $ 2,621 $ (927 ) $ (2,681 )
Summary of Reconciliation of the Income Tax Benefit (Expense) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes	A reconciliation of the income tax benefit (expense) at the statutory income tax rate and the effective tax rate for income before income taxes for the years ended December 31, 2019, 2018, and 2017 is as follows (in thousands): For the Years Ended December 31, 2019 2018 2017 Income before income tax $ 373,780 $ 1,019,404 $ 293,919 Income tax at the U.S. statutory federal rate ( 21% 2019 and 2018 and 35% in 2017) (78,494 ) (214,075 ) (102,872 ) Decrease (increase) in income tax resulting from: Foreign rate differential 438 2,643 2,326 State income taxes, net of federal benefit 1,621 (379 ) — U.S. earnings not subject to federal income tax 85,495 208,472 98,026 Equity investments 1,091 46 (3,293 ) Change in valuation allowance (7,911 ) 2,668 5,391 Other items, net 381 (302 ) (2,259 ) Total income tax benefit (expense) $ 2,621 $ (927 ) $ (2,681 )
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2019 and 2018, components of our deferred tax assets and liabilities were as follows (in thousands): 2019 2018 Deferred tax assets: Operating loss and interest deduction carry forwards $ 28,684 $ 21,984 Other 1,711 277 Total deferred tax assets 30,395 22,261 Valuation allowance (11,355 ) (3,444 ) Total net deferred tax assets $ 19,040 $ 18,817 Deferred tax liabilities: Property and equipment $ (7,324 ) $ (12,359 ) Net unbilled revenue (1,449 ) (1,633 ) Partnership investments — — Other (737 ) (300 ) Total deferred tax liabilities (9,510 ) (14,292 ) Net deferred tax asset (liability) $ 9,530 $ 4,525
Schedule of Net NOL Carryforwards	At December 31, 2019, we had net NOL carryforwards as follows (in thousands): U.S. Luxembourg Germany U.K. Australia Gross NOL carryforwards $ 192,358 $ 9,946 $ 1,426 $ 5,416 $ 12,939 Tax-effected NOL carryforwards 22,960 2,481 226 921 1,941 Valuation allowance (6,212 ) (2,481 ) (226 ) (921 ) — Net deferred tax asset - NOL carryforwards $ 16,748 $ — $ — $ — $ 1,941 Expiration periods 2027-indefinite 2034-indefinite Indefinite Indefinite Indefinite
Schedule of Per Share Distributions to Stockholders	A schedule of per share distributions we paid and reported to our stockholders is set forth in the following: For the Years Ended December 31, 2019 2018 2017 Common share distribution $ 1.010000 $ 0.990000 $ 0.950000 Ordinary income 0.701910 0.438792 0.655535 Capital gains(1) 0.275040 0.551208 0.021022 Unrecaptured Sec. 1250 gain 0.041160 0.132280 0.004647 Section 199A Dividends 0.701910 0.438792 — Return of capital 0.033050 — 0.273443 (1)Capital gains include unrecaptured Sec. 1250 gains.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Calculation of Earnings Per Share	Medical Properties Trust, Inc. Our earnings per share were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2019 2018 2017 Numerator: Net income $ 376,401 $ 1,018,477 $ 291,238 Non-controlling interests’ share in earnings (1,717 ) (1,792 ) (1,445 ) Participating securities’ share in earnings (2,308 ) (3,685 ) (1,409 ) Net income, less participating securities’ share in earnings $ 372,376 $ 1,013,000 $ 288,384 Denominator: Basic weighted-average common shares 427,075 365,364 349,902 Dilutive potential common shares 1,224 907 539 Diluted weighted-average common shares 428,299 366,271 350,441 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2019 2018 2017 Numerator: Net income $ 376,401 $ 1,018,477 $ 291,238 Non-controlling interests’ share in earnings (1,717 ) (1,792 ) (1,445 ) Participating securities’ share in earnings (2,308 ) (3,685 ) (1,409 ) Net income, less participating securities’ share in earnings $ 372,376 $ 1,013,000 $ 288,384 Denominator: Basic weighted-average units 427,075 365,364 349,902 Dilutive potential units 1,224 907 539 Diluted weighted-average units 428,299 366,271 350,441

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-based Award Activity	The following summarizes stock-based award activity in 2019 and 2018 (which includes awards granted in 2019, 2018, 2017, and any applicable prior years), respectively For the Year Ended December 31, 2019: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 923,848 $ 14.29 4,133,435 $ 9.21 Awarded 681,378 $ 19.24 2,438,292 $ 15.25 Vested (478,104 ) $ 14.73 (1,051,637 ) $ 10.43 Forfeited (4,682 ) $ 13.44 (38,935 ) $ 10.13 Nonvested awards at end of year 1,122,440 $ 17.11 5,481,155 $ 11.66 For the Year Ended December 31, 2018: Vesting Based on Service Vesting Based on Market/Performance Conditions Shares Weighted-Average Value at Award Date Shares Weighted-Average Value at Award Date Nonvested awards at beginning of the year 276,280 $ 12.68 2,676,755 $ 7.86 Awarded 958,480 $ 14.31 1,750,834 $ 11.61 Vested (307,275 ) $ 12.92 (288,404 ) $ 11.25 Forfeited (3,637 ) $ 13.05 (5,750 ) $ 9.35 Nonvested awards at end of year 923,848 $ 14.29 4,133,435 $ 9.21

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Summary of Fair Value Information of Financial Instruments	The following table summarizes fair value estimates for our financial instruments (in thousands): December 31, 2019 December 31, 2018 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 31,357 $ 30,472 $ 25,855 $ 24,942 Loans(1) 1,704,854 1,742,153 1,471,520 1,490,758 Debt, net (7,023,679 ) (7,331,816 ) (4,037,389 ) (3,947,795 ) (1) Excludes mortgage 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 December 31, 2019 and 2018, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2019 As of December 31, 2018 Asset Type Asset (Liability) Fair Value Original Cost Fair Value Original Cost Classification Mortgage loans $ 115,000 $ 115,000 $ 115,000 $ 115,000 Mortgage loans

Leases (Lessee) (Tables)

Leases (Lessee) (Tables)	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Summary of Lease Expense	The following is a summary of our lease expense (in thousands): Income Statement For the Year Ended December 31, Classification 2019 Operating lease cost (1) (2) $ 9,262 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 Interest on lease liabilities Interest 117 Sublease income Other (3,478 ) Total lease cost $ 5,952 (1) Includes short-term leases. (2) $5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income.
Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments Table Text Block	Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2019 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2020 $ 6,098 $ 125 $ (3,156 ) $ 3,067 2021 6,279 126 (3,498 ) 2,907 2022 6,470 128 (3,630 ) 2,968 2023 6,533 129 (3,632 ) 3,030 2024 5,635 130 (3,651 ) 2,114 Thereafter 180,280 4,915 (90,199 ) 94,996 (1) Total undiscounted minimum lease payments $ 211,295 $ 5,553 $ (107,766 ) $ 109,082 Less: interest (134,942 ) (3,621 ) Present value of lease liabilities $ 76,353 $ 1,932 (1) Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases.
Summary of Supplemental Balance Sheet Information	Supplemental balance sheet information is as follows (in thousands, except lease terms and discount rate): Balance Sheet Classification December 31, 2019 Right of use assets: Operating leases - real estate Land $ 59,492 Finance leases - real estate Land 1,888 Real estate right of use assets, net $ 61,380 Operating leases - corporate Other assets 9,866 Total right of use assets, net $ 71,246 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 76,353 Financing leases Obligations to tenants and other lease liabilities 1,932 Total lease liabilities $ 78,285 Weighted-average remaining lease term: Operating leases 31.9 Finance leases 36.9 Weighted-average discount rate: Operating leases 6.3 % Finance leases 6.6 %
Summary of Supplemental Cash Flow Information	The following is supplemental cash flow information (in thousands): For the Year Ended December 31, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 5,937 Operating cash flows from finance leases 114 Financing cash flows from finance leases 10 Right-of-use assets obtained in exchange for lease obligations: Operating leases 1,818 Finance leases —

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2019
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Summary of Other Assets	The following is a summary of our other assets on our consolidated balance sheets (in thousands): At December 31, 2019 2018 Debt issue costs, net(1) $ 2,492 $ 4,793 Other corporate assets 206,765 115,416 Prepaids and other assets 90,342 61,757 Total other assets $ 299,599 $ 181,966 (1)

Quarterly Financial Data (una_2

Quarterly Financial Data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2019
Unaudited Quarterly Financial Information	The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2019 and 2018: (amounts in thousands, except for per share data) For the Three Month Periods in 2019 Ended March 31 June 30 September 30 December 31 Revenues $ 180,454 $ 192,549 $ 224,756 $ 256,438 Net income 76,291 79,920 90,267 129,923 Net income attributable to MPT common stockholders 75,822 79,438 89,786 129,638 Net income attributable to MPT common stockholders per share — basic $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average shares outstanding — basic 380,551 394,574 439,581 493,593 Net income attributable to MPT common stockholders per share — diluted $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average shares outstanding — diluted 381,675 395,692 440,933 494,893 For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT common stockholders 90,601 111,567 736,034 78,483 Net income attributable to MPT common stockholders per share — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted-average shares outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT common stockholders per share —diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted-average shares outstanding — diluted 365,343 365,541 366,467 367,732
MPT Operating Partnership, L.P. [Member]
Unaudited Quarterly Financial Information	The following is a summary of the unaudited quarterly financial information for the years ended December 31, 2019 and 2018: (amounts in thousands, except for per unit data) For the Three Month Periods in 2019 Ended March 31 June 30 September 30 December 31 Revenues $ 180,454 $ 192,549 $ 224,756 $ 256,438 Net income 76,291 79,920 90,267 129,923 Net income attributable to MPT Operating Partnership partners 75,822 79,438 89,786 129,638 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average units outstanding — basic 380,551 394,574 439,581 493,593 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.20 $ 0.20 $ 0.20 $ 0.26 Weighted-average units outstanding — diluted 381,675 395,692 440,933 494,893 For the Three Month Periods in 2018 Ended March 31 June 30 September 30 December 31 Revenues $ 205,046 $ 201,902 $ 196,996 $ 180,578 Net income 91,043 112,017 736,476 78,941 Net income attributable to MPT Operating Partnership partners 90,601 111,567 736,034 78,483 Net income attributable to MPT Operating Partnership partners per unit — basic $ 0.25 $ 0.30 $ 2.01 $ 0.21 Weighted-average units outstanding — basic 364,882 364,897 365,024 366,655 Net income attributable to MPT Operating Partnership partners per unit — diluted $ 0.25 $ 0.30 $ 2.00 $ 0.21 Weighted-average units outstanding — diluted 365,343 365,541 366,467 367,732

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jan. 01, 2020
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100.00%
Expected lease-up periods for estimating lost rentals, in months	6 months
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Number of years of federal income tax at corporate rates on failure to qualify as REIT	4 years
Offsetting lease liability	$ 76,353,000
ASU 2016-02 [Member]
Significant Accounting Policies [Line Items]
Operating lease right-of-use asset	84,000,000
Offsetting lease liability	$ 84,000,000
Minimum [Member] | ASU 2016-13 [Member] | Subsequent Event [Member]
Significant Accounting Policies [Line Items]
Credit loss reserve expected				$ 5,000
Maximum [Member] | ASU 2016-13 [Member] | Subsequent Event [Member]
Significant Accounting Policies [Line Items]
Credit loss reserve expected				$ 15,000
Time-Based Awards [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] | Minimum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	3 years
Market Conditions Based Awards [Member] | Maximum [Member]
Significant Accounting Policies [Line Items]
Stock award service period in years	5 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Estimated Useful Lives of Related Real Estate and Other Assets (Detail)	12 Months Ended
	Dec. 31, 2019
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	39 years
Tenant lease intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	23 years 8 months 12 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	7 years 8 months 12 days

Real Estate Activities - Assets

Real Estate Activities - Assets Acquired (Detail) - USD ($) $ in Thousands		Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Equity investments and other assets		$ 415,836	$ 245,267	$ 100,000
Liabilities assumed		(2,637)		(878)
Total assets acquired		4,565,594	1,430,995	2,246,788
Loans repaid	[1]		(764,447)
Total net assets acquired		4,565,594	666,548	2,246,788
Land [Member]
Business Acquisition [Line Items]
Total assets acquired		400,539	71,880	240,993
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		1,951,066	686,739	985,219
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Total assets acquired		227,468	90,651	181,004
Investment in Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired		1,386,797		40,450
Other Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		135,258	$ 336,458
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		$ 51,267		$ 700,000
[1]	The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.

Real Estate Activities - Asse_2

Real Estate Activities - Assets Acquired (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Loans repaid	[1]		$ 764,447
Weighted average useful life of acquired intangible lease assets (in years)		21 years 7 months 6 days
Intangible Lease Assets - Subject to Amortization [Member]
Business Acquisition [Line Items]
Weighted average useful life of acquired intangible lease assets (in years)		19 years 1 month 6 days	27 years 10 months 24 days	27 years 8 months 12 days
Steward [Member]
Business Acquisition [Line Items]
Loans repaid			$ 800,000
[1]	The 2018 column includes $0.8 billion of loans advanced to Steward in 2016 and repaid in 2018 as part of sale leaseback conversion described below.

Real Estate Activities - 2019 A

Real Estate Activities - 2019 Activity - Additional Information (Detail) € in Millions, £ in Millions, SFr in Millions, $ in Millions

Dec. 23, 2019GBP (£)HospitalRenewalOption

Dec. 17, 2019USD ($)HospitalLeaseRenewalOption

Dec. 03, 2019EUR (€)Hospital

Nov. 28, 2019EUR (€)

Aug. 30, 2019USD ($)HospitalRenewalOption

Aug. 23, 2019USD ($)HospitalRenewalOptionHealth_Center

Aug. 16, 2019GBP (£)Hospital

Jun. 28, 2019CHF (SFr)

Jun. 10, 2019USD ($)HospitalRenewalOption

Jun. 06, 2019AUD ($)Hospital

May 27, 2019CHF (SFr)_Campus

Apr. 12, 2019Hospital

Apr. 03, 2019

Aug. 28, 2018EUR (€)Hospital

Dec. 31, 2019USD ($)Hospital

Dec. 31, 2018USD ($)

Aug. 31, 2018

Business Acquisition [Line Items]

Term of lease extension, years

5 years

Mortgage loan balance | $

$ 1,819,854,000

$ 1,586,520,000

Term loan | $

$ 112,900,000

Additional number of businesses acquired

2

Performance thresholds achievement period

3 years

Weighted average remaining lease term

23 years

31 years 10 months 24 days

Other Acquisitions [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 135,000,000

Spain [Member] | Spanish PropCo. [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

45.00%

Ramsay [Member]

Business Acquisition [Line Items]

Term of lease

18 years

Swiss Healthcare Real Estate Company Infracore S A [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 236.6

Swiss Healthcare Real Estate Company Infracore S A [Member] | Joint Venture Partner [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

46.00%

Aevis Victoria SA [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 47

Ownership interest in joint venture under the cost method

4.90%

Vibra [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 254,000,000

Term of lease

20 years

Number of lease extension options | RenewalOption

3

Lease extension options, description

three five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Maximum [Member]

Business Acquisition [Line Items]

Term of lease

15 years

Future purchase price adjustment | $

$ 250,000,000

Minimum [Member]

Business Acquisition [Line Items]

Term of lease

10 years

Prospect [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 1,550,000,000

Term of lease

15 years

Number of lease extension options | RenewalOption

3

Prospect [Member] | Investment in Financing Leases [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 1,400,000,000

Secure Income REIT [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 347

Secure Income REIT [Member] | England [Member]

Business Acquisition [Line Items]

