Medical Properties Trust (MPW) 10-K 1 Mar 22 2021 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) shares in Millions, $ in Billions	12 Months Ended
	Dec. 31, 2021	Feb. 18, 2022	Jun. 30, 2021
Document Information [Line Items]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2021
Document Fiscal Year Focus	2021
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
ICFR Auditor Attestation Flag	true
Entity Common Stock, Shares Outstanding		599.9
Entity Public Float			$ 11.7
Title of 12(b) Security	Common stock, par value $0.001 per share, of Medical Properties Trust, Inc.
Security Exchange Name	NYSE
Entity File Number	001-32559
Entity Tax Identification Number	20-0191742
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	205
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	MD
Document Annual Report	true
Document Transition Report	false
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Document Type	10-K
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 26, 2022 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, 2021
Document Fiscal Year Focus	2021
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	Yes
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
ICFR Auditor Attestation Flag	true
Entity File Number	333-177186
Entity Tax Identification Number	20-0242069
Entity Address, Address Line One	1000 Urban Center Drive
Entity Address, Address Line Two	Suite 501
Entity Address, City or Town	Birmingham
Entity Address, State or Province	AL
Entity Address, Postal Zip Code	35242
City Area Code	205
Local Phone Number	969-3755
Entity Incorporation, State or Country Code	DE
Entity Interactive Data Current	Yes
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Birmingham, Alabama
Auditor Firm ID	238
Document Type	10-K

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Real estate assets
Land	$ 1,961,478	$ 1,463,200
Buildings and improvements	10,581,992	9,286,507
Construction in progress	101,439	30,139
Intangible lease assets	1,417,813	1,299,081
Investment in financing leases	2,053,327	2,010,922
Real estate held for sale	1,096,505
Mortgage loans	213,211	248,080
Gross investment in real estate assets	17,425,765	14,337,929
Accumulated depreciation	(853,879)	(728,176)
Accumulated amortization	(139,221)	(105,353)
Net investment in real estate assets	16,432,665	13,504,400
Cash and cash equivalents	459,227	549,884
Interest and rent receivables	56,229	46,208
Straight-line rent receivables	728,522	490,462
Equity investments	1,181,025	1,123,623
Other loans	1,328,653	858,368
Other assets	333,480	256,069
Total Assets	20,519,801	16,829,014
Liabilities
Debt, net	11,282,770	8,865,458
Accounts payable and accrued expenses	607,792	438,750
Deferred revenue	25,563	36,177
Obligations to tenants and other lease liabilities	158,005	144,772
Total Liabilities	12,074,130	9,485,157
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 — 596,814 shares at December 31, 2021 and 541,419 shares at December 31, 2020	597	541
Additional paid-in capital	8,564,786	7,461,503
Distributions in excess of net income	(87,691)	(71,411)
Accumulated other comprehensive loss	(36,727)	(51,324)
Treasury shares, at cost	(777)	(777)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,440,188	7,338,532
Non-controlling interests	5,483	5,325
Total Equity / Capital	8,445,671	7,343,857
Total Liabilities and Equity / Capital	20,519,801	16,829,014
MPT Operating Partnership, L.P. [Member]
Real estate assets
Land	1,961,478	1,463,200
Buildings and improvements	10,581,992	9,286,507
Construction in progress	101,439	30,139
Intangible lease assets	1,417,813	1,299,081
Investment in financing leases	2,053,327	2,010,922
Real estate held for sale	1,096,505
Mortgage loans	213,211	248,080
Gross investment in real estate assets	17,425,765	14,337,929
Accumulated depreciation	(853,879)	(728,176)
Accumulated amortization	(139,221)	(105,353)
Net investment in real estate assets	16,432,665	13,504,400
Cash and cash equivalents	459,227	549,884
Interest and rent receivables	56,229	46,208
Straight-line rent receivables	728,522	490,462
Equity investments	1,181,025	1,123,623
Other loans	1,328,653	858,368
Other assets	333,480	256,069
Total Assets	20,519,801	16,829,014
Liabilities
Debt, net	11,282,770	8,865,458
Accounts payable and accrued expenses	430,908	290,757
Deferred revenue	25,563	36,177
Obligations to tenants and other lease liabilities	158,005	144,772
Payable due to Medical Properties Trust, Inc.	176,494	147,603
Total Liabilities	12,073,740	9,484,767
Commitments and Contingencies
Equity / Capital
General partner — issued and outstanding — 5,968 units at December 31, 2021 and 5,414 units at December 31, 2020	84,847	73,977
Accumulated other comprehensive loss	(36,727)	(51,324)
Total Medical Properties Trust, Inc. Stockholders' Equity (MPT Operating Partnership, L.P. capital)	8,440,578	7,338,922
Non-controlling interests	5,483	5,325
Total Equity / Capital	8,446,061	7,344,247
Total Liabilities and Equity / Capital	20,519,801	16,829,014
MPT Operating Partnership, L.P. [Member] | Common Units
Equity / Capital
Limited Partners — issued and outstanding — 590,846 units at December 31, 2021 and 536,005 units at December 31, 2020	$ 8,392,458	$ 7,316,269

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2021	Dec. 31, 2020
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	596,814,000	541,419,000
Common stock, shares outstanding	596,814,000	541,419,000
General Partner [Member] | MPT Operating Partnership, L.P. [Member]
General partner, units issued	5,968,000	5,414,000
General partner, units outstanding	5,968,000	5,414,000
Common Units | MPT Operating Partnership, L.P. [Member]
Limited Partners, units issued	590,846,000	536,005,000
Limited Partners, units outstanding	590,846,000	536,005,000

Consolidated Statements of Net

Consolidated Statements of Net Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Revenues
Rent billed	$ 931,942	$ 741,311	$ 474,151
Straight-line rent	241,433	158,881	110,456
Income from financing leases	202,599	206,550	119,617
Interest and other income	168,695	142,496	149,973
Total revenues	1,544,669	1,249,238	854,197
Expenses
Interest	367,393	328,728	237,830
Real estate depreciation and amortization	321,249	264,245	152,313
Property-related	39,098	24,890	23,992
General and administrative	145,638	131,663	96,411
Total expenses	873,378	749,526	510,546
Other income (expense)
Gain (loss) on sale of real estate	52,471	(2,833)	41,560
Real estate impairment charges		(19,006)	(21,031)
Earnings from equity interests	28,488	20,417	16,051
Debt refinancing and unutilized financing costs	(27,650)	(28,180)	(6,106)
Other (including mark-to-market adjustments on equity securities)	6,288	(6,782)	(345)
Total other income (expense)	59,597	(36,384)	30,129
Income before income tax	730,888	463,328	373,780
Income tax (expense) benefit	(73,948)	(31,056)	2,621
Net income	656,940	432,272	376,401
Net income attributable to non-controlling interests	(919)	(822)	(1,717)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 656,021	$ 431,450	$ 374,684
Earnings per common share — basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 1.11	$ 0.81	$ 0.87
Weighted average shares (units) outstanding basic	588,817	529,239	427,075
Weighted average shares (units) outstanding diluted	590,139	530,461	428,299
MPT Operating Partnership, L.P. [Member]
Revenues
Rent billed	$ 931,942	$ 741,311	$ 474,151
Straight-line rent	241,433	158,881	110,456
Income from financing leases	202,599	206,550	119,617
Interest and other income	168,695	142,496	149,973
Total revenues	1,544,669	1,249,238	854,197
Expenses
Interest	367,393	328,728	237,830
Real estate depreciation and amortization	321,249	264,245	152,313
Property-related	39,098	24,890	23,992
General and administrative	145,638	131,663	96,411
Total expenses	873,378	749,526	510,546
Other income (expense)
Gain (loss) on sale of real estate	52,471	(2,833)	41,560
Real estate impairment charges		(19,006)	(21,031)
Earnings from equity interests	28,488	20,417	16,051
Debt refinancing and unutilized financing costs	(27,650)	(28,180)	(6,106)
Other (including mark-to-market adjustments on equity securities)	6,288	(6,782)	(345)
Total other income (expense)	59,597	(36,384)	30,129
Income before income tax	730,888	463,328	373,780
Income tax (expense) benefit	(73,948)	(31,056)	2,621
Net income	656,940	432,272	376,401
Net income attributable to non-controlling interests	(919)	(822)	(1,717)
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 656,021	$ 431,450	$ 374,684
Earnings per common share — basic and diluted
Net income attributable to MPT common stockholders (Operating Partnership partners)	$ 1.11	$ 0.81	$ 0.87
Weighted average shares (units) outstanding basic	588,817	529,239	427,075
Weighted average shares (units) outstanding diluted	590,139	530,461	428,299

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Net income	$ 656,940	$ 432,272	$ 376,401
Other comprehensive income:
Unrealized gain (loss) on interest rate swaps, net of tax	52,288	(33,091)	(9,033)
Foreign currency translation (loss) gain	(37,691)	44,672	4,330
Total comprehensive income	671,537	443,853	371,698
Comprehensive income attributable to non-controlling interests	(919)	(822)	(1,717)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	670,618	443,031	369,981
MPT Operating Partnership, L.P. [Member]
Net income	656,940	432,272	376,401
Other comprehensive income:
Unrealized gain (loss) on interest rate swaps, net of tax	52,288	(33,091)	(9,033)
Foreign currency translation (loss) gain	(37,691)	44,672	4,330
Total comprehensive income	671,537	443,853	371,698
Comprehensive income attributable to non-controlling interests	(919)	(822)	(1,717)
Comprehensive income attributable to MPT common stockholders (Operating Partnership Partners)	$ 670,618	$ 443,031	$ 369,981

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]	Cumulative Effect, Period of Adoption, Adjustment [Member]	Cumulative Effect, Period of Adoption, Adjustment [Member]MPT Operating Partnership, L.P. [Member]	Cumulative Effect, Period of Adoption, Adjustment [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]	Common Par Value [Member]Cumulative Effect, Period of Adoption, Adjustment [Member]MPT Operating Partnership, L.P. [Member]Limited Partner [Member]	Additional Paid-in Capital [Member]	Retained Earnings (Deficit) [Member]	Retained Earnings (Deficit) [Member]Cumulative Effect, Period of Adoption, Adjustment [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, 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
Beginning balance (in shares) at Dec. 31, 2018			3,706				370,637	366,931										232
Net income	376,401	376,401	$ 3,746					$ 370,938			374,684					1,717	1,717
Unrealized gain (loss) on interest rate swaps, net of tax	(9,033)	(9,033)											(9,033)	(9,033)
Foreign currency translation gain (loss)	4,330	4,330											4,330	4,330
Stock vesting and amortization of stock-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 (Accounting Standards Update 2016-13) at Dec. 31, 2019					$ (8,399)	$ (84)			$ (8,315)
Ending balance (in shares) at Dec. 31, 2019			5,176				517,522	512,346										232
Net income	432,272	432,272	$ 4,315					$ 427,135			431,450					822	822
Unrealized gain (loss) on interest rate swaps, net of tax	(33,091)	(33,091)											(33,091)	(33,091)
Foreign currency translation gain (loss)	44,672	44,672											44,672	44,672
Stock vesting and amortization of stock-based compensation	47,154	47,154	$ 472				$ 2	$ 46,682		47,152
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			29				2,893	2,864
Sale of non-controlling interests	5,097	5,097														5,097	5,097
Redemption of MOP units	(4,928)	(4,928)						$ (4,928)		(4,928)
Redemption of common units (shares)								(232)
Conversion of LTIP units to common units (shares)								232										(232)
Distributions to non-controlling interests, net	(701)	(701)														(701)	(701)
Proceeds from offering (net of offering costs)	411,101	411,101	$ 4,111				$ 21	$ 406,990		411,080
Proceeds from offering (net of offering costs) (shares)			209				21,004	20,795
Dividends (Distributions) declared	(577,474)	(577,474)	$ (5,776)					$ (571,698)			(577,474)
Ending balance at Dec. 31, 2020	7,343,857	7,344,247	$ 73,977				$ 541	$ 7,316,269		7,461,503	(71,411)		(51,324)	(51,324)	(777)	5,325	5,325
Ending balance (Accounting Standards Update 2016-02) at Dec. 31, 2020				$ (8,399)								$ (8,399)
Ending balance (in shares) at Dec. 31, 2020			5,414				541,419	536,005
Net income	656,940	656,940	$ 6,560					$ 649,461			656,021					919	919
Unrealized gain (loss) on interest rate swaps, net of tax	52,288	52,288											52,288	52,288
Foreign currency translation gain (loss)	(37,691)	(37,691)											(37,691)	(37,691)
Stock vesting and amortization of stock-based compensation	52,110	52,110	$ 521				$ 3	$ 51,589		52,107
Stock (Unit) vesting and amortization of stock (unit)-based compensation (shares)			23				2,332	2,309
Distributions to non-controlling interests, net	(761)	(761)														(761)	(761)
Proceeds from offering (net of offering costs)	1,051,229	1,051,229	$ 10,512				$ 53	$ 1,040,717		1,051,176
Proceeds from offering (net of offering costs) (shares)			531				53,063	52,532
Dividends (Distributions) declared	(672,301)	(672,301)	$ (6,723)					$ (665,578)			(672,301)
Ending balance at Dec. 31, 2021	$ 8,445,671	$ 8,446,061	$ 84,847				$ 597	$ 8,392,458		$ 8,564,786	$ (87,691)		$ (36,727)	$ (36,727)	$ (777)	$ 5,483	$ 5,483
Ending balance (in shares) at Dec. 31, 2021			5,968				596,814	590,846

Consolidated Statements of Eq_2

Consolidated Statements of Equity / Capital (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
MPT Operating Partnership, L.P. [Member]
Dividends (Distributions) declared per common share / unit	$ 1.12	$ 1.08	$ 1.02
MPT Operating Partnership, L.P. [Member] | General Partner [Member]
Dividends (Distributions) declared per common share / unit	1.12	1.08	1.02
Retained Earnings (Deficit) [Member]
Dividends (Distributions) declared per common share / unit	1.12	1.08	1.02
Common Par Value [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Dividends (Distributions) declared per common share / unit	$ 1.12	$ 1.08	$ 1.02

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating activities
Net income	$ 656,940	$ 432,272	$ 376,401
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	333,781	275,953	156,575
Amortization of deferred financing costs and debt discount	16,856	13,099	8,881
Straight-line rent revenue and other	(288,717)	(226,906)	(138,806)
Share / (Unit)-based compensation expense	52,110	47,154	32,188
(Gain) loss from sale of real estate	(52,471)	2,833	(41,560)
Impairment charges		19,006	21,031
Straight-line rent and other (recovery) write-off	(2,271)	26,415	22,447
Debt refinancing and unutilized financing costs	27,650	28,180	6,106
Tax rate and other changes	42,746	9,295
Pre-acquisition rent collected - Circle Transaction		(35,020)
Other adjustments	11,913	8,134	(2,271)
Changes in:
Interest and rent receivables	(23,867)	(2,438)	12,906
Other assets	(4,375)	18,264	(4,992)
Accounts payable and accrued expenses	54,058	(18,424)	39,630
Deferred revenue	(12,697)	19,819	5,581
Net cash provided by operating activities	811,656	617,636	494,117
Investing activities
Cash paid for acquisitions and other related investments	(5,350,239)	(4,249,180)	(4,565,594)
Net proceeds from sale of real estate	246,468	94,177	111,766
Principal received on loans receivable	1,595,708	1,306,187	920
Investment in loans receivable	(58,932)	(62,651)	(54,088)
Construction in progress and other	(67,725)	(68,350)	(83,798)
Proceeds from sale and return of equity investment	65,546	69,224
Capital additions and other investments, net	(289,239)	(36,180)	(293,163)
Net cash used for investing activities	(3,858,413)	(2,946,773)	(4,883,957)
Financing activities
Proceeds from term debt, net of discount	3,407,535	2,215,950	3,048,424
Payments of term debt	(1,390,994)	(800,000)
Revolving credit facilities, net	559,985	162,633	(65,736)
Dividends / Distribution paid	(643,473)	(567,969)	(411,697)
Lease deposits and other obligations to tenants	17,815	21,706	(12,260)
Proceeds from sale of common shares, net of offering costs	1,051,229	411,101	2,533,210
Payment of debt refinancing, deferred financing costs and other financing activities	(54,489)	(42,347)	(50,057)
Net cash provided by financing activities	2,947,608	1,401,074	5,041,884
(Decrease) increase in cash, cash equivalents, and restricted cash for the year	(99,149)	(928,063)	652,044
Effect of exchange rate changes	4,662	16,441	(6,478)
Cash, cash equivalents, and restricted cash at beginning of year	556,369	1,467,991	822,425
Cash, cash equivalents, and restricted cash at end of year	461,882	556,369	1,467,991
Interest paid, including capitalized interest of $3,289 in 2021, $3,030 in 2020, and $3,936 in 2019	326,406	309,920	211,163
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	176,494	147,666	138,161
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	549,884	1,462,286	820,868
Restricted cash, included in Other assets at beginning of period	$ 6,485	$ 5,705	$ 1,557
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 556,369	$ 1,467,991	$ 822,425
Cash and cash equivalents at end of period	459,227	549,884	1,462,286
Restricted cash, included in Other assets at end of period	$ 2,655	$ 6,485	$ 5,705
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 461,882	$ 556,369	$ 1,467,991
MPT Operating Partnership, L.P. [Member]
Operating activities
Net income	656,940	432,272	376,401
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	333,781	275,953	156,575
Amortization of deferred financing costs and debt discount	16,856	13,099	8,881
Straight-line rent revenue and other	(288,717)	(226,906)	(138,806)
Share / (Unit)-based compensation expense	52,110	47,154	32,188
(Gain) loss from sale of real estate	(52,471)	2,833	(41,560)
Impairment charges		19,006	21,031
Straight-line rent and other (recovery) write-off	(2,271)	26,415	22,447
Debt refinancing and unutilized financing costs	27,650	28,180	6,106
Tax rate and other changes	42,746	9,295
Pre-acquisition rent collected - Circle Transaction		(35,020)
Other adjustments	11,913	8,134	(2,271)
Changes in:
Interest and rent receivables	(23,867)	(2,438)	12,906
Other assets	(4,375)	18,264	(4,992)
Accounts payable and accrued expenses	54,058	(18,424)	39,630
Deferred revenue	(12,697)	19,819	5,581
Net cash provided by operating activities	811,656	617,636	494,117
Investing activities
Cash paid for acquisitions and other related investments	(5,350,239)	(4,249,180)	(4,565,594)
Net proceeds from sale of real estate	246,468	94,177	111,766
Principal received on loans receivable	1,595,708	1,306,187	920
Investment in loans receivable	(58,932)	(62,651)	(54,088)
Construction in progress and other	(67,725)	(68,350)	(83,798)
Proceeds from sale and return of equity investment	65,546	69,224
Capital additions and other investments, net	(289,239)	(36,180)	(293,163)
Net cash used for investing activities	(3,858,413)	(2,946,773)	(4,883,957)
Financing activities
Proceeds from term debt, net of discount	3,407,535	2,215,950	3,048,424
Payments of term debt	(1,390,994)	(800,000)
Revolving credit facilities, net	559,985	162,633	(65,736)
Dividends / Distribution paid	(643,473)	(567,969)	(411,697)
Lease deposits and other obligations to tenants	17,815	21,706	(12,260)
Proceeds from sale of units, net of offering costs	1,051,229	411,101	2,533,210
Payment of debt refinancing, deferred financing costs and other financing activities	(54,489)	(42,347)	(50,057)
Net cash provided by financing activities	2,947,608	1,401,074	5,041,884
(Decrease) increase in cash, cash equivalents, and restricted cash for the year	(99,149)	(928,063)	652,044
Effect of exchange rate changes	4,662	16,441	(6,478)
Cash, cash equivalents, and restricted cash at beginning of year	556,369	1,467,991	822,425
Cash, cash equivalents, and restricted cash at end of year	461,882	556,369	1,467,991
Interest paid, including capitalized interest of $3,289 in 2021, $3,030 in 2020, and $3,936 in 2019	326,406	309,920	211,163
Supplemental schedule of non-cash financing activities:
Dividends declared, unpaid	176,494	147,666	138,161
Cash, cash equivalents, and restricted cash are comprised of the following:
Cash and cash equivalents at beginning of period	549,884	1,462,286	820,868
Restricted cash, included in Other assets at beginning of period	$ 6,485	$ 5,705	$ 1,557
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at beginning of year	$ 556,369	$ 1,467,991	$ 822,425
Cash and cash equivalents at end of period	459,227	549,884	1,462,286
Restricted cash, included in Other assets at end of period	$ 2,655	$ 6,485	$ 5,705
Restricted Cash and Cash Equivalents, Asset, Statement of Financial Position [Extensible List]	Other Assets	Other Assets	Other Assets
Cash, cash equivalents, and restricted cash at end of year	$ 461,882	$ 556,369	$ 1,467,991

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Interest paid, capitalized	$ 3,289	$ 3,030	$ 3,936
MPT Operating Partnership, L.P. [Member]
Interest paid, capitalized	$ 3,289	$ 3,030	$ 3,936

Organization

Organization	12 Months Ended
	Dec. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [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 healthcare real estate. Our operating partnership subsidiary, MPT Operating Partnership, L.P. (the “Operating Partnership”), through which we conduct all of our operations, was formed in September 2003. At present, we own all of the partnership interests in the Operating Partnership and have elected to report our required disclosures and that of the Operating Partnership on a combined basis, except where material differences exist. We operate as a real estate investment trust (“REIT”). Accordingly, we 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, of a significant nature, in the U.S. from foreign-based income as the majority of such income flows through our REIT. Our primary business strategy is to acquire and develop real estate and improvements, primarily for long-term lease to providers of healthcare services, such as operators of general acute care hospitals, behavioral health facilities, inpatient physical rehabilitation hospitals, long-term acute care hospitals, and freestanding ER/urgent care facilities. We also make mortgage and other loans to operators of similar facilities. In addition, we may obtain profits or equity interests in our tenants, from time-to-time, in order to enhance our overall return. Our business model facilitates acquisitions and recapitalizations, and allows operators of healthcare facilities to unlock the value of their real estate to fund facility improvements, technology upgrades, and other investments in operations. At December 31, 2021, we have investments in 438 facilities in 32 states in the U.S., in six countries in Europe, one country in South America, and across Australia. We manage our business as a single business segment.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements are reasonable and supportable based on the information available as of December 31, 2021 (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Although the effects of COVID-19 and related variants seem to be lessening, government restrictions appear to be easing, and most hospitals around the world have generally returned to their normal operations, the ultimate impact to our tenants’ results of operations and liquidity and their ability to pay our rent and interest due to the impact of COVID-19 still cannot be predicted with 100% confidence. This makes any estimates and assumptions as of December 31, 2021, inherently less certain than they would be absent the potential impact of COVID-19. 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, 2021, we had loans and/or equity investments in certain variable interest entities approximating $570 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have 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”). 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 other-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investment in Steward Health Care System LLC (“Steward”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income. Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets. Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards 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). For lessors, we apply this standard as follows: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the 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 rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under ASU 2016-02, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method. Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received 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: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months, but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time. Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, 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, 2021 are as follows: Buildings and improvements 35.8 years Lease intangibles 24.9 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.6 years Credit Losses: Losses from Rent Receivables: Losses from Operating Lease Receivables: Losses on Financing Lease Receivables: receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adju st the credit loss reserve based on the fair value of the underlying collateral. With the adoption of ASU 2016-13, we made the accounting policy election to exclude interest receivables from the credit loss reserve analysis. Such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash. Loans The following table summarizes our credit loss reserves (in thousands): December 31, 2021 December 31, 2020 Balance at beginning of the year $ 8,726 $ — Cumulative effect of change in accounting principle — 8,399 Provision for credit loss 41,710 3,255 Expected credit losses related to financial instruments sold or repaid (1,909 ) (2,928 ) Balance at end of year $ 48,527 $ 8,726 Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income by the weighted-average number of shares/units outstanding during the period. Diluted earnings per common share/unit is calculated by including the effect of dilutive securities. Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit. Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of TRS entities, including MPT Development Services, Inc. (“MDS”) and many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities. With the property acquisitions and investments in Europe, Australia, and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes, of a significant nature, in the U.S. as the majority such income from our international properties flows through our REIT income tax returns. For our TRS entities and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets /liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available. Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. 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 assets” on our consolidated balance sheets. Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity/partnership capital on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets. Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose 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 valuation models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity investment in the international joint venture and equity interest in Springstone, LLC (“Springstone”), along with any related investments such as loans (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 investments that existed at December 31, 2021. 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

Real Estate and Other Activitie

Real Estate and Other Activities	12 Months Ended
	Dec. 31, 2021
Real Estate [Abstract]
Real Estate and Other Activities	3. Real Estate and Other Activities New Investments For the years ended December 31, 2021, 2020, and 2019, we acquired or invested in the following net assets (in thousands): 2021 2020 2019 Land and land improvements $ 642,312 $ 365,281 $ 400,539 Buildings 2,381,654 2,547,313 1,951,066 Intangible lease assets — subject to amortization (weighted-average useful life of 34.5 years in 2021, 27.5 years in 2020, and 19.1 years in 2019) 262,385 642,699 227,468 Investment in financing leases — 114,797 1,386,797 Equity investments 123,427 233,593 415,836 Mortgage loans 1,113,300 176,840 51,267 Other loans and assets 909,669 309,523 135,258 Liabilities assumed (82,508 ) (140,866 ) (2,637 ) $ 5,350,239 $ 4,249,180 $ 4,565,594 Loans repaid(1) (1,103,410 ) (834,743 ) — Total net assets acquired $ 4,246,829 $ 3,414,437 $ 4,565,594 (1) The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership in a portfolio of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as described below. 2021 Activity Priory Group Transaction On January 19, 2021, we completed the first of two phases in the Priory transaction in which we funded an £800 million interim mortgage loan on an identified portfolio of Priory real estate assets in the United Kingdom. On June 25, 2021, we completed the second phase of the transaction in which we converted this mortgage loan to fee simple ownership in a portfolio of 35 select real estate assets from Priory (which is currently owned by Waterland Private Equity Fund VII C.V. (“Waterland VII”)) in individual sale-and-leaseback transactions. The applicable purchase price for the assets was paid by us by proportionally converting and reducing the principal balance of the interim mortgage loan we made to Waterland VII in phase one. Therefore, the net aggregate purchase price for the real estate assets we acquired from Priory was approximately £800 million, plus customary stamp duty, tax, and other transaction costs. As part of the real estate acquisition (for which some of the assets were acquired by the share purchase of real estate holding entities), we incurred deferred income tax liabilities and other liabilities of approximately £47.1 million. In addition to the real estate investment, on January 19, 2021, we made a £250 million acquisition loan to Waterland VII, in connection with the closing of Waterland VII’s acquisition of Priory, which was repaid in full plus interest on October 22, 2021. Finally, we acquired a 9.9% passive equity interest in the Waterland VII affiliate that indirectly owns Priory. Other Transactions On December 2, 2021, we acquired the remaining 50% interest in a general acute hospital operated by IMED Hospitales in Valencia, Spain, which was formerly owned by our joint venture partner. We followed the asset acquisition cost accumulation model to account for this acquisition and included the carrying amount of our previously held equity interest, along with the approximately €46 million consideration paid and direct transaction costs incurred, in determining the total cost allocated to the net assets acquired. On October 21, 2021, we acquired an acute care facility in Portugal for €17.8 million. This facility is leased to Atrys Health pursuant to a long-term master lease with annual escalations. On October 19, 2021, we invested in 18 inpatient behavioral health facilities throughout the U.S. and an interest in the operations of Springstone for total consideration of $950 million (including an acquisition loan of approximately $185 million), plus closing and other transaction costs. We also incurred deferred income tax liabilities of approximately $8.0 million. These facilities are leased to Springstone pursuant to a long-term master lease with annual escalations and multiple extension options. On August 1, 2021, we completed the acquisition of five general acute care hospitals located in South Florida for approximately $900 million, plus closing and other transaction costs. These hospitals are leased to Steward pursuant to the master lease, with annual inflation-based escalators, that had its initial fixed term recently extended by 10 years to 2041. On July 6, 2021, we acquired four acute care hospitals and two on-campus medical office buildings in Los Angeles, California for $215 million. These hospitals are leased to Pipeline Health Systems pursuant to a long-term lease with annual inflation-based escalators. On July 6, 2021, we also acquired an acute care hospital in Stirling, Scotland for £15.6 million. This hospital is leased to Circle Health Ltd. (“Circle”) pursuant to a long-term lease with annual inflation-based escalators. On April 16, 2021, we made a CHF 145 million investment in Swiss Medical Network, our tenant via our Infracore SA (“Infracore”) equity investment. On January 8, 2021, we made a $335 million loan to affiliates of Steward, all of the proceeds of which were used to redeem a similarly sized convertible loan from Steward’s former private equity sponsor. 2020 Activity Circle Transaction On January 8, 2020, we acquired a portfolio of 30 acute care hospitals located throughout the United Kingdom for approximately £1.5 billion from affiliates of BMI Healthcare, Inc. (“BMI”). In a related transaction, affiliates of Circle acquired BMI and assumed its operations in the United Kingdom. As part of our acquisition, we inherited 30 existing leases with the operator that had initial fixed terms ending in 2050, with no renewal options but with annual inflation-based escalators. Effective June 16, 2020, these 30 leases were amended to include two five-year Other Transactions On December 31, 2020, we acquired an inpatient rehabilitation hospital in South Carolina for approximately $17 million. As part of the transaction, we acquired the fee simple real estate of three inpatient rehabilitation hospitals and one long-term acute care hospital in exchange for the reduction of the mortgage loans made to Ernest for such properties in 2012. The approximate $115 million investment in all five of these facilities is leased to Ernest pursuant to an existing long-term master lease with multiple extension options and annual escalation provisions. On December 29, 2020, we increased our equity ownership and related investment in Infracore by investing an additional CHF 206.5 million. We are accounting for our total investment in this joint venture (this investment along with our initial investment in 2019 as noted below) under the equity method. On August 13, 2020, we acquired a general acute care hospital in Lynwood, California for a total investment of approximately $300 million. This property is leased to Prime Healthcare Services, Inc. (“Prime”) pursuant to a long-term master lease with annual escalations and multiple extension options. On July 8, 2020, we acquired the fee simple real estate of two general acute care hospitals located in the Salt Lake City, Utah area, Davis Hospital & Medical Center and Jordan Valley Medical Center, in exchange for the reduction of the mortgage loans made to Steward for such properties and additional cash consideration of $200 million based on their relative fair value. The approximate $950 million investment in these two facilities is subject to the Steward master lease. On June 24, 2020, we originated a CHF 45 million secured loan to Infracore, which was paid in full on December 2, 2020. On May 13, 2020, we formed a joint venture for the purpose of investing in the operations of international hospitals. As part of the formation, we originated a $205 million acquisition loan. We have a 49% interest in this joint venture and are accounting for our investment using the fair value option election. The joint venture simultaneously purchased from Steward the rights and existing assets related to all present and future international opportunities previously owned by Steward for strategic, regulatory, and risk management purposes. Through this joint venture, we invested, on November 17, 2020, in the real estate of three general acute care hospitals in Colombia for approximately $135 million. These properties are operated by the international joint venture. Other acquisitions in 2020 included three inpatient rehabilitation hospitals, two general acute care hospitals, and one private acute care hospital totaling approximately $300 million. One inpatient rehabilitation facility, located in Dahlen, Germany, was acquired on August 5, 2020 for €12.5 million and is leased to MEDIAN Kliniken S.á.r.l. (“MEDIAN”) pursuant to the existing master lease. One of the general acute care facilities, located in Darlington, United Kingdom, was acquired on August 7, 2020 for £29.4 million and is leased to Circle pursuant to a long-term lease. The other general acute care hospital, located in London, United Kingdom, was acquired on November 25, 2020 for £50 million via the purchase of a 999-year ground lease and is leased to The Royal Marsden NHS Foundation Trust pursuant to a long-term lease. The inpatient rehabilitation hospitals, one in Texas and one in Indiana, were acquired on December 17, 2020 for approximately $58 million and are leased to Curahealth Hospitals (now Post Acute Medical, LLC) pursuant to a long-term lease. The private acute care hospital, located in Reading, United Kingdom, was acquired on December 18, 2020 for £85.0 million and is leased to Circle pursuant to the existing long-term Circle master lease. 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 million. The properties were leased to LifePoint under one master lease agreement. The master lease had 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 included 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 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. The master leases and mortgage loan have substantially similar terms, with an initial 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 that 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 A$1.2 billion plus stamp duties and registration fees of A$66.6 million. The properties are leased to Healthscope, pursuant to master lease agreements that had an average initial term of 20 years, upon our acquisition, with annual fixed escalations and multiple extension options. 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 (which we account for under the equity method) was effected through our purchase of a stake in a Swiss healthcare real estate company, Infracore, 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 that had an average 23-year remaining term upon our acquisition and are subject to annual escalation provisions. Additionally, we purchased a 4.9% stake in Aevis for approximately CHF 47 million on June 28, 2019 that we mark to fair value through income. 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 that had an initial lease term of 25 years upon our investment. 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 had an average remaining lease term of 14 years upon our acquisition. The leases provide for fixed escalations every five years, include two five-year Other acquisitions during 2019 included three acute care hospitals and one inpatient rehabilitation second third Development Activities 2021 Activity In the fourth quarter of 2021, we agreed to finance the development of and lease an acute care facility in Texarkana, Texas for $169.4 million. This facility will be leased to Steward and is expected to commence rent in the second quarter of 2024. 2020 Activity On November 23, 2020, we agreed to finance the development of and lease an inpatient rehabilitation facility in Stockton, California for $47.7 million. This facility will be leased to Ernest and is expected to commence rent in the second quarter of 2022. On May 15, 2020, we agreed to finance the development of and lease an inpatient rehabilitation facility in Bakersfield, California for $47.9 million. This facility will be leased to Ernest and is expected to commence rent in the first quarter of 2022. During the 2020 second quarter, we completed construction on one general acute care facility and one inpatient rehabilitation facility, both located in Birmingham, England. We began recognizing revenue on these two properties on June 29, 2020. These facilities are being leased to Circle pursuant to a long-term lease. During the 2020 first quarter, we completed construction and began recording rental income on a general acute care facility located in Idaho Falls, Idaho. This facility commenced rent on January 21, 2020 and is leased to Surgery Partners, Inc. pursuant to an existing long-term lease. 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 commenced rent on December 18, 2020 and is leased to NeuroPsychiatric Hospitals pursuant to a long-term lease. See table below for a status summary of our current development projects (in thousands): Property Commitment Costs Incurred as of December 31, 2021 Estimated Rent Commencement Date Ernest (Bakersfield, California) $ 47,929 $ 42,132 1Q 2022 Ernest (Stockton, California) 47,700 31,197 2Q 2022 Steward (Texarkana, Texas) 169,408 28,110 2Q 2024 $ 265,037 $ 101,439 Disposals 2021 Activity Joint Venture Transaction On August 28, 2021, we entered into a definitive agreement with Macquarie Asset Management (“MAM”) to form a partnership (the “Macquarie Transaction”), pursuant to which a fund managed by MAM will acquire, for cash consideration, a 50% interest in a portfolio of eight Massachusetts-based general acute care hospitals that we currently own and lease to Steward. The transaction values the portfolio at approximately $1.7 billion. We expect to recognize a gain, net of transaction costs, of approximately $0.5 billion from this transaction, which we expect to close in the 2022 first quarter. The partnership plans to raise nonrecourse secured debt of up to 55% of asset value, and we expect to receive total proceeds, including proceeds from the expected secured debt, of approximately $1.3 billion. There is no certainty as to the amount or terms of expected secured debt financing, and the ultimate amount and terms may affect the completion of the transaction, the transaction value, proceeds, and gain on real estate. At December 31, 2021, the eight facilities subject to the joint venture were designated as held for sale and made up of the following net assets (in thousands): As of December 31, 2021 Real estate held for sale $ 1,096,505 Straight-line rent receivables 120,268 Other assets, net 4,234 Total $ 1,221,007 Other Disposal Transactions During the 2021 fourth quarter, we sold our interest in the operations of three operators (two of which were in Germany) for proceeds of approximately $54.5 million, resulting in a net gain of approximately $40 million. During 2021, we also completed the sale of 16 facilities and an ancillary property for approximately $246 million, resulting in a net gain on real estate of approximately $52.5 million. 2020 Activity During 2020, we completed the sale of nine facilities and six ancillary properties for approximately $94 million, resulting in a net loss of $2.8 million. 2019 Activity During 2019, we completed the sale of five facilities resulting in a gain on real estate of $41.6 million. Intangible Assets At December 31, 2021 and 2020, our intangible lease assets were $1.4 billion ($1.3 billion, net of accumulated amortization) and $1.3 billion ($1.2 billion, net of accumulated amortization), respectively. We recorded amortization expense related to intangible lease assets of $56.0 million, $42.4 million, and $21.5 million in 2021, 2020, and 2019, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2022 $ 57,433 2023 57,368 2024 57,334 2025 57,186 2026 56,917 As of December 31, 2021, capitalized lease intangibles have a weighted-average remaining life of 22.9 years. Leasing Operations (Lessor) We acquire and develop healthcare facilities and lease the facilities to healthcare operating companies under long-term net leases (typical initial fixed terms of at least 15 years) and most include renewal options at the election of our tenants, generally in five year increments. Over 99% of our leases provide annual rent escalations based on increases in the CPI (or similar index outside the U.S.) and/or fixed minimum annual rent escalations. Many of our domestic leases contain purchase options with pricing set at various terms but in no case less than our total investment. For five properties with a carrying value of $231 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 as noted below, 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, 2021 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2022 $ 1,078,148 $ 168,190 $ 1,246,338 2023 1,099,027 171,553 1,270,580 2024 1,117,353 174,984 1,292,337 2025 1,135,695 178,484 1,314,179 2026 1,154,286 182,054 1,336,340 Thereafter 29,555,221 4,513,925 34,069,146 $ 35,139,730 $ 5,389,190 $ 40,528,920 At December 31, 2021, leases on 13 Ernest facilities and five Prime facilities are accounted for as DFLs and leases on 13 of our Prospect facilities and five of our Ernest 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, 2021 As of December 31, 2020 Minimum lease payments receivable $ 1,183,855 $ 1,228,966 Estimated residual values 203,818 203,818 Less: Unearned income and allowance for credit loss (918,584 ) (969,061 ) Net investment in direct financing leases 469,089 463,723 Other financing leases (net of allowance for credit loss) 1,584,238 1,547,199 Total investment in financing leases $ 2,053,327 $ 2,010,922 COVID-19 Rent Deferrals Due to the COVID-19 pandemic and its impact on our tenants’ business during 2020, we agreed to defer collection of less than 2% of our annual rent. In 2021, we collected approximately $2.8 million of previously deferred rent. Pursuant to our agreements with certain tenants, we expect the remaining outstanding deferred rent balance of approximately $8.6 million as of December 31, 2021, to be paid over specified periods in the future, with interest. Adeptus Health As discussed in previous filings, our original real estate portfolio of approximately 60 properties leased to Adeptus Health, Inc. (“Adeptus”) has gone through significant changes starting with Adeptus filing for Chapter 11 bankruptcy in 2017. With this filing and other subsequent events (including COVID-19 implications in 2020), we transitioned all of our facilities away from Adeptus, which resulted in impairment charges including approximately $20 million (of which one-half related to straight-line rent write-offs) and $2 million in 2020 and 2019, respectively. However, these transition measures have also provided for new tenant relationships being formed with strong credit worthy operators such as Ochsner Health System, Dignity Health, UC Health (University of Colorado), and HCA Healthcare, Inc. (“HCA”), that are now leasing over 40 of these transitional facilities under long-term leases. In addition, we have been able to dispose of 12 properties generating cash proceeds for re-investment purposes, including the sale of our Carrollton, Texas property in February 2022 for approximately $43 million, which exceeded our net book value. At December 31, 2021, only three of these transitional properties, representing less than 0.5% of our total assets, remain vacant, and each of these properties are in various stages of being re-leased or sold. At December 31, 2021, we believe our investment in these real estate assets are fully recoverable, but no assurances can be given that we will not have any further impairments in future periods. Alecto Facilities As noted in previous filings, we originally leased four acute care facilities to and had a mortgage loan on a fifth property (Olympia Medical Center) with Alecto Healthcare Services LLC (“Alecto”), along with working capital loans. During 2019, we incurred approximately $20 million in real estate impairment charges. During the first quarter of 2020, we donated the Wheeling facility to a local municipality, resulting in a $9.1 million real estate impairment charge. In addition, we re-leased one acute care facility and sold another facility in 2020. In the first quarter of 2021, Alecto completed the sale of Olympia Medical Center to the UCLA Health System. Our proceeds of approximately $51 million from this sale were used to pay off the mortgage and working capital loans in full, with the remaining proceeds used to recover certain previously reserved past due receivables. At December 31, 2021, we continue to lease one acute care facility to Alecto, representing less than 0.1% of our total assets. Halsen Healthcare On September 30, 2019, we acquired the real estate of Watsonville Community Hospital in Watsonville, California for $40 million, which was then leased to Halsen Healthcare. In addition, we made a working capital loan to Halsen Healthcare. The hospital operator faced significant financial challenges over a two-year period that were worsened by revenue losses during the COVID-19 pandemic. During this time, we increased the working capital loan balance in an effort to support the operator of this facility. On December 5, 2021, Halsen Healthcare filed Chapter 11 bankruptcy in order to reorganize, while keeping the hospital open. As such, we recorded a credit loss reserve (approximately $40 million) in the fourth quarter of 2021 and wrote off approximately $2.5 million of billed and straight-line rent receivables. At December 31, 2021, we believe our total investment in the Watsonville property, representing less than 0.5% of total assets, is fully recoverable, but no assurances can be given that we will not have any further write-offs or impairments in future periods. Other Leasing Activity 2021 Activity On December 23, 2021, LifePoint announced the completion of the transaction with Kindred Healthcare (“Kindred”), in which LifePoint acquired Kindred, and announced the related launch of ScionHealth, a new healthcare company made up of a combination of former Kindred and LifePoint hospitals. With this transaction, we have eight properties leased to ScionHealth and nine properties leased to LifePoint. 2020 Activity On July 24, 2020, we re-leased our five San Antonio, Texas free standing emergency facilities (with a total investment of approximately $30 million) to Methodist Healthcare System of San Antonio, a joint venture between HCA and Methodist Healthcare Ministries of South Texas, pursuant to a long-term master lease. As a result, we recorded an approximate $1.5 million write-off of straight-line rent in the 2020 third quarter. Loans The following is a summary of our loans (net of allowance for credit loss) ($ amounts in thousands): As of December 31, 2021 As of December 31, 2020 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 213,211 8.7 % $ 248,080 8.5 % Acquisition loans 523,829 7.7 % 338,273 7.6 % Other loans 804,824 6.2 % 520,095 5.8 % $ 1,541,864 $ 1,106,448 Our mortgage loans at December 31, 2021 cover five of our properties with three operators. The increase in acquisition loans primarily relates to the $185 million loan to Springstone in the fourth quarter of 2021. Other loans consist of loans to our tenants for working capital and other purposes and include our shareholder loan made in 2018 to the joint venture with Primotop in the amount of €297 million. The increase in other loans is primarily related to the $335 million loan to affiliates of Steward (as more fully described above), partially offset by the repayment of $75 million in other loans from Prime. Other Investment Activities On October 13, 2021, we funded an additional €27 million to Priory in order to maintain our 9.9% equity interest. Pursuant to our existing 9.9% equity interest in Steward, we received an $11 million cash distribution during the first quarter of 2021, which was accounted for as a return of capital. Pursuant to our 4.9% stake in Aevis, we recorded an $8.2 million favorable non-cash fair value adjustment to mark our investment in Aevis stock to market during 2021; whereas, this was a $5.8 million unfavorable non-cash fair value adjustment for 2020. 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, 2021, our largest single property represented approximately 2.7% of our total assets, slightly down from the 3.2% at December 31, 2020. 2) Operator concentration – For the year ended December 31, 2021, revenue from Steward, Circle, and Prospect individually represented more than 10% of our total revenues. In comparison, Steward, Circle, Prospect, and Prime individually represented more than 10% of our total revenues for the year ended December 31, 2020. 3) Geographic concentration – At December 31, 2021, investments in the U.S, Europe, Australia, and South America represented approximately 64%, 30%, 5%, and 1%, respectively, of our total assets compared to 65%, 28%, 6%, and 1%, respectively, of our total assets at December 31, 2020. 4) Facility type concentration – For the year ended December 31, 2021, approximately 81% of our revenues were generated from our general acute care facilities, while revenues from our behavioral and rehabilitation facilities made up 8% and 7%, respectively. Freestanding ER/urgent care facilities and long-term acute care facilities combined to make up the remaining 4%. In comparison, general acute care, rehabilitation, and long-term acute care facilities made up 87%, 8%, and 3%, respectively, of our total revenues for the year ended December 31, 2020, while freestanding ER/urgent care facilities and behavioral health facilities combined to make up the remaining 2%. Related Party Transactions Lease and interest revenue earned from tenants and real estate joint ventures in which we had an equity interest (accounted for under either the equity or fair value option methods) during the year were $63.9 million, $29.8 million, and $85.3 million for 2021, 2020, and 2019, respectively. See subsections “New Investments” and “Disposals” in this Note 3 as it relates to our investments in Springstone and the new international, Primotop, and Infracore ventures for other related party transactions during 2021, 2020, and 2019.