Number of private hospitals acquired

8

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired

10

Purchase price of acquisition | $

$ 700,000,000

Acute Care Hospital [Member] | Other Acquisitions [Member]

Business Acquisition [Line Items]

Number of facilities acquired

3

Acute Care Hospital [Member] | Spain [Member]

Business Acquisition [Line Items]

Number of facilities acquired

2

Purchase price of acquisition | €

€ 117.3

Acute Care Hospital [Member] | Portugal [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 28.2

Acute Care Hospital [Member] | Germany [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

50.00%

Acute Care Hospital [Member] | Vibra [Member]

Business Acquisition [Line Items]

Number of facilities acquired

7

Acute Care Hospital [Member] | Steward Health Care System LLC [Member] | Texas [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Acute Care Hospital [Member] | BMI Healthcare [Member] | England [Member]

Business Acquisition [Line Items]

Number of facilities acquired

30

Purchase price of acquisition | £

£ 1,500

Number of lease extension options | RenewalOption

2

Lease extension options, description

two five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Acute Care Hospital [Member] | BMI Healthcare [Member] | Poole, England [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Term of lease

14 years

Fixed annual escalations

2.50%

Acute Care Hospital [Member] | Halsen Healthcare [Member] | California [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Acute Care Hospital [Member] | Mortgage Loans [Member]

Business Acquisition [Line Items]

Mortgage loan balance | $

$ 51,300,000

Life Point [Member]

Business Acquisition [Line Items]

Number of master leases | Lease

1

Term of lease

20 years

Number of lease extension options | RenewalOption

2

Lease extension options, description

two five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Acute Care Campus [Member] | Swiss Healthcare Real Estate Company Infracore S A [Member]

Business Acquisition [Line Items]

Number of facilities acquired | _Campus

13

Acute Care Campus [Member] | Prospect [Member]

Business Acquisition [Line Items]

Number of facilities acquired

14

Acute Care Campus [Member] | Prospect [Member] | Investment in Financing Leases [Member]

Business Acquisition [Line Items]

Number of facilities acquired

11

Behavioral Health Care Facility [Member] | Prospect [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Health_Center

2

Behavioral Health Care Facility [Member] | Prospect [Member] | Investment in Financing Leases [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Health_Center

2

Hospital [Member] | Australia [Member]

Business Acquisition [Line Items]

Number of facilities acquired

11

Purchase price of acquisition | $

$ 1,200

Stamp duties and registration fees | $

$ 66.6

Hospital [Member] | Healthscope [Member]

Business Acquisition [Line Items]

Term of lease

20 years

Additional Properties [Member] | Swiss Healthcare Real Estate Company Infracore S A [Member] | Switzerland [Member]

Business Acquisition [Line Items]

Number of facilities acquired | _Campus

2

HM Hospital [Member] | Spain [Member]

Business Acquisition [Line Items]

Term of lease

25 years

Jose de Mello [Member] | Portugal [Member]

Business Acquisition [Line Items]

Term of lease

17 years

Inpatient Rehabilitation Hospital [Member] | Germany [Member]

Business Acquisition [Line Items]

Number of facilities acquired

3

Purchase price of acquisition | €

€ 17.3

Inpatient Rehabilitation Hospital [Member] | Germany [Member] | Other Acquisitions [Member]

Business Acquisition [Line Items]

Number of facilities acquired

1

Inpatient Rehabilitation Hospital [Member] | Vibra [Member]

Business Acquisition [Line Items]

Number of facilities acquired

3

Community Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired

7

Number of lease extension options | RenewalOption

2

Lease extension options, description

two five-year extension options

Existence of option to extend

true

Term of lease extension, years

5 years

Leases fixed escalations

5 years

Community Hospital [Member] | Kansas [Member]

Business Acquisition [Line Items]

Number of facilities acquired

7

Purchase price of acquisition | $

$ 145,400,000

Community Hospital [Member] | Saint Luke's Health System [Member]

Business Acquisition [Line Items]

Term of lease

14 years

Real Estate Activities - 2018 A

Real Estate Activities - 2018 Activity - Additional Information (Detail) $ in Thousands, € in Millions

Dec. 17, 2019USD ($)Hospital

Aug. 31, 2018EUR (€)

Aug. 28, 2018EUR (€)Hospital

Nov. 29, 2017Hospital

Jun. 22, 2017EUR (€)

Mar. 31, 2017USD ($)

Aug. 31, 2018USD ($)Hospital

Aug. 31, 2018EUR (€)Hospital

Mar. 31, 2018USD ($)

Jan. 30, 2017EUR (€)

Oct. 31, 2016USD ($)

Dec. 31, 2018EUR (€)Hospital

Jan. 30, 2017EUR (€)Hospital

Dec. 31, 2019USD ($)

Dec. 31, 2018USD ($)Hospital

Dec. 31, 2017USD ($)

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method value included in other assets | $

$ 926,990

$ 520,058

Gain on sale of real estate | $

$ 7,400

Mortgage financing | $

61,712

$ 50,783

$ 717,928

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

10

Gain on sale of real estate | $

$ 41,600

Purchase price of acquisition | $

$ 700,000

General Acute Care Hospital and Healthcare System [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

5

Mortgage financing | $

$ 764,400

$ 764,400

Germany [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Ownership interest in joint venture under the equity method

50.00%

50.00%

Ownership interest in joint venture under the equity method value included in other assets

€ 210

€ 210

Shareholder loan to joint venture

290

290

Gain on sale of real estate

500

Germany [Member] | Acute Care Hospital [Member] | MEDIAN [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

€ 19.4

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

€ 23

€ 44.1

Germany [Member] | Rehabilitation Hospital with Covenant Health System [Member] | MEDIAN [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Term of lease

27 years

27 years

Germany [Member] | Inpatient Rehabilitation Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Purchase price of acquisition

€ 17.3

Germany [Member] | Fair Value [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Aggregate fair value of ownership interest

€ 1,635

€ 1,635

Pasco, Washington [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 17,500

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

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

4

Texas [Member] | General Acute Care Hospital and Healthcare System [Member] | Steward [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

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%

50.00%

Number of facilities acquired | Hospital

71

71

Proceeds from joint venture

€ 1,140

Gain on sale of real estate

€ 500

Real Estate Activities - 2017 A

Real Estate Activities - 2017 Activity - Additional Information (Detail) $ in Thousands, € in Millions

Dec. 17, 2019USD ($)Hospital

Nov. 29, 2017EUR (€)Hospital

Sep. 29, 2017USD ($)HospitalHealth_Center

Jun. 22, 2017EUR (€)

Jun. 01, 2017USD ($)

May 01, 2017USD ($)HospitalBed

Jan. 30, 2017EUR (€)

Dec. 31, 2016EUR (€)Property

Jul. 31, 2016EUR (€)Hospital

Dec. 31, 2018EUR (€)Hospital

Sep. 30, 2017EUR (€)Hospital

Jun. 30, 2017EUR (€)Hospital

Jan. 30, 2017EUR (€)Hospital

Dec. 31, 2019USD ($)

Dec. 31, 2018USD ($)

Dec. 31, 2017USD ($)

Aug. 28, 2018

Business Acquisition [Line Items]

Amount of mortgage loan

$ 61,712

$ 50,783

$ 717,928

Subsidiaries [Member]

Business Acquisition [Line Items]

Amount of mortgage loan

$ 700,000

Number of mortgage facilities | Hospital

2

Equity interest acquired

$ 100,000

Combined purchase price and investment amount

1,500,000

Subsidiaries [Member] | IASIS Healthcare [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 700,000

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

10

Purchase price of acquisition

$ 700,000

Acute Care Hospital [Member] | Germany [Member] | MEDIAN [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 19.4

Lease agreement, end date

2042-12

Purchase price of acquisition funded | €

€ 18.6

Remaining payment period

4 years

Acute Care Hospital [Member] | West Virginia and Ohio [Member] | Alecto Healthcare Services [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 40,000

Acute Care Hospital [Member] | IDAHO, Lewiston | St. Joseph Regional Medical Center [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 87,500

Number of beds acquired | Bed

145

Acute Care Hospital [Member] | IASIS Healthcare [Member]

Business Acquisition [Line Items]

Number of facilities closed | Hospital

10

Acute Care Hospital [Member] | Subsidiaries [Member] | IASIS Healthcare [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

8

Behavioral Health Care Facility [Member] | IASIS Healthcare [Member]

Business Acquisition [Line Items]

Number of facilities closed | Health_Center

1

Behavioral Health Care Facility [Member] | Subsidiaries [Member] | IASIS Healthcare [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Health_Center

1

Community Health Systems, Inc. [Member] | Florida, Ohio, and Pennsylvania [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

8

Purchase price of acquisition

$ 301,300

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

€ 23

€ 44.1

Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | Third Master Lease [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

20

2

11

Acquisition costs | €

€ 215.7

€ 39.2

€ 127

Number of properties closed | Property

7

Amount of properties closed | €

€ 49.5

Rehabilitation Hospital with Covenant Health System [Member] | Germany [Member] | MEDIAN [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Acquisition costs | €

€ 80

Term of lease

27 years

27 years

Lease agreement, end date

2044-11

Real Estate Activities - Develo

Real Estate Activities - Development Activities - Additional Information (Detail) $ in Millions	Oct. 25, 2019USD ($)	Dec. 31, 2019	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)Facility
Ernest [Member] | Development Activities [Member]
Business Acquisition [Line Items]
Estimated total development cost			$ 25.5
Behavioral Hospital [Member] | Houston, Texas [Member]
Business Acquisition [Line Items]
Estimated total development cost	$ 27.5
Acute Care Facilities [Member] | Adeptus Health [Member] | Development Activities [Member]
Business Acquisition [Line Items]
Number of facilities constructed | Facility				4
Acquisition costs				$ 68
Acute Care Facilities [Member] | Spain [Member] | IMED [Member] | Development Activities [Member]
Business Acquisition [Line Items]
Lessor direct financing lease description		quarterly fixed rent payments that started on October 1, 2017 with annual increases of 1% beginning April 1, 2020.
Lease rent increase percentage				1.00%
Ownership interests acquired				50.00%
Term of lease, years				30 years

Real Estate Activities - Summar

Real Estate Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Business Acquisition [Line Items]
Commitment	$ 209,927
Costs Incurred as of December 31, 2019	168,212
Circle [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Commitment	47,532
Costs Incurred as of December 31, 2019	$ 41,920
Estimated Rent Commencement Date	2Q 2020
Circle Rehabilitation [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Commitment	$ 21,427
Costs Incurred as of December 31, 2019	$ 17,385
Estimated Rent Commencement Date	2Q 2020
Surgery Partners [Member] | Idaho Falls, ID [Member]
Business Acquisition [Line Items]
Commitment	$ 113,468
Costs Incurred as of December 31, 2019	$ 96,639
Estimated Rent Commencement Date	1Q 2020
NeuroPsychiatric Hospitals [Member] | Houston, Texas [Member]
Business Acquisition [Line Items]
Commitment	$ 27,500
Costs Incurred as of December 31, 2019	$ 12,268
Estimated Rent Commencement Date	4Q 2020

Real Estate Activities - Dispos

Real Estate Activities - Disposals - Additional Information (Detail) $ in Thousands, € in Millions	Oct. 04, 2018USD ($)	Aug. 31, 2018USD ($)Hospital	Aug. 31, 2018EUR (€)Hospital	Jun. 04, 2018USD ($)Hospital	Mar. 01, 2018USD ($)	Mar. 31, 2017USD ($)	Aug. 31, 2018EUR (€)	Dec. 31, 2019USD ($)Hospital	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Aug. 23, 2019USD ($)
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								$ 1,819,854	$ 1,586,520
Net proceeds from sale of real estate								$ 111,766	$ 1,513,666	$ 64,362
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
Ernest [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities	$ 176,000
North Cypress [Member] | Houston, Texas [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
Vibra [Member] | California, Texas, and Oregon [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
Vibra [Member] | California, Texas, and Oregon [Member] | Working Capital Loans [Member]
Debt Instrument [Line Items]
Loans, Balance				1,500
Vibra [Member] | California, Texas, and Oregon [Member] | Mortgage Loans [Member]
Debt Instrument [Line Items]
Loans, Balance				$ 18,300
Acute Care Hospital [Member]
Debt Instrument [Line Items]
Number of hospitals sold | Hospital								5
Proceeds from sale of facilities								$ 97,000
Gain on real estate dispositions								$ 41,600
Acute Care Hospital [Member] | Mortgage Loans [Member]
Debt Instrument [Line Items]
Loans, Balance											$ 51,300
Acute Care Hospital [Member] | Germany [Member]
Debt Instrument [Line Items]
Gain on real estate dispositions | €							€ 500
Acute Care Hospital [Member] | Primotop Holdings S.a.r.l. [Member] | Germany [Member]
Debt Instrument [Line Items]
Proceeds from sale of facilities | €			€ 1,635
Gain on real estate dispositions | €			€ 500
Number of properties sold | Hospital		71	71
General Acute Care Hospital and Healthcare System [Member] | North Cypress [Member] | Houston, Texas [Member]
Debt Instrument [Line Items]
Number of properties sold | Hospital		1	1
Long-term Acute Care Hospital [Member] | Vibra [Member] | California, Texas, and Oregon [Member]
Debt Instrument [Line Items]
Number of properties sold | Hospital				3

Real Estate Activities - Summ_2

Real Estate Activities - Summary of Operations for Disposed Assets (Detail) - 2018 [Member] - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2018	Dec. 31, 2017
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Revenues		$ 88,838	$ 132,039
Real estate depreciation and amortization		(15,849)	(31,870)
Property-related expenses		(531)	(404)
Other	[1]	709,717	(14,168)
Income from real estate dispositions, net		$ 782,175	$ 85,597
[1]	Includes approximately $720 million of gains on sale for the twelve months ended December 31, 2018.