Debt

Debt	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Debt	4. Debt The following is a summary of debt (dollar amounts in thousands): As of December 31, 2021 As of December 31, 2020 Revolving credit facility(A) $ 730,000 $ 165,407 Interim credit facilities 869,606 — Term loan 200,000 200,000 British pound sterling term loan(B) 947,240 956,900 Australian term loan facility(B) 871,560 923,280 4.000% Senior Unsecured Notes due 2022(B) — 610,800 2.550% Senior Unsecured Notes due 2023(B) 541,280 546,800 3.325% Senior Unsecured Notes due 2025(B) 568,500 610,800 0.993% Senior Unsecured Notes due 2026(B) 568,500 — 2.500% Senior Unsecured Notes due 2026(B) 676,600 — 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) 811,920 820,200 4.625% Senior Unsecured Notes due 2029 900,000 900,000 3.375% Senior Unsecured Notes due 2030(B) 473,620 — 3.500% Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 11,358,826 $ 8,934,187 Debt issue costs and discount, net (76,056 ) (68,729 ) $ 11,282,770 $ 8,865,458 (A) The 2020 column includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period-end. As of December 31, 2021, 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): 2022 $ 869,606 2023 541,280 2024 1,601,560 2025 1,515,740 2026 1,945,100 Thereafter 4,885,540 Total $ 11,358,826 Credit Facility Our current unsecured credit facility (“Credit Facility”) includes a $1.3 billion unsecured revolving loan facility and a $200 million unsecured term loan facility. On January 15, 2021, we amended our Credit Facility. The amendment extended the maturity of our unsecured revolving loan facility to February 1, 2024 and can be extended for an additional 12 months at our option. The maturity date of our term loan facility was extended to February 1, 2026. In addition to extending the maturity date, the amendment improved interest rate pricing for both facilities. Under the amended Credit Facility and at our election, loans may be made as either ABR Loans or Eurocurrency Loans. The applicable margin for term loans that are ABR Loans is adjustable on a sliding scale from 0.00% to 0.85% based on our current credit rating. The applicable margin for term loans that are Eurocurrency Loans is adjustable on a sliding scale from 0.85% to 1.85% 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 0.55% based on our current credit rating. The applicable margin for revolving loans that are Eurocurrency Loans is adjustable on a sliding scale from 0.825% to 1.55% based on our current credit rating. The amended Credit Facility retained the facility fee that 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, 2021, we had $730.0 million outstanding on the revolving credit facility, whereas, we had $165.4 million outstanding on our revolving credit facility at December 31, 2020. At December 31, 2021 and 2020, our availability under our revolving credit facility was $0.6 billion and $1.1 billion, respectively. The weighted-average interest rate on the revolving facility was 1.3% and 1.4% during 2021 and 2020, respectively. At December 31, 2021 and 2020, the interest rate in effect on our term loan was 1.56% and 1.65%, respectively. Interim Credit Facilities January 2021 Interim Credit Facility On January 15, 2021, we entered into a $900 million interim credit facility (“January 2021 Interim Credit Facility”), of which we borrowed £500 million to partially fund the Priory Group Transaction. We paid off and terminated this facility on March 26, 2021 with the issuance of the 2.500% Senior Unsecured Notes due 2026 and the 3.375% Senior Unsecured Notes due 2030. July 2021 Interim Credit Facility On July 27, 2021, we entered into a $1 billion interim credit facility with Barclays Bank PLC as administrative agent (“July 2021 Interim Credit Facility”), and several lenders from time-to-time are parties thereto. This facility matures on July 28, 2022 and bears interest at a variable rate. We used this facility to partially fund the acquisition of five South Florida facilities in August 2021 and the Springstone investments in October 2021. At December 31, 2021, the outstanding balance under this facility was $869.6 million at a rate of 1.610%. Non-U.S. Term Loans British Pound Sterling Term Loan On January 6, 2020, we entered into a £700 million unsecured sterling-denominated term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan matures on January 15, 2025. The applicable margin under the term loan is adjustable based on a pricing grid from 0.85% to 1.65% dependent on our current credit rating. On March 4, 2020, we entered into an interest rate swap transaction (effective March 6, 2020) to fix the interest rate to approximately 0.70% for the duration of the loan. The current applicable margin for the pricing grid (which can vary based on our credit rating) is 1.25% for an all-in fixed rate of 1.95%. Australian Term Loan On May 23, 2019, we entered into an A$1.2 billion term loan with Bank of America, N.A., as administrative agent, and several lenders from time-to-time are parties thereto. The term loan 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 as long as the reference rate stays above 0.00%. The current applicable margin for the pricing grid (which can vary based on our credit rating) is 1.25% for an all-in fixed rate of 2.45%. At December 31, 2021, we had a derivative asset of approximately $12.4 million related to the sterling-denominated term loan interest rate swap and a derivative liability of approximately $4.2 million related to the Australian dollar term loan interest rate swap, included in “Other assets” and "Accounts payable and accrued expenses" , respectively, on our consolidated balance sheets . At December 31, 2020, we had a derivative liability of approximately $ 51.3 million associated with these interest rate swaps , included in “Accounts payable and accrued expenses” on our consolidated balance sheets . Senior Unsecured Notes The following are the basic terms of our senior unsecured notes at December 31, 2021 (par value amounts in thousands): Offering Completion Date Maturity Date Par Value % of Par Value Interest Payment Frequency 2.550% Senior Unsecured Notes due 2023 December 5, 2019 December 5, 2023 £ 400,000 100.000 % Annually 3.325% Senior Unsecured Notes due 2025 March 24, 2017 March 24, 2025 € 500,000 100.000 % Annually 0.993% Senior Unsecured Notes due 2026 October 6, 2021 October 15, 2026 € 500,000 100.000 % Annually 2.500% Senior Unsecured Notes due 2026 March 24, 2021 March 24, 2026 £ 500,000 99.937 % Annually 5.250% Senior Unsecured Notes due 2026 July 22, 2016 August 1, 2026 $ 500,000 100.000 % Semi-annually 5.000% Senior Unsecured Notes due 2027 September 7, 2017 October 15, 2027 $ 1,400,000 100.000 % Semi-annually 3.692% Senior Unsecured Notes due 2028 December 5, 2019 June 5, 2028 £ 600,000 99.998 % Annually 4.625% Senior Unsecured Notes due 2029 July 26, 2019 August 1, 2029 $ 900,000 99.500 % Semi-annually 3.375% Senior Unsecured Notes due 2030 March 24, 2021 April 24, 2030 £ 350,000 99.448 % Annually 3.500% Senior Unsecured Notes due 2031 December 4, 2020 March 15, 2031 $ 1,300,000 100.000 % Semi-annually Typically, we may redeem some or all of the notes at any time, but may require a redemption premium that will decrease over time. In the event of a change of control, each holder of the notes may require us to repurchase some or all of our notes at a repurchase price equal to 101% of the aggregate principal amount of the notes plus accrued and unpaid interest to the date of purchase. Debt Refinancing and Unutilized Financing Costs 2021 With the amendment of our Credit Facility, the termination of our January 2021 Interim Credit Facility, and duration fees incurred on our July 2021 Interim Credit Facility, we incurred approximately $7.3 million of debt refinancing costs in 2021. With proceeds from our 0.993% Senior Unsecured Notes due 2026 offering, on October 22, 2021, we redeemed all of our outstanding €500 million aggregate principal amount of 4.000% senior unsecured notes that were due in 2022, including accrued and unpaid interest. As a result of this redemption, we incurred a charge of approximately $20 million (including redemption premiums and accelerated amortization of deferred debt issuance costs). 2020 With proceeds from our 3.500% Senior Unsecured Notes due 2031 offering in 2020, we redeemed all of our outstanding $500.0 million aggregate principal amount of 6.375% senior unsecured notes that were due in 2024 and $300.0 million aggregate principal amount of 5.500% senior unsecured notes that were due in 2024, including accrued and unpaid interest. As a result of these redemptions, we incurred a charge of approximately $28 million (including redemption premiums and accelerated amortization of deferred debt issuance costs). 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 approximately $4 million of underwriting and other fees. However, this commitment was cancelled with the completion of the debt and equity offerings in July 2019 (as more fully described in the table above and in Note 9 ), 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 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. 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. At December 31, 2021, 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, 2021, we were in compliance with all such financial and operating covenants.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2021
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 entities is subject to applicable U.S. federal, state, and local income taxes. Our international subsidiaries are also subject to income taxes in the jurisdictions in which they operate. From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands): For the Years Ended December 31, 2021 2020 2019 Current income tax (expense) benefit: Domestic $ (1,559 ) $ 63 $ 61 Foreign (18,964 ) (10,203 ) (1,669 ) (20,523 ) (10,140 ) (1,608 ) Deferred income tax (expense) benefit: Domestic 6,915 (10,680 ) 5,490 Foreign (60,340 ) (10,236 ) (1,261 ) (53,425 ) (20,916 ) 4,229 Income tax (expense) benefit $ (73,948 ) $ (31,056 ) $ 2,621 A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on income before income taxes for the years ended December 31, 2021, 2020, and 2019 is as follows (in thousands): For the Years Ended December 31, 2021 2020 2019 Income before income tax $ 730,888 $ 463,328 $ 373,780 Income tax at the U.S. statutory federal rate (21% in 2021, 2020, and 2019) (153,486 ) (97,299 ) (78,494 ) Decrease (increase) in income tax resulting from: Foreign rate differential 2,742 2,160 438 State income taxes, net of federal benefit — 970 1,621 U.S. earnings not subject to federal income tax 132,266 82,921 85,495 Equity investments — 380 1,091 Change in valuation allowance (10,040 ) (8,514 ) (7,911 ) Statutory tax rate change (43,924 ) (9,471 ) — Interest disallowance (646 ) — — Other items, net (860 ) (2,203 ) 381 Total income tax (expense) benefit $ (73,948 ) $ (31,056 ) $ 2,621 The foreign provision for income taxes is based on foreign profit before income taxes of $164.0 million, $62.1 million, and $10.7 million in 2021, 2020, and 2019, respectively. The domestic provision for income taxes is based on income (loss) before income taxes of $(29.7) million in 2021, $6.4 million in 2020, and $(44.1) million in 2019 from our TRS entities. At December 31, 2021 and 2020, components of our deferred tax assets and liabilities were as follows (in thousands): 2021 2020 Deferred tax assets: Operating loss and interest deduction carry forwards $ 197,876 $ 150,001 Interest rate swap — 9,150 Other 1,815 6,973 Total deferred tax assets 199,691 166,124 Valuation allowance (61,747 ) (36,977 ) Total net deferred tax assets $ 137,944 $ 129,147 Deferred tax liabilities: Property and equipment $ (320,546 ) $ (211,018 ) Net unbilled revenue (43,366 ) (14,776 ) Partnership investments (15,963 ) — Other (3,836 ) (4,010 ) Total deferred tax liabilities (383,711 ) (229,804 ) Net deferred tax asset (liability) $ (245,767 ) $ (100,657 ) During the 2021 second quarter, the United Kingdom enacted an increase in its corporate income tax rates from 19% to 25% effective April 1, 2023, which resulted in a one-time adjustment to our net deferred tax liabilities of approximately $43 million. Similarly, in the 2020 third quarter, we incurred an approximate $9 million charge for the change in the corporate income tax rate from 17% to 19% in the United Kingdom. At December 31, 2021, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 239,520 $ 699,514 Tax-effected NOL carryforwards $ 28,837 $ 169,039 Valuation allowance (6,291 ) (45,578 ) Net deferred tax asset - NOL carryforwards $ 22,546 $ 123,461 Expiration periods 2030-indefinite indefinite Valuation Allowance A valuation allowance has been recorded on certain foreign and domestic net operating loss carryforwards and other net deferred tax assets that may not be realized. As of each reporting date, we consider all new evidence that could impact the future realization of our deferred tax assets. In the evaluation of the need for a valuation allowance on our deferred income tax assets, we consider all available positive and negative evidence, including scheduled reversals of deferred income tax liabilities, carryback of future period losses to prior periods, projected future taxable income, tax planning strategies, and recent financial performance. During 2021, a valuation allowance of $24.8 million has been recorded against a portion of our international deferred tax assets to recognize only the components of the deferred tax assets that is more likely than not to be realized. The valuation allowance was primarily recorded against deferred tax assets for NOLs, non-depreciable basis of real property, and other tax attributes that we believe will not be realized. Valuation allowance activity recorded generally follows the activity of the associated deferred tax asset that is not expected to be recognized. From time-to-time, we may acquire deferred tax assets as part of real estate transactions and will assess the need for a valuation allowance as part of the opening balance sheet. Additionally, valuation allowances will be remeasured for foreign currency translation fluctuations through other comprehensive income. We have no material uncertain tax position liabilities and related interest or penalties. REIT Status We have met the annual REIT distribution requirements by payment of at least 90% of our taxable income in 2021, 2020, and 2019. 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, 2021 2020 2019 Common share distribution $ 1.110000 $ 1.070000 $ 1.010000 Ordinary income 0.764580 0.603050 0.701910 Capital gains(1) 0.165420 — 0.275040 Unrecaptured Sec. 1250 gain 0.058270 — 0.041160 Section 199A Dividends 0.764580 0.603050 0.701910 Return of capital 0.180000 0.466950 0.033050 (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 TRS entities on behalf of Medical Properties Trust, Inc., which are subject to U.S. federal, state, and local income taxes at regular corporate rates, and its international subsidiaries are subject to income taxes in the jurisdictions in which they operate. See discussion above under Medical Properties Trust, Inc. for more details of income taxes associated with our TRS entities and international operations.

Earnings Per Share_Unit

Earnings Per Share/Unit	12 Months Ended
	Dec. 31, 2021
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, 2021 2020 2019 Numerator: Net income $ 656,940 $ 432,272 $ 376,401 Non-controlling interests’ share in earnings (919 ) (822 ) (1,717 ) Participating securities’ share in earnings (2,161 ) (2,105 ) (2,308 ) Net income, less participating securities’ share in earnings $ 653,860 $ 429,345 $ 372,376 Denominator: Basic weighted-average common shares 588,817 529,239 427,075 Dilutive potential common shares 1,322 1,222 1,224 Diluted weighted-average common shares 590,139 530,461 428,299 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2021 2020 2019 Numerator: Net income $ 656,940 $ 432,272 $ 376,401 Non-controlling interests’ share in earnings (919 ) (822 ) (1,717 ) Participating securities’ share in earnings (2,161 ) (2,105 ) (2,308 ) Net income, less participating securities’ share in earnings $ 653,860 $ 429,345 $ 372,376 Denominator: Basic weighted-average units 588,817 529,239 427,075 Dilutive potential units 1,322 1,222 1,224 Diluted weighted-average units 590,139 530,461 428,299

Stock Awards

Stock Awards	12 Months Ended
	Dec. 31, 2021
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 replacing 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 12.9 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 and performance awards based on company-specific performance hurdles. See below for further details on each of these stock-based awards: Service-Based Awards In 2021, 2020, and 2019, 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 2021, 2020, and 2019, the Compensation Committee granted performance-based awards to employees. Generally, dividends are not paid on performance awards until the award is earned. See below for details of such performance-based award grants: In 2021, 2020, and 2019, a target number of stock awards were granted to employees that could be earned based on the achievement of specific performance thresholds as set by our Compensation Committee. The performance thresholds were based on a three-year Certain performance awards granted were subject to a modifier which increases or decreases the actual shares earned in each performance period. The modifier for the 2021 and 2020 awards was based on two components: 1) how our total shareholder return (“TSR”) compared to the SNL U.S. REIT Healthcare Index (“SNL Index”) and 2) how our TSR compared to a threshold set by the Compensation Committee. For 2019 awards, the modifier was based on how our TSR compared to the SNL Index. The following summarizes stock-based award activity in 2021 and 2020 (which includes awards granted in 2021, 2020, 2019, and any applicable prior years), respectively: For the Year Ended December 31, 2021: 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 1,057,054 $ 18.79 5,086,983 $ 14.41 Awarded 651,113 $ 20.83 1,957,802 $ 17.94 Vested (781,076 ) $ 18.77 (1,551,482 ) $ 13.73 Forfeited (4,137 ) $ 18.69 (15,767 ) $ 16.72 Nonvested awards at end of year 922,954 $ 20.26 5,477,536 $ 15.86 For the Year Ended December 31, 2020: 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 1,122,440 $ 17.11 5,481,155 $ 11.66 Awarded 635,855 $ 19.65 1,800,898 $ 19.42 Vested (699,215 ) $ 16.80 (2,193,906 ) $ 11.35 Forfeited (2,026 ) $ 18.40 (1,164 ) $ 18.22 Nonvested awards at end of year 1,057,054 $ 18.79 5,086,983 $ 14.41 The value of stock-based awards is charged to compensation expense over the service periods. For the years ended December 31, 2021, 2020, and 2019, we recorded $52.1 million, $47.2 million, and $32.2 million, respectively, of non-cash compensation expense. The remaining unrecognized cost from stock-based awards at December 31, 2021, is $49.9 million, which will be recognized over a weighted-average period of 1.1 years. Stock-based awards that vested in 2021, 2020, and 2019, had a value of $49.9 million, $58.9 million, and $25.9 million, respectively.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies Commitments On September 15, 2021, we entered into definitive agreements to lease five general acute care hospitals, representing 5.5% of our total assets at December 31, 2021, located in Utah to HCA following an agreement by HCA to purchase the operations of these five facilities from Steward. Upon completion of the transaction between HCA and Steward, we will enter into a new master lease with HCA for these five facilities (the “HCA Transaction”). The consummation of the HCA Transaction, which is subject to regulatory approval, is expected in the first half of 2022. Contingencies We are a party to various legal proceedings incidental to our business. In the opinion of management, after consultation with legal counsel, the ultimate liability, if any, with respect to those proceedings is not presently expected to materially affect our financial position, results of operations, or cash flows.

Common Stock_Partner's Capital

Common Stock/Partner's Capital	12 Months Ended
	Dec. 31, 2021
Equity [Abstract]
Common Stock/Partner's Capital	9. Common Stock/Partner’s Capital Medical Properties Trust, Inc. 2021 Activity On January 11, 2021, we completed an underwritten public offering of 36.8 million shares of our common stock, resulting in net proceeds of approximately $711 million, after deducting underwriting discounts and commissions and offering expenses. In addition, we sold 16.3 million shares of common stock under our at-the-market equity offering program during 2021, resulting in net proceeds of approximately $340 million. 2020 Activity In 2020, we sold 21.0 million shares of common stock under our at-the-market equity offering program, resulting in net proceeds of approximately $411 million. 2019 Activity On November 8, 2019, we completed an underwritten public offering of 57.5 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 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. MPT Operating Partnership, L.P. At December 31, 2021, the Operating Partnership is made up of a general partner, Medical Properties Trust, LLC (“General Partner”) and limited partners, including the Company (which owns 100% of the General Partner) and MPT TRS, Inc. (which is 100% owned by the General Partner). By virtue of its ownership of the General Partner, the Company has a 100% ownership interest in the Operating Partnership. In regards to distributions, the Operating Partnership shall distribute cash at such times and in such amounts as are determined by the General Partner in its sole and absolute discretion, to common unit holders who are common unit holders on the record date. However, per the Second Amended and Restated Agreement of Limited Partnership of MPT Operating Partnership, L.P. (“Operating Partnership Agreement”), the General Partner shall use its reasonable efforts to cause the Operating Partnership to distribute amounts sufficient to enable the Company to pay stockholder dividends that will allow the Company to (i) meet its distribution requirement for qualification as a REIT and (ii) avoid any U.S. federal income or excise tax liability imposed by the Code, other than to the extent the Company elects to retain and pay income tax on its net capital gain. In accordance with the Operating Partnership Agreement, LTIP units are treated as common units for distribution purposes. The Operating Partnership’s net income will generally be allocated first to the General Partner to the extent of any cumulative losses and then to the 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. On December 28, 2020, approximately 232 thousand LTIP units were converted to common units and then redeemed for approximately $ 4.9 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, 2021
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, 2021 December 31, 2020 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 56,229 $ 56,564 $ 46,208 $ 45,381 Loans(1) 991,609 991,954 751,341 756,608 Debt, net (11,282,770 ) (11,526,388 ) (8,865,458 ) (9,226,564 ) (1) Excludes the acquisition loan and mortgage loan made in October 2021 to Springstone and the acquisition loan made in May 2020 to our international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia (see Note 3 for further details), as these assets are accounted for under the fair value option method . Items Measured at Fair Value on a Recurring Basis Our equity investment and related loan to the international joint venture, our loan investment in the real estate of three hospitals operated by subsidiaries of the international joint venture in Colombia, and our equity investment and related loans in Springstone are measured at fair value on a recurring basis as we elected to account for these investments using the fair value option at the point of initial investment. We elected to account for these investments at fair value due to the size of the investments and because we believe this method was more reflective of current values. At December 31, 2021 and 2020, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2021 As of December 31, 2020 Asset (Liability) Fair Value Original Cost Fair Value Original Cost Asset Type Classification Mortgage loans $ 143,068 $ 143,068 $ 136,332 $ 136,332 Mortgage loans Equity investment and other loans 409,638 409,638 218,775 218,775 Equity investments/Other loans Our loans to Springstone and the international joint venture and its subsidiaries are recorded at fair value based on Level 2 inputs by discounting the estimated cash flows using the market rates at which similar loans would be made to borrowers with similar credit ratings and the same remaining maturities. Our equity investment in Springstone and the international joint venture is recorded at fair value based on Level 3 inputs, by using a discounted cash flow model, which requires significant estimates of our investee such as projected revenue and expenses and appropriate consideration of the underlying risk profile of the forecasted assumptions associated with the investee. We classify our valuations of equity investment s as Level 3, as we use certain unobservable inputs to the valuation methodology that are significant to the fair value measurement, and the valuation s require management judgment due to absence of quoted market prices. For th e cash flow model s , our observable inputs include use of a capitalization rate and discount rate (which is based on a weighted-average cost of capital) and our unobservable input includes an adjustment for a marketability discount (“DLOM”). I n regards to the underlying projections used in the discounted cash flow model, such projections are provided by the investee s . However, we will modify such projections as needed based on our review and analysis of historical results, meetings with key members of management, and our understanding of trends and developments within the healthcare industry. Given our international joint venture equity investment is in an entity that was a start-up company in 2020 and given our equity investment in Springstone was made late in 2021, we believe the fair value of these equity investments are in line with our cost basis. Thus, we have not recognized any unrealized gain/loss on such investments in 2020 or 2021. The DLOM on our Springstone and international joint venture equity investments was 40% at December 31, 2021. In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors, including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated Increase (Decrease) in Fair Value + 100 basis points $ (41 ) - 100 basis points 41 Items Measured at Fair Value on a Nonrecurring Basis In addition to items that are measured at fair value on a recurring basis, we have assets and liabilities that are measured, from time-to-time, at fair value on a nonrecurring basis, such as for long-lived asset impairment purposes (see Note 3 ). In these cases, fair value is based on estimated cash flows discounted at a risk-adjusted rate of interest by using Level 2 inputs as more fully described in Note 2 .