Real Estate Activities - Summ_3

Real Estate Activities - Summary of Operations for Disposed Assets (Parenthetical) (Detail) € in Millions, $ in Millions	Mar. 31, 2017USD ($)	Aug. 31, 2018EUR (€)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate	$ 7.4
Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate			$ 41.6
Germany [Member] | Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate | €		€ 500
2018 [Member] | Germany [Member] | Acute Care Hospital [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Gain on sale of real estate				$ 720

Real Estate Activities - Intang

Real Estate Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Combinations [Abstract]
Intangible lease assets	$ 622,056	$ 403,138
Accumulated amortization, net	556,700	352,500
Amortization expense related to intangible lease assets	$ 21,500	$ 17,600	$ 15,800
Capitalized lease intangibles, weighted average life (in years)	21 years 7 months 6 days

Real Estate Activities - Amorti

Real Estate Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2019USD ($)
Business Combinations [Abstract]
2020	$ 27,795
2021	27,781
2022	27,767
2023	27,702
2024	$ 27,668

Real Estate Activities - Leasin

Real Estate Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2019USD ($)LeaseProperty
Lessor Lease Description [Line Items]
Lease renewal term	5 years
Annual rent escalations	97.00%
Number of properties | Property	5
Carrying value of lease requiring residual value guarantee | $	$ 210
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	14
Prime Facilities [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	10
Prospect [Member]
Lessor Lease Description [Line Items]
Number of financing leases	13
Minimum [Member]
Lessor Lease Description [Line Items]
Term of lease	10 years
Fixed minimum annual escalations	0.50%
Maximum [Member]
Lessor Lease Description [Line Items]
Term of lease	15 years
Fixed minimum annual escalations	3.00%

Real Estate Activities - Summ_4

Real Estate Activities - Summary of Total Future Minimum Lease Payments to be Received (Detail) - Minimum [Member] $ in Thousands	Dec. 31, 2019USD ($)
Lessor Lease Description [Line Items]
2020	$ 755,207
2021	774,041
2022	785,203
2023	799,821
2024	812,953
Thereafter	17,682,144
Future minimum lease payments to be received	21,609,369
Operating Leases [Member]
Lessor Lease Description [Line Items]
2020	589,140
2021	604,653
2022	612,427
2023	623,590
2024	633,197
Thereafter	12,779,610
Future minimum lease payments to be received	15,842,617
Financing Leases [Member]
Lessor Lease Description [Line Items]
2020	166,067
2021	169,388
2022	172,776
2023	176,231
2024	179,756
Thereafter	4,902,534
Future minimum lease payments to be received	$ 5,766,752

Real Estate Activities - Compon

Real Estate Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 1,884,921	$ 2,091,504
Estimated residual values	394,195	424,719
Less unearned income	(1,618,252)	(1,832,170)
Net investment in direct financing leases	660,864	684,053
Other financing leases	1,399,438
Total investment in financing leases	$ 2,060,302	$ 684,053

Real Estate Activities - Adeptu

Real Estate Activities - Adeptus Health Transition Properties - Additional Information (Detail) - Adeptus Health Transition Properties [Member] $ in Millions	Oct. 02, 2017Property	Dec. 31, 2019USD ($)Facility	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of facilities transitioned | Property	16
Amortization of straight-line rent receivables		$ 1.5	$ 6.1
Real estate impairment charge		$ 0.5	$ 18
Number of transitioned facilities not re-leased | Facility		3
Percentage of investment in remaining transition facilities on total assets		0.10%

Real Estate Activities - Alecto

Real Estate Activities - Alecto Healthcare Facilities - Additional Information (Detail) - Alecto Healthcare Services [Member] $ in Millions	3 Months Ended	12 Months Ended
	Dec. 31, 2019USD ($)Property	Dec. 31, 2019Property	Dec. 31, 2018USD ($)
Business Acquisition [Line Items]
Number of leased properties		4
Real estate impairment charge | $	$ 20		$ 30
Ohio [Member]
Business Acquisition [Line Items]
Number of leased properties terminated	2
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of Total Gross Assets		0.60%

Real Estate Activities - Summ_5

Real Estate Activities - Summary of Loans (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Loans [Line Items]
Mortgage loans	$ 1,275,022	$ 1,213,322
Acquisition loans	123,893	3,454
Other loans	420,939	369,744
Total	$ 1,819,854	$ 1,586,520
Mortgage Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	9.00%	8.80%
Acquisition Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	7.70%	10.80%
Other Loans [Member]
Loans [Line Items]
Loans, Weighted Average Interest Rate	5.70%	5.40%

Real Estate Activities - Loans

Real Estate Activities - Loans - Additional Information (Detail) $ in Thousands, € in Millions	12 Months Ended
	Dec. 31, 2019USD ($)HospitalPropertyOperator	Dec. 31, 2019EUR (€)PropertyOperator	Dec. 31, 2018USD ($)
Loans [Line Items]
Acquisition loans	$ 123,893		$ 3,454
Acute Care Hospitals [Member]
Loans [Line Items]
Acquisition loans	$ 112,900
Number of hospitals acquired | Hospital	2
Primotop Holdings S.a.r.l. [Member]
Loans [Line Items]
Shareholder loan to joint venture | €		€ 290
Mortgage Loans [Member] | Steward Health Care System LLC [Member]
Loans [Line Items]
Number of Real Estate Properties | Property	11	11
Number Of Operators | Operator	5	5
Increase in mortgage loans	$ 51,300

Real Estate Activities - Concen

Real Estate Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2019USD ($)Investment	Dec. 31, 2018USD ($)Investment	Dec. 31, 2017USD ($)
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants | $	$ 451.1	$ 501.4	$ 422.4
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	74.00%	80.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	20.00%	20.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Australia [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	6.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	24.00%	38.00%
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital and Healthcare System [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	87.00%	76.00%
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Hospital with Covenant Health System [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10.00%	20.00%
Revenue [Member] | Customer Concentration Risk [Member] | Long-term Acute Care Hospital [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	3.00%	4.00%
Revenue [Member] | Credit Concentration Risk [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	42.00%	39.00%
Revenue [Member] | Credit Concentration Risk [Member] | Prime [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	15.00%	16.00%
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk [Member]
Business Acquisition [Line Items]
Number of investment in property | Investment	0	0
Maximum percentage of entity's assets invested on single property	2.60%	4.00%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands		Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Debt		$ 7,089,520
Debt issue costs and discount, net		(65,841)	$ (37,370)
Debt, net		7,023,679	4,037,389
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	[1]		28,059
Term Loan [Member]
Debt Instrument [Line Items]
Debt		200,000	200,000
Term Loan [Member] | Australia [Member]
Debt Instrument [Line Items]
Debt	[2]	842,520
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Debt	[2]	560,650	573,350
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Debt	[2]	530,280
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt		300,000	300,000
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Debt		500,000	500,000
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt	[2]	560,650	573,350
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Debt		500,000	500,000
5.000% Senior Unsecured Notes Due 2027 [Member]
Debt Instrument [Line Items]
Debt		1,400,000	1,400,000
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Debt	[2]	795,420
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt		900,000
Senior Unsecured Debt [Member]
Debt Instrument [Line Items]
Debt		$ 7,089,520	$ 4,074,759
[1]	Includes £22 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2018.
[2]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - Summary of Debt (Parenth

Debt - Summary of Debt (Parenthetical) (Detail) $ in Thousands, £ in Millions		Dec. 31, 2019USD ($)		Dec. 05, 2019	Jul. 26, 2019	Dec. 31, 2018USD ($)		Dec. 31, 2018GBP (£)		Sep. 07, 2017	Mar. 24, 2017	Aug. 19, 2015	Apr. 17, 2014
Debt Instrument [Line Items]
Debt		$ 7,089,520
4.000% Senior Unsecured Notes due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.00%	[1]			4.00%	[1]	4.00%	[1]			4.00%
Debt	[1]	$ 560,650				$ 573,350
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.55%	[1]	2.55%
Debt	[1]	$ 530,280
5.500% Senior Unsecured Notes Due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.50%				5.50%		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%		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%	[1]		3.325%
Debt	[1]	$ 560,650				$ 573,350
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.25%				5.25%		5.25%
Debt		$ 500,000				$ 500,000
5.000% Senior Unsecured Notes Due 2027 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.00%				5.00%		5.00%		5.00%
Debt		$ 1,400,000				$ 1,400,000
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.692%	[1]	3.692%
Debt	[1]	$ 795,420
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.625%			4.625%
Debt		$ 900,000
GBP-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | £								£ 22
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - Principal Payments Due f

Debt - Principal Payments Due for Debt (Detail) $ in Thousands	Dec. 31, 2019USD ($)
Debt Disclosure [Abstract]
2022	$ 760,650
2023	530,280
2024	1,642,520
Thereafter	4,156,070
Total	$ 7,089,520

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Detail) € in Millions	Feb. 01, 2017USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)	Feb. 01, 2017EUR (€)
Debt Instrument [Line Items]
Aggregate committed amount of credit facility	$ 500,000,000
Minimum [Member]
Debt Instrument [Line Items]
Commitment fee	0.125%
Maximum [Member]
Debt Instrument [Line Items]
Commitment fee	0.30%
Unsecured Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 1,300,000,000
Debt instrument maturity date	Feb. 28, 2021
Aggregate committed amount of credit facility		$ 1,300,000,000
Credit facilities, amount outstanding		$ 0	$ 28,100,000
Credit facilities, weighted average interest rate		2.00%	2.70%
Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt	$ 200,000,000			€ 200
Debt instrument maturity date	Feb. 1, 2022
Interest rate at end of period		3.30%	3.89%
Alternate Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin	0.00%
Applicable margin for revolving loans	0.00%
Alternate Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin	0.95%
Applicable margin for revolving loans	0.65%
Eurodollar Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin	0.90%
Applicable margin for revolving loans	0.875%
Eurodollar Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin	1.95%
Applicable margin for revolving loans	1.65%
Euro [Member] | Term Loans [Member]
Debt Instrument [Line Items]
Debt instrument maturity date	Jan. 31, 2020

Debt - Australian Term Loan Fac

Debt - Australian Term Loan Facility - Additional Information (Detail)	Jun. 27, 2019	May 23, 2019AUD ($)	Dec. 31, 2019	Dec. 31, 2017USD ($)	Feb. 01, 2017USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity					$ 500,000,000
Term Loans [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity				$ 1,000,000,000
Term Loans [Member] | Bank of America, N.A | Australia [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,200,000,000
Debt instrument effective date	Jul. 3, 2019
Effective interest rate	1.20%
Senior unsecured notes, interest rate			2.45%
Debt instrument maturity date		May 23, 2024
Term Loans [Member] | Bank of America, N.A | Australia [Member] | Minimum [Member]
Debt Instrument [Line Items]
Interest rate adjustable based on pricing grid, percentage		0.85%
Term Loans [Member] | Bank of America, N.A | Australia [Member] | Maximum [Member]
Debt Instrument [Line Items]
Interest rate adjustable based on pricing grid, percentage		1.65%
Term Loans [Member] | Bank of America, N.A | Australia [Member] | Credit Rating
Debt Instrument [Line Items]
Variable interest rate			1.25%

Debt - 4.000% Senior Unsecured

Debt - 4.000% Senior Unsecured Notes Due 2022 - Additional Information (Detail) - 4.000% Senior Unsecured Notes due 2022 [Member] - EUR (€)	Aug. 19, 2015	Dec. 31, 2019		Dec. 31, 2018	[1]
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 500,000,000
Senior unsecured notes, interest rate	4.00%	4.00%	[1]	4.00%
Senior unsecured notes, payable term		Interest on the notes is payable annually on August 19 of each year.
Senior unsecured notes, maturity date	Aug. 19, 2022
Senior unsecured notes, redemption period	90 days
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, redemption description		notes are redeemed prior to 90 days before maturity, the redemption price will be 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 4.000% Senior Unsecured Notes due 2022 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase
Redeemed Prior to 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%
Redeemed Beginning on or After 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - 2.550% Senior Unsecured

Debt - 2.550% Senior Unsecured Notes Due 2023 - Additional Information (Detail) - 2.550% Senior Unsecured Notes due 2023 [Member] - EUR (€)	Dec. 05, 2019	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 400,000,000
Senior unsecured notes, interest rate	2.55%	2.55%	[1]
Senior unsecured notes, payable term		Interest on the notes is payable annually on December 5 of each year.
Senior unsecured notes, maturity date	Dec. 5, 2023
Senior unsecured notes, redemption period	30 days
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, redemption price percentage	100.00%
Senior unsecured notes, redemption description		We may redeem some or all of the 2.550% Senior Unsecured Notes due 2023 at any time. If the notes are redeemed prior to 30 days before maturity, the redemption price will be equal to 100% of the principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 2.550% Senior Unsecured Notes due 2023 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase.
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - 5.500% Senior Unsecured

Debt - 5.500% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 5.500% Senior Unsecured Notes Due 2024 [Member] - USD ($)	Apr. 17, 2014	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 300,000,000
Senior unsecured notes, interest rate	5.50%	5.50%	5.50%
Senior unsecured notes, payable term		Interest on the notes is payable semi-annually on May 1 and November 1 of each year.
Senior unsecured notes, maturity date	May 1, 2024
Senior notes, earliest redemption date	May 1, 2019
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time prior to May 1, 2019 at a “make-whole” redemption price. On or after May 1, 2019, we may redeem some or all of the notes at a premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase

Debt - 6.375% Senior Unsecured

Debt - 6.375% Senior Unsecured Notes Due 2024 - Additional Information (Detail) - 6.375% Senior Unsecured Notes due 2024 [Member] - USD ($)	Feb. 22, 2016	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		6.375%	6.375%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, maturity date	Mar. 1, 2024
Senior unsecured notes, interest rate	6.375%
Debt instrument, redemption price percentage	106.375%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, payable term		Interest on the notes is payable on March 1 and September 1 of each year.
Senior notes, earliest redemption date	Mar. 1, 2019
Senior unsecured notes, redemption description		we may redeem up to 35% of the notes at a redemption price equal to 106.375% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase
Maximum [Member] | Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 3.325% Senior Unsecured

Debt - 3.325% Senior Unsecured Notes Due 2025 - Additional Information (Detail) - 3.325% Senior Unsecured Notes Due 2025 [Member] - EUR (€)	Mar. 24, 2017	Dec. 31, 2019		Dec. 31, 2018	[1]
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 500,000,000
Senior unsecured notes, interest rate	3.325%	3.325%	[1]	3.325%
Senior unsecured notes, payable term		Interest on the notes is payable annually on March 24 of each year.
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, maturity date	Mar. 24, 2025
Senior unsecured notes, redemption period	90 days
Senior unsecured notes, redemption description		notes are redeemed prior to 90 days before maturity, the redemption price will be equal to 100% of their principal amount, plus a make-whole premium, plus accrued and unpaid interest up to, but excluding, the applicable redemption date. Within the period beginning on or after 90 days before maturity, the notes may be redeemed, in whole or in part, at a redemption price equal to 100% of their principal amount, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.325% Senior Unsecured Notes due 2025 are fully and unconditionally guaranteed on a senior unsecured basis by us. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest up to, but excluding, the date of the purchase
Redeemed Prior to 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%
Redeemed Beginning on or After 90 Days [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption price percentage	100.00%
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Debt - 5.250% Senior Unsecured

Debt - 5.250% Senior Unsecured Notes Due 2026 - Additional Information (Detail) - 5.250% Senior Unsecured Notes Due 2026 [Member] - USD ($)	Jul. 22, 2016	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		5.25%	5.25%
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 500,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on February 1 and August 1 of each year.
Senior unsecured notes, interest rate	5.25%
Senior unsecured notes, maturity date	Aug. 1, 2026
Senior notes, earliest redemption date	Aug. 1, 2021
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time prior to August 1, 2021 at a “make whole” redemption price. On or after August 1, 2021, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2019, we may redeem up to 35% of the notes at a redemption price equal to 105.250% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.
Debt instrument, redemption price percentage	105.25%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Revolving Credit Facility [Member] | Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	35.00%

Debt - 5.000% Senior Unsecured

Debt - 5.000% Senior Unsecured Notes Due 2027 - Additional Information (Detail) - 5.000% Senior Unsecured Notes Due 2027 [Member] - USD ($)	Sep. 07, 2017	Dec. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Senior unsecured notes face amount	$ 1,400,000,000
Senior unsecured notes, payable term		Interest on the notes is payable on April 15 and October 15 of each year
Senior unsecured notes, interest rate	5.00%	5.00%	5.00%
Senior unsecured notes, maturity date	Oct. 15, 2027
Senior notes, earliest redemption date	Oct. 15, 2022
Senior unsecured notes, redemption description		we may redeem up to 40% of the notes at a redemption price equal to 105% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.
Debt instrument, redemption price percentage	105.00%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	40.00%

Debt - 3.692% Senior Unsecured

Debt - 3.692% Senior Unsecured Notes Due 2028 - Additional Information (Detail) - 3.692% Senior Unsecured Notes due 2028 [Member] - EUR (€)	Dec. 05, 2019	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 600,000,000
Senior unsecured notes, interest rate	3.692%	3.692%	[1]
Percentage of par value on senior notes	99.998%
Senior unsecured notes, payable term		Interest on the notes is payable on June 5 of each year.
Senior unsecured notes, maturity date	Jun. 5, 2028
Senior unsecured notes, redemption period	30 days
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Senior unsecured notes, redemption price percentage	100.00%
Senior unsecured notes, redemption description		We may redeem some or all of the 3.692% Senior Unsecured Notes due 2028 at any time. If the notes are redeemed prior to 30 days before maturity, the redemption price will be equal to 100% of the principal amount, plus a make-whole premium, plus accrued and unpaid interest to, but excluding, the applicable redemption date. The 3.692% Senior Unsecured Notes due 2028 are fully and unconditionally guaranteed on an unsecured basis by us. In the event of change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of the purchase.
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period end.