Leases (Lessee)

Leases (Lessee)	12 Months Ended
	Dec. 31, 2021
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 offices and equipment. Our leases have remaining lease terms that vary in years, and some of the leases have initial fixed terms (or renewal options available) that extend the leases up to, or just beyond, the depreciable life of the properties that occupy the leased land. Renewal options that we are reasonably certain to exercise are recognized in our right-of-use assets and lease liabilities. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at lease commencement date in determining the present value of future payments. The following is a summary of our lease expense (in thousands): Income Statement For the Years Ended December 31, Classification 2021 2020 Operating lease cost (1) (2) $ 10,694 $ 9,910 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 Interest on lease liabilities Interest 128 128 Sublease income Other (4,466 ) (2,614 ) Total lease cost $ 6,407 $ 7,475 (1) Includes short-term leases. (2) $6.3 million and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2021 and 2020, 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, 2021 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2022 $ 7,376 $ 128 $ (4,143 ) $ 3,361 2023 7,448 129 (3,963 ) 3,614 2024 6,559 130 (3,987 ) 2,702 2025 5,666 131 (4,044 ) 1,753 2026 5,255 133 (4,015 ) 1,373 Thereafter 239,727 4,650 (71,286 ) 173,091 (1) Total undiscounted minimum lease payments $ 272,031 $ 5,301 $ (91,438 ) $ 185,894 Less: interest (186,814 ) (3,364 ) Present value of lease liabilities $ 85,217 $ 1,937 (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, 2021 December 31, 2020 Right of use assets: Operating leases - real estate Land $ 68,616 $ 73,373 Finance leases - real estate Land 1,785 1,836 Total real estate right of use assets $ 70,401 $ 75,209 Operating leases - corporate Other assets 7,458 8,234 Total right of use assets $ 77,859 $ 83,443 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 85,217 $ 90,006 Financing leases Obligations to tenants and other lease liabilities 1,937 1,935 Total lease liabilities $ 87,154 $ 91,941 Weighted-average remaining lease term: Operating leases 40.6 41.1 Finance leases 34.9 35.9 Weighted-average discount rate: Operating leases 6.4 % 6.4 % Finance leases 6.6 % 6.6 % The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,330 $ 6,080 Operating cash flows from finance leases 126 125 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases 1,120 13,832

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2021
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): As of December 31, 2021 2020 Debt issue costs, net(1) $ 5,488 $ 192 Other corporate assets 193,749 167,929 Prepaids and other assets 134,243 87,948 Total other assets $ 333,480 $ 256,069 (1) Relates to our revolving credit facility Other corporate assets include land and land improvements associated with our corporate offices, furniture and fixtures, equipment, corporate vehicles, aircraft, enterprise and other software, deposits, and right-of-use assets associated with corporate leases. Included in prepaids and other assets is prepaid insurance, prepaid taxes, deferred income tax assets (net of valuation allowances, if any), and lease inducements made to tenants, among other items. In addition to the assets above, we have equity investments of $1.2 billion and $1.1 billion at December 31, 2021 and 2020, respectively. The increase year-over-year is primarily related to new investments in Swiss Medical Network, Priory, and Aspris Children’s Services during 2021, partially offset by the sale of three equity investments during 2021, as discussed further in Note 3

Schedule II_ Valuation and Qual

Schedule II: Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2021
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, 2021 Additions Deductions Year Ended December 31, Balance at Beginning of Year(1) Charged Against Operations(1) Charged to Other Accounts Net Recoveries/ Write-offs(1) Balance at End of Year(1) (In thousands) 2021 $ 146,637 $ 69,131 (2) $ 7,340 (3) $ (68,947 ) (4) $ 154,161 2020 $ 109,803 $ 58,044 (5) $ 22,944 (6) $ (44,154 ) (7) $ 146,637 2019 $ 66,131 $ 50,893 (8) $ — $ (7,221 ) (9) $ 109,803 (1) Includes real estate impairment reserves, allowance for doubtful accounts, straight-line rent reserves, credit loss reserves, tax valuation allowances, and other reserves. (2) Represents a $41.7 million increase in credit loss reserves on financing-type receivables, $8 million increase in accounts receivable and other reserves, and an approximately $20 million increase in valuation allowances to reserve against our net deferred tax assets in 2021. (3) Represents $7.3 million of tax valuation allowances recorded as part of the purchase price allocation of the Priory Transaction as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K. (4) Includes a $22.4 million decrease in real estate impairment reserves related to disposals in 2021, a $38.7 million decrease in accounts receivable and other reserves, $6.0 million decrease of equity investment impairment reserve related to disposals in 2021, and $1.9 million of credit loss recovery related to loan paydowns in 2021. (5) Represents a $19.0 million increase to real estate impairment reserves, $23.9 million increase in accounts receivable and other reserves, $3.3 million increase in credit loss reserves on financing-type receivables, and a $11.9 million increase in valuation allowances to reserve against our net deferred tax assets in 2020. (6) Reflects $8.4 million of a credit loss reserve recorded on January 1, 2020 to equity as the cumulative effect of a change in accounting principle adjustment upon adoption of ASU No. 2016-13, “Measurement of Credit Losses on Financial Instruments” along with $14.5 million of tax valuation allowances recorded as part of the purchase price allocation of the Circle Transaction as disclosed in Note 3 to Item 8 of this Annual Report on Form 10-K. (7) Includes a $40.5 million decrease in real estate impairment reserves related to disposals in 2020, $2.9 million of credit loss recovery related to loan paydowns in 2020, and a $0.8 million decrease in tax valuation allowances. (8) Represents a $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. (9) Includes a $7.2 million decrease in real estate impairment reserves related to disposals in 2019.

SCHEDULE III - REAL ESTATE INVE

SCHEDULE III - REAL ESTATE INVESTMENTS AND ACCUMULATED DEPRECIATION	12 Months Ended
	Dec. 31, 2021
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, 2021 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Aberdeen, UK Acute care general hospital $ 4,384 $ 107,058 $ 135 $ — $ 4,519 $ 107,058 $ 111,577 $ 5,371 $ — 1985 January 9, 2020 40 Altoona, WI Acute care general hospital — 29,062 — — — 29,062 29,062 5,328 — 2014 August 31, 2014 40 Alvin, TX Freestanding ER 105 4,087 — — 105 4,087 4,192 769 — 2014 March 19, 2014 40 Anaheim, CA Acute care general hospital 1,875 21,813 — 10 1,875 21,823 23,698 8,275 — 1964 November 8, 2006 40 Arnold, UK Behavioral health facility 147 10,540 360 — 507 10,540 11,047 145 — 2008 June 25, 2021 40 Ashtead, UK Acute care general hospital 39,119 75,253 1,019 — 40,138 75,253 115,391 4,588 — 1981 August 16, 2019 40 Aurora, CO Freestanding ER 2,891 4,812 — — 2,891 4,812 7,703 752 — 2015 September 17, 2015 40 Austin, TX Freestanding ER 3,722 4,200 — — 3,722 4,200 7,922 538 — 2017 March 2, 2017 40 Avondale, AZ Behavioral health facility 5,383 65,080 — — 5,383 65,080 70,463 293 — 2016 October 19, 2021 40 Ayer, MA Acute care general hospital 9,048 77,913 4,548 — 9,048 82,461 91,509 5,898 — 1970-2013 June 27, 2018 47 Ayr, UK Behavioral health facility 17,729 51,716 329 — 18,058 51,716 69,774 661 — 2004 June 25, 2021 40 Bad Salzuflen, Germany Rehabilitation hospital 9,888 27,378 930 — 10,818 27,378 38,196 3,048 — 1974, 2016 November 30, 2017 40 Bad Salzuflen, Germany Rehabilitation hospital 7,002 24,077 350 — 7,352 24,077 31,429 2,553 — 1989, 2016 November 30, 2017 40 Bad Oeynhausen, Germany Rehabilitation hospital 1,033 2,835 126 — 1,159 2,835 3,994 324 — 1973, 2010 November 30, 2017 40 Basingstoke, UK Acute care general hospital 13,532 53,347 203 — 13,735 53,347 67,082 2,694 — 1984 January 9, 2020 40 Bassenheim, Germany Rehabilitation hospital 999 5,448 170 — 1,169 5,448 6,617 441 — 1887, 1983 February 9, 2019 39 Bath, UK Acute care general hospital 1,604 33,245 — — 1,604 33,245 34,849 6,233 — 2008, 2009 July 1, 2014 40 Bath, UK Acute care general hospital 7,443 13,874 203 — 7,646 13,874 21,520 721 — 1992 January 9, 2020 40 Beckenham, UK Acute care general hospital 5,751 22,266 54 — 5,805 22,266 28,071 1,121 — 1981 January 9, 2020 40 Bedford, UK Acute care general hospital 1,583 7,976 54 — 1,637 7,976 9,613 406 — 1982 January 9, 2020 40 Bellflower, CA Behavioral health facility 2,563 — — — 2,563 — 2,563 — — 1972 August 23, 2019 — Bennettsville, SC Acute care general hospital 794 15,773 — — 794 15,773 16,567 7,689 — 1984 April 1, 2008 42 Big Spring, TX Acute care general hospital 1,655 21,254 816 — 1,655 22,070 23,725 1,671 — 1973 April 12, 2019 41 Birmingham, UK Acute care general hospital 9,103 47,756 — — 9,103 47,756 56,859 1,784 — 2017 April 3, 2017 40 Birmingham, UK Acute care general hospital 10,098 99,773 386 — 10,484 99,773 110,257 5,040 — 1982 January 9, 2020 40 Birmingham, UK Rehabilitation hospital — 19,885 — — — 19,885 19,885 743 — 2018 June 29, 2020 40 Birmingham, UK Behavioral health facility — 20,376 438 — 438 20,376 20,814 273 — 1900, 1984, 2016 June 25, 2021 40 Blackburn, UK Acute care general hospital 2,706 54,210 122 — 2,828 54,210 57,038 2,727 — 1957 January 9, 2020 40 Blackburn, UK Behavioral health facility 19,620 57,757 1,670 — 21,290 57,757 79,047 792 — 1930 June 25, 2021 40 Bloomington, IN Acute care general hospital 2,392 28,212 5,000 408 2,392 33,620 36,012 12,608 — 2006 August 8, 2006 40 Blue Springs, MO Acute care general hospital 4,347 23,494 — — 4,347 23,494 27,841 4,269 — 1980 February 13, 2015 40 Boardman, OH Long term acute care hospital 79 275 — — 79 275 354 18 — 2008 August 30, 2019 40 Boise, ID Long term acute care hospital 1,558 11,027 — — 1,558 11,027 12,585 864 — 2008 February 29, 2012 50 Bolton, UK Acute care general hospital 1,624 47,335 61 — 1,685 47,335 49,020 2,375 — 1989 January 9, 2020 40 Boonton Township, NJ Behavioral health facility 6,712 17,031 — — 6,712 17,031 23,743 556 — 1952, 1971-1978 September 30, 2015 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Bossier City, LA Long term acute care hospital 900 17,818 944 — 900 18,762 19,662 6,214 — 1982 April 1, 2008 40 Bowling Green, KY Rehabilitation hospital 3,486 56,296 — — 3,486 56,296 59,782 3,662 — 1992 August 30, 2019 40 Braunfels, Germany Acute care general hospital 2,183 13,954 57 — 2,240 13,954 16,194 2,292 — 1977 June 30, 2015 40 Brighton, MA Acute care general hospital 18,540 146,491 52,118 — 18,540 198,609 217,149 19,400 — 1917-2009 October 3, 2016 41 Brockton, MA Acute care general hospital 18,328 67,248 5,358 — 18,328 72,606 90,934 10,793 — 1965-2010 October 3, 2016 41 Bromley, UK Behavioral health facility 7,084 16,503 594 — 7,678 16,503 24,181 229 — 1714, 1830, 2021 June 25, 2021 40 Broomfield, CO Freestanding ER 825 3,895 — — 825 3,895 4,720 730 — 2014 July 3, 2014 40 Bundoora, Australia Acute care general hospital 6,654 64,096 4,482 — 6,940 68,292 75,232 4,607 — 1979 June 7, 2019 37 Bury, UK Behavioral health facility 8,173 20,617 872 — 9,045 20,617 29,662 298 — 2003 June 25, 2021 40 Bussage, UK Behavioral health facility 8,848 3,990 176 — 9,024 3,990 13,014 56 — 1970 June 25, 2021 40 Campbelltown, Australia Acute care general hospital 1,055 54,756 51 — 1,106 54,756 55,862 3,546 — 2007 June 7, 2019 40 Canterbury, UK Acute care general hospital 9,675 29,325 88 — 9,763 29,325 39,088 1,478 — 1982 January 9, 2020 40 Carmarthen, UK Acute care general hospital 866 27,185 101 — 967 27,185 28,152 1,373 — 1990 January 9, 2020 40 Carrollton, TX Acute care general hospital 729 34,342 374 — 729 34,716 35,445 5,559 — 2015 July 17, 2015 40 Carrollton, TX Behavioral health facility 4,941 52,579 — — 4,941 52,579 57,520 237 — 2012 October 19, 2021 40 Casper, WY Rehabilitation hospital 1,785 — — — 1,785 — 1,785 — — 2012 February 29, 2012 — Caterham, UK Acute care general hospital 10,816 22,158 400 — 11,216 22,158 33,374 1,370 — 1982 August 16, 2019 40 Chandler, AZ Freestanding ER 3,619 4,783 — — 3,619 4,783 8,402 797 — 2015 April 24, 2015 40 Chandler, AZ Freestanding ER 750 3,853 — — 750 3,853 4,603 602 — 2015 October 7, 2015 40 Cheadle, UK Acute care general hospital 32,477 173,216 406 — 32,883 173,216 206,099 8,715 — 1981 January 9, 2020 40 Cheadle, UK Behavioral health facility 29,205 100,805 2,485 — 31,690 100,805 132,495 1,365 — 1849, 2018 June 25, 2021 40 Cheraw, SC Acute care general hospital 657 19,576 — — 657 19,576 20,233 9,542 — 1982 April 1, 2008 42 Clarksville, TX Rehabilitation hospital 2,460 25,540 — — 2,460 25,540 28,000 710 — 2019 December 17, 2020 39 Cologne, Germany Acute care general hospital 4,456 15,413 103 — 4,559 15,413 19,972 1,765 — 2011 June 23, 2017 40 Colorado Springs, CO Freestanding ER 600 4,231 — — 600 4,231 4,831 802 — 2014 June 5, 2014 40 Columbus, OH Behavioral health facility 2,101 44,504 — — 2,101 44,504 46,605 203 — 2017 October 19, 2021 40 Commerce City, TX Freestanding ER 707 4,248 — — 707 4,248 4,955 752 — 2014 December 11, 2014 40 Conroe, TX Behavioral health facility 3,855 39,156 — — 3,855 39,156 43,011 182 — 2018 October 19, 2021 40 Converse, TX Freestanding ER 750 4,423 — — 750 4,423 5,173 746 — 2015 April 10, 2015 40 Coral Gables, FL Acute care general hospital 26,215 84,584 — — 26,215 84,584 110,799 913 — 1959 August 1, 2021 40 Crown Point, IN Long term acute care hospital 302 528 — — 302 528 830 39 — 2008 August 30, 2019 40 Croydon, UK Acute care general hospital 10,352 44,330 217 — 10,569 44,330 54,899 2,245 — 1982 January 9, 2020 40 Dahlen, Germany Rehabilitation hospital 948 11,679 434 — 1,382 11,679 13,061 455 — 1994 July 8, 2020 40 Dallas, TX Long term acute care hospital 1,000 13,589 — 368 1,421 13,536 14,957 5,189 — 2006 September 5, 2006 40 Darlington, UK Acute care general hospital 1,854 38,071 365 — 2,219 38,071 40,290 1,383 — 2001 August 7, 2020 40 Darlington, UK Behavioral health facility 20,168 51,315 2,415 — 22,583 51,315 73,898 752 — 1935, 2018, 2020 June 25, 2021 40 Darlington, UK Behavioral health facility 5,108 28,014 449 — 5,557 28,014 33,571 369 — 1960, 1990 June 25, 2021 40 Denver, CO Freestanding ER 1,276 4,276 — — 1,276 4,276 5,552 704 — 2015 June 8, 2015 40 Denville, NJ Acute care general hospital 15,709 55,772 — — 15,709 55,772 71,481 1,781 — 1953, 1969-2008 September 30, 2015 40 Detroit, MI Long term acute care hospital 1,220 8,687 — (364 ) 1,220 8,323 9,543 2,893 — 1956 May 22, 2008 40 Diss, UK Behavioral health facility 2,406 11,034 687 — 3,093 11,034 14,127 169 — 1840 (2) June 25, 2021 40 Dodge City, KS Acute care general hospital 1,124 52,705 — — 1,124 52,705 53,829 2,844 — 1976 December 17, 2019 40 Dorchester, MA Acute care general hospital 14,428 219,575 6,725 — 14,428 226,300 240,728 16,117 — 1953-2015 October 15, 2018 42 Dorchester, UK Acute care general hospital 513 33,313 61 — 574 33,313 33,887 1,674 — 1981 January 9, 2020 40 Dormagen, Germany Rehabilitation hospital 1,827 5,818 139 — 1,966 5,818 7,784 516 — 1993, 2006 August 28, 2018 40 Dover, NJ Acute care general hospital 3,865 8,693 — — 3,865 8,693 12,558 295 — 1925, 1927-2008 September 30, 2015 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Droitwich, UK Acute care general hospital — 16,261 81 — 81 16,261 16,342 824 — 1984 January 9, 2020 40 Dublin, OH Behavioral health facility 5,118 70,305 — — 5,118 70,305 75,423 312 — 2012 October 19, 2021 40 El Paso, TX Rehabilitation hospital 4,268 21,345 — — 4,268 21,345 25,613 620 — 2018 December 17, 2020 38 Englewood, CO Behavioral health facility 3,369 65,905 — — 3,369 65,905 69,274 297 — 2017 October 19, 2021 40 Euxton, UK Acute care general hospital 4,047 37,797 861 — 4,908 37,797 42,705 2,372 — 1981 August 16, 2019 40 Fall River, MA Acute care general hospital 3,526 82,358 28,556 — 3,526 110,914 114,440 12,508 — 1950-2012 October 3, 2016 41 Firestone, TX Freestanding ER 495 3,963 — — 495 3,963 4,458 751 — 2014 June 6, 2014 40 Flagstaff, AZ Rehabilitation hospital 3,049 22,464 — — 3,049 22,464 25,513 2,153 — 2016 August 23, 2016 40 Florence, AZ Acute care general hospital 900 28,462 105 — 900 28,567 29,467 6,960 — 2012 February 7, 2012 40 Folsom, CA Long term acute care hospital 3,291 21,293 — — 3,291 21,293 24,584 1,475 — 2009 August 30, 2019 40 Fort Worth, TX Freestanding ER 2,701 4,392 — — 2,701 4,392 7,093 741 — 2015 March 27, 2015 40 Fort Worth, TX Behavioral health facility 3,406 34,862 — — 3,406 34,862 38,268 161 — 2014 October 19, 2021 40 Fountain, CO Freestanding ER 1,508 4,131 — — 1,508 4,131 5,639 766 — 2014 July 31, 2014 40 Fresno, CA Rehabilitation hospital 5,507 70,473 — — 5,507 70,473 75,980 4,430 — 1991 August 30, 2019 40 Frome, UK Behavioral health facility 2,419 18,655 660 — 3,079 18,655 21,734 263 — 1980 June 25, 2021 40 Frome, UK Behavioral health facility 9,920 11,388 1,660 — 11,580 11,388 22,968 212 — 1700, 2015, 2017 June 25, 2021 40 Garden Grove, CA Acute care general hospital 5,502 10,748 — 51 5,502 10,799 16,301 3,547 — 1982 November 25, 2008 40 Garden Grove, CA Medical Office Building 862 7,888 — 28 862 7,916 8,778 2,594 — 1982 November 25, 2008 40 Gardena, CA Acute care general hospital 14,010 65,288 — — 14,010 65,288 79,298 882 — 1966 July 6, 2021 40 Georgetown, TX Behavioral health facility 4,569 23,028 — — 4,569 23,028 27,597 106 — 2014 October 19, 2021 40 Gilbert, AZ Freestanding ER 1,517 4,661 — — 1,517 4,661 6,178 748 — 2015 July 22, 2015 40 Gilbert, AZ Behavioral health facility 4,790 45,384 — — 4,790 45,384 50,174 201 — 2020 October 19, 2021 40 Glasgow, UK Acute care general hospital 6,698 139,848 149 — 6,847 139,848 146,695 7,012 — 1983 January 9, 2020 40 Glasgow, UK Behavioral health facility 1,135 16,606 383 — 1,518 16,606 18,124 225 — 1900, 1980 June 25, 2021 40 Glen Waverly, Australia Rehabilitation hospital 30,764 23,768 835 — 31,599 23,768 55,367 2,189 — 1972 June 7, 2019 32 Glendale, AZ Freestanding ER 1,144 6,087 — — 1,144 6,087 7,231 786 — 2016 October 21, 2016 40 Glendale, AZ Freestanding ER 1,210 4,046 — — 1,210 4,046 5,256 666 — 2015 June 5, 2015 40 Gloucester, UK Acute care general hospital 4,869 65,235 1,062 — 5,931 65,235 71,166 4,031 — 1990 August 16, 2019 40 Godalming, UK Behavioral health facility 9,059 20,181 886 — 9,945 20,181 30,126 293 — 1796, 2007 June 25, 2021 40 Goodyear, AZ Freestanding ER 1,800 4,713 — — 1,800 4,713 6,513 677 — 2016 April 4, 2016 40 Great Missenden, UK Acute care general hospital 12,179 111,784 332 — 12,511 111,784 124,295 5,633 — 1981 January 9, 2020 40 Grefath, Germany Rehabilitation hospital 1,136 3,119 101 — 1,237 3,119 4,356 282 — 1886, 1983 August 28, 2018 40 Guildford, UK Acute care general hospital 7,185 38,719 129 — 7,314 38,719 46,033 1,953 — 1989 January 9, 2020 40 Halsall, UK Acute care general hospital 1,524 33,120 618 — 2,142 33,120 35,262 2,052 — 1986 August 16, 2019 40 Harrow, UK Acute care general hospital 40,596 42,958 223 — 40,819 42,958 83,777 2,178 — 1980 January 9, 2020 40 Hartsville, SC Acute care general hospital 2,050 43,970 — — 2,050 43,970 46,020 8,038 — 1999 August 31, 2015 34 Hassocks, UK Behavioral health facility 3,557 30,479 2,272 — 5,829 30,479 36,308 469 — 1998 June 25, 2021 40 Hastings, PA Acute care general hospital 603 8,834 — — 603 8,834 9,437 726 — 1924 December 17, 2019 30 Hausman, TX Acute care general hospital 1,500 8,957 — — 1,500 8,957 10,457 1,958 — 2013 March 1, 2013 40 Haverhill, MA Acute care general hospital 5,651 105,848 3,185 — 5,651 109,033 114,684 8,594 — 1982-2005 August 31, 2018 40 Heidelberg, Germany Rehabilitation hospital 6,350 36,693 74 — 6,424 36,693 43,117 5,072 — 1885, 1991 June 22, 2016 40 Helotes, TX Freestanding ER 1,900 5,115 — — 1,900 5,115 7,015 746 — 2016 March 10, 2016 40 Hemel Hempstead, UK Behavioral health facility 12,480 6,702 795 — 13,275 6,702 19,977 117 — 1901, 1990 June 25, 2021 40 Hialeah, FL Acute care general hospital 18,802 107,783 — — 18,802 107,783 126,585 1,189 — 1950 August 1, 2021 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Hialeah, FL Acute care general hospital 75,339 222,399 75,000 — 75,339 297,399 372,738 2,647 — 1969 August 1, 2021 40 Highland Hills, OH Behavioral health facility 3,148 44,181 — — 3,148 44,181 47,329 202 — 2015 October 19, 2021 40 Highland Village, TX Freestanding ER 3,265 1,551 — — 3,265 1,551 4,816 411 — 2015 September 22, 2015 40 Highlands Ranch, CO Freestanding ER 4,200 4,779 — — 4,200 4,779 8,979 647 — 2016 July 25, 2016 40 Hill County, TX Acute care general hospital 1,120 17,882 374 — 1,120 18,256 19,376 13,549 — 1980 September 17, 2010 15 Hinckley, UK Behavioral health facility 2,175 17,867 446 — 2,621 17,867 20,488 242 — 1892, 2007 June 25, 2021 40 Hook, UK Behavioral health facility 5,269 10,968 487 — 5,756 10,968 16,724 162 — 1980 June 25, 2021 40 Hoover, AL Freestanding ER — 7,581 — — — 7,581 7,581 1,476 — 2015 May 1, 2015 34 Hoover, AL Freestanding ER — 1,034 296 — — 1,330 1,330 228 — 2015 May 1, 2015 34 Hope, AR Acute care general hospital 1,651 3,359 2,732 — 1,651 6,091 7,742 897 — 1984-2001 September 29, 2017 41 Hot Springs, AR Acute care general hospital 5,844 59,432 21,221 — 5,844 80,653 86,497 13,122 — 1985 August 31, 2015 40 Houston, TX Acute care general hospital 28,687 104,028 52,051 — 28,687 156,079 184,766 9,735 — 1940-1950 September 29, 2017 41 Houston, TX Freestanding ER 950 3,996 — — 950 3,996 4,946 525 — 2016 September 26, 2016 40 Houston, TX Behavioral health facility 6,063 19,881 2,565 — 6,063 22,446 28,509 561 — 2020 October 25, 2019 40 Houston, TX Acute care general hospital 3,501 34,530 8,477 16,589 3,274 59,823 63,097 17,863 — 1960 August 10, 2007 40 Houston, TX Acute care general hospital 4,047 36,862 — — 4,047 36,862 40,909 5,069 — 2016 July 7, 2016 40 Huntington Park, CA Acute care general hospital 3,132 5,002 — — 3,132 5,002 8,134 77 — 1967 July 6, 2021 40 Huntington Park, CA Acute care general hospital 3,935 6,103 — — 3,935 6,103 10,038 92 — 1960-1969 July 6, 2021 40 Idaho Falls, ID Acute care general hospital 1,823 37,467 11,236 4,665 1,823 53,368 55,191 14,993 — 2002 April 1, 2008 40 Idaho Falls, ID Acute care general hospital 1,880 107,403 — — 1,880 107,403 109,283 5,146 — 2020 December 19, 2017 40 Johnstown, PA Acute care general hospital 8,877 247,042 — 117 8,877 247,159 256,036 16,717 — 1924 December 17, 2019 30 Kansas City, KS Acute care general hospital 2,351 13,665 — — 2,351 13,665 16,016 763 — 2017 June 10, 2019 50 Kansas City, MO Acute care general hospital 10,497 64,419 — — 10,497 64,419 74,916 11,354 — 1978 February 13, 2015 40 Katy, TX Freestanding ER 1,580 4,174 — — 1,580 4,174 5,754 548 — 2016 October 10, 2016 40 Katy, TX Freestanding ER 2,178 3,873 — — 2,178 3,873 6,051 597 — 2015 October 21, 2015 40 Kingswood, Australia Acute care general hospital 24,282 80,488 3,346 — 24,751 83,365 108,116 5,292 — 2000 June 7, 2019 40 Lafayette, IN Rehabilitation hospital 800 14,968 (25 ) — 800 14,943 15,743 3,320 — 2013 February 1, 2013 40 Lafayette, IN Behavioral health facility 3,321 10,884 — — 3,321 10,884 14,205 60 — 2012 October 19, 2021 40 Lander, WY Acute care general hospital 761 42,849 — — 761 42,849 43,610 2,290 — 1983 December 17, 2019 40 Lauderdale Lakes, FL Acute care general hospital 10,657 150,313 — — 10,657 150,313 160,970 1,776 — 1975 August 1, 2021 40 Lawton, OK Acute care general hospital 3,944 63,031 — — 3,944 63,031 66,975 3,385 — 1985 December 17, 2019 40 Layton, UT Acute care general hospital 14,360 370,154 5,369 — 14,360 375,523 389,883 13,647 — 1976-2010 September 29, 2017 40 League City, TX Freestanding ER 1,316 3,901 — — 1,316 3,901 5,217 634 — 2015 June 19, 2015 40 Leawood, KS Acute care general hospital 2,513 13,938 — — 2,513 13,938 16,451 774 — 2017 June 10, 2019 50 Leeds, UK Behavioral health facility 2,065 10,123 358 — 2,423 10,123 12,546 142 — 1990 June 25, 2021 40 Lehi, UT Acute care general hospital 13,403 29,950 1,675 (35 ) 13,368 31,625 44,993 3,812 — 2015 September 29, 2017 45 Lewiston, ID Acute care general hospital 5,389 75,435 — — 5,389 75,435 80,824 11,904 — 1922 May 1, 2017 40 Little Elm, TX Freestanding ER 1,241 3,491 — — 1,241 3,491 4,732 703 — 2013 December 1, 2013 40 Liverpool, Australia Acute care general hospital 13,786 43,209 96 — 13,882 43,209 57,091 3,745 — 1975 June 7, 2019 30 London, UK Acute care general hospital 9,743 64,842 81 — 9,824 64,842 74,666 3,253 — 1984 January 9, 2020 40 London, UK Acute care general hospital 3,464 4,409 27 — 3,491 4,409 7,900 224 — 1987 January 9, 2020 40 London, UK Acute care general hospital 13,207 86,380 27 — 13,234 86,380 99,614 4,323 — 1977 January 9, 2020 40 London, UK Behavioral health facility 6,133 16,640 416 — 6,549 16,640 23,189 229 — 1900, 1960 June 25, 2021 40 London, UK Behavioral health facility 14,391 7,241 288 14,679 7,241 21,920 104 — 1992 June 25, 2021 40 Longmont, CO Freestanding ER 1,799 4,181 — — 1,799 4,181 5,980 618 — 2016 February 10, 2016 40 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Los Angeles, CA Acute care general hospital 12,562 40,164 — — 12,562 40,164 52,726 519 — 1972 July 6, 2021 40 Lubbock, TX Rehabilitation hospital 1,376 28,292 3,648 — 1,376 31,940 33,316 5,094 — 2008 June 16, 2015 40 Lynwood, CA Acute care general hospital 30,116 148,527 — — 30,116 148,527 178,643 5,286 — 1940, 1989-2000 August 13, 2020 40 Mandeville, LA Freestanding ER 2,800 5,370 — — 2,800 5,370 8,170 694 — 2016 October 28, 2016 40 Marrero, LA Freestanding ER 1,608 5,801 — — 1,608 5,801 7,409 798 — 2016 July 15, 2016 40 McKinney, TX Freestanding ER 2,668 4,060 — — 2,668 4,060 6,728 876 — 2015 July 31, 2015 30 McKinney, TX Behavioral health facility 2,934 — — — 2,934 — 2,934 — — 2021 October 19, 2021 - McMinnville, OR Acute care general hospital 5,000 97,900 — — 5,000 97,900 102,900 14,135 — 1996 August 31, 2015 41 Melbourne, FL Acute care general hospital 5,642 17,087 21,214 — 5,642 38,301 43,943 2,947 — 2002 May 1, 2017 42 Melton Mowbray, UK Behavioral health facility 5,387 16,993 673 — 6,060 16,993 23,053 243 — 1990 June 25, 2021 40 Mesa, AZ Acute care general hospital 6,534 100,042 4,136 — 6,534 104,178 110,712 21,948 — 2007 September 26, 2013 40 Methuen, MA Acute care general hospital 23,809 89,505 13,365 — 23,809 102,870 126,679 13,187 — 1950-2011 October 3, 2016 41 Meyersdale, PA Acute care general hospital 390 4,280 — — 390 4,280 4,670 365 — 1960 December 17, 2019 30 Miami, FL Acute care general hospital 44,400 107,203 — — 44,400 107,203 151,603 1,395 — 1955 August 1, 2021 40 Milton Keynes, UK Acute care general hospital 5,480 38,117 95 — 5,575 38,117 43,692 1,918 — 1983 January 9, 2020 40 Monmouth, UK Behavioral health facility 15,189 12,283 1,293 — 16,482 12,283 28,765 208 — 2017 June 25, 2021 40 Montclair, NJ Acute care general hospital 7,900 99,640 577 — 8,477 99,640 108,117 19,799 — 1920-2000 April 1, 2014 40 Mount Pleasant, SC Long term acute care hospital 597 2,198 — — 597 2,198 2,795 149 — 2012 August 30, 2019 40 New Braunfels, TX Rehabilitation hospital 1,853 10,622 — — 1,853 10,622 12,475 299 — 2011 February 29, 2012 40 New Orleans, LA Freestanding ER 2,850 6,125 — — 2,850 6,125 8,975 804 — 2016 September 23, 2016 40 Newark, NJ Acute care general hospital 32,957 24,553 — — 32,957 24,553 57,510 744 — 1919, 1920-2003 May 2, 2016 40 Newburgh, IN Behavioral health facility 1,215 7,266 — — 1,215 7,266 8,481 36 — 2010 October 19, 2021 40 Northland, MO Long term acute care hospital 834 17,182 — — 834 17,182 18,016 4,689 — 2007 February 14, 2011 40 Norwalk, CA Acute care general hospital 2,811 5,940 — — 2,811 5,940 8,751 93 — 1959, 1995 July 6, 2021 40 Norwalk, CA Acute care general hospital 7,925 30,465 — — 7,925 30,465 38,390 407 — 1958-1978 July 6, 2021 40 Norwood, MA Acute care general hospital 7,073 154,496 16,180 — 7,073 170,676 177,749 12,760 — 1926-2001 June 27, 2018 46 Nottingham, UK Acute care general hospital 5,007 48,842 257 — 5,264 48,842 54,106 2,476 — 1983 January 9, 2020 40 Nottingham, UK Behavioral health facility 9,748 9,526 894 — 10,642 9,526 20,168 157 — 2000 June 25, 2021 40 Nottingham, UK Behavioral health facility 10,678 3,451 121 — 10,799 3,451 14,250 48 — 1980 June 25, 2021 40 Odessa, TX Acute care general hospital 6,535 123,518 11,629 — 6,535 135,147 141,682 13,569 — 1973-2004 September 29, 2017 41 Ogden, UT Rehabilitation hospital 1,759 16,414 — — 1,759 16,414 18,173 3,203 — 2014 March 1, 2014 40 Oklahoma City, OK Behavioral health facility 3,641 3,091 — — 3,641 3,091 6,732 26 — 2017 October 19, 2021 40 Olathe, KS Behavioral health facility 5,966 56,125 — — 5,966 56,125 62,091 260 — 2015 October 19, 2021 40 Olathe, KS Acute care general hospital 3,485 14,484 — — 3,485 14,484 17,969 813 — 2018 June 10, 2019 50 Orpington, UK Acute care general hospital 10,826 45,401 162 — 10,988 45,401 56,389 2,292 — 1987 January 9, 2020 40 Ottumwa, IA Acute care general hospital 2,377 48,697 — — 2,377 48,697 51,074 3,623 — 1950 December 17, 2019 30 Overland Park, KS Acute care general hospital 2,974 14,405 — — 2,974 14,405 17,379 812 — 2017 June 10, 2019 50 Overland Park, KS Acute care general hospital 3,191 14,263 — — 3,191 14,263 17,454 845 — 2019 June 10, 2019 50 Overlook, TX Acute care general hospital 2,452 9,666 7 — 2,452 9,673 12,125 2,140 — 2012 February 1, 2013 40 Palestine, TX Acute care general hospital 1,848 95,257 — — 1,848 95,257 97,105 4,993 — 1988 December 17, 2019 40 Parker, CO Freestanding ER 1,300 4,448 — — 1,300 4,448 5,748 686 — 2015 November 6, 2015 40 Pasco, WA Acute care general hospital 2,594 13,195 — — 2,594 13,195 15,789 1,503 — 1920 August 31, 2018 30 Pearland, TX Freestanding ER 1,075 3,577 — — 1,075 3,577 4,652 656 — 2014 September 8, 2014 40 Perth, Australia Acute care general hospital 106,021 37,654 2,528 — 106,241 39,962 146,203 3,386 — 1965 June 7, 2019 30 Initial Costs Additions Subsequent to Acquisition Cost at December 31, 2021(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) Petersburg, VA Rehabilitation hospital 1,302 9,121 — — 1,302 9,121 10,423 3,078 — 2006 July 1, 2008 40 Phoenix, AZ Behavioral health facility 2,396 26,521 2,985 — 2,396 29,506 31,902 3,360 — 1979 September 29, 2017 42 Phoenix, AZ Acute care general hospital 12,695 73,773 4,499 — 12,695 78,272 90,967 8,821 — 1968-1976 September 29, 2017 43 Phoenix, AZ Acute care general hospital 5,576 45,782 — — 5,576 45,782 51,358 5,627 — 2017 February 10, 2017 40 Phoenix, AZ Freestanding ER 1,132 5,052 — — 1,132 5,052 6,184 600 — 2017 April 13, 2017 40 Plano, TX Freestanding ER 4,272 2,492 — — 4,272 2,492 6,764 435 — 2016 September 30, 2016 40 Poole, UK Acute care general hospital 1,922 40,797 549 — 2,471 40,797 43,268 2,905 — 1996 April 3, 2019 40 Poplar Bluff, MO Acute care general hospital 2,659 38,693 — 1 2,659 38,694 41,353 13,247 — 1980 April 22, 2008 40 Port Arthur, TX Acute care general hospital 12,972 78,051 6,877 — 12,972 84,928 97,900 16,573 — 2005 September 26, 2013 40 Port Huron, MI Acute care general hospital 2,531 14,252 — — 2,531 14,252 16,783 2,921 — 1953, 1973-1983 December 31, 2015 30 Post Falls, ID Rehabilitation hospital 417 12,175 1,905 — 767 13,730 14,497 2,755 — 2013 December 31, 2013 40 Preston, UK Behavioral health facility 8,748 27,645 542 — 9,290 27,645 36,935 371 — 1850, 2018, 2021 June 25, 2021 40 Princes Risborough, UK Acute care general hospital 4,955 — — — 4,955 — 4,955 — — N/A January 9, 2020 40 Raleigh, NC Behavioral health facility 3,469 27,707 — — 3,469 27,707 31,176 136 — 2018 October 19, 2021 40 Reading, UK Acute care general hospital 36,489 49,078 496 — 36,985 49,078 86,063 2,991 — 1990 August 16, 2019 40 Reading, UK Acute care general hospital 26,996 88,538 635 — 27,631 88,538 116,169 2,256 — 2012 December 18, 2020 40 Redding, CA Acute care general hospital 1,555 53,863 — 13 1,555 53,876 55,431 19,425 — 1974 August 10, 2007 40 Remscheid, Germany Rehabilitation hospital 1,021 2,603 59 — 1,080 2,603 3,683 230 — 1951, 1983 August 28, 2018 40 Richmond, TX Behavioral health facility 4,602 6,224 — — 4,602 6,224 10,826 36 — 2014 October 19, 2021 40 Richmond, VA Long term acute care hospital 1,302 10,071 — — 1,302 10,071 11,373 761 — 1989 August 30, 2019 40 Ringwood, Australia Acute care general hospital 4,166 19,323 138 — 4,304 19,323 23,627 1,469 — 1973 June 7, 2019 35 Riverton, WY Acute care general hospital 1,163 29,647 — — 1,163 29,647 30,810 1,838 — 1983 December 17, 2019 36 Roaring Springs, PA Acute care general hospital 1,446 9,549 — — 1,446 9,549 10,995 811 — 1924 December 17, 2019 30 Rochdale, MA Long term acute care hospital 654 3,368 — — 654 3,368 4,022 230 — 1989 August 30, 2019 40 Rochdale, MA Acute care general hospital 67 344 — — 67 344 411 23 — 1989 August 30, 2019 40 Rochdale, UK Acute care general hospital 3,654 43,317 149 — 3,803 43,317 47,120 2,186 — 1965 January 9, 2020 40 Rockledge, FL Acute care general hospital 13,919 23,282 7,565 — 13,919 30,847 44,766 4,458 — 1950, 1970 May 1, 2017 42 Roeland Park, KS Acute care general hospital 1,569 15,103 — — 1,569 15,103 16,672 830 — 2018 June 10, 2019 50 Romford, UK Behavioral health facility 4,958 9,317 733 — 5,691 9,317 15,008 147 — 1980 June 25, 2021 40 Rosenberg, TX Freestanding ER 1,289 4,505 — — 1,289 4,505 5,794 676 — 2016 January 15, 2016 40 Rowley, UK Acute care general hospital 2,489 19,453 602 — 3,091 19,453 22,544 1,243 — 1986 August 16, 2019 40 Royston, UK Behavioral health facility 5,636 21,310 1,521 — 7,157 21,310 28,467 336 — 1906, 1970 June 25, 2021 40 Salt Lake City, UT Acute care general hospital 13,590 101,915 15,268 — 13,590 117,183 130,773 11,686 — 1906-1987 September 29, 2017 41 San Antonio, TX Acute care general hospital 8,053 29,333 7,981 — 8,053 37,314 45,367 3,671 — 1978-2002 September 29, 2017 41 San Antonio, TX Freestanding ER 3,167 4,801 — — 3,167 4,801 7,968 610 — 2016 December 9, 2016 40 San Antonio, TX Freestanding ER 351 3,952 — — 351 3,952 4,303 765 — 2014 January 1, 2014 40 San Antonio, TX Acute care general hospital 2,248 5,880 — — 2,248 5,880 8,128 1,346 — 2012 October 2, 2012 40 San Antonio, TX Freestanding ER 2,448 4,253 — — 2,448 4,253 6,701 549 — 2016 October 27, 2016 40 San Bernardino, CA Acute care general hospital 2,209 37,498 — — 2,209 37,498 39,707 2,390 — 1993 August 30, 2019 40 San Diego, CA Acute care general hospital 12,663 52,431 — — 12,663 52,431 65,094 14,309 — 1973 February 9, 2011 40 San Diego, CA Acute care general hospital 6,550 15,653 — 77 6,550 15,730 22,280 5,766 — 1964 May 9, 2007 40 San Dimas, CA Acute care general hospital 6,160 6,839 — 34 6,160 6,873 13,033 2,252 — 1972 November 25, 2008 40 The changes in total real estate assets (excluding construction in progress, intangible lease assets, investment in financing leases, and mortgage loans) are as follows for the years ended (in thousands): December 31, 2021 December 31, 2020 December 31, 2019 COST Balance at beginning of period $ 10,749,707 $ 7,312,486 $ 4,781,149 Acquisitions 3,023,966 2,912,594 2,436,265 Transfers from construction in progress — 202,999 — Additions 167,164 55,137 173,785 Dispositions (229,584 ) (105,360 ) (106,536 ) Other (82,504 ) (3) 371,851 (3) 27,823 (3) Balance at end of period $ 13,628,749 (4) $ 10,749,707 $ 7,312,486 The changes in accumulated depreciation are as follows for the years ended (in thousands): December 31, 2021 December 31, 2020 December 31, 2019 ACCUMULATED DEPRECIATION Balance at beginning of period $ 728,176 $ 504,651 $ 414,331 Depreciation 262,063 222,580 130,851 Depreciation on disposed property (35,551 ) (6,653 ) (40,952 ) Other (4,319 ) 7,598 421 Balance at end of period $ 950,369 (5) $ 728,176 $ 504,651 (3) Includes foreign currency fluctuations for all years and $13.8 million and $61.4 million of right-of-use assets in 2020 and 2019, respectively. (4) Includes $1.1 billion of land and building cost reflected in real estate held for sale at December 31, 2021. Excludes intangible lease assets that are included in real estate held for sale of $125.1 million at December 31, 2021. (5) Includes $96.5 million of accumulated depreciation reflected in real estate held for sale at December 31, 2021. Excludes accumulated amortization related to intangible lease assets that are included in real estate held for sale of $17.5 million at December 31, 2021.