Deb - 4.625% Senior Unsecured N

Deb - 4.625% Senior Unsecured Notes Due 2029 - Additional Information (Detail) - 4.625% Senior Unsecured Notes Due 2029 [Member] - EUR (€)	Jul. 26, 2019	Dec. 31, 2019
Debt Instrument [Line Items]
Senior unsecured notes face amount	€ 900,000,000
Senior unsecured notes, interest rate	4.625%	4.625%
Senior unsecured notes, payable term		Interest on the notes is payable on February 1 and August 1 of each year, commencing on February 1, 2020.
Percentage of par value on senior notes	99.50%
Debt instrument maturity date	Aug. 1, 2029
Senior notes, earliest redemption date	Aug. 1, 2024
Senior unsecured notes, redemption description		We may redeem some or all of the notes at any time prior to August 1, 2024 at a “make whole” redemption price. On or after August 1, 2024, we may redeem some or all of the notes at a premium that will decrease over time. In addition, at any time prior to August 1, 2022, we may redeem up to 40% of the notes at a redemption price equal to 104.625% of the aggregate principal amount thereof, plus accrued and unpaid interest thereon, using proceeds from one or more equity offerings. In the event of a change in control, each holder of the notes may require us to repurchase some or all of the notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase.
Debt instrument, redemption price percentage	104.625%
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%
Maximum [Member]
Debt Instrument [Line Items]
Senior unsecured notes, redemption percentage on principal amount	40.00%

Debt - Additional Information (

Debt - Additional Information (Detail) € in Millions	Dec. 17, 2019Hospital	Aug. 31, 2018Hospital	Aug. 03, 2018EUR (€)	Jul. 31, 2019USD ($)	Aug. 31, 2018Hospital	Dec. 31, 2017USD ($)	Dec. 31, 2017EUR (€)	Dec. 23, 2019USD ($)	Feb. 01, 2017USD ($)
Debt Instrument [Line Items]
Aggregate committed amount of credit facility									$ 500,000,000
Term Loans [Member]
Debt Instrument [Line Items]
Accelerated debt issue cost amortization expense								$ 2,000,000
Payments of lines of credit | €							€ 200
Aggregate committed amount of credit facility						$ 1,000,000,000
Debt refinancing costs						32,600,000
Barclays Bank P L C [Member] | Senior Unsecured Term Loan Facility [Member]
Debt Instrument [Line Items]
Underwriting and other fees				$ 4,200,000
Mortgage Loans [Member]
Debt Instrument [Line Items]
Prepayment of mortgage loans						$ 12,900,000
Acute Care Hospital [Member]
Debt Instrument [Line Items]
Number of facilities acquired | Hospital	10
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
Number of facilities acquired | Hospital					71
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%			2.30%

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Percentage of dividends which could be paid from adjusted operating funds	95.00%
Percentage of dividends which could be paid from operation funds	95.00%
Maximum percentage of total unencumbered assets	150.00%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification	90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption	100.00%
Amount of foreign income (loss) before income taxes	$ 10,700,000	$ 18,600,000	$ (100,000)
Amount of domestic income (loss) before income taxes	(44,100,000)	$ 8,000,000	$ 13,900,000
Valuation allowance not expected to be realized	5,900,000
Uncertain tax position liabilities and related interest or penalties	$ 0

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax Benefit (Expense) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Current income tax benefit (expense):
Domestic	$ 61	$ 125	$ 41
Foreign	(1,669)	(3,294)	(3,062)
Total income tax expense	(1,608)	(3,169)	(3,021)
Deferred income tax benefit (expense):
Domestic	5,490	3,713	233
Foreign	(1,261)	(1,471)	107
Total income tax expense	4,229	2,242	340
Income tax benefit (expense)	$ 2,621	$ (927)	$ (2,681)

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of the Income Tax Benefit (Expense) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income before income tax	$ 373,780	$ 1,019,404	$ 293,919
Income tax at the U.S. statutory federal rate (21% in 2019 and 2018 and 35% in 2017)	(78,494)	(214,075)	(102,872)
Decrease (increase) in income tax resulting from:
Foreign rate differential	438	2,643	2,326
State income taxes, net of federal benefit	1,621	(379)
U.S. earnings not subject to federal income tax	85,495	208,472	98,026
Equity investments	1,091	46	(3,293)
Change in valuation allowance	(7,911)	2,668	5,391
Other items, net	381	(302)	(2,259)
Income tax benefit (expense)	$ 2,621	$ (927)	$ (2,681)

Income Taxes - Summary of Rec_2

Income Taxes - Summary of Reconciliation of the Income Tax Benefit (Expense) at the Statutory Income Tax Rate and the Effective Tax Rate for Income before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	21.00%	21.00%	35.00%

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 28,684	$ 21,984
Other	1,711	277
Total deferred tax assets	30,395	22,261
Valuation allowance	(11,355)	(3,444)
Total net deferred tax assets	19,040	18,817
Property and equipment	(7,324)	(12,359)
Net unbilled revenue	(1,449)	(1,633)
Other	(737)	(300)
Total deferred tax liabilities	(9,510)	(14,292)
Net deferred tax asset (liability)	$ 9,530	$ 4,525

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net NOL Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 192,358
Tax-effected NOL carryforwards	22,960
Valuation allowance	(6,212)
Net deferred tax asset - NOL carryforwards	$ 16,748
Expiration periods	2027
Expiration periods	indefinite
Luxembourg [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 9,946
Tax-effected NOL carryforwards	2,481
Valuation allowance	$ (2,481)
Expiration periods	2034
Expiration periods	indefinite
Germany [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 1,426
Tax-effected NOL carryforwards	226
Valuation allowance	$ (226)
Expiration periods	Indefinite
U.K. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 5,416
Tax-effected NOL carryforwards	921
Valuation allowance	$ (921)
Expiration periods	Indefinite
Australia [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 12,939
Tax-effected NOL carryforwards	1,941
Net deferred tax asset - NOL carryforwards	$ 1,941
Expiration periods	Indefinite

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Common share distribution	$ 1.010000	$ 0.990000	$ 0.950000
Ordinary income	0.701910	0.438792	0.655535
Capital gains	0.275040	0.551208	0.021022
Unrecaptured Sec. 1250 gain	0.041160	0.132280	0.004647
Section 199A Dividends	0.701910	$ 0.438792
Return of capital	$ 0.033050		$ 0.273443

Earnings Per Share_Unit - Calcu

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 129,923	$ 90,267	$ 79,920	$ 76,291	$ 78,941	$ 736,476	$ 112,017	$ 91,043	$ 376,401	$ 1,018,477	$ 291,238
Non-controlling interests’ share in earnings									(1,717)	(1,792)	(1,445)
Participating securities’ share in earnings									(2,308)	(3,685)	(1,409)
Net income, less participating securities’ share in earnings									$ 372,376	$ 1,013,000	$ 288,384
Basic weighted-average common shares	493,593	439,581	394,574	380,551	366,655	365,024	364,897	364,882	427,075	365,364	349,902
Dilutive potential common shares									1,224	907	539
Diluted weighted-average common shares	494,893	440,933	395,692	381,675	367,732	366,467	365,541	365,343	428,299	366,271	350,441
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 129,923	$ 90,267	$ 79,920	$ 76,291	$ 78,941	$ 736,476	$ 112,017	$ 91,043	$ 376,401	$ 1,018,477	$ 291,238
Non-controlling interests’ share in earnings									(1,717)	(1,792)	(1,445)
Participating securities’ share in earnings									(2,308)	(3,685)	(1,409)
Net income, less participating securities’ share in earnings									$ 372,376	$ 1,013,000	$ 288,384
Basic weighted-average common shares	493,593	439,581	394,574	380,551	366,655	365,024	364,897	364,882	427,075	365,364	349,902
Dilutive potential common shares									1,224	907	539
Diluted weighted-average common shares	494,893	440,933	395,692	381,675	367,732	366,467	365,541	365,343	428,299	366,271	350,441

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	Jan. 01, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share based payment award, term performance period				5 years
Share / (Unit)-based compensation expense		$ 32,188	$ 16,505	$ 9,949
Stock-based compensation expense, unrecognized cost		$ 53,200
Stock-based compensation expense, unrecognized cost, reorganization period (in years)		1 year 7 months 6 days
Stock-based awards, fair value		$ 25,900	$ 8,400	$ 10,400
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years		10 years
Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Reserved shares of new common stock for awards under the Equity Incentive Plan		12,900,000,000
Common stock remaining for future stock awards transferred to the equity incentive plan		10,800,039,000
Maximum number of shares of common stock that may be awarded		5,000,000,000
Service-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years
Performance-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years				3 years
Share-based compensation arrangement by share based payment award, expected service period (in years)		3 years		1 year
First Market Based Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years	3 years
Share-based compensation arrangement by share based payment award, expected service period (in years)				3 years
Share based payment award, weighted average risk-free rate of return				1.00%
Share based payment award, expected volatility rate				25.00%
Common stock options awarded, dividend yield				6.90%
Second Market Based Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)				5 years
Share based payment award, weighted average risk-free rate of return				1.90%
Share based payment award, expected volatility rate				25.00%
Common stock options awarded, dividend yield				6.90%
Third Market Based Award [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock awards vesting period in years		3 years
Share-based compensation arrangement by share based payment award, expected service period (in years)				3 years
Share based payment award, weighted average risk-free rate of return				1.50%
Share based payment award, expected volatility rate				25.00%
Common stock options awarded, dividend yield				6.90%

Stock Awards - Stock-based Awar

Stock Awards - Stock-based Award Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	923,848	276,280
Awarded, Shares	681,378	958,480
Vested, Shares	(478,104)	(307,275)
Forfeited, Shares	(4,682)	(3,637)
Nonvested awards at end of year, Shares	1,122,440	923,848
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 14.29	$ 12.68
Awarded, Weighted Average Value at Award Date	19.24	14.31
Vested, Weighted Average Value at Award Date	14.73	12.92
Forfeited, Weighted Average Value at Award Date	13.44	13.05
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 17.11	$ 14.29
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	4,133,435	2,676,755
Awarded, Shares	2,438,292	1,750,834
Vested, Shares	(1,051,637)	(288,404)
Forfeited, Shares	(38,935)	(5,750)
Nonvested awards at end of year, Shares	5,481,155	4,133,435
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 9.21	$ 7.86
Awarded, Weighted Average Value at Award Date	15.25	11.61
Vested, Weighted Average Value at Award Date	10.43	11.25
Forfeited, Weighted Average Value at Award Date	10.13	9.35
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 11.66	$ 9.21

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) $ in Millions, £ in Billions	Jan. 06, 2020USD ($)	Dec. 23, 2019GBP (£)HospitalRenewalOption	Dec. 17, 2019USD ($)Hospital	Dec. 31, 2019
Commitment And Contingencies [Line Items]
Term of lease extension, years				5 years
Acute Care Hospital [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired			10
Purchase price of acquisition | $			$ 700
Acute Care Hospital [Member] | England [Member] | BMI [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired		30
Purchase price of acquisition | £		£ 1.5
Number of leased properties		52
Initial fixed term of lease		2050
Existence of option to extend		true
Number of lease extension options | RenewalOption		2
Term of lease extension, years		5 years
Lease extension options, description				two five-year extension options
Acute Care Hospital [Member] | Term Loan [Member] | England [Member] | Subsequent Event [Member] | BMI [Member]
Commitment And Contingencies [Line Items]
Senior unsecured notes face amount | $	$ 700
Debt instrument term	5 years

Common Stock_Partners' Capital

Common Stock/Partners' Capital - Additional Information (Detail) $ / shares in Units, $ in Thousands	Feb. 21, 2020shares	Dec. 27, 2019USD ($)	Nov. 08, 2019USD ($)shares	Jul. 18, 2019USD ($)shares	May 01, 2017USD ($)shares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2019USD ($)PartnerEmployee$ / sharesshares	Dec. 31, 2018USD ($)$ / sharesshares	Dec. 31, 2017USD ($)shares	Nov. 04, 2019$ / sharesshares	Nov. 03, 2019shares
Class Of Stock [Line Items]
Common stock, par value | $ / shares						$ 0.001	$ 0.001	$ 0.001		$ 0.001
Common stock, shares authorized						750,000,000	750,000,000	750,000,000		750,000,000	500,000,000
Common stock, shares issued						370,637,000	517,522,000	370,637,000
Proceeds from sale of common shares / units, net of offering costs | $							$ 2,533,210	$ 94,239	$ 547,785
Redemption of common units | $								816
Employee [Member]
Class Of Stock [Line Items]
Number of partners shared remaining ownership percentage | Employee							2
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Number of other partners | Partner							2
Redemption of common units | $								$ 816
MPT Operating Partnership, L.P. [Member] | Medical Properties Trust, LLC. [Member]
Class Of Stock [Line Items]
Percentage of ownership of general partner							100.00%
MPT Operating Partnership, L.P. [Member] | Operating Partnership [Member]
Class Of Stock [Line Items]
Percentage of ownership limited partner							99.90%
Common Par Value [Member]
Class Of Stock [Line Items]
Number of share sold							145,349,000	5,614,000	43,125,000
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Class Of Stock [Line Items]
Number of share sold							143,894,000	5,558,000	42,694,000
Conversion of LTIP units to common units								60,000
Redemption of common units | $								$ 816
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs | $						$ 95,000	$ 650,000
At-the-Market Equity Offering Program [Member] | Maximum [Member]
Class Of Stock [Line Items]
Value of stock | $		$ 1,000
Sales commission percentage		2.00%
At-the-Market Equity Offering Program [Member] | Common Par Value [Member]
Class Of Stock [Line Items]
Number of share sold						5,600,000	36,100,000
At-the-Market Equity Offering Program [Member] | Common Par Value [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Number of share sold	2,400,000
Public Offering [Member]
Class Of Stock [Line Items]
Common stock, shares issued			57,500,000	51,750,000	43,100,000
Additional shares purchased by underwriters			7,500,000	858,100,000	5,600,000
Proceeds from sale of common shares / units, net of offering costs | $			$ 1,026,000	$ 6,750	$ 548,000

Fair Value of Financial Instr_3

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 31,357	$ 25,855
Loans, Book value	1,704,854	1,471,520
Debt, net Book value	(7,023,679)	(4,037,389)
Interest and rent receivables, Fair value	30,472	24,942
Loans, Fair value	1,742,153	1,490,758
Debt, net Fair value	$ (7,331,816)	$ (3,947,795)

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) - Fair Value Measurements, Recurring [Member] - Mortgage Loans [Member] - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 115,000	$ 115,000
Original Cost	$ 115,000	$ 115,000

Leases (Lessee) - Additional In

Leases (Lessee) - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Lessee Lease Description [Line Items]
Lease expenses		$ 9.4	$ 9.8
Sublease rental income		$ 4.3	$ 6.6
Minimum [Member]
Lessee Lease Description [Line Items]
Lessee, operating and finance leases remaining lease term	4 years 6 months
Maximum [Member]
Lessee Lease Description [Line Items]
Lessee, operating and finance leases remaining lease term	54 years

Leases (Lessee) - Summary of Le

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 9,262
Finance lease cost:
Sublease income			$ (4,300)	$ (6,600)
Total lease cost		5,952
Real Estate Depreciation and Amortization [Member]
Finance lease cost:
Amortization of right-of-use assets		51
Interest [Member]
Finance lease cost:
Interest on lease liabilities		117
Other [Member]
Finance lease cost:
Sublease income		$ (3,478)
[1]	$5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income.
[2]	Includes short-term leases.

Leases (Lessee) - Summary of _2

Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Lessee Lease Description [Line Items]
Operating lease cost	$ 9,262	[1],[2]
Property-related [Member]
Lessee Lease Description [Line Items]
Operating lease cost	$ 5,800
[1]	$5.8 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income.
[2]	Includes short-term leases.