SCHEDULE IV - MORTGAGE LOANS ON

SCHEDULE IV - MORTGAGE LOANS ON REAL ESTATE	12 Months Ended
	Dec. 31, 2021
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, 2021 Column A Column B Column C Column D Column E Column F Column G(1) 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 Colombia(4) 8.95 % 2035 (2 ) $ 120,167 $ 120,167 (3 ) Vibra 11.50 % 2024 (2 ) 18,986 18,986 (3 ) Prospect 7.65 % 2034 (2 ) 51,267 51,267 (3 ) Springstone 7.00 % 2041 (2 ) 22,900 22,900 (3 ) $ 213,320 $ 213,320 (5 ) (1) The aggregate cost for federal income tax purposes is $213.3 million. ( 2 ) There were no prior liens on loans as of December 31, 2021. ( 3 ) The mortgage loan was not delinquent with respect to principal or interest. ( 4 ) Mortgage loans covering three properties. ( 5 ) Excludes allowance for credit loss of $0.1 million at December 31, 2021. Changes in mortgage loans (excluding allowance for credit loss for 2021 and 2020 only and unamortized loan issue costs for 2019 only) for the years ended December 31, 2021, 2020, and 2019 are summarized as follows: Year Ended December 31, 2021 2020 2019 (Dollar amounts in thousands) Balance at beginning of year $ 248,335 $ 1,274,995 $ 1,213,283 Additions during year: New mortgage loans and additional advances on existing loans 1,128,695 (6) 193,590 61,712 Exchange rate fluctuations (3,640 ) 9,785 — 1,373,390 1,478,370 1,274,995 Deductions during year: Collection of principal (1,160,070 ) (6) (1,230,035 ) (7) — (1,160,070 ) (1,230,035 ) — Balance at end of year $ 213,320 $ 248,335 $ 1,274,995 ( 6 ) Includes an £800 million mortgage loan advanced to Priory in the first quarter of 2021 that was redeemed as part of the acquisition of the underlying fee simple real estate in the second quarter of 2021 as more fully described in Note 3 to Item 8 of this Annual Report on Form 10-K. (7) Includes $835 million of mortgage loans that were used to acquire the underlying fee simple real estate as more fully described in Note 3

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates: The preparation of our consolidated financial statements in conformity with accounting principles generally accepted in the U.S. requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. We believe the estimates and assumptions underlying our consolidated financial statements are reasonable and supportable based on the information available as of December 31, 2021 (particularly as it relates to our assessments of the recoverability of our real estate and the adequacy of our credit loss reserves on loans and financing receivables). Although the effects of COVID-19 and related variants seem to be lessening, government restrictions appear to be easing, and most hospitals around the world have generally returned to their normal operations, the ultimate impact to our tenants’ results of operations and liquidity and their ability to pay our rent and interest due to the impact of COVID-19 still cannot be predicted with 100% confidence. This makes any estimates and assumptions as of December 31, 2021, inherently less certain than they would be absent the potential impact of COVID-19. 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, 2021, we had loans and/or equity investments in certain variable interest entities approximating $570 million, which represents our maximum exposure to loss as a result of our involvement in such entities. We have 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”). 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 other-than-temporary, an impairment is recorded. Investments in entities in which we do not control nor do we have the ability to significantly influence and for which there is no readily determinable fair value (such as our investment in Steward Health Care System LLC (“Steward”)) are accounted for at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions involving the investee. Cash distributions on these types of investments are recorded to either income upon receipt (if a return on investment) or as a reduction of our investment (if the distributions received are in excess of our share of the investee’s earnings). For similar investments but for which there are readily determinable fair values, such investments are measured at fair value, with unrealized gains and losses recorded in income.
Cash and Cash Equivalents	Cash and Cash Equivalents: Certificates of deposit, short-term investments with original maturities of three months or less, and money-market mutual funds are considered cash equivalents. The majority of our cash and cash equivalents are held at major commercial banks, which at times may exceed the Federal Deposit Insurance Corporation limit. We have not experienced any losses to-date on our invested cash. Cash and cash equivalents which have been restricted as to its use are recorded in other assets.
Revenue Recognition	Revenue Recognition: Our revenues are primarily from leases and loans. For leases, we follow Accounting Standards 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). For lessors, we apply this standard as follows: Operating Lease Revenue We receive income from operating leases based on the fixed required rents (base rents) per the lease agreements. Rent revenue from base rents is recorded on the 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 rents earned over the term of a lease, taking into account contractual rent increases over the lease term. The straight-line method typically has the effect of recording more rent revenue from a lease than a tenant is required to pay early in the term of the lease. During the later parts of a lease term, this effect reverses with less rent revenue recorded than a tenant is required to pay. Rent revenue, as recorded on the straight-line method, in our consolidated statements of net income is presented as two amounts: rent billed and straight-line rent. Rent billed revenue is the amount of base rent actually billed to our tenants each period as required by the lease. Straight-line rent revenue is the difference between rent revenue earned based on the straight-line method and the amount recorded as rent billed revenue. We record the difference between rent revenues earned and amounts due per the respective lease agreements, as applicable, as an increase or decrease to straight-line rent receivables. Rental payments received prior to their recognition as income are classified as deferred revenue. Financing Lease Revenue Under ASU 2016-02, if an acquisition and subsequent lease of a property back to the seller does not meet the definition of a sale, we must account for the transaction as a financing lease with income recognized using the imputed interest method. Another type of financing lease is a direct financing lease (“DFL”). For leases accounted for as DFLs, the future minimum lease payments are recorded as a receivable at lease inception, while, the difference between the future minimum lease payments and the estimated residual values less the cost of the properties is recorded as unearned income. Unearned income is deferred and amortized to income over the lease term to provide a constant yield when collectability of the lease payments is reasonably assured. Investments in DFLs are presented net of unearned income. Other Leasing Revenue We begin recording base rent income from our development projects when the lessee takes physical possession of the facility, which may be different from the stated start date of the lease. Also, during construction of our development projects, we may be entitled to accrue rent based on the cost paid during the construction period (construction period rent). We accrue construction period rent as a receivable with a corresponding offset to deferred revenue during the construction period. When the lessee takes physical possession of the facility, we begin recognizing the deferred construction period revenue on the straight-line method over the term of the lease. We also receive additional rent (contingent rent) under some leases based on increases in the consumer price index (“CPI”) (or similar index outside the U.S.) or when CPI exceeds the annual minimum percentage increase as stipulated in the lease. Contingent rents are recorded as rent billed revenue in the period earned. Tenant payments for ground leases along with other operating expenses, such as property taxes and insurance, that are paid directly by us and reimbursed by our tenants are presented on a gross basis with the related revenues recorded in “Interest and other income” and the related expenses in “Property-related” in our consolidated statements of net income. All payments of other operating expenses made directly by the tenant to the applicable government or appropriate third-party vendor are recorded on a net basis. Interest Revenue We receive interest income from our tenants/borrowers on mortgage loans, working capital loans, and other long-term loans. Interest income from these loans is recognized as earned based upon the principal outstanding and terms of the loans. Other Revenue Commitment fees received 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: We account for acquisitions of real estate under asset acquisition accounting rules. Under this accounting standard, we allocate the purchase price (including any third-party transaction costs directly related to the acquisition) of acquired properties to tangible and identified intangible assets acquired and liabilities assumed (if any) based on their relative fair values. In making estimates of fair values for purposes of allocating purchase prices of acquired real estate, we may utilize a number of sources, from time-to-time, including available real estate broker data, independent appraisals that may be obtained in connection with the acquisition, internal data from previous acquisitions or developments, and other market data, including market comparables for significant assumptions such as market rental, capitalization, and discount rates. We also consider information obtained about each property as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the tangible and intangible assets acquired. We measure the aggregate value of lease intangible assets acquired based on the difference between (i) the property valued with new or in-place leases adjusted to market rental rates and (ii) the property valued as if vacant. Management’s estimates of value are made using methods similar to those used by independent appraisers (e.g., discounted cash flow analysis). Factors considered by management in our analysis include an estimate of carrying costs during hypothetical expected lease-up periods, considering current market conditions, and costs to execute similar leases. We also consider information obtained about each targeted facility as a result of our pre-acquisition due diligence, marketing, and leasing activities in estimating the fair value of the intangible assets acquired. In estimating carrying costs, management includes real estate taxes, insurance, and other operating expenses and estimates of lost rentals at market rates during the expected lease-up periods, which we expect to be about six months, but can be longer depending on specific local market conditions. Management also estimates costs to execute similar leases including leasing commissions, legal costs, and other related expenses to the extent that such costs are not already incurred in connection with a new lease origination as part of the transaction. Other intangible assets acquired may include customer relationship intangible values which are based on management’s evaluation of the specific characteristics of each prospective tenant’s lease and our overall relationship with that tenant. Characteristics to be considered by management in allocating these values include the nature and extent of our existing business relationships with the tenant, growth prospects for developing new business with the tenant, the tenant’s credit quality, and expectations of lease renewals, including those existing under the terms of the lease agreement, among other factors. We amortize the value of our lease intangible assets to expense over the term of the respective leases. If a lease is terminated early, the unamortized portion of the lease intangibles are charged to expense. We record above-market and below-market in-place lease values, if any, for our facilities, which are based on the present value of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) management’s estimate of fair market lease rates for the corresponding in-place leases, measured over a period equal to the remaining non-cancelable term of the lease. We amortize any resulting capitalized above-market lease values as a reduction of rental income over the lease term. We amortize any resulting capitalized below-market lease values as an increase to rental income over the lease term. If a lease is terminated early, the unamortized portion of the capitalized above/below market lease value is recognized in rental income at that time.
Real Estate and Depreciation	Real Estate and Depreciation: Real estate, consisting of land, buildings and improvements, 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, 2021 are as follows: Buildings and improvements 35.8 years Lease intangibles 24.9 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.6 years
Losses from Rent Receivables	Credit Losses: Losses from Rent Receivables: Losses from Operating Lease Receivables: Losses on Financing Lease Receivables: receivable is under performing and is deemed uncollectible based on the lessee’s overall financial condition, we will adju st the credit loss reserve based on the fair value of the underlying collateral. With the adoption of ASU 2016-13, we made the accounting policy election to exclude interest receivables from the credit loss reserve analysis. Such receivables are impaired and an allowance recorded when it is deemed probable that we will be unable to collect all amounts due. Like operating lease receivables, the need for an allowance is based upon our assessment of the lessee’s overall financial condition, economic resources and payment record, the prospects for support from any financially responsible guarantors, and, if appropriate, the realizable value of any collateral. Financing leases are placed on non-accrual status when we determine that the collectability of contractual amounts is not reasonably assured. If on non-accrual status, we generally account for the financing lease on a cash basis, in which income is recognized only upon receipt of cash.
Loans	Loans The following table summarizes our credit loss reserves (in thousands): December 31, 2021 December 31, 2020 Balance at beginning of the year $ 8,726 $ — Cumulative effect of change in accounting principle — 8,399 Provision for credit loss 41,710 3,255 Expected credit losses related to financial instruments sold or repaid (1,909 ) (2,928 ) Balance at end of year $ 48,527 $ 8,726
Earnings Per Share/Units	Earnings Per Share/Units: Basic earnings per common share/unit is computed by dividing net income by the weighted-average number of shares/units outstanding during the period. Diluted earnings per common share/unit is calculated by including the effect of dilutive securities. Our unvested restricted stock awards contain non-forfeitable rights to dividends, and accordingly, these awards are deemed to be participating securities. These participating securities are included in the earnings allocation in computing both basic and diluted earnings per common share/unit.
Income Taxes	Income Taxes: We conduct our business as a REIT under Sections 856 through 860 of the Internal Revenue Code of 1986, as amended (“the Code”). To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute to stockholders at least 90% of our REIT’s ordinary taxable income. As a REIT, we generally pay little U.S. federal and state income tax because of the dividends paid deduction that we are allowed to take. If we fail to qualify as a REIT in any taxable year, we will then be subject to U.S. federal income taxes on our taxable income at regular corporate rates and will not be permitted to qualify for treatment as a REIT for federal income tax purposes for four years following the year during which qualification is lost, unless the Internal Revenue Service grants us relief under certain statutory provisions. Such an event could materially adversely affect our net income and net cash available for distribution to stockholders. However, we intend to operate in such a manner so that we will remain qualified as a REIT for U.S. federal income tax purposes. Our financial statements include the operations of TRS entities, including MPT Development Services, Inc. (“MDS”) and many other entities, which are single member LLCs that are disregarded for tax purposes and are reflected in the tax returns of MDS. None of our TRS entities are entitled to a dividends paid deduction and are subject to U.S. federal, state, and local income taxes. Our TRS entities are authorized to provide property development, leasing, and management services for third-party owned properties, and we will make non-mortgage loans to and/or investments in our lessees through these entities. With the property acquisitions and investments in Europe, Australia, and South America, we are subject to income taxes internationally. However, we do not expect to incur any additional income taxes, of a significant nature, in the U.S. as the majority such income from our international properties flows through our REIT income tax returns. For our TRS entities and international subsidiaries, we determine deferred tax assets and liabilities based on the differences between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Any increase or decrease in our deferred tax assets /liabilities that results from a change in circumstances and that causes us to change our judgment about expected future tax consequences of events, is reflected in our tax provision when such changes occur. Deferred income taxes also reflect the impact of operating loss carryforwards. A valuation allowance is provided if we believe it is more likely than not that all or some portion of our deferred tax assets will not be realized. Any increase or decrease in the valuation allowance that results from a change in circumstances, and that causes us to change our judgment about our ability to realize the related deferred tax asset, is reflected in our tax provision when such changes occur. The calculation of our income taxes involves dealing with uncertainties in the application of complex tax laws and regulations in a multitude of jurisdictions across our global operations. An income tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, on the basis of technical merits. However, if a more likely than not position cannot be reached, we record a liability as an offset to the tax benefit and adjust the liabilities when our judgment changes as a result of the evaluation of new information not previously available. Because of the complexity of some of these uncertainties, the ultimate resolution may result in a payment that is materially different from our current estimate of the uncertain tax position liabilities. These differences will be reflected as increases or decreases to income tax expense in the period in which new information is available.
Stock-Based Compensation	Stock-Based Compensation: We adopted the 2019 Equity Incentive Plan (the “Equity Incentive Plan”) during the second quarter of 2019. 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 assets” on our consolidated balance sheets.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions: Certain of our international subsidiaries’ functional currencies are the local currencies of their respective countries. We translate the results of operations of our foreign subsidiaries into U.S. dollars using average rates of exchange in effect during the period, and we translate balance sheet accounts using exchange rates in effect at the end of the period. We record resulting currency translation adjustments in accumulated other comprehensive income (loss), a component of stockholders’ equity/partnership capital on our consolidated balance sheets. Certain of our U.S. subsidiaries will enter into short-term and long-term transactions denominated in a foreign currency from time-to-time. Gains or losses resulting from these foreign currency transactions are revalued into U.S. dollars at the rates of exchange prevailing at the dates of the transactions. The effects of revaluation gains or losses on our short-term transactions are included in other income in the consolidated statements of income, while the revaluation effects on our long-term investments are recorded in accumulated other comprehensive income (loss) on our consolidated balance sheets.
Derivative Financial Investments and Hedging Activities	Derivative Financial Investments and Hedging Activities: During our normal course of business, we may use certain types of derivative instruments for the purpose of managing interest rate and/or foreign currency risk. We record our derivative and hedging instruments at fair value on the balance sheet. Changes in the estimated fair value of derivative instruments that are not designated as hedges or that do not meet the criteria for hedge accounting are recognized in earnings. For derivatives designated as cash flow hedges, the change in the estimated fair value of the effective portion of the derivative is recognized in accumulated other comprehensive income (loss) on our consolidated balance sheets, whereas the change in the estimated fair value of the ineffective portion is recognized in earnings. For derivatives designated as fair value hedges, the change in the estimated fair value of the effective portion of the 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 valuation models. We also consider counterparty’s and our own credit risk on derivatives and other liabilities measured at their estimated fair value. Fair Value Option Election: For our equity investment in the international joint venture and equity interest in Springstone, LLC (“Springstone”), along with any related investments such as loans (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 investments that existed at December 31, 2021.
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. We record a right-of-use asset and a lease liability for all material leases with a term greater than 12 months regardless of their classification. Leases with a term of 12 months or less are off balance sheet with lease expense recognized on a straight-line basis over the lease term.
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 Reference Rate Reform In March 2020, the Financial Accounting Standards Board (“FASB”) issued ASU No. 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting” (“ASU 2020-04”) to simplify the accounting for contract modifications made to replace the London Interbank Offered Rate (“LIBOR”) or other reference rates that are expected to be discontinued because of reference rate reform. The guidance provides optional expedients and exceptions for applying generally accepted accounting principles (“GAAP”) to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criterion are met. The optional expedients and exceptions can be applied to contract modifications made until December 31, 2022. On January 7, 2021, the FASB issued ASU No. 2021-01, “Reference Rate Reform (Topic 848)” (“ASU 2021-01”), which clarifies that certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting apply to derivatives that are affected by the transition. We have evaluated our contracts that are referenced to LIBOR or other reference rates expected to be discontinued. Our British pound sterling term loan and corresponding interest rate swap were modified with the Sterling Overnight Index Average (SONIA) Rate as a replacement reference rate during the fourth quarter of 2021, and we accounted for such modifications using the expedients and exceptions provided for in ASU 2020-04 and ASU 2021-01. We are continuing to evaluate the need to modify our U.S. dollar LIBOR contracts, such as our unsecured credit facility, but the requirement to replace the U.S. dollar LIBOR has been extended to June 30, 2023. Moreover, we do not expect any impact to our Australian dollar term loan and corresponding interest rate swap, as these contracts are not referenced to rates that are expected to be discontinued.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2021
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, 2021 are as follows: Buildings and improvements 35.8 years Lease intangibles 24.9 years Leasehold improvements 17.0 years Furniture, equipment, and other 7.6 years
Summary of Credit Loss Reserves	The following table summarizes our credit loss reserves (in thousands): December 31, 2021 December 31, 2020 Balance at beginning of the year $ 8,726 $ — Cumulative effect of change in accounting principle — 8,399 Provision for credit loss 41,710 3,255 Expected credit losses related to financial instruments sold or repaid (1,909 ) (2,928 ) Balance at end of year $ 48,527 $ 8,726

Real Estate and Other Activit_2

Real Estate and Other Activities (Tables)	12 Months Ended
	Dec. 31, 2021
Real Estate [Abstract]
Net Assets Acquired	For the years ended December 31, 2021, 2020, and 2019, we acquired or invested in the following net assets (in thousands): 2021 2020 2019 Land and land improvements $ 642,312 $ 365,281 $ 400,539 Buildings 2,381,654 2,547,313 1,951,066 Intangible lease assets — subject to amortization (weighted-average useful life of 34.5 years in 2021, 27.5 years in 2020, and 19.1 years in 2019) 262,385 642,699 227,468 Investment in financing leases — 114,797 1,386,797 Equity investments 123,427 233,593 415,836 Mortgage loans 1,113,300 176,840 51,267 Other loans and assets 909,669 309,523 135,258 Liabilities assumed (82,508 ) (140,866 ) (2,637 ) $ 5,350,239 $ 4,249,180 $ 4,565,594 Loans repaid(1) (1,103,410 ) (834,743 ) — Total net assets acquired $ 4,246,829 $ 3,414,437 $ 4,565,594 (1) The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership in a portfolio of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as 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, 2021 Estimated Rent Commencement Date Ernest (Bakersfield, California) $ 47,929 $ 42,132 1Q 2022 Ernest (Stockton, California) 47,700 31,197 2Q 2022 Steward (Texarkana, Texas) 169,408 28,110 2Q 2024 $ 265,037 $ 101,439
Summary of Joint Venture Designated as Held for Sale	As of December 31, 2021 Real estate held for sale $ 1,096,505 Straight-line rent receivables 120,268 Other assets, net 4,234 Total $ 1,221,007
Amortization Expense from Existing Lease Intangible Assets	We recorded amortization expense related to intangible lease assets of $56.0 million, $42.4 million, and $21.5 million in 2021, 2020, and 2019, respectively, and expect to recognize amortization expense from existing lease intangible assets as follows (amounts in thousands): For the Year Ended December 31: 2022 $ 57,433 2023 57,368 2024 57,334 2025 57,186 2026 56,917
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, 2021 (amounts in thousands): Total Under Operating Leases Total Under Financing Leases Total 2022 $ 1,078,148 $ 168,190 $ 1,246,338 2023 1,099,027 171,553 1,270,580 2024 1,117,353 174,984 1,292,337 2025 1,135,695 178,484 1,314,179 2026 1,154,286 182,054 1,336,340 Thereafter 29,555,221 4,513,925 34,069,146 $ 35,139,730 $ 5,389,190 $ 40,528,920
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, 2021 As of December 31, 2020 Minimum lease payments receivable $ 1,183,855 $ 1,228,966 Estimated residual values 203,818 203,818 Less: Unearned income and allowance for credit loss (918,584 ) (969,061 ) Net investment in direct financing leases 469,089 463,723 Other financing leases (net of allowance for credit loss) 1,584,238 1,547,199 Total investment in financing leases $ 2,053,327 $ 2,010,922
Summary of Loans (Net of Allowance for Credit Loss)	The following is a summary of our loans (net of allowance for credit loss) ($ amounts in thousands): As of December 31, 2021 As of December 31, 2020 Balance Weighted-Average Interest Rate Balance Weighted-Average Interest Rate Mortgage loans $ 213,211 8.7 % $ 248,080 8.5 % Acquisition loans 523,829 7.7 % 338,273 7.6 % Other loans 804,824 6.2 % 520,095 5.8 % $ 1,541,864 $ 1,106,448

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Summary of Debt	The following is a summary of debt (dollar amounts in thousands): As of December 31, 2021 As of December 31, 2020 Revolving credit facility(A) $ 730,000 $ 165,407 Interim credit facilities 869,606 — Term loan 200,000 200,000 British pound sterling term loan(B) 947,240 956,900 Australian term loan facility(B) 871,560 923,280 4.000% Senior Unsecured Notes due 2022(B) — 610,800 2.550% Senior Unsecured Notes due 2023(B) 541,280 546,800 3.325% Senior Unsecured Notes due 2025(B) 568,500 610,800 0.993% Senior Unsecured Notes due 2026(B) 568,500 — 2.500% Senior Unsecured Notes due 2026(B) 676,600 — 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) 811,920 820,200 4.625% Senior Unsecured Notes due 2029 900,000 900,000 3.375% Senior Unsecured Notes due 2030(B) 473,620 — 3.500% Senior Unsecured Notes due 2031 1,300,000 1,300,000 $ 11,358,826 $ 8,934,187 Debt issue costs and discount, net (76,056 ) (68,729 ) $ 11,282,770 $ 8,865,458 (A) The 2020 column includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020. (B) Non-U.S. dollar denominated debt that reflects the exchange rate at period-end.
Principal Payments Due on Debt	As of December 31, 2021, 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): 2022 $ 869,606 2023 541,280 2024 1,601,560 2025 1,515,740 2026 1,945,100 Thereafter 4,885,540 Total $ 11,358,826
Basic Terms of Senior Unsecured Notes	The following are the basic terms of our senior unsecured notes at December 31, 2021 (par value amounts in thousands): Offering Completion Date Maturity Date Par Value % of Par Value Interest Payment Frequency 2.550% Senior Unsecured Notes due 2023 December 5, 2019 December 5, 2023 £ 400,000 100.000 % Annually 3.325% Senior Unsecured Notes due 2025 March 24, 2017 March 24, 2025 € 500,000 100.000 % Annually 0.993% Senior Unsecured Notes due 2026 October 6, 2021 October 15, 2026 € 500,000 100.000 % Annually 2.500% Senior Unsecured Notes due 2026 March 24, 2021 March 24, 2026 £ 500,000 99.937 % Annually 5.250% Senior Unsecured Notes due 2026 July 22, 2016 August 1, 2026 $ 500,000 100.000 % Semi-annually 5.000% Senior Unsecured Notes due 2027 September 7, 2017 October 15, 2027 $ 1,400,000 100.000 % Semi-annually 3.692% Senior Unsecured Notes due 2028 December 5, 2019 June 5, 2028 £ 600,000 99.998 % Annually 4.625% Senior Unsecured Notes due 2029 July 26, 2019 August 1, 2029 $ 900,000 99.500 % Semi-annually 3.375% Senior Unsecured Notes due 2030 March 24, 2021 April 24, 2030 £ 350,000 99.448 % Annually 3.500% Senior Unsecured Notes due 2031 December 4, 2020 March 15, 2031 $ 1,300,000 100.000 % Semi-annually

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Schedule of Income Tax Benefit (Expense)	From our TRS entities and our foreign operations, income tax (expense) benefit were as follows (in thousands): For the Years Ended December 31, 2021 2020 2019 Current income tax (expense) benefit: Domestic $ (1,559 ) $ 63 $ 61 Foreign (18,964 ) (10,203 ) (1,669 ) (20,523 ) (10,140 ) (1,608 ) Deferred income tax (expense) benefit: Domestic 6,915 (10,680 ) 5,490 Foreign (60,340 ) (10,236 ) (1,261 ) (53,425 ) (20,916 ) 4,229 Income tax (expense) benefit $ (73,948 ) $ (31,056 ) $ 2,621
Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes	A reconciliation of income tax (expense) benefit from the statutory income tax rate to the effective tax rate based on income before income taxes for the years ended December 31, 2021, 2020, and 2019 is as follows (in thousands): For the Years Ended December 31, 2021 2020 2019 Income before income tax $ 730,888 $ 463,328 $ 373,780 Income tax at the U.S. statutory federal rate (21% in 2021, 2020, and 2019) (153,486 ) (97,299 ) (78,494 ) Decrease (increase) in income tax resulting from: Foreign rate differential 2,742 2,160 438 State income taxes, net of federal benefit — 970 1,621 U.S. earnings not subject to federal income tax 132,266 82,921 85,495 Equity investments — 380 1,091 Change in valuation allowance (10,040 ) (8,514 ) (7,911 ) Statutory tax rate change (43,924 ) (9,471 ) — Interest disallowance (646 ) — — Other items, net (860 ) (2,203 ) 381 Total income tax (expense) benefit $ (73,948 ) $ (31,056 ) $ 2,621
Schedule of Deferred Tax Assets and Liabilities	At December 31, 2021 and 2020, components of our deferred tax assets and liabilities were as follows (in thousands): 2021 2020 Deferred tax assets: Operating loss and interest deduction carry forwards $ 197,876 $ 150,001 Interest rate swap — 9,150 Other 1,815 6,973 Total deferred tax assets 199,691 166,124 Valuation allowance (61,747 ) (36,977 ) Total net deferred tax assets $ 137,944 $ 129,147 Deferred tax liabilities: Property and equipment $ (320,546 ) $ (211,018 ) Net unbilled revenue (43,366 ) (14,776 ) Partnership investments (15,963 ) — Other (3,836 ) (4,010 ) Total deferred tax liabilities (383,711 ) (229,804 ) Net deferred tax asset (liability) $ (245,767 ) $ (100,657 )
Schedule of Net NOL and Other Tax Attribute Carryforwards	At December 31, 2021, we had net NOL and other tax attribute carryforwards as follows (in thousands): U.S. Foreign Gross NOL carryforwards $ 239,520 $ 699,514 Tax-effected NOL carryforwards $ 28,837 $ 169,039 Valuation allowance (6,291 ) (45,578 ) Net deferred tax asset - NOL carryforwards $ 22,546 $ 123,461 Expiration periods 2030-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, 2021 2020 2019 Common share distribution $ 1.110000 $ 1.070000 $ 1.010000 Ordinary income 0.764580 0.603050 0.701910 Capital gains(1) 0.165420 — 0.275040 Unrecaptured Sec. 1250 gain 0.058270 — 0.041160 Section 199A Dividends 0.764580 0.603050 0.701910 Return of capital 0.180000 0.466950 0.033050 (1) Capital gains include unrecaptured Sec. 1250 gains.

Earnings Per Share_Unit (Tables

Earnings Per Share/Unit (Tables)	12 Months Ended
	Dec. 31, 2021
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, 2021 2020 2019 Numerator: Net income $ 656,940 $ 432,272 $ 376,401 Non-controlling interests’ share in earnings (919 ) (822 ) (1,717 ) Participating securities’ share in earnings (2,161 ) (2,105 ) (2,308 ) Net income, less participating securities’ share in earnings $ 653,860 $ 429,345 $ 372,376 Denominator: Basic weighted-average common shares 588,817 529,239 427,075 Dilutive potential common shares 1,322 1,222 1,224 Diluted weighted-average common shares 590,139 530,461 428,299 MPT Operating Partnership, L.P. Our earnings per unit were calculated based on the following (amounts in thousands): For the Years Ended December 31, 2021 2020 2019 Numerator: Net income $ 656,940 $ 432,272 $ 376,401 Non-controlling interests’ share in earnings (919 ) (822 ) (1,717 ) Participating securities’ share in earnings (2,161 ) (2,105 ) (2,308 ) Net income, less participating securities’ share in earnings $ 653,860 $ 429,345 $ 372,376 Denominator: Basic weighted-average units 588,817 529,239 427,075 Dilutive potential units 1,322 1,222 1,224 Diluted weighted-average units 590,139 530,461 428,299

Stock Awards (Tables)

Stock Awards (Tables)	12 Months Ended
	Dec. 31, 2021
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-based Award Activity	The following summarizes stock-based award activity in 2021 and 2020 (which includes awards granted in 2021, 2020, 2019, and any applicable prior years), respectively: For the Year Ended December 31, 2021: 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 1,057,054 $ 18.79 5,086,983 $ 14.41 Awarded 651,113 $ 20.83 1,957,802 $ 17.94 Vested (781,076 ) $ 18.77 (1,551,482 ) $ 13.73 Forfeited (4,137 ) $ 18.69 (15,767 ) $ 16.72 Nonvested awards at end of year 922,954 $ 20.26 5,477,536 $ 15.86 For the Year Ended December 31, 2020: 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 1,122,440 $ 17.11 5,481,155 $ 11.66 Awarded 635,855 $ 19.65 1,800,898 $ 19.42 Vested (699,215 ) $ 16.80 (2,193,906 ) $ 11.35 Forfeited (2,026 ) $ 18.40 (1,164 ) $ 18.22 Nonvested awards at end of year 1,057,054 $ 18.79 5,086,983 $ 14.41

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2021
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, 2021 December 31, 2020 Asset (Liability) Book Value Fair Value Book Value Fair Value Interest and rent receivables $ 56,229 $ 56,564 $ 46,208 $ 45,381 Loans(1) 991,609 991,954 751,341 756,608 Debt, net (11,282,770 ) (11,526,388 ) (8,865,458 ) (9,226,564 ) (1) Excludes the acquisition loan and mortgage loan made in October 2021 to Springstone and the acquisition loan made in May 2020 to our international joint venture, along with the related subsequent investment in the real estate of three hospitals in Colombia (see Note 3 for further details), as these assets are accounted for under the fair value option method .
Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis	At December 31, 2021 and 2020, the amounts recorded under the fair value option method were as follows (in thousands): As of December 31, 2021 As of December 31, 2020 Asset (Liability) Fair Value Original Cost Fair Value Original Cost Asset Type Classification Mortgage loans $ 143,068 $ 143,068 $ 136,332 $ 136,332 Mortgage loans Equity investment and other loans 409,638 409,638 218,775 218,775 Equity investments/Other loans
Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations	The DLOM on our Springstone and international joint venture equity investments was 40% at December 31, 2021. In arriving at the DLOM, we started with a DLOM range based on the results of studies supporting valuation discounts for other transactions or structures without a public market. To select the appropriate DLOM within the range, we then considered many qualitative factors, including the percent of control, the nature of the underlying investee’s business along with our rights as an investor pursuant to the operating agreement, the size of investment, expected holding period, number of shareholders, access to capital marketplace, etc. To illustrate the effect of movements in the DLOM, we performed a sensitivity analysis below by using basis point variations (dollars in thousands): Basis Point Change in Marketability Discount Estimated Increase (Decrease) in Fair Value + 100 basis points $ (41 ) - 100 basis points 41

Leases (Lessee) (Tables)

Leases (Lessee) (Tables)	12 Months Ended
	Dec. 31, 2021
Leases [Abstract]
Summary of Lease Expense	The following is a summary of our lease expense (in thousands): Income Statement For the Years Ended December 31, Classification 2021 2020 Operating lease cost (1) (2) $ 10,694 $ 9,910 Finance lease cost: Amortization of right-of-use assets Real estate depreciation and amortization 51 51 Interest on lease liabilities Interest 128 128 Sublease income Other (4,466 ) (2,614 ) Total lease cost $ 6,407 $ 7,475 (1) Includes short-term leases. (2) $6.3 million and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2021 and 2020, respectively.
Schedule Of Future Minimum Rental Payments For Leases Sublease Receivable And Net Payments	Fixed minimum payments due over the remaining lease term under non-cancelable leases of more than one year and amounts to be received in the future from non-cancelable subleases over their remaining lease term at December 31, 2021 are as follows (amounts in thousands): Operating Leases Finance Leases Amounts To Be Received From Subleases Net Payments 2022 $ 7,376 $ 128 $ (4,143 ) $ 3,361 2023 7,448 129 (3,963 ) 3,614 2024 6,559 130 (3,987 ) 2,702 2025 5,666 131 (4,044 ) 1,753 2026 5,255 133 (4,015 ) 1,373 Thereafter 239,727 4,650 (71,286 ) 173,091 (1) Total undiscounted minimum lease payments $ 272,031 $ 5,301 $ (91,438 ) $ 185,894 Less: interest (186,814 ) (3,364 ) Present value of lease liabilities $ 85,217 $ 1,937 (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, 2021 December 31, 2020 Right of use assets: Operating leases - real estate Land $ 68,616 $ 73,373 Finance leases - real estate Land 1,785 1,836 Total real estate right of use assets $ 70,401 $ 75,209 Operating leases - corporate Other assets 7,458 8,234 Total right of use assets $ 77,859 $ 83,443 Lease liabilities: Operating leases Obligations to tenants and other lease liabilities $ 85,217 $ 90,006 Financing leases Obligations to tenants and other lease liabilities 1,937 1,935 Total lease liabilities $ 87,154 $ 91,941 Weighted-average remaining lease term: Operating leases 40.6 41.1 Finance leases 34.9 35.9 Weighted-average discount rate: Operating leases 6.4 % 6.4 % Finance leases 6.6 % 6.6 %
Summary of Supplemental Cash Flow Information	The following is supplemental cash flow information (in thousands): For the Years Ended December 31, 2021 2020 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 7,330 $ 6,080 Operating cash flows from finance leases 126 125 Non-cash activities - Right-of-use assets obtained in exchange for lease obligations: Operating leases 1,120 13,832

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2021
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Summary of Other Assets	The following is a summary of our other assets on our consolidated balance sheets (in thousands): As of December 31, 2021 2020 Debt issue costs, net(1) $ 5,488 $ 192 Other corporate assets 193,749 167,929 Prepaids and other assets 134,243 87,948 Total other assets $ 333,480 $ 256,069 (1) Relates to our revolving credit facility

Organization - Additional Infor

Organization - Additional Information (Detail)	Dec. 31, 2021FacilityStateCountry
Business Acquisition [Line Items]
Number of facilities | Facility	438
Number of states | State	32
Europe [Member]
Business Acquisition [Line Items]
Number of countries	6
South America [Member]
Business Acquisition [Line Items]
Number of countries	1

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Significant Accounting Policies [Line Items]
Threshold ownership percentage for inter company balances and transactions elimination	100.00%
Loans and/or equity investments in variable interest entities	$ 570
Expected lease-up periods for estimating lost rentals, in months	6 months
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 1, 2020
Accounting Standards Update [Extensible List]	Accounting Standards Update 2016-13
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
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, 2021
Buildings and improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	35 years 9 months 18 days
Lease Intangibles [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	24 years 10 months 24 days
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	17 years
Furniture, equipment and other [Member]
Property, Plant and Equipment [Line Items]
Weighted average useful lives of related real estate and other assets	7 years 7 months 6 days

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Credit Loss Reserves (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Balance at beginning of the year	$ 8,726
Cumulative effect of change in accounting principle		$ 8,399
Provision for credit loss	41,710	3,255
Expected credit losses related to financial instruments sold or repaid	(1,909)	(2,928)
Balance at end of year	$ 48,527	$ 8,726

Real Estate and Other Activit_3

Real Estate and Other Activities - Net Assets Acquired (Detail) - USD ($) $ in Thousands		Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Total assets acquired		$ 5,350,239	$ 4,249,180	$ 4,565,594
Liabilities assumed		(82,508)	(140,866)	(2,637)
Loans repaid	[1]	(1,103,410)	(834,743)
Total net assets acquired		4,246,829	3,414,437	4,565,594
Land and Land Improvements [Member]
Business Acquisition [Line Items]
Total assets acquired		642,312	365,281	400,539
Building [Member]
Business Acquisition [Line Items]
Total assets acquired		2,381,654	2,547,313	1,951,066
Intangible Lease Assets {Member]
Business Acquisition [Line Items]
Total assets acquired		262,385	642,699	227,468
Mortgage Loans [Member]
Business Acquisition [Line Items]
Total assets acquired		1,113,300	176,840	51,267
Investments in Financing Leases [Member]
Business Acquisition [Line Items]
Total assets acquired			114,797	1,386,797
Equity Investments [Member]
Business Acquisition [Line Items]
Total assets acquired		123,427	233,593	415,836
Other Loans and Assets [Member]
Business Acquisition [Line Items]
Total assets acquired		$ 909,669	$ 309,523	$ 135,258
[1]	The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership in a portfolio of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as described below.

Real Estate and Other Activit_4

Real Estate and Other Activities - Net Assets Acquired (Parenthetical) (Detail) $ in Thousands, £ in Millions		12 Months Ended
		Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)Hospital	Dec. 31, 2019USD ($)Hospital	Jun. 30, 2021Property	Mar. 31, 2021GBP (£)
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		22 years 10 months 24 days
Advanced to the mortgage loan	[1]	$ 1,103,410	$ 834,743
Ernest [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital				4
Priory Group [Member]
Business Acquisition [Line Items]
Number of real estate assets acquired | Property					35
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital			2
Mortgage Loans [Member] | Ernest [Member]
Business Acquisition [Line Items]
Advanced to the mortgage loan				$ 100,000
Mortgage Loans [Member] | Priory Group [Member]
Business Acquisition [Line Items]
Advanced to the mortgage loan | £						£ 800
Mortgage Loans [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Advanced to the mortgage loan			$ 740,000
Intangible Lease Assets {Member]
Business Acquisition [Line Items]
Weighted-average useful life of acquired intangible lease assets (in years)		34 years 6 months	27 years 6 months	19 years 1 month 6 days
[1]	The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership in a portfolio of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as described below.

Real Estate and Other Activit_5

Real Estate and Other Activities - 2021 Activity - Additional Information (Detail) € in Millions, £ in Millions, SFr in Millions, $ in Millions

Dec. 02, 2021EUR (€)

Oct. 21, 2021EUR (€)

Oct. 19, 2021USD ($)

Oct. 13, 2021EUR (€)

Aug. 01, 2021USD ($)Hospital

Jul. 06, 2021USD ($)Hospital

Jul. 06, 2021GBP (£)Hospital

Jun. 25, 2021GBP (£)Property

Jan. 19, 2021GBP (£)

Nov. 25, 2020GBP (£)

Dec. 17, 2019USD ($)Hospital

Nov. 28, 2019EUR (€)

Dec. 31, 2021Hospital

Dec. 31, 2020Hospital

Jun. 30, 2021Property

Apr. 16, 2021CHF (SFr)

Jan. 08, 2021USD ($)

Aug. 31, 2018USD ($)

Swiss Medical Network [Member]

Business Acquisition [Line Items]

Equity investment | SFr

SFr 145

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 700

Number of facilities acquired | Hospital

10

2

United Kingdom [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Valencia, Spain [Member] | General Acute Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 46

Ownership interest

50.00%

Portugal [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 17.8

€ 28.2

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

Business Acquisition [Line Items]

Purchase price of acquisition

$ 900

Number of facilities acquired | Hospital

5

Los Angeles, California [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

4

4

Los Angeles, California [Member] | On Campus Medical Office Buildings [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

2

2

Los Angeles, California [Member] | Acute Care Hospital and On Campus Medical Office Buildings [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 215

Stirling, Scotland [Member] | Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 15.6

Priory Group [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 27

Number of real estate assets acquired | Property

35

Deferred income tax liabilities and other liabilities, incurred | £

£ 47.1

Ownership interest

9.90%

Waterland Private Equity Fund VII C.V. [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 250

Number of real estate assets acquired | Property

35

Payment for acquisition | £

£ 800

Ownership interest

9.90%

Waterland Private Equity Fund VII C.V. [Member] | United Kingdom [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 800

Springstone Inc. [Member]

Business Acquisition [Line Items]

Purchase price of acquisition

$ 185

Consideration of other transaction costs

950

Incurred deferred income tax liabilities

$ 8

Steward Health Care System LLC [Member]

Business Acquisition [Line Items]

Ownership interest

9.90%

Number of facilities acquired | Hospital

2

Other loan to affiliates

$ 335

$ 335

Steward Health Care System LLC [Member] | Florida [Member] | General Acute Care Hospitals [Member]

Business Acquisition [Line Items]

Lease extension expiration term

10 years

Lease extension expiration year

2041

Real Estate and Other Activit_6

Real Estate and Other Activities - 2020 Activity - Additional Information (Detail) $ in Thousands, € in Millions, £ in Millions, SFr in Millions

Dec. 29, 2020CHF (SFr)

Dec. 18, 2020GBP (£)Hospital

Dec. 17, 2020USD ($)Hospital

Nov. 25, 2020GBP (£)

Nov. 17, 2020USD ($)Hospital

Aug. 13, 2020USD ($)

Aug. 07, 2020GBP (£)Hospital

Aug. 05, 2020EUR (€)

Jul. 08, 2020USD ($)Hospital

Jun. 16, 2020RenewalOption

Jan. 08, 2020GBP (£)Hospital

Dec. 17, 2019USD ($)Hospital

Dec. 31, 2021USD ($)Hospital

Dec. 31, 2020USD ($)FacilityHospital

Jun. 24, 2020CHF (SFr)

May 13, 2020USD ($)

Dec. 31, 2019USD ($)

Business Acquisition [Line Items]

Term of lease extension, years

5 years

Acquisition loan | $

$ 5,350,239

$ 4,249,180

$ 4,565,594

Term of lease

15 years

Joint Venture Partner [Member] | Other Loans [Member]

Business Acquisition [Line Items]

Acquisition loan | $

$ 205,000

Steward [Member] | Joint Venture Partner [Member]

Business Acquisition [Line Items]

Ownership interest

49.00%

Infracore [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 206.5

Secured loan | SFr

SFr 45

South Carolina [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

17,000

Net investment in lease | $

$ 115,000

Investment in number of facilities | Facility

5

Utah [Member] | Steward [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

2

Purchase price of acquisition | $

$ 200,000

Utah [Member] | Steward [Member] | Davis and Jordan Valley Facilities [Member]

Business Acquisition [Line Items]

Net investment in lease | $

$ 950,000

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

10

2

Purchase price of acquisition | $

$ 700,000

Acute Care Hospital [Member] | United Kingdom [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Lessor operating lease ground lease term

999 years

Acute Care Hospital [Member] | United Kingdom [Member] | BMI [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

30

Purchase price of acquisition | £

£ 1,500

Initial fixed term of lease

2050

Existence of option to extend

true

false

Number of lease extension options | RenewalOption

2

Term of lease extension, years

5 years

Lease extension options, description

two five-year renewal options

Acute Care Hospital [Member] | South Carolina [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Acute Care Hospital [Member] | California [Member] | Prime Healthcare Services [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 300,000

Acute Care Hospital [Member] | Colombia [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Purchase price of acquisition | $

$ 135,000

Acute Care Hospital [Member] | Darlington, United Kingdom [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Purchase price of acquisition | £

£ 29.4

Inpatient Rehabilitation Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 58,000

Inpatient Rehabilitation Hospital [Member] | South Carolina [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Inpatient Rehabilitation Hospital [Member] | Dahlen, Germany [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Purchase price of acquisition | €

€ 12.5

Inpatient Rehabilitation Hospital [Member] | Texas [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Inpatient Rehabilitation Hospital [Member] | Indiana [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Private Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Private Acute Care Hospital [Member] | Reading, United Kingdom [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 85

Inpatient Rehabilitation Hospital, Acute Care Hospital and Private Acute Care Hospital [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 300,000

Real Estate and Other Activit_7

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

Oct. 21, 2021EUR (€)

Dec. 29, 2020CHF (SFr)

Dec. 17, 2020USD ($)Hospital

Nov. 25, 2020GBP (£)

Dec. 17, 2019USD ($)HospitalRenewalOptionLease

Dec. 03, 2019EUR (€)Hospital

Nov. 28, 2019EUR (€)

Aug. 30, 2019USD ($)RenewalOption

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

Dec. 31, 2021USD ($)Hospital

Dec. 31, 2019USD ($)Hospital

Dec. 31, 2020USD ($)

Business Acquisition [Line Items]

Term of lease

15 years

Term of lease extension, years

5 years

Mortgage loan balance | $

$ 1,541,864,000

$ 1,106,448,000

Weighted average remaining lease term

40 years 7 months 6 days

41 years 1 month 6 days

Other Acquisitions [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 135,000,000

Infracore [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 206.5

Swiss Medical Network [Member]

Business Acquisition [Line Items]

Weighted average remaining lease term

23 years

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%

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

Switzerland [Member] | Infracore [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | SFr

SFr 236.6

Spain [Member] | Spanish Prop Co. [Member]

Business Acquisition [Line Items]

Ownership interest

45.00%

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

Existence of option to extend

true

Term loan | $

$ 112,900,000

Future purchase price adjustment | $

$ 250,000,000

Performance thresholds achievement period

3 years

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] | United Kingdom [Member]

Business Acquisition [Line Items]

Number of private hospitals acquired | Hospital

8

Acute Care Hospital [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

10

2

Purchase price of acquisition | $

$ 700,000,000

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

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

3

Acute Care Hospital [Member] | United Kingdom [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | £

£ 50

Acute Care Hospital [Member] | Spain [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

2

Purchase price of acquisition | €

€ 117.3

Acute Care Hospital [Member] | Portugal [Member]

Business Acquisition [Line Items]

Purchase price of acquisition | €

€ 17.8

€ 28.2

Acute Care Hospital [Member] | Texas [Member] | Steward [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Acute Care Hospital [Member] | Poole, England [Member] | Circle [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

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

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Acute Care Hospital [Member] | Prospect [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] | Switzerland [Member] | Infracore [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 | Hospital

14

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

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

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] | Healthscope [Member]

Business Acquisition [Line Items]

Term of lease

20 years

Hospital [Member] | Australia [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

11

Purchase price of acquisition | $

$ 1,200

Stamp duties and registration fees | $

$ 66.6

Additional Properties [Member] | Switzerland [Member] | Infracore [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]

Business Acquisition [Line Items]

Purchase price of acquisition | $

$ 58,000,000

Inpatient Rehabilitation Hospital [Member] | Texas [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

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

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

1

Community Hospital [Member]

Business Acquisition [Line Items]

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] | Saint Luke's Health System [Member]

Business Acquisition [Line Items]

Term of lease

14 years

Community Hospital [Member] | Kansas [Member]

Business Acquisition [Line Items]

Number of facilities acquired | Hospital

7

Purchase price of acquisition | $

$ 145,400,000

Real Estate and Other Activit_8

Real Estate and Other Activities - Development Activities - Additional Information (Detail) $ in Thousands	Dec. 17, 2019Hospital	Oct. 25, 2019USD ($)	Jun. 30, 2020Hospital	Dec. 31, 2021USD ($)Hospital	Dec. 31, 2019Hospital	Nov. 23, 2020USD ($)	May 15, 2020USD ($)
Business Acquisition [Line Items]
Expected commence rent | $				$ 265,037
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Number of facilities acquired	10			2
Behavioral Hospital [Member] | Houston, Texas [Member]
Business Acquisition [Line Items]
Estimated total development cost | $		$ 27,500
Ernest [Member]
Business Acquisition [Line Items]
Number of facilities acquired					4
Development Activities [Member] | Ernest [Member]
Business Acquisition [Line Items]
Expected commence rent | $						$ 47,700	$ 47,900
Development Activities [Member] | Circle [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired			2
Development Activities [Member] | Circle [Member] | Acute Care Hospital [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired			1
Development Activities [Member] | Circle [Member] | Inpatient Rehabilitation Hospital [Member] | Birmingham, England [Member]
Business Acquisition [Line Items]
Number of facilities acquired			1
Development Activities [Member] | Steward [Member]
Business Acquisition [Line Items]
Expected commence rent | $				$ 169,400

Real Estate and Other Activit_9

Real Estate and Other Activities - Summary of Status on Current Development Projects (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)
Business Acquisition [Line Items]
Commitment	$ 265,037
Costs Incurred as of December 31, 2021	101,439
Ernest [Member] | Bakersfield, California [Member]
Business Acquisition [Line Items]
Commitment	47,929
Costs Incurred as of December 31, 2021	$ 42,132
Estimated Rent Commencement Date	1Q 2022
Ernest [Member] | Stockton, California [Member]
Business Acquisition [Line Items]
Commitment	$ 47,700
Costs Incurred as of December 31, 2021	$ 31,197
Estimated Rent Commencement Date	2Q 2022
Steward [Member] | Texarkana, Texas [Member]
Business Acquisition [Line Items]
Commitment	$ 169,408
Costs Incurred as of December 31, 2021	$ 28,110
Estimated Rent Commencement Date	2Q 2024

Real Estate and Other Activi_10

Real Estate and Other Activities - Disposals - Additional Information (Detail) $ in Millions	Aug. 28, 2021USD ($)Hospital	Dec. 31, 2021USD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)Hospital	Jan. 08, 2021
Business Acquisition [Line Items]
Gain (loss) on real estate dispositions		$ (40)	$ 52.5	$ (2.8)
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Ownership interest					9.90%
Number of facilities acquired | Hospital				2
Massachusetts-based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Ownership interest	50.00%
Number of facilities acquired | Hospital	8
Purchase price of acquisition	$ 1,700
Gain (loss) on real estate dispositions	$ 500
Massachusetts-based General Acute Care Hospitals [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Number of facilities acquired | Hospital	8
Maximum secured debt percentage of asset value	55.00%
Proceeds from expected secured debt	$ 1,300

Real Estate and Other Activi_11

Real Estate and Other Activities - Summary of Joint Venture Designated as Held for Sale (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Real estate held for sale	$ 1,096,505
Straight-line rent receivables	728,522	$ 490,462
Other assets	333,480	256,069
Total Assets	20,519,801	$ 16,829,014
Massachusetts-based General Acute Care Hospitals [Member]
Business Acquisition [Line Items]
Real estate held for sale	1,096,505
Straight-line rent receivables	120,268
Other assets	4,234
Total Assets	$ 1,221,007

Real Estate and Other Activi_12

Real Estate and Other Activities - Other Disposal Transactions - Additional Information (Detail) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2021USD ($)Operator	Dec. 31, 2021USD ($)FacilityOperator	Dec. 31, 2020USD ($)FacilityProperty	Dec. 31, 2019USD ($)Hospital
Business Acquisition [Line Items]
Number of operations sold | Operator	3	3
Proceeds from sale of facilities	$ 54,500	$ 246,000	$ 94
Gain (loss) on real estate dispositions	$ (40,000)	$ 52,500	$ (2,800)
Number of facilities sold | Facility		16	9
Number of properties sold | Property			6
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Gain (loss) on real estate dispositions				$ 41,600
Number of hospitals sold | Hospital				5

Real Estate and Other Activi_13

Real Estate and Other Activities - Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Combinations [Abstract]
Intangible lease assets	$ 1,417,813	$ 1,299,081
Accumulated amortization, net	1,300,000	1,200,000
Amortization expense related to intangible lease assets	$ 56,000	$ 42,400	$ 21,500
Capitalized lease intangibles, weighted average life (in years)	22 years 10 months 24 days

Real Estate and Other Activi_14

Real Estate and Other Activities - Amortization Expense from Existing Lease Intangible Assets (Detail) $ in Thousands	Dec. 31, 2021USD ($)
Business Combinations [Abstract]
2022	$ 57,433
2023	57,368
2024	57,334
2025	57,186
2026	$ 56,917

Real Estate and Other Activi_15

Real Estate and Other Activities - Leasing Operations (Lessor) - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2021USD ($)PropertyLease
Lessor Lease Description [Line Items]
Term of lease	15 years
Lease renewal term	5 years
Annual rent escalations	99.00%
Number of properties | Property	5
Carrying value of lease requiring residual value guarantee | $	$ 231
Ernest [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	13
Number of financing leases	5
Prime Facilities [Member]
Lessor Lease Description [Line Items]
Number of direct financing leases	5
Prospect [Member]
Lessor Lease Description [Line Items]
Number of financing leases	13

Real Estate and Other Activi_16

Real Estate and Other Activities - Summary of Total Future Minimum Lease Payments to be Received (Detail) - Minimum [Member] $ in Thousands	Dec. 31, 2021USD ($)
Lessor Lease Description [Line Items]
2022	$ 1,246,338
2023	1,270,580
2024	1,292,337
2025	1,314,179
2026	1,336,340
Thereafter	34,069,146
Future minimum lease payments to be received	40,528,920
Operating Leases [Member]
Lessor Lease Description [Line Items]
2022	1,078,148
2023	1,099,027
2024	1,117,353
2025	1,135,695
2026	1,154,286
Thereafter	29,555,221
Future minimum lease payments to be received	35,139,730
Financing Leases [Member]
Lessor Lease Description [Line Items]
2022	168,190
2023	171,553
2024	174,984
2025	178,484
2026	182,054
Thereafter	4,513,925
Future minimum lease payments to be received	$ 5,389,190

Real Estate and Other Activi_17

Real Estate and Other Activities - Components of Total Investment in Financing Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Direct Financing Lease Net Investment In Leases [Abstract]
Minimum lease payments receivable	$ 1,183,855	$ 1,228,966
Estimated residual values	203,818	203,818
Less: Unearned income and allowance for credit loss	(918,584)	(969,061)
Net investment in direct financing leases	469,089	463,723
Other financing leases (net of allowance for credit loss)	1,584,238	1,547,199
Total investment in financing leases	$ 2,053,327	$ 2,010,922

Real Estate and Other Activi_18

Real Estate and Other Activities - Rent Deferrals - Additional Information (Detail) $ in Millions	Dec. 31, 2021USD ($)
Business Acquisition [Line Items]
Maximum percentage of deferred rent on annual rent	2.00%
COVID-19 Pandemic [Member]
Business Acquisition [Line Items]
Deferred lease income	$ 2.8
Percentage of deferred revenue lease	$ 8.6

Real Estate and Other Activi_19

Real Estate and Other Activities - Adeptus Health - Additional Information (Detail) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2021USD ($)	Dec. 31, 2021USD ($)FacilityPropertyLease	Dec. 31, 2020USD ($)Property	Dec. 31, 2019USD ($)
Business Acquisition [Line Items]
Number of properties sold | Property			6
Proceeds from sale of facilities	$ 54,500	$ 246,000	$ 94
Adeptus Health [Member]
Business Acquisition [Line Items]
Number of leased properties | Lease		60
Real estate impairment charge			$ 20,000	$ 2,000
Number of properties sold | Property		12
Proceeds from sale of facilities		$ 43
Number of facilities transitioned | Facility		3
Adeptus Health [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of vacant on leased property	0.50%	0.50%

Real Estate and Other Activi_20

Real Estate and Other Activities - Alecto Facilities - Additional Information (Detail) - Alecto Healthcare Services [Member] $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2020USD ($)	Dec. 31, 2021USD ($)Property	Dec. 31, 2020Property	Dec. 31, 2019USD ($)
Business Acquisition [Line Items]
Number of leased properties		4
Real estate impairment charge | $	$ 9.1			$ 20
Number of re-leased properties			1
Number of additional leased properties		1
Proceeds from sale of mortgage loans | $		$ 51
Total Gross Assets [Member] | Customer Concentration Risk [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of total assets		0.10%

Real Estate and Other Activi_21

Real Estate and Other Activities - Halsen Healthcare - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 17, 2019	Sep. 30, 2019	Dec. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Credit loss reserve					$ 8,399
Halsen Healthcare [Member]
Business Acquisition [Line Items]
Credit loss reserve			$ 40,000	$ 40,000
Write off of billed and straight-line rent receivables			$ 2,500
Watsonville, California [Member] | Halsen Healthcare [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of assets fully recoverable				0.50%
Acute Care Hospital [Member]
Business Acquisition [Line Items]
Purchase price of acquisition	$ 700,000
Acute Care Hospital [Member] | Watsonville, California [Member]
Business Acquisition [Line Items]
Purchase price of acquisition		$ 40,000

Real Estate and Other Activi_22

Real Estate and Other Activities - Other Leasing Activity - Additional Information (Detail) $ in Millions	Jul. 24, 2020USD ($)Property	Sep. 30, 2020USD ($)	Dec. 23, 2021Property
ScionHealth Master Lease [Member]
Business Acquisition [Line Items]
Number of properties			8
LifePoint Master Lease [Member]
Business Acquisition [Line Items]
Number of properties			9
Methodist [Member] | Texas [Member]
Business Acquisition [Line Items]
Total investments | $	$ 30
Number of re-leased properties	5
Straight-line rent and other write-off, net of tax | $		$ 1.5

Real Estate and Other Activi_23

Real Estate and Other Activities - Summary of Loans (Net of Allowance for Credit Loss) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Loans [Line Items]
Mortgage loans	$ 213,211	$ 248,080
Mortgage loan balance	1,541,864	1,106,448
Mortgage Loans [Member]
Loans [Line Items]
Mortgage loans	$ 213,211	$ 248,080
Loans, Weighted Average Interest Rate	8.70%	8.50%
Acquisition Loans [Member]
Loans [Line Items]
Acquisition loans	$ 523,829	$ 338,273
Loans, Weighted Average Interest Rate	7.70%	7.60%
Other Loans [Member]
Loans [Line Items]
Other loans	$ 804,824	$ 520,095
Loans, Weighted Average Interest Rate	6.20%	5.80%

Real Estate and Other Activi_24

Real Estate and Other Activities - Loans - Additional Information (Detail) € in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2021USD ($)PropertyOperator	Dec. 31, 2021EUR (€)PropertyOperator	Jan. 08, 2021USD ($)	Aug. 31, 2018USD ($)
Springstone Inc. [Member]
Loans [Line Items]
Acquisition loans	$ 185
Steward Health Care System LLC [Member]
Loans [Line Items]
Other loan to affiliates			$ 335	$ 335
Repayments of other loan	$ 75
Primotop Holdings S.a.r.l. [Member]
Loans [Line Items]
Shareholder loan to joint venture | €		€ 297
Mortgage Loans [Member] | Steward Health Care System LLC [Member]
Loans [Line Items]
Number of real estate assets acquired | Property	5	5
Number of operators | Operator	3	3

Real Estate and Other Activi_25

Real Estate and Other Activities - Other Investment Activities - Additional Information (Detail) € in Millions, SFr in Millions	Oct. 13, 2021EUR (€)	Jan. 08, 2021USD ($)	Jun. 28, 2019CHF (SFr)	Dec. 31, 2021USD ($)
COVID-19 Pandemic [Member]
Business Acquisition [Line Items]
Unfavorable non-cash fair value adjustment on investment				$ 5,800
Aevis Victoria SA [Member]
Business Acquisition [Line Items]
Purchase price of acquisition | SFr			SFr 47
Favorable non-cash fair value adjustment on investment				$ 8,200
Ownership interest in joint venture under the cost method			4.90%	4.90%
Priory Group [Member]
Business Acquisition [Line Items]
Purchase price of acquisition | €	€ 27
Ownership interest	9.90%
Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Distribution on Steward equity investment		$ 11,000,000
Ownership interest		9.90%

Real Estate and Other Activi_26

Real Estate and Other Activities - Concentration of Credit Risks and Related Party Transactions - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Related Party Transactions [Member]
Business Acquisition [Line Items]
Lease and interest revenue earned from tenants	$ 63.9	$ 29.8	$ 85.3
Total Gross Assets [Member] | Geographic Concentration [Member] | U.S. [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	64.00%	65.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Europe [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	30.00%	28.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | Australia [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	5.00%	6.00%
Total Gross Assets [Member] | Geographic Concentration [Member] | South America [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	1.00%	1.00%
Revenue [Member] | Customer Concentration Risk [Member] | General Acute Care Hospital And Healthcare System
Business Acquisition [Line Items]
Percentage of concentration risk	81.00%	87.00%
Revenue [Member] | Customer Concentration Risk [Member] | Rehabilitation Hospital
Business Acquisition [Line Items]
Percentage of concentration risk	8.00%	8.00%
Revenue [Member] | Customer Concentration Risk [Member] | Freestanding ER/Urgent Care Facilities and Behavioral Health Facilities [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	4.00%	2.00%
Revenue [Member] | Customer Concentration Risk [Member] | Long Term Acute Care Hospital
Business Acquisition [Line Items]
Percentage of concentration risk	7.00%	3.00%
Revenue [Member] | Operator Concentration Risk [Member] | Steward Health Care System LLC [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10.00%	10.00%
Revenue [Member] | Operator Concentration Risk [Member] | Circle [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10.00%
Revenue [Member] | Operator Concentration Risk [Member] | Circle [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		10.00%
Revenue [Member] | Operator Concentration Risk [Member] | Prospect [Member]
Business Acquisition [Line Items]
Percentage of concentration risk	10.00%
Revenue [Member] | Operator Concentration Risk [Member] | Prospect [Member] | Maximum [Member]
Business Acquisition [Line Items]
Percentage of concentration risk		10.00%
Pro Forma [Member] | Total Gross Assets [Member] | Customer Concentration Risk [Member]
Business Acquisition [Line Items]
Maximum percentage of entity's assets invested on single property	2.70%	3.20%

Debt - Summary of Debt (Detail)

Debt - Summary of Debt (Detail) - USD ($) $ in Thousands		Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Debt		$ 11,358,826	$ 8,934,187
Debt issue costs and discount, net		(76,056)	(68,729)
Debt, net		11,282,770	8,865,458
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt	[1]	730,000	165,407
Interim Credit Facility [Member]
Debt Instrument [Line Items]
Debt		869,606
Term Loan [Member]
Debt Instrument [Line Items]
Debt		200,000	200,000
Term Loan [Member] | British Pound Sterling [Member]
Debt Instrument [Line Items]
Debt	[2]	947,240	956,900
Term Loan [Member] | Australia [Member]
Debt Instrument [Line Items]
Debt	[2]	871,560	923,280
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Debt	[2]		610,800
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Debt	[2]	541,280	546,800
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Debt	[2]	568,500	610,800
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	568,500
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Debt	[2]	676,600
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]	811,920	820,200
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Debt		900,000	900,000
3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Debt	[2]	473,620
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Debt		$ 1,300,000	$ 1,300,000
[1]	The 2020 column includes £121 million of GBP-denominated borrowings that reflect the exchange rate at December 31, 2020.
[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, 2021USD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2020GBP (£)
Debt Instrument [Line Items]
Debt		$ 11,358,826	$ 8,934,187
GBP-denominated Borrowings [Member]
Debt Instrument [Line Items]
Debt | £				£ 121
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	4.00%	4.00%	4.00%
Debt	[1]		$ 610,800
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	2.55%	2.55%	2.55%
Debt	[1]	$ 541,280	$ 546,800
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	3.325%	3.325%	3.325%
Debt	[1]	$ 568,500	$ 610,800
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	0.993%	0.993%	0.993%
Debt	[1]	$ 568,500
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	2.50%	2.50%	2.50%
Debt	[1]	$ 676,600
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%
Debt		$ 1,400,000	$ 1,400,000
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	3.692%	3.692%	3.692%
Debt	[1]	$ 811,920	$ 820,200
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		4.625%	4.625%	4.625%
Debt		$ 900,000	$ 900,000
3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]	3.375%	3.375%	3.375%
Debt	[1]	$ 473,620
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.50%	3.50%	3.50%
Debt		$ 1,300,000	$ 1,300,000
[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) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
2022	$ 869,606
2023	541,280
2024	1,601,560
2025	1,515,740
2026	1,945,100
Thereafter	4,885,540
Total	$ 11,358,826	$ 8,934,187

Debt - Credit Facility - Additi

Debt - Credit Facility - Additional Information (Detail) - USD ($)	Jan. 15, 2021	Dec. 31, 2021	Dec. 31, 2020	Feb. 01, 2017
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. 1, 2024
Credit facilities, amount outstanding		$ 730,000,000	$ 165,400,000
Line of credit facility, Borrowing capacity		$ 600,000,000	$ 1,100,000,000
Credit facilities, weighted average interest rate		1.30%	1.40%
Alternate Base Rate [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.00%
Applicable margin for revolving loans	0.00%
Alternate Base Rate [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.55%
Eurodollar Loans [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	0.85%
Applicable margin for revolving loans	0.825%
Eurodollar Loans [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin for term loan	1.85%
Applicable margin for revolving loans	1.55%
Term Loans [Member]
Debt Instrument [Line Items]
Amount of senior unsecured debt				$ 200,000,000
Debt instrument maturity date	Feb. 1, 2026
Interest rate at end of period		1.56%	1.65%

Debt - Interim Credit Facility

Debt - Interim Credit Facility - Additional Information (Detail) £ in Millions		Jan. 15, 2021USD ($)	Dec. 31, 2021	Jan. 15, 2021GBP (£)	Dec. 31, 2020
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]		2.50%		2.50%
3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]		3.375%		3.375%
Interim Credit Facility [Member]
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity | $		$ 900,000,000
Line of credit | £				£ 500
Line of credit, terminated date		Mar. 26, 2021
Interim Credit Facility [Member] | 2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		2.50%		2.50%
Interim Credit Facility [Member] | 3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate		3.375%		3.375%
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period-end.