Leases (Lessee) - Schedule of F

Leases (Lessee) - Schedule of Fixed Minimum Rental Payments Due under Leases with Non-Cancelable Terms (Detail) $ in Thousands	Dec. 31, 2019USD ($)
Leases [Abstract]
Operating Leases, 2020	$ 6,098
Operating Leases, 2021	6,279
Operating Leases, 2022	6,470
Operating Leases, 2023	6,533
Operating Leases, 2024	5,635
Operating Leases, Thereafter	180,280
Operating Leases, Total undiscounted minimum lease payments	211,295
Operating Leases, Less: interest	(134,942)
Operating Leases, Present value of lease liabilities	76,353
Finance Leases, 2020	125
Finance Leases, 2021	126
Finance Leases, 2022	128
Finance Leases, 2023	129
Finance Leases, 2024	130
Finance Leases, Thereafter	4,915
Finance Leases, Total undiscounted minimum lease payments	5,553
Finance Leases, Less: interest	(3,621)
Finance Leases, Present value of lease liabilities	1,932
Amounts To Be Received From Subleases, 2020	(3,156)
Amounts To Be Received From Subleases, 2021	(3,498)
Amounts To Be Received From Subleases, 2022	(3,630)
Amounts To Be Received From Subleases, 2023	(3,632)
Amounts To Be Received From Subleases, 2024	(3,651)
Amounts To Be Received From Subleases, Thereafter	(90,199)
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments	(107,766)
Net Payments, 2020	3,067
Net Payments, 2021	2,907
Net Payments, 2022	2,968
Net Payments, 2023	3,030
Net Payments, 2024	2,114
Net Payments, Thereafter	94,996	[1]
Net Payments, Total undiscounted minimum lease payments	$ 109,082
[1]	Reflects certain ground leases, in which we are the lessee, that have longer initial fixed terms than our existing sublease to our tenants. However, we would expect to either renew the related sublease, enter into a lease with a new tenant, or early terminate the ground lease to reduce or avoid any significant impact from such ground leases.

Leases (Lessee) - Summary of Su

Leases (Lessee) - Summary of Supplemental Balance Sheet Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	May 27, 2019
Right of use assets:
Real estate right of use assets, net	$ 61,380
Total right of use assets, net	71,246
Lease liabilities:
Operating leases	$ 76,353
Operating Lease, Liability, Statement of Financial Position [Extensible List]	mpw:ObligationsToTenantsAndOtherLeaseLiabilities
Financing leases	$ 1,932
Finance Lease, Liability, Statement of Financial Position [Extensible List]	mpw:ObligationsToTenantsAndOtherLeaseLiabilities
Total lease liabilities	$ 78,285
Weighted-average remaining lease term:
Operating leases	31 years 10 months 24 days	23 years
Finance leases	36 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.30%
Finance leases	6.60%
Real Estate [Member]
Right of use assets:
Operating leases	$ 59,492
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:Land
Finance leases	$ 1,888
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:Land
Corporate [Member]
Right of use assets:
Operating leases	$ 9,866
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	us-gaap:OtherAssets

Leases (Lessee) - Summary of _3

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 5,937
Operating cash flows from finance leases	114
Financing cash flows from finance leases	10
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 1,818

Other Assets - Summary of Other

Other Assets - Summary of Other Assets (Detail) - USD ($) $ in Thousands		Dec. 31, 2019	Dec. 31, 2018
Other Assets [Abstract]
Debt issue costs, net	[1]	$ 2,492	$ 4,793
Other corporate assets		206,765	115,416
Prepaids and other assets		90,342	61,757
Total other assets		$ 299,599	$ 181,966
[1]	Relates to revolving credit facility

Other Assets - Additional Infor

Other Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Other Assets [Abstract]
Equity investments	$ 926,990	$ 520,058

Quarterly Financial Data (Una_3

Quarterly Financial Data (Unaudited) - Unaudited Quarterly Financial Information (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Quarterly Financial Information [Line Items]
Revenues	$ 256,438	$ 224,756	$ 192,549	$ 180,454	$ 180,578	$ 196,996	$ 201,902	$ 205,046	$ 854,197	$ 784,522	$ 704,745
Net income	129,923	90,267	79,920	76,291	78,941	736,476	112,017	91,043	376,401	1,018,477	291,238
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 129,638	$ 89,786	$ 79,438	$ 75,822	$ 78,483	$ 736,034	$ 111,567	$ 90,601	$ 374,684	$ 1,016,685	$ 289,793
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.26	$ 0.20	$ 0.20	$ 0.20	$ 0.21	$ 2.01	$ 0.30	$ 0.25	$ 0.87	$ 2.77	$ 0.82
Weighted average shares (units) outstanding — basic	493,593	439,581	394,574	380,551	366,655	365,024	364,897	364,882	427,075	365,364	349,902
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.26	$ 0.20	$ 0.20	$ 0.20	$ 0.21	$ 2	$ 0.30	$ 0.25	$ 0.87	$ 2.76	$ 0.82
Weighted average shares (units) outstanding — diluted	494,893	440,933	395,692	381,675	367,732	366,467	365,541	365,343	428,299	366,271	350,441
MPT Operating Partnership, L.P. [Member]
Quarterly Financial Information [Line Items]
Revenues	$ 256,438	$ 224,756	$ 192,549	$ 180,454	$ 180,578	$ 196,996	$ 201,902	$ 205,046	$ 854,197	$ 784,522	$ 704,745
Net income	129,923	90,267	79,920	76,291	78,941	736,476	112,017	91,043	376,401	1,018,477	291,238
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 129,638	$ 89,786	$ 79,438	$ 75,822	$ 78,483	$ 736,034	$ 111,567	$ 90,601	$ 374,684	$ 1,016,685	$ 289,793
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.26	$ 0.20	$ 0.20	$ 0.20	$ 0.21	$ 2.01	$ 0.30	$ 0.25	$ 0.87	$ 2.77	$ 0.82
Weighted average shares (units) outstanding — basic	493,593	439,581	394,574	380,551	366,655	365,024	364,897	364,882	427,075	365,364	349,902
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 0.26	$ 0.20	$ 0.20	$ 0.20	$ 0.21	$ 2	$ 0.30	$ 0.25	$ 0.87	$ 2.76	$ 0.82
Weighted average shares (units) outstanding — diluted	494,893	440,933	395,692	381,675	367,732	366,467	365,541	365,343	428,299	366,271	350,441

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Valuation And Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 66,131	$ 16,397	$ 18,852
Additions, Charged Against Operations	50,893	57,285	2,525
Deductions, Net Recoveries/Write-offs	(7,221)	(7,551)	(4,980)
Balance at End of Year	$ 109,803	$ 66,131	$ 16,397

Schedule II - Schedule of Val_2

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Increase in real estate impairment reserve		$ 21	$ 48
Increase in accounts receivable and other reserves		22
Increase (decrease) in valuation allowance		7.9	(7.7)	$ (4.9)
Increase (decrease) in real estate impairment reserve related to disposals		$ (7.2)
Increase in accounts receivable reserve			$ 9.3
Domestic Valuation Allowances [Member]
Increase (decrease) in valuation allowance	$ (4.4)