Debt - July 2021 Interim Credit

Debt - July 2021 Interim Credit Facility - Additional Information (Detail) - Interim Credit Facility [Member] £ in Millions	Jul. 27, 2021USD ($)	Dec. 31, 2021USD ($)	Jan. 15, 2021USD ($)	Jan. 15, 2021GBP (£)
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity			$ 900,000,000
Line of credit | £				£ 500
Barclays Bank PLC [Member]
Debt Instrument [Line Items]
Line of credit facility, Borrowing capacity	$ 1,000,000,000
Debt instrument maturity date	Jul. 28, 2022
Line of credit		$ 869,600,000
Line of credit facility, interest rate		1.61%

Debt - British Pound Sterling T

Debt - British Pound Sterling Term Loan - Additional Information (Detail) - Term Loan [Member] - Bank of America, N.A - British Pound Sterling [Member] - GBP (£)	Mar. 04, 2020	Jan. 06, 2020	Dec. 31, 2021
Debt Instrument [Line Items]
Maximum borrowing capacity		£ 700,000,000
Debt instrument maturity date		Jan. 15, 2025
Debt instrument effective date	Mar. 6, 2020
Effective interest rate	0.70%
Senior unsecured notes, interest rate			1.95%
Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		0.85%
Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		1.65%
Credit Rating
Debt Instrument [Line Items]
Variable interest rate			1.25%

Debt - Australian Term Loan - A

Debt - Australian Term Loan - Additional Information (Detail) $ in Millions	Jun. 27, 2019	May 23, 2019AUD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2020USD ($)
Accounts Payable and Accrued Expenses
Debt Instrument [Line Items]
Derivative liability			$ 4.2	$ 51.3
Other Assets [Member]
Debt Instrument [Line Items]
Derivative asset			$ 12.4
Term Loan [Member] | Bank of America, N.A | Australia [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,200,000,000
Debt instrument maturity date		May 23, 2024
Debt instrument effective date	Jul. 3, 2019
Effective interest rate	1.20%
Senior unsecured notes, interest rate	2.45%
Reference rate	0.00%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Minimum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		0.85%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Maximum [Member]
Debt Instrument [Line Items]
Applicable margin adjustable based on pricing grid, percentage		1.65%
Term Loan [Member] | Bank of America, N.A | Australia [Member] | Credit Rating
Debt Instrument [Line Items]
Variable interest rate	1.25%

Debt - Basic Terms of Senior Un

Debt - Basic Terms of Senior Unsecured Notes (Details) - 12 months ended Dec. 31, 2021	USD ($)	GBP (£)	EUR (€)
2.550% Senior Unsecured Notes due 2023 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 5, 2019
Debt instrument maturity date	Dec. 5, 2023
Par Value | €			€ 400,000,000
% of Par Value	100.00%
Interest Payment Frequency	Annually
3.325% Senior Unsecured Notes Due 2025 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2017
Debt instrument maturity date	Mar. 24, 2025
Par Value		£ 500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Annually
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Oct. 6, 2021
Debt instrument maturity date	Oct. 15, 2026
Par Value | €			500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Annually
2.500% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Mar. 24, 2026
Par Value		500,000,000
% of Par Value	99.937%
Interest Payment Frequency	Annually
5.250% Senior Unsecured Notes Due 2026 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 22, 2016
Debt instrument maturity date	Aug. 1, 2026
Par Value | $	$ 500,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually
5.000% Senior Unsecured Notes Due 2027 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Sep. 7, 2017
Debt instrument maturity date	Oct. 15, 2027
Par Value | €			€ 1,400,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually
3.692% Senior Unsecured Notes due 2028 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 5, 2019
Debt instrument maturity date	Jun. 5, 2028
Par Value | $	$ 600,000,000
% of Par Value	99.998%
Interest Payment Frequency	Annually
4.625% Senior Unsecured Notes Due 2029 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Jul. 26, 2019
Debt instrument maturity date	Aug. 1, 2029
Par Value		900,000,000
% of Par Value	99.50%
Interest Payment Frequency	Semi-annually
3.375% Senior Unsecured Notes Due 2030 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Mar. 24, 2021
Debt instrument maturity date	Apr. 24, 2030
Par Value | $	$ 350,000,000
% of Par Value	99.448%
Interest Payment Frequency	Annually
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Offering Completion Date	Dec. 4, 2020
Debt instrument maturity date	Mar. 15, 2031
Par Value		£ 1,300,000,000
% of Par Value	100.00%
Interest Payment Frequency	Semi-annually

Debt - Senior Unsecured Notes -

Debt - Senior Unsecured Notes - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2021
Senior Unsecured Notes [Member]
Debt Instrument [Line Items]
Senior notes, repurchased price percentage on principal amount plus accrued and unpaid interest	101.00%

Debt - Additional Information (

Debt - Additional Information (Detail) € in Millions, $ in Millions		1 Months Ended	12 Months Ended
		Jul. 31, 2019USD ($)	Dec. 31, 2021USD ($)	Dec. 31, 2021EUR (€)	Dec. 31, 2020USD ($)	Dec. 23, 2019USD ($)
0.993% Senior Unsecured Notes due 2026 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]		0.993%	0.993%	0.993%
Senior unsecured notes, maturity year			2026	2026
4.000% Senior Unsecured Notes Due 2022 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate	[1]		4.00%	4.00%	4.00%
Senior unsecured notes, maturity year			2022	2022
Senior unsecured notes redemption amount including accrued and unpaid interest | €				€ 500
Term Loans [Member]
Debt Instrument [Line Items]
Debt refinancing costs				€ 20	$ 28
Accelerated debt issue cost amortization expense						$ 2
3.500% Senior Unsecured Notes Due 2031 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate			3.50%	3.50%	3.50%
Senior unsecured notes, maturity year					2031
6.375% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate					6.375%
Senior unsecured notes, maturity year					2024
Senior unsecured notes redemption amount including accrued and unpaid interest					$ 500
5.500% Senior Unsecured Notes due 2024 [Member]
Debt Instrument [Line Items]
Senior unsecured notes, interest rate					5.50%
Senior unsecured notes, maturity year					2024
Senior unsecured notes redemption amount including accrued and unpaid interest					$ 300
Senior Unsecured Term Loan Facility [Member] | Barclays Bank PLC [Member]
Debt Instrument [Line Items]
Underwriting and other fees		$ 4
Waterland Private Equity Fund VII C.V. [Member] | Interim Credit Facility [Member]
Debt Instrument [Line Items]
Debt refinancing costs			$ 7.3
[1]	Non-U.S. dollar denominated debt that reflects the exchange rate at period-end.

Debt - Covenants - Additional I

Debt - Covenants - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2021
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 ($)	Apr. 01, 2023	Jun. 30, 2021	Sep. 30, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Taxes [Line Items]
Percentage of ordinary taxable income to be distributed for real estate investment trust qualification				90.00%	90.00%	90.00%
Percentage of taxable income to be distributed for federal income tax assumption				100.00%
Amount of foreign income (loss) before income taxes				$ 164,000,000	$ 62,100,000	$ 10,700,000
Amount of domestic income (loss) before income taxes				$ (29,700,000)	$ 6,400,000	$ (44,100,000)
Income tax at the US statutory federal rate				21.00%	21.00%	21.00%
Change in the corporate income tax rate , charge				$ 43,924,000	$ 9,471,000
Valuation allowance not expected to be realized				24,800,000
Uncertain tax position liabilities and related interest or penalties				$ 0
United Kingdom [Member]
Income Taxes [Line Items]
Income tax at the US statutory federal rate		19.00%
Deferred tax liabilities, one time adjustment		$ 43,000,000
Change in the corporate income tax rate , charge			$ 9,000,000
United Kingdom [Member] | Minimum [Member]
Income Taxes [Line Items]
Income tax at the US statutory federal rate			17.00%
United Kingdom [Member] | Maximum [Member]
Income Taxes [Line Items]
Income tax at the US statutory federal rate			19.00%
United Kingdom [Member] | Forecast [Member]
Income Taxes [Line Items]
Income tax at the US statutory federal rate	25.00%

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax (Expense) Benefit (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Current income tax (expense) benefit:
Domestic	$ (1,559)	$ 63	$ 61
Foreign	(18,964)	(10,203)	(1,669)
Total income tax expense	(20,523)	(10,140)	(1,608)
Deferred income tax (expense) benefit:
Domestic	6,915	(10,680)	5,490
Foreign	(60,340)	(10,236)	(1,261)
Total income tax expense	(53,425)	(20,916)	4,229
Income tax (expense) benefit	$ (73,948)	$ (31,056)	$ 2,621

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of Income Tax (Expense) Benefit from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income before income tax	$ 730,888	$ 463,328	$ 373,780
Income tax at the U.S. statutory federal rate (21% in 2021, 2020, and 2019)	(153,486)	(97,299)	(78,494)
Decrease (increase) in income tax resulting from:
Foreign rate differential	2,742	2,160	438
State income taxes, net of federal benefit		970	1,621
U.S. earnings not subject to federal income tax	132,266	82,921	85,495
Equity investments		380	1,091
Change in valuation allowance	(10,040)	(8,514)	(7,911)
Statutory tax rate change	(43,924)	(9,471)
Interest disallowance	(646)
Other items, net	(860)	(2,203)	381
Income tax (expense) benefit	$ (73,948)	$ (31,056)	$ 2,621

Income Taxes - Summary of Rec_2

Income Taxes - Summary of Reconciliation of Income Tax Benefit (Expense) from the Statutory Income Tax Rate to the Effective Tax Rate Based on Income before Income Taxes (Parenthetical) (Detail)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income tax at the US statutory federal rate	21.00%	21.00%	21.00%

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Operating loss and interest deduction carry forwards	$ 197,876	$ 150,001
Interest rate swap		9,150
Other	1,815	6,973
Total deferred tax assets	199,691	166,124
Valuation allowance	(61,747)	(36,977)
Total net deferred tax assets	137,944	129,147
Property and equipment	(320,546)	(211,018)
Net unbilled revenue	(43,366)	(14,776)
Partnership investments	(15,963)
Other	(3,836)	(4,010)
Total deferred tax liabilities	(383,711)	(229,804)
Net deferred tax asset (liability)	$ (245,767)	$ (100,657)

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net NOL and Other Tax Attribute Carryforwards (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)
U.S. [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 239,520
Tax-effected NOL carryforwards	28,837
Valuation allowance	(6,291)
Net deferred tax asset - NOL carryforwards	$ 22,546
Expiration periods	2030
Expiration periods	indefinite
Foreign [Member]
Income Taxes [Line Items]
Gross NOL carryforwards	$ 699,514
Tax-effected NOL carryforwards	169,039
Valuation allowance	(45,578)
Net deferred tax asset - NOL carryforwards	$ 123,461
Expiration periods	indefinite

Income Taxes - Schedule of Per

Income Taxes - Schedule of Per Share Distributions to Stockholders (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Common share distribution	$ 1.110000	$ 1.070000	$ 1.010000
Ordinary income	0.764580	0.603050	0.701910
Capital gains	0.165420		0.275040
Unrecaptured Sec. 1250 gain	0.058270		0.041160
Section 199A Dividends	0.764580	0.603050	0.701910
Return of capital	$ 0.180000	$ 0.466950	$ 0.033050

Earnings Per Share_Unit - Calcu

Earnings Per Share/Unit - Calculation of Earnings Per Share (Detail) - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 656,940	$ 432,272	$ 376,401
Non-controlling interests’ share in earnings	(919)	(822)	(1,717)
Participating securities’ share in earnings	(2,161)	(2,105)	(2,308)
Net income, less participating securities’ share in earnings	$ 653,860	$ 429,345	$ 372,376
Basic weighted-average common shares	588,817	529,239	427,075
Dilutive potential common shares	1,322	1,222	1,224
Diluted weighted-average common shares	590,139	530,461	428,299
MPT Operating Partnership, L.P. [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Net income	$ 656,940	$ 432,272	$ 376,401
Non-controlling interests’ share in earnings	(919)	(822)	(1,717)
Participating securities’ share in earnings	(2,161)	(2,105)	(2,308)
Net income, less participating securities’ share in earnings	$ 653,860	$ 429,345	$ 372,376
Basic weighted-average common shares	588,817	529,239	427,075
Dilutive potential common shares	1,322	1,222	1,224
Diluted weighted-average common shares	590,139	530,461	428,299

Stock Awards - Additional Infor

Stock Awards - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share / (Unit)-based compensation expense	$ 52,110	$ 47,154	$ 32,188
Stock-based compensation expense, unrecognized cost	$ 49,900
Stock-based compensation expense, unrecognized cost, reorganization period (in years)	1 year 1 month 6 days
Stock-based awards, fair value	$ 49,900	$ 58,900	$ 25,900
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
Common stock remaining for future stock awards transferred to the equity incentive plan	5,700,000
Maximum number of shares of common stock that may be awarded	5,000,000
Service-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)	3 years
Performance-Based Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation arrangement by share based payment award, expected service period (in years)	3 years

Stock Awards - Stock-based Awar

Stock Awards - Stock-based Award Activity (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Vesting Based on Service [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	1,057,054	1,122,440
Awarded, Shares	651,113	635,855
Vested, Shares	(781,076)	(699,215)
Forfeited, Shares	(4,137)	(2,026)
Nonvested awards at end of year, Shares	922,954	1,057,054
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 18.79	$ 17.11
Awarded, Weighted Average Value at Award Date	20.83	19.65
Vested, Weighted Average Value at Award Date	18.77	16.80
Forfeited, Weighted Average Value at Award Date	18.69	18.40
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 20.26	$ 18.79
Vesting Based on Market/Performance Conditions [Member]
Employee Restricted Equity Awards Vesting Activity [Line Items]
Nonvested awards at beginning of the year, Shares	5,086,983	5,481,155
Awarded, Shares	1,957,802	1,800,898
Vested, Shares	(1,551,482)	(2,193,906)
Forfeited, Shares	(15,767)	(1,164)
Nonvested awards at end of year, Shares	5,477,536	5,086,983
Nonvested awards at beginning of the year, Weighted Average Value at Award Date	$ 14.41	$ 11.66
Awarded, Weighted Average Value at Award Date	17.94	19.42
Vested, Weighted Average Value at Award Date	13.73	11.35
Forfeited, Weighted Average Value at Award Date	16.72	18.22
Nonvested awards at end of year, Weighted Average Value at Award Date	$ 15.86	$ 14.41

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - Hospital	Sep. 15, 2021	Dec. 17, 2019	Dec. 31, 2021	Dec. 31, 2020
Steward Health Care System LLC [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired				2
HCA Healthcare [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired	5
Percentage of total assets leased			5.50%
HCA Healthcare [Member] | Steward Health Care System LLC [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired	5
Acute Care Hospital [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired		10	2
Acute Care Hospital [Member] | HCA Healthcare [Member]
Commitment And Contingencies [Line Items]
Number of facilities acquired	5

Common Stock_Partners' Capital

Common Stock/Partners' Capital - Additional Information (Detail) - USD ($) shares in Thousands, $ in Thousands	Jan. 11, 2021	Dec. 28, 2020	Nov. 08, 2019	Jul. 18, 2019	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Class Of Stock [Line Items]
Common stock, shares issued					596,814	541,419
Proceeds from sale of common shares / units, net of offering costs					$ 1,051,229	$ 411,101	$ 2,533,210
Redemption of common units						4,928
MPT Operating Partnership, L.P. [Member]
Class Of Stock [Line Items]
Redemption of common units		$ 4,900				$ 4,928
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] | MPT TRS, Inc [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					100.00%
Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					53,063	21,004	145,349
Common Units [Member] | MPT Operating Partnership, L.P. [Member] | Limited Partner [Member]
Class Of Stock [Line Items]
Number of share sold					52,532	20,795	143,894
Conversion of LTIP units to common units		232				232
Redemption of common units						$ 4,928
Public Offering [Member]
Class Of Stock [Line Items]
Common stock, shares issued	36,800		57,500	51,750
Proceeds from sale of common shares / units, net of offering costs	$ 711,000		$ 1,026,000
Additional shares purchased by underwriters				858,100
At-the-Market Equity Offering Program [Member]
Class Of Stock [Line Items]
Proceeds from sale of common shares / units, net of offering costs					$ 340,000		$ 650,000
At-the-Market Equity Offering Program [Member] | Common Units [Member]
Class Of Stock [Line Items]
Number of share sold					16,300	21,000	36,100

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, 2021	Dec. 31, 2020
Fair Value Disclosures [Abstract]
Interest and rent receivables, Book value	$ 56,229	$ 46,208
Loans, Book value	991,609	751,341
Debt, net Book value	(11,282,770)	(8,865,458)
Interest and rent receivables, Fair value	56,564	45,381
Loans, Fair value	991,954	756,608
Debt, net Fair value	$ (11,526,388)	$ (9,226,564)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Summary of Fair Value Information of Financial Instruments (Parenthetical) (Detail) - Fair Value, Recurring - Colombia [Member]	12 Months Ended
	Dec. 31, 2021Health_Center
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired	3
Acquisition Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired	3

Fair Value of Financial Instr_5

Fair Value of Financial Instruments - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2021Health_Center
Springstone Inc. and International Joint Venture [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Percentage of equity investment	40.00%
Fair Value, Recurring | Colombia [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Number of facilities acquired	3

Fair Value of Financial Instr_6

Fair Value of Financial Instruments - Equity Interest in Related Party and Related Loans Measured at Fair Value on Recurring Basis (Detail) - Fair Value, Recurring - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Mortgage Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	$ 143,068	$ 136,332
Original Cost	143,068	136,332
Equity Method Investment and Other Loans [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Fair Value	409,638	218,775
Original Cost	$ 409,638	$ 218,775

Fair Value of Financial Instr_7

Fair Value of Financial Instruments - Schedule of Effects of Movement in DLOM by Sensitivity Analysis by Using Basis Point Variations (Detail) - Springstone Inc. and International Joint Venture [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2021USD ($)
+ 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ (41)
- 100 Basis Points [Member]
Financial Instruments Measured At Fair Value On Recurring Basis [Line Items]
Estimated Increase (Decrease) in Fair Value	$ 41

Leases (Lessee) - Summary of Le

Leases (Lessee) - Summary of Lease Expense (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2021	Dec. 31, 2020
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 10,694	$ 9,910
Finance lease cost:
Total lease cost		6,407	7,475
Real Estate Depreciation and Amortization [Member]
Finance lease cost:
Amortization of right-of-use assets		51	51
Interest [Member]
Finance lease cost:
Interest on lease liabilities		128	128
Other [Member]
Finance lease cost:
Sublease income		$ (4,466)	$ (2,614)
[1]	$6.3 million and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2021 and 2020, respectively.
[2]	Includes short-term leases.

Leases (Lessee) - Summary of _2

Leases (Lessee) - Summary of Lease Expense (Parenthetical) (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2021	Dec. 31, 2020
Lessee Lease Description [Line Items]
Operating lease cost	[1],[2]	$ 10,694	$ 9,910
Property-related [Member]
Lessee Lease Description [Line Items]
Operating lease cost		$ 6,300	$ 6,000
[1]	$6.3 million and $6.0 million included in “Property-related”, with the remainder reflected in the “General and administrative” line of our consolidated statements of net income for 2021 and 2020, respectively.
[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) - USD ($) $ in Thousands		Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating Leases, 2021		$ 7,376
Operating Leases, 2022		7,448
Operating Leases, 2023		6,559
Operating Leases, 2024		5,666
Operating Leases, 2025		5,255
Operating Leases, Thereafter		239,727
Operating Leases, Total undiscounted minimum lease payments		272,031
Operating Leases, Less: interest		(186,814)
Operating Leases, Present value of lease liabilities		85,217	$ 90,006
Finance Leases, 2021		128
Finance Leases, 2022		129
Finance Leases, 2023		130
Finance Leases, 2024		131
Finance Leases, 2025		133
Finance Leases, Thereafter		4,650
Finance Leases, Total undiscounted minimum lease payments		5,301
Finance Leases, Less: interest		(3,364)
Finance Leases, Present value of lease liabilities		1,937	$ 1,935
Amounts To Be Received From Subleases, 2021		(4,143)
Amounts To Be Received From Subleases, 2022		(3,963)
Amounts To Be Received From Subleases, 2023		(3,987)
Amounts To Be Received From Subleases, 2024		(4,044)
Amounts To Be Received From Subleases, 2025		(4,015)
Amounts To Be Received From Subleases, Thereafter		(71,286)
Amounts To Be Received From Subleases, Total undiscounted minimum lease payments		(91,438)
Net Payments, 2021		3,361
Net Payments, 2022		3,614
Net Payments, 2023		2,702
Net Payments, 2024		1,753
Net Payments, 2025		1,373
Net Payments, Thereafter	[1]	173,091
Net Payments, Total undiscounted minimum lease payments		$ 185,894
[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, 2021	Dec. 31, 2020	Dec. 31, 2019
Right of use assets:
Operating leases	$ 7,458	$ 8,234
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Other assets	Other assets
Total real estate right of use assets	$ 70,401	$ 75,209	$ 61,400
Total right of use assets	77,859	83,443
Lease liabilities:
Operating leases	$ 85,217	$ 90,006
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Financing leases	$ 1,937	$ 1,935
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]	us-gaap:OtherLiabilities	us-gaap:OtherLiabilities
Total lease liabilities	$ 87,154	$ 91,941
Weighted-average remaining lease term:
Operating leases	40 years 7 months 6 days	41 years 1 month 6 days
Finance leases	34 years 10 months 24 days	35 years 10 months 24 days
Weighted-average discount rate:
Operating leases	6.40%	6.40%
Finance leases	6.60%	6.60%
Real Estate [Member]
Right of use assets:
Operating leases	$ 68,616	$ 73,373
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Land	Land
Finance leases	$ 1,785	$ 1,836
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Land	Land

Leases (Lessee) - Summary of _3

Leases (Lessee) - Summary of Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 7,330	$ 6,080
Operating cash flows from finance leases	126	125
Non-cash activities - Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 1,120	$ 13,832

Other Assets - Summary of Other

Other Assets - Summary of Other Assets on our Condensed Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands		Dec. 31, 2021	Dec. 31, 2020
Other Assets [Abstract]
Debt issue costs, net	[1]	$ 5,488	$ 192
Other corporate assets		193,749	167,929
Prepaids and other assets		134,243	87,948
Total other assets		$ 333,480	$ 256,069
[1]	Relates to our revolving credit facility

Other Assets - Additional Infor

Other Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Other Assets [Abstract]
Equity investments	$ 1,181,025	$ 1,123,623

Schedule II - Schedule of Valua

Schedule II - Schedule of Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Valuation And Qualifying Accounts [Abstract]
Balance at Beginning of Year	$ 146,637	$ 109,803	$ 66,131
Additions, Charged Against Operations	69,131	58,044	50,893
Addition, Charged to Other Accounts	7,340	22,944
Deductions, Net Recoveries/Write-offs	(68,947)	(44,154)	(7,221)
Balance at End of Year	$ 154,161	$ 146,637	$ 109,803

Schedule II - Schedule of Val_2

Schedule II - Schedule of Valuation and Qualifying Accounts (Parenthetical) (Detail) - USD ($) $ in Thousands	Jan. 08, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Jan. 01, 2020
Increase in real estate impairment reserves			$ 19,000	$ 21,000
Equity investment impairments reserve related to disposals		$ 6,000
Increase in accounts receivable and other reserves		8,000	23,900	22,000
Decrease in accounts receivable and other reserves		38,700
Increase (decrease) in valuation allowances			800
Tax valuation allowances recorded as part of purchase price allocation		7,340	22,944
Cumulative effect of change in accounting principle			8,399
Valuation allowances recorded as part of the purchase price allocation of the Circle Transaction	$ 14,500
Increase (decrease) in real estate impairment reserves related to disposals		(22,400)	(40,500)	(7,200)
Credit loss recovery related to loan paydowns		1,900	2,900
Increase in credit loss reserves on financing-type receivables		41,700	3,300
Priory Group [Member]
Tax valuation allowances recorded as part of purchase price allocation		7,300
Accounting Standards Update 2016-13
Cumulative effect of change in accounting principle					$ 8,400
Valuation Allowance, Deferred Tax Asset [Member]
Increase (decrease) in valuation allowances		$ 20,000	$ 11,900	$ 7,900

Schedule III - Real Estate In_2

Schedule III - Real Estate Investments and Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Initial costs, land	$ 2,003,814
Initial costs, buildings	10,998,157
Additions subsequent to acquisition, Improvements	604,911
Additions subsequent to acquisition, carrying costs	21,867
Land at cost	2,059,236
Buildings at cost	11,569,513
Total at cost	13,628,749	$ 10,749,707	$ 7,312,486	$ 4,781,149
Accumulated Depreciation	853,879	$ 728,176
Property Including Held for Sale [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Accumulated Depreciation	$ 950,369
Princes Risborough, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,955
Land at cost	4,955
Total at cost	4,955
Encumbrances	$ 0
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Ashtead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 39,119
Initial costs, buildings	75,253
Additions subsequent to acquisition, Improvements	1,019
Land at cost	40,138
Buildings at cost	75,253
Total at cost	115,391
Accumulated Depreciation	4,588
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Beckenham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,751
Initial costs, buildings	22,266
Additions subsequent to acquisition, Improvements	54
Land at cost	5,805
Buildings at cost	22,266
Total at cost	28,071
Accumulated Depreciation	1,121
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,477
Initial costs, buildings	173,216
Additions subsequent to acquisition, Improvements	406
Land at cost	32,883
Buildings at cost	173,216
Total at cost	206,099
Accumulated Depreciation	8,715
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Dorchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 513
Initial costs, buildings	33,313
Additions subsequent to acquisition, Improvements	61
Land at cost	574
Buildings at cost	33,313
Total at cost	33,887
Accumulated Depreciation	1,674
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Euxton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,047
Initial costs, buildings	37,797
Additions subsequent to acquisition, Improvements	861
Land at cost	4,908
Buildings at cost	37,797
Total at cost	42,705
Accumulated Depreciation	2,372
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Great Missenden, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,179
Initial costs, buildings	111,784
Additions subsequent to acquisition, Improvements	332
Land at cost	12,511
Buildings at cost	111,784
Total at cost	124,295
Accumulated Depreciation	5,633
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Torquay, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,812
Initial costs, buildings	37,991
Additions subsequent to acquisition, Improvements	357
Land at cost	3,168
Buildings at cost	37,992
Total at cost	41,160
Accumulated Depreciation	2,286
Encumbrances	$ 0
Date of Construction	1981
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,604
Initial costs, buildings	33,245
Land at cost	1,604
Buildings at cost	33,245
Total at cost	34,849
Accumulated Depreciation	6,233
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] | Arnold, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 147
Initial costs, buildings	10,540
Additions subsequent to acquisition, Improvements	360
Land at cost	507
Buildings at cost	10,540
Total at cost	11,047
Accumulated Depreciation	145
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | 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	864
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	18
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, IN [Member]
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	39
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] | Denville, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 15,709
Initial costs, buildings	55,772
Land at cost	15,709
Buildings at cost	55,772
Total at cost	71,481
Accumulated Depreciation	1,781
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Dover NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,865
Initial costs, buildings	8,693
Land at cost	3,865
Buildings at cost	8,693
Total at cost	12,558
Accumulated Depreciation	295
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Sep. 30, 2015
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	5,094
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jun. 16, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2008 [Member] | Sheffield, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,766
Initial costs, buildings	47,422
Additions subsequent to acquisition, Improvements	264
Land at cost	7,030
Buildings at cost	47,422
Total at cost	54,452
Accumulated Depreciation	2,406
Encumbrances	$ 0
Date of Construction	2008
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	5,328
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	769
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 19, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	752
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Dec. 11, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	730
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 3, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	802
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 5, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	751
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jun. 6, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | Fort Worth T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,406
Initial costs, buildings	34,862
Land at cost	3,406
Buildings at cost	34,862
Total at cost	38,268
Accumulated Depreciation	161
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	766
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jul. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | Georgetown, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,569
Initial costs, buildings	23,028
Land at cost	4,569
Buildings at cost	23,028
Total at cost	27,597
Accumulated Depreciation	106
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	656
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Sep. 8, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	765
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Jan. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | Richmond, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,602
Initial costs, buildings	6,224
Land at cost	4,602
Buildings at cost	6,224
Total at cost	10,826
Accumulated Depreciation	36
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Fourteen | 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	781
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Aug. 29, 2014
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	$ 999
Initial costs, buildings	5,448
Additions subsequent to acquisition, Improvements	170
Land at cost	1,169
Buildings at cost	5,448
Total at cost	6,617
Accumulated Depreciation	441
Encumbrances	$ 0
Date of Construction	1887
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	39 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	8,275
Encumbrances	$ 0
Date of Construction	1964
Date Acquired	Nov. 8, 2006
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	5,766
Encumbrances	$ 0
Date of Construction	1964
Date Acquired	May 9, 2007
Life on which depreciation in latest income statements is computed (Years)	40 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	$ 9,888
Initial costs, buildings	27,378
Additions subsequent to acquisition, Improvements	930
Land at cost	10,818
Buildings at cost	27,378
Total at cost	38,196
Accumulated Depreciation	3,048
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	19,425
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
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	54,977
Land at cost	5,733
Buildings at cost	104,113
Total at cost	109,846
Accumulated Depreciation	8,269
Encumbrances	$ 0
Date of Construction	1974
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 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	$ 9,103
Initial costs, buildings	47,756
Land at cost	9,103
Buildings at cost	47,756
Total at cost	56,859
Accumulated Depreciation	1,784
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 3, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Austin T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,722
Initial costs, buildings	4,200
Land at cost	3,722
Buildings at cost	4,200
Total at cost	7,922
Accumulated Depreciation	538
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] | Columbus OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,101
Initial costs, buildings	44,504
Land at cost	2,101
Buildings at cost	44,504
Total at cost	46,605
Accumulated Depreciation	203
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Englewood, CO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,369
Initial costs, buildings	65,905
Land at cost	3,369
Buildings at cost	65,905
Total at cost	69,274
Accumulated Depreciation	297
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,920
Initial costs, buildings	11,388
Additions subsequent to acquisition, Improvements	1,660
Land at cost	11,580
Buildings at cost	11,388
Total at cost	22,968
Accumulated Depreciation	212
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Kansas City, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,351
Initial costs, buildings	13,665
Land at cost	2,351
Buildings at cost	13,665
Total at cost	16,016
Accumulated Depreciation	763
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	774
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] | 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	812
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2017 [Member] | Monmouth, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 15,189
Initial costs, buildings	12,283
Additions subsequent to acquisition, Improvements	1,293
Land at cost	16,482
Buildings at cost	12,283
Total at cost	28,765
Accumulated Depreciation	208
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Oklahoma City, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,641
Initial costs, buildings	3,091
Land at cost	3,641
Buildings at cost	3,091
Total at cost	6,732
Accumulated Depreciation	26
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Phoenix A Z
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	5,627
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Feb. 10, 2017
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	600
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Apr. 13, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2017 [Member] | Texarkana, Texas [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,562
Land at cost	14,562
Total at cost	14,562
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	0 years
2017 [Member] | Valencia, Spain [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,354
Initial costs, buildings	71,087
Additions subsequent to acquisition, Improvements	4,107
Land at cost	11,461
Buildings at cost	71,087
Total at cost	82,548
Accumulated Depreciation	171
Encumbrances	$ 0
Date of Construction	2017
Date Acquired	Dec. 2, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 9,888
Initial costs, buildings	27,378
Additions subsequent to acquisition, Improvements	930
Land at cost	10,818
Buildings at cost	27,378
Total at cost	38,196
Accumulated Depreciation	3,048
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, buildings	$ 20,376
Additions subsequent to acquisition, Improvements	438
Land at cost	438
Buildings at cost	20,376
Total at cost	20,814
Accumulated Depreciation	273
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Avondale, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,383
Initial costs, buildings	65,080
Land at cost	5,383
Buildings at cost	65,080
Total at cost	70,463
Accumulated Depreciation	293
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Goodyear, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,800
Initial costs, buildings	4,713
Land at cost	1,800
Buildings at cost	4,713
Total at cost	6,513
Accumulated Depreciation	677
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] | 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	2,153
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Aug. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Helotes, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,900
Initial costs, buildings	5,115
Land at cost	1,900
Buildings at cost	5,115
Total at cost	7,015
Accumulated Depreciation	746
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] | 2020 [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	786
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] | 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	525
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] | 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	647
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] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,580
Initial costs, buildings	4,174
Land at cost	1,580
Buildings at cost	4,174
Total at cost	5,754
Accumulated Depreciation	548
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] | Houston T X
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	5,069
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jul. 7, 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	$ 1,799
Initial costs, buildings	4,181
Land at cost	1,799
Buildings at cost	4,181
Total at cost	5,980
Accumulated Depreciation	618
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 Louisiana
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	694
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 Louisiana
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,608
Initial costs, buildings	5,801
Land at cost	1,608
Buildings at cost	5,801
Total at cost	7,409
Accumulated Depreciation	798
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] | 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	804
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 23, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,167
Initial costs, buildings	4,801
Land at cost	3,167
Buildings at cost	4,801
Total at cost	7,968
Accumulated Depreciation	610
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] | Plano T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 4,272
Initial costs, buildings	2,492
Land at cost	4,272
Buildings at cost	2,492
Total at cost	6,764
Accumulated Depreciation	435
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Sep. 30, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Rosenberg, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,289
Initial costs, buildings	4,505
Land at cost	1,289
Buildings at cost	4,505
Total at cost	5,794
Accumulated Depreciation	676
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Jan. 15, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,448
Initial costs, buildings	4,253
Land at cost	2,448
Buildings at cost	4,253
Total at cost	6,701
Accumulated Depreciation	549
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Oct. 27, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | The Woodlands, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,035
Initial costs, buildings	4,524
Land at cost	2,035
Buildings at cost	4,524
Total at cost	6,559
Accumulated Depreciation	650
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Mar. 28, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Toledo, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,168
Initial costs, buildings	17,740
Land at cost	1,168
Buildings at cost	17,740
Total at cost	18,908
Accumulated Depreciation	2,550
Encumbrances	$ 0
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	$ 2,158
Initial costs, buildings	29,750
Additions subsequent to acquisition, Improvements	453
Land at cost	2,611
Buildings at cost	29,750
Total at cost	32,361
Accumulated Depreciation	1,738
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 28, 2019
Life on which depreciation in latest income statements is computed (Years)	37 years
1989 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 7,002
Initial costs, buildings	24,077
Additions subsequent to acquisition, Improvements	350
Land at cost	7,352
Buildings at cost	24,077
Total at cost	31,429
Accumulated Depreciation	2,553
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Bolton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,624
Initial costs, buildings	47,335
Additions subsequent to acquisition, Improvements	61
Land at cost	1,685
Buildings at cost	47,335
Total at cost	49,020
Accumulated Depreciation	2,375
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Guildford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,185
Initial costs, buildings	38,719
Additions subsequent to acquisition, Improvements	129
Land at cost	7,314
Buildings at cost	38,719
Total at cost	46,033
Accumulated Depreciation	1,953
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Lynwood, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,116
Initial costs, buildings	148,527
Land at cost	30,116
Buildings at cost	148,527
Total at cost	178,643
Accumulated Depreciation	5,286
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 13, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1989 [Member] | Richmond, VA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,302
Initial costs, buildings	10,071
Land at cost	1,302
Buildings at cost	10,071
Total at cost	11,373
Accumulated Depreciation	761
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	230
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	23
Encumbrances	$ 0
Date of Construction	1989
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Ayr, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 17,729
Initial costs, buildings	51,716
Additions subsequent to acquisition, Improvements	329
Land at cost	18,058
Buildings at cost	51,716
Total at cost	69,774
Accumulated Depreciation	661
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2004 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	11,629
Land at cost	6,535
Buildings at cost	135,147
Total at cost	141,682
Accumulated Depreciation	13,569
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2004 [Member] | Webster Texas
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	9,282
Encumbrances	$ 0
Date of Construction	2004
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,033
Initial costs, buildings	2,835
Additions subsequent to acquisition, Improvements	126
Land at cost	1,159
Buildings at cost	2,835
Total at cost	3,994
Accumulated Depreciation	324
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1973 [Member] | Big Spring, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,655
Initial costs, buildings	21,254
Additions subsequent to acquisition, Improvements	816
Land at cost	1,655
Buildings at cost	22,070
Total at cost	23,725
Accumulated Depreciation	1,671
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Apr. 12, 2019
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Odessa, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,535
Initial costs, buildings	123,518
Additions subsequent to acquisition, Improvements	11,629
Land at cost	6,535
Buildings at cost	135,147
Total at cost	141,682
Accumulated Depreciation	13,569
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1973 [Member] | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,921
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] | Ringwood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,166
Initial costs, buildings	19,323
Additions subsequent to acquisition, Improvements	138
Land at cost	4,304
Buildings at cost	19,323
Total at cost	23,627
Accumulated Depreciation	1,469
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	35 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	14,309
Encumbrances	$ 0
Date of Construction	1973
Date Acquired	Feb. 9, 2011
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	$ 2,891
Initial costs, buildings	4,812
Land at cost	2,891
Buildings at cost	4,812
Total at cost	7,703
Accumulated Depreciation	752
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] | Chandler, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,619
Initial costs, buildings	4,783
Land at cost	3,619
Buildings at cost	4,783
Total at cost	8,402
Accumulated Depreciation	797
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	374
Land at cost	729
Buildings at cost	34,716
Total at cost	35,445
Accumulated Depreciation	5,559
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] | 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	746
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	$ 1,276
Initial costs, buildings	4,276
Land at cost	1,276
Buildings at cost	4,276
Total at cost	5,552
Accumulated Depreciation	704
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	6,725
Land at cost	14,428
Buildings at cost	226,300
Total at cost	240,728
Accumulated Depreciation	16,117
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] | Fort Worth T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,701
Initial costs, buildings	4,392
Land at cost	2,701
Buildings at cost	4,392
Total at cost	7,093
Accumulated Depreciation	741
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] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,920
Initial costs, buildings	11,388
Additions subsequent to acquisition, Improvements	1,660
Land at cost	11,580
Buildings at cost	11,388
Total at cost	22,968
Accumulated Depreciation	212
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | 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	748
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] | 2020 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,210
Initial costs, buildings	4,046
Land at cost	1,210
Buildings at cost	4,046
Total at cost	5,256
Accumulated Depreciation	666
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] | Highland Hills, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,148
Initial costs, buildings	44,181
Land at cost	3,148
Buildings at cost	44,181
Total at cost	47,329
Accumulated Depreciation	202
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Highland Village T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 3,265
Initial costs, buildings	1,551
Land at cost	3,265
Buildings at cost	1,551
Total at cost	4,816
Accumulated Depreciation	411
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
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	1,476
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] | Katy, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,178
Initial costs, buildings	3,873
Land at cost	2,178
Buildings at cost	3,873
Total at cost	6,051
Accumulated Depreciation	597
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] | 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	1,675
Additions subsequent to acquisition, carrying costs	(35)
Land at cost	13,368
Buildings at cost	31,625
Total at cost	44,993
Accumulated Depreciation	3,812
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] | League City, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,316
Initial costs, buildings	3,901
Land at cost	1,316
Buildings at cost	3,901
Total at cost	5,217
Accumulated Depreciation	634
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jun. 19, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 [Member] | Mc Kinney T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 2,668
Initial costs, buildings	4,060
Land at cost	2,668
Buildings at cost	4,060
Total at cost	6,728
Accumulated Depreciation	876
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Jul. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
2015 [Member] | Olathe, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,966
Initial costs, buildings	56,125
Land at cost	5,966
Buildings at cost	56,125
Total at cost	62,091
Accumulated Depreciation	260
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	50 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	686
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] | Santa Maria de Feira, PT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,535
Initial costs, buildings	18,199
Additions subsequent to acquisition, Improvements	364
Land at cost	1,899
Buildings at cost	18,199
Total at cost	20,098
Accumulated Depreciation	80
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 21, 2021
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	11,500
Land at cost	4,428
Buildings at cost	84,728
Total at cost	89,156
Accumulated Depreciation	9,992
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 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	4,548
Land at cost	9,048
Buildings at cost	82,461
Total at cost	91,509
Accumulated Depreciation	5,898
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] | Bussage, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,848
Initial costs, buildings	3,990
Additions subsequent to acquisition, Improvements	176
Land at cost	9,024
Buildings at cost	3,990
Total at cost	13,014
Accumulated Depreciation	56
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1970 [Member] | 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	7,565
Land at cost	13,919
Buildings at cost	30,847
Total at cost	44,766
Accumulated Depreciation	4,458
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	42 years
1970 [Member] | Royston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,636
Initial costs, buildings	21,310
Additions subsequent to acquisition, Improvements	1,521
Land at cost	7,157
Buildings at cost	21,310
Total at cost	28,467
Accumulated Depreciation	336
Encumbrances	$ 0
Date of Construction	1970
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bath, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,443
Initial costs, buildings	13,874
Additions subsequent to acquisition, Improvements	203
Land at cost	7,646
Buildings at cost	13,874
Total at cost	21,520
Accumulated Depreciation	721
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Bowling Green, KY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 3,486
Initial costs, buildings	56,296
Land at cost	3,486
Buildings at cost	56,296
Total at cost	59,782
Accumulated Depreciation	3,662
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] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 14,391
Initial costs, buildings	7,241
Additions subsequent to acquisition, Improvements	288
Land at cost	14,679
Buildings at cost	7,241
Total at cost	21,920
Accumulated Depreciation	104
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Stirling, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 771
Initial costs, buildings	20,738
Additions subsequent to acquisition, Improvements	349
Land at cost	1,120
Buildings at cost	20,738
Total at cost	21,858
Accumulated Depreciation	271
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1992 [Member] | Wichita, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,019
Initial costs, buildings	18,373
Additions subsequent to acquisition, carrying costs	1
Land at cost	1,019
Buildings at cost	18,374
Total at cost	19,393
Accumulated Depreciation	6,315
Encumbrances	$ 0
Date of Construction	1992
Date Acquired	Apr. 4, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, buildings	$ 20,376
Additions subsequent to acquisition, Improvements	438
Land at cost	438
Buildings at cost	20,376
Total at cost	20,814
Accumulated Depreciation	273
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | 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	7,689
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] | Basingstoke, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,532
Initial costs, buildings	53,347
Additions subsequent to acquisition, Improvements	203
Land at cost	13,735
Buildings at cost	53,347
Total at cost	67,082
Accumulated Depreciation	2,694
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Droitwich, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, buildings	$ 16,261
Additions subsequent to acquisition, Improvements	81
Land at cost	81
Buildings at cost	16,261
Total at cost	16,342
Accumulated Depreciation	824
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Hope A R
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	2,732
Land at cost	1,651
Buildings at cost	6,091
Total at cost	7,742
Accumulated Depreciation	897
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] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,743
Initial costs, buildings	64,842
Additions subsequent to acquisition, Improvements	81
Land at cost	9,824
Buildings at cost	64,842
Total at cost	74,666
Accumulated Depreciation	3,253
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1984 [Member] | Swindon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,521
Initial costs, buildings	63,533
Additions subsequent to acquisition, Improvements	142
Land at cost	5,663
Buildings at cost	63,533
Total at cost	69,196
Accumulated Depreciation	3,196
Encumbrances	$ 0
Date of Construction	1984
Date Acquired	Jan. 9, 2020
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	$ 26,294
Initial costs, buildings	216,294
Additions subsequent to acquisition, Improvements	7,682
Land at cost	27,285
Buildings at cost	222,985
Total at cost	250,270
Accumulated Depreciation	14,206
Encumbrances	$ 0
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	4,269
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Feb. 13, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,419
Initial costs, buildings	18,655
Additions subsequent to acquisition, Improvements	660
Land at cost	3,079
Buildings at cost	18,655
Total at cost	21,734
Accumulated Depreciation	263
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,135
Initial costs, buildings	16,606
Additions subsequent to acquisition, Improvements	383
Land at cost	1,518
Buildings at cost	16,606
Total at cost	18,124
Accumulated Depreciation	225
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Harrow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 40,596
Initial costs, buildings	42,958
Additions subsequent to acquisition, Improvements	223
Land at cost	40,819
Buildings at cost	42,958
Total at cost	83,777
Accumulated Depreciation	2,178
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Hill County, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,120
Initial costs, buildings	17,882
Additions subsequent to acquisition, Improvements	374
Land at cost	1,120
Buildings at cost	18,256
Total at cost	19,376
Accumulated Depreciation	13,549
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Sep. 17, 2010
Life on which depreciation in latest income statements is computed (Years)	15 years
1980 [Member] | Hook, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,269
Initial costs, buildings	10,968
Additions subsequent to acquisition, Improvements	487
Land at cost	5,756
Buildings at cost	10,968
Total at cost	16,724
Accumulated Depreciation	162
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 10,678
Initial costs, buildings	3,451
Additions subsequent to acquisition, Improvements	121
Land at cost	10,799
Buildings at cost	3,451
Total at cost	14,250
Accumulated Depreciation	48
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | 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	13,247
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Apr. 22, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Romford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,958
Initial costs, buildings	9,317
Additions subsequent to acquisition, Improvements	733
Land at cost	5,691
Buildings at cost	9,317
Total at cost	15,008
Accumulated Depreciation	147
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | Sharon, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	5,428
Land at cost	6,179
Buildings at cost	14,494
Total at cost	20,673
Accumulated Depreciation	2,731
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1980 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,442
Initial costs, buildings	23,599
Additions subsequent to acquisition, Improvements	397
Land at cost	1,839
Buildings at cost	23,599
Total at cost	25,438
Accumulated Depreciation	313
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1980 [Member] | 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	$ 5,374
Initial costs, buildings	58,314
Additions subsequent to acquisition, Improvements	6,644
Additions subsequent to acquisition, carrying costs	(114)
Land at cost	5,260
Buildings at cost	64,958
Total at cost	70,218
Accumulated Depreciation	20,731
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] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 21,810
Initial costs, buildings	76,287
Additions subsequent to acquisition, Improvements	1,187
Land at cost	22,997
Buildings at cost	76,287
Total at cost	99,284
Accumulated Depreciation	1,009
Encumbrances	$ 0
Date of Construction	1980
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Aberdeen, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,384
Initial costs, buildings	107,058
Additions subsequent to acquisition, Improvements	135
Land at cost	4,519
Buildings at cost	107,058
Total at cost	111,577
Accumulated Depreciation	5,371
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Hot Springs, AR [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,844
Initial costs, buildings	59,432
Additions subsequent to acquisition, Improvements	21,221
Land at cost	5,844
Buildings at cost	80,653
Total at cost	86,497
Accumulated Depreciation	13,122
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Lawton, OK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,944
Initial costs, buildings	63,031
Land at cost	3,944
Buildings at cost	63,031
Total at cost	66,975
Accumulated Depreciation	3,385
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1985 [Member] | Southampton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,527
Initial costs, buildings	20,121
Additions subsequent to acquisition, Improvements	1,323
Land at cost	6,850
Buildings at cost	20,121
Total at cost	26,971
Accumulated Depreciation	312
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 25, 2021
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	$ 2,169
Initial costs, buildings	22,159
Additions subsequent to acquisition, Improvements	11,736
Land at cost	2,731
Buildings at cost	33,333
Total at cost	36,064
Accumulated Depreciation	1,552
Encumbrances	$ 0
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	$ 2,625
Initial costs, buildings	36,767
Additions subsequent to acquisition, Improvements	312
Land at cost	2,937
Buildings at cost	36,767
Total at cost	39,704
Accumulated Depreciation	2,442
Encumbrances	$ 0
Date of Construction	1985
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,098
Initial costs, buildings	99,773
Additions subsequent to acquisition, Improvements	386
Land at cost	10,484
Buildings at cost	99,773
Total at cost	110,257
Accumulated Depreciation	5,040
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bedford, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,583
Initial costs, buildings	7,976
Additions subsequent to acquisition, Improvements	54
Land at cost	1,637
Buildings at cost	7,976
Total at cost	9,613
Accumulated Depreciation	406
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Bossier City, LA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 900
Initial costs, buildings	17,818
Additions subsequent to acquisition, Improvements	944
Land at cost	900
Buildings at cost	18,762
Total at cost	19,662
Accumulated Depreciation	6,214
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	9,542
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	$ 10,816
Initial costs, buildings	22,158
Additions subsequent to acquisition, Improvements	400
Land at cost	11,216
Buildings at cost	22,158
Total at cost	33,374
Accumulated Depreciation	1,370
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Canterbury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 9,675
Initial costs, buildings	29,325
Additions subsequent to acquisition, Improvements	88
Land at cost	9,763
Buildings at cost	29,325
Total at cost	39,088
Accumulated Depreciation	1,478
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Croydon, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,352
Initial costs, buildings	44,330
Additions subsequent to acquisition, Improvements	217
Land at cost	10,569
Buildings at cost	44,330
Total at cost	54,899
Accumulated Depreciation	2,245
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Haverhill, MA [Member]
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	3,185
Land at cost	5,651
Buildings at cost	109,033
Total at cost	114,684
Accumulated Depreciation	8,594
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] | 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	3,547
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] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,385
Initial costs, buildings	47,588
Additions subsequent to acquisition, Improvements	10,486
Land at cost	5,385
Buildings at cost	58,074
Total at cost	63,459
Accumulated Depreciation	7,695
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
2018 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, buildings	$ 19,885
Buildings at cost	19,885
Total at cost	19,885
Accumulated Depreciation	743
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 29, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Conroe, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,855
Initial costs, buildings	39,156
Land at cost	3,855
Buildings at cost	39,156
Total at cost	43,011
Accumulated Depreciation	182
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 29,205
Initial costs, buildings	100,805
Additions subsequent to acquisition, Improvements	2,485
Land at cost	31,690
Buildings at cost	100,805
Total at cost	132,495
Accumulated Depreciation	1,365
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,168
Initial costs, buildings	51,315
Additions subsequent to acquisition, Improvements	2,415
Land at cost	22,583
Buildings at cost	51,315
Total at cost	73,898
Accumulated Depreciation	752
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | El Paso, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 4,268
Initial costs, buildings	21,345
Land at cost	4,268
Buildings at cost	21,345
Total at cost	25,613
Accumulated Depreciation	620
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	38 years
2018 [Member] | 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	813
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2018 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,748
Initial costs, buildings	27,645
Additions subsequent to acquisition, Improvements	542
Land at cost	9,290
Buildings at cost	27,645
Total at cost	36,935
Accumulated Depreciation	371
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Raleigh, NC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,469
Initial costs, buildings	27,707
Land at cost	3,469
Buildings at cost	27,707
Total at cost	31,176
Accumulated Depreciation	136
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2018 [Member] | Roeland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,569
Initial costs, buildings	15,103
Land at cost	1,569
Buildings at cost	15,103
Total at cost	16,672
Accumulated Depreciation	830
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	958
Encumbrances	$ 0
Date of Construction	2018
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
1900 [Member] | Birmingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, buildings	$ 20,376
Additions subsequent to acquisition, Improvements	438
Land at cost	438
Buildings at cost	20,376
Total at cost	20,814
Accumulated Depreciation	273
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | Bellflower, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,563
Land at cost	2,563
Total at cost	2,563
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Aug. 23, 2019
1972 [Member] | Glen Waverly, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 30,764
Initial costs, buildings	23,768
Additions subsequent to acquisition, Improvements	835
Land at cost	31,599
Buildings at cost	23,768
Total at cost	55,367
Accumulated Depreciation	2,189
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] | Los Angeles, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,562
Initial costs, buildings	40,164
Land at cost	12,562
Buildings at cost	40,164
Total at cost	52,726
Accumulated Depreciation	519
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1972 [Member] | San Dimas, CA [member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,160
Initial costs, buildings	6,839
Additions subsequent to acquisition, carrying costs	34
Land at cost	6,160
Buildings at cost	6,873
Total at cost	13,033
Accumulated Depreciation	2,252
Encumbrances	$ 0
Date of Construction	1972
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1957 [Member] | Blackburn, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,706
Initial costs, buildings	54,210
Additions subsequent to acquisition, Improvements	122
Land at cost	2,828
Buildings at cost	54,210
Total at cost	57,038
Accumulated Depreciation	2,727
Encumbrances	$ 0
Date of Construction	1957
Date Acquired	Jan. 9, 2020
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	5,000
Additions subsequent to acquisition, carrying costs	408
Land at cost	2,392
Buildings at cost	33,620
Total at cost	36,012
Accumulated Depreciation	12,608
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] | 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	5,189
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] | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,827
Initial costs, buildings	5,818
Additions subsequent to acquisition, Improvements	139
Land at cost	1,966
Buildings at cost	5,818
Total at cost	7,784
Accumulated Depreciation	516
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
2006 [Member] | Petersburg V A
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,302
Initial costs, buildings	9,121
Land at cost	1,302
Buildings at cost	9,121
Total at cost	10,423
Accumulated Depreciation	3,078
Encumbrances	$ 0
Date of Construction	2006
Date Acquired	Jul. 1, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
1930 [Member] | Blackburn, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 19,620
Initial costs, buildings	57,757
Additions subsequent to acquisition, Improvements	1,670
Land at cost	21,290
Buildings at cost	57,757
Total at cost	79,047
Accumulated Depreciation	792
Encumbrances	$ 0
Date of Construction	1930
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1952 [Member] | Boonton Township, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,712
Initial costs, buildings	17,031
Land at cost	6,712
Buildings at cost	17,031
Total at cost	23,743
Accumulated Depreciation	556
Encumbrances	$ 0
Date of Construction	1952
Date Acquired	Sep. 30, 2015
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	$ 1,604
Initial costs, buildings	33,245
Land at cost	1,604
Buildings at cost	33,245
Total at cost	34,849
Accumulated Depreciation	6,233
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	52,118
Land at cost	18,540
Buildings at cost	198,609
Total at cost	217,149
Accumulated Depreciation	19,400
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	1,475
Encumbrances	$ 0
Date of Construction	2009
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Bassenheim, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 999
Initial costs, buildings	5,448
Additions subsequent to acquisition, Improvements	170
Land at cost	1,169
Buildings at cost	5,448
Total at cost	6,617
Accumulated Depreciation	441
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Feb. 9, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1983 [Member} | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,698
Initial costs, buildings	139,848
Additions subsequent to acquisition, Improvements	149
Land at cost	6,847
Buildings at cost	139,848
Total at cost	146,695
Accumulated Depreciation	7,012
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,136
Initial costs, buildings	3,119
Additions subsequent to acquisition, Improvements	101
Land at cost	1,237
Buildings at cost	3,119
Total at cost	4,356
Accumulated Depreciation	282
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
Accumulated Depreciation	2,290
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,007
Initial costs, buildings	48,842
Additions subsequent to acquisition, Improvements	257
Land at cost	5,264
Buildings at cost	48,842
Total at cost	54,106
Accumulated Depreciation	2,476
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Milton Keynes, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 5,480
Initial costs, buildings	38,117
Additions subsequent to acquisition, Improvements	95
Land at cost	5,575
Buildings at cost	38,117
Total at cost	43,692
Accumulated Depreciation	1,918
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,921
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1983 [Member} | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,021
Initial costs, buildings	2,603
Additions subsequent to acquisition, Improvements	59
Land at cost	1,080
Buildings at cost	2,603
Total at cost	3,683
Accumulated Depreciation	230
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1983 [Member} | Riverton, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,163
Initial costs, buildings	29,647
Land at cost	1,163
Buildings at cost	29,647
Total at cost	30,810
Accumulated Depreciation	1,838
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} | 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	1,472
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Sep. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	39 years
1983 [Member} | West Jordan, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 16,897
Initial costs, buildings	233,256
Additions subsequent to acquisition, Improvements	4,146
Land at cost	16,897
Buildings at cost	237,402
Total at cost	254,299
Accumulated Depreciation	9,639
Encumbrances	$ 0
Date of Construction	1983
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2016 [Member] | Bad Salzuflen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 7,002
Initial costs, buildings	24,077
Additions subsequent to acquisition, Improvements	350
Land at cost	7,352
Buildings at cost	24,077
Total at cost	31,429
Accumulated Depreciation	2,553
Encumbrances	$ 0
Date of Construction	2016
Date Acquired	Nov. 30, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Bad Oeynhausen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,033
Initial costs, buildings	2,835
Additions subsequent to acquisition, Improvements	126
Land at cost	1,159
Buildings at cost	2,835
Total at cost	3,994
Accumulated Depreciation	324
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	5,358
Land at cost	18,328
Buildings at cost	72,606
Total at cost	90,934
Accumulated Depreciation	10,793
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] | Layton, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,360
Initial costs, buildings	370,154
Additions subsequent to acquisition, Improvements	5,369
Land at cost	14,360
Buildings at cost	375,523
Total at cost	389,883
Accumulated Depreciation	13,647
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Newburgh, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,215
Initial costs, buildings	7,266
Land at cost	1,215
Buildings at cost	7,266
Total at cost	8,481
Accumulated Depreciation	36
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2010 [Member] | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,932
Land at cost	3,363
Buildings at cost	10,932
Total at cost	14,295
Accumulated Depreciation	3,554
Encumbrances	$ 0
Date of Construction	2010
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [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	11,904
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1981 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,737
Land at cost	2,417
Buildings at cost	17,594
Total at cost	20,011
Accumulated Depreciation	2,576
Encumbrances	$ 0
Date of Construction	1922
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	46 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	4,548
Land at cost	9,048
Buildings at cost	82,461
Total at cost	91,509
Accumulated Depreciation	5,898
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, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,500
Initial costs, buildings	8,957
Land at cost	1,500
Buildings at cost	8,957
Total at cost	10,457
Accumulated Depreciation	1,958
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	3,320
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] | Little Elm, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, land	$ 1,241
Initial costs, buildings	3,491
Land at cost	1,241
Buildings at cost	3,491
Total at cost	4,732
Accumulated Depreciation	703
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 Idaho
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 417
Initial costs, buildings	12,175
Additions subsequent to acquisition, Improvements	1,905
Land at cost	767
Buildings at cost	13,730
Total at cost	14,497
Accumulated Depreciation	2,755
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	3,292
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Aug. 1, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2013 [Member] | West Chester, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,670
Initial costs, buildings	61,739
Land at cost	3,670
Buildings at cost	61,739
Total at cost	65,409
Accumulated Depreciation	282
Encumbrances	$ 0
Date of Construction	2013
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1971 [Member] | Boonton Township, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,712
Initial costs, buildings	17,031
Land at cost	6,712
Buildings at cost	17,031
Total at cost	23,743
Accumulated Depreciation	556
Encumbrances	$ 0
Date of Construction	1971
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,925
Initial costs, buildings	30,465
Land at cost	7,925
Buildings at cost	30,465
Total at cost	38,390
Accumulated Depreciation	407
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | Boonton Township, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,712
Initial costs, buildings	17,031
Land at cost	6,712
Buildings at cost	17,031
Total at cost	23,743
Accumulated Depreciation	556
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1978 [Member] | Phoenix A Z
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	4,499
Land at cost	12,695
Buildings at cost	78,272
Total at cost	90,967
Accumulated Depreciation	8,821
Encumbrances	$ 0
Date of Construction	1968
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
2007 [Member] | Campbelltown, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,055
Initial costs, buildings	54,756
Additions subsequent to acquisition, Improvements	51
Land at cost	1,106
Buildings at cost	54,756
Total at cost	55,862
Accumulated Depreciation	3,546
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] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,059
Initial costs, buildings	20,181
Additions subsequent to acquisition, Improvements	886
Land at cost	9,945
Buildings at cost	20,181
Total at cost	30,126
Accumulated Depreciation	293
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Hinckley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,175
Initial costs, buildings	17,867
Additions subsequent to acquisition, Improvements	446
Land at cost	2,621
Buildings at cost	17,867
Total at cost	20,488
Accumulated Depreciation	242
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Northland, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 834
Initial costs, buildings	17,182
Land at cost	834
Buildings at cost	17,182
Total at cost	18,016
Accumulated Depreciation	4,689
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Feb. 14, 2011
Life on which depreciation in latest income statements is computed (Years)	40 years
2007 [Member] | Mesa, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,534
Initial costs, buildings	100,042
Additions subsequent to acquisition, Improvements	4,136
Land at cost	6,534
Buildings at cost	104,178
Total at cost	110,712
Accumulated Depreciation	21,948
Encumbrances	$ 0
Date of Construction	2007
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
2015 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	602
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
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Freestanding ER
Initial costs, buildings	$ 1,034
Additions subsequent to acquisition, Improvements	296
Buildings at cost	1,330
Total at cost	1,330
Accumulated Depreciation	228
Encumbrances	$ 0
Date of Construction	2015
Date Acquired	May 1, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
1978 [Member] | Kansas City, MO [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,497
Initial costs, buildings	64,419
Land at cost	10,497
Buildings at cost	64,419
Total at cost	74,916
Accumulated Depreciation	11,354
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	7,981
Land at cost	8,053
Buildings at cost	37,314
Total at cost	45,367
Accumulated Depreciation	3,671
Encumbrances	$ 0
Date of Construction	1978
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1977 [Member] | Braunfels Germany
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,183
Initial costs, buildings	13,954
Additions subsequent to acquisition, Improvements	57
Land at cost	2,240
Buildings at cost	13,954
Total at cost	16,194
Accumulated Depreciation	2,292
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jun. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1977 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,207
Initial costs, buildings	86,380
Additions subsequent to acquisition, Improvements	27
Land at cost	13,234
Buildings at cost	86,380
Total at cost	99,614
Accumulated Depreciation	4,323
Encumbrances	$ 0
Date of Construction	1977
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1917 [Member] | Brighton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,540
Initial costs, buildings	146,491
Additions subsequent to acquisition, Improvements	52,118
Land at cost	18,540
Buildings at cost	198,609
Total at cost	217,149
Accumulated Depreciation	19,400
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	5,358
Land at cost	18,328
Buildings at cost	72,606
Total at cost	90,934
Accumulated Depreciation	10,793
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	$ 106,021
Initial costs, buildings	37,654
Additions subsequent to acquisition, Improvements	2,528
Land at cost	106,241
Buildings at cost	39,962
Total at cost	146,203
Accumulated Depreciation	3,386
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1965 [Member] | Rochdale, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,654
Initial costs, buildings	43,317
Additions subsequent to acquisition, Improvements	149
Land at cost	3,803
Buildings at cost	43,317
Total at cost	47,120
Accumulated Depreciation	2,186
Encumbrances	$ 0
Date of Construction	1965
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1714 [Member] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,084
Initial costs, buildings	16,503
Additions subsequent to acquisition, Improvements	594
Land at cost	7,678
Buildings at cost	16,503
Total at cost	24,181
Accumulated Depreciation	229
Encumbrances	$ 0
Date of Construction	1714
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1979 [Member] | Bundoora, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,654
Initial costs, buildings	64,096
Additions subsequent to acquisition, Improvements	4,482
Land at cost	6,940
Buildings at cost	68,292
Total at cost	75,232
Accumulated Depreciation	4,607
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 A Z
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,396
Initial costs, buildings	26,521
Additions subsequent to acquisition, Improvements	2,985
Land at cost	2,396
Buildings at cost	29,506
Total at cost	31,902
Accumulated Depreciation	3,360
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	Acute care general hospital
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	1,672
Encumbrances	$ 0
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	$ 6,019
Initial costs, buildings	45,750
Additions subsequent to acquisition, Improvements	358
Land at cost	6,377
Buildings at cost	45,750
Total at cost	52,127
Accumulated Depreciation	3,570
Encumbrances	$ 0
Date of Construction	1979
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	34 years
2012 [Member] | Carrollton, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,941
Initial costs, buildings	52,579
Land at cost	4,941
Buildings at cost	52,579
Total at cost	57,520
Accumulated Depreciation	237
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Casper, WY [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,785
Land at cost	1,785
Total at cost	1,785
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Feb. 29, 2012
2012 [Member] | Dublin, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,118
Initial costs, buildings	70,305
Land at cost	5,118
Buildings at cost	70,305
Total at cost	75,423
Accumulated Depreciation	312
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | 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	28,556
Land at cost	3,526
Buildings at cost	110,914
Total at cost	114,440
Accumulated Depreciation	12,508
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	6,960
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] | Lafayette, IN [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,321
Initial costs, buildings	10,884
Land at cost	3,321
Buildings at cost	10,884
Total at cost	14,205
Accumulated Depreciation	60
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Overlook, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,452
Initial costs, buildings	9,666
Additions subsequent to acquisition, Improvements	7
Land at cost	2,452
Buildings at cost	9,673
Total at cost	12,125
Accumulated Depreciation	2,140
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] | 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	149
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | San Antonio, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,248
Initial costs, buildings	5,880
Land at cost	2,248
Buildings at cost	5,880
Total at cost	8,128
Accumulated Depreciation	1,346
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Oct. 2, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
2012 [Member] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 26,996
Initial costs, buildings	88,538
Additions subsequent to acquisition, Improvements	635
Land at cost	27,631
Buildings at cost	88,538
Total at cost	116,169
Accumulated Depreciation	2,256
Encumbrances	$ 0
Date of Construction	2012
Date Acquired	Dec. 18, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Three | Bury, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,173
Initial costs, buildings	20,617
Additions subsequent to acquisition, Improvements	872
Land at cost	9,045
Buildings at cost	20,617
Total at cost	29,662
Accumulated Depreciation	298
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Three | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	744
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 2, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Two Thousand Three | Youngstown, OH [Member]
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	488
Land at cost	4,335
Buildings at cost	4,053
Total at cost	8,388
Accumulated Depreciation	2,428
Encumbrances	$ 0
Date of Construction	2003
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1990 [Member] | Carmarthen, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 866
Initial costs, buildings	27,185
Additions subsequent to acquisition, Improvements	101
Land at cost	967
Buildings at cost	27,185
Total at cost	28,152
Accumulated Depreciation	1,373
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,108
Initial costs, buildings	28,014
Additions subsequent to acquisition, Improvements	449
Land at cost	5,557
Buildings at cost	28,014
Total at cost	33,571
Accumulated Depreciation	369
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Gloucester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,869
Initial costs, buildings	65,235
Additions subsequent to acquisition, Improvements	1,062
Land at cost	5,931
Buildings at cost	65,235
Total at cost	71,166
Accumulated Depreciation	4,031
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Hemel Hempstead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 12,480
Initial costs, buildings	6,702
Additions subsequent to acquisition, Improvements	795
Land at cost	13,275
Buildings at cost	6,702
Total at cost	19,977
Accumulated Depreciation	117
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Melton Mowbray, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,387
Initial costs, buildings	16,993
Additions subsequent to acquisition, Improvements	673
Land at cost	6,060
Buildings at cost	16,993
Total at cost	23,053
Accumulated Depreciation	243
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1990 [Member] | Reading, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 36,489
Initial costs, buildings	49,078
Additions subsequent to acquisition, Improvements	496
Land at cost	36,985
Buildings at cost	49,078
Total at cost	86,063
Accumulated Depreciation	2,991
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1956 [Member] | Detroit, MI [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Long term acute care hospital
Initial costs, land	$ 1,220
Initial costs, buildings	8,687
Additions subsequent to acquisition, carrying costs	(364)
Land at cost	1,220
Buildings at cost	8,323
Total at cost	9,543
Accumulated Depreciation	2,893
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	6,725
Land at cost	14,428
Buildings at cost	226,300
Total at cost	240,728
Accumulated Depreciation	16,117
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] | Denville, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 15,709
Initial costs, buildings	55,772
Land at cost	15,709
Buildings at cost	55,772
Total at cost	71,481
Accumulated Depreciation	1,781
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1953 [Member] | Port Huron, MI
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,531
Initial costs, buildings	14,252
Land at cost	2,531
Buildings at cost	14,252
Total at cost	16,783
Accumulated Depreciation	2,921
Encumbrances	$ 0
Date of Construction	1953
Date Acquired	Dec. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	30 years
1849 [Member] | Cheadle, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 29,205
Initial costs, buildings	100,805
Additions subsequent to acquisition, Improvements	2,485
Land at cost	31,690
Buildings at cost	100,805
Total at cost	132,495
Accumulated Depreciation	1,365
Encumbrances	$ 0
Date of Construction	1849
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1976 [Member] | Dodge City, KS [Member]
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
Accumulated Depreciation	2,844
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] | Layton, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,360
Initial costs, buildings	370,154
Additions subsequent to acquisition, Improvements	5,369
Land at cost	14,360
Buildings at cost	375,523
Total at cost	389,883
Accumulated Depreciation	13,647
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
1976 [Member] | Phoenix A Z
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	4,499
Land at cost	12,695
Buildings at cost	78,272
Total at cost	90,967
Accumulated Depreciation	8,821
Encumbrances	$ 0
Date of Construction	1976
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	43 years
2019 [Member] | Clarksville, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,460
Initial costs, buildings	25,540
Land at cost	2,460
Buildings at cost	25,540
Total at cost	28,000
Accumulated Depreciation	710
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Dec. 17, 2020
Life on which depreciation in latest income statements is computed (Years)	39 years
2019 [Member] | Overland Park, KS [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,191
Initial costs, buildings	14,263
Land at cost	3,191
Buildings at cost	14,263
Total at cost	17,454
Accumulated Depreciation	845
Encumbrances	$ 0
Date of Construction	2019
Date Acquired	Jun. 10, 2019
Life on which depreciation in latest income statements is computed (Years)	50 years
2011 [Member] | Cologne Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,456
Initial costs, buildings	15,413
Additions subsequent to acquisition, Improvements	103
Land at cost	4,559
Buildings at cost	15,413
Total at cost	19,972
Accumulated Depreciation	1,765
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	13,365
Land at cost	23,809
Buildings at cost	102,870
Total at cost	126,679
Accumulated Depreciation	13,187
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Oct. 3, 2016
Life on which depreciation in latest income statements is computed (Years)	41 years
2011 [Member] | New Braunfels, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,853
Initial costs, buildings	10,622
Land at cost	1,853
Buildings at cost	10,622
Total at cost	12,475
Accumulated Depreciation	299
Encumbrances	$ 0
Date of Construction	2011
Date Acquired	Feb. 29, 2012
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Coral Gables, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 26,215
Initial costs, buildings	84,584
Land at cost	26,215
Buildings at cost	84,584
Total at cost	110,799
Accumulated Depreciation	913
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Aug. 1, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1982 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,811
Initial costs, buildings	5,940
Land at cost	2,811
Buildings at cost	5,940
Total at cost	8,751
Accumulated Depreciation	93
Encumbrances	$ 0
Date of Construction	1959
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Dahlen, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 948
Initial costs, buildings	11,679
Additions subsequent to acquisition, Improvements	434
Land at cost	1,382
Buildings at cost	11,679
Total at cost	13,061
Accumulated Depreciation	455
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jul. 8, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1994 [Member] | Worthing, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,037
Initial costs, buildings	32,043
Additions subsequent to acquisition, Improvements	101
Land at cost	7,138
Buildings at cost	32,043
Total at cost	39,181
Accumulated Depreciation	1,616
Encumbrances	$ 0
Date of Construction	1994
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,854
Initial costs, buildings	38,071
Additions subsequent to acquisition, Improvements	365
Land at cost	2,219
Buildings at cost	38,071
Total at cost	40,290
Accumulated Depreciation	1,383
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Aug. 7, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2001 [Member] | Hope A R
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	2,732
Land at cost	1,651
Buildings at cost	6,091
Total at cost	7,742
Accumulated Depreciation	897
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	16,180
Land at cost	7,073
Buildings at cost	170,676
Total at cost	177,749
Accumulated Depreciation	12,760
Encumbrances	$ 0
Date of Construction	2001
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
Nineteen Twenty Five | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,168
Initial costs, buildings	51,315
Additions subsequent to acquisition, Improvements	2,415
Land at cost	22,583
Buildings at cost	51,315
Total at cost	73,898
Accumulated Depreciation	752
Encumbrances	$ 0
Date of Construction	1935
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Twenty Five | Dover NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,865
Initial costs, buildings	8,693
Land at cost	3,865
Buildings at cost	8,693
Total at cost	12,558
Accumulated Depreciation	295
Encumbrances	$ 0
Date of Construction	1925
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty | Darlington UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,108
Initial costs, buildings	28,014
Additions subsequent to acquisition, Improvements	449
Land at cost	5,557
Buildings at cost	28,014
Total at cost	33,571
Accumulated Depreciation	369
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty | Houston T X
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	17,863
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Aug. 10, 2007
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,935
Initial costs, buildings	6,103
Land at cost	3,935
Buildings at cost	6,103
Total at cost	10,038
Accumulated Depreciation	92
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,133
Initial costs, buildings	16,640
Additions subsequent to acquisition, Improvements	416
Land at cost	6,549
Buildings at cost	16,640
Total at cost	23,189
Accumulated Depreciation	229
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Sixty | Meyersdale, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 390
Initial costs, buildings	4,280
Land at cost	390
Buildings at cost	4,280
Total at cost	4,670
Accumulated Depreciation	365
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
Nineteen Sixty | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,932
Land at cost	3,363
Buildings at cost	10,932
Total at cost	14,295
Accumulated Depreciation	3,554
Encumbrances	$ 0
Date of Construction	1960
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1840 [Member] | Diss, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,406
Initial costs, buildings	11,034
Additions subsequent to acquisition, Improvements	687
Land at cost	3,093
Buildings at cost	11,034
Total at cost	14,127
Accumulated Depreciation	169
Encumbrances	$ 0
Date of Construction	1840
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Ninety Three | Dormagen Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,827
Initial costs, buildings	5,818
Additions subsequent to acquisition, Improvements	139
Land at cost	1,966
Buildings at cost	5,818
Total at cost	7,784
Accumulated Depreciation	516
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Ninety Three | 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	2,390
Encumbrances	$ 0
Date of Construction	1993
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1830 [Member] | Bromley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,084
Initial costs, buildings	16,503
Additions subsequent to acquisition, Improvements	594
Land at cost	7,678
Buildings at cost	16,503
Total at cost	24,181
Accumulated Depreciation	229
Encumbrances	$ 0
Date of Construction	1830
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1969 [Member] | Denville, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 15,709
Initial costs, buildings	55,772
Land at cost	15,709
Buildings at cost	55,772
Total at cost	71,481
Accumulated Depreciation	1,781
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1969 [Member] | Hialeah, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 75,339
Initial costs, buildings	222,399
Additions subsequent to acquisition, Improvements	75,000
Land at cost	75,339
Buildings at cost	297,399
Total at cost	372,738
Accumulated Depreciation	2,647
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Aug. 1, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1969 [Member] | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,935
Initial costs, buildings	6,103
Land at cost	3,935
Buildings at cost	6,103
Total at cost	10,038
Accumulated Depreciation	92
Encumbrances	$ 0
Date of Construction	1969
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Twenty Seven | Dover NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,865
Initial costs, buildings	8,693
Land at cost	3,865
Buildings at cost	8,693
Total at cost	12,558
Accumulated Depreciation	295
Encumbrances	$ 0
Date of Construction	1927
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | Brockton, MA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,084
Initial costs, buildings	16,503
Additions subsequent to acquisition, Improvements	594
Land at cost	7,678
Buildings at cost	16,503
Total at cost	24,181
Accumulated Depreciation	229
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | Mc Kinney T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,934
Land at cost	2,934
Total at cost	2,934
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Oct. 19, 2021
2021 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,748
Initial costs, buildings	27,645
Additions subsequent to acquisition, Improvements	542
Land at cost	9,290
Buildings at cost	27,645
Total at cost	36,935
Accumulated Depreciation	371
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2021 [Member] | Stockton, California [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,886
Land at cost	2,886
Total at cost	2,886
Encumbrances	$ 0
Date of Construction	2021
Date Acquired	Nov. 23, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Darlington, United Kingdom [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,168
Initial costs, buildings	51,315
Additions subsequent to acquisition, Improvements	2,415
Land at cost	22,583
Buildings at cost	51,315
Total at cost	73,898
Accumulated Depreciation	752
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,880
Initial costs, buildings	107,403
Land at cost	1,880
Buildings at cost	107,403
Total at cost	109,283
Accumulated Depreciation	5,146
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Dec. 19, 2017
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Houston T X
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,063
Initial costs, buildings	19,881
Additions subsequent to acquisition, Improvements	2,565
Land at cost	6,063
Buildings at cost	22,446
Total at cost	28,509
Accumulated Depreciation	561
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 25, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Tadley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 20,486
Initial costs, buildings	20,266
Additions subsequent to acquisition, Improvements	1,748
Land at cost	22,234
Buildings at cost	20,266
Total at cost	42,500
Accumulated Depreciation	333
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Windsor, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,387
Initial costs, buildings	4,976
Additions subsequent to acquisition, Improvements	308
Land at cost	7,695
Buildings at cost	4,976
Total at cost	12,671
Accumulated Depreciation	76
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 | Halsall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,524
Initial costs, buildings	33,120
Additions subsequent to acquisition, Improvements	618
Land at cost	2,142
Buildings at cost	33,120
Total at cost	35,262
Accumulated Depreciation	2,052
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1986 | Rowley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,489
Initial costs, buildings	19,453
Additions subsequent to acquisition, Improvements	602
Land at cost	3,091
Buildings at cost	19,453
Total at cost	22,544
Accumulated Depreciation	1,243
Encumbrances	$ 0
Date of Construction	1986
Date Acquired	Aug. 16, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1999 [Member] | Hartsville, SC [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,050
Initial costs, buildings	43,970
Land at cost	2,050
Buildings at cost	43,970
Total at cost	46,020
Accumulated Depreciation	8,038
Encumbrances	$ 0
Date of Construction	1999
Date Acquired	Aug. 31, 2015
Life on which depreciation in latest income statements is computed (Years)	34 years
1924 [Member] | Hastings, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 603
Initial costs, buildings	8,834
Land at cost	603
Buildings at cost	8,834
Total at cost	9,437
Accumulated Depreciation	726
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1924 [Member] | Johnstown, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 8,877
Initial costs, buildings	247,042
Additions subsequent to acquisition, carrying costs	117
Land at cost	8,877
Buildings at cost	247,159
Total at cost	256,036
Accumulated Depreciation	16,717
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1924 [Member] | Roaring Springs, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,446
Initial costs, buildings	9,549
Land at cost	1,446
Buildings at cost	9,549
Total at cost	10,995
Accumulated Depreciation	811
Encumbrances	$ 0
Date of Construction	1924
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1950 [Member]
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	52,051
Land at cost	28,687
Buildings at cost	156,079
Total at cost	184,766
Accumulated Depreciation	9,735
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	28,556
Land at cost	3,526
Buildings at cost	110,914
Total at cost	114,440
Accumulated Depreciation	12,508
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] | Hialeah, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 18,802
Initial costs, buildings	107,783
Land at cost	18,802
Buildings at cost	107,783
Total at cost	126,585
Accumulated Depreciation	1,189
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	Aug. 1, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Houston, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 28,687
Initial costs, buildings	104,028
Additions subsequent to acquisition, Improvements	52,051
Land at cost	28,687
Buildings at cost	156,079
Total at cost	184,766
Accumulated Depreciation	9,735
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1950 [Member] | Lynwood, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,116
Initial costs, buildings	148,527
Land at cost	30,116
Buildings at cost	148,527
Total at cost	178,643
Accumulated Depreciation	5,286
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Aug. 13, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1950 [Member] | Ottumwa, IA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,377
Initial costs, buildings	48,697
Land at cost	2,377
Buildings at cost	48,697
Total at cost	51,074
Accumulated Depreciation	3,623
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] | 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	13,365
Land at cost	23,809
Buildings at cost	102,870
Total at cost	126,679
Accumulated Depreciation	13,187
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] | 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	7,565
Land at cost	13,919
Buildings at cost	30,847
Total at cost	44,766
Accumulated Depreciation	4,458
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, PA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,179
Initial costs, buildings	9,066
Additions subsequent to acquisition, Improvements	5,428
Land at cost	6,179
Buildings at cost	14,494
Total at cost	20,673
Accumulated Depreciation	2,731
Encumbrances	$ 0
Date of Construction	1950
Date Acquired	May 1, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1991 [Member] | Fresno, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 5,507
Initial costs, buildings	70,473
Land at cost	5,507
Buildings at cost	70,473
Total at cost	75,980
Accumulated Depreciation	4,430
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Aug. 30, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1991 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,350
Initial costs, buildings	36,693
Additions subsequent to acquisition, Improvements	74
Land at cost	6,424
Buildings at cost	36,693
Total at cost	43,117
Accumulated Depreciation	5,072
Encumbrances	$ 0
Date of Construction	1991
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1700 [Member] | Frome, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,920
Initial costs, buildings	11,388
Additions subsequent to acquisition, Improvements	1,660
Land at cost	11,580
Buildings at cost	11,388
Total at cost	22,968
Accumulated Depreciation	212
Encumbrances	$ 0
Date of Construction	1700
Date Acquired	Jun. 25, 2021
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	2,594
Encumbrances	$ 0
Date of Construction	1982
Date Acquired	Nov. 25, 2008
Life on which depreciation in latest income statements is computed (Years)	40 years
2020 [Member] | Gilbert, AZ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 4,790
Initial costs, buildings	45,384
Land at cost	4,790
Buildings at cost	45,384
Total at cost	50,174
Accumulated Depreciation	201
Encumbrances	$ 0
Date of Construction	2020
Date Acquired	Oct. 19, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1966 [Member] | Gardena, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 14,010
Initial costs, buildings	65,288
Land at cost	14,010
Buildings at cost	65,288
Total at cost	79,298
Accumulated Depreciation	882
Encumbrances	$ 0
Date of Construction	1966
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | Glasgow, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,135
Initial costs, buildings	16,606
Additions subsequent to acquisition, Improvements	383
Land at cost	1,518
Buildings at cost	16,606
Total at cost	18,124
Accumulated Depreciation	225
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 6,133
Initial costs, buildings	16,640
Additions subsequent to acquisition, Improvements	416
Land at cost	6,549
Buildings at cost	16,640
Total at cost	23,189
Accumulated Depreciation	229
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1900 [Member] | York, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 21,810
Initial costs, buildings	76,287
Additions subsequent to acquisition, Improvements	1,187
Land at cost	22,997
Buildings at cost	76,287
Total at cost	99,284
Accumulated Depreciation	1,009
Encumbrances	$ 0
Date of Construction	1900
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1796 [Member] | Godalming, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,059
Initial costs, buildings	20,181
Additions subsequent to acquisition, Improvements	886
Land at cost	9,945
Buildings at cost	20,181
Total at cost	30,126
Accumulated Depreciation	293
Encumbrances	$ 0
Date of Construction	1796
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1886 [Member] | Grefath, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,136
Initial costs, buildings	3,119
Additions subsequent to acquisition, Improvements	101
Land at cost	1,237
Buildings at cost	3,119
Total at cost	4,356
Accumulated Depreciation	282
Encumbrances	$ 0
Date of Construction	1886
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Ninety Eight | Hassocks, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 3,557
Initial costs, buildings	30,479
Additions subsequent to acquisition, Improvements	2,272
Land at cost	5,829
Buildings at cost	30,479
Total at cost	36,308
Accumulated Depreciation	469
Encumbrances	$ 0
Date of Construction	1998
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1885 [Member] | Heidelberg, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 6,350
Initial costs, buildings	36,693
Additions subsequent to acquisition, Improvements	74
Land at cost	6,424
Buildings at cost	36,693
Total at cost	43,117
Accumulated Depreciation	5,072
Encumbrances	$ 0
Date of Construction	1885
Date Acquired	Jun. 22, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Zero One | Hemel Hempstead, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 12,480
Initial costs, buildings	6,702
Additions subsequent to acquisition, Improvements	795
Land at cost	13,275
Buildings at cost	6,702
Total at cost	19,977
Accumulated Depreciation	117
Encumbrances	$ 0
Date of Construction	1901
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2005 [Member] | Haverhill, MA [Member]
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	3,185
Land at cost	5,651
Buildings at cost	109,033
Total at cost	114,684
Accumulated Depreciation	8,594
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	6,877
Land at cost	12,972
Buildings at cost	84,928
Total at cost	97,900
Accumulated Depreciation	16,573
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	6,595
Encumbrances	$ 0
Date of Construction	2005
Date Acquired	Dec. 21, 2010
Life on which depreciation in latest income statements is computed (Years)	40 years
2002 [Member] | Idaho Falls, ID [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,823
Initial costs, buildings	37,467
Additions subsequent to acquisition, Improvements	11,236
Additions subsequent to acquisition, carrying costs	4,665
Land at cost	1,823
Buildings at cost	53,368
Total at cost	55,191
Accumulated Depreciation	14,993
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 F L
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	21,214
Land at cost	5,642
Buildings at cost	38,301
Total at cost	43,943
Accumulated Depreciation	2,947
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	7,981
Land at cost	8,053
Buildings at cost	37,314
Total at cost	45,367
Accumulated Depreciation	3,671
Encumbrances	$ 0
Date of Construction	2002
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1892 [Member] | Hinckley, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,175
Initial costs, buildings	17,867
Additions subsequent to acquisition, Improvements	446
Land at cost	2,621
Buildings at cost	17,867
Total at cost	20,488
Accumulated Depreciation	242
Encumbrances	$ 0
Date of Construction	1892
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Kingswood, Australia [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 24,282
Initial costs, buildings	80,488
Additions subsequent to acquisition, Improvements	3,346
Land at cost	24,751
Buildings at cost	83,365
Total at cost	108,116
Accumulated Depreciation	5,292
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] | Lynwood, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 30,116
Initial costs, buildings	148,527
Land at cost	30,116
Buildings at cost	148,527
Total at cost	178,643
Accumulated Depreciation	5,286
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Aug. 13, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Nottingham, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 9,748
Initial costs, buildings	9,526
Additions subsequent to acquisition, Improvements	894
Land at cost	10,642
Buildings at cost	9,526
Total at cost	20,168
Accumulated Depreciation	157
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Montclair New Jersey
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	19,799
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
2000 [Member] | Warren, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 2,417
Initial costs, buildings	15,857
Additions subsequent to acquisition, Improvements	1,737
Land at cost	2,417
Buildings at cost	17,594
Total at cost	20,011
Accumulated Depreciation	2,576
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] | Willenhall, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,359
Initial costs, buildings	17,285
Additions subsequent to acquisition, Improvements	388
Land at cost	7,747
Buildings at cost	17,285
Total at cost	25,032
Accumulated Depreciation	234
Encumbrances	$ 0
Date of Construction	2000
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1967 [Member] | Huntington Park, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,132
Initial costs, buildings	5,002
Land at cost	3,132
Buildings at cost	5,002
Total at cost	8,134
Accumulated Depreciation	77
Encumbrances	$ 0
Date of Construction	1967
Date Acquired	Jul. 6, 2021
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	$ 13,786
Initial costs, buildings	43,209
Additions subsequent to acquisition, Improvements	96
Land at cost	13,882
Buildings at cost	43,209
Total at cost	57,091
Accumulated Depreciation	3,745
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Jun. 7, 2019
Life on which depreciation in latest income statements is computed (Years)	30 years
1975 [Member] | Lauderdale Lakes, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,657
Initial costs, buildings	150,313
Land at cost	10,657
Buildings at cost	150,313
Total at cost	160,970
Accumulated Depreciation	1,776
Encumbrances	$ 0
Date of Construction	1975
Date Acquired	Aug. 1, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | London, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,464
Initial costs, buildings	4,409
Additions subsequent to acquisition, Improvements	27
Land at cost	3,491
Buildings at cost	4,409
Total at cost	7,900
Accumulated Depreciation	224
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Orpington, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 10,826
Initial costs, buildings	45,401
Additions subsequent to acquisition, Improvements	162
Land at cost	10,988
Buildings at cost	45,401
Total at cost	56,389
Accumulated Depreciation	2,292
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1987 [Member] | Salt Lake City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,590
Initial costs, buildings	101,915
Additions subsequent to acquisition, Improvements	15,268
Land at cost	13,590
Buildings at cost	117,183
Total at cost	130,773
Accumulated Depreciation	11,686
Encumbrances	$ 0
Date of Construction	1987
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
Aberdeen, UK [Member] | Leeds, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 2,065
Initial costs, buildings	10,123
Additions subsequent to acquisition, Improvements	358
Land at cost	2,423
Buildings at cost	10,123
Total at cost	12,546
Accumulated Depreciation	142
Encumbrances	$ 0
Date of Construction	1990
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1926 [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	16,180
Land at cost	7,073
Buildings at cost	170,676
Total at cost	177,749
Accumulated Depreciation	12,760
Encumbrances	$ 0
Date of Construction	1926
Date Acquired	Jun. 27, 2018
Life on which depreciation in latest income statements is computed (Years)	46 years
Coral Gables, FL [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	3,203
Encumbrances	$ 0
Date of Construction	2014
Date Acquired	Mar. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1996 [Member] | Mcminnville Oregon
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	14,135
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	$ 1,922
Initial costs, buildings	40,797
Additions subsequent to acquisition, Improvements	549
Land at cost	2,471
Buildings at cost	40,797
Total at cost	43,268
Accumulated Depreciation	2,905
Encumbrances	$ 0
Date of Construction	1996
Date Acquired	Apr. 3, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1955 [Member] | Miami, FL [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 44,400
Initial costs, buildings	107,203
Land at cost	44,400
Buildings at cost	107,203
Total at cost	151,603
Accumulated Depreciation	1,395
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Aug. 1, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1955 [Member] | Windsor, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 12,842
Initial costs, buildings	111,315
Additions subsequent to acquisition, Improvements	108
Land at cost	12,950
Buildings at cost	111,315
Total at cost	124,265
Accumulated Depreciation	5,580
Encumbrances	$ 0
Date of Construction	1955
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
1988 [Member] | Palestine, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 1,848
Initial costs, buildings	95,257
Land at cost	1,848
Buildings at cost	95,257
Total at cost	97,105
Accumulated Depreciation	4,993
Encumbrances	$ 0
Date of Construction	1988
Date Acquired	Dec. 17, 2019
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | Montclair, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,900
Initial costs, buildings	99,640
Additions subsequent to acquisition, Improvements	577
Land at cost	8,477
Buildings at cost	99,640
Total at cost	108,117
Accumulated Depreciation	19,799
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Apr. 1, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | Pasco, WA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,594
Initial costs, buildings	13,195
Land at cost	2,594
Buildings at cost	13,195
Total at cost	15,789
Accumulated Depreciation	1,503
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Aug. 31, 2018
Life on which depreciation in latest income statements is computed (Years)	30 years
1920 [Member] | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	744
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	May 2, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1920 [Member] | Sussex, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 477
Initial costs, buildings	2,097
Land at cost	477
Buildings at cost	2,097
Total at cost	2,574
Accumulated Depreciation	70
Encumbrances	$ 0
Date of Construction	1920
Date Acquired	Sep. 30, 2015
Life on which depreciation in latest income statements is computed (Years)	40 years
1919 [Member] | Newark, NJ [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 32,957
Initial costs, buildings	24,553
Land at cost	32,957
Buildings at cost	24,553
Total at cost	57,510
Accumulated Depreciation	744
Encumbrances	$ 0
Date of Construction	1919
Date Acquired	May 2, 2016
Life on which depreciation in latest income statements is computed (Years)	40 years
1958 [Member] | Norwalk, CA [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 7,925
Initial costs, buildings	30,465
Land at cost	7,925
Buildings at cost	30,465
Total at cost	38,390
Accumulated Depreciation	407
Encumbrances	$ 0
Date of Construction	1958
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1995 [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 2,811
Initial costs, buildings	5,940
Land at cost	2,811
Buildings at cost	5,940
Total at cost	8,751
Accumulated Depreciation	93
Encumbrances	$ 0
Date of Construction	1995
Date Acquired	Jul. 6, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
Nineteen Zero Six | Salt Lake City, UT [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 13,590
Initial costs, buildings	101,915
Additions subsequent to acquisition, Improvements	15,268
Land at cost	13,590
Buildings at cost	117,183
Total at cost	130,773
Accumulated Depreciation	11,686
Encumbrances	$ 0
Date of Construction	1906
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
Nineteen Zero Six | Royston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,636
Initial costs, buildings	21,310
Additions subsequent to acquisition, Improvements	1,521
Land at cost	7,157
Buildings at cost	21,310
Total at cost	28,467
Accumulated Depreciation	336
Encumbrances	$ 0
Date of Construction	1906
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1850 [Member] | Preston, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 8,748
Initial costs, buildings	27,645
Additions subsequent to acquisition, Improvements	542
Land at cost	9,290
Buildings at cost	27,645
Total at cost	36,935
Accumulated Depreciation	371
Encumbrances	$ 0
Date of Construction	1850
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1850 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,442
Initial costs, buildings	23,599
Additions subsequent to acquisition, Improvements	397
Land at cost	1,839
Buildings at cost	23,599
Total at cost	25,438
Accumulated Depreciation	313
Encumbrances	$ 0
Date of Construction	1850
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1951 [Member] | Remscheid, Germany [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Rehabilitation hospital
Initial costs, land	$ 1,021
Initial costs, buildings	2,603
Additions subsequent to acquisition, Improvements	59
Land at cost	1,080
Buildings at cost	2,603
Total at cost	3,683
Accumulated Depreciation	230
Encumbrances	$ 0
Date of Construction	1951
Date Acquired	Aug. 28, 2018
Life on which depreciation in latest income statements is computed (Years)	40 years
1913 [Member] | Sherman, TX [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 3,363
Initial costs, buildings	10,932
Land at cost	3,363
Buildings at cost	10,932
Total at cost	14,295
Accumulated Depreciation	3,554
Encumbrances	$ 0
Date of Construction	1913
Date Acquired	Oct. 31, 2014
Life on which depreciation in latest income statements is computed (Years)	40 years
1820 [Member] | Southampton, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 5,527
Initial costs, buildings	20,121
Additions subsequent to acquisition, Improvements	1,323
Land at cost	6,850
Buildings at cost	20,121
Total at cost	26,971
Accumulated Depreciation	312
Encumbrances	$ 0
Date of Construction	1820
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1940 [Member] | 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	11,500
Land at cost	4,428
Buildings at cost	84,728
Total at cost	89,156
Accumulated Depreciation	9,992
Encumbrances	$ 0
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	$ 6,051
Initial costs, buildings	10,986
Additions subsequent to acquisition, Improvements	2,708
Land at cost	6,051
Buildings at cost	13,694
Total at cost	19,745
Accumulated Depreciation	1,967
Encumbrances	$ 0
Date of Construction	1940
Date Acquired	Sep. 29, 2017
Life on which depreciation in latest income statements is computed (Years)	41 years
1770 [Member] | Usk, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 1,442
Initial costs, buildings	23,599
Additions subsequent to acquisition, Improvements	397
Land at cost	1,839
Buildings at cost	23,599
Total at cost	25,438
Accumulated Depreciation	313
Encumbrances	$ 0
Date of Construction	1770
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1962 [Member] | 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	19,116
Land at cost	12,552
Buildings at cost	87,997
Total at cost	100,549
Accumulated Depreciation	16,316
Encumbrances	$ 0
Date of Construction	1962
Date Acquired	Sep. 26, 2013
Life on which depreciation in latest income statements is computed (Years)	40 years
1911 [Member] | Winchester, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 6,766
Initial costs, buildings	10,923
Additions subsequent to acquisition, Improvements	129
Land at cost	6,895
Buildings at cost	10,923
Total at cost	17,818
Accumulated Depreciation	563
Encumbrances	$ 0
Date of Construction	1911
Date Acquired	Jan. 9, 2020
Life on which depreciation in latest income statements is computed (Years)	40 years
Eighteen Hundred | Woking, UK [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Behavioral health facility
Initial costs, land	$ 7,387
Initial costs, buildings	4,976
Additions subsequent to acquisition, Improvements	308
Land at cost	7,695
Buildings at cost	4,976
Total at cost	12,671
Accumulated Depreciation	76
Encumbrances	$ 0
Date of Construction	1800
Date Acquired	Jun. 25, 2021
Life on which depreciation in latest income statements is computed (Years)	40 years
1929 [Member] | Youngstown, OH [Member]
SEC Schedule III, Real Estate and Accumulated Depreciation [Line Items]
Type of property	Acute care general hospital
Initial costs, land	$ 4,335
Initial costs, buildings	3,565
Additions subsequent to acquisition, Improvements	488
Land at cost	4,335
Buildings at cost	4,053
Total at cost	8,388
Accumulated Depreciation	2,428
Encumbrances	$ 0
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, 2021USD ($)
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Aggregate cost for federal income tax purposes	$ 11.3