Schedule III - Real Estate In_2

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 1,003,149
Initial costs, buildings	5,916,757
Additions subsequent to acquisition, Improvements	370,918
Additions subsequent to acquisition, carrying costs	21,662
Land at cost	1,017,402
Buildings at cost	6,295,084
Total at cost	7,312,486	$ 4,781,149	$ 5,438,148	$ 3,968,042
Accumulated Depreciation	$ 504,651	$ 414,331
1981 [Member] | Ashtead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 38,324
Initial costs, buildings	73,722
Additions subsequent to acquisition, Improvements	998
Land at cost	39,322
Buildings at cost	73,722
Total at cost	113,044
Accumulated Depreciation	642
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Euxton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,964
Initial costs, buildings	37,028
Additions subsequent to acquisition, Improvements	844
Land at cost	4,808
Buildings at cost	37,028
Total at cost	41,836
Accumulated Depreciation	332
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Torquay, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,754
Initial costs, buildings	37,219
Additions subsequent to acquisition, Improvements	349
Land at cost	3,103
Buildings at cost	37,219
Total at cost	40,322
Accumulated Depreciation	$ 320
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,571
Initial costs, buildings	32,569
Land at cost	1,571
Buildings at cost	32,569
Total at cost	34,140
Accumulated Depreciation	4,478
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Boise, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,558
Initial costs, buildings	11,027
Land at cost	1,558
Buildings at cost	11,027
Total at cost	12,585
Accumulated Depreciation	403
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	50 years
2008 [Member] | Boardman, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 79
Initial costs, buildings	275
Land at cost	79
Buildings at cost	275
Total at cost	354
Accumulated Depreciation	3
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Crown Point I N
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 302
Initial costs, buildings	528
Land at cost	302
Buildings at cost	528
Total at cost	830
Accumulated Depreciation	6
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Lubbock, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,376
Initial costs, buildings	28,292
Additions subsequent to acquisition, Improvements	3,648
Land at cost	1,376
Buildings at cost	31,940
Total at cost	33,316
Accumulated Depreciation	3,469
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jun. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1887 [Member} | Bassenheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 998
Initial costs, buildings	5,372
Additions subsequent to acquisition, Improvements	168
Land at cost	1,166
Buildings at cost	5,372
Total at cost	6,538
Accumulated Depreciation	136
Encumbrances	$ 0
Date of Construction	1887
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,571
Initial costs, buildings	32,569
Land at cost	1,571
Buildings at cost	32,569
Total at cost	34,140
Accumulated Depreciation	4,478
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Jul. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,540
Initial costs, buildings	146,491
Additions subsequent to acquisition, Improvements	39,036
Land at cost	18,540
Buildings at cost	185,527
Total at cost	204,067
Accumulated Depreciation	12,301
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2009 [Member] | Folsom, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 3,291
Initial costs, buildings	21,293
Land at cost	3,291
Buildings at cost	21,293
Total at cost	24,584
Accumulated Depreciation	211
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2009 [Member] | Springfield, IL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 542
Initial costs, buildings	1,458
Land at cost	542
Buildings at cost	1,458
Total at cost	2,000
Accumulated Depreciation	$ 14
Date of Construction	2009
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Bassenheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 998
Initial costs, buildings	5,372
Additions subsequent to acquisition, Improvements	168
Land at cost	1,166
Buildings at cost	5,372
Total at cost	6,538
Accumulated Depreciation	136
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,120
Initial costs, buildings	3,076
Additions subsequent to acquisition, Improvements	99
Land at cost	1,219
Buildings at cost	3,076
Total at cost	4,295
Accumulated Depreciation	111
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,007
Initial costs, buildings	2,567
Additions subsequent to acquisition, Improvements	58
Land at cost	1,065
Buildings at cost	2,567
Total at cost	3,632
Accumulated Depreciation	91
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Lander, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 761
Initial costs, buildings	42,849
Land at cost	761
Buildings at cost	42,849
Total at cost	43,610
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Milwaukee, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 558
Initial costs, buildings	1,442
Land at cost	558
Buildings at cost	1,442
Total at cost	2,000
Accumulated Depreciation	15
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member] | Riverton, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,163
Initial costs, buildings	29,647
Land at cost	1,163
Buildings at cost	29,647
Total at cost	30,810
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	36 years
1983 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	1,947
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1983 [Member] | Watsonville, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 16,488
Initial costs, buildings	17,800
Land at cost	16,488
Buildings at cost	17,800
Total at cost	34,288
Accumulated Depreciation	$ 163
Date of Construction	1983
Date Acquired	Sep. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1983 [Member] | Wheeling, WV [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,480
Initial costs, buildings	7,920
Land at cost	1,480
Buildings at cost	7,920
Total at cost	$ 9,400
Date of Construction	1983
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
1977 [Member] | Braunfels, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,153
Initial costs, buildings	13,761
Additions subsequent to acquisition, Improvements	56
Land at cost	2,209
Buildings at cost	13,761
Total at cost	15,970
Accumulated Depreciation	1,565
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1885 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,262
Initial costs, buildings	36,187
Additions subsequent to acquisition, Improvements	73
Land at cost	6,335
Buildings at cost	36,187
Total at cost	42,522
Accumulated Depreciation	3,183
Encumbrances	$ 0
Date of Construction	1885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,262
Initial costs, buildings	36,187
Additions subsequent to acquisition, Improvements	73
Land at cost	6,335
Buildings at cost	36,187
Total at cost	42,522
Accumulated Depreciation	3,183
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Fresno, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,507
Initial costs, buildings	70,564
Land at cost	5,507
Buildings at cost	70,564
Total at cost	76,071
Accumulated Depreciation	633
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,313
Land at cost	9,313
Total at cost	9,313
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 3, 2017
Life on which depreciation in latest income statements is computed (Years)	0 years
2017 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,903
Initial costs, buildings	4,267
Land at cost	1,903
Buildings at cost	4,267
Total at cost	6,170
Accumulated Depreciation	325
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	May 8, 2017
Life on which depreciation in latest income statements is computed (Years)	35 years
2017 [Member] | Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,846
Initial costs, buildings	4,200
Land at cost	3,846
Buildings at cost	4,200
Total at cost	8,046
Accumulated Depreciation	330
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Mar. 2, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Kansas City, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,351
Initial costs, buildings	13,665
Land at cost	2,351
Buildings at cost	13,665
Total at cost	16,016
Accumulated Depreciation	172
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Leawood, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,513
Initial costs, buildings	13,938
Land at cost	2,513
Buildings at cost	13,938
Total at cost	16,451
Accumulated Depreciation	175
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,132
Initial costs, buildings	5,052
Land at cost	1,132
Buildings at cost	5,052
Total at cost	6,184
Accumulated Depreciation	$ 347
Date of Construction	2017
Date Acquired	Apr. 13, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,974
Initial costs, buildings	14,405
Land at cost	2,974
Buildings at cost	14,405
Total at cost	17,379
Accumulated Depreciation	183
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Texarkana, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,562
Land at cost	14,562
Total at cost	$ 14,562
Date of Construction	2017
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	0 years
2011 [Member] | Cologne, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,394
Initial costs, buildings	15,201
Additions subsequent to acquisition, Improvements	101
Land at cost	4,495
Buildings at cost	15,201
Total at cost	19,696
Accumulated Depreciation	967
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Jun. 23, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2011 [Member] | Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Additions subsequent to acquisition, Improvements	9,184
Land at cost	23,809
Buildings at cost	98,689
Total at cost	122,498
Accumulated Depreciation	8,500
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1974 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 9,752
Initial costs, buildings	27,000
Additions subsequent to acquisition, Improvements	917
Land at cost	10,669
Buildings at cost	27,000
Total at cost	37,669
Accumulated Depreciation	1,534
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Redding, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,555
Initial costs, buildings	53,863
Additions subsequent to acquisition, carrying costs	13
Land at cost	1,555
Buildings at cost	53,876
Total at cost	55,431
Accumulated Depreciation	16,732
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1974 [Member] | Sebastian, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,733
Initial costs, buildings	49,136
Additions subsequent to acquisition, Improvements	38,272
Land at cost	5,733
Buildings at cost	87,408
Total at cost	93,141
Accumulated Depreciation	$ 3,736
Date of Construction	1974
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2016 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 9,752
Initial costs, buildings	27,000
Additions subsequent to acquisition, Improvements	917
Land at cost	10,669
Buildings at cost	27,000
Total at cost	37,669
Accumulated Depreciation	1,534
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 950
Initial costs, buildings	3,996
Land at cost	950
Buildings at cost	3,996
Total at cost	4,946
Accumulated Depreciation	325
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 26, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Glendale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,144
Initial costs, buildings	6,087
Land at cost	1,144
Buildings at cost	6,087
Total at cost	7,231
Accumulated Depreciation	482
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 21, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | New Orleans, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,850
Initial costs, buildings	6,125
Land at cost	2,850
Buildings at cost	6,125
Total at cost	8,975
Accumulated Depreciation	498
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,629
Initial costs, buildings	4,174
Land at cost	1,629
Buildings at cost	4,174
Total at cost	5,803
Accumulated Depreciation	339
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | The Woodlands, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,050
Initial costs, buildings	4,524
Land at cost	2,050
Buildings at cost	4,524
Total at cost	6,574
Accumulated Depreciation	424
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | DeSoto, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,234
Land at cost	750
Buildings at cost	4,234
Total at cost	4,984
Accumulated Depreciation	379
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	May 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,267
Initial costs, buildings	4,801
Land at cost	3,267
Buildings at cost	4,801
Total at cost	8,068
Accumulated Depreciation	370
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Dec. 9, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Flagstaff, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,049
Initial costs, buildings	22,464
Land at cost	3,049
Buildings at cost	22,464
Total at cost	25,513
Accumulated Depreciation	1,030
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Aug. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Frisco, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,500
Initial costs, buildings	3,863
Additions subsequent to acquisition, Improvements	27
Additions subsequent to acquisition, carrying costs	(89)
Land at cost	1,411
Buildings at cost	3,890
Total at cost	5,301
Accumulated Depreciation	543
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 13, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Garland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,643
Initial costs, buildings	4,648
Land at cost	2,643
Buildings at cost	4,648
Total at cost	7,291
Accumulated Depreciation	368
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Goodyear Arizona
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,800
Initial costs, buildings	4,713
Land at cost	1,800
Buildings at cost	4,713
Total at cost	6,513
Accumulated Depreciation	442
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Apr. 4, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Helotes, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,900
Initial costs, buildings	5,115
Land at cost	1,900
Buildings at cost	5,115
Total at cost	7,015
Accumulated Depreciation	490
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Highlands Ranch, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,200
Initial costs, buildings	4,779
Land at cost	4,200
Buildings at cost	4,779
Total at cost	8,979
Accumulated Depreciation	408
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 25, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Longmont, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,855
Initial costs, buildings	4,181
Land at cost	1,855
Buildings at cost	4,181
Total at cost	6,036
Accumulated Depreciation	409
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Feb. 10, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Mandeville, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,800
Initial costs, buildings	5,370
Land at cost	2,800
Buildings at cost	5,370
Total at cost	8,170
Accumulated Depreciation	425
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Marrero, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,658
Initial costs, buildings	5,801
Land at cost	1,658
Buildings at cost	5,801
Total at cost	7,459
Accumulated Depreciation	508
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Plano, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,418
Initial costs, buildings	2,492
Land at cost	4,418
Buildings at cost	2,492
Total at cost	6,910
Accumulated Depreciation	316
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,525
Initial costs, buildings	4,253
Land at cost	2,525
Buildings at cost	4,253
Total at cost	6,778
Accumulated Depreciation	337
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Rosenberg, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,331
Initial costs, buildings	4,505
Land at cost	1,331
Buildings at cost	4,505
Total at cost	5,836
Accumulated Depreciation	$ 450
Date of Construction	2016
Date Acquired	Jan. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Columbus, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,726
Land at cost	1,726
Total at cost	$ 1,726
Date of Construction	2016
Date Acquired	Aug. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	0 years
2016 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,047
Initial costs, buildings	36,862
Land at cost	4,047
Buildings at cost	36,862
Total at cost	40,909
Accumulated Depreciation	$ 3,225
Date of Construction	2016
Date Acquired	Jul. 7, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Toledo, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,205
Initial costs, buildings	17,740
Land at cost	1,205
Buildings at cost	17,740
Total at cost	18,945
Accumulated Depreciation	$ 1,663
Date of Construction	2016
Date Acquired	Apr. 1, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Viseu, Portugal [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,128
Initial costs, buildings	29,228
Additions subsequent to acquisition, Improvements	446
Land at cost	2,574
Buildings at cost	29,228
Total at cost	31,802
Accumulated Depreciation	$ 85
Date of Construction	2016
Date Acquired	Nov. 28, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1989 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,905
Initial costs, buildings	23,745
Additions subsequent to acquisition, Improvements	345
Land at cost	7,250
Buildings at cost	23,745
Total at cost	30,995
Accumulated Depreciation	1,285
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Richmond, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,307
Initial costs, buildings	10,071
Land at cost	1,307
Buildings at cost	10,071
Total at cost	11,378
Accumulated Depreciation	109
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Rochdale, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 654
Initial costs, buildings	3,368
Land at cost	654
Buildings at cost	3,368
Total at cost	4,022
Accumulated Depreciation	33
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Rochdale, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 67
Initial costs, buildings	344
Land at cost	67
Buildings at cost	344
Total at cost	411
Accumulated Depreciation	3
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Tulsa, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,128
Initial costs, buildings	4,477
Land at cost	1,128
Buildings at cost	4,477
Total at cost	5,605
Accumulated Depreciation	$ 44
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 One [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,905
Initial costs, buildings	23,745
Additions subsequent to acquisition, Improvements	345
Land at cost	7,250
Buildings at cost	23,745
Total at cost	30,995
Accumulated Depreciation	1,285
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,501
Initial costs, buildings	34,530
Additions subsequent to acquisition, Improvements	8,477
Additions subsequent to acquisition, carrying costs	16,589
Land at cost	3,274
Buildings at cost	59,823
Total at cost	63,097
Accumulated Depreciation	14,583
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1960 [Member] | Meyersdale, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 390
Initial costs, buildings	4,280
Land at cost	390
Buildings at cost	4,280
Total at cost	4,670
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1960 [Member] | Sherman Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,493
Initial costs, buildings	10,690
Land at cost	4,493
Buildings at cost	10,690
Total at cost	15,183
Accumulated Depreciation	$ 2,934
Date of Construction	1960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	2,795
Additions subsequent to acquisition, Improvements	124
Land at cost	1,143
Buildings at cost	2,795
Total at cost	3,938
Accumulated Depreciation	163
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,663
Initial costs, buildings	52,431
Land at cost	12,663
Buildings at cost	52,431
Total at cost	65,094
Accumulated Depreciation	11,688
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Feb. 9, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Big Spring Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,655
Initial costs, buildings	21,254
Land at cost	1,655
Buildings at cost	21,254
Total at cost	22,909
Accumulated Depreciation	453
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Apr. 12, 2019
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	1,947
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1973 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	1,961
Land at cost	6,535
Buildings at cost	125,479
Total at cost	132,014
Accumulated Depreciation	7,122
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Ringwood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,027
Initial costs, buildings	18,679
Additions subsequent to acquisition, Improvements	134
Land at cost	4,161
Buildings at cost	18,679
Total at cost	22,840
Accumulated Depreciation	321
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	35 years
2010 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	2,795
Additions subsequent to acquisition, Improvements	124
Land at cost	1,143
Buildings at cost	2,795
Total at cost	3,938
Accumulated Depreciation	163
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,328
Initial costs, buildings	67,248
Additions subsequent to acquisition, Improvements	4,937
Land at cost	18,328
Buildings at cost	72,185
Total at cost	90,513
Accumulated Depreciation	7,037
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2010 [Member] | Sherman Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,493
Initial costs, buildings	10,690
Land at cost	4,493
Buildings at cost	10,690
Total at cost	15,183
Accumulated Depreciation	$ 2,934
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | Dormagen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,802
Initial costs, buildings	5,737
Additions subsequent to acquisition, Improvements	137
Land at cost	1,939
Buildings at cost	5,737
Total at cost	7,676
Accumulated Depreciation	203
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1993 [Member] | San Bernardino, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,209
Initial costs, buildings	37,498
Land at cost	2,209
Buildings at cost	37,498
Total at cost	39,707
Accumulated Depreciation	$ 341
Date of Construction	1993
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dormagen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,802
Initial costs, buildings	5,737
Additions subsequent to acquisition, Improvements	137
Land at cost	1,939
Buildings at cost	5,737
Total at cost	7,676
Accumulated Depreciation	203
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Dallas, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,000
Initial costs, buildings	13,589
Additions subsequent to acquisition, carrying costs	368
Land at cost	1,421
Buildings at cost	13,536
Total at cost	14,957
Accumulated Depreciation	4,512
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Sep. 5, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Bloomington, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,392
Initial costs, buildings	28,212
Additions subsequent to acquisition, Improvements	5,016
Additions subsequent to acquisition, carrying costs	408
Land at cost	2,392
Buildings at cost	33,636
Total at cost	36,028
Accumulated Depreciation	10,877
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Petersburg, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	2,622
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Jul. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1886 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,120
Initial costs, buildings	3,076
Additions subsequent to acquisition, Improvements	99
Land at cost	1,219
Buildings at cost	3,076
Total at cost	4,295
Accumulated Depreciation	111
Encumbrances	$ 0
Date of Construction	1886
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1951 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,007
Initial costs, buildings	2,567
Additions subsequent to acquisition, Improvements	58
Land at cost	1,065
Buildings at cost	2,567
Total at cost	3,632
Accumulated Depreciation	91
Encumbrances	$ 0
Date of Construction	1951
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,345
Initial costs, buildings	3,678
Land at cost	1,345
Buildings at cost	3,678
Total at cost	5,023
Accumulated Depreciation	506
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Allen, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,550
Initial costs, buildings	414
Land at cost	1,550
Buildings at cost	414
Total at cost	1,964
Accumulated Depreciation	465
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 14, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Alvin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 105
Initial costs, buildings	4,087
Land at cost	105
Buildings at cost	4,087
Total at cost	4,192
Accumulated Depreciation	564
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Austin, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,140
Initial costs, buildings	1,693
Land at cost	1,140
Buildings at cost	1,693
Total at cost	2,833
Accumulated Depreciation	483
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	May 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Broomfield, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 825
Initial costs, buildings	3,895
Land at cost	825
Buildings at cost	3,895
Total at cost	4,720
Accumulated Depreciation	536
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 3, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Cedar Hill. TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,122
Initial costs, buildings	3,644
Land at cost	1,122
Buildings at cost	3,644
Total at cost	4,766
Accumulated Depreciation	501
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 23, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,310
Initial costs, buildings	3,639
Land at cost	1,310
Buildings at cost	3,639
Total at cost	4,949
Accumulated Depreciation	500
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 15, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Commerce City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 707
Initial costs, buildings	4,248
Land at cost	707
Buildings at cost	4,248
Total at cost	4,955
Accumulated Depreciation	540
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 351
Initial costs, buildings	3,952
Land at cost	351
Buildings at cost	3,952
Total at cost	4,303
Accumulated Depreciation	567
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jan. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	41 years
2014 [Member] | Dulles, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,076
Initial costs, buildings	3,784
Land at cost	1,076
Buildings at cost	3,784
Total at cost	4,860
Accumulated Depreciation	504
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 12, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Firestone, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 495
Initial costs, buildings	3,963
Land at cost	495
Buildings at cost	3,963
Total at cost	4,458
Accumulated Depreciation	553
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 6, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Fountain, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,508
Initial costs, buildings	4,131
Land at cost	1,508
Buildings at cost	4,131
Total at cost	5,639
Accumulated Depreciation	559
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Pearland, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,075
Initial costs, buildings	3,577
Land at cost	1,075
Buildings at cost	3,577
Total at cost	4,652
Accumulated Depreciation	477
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 8, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Colorado Springs, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 600
Initial costs, buildings	4,231
Land at cost	600
Buildings at cost	4,231
Total at cost	4,831
Accumulated Depreciation	591
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Altoona, WI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 29,062
Buildings at cost	29,062
Total at cost	29,062
Accumulated Depreciation	3,875
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Ogden, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,759
Initial costs, buildings	16,414
Land at cost	1,759
Buildings at cost	16,414
Total at cost	18,173
Accumulated Depreciation	2,382
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Sienna, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,000
Initial costs, buildings	3,591
Land at cost	1,000
Buildings at cost	3,591
Total at cost	4,591
Accumulated Depreciation	$ 479
Date of Construction	2014
Date Acquired	Aug. 20, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2014 [Member] | Thornton, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,350
Initial costs, buildings	4,259
Land at cost	1,350
Buildings at cost	4,259
Total at cost	5,609
Accumulated Depreciation	$ 568
Date of Construction	2014
Date Acquired	Aug. 29, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Aurora, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,989
Initial costs, buildings	4,812
Land at cost	2,989
Buildings at cost	4,812
Total at cost	7,801
Accumulated Depreciation	511
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Ft. Worth, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,782
Initial costs, buildings	4,392
Land at cost	2,782
Buildings at cost	4,392
Total at cost	7,174
Accumulated Depreciation	522
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Mar. 27, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Glendale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,248
Initial costs, buildings	4,046
Land at cost	1,248
Buildings at cost	4,046
Total at cost	5,294
Accumulated Depreciation	464
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 5, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,732
Initial costs, buildings	4,783
Land at cost	3,732
Buildings at cost	4,783
Total at cost	8,515
Accumulated Depreciation	558
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Apr. 24, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Carrollton, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 729
Initial costs, buildings	34,342
Additions subsequent to acquisition, Improvements	222
Land at cost	729
Buildings at cost	34,564
Total at cost	35,293
Accumulated Depreciation	3,817
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 17, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,245
Initial costs, buildings	3,873
Land at cost	2,245
Buildings at cost	3,873
Total at cost	6,118
Accumulated Depreciation	403
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 21, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Conroe, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,338
Initial costs, buildings	3,712
Land at cost	1,338
Buildings at cost	3,712
Total at cost	5,050
Accumulated Depreciation	410
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 29, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Converse, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	4,423
Land at cost	750
Buildings at cost	4,423
Total at cost	5,173
Accumulated Depreciation	525
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Apr. 10, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Denver, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,314
Initial costs, buildings	4,276
Land at cost	1,314
Buildings at cost	4,276
Total at cost	5,590
Accumulated Depreciation	490
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 8, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Dorchester, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,428
Initial costs, buildings	219,575
Additions subsequent to acquisition, Improvements	6,638
Land at cost	14,428
Buildings at cost	226,213
Total at cost	240,641
Accumulated Depreciation	6,885
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 15, 2018
Life on which depreciation in latest income statements is computed (Years)	42 years
2015 [Member] | Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,517
Initial costs, buildings	4,661
Land at cost	1,517
Buildings at cost	4,661
Total at cost	6,178
Accumulated Depreciation	515
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Highland Village, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,501
Initial costs, buildings	1,551
Land at cost	3,501
Buildings at cost	1,551
Total at cost	5,052
Accumulated Depreciation	344
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 22, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 7,581
Buildings at cost	7,581
Total at cost	7,581
Accumulated Depreciation	1,033
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
2015 [Member] | Lehi, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,403
Initial costs, buildings	29,950
Additions subsequent to acquisition, Improvements	601
Additions subsequent to acquisition, carrying costs	(35)
Land at cost	13,368
Buildings at cost	30,551
Total at cost	43,919
Accumulated Depreciation	2,000
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	45 years
2015 [Member] | McKinney, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,775
Initial costs, buildings	4,060
Land at cost	2,775
Buildings at cost	4,060
Total at cost	6,835
Accumulated Depreciation	603
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2015 [Member] | Parker, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,300
Initial costs, buildings	4,448
Land at cost	1,300
Buildings at cost	4,448
Total at cost	5,748
Accumulated Depreciation	463
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Nov. 6, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,423
Initial costs, buildings	3,772
Land at cost	1,423
Buildings at cost	3,772
Total at cost	5,195
Accumulated Depreciation	$ 456
Date of Construction	2015
Date Acquired	Feb. 18, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,228
Additions subsequent to acquisition, Improvements	6,852
Land at cost	4,428
Buildings at cost	80,080
Total at cost	84,508
Accumulated Depreciation	$ 6,446
Date of Construction	2015
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2015 [Member] | League City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,356
Initial costs, buildings	3,901
Land at cost	1,356
Buildings at cost	3,901
Total at cost	5,257
Accumulated Depreciation	$ 439
Date of Construction	2015
Date Acquired	Jun. 19, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1970 [Member] | Ayer, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,048
Initial costs, buildings	77,913
Additions subsequent to acquisition, Improvements	2,299
Land at cost	9,048
Buildings at cost	80,212
Total at cost	89,260
Accumulated Depreciation	2,768
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	47 years
1970 [Member] | Rockledge, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,919
Initial costs, buildings	23,282
Additions subsequent to acquisition, Improvements	5,512
Land at cost	13,919
Buildings at cost	28,794
Total at cost	42,713
Accumulated Depreciation	2,404
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
2013 [Member] | Ayer, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,048
Initial costs, buildings	77,913
Additions subsequent to acquisition, Improvements	2,299
Land at cost	9,048
Buildings at cost	80,212
Total at cost	89,260
Accumulated Depreciation	2,768