Schedule III - Changes in Total

Schedule III - Changes in Total Real Estate Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020		Dec. 31, 2019
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 10,749,707	$ 7,312,486		$ 4,781,149
Acquisitions	3,023,966	2,912,594		2,436,265
Transfers from construction in progress		202,999
Additions	167,164	55,137		173,785
Dispositions	(229,584)	(105,360)		(106,536)
Other	(82,504)	371,851	[1]	27,823	[1]
Balance at end of period	$ 13,628,749	$ 10,749,707		$ 7,312,486
[1]	Includes foreign currency fluctuations for all years and $13.8 million and $61.4 million of right-of-use assets in 2020 and 2019, respectively.

Schedule III - Changes in Accum

Schedule III - Changes in Accumulated Depreciation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Balance at beginning of period	$ 728,176	$ 504,651	$ 414,331
Depreciation	262,063	222,580	130,851
Depreciation on disposed property	(35,551)	(6,653)	(40,952)
Other	(4,319)	7,598	421
Balance at end of period	$ 950,369	$ 728,176	$ 504,651

Schedule III - Changes in Acc_2

Schedule III - Changes in Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Real Estate And Accumulated Depreciation Disclosure [Abstract]
Right-of-use-assets	$ 70,401	$ 75,209	$ 61,400
Changes in right-of-use asset	1,120	$ 13,832
Land and building cost	1,100,000
Intangible lease assets included in real estate held for sale	125,100
Real estate held for sale accumulated depreciation	96,500
Accumulated amortization included in real estate held for sale	$ 17,500

Schedule IV - Schedule of Mortg

Schedule IV - Schedule of Mortgage Loans on Real Estate (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Face Amount of Mortgages	213,320,000
Carrying Amount of Mortgages	213,320,000	$ 248,335,000	$ 1,274,995,000	$ 1,213,283,000
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] | Colombia [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	8.95%
Final Maturity Date	2035
Face Amount of Mortgages	$ 120,167,000
Carrying Amount of Mortgages	120,167,000
Principal Amount of Loans Subject to Delinquent Principal or Interest	$ 0
Long-Term First Mortgage Loan [Member] | Springstone Inc. [Member]
Mortgage Loans on Real Estate [Line Items]
Interest Rate	7.00%
Final Maturity Date	2041
Face Amount of Mortgages	$ 22,900,000
Carrying Amount of Mortgages	22,900,000
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	7.65%
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)	12 Months Ended
	Dec. 31, 2021USD ($)Property
Mortgage Loans on Real Estate [Line Items]
Prior Liens	$ 0
Carrying amount of mortgages, federal income tax purposes	213,300,000
Unamortized loan issue costs	$ 100,000
Colombia [Member] | Long-Term First Mortgage Loan [Member]
Mortgage Loans on Real Estate [Line Items]
Number of properties | Property	3
Interest Rate	8.95%

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, 2021	Dec. 31, 2020	Dec. 31, 2019
Mortgage Loans On Real Estate [Abstract]
Balance at beginning of year	$ 248,335	$ 1,274,995	$ 1,213,283
New mortgage loans and additional advances on existing loans	1,128,695	193,590	61,712
Exchange rate fluctuations	(3,640)	9,785
Mortgage loans on real estate including additions during year	1,373,390	1,478,370	1,274,995
Collection of principal	(1,160,070)	(1,230,035)
Deductions during year	(1,160,070)	(1,230,035)
Balance at end of year	$ 213,320	$ 248,335	$ 1,274,995

Schedule IV - Changes in Mort_2

Schedule IV - Changes in Mortgage Loans Excluding Unamortized Loan Issue Costs (Parenthetical) (Detail) $ in Thousands, £ in Millions		Dec. 31, 2021USD ($)	Mar. 31, 2021GBP (£)	Dec. 31, 2020USD ($)
Mortgage Loans on Real Estate [Line Items]
Advanced to the mortgage loan	[1]	$ 1,103,410		$ 834,743
Mortgage Loans [Member]
Mortgage Loans on Real Estate [Line Items]
Advanced to the mortgage loan				$ 835,000
Mortgage Loans [Member] | Priory Group [Member]
Mortgage Loans on Real Estate [Line Items]
Advanced to the mortgage loan | £			£ 800
[1]	The 2021 column includes an £800 million mortgage loan advanced to the Priory Group (“Priory”) in the first quarter of 2021 and converted to fee simple ownership in a portfolio of 35 properties in the second quarter of 2021 as described below. The 2020 column includes approximately $740 million of loans advanced to Steward in 2017 and exchanged for the fee simple real estate of two hospitals as described below, as well as approximately $100 million of loans advanced to Ernest Health, Inc. (“Ernest”) in 2012 and exchanged for the fee simple real estate of four hospitals as described below.