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	47 years
2013 [Member] | Hausman T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,500
Initial costs, buildings	8,957
Land at cost	1,500
Buildings at cost	8,957
Total at cost	10,457
Accumulated Depreciation	1,509
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Mar. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 800
Initial costs, buildings	14,968
Additions subsequent to acquisition, Improvements	(25)
Land at cost	800
Buildings at cost	14,943
Total at cost	15,743
Accumulated Depreciation	2,572
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Lehi, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,241
Initial costs, buildings	3,491
Land at cost	1,241
Buildings at cost	3,491
Total at cost	4,732
Accumulated Depreciation	528
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Post Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 417
Initial costs, buildings	12,175
Additions subsequent to acquisition, Improvements	1,905
Land at cost	767
Buildings at cost	13,730
Total at cost	14,497
Accumulated Depreciation	2,069
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Dec. 31, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | Spartanburg, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,135
Initial costs, buildings	15,717
Land at cost	1,135
Buildings at cost	15,717
Total at cost	16,852
Accumulated Depreciation	$ 2,505
Date of Construction	2013
Date Acquired	Aug. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Bennettsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 794
Initial costs, buildings	15,773
Land at cost	794
Buildings at cost	15,773
Total at cost	16,567
Accumulated Depreciation	4,525
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	42 years
1984 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,274
Land at cost	1,651
Buildings at cost	5,633
Total at cost	7,284
Accumulated Depreciation	418
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1984 [Member] | Olympia, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,220
Initial costs, buildings	89,348
Additions subsequent to acquisition, Improvements	15,930
Land at cost	7,220
Buildings at cost	105,278
Total at cost	112,498
Accumulated Depreciation	8,935
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jul. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Wantirna, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 25,419
Initial costs, buildings	209,087
Additions subsequent to acquisition, Improvements	958
Land at cost	26,377
Buildings at cost	209,087
Total at cost	235,464
Accumulated Depreciation	$ 3,095
Date of Construction	1984
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Blue Springs, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,347
Initial costs, buildings	23,494
Land at cost	4,347
Buildings at cost	23,494
Total at cost	27,841
Accumulated Depreciation	3,034
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Hill County, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,120
Initial costs, buildings	17,882
Land at cost	1,120
Buildings at cost	17,882
Total at cost	19,002
Accumulated Depreciation	11,089
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Sep. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	15 years
1980 [Member] | Poplar Bluff, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,659
Initial costs, buildings	38,693
Additions subsequent to acquisition, carrying costs	1
Land at cost	2,659
Buildings at cost	38,694
Total at cost	41,353
Accumulated Depreciation	11,309
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Sharon P A
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	6,435
Land at cost	6,179
Buildings at cost	15,501
Total at cost	21,680
Accumulated Depreciation	$ 1,826
Date of Construction	1980
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1980 [Member] | West Valley City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,516
Initial costs, buildings	58,314
Additions subsequent to acquisition, Improvements	7,150
Additions subsequent to acquisition, carrying costs	(114)
Land at cost	5,402
Buildings at cost	65,464
Total at cost	70,866
Accumulated Depreciation	$ 17,332
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bossier City, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 900
Initial costs, buildings	17,818
Additions subsequent to acquisition, Improvements	800
Land at cost	900
Buildings at cost	18,618
Total at cost	19,518
Accumulated Depreciation	5,255
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Cheraw, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 657
Initial costs, buildings	19,576
Land at cost	657
Buildings at cost	19,576
Total at cost	20,233
Accumulated Depreciation	5,616
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	42 years
1982 [Member] | Caterham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,596
Initial costs, buildings	21,707
Additions subsequent to acquisition, Improvements	391
Land at cost	10,987
Buildings at cost	21,707
Total at cost	32,694
Accumulated Depreciation	192
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,502
Initial costs, buildings	10,748
Additions subsequent to acquisition, carrying costs	51
Land at cost	5,502
Buildings at cost	10,799
Total at cost	16,301
Accumulated Depreciation	3,006
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Haverhill Massachusetts
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,651
Initial costs, buildings	105,848
Additions subsequent to acquisition, Improvements	3,384
Land at cost	5,651
Buildings at cost	109,232
Total at cost	114,883
Accumulated Depreciation	3,794
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,387
Initial costs, buildings	47,586
Additions subsequent to acquisition, Improvements	9,894
Land at cost	5,387
Buildings at cost	57,480
Total at cost	62,867
Accumulated Depreciation	$ 4,186
Date of Construction	1982
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1917 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,540
Initial costs, buildings	146,491
Additions subsequent to acquisition, Improvements	39,036
Land at cost	18,540
Buildings at cost	185,527
Total at cost	204,067
Accumulated Depreciation	12,301
Encumbrances	$ 0
Date of Construction	1917
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1965 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,328
Initial costs, buildings	67,248
Additions subsequent to acquisition, Improvements	4,937
Land at cost	18,328
Buildings at cost	72,185
Total at cost	90,513
Accumulated Depreciation	7,037
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1965 [Member] | Perth, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 102,488
Initial costs, buildings	36,399
Additions subsequent to acquisition, Improvements	213
Land at cost	102,701
Buildings at cost	36,399
Total at cost	139,100
Accumulated Depreciation	723
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1992 [Member] | Bowling Green, KY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,486
Initial costs, buildings	56,296
Land at cost	3,486
Buildings at cost	56,296
Total at cost	59,782
Accumulated Depreciation	523
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Wichita, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	18,373
Additions subsequent to acquisition, carrying costs	1
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	$ 5,396
Date of Construction	1992
Date Acquired	Apr. 4, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Bundoora, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,432
Initial costs, buildings	61,961
Additions subsequent to acquisition, Improvements	276
Land at cost	6,708
Buildings at cost	61,961
Total at cost	68,669
Accumulated Depreciation	995
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1979 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,396
Initial costs, buildings	26,521
Additions subsequent to acquisition, Improvements	12,253
Land at cost	2,396
Buildings at cost	38,774
Total at cost	41,170
Accumulated Depreciation	1,583
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
1979 [Member] | San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 1,915
Initial costs, buildings	5,085
Additions subsequent to acquisition, carrying costs	18
Land at cost	1,915
Buildings at cost	5,103
Total at cost	7,018
Accumulated Depreciation	$ 1,417
Date of Construction	1979
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Sunnybank, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,819
Initial costs, buildings	44,225
Additions subsequent to acquisition, Improvements	346
Land at cost	6,165
Buildings at cost	44,225
Total at cost	50,390
Accumulated Depreciation	$ 779
Date of Construction	1979
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	34 years
2012 [Member] | Casper, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,888
Land at cost	1,888
Total at cost	1,888
Accumulated Depreciation	0
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	0 years
2012 [Member] | Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,526
Initial costs, buildings	82,358
Additions subsequent to acquisition, Improvements	24,463
Land at cost	3,526
Buildings at cost	106,821
Total at cost	110,347
Accumulated Depreciation	7,843
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2012 [Member] | Florence, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 900
Initial costs, buildings	28,462
Additions subsequent to acquisition, Improvements	105
Land at cost	900
Buildings at cost	28,567
Total at cost	29,467
Accumulated Depreciation	5,531
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 7, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Mount Pleasant, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 597
Initial costs, buildings	2,198
Land at cost	597
Buildings at cost	2,198
Total at cost	2,795
Accumulated Depreciation	21
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Overlook, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,452
Initial costs, buildings	9,666
Additions subsequent to acquisition, Improvements	7
Land at cost	2,452
Buildings at cost	9,673
Total at cost	12,125
Accumulated Depreciation	1,654
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,248
Initial costs, buildings	5,880
Land at cost	2,248
Buildings at cost	5,880
Total at cost	8,128
Accumulated Depreciation	$ 1,052
Date of Construction	2012
Date Acquired	Oct. 2, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Campbelltown, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,019
Initial costs, buildings	52,932
Additions subsequent to acquisition, Improvements	50
Land at cost	1,069
Buildings at cost	52,932
Total at cost	54,001
Accumulated Depreciation	774
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,534
Initial costs, buildings	100,042
Additions subsequent to acquisition, Improvements	1,885
Land at cost	6,534
Buildings at cost	101,927
Total at cost	108,461
Accumulated Depreciation	16,494
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 834
Initial costs, buildings	17,182
Land at cost	834
Buildings at cost	17,182
Total at cost	18,016
Accumulated Depreciation	3,830
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 One [Member] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 750
Initial costs, buildings	3,853
Land at cost	750
Buildings at cost	3,853
Total at cost	4,603
Accumulated Depreciation	409
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 7, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 One [Member] | Hoover, AL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, buildings	$ 1,034
Additions subsequent to acquisition, Improvements	296
Buildings at cost	1,330
Total at cost	1,330
Accumulated Depreciation	148
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
2004 [Member] | Webster, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 663
Initial costs, buildings	33,751
Land at cost	663
Buildings at cost	33,751
Total at cost	34,414
Accumulated Depreciation	7,594
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	2,138
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	39 years
2004 [Member] | Martin's Ferry, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,380
Initial costs, buildings	4,620
Land at cost	1,380
Buildings at cost	4,620
Total at cost	6,000
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
2004 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	1,961
Land at cost	6,535
Buildings at cost	125,479
Total at cost	132,014
Accumulated Depreciation	7,122
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1956 [Member] | Detroit, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,220
Initial costs, buildings	8,687
Additions subsequent to acquisition, carrying costs	(364)
Land at cost	1,220
Buildings at cost	8,323
Total at cost	9,543
Accumulated Depreciation	2,480
Encumbrances	$ 0
Date of Construction	1956
Date Acquired	May 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1953 [Member] | Dorchester, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,428
Initial costs, buildings	219,575
Additions subsequent to acquisition, Improvements	6,638
Land at cost	14,428
Buildings at cost	226,213
Total at cost	240,641
Accumulated Depreciation	6,885
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Oct. 15, 2018
Life on which depreciation in latest income statements is computed (Years)	42 years
1953 [Member] | Port Huron, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	1,947
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1930 [Member] | Easton, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,898
Initial costs, buildings	40,245
Additions subsequent to acquisition, Improvements	5,511
Land at cost	13,898
Buildings at cost	45,756
Total at cost	59,654
Accumulated Depreciation	2,948
Encumbrances	$ 0
Date of Construction	1930
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2005 [Member] | Easton, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,898
Initial costs, buildings	40,245
Additions subsequent to acquisition, Improvements	5,511
Land at cost	13,898
Buildings at cost	45,756
Total at cost	59,654
Accumulated Depreciation	2,948
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2005 [Member] | Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 150
Initial costs, buildings	10,449
Land at cost	150
Buildings at cost	10,449
Total at cost	10,599
Accumulated Depreciation	3,499
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Jan. 4, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Haverhill Massachusetts
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,651
Initial costs, buildings	105,848
Additions subsequent to acquisition, Improvements	3,384
Land at cost	5,651
Buildings at cost	109,232
Total at cost	114,883
Accumulated Depreciation	3,794
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Port Arthur, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,972
Initial costs, buildings	78,051
Additions subsequent to acquisition, Improvements	3,384
Land at cost	12,972
Buildings at cost	81,435
Total at cost	94,407
Accumulated Depreciation	12,241
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Tomball, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,299
Initial costs, buildings	23,982
Land at cost	1,299
Buildings at cost	23,982
Total at cost	25,281
Accumulated Depreciation	$ 5,396
Date of Construction	2005
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
1939 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,044
Encumbrances	$ 0
Date of Construction	1939
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	104,028
Additions subsequent to acquisition, Improvements	17,462
Land at cost	28,687
Buildings at cost	121,490
Total at cost	150,177
Accumulated Depreciation	3,695
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Fall River, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,526
Initial costs, buildings	82,358
Additions subsequent to acquisition, Improvements	24,463
Land at cost	3,526
Buildings at cost	106,821
Total at cost	110,347
Accumulated Depreciation	7,843
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Methuen, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,809
Initial costs, buildings	89,505
Additions subsequent to acquisition, Improvements	9,184
Land at cost	23,809
Buildings at cost	98,689
Total at cost	122,498
Accumulated Depreciation	8,500
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Ottumwa, IA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,377
Initial costs, buildings	48,697
Land at cost	2,377
Buildings at cost	48,697
Total at cost	51,074
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1950 [Member] | Rockledge, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,919
Initial costs, buildings	23,282
Additions subsequent to acquisition, Improvements	5,512
Land at cost	13,919
Buildings at cost	28,794
Total at cost	42,713
Accumulated Depreciation	2,404
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
1950 [Member] | Sharon P A
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	6,435
Land at cost	6,179
Buildings at cost	15,501
Total at cost	21,680
Accumulated Depreciation	$ 1,826
Date of Construction	1950
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1976 [Member] | Dodge City, KS
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,124
Initial costs, buildings	52,705
Land at cost	1,124
Buildings at cost	52,705
Total at cost	53,829
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1976 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,978
Land at cost	12,695
Buildings at cost	78,751
Total at cost	91,446
Accumulated Depreciation	4,580
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
1972 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,044
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Glen Waverly, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 29,739
Initial costs, buildings	22,976
Additions subsequent to acquisition, Improvements	807
Land at cost	30,546
Buildings at cost	22,976
Total at cost	53,522
Accumulated Depreciation	478
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	32 years
1972 [Member] | San Dimas, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,160
Initial costs, buildings	6,839
Additions subsequent to acquisition, carrying costs	34
Land at cost	6,160
Buildings at cost	6,873
Total at cost	13,033
Accumulated Depreciation	$ 1,907
Date of Construction	1972
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Fairmont, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,000
Initial costs, buildings	6,072
Additions subsequent to acquisition, Improvements	5,278
Land at cost	1,277
Buildings at cost	11,073
Total at cost	12,350
Accumulated Depreciation	2,044
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Sep. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Fort Lauderdale, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,499
Initial costs, buildings	21,939
Additions subsequent to acquisition, carrying costs	1
Land at cost	3,499
Buildings at cost	21,940
Total at cost	25,439
Accumulated Depreciation	6,412
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Hot Springs, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,100
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	21,221
Land at cost	7,100
Buildings at cost	80,653
Total at cost	87,753
Accumulated Depreciation	8,904
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Lawton, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,944
Initial costs, buildings	63,031
Land at cost	3,944
Buildings at cost	63,031
Total at cost	66,975
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | St. Albans Park, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,097
Initial costs, buildings	21,421
Additions subsequent to acquisition, Improvements	544
Land at cost	2,641
Buildings at cost	21,421
Total at cost	24,062
Accumulated Depreciation	$ 339
Date of Construction	1985
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Strathpine, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,538
Initial costs, buildings	35,542
Additions subsequent to acquisition, Improvements	301
Land at cost	2,839
Buildings at cost	35,542
Total at cost	38,381
Accumulated Depreciation	$ 533
Date of Construction	1985
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 One [Member] | Garden Grove, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Medical Office Building
Initial costs, land	$ 862
Initial costs, buildings	7,888
Additions subsequent to acquisition, carrying costs	28
Land at cost	862
Buildings at cost	7,916
Total at cost	8,778
Accumulated Depreciation	2,198
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Gloucester United Kingdom
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,770
Initial costs, buildings	63,907
Additions subsequent to acquisition, Improvements	1,041
Land at cost	5,811
Buildings at cost	63,907
Total at cost	69,718
Accumulated Depreciation	564
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Eighty Six | Halsall United Kingdom
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,493
Initial costs, buildings	32,446
Additions subsequent to acquisition, Improvements	605
Land at cost	2,098
Buildings at cost	32,446
Total at cost	34,544
Accumulated Depreciation	287
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Eighty Six | Rowley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,439
Initial costs, buildings	19,057
Additions subsequent to acquisition, Improvements	590
Land at cost	3,029
Buildings at cost	19,057
Total at cost	22,086
Accumulated Depreciation	$ 174
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1922 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,384
Land at cost	2,417
Buildings at cost	17,241
Total at cost	19,658
Accumulated Depreciation	1,440
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
1922 [Member] | Lewiston, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,389
Initial costs, buildings	75,435
Land at cost	5,389
Buildings at cost	75,435
Total at cost	80,824
Accumulated Depreciation	6,802
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Ninety Nine | Hartsville South Carolina
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,050
Initial costs, buildings	43,970
Land at cost	2,050
Buildings at cost	43,970
Total at cost	46,020
Accumulated Depreciation	5,263
Encumbrances	$ 0
Date of Construction	1999
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
Nineteen Ninety Nine | Reading, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 35,747
Initial costs, buildings	48,080
Additions subsequent to acquisition, Improvements	486
Land at cost	36,233
Buildings at cost	48,080
Total at cost	84,313
Accumulated Depreciation	419
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,384
Land at cost	2,417
Buildings at cost	17,241
Total at cost	19,658
Accumulated Depreciation	1,440
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	46 years
2000 [Member] | Kingswood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 23,473
Initial costs, buildings	77,806
Additions subsequent to acquisition, Improvements	453
Land at cost	23,926
Buildings at cost	77,806
Total at cost	101,732
Accumulated Depreciation	1,155
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,640
Additions subsequent to acquisition, Improvements	577
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	14,741
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Twenty Six | Hastings P A
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 603
Initial costs, buildings	8,834
Land at cost	603
Buildings at cost	8,834
Total at cost	9,437
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
Nineteen Twenty Six | Norwood, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,073
Initial costs, buildings	154,496
Additions subsequent to acquisition, Improvements	27,385
Land at cost	7,073
Buildings at cost	181,881
Total at cost	188,954
Accumulated Depreciation	5,392
Encumbrances	$ 0
Date of Construction	1926
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
2001 [Member] | Hope, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,651
Initial costs, buildings	3,359
Additions subsequent to acquisition, Improvements	2,274
Land at cost	1,651
Buildings at cost	5,633
Total at cost	7,284
Accumulated Depreciation	418
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2001 [Member] | Norwood, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,073
Initial costs, buildings	154,496
Additions subsequent to acquisition, Improvements	27,385
Land at cost	7,073
Buildings at cost	181,881
Total at cost	188,954
Accumulated Depreciation	5,392
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
1940 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	104,028
Additions subsequent to acquisition, Improvements	17,462
Land at cost	28,687
Buildings at cost	121,490
Total at cost	150,177
Accumulated Depreciation	3,695
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1940 [Member] | Taunton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,428
Initial costs, buildings	73,228
Additions subsequent to acquisition, Improvements	6,852
Land at cost	4,428
Buildings at cost	80,080
Total at cost	84,508
Accumulated Depreciation	$ 6,446
Date of Construction	1940
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
1940 [Member] | Tempe, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,050
Initial costs, buildings	10,986
Additions subsequent to acquisition, Improvements	6,773
Land at cost	6,050
Buildings at cost	17,759
Total at cost	23,809
Accumulated Depreciation	$ 903
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2002 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,822
Initial costs, buildings	37,467
Additions subsequent to acquisition, Improvements	8,235
Additions subsequent to acquisition, carrying costs	4,665
Land at cost	1,822
Buildings at cost	50,367
Total at cost	52,189
Accumulated Depreciation	12,258
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Apr. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Melbourne, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,642
Initial costs, buildings	17,087
Additions subsequent to acquisition, Improvements	2,686
Land at cost	5,642
Buildings at cost	19,773
Total at cost	25,415
Accumulated Depreciation	1,522
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
2002 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	29,333
Additions subsequent to acquisition, Improvements	1,945
Land at cost	8,053
Buildings at cost	31,278
Total at cost	39,331
Accumulated Depreciation	$ 1,868
Date of Construction	2002
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1978 [Member] | Kansas City, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,497
Initial costs, buildings	64,419
Land at cost	10,497
Buildings at cost	64,419
Total at cost	74,916
Accumulated Depreciation	8,071
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,053
Initial costs, buildings	29,333
Additions subsequent to acquisition, Improvements	1,945
Land at cost	8,053
Buildings at cost	31,278
Total at cost	39,331
Accumulated Depreciation	$ 1,868
Date of Construction	1978
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1954 [Member] | Camden, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 22,739
Buildings at cost	22,739
Total at cost	22,739
Accumulated Depreciation	2,138
Encumbrances	$ 0
Date of Construction	1954
Date Acquired	Oct. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	39 years
Nineteen Twenty Four | Johnstown, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,877
Initial costs, buildings	247,042
Land at cost	8,877
Buildings at cost	247,042
Total at cost	255,919
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
Nineteen Twenty Four | Roaring Springs, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,447
Initial costs, buildings	9,549
Land at cost	1,447
Buildings at cost	9,549
Total at cost	10,996
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1996 [Member] | McMinnville, OR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,000
Initial costs, buildings	97,900
Land at cost	5,000
Buildings at cost	97,900
Total at cost	102,900
Accumulated Depreciation	9,146
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	41 years
1996 [Member] | Poole, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,883
Initial costs, buildings	39,969
Additions subsequent to acquisition, Improvements	538
Land at cost	2,421
Buildings at cost	39,969
Total at cost	42,390
Accumulated Depreciation	776
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Apr. 3, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Ninety Five | Lafayette, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 599
Initial costs, buildings	1,401
Land at cost	599
Buildings at cost	1,401
Total at cost	2,000
Accumulated Depreciation	17
Encumbrances	$ 0
Date of Construction	1995
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1975 [Member] | Liverpool, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,327
Initial costs, buildings	41,769
Additions subsequent to acquisition, Improvements	93
Land at cost	13,420
Buildings at cost	41,769
Total at cost	55,189
Accumulated Depreciation	817
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1920 [Member] | Martin's Ferry, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,380
Initial costs, buildings	4,620
Land at cost	1,380
Buildings at cost	4,620
Total at cost	6,000
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
1920 [Member] | Pasco, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,594
Initial costs, buildings	13,195
Land at cost	2,594
Buildings at cost	13,195
Total at cost	15,789
Accumulated Depreciation	601
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	30 years
1920 [Member] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,640
Additions subsequent to acquisition, Improvements	577
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	14,741
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1944 [Member] | Martin's Ferry, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,380
Initial costs, buildings	4,620
Land at cost	1,380
Buildings at cost	4,620
Total at cost	6,000
Encumbrances	$ 0
Date of Construction	1944
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
1968 [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,695
Initial costs, buildings	73,773
Additions subsequent to acquisition, Improvements	4,978
Land at cost	12,695
Buildings at cost	78,751
Total at cost	91,446
Accumulated Depreciation	4,580
Encumbrances	$ 0
Date of Construction	1968
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
2018 [Member] | Olathe, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,485
Initial costs, buildings	14,484
Land at cost	3,485
Buildings at cost	14,484
Total at cost	17,969
Accumulated Depreciation	183
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Roeland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,569
Initial costs, buildings	15,103
Land at cost	1,569
Buildings at cost	15,103
Total at cost	16,672
Accumulated Depreciation	188
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Shawnee, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,076
Initial costs, buildings	14,945
Land at cost	3,076
Buildings at cost	14,945
Total at cost	18,021
Accumulated Depreciation	$ 216
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2019 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,191
Initial costs, buildings	14,264
Land at cost	3,191
Buildings at cost	14,264
Total at cost	17,455
Accumulated Depreciation	191
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
1988 [Member] | Palestine, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,848
Initial costs, buildings	95,258
Land at cost	1,848
Buildings at cost	95,258
Total at cost	97,106
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1964 [Member] | San Diego, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,550
Initial costs, buildings	15,653
Additions subsequent to acquisition, carrying costs	77
Land at cost	6,550
Buildings at cost	15,730
Total at cost	22,280
Accumulated Depreciation	4,979
Encumbrances	$ 0
Date of Construction	1964
Date Acquired	May 9, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
1964 [Member] | Anaheim, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,875
Initial costs, buildings	21,813
Additions subsequent to acquisition, carrying costs	10
Land at cost	1,875
Buildings at cost	21,823
Total at cost	23,698
Accumulated Depreciation	$ 7,183
Date of Construction	1964
Date Acquired	Nov. 8, 2006
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Salt Lake City U T
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,590
Initial costs, buildings	101,915
Additions subsequent to acquisition, Improvements	15,109
Land at cost	13,590
Buildings at cost	117,024
Total at cost	130,614
Accumulated Depreciation	$ 5,822
Date of Construction	1987
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2017 One [Member] | Phoenix, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,576
Initial costs, buildings	45,782
Land at cost	5,576
Buildings at cost	45,782
Total at cost	51,358
Accumulated Depreciation	3,338
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Feb. 10, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2003 [Member] | Youngstown O H
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,335
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	824
Land at cost	4,335
Buildings at cost	4,389
Total at cost	8,724
Accumulated Depreciation	$ 1,561
Date of Construction	2003
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1906 [Member] | Salt Lake City U T
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,590
Initial costs, buildings	101,915
Additions subsequent to acquisition, Improvements	15,109
Land at cost	13,590
Buildings at cost	117,024
Total at cost	130,614
Accumulated Depreciation	$ 5,822
Date of Construction	1906
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1913 [Member] | Sherman Texas
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,493
Initial costs, buildings	10,690
Land at cost	4,493
Buildings at cost	10,690
Total at cost	15,183
Accumulated Depreciation	$ 2,934
Date of Construction	1913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1962 [Member] | West Monroe, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,000
Initial costs, buildings	69,433
Additions subsequent to acquisition, Improvements	16,187
Land at cost	12,552
Buildings at cost	85,068
Total at cost	97,620
Accumulated Depreciation	$ 11,845
Date of Construction	1962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1914 [Member] | Wheeling, WV [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,480
Initial costs, buildings	7,920
Land at cost	1,480
Buildings at cost	7,920
Total at cost	$ 9,400
Date of Construction	1914
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
1925 [Member] | Wheeling, WV [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,480
Initial costs, buildings	7,920
Land at cost	1,480
Buildings at cost	7,920
Total at cost	$ 9,400
Date of Construction	1925
Date Acquired	Jun. 1, 2017
Life on which depreciation in latest income statements is computed (Years)	8 years
1929 [Member] | Youngstown O H
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,335
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	824
Land at cost	4,335
Buildings at cost	4,389
Total at cost	8,724
Accumulated Depreciation	$ 1,561
Date of Construction	1929
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years

Schedule III - Real Estate In_3

Schedule III - Real Estate Investments and Accumulated Depreciation (Parenthetical) (Detail) $ in Billions	Dec. 31, 2019USD ($)
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 7.8

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period		$ 4,781,149	$ 5,438,148	$ 3,968,042
Acquisitions		2,436,265	758,619	1,256,245
Transfers from construction in progress			25,513	74,441
Additions		173,785	96,775	36,828
Dispositions		(106,536)	(1,318,238)	(53,372)
Other	[1]	27,823	(219,668)	155,964
Balance at end of period		$ 7,312,486	$ 4,781,149	$ 5,438,148
[1]	Includes foreign currency fluctuations for all years, $61.4 million of right-of-use assets (2019 only), and purchase price allocation adjustments (2017 only).

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 414,331	$ 407,349	$ 292,786
Depreciation	130,851	115,497	109,307
Depreciation on disposed property	(40,952)	(101,967)	(1,438)
Other	421	(6,548)	6,694
Balance at end of period	$ 504,651	$ 414,331	$ 407,349

Schedule III - Changes in Acc_2

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) $ in Thousands	Dec. 31, 2019USD ($)
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Right-of-use-assets	$ 61,380

Schedule IV - Schedule of Mortg

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	1,274,995,000
Carrying Amount of Mortgages	1,274,995,000	$ 1,213,283,000	$ 1,778,264,000	$ 1,060,336,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Periodic Payment Terms	Payable in monthly installments of interest plus principal payable in full at maturity
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.00%
Final Maturity Date	2022
Face Amount of Mortgages	$ 70,000,000
Carrying Amount of Mortgages	70,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	12.40%
Final Maturity Date	2022
Face Amount of Mortgages	$ 20,000,000
Carrying Amount of Mortgages	20,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Desert Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.00%
Final Maturity Date	2021
Face Amount of Mortgages	$ 12,500,000
Carrying Amount of Mortgages	12,500,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Chino Valley Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.00%
Final Maturity Date	2022
Face Amount of Mortgages	$ 50,000,000
Carrying Amount of Mortgages	50,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Paradise Valley Hospital [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.20%
Final Maturity Date	2022
Face Amount of Mortgages	$ 25,000,000
Carrying Amount of Mortgages	25,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Ernest [member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	10.20%
Final Maturity Date	2032
Face Amount of Mortgages	$ 115,000,000
Carrying Amount of Mortgages	115,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Centinela Hospital Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.90%
Final Maturity Date	2022
Face Amount of Mortgages	$ 100,000,000
Carrying Amount of Mortgages	100,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Olympia Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	10.90%
Final Maturity Date	2024
Face Amount of Mortgages	$ 25,000,000
Carrying Amount of Mortgages	25,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | St. Joseph Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	9.30%
Final Maturity Date	2025
Face Amount of Mortgages	$ 30,000,000
Carrying Amount of Mortgages	30,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | St. Mary's Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	9.30%
Final Maturity Date	2025
Face Amount of Mortgages	$ 10,000,000
Carrying Amount of Mortgages	10,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Lake Huron Medical Center [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	9.30%
Final Maturity Date	2025
Face Amount of Mortgages	$ 10,000,000
Carrying Amount of Mortgages	10,000,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Steward [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7.80%
Final Maturity Date	2031
Face Amount of Mortgages	$ 737,242,000
Carrying Amount of Mortgages	737,242,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Vibra [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	11.50%
Final Maturity Date	2024
Face Amount of Mortgages	$ 18,986,000
Carrying Amount of Mortgages	18,986,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Prospect [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7.50%
Final Maturity Date	2034
Face Amount of Mortgages	$ 51,267,000
Carrying Amount of Mortgages	51,267,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0

Schedule IV - Schedule of Mor_2

Schedule IV - Schedule of Mortgage Loans on Real Estate (Parenthetical) (Detail)	Dec. 31, 2019USD ($)Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	1,300,000,000
Unamortized loan issue costs	$ 30,000
Ernest [member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	4
Steward [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	2

Schedule IV - Changes in Mortga

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Mortgage Loans On Real Estate [Abstract]
Balance at beginning of year	$ 1,213,283	$ 1,778,264	$ 1,060,336
New mortgage loans and additional advances on existing loans	61,712	50,783	717,928
Mortgage loans on real estate including additions during year	1,274,995	1,829,047	1,778,264
Collection of principal		(615,764)
Deductions during year		(615,764)
Balance at end of year	$ 1,274,995	$ 1,213,283	$ 1,778,